Shortages in Healthcare: Why? How Do We Fix Them?

Why Are There Shortages in Healthcare and How Do We Fix Them?
There will be a shortage of 21,000 - 55,000 primary care physicians by 2033. Additionally, there are 195,000 vacancies for nursing positions in America every year because of the nursing shortage.
Shortages in healthcare are determined by the Law of Supply and Demand. In a normal market situation, supply and demand reach an equilibrium price and an equilibrium quantity. As a result, there is NO Shortage.
However, if the price is set artificially low, then not enough will be supplied relative to demand and there will be a shortage.
In the case of labor, the 'price' of labor is the wage. The 'quantity of labor' is the number of people and the number of hours worked in that profession.
If there is a shortage, by definition there must be Rationing. Rationing comes in two forms:
1) Queue Rationing, i.e. a 'Waiting List'
2) Price Rationing, i.e. rationing based on ability to pay
Healthcare has both forms of rationing, ranging from trauma surgery weekend coverage (Queue Rationing) to Lasik eye surgery (Price Rationing).
Both forms have their Pros and Cons, which can be debated forever. The point is not which is 'better' or 'worse,' but rather that shortages in healthcare are 1) explainable, 2) have straightforward consequences and 3) can be addressed differently in different situations by different groups of people.
There is no 'One Solution' and that's ok.
Sources:
www.health.harvard.edu/blog/w...
www.nursingworld.org/practice...
lpeproject.org/blog/the-econo...
www.forbes.com/sites/johngood...
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[@tannermurphree8247]

I am an RN who returned to my former career after year in the hospital. There’s a shortage because the job sucks, endless meetings and anxiety over pleasing the regulators.

[@ahealthcarez]

Thank you for sharing your experience.

[@komilakarimova8919]

I just started watching your videos and honestly impressed! You deliver information in a simple way and with a high quality! It's very rare today to find a person with this unique ability. Appreciate your work a lot!

[@ahealthcarez]

Thank you for your feedback.

[@TheRoland444]

Outstanding informational insight on "everything medical as its relates to human involvement & effort" within the "real world" challenges & constraints, the business of healthcare.

[@silviagarcia8254]

Apply the same laws to dentistry--there is no shortage of dentistry, why? they're all cash pay and you can get a tooth issue basically whenever you want. Dental insurance is extremely limited and costly and a business for the insurance company to lure the patient by covering some basics but not the complex. If primary care stopped accepting third party payment en masse, we'd see a stabilization of pay and supply, more doctors would choose this field because it would be an attractive lifestyle. Right now it is atrocious pay, abuse from employers and patients, and very limited concierge practices. So noboy is rushing into family practice or internal med, sadly. They want dermatology and ophthalmology.

[@ahealthcarez]

Thank you for sharing your thoughts.

[@tannermurphree8247]

Thank you

[@carlwattjr]

Limited spaces in med school by ama. Limited salary of nurses by hospitals

[@ahealthcarez]

Hospitals have monopsony power in nursing labor market. Nurses likely to become more unionized to counter.

[@carlwattjr]

@@ahealthcarez what about the limits on supply of doctors, a much bigger cost factor? No limits on nursing schools so it seems like mainly the increasing stress of the job is limiting supply because the job can’t compete with other options. But again, thanks for raising and explaining all these details of healthcare. Really appreciated.

[@carlwattjr]

@@ahealthcarez you might consider an episode on how the difference in quality management between healthcare and all other industries has left healthcare weak on the ability to improve to lower cost. ISO 9000 and other qms in all other industries requires working process improvement. Healthcare seems to just be audited to regulations, leaving healthcare largely passively waiting for regulators to tell them how to change. I am an expert on lean in aerospace if you ever want free advice in that area.

[@concernedcitizen780]

Making medical school cost lower would help. I see medical students $ 500,000 in debt.

[@jeffsmith9420]

Don't worry he will never address that or the fact that US MDs are already the highest paid in the world.

