I will continue to insist in every thread regarding health/medicine that any policy conversation mention, AGAIN, that the USA’s lack of a Public Health System is stupid, expensive, cruel, and curable. Why do I keep screaming? Because USAians have almost zero comprehension of this fundamental lack and how it underlies so much of the substance of so-called “thoughts” about suddenly having a medical bill.
We are so so stupid. Even most doctors and nurses in the USA are clueless about how and why our medical INDUSTRY is structured so oddly.
This article will really whiz you off. Turns out large numbers of doctors and nurses hate working in our horrible health care system, feel brutalized by their jobs, and suffer mental health issues as a result.
Anecdotally, I know three ER doctors. One of them hates her job so much she won’t talk about work and is trying to become an administrator. One left emergency medicine altogether and is now wellness doctor at a much lower salary. The other one is in Brazil and loves his job.
Some years ago, a psychiatrist named Wendy Dean read an article about a physician who died by suicide. Such deaths were distressingly common, she discovered. The suicide rate among doctors appeared to be even higher than the rate among active military members, a notion that startled Dean, who was then working as an administrator at a U.S. Army medical research center in Maryland.
Some how they would have to. How else would they know what I as an anesthesiologist made or my wife as a hematopathologist made? Tax returns only listed “physician” as occupation. Even if they were cross referencing another database that showed what my particular specialty was, they still have to match it to my reported income somehow.
Medicare for all doesn’t get you “training cases”. You are misunderstanding residency training.
Say you work at a widget factory. To be proficient at making widgets, you need to produce 1000 over the course of 4 years. The factory has enough supplies to hire 100 widget makers. The public screams, we need more widgets! Make the factory double their widget makers. So the powers that be pass a law. There are now 200 widget makers but still the same supplies. So now you have one of 2 outcomes. It takes twice as long to get proficient at making widgets or you are training subpar widget makers that make subpar widgets.
They have their own unique history of racism, ignorance, and innumeracy. None of those faults are singular to the USA.
Sure it does. If you have more people coming through the hospital door, you’ve got more cancers, more brain tumors, (more leprosy and head lice in Florida) that you can train a resident on.
At 8:20 he could have just looked up the figures. The figures never would have been classified. He was lazy in his journey.
The real reason minimum wage has not rise in the US since what 1995 roughly is because of outsourcing. We were not producing enough as a nation to pay people more as workers.
Some economist! He has no handle on the topic. But by golly pay the poor less.
A bit late to this party but here are a few snapshots from the London Docklands Museum housed in one of the few remaining warehouses of the West India Dock…epicenter of the world’s slave trade in the 1700s. One exhibit there was London, Sugar and Slavery that outlined the routes to acquire and then transport slaves to the W Indies and the reverse trip with sugar and rum
The average US medical school graduate carries $200,000 debt to pay for that education. On average, that graduate is 28 years old. So that person is pushing 30 with a mortgage-size debt but no house. To become a family practitioner or primary care physician, your first line of medical treatment, that graduate is looking at another 3 years of residency where he/she will make about a $100K/year. Primary care physicians max out at about $250K/year.
To make the the big money one needs to get into the specialties that involve surgery, where the residency requirements almost double, particularly if one wants to do research as well.
To sum up, to make that $350K average salary one has to go through 8 years of formal schooling after high school, another five years of apprenticeship (residency), and about $200k in debt. Your average specialist is approaching his/her mid-30s when the career is finally able to start. For women that means the biological clock is ticking loudly.
Compare that with the undergrad majoring in finance, then jumping to an analyst position at a major firm immediately upon graduation. Or the engineering/comp sci grad joining a Silicon Valley group with stock options.
If you are a smart kid who wants to make money and retire early, the choice of career is pretty obvious. It ain’t medicine. I mean doctors aren’t poor by any means, but it is a lot of delayed gratification and immediate hard work.
You’ve made statements along these lines multiple times in the past and when I’ve made an effort to check, have never found a website that compares salaries that has physicians in European countries come anywhere close to this figure.
As for poaching overseas docs, it’s incredibly hard for the average foreign medical graduate to satisfy the requirements for licensure, so I can’t imagine where this notion comes from.
Nope. And I can give you a real life example that happened to me.
I trained in a very busy teaching hospital. They did 400-500 deliveries a month (basically ALL medicaid patients came here). So busy that L&D had to be staffed with 2 anesthesia people to handle our end of things. Sometimes a 3rd would need to be added in emergencies. Plenty of cases to train anesthesia residents. Then, the local OB/Gyns decided they would start taking Medicaid patients about a month before I started my rotation. Can you guess what happened? We went from 400-500 deliveries a month to 1 in that first week. That entire month I did 5 cases and that was doing ALL the ones available, not “sharing” with anyone. That is you “medicaid/medicare for all” scenario. Not going to train physicians that way.
Why did this happen? If you were a low income/poor patient, where would you go? Teaching hospital to be seen by someone “learning” or go to a private place that was easily arguably nicer and be seen by someone with years of experience? No cost difference to you. The choice is simple.
You are failing to understand the difference between teaching hospitals and private practice.
I am going by my cousin’s wife in Waterford Ireland. She is a radiologist. She is claiming Irish doctors are paid on a par with American doctors across the board. She has doctor friends in the US from the US and Ireland. She has worked as a fellow at Yale and over three fellows at Duke.
I am going by the MD shortage in UK. The UK shortchanges medical spending.
I am going by higher budgets for medicine in Germany and France. While older doctors from Germany and France might not want to study in English to come to America, if younger doctors were paid less in Germany or France the US would poach them. Younger doctors would have the energy to leave. While my cousin’s wife was less specific she did say European doctors are paid like American doctors.
What do you mean exactly by “the US would poach them”. The US does not make it easy for foreign medical graduates to practice in the US. Quite the opposite.
I’m sure anyone remotely interested in whether salaries are as favourable in Europe as your anecdotes say willfact check for themselves. Most folk who I know who practise in European countries don’t report such eye popping figures…and they don’t expect such salaries either since most graduate with a miniscule debt burden as compared to US graduates.
While I agree with your sentiment, I think you miss a fundamental point. I don’t believe there is any health care system that will work in today’s America. That is because the primary problem with US health care is that Americans as a group (and particularly the Boomers) are spoiled, lazy and weak when it comes to their health. The American health care system is stressed primarily by afflictions that are avoidable by common sense nutrition and exercise behaviors. But Americans would rather make excuses and blame genetics or corporations for their gluttony and unwillingness to be physically active. No health care system can be financially viable when 40% of its population will retire obese, which is the current behavior of the US Boomer generation.
Obesity substantially increases the incidence and severity of arthritis, high blood pressure, and diabetes. There is growing evidence that obesity increases the probability of dementia. Given all that, no health care system can succeed with an aging population growing so fat so fast.
As a famous commodore and comic character once said: “We have met the enemy and he is us”
{{ Analysts have predicted that Lilly’s drug, known generically as tirzepatide, could become one of the top-selling drugs ever, with annual sales topping $50 billion. }}
Lilly’s drug is an injectible. Pfizer trying to reverse-engineer a tablet form of the drug which will be more palitable to needle-shy Americans.
