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Why do doctors need to be paid integer multiples more in the US than every other country on earth? This is not rhetorical, I mean it sincerely. And I’m aware t
by bigmadshoe 2mo ago
Why do doctors need to be paid integer multiples more in the US than every other country on earth? This is not rhetorical, I mean it sincerely.
And I’m aware that medical debt is a big issue, but it seems like a chicken-or-the-egg type problem. Of course you can charge $500k for a medical degree when the doctor can make it back and then some in 5-10 years.
- tptacek 2mo agoThey don't! It's a huge problem! It's probably the problem in US health care, which, despite my own belief that single-payer is bad policy, is in fact a total shitshow.
- cwmoore 2mo agoI think there's also the gamified confusion of over how much goes to the physician versus how much goes to administrating orgs and liability coverage.
- tptacek 2mo agoWe have numbers for this, we don't need to derive them axiomatically. Practitioner compensation is the largest component of health provider spending. Liability coverage is the second largest component of admin spending, which is 25% of provider spending.
- cwmoore 2mo ago“We have numbers” is always refreshing, especially in a shell game. Cost of all licensed medical practitioners? Or overweighting incomes of outlier CEO physicians? 25% is a steep tax on health in any case.
- tptacek 2mo agoAt the point where you're just dismissing the CMS NHE, you're well into the terrain of unfalsifiability.
- cwmoore 2mo agoFair enough, but it is a political topic, and there are different and more confusing slices of the healthcare system exposed to patients than org spending breakdowns. Not sure how many of this thread's comments could hold water if falsification were universally applied.
- tptacek 2mo agoJust so that people reading this thread know that there is the medical expense version of the Bureau of Labor Statistics, and it lives inside Medicare (CMS), and it publishes data. Most things people are trying to derive axiomatically on this thread, you can just look up. It's really easy now with Claude and GPT5; just ask them a question and tell them to answer it for you, with cites, from the NHE. (The data I argue from precedes widespread LLM research; I built a site for this a couple years ago and didn't bother to update my data, because I assume it didn't get much better.)
- deleted 2mo ago[deleted]
- thorncorona 2mo agobecause in the us everything is integer multiple times more expensive
- tptacek 2mo agoNo, that's not why. Doctors also make drastically more than the median wage. Doctors make so much in the US because we have artificial scarcity of doctors.
- thorncorona 2mo agoi mean sure, but all skilled labor is trending towards 200-300K wages in the us. if a "senior" software engineer can make half a mil, and an electrician can make 200k, of course doctor pay are high. who is going to take 10-15 years of school and debt otherwise?
- tptacek 2mo agoNo it isn't! The median wage for an electrician in the United States is about $65,000. It's nowhere near $200,000. The median general skilled wage is lower than that.
- starkparker 1mo ago"Gen Z electricians making $240-280k in data centers" was a viral ploy by Mike Rowe on a podcast to promote his trades-training hustle. > "The electricians that I interviewed and met two months ago in a data center in Plano, Texas, all under 30 years old, all making $240,000 to $280,000 a year, all with as much overtime as they want, none with any debt, all three of whom were poached three times in the prior 18 months," Rowe said ... Google AI summaries then pick up wealth/finance grifter social media clickbait about it and parrots it as a fact. There are contract data-center electrical jobs paying $55-65/hr (some with signing bonuses, per-diems, and benefits on top), but they only come close to $200,000 takehome by working 12/7 with generous overtime. And these are 5+ years of experience, OSHA 30, journeyman license, bring-your-own-tools. They're also exceptional; most are still $25-40/hr.
- nickff 2mo agoNurses are also highly-paid in the USA (relative to other developed countries), and they make up a large part of the wage expenditure in the system. This may not make a difference to your point, but it is important to note that doctors are not the whole problem.
- Auracle 1mo agoFor those that have never looked it up, the median RN salary in the US is about $100k a year. Germany and the UK are more like $60k. It’s funny, because it’s a career that feels both overpaid and underpaid to me. I went to a college where almost half of the students were going for nursing - and you certainly don’t need to be especially intelligent. At least to an outsider, some nursing fields seem damned easy. The nurse that sees me before my GP? Pretty easy job. Other specialties? Like the nurses that needed to clean up my wife after she massively bled during/after a c-section and they had to give her medications that also caused all sorts of other fluids to intermingle with the blood? Or the nurses that had to stand there for 10 minutes squeezing our infant daughter’s heel in the NICU to try to get enough blood out while she screamed as hard as a little baby can? $100k doesn’t seem like enough. Odd occupation. For $60k I’d rather work at Costco, that’s for certain.