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View Diary: Why healthcare costs so much in the U.S. (181 comments)

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  •  out of curiousity (2+ / 0-)
    Recommended by:
    tardis10, frisco

    How much do you think these doctors should make?

    family doctors
    internists
    pediatricians

    Do you believe they get Ferraris? seriously?

    Beliefs like this drive professionals towards republicans.

    $ to DFA, none to DSCC/DCCC/DNC

    by grrr on Fri May 13, 2011 at 06:53:54 PM PDT

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    •  Yeah at a gs station in Pleasanton Cal. He was a (1+ / 0-)
      Recommended by:
      mamamedusa

      psurgin - as per his vanity plate. Brand new Ferrai - Musta cost 200 grand.

      I thinlk that we can pay them as much as they can get but the uppermost tax rate goes above 50% or whatever it takes to provide healt care to everyone who needs it. (of course with reciprocating agreements with other countries)

      I guess what I'm saying that it's more important that people get adequate health care that won't destroy their lives with the cost and that can be done either by paying doctors less or taxing them more. I don't give a shit which way.

      Slow thinkers - keep right

      by Dave the Wave on Fri May 13, 2011 at 07:04:10 PM PDT

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      •  asdf (3+ / 0-)
        Recommended by:
        Jojos Mojo, Odysseus, tardis10

        I assume psurgin means plastic surgeon:

        your answer didn't answer my question. Please re-read my question. And check my answer below.

        psurgin - as per his vanity plate. Brand new Ferrai - Musta cost 200 grand.

        For what it's worth, I share your wish for universal health care. I don't think the doctors I've listed make too much.

        Plastic surgeons can wash their hands of insurance companies. Elective plastic surgery is usually not covered by insurance.

        The rest of the docs are on the front lines...including the surgeons.

        $ to DFA, none to DSCC/DCCC/DNC

        by grrr on Fri May 13, 2011 at 07:11:23 PM PDT

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        •  True. They pay surgeons much more. (0+ / 0-)

          Medicare can pay a surgeon $3000 for a laminectomy or $30,000 for a spinal fusion. Guess which they do? If a CTL surgeon can perform 3 spinal fusions per week and they do it 40 weeks per year they gross 3.6 million from spinal fusions.

          Slow thinkers - keep right

          by Dave the Wave on Fri May 13, 2011 at 07:28:04 PM PDT

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          •  Check your facts (2+ / 0-)
            Recommended by:
            grrr, DrFood

            1) Some spinal surgeons do 2-4 spinal fusions a DAY, several days a week. They are not getting paid $30k per fusion. If they were, they'd be retired. $30k may be part of what the patient is charged, but the surgeon doesn't see anywhere near that amount.
            2) You saw ONE surgeon with a big enough ego to waste money on a Ferrari and from this you draw the conclusion that ALL physicians are grossly overpaid? This logic does not make your point very persuasive.

    •  by the way (2+ / 0-)
      Recommended by:
      frisco, mamamedusa

      once you've guessed

      here's a link to the answer

      Nurse's salaries range in the US from 45-65K.

      $ to DFA, none to DSCC/DCCC/DNC

      by grrr on Fri May 13, 2011 at 07:04:15 PM PDT

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      •  This 20x number (2+ / 0-)
        Recommended by:
        TerryDarc, Odysseus

        Is coming from average salaries- the super-outrageous plastic surgeon/dermatologist salaries drive the number up.  I recently heard a soon-to graduate FM resident discussing his highest job offer at 165K, and this is in an area with very high taxes and cost of living.  Add malpractice insurance and health insurance for you and yours in the open market, and you're probably barely clearing 100K, not even double what a nurse makes.

    •  Average for a family doc (2+ / 0-)
      Recommended by:
      Odysseus, elfling

      straight out of residency is around $120K/year. In some parts of the country that still a helluva lot of money. In others, not so much.

      "Reality divorced the wingnuts after the wingnuts were discovered to be fucking goofy." - DWG

      by Jojos Mojo on Fri May 13, 2011 at 07:56:23 PM PDT

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      •  120K/year (1+ / 0-)
        Recommended by:
        grrr

        Would be fine for family/ped/IM docs (as a nationwide average; in some high-COL areas it would need to be higher) if they either went to med school for free or had each year in their practice of those specialties treated as a non-taxable in-kind repayment of their student loans (both undergrad and professional).

        Otherwise, you'd have to consider the fact that someone with the same academic abilities as a med-school graduate could make a whole lot more money by going into a different field with the same academic demands. Going into medicine shouldn't mean making ten times less than your brother who goes into finance (obviously, this means rethinking the extravagant compensation levels found in finance).

        If you Google "headache brain tumor", you will come away convinced that your headache is actually cancer—Seth Mnookin

        by ebohlman on Sat May 14, 2011 at 12:01:26 AM PDT

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      •  asdf (0+ / 0-)

        out of the gate, a family doctor who just graduated has the same medicolegal responsiblity as a family doctor practicing for 20 years.

