A committee of doctors from the Institute of Medicine has recommended that the growth in medical school capacity be cut off immediately. Medical schools have so many more new places for students that the doctor supply should jump about 50 percent in the next decade.
That, according to the committee, won't bring down prices. The free market model doesn't work. If it did, a huge jump in the supply of doctors while the demand remained steady would bring about a significant decline in medical costs.
The study group says, however, that new doctors merely generate new costs. That seems to be the case with a number of occupations. The multiplication of the members of the bar has not resulted in a drop in legal fees. Lawyers are more plentiful than fruit files around a rotten banana and the costs are higher than ever. Something of the same sort obtains with teachers. The fewer pupils of the post-baby-boom age have not given school boards a buyers' market with which to cut costs and lower taxes.
Instead, teachers have shamed parents, made them feel guilty by telling them that if we don't lower the class size - i.e., spread the work around by paying the same number of people to do less of it - the kids won't learn to read. Under the slogan of nothing but the best for the kiddie-poos, it's been much of the best for the teachers.
This white-collar racketeering has been going on for so long and so successfully that it's extremely difficult to fathom what's being proposed for the faculty and what's truly being advocate for the best interests of the pupils. Is bilingual education another teachers' college scam or will it help? Whence cometh this latter-Will this help the handicapped or the be placed in regular school programs? Will this help the handicapped or the normal children or is it but another scheme to find employment for teachers who might otherwise have to go into another line of work?
Specialization, licensure and the creation of ornate administrative apparatuses that suck up professionally trained bodies to do nonprofessional work, these and 10 dozen other devices serve to nullify supply and demand when it comes to compensation for certain occupational groups. In all likelihood, after we've achieved a 50 percent increase in the number of physicians. They still won't make house calls, because so many new ways will have been found to keep doctors from practicing medicine and competing on an open market for customers.
Look at what's happened in hospitals obstetrical wards. In the face of an absolute drop in the level of demand some hospitals have made the first faint moves toward competition. In order to attract paying customers, they have dropped the barbaric rules that prohibited older children from visiting their new baby sib and their mother. Such feeble moves toward competition are described as "innovative" but they really represent the sort of responsiveness that free-market competition facilitates.
Some of the demands that the law compels abortions to be performed in hospital facilities may arise from a dearth of customers in the OB wards. And it strains credulity to assume that much of the talk about too many hospital beds and "duplication" of facilities was not born of a desire to avoid price competition between institutions. Thus do all the high credential occupations build structural devices that reverse the law of supply and demand.
Greater lay participation and power on the boards, agencies and commissions that set the rules and license these occupations might help to institute a degree of free-market activity. Putting laymen on the governing bodies of bar and medical asociations is long overdue is only for the ventilation they might provide, but it's no sure cure. Laymen have controlled school boards since inception of public education but can hardly be said to have beaten off the intractable professionalism of rising cost and drooping accomplishment.
Nonetheless, power to nonprofessionals is the only practical hope of breaking up and restructuring the learned occupations.