4 ms·

I don't believe any medical professional in Germany has wage exceeding 150k EUR yearly after taxes - doctors in the US sometimes have multiples of that, coincid

I don't believe any medical professional in Germany has wage exceeding 150k EUR yearly after taxes - doctors in the US sometimes have multiples of that, coincidentally 5x to 10x more is not unusual.

Redoubts 6y ago
I’m sure German doctors don’t have oodles of student debt too.
- emteycz 6y ago
  Yeah, that for sure.
travisp 6y ago
It's true that US doctors are paid more (although the gap isn't as big as it used to be). However, pay for US doctors makes up a fairly small portion of overall US medical expenditures (less than 10%). So, you could ask every doctor to work for free and not significantly change costs.
- tfehring 6y ago
  There’s a similar (but smaller) differential for other medical professionals too. But more generally, when I’ve done high-level comparisons of medical spending between the US and Western European countries, it seems like every single cost element is more or less proportionately higher in the US. It seems like basically everyone is spending money in roughly the same proportions, including on things like doctors’ salaries - everything is just scaled up by ~40% to ~100% in the US, depending on which country you compare it to.
  - aksss 6y ago
    And doing so more frequently in the US, so cost is higher but so is rate of consumption, particularly of services and products that make us feel like we have more mastery over outcomes but in fact do not result in better outcomes on the whole.
  - deleted 6y ago
    [deleted]
- huitzitziltzin 6y ago
  >pay for US doctors makes up a fairly small portion of overall US medical expenditures (less than 10%) That is likely too low. The Centers for Medicare and Medicaid Services provides a National Health Expenditure estimate annually. [1] Physician and clinical services represented $772 billion out of about $3.8 trillion, so more like 20%. Hospital services are the other big one: about $1.2 trillion. US physicians are paid terrifically relative to their counterparts almost anywhere else, this is especially true for specialists. In fact, physicians represent about 15% - 16% of the top 1% of income earners in the US. See table 2 from this paper: https://web.williams.edu/Economics/wp/BakijaColeHeimJobsIncomeGrowthTopEarners.pdf https://web.williams.edu/Economics/wp/BakijaColeHeimJobsInco... which was written using tax return data, not, e.g., self-reported income data. [1] https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
  - travisp 6y ago
    "Physician and clinical services" includes far more than pay for US doctors -- it's the entire costs for "services provided in establishments operated by Doctors of Medicine (M.D.) and Doctors of Osteopathy (D.O.), outpatient care centers, plus the portion of medical laboratories services that are billed independently by the laboratories". Doctors do not get even close to all of that money paid to them. > In fact, physicians represent about 15% - 16% of the top 1% of income earners in the US. This may be accurate, I'm unsure, but it wouldn't change that if US doctors were paid the same as their European counterparts, it would not make a truly significant change in overall US medical spending (this would even be true if doctors did actually make up 20% of medical expenditures, like you assert earlier).
dante_dev 6y ago
Just throwing some data, average general practice doctor is 150k$ in US vs 61k$ in germany. https://www.payscale.com/research/DE/Job=Physician_%2F_Doctor%2C_General_Practice/Salary https://www.payscale.com/research/DE/Job=Physician_%2F_Docto... https://www.payscale.com/research/US/Job=Physician_%2F_Doctor%2C_General_Practice/Salary https://www.payscale.com/research/US/Job=Physician_%2F_Docto...
- persedes 6y ago
  I believe that doctors in the US get paid more than in germany, but 60k seems very very low. Teachers have an income in that range.... Edit: Looking at some german articles, maybe they did not convert from eur to usd, ~80,000-100,000$ (depending on expertise etc) seems more likely for a dr working at a hospital (which is still low imho compared to US salaries...). https://www.arzt-wirtschaft.de/wie-hoch-ist-das-gehalt-bzw-das-einkommen-eines-arztes/ https://www.arzt-wirtschaft.de/wie-hoch-ist-das-gehalt-bzw-d...
  - dante_dev 6y ago
    I think the difference in wages narrows down with specializations. I linked just the "general practitioner" because I couldn't find an average including all the specializations.
  - amagasaki 6y ago
    And furthermore you have to differentiate between "assistance" doctors (~82k $) and "chef" doctors (~336k $). (I don't know the comparable titles in the US system) Both values are taken from the parent's article and converted using Google. Of course, mostly without serious student debt
  - the_monocle 6y ago
    You have to keep in mind that med school and the equivalent of premed in germany is completely free. Of course that does not make up for the pay difference completely but it changes the perspective quite a bit imo, since med school in the US is extremely expensive. Additionally I could totally see doctors being ok with less pay for the trade off of living in a more fair system. Coincidentally I know one expat here that specifically does not want to return to the US to become a doctor there for that very reason. She specifically does not want to move back because she feels the healthcare system in the US is unfair and she would be profiting off of that system.
notsureaboutpg 6y ago
Can confirm. $600k+ is normal in low cost of living areas in the US. Excessive pay for doctors is definitely part of the problem here. People don't like to hear it and don't like to admit it because the work they do is so important and because there are other, bigger costs, and I get that. But difficult situations have difficult answers, and doctor pay is huge in the US in a way it isn't in every other country and doctors themselves know this. It may not fix the problem overnight, but regular people would see instant savings if we fixed this issue.
electriclove 6y ago
Is this getting downvoted for saying German docs don't make more than 150k EUR or that US docs sometimes make multiples of that?
u678u 6y ago
Yeah surgeons make multiples https://www.physiciansweekly.com/2018-physician-compensation-report-released/ https://www.physiciansweekly.com/2018-physician-compensation.... That doesn't include profits from owning their own biz.
sithlord 6y ago
not 100% sure on this, but don't most doctors in other countries go to medical school for free? Whereas US doctors are going into 3-400k+ debt.