        I might add that the frustration of primary care is overwhelming - fighting with insurance companies with their endless demands of paperwork the companies put in place to prevent payment is exhausting.

        Doctors went to med school to practice their craft, not do endless meaningless paperwork , much of which adds no value to patient care. The hourly rate is not even close to a 40 hour week.

        $ to DFA, none to DSCC/DCCC/DNC

        by grrr on Sat May 14, 2011 at 06:12:14 AM PDT

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    •  I already know. I have friends who are doctors, (4+ / 0-)

      nurses, and surgeons. Of course those medical professional you listed don't drive Ferrarris.  The point is that other countries manage to provide better results for their populations than we do and it costs less.  I think the idea in this country that it's not possible to have the best health care in the world if we limit costs or salaries.  it's simply not true.

      I really feel for medical professionals if they are hit hard, but i feel much more for the increasingly huge percentage (and growing) of Americans who can't get medical care at all.  But that's the problem with this country in the first place.  The truly wealthy have captured the American Dream and knocking them down a peg seems counter-intuitive.

      Would we be so happy to have a military that dwarfs all others combined if it was a line item deduction on our paychecks next to FICA."

      by Back In Blue on Fri May 13, 2011 at 08:10:26 PM PDT

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      •  asdf (1+ / 0-)
        Recommended by:
        miningcityguy
        The point is that other countries manage to provide better results for their populations than we do and it costs less.

        I agree.

        I think the idea in this country that it's not possible to have the best health care in the world if we limit costs or salaries.  it's simply not true.

        I am going to make the argument that knocking out the middle man of insurance out would do a lot to reduce prices. Even much better insurance regulations would help a lot.  So would efficient electronic medical records to prevent duplication of tests, and to improve communication. So would paying for results instead of visits.

        I don't believe that the salaries of overworked doctors are the issue, though I do think as the middle class is eroded, there will be further drops in the salaries of health care providers, including doctors.

        Doctors' and nurses' salaries depend on the health of a strong middle class. Destroy the middle class, and health care will be poorly funded. There will be boutique practices for the very rich. The rest of us will have mediocre health care.

        Thus, doctors and other health care providers are natural allies of the progressive movement. I believe that attacking them for their salaries is like attacking union members for their benefits.

        $ to DFA, none to DSCC/DCCC/DNC

        by grrr on Sat May 14, 2011 at 06:43:02 AM PDT

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        •  asdf (1+ / 0-)
          Recommended by:
          grrr

          all of that will help tremendously.  I would go further and just go single payer and get rid of insurance period.  It does nothing to control costs, just takes money out of the health care system.

          I'm not attacking health professionals in general and don't want to see their salaries reduced. I'm just pointing out that in other universal health-care systems the doctors actually make less and produce better results.  It's something that can't be ignored in the equation.  

          Would we be so happy to have a military that dwarfs all others combined if it was a line item deduction on our paychecks next to FICA."

          by Back In Blue on Sat May 14, 2011 at 09:58:41 PM PDT

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          •  agreed (1+ / 0-)
            Recommended by:
            Back In Blue
            I would go further and just go single payer and get rid of insurance period.  It does nothing to control costs, just takes money out of the health care system.

            I guess politically its been so difficult, that even tighter regulations would make some difference.  I would prefer single payer, as long as there was accountability to the citizens paying for this.

            $ to DFA, none to DSCC/DCCC/DNC

            by grrr on Sun May 15, 2011 at 12:15:09 PM PDT

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          •  I also agree with this (1+ / 0-)
            Recommended by:
            Back In Blue
            I'm just pointing out that in other universal health-care systems the doctors actually make less and produce better results.

            Plenty of doctors would agree -  reward docs for better care, not more care. Just make sure there is an infrastructure - eg Electronic Medical Records, sufficient support staff, etc - to let doctors do what they love...practice medicine!

            $ to DFA, none to DSCC/DCCC/DNC

            by grrr on Sun May 15, 2011 at 12:17:04 PM PDT

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    •  On top of paying student debt, it costs a small (4+ / 0-)
      Recommended by:
      PrahaPartizan, grrr, mamamedusa, elfling

      fortune to start a private practice. That's why these days, a lot of new doctors go to work for a corporate medical clinic, often associated with a large hospital corporation. They don't make much money, but they can make their loan payments and don't have to worry much about the business side of a medical practice, insurance, billing, collections, etc., although they may be pressured by the corporate accountants to spend less time with patients, see more patients, and generate more profit for the shareholders.

      Men never do evil so completely and cheerfully as when they do it from a religious conviction. -- Blaise Pascal

      by RJDixon74135 on Fri May 13, 2011 at 10:52:35 PM PDT

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