Why do doctors earn so much?

MONDAY, AUGUST 14, 2023

Post analysis piece disappears: Online, the Washington Post analysis piece appeared way back on August 4.

It was briefly featured on the Post's website. We found the headline intriguing:

The average doctor in the U.S. makes $350,000 a year. Why?

Just for the record, the analysis piece came from Andrew Van Dam at the Post's "Department of Data." That site says it's "dedicated to exploring the weird and wondrous power of the data that defines our world."

At any rate, $350,000 per year for the average doctor? Was that a lot, or was that a little? We weren't entirely sure.

Van Dam seemed to think it was a lot! Early in his report, he offered this overview of the "unimpeachable" working paper from which he derived his data:

VAN DAM (8/4/23): By accounting for all streams of income, [the authors] revealed that doctors make more than anyone thought—and more than any other occupation we’ve measured. In the prime earning years of 40 to 55, the average physician made $405,000 in 2017—almost all of it (94 percent) from wages. Doctors in the top 10 percent averaged $1.3 million. And those in the top 1 percent averaged an astounding $4 million, though most of that (85 percent) came from business income or capital gains.

For better or worse, we live in a world where second-string shortstops may make more money than that. We still weren't sure what to make of these data. Then, Van Dam offered this:

VAN DAM: “In general, U.S. physicians are making about 50 percent more than German physicians and about more than twice as much as U.K. physicians,” internal medicine physician Atul Grover told us. Grover leads the Association of American Medical Colleges’ Research and Action Institute, teaches medicine at George Washington University and speaks with the easy authority and charisma of someone who probably deserves to be earning several times what we do.

Our physicians earn twice as much as those in the U.K.? Now we were on more familiar ground, wondering why per capita spending on American health care exceeds that in comparable nations, often by vast amounts. 

Per capita, we spend way more on heath care than peer nations do. According to the OECD, here's how some of the numbers looked on one of the last occasions when we bothered to check:

Per capita spending, health care, 2015
United States: $9451
Germany: $5267
Canada: $4608
Australia: $4420
France: $4407
Japan: $4150
United Kingdom: $4003

Where's all that extra money going? At some point, we finally learned that it makes little sense to ask.

Pauk Krugman tried to raise this issue in a detailed series of columns back in 2005. Predictably, his columns generated exactly zero discussion across the high-end mainstream press corps Topics like these get little play within our failing nation's high end pseudo-discourse.

Why do we spend so much on health care? In a similar vein, what explains our nation's remarkable college costs? Our high-end press corps avoids such topics. We can't tell you why.

In his analysis piece for the Post, Van Dam went into substantial detail about one part of the unexamined question regarding health care spending. Yesterday, the Post finally published his piece in the paper's print editions:

The piece got buried on page G3, inside the Business section.

For the record, physicians' pay is only one part of this complex matter: You'll rarely see such topics discussed within out failing press corps. 

You'll never see such topics discussed by the massively overpaid corporate stars on our blue tribe's "cable news" stations. Dearest darlings, use your heads:

It simply isn't done!

14 comments:

  1. Darling, it doesn’t count when you had to be shamed into doing it (see my recent comment).

    Somerby thinks he can manipulate his readers like they were 5th graders.

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  2. Not sure if still the case but UK paid for med school if you passed and became a doctor with the salary being substantial but nowhere near US doctors. Doubt it would ever be considered here even with universal health care, but makes sense to me.

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  3. Doctors do not earn more than comparably educated professionals.

    Does anyone really think doctors are paid too much for what they did during the height of hospitalizations for covid?

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    1. That's a fairly small subset of doctors who were on the front line of COVID. Yes, doctors do make too much money. But to step back from that: the entire fee-for-service model is geared towards generating income and not necessarily favorable patient outcomes.

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    2. It is going to get worse when doctors and technicians are replaced by AI. We live in a capitalist economy. Singling out one occupation and chastising it for participating in an arrangement doctors did not create, is unfair. When people are sick or injured, they want the care of a loving parent, not a car mechanic. The longing for someone to make everything all right is incompatible with charging money, in the first place. Questioning how much money is right neglects the complexity of people's feelings about their caregivers. Doctors charge the right amount to support themselves after extensive training and a great deal of self-sacrifice. You have no idea the stress and responsibility they carry, the unpleasantness of many of their workdays, all to help people who lately have been downright hostile because of misguided political beliefs.

      When you are willing to give up your salary in whatever job you work at, because someone on the internet thinks you are paid too much, let me know and you can tell me how little you think doctors should be paid. Doctors are another group that has been resigning lately, along with teachers. Let's see how well you like it when appts become harder to get, the wait in an emergency room gets much longer, and waiting lists for elective surgeries are years long. And let's see how you like it when the people willing to become doctors for low pay show their incompetence at your physical expense.

