Similar rules prevent cheaper medicine via nurses directly managing patients, even though randomized trials suggest nurses are just as effective. This all just shows what a strong lock doctors have on medicine right? Well, consider the example of school nurses.
Most states have special laws allowing school nurses to directly manage students as patients. True, school nurses can’t do everything docs can, but nurses who offered these same services to passersby at a shopping mall, without direct doc supervision, would violate medical licensing laws. Apparently, we like the comfort of knowing that medical help is onsite at school, but know that an onsite doctor would be very expensive, and so compromise with school nurses.
I’m not sure what takeaway those three have from this, but to me it goes to show that there are certain kinds of activities that are efficiently undertaken by public sector entities. In particular, “take this fixed pool of resources and apply it to improving health outcomes” is something governments are pretty good at. The UK, your local public school, and even the otherwise poverty-inducing government of Cuba are all extremely cost-effective health care delivery systems. So is the Veterans’ Administration system in the United States.