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America's doctors are overpaid


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2013 Feb 25, 9:15am   32,314 views  150 comments

by tovarichpeter   ➕follow (7)   💰tip   ignore  

http://www.slate.com/articles/business/moneybox/2013/02/american_doctors_are_overpaid_medicare_is_cheaper_than_private_insurance.html

American health care costs a lot because the prices Americans pay for health care services are very high. And hospitals charge those high prices for the same reason any other business would—because they can. It’s easy to see why a health care provider is almost uniquely well-positioned to bilk you. If you don’t get treatment, you or someone you love might die. It’s a high-pressure emotional situation that makes it extremely difficult to bargain, comparison shop, or just decide to cut back. Most of us, fortunately, get to outsource most of that bargaining to our insurance companies. Cold-blooded executives, not...

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41   Homeboy   2013 Feb 27, 4:04am  

justme says

They make considerably more than that. This survey from 2011 shows nobody making less than $199k, and many make LOTS more. And keep in mind, these are NATIONAL averages. Bay area doctors make considerably more.

http://www.profilesdatabase.com/resources/2011-2012-physician-salary-survey

Note, the number you see are net of any-and-all kinds of expenses and fake writeoffs.

They pay very low income taxes because they overcharge uninsured patients 3x-10x, and then use debt forgiveness/writeoffs as deductions against their income, and therefore get very low net tax rates.

I don't feel sorry for them at all. They are part of the racket.

I saw that page, but it doesn't contain an overall average, so I didn't cite it. Another source cited $150K as the overall average. You are trying to compare an average with individual data points. Apples and oranges.

Anyway, doesn't matter if it's $150K or $200K, those aren't exorbitant salaries for what they do, especially if you compare it to a professional athlete, an investment banker, or a CEO of a large corporation. There are even computer programmers that make more than doctors.

42   Homeboy   2013 Feb 27, 4:06am  

elliemae says

One could argue that basketball players entertain people, giving them something to do instead of killing each other. So they save lives...

You're really reaching, there.

43   Homeboy   2013 Feb 27, 4:07am  

justme says

I don't feel sorry for them at all. They are part of the racket.

I don't "feel sorry" for them. I just don't harbor an insane hatred for them as you guys do.

44   justme   2013 Feb 27, 4:35am  

Homeboy says

You are trying to compare an average with individual data points. Apples and oranges.

I'm comparing the *lowest* paying specialty listed at $199k with your "average" of $150k. The numbers do not agree at all. I'm sure you must be aware that the average cannot be smaller than the minimum.

Homeboy says

I don't "feel sorry" for them. I just don't harbor an insane hatred for them as you guys do.

I don't know who "you guys" are, but since you quoted me when you wrote that, I'll take exception to your notion of "insane hatred". Pointing out that some doctors charging $2800 per hour are overpaid, and by a LOT, in no way constitutes "insane hatred". That is pure hyperbole.

Homeboy says

Anyway, doesn't matter if it's $150K or $200K, those aren't exorbitant salaries for what they do,

Most doctors are making considerably more than that. You are just hyping again.

45   Rin   2013 Feb 27, 5:27am  

Homeboy says

Anyway, doesn't matter if it's $150K or $200K, those aren't exorbitant salaries for what they do, especially if you compare it to a professional athlete, an investment banker, or a CEO of a large corporation.

It seems like you don't understand the difference between the labor "working" classes and that of the ownership. Of course, the owners of a hedge fund or partners at IB, are making a mint but that's because they have proprietorship of hundreds of millions to billions of dollars of capital. And likewise, an NBA player has a collective bargaining union which has guaranteed that no NBA player will ever not be at least a single time millionaire, all paid for by advertisers and ticket sales. However, leave the main organization and play for the D-League and those guys earn as much as a regular working Joe.

And yes, a profession with a mean above $200K is a big deal, esp when you can train the soon to be laid off 4000+ NASA engineers to do that work, at half price.

