X-Message-Number: 5064
From:  (David Stodolsky)
Subject: Re: The state of medicine
Date: Sat, 28 Oct 95 00:13:21 +0100

>and press are true; in particular relating to loss of physician and patient
>autonomy, degradation od the doctor-patient relationship, overwork to the
>point of life threatening complications in treated patients, chronic

This appears to be a long-term effect of decisions made after WWII.
>From Stefflre (1986, p 4.):

"The fewer-the-better notion of economic bargaining power
implicit in this notion of a market is relevant to this aspect of
the process. From the point of view of political bargaining power,
the more participants like you (and the better you all are organized),
the better off you are. Here the logic of the market and the logic
of the arena run in different directions and lead, in the real world,
to some interesting forms of compromise (trade associations, guilds,
cartels, and the like).

An interesting illustration of this paradox is an analysis of the
behavior of the medical and legal professions in response to the increased
numbers of students with government funding after World War II. The
legal profession expanded its training facilities, and prices dropped.
The medical profession kept its production of doctors tightly controlled,
and prices -- relative to those of lawyers -- went up. However, the
increasing numbers of lawyers contributed to the increased legal
constraints upon, and legal risks for, doctors, and the medical profession
while benefiting in the economic short run now finds itself in a weaker
legal and political position vis-a-vis its neighboring profession than
it had prior to World War II."


For comparison, in Denmark the doctors are, for the most part, organized
in a Union which bargains directly with the Association of Counties over
salary, etc. There is virtually no involvement of lawyers, including those
associated with insurance companies, etc. in medical affairs. The
elimination of this type of overhead results in about twice as much
medical care per unit of expenditure. 

David S. Stodolsky      Euromath Center     University of Copenhagen
   Tel.: +45 38 33 03 30   Fax: +45 38 33 88 80 (C)


Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=5064