You've touched on something that they don't mention in the article, which is that one of the obvious solutions to our "shortage" (such as it is) is to recognize doctors from other countries. I've met more than one doctor who is driving a cab because they won't recognize the guy's degree from his African university. If they streamlined the process for certifying doctors whose degrees were earned outside of North America, a lot of our issues would go away.

Now, it *is* easier to get care in the city, so I don't see the problems that people in the way-the-heck-out suburbs see. I live in downtown Toronto and have never had to wait longer for any kind of care than I had to wait in the US. In fact, my experiences with the health care system up here have been far more positive than in the US.

The article makes Whitby sound like some sort of happenin' oasis in the south of France and, um, it's not. :) I mean, it's not the same issue they have up in the territories (the entire territory of Nunavut has less than 30,000 people) but they do have an issue.

Keep in mind that I'm not excusing the problem: the Canadian system isn't perfect. It needs to be fixed, but I think that we can make a big difference with nothing more than regulatory changes. Romanow's report made some recommendations for increases in health care spending that we might see to some degree. We still have a long way to go before we're spending as much on health care as people in the US are, and I think that Canadians often lose sight of the fact that we are getting a lot of our health care on the (relative) cheap.

I've got a doctor who got her medical degree in India... but she did have to pass the boards here in the U.S. Lots of the doctors in NYC got their medical training elsewhere. Regulation can, indeed, slow a profession down -- this is always a big issue among actuaries, because alot of the exams they make us take, and the process in general, seems to be out-of-step with what we actually do. They seem to be more gatekeepers in making sure the supply of actuaries is "just right" - standards too high, and no one gets in, standards too low, and the credentials are debased. It's a tough balance - you don't want to let in incompetent doctors who will hurt people, but then, you could also be turning away people who =are= competent.

Still, there are lots of professions where there's this kind of problem in preventing a supply of workers in particular locations. Teachers are one example. I would never become a public school teacher, in NYC at any rate, because of the idiotic training requirements (not to mention that the profession has lost its luster since it requires only an education degree, as opposed to demonstration of knowledge of what you're going to teach.) Some remote areas are having trouble getting enough teachers, especially in particular subjects. Luckily, they've been allowed to get visas for foreign teachers to fill these slots (this was a big story in the Raleigh paper while I was there a few weeks ago - rural counties looking in other countries for teachers).

One needs worker mobility to fill slots, but still, one has to note that one can't force people to live in any particular place. People keep asking me if I would transfer to Charlotte, and my answer is always "Hell no, I won't go!" Then they say "But you'd lose your job if they tell you to transfer." That's true, but no one can make me move to Charlotte. Of course, if they paid me $500K a year, then I would be bribeable, because then I'd just keep my NYC apt and fly back on the weekends or some such. But the money involved would be way more than I'm worth, and they would be better off hiring someone new in Charlotte. In the case of rural NC, the people from those areas who do go and get trained as teachers decide to work elsewhere afterwards. There are lots more people deciding that they want to leave Turkey Neck, NC to live in NYC (or Raleigh, or Greensboro) than vice-versa.

The gatekeeper for foreign trained doctors coming to Canada is getting a residency. They can take and pass the exams, but only a very small number of residencies are available each year to non-Canadians, and as far as I can tell, it's purely because the medical associations wish to control the supply.

Well, that's definitely something the government can take care of. They can demand more residency spots in hospitals, etc., if they want to stay part of Medicare.