46   dublin hillz   2013 Feb 27, 8:46am  

Professional athletes should make a lot of money, they entertain the population, provide alternative avenues of focus and generate discussions in various interpersonal settings. And it is more profitable to enroll children in sports while emphasizing their education than lets say enroll them in useless piano lessons while emphasizing education in terms of diversifying their career options and earning potential not to mention the plain old benefits of excercise and fun. I will never understand why ahem "tigers" pay all that money for music lessons other than to instill some sort of sadistic discipline to teach their kids to sit on their ass and perform monotonous tasks.

47   curious2   2013 Feb 27, 8:56am  

Homefool's doctors are overpaid to keep him addicted to the "not habit forming" pills upon which he has become physically dependent. Everyone is required to pay them, thanks to the "Mental Health Parity and Addiction Equity Act" (mandatory coverage regardless of actual benefit) and Obamacare. Emergency doctors who save lives for $30/hour are probably underpaid. If we had a national health service for vaccines and true emergencies, and a truly free market for everything else, we could save money even if emergency doctors got paid more, because we wouldn't be stuck overpaying Homefool's pushers. But that's why Congress enacted that legislation: our "Representatives" are controlled by PhRMA and other industry lobbyists, and they do what's most lucrative for themselves.

48   CL   2013 Feb 27, 8:58am  

dublin hillz says

Professional athletes should make a lot of money, they entertain the population,

I'd say that they deserve it simply because there are so few that make it to that echelon. Even when they do, their careers are often short due to strain and injury.

So, the best in the world compete and win repeatedly to get highly paid for a short time. Sounds fair. Maybe even less fair for them if you think about it.

49   justme   2013 Feb 27, 9:07am  

CL says

I'd say that they deserve it simply because there are so few that make it to that echelon. Even when they do, their careers are often short due to strain and injury.

You have a point, but there is a big problem with professional sports in the US: They are monopolies that have specific antitrust exemptions.

And not only are the major sports leagues monopolies, but they manage at the same time to be the most socialist institutions in the country.

Why? Because the WORST performing teams are rewarded for their failings by getting the top draft picks of new players. That is, teams are awarded better new players according to their need.

(that ought to make some right-wingnut sports-fans heads explode, after all, what is more American than NFL, NBA and MLB?)

50   Dan8267   2013 Feb 27, 10:06am  

CL says

I'd say that they deserve it simply because there are so few that make it to that echelon. Even when they do, their careers are often short due to strain and injury.

I'd rather a thousand doctors make $300,000/yr than one CEO make $300,000,000/yr. At least doctors do something useful for society.

51   CL   2013 Feb 27, 10:15am  

justme says

Why? Because the WORST performing teams are rewarded for their failings by getting the top draft picks of new players

That's why they're fun to watch! If sports were like American capitalism, the best teams would get even more money, and get the first draft picks, etc. And the same teams would be virtually guaranteed to win, year after year.

Dan8267 says

I'd rather a thousand doctors make $300,000/yr than one CEO make $300,000,000/yr. At least doctors do something useful for society.

Of course.

52   Rin   2013 Feb 27, 10:33am  

CL says

That's why they're fun to watch! If sports were like American capitalism, the best teams would get even more money, and get the first draft picks, etc. And the same teams would be virtually guaranteed to win, year after year.

If anything, the Miami Heat management attempted to become capitalistic by getting the big three all stars in their prime: LeBron James, Dwayne Wade, and Chris Bosh to come together to beat regular teams, which are constricted by the cap & trade limitations of the league. Thus, this may set a trend in the future, where players themselves get together, and decide where they want to camp out for championship rings.

53   Rin   2013 Feb 27, 10:34am  

Dan8267 says

I'd rather a thousand doctors make $300,000/yr than one CEO make $300,000,000/yr. At least doctors do something useful for society.

That's fine, just provide a passage for other scientists and engineers to enter the field, mid-career, without starting out as freshman MD students.

54   curious2   2013 Feb 27, 11:24am  

Dan8267 says

At least doctors do something useful for society.

Many do, and many don't. The problem is perverse incentives that often create an inverse correlation between how useful they are and how much they get paid. The careful doctor who takes time to listen to every patient pays the same malpractice premium as the butcher and the poisoner in the same area, and every doctor who takes insurance needs full-time billing staff to fight with the insurers, so they all end up on the same insurance treadmill that demands mass production of prescriptions and procedures. Homefool's prescribers make a mint off his mandatory subsidized insurance, at everyone's expense, while honest doctors are forced to retire.

