"In the United States, administrative tasks consumed 13.5 percent of physicians' time, valued at $15.5 billion. Physicians spent 8.3 percent of their gross income on clinical employees; the administrative portion (13.5 percent) of compensation of these employees was $3.0 billion. Physicians' costs for clerical staff averaged 12.3 percent of physicians' gross income, or $33.1 billion. The one third of physicians' office rent and expenses attributable to administration represented 4.6 percent of physicians' gross income, or $12.4 billion. Finally, the half of "other professional expenses" (a category that includes accounting and legal fees) attributable to administration accounted for 3.2 percent of physicians' income, or $8.6 billion. In total, physicians' administrative work and costs amounted to $72.6 billion — $261 per capita, or 26.9 percent of physicians' gross income.
Canadian physicians devoted 8.4 percent of their professional time to practice management and administration, valued at $592 million. They spent 6.1 percent of their gross income on clinical office staff. The administrative portion (8.4 percent) of compensation of these employees amounted to $53 million. Physicians' costs for clerical staff averaged 6.9 percent of their gross income, or $716 million. The one third of physicians' office rent and expenses attributable to administration totaled $193 million. Finally, the 50 percent of "other professional expenses" attributable to administration cost $116 million. In total, physicians' administrative work and costs amounted to $1.7 billion — $55 per capita, or 16.1 percent of their gross income."
First, total costs are 43 times higher (72.6B vs. 1.7B) in the US vs. Canada. Most of these "percentages", which I find rather unreliable, are actually pretty close: 13.5% vs. 8.4% for "administrative time", 8.3% vs. 6.1% for clinical employees, 12.3% vs. 6.9% for clerical employees, and 28.9% vs. 18.2% for "other".
Basically, having to deal with multiple insurance payers adds 5-6% more administrative time and clerical employee cost. I would have assumed Canada to have almost zero administrative overhead in a "single-payer" system. How are Canadian physicians spending 8.4% of their time devoted to administrative work vs. US physicians at 13.5%, when we're supposed to be orders of magnitude more bureaucratic?
Interestingly, the "other category", which is either uncontrollable (rent), should be close to the same (supplies), accounting (same?), legal fees (no idea), and outside billing (minus malpractice insurance), accounts for an 11% difference. By far the largest.
Also, if you extrapolate the "valued time" number to total wage, assume 300 million and 30 million as the relative populations with 2.4 and 2.2/1000 doctors (Wikipedia), the wages earned are ~$160,000 vs. $108,000. Subtracting total administrative costs, the wages are $117,000 vs. $91,000. So, even in a more efficient system but with UHC, Canadian physicians still earn less, but not drastically so (roughly 22% less).
I have no idea what the total tax liability is for a Canadian physician so that's as far as I can go. I also assume this is for PP physicians.
Personally, I'd probably take 20% less salary for UHC (not necessarily single payer). Unfortunately, there are so many other variables that aren't accounted for, but the differences aren't that dramatic. Administrative costs are a problem, but not the only problem.