[@user-hx8lt9fk9d]

Same thing is happening with public school teachers

[@ahealthcarez]

Thank you for sharing your thoughts.

[@mdaverde]

Great video, surprised you didn't talk about the reduced doctor headcount due to residency funding

[@ahealthcarez]

Thank you for watching and for your feedback.

[@haddadda]

They should open more med school spots

[@ahealthcarez]

Thank you for sharing your thoughts.

[@Koru-Health]

Partially correct, but the underlying culprit (for MDs) is the GME funding that pays for residency programs. This funding, primarily through the Social Security Administration (CMS) is a set pool of funds controlled by congress. With a fixed and rarely increasing funding pool for residency programs the number of residency positions available in the US each year is restricted. It would not make sense for a university to graduate more MDs than they can place in residencies.

[@concernedcitizen780]

Maybe cutting the cost of Nursing, medical school and expand those schools. I know medical students $500,000 in debt and nursing students $90,000 in debt

[@brianree2220]

Thank you for creating these videos. You breakdown the information so its easy to understand!

[@ahealthcarez]

Thank you for watching and for your feedback.

[@claashorst]

Tip Top! Shared in the discussion in Germany and Switzerland via Linkedin & FB. Thank you very much.

[@ahealthcarez]

Thank you for sharing.

[@shanap7491]

There are a lot of Uber-like nurse staffing companies that are cropping up. I would like to hear more about this.

[@ahealthcarez]

Thank you for your suggestion.

[@TraderZeta]

Great video. You have great presence. I am very fascinated on your thoughts on how the university system could have some impact on the situation.

[@ahealthcarez]

Thank you for watching and for your feedback.

[@briansweeney5759]

Of course some practitioners can afford to buy their own equipment (eg a LASIK machine) and be somewhat ‘affordable’- however more complex areas - eg neurosurgery, transplant surgery, dialysis- require more equipment, theatres, ICU beds, nurses, therapists - which individual specialists could not provide or bill for…

[@ahealthcarez]

Thank you for sharing your thoughts.

[@otiliapopescu9264]

That's a great video, thank you, I observed you only depict facts, but why not solutions on them?

[@ahealthcarez]

Thank you for watching and for your feedback.

[@SpecialK711]

From Artificial Pricing to Artificial Care => Robo-doc in-a-box here we come. Would be great to hear you speak about the various business venture opportunities being forged as a result of the shortages.

[@ahealthcarez]

Thank you for your comment.

[@komilakarimova8919]

So to have enough nurses and primary care physicians should their wages be increased? Why do you think it never be solved?

[@ahealthcarez]

Their pay is increased in a cash-pay environment where the customer pays the provider. It’s the 3rd party payment by government and insurance companies that creates the shortage because they suppress the wage below the market level.

[@SpecialK711]

​@ahealthcarez Yes, and they also add significantly to the administrative burden, which is causing many to drop out

[@BurqueMD]

Have you thought about writing a book? I have found your videos so helpful!

[@ahealthcarez]

I have. ‘Healthcare Money Campfire Stories’ available on Amazon. 👍

[@BurqueMD]

@@ahealthcarez great, I'm getting it. Thanks!

[@NANA-nd1kq]

Will you discuss Singapore model of care provision?
Hybrid of government-subsidized catastrophic care and self-pay using tax-advantaged HSAs.

[@ahealthcarez]

Great suggestion. Thank you.

[@iMeta4]

Health economics, I did not expect to see you so soon since that one class. This cannot be helped. 🤣 And I meant the topic, not shortages. Thank you US. 😒

[@ahealthcarez]

Thank you for watching and for your comment.

[@jeffsmith9420]

Funny how Bickler keeps deleting my comments pointing out why his analysis is nonsense. Maybe it would make more sense to try and actually understand what he is talking about.

[@azppmd]

Let me know your address and I'll ship you a microphone. Do you need 3.5mm input? On what device are you recording?
I bounced after the first 3 seconds.

[@ahealthcarez]

Thank you for your feedback.