I don't believe any medical professional in Germany has wage exceeding 150k EUR yearly after taxes - doctors in the US sometimes have multiples of that, coincidentally 5x to 10x more is not unusual.

Redoubts 6y ago

I’m sure German doctors don’t have oodles of student debt too.

emteycz 6y ago
Yeah, that for sure.

travisp 6y ago

It's true that US doctors are paid more (although the gap isn't as big as it used to be). However, pay for US doctors makes up a fairly small portion of overall US medical expenditures (less than 10%). So, you could ask every doctor to work for free and not significantly change costs.

tfehring 6y ago
There’s a similar (but smaller) differential for other medical professionals too. But more generally, when I’ve done high-level comparisons of medical spending between the US and Western European countries, it seems like every single cost element is more or less proportionately higher in the US. It seems like basically everyone is spending money in roughly the same proportions, including on things like doctors’ salaries - everything is just scaled up by ~40% to ~100% in the US, depending on which country you compare it to.
- aksss 6y ago
  And doing so more frequently in the US, so cost is higher but so is rate of consumption, particularly of services and products that make us feel like we have more mastery over outcomes but in fact do not result in better outcomes on the whole.
- deleted 6y ago
  [deleted]
huitzitziltzin 6y ago
>pay for US doctors makes up a fairly small portion of overall US medical expenditures (less than 10%) That is likely too low. The Centers for Medicare and Medicaid Services provides a National Health Expenditure estimate annually. [1] Physician and clinical services represented $772 billion out of about $3.8 trillion, so more like 20%. Hospital services are the other big one: about $1.2 trillion. US physicians are paid terrifically relative to their counterparts almost anywhere else, this is especially true for specialists. In fact, physicians represent about 15% - 16% of the top 1% of income earners in the US. See table 2 from this paper: https://web.williams.edu/Economics/wp/BakijaColeHeimJobsIncomeGrowthTopEarners.pdf https://web.williams.edu/Economics/wp/BakijaColeHeimJobsInco... which was written using tax return data, not, e.g., self-reported income data. [1] https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...
- travisp 6y ago
  "Physician and clinical services" includes far more than pay for US doctors -- it's the entire costs for "services provided in establishments operated by Doctors of Medicine (M.D.) and Doctors of Osteopathy (D.O.), outpatient care centers, plus the portion of medical laboratories services that are billed independently by the laboratories". Doctors do not get even close to all of that money paid to them. > In fact, physicians represent about 15% - 16% of the top 1% of income earners in the US. This may be accurate, I'm unsure, but it wouldn't change that if US doctors were paid the same as their European counterparts, it would not make a truly significant change in overall US medical spending (this would even be true if doctors did actually make up 20% of medical expenditures, like you assert earlier).

dante_dev 6y ago

Just throwing some data, average general practice doctor is 150k$ in US vs 61k$ in germany. https://www.payscale.com/research/DE/Job=Physician_%2F_Doctor%2C_General_Practice/Salary https://www.payscale.com/research/DE/Job=Physician_%2F_Docto... https://www.payscale.com/research/US/Job=Physician_%2F_Doctor%2C_General_Practice/Salary https://www.payscale.com/research/US/Job=Physician_%2F_Docto...

persedes 6y ago
I believe that doctors in the US get paid more than in germany, but 60k seems very very low. Teachers have an income in that range.... Edit: Looking at some german articles, maybe they did not convert from eur to usd, ~80,000-100,000$ (depending on expertise etc) seems more likely for a dr working at a hospital (which is still low imho compared to US salaries...). https://www.arzt-wirtschaft.de/wie-hoch-ist-das-gehalt-bzw-das-einkommen-eines-arztes/ https://www.arzt-wirtschaft.de/wie-hoch-ist-das-gehalt-bzw-d...
- dante_dev 6y ago
  I think the difference in wages narrows down with specializations. I linked just the "general practitioner" because I couldn't find an average including all the specializations.
- amagasaki 6y ago
  And furthermore you have to differentiate between "assistance" doctors (~82k $) and "chef" doctors (~336k $). (I don't know the comparable titles in the US system) Both values are taken from the parent's article and converted using Google. Of course, mostly without serious student debt
- the_monocle 6y ago
  You have to keep in mind that med school and the equivalent of premed in germany is completely free. Of course that does not make up for the pay difference completely but it changes the perspective quite a bit imo, since med school in the US is extremely expensive. Additionally I could totally see doctors being ok with less pay for the trade off of living in a more fair system. Coincidentally I know one expat here that specifically does not want to return to the US to become a doctor there for that very reason. She specifically does not want to move back because she feels the healthcare system in the US is unfair and she would be profiting off of that system.

notsureaboutpg 6y ago

Can confirm. $600k+ is normal in low cost of living areas in the US. Excessive pay for doctors is definitely part of the problem here. People don't like to hear it and don't like to admit it because the work they do is so important and because there are other, bigger costs, and I get that. But difficult situations have difficult answers, and doctor pay is huge in the US in a way it isn't in every other country and doctors themselves know this. It may not fix the problem overnight, but regular people would see instant savings if we fixed this issue.

electriclove 6y ago

Is this getting downvoted for saying German docs don't make more than 150k EUR or that US docs sometimes make multiples of that?

u678u 6y ago

Yeah surgeons make multiples https://www.physiciansweekly.com/2018-physician-compensation-report-released/ https://www.physiciansweekly.com/2018-physician-compensation.... That doesn't include profits from owning their own biz.

sithlord 6y ago

not 100% sure on this, but don't most doctors in other countries go to medical school for free? Whereas US doctors are going into 3-400k+ debt.