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Doctor's Salaries and pittmike's unknown sugar intake https://mail.chicagofanatics.com/viewtopic.php?f=47&t=109217 |
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Author: | rogers park bryan [ Thu Oct 26, 2017 3:13 pm ] |
Post subject: | Doctor's Salaries and pittmike's unknown sugar intake |
I dont see a lot of stuff on Dr's pay considering how often Healthcare is debated. THis make sense to anyone or Nah? The problem of doctors’ salaries An economist argues that American doctors get paid too much—and offers some bold ideas on what to do about it. By DEAN BAKER 10/25/2017 05:03 AM EDT The United States pays more than twice as much per person for health care as other wealthy countries. We tend to blame the high prices on things like drugs and medical equipment, in part because the price tag for many life-saving drugs is less than half the U.S. price in Canada or Europe. But an unavoidable part of the high cost of U.S. health care is how much we pay doctors — twice as much on average as physicians in other wealthy countries. Because our doctors are paid, on average, more than $250,000 a year (even after malpractice insurance and other expenses), and more than 900,000 doctors in the country, that means we pay an extra $100 billion a year in doctor salaries. That works out to more than $700 per U.S. household per year. We can think of this as a kind of doctors’ tax. Doctors and other highly paid professionals stand out in this respect. Our autoworkers and retail clerks do not in general earn more than their counterparts in other wealthy countries. Most Americans are likely to be sympathetic to the idea that doctors should be well paid. After all, it takes many years of education and training, including long hours as an intern and resident, to become a doctor. And people generally respect and trust their doctors. But they likely don’t realize how out of line our doctors’ pay is with doctors in other wealthy countries. However, as an economist, I look for structural explanations for pay disparities like this. And when economists like me look at medicine in America – whether we lean left or right politically – we see something that looks an awful lot like a cartel. The word “cartel” has some bad connotations; most people’s thoughts probably jump to OPEC and the 1970s crisis caused by its reduction in the supply of oil. But a cartel is not necessarily completely negative. It means that the suppliers of a good or service have control over the supply. This control can be used to ensure quality, as is the case with many agricultural cartels around the world. However, controlling supply also lets the cartel exert some control over price. In the United States, the supply of doctors is tightly controlled by the number of medical school slots, and more importantly, the number of medical residencies. Those are both set by the American Council for Graduate Medical Education, a body dominated by physicians’ organizations. The United States, unlike other countries, requires physicians to complete a U.S. residency program to practice. (Since 2011, graduates of Canadian programs have also been allowed to practice in the U.S., although there are still substantial obstacles.) This means that U.S. doctors get to legally limit their competition. As a result, U.S. doctors receive higher pay, and like anyone in a position to exploit a cartel, they also get patients to buy services (i.e., from specialists) that they don’t really need. There are two parts to the high pay received by our doctors relative to doctors elsewhere, both connected to the same cause. The first is that our doctors get higher pay in every category of medical practice, including general practitioner. If we compare our cardiologists to cardiologists in Europe or Canada, our heart doctors earn a substantial premium. The same is true of our neurologists, surgeons, and every other category of medical specialization. Even family practitioners clock in as earning more than $200,000 a year, enough to put them at the edge of the top 1 percent of wage earners in the country. The other reason that our physicians earn so much more is that roughly two-thirds are specialists. This contrasts with the situation in other countries, where roughly two-thirds of doctors are general practitioners. This means we are paying specialists’ wages for many tasks that elsewhere are performed by general practitioners. Since there is little evidence of systematically better outcomes in the United States, the increased use of specialists does not appear to be driven by medical necessity. In recent years, the number of medical residents has become so restricted that even the American Medical Association is pushing to have the number of slots increased. The major obstacle at this point is funding. It costs a teaching hospital roughly $150,000 a year for a residency slot. Most of the money comes from Medicare, with a lesser amount from Medicaid and other government sources. The number of slots supported by Medicare has been frozen for two decades after Congress lowered it in 1997 at the request of the American Medical Association and other doctors’ organizations. Furthermore, Medicare exerts little control