The largest complaint about the US healthcare system is that costs are too high. Did you know that Congress has a cap on how many doctors can be created each year? Yep. Again, here is another problem made worse by government meddling.
Even worse, 3500 of those spots each year are taken by foreign doctors on H1B visas. That’s 3500 Americans each year who have graduated med school, but will never become doctors.
4 Comments
@HomeInSC · September 20, 2025 at 9:18 am
That is absolutely disgusting. Politicians are, by and large, pretty damned stupid.
Our eldest did OK. Finished MD/PhD and matched an excellent residency. The prioritizing of foreign over domestic students and residents is evil. As long as the standards are high, the more Americans the better.
Tsgt Joe · September 20, 2025 at 9:26 am
How does that work? If you graduate med school, how does govt stop you from becoming a doctor. Isn’t licensure a state thing, like nurses?
Divemedic · September 20, 2025 at 11:36 am
Medicare is the 800 pound gorilla in healthcare. It controls everything. Ninety-eight percent of all US medical residencies are funded by the federal government: 86 percent through Medicare and Medicaid and Veterans Affairs. Another 12 percent comes from state matching of federal Medicaid funds.
Congress passed a law in 1997 that sets how many doctors can enter residency, and effectively bars all others from practicing, even if they are highly qualified. You can’t practice medicine in the United States without completing residency. The 1997 Balanced Budget Act capped residency training funds at their 1997 level, where they remained for 25 years. A hospital already training 20 residents could keep its 20 residency slots, but the government would not allow it to hire or train more doctors. Nor could new donors or hospitals create new residency training programs. The total number of medical residents — 98,258 in 1997 — was locked in. The government even forced the closing of some medical schools and paid some hospitals not to train doctors. Today’s unmatched residents weren’t even born yet when their opportunity to serve was capped.
It’s even worse- now the US has 78 million more residents, but the same number of doctors. This alters the supply/demand curve and creates a mismatch that increases costs. That’s why Lakeland, FL has one third of the doctors per capita than does Boston. Federal dollars spent on medical education don’t go to students; the funded spots are owned by institutions, mostly teaching hospitals. Because those institutions are generally in high-concentration urban areas (or at least the urban areas that were highly concentrated in 1997) and because general practitioners tend to open practices within 100 miles of where they completed a residency, new doctors for rural America are difficult to come by.
SO how do hospitals stretch those residency funds? Immigrants. 30% of residents are international medical graduates are filled by docs with H1-B visas.
Slow Joe Crow · September 20, 2025 at 2:36 pm
Dang, I knew there,was an artificial cap on medical students, but I always thought it was the AMA’s doing. I’m not surprised that this was a government screw up, and no one in government has tried to fix it