Health policy experts have never been shy about their antagonism towards doctors.
The focus now appears to be on physician pay, with the Washington Post’s Steven Pearlstein, for one, continuing his anti-physician columns. Derek Thompson, over at The Atlantic (via @AllergyNotes), continues the assault, with a recent blog entry wondering if doctors deserve to be paid less.
I touched upon this topic last year, in a USA Today op-ed, Doctors’ pay cuts save little in health care costs, and paraphrased prominent Princeton economist Uwe Reinhardt saying that cutting physician pay 20 percent will only result in 2 percent of health care savings. And besides, if the current system stays in place, doctors whose pay is cut will simply respond by doing more procedures.
Furthermore, many health policy experts bring out the tired statistic comparing American physician salaries with those abroad. The problem is that these are not apples-to-apples comparisons. Both the cost of medical school and malpractice insurance are exponentially higher Stateside. Fully subsidize medical school and bring malpractice premiums down to the levels of other countries first, before talking about tackling doctors’ pay.
Until then, comparing physician salaries with those in Europe is a largely meaningless exercise, and only serves to expose many health wonks’ innate contempt for the medical profession.
Related posts:
- What is responsible for high health care costs?
- Are doctors are hurt financially by single-payer health care?
- Health care policy experts versus the public, an obstacle to reform
- Would you accept a lower salary if you could graduate from medical school debt free?
- Should health policy be mandatory for medical students?
- Technology wonks try to fix health care
- How mainstream news butchers health policy
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I not sure anyone who does 4 years of college 4 years of med school and at least 3 years of post grad training before generating any income would be considered a whiner. I am saying we will get the kind of medical care we deserve collectively as a society. If we want better outcome results then our collective society can get up off our butts eat right lose weight exercise and quit blaming someone else other than our own bad choices.
“Well I do. I have a patient who owns a plumbing company that employes 10 plumbers and he told me that last year all but 1 made over 100 K and 2 made over 200 K.”
That’s one. You want to play the averages and see how you come out as a plumber, go for it. Bet the average plumbersalary is less than 1/2 the average physician.
“I live in a metropolitan area in the Southeast, there is a law school here churning out lawyers and still the going rate for lawyers is $250.00 to $300.00 per hour. ”
So what’s their net? Because that is what matters. And what’s the AVERAGE attorney net?
i couldn’t agree more..
i mean with the trenchdoc’s last comment about “making right choices to become healthy.”
Another approach would be to just bide out your problem just like a home construction job. You choose a doc – take your medical problems to him with a list of your expected outcomes and ask for a bid on what it would take to get you the outcomes you wanted. You pay half up front and the balance upon reaching the desired outcomes. How many of you would do this as a patient? As a Doc, I would come out ahead because now I get 40 percent of what I charge and then my overhead is 55 percent – 15 percent of that is to collect what the insurance company has already agreed to pay me.
This is capitalism at its best.
i agree. my husband had also eluded to this alternative. there wouldn’t be a need for billing services, too. however, you probably would need well-drafted contracts with the patients; you know what the indians did to dr. whitman when he couldn’t fix the measles outbreak in 1840s
. just kidding; this would also give both parties a personal responsibility. by the way, we still have the problem of low or no income people and the children being left out of this system as well.
Trench Doc: where do you want the line to form? All HSA account holders, many disgruntled Medicare recips who have ‘gone bare’(no docs in town can afford to accept new Medicare pts.), and most adults who have had a tutorial in generally shameful insurance company reimbursement practices would all be eager clients.
Here is what I believe a critical mass of patients for any local practice would agree to:
1. Your plan as you outlined above. Presumably estimates would be disclosed up front like plastic surgeons and dentists have always readily done.
2.Work together to establish a contractual agreement on fast-track medmal settlement if god forbid it should ever be needed.
That is, patient is willing to forego painand suffering damages, and accept binding arbitration for some capped amount which would pay for fixing the problem and disability support.
3.Allow the patient some leeway to elect to forego tests which the doc agrees may be extraneous, and allow pt. to go to strip mall labs, or any cheapest purveyor of serum tests or imaging.
When can you start?
That is a pretty good outline. Just pay me a 6 month retainer fee up front to cover all office visits. I can outsoure th labs and it would be cheaper for both of us because I would not need staff and equipment for the lab. I could do this with one or two support staff in a 1200 sq ft office.
Trench Doc
When can I start?
Honestly, you have outlined such a better system than what we live and die with now.
Why is administration so deafeningly silent on promoting HSAs, or cash pay systems?
The math on ‘regular’ health insurance screams for citizens to convert to HSA. Save two years of those premiums and you can afford to have a cardiac event, and get change back.
“That is a pretty good outline. Just pay me a 6 month retainer fee up front to cover all office visits”
this is called “concierge medicine”.
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