over the fields of specialization in the residency slots it supports, largely leaving this up to the teaching hospitals, which have an incentive to offer residencies in specialties from which they can get the most revenue per resident. This means they are more likely to train someone in neurology or cardiology than as a family practitioner. Policymakers have a number of tools to use to introduce more competition, weaken the doctors’ cartel and get their pay more in line with counterparts elsewhere. One would be simply to fund more residency slots. Medicare could also limit the slots for many areas of specialization and instead insist that more of its funding go to train people as family practitioners. A second route would be to end the requirement that foreign doctors complete a U.S. residency program in order to practice medicine in the United States. This means setting up arrangements through which qualified foreign doctors could be licensed to practice in the United States after completing an equivalent residency program in another country. The admission of many more doctors would put downward pressure on the pay of doctors in the United States, as insurers would have a new pool of physicians to add to their networks who will accept somewhat lower compensation. Physicians in training at George Washington University Hospital in Washington, D.C. Physicians in training at George Washington University Hospital in Washington, D.C. | Alexandra Garcia/The Washington Post via Getty Images Another approach is to not only change the rules around who can practice, but to change the rules around what doctors do. There are many procedures now performed by doctors that can be performed by nurse practitioners and other lower-paid health professionals. For example, many states now allow nurse practitioners to prescribe medicine without the supervision of a doctor, and there is no evidence that this has resulted in worse outcomes for patients. (It does, however, reduce health care costs.) The scope of practice of nurse practitioners and other health professionals can be extended in this and other areas for which they are fully competent. This would both directly save money and further reduce the demand for doctors, putting more downward pressure on their pay. Yet one more approach is being tested in Missouri, Kansas and Arkansas: While a doctor can’t practice independently without completing a U.S. residency program, those states recently passed laws allowing foreign-trained doctors to practice under the supervision of a U.S.-trained doctor. This should also help to increase the supply of doctors. The other major policy tool in reducing the amount we spend on doctors would be to reduce the use of medical specialists by changing the standards of care, the legal baseline that doctors and hospitals are expected to meet to avoid malpractice liability. This is largely a legal concept. While any licensed doctor can in principle perform any medical procedure, a family practitioner could be exposing herself to considerable legal liability if, for example, she gave a patient a heart exam that was typically performed by a cardiologist. To get around this, it should be possible for doctors, hospitals insurers, and other providers to refer to the standards of care in other countries as a legal defense in malpractice cases. This would not be a protection against genuine malpractice; it would just mean that the use of generalists would not be evidence, by itself, of improper care. There are enormous obstacles to any effort to reduce the pay of doctors. The restrictions that limit competition and keep physicians’ pay high are mostly obscure and not even understood by many policy wonks. Any efforts to change them in ways that seriously threaten doctors’ pay will encounter massive opposition from a very powerful political lobby. Furthermore, doctors generally enjoy a great deal of respect in society, and Americans tend not to think of their high salaries as part of the health care cost problem. But if we want to stop paying a $100 billion premium for health care that doesn’t make us healthier, we’re going to need to overcome those political barriers. Getting U.S. health care costs down is a herculean task; getting doctors’ pay in line is a big part of the solution. It’s time we broke up the doctor cartel. The fact that most people like their doctors will make the effort harder. Most of us like our letter carriers too, but that doesn’t mean they should make $250,000 a year. Dean Baker is co-director of the Center for Economic and Policy Research, a progressive think tank focused on economic policy. |
Author: | Terry's Peeps [ Thu Oct 26, 2017 3:18 pm ] |
Post subject: | Re: Doctor's Salaries |
Interesting. Not sure you want a bunch of Dr. Nicks running around but it's worth looking at the differences in pay and what causes it. |
Author: | Bagels [ Thu Oct 26, 2017 3:20 pm ] |
Post subject: | Re: Doctor's Salaries |
rogers park bryan wrote: THis make sense to anyone or Nah? Nahhhhhhhs |
Author: | Hank Scorpio [ Thu Oct 26, 2017 3:20 pm ] |
Post subject: | Re: Doctor's Salaries |
Better start with college costs firsts. No one is going to sign up for 8 years of school and the debt that goes along with it to make 75K per year. |
