I know people like to reinforce to themselves what they think they know, but I'll say it again:
The link attached has nothing to do with physician services. They are for Hospital fees (which are HUGE compared to physician fees).
Medical provider fees account for less than 20% of US healthcare expenditure. Fact. Obviously there is a LOT more to medical costs in the US than how much physicians are paid.
Also you would be surprised how much (or little) physicians are paid. A knee arthroscopy for instance can pay as little as $200 for the orthopedic surgeon. The anesthesiologist would get his fee as well, depending on what kind of block was used but it won't be much more than the above.
Now, if this was done IN A HOSPITAL
you would have to pay hospital fees, and this is where it starts to get expensive. In an outpatient center, it will be WAY cheaper.
Doctors by law are not allowed to own hospitals, so let the multimillionaire Hospital administrators be the subject of your ire, not the hardworking docs out there.
Healthcare is expensive in this country because of the massive amounts of bureaucracy involved in healthcare delivery.
For example in India a good surgeon would get 200K whereas a good American surgeon would get 600 700 k.
A general surgeon making 700k a year either works in a region with a good payer mix (basically all private insurance, upper middle class neighbourhood, self-pay etc) and/or has ancillary sources of revenue (owner of his practice, probably owns outpatient radiologic center etc)
700k is on the high side of the general surgeon compensation bell curve.
Also, how much malpractice insurance does that surgeon have to pay, compared to Indian doctors? US physicians pay the highest malpractice premiums in the world, and US surgeons are even higher.
The New Yorker actually wrote about this in detail in 2009. If you're interested in health care, it's an extremely interesting analysis! Atul Gawande is an excellent medical journalist -- I recommend his "Cheesecake Factory" article from TNY as well.
Atul Gawande is a brilliant general surgeon and good writer and I have read his earlier books 'good' and 'better'.
I read the Cheesecake Factory article but didn't fully agree with it. You cannot reduce medicine to algorithms because it is a personal service industry. Maybe for certain surgical procedures like a routine cholecystectomy or appendectomy it will work, but it doesn't quite work for internists dealing with patients with chronic illnesses and comorbidities.
One should be careful what they wish for, when suggesting the medical industry appropriate the Cheesecake Factory's delivery model.
Basically how medical billing works right now is that doctors are paid per procedure they order (fee for service) NOT per patient. That incentive coupled with defensive medicine (not wanting to be sued for malpractice) often leads to unnecessary tests or procedures. The ACA has clauses that are trying to encourage doctors to provide better care for less money. For example, paying doctors a set amount to treat a certain illness based on what they've ascertained an "average" amount would be. ACOs (Accountable Care Organization) are also being set up, which again encourage better care for less money.
There is no evidence that ACOs will be better than what we have now. On the contrary ACOs are eerily similar to HMOs of the 90s which flopped.
There are a number of untested
models in the ACA (ACOs, PCMH) supposed to 'reform' our healthcare. However, it's a hope and pray it works situation as these have not been tested in a sample US market to see if it works.
Also several countries with less expensive care, operate on a fee for service payment model so to say that that's why fees are high begs the question.
Another reason medical costs are so high is the entire system that's set up -- think about how much money is spent just on insurers, medical billing, marketing, etc. A single payer system would have helped cut costs since the middle man is out of the picture, but it A) never would have passed Congress and B) the insurance lobby would have fought tooth and nail.
This is the main reason. Medical billing is A MESS! I mean it is fucked up beyond all recognition.
That is one and only reason. Average doctor is paid 5 times an average worker is paid in USA. In any country with any kind of resemblance of universal healthcare that ratio does not exceed 2.5. Until that is changed, any attempt at real healthcare reform is futile.
Did not realize you have a socialist side. Take it back to Russia
Average doctor is paid way more than an average US worker because they are not average US workers. You of all people should recognize that you want to incentivize the best to such professions.