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What good are doctors if there are no patients (payers)…
Oh wow! Just peachy. I didn’t realize it would be so simple. I’m casting my vote for Hilary now.
Anon 1:52 –
Why do you assume that physicians will continue to be well paid under such a system? As it stands today, in the current semi-socialized medicare system, that reimbursement has fallen steadily since 1993 (inflation adjusted). Even still, those with a choice and opportunity for higher reimbursement elsewhere, do not accept it.
As is always true, universal coverage will increase demand, since the “price” to the “consumer” will approach zero. As reimbursements decline (as there will be a relatively fixed pie, in spite of increasing demand) supply will decline (even if slowly). In any case, there will inevitably be a shortage (whether due to infinitely increased demand or slowly declining supply).
Economics.
” As it stands today, in the current semi-socialized medicare system, that reimbursement has fallen steadily since 1993 (inflation adjusted). Even still, those with a choice and opportunity for higher reimbursement elsewhere, do not accept it.”
And still you’re the highest paid of any profession in the world. And you would almost certainly be under a universal healthcare system.
The pie will not be fixed, the pie will increase every year until the baby boomers start to decline.
This is the fallacy of universal coverage. It does not equal universal access. Limited access already exists for patients covered by the government plans (Medicare, Medicaid, Tricare, Chips, etc.). At best, providers would set market-driven prices and patients or secondary insurance would reimburse patients, not doctors, the difference. The best way to hold down costs is to make patients directly responsible for paying for care rather than able to pass the buck to a third party. Doctors are likely to respond by packaging care items rather than a la carte pricing, resulting in greater patient value.
Anon 7:35, where do you get the idea that physicians in (the USA, I’m guessing you are talking about) are the highest paid profession in the world? That just isn’t true. Plenty of other occupations earn better, including lawyers who do corporate and finance work, bankers, dentists, fast food franchise restaurant owners, and major-league sports players (make far more).
So I’m calling you out as a liar. Worse, you completely ignore the fact that medicine is the most costly field to enter in terms of lost opportunity to earn and total cost of education.
If you think an average figure of attending physician income cited by the Dept. of Labor is a truthful representation of the return on a medical career, then you are knowingly misusing a flawed statistic. Nice try, but you aren’t believable.
“The pie will not be fixed, the pie will increase every year until the baby boomers start to decline.”
Well, it hasn’t yet. Where do you propose the money will come from to keep reimbursement constant while demand increases?
“If you think an average figure of attending physician income cited by the Dept. of Labor is a truthful representation of the return on a medical career, then you are knowingly misusing a flawed statistic. Nice try, but you aren’t believable.”
If the Dept. of Labor’s avg. salary statistics don’t satisfy you, how did you come to your conclusions? What’s your source?
Why do you get to choose the highest paid subsets of certain professions to contrast the average salary of all physicians?
If you’re going to call me a liar, I hope you have a source to back up your own claims. Since the US Dept. of Labor figures are “lies”.
“Well, it hasn’t yet. Where do you propose the money will come from to keep reimbursement constant while demand increases?”
Same place it’s coming from now – taxes. The cost to the US taxpayer isn’t going to decline. Under any system so far proposed.
So the demand will increase, the pie will get bigger, and an overwhelming number of taxpayers will soon leave the job market (and therefore pay significantly less tax.)
90 % marginal tax rate here we come! Yeah Hillary!
Anon 12:02:
Average starting salary of an investment banker $134,000,
after 10 years, $1,000,000
[Source: Princeton Review]
for typical global head of investment banking: $7,000,000 to 10,000,000
[source: WSJ]
(Excluding bonuses, profit share and other compensation.)
Average NFL player salary (year 2006) $1.4 million
[source: Wiki]
Average NBA player salary, $2 million
[source: ESPN]
Excluding endorsement contracts and other related income.
Anon, 3:06:
Some of the salaries, I agree with you, and I don’t think doctors are the highest paying profession (hedge fund managers, etc. take home quite a bit of money as well). But some of the careers you listed aren’t something the average person can really hope for without luck/significant athletic talent. With really hard work, one would be more likely to get into medical school than say, drafted for a professional sport (in my opinion). Doctors do generally have a nice salary (above what the average American makes, although how above isn’t certain in the future) and it is a profession more people can hope to reach and train to get into. This is just my opinion, and I hope it makes sense.
Doctors do have a nice salary, but that still has to be considered with stress (including malpractice based stress) and student debt, plus the amount of time they are still in school while other professions are climbing the career ladder. I don’t think they are the highest paid profession in the world, possibly more likely the highest paid profession the average Joe can hope to attain (but I’m still not sure about that, I don’t have figures).
So basically, Anon 3:06, you took the cream of the crop of athletes and bankers and then contrasted it with physicians overall.
I’m glad you’re a doctor because your statistics skills wouldn’t let you last long as a banker.
This is probably going to be misinterpreted and attacked, but I’m going to say it anyway: neither the average person nor the slightly above average person could possibly hope to successfully complete training in an American medical school and residency.
