Another idiot

[urge]

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The problem of doctors’ salaries

Conveniently leaves behind that American doctors are burdened with debt while other countries pay them to study.

Doesn’t address that a minimum wage employee makes $15 an hour. How much should a doctor make after 8yrs of schooling then?

Doesn’t address that the minimum wage is not $15 in foreign countries.

Wait until he checks how much nurses make working only 36 hrs a week, and then compare it to a foreign country.

 

[Twiggidy]

The problem of doctors’ salaries

Conveniently leaves behind that American doctors are burdened with debt while other countries pay them to study.

Doesn’t address that a minimum wage employee makes $15 an hour. How much should a doctor make after 8yrs of schooling then?

Doesn’t address that the minimum wage is not $15 in foreign countries.

Wait until he checks how much nurses make workin only 36 hrs a week, and then compare it to a foreign country.

That guy is a gas bag. If you read his Twitter mentions, he's giving nothing but snarky remarks to people making your same counterpoints. He definitely has it out for doctors for some personal reason.

 

[WholeLottaGame7]

The problem of doctors’ salaries

Conveniently leaves behind that American doctors are burdened with debt while other countries pay them to study.

Doesn’t address that a minimum wage employee makes $15 an hour. How much should a doctor make after 8yrs of schooling then?

Doesn’t address that the minimum wage is not $15 in foreign countries.

Wait until he checks how much nurses make working only 36 hrs a week, and then compare it to a foreign country.

For an economist, he seems to have a really poor grasp of economics. Ironic that he thinks WE'RE the ones that are overpaid...

$10 bucks he's being subsidized by some insurance company or hospital CEO

 

[AdmiralChz]

For an economist, he seems to have a really poor grasp of economics. Ironic that he thinks WE'RE the ones that are overpaid...

$10 bucks he's being subsidized by some insurance company or hospital CEO

It is basic, BASIC Health Economics (my major, albeit some time ago) that income of providers is not the driving force behind increasing healthcare costs! Otherwise all our incomes would’ve 3-5x (or more) over the last 20 years way outpacing inflation.

I’m not an expert in the literature, but most experts if you ask them to simplify arguments believe it is often the “medical arms race” behind much of increased costs as well as hospital consolidation/poor ability to compete on an equal playing field which stifles profit-maximization and promotes laziness in cost control. Just think about it from what we see on a regular basis - DaVinci Robot use, orthopedic implants with 3-4 medical reps present, intraoperative MRI or newer and “better” CT/MRIs costing often more than $1 million.

There was an attempt a couple decades ago to limit these costs by states - largely the basis for “Certificates if Need.” Basically the hospital needs to prove to the state that the new MRI, cardiac tower, DaVinci machine is actually needed in the community. It’s good in theory, but essentially the large academic and monopolistic hospital corporations never get turned down (largely political!).

Sorry for the rant, but TL;DR - physician income isn’t a main factor in our escalating healthcare cost.

 

[deleted87051]

It is basic, BASIC Health Economics (my major, albeit some time ago) that income of providers is not the driving force behind increasing healthcare costs! Otherwise all our incomes would’ve 3-5x (or more) over the last 20 years way outpacing inflation.

I’m not an expert in the literature, but most experts if you ask them to simplify arguments believe it is often the “medical arms race” behind much of increased costs as well as hospital consolidation/poor ability to compete on an equal playing field which stifles profit-maximization and promotes laziness in cost control. Just think about it from what we see on a regular basis - DaVinci Robot use, orthopedic implants with 3-4 medical reps present, intraoperative MRI or newer and “better” CT/MRIs costing often more than $1 million.

There was an attempt a couple decades ago to limit these costs by states - largely the basis for “Certificates if Need.” Basically the hospital needs to prove to the state that the new MRI, cardiac tower, DaVinci machine is actually needed in the community. It’s good in theory, but essentially the large academic and monopolistic hospital corporations never get turned down (largely political!).

