In the comments to my post on Wal-Mart's health offerings, Joel writes:
when you try to make the much needed cuts in healthcare cost---leavethe doctors pay alone. Why? Say for one of my patients with prostatecancer who i do a prostatectomy (removing their prostate) the hospitalbill is around $24K. But I only get $1,800. Do the math the doctors areno longer these fat cats. After 4 yrs of college, 4 years of medicalschool, 6 years of residency, and 3 years of fellowship...whewww I needa break. I think I deserve all of that $1,800.
Fair enough. Which reminds me of a graph I've been meaning to post, an international comparison of doctor's salaries:
Quite a jump we have on the rest of the world there. Now, Joel is right: given what it costs to go to medical school, cutting doctor's salaries would be a foll's maneuver. But what about a bargain? Doctors, to some extent, work for the public good. Why shouldn't the country subsidize their education -- particularly if they go into high-need specialties or work in inadequately served areas -- but lower their pay? Or at least allow for many more nurse practitioners? As part of it, we can follow this doc's advice and use the power of the state to restore job quality for doctor's, allowing them to turn their attention from paperwork and bureaucratic haggling and back to patient care. Because the truth is, our nation's doctors are great, but they're not twice as good as Germany's, or Canada's, or Japan's. Not near it. Our rates of negligent malpractice remain high, and our outcomes are no better. And being a doctor shouldn't be about the money anyway, though the cost of following that route has ensured it will be. We've scattered perverse incentives all about, and offering a more affordable path and enjoyable career in return for somewhat lower salaries would go far towards fixing them.
