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Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopo

Until Americans find Physicians (and Pharmacists) as the enemy, it will never happen. They(AMA and APA) are top lobbyists that entrench themselves using monopolistic practices. Sure school can cost 500k, but with 200 to 300k+ per year salaries, they can kill that debt. (This is their common defense)

peterhadlaw 7y ago
So you mean ... the government that enables such licensing, monopolistic behavior, and moat building?
- wuliwong 7y ago
  Bingo. But we will still see more regulation implemented to attempt to resolve this.
lotsofpulp 7y ago
I don’t know any pharmacist making $200k, and their pay is getting crushed right now due to tons of supply since there is no limit on the number of new pharmacists. Anyone currently pursuing pharmacy is in a poor ROI situation, especially if they’re paying for school. Their pay is in now way comparable to doctors, who have a structural advantage due to the limited number of new doctors each year.
jostmey 7y ago
I think you're stumbling on a root cause of America's healthcare crisis. I think most American's don't understand just how much physicians make--and where did you get those figures because clinicians I know make a good deal more than 200-300k
- snowwrestler 7y ago
  It's an uncomfortable subject because the vast majority of front-line medical professionals like doctors, specialists, surgeons, nurses etc. are doing that job with passion and honesty to help people. But it's also true, and I think well-known at least in a vague sense, that one can make a pretty good living in the medical field. For-profit insurance companies come in for the most hate since they are in the position to deny care. But their profit margins are not sky-high. Whether or not one believes that private health insurance is a terrible idea, the facts are pretty clear that there is a lot more to the high cost of U.S. healthcare than just private insurance. There is a lot of cost everywhere in the medical system... that's the other side of those professionals making a good living. I'm not going to pretend I have a good answer to this.
  - maximente 7y ago
    > It's an uncomfortable subject because the vast majority of front-line medical professionals like doctors, specialists, surgeons, nurses etc. are doing that job with passion and honesty to help people. don't take this personally, but: this is an oft repeated meme that, in my experience, not really true, at least for MDs and nurses (to include doctors, specialists and surgeons). it certainly contributes to the sort of hero status of health care workers though. physicians in the US earn a ton for a high-prestige, high social power, high earnings, generally safe career. in return they must sacrifice these earnings and social status for most of their 20s due to ridiculous quotas and standards in medical school, propped up by AMA; this makes the system higher prestige and sought after, a nice vicious (or virtuous for them) cycle. the AMA also has them on the hook in a debt-slavery sort of way, because normal wages would never repay their ridiculous medical debt (see e.g. mid/low tier lawyers and law school outcomes when that got popular) nursing, likewise, is seen as a j o b that offers some safety/consistency in return for investing time into education. that these individuals """help people""" is generally of tertiary or lesser concern; much more "help" could be done by opening an affordable grocery store in a food desert. all but the most naive students either readily admit this or cop to it once asked.
- jcranberry 7y ago
