The ones that made it here had to redo their training through the US system to be eligible for the American boards.... a process that takes at least 3-6 more years (at a very low stipend reimbursement as a resident) depending on the specialty. For many foreign medical graduates, this involves repeating a lot of the training that they've already been through in their countries... the only reason they go through it is with the opportunity to practice in a top credentialed environment with the opportunity to be finally reimbursed for their hard work. If you take that away, foreign medical graduates have very little incentive to leave their homeland to come here and start all over again on a very hard road. The issue with the rising health care coss is more to do with corrupt hospital systems than it does doctor's salaries.
Import doctors from India. Import PHD's from china. Import tech support from somewhere. Import programmers from somewhere else. Import laborers from everywhere else. I have no problems importing them cause we can't produce enough of them in the US and they cost too much. But... we want good paying jobs w/ good benefits.
There's already a shortage in the general supply of doctors let alone skilled surgeons. A national healthcare system will only expose that shortage even more. As has been mentioned, a good percentage of those costs cover admin expenses and malpractice insurance. We red tape everything to the point where surgeons cash out in favor of face lifts and boob jobs. I'd find a way to subsidize the cost of tuition, like Germany's model, while putting several performance stipulations (full ride w/ GPA 3.5 or higher...80% with 3.0) and a x year mandatory service to settle the subsidy. Currently student loans aren't squashed because of crafty doctors long ago who declared bankruptcy to avoid their medical bills. Enforce individual contracts and encourage contingency track planning for those who change their mind (dental, vision, assistant skills) or can't cut it.
Why do we have a shortage of doctors? medical schools could expand their enrollment, that is what ever other industry do when there is a shortage, but not the medical schools. It is much more important to the number of doctors down and income high then to relief the doctor shortage. Why do we need four years of college before becoming a doctor? Most of the other countries in the world do not do it this way. You can have a bachelor degree for most doctors, a master degree and phd degree for more advanced training like they do with the nurses. We need to remove obstacles to becoming doctors. Government should sponsor doctor training and send them to areas that need doctors like they do with teachers in some areas.
I need the Freakanomics guys to tell me about where this money goes. You need money circulating in the economy to have growth. What seems to be excessive health care costs or military hardware cost generates a lot of cash flow; it pays salaries, for construction, for research, for modernization. My guess is that the excess that is lost to circulation goes to capital gains that are under-taxed, but it's just an assumption.