Sorry for the rant, but TL;DR - physician income isn’t a main factor in our escalating healthcare cost.

It’s not just medical equipment either. Every new hospital built in my city is at least a billion dollars and have lobbies that rival any Ritz Carlton. They pander to the consumer, umm patient. It’s the American way and it’s obscene. You don’t see that in my home country where hospitals are very simple but functional.

 

[Reveler]

Agreed, as an economist, his position is terribly short-sighted. There are so many people taking money out of the system, and so many intermediaries drawing from the well without directly contributing to patient care. So much defensive medicine is practiced, and so much documentation is created, that cost inherently balloons. CMS guidelines that patients meet requirements for "qualifying hospital stays" of 3 days (not counting day of d/c) prior to SNF placement leads to prolonged stays; this is obviously only one example. The problem, as we know, is NOT physician reimbursement (well, in this sense)..

 

[OB1🤙]

 

[Reveler]

Administrative job growth in healthcare isn't good for America
"Where do all those healthcare dollars go—money that is desperately needed to pay providers? It is being consumed by those shiny new administrative jobs, hundreds of thousands of them."

 

[Planktonmd]

Physicians in other "wealthy countries" don't make less money than american physicians! This is simply a lie!
Also, physicians in other "wealthy" countries work significantly less hours and take significantly more time off than american physicians but still make equal or more money. These physicians in other "wealthy" countries are also represented by unions who actually protect their rights.

 

[parcus]

It’s not just medical equipment either. Every new hospital built in my city is at least a billion dollars and have lobbies that rival any Ritz Carlton. They pander to the consumer, umm patient. It’s the American way and it’s obscene. You don’t see that in my home country where hospitals are very simple but functional.

What country is that?

 

[deleted87051]

What country is that?

East Asia, first world.

Same with Mexico where many hospitals are modern and well equipped, but not built like tourist attractions or a luxury shopping center.

 

[mmag]

Pay me like a French doctor. You know you want to.

 

[deleted643396]

I can almost guarantee that either he or his little "think tank" is sponsored by an organization that would benefit from lowering physician compensation. This article is embarrassingly ill-informed and so narrow in scope that it doesn't even remotely touch on the biggest drivers of increasing healthcare costs in this country.

 

[zero0]

Fake news

 

[leaverus]

why are you guys making these counter-points here? there's only other anesthesiologists on this forum; you don't have to convince any of US

 

[powermd]

I create more value to society spending five minutes at work in my clinic than this worm has in his entire career. What a hateful, jealous, pitiful little *****. I hope his personal physician reads this bile.

 

[BLADEMDA]

The problem of doctors’ salaries

Conveniently leaves behind that American doctors are burdened with debt while other countries pay them to study.

Doesn’t address that a minimum wage employee makes $15 an hour. How much should a doctor make after 8yrs of schooling then?

Doesn’t address that the minimum wage is not $15 in foreign countries.

Wait until he checks how much nurses make working only 36 hrs a week, and then compare it to a foreign country.

"Another approach is to not only change the rules around who can practice, but to change the rules around what doctors do. There are many procedures now performed by doctors that can be performed by nurse practitioners and other lower-paid health professionals. For example, many states now allow nurse practitioners to prescribe medicine without the supervision of a doctor, and there is no evidence that this has resulted in worse outcomes for patients. (It does, however, reduce health care costs.) The scope of practice of nurse practitioners and other health professionals can be extended in this and other areas for which they are fully competent."

from that same author

 

[powermd]

"Another approach is to not only change the rules around who can practice, but to change the rules around what doctors do. There are many procedures now performed by doctors that can be performed by nurse practitioners and other lower-paid health professionals. For example, many states now allow nurse practitioners to prescribe medicine without the supervision of a doctor, and there is no evidence that this has resulted in worse outcomes for patients. (It does, however, reduce health care costs.) The scope of practice of nurse practitioners and other health professionals can be extended in this and other areas for which they are fully competent."

from that same author

This economist conveniently ignores the most expensive implement in healthcare- the docto.... I mean... "provider's" pen. I haven't seen a study directly comparing the cost of care delivered by midlevel practitioners vs physicians (inclusive of imaging, labs, specialist referrals, and consequent spending), but which group is in the better position to deliver more cost-effective care? Particularly in light of the fact that a 99204 pays the same regardless of the letters after your name.

