Pharmaceuticals are obviously a much bigger component of healthcare costs, but that doesn't mean salaries aren't inflated. In my former career I spent over a year as a consultant with a large network of hospitals in Pennsylvania, and I understand very well how their profit models work.
A kid that breaks his leg playing sports will easily incur a bill over $30,000 after surgery. A visit with a cardiologist (or any specialist) and a stress test or echo will cost over $3500. A 15 minute ER visit that doesn't even result in seeing a physcian or any testing will still cost over $500. So, while outrageous pharmaceutical prices obviously contribute to high insurance bills, healthcare is still unaffordable when all those variables are removed.
Why are the costs so high? When hospitals formulate their models, they have to do so with extraordinarily high fixed costs (read: salaries). The need to accrue a certain amount of revenue every month just to cover non-variable costs -- most of the time this doesn't even include doctors. They also need to do this under the assumption that a certain number of patients will never pay their bill (yes, part of your bill is to cover for the guy that won't pay his). They also need to make a certain amount of money per year to cover ammortization and depreciation of the hundreds of millions of dollars of equipment they buy. After all this, physician bills are added on TOP of those prices, which are also inflated because even when a patient doesn't pay, the doctor still receives his share and that needs to be accounted for. Finally, they add a percentage to all this so they can make a profit.
I am a big believer in a free market economy, but in healthcare it doesn't make much sense. When you have medical schools, medical equipment companies, pharmaceutical companies, hospitals, lenders, and insurance companies all needing to make a profit, it has a snowball effect that makes the end-consumer cost unaffordable. The U.S. spends more, as a total dollar amount, per capita, and as a percentage of GDP on healthcare than any other developed country on earth. Yet, almost all objective rankings for efficiency do not rank us in the top 10.
Salaries in healthcare (including doctors) are absolutely too high, but this can't change unless there's a complete overhaul to the system. You can't ask someone to incur 10 years and $500k worth of training costs to only make $80k. Most (I hope) doctors join medicine to help people, but they're also not stupid and won't subject themselves to a lifetime of poverty to do it. Allow any healthcare provider to exit their training with zero debt and I think they'll be more amicable toward a significant reduction in pay.
