4 ms·

You're completely wrong. "The average physician's net income declined 7 percent from 1995 to 2003, after adjusting for inflation, while incomes of lawyers and

by logjam 15y ago

You're completely wrong. "The average physician's net income declined 7 percent from 1995 to 2003, after adjusting for inflation, while incomes of lawyers and other professionals rose by 7 percent during the period." http://www.nytimes.com/2006/06/22/business/22doctors.html http://www.nytimes.com/2006/06/22/business/22doctors.html "...none of this really matters, because doctors' salaries aren't a large enough chunk of health care spending in the United States to make a difference. According to Reinhardt, doctors' net take-home pay (that is, income minus expenses) amounts to only about 10 percent of overall health care spending. So if you cut that by 10 percent in the name of cost savings, you'd only save about $26 billion. That's a drop in the ocean compared with overhead for insurance companies, billing expenses for doctors' offices, and advertising for drug companies. The real savings in health care will come from these expenses." http://www.slate.com/id/2227965/ http://www.slate.com/id/2227965/ The rest of your comment is incorrect as well. The AMA does not license physicians, state governments do. Many physicians don't even belong to the AMA. The AMA lobbies for physicians, but it's not in any way like a union (not that there's anything wrong with unions). Resident physicians in particular would probably lead better lives if in fact there were something like a union to limit hospitals and training programs that have traditionally worked these young physicians upwards of 100 hours a week for what amounts to minimum wage. Resident physician hours and primary care doc hours are still onerous, and most are paying education debut averaging $150,000. Physicians can practice without any involvement with a hospital, and many do. In any event, the idea of using hospital CEOs or CFOs to determine "good" doctors is about as misguided as asking British Petroleum to determine "safe" drilling engineers. There is a reason for (some) licensing. We tried the adolescent libertarian fantasy of letting the "free market" drive things like medical training and licensure back in the early days of the 20th century. You could characterize the vast majority of medical education in that era as training in quackery, before people like Abraham Flexner got involved: http://www.npr.org/templates/story/story.php?storyId=93666259 http://www.npr.org/templates/story/story.php?storyId=9366625...

kiba 15y ago
You're completely wrong. "The average physician's net income declined 7 percent from 1995 to 2003, after adjusting for inflation, while incomes of lawyers and other professionals rose by 7 percent during the period." http://www.nytimes.com/2006/06/22/business/22doctors.html http://www.nytimes.com/2006/06/22/business/22doctors.html "...none of this really matters, because doctors' salaries aren't a large enough chunk of health care spending in the United States to make a difference. According to Reinhardt, doctors' net take-home pay (that is, income minus expenses) amounts to only about 10 percent of overall health care spending. So if you cut that by 10 percent in the name of cost savings, you'd only save about $26 billion. That's a drop in the ocean compared with overhead for insurance companies, billing expenses for doctors' offices, and advertising for drug companies. The real savings in health care will come from these expenses." http://www.slate.com/id/2227965/ http://www.slate.com/id/2227965/ Interesting data, but the question is if licensing scarcity increase salaries than without. The salary decrease in 1995 to 2003 doesn't tell us anything other than.....net income decrease. The rest of your comment is incorrect as well. The AMA does not license physicians, state governments do. Many physicians don't even belong to the AMA. The AMA lobbies for physicians, but it's not in any way like a union (not that there's anything wrong with unions). Would it be possible that AMA effectively limits licensing rate through their lobbying? There is a reason for (some) licensing. We tried the adolescent libertarian fantasy of letting the "free market" drive things like medical training and licensure back in the early days of the 20th century. You could characterize the vast majority of medical education in that era as training in quackery, before people like Abraham Flexner got involved: Interesting data, but not enough details to support your statement. We need more details on what kind of reforms were made, privately or governmental.
- carbocation 15y ago
  Logjam's comments on the Flexner repor are widely accepted to be true. If you're not familiar with it, it's worth reading the wikipedia article on the subject. Pre-Flexner, it was a dangerous, anything-goes world.
  - kiba 15y ago
    I am not disputing Flexner's report at all. I am asking Logjams to provide me with a list of reforms, private and governmental.
OstiaAntica 15y ago
The AMA is totally a guild and its primary mission is to limit the number of people able to practice of medicine, thereby driving up doctors' salaries. They don't need to organize as a formal union because the federal government actively sets the number of doctors in the U.S., so they can manipulate public policy instead. I can tell you first-hand that AMA lobbied hard to reduce the number of medical school slots in America, there actually was an AMA-backed federal program in the mid-1990s that paid schools for the lost revenue from being forced to admit fewer students! The AMA also works to prevent nurses and midwives and the like from performing simple medicine and competing with doctors.

by logjam 15y ago

kiba 15y ago

You're completely wrong. "The average physician's net income declined 7 percent from 1995 to 2003, after adjusting for inflation, while incomes of lawyers and other professionals rose by 7 percent during the period." http://www.nytimes.com/2006/06/22/business/22doctors.html http://www.nytimes.com/2006/06/22/business/22doctors.html "...none of this really matters, because doctors' salaries aren't a large enough chunk of health care spending in the United States to make a difference. According to Reinhardt, doctors' net take-home pay (that is, income minus expenses) amounts to only about 10 percent of overall health care spending. So if you cut that by 10 percent in the name of cost savings, you'd only save about $26 billion. That's a drop in the ocean compared with overhead for insurance companies, billing expenses for doctors' offices, and advertising for drug companies. The real savings in health care will come from these expenses." http://www.slate.com/id/2227965/ http://www.slate.com/id/2227965/ Interesting data, but the question is if licensing scarcity increase salaries than without. The salary decrease in 1995 to 2003 doesn't tell us anything other than.....net income decrease. The rest of your comment is incorrect as well. The AMA does not license physicians, state governments do. Many physicians don't even belong to the AMA. The AMA lobbies for physicians, but it's not in any way like a union (not that there's anything wrong with unions). Would it be possible that AMA effectively limits licensing rate through their lobbying? There is a reason for (some) licensing. We tried the adolescent libertarian fantasy of letting the "free market" drive things like medical training and licensure back in the early days of the 20th century. You could characterize the vast majority of medical education in that era as training in quackery, before people like Abraham Flexner got involved: Interesting data, but not enough details to support your statement. We need more details on what kind of reforms were made, privately or governmental.

carbocation 15y ago
Logjam's comments on the Flexner repor are widely accepted to be true. If you're not familiar with it, it's worth reading the wikipedia article on the subject. Pre-Flexner, it was a dangerous, anything-goes world.
- kiba 15y ago
  I am not disputing Flexner's report at all. I am asking Logjams to provide me with a list of reforms, private and governmental.

OstiaAntica 15y ago

The AMA is totally a guild and its primary mission is to limit the number of people able to practice of medicine, thereby driving up doctors' salaries. They don't need to organize as a formal union because the federal government actively sets the number of doctors in the U.S., so they can manipulate public policy instead. I can tell you first-hand that AMA lobbied hard to reduce the number of medical school slots in America, there actually was an AMA-backed federal program in the mid-1990s that paid schools for the lost revenue from being forced to admit fewer students! The AMA also works to prevent nurses and midwives and the like from performing simple medicine and competing with doctors.