Author: | Hussra [ Thu Oct 26, 2017 3:20 pm ] |
Post subject: | Re: Doctor's Salaries |
http://www.businessinsider.com/ibms-wat ... rld-2014-4 |
Author: | Hatchetman [ Thu Oct 26, 2017 3:21 pm ] |
Post subject: | Re: Doctor's Salaries |
CAUTION: ECONOMIST AT WORK US Medical Expenses = $3.5 Trillion Doctors Cost = $0.225 Trillion ------------------------------------ Doctors cost Too Much |
Author: | DannyB [ Thu Oct 26, 2017 3:21 pm ] |
Post subject: | Re: Doctor's Salaries |
$100 billion out of $3.5 trillion in health care costs is meaningless. Plus, no mention of the cost of medical education. The real problem is that nitwit think tank burritos are allowed to exist. |
Author: | denisdman [ Thu Oct 26, 2017 3:22 pm ] |
Post subject: | Re: Doctor's Salaries |
As a guy that was pre-med in college and actually finished with a science undergrad degree, I realized that becoming a doctor wasn't worth it from a financial perspective. I estimated it would take until 30-32 years of age to actually begin my career, and that was if I could get through medical school without being weeded out. That doesn't even factor in the amount of tuition and lost wages of becoming a doctor. I looked around my 400 level Biochem classes at UIC and what did I find? The majority of the students were foreigners mainly from Russia and China who were much more committed to studying for the next eight years (school plus internship) than a guy whose high school sweet heart was pushing to get married and start our real lives. So my point is, the doctors in this country deserve what they make given what they have to go through to become licensed. |
Author: | rogers park bryan [ Thu Oct 26, 2017 3:23 pm ] |
Post subject: | Re: Doctor's Salaries |
DannyB wrote: $100 billion out of $3.5 trillion in health care costs is meaningless. Plus, no mention of the cost of medical education. The real problem is that nitwit think tank burritos are allowed to exist. Ironic since these lib beta cucks would never be caught dead near an ACTUAL tank |
Author: | denisdman [ Thu Oct 26, 2017 3:23 pm ] |
Post subject: | Re: Doctor's Salaries |
Hank Scorpio wrote: Better start with college costs firsts. No one is going to sign up for 8 years of school and the debt that goes along with it to make 75K per year. Well you beat me to it because I typed too much! But hey I have a BioChem degree hanging on my wall and used to know the full chemical structure of DNA and amino acids. Now I can't do my daughter's chemistry homework. |
Author: | rogers park bryan [ Thu Oct 26, 2017 3:24 pm ] |
Post subject: | Re: Doctor's Salaries |
I mean, I always figure, they go through eleventy million dollars and years of school, they deserve it. So how do we lower the cost of medicine otherwise? |
Author: | denisdman [ Thu Oct 26, 2017 3:25 pm ] |
Post subject: | Re: Doctor's Salaries |
rogers park bryan wrote: I mean, I always figure, they go through eleventy million dollars and years of school, they deserve it. So how do we lower the cost of medicine otherwise? Great question. We overconsume medical services in part due to poor health and chronic conditions like type 2 diabetes. Look at your parents' pill regimens (if they are still around). |
Author: | Hatchetman [ Thu Oct 26, 2017 3:26 pm ] |
Post subject: | Re: Doctor's Salaries |
rogers park bryan wrote: So how do we lower the cost of medicine otherwise? Death panels. |
Author: | Don Tiny [ Thu Oct 26, 2017 3:29 pm ] |
Post subject: | Re: Doctor's Salaries |
Bagels wrote: rogers park bryan wrote: THis make sense to anyone or Nah? Nahhhhhhhs ![]() ![]() |
Author: | rogers park bryan [ Thu Oct 26, 2017 3:30 pm ] |
Post subject: | Re: Doctor's Salaries |
Hatchetman wrote: rogers park bryan wrote: So how do we lower the cost of medicine otherwise? Death panels. Now, you're talking. Were we really meant to live beyond 90? |
Author: | Ogie Oglethorpe [ Thu Oct 26, 2017 3:32 pm ] |
Post subject: | Re: Doctor's Salaries |
Doctors vs. UPS Drivers https://www.youtube.com/watch?v=2503XQU1feE Remember when calculating earnings you need to figure opportunity cost of the years they do not earn wages, plus there is the additional debt incurred going to school. |
Author: | DannyB [ Thu Oct 26, 2017 3:35 pm ] |
Post subject: | Re: Doctor's Salaries |
I have five (5) in-laws who are doctors and they're always whining about shit. I would have sent that to them to needle them but would have ultimately embarrassed myself. I emailed that jerk-off to tell him how stupid he is. |
Author: | Douchebag [ Thu Oct 26, 2017 3:58 pm ] |
Post subject: | Re: Doctor's Salaries |
Hatchetman wrote: CAUTION: ECONOMIST AT WORK US Medical Expenses = $3.5 Trillion Doctors Cost = $0.225 Trillion ------------------------------------ Doctors cost Too Much This whole article was probably funded by huge hospital companies that want to drive down employee wages. |
Author: | FavreFan [ Thu Oct 26, 2017 4:06 pm ] |
Post subject: | Re: Doctor's Salaries |
rogers park bryan wrote: I mean, I always figure, they go through eleventy million dollars and years of school, they deserve it. So how do we lower the cost of medicine otherwise? Ban fast food |
Author: | Frank Coztansa [ Thu Oct 26, 2017 4:08 pm ] |
Post subject: | Re: Doctor's Salaries |