55   MMR   2013 Feb 27, 11:25am  

Yeah that really chaps my hide.

dublin hillz says

I will never understand why ahem "tigers" pay all that money for music lessons other than to instill some sort of sadistic discipline to teach their kids to sit on their ass and perform monotonous tasks.

56   MMR   2013 Feb 27, 11:37am  

That's a damn good point.

Rin says

Here's the other aspect ... how many professions out there, can one move to let's say Des Moines Iowa, pay $600/month in rent (or mortgage for a nice condo or house), earn over $250K/yr, and fly to a more happening city like Chicago or wherever, once a month on weekends, and be able to pay off one's school loans in a few short years?

Most other fields force one to move to high cost locales: Silicon Valley, NYC, DC, Boston, and use up a bigger chunk of a $100K salary, just for housing and general costs of living. In Iowa, a physician is the next big thing to being the landed owner of the corn fields.

Once those loans are paid off, it's goodbye to the corn fields and hello to an east or west coast city.

57   Rin   2013 Feb 27, 12:27pm  

MMR says

that's a damn good point.

Rin says

Here's the other aspect ... how many professions out there, can one move to let's say Des Moines Iowa, pay $600/month in rent (or mortgage for a nice condo or house), earn over $250K/yr, and fly to a more happening city like Chicago or wherever, once a month on weekends, and be able to pay off one's school loans in a few short years?

Just to give an example, here's a 2br / 2bath condo in Des Moines ...
http://www.zillow.com/homedetails/2229-Grand-Ave-UNIT-6-West-Des-Moines-IA-50265/2114421703_zpid

$100K, put $20K down, one can even take out a 15 yr mortgage at less than $600 per month. At $250K per year, that's 2.9% of one's pre-tax income, tied up in housing costs. In two & half years, all medical loans could be paid off, and then, one can sell that place, probably for $100-$110K, and lose nothing during that sojourn in Iowa.

Even in central/western MA, 1.5+ hours from Boston, I could only find dilapidated places for $100K. The going price for anything decent, started at $180K, with a mean closer to $220K. And for anything in the Rte 95/metro Boston region (outside of bad neighborhoods), biddings start at $450K.

58   carrieon   2013 Feb 27, 12:44pm  

If you don’t get treatment, you or someone you love might die. It’s a high-pressure emotional situation that makes it extremely difficult to bargain, comparison shop, or just decide to cut back.

Fear tactics don't work on the educated that chose to stay alive. Just pick up a book to do your own research. Otherwise, the opposite is true. The American medical system is there to kill you, after they milk you for all your money.

59   JodyChunder   2013 Feb 27, 12:47pm  

Rin says

Just to give an example, here's a 2br / 2bath condo in Des Moines ...

And FWIW, Des Moines is a good city with progressive local government. Kill-your-ass cold, though.

60   Rin   2013 Feb 27, 1:11pm  

JodyChunder says

Rin says

Just to give an example, here's a 2br / 2bath condo in Des Moines ...

And FWIW, Des Moines is a good city with progressive local government. Kill-your-ass cold, though.

Then for those with roots or nearby family in the midwest, it would probably be a nice place to settle down in, long term.

61   Homeboy   2013 Feb 27, 1:12pm  

justme says

I don't know who "you guys" are, but since you quoted me when you wrote that, I'll take exception to your notion of "insane hatred". Pointing out that some doctors charging $2800 per hour are overpaid, and by a LOT, in no way constitutes "insane hatred". That is pure hyperbole.

Hmmm...kinda sounds like you're flipping out a bit here. I'll stay with the "insane hatred" diagnosis. And your "example" is ridiculous. We're talking about how much doctors MAKE. Doctors do not make $2800 per hour. If you made that much an hour and worked a normal 40 hour week, that would be over $5 million.

