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On the contrary, you proved mine. I worked in medical devices and hospitals for a significant portion of my career, and I really don't care that you aren't impr

On the contrary, you proved mine. I worked in medical devices and hospitals for a significant portion of my career, and I really don't care that you aren't impressed by the term "cartel", that's your prerogative to turn a blind eye to the facts. It's a combination of inflated salaries plus numerical shortage of doctors (the two are related) causing the root issues here. You claim to be familiar with other health systems; care to explain why in every other developed nation where doctors are not so overpaid, health care costs are reasonable? NPs and PAs are not allowed to perform a significant number of medical procedures; I see you ignore that, conveniently, and bringing it up isn't much other than a red herring. The "cartel" term has been used both colloquially and in academic literature for quite some time: https://www.jstor.org/stable/2352286?seq=1#page_scan_tab_contents https://www.jstor.org/stable/2352286?seq=1#page_scan_tab_con... Here are some other reading links. http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel https://wallstreetpit.com/5769-medical-cartel-md-salaries-high/ https://wallstreetpit.com/5769-medical-cartel-md-salaries-hi... https://www.forbes.com/sites/timworstall/2017/06/04/milton-friedman-told-us-the-answer-decades-ago-now-itll-probably-be-ibms-watson/#363863b61bce https://www.forbes.com/sites/timworstall/2017/06/04/milton-f... https://fee.org/articles/the-medical-cartel-is-keeping-health-care-costs-high/ https://fee.org/articles/the-medical-cartel-is-keeping-healt...

deleted 7y ago
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throwaway5752 7y ago
For the record I want to say that the second link you pasted - http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel -actually argues against even more effectively than I was able to.
- oarabbus_ 7y ago
  I'm very glad you pointed that out; I mean, jparks makes the same claim you make - that salaries aren't the problem - and doesn't address the artificial restriction of doctors at all. In other words, he fails to refute the "AMA isn't a cartel" claim. If you prevent the AMA from artificially restricting doctor supply, the overall cost of health care drops significantly, and the health of the population increases considerably. As a consequence of the overwhelmingly positive benefit of lifting the artificial supply of MD (or DO), doctor salaries will naturally drop, as necessitated by economics.
  - kelnos 7y ago
    I think you're focusing a bit too hard on this. If we broke the AMA cartel, prices would not magically fall to be in line with other developed nations. The AMA cartel is certainly a factor, and not small one, but it's not the only factor. We also need to fix the high administrator-to-doctor ratio that adds costs. Insurance companies provide little value and just extract money from people. They need to go away. Many low-income people skip out on preventative visits because they can't afford them. This leads to high-cost illnesses later down the road that could have been prevented or mitigated with proper care. So yes, doctor salaries are inflated, there is a shortage of doctors, and the AMA is a cartel that limits supply. But there's more to it than that.
    - oarabbus_ 7y ago
      With more doctors (and consequently lower salaries) the cost of preventative care drops, no? And perhaps just as importantly, the EASE and time-delay of getting an appointment drops. Blue collar workers tend to wait, as you said, until an illness becomes critical - because they have to work 9-5, the same hours doctors work. With an additional 25 or 50% of MD workforce, we can easily begin offering preventative care services outside of 8-5, allowing low-income people to get the preventative care they deserve without affecting their livelihood. We should strive for primary care visits to be available 7am-7pm (at least), 7 days a week, in every hospital/clinic in the nation. And specialist visits should be bookable in ~2-3 weeks max, not the 6+ week timeline many individuals requiring a specialist face. I agree with all your points, and definitely the administration costs I hope will drop as we get better ML/AI technology. I don't personally see a realistic way to get rid of the insurance companies, but they can be quite harmful. Finally I also would like to double down that the "cartel" aspect is the single largest contributing factor.

deleted 7y ago

[deleted]

throwaway5752 7y ago

For the record I want to say that the second link you pasted - http://www.jparksmd.com/blog/a-massively-overpaid-cartel http://www.jparksmd.com/blog/a-massively-overpaid-cartel -actually argues against even more effectively than I was able to.

oarabbus_ 7y ago
I'm very glad you pointed that out; I mean, jparks makes the same claim you make - that salaries aren't the problem - and doesn't address the artificial restriction of doctors at all. In other words, he fails to refute the "AMA isn't a cartel" claim. If you prevent the AMA from artificially restricting doctor supply, the overall cost of health care drops significantly, and the health of the population increases considerably. As a consequence of the overwhelmingly positive benefit of lifting the artificial supply of MD (or DO), doctor salaries will naturally drop, as necessitated by economics.
- kelnos 7y ago
  I think you're focusing a bit too hard on this. If we broke the AMA cartel, prices would not magically fall to be in line with other developed nations. The AMA cartel is certainly a factor, and not small one, but it's not the only factor. We also need to fix the high administrator-to-doctor ratio that adds costs. Insurance companies provide little value and just extract money from people. They need to go away. Many low-income people skip out on preventative visits because they can't afford them. This leads to high-cost illnesses later down the road that could have been prevented or mitigated with proper care. So yes, doctor salaries are inflated, there is a shortage of doctors, and the AMA is a cartel that limits supply. But there's more to it than that.
  - oarabbus_ 7y ago
    With more doctors (and consequently lower salaries) the cost of preventative care drops, no? And perhaps just as importantly, the EASE and time-delay of getting an appointment drops. Blue collar workers tend to wait, as you said, until an illness becomes critical - because they have to work 9-5, the same hours doctors work. With an additional 25 or 50% of MD workforce, we can easily begin offering preventative care services outside of 8-5, allowing low-income people to get the preventative care they deserve without affecting their livelihood. We should strive for primary care visits to be available 7am-7pm (at least), 7 days a week, in every hospital/clinic in the nation. And specialist visits should be bookable in ~2-3 weeks max, not the 6+ week timeline many individuals requiring a specialist face. I agree with all your points, and definitely the administration costs I hope will drop as we get better ML/AI technology. I don't personally see a realistic way to get rid of the insurance companies, but they can be quite harmful. Finally I also would like to double down that the "cartel" aspect is the single largest contributing factor.