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> The whole "capitalism will solve it" thing just isn't working. There's no capitalism in US health care system - you alluded to it yourself with lack of price

> The whole "capitalism will solve it" thing just isn't working. There's no capitalism in US health care system - you alluded to it yourself with lack of price transparency example. The key issue is medical cartel with AMA at the core who lobby hard to restrict supply of physicians as well as narrow scope of practice for everybody else. As a result you have people having to go through a gatekeeping 500k-a-year dermatologist to get a prescription for $250 creams which you can buy over the counter in the UK for 10 pounds. Nobody really talks about medical cartel in politics because doctors are popular with average Joe - unlike insurance and drug companies.

chimeracoder 7y ago
> There's no capitalism in US health care system - you alluded to it yourself with lack of price transparency example. This is true. > The key issue is medical cartel with AMA at the core, The AMA has basically zero power over any of the issues you describe. > AMA lobbies hard to restrict supply of physicians as well as narrow scope of practice for everybody else. No, the number of physicians is limited by the number of residency programs, which is determined by how much funding there is. Residency programs are not self-sustaining, so they're funded by Medicare. > As a result you have people having to go through a gatekeeping 500k-a-year dermatologist Most physicians take home a lot less than you'd think. The gross salary is misleading, because physicians also have high licensing, insurance, equipment, and continuing education costs. The gross pay does not take these expenses into account, and furthermore, these expenses are typically not tax-deductible for most physicians. It varies heavily by region and specialty, but the average (not top - average) physician in a city like New York or San Francisco actually has a lower take-home pay than a mid-level FAANG engineer[0] in either city. [0] e.g. an L4 engineer at Google.
- Ididntdothis 7y ago
  "It varies heavily by region and specialty, but the average (not top - average) physician in a city like New York or San Francisco actually has a lower take-home pay than a mid-level FAANG engineer in either city. " That's a pretty high bar though.
  - chimeracoder 7y ago
    > That's a pretty high bar though. Depends on what your reference point is. I think most people on HN would be surprised to learn that their doctor likely makes less take-home pay than the second-lowest level of engineer - L4, "SWE III" - at Google.

chimeracoder 7y ago

> There's no capitalism in US health care system - you alluded to it yourself with lack of price transparency example. This is true. > The key issue is medical cartel with AMA at the core, The AMA has basically zero power over any of the issues you describe. > AMA lobbies hard to restrict supply of physicians as well as narrow scope of practice for everybody else. No, the number of physicians is limited by the number of residency programs, which is determined by how much funding there is. Residency programs are not self-sustaining, so they're funded by Medicare. > As a result you have people having to go through a gatekeeping 500k-a-year dermatologist Most physicians take home a lot less than you'd think. The gross salary is misleading, because physicians also have high licensing, insurance, equipment, and continuing education costs. The gross pay does not take these expenses into account, and furthermore, these expenses are typically not tax-deductible for most physicians. It varies heavily by region and specialty, but the average (not top - average) physician in a city like New York or San Francisco actually has a lower take-home pay than a mid-level FAANG engineer[0] in either city. [0] e.g. an L4 engineer at Google.

Ididntdothis 7y ago
"It varies heavily by region and specialty, but the average (not top - average) physician in a city like New York or San Francisco actually has a lower take-home pay than a mid-level FAANG engineer in either city. " That's a pretty high bar though.
- chimeracoder 7y ago
  > That's a pretty high bar though. Depends on what your reference point is. I think most people on HN would be surprised to learn that their doctor likely makes less take-home pay than the second-lowest level of engineer - L4, "SWE III" - at Google.