Why do Canadian doctors working under public insurance make more than US docs that opt the same?

[Alakazam123]

I always thought people disliked Medicare and Medicaid here because of the lowered reimbursements. How is Canada able to sustain, and pay their physicians a sustainable wage, while we are unable to do so with the government system. Doesn't the US have more money than Canada?

What's wrong with our government system?

---

Members don't see this ad.

 

[Alakazam123]

Don't doctor's salaries only account for about 5% of healthcare costs? Most of the USA's healthcare costs are a problem of middle-men right?

 

[Quantal Reasoning]

... they don't? With the exception of ophthalmologists, unless that was reworked

 

[doc05]

I think your question is based on a general misunderstanding of the system.

 

[Alakazam123]

I think your question is based on a general misunderstanding of the system.

The typical issue here is the insanely high malpractice insurance fees for some specialties, combined with massive student loan burden to pay off, as well as other overhead costs. Canadian physicians, from what I understand do not have that issue.

For instance, a Canadian orthopedic surgeon I read about, made $500,000 annual salary by billing the Canadian government for his services as usual. If I'm right, given the low reimbursement from Medicaid and Medicare, I don't think an Orthopedic surgeon here could make that much simply based on those two right?

What I'm wondering is why this is, and how we can fix it?

 

[Treebeard]

Most developed nations believe that the health of the population is a priority and fund a system to that end.

The populace of the United States seem to believe that 1) the health of some investors' wallets its the only priority, and 2) the government is an evil syndicate just one step away from locking then entire populace in a concentration camp and creating death panels that will put out anyone who gets a sniffle.

 

[libertyyne]

1. Healthcare services costs are higher in the US compared to other industrialized nations
2. Malpractice only accounts for a small portion of costs , and states that have undergone tort reform are not likely to spend less or cost less , or practice less defensive medicine .
3. Medical costs in the us are partially driven by overutilization of services and procedures based on physican and patient preferneces. the estimates vary but 1/4-1/3 of all costs can be contributed to this.
4. There is an immense amount of waste in the US system including adminsitrative and redundancy.
5. Physican salaries account for a small portion of costs.
6. US pays more, gets less coverage, and in general has poorer outcomes.

The US Gov is really good at running [example] and [example] and [example] that I believe they should be in charge of my healthcare as well. Said no one ever.

Or 22 trillion or so in debt and need to add more because you know, the gom'mint is an efficient machine that knows what is best for me.

Almost every person that is in their early 60s cant wait to get on medicare.

 

[Alakazam123]

1. Healthcare services costs are higher in the US compared to other industrialized nations
2. Malpractice only accounts for a small portion of costs , and states that have undergone tort reform are not likely to spend less or cost less , or practice less defensive medicine .
3. Medical costs in the us are partially driven by overutilization of services and procedures based on physican and patient preferneces. the estimates vary but 1/4-1/3 of all costs can be contributed to this.
4. There is an immense amount of waste in the US system including adminsitrative and redundancy.
5. Physican salaries account for a small portion of costs.
6. US pays more, gets less coverage, and in general has poorer outcomes.


Almost every person that is in their early 60s cant wait to get on medicare.

Thank you for the explanation, this clears it up for me

I just have two more questions please:

1. What used to be different back in the 70s and 80s where healthcare was cheap, AND doctors salaries were quite high?

2. What upsets surgeons about malpractice issues? Isn't accountability good?

 

[libertyyne]

Because it is subsidized by a younger generation that is unable to support the costs. They lose around 400,000,000,000.00 (I threw in the cents for the extra zeros) a year of which is borrowed and interest paid so... a lot of money is borrowed to pay for that lovely program.


Sent from my iPhone using SDN

Ah yes, but lets go back to the time before medicare and remember the social outrage of retirees going to the poor house because of healthcare costs. Every industrialized nation has figured this out and does just fine. We have more expensive care in this country and poorer outcomes even after adjusting for poor lifestyle choices. Even Ayn rand went on SS! Talk about being consistent with values.

 

[Treebeard]

You gave the example of a well run government program by responding to my post. I rebutted it. I didn’t say it was a horrible program, i was pointing out that nothing the government touches works as intended.


Sent from my iPhone using SDN

Do you realize that every single industrialized nation other than the US has a form of universal healthcare? And their people are happy with those systems? Sure there are some issues and you can find some anecdotes of disgruntled patients and negative interactions, but the idea of repealing the national health system is never a tenable political opinion, even among the most conservative mainstream political parties.

 

[aafisahar]

Thank you for the explanation, this clears it up for me

I just have two more questions please:

1. What used to be different back in the 70s and 80s where healthcare was cheap, AND doctors salaries were quite high?

In the 70s, your first heart failure exacerbation, your first COPD exacerbation, MI, etc etc was often times fatal. The Rx for STEMIs and NSTEMIs was complete bedrest and literally sit and watch you complete your infarct. We didn't have PCI, we didn't have impellas and balloon pumps.

If you got sick and it wasn't easily treatable(eg pnemonia, cellulitis, etc etc) you were hosed.

 

[WedgeDawg]

Moving to TIH

 

[Alakazam123]

In the 70s, your first heart failure exacerbation, your first COPD exacerbation, MI, etc etc was often times fatal. The Rx for STEMIs and NSTEMIs was complete bedrest and literally sit and watch you complete your infarct. We didn't have PCI, we didn't have impellas and balloon pumps.

If you got sick and it wasn't easily treatable(eg pnemonia, cellulitis, etc etc) you were hosed.

So basically, lack of sophistication of medical care inadvertently made medical care cheap. However, today with the advances in pharmaceutical research and medical device research, the prices have gone up?

 

[Treebeard]

So basically, lack of sophistication of medical care inadvertently made medical care cheap. However, today with the advances in pharmaceutical research and medical device research, the prices have gone up?

This is a nice little hypothesis, unfortunately it is untrue. Health Care Spending in the United States and Other High-Income Countries

"The US had similar rates of utilization (US discharges per 100 000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100 000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries."

The US is practicing very similar medicine to other countries (with the exception of scans - we do a ton of scans, though one could argue we do a ton of unnecessary scans). The insane administration costs (which are a direct product of our confusing multi-layered system) and pharmaceutical costs (which are a direct product of our profit-centered system) seem to be the highest cost sinks.

 

[deleted480308]

This is a nice little hypothesis, unfortunately it is untrue. Health Care Spending in the United States and Other High-Income Countries

"The US had similar rates of utilization (US discharges per 100 000 were 192 for acute myocardial infarction, 365 for pneumonia, 230 for chronic obstructive pulmonary disease; procedures per 100 000 were 204 for hip replacement, 226 for knee replacement, and 79 for coronary artery bypass graft surgery). Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries. For pharmaceutical costs, spending per capita was $1443 in the US vs a range of $466 to $939 in other countries."

The US is practicing very similar medicine to other countries (with the exception of scans - we do a ton of scans, though one could argue we do a ton of unnecessary scans). The insane administration costs (which are a direct product of our confusing multi-layered system) and pharmaceutical costs (which are a direct product of our profit-centered system) seem to be the highest cost sinks.

Does the pharmacy costs there compare actual meds to each other or just total pharm bill per patient?