Medicare fix

[ARubberChickenWithAPulley]

Of course any legislation to cut doctors paychecks would be fought tooth and nail by the AMA with advertisements and lobbying. That is the kind of thing that no politician has the guts to face.

In fairness, as a whole, though physician salaries are higher in the U.S., they don't make that big a difference in the long run (I think even if you cut all physician salaries by 10%, it might save 1%-2% in costs). It's not so much the salaries as the cost of individual treatments that matter... though to some extent, I'm sure it would come out in the wash at the end. But I believe we pay more for just about everything in the supply chain... from drugs, on down to equipment, to payments to hospitals, etc.

We'd really see lobbying from a lot of groups, in any event. Certainly the AHA (American Hospital Association), definitely PhRMA, medical device manufacturers.... ultimately, we pay more for just about everything, so to cut down on the cost, we'd have to set lower prices on just about everything. And, in fact, we did see lobbying from all those groups, and some quite successfully.

The not-so-subtle shift from "health care" reform to "health insurance" reform made it pretty clear that the main focus turned to coverage, rather than cost (coverage also absolutely needed to be addressed, so I don't necessarily fault them, but they need to address cost at some point too).

 

[TragicMonkey]

Something doesn't seem to balance out here. Some Doctors claim they are going to go out of business, while others are making 25 times what their wage slaves get. That is a range of $0 to $500,000.

Perhaps some kind of price fixing is needed here? Or just a few thousand doses of truth serum?

Because "healthcare" is a very wide and varied field. You might as well say "I work in computers"--which could mean you're the IT director of a huge firm and making six figures, or it could mean you're doing data entry for eight bucks an hour.

My employers make tons of money because we're an oncology practice. I don't know if there are any richer fruits than that on the medical tree. Of course it's not just the specialty that matters, but also your business size, location, market share, and number of patients. A single general practitioner doctor in a small office in a rural part of the country will make much less than a doctor who's in a group of a hundred other specialty doctors in a big city. And then there's how the business is set up--my practice is owned by some of the doctors, who get a percentage and not a salary, while the other doctors get a set salary. And there's things like where you get your drugs and supplies, do you have your business office operations contracted out, how many poor and indigent do you treat for free or reduced, etc etc. Healthcare is so much more complex than patients know. I didn't know until I started working in it. (And to anticipate what's come up many times in the past, no, you can't cut all the costs by firing everybody except doctors and nurses. Dear god in heaven, you think a doctor's going to perform surgery all day then sit before a computer and run reports out a database, or research the new HCPCS codes?)