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The real problem with health care is that it's a gravy train for all involved. Doctors, who don't invent anything new and who just practice garden-variety medic

The real problem with health care is that it's a gravy train for all involved. Doctors, who don't invent anything new and who just practice garden-variety medicine are wildly overpaid. They don't like it be known, but the average doctor earns a quarter-million a year. Totally unjustified. Then there are the medical device manufacturers, big Pharma and the hospitals. They all are getting rich off the current system. That's what needs to change.

kingbirdy 9y ago
Doctors are so highly paid as a function of their scarcity, which is itself a function of the high barriers to entry (intense schooling, selective admissions, high costs). I think the first 2 barriers are necessary to keep quality high, but doing something about the 3rd could help lower costs by increasing the supply of doctors, and I certainly think that's a better solution than being mad at the doctors for accepting a high salary that's offered to them.
- MagnumOpus 9y ago
  Schooling costs are high because of the length of the program - four years of pre-med, four years of med school. Compare in the UK - five years instead of eight, taking 2 years of pre-clinical courses and 3 years of clinical courses, subsidised to a good extent by the state. UK doctors seem equally skilled, and have minimal student debt. Scarcity being a function of selective admissions is a tautology. To be useful, selectivity would need to be to some objective minimum standard, rather than enforcing an ever-changing standard that enforces the restriction of the profession to an arbitrary small number of entrants.
potatote 9y ago
I believe that the big pharma and the insurance companies are certainly part of the problem, but rarely do we mention doctors as a contributing factor (albeit relatively small) to the high cost. The American Medical Association (AMA) does its duty to restrict the supply of doctors [1]. Countries like India, which produces plenty of high quality doctors, does not require aspiring doctors to go through an additional (unnecessary) 4 years of undergrad education. That would hugely cut the cost down in training the doctors. Secondly, doctors on average makes $200K/year [2] or more. I have four housemates, who were trained in Myanmar (went through five years of medical school there right after high school) and scored above 95th percentile or more in all three steps of their USMLEs, to get into the residency programs in the US. One of them is going into general practice (family medicine) in Virginia and her starting salary is: $210K/year. I have no doubt that she (or anyone who has been trained 5 years in a decent med school--without the 4-year undergrad prior to that) is more than capable of treating generic diseases and illnesses. But this shows that we can train doctors cheaper and that we can reduce their pay by quite a bit (no hard-working person in other profession--except maybe Banking--could easily earn $210K/year to do such a relatively uneventful--in my opinion--job). I regret quitting med school in Myanmar in the third year. Then, I thought med school training involves too much rote learning (a lot of memorization in organic chem for example) and that I'd rather do something more 'exciting' like tech or math. I was wrong. [1] https://mises.org/library/how-government-helped-create-coming-doctor-shortage https://mises.org/library/how-government-helped-create-comin... [2] https://www.theatlantic.com/health/archive/2015/01/physician-salaries/384846/ https://www.theatlantic.com/health/archive/2015/01/physician...
- elefanten 9y ago
  We probably don't hear about doctors' salaries as part of the problem because they're not a huge problem. A cursory web search indicates theres about a million doctors in the US. If you cut each of their salaries by 100,000 (which probably isn't feasible) then you would save 100 billion. Sounds like a lot, right? Until you note its just $300 out of $10,000 spent per person each year. And what's the trade-off? Despite your opinion that it's boring or potentially not very challenging... there are pretty logical reasons why people would still want a relatively disciplined, intelligent and careful person as their doctor. The lengthy and onerous requirements for schooling are filtering for more than just the ability to perform a series of carefully defined procedures.

kingbirdy 9y ago

Doctors are so highly paid as a function of their scarcity, which is itself a function of the high barriers to entry (intense schooling, selective admissions, high costs). I think the first 2 barriers are necessary to keep quality high, but doing something about the 3rd could help lower costs by increasing the supply of doctors, and I certainly think that's a better solution than being mad at the doctors for accepting a high salary that's offered to them.

MagnumOpus 9y ago
Schooling costs are high because of the length of the program - four years of pre-med, four years of med school. Compare in the UK - five years instead of eight, taking 2 years of pre-clinical courses and 3 years of clinical courses, subsidised to a good extent by the state. UK doctors seem equally skilled, and have minimal student debt. Scarcity being a function of selective admissions is a tautology. To be useful, selectivity would need to be to some objective minimum standard, rather than enforcing an ever-changing standard that enforces the restriction of the profession to an arbitrary small number of entrants.

potatote 9y ago

I believe that the big pharma and the insurance companies are certainly part of the problem, but rarely do we mention doctors as a contributing factor (albeit relatively small) to the high cost. The American Medical Association (AMA) does its duty to restrict the supply of doctors [1]. Countries like India, which produces plenty of high quality doctors, does not require aspiring doctors to go through an additional (unnecessary) 4 years of undergrad education. That would hugely cut the cost down in training the doctors. Secondly, doctors on average makes $200K/year [2] or more. I have four housemates, who were trained in Myanmar (went through five years of medical school there right after high school) and scored above 95th percentile or more in all three steps of their USMLEs, to get into the residency programs in the US. One of them is going into general practice (family medicine) in Virginia and her starting salary is: $210K/year. I have no doubt that she (or anyone who has been trained 5 years in a decent med school--without the 4-year undergrad prior to that) is more than capable of treating generic diseases and illnesses. But this shows that we can train doctors cheaper and that we can reduce their pay by quite a bit (no hard-working person in other profession--except maybe Banking--could easily earn $210K/year to do such a relatively uneventful--in my opinion--job). I regret quitting med school in Myanmar in the third year. Then, I thought med school training involves too much rote learning (a lot of memorization in organic chem for example) and that I'd rather do something more 'exciting' like tech or math. I was wrong. [1] https://mises.org/library/how-government-helped-create-coming-doctor-shortage https://mises.org/library/how-government-helped-create-comin... [2] https://www.theatlantic.com/health/archive/2015/01/physician-salaries/384846/ https://www.theatlantic.com/health/archive/2015/01/physician...

elefanten 9y ago
We probably don't hear about doctors' salaries as part of the problem because they're not a huge problem. A cursory web search indicates theres about a million doctors in the US. If you cut each of their salaries by 100,000 (which probably isn't feasible) then you would save 100 billion. Sounds like a lot, right? Until you note its just $300 out of $10,000 spent per person each year. And what's the trade-off? Despite your opinion that it's boring or potentially not very challenging... there are pretty logical reasons why people would still want a relatively disciplined, intelligent and careful person as their doctor. The lengthy and onerous requirements for schooling are filtering for more than just the ability to perform a series of carefully defined procedures.