I don’t know Scapel, I’m just saying it is commonly thought that you can study to increase your chance of good grades, etc. while if you practice your basketball skills everyday, your chances are probably not going to pay off as much (meaning, no NBA deal, plus such things would involve things like height as well). Does that make sense? I suppose it would involve someone’s opinion on “intelligence” in general…
Plus, what are there, around 500 players in the NBA? They are paid so much because their talent is scarce, same with doctors. Personally, I don’t think doctors are overpaid (I was just trying to address the criticism I felt would follow such display of salaries), but I do believe it is one of the top professions someone, with hard work or inherent intelligence, can “hope” to attain to.
Oops, Scalpel, sorry. Another criticism would be that doctors, in the past anyway, seem to have more security in their salaries, more so than a lawyer or business professional would. The other careers may be seen as more risky, but you know, that is why medical school is so hard to get into and one reason medical school costs a lot. Education today, regardless of major, is really a big, somewhat risky investment.
And I do get a bit tired of people saying that it is simply a “personal choice” and to deal with it when tuition inflation is on par with that of healthcare (and no, I don’t support the government paying for everyone’s tuition) ; Scalpel is right, it does take someone “above average” to get through everything (how they reach an above average level, we may disagree on, but this should include the academic and psychological stress the field involves).
I don’t believe for a second that half of these doctors/medical students wouldn’t be successful in other fields, but I suppose the advice for half of the future doctors would be to stop whining about it, and seek a business degree with $20,000 worth or debt instead (compared to a projected $150-200,000 for medical school), the other half of medical students can always just specialize to make their money or join those “boutique” practices and deal with being called immoral/greedy. Of course, standards won’t have to be lowered, and we can pump in foreign medical graduates for PCP, etc., except that the UK and Europe may be a bigger lure for them in the future (falling dollar, possible adoption of standards the other countries already have-which may harm the old US edge, etc.).
I’ll stop ranting about student debt now (I acknowledge I’m prone to ranting about it), but I believe it should factor in when looking at compensation, along with time spent seeking a degree. Just my opinion though; as I see these UHC discussions taking on the classic “eating your cake and having it too” proverb without being completely realistic.
I don’t think the average person can practice enough to succeed in the NBA, but I also don’t think the average person could study hard enough to become a physician.
All I’m really trying to say is that both professions require more than just hard work and the desire to succeed. Go to any college and the freshman biology class is filled with above-average people who think they have what it takes to become a doctor. After they discover organic chemistry, reality usually sets in.
I would disagree. While one must have some basic intelligence, there is no profession that one cannot attain. I’m excepting those where particular athletic prowess is required, of course.
We’re not even talking about intelligence here, we’re talking about grades (dismissing the standard entrance exams as now you can study, get a coach, have your rich parents plan ahead and get you diagnosed with a learning disabilities, etc.). I think if started earlier, long before college, someone can work hard enough to become an “above average” student and may even be better off than others, as they’ve worked hard and been competitive by default for most of their academic careers and know it will be a challenge. Physical talent may be harder to foster and more difficult to reach the payoff one is aiming for (professional sports). Saying that, they can succeed with scholarships (before I sound like a sports snob, sports can be great and useful).
I also disagree that it is just the “above average” student who may succeed, I know “perfect” students who tend to cry and throw a fit when things don’t go their way academically or simply take far too long to “pull their weight” (probably perfectionism kicking in though); it is just my opinion, but I don’t think those are great traits to bring into the medical field and I do question if they will “grow out of it” or learn to adapt their skills. Also, some of those students are being pushed into their careers; so I think general passion should factor in this.
Also, while it will look bad when applying for medical schools, people can always just take the class over. Medical school is very hard, I don’t think anyone disagrees with that (if they do, perhaps they should try applying), but I don’t think anyone’s future is set in stone (fancy that, I’m the idealistic one now! Perhaps I should talk about my human rights now?).
Hello,
I just practiced in Australia for a year. They don’t have socialized medicine,just medicare for all. You could call it socialized insurance. Docs pay less than $9000 per year for a top-notch medical education. The residents I worked with were phenomenal. And the clincher – the salary for working in the public hospital system was $247,000 per year, with the tax rate around 40% for employees in the public system. My take home pay there was higher than my gross salary here(Taxes are reduced for Australian public sector doctors as a retention bonus because you can go into private practice and make a lot more money) And there is a standard public doc benefit of 5 weeks vacation and 5 weeks conference time per year. And a $25,000 conference budget per year (above salary). And a fantastic, rewarding medical system with same meds, technology as the US. Except we actually had time to practice the way you are supposed to – you know, calling the family,researching their illness, calling other doctors, reading old charts, spending more time with the patient. Resulting in better care. It’s a great system. It costs the australian government only 9% of GDP for all citizens(versus 14% of GDP here for all citizens, including the ones with no insurance). It’s easy to open a private practice in any town or neighborhood there, too, since everyone on your block has insurance and you don’t need staff to do lots of insurance paperwork. As a doctor it was the most rewarding time of my career. I was treating rich, poor and working class patients who were all healthier and happier and much more respectful of doctors and I never had to tell a patient that they couldn’t afford my care…So, American doctors have been brainwashed just as much everyone else, by the corporate interests who are profiting off of the human suffering of the current system.
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