Season Team Lg Salary 1984-85 Philadelphia 76ers NBA $1,054,000 1985-86 Philadelphia 76ers NBA $1,485,000 Career (may be incomplete) $2,539,000 |
Author: | rogers park bryan [ Thu Oct 26, 2017 4:08 pm ] |
Post subject: | Re: Doctor's Salaries |
Frank Coztansa wrote: Season Team Lg Salary 1984-85 Philadelphia 76ers NBA $1,054,000 1985-86 Philadelphia 76ers NBA $1,485,000 Career (may be incomplete) $2,539,000 Not bad. |
Author: | Ogie Oglethorpe [ Thu Oct 26, 2017 4:14 pm ] |
Post subject: | Re: Doctor's Salaries |
FavreFan wrote: rogers park bryan wrote: I mean, I always figure, they go through eleventy million dollars and years of school, they deserve it. So how do we lower the cost of medicine otherwise? Ban fast food Death panels for people over 300 lbs? |
Author: | tommy [ Thu Oct 26, 2017 4:33 pm ] |
Post subject: | Re: Doctor's Salaries |
denisdman wrote: rogers park bryan wrote: I mean, I always figure, they go through eleventy million dollars and years of school, they deserve it. So how do we lower the cost of medicine otherwise? Great question. We overconsume medical services in part due to poor health and chronic conditions like type 2 diabetes. Look at your parents' pill regimens (if they are still around). Sometimes, libertarians show us the way. |
Author: | Curious Hair [ Thu Oct 26, 2017 4:40 pm ] |
Post subject: | Re: Doctor's Salaries |
denisdman wrote: So my point is, the doctors in this country deserve what they make given what they have to go through to become licensed. Doctors should make a little less money but be made to assume much less debt. Quote: The word “cartel” has some bad connotations; most people’s thoughts probably jump to OPEC and the 1970s crisis caused by its reduction in the supply of oil. But a cartel is not necessarily completely negative. Finally, someone is standing up for cartels! |
Author: | good dolphin [ Thu Oct 26, 2017 4:48 pm ] |
Post subject: | Re: Doctor's Salaries |
Ogie Oglethorpe wrote: Doctors vs. UPS Drivers https://www.youtube.com/watch?v=2503XQU1feE Remember when calculating earnings you need to figure opportunity cost of the years they do not earn wages, plus there is the additional debt incurred going to school. I've said it before, the guys I know who became cops could have done so out of high school (now associates is a requirement) and will be retired by 55. The ones who don't progress much will earn upper five figures base with almost unlimited potential for overtime and ability to take no work side jobs. The smart ones who were able to pass detective, sargent and lieutenant tests make well into the 100s with the same overtime and side job possibilities. They will retire with nice pensions and immediately find employment in other jobs if they have any initiative. I'm not sure I'm ahead by much taking everything into consideration. |
Author: | 312player [ Thu Oct 26, 2017 5:16 pm ] |
Post subject: | Re: Doctor's Salaries |
Hatchetman wrote: CAUTION: ECONOMIST AT WORK US Medical Expenses = $3.5 Trillion Doctors Cost = $0.225 Trillion ------------------------------------ Doctors cost Too Much Exactly..it's chump change. Whoever wrote this is very gullible and naive. |
Author: | pittmike [ Thu Oct 26, 2017 5:20 pm ] |
Post subject: | Re: Doctor's Salaries |
Kill everyone at 85 and take all the money they have left. |
Author: | denisdman [ Thu Oct 26, 2017 5:20 pm ] |
Post subject: | Re: Doctor's Salaries |
Curious Hair wrote: denisdman wrote: So my point is, the doctors in this country deserve what they make given what they have to go through to become licensed. Doctors should make a little less money but be made to assume much less debt. I think every doctor would take that trade off. They have to invest a material amount of time and money for an uncertain payoff. And then it is a high stress job with generally poor hours (on call). I am glad I changed it up before I got sucked in. |
Author: | denisdman [ Thu Oct 26, 2017 5:21 pm ] |
Post subject: | Re: Doctor's Salaries |
pittmike wrote: Kill everyone at 85 and take all the money they have left. What if they marry IceGirl on the eve of their 85th birthday? Does she get the money still? |
Author: | leashyourkids [ Thu Oct 26, 2017 5:23 pm ] |
Post subject: | Re: Doctor's Salaries |
good dolphin wrote: Ogie Oglethorpe wrote: Doctors vs. UPS Drivers https://www.youtube.com/watch?v=2503XQU1feE Remember when calculating earnings you need to figure opportunity cost of the years they do not earn wages, plus there is the additional debt incurred going to school. I've said it before, the guys I know who became cops could have done so out of high school (now associates is a requirement) and will be retired by 55. The ones who don't progress much will earn upper five figures base with almost unlimited potential for overtime and ability to take no work side jobs. The smart ones who were able to pass detective, sargent and lieutenant tests make well into the 100s with the same overtime and side job possibilities. They will retire with nice pensions and immediately find employment in other jobs if they have any initiative. I'm not sure I'm ahead by much taking everything into consideration. Sorry you're poor. |
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