Today all U.S. graduate medical school is tightly controlled by one entity, the ACGME or Association of Collegiate Graduate Medical Education. The control is absolute, dictating the number of students and the curriculum at every institution. This monopoly: 1) prevents a free market by limiting the number of doctors; 2) prevents numerous highly qualified students from becoming doctors; 3) raises the cost of education through artificial scarcity; 4) increases costs to consumers; and 5) ensures a single orthodoxy among all doctors, limiting freedom of philosophy, thought and practice.
The solution is twofold, both directly actionable by the executive branch. First, break up the monopoly into multiple groups, forcing them to compete with each other. It is important to note that, while “the match” and a few other aspects of medical licensing have been specifically exempted from antitrust liability by congress, this aspect has not been exempted, despite clearly being a monopoly that imposes enormous detrimental costs to society at large. And second, create a new graduate school medical accreditor to serve as a baseline, ensuring rapid policy changes among the legacy accreditors. This could be handled by a state or group of states, or even any branch of the military or VA, having sufficient experience to know and assess the minimum requirements to practice effectively.
Over time this will lead to increased supply of doctors and lower cost to receive personal care and attention, a greater competition of ideas and types of care. Furthermore, it allows us to employ and reward the talents of many of our country’s best and brightest who are now turned away only because of artificial monopolistic restraints.