All good points, but I'm talking about the current situation. At this point in time, the workforce in the US has been expanding thanks to the echo boomers. While it is true that the rate of population growth has been declining since 1990, that effect is greatly delayed. Factoring in college, most of them didn't even enter the workforce until last year, and many still haven't entered the workforce as graduate programs have become more popular (and time to graduation for BS/BA degrees now often taking 5-6 years).
Another important factor is that population growth (at least in the US, I'm not familiar with other countries) is cyclical. You have the boom generations which are where you get rapid population growth, followed by the intermediate generations which are much smaller and thus produce far fewer progeny, which are then followed by the previous boom generation's children now having children. The 90s marked one of those periods where an intermediate generation was having children. We're now at point, however, where the echo boomers are having kids.
Even assuming everything I said above is wrong though, the fact remains that the current US population is estimated to be 318 million up from 226 million in 1980. That's the problem. It doesn't matter that growth slowed a bit in the 90s, we still added ~33 million people to the population during that decade. Likewise, since 1987 the world population has increased by 2 billion. At the same time improved technology has been decimating job fields. And thanks to increased globalization and the rise of new major economies such as India and China, the competition for jobs has grown even more intense than it otherwise would have. Since 1980, we have 100 million more Americans competing for far fewer jobs in a global economy that has exploded in size during the same time period.
And as we as biologists know, in a complex system everything is interrelated. While medicine itself is insulated from outsourcing, it is not insulated from the effects outsourcing has on the rest of the economy. When you eliminate one career field, everyone who used to, or would have, worked in that field must move to new ones. That bloats up more career fields and makes them less viable than they used to be due to higher competition and the lower pay and benefits that results from increased workers for the same number of jobs. Since the 1970s the US has lost a tremendous number of low-education jobs, which has caused a lot of people to pursue a college education who otherwise would have stopped with a high school diploma. That led to an oversaturation of BS/BA degrees, so the kids who would have normally stopped at the BS/BA level then went on to get advanced degrees. The result has been an oversaturation of professional workers and as a result just about every career has deteriorated since the 80s. Medicine is unique in that thanks to the rent seeking system of med school admissions and residency slots it has been able to artificially suppress the supply of physicians. However, medicine isn't immune to the overall troubles of the job market. The hardships felt by the rest of population as a result of everything above have caused the population to become less able to gain healthcare access. Of course, because healthcare is a necessity society isn't just going to stand by while fewer and fewer people can get treatment, and the result has been the passing of legislation intended to increase healthcare access at the cost of physician lifestyle and salary.