 

[Perrotfish]

For an economist, he seems to have a really poor grasp of economics. Ironic that he thinks WE'RE the ones that are overpaid...

$10 bucks he's being subsidized by some insurance company or hospital CEO

Everyone is overpaid, and everyone's individual pay problem is 'just a drop in the bucket'. The problem is, as anyone with a leaky roof knows, you can fill a bucket with drops. That's the problem with trying to cut healthcare costs: no matter which problem you try to address the person you're looking as says 'we're only 5% of the total costs!' If you address any one sliver of the pie, whether physician salaries, nurse salaries, the bloated administration, tort reform, over testing, or anything else you only decrease the total cost of healthcare by 3-5%. Because each individual group is usually sympathetic in the eyes of the public, and because each individual reform would have such a small effect, everyone argues their way out of any reforms at all and costs just keep rising.

I think we can agree that some components of our overall healthcare costs are more parasitic that others. Most of us would like to them go after the pay of healthcare administrators and pharm executives before they go after physicians and nurses, but that's due to our sense of justice rather than because of economics. If we really wanted healthcare to be affordable they are, eventually, going to need to cut costs anywhere.

 

[parcus]

Everyone is overpaid, and everyone's individual pay problem is 'just a drop in the bucket'. The problem is, as anyone with a leaky roof knows, you can fill a bucket with drops. That's the problem with trying to cut healthcare costs: no matter which problem you try to address the person you're looking as says 'we're only 5% of the total costs!' If you address any one sliver of the pie, whether physician salaries, nurse salaries, the bloated administration, tort reform, over testing, or anything else you only decrease the total cost of healthcare by 3-5%. Because each individual group is usually sympathetic in the eyes of the public, and because each individual reform would have such a small effect, everyone argues their way out of any reforms at all and costs just keep rising.

I think we can agree that some components of our overall healthcare costs are more parasitic that others. Most of us would like to them go after the pay of healthcare administrators and pharm executives before they go after physicians and nurses, but that's due to our sense of justice rather than because of economics. If we really wanted healthcare to be affordable they are, eventually, going to need to cut costs anywhere.

Same if valid for most of the rest of society too. This is not exclusive to the US at all either, sadly. Everyone wants to keep their little privileges, so it's very hard to get rid of any of them.

 

[parcus]

East Asia, first world.

Same with Mexico where many hospitals are modern and well equipped, but not built like tourist attractions or a luxury shopping center.

It would be nice to know which country, exactly. I don't understand the secrecy. I think the "looks" of the hospitals reflect the higher wealth American society has in general; It's probably not the main reason why healthcare is so expensive there either, as that is noticeable in other aspects of the US as well (house of the average person there vs here, cars, technology).

 

[deleted87051]

It would be nice to know which country, exactly. I don't understand the secrecy. I think the "looks" of the hospitals reflect the higher wealth American society has in general; It's probably not the main reason why healthcare is so expensive there either, as that is noticeable in other aspects of the US as well (house of the average person there vs here, cars, technology).

It’s a wealthy first world country. They have opulent hotels and shopping centers. Just not opulent hospitals.

 

[acidbase1]

Good luck finding physicians who are willing to go through 12 years of hell for 150k. Hell, I’d just be an engineer

 

[Perrotfish]

Doesn’t address that a minimum wage employee makes $15 an hour..

Also, since no one else mentioned it, national minimum wage in the US is $7.25. The highest state minimum age is $11/hr.

 

[anbuitachi]

Prob cause doctors are weak. No one would publish those things about nurses and get away with it