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    3. 8:38 I understand your sentiments, but going to have to agree with Ilya, doctors are grossly overpaid.

      I have had a lot of experience with doctors, as many of us have, and I have found very few who are not primarily motivated by financial interests, and few that display a high level of competency.

      I support making med school free and a reduction in doctor incomes, mainly because it will weed out those who enter the profession looking to get wealthy, which in my experience is the vast majority of doctors, and of the health care profession in general.

      For profit health care is nonsensical and inhumane, and it is a choice, and it is not mandated by a society that is primarily capitalistic, in fact the US is nearly the last hold out, and it’s a disgrace.

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  4. So, does Bob think the WP is really great now?

    Will I hear this discussed on Red Tribe TV?
    Would Bob care if they didn’t?
    The pay of our officeholders, actually, is a relevant topic, and you won’t hear anything about it. It quite possible that has something to do with the high salaries of the folks on TV.
    But Bob has little interest in this topic, the whole point was to spank MSNBC at the end.

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  5. Looks like Bobby got his itemized hospital bill. All nooks and crannys in the US healthcare system are profit centers. Read Elisabeth Rosenthal's "An American Sickness". The fact that Bobby hasn't paid attention doesn't mean that this topic hasn't been covered, but agreed that it does not make roundtable discussions like D Trump and H Biden. Democratic efforts at controlling healthcare costs have been uniformly met with resistance by Republicans, whose nonsensical mantra is that the free market, if applied, would fix this. Despite that no other country uses the free market to keep costs down. Socialized medicine, like Medicare, can keep costs down by strict price controls. And while the argument that US MDs make too much has legitimacy, it is likely not quite as bad as it appears. I have known " burned out" MDs to leave fee for service medicine for the socialized medicine of the VA at substantial salary reductions because of workload issues. I tried to get a handle years ago on the typical work week in European healthcare and got the impression from my reading that the hours per week put in by French and German doctors was substantially lower than those in the US.Tennis pros at private clubs, electricians with GEDs, and master mechanics all can make 100 k with far less hours spent working, stress, years of training and debt accrued than MDs. Accountants can make over 200k. There are many in the business community who have comparable W2's with less education and hours worked.

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    1. Unamusing, TDH has been on this for years. he's discussed Rosenthal's NYT articles. I'm not sure it's solely due to GOP intransigence that the problem doesn't get solved. It's not clear how far the dems would go on this. And it's hardly a simple problem. How to untangle is certainly beyond my knowhow . Medicare for all, maybe, but would it be another ginormous government expense? is there any reasonable prospect of it? What's unamusing is your device of calling the blogger "Bobby." Are you buddies? Sounds arrogant and inappropriately disrespectful.

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    2. Somerby frequently disparages others including his readers, so no apologies but it is admittedly gratuitous and not particularly useful. Price controls seems to me to be the only workable approach to the cost problem but it is more complicated than Medicare for all. Hospitals have low margins in general and it is my understanding that if all they were reimbursed exclusively in Medicare rates, many would go under. The cost of care is so convoluted that it can be credibly stated that most physicians don't know how much tests or procedures they order cost, it being the case that various insurers and plans contract for rates of reimbursement individually with physician groups , labs, and hospital systems. The system is intentionally opaque. No one on the pharmaceutical side has any interest in informing the physician about the cost of a drug they are marketing, for example.

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    3. “Medicare for all, maybe, but would it be another ginormous government expense?”

      This can only be a question from someone who has not bothered to look into the issue at all, which is more likely a willful circumstance.

      2:53 as one of bad faith commenters heroes here, your disdain for Unamused is quite rich indeed.

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    4. When there are no GOP members advocating in any common public forum for significant changes in healthcare provision it can be confidently stated that the GOP has no interest in cost reform. All they seem capable of is shouting “socialized medicine” when challenged.

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  6. The average UPS driver makes 145k annually, going up to 170k in 5 years. A 4 year degree in cybersecurity computer tech gets a starting salary typically of 125 k. A nurse practitioner gets around 110 k. None of these people spent 4 years undergrad, 4 years med school, and 3 years residency followed in some cases by 3 more years of subspecialty fellowship training, incurring hundreds of thousands in debt. An equipment rep for a surgical device company can easily make 250k annually with an undergraduate degree. So not overly concerned about the amount paid to those who excelled academically, top of their rigorous undergraduate classes,and now put in 60-80 hours weekly practicing medicine.

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    1. Make doctors compete internationally. Pit doctors from the U.S. against doctors from Viet Nam, China, Laos, India, etc, like we did with union laborers. If some hospital is willing to pay them $250K annually, instead of paying a doctor from a foreign country $100K annually, that's the hospitals choice.
      #capitalism

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