62   Homeboy   2013 Feb 27, 1:18pm  

Rin says

It seems like you don't understand the difference between the labor "working" classes and that of the ownership. Of course, the owners of a hedge fund or partners at IB, are making a mint but that's because they have proprietorship of hundreds of millions to billions of dollars of capital. And likewise, an NBA player has a collective bargaining union which has guaranteed that no NBA player will ever not be at least a single time millionaire, all paid for by advertisers and ticket sales. However, leave the main organization and play for the D-League and those guys earn as much as a regular working Joe.

It seems you entirely missed the point. You are arguing WHY NBA players make what they do. What is the point of such an argument? The fact that they make that much renders it self evident that they are able to do so.

What is this thread about? Slate claims that doctors are overpaid. Why are they overpaid, asks Slate? "Because they can", they answer. Similarly, why do NBA athletes make way too much money? Because they can.

You are simply describing the mechanism by which NBA players make 33 times as much money as doctors do, which rates a big fat "duh" from me.

Why, in your mind, is it o.k. for NBA players to make 5 million "because they can", yet it apparently is some sort of outrage that doctors make 33 times less than that "because they can"?

63   Homeboy   2013 Feb 27, 1:28pm  

justme says

I'm comparing the *lowest* paying specialty listed at $199k with your "average" of $150k. The numbers do not agree at all. I'm sure you must be aware that the average cannot be smaller than the minimum.

That is not the minimum salary of a doctor. Bone up on your critical thinking skills.

64   Homeboy   2013 Feb 27, 1:33pm  

CL says

I'd say that they deserve it simply because there are so few that make it to that echelon. Even when they do, their careers are often short due to strain and injury.

So, the best in the world compete and win repeatedly to get highly paid for a short time. Sounds fair. Maybe even less fair for them if you think about it.

That makes no sense. A typical wage earner could work for 30 years and still in their entire life, not make anywhere close to what an NBA player makes in a single year. This is not simply compensation for having a short career; it goes way, way, way beyond that. And besides that, NBA players get a pension after they retire. Sorry, try again.

65   Rin   2013 Feb 27, 1:41pm  

Homeboy says

It seems you entirely missed the point. You are arguing WHY NBA players make what they do. What is the point of such an argument?

What point am I missing? I have an A- undergrad GPA; I also took the MCAT and scored a 34. Instead of attending medical school, since I had *the numbers* for admissions, I went into the biopharma industry and eventually found myself in IT and then, hedge fund work.

Now, despite my interest in junior varsity basketball, there's pretty much, zero chance of me making it into the NBA, or even one of the smaller leagues, where players don't make over $100K. Here why ... I can't develop LeBron James' athleticism, by simply running and lifting weights. Those are attributes which one needs to be born with, to want to be in the NBA. I would not make any of David Stern's cutoffs, to be in his clubhouse.

In contrast to professional b-ball, numerous scientists and engineers have the intellectual ability to complete medical school and become doctors. Doctors are not all born with photographic memory and 220 IQs. The problem ... not enough seats (overall) and two, everyone needs to borrow up to 4 years worth of tuition & expenses, to attend any US medical school.

My conclusion is that medicine is another educated labor field, not too distinct from engineering or the applied sciences. There's no shortage of entrants into any of the aforementioned areas, and many non-management S&Es earn less than $120K/yr, esp the postdocs in biosciences, who earn less than $45K/yr.

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

66   curious2   2013 Feb 27, 2:06pm  

Rin says

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

But that's why it doesn't happen. PhRMA doesn't want more entrants with less debt, especially engineers, because the current entrants are so much easier to control: indoctrinated into allopathy, deeply in debt, needing to prescribe whatever PhRMA wants to sell. Actual scientists?!? No way, they might cure something, or at least notice that Homefool's toxic SSRI's don't work, which would disrupt the business model of making diseases into revenue centers (and manufacturing diseases to turn them into still more revenue centers). You seem to be suffering the engineer's cognitive failure to grasp that the medical industrial complex is not designed to help people, it is designed to make money. There are plenty of ways to increase the supply of qualified doctors, e.g. by not driving the honest ones out of the profession (see above), and costs could be reduced further by eliminating the federally mandated artificial demand (Rx requirements, Obamacare, etc.). But those don't happen either, for the same reason, they would interfere with the revenue model.