  Average salary of physicians from the bureau of labor statistics [1]: Anesthesiologists $267,020 Surgeons 255,110 Obstetricians and gynecologists 238,320 Psychiatrists 220,380 Family and general practitioners 211,780 Physicians and surgeons, all other 203,880 Internists, general 196,490 Pediatricians, general 183,240 Doctors go through 4 extra years of school and then 5-7 years as a resident where they are paid an average of 60k and work ridiculous hours. During that period they're always on call, work twice as much as average workers in other industries, and don't get regular holidays. I have a surgical resident friend who regularly works over 100 hours a week, sometimes having as much as three 24 shifts in a week--and frequently he'll have <8 hour periods to go home and rest before returning to work. Plus, doctor's expenses can include medical malpractice insurance premiums if not provided by their place of work, which, depending on state and specialization, can range up to several hundred thousand dollars (!!!)[2]. I just don't see how doctors are overpaid considering the amount of training they have to go through, their work conditions, and the risks involved. 1. https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm#tab-5 https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.h... 2. https://www.gallaghermalpractice.com/blog/post/how-much-does-medical-malpractice-insurance-cost https://www.gallaghermalpractice.com/blog/post/how-much-does...
deleted 7y ago
[deleted]
analog31 7y ago
Make med school free in return for doctors working for the government, for a decent professional salary. This would also potentially change the mix of people who want to become doctors -- more middle class. I don't believe that salaries tell the whole story of doctor income. Doctors are well positioned as insiders to make investments in the medical industry, ranging from ownership of clinics and diagnostic equipment, to owning entire provider networks. An effect of the cost of doctor education is that it favors students from wealthy families, who are also positioned as investors. Meanwhile, every interest group in the system will cry poor, and claim that someone else is gouging us, which is an almost certain sign that they're all gouging us. I've got a lot of doctors as friends, and I don't pity them.
kerkeslager 7y ago
With my skillset (software engineer) I can easily pull low six figures. And I'm confident that doctors provide more value than I do. I'm pretty sure I've never saved anyone's life. So I have zero problem paying doctors 2 or 3 times my pay, which is about what you're saying they get paid. Health insurance CEOs make, in some cases, literally hundreds of times my salary, while literally killing people for profit. I'm going to go out on a limb and say you've misidentified the problem. Now, certainly bringing down the cost of medical education, and allowing people with less education (i.e. nurse practitioners) to do more, would both help lower the cost of healthcare. But if we're talking about who we should consider "the enemy", it's certainly not doctors. The entire raison d'être of capitalism is that it's supposedly meritocratic. Are you really claiming that curing illness and sometimes saving people's lives isn't meritable?
- leetcrew 7y ago
  not sure what kind of work you do, but if you make tools that save people time and you have many users, it could add up to many lifetimes not spent on some menial task. not quite the same, but I would argue that helping many people allocate their time towards activities they actually value is just as important as saving individual lives.
  - EpicEng 7y ago
    >I would argue that helping many people allocate their time towards activities they actually value is just as important as saving individual lives. I think you'd pretty easily get trounced making that argument. People would much rather be alive to do something less efficiently than to... not be alive at all. This argument is a bit insane to me.
    - leetcrew 7y ago
      think about the people you care about. would you rather live more years or spend more time with them over a shorter life? what would they prefer? it's an inherently subjective question, and I don't think the answer is obvious. I certainly don't think one of the answers is "insane".
dv_dt 7y ago
Iirc, the AMA recently pulled out of the health insurance lobbying group who is a major influence against Medicare for All and all its variants. This due to a vote by its membership. edit: https://www.commondreams.org/views/2019/08/18/ama-gets-out-way-medicareforall https://www.commondreams.org/views/2019/08/18/ama-gets-out-w...

