Bill of Health is the Harvard Petrie-Flom Center's blog on health law, bioethics and policy, including vaccines, FDA authorizations and medical licensing.
HN links it for explainers on FDA approval versus emergency use authorization and on AMA scope-of-practice lobbying, which commenters tie to doctor supply.
> Min wage. changes the supply, not demand.
If you raise the price of something–anything–it lowers demand. That's why minimum wage laws create unemployment.
> It may or may not yield less employment depending on elasticity.
If you're earning your employer $10/h and the minimum wage rises to $11, you will not have a job. Either right away if the employer realizes it, or eventually when they go out of business if they don't.
Adding elasticity to the equation unnecessarily complicates this. Some things have elastic demand, others have inelastic demand. Why focus only on the relevant case for the point you're making? The overall effect of a price increase is decreased demand.
> If businesses are flush with profits, then they'll eat the higher labour input and that's it
Profits have nothing to do with it. If a business has employees at some wage and the minimum wage rises above that wage, they will, at least eventually, replace the low-wage employees with new ones (or with automation) that add at least as much value as they are paid (or cost). Profits don't magically make businesses waste money on inexperienced employees where they could otherwise be more efficient with more experienced employees at the same price or with automation.
> Otherwise, prices may rise
Not without an associated drop in demand.
> You can see this more acutely in healthcare, where there are stronger regs, because the power asymmetry is bigger aka the supplier has the power of 'life or death' over…
> Guess you deleted this part.
It detracted from the overall point. But yes, I do look forward to the day artificial intelligence mostly replaces humans in this industry. I think the benefits are self-evident.
> If a better system existed given the current set of parameters, I believe it would have come into existence.
One of these "parameters," as your call them, includes the AMA and doctors restricting the number of new doctors who can be trained in the past https://usatoday30.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm , actively fighting against allowing Nurse Practitioners and other trained providers from providing routine services that would lessen the requirement of doctors https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/ , fighting against collection of misdiagnosis data (as mentioned above), lobbying against banning pharmaceutical companies from giving money or gifts to doctors (in fact, the majority of doctors say that accepting these gifts is OK, despite research repeatedly showing that these nudges change behavior and lead to practises like overprescribing opiates — https://www.statnews.com/2020/12/04/drug-companies-payments-gifts-affect-physician-prescribing/ ), refusing to adopt practises that reduce mortality (see: the checklist example from above) and on and on.
This trend is not unique to the US. Similar efforts exist everywhere doctors do. The profession was associated with status in the past (and…
Disclaimer: this is not legal or medical advice, but an encouragement to read the research for yourself and accumulate an understanding of the issues for your decision making. If you know any good studies or criticisms, please add them.
Emergency Use Authorization (EUA) and Biologics License Application (BLA) description: https://blog.petrieflom.law.harvard.edu/2021/06/15/whats-the-difference-between-vaccine-approval-bla-and-authorization-eua/.
There are already lawsuits challenging EUA vaccine mandates. They’d be moot, though, after FDA approval, since the Supreme Court has upheld states’ vaccination mandates (cf. Jacobson v. Massachusetts)
Some issues around BLA/FDA approval:
First, a BLA has some implications. It would likely force the FDA to revoke EUAs to all other candidates (one of the conditions for an EUA is that no other viable approved treatments exist. Some of the controversy around ivermectin and off label use is related to this condition). This would impede development of other treatments, current and future.
Second, the history of SARS-cov vaccines is promising, but incomplete. Many previous trials showed good progress (high antibody titre levels, etc.), but tended to fare poorly on later virus challenges. eg
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0035421
Third, sometimes, side effects might not be sufficiently analyzed until well after authorization, eg “Dengvaxia”: a dengue fever (R0=65, CFR=20-30%) vaccine that was…
> And if you think they're saying something else in private then let's see proof. This is not a place for baseless conspiracy theories.
With all due respect, not everything that lacks proof is a conspiracy theory. I've spent a bunch of time in discussions with physicians. There's a consensus that AMA is largely ineffective and it's implied that it's ineffectiveness is valuable for inflating physician salaries.
This is a great write up that highlight how the AMA created the situation to begin with: https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/
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I did find a great example of AMA's double speak on this issue. A bunch of states have started looking for alternatives for providing care to their populations. Some states are now loosening regulation to allow mid-levels to practice. 6 states are now allowing physicians to practice (in certain fields) without completing residency.
That sounds great right? All of these groups have completed 3 to 4+ years of graduate medical education. They might not be as skilled as a physician, but they can certainly provide basic care. AMA doesn't think that's great.
> The AMA opposes enactment of legislation to authorize the independent practice of medicine by any individual who has not completed the state’s requirements for licensure to engage in the practice of
medicine and…
> Medical school class sizes are not artificially restricted. Schools limit class sizes to ensure that almost all graduates can find a residency program slot.
This is paradoxical. Class sizes are limited by the school, but not artificially limited?
Medical school class sizes are artificially restricted by outsized requirements for admissions. For example, the requirement of an undergraduate degree in order to enter medical school is not something that exists in Europe. Or that the admissions and exam requirements are much less hyper-competitive in Europe, than the U.S. This is, of course, “to restrict the supply of residents, so each one can find a job.” It’s still artificial restriction, rather than a natural bottleneck.
The same AMA that “Twenty years ago, the AMA lobbied for reducing the number of medical schools, capping federal funding for residencies, and cutting a quarter of all residency positions,”[0] is now asking for support in reversing its schemes? That’s rich. The same AMA that makes hundreds of millions in revenues, by speculating in securities[1].
Like an alma mater asking you to donate to its investment coffers after it’s shackled you with debt.
[0] https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/
[1] https://www.epsilontheory.com/ama-bitfd/
>It does not stand to reason, since care provided by residents is quite cheap to hospitals from the perspective of labor.
The AMA represents doctors, not hospitals, and doctors benefit from scarcity. Hospitals benefit from residency grants, existing doctors do not.
>Do you have evidence of this lobbying?
Here is a source [1]
>Hospitals have no obligation to hire the residents they produce, so an optimal behavior would seem to be training many residents and not hiring them.
Optimal only if they can make money from the residents. Due to the bizarre natures of US medical reimbursement, resident physicians do not bill for their services [2]. While they may provide value in other ways, they are viewed as cost on the balance sheet. This is further complicated by the fact that hospitals dont want to bear this cost if they can get a grant, or simply hire a doctor away from another hospital. Getting rid of the grants would be a step in the right direction.
https://blog.petrieflom.law.harvard.edu/2022/03/15/ama-scope-of-practice-lobbying/
https://thesheriffofsodium.com/2022/02/04/how-much-are-resident-physicians-worth/#:~:text=Governmental%20subsidies,additional%20revenue%20stream%3A%20governmental%20subsidies.