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Mother of InventionHow the Government Created "Free-Market" Health Care$
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Robert I. Field

Print publication date: 2013

Print ISBN-13: 9780199746750

Published to Oxford Scholarship Online: January 2014

DOI: 10.1093/acprof:oso/9780199746750.001.0001

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How the Government Created the Medical Profession

How the Government Created the Medical Profession

(p.122) 5 How the Government Created the Medical Profession
Mother of Invention

Robert I. Field

Oxford University Press

American physicians have not always enjoyed the high incomes and social standing they do today. The American Medical Association worked with state governments in the late nineteenth and early twentieth centuries to implement licensure requirements and professional self-regulation of training to standardize practice, improve quality, and boost incomes by restricting entry. Federal workforce programs in the mid-twentieth century greatly increased the profession’s size. However, the most important driver of the profession’s standing today isMedicare. Its guaranteed reimbursement dramatically increased earnings, especially in specialties that focus onelderly patients. It also reinforced, albeit inadvertently, an income differential favoring specialty practiceover primary care. Additional public support has come from the National Institutes of Health, which helps to develop technologies on which specialists rely. Government programs did not create the medical profession, however without them, the profession would be smaller, less technologically capable, and far less remunerative.

Keywords:   Physicians, Medicare, Primary care, Medical specialist, Licensure, Medical education, American Medical Association, Cardiology

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