67   Rin   2013 Feb 27, 2:17pm  

curious2 says

Actual scientists?!? No way, they might cure something, or at least notice that Homefool's toxic SSRI's don't work, which would disrupt the business model of making diseases into revenue centers (and manufacturing diseases to turn them into still more revenue centers). You seem to be suffering the engineer's cognitive failure to grasp that the medical industrial complex is not designed to help people, it is designed to make money.

Sure, I got all that, however, if they're going to use the examination system, as the primary gateway, then they have to either live or die by it. Realize, medicine is not management consulting, where BS reigns supreme. In the end, 90% on an exam involving any applied science, like causes of genomic mutations, is still an 'A' mark. This is where medicine can't pull the same stunts as bankers, in restricting access to the field.

The only thing they can do is threaten to fire scientists, if they blow the whistle on the existing practices. And for the most part, that's not much different from corporate America, where clearly, better work could be done, if S&Es had more freedom from management. And likewise, engineers entering medicine, will be forced to follow the rules or be blacklisted. End result, doctors salaries go from $250K, down to $150K, but again, everyone plays the game.

68   Meccos   2013 Feb 27, 2:40pm  

Rin says

My conclusion is that medicine is another educated labor field, not too distinct from engineering or the applied sciences.

Yeah, im sure cutting into someone's chest and heart is not too distinct from designing a circuit board... Gotta have nerves of steel and steady hands to design those boards eh?

69   Rin   2013 Feb 27, 2:42pm  

Meccos says

Every time you speak about doctors making too much money and how "scientists and engineers" are just as smart, it only makes you sound like you regret the choices you made and are very bitter about it.

I earn over $700K/yr, working in a hedge fund. My regret about my line of work is that it's basically sales and not, science & engineering, a worthy profession for someone, who cares about something other than the bottom line.

I've railed against management consultants and their like, because unlike in my prior line of work, those individuals are empty suits with little to contribute to the world.

And thus, my only goal now, is to become financially independent, and then, apply to medical school, and contribute something of value, without needing to worry about an income stream. And yes, unlike many others, I've seen all sides of the fence.

70   Rin   2013 Feb 27, 2:43pm  

Meccos says

Yeah, im sure cutting into someone's chest and heart is not too distinct from designing a circuit board... Gotta have nerves of steel and steady hands to design those boards eh?

Tell that to a dermatologist, neurologist, pathologist, or radiologist. I'm sure they're all cutting out someone's chest.

71   Rin   2013 Feb 27, 2:50pm  

Meccos says

Stop complaining and go become a doctor yourself.... furthermore dont make stupid requests like the quote above... it only hurts your arguments about doctors making too much money.

Does it hurt my argument or are you simply trying to find a way of shutting me down? In other words, do you, yourself, have a photographic memory and a 220 IQ & thus, are too brilliant for ordinary Joes like myself who've studied applied chemistry and chemical engineering. My arguments stem from the fact that many S&Es have the intellect to pass the medical school basic sciences curriculum. That hasn't changed.

72   Meccos   2013 Feb 27, 2:56pm  

Rin says

I earn over $700K/yr, working in a hedge fund. My regret about my line of work is that it's basically sales and not, science & engineering, a worthy profession for someone, who cares about something other than the bottom line.

Great... go get into medical school and do something instead of bitching all day. And if you truly wanted to speak about people getting paid too much, then you should investigate your current line of business.... especially yourself.

Um scientists and engineers are not the only worthy profession. Please get your head out of your ass...

BTW, there are some people in every profession who care only about the bottom line. SInce we are on the topic of medicine, look at big pharma and medical device companies. They are filled with "scientist and engineers" who care only about the bottom line.

Rin says

those individuals are empty suits with little to contribute to the world.

YOu mean like working in a hedge fund?

Rin says

And thus, my only goal now, is to become financially independent, and then, apply to medical school, and contribute something of value, without needing to worry about an income stream. And yes, unlike many others, I've seen all sides of the fence.

