The 'filthy rich doctors' explanation for high U.S. health care costs

well, when you figure in the fact that French doctors aren't a couple of hundred thou in debt before they hang out a shingle, don't have to pay high health insurance premiums for themselves or their employees, and probably don't have to pay for malpractice insurance, 55K is a pretty good average pay rate.

Boy, can you imagine the shortage of doctors (and nurses) in the US if we capped salaries at $55K? What would they start out, $35K?

And at what point do aspiring youth decide "Eh, it's not worth all the effort. I can just go to work at Starbucks part time and get free government health care."

Paying doctors less money is dangerous. Doctors go through medical school and residency, something that would frighten most people if they had to go through this to get a job. Doctors have a set of techincal skills that cannot be easily duplicated. They work extremely hard at learning extremely complex information. I think that it is irresponsible and ignorant to blame doctors themselves for the rise in health care costs. Many doctors put in more work in six months than most people do in a year. How much sense does it make to shortchange someone who is saving lives?

"Boy, can you imagine the shortage of doctors (and nurses) in the US if we capped salaries at $55K? What would they start out, $35K? "

Boy can you imagine what would happen if commenters actually read the post correctly, and noted that French GPs AVERAGED 55K/yr...

I mean, we might actually have the foundation for an intelligent discussion....

/Snark off

Many high risk specialties are underpaid. $195,000 a year may sound like a lot of money. But check out the recent top 50 multi-milltionare athletes. Many can barely read and write and what do they contribute to the well being of the public. Most doctors have to struggle to make the medium income. Long hours, huge overhead, and a monstrous staff chasing insurance carriers to get paid and prove medical necessity. The real criminal in the system is the insurance carriers who avoid/stall payment at every level of care. They control market pressures, limit access, and slow down the delivery system. We do not need a single payer system, we need a single administrated system and let the insurance companies compete for market share. Everyone has coverage, cut the paper chase/shuffling. Fine doctors and insurance companies that abuse their privileges.

Glen Rasmussen, you are correct.

I do not why people insist on blaming laborers (doctors) for problems that come from the corporations (insurance companies). People blaim gas station attendants for raising prices on gasoline. But they are not to blame. The petroleum companies are. The same goes with doctors. Doctors do not control the prices for their services. In order to make a living, they have to mark up prices because of equipment, drugs, insurance, and a bunch of other bureaucratic mess that is helping to destroy health care in the U.S.

"We do not need a single payer system, we need a single administrated system and let the insurance companies compete for market share."

Lets get a little more specific, Glen. Who is the single administrator? How does this entity ensure that everyone is covered? How do they set up this competition for market share?

"Why isn't young Klein concerned with why doctors are pretty much guaranteed to become millionaires in the US"

Funny, a conservative worried about someone making too much money? Free market, beh-beh!

I recently had this conversation with a friend of mine who is in medical school. We were discussing salary caps and how I feel that the salaries of doctors are outlandish and that salary caps for doctors didn't sound like a bad idea. She got pretty riled up and said that if doctors didn't get to look forward to all that money, then they would never become doctors in the first place. That - to me - is really interesting. I wasn't sure what I thought about it at first, and now I know I disagree. I recently finished law school (granted, not as ridiculously awful as medical school), and a lot of folks there felt the same way about possible caps on their own salaries as lawyers. It got me to thinking. It is those really greedy ones in both professions that give both professions a bad name. Plenty of people become doctors and then work in inner city hospitals or travel the world providing medical care in third world countries, doing good work for the sake of doing good work. Plenty of people become lawyers for the sake of helping people, and become public defenders or legal aid attorneys, and work just as hard for much less money than their corporate-whore counterparts. We should really look at the reality of this situation, and the level to which these 2 professions hold a monopoly on things that people desperately need access to. Because I don't tend to pander to greedy people, I would completely support capping salaries of doctors if it was part of a holistic re-imagining of how access to health care should work. This would have to include serious controls over: 1) what the pharmaceutical companies can do, how they can market, what they can charge; 2) costs of a medical education, so that students don't have to go thousands and thousands of dollars in debt just to get their training; 3) costs of insurance for doctors; and 4) costs of insurance for people, and availability of insurance for everyone. Without addressing these things as a whole, progress can't really be made, because these things are all elements of the same big problem. Simple/simplistic solutions are not going to work for our health care crisis, we need to really get creative and start challenging some of the traditions we take for granted, and holding our professionals to a higher degree of social responsibility.

I'm a lawyer. A couple of years ago I had a conversation with my kid's pediatrician. He observed that lawyers, on average, made only about 60-70% what doctors did and that the legal profession should limit the number of law school graduates the way the medical profession limited the number of medical school graduates. I thought it was an interesting conversation.

Seeing as how so many women (take me to task all you want but in general woman want to work fewer hours to spend time with family) have gone into medicine I think it would work just fine if:

-education was paid for
-35 hour work week
-6 weeks paid vacation
-rent stipend for expensive cities
-generous pension

But I don't think that's what the people suggesting this plan have in mind (but it is what they have in France). They want to cut doctors off at 55 or so k a year thinking that it will save money.

