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We try to make sense of a real problem many of us feel: paying a lot for U.S. healthcare while still waiting months to see a doctor. We trace how engineered transaction costs, from the Flexner Report to modern residency caps, restrict physician supply and protect price power while leaving clinicians overworked and patients stuck. 
• getting “fired” by a health system and what it reveals about access 
• why shortages don’t clear when prices rise, and how transaction costs block entry 
• the Flexner Report as quality reform and supply restriction 
• evidence of conflicts of interest and rushed methods behind the Flexner narrative 
• Ruben Kessel’s puzzle on persistent price discrimination in medicine 
• hospital privileges and county medical societies as cartel discipline 
• why advertising bans and professional norms can function as anti-competition tools 
• how residency caps and accreditation keep the bottleneck in place today 
• a listener letter on data center payments as compensation versus bribes 
• book of the week recommendation and a few parting thoughts 

Links:

• The infamous Flexner Report:  http://archive.carnegiefoundation.org/publications/pdfs/elibrary/Carnegie_Flexner_Report.pdf
• Hiatt and Stockton on the Flexner Report:  "The Impact of the Flexner Report on the Fate of Medical Schools in North America After 1909"
• Hiatt: "Around the Continent in 180 Days."
• Hiatt: "The Amazing Logistics of Flexner's Fieldwork."
• Kessell, Journal of Law and Economics, 1958:  "Price Discrimination in Medicine."
• Ernest Jones, "The God complex" in Essays in Applied Psycho-Analysis.

Earliest source I could find for the TWEJ:  https://www.netfunny.com/rhf/jokes/old89/godplay.840.html

PA data center story: https://www.thecentersquare.com/pennsylvania/article_3b615fd8-5d36-45c4-bfb6-4a3162104f0b.html

Book-o-da-week:  Daniel Hannan, Inventing Freedom, Broadside Press. https://www.amazon.com/Inventing-Freedom-English-Speaking-Peoples-Modern/dp/006223174X/

If you have questions or comments, or want to suggest a future topic, email the show at taitc.email@gmail.com !

You can follow Mike Munger on Twitter at @mungowitz