700k should make you fairly financially independent already... whats stopping you? Furthermore since you are going into medicine and will be "way overpaid" as you suggest why do you even need the money???

Lastly, I find it funny that you think when you go into medicine you will contribute something of value, yet you seem to imply that physicians currently do not contribute something of value. Your ego is enormous, but i guarantee you, once you get into medical school and residency your ego will be shattered in many ways.

73   Meccos   2013 Feb 27, 3:03pm  

Rin says

Meccos says

Yeah, im sure cutting into someone's chest and heart is not too distinct from designing a circuit board... Gotta have nerves of steel and steady hands to design those boards eh?

Tell that to a dermatologist, neurologist, pathologist, or radiologist. I'm sure they're all cutting out someone's chest.

Tell the cardiothoracic surgeon who is cutting into someone's heart that his job is indistinct from the lab rat working in microbiology.

Tell the neurosurgeon that sawing open someones head that his job is indistinct from someone writing code.

Tell the pain physician who is implanting spinal cord stimulators onto someones spinal cord that his job is indistinct to designing a circuit.

BTW, the radiologist, pathologist, dermatologist that you seem to belittle make life and death decisions all day. They are crucial in the diagnosis of a malignant cancer that may one day save you or a loved one.

OH btw, you want to go into medical school so that "you can contribute"... which useless field are you going into???

74   curious2   2013 Feb 27, 3:14pm  

Meccos says

the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend

In other words, barriers to entry that increase costs without improving results.

75   curious2   2013 Feb 27, 3:29pm  

@Meccos, you're getting upset and contradicting yourself, please try switching to de-caf. You're also setting up an all-or-nothing false choice fallacy, i.e. all of the current medical industrial complex or faith healing. Other countries find plenty of middle ground. Some medicines are useful, others are not, but paid salesmen are not necessarily the best or most objective guides.

76   Meccos   2013 Feb 27, 3:30pm  

Hm. why are my posts being deleted... Lovely...

77   Meccos   2013 Feb 27, 5:05pm  

Rin says

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

Every time you speak about doctors making too much money and how "scientists and engineers" are just as smart, it only makes you sound like you regret the choices you made and are very bitter about it.

Stop complaining and go become a doctor yourself.... furthermore dont make stupid requests like the quote above... it only hurts your arguments about doctors making too much money.

78   Meccos   2013 Feb 27, 5:05pm  

Rin says

Does it hurt my argument or are you simply trying to find a way of shutting me down? In other words, do you, yourself, have a photographic memory and a 220 IQ & thus, are too brilliant for ordinary Joes like myself who've studied applied chemistry and chemical engineering. My arguments stem from the fact that many S&Es have the intellect to pass the medical school basic sciences curriculum. That hasn't changed.

NO one ever said that you have to be a genius to be a physician. I believe you made that argument up by yourself. However just because you studied applied chemistry and chemical engineering doesnt make you fit to be physician.
BTW, i agree with you. Many non-medical people can bass the basic science curriculum. No one will disagree with you about that. Unfortunately the basic sciences are a FRACTION of what is taught in medical school. In fact the basic sciences probably make up less than a year of the medical school curriculum. Furthermore, the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend.... perhaps you do since you are quoted as saying the following:
Rin says

Allow more scientists and engineers to enter the field of medicine, by shortening the number of years of borrowed money, and you'll see qualified entrants into the practice.

79   Meccos   2013 Feb 27, 5:05pm  

curious2 says

Meccos says

the difficulties of becoming a physician is only partially about learning the subject matter, but also the sacrifices in time and effort which you do not seem to comprehend

In other words, barriers to entry that increase costs without improving results.

Yeah your so-called "barrier to entry" is called medical school and residency. Yes you actually have to spend some time to learn the stuff... Heaven forbid people actually force you to learn things in great detail before they let you cut people open or prescribe medications that may kill someone...

Its not like the "scientist and engineers" who can learn their craft during the 4 years of undergraduate school...

80   Meccos   2013 Feb 27, 5:05pm  

@curious

Instead of complaining about these "barriers", perhaps you should rebel against the medical establishment and go see the neighborhood shaman next time you have some serious medical issue...

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