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> (We all know why) Do we? Please educate me then. I have a few guesses, the primary ones being artificially limited numbers of doctors, the artificially infla

> (We all know why) Do we? Please educate me then. I have a few guesses, the primary ones being artificially limited numbers of doctors, the artificially inflated cost of a medical degree, and the elite status that doctors hold. A runner up guess is that Americans have the delusion that modern medicine has a near perfect solution for every problem, so doctors do not factor in cost when prescribing treatment, even when extreme costs are associated with marginally better outcomes. The funny thing about this is that because of the extremely high cost of modern medicine in practice, prescribing treatments that have the best health outcomes at the present can cause years, decades, or lifetimes of poor health and hardship due to the burdens of debt and stress. If I had to pay $10 grand for some stitches that I could do myself (which is a fairly common amount for say, 30 stitches), that cost would decrease both my life expectancy and my personal happiness.

jac241 7y ago
It's easy to point at physicians and say they're artificially limiting the number of physicians created but they are not. Residency spots are funded by Medicare and that is the limiting factor. The hospitals get paid 150k for each resident, pass 55k on to the resident as salary, and keep the rest. Hospitals could choose to pay for their own residency positions, but they don't because then Medicare wouldn't be willing to subsidise the spots anymore. You could suggest we replace the high paid physicians with nurse practitioners or physician assistants but that is ignoring the fact that they are paid in the exact same way (and soon to be amount - executive order signed to equalize Medicare payments b/w midlevels and physicians) as physicians! If an NP or PA sees 25 patients in a day, they will bill for the exact same amount as a physician would. Additionally, the midlevels would order more tests and imaging on average than physicians, driving healthcare costs ever higher. There's a reason hospitals love midlevels so much and are helping to push for their independent practice. Each unnecessary test or CT scan is extra $$$ to the hospital.

jac241 7y ago

It's easy to point at physicians and say they're artificially limiting the number of physicians created but they are not. Residency spots are funded by Medicare and that is the limiting factor. The hospitals get paid 150k for each resident, pass 55k on to the resident as salary, and keep the rest. Hospitals could choose to pay for their own residency positions, but they don't because then Medicare wouldn't be willing to subsidise the spots anymore. You could suggest we replace the high paid physicians with nurse practitioners or physician assistants but that is ignoring the fact that they are paid in the exact same way (and soon to be amount - executive order signed to equalize Medicare payments b/w midlevels and physicians) as physicians! If an NP or PA sees 25 patients in a day, they will bill for the exact same amount as a physician would. Additionally, the midlevels would order more tests and imaging on average than physicians, driving healthcare costs ever higher. There's a reason hospitals love midlevels so much and are helping to push for their independent practice. Each unnecessary test or CT scan is extra $$$ to the hospital.