Thanks for having me here. Hope to be able to share as much as I may learn.
Chris
I haven't heard of "Sahva" before. Am I right it's like the governing body of the health care system? As everywhere the health care costs have skyrocketed and now more than ever before the pressure is on to make shoes cheaper as long as they last 18 or so months. Do remember that before in the Netherlands customers could get their shoes replaced every 12 months. And I have heard of program's that have a benefit every 6 months.
Just as important is the organization of orthopedic shoemakers that deals with the health insurance on a national level. This is the way it used to by. I believe that currently they are no longer allowed to negotiate for national contracts and individual shops have to compete. But back when I left Europe, some 10 years ago contracts were still negotiated on a national level. In order to justify the relative high prices they had to show investments in the future of the branch with a result on of the best training programs anywhere. They got away with it because there was a fear that if you have the orthopedic shoemakers compete and a lot of them would go down (remember their crafts people not administrators or negotiators so they don't stand much of a chance against some big shot insurance company negotiator) and the "art" would be lost. The situation now has changed like night and day. I still have family in the business in the Netherlands and hear some things about if every now and than. The pressure is on now to produce cheaper and have the shoes last longer. The results in innovations and education will not be noticed till much later when a good part of the current establishment retires and the art will be lost.
I have to say that there are some good orthopedic shoe makers here in the US, even if you don't count me in.
but they are to the best of my knowledge not organized and it's much of an individual undertaking. There is the PFA that keeps itself occupied with orthopedic shoes but I haven't met anybody there that can come close to the average European orthopedic shoemaker. In fact to pass their certification the only things you need to know about shoes is book knowledge. No hands on and as all that make shoes and boots should remember from when they started in the business just book knowledge doesn't cut it. As for the schooling of cobblers here, I have no idea. I have seen a subject group on the board dealing with schools so you may want to post a question there. The interesting thing is that here in New England I do not know any cobblers that have been formally educated in the US. I know "the old guys" the emigrants that came over as cobblers or learned only from their father and are ready to retire now. And than there is this one who was a doctor, he got himself into a midlife crisis but in stead of dumping his wife for a 20yo and buying a sports car he gave up his practice and bought a cobbler shop. He is all self thought with the help from some other cobblers and he's loving is. Frankly he has gotten quite good at it but it must have been a steep learning curve.
Let me finish by giving my 2 cents worth on the wet/dry lasting debate. I don't make western style boots as of now, the only boots are orthopedic lace up style. I only dry last. I find that chrome leather gets hard and sometimes almost brittle by the time they dry and I am afraid of stains. Sure part of this is the quality of the leather but I rather not take the chance. The way I select leathers for my customer has more to do with their orthopedic footwear needs than durability. Not that I want my shoes to fall apart in no time but I can't give an older lady with arthritis a heavy boot leather. The only times I am tempted to wet last is with a bad fitting upper and I keep finding out that it's cheaper and easier to just throw that upper in the trash and start with a new set op patterns. I have not seen many orthopedic shoemakers wet last. I think part of the reason is the softness of the leathers is often critical to a functional shoe and wet lasting seems to take some of that away. I also have to admit I don't use leather counter or toe boxes anymore and to apply my man made counter in a wet upper would be much harder than dry lasting.
I have seen orthopedic shops order special "moist chambers" where a high humidity and temperature is maintained. The uppers are hang in there for a couple of hours before lasting. It seems the ones that need this most are the ones with questionable patterns. I'm NOT saying that everybody that wet lasts can't make patterns I'm just saying in the orthopedic shoe business it is not common practice in spite of sometimes really freaky looking lasts.
Of course this also raises questions about the long term "beauty" of the shoe/boot...will it hold its shape, size, and good looks as it breaks in? I don't know, but in the case of pull-on boots, at least, I am doubtful. 
!!!!!!!