[Bret L]

(( Nevertheless, if I became Supreme Dictator, the first two groups
I'd put up against the bullet-pockmarked wall-after the $PLC. La Raza,
and the ADL of course-would be the American Bar Association and the
American Medical Association. Bret.))

Obamacare Blamed for Impending Shortage of Doctors

By Rob Sanchez

"The Wall Street Journal has joined a chorus of news reports that claim that there is a looming shortage of doctors. Of course we have heard similar shortage shouting about doctors for decades, but this time the hysteria is centered on the fact that Obamacare will give millions of additional people access to health care -- and that will create problems for a system that won't be able to cope with the need for large numbers of new primary care physicians.

Where there is shortage shouting there is usually someone calling for
more H-1B visas, or some other type of scheme to allow more foreign
workers into the U.S. The following paragraph from the WSJ activated
my alarm bells:

While doctors trained in other countries could theoretically help
the primary-care shortage, they hit the same bottleneck with resident
slots, because they must still complete a U.S. residency in order to
get a license to practice medicine independently in the U.S. In the
2010 class of residents, some 13% of slots are filled by non-U.S.
citizens who completed medical school outside the U.S.
Medical Schools Can't Keep Up, By Suzanne Sataline And Shirley S.
Wang, Wsj, April 12, 2010

There you have it folks! If the U.S. could find a way of stealing more
doctors from foreign countries we could supply all the doctors we need
to solve the impending medical care crisis that Obamacare is going to
create. Ooops! Wasn't Obamacare supposed to solve the crisis?

There is one problem that the cheap labor lobby and the open border
globalists will have to solve before they let more foreign doctors
into the U.S. It's not as simple as increasing the number of visas,
because as I have explained before the number of visas that can be
issued to foreign doctors is almost unlimited. To learn more about
doctor visas please read my recently published article: The Most
Generous Nation in the World... at Giving Jobs Away, by Rob Sanchez.

Whenever you hear that we need to expand immigration or create a new
visa to import more doctors, just remember that what you heard is pure
bunk!

So, the availability of visas is no obstacle to bringing in more
foreign doctors because an unlimited number of doctors could immigrate
to the U.S. to practice medicine if they could get certified to do so.
In order to get certified all medical graduates (whether citizen or
foreign national) have to serve out a period of from 3 to 7 years of
indentured servitude which is commonly called "residency" (medical
students claim it's slavery but that's because they don't understand
what indenture means). Increasing the number of doctors requires more
residency positions -- and that decision is controlled by the American
Medical Association (AMA).

This is how the system works, according to the AMA:

The Educational Commission for Foreign Medical Graduates (ECFMG)
serves the public interest by offering a program of evaluation,
examination, and certification for physicians who were educated
outside the United States and Canada. Physicians educated outside the
United States and Canada, termed international medical graduates
(IMGs), may be citizens of the United States or Canada who chose to be
educated elsewhere or non-citizens who were admitted to the United
States by US immigration authorities.
Educational Commission for Foreign Medical Graduates, AMA

While the AMA argues that their strict certification standards
increase the quality of physicians, protagonists claim that the AMA
deliberately limits the number in order to create artificial shortages
of doctors, which in turn causes the wages of doctors to increase
because of market pressures.

Assuming that the AMA is going to retain their control of the market
when Obamacare is in place, there doesn't seem to be a way for greedy
hospitals to import more foreign doctors, but wait .... how about a
scenario where the rug is pulled out from underneath the AMA by
passing laws that allow residencies in foreign countries? In this
scenario a doctor could transfer their residencies in the same way
college students change schools.

Uber-libertarian Dean Baker has thought this thing through. He
suggests that the government usurp the AMA to increase the number of
doctors. Side benefits will include a dramatic decline in the salaries
of doctors as the foreigners flood into the U.S. and compete for jobs.
Ahhhhhh! It's the old supply and demand curve, which is usually denied
by economists, libertarians, neo-cons, and neo-liberals when they
advocate expanding the labor force by using immigration.

What if, however, the government sought to remove the licensing
barriers for foreign physicians? Compensation in the most highly paid
medical specialties averages far above $250,000 a year (even after
paying malpractice fees). Many doctors trained outside the United
States would find these positions attractive even if they only paid
$100,000 a year. Opening medical practice to foreign competition would
allow for the same sorts of gains from trade that we have seen with
opening trade in apparel and textiles - except that we spend far more
on doctors each year than we do on clothes.
Why Don't We Globalize Health Care?, by Dean Baker, Counterpunch,
August 4, 2009

You gotta like the way Baker compares doctors to textile workers!
Personally I think it would do doctors some good if their bloated egos
were cut down! If that doesn't bust the behinds of overpaid American
doctors Baker has other plans to shrink the AMA's influence, like for
example increasing "medical tourism" (from the same article).

There are clear ways to take advantage of lower costs in other
countries, making our own system more affordable without diminishing
the quality. We could allow more foreign-born doctors to work in the
United States, for instance. We could encourage the "medical tourism"
that allows Americans to have major procedures performed in other
countries, and we could permit Medicare beneficiaries to buy into the
lower-cost healthcare systems of other wealthy countries.

Baker's strategy for forcing down the salaries of doctors seems to
make sense, in the short term. Unfortunately the laws of supply and
demand will dictate that American students won't choose medical
careers as doctors, which will reduce the supply of domestic doctors.
Of course third-world countries could probably send us as many
replacements as we need so if price and availability is the main
issue, Baker's solution makes sense.

Don't think for a second that the medical robber barons in the U.S.
were the first to think about the idea of global physicians. Europe is
way ahead of us. Here is one from the BBC:

...patients risked being treated by doctors who were incompetent
or were not fluent in English. [snipped] European regulations which
allow free movement of labour mean the GMC is unable to carry out
clinical or language checks on doctors from EU countries as it does
for those from elsewhere in the world."System of vetting foreign
medics 'needs improving'", by Nick Triggle, BBC News

Canada is experiencing the controversy in a big way. Their "problem"
will be solved by calling it an issue of basic human rights! If Canada
is an example of our future, expect the AMA to be characterized as
racists, protectionists, and xenophobes.

Watch this video for what's going on in Canada: Doctors Without
Residency

This short documentary highlights how discrimination prevents
foreign-trained doctors from practicing in Canada -- even after
they've received their Canadian qualifications.
Interviews with medical professionals and human rights
advocates illustrate how systemic racism plays a role.
Doctors Without Residency, Tetchena Bellange, 2010

So, what does the future hold? Senator Bill Nelson (D-FL) and
Congressman Joseph Crowley (D-NY) sponsored a bill that would increase
Medicare residency slots by 15%. That's not going to help much if
there is really a shortage. I predict there will be big pressure for a
bill that will allow foreign doctors to transfer their residency, or
there will be legislative proposals to allow some type of limited
global residency like the EU. It will be interesting to see how long
the AMA will be able to resist onslaught of foreign doctors. Remember
PATCO? "


http://blog.vdare.com/archives/2010/...ge-of-doctors/