I know a good number of dedicated doctors who want nothing more than to do research and help, but taking a vow of poverty (55k in NYC?) isn't part of the plan.

One needs to be careful when painting with a broad brush. I am a forty year old physician who worked and borrowed my way through college and medical school. During school breaks, I did not travel to tropical beaches but worked to help off-set the cost of my education. When I finished my residency trianing at age 30 and was ready to enter practice, I was tens of thousands of dollars in debt with student loans.

I typically work about 60 hours a week and am likely to be awakened at 2:00 am when I am at home. I make a comfortable living but "millionaire" is nowhere in my future.

I've also heard that the average income for doctors varies wildly depending on their exact specialty/field.

I don't think pediatricians make that much.

I've also heard that the average income for doctors varies wildly depending on their exact specialty/field.

I don't think pediatricians make that much.

I don't know a lot of millionaire doctors either.
It is purely ignorance that speaks of such things. Given that many doctors spend between 11-15 years for college, medical school, residency, and fellowship training beyond a k-12 education, and many are in educational debt over 100,000 dollars to pay them 55k is beyond idiotic. Couple that with the tremendous responsibility that a doctor has, the stress, the need for continuing medical education, keeping the malpractice lawyers at bay, time lost from family to care for patients, paying higher and higher overhead, and oh by the way, dealing with ever decreasing reimbursements (not to mention all the free work that we do when patients cannot or will not pay) - for example, medicare reimbursements are to fall 10% in 2008, and another 30% (that's 40% people) by 2015, anyone who thinks that doctors should make that little money are simply ignorant. I wonder if people like this mind that the median salary for a NFL player is between 300,000 - 650,000 dollars a year. Or consider the amount of money that William McGuire, the CEO of United Health made in 2005 - 124.8 million dollars - and that's not counting his stock options.

Get some perspective. No one in their right mind would go into medical school for 50k. If you prefer non-American trained doctors taking care of you then this is the way to make that happen.

Again, the ignorance of Mr. Jones would be funny if not so sad.

Capping physician's salaries is the fastest way to dilute the talent pool among medical practitioners. Health care would be marginally cheaper, but it would be considerably less valuable.

Unless the government becomes the single payer for all of health care, there's no way to implement this anyway.

One wonders how much Fred Jones makes (or should make)....

If you were paid for ignorance then Fred Jones would be as rich as Warren Buffet.

Why is it sad that your blog was given print inches? Doctors are wallowing in cash, but they are in some ways, earning it. Long hours, weekend and holidays are all trashed. Why? American education sucks. Defense budget too big, education too small. Matter of fact, as much as we like to call them rifle droppers (WWII reference), and snotty, they have great ideas. They have a good education system and a good health care system, seems to me they got their priorities straight.
As far as doctors getting rich here, why aren't more people becoming doctors? Seems like that's a real lucrative job right now, except being a lobbyist might be easier

Why is it sad that your blog was given print inches? Doctors are wallowing in cash, but they are in some ways, earning it. Long hours, weekend and holidays are all trashed. Why? American education sucks. Defense budget too big, education too small. Matter of fact, as much as we like to call them rifle droppers (WWII reference), and snotty, they have great ideas. They have a good education system and a good health care system, seems to me they got their priorities straight.
As far as doctors getting rich here, why aren't more people becoming doctors? Seems like that's a real lucrative job right now, except being a lobbyist might be easier

artificial scarcity == cartel

supply of doctor is controlled at two points::
medical school class size + residency numbers

http://www.usatoday.com/news/health/2005-03-02-doctor-shortage_x.htm

pssble sln:
standardized national credentialing with open access to anyone willing to pay for cost of administration

(ie paying 100K+ tuition should not be req. for board exams... to put this in perspective, several top med schools do not offer examinations... students simply pay enormous tuition for the right to sit for the natl board exam?)

If there were a salary cap on doctors salary at 55k, they'd probably find themselves not able to afford malpractice insurance.

Which would be fine, because at 55k per year, it wouldn't be worth the time or money for a lawsuit.

I am married to a doctor and we are far from rich. That is all I have to say.

It's interesting to me that these doctors who cry about having thousands of dollars in education loans to pay off and are pleading poverty can still manager to own two or more homes, travel the globe, take weeks of vacation time and still run a thriving practice. No wonder you can never see the doctor! Hum, who's really running the doctor's practice and earning these inflated salaries for the doctors, the PA's!!
My point, you're still millionaires, maybe not liquid, but on paper. Boo-hoo!!!

Think about how many what kind of culture surrounds an "elite" tier of doctors. Creating a higher social class for doctors produces detachment from the people they serve, and when money becomes the issue, basic services like health care that are so intimately linked to the human experience become commodified, which is dangerous. I can't tell you how many doctors i've seen that are greedy, and self absorbed to the point that it becomes anti-social. There is a problem in giving doctors more money than anyone should be able to live off of. Cap the wage!!