1) There is a perception that the salaries of American physicians are too high, making them a frequent target to cut.
My take: When expressed in GDP per capita, American physicians are indeed compensated at a higher rate compared to other countries. However, context is needed. New American physicians graduate with a mortgage-sized $150,000 debt. In Canada and Europe, medical education is heavily subsidized. Furthermore, American physicians pay significantly more in malpractice insurance. When these points are factored in, the contrast in salaries aren’t as stark. I will not take any suggestion to reduce the salaries of American physicians seriously, unless it is accompanied with proposals to reduce the burden of malpractice insurance and subsidizing medical education.
As an aside, I would also be curious to see how the salaries of American CEOs and lawyers compare with those abroad. Are they also compensated at a higher rate when compared to Canada and Europe? If so, where is the outrage against American attorney’s salaries?
2) The Boston Globe’s Steve Bailey writes: “Massachusetts did what no other state was willing to do because it got tired of access being held hostage to cost. But broadening coverage without slowing costs will not work. In the end, it will break the bank.”
My take: Thanks for stating the obvious Steve. Promising universal coverage is an easy political sell. Obviously, everyone wants health care for all. Implementation however, tells a different story. Massachusetts is finding out that costs will increase with universal coverage, no matter how they dress it up. As the public slowly realizes that universal coverage will be on their dime, I would be curious to see if the enthusiasm lasts.
By promising universal coverage up front, leaders are going for the political slam dunk. This is a mistake. Without paying attention to what’s really ailing our health care system, like runaway costs and primary care infrastructure, they will find out that the easy way out is going to lead to a hard road ahead.
Hillary and Obama are in danger of falling into the Massachusetts trap. But with the Democratic primary so closely contested, don’t bet on any deviation from their misguided universal coverage rhetoric.
