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February 21, 2013

The Rest of the World Still Has Plenty of People Who Want to be Doctors

Posted in: healthcare

For the most part I found this very long Time article by Steven Brill about the problems with American health care cost to be interesting. It did correctly highlight that the biggest problem is that Americans are overcharged for almost everything related to medicine, but I was thrown off by his bizarre insistence this doesn’t include doctors. After making a pretty strong case for Medicare-for-all Brill argues that it won’t work because that would somehow turn all doctors into paupers.

In fact, those numbers would seem to argue for lowering the Medicare age, not raising it — and not just from Janice S.’s standpoint but also from the taxpayers’ side of the equation. That’s not a liberal argument for protecting entitlements while the deficit balloons. It’s just a matter of hardheaded arithmetic. [...]

If that logic applies to 64-year-olds, then it would seem to apply even more readily to healthier 40-year-olds or 18-year-olds. This is the single-payer approach favored by liberals and used by most developed countries.

Then again, however much hospitals might survive or struggle under that scenario, no doctor could hope for anything approaching the income he or she deserves (and that will make future doctors want to practice) if 100% of their patients yielded anything close to the low rates Medicare pays.

(emphasis mine)

This is simply an absurd statement. American doctors are among the best paid, if not the best paid doctors, in the entire world. An American primary care doctor will make about 40 percent more than a German doctor. Most first world country pays their doctors noticeably less, yet these countries still have plenty of doctors and people who want to be doctors.

While it is impossible to address the completely subjective claim that American doctors should simply “deserve” to be paid so much more than their international peers, there is zero reason to believe Medicare-for-all would stop people from wanting to become doctors or prevent them from making a very good salary. A surgeon that saw only Medicare patients would still make hundreds of thousands a year.

Brill even earlier acknowledged that some Central Florida hospitals thrive by almost exclusively serving Medicare patients. It stands to reason that to attract doctors these hospital are paying competitive salaries

Being a doctor is a very socially desirable job, and in other countries with a single payer system it is still one of the highest paid jobs there are. While Medicare pays slightly less than private insurance in the United States for many procedures, it still tends to pay more than private or public insurance in other countries and all those countries have plenty of doctors and would-be doctors.

The idea that Medicare-for-all would turn being a doctor into an undesirable impoverished profession is pure fantasy.

Photo by Kathy McGraw under Creative Commons license


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