peterhadlaw 7y ago

So you mean ... the government that enables such licensing, monopolistic behavior, and moat building?

wuliwong 7y ago
Bingo. But we will still see more regulation implemented to attempt to resolve this.

lotsofpulp 7y ago

I don’t know any pharmacist making $200k, and their pay is getting crushed right now due to tons of supply since there is no limit on the number of new pharmacists. Anyone currently pursuing pharmacy is in a poor ROI situation, especially if they’re paying for school. Their pay is in now way comparable to doctors, who have a structural advantage due to the limited number of new doctors each year.

jostmey 7y ago

I think you're stumbling on a root cause of America's healthcare crisis. I think most American's don't understand just how much physicians make--and where did you get those figures because clinicians I know make a good deal more than 200-300k

snowwrestler 7y ago
It's an uncomfortable subject because the vast majority of front-line medical professionals like doctors, specialists, surgeons, nurses etc. are doing that job with passion and honesty to help people. But it's also true, and I think well-known at least in a vague sense, that one can make a pretty good living in the medical field. For-profit insurance companies come in for the most hate since they are in the position to deny care. But their profit margins are not sky-high. Whether or not one believes that private health insurance is a terrible idea, the facts are pretty clear that there is a lot more to the high cost of U.S. healthcare than just private insurance. There is a lot of cost everywhere in the medical system... that's the other side of those professionals making a good living. I'm not going to pretend I have a good answer to this.
- maximente 7y ago
  > It's an uncomfortable subject because the vast majority of front-line medical professionals like doctors, specialists, surgeons, nurses etc. are doing that job with passion and honesty to help people. don't take this personally, but: this is an oft repeated meme that, in my experience, not really true, at least for MDs and nurses (to include doctors, specialists and surgeons). it certainly contributes to the sort of hero status of health care workers though. physicians in the US earn a ton for a high-prestige, high social power, high earnings, generally safe career. in return they must sacrifice these earnings and social status for most of their 20s due to ridiculous quotas and standards in medical school, propped up by AMA; this makes the system higher prestige and sought after, a nice vicious (or virtuous for them) cycle. the AMA also has them on the hook in a debt-slavery sort of way, because normal wages would never repay their ridiculous medical debt (see e.g. mid/low tier lawyers and law school outcomes when that got popular) nursing, likewise, is seen as a j o b that offers some safety/consistency in return for investing time into education. that these individuals """help people""" is generally of tertiary or lesser concern; much more "help" could be done by opening an affordable grocery store in a food desert. all but the most naive students either readily admit this or cop to it once asked.
jcranberry 7y ago
Average salary of physicians from the bureau of labor statistics [1]: Anesthesiologists $267,020 Surgeons 255,110 Obstetricians and gynecologists 238,320 Psychiatrists 220,380 Family and general practitioners 211,780 Physicians and surgeons, all other 203,880 Internists, general 196,490 Pediatricians, general 183,240 Doctors go through 4 extra years of school and then 5-7 years as a resident where they are paid an average of 60k and work ridiculous hours. During that period they're always on call, work twice as much as average workers in other industries, and don't get regular holidays. I have a surgical resident friend who regularly works over 100 hours a week, sometimes having as much as three 24 shifts in a week--and frequently he'll have <8 hour periods to go home and rest before returning to work. Plus, doctor's expenses can include medical malpractice insurance premiums if not provided by their place of work, which, depending on state and specialization, can range up to several hundred thousand dollars (!!!)[2]. I just don't see how doctors are overpaid considering the amount of training they have to go through, their work conditions, and the risks involved. 1. https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm#tab-5 https://www.bls.gov/ooh/healthcare/physicians-and-surgeons.h... 2. https://www.gallaghermalpractice.com/blog/post/how-much-does-medical-malpractice-insurance-cost https://www.gallaghermalpractice.com/blog/post/how-much-does...

deleted 7y ago

[deleted]

analog31 7y ago

Make med school free in return for doctors working for the government, for a decent professional salary. This would also potentially change the mix of people who want to become doctors -- more middle class. I don't believe that salaries tell the whole story of doctor income. Doctors are well positioned as insiders to make investments in the medical industry, ranging from ownership of clinics and diagnostic equipment, to owning entire provider networks. An effect of the cost of doctor education is that it favors students from wealthy families, who are also positioned as investors. Meanwhile, every interest group in the system will cry poor, and claim that someone else is gouging us, which is an almost certain sign that they're all gouging us. I've got a lot of doctors as friends, and I don't pity them.

kerkeslager 7y ago

With my skillset (software engineer) I can easily pull low six figures. And I'm confident that doctors provide more value than I do. I'm pretty sure I've never saved anyone's life. So I have zero problem paying doctors 2 or 3 times my pay, which is about what you're saying they get paid. Health insurance CEOs make, in some cases, literally hundreds of times my salary, while literally killing people for profit. I'm going to go out on a limb and say you've misidentified the problem. Now, certainly bringing down the cost of medical education, and allowing people with less education (i.e. nurse practitioners) to do more, would both help lower the cost of healthcare. But if we're talking about who we should consider "the enemy", it's certainly not doctors. The entire raison d'être of capitalism is that it's supposedly meritocratic. Are you really claiming that curing illness and sometimes saving people's lives isn't meritable?

leetcrew 7y ago
not sure what kind of work you do, but if you make tools that save people time and you have many users, it could add up to many lifetimes not spent on some menial task. not quite the same, but I would argue that helping many people allocate their time towards activities they actually value is just as important as saving individual lives.
- EpicEng 7y ago
  >I would argue that helping many people allocate their time towards activities they actually value is just as important as saving individual lives. I think you'd pretty easily get trounced making that argument. People would much rather be alive to do something less efficiently than to... not be alive at all. This argument is a bit insane to me.
  - leetcrew 7y ago
    think about the people you care about. would you rather live more years or spend more time with them over a shorter life? what would they prefer? it's an inherently subjective question, and I don't think the answer is obvious. I certainly don't think one of the answers is "insane".

dv_dt 7y ago

Iirc, the AMA recently pulled out of the health insurance lobbying group who is a major influence against Medicare for All and all its variants. This due to a vote by its membership. edit: https://www.commondreams.org/views/2019/08/18/ama-gets-out-way-medicareforall https://www.commondreams.org/views/2019/08/18/ama-gets-out-w...