By NextBestFitExpand capacity before demand peaks
Year 0 onward; continuous · HRSA; UHA; states (scope of practice)Discuss this step
How other countries handled this same piece of implementation, what happened, and what it means for this plan.
Side by side
| Country | Approach | Result | Lesson for this plan |
|---|---|---|---|
| This plan (U.S.) | Utilization rises by $349.6B a year at steady state. Without more clinicians and facilities, that demand turns into longer waits. This step funds training slots, scope-of-practice changes, and facilities in shortage areas. | ||
| Canada | Cut medical-school enrollment by about 10% in the 1990s to contain costs. | Contributed to later physician shortages and long waits. | Cutting training to save money produces queues a decade later. |
| United Kingdom | NHS Long Term Workforce Plan (2023) to double medical-school places by 2031. | Expansion after years of shortages; results years away. | Training must be expanded before demand rises. |
| Japan | Highest number of hospital beds and MRI/CT units per capita in the OECD. | Very short waits, but long stays and overuse. | Abundant capacity eliminates waits at some cost in efficiency. |
| Australia | Nurse practitioners and pharmacists given expanded prescribing; rural generalist pathway. | Expanded rural access. | Scope-of-practice expansion is the fastest capacity lever. |
Canada
- What they did
- Cut medical-school enrollment by about 10% in the 1990s to contain costs.
- What happened
- Contributed to later physician shortages and long waits.
- Lesson for this plan
- Cutting training to save money produces queues a decade later.
Sources: Fraser Institute (2025)
United Kingdom
- What they did
- NHS Long Term Workforce Plan (2023) to double medical-school places by 2031.
- What happened
- Expansion after years of shortages; results years away.
- Lesson for this plan
- Training must be expanded before demand rises.
Japan
- What they did
- Highest number of hospital beds and MRI/CT units per capita in the OECD.
- What happened
- Very short waits, but long stays and overuse.
- Lesson for this plan
- Abundant capacity eliminates waits at some cost in efficiency.
Australia
- What they did
- Nurse practitioners and pharmacists given expanded prescribing; rural generalist pathway.
- What happened
- Expanded rural access.
- Lesson for this plan
- Scope-of-practice expansion is the fastest capacity lever.
More precedent
- Canada cut medical-school enrollment in the 1990s to control costs; the result was long-term shortages.
- OECD comparisons show the U.S. has far more MRI and CT units per capita than Canada or the UK, so the U.S. starts from higher diagnostic capacity.