Part One: The federal government proposes to pay medical centers not to train graduate medical students because of a perceived oversupply of physicians. The government traditionally intervenes in the operation of the health care market by funding a large proportion of the education of health professionals. The government does so to achieve certain goals. If these goals are not met, certain policy adjustments are considered. The federal government's goals regarding health care access have not been met. Therefore, government intervention to address the social consequences of the oversupply of physicians is warranted.
Granted, not all experts agree that there is an oversupply of physicians or the extent to which such an oversupply would be harmful. Reinhardt (1991) claims that health manpower forecasting has limited utility: "One may describe health services research as an attempt to enhance the accuracy of the folklore upon which policymakers base their decisions" (p. 283). From an economic perspective, modern technology will increasingly result in a substitution of technology for human capital. This substitution will make it difficult to assess optimum physician/patient ratios for the future. Reinhardt (1991) further cites the Council on Graduate Medical Education's conclusion that there is little evidence to suggest that there is a direct link between the oversupply of physicians and negative consequences to society.
Some medical sociologists contend that market forces are sufficient to correct any imbalance in the supply of physicians. If there are too many physicians, hospitals will simply adjust their staffing patterns. Modern hospitals are engaged in a quest for efficiency, and are sensitive to supply and demand. Therefore, the market should dictate the optimum size of the physician supply.
The policy of not training graduate medical students might address the oversupply of physicians; however, it will no...