A quandry involving Medi-Cal, going from paying badly to not at all

[jyl]

How much do doctors earn and hospitals make in other countries that have some form of single payor healthcare, e.g. Canada, UK, France, Germany? How do those economic models work, for the providers?

[tabs]

WHY jYL what is wrong with you, your a BAD Pelican you ask intelliegnet questions...

[Nathans_Dad]

Originally Posted by jyl

How much do doctors earn and hospitals make in other countries that have some form of single payor healthcare, e.g. Canada, UK, France, Germany? How do those economic models work, for the providers?

Your question intrigued me so I decided to do a little quick internet research. The findings honestly shocked me. I had no idea it was this bad.

This is from 2006:


I suspect that wasn't the answer you were looking for jyl but there's the truth.

[jyl]

I had thought doctors in other countries made less money, so that doesn't surprise me.

In the US, my guess is that if the avg hospital doc made $100K, there would be a significant doctor shortage, given the cost of medical school and the length of training needed. Is that true? If so, how does it work in those other countries? Is there a doctor shortage, and why or why not?

[Moses]

Originally Posted by jyl

I had thought doctors in other countries made less money, so that doesn't surprise me.

In the US, my guess is that if the avg hospital doc made $100K, there would be a significant doctor shortage, given the cost of medical school and the length of training needed. Is that true? If so, how does it work in those other countries? Is there a doctor shortage, and why or why not?

No shortage. Quality of medical school applicants decreases dramatically, though. After the Iron Curtain fell, this country would not honor medical diplomas from many eastern European nations. In many cases postal workers made more than doctors. Hardly the way to recruit "the best and the brightest".

[Noah930]

Originally Posted by jyl

I had thought doctors in other countries made less money, so that doesn't surprise me.

In the US, my guess is that if the avg hospital doc made $100K, there would be a significant doctor shortage, given the cost of medical school and the length of training needed. Is that true? If so, how does it work in those other countries? Is there a doctor shortage, and why or why not?

Oftentimes, in foreign countries the cost of medical school is not borne by the students. Here, in the US, tuition costs will vary widely. Even a state school will cost several thousand dollars (not a big deal), and private med schools will easily run $40K for tuition, alone. Annually. Times four years.

I also wish I made what is depicted in the chart, above. That's significantly more than what I earn.

[red-beard]

My niece in Mexico is applying for med-school. For them, you apply to med-school out of high-school, and you do under-grad and med-school over 7 years. It is paid for by the government. And it is not easy to get into ANY medi-school in Mexico, even the crummy ones. So, there is not a huge school debt to pay afterwards.

I don't know how much doctors make in Mexico, but I do know they take bribes, to change the order of when a patient gets care or surgery.

[Moses]

Originally Posted by red-beard

My niece in Mexico is applying for med-school. For them, you apply to med-school out of high-school, and you do under-grad and med-school over 7 years. It is paid for by the government. And it is not easy to get into ANY medi-school in Mexico, even the crummy ones. So, there is not a huge school debt to pay afterwards.

I don't know how much doctors make in Mexico, but I do know they take bribes, to change the order of when a patient gets care or surgery.

If you live in a country where every other job sucks even worse than being a doctor, you can still attract the best and the brightest.

[Nathans_Dad]

As above, assuming that everyone's wages don't fall by 50% then obviously the best and brightest will choose to go into other professions.

So, the real question is, do you want cheaper healthcare at the cost of knowing that the guy about to cut you open barely graduated college?

[Dixie]

How much do doctors earn and hospitals make in other countries that have some form of single payor healthcare...

There is another important question that complements this one (and I'm not Trolling).

How much do tort lawyers earn, and how much is malpractice insurance, in these other countries?

[Nathans_Dad]

While tort reform is an important part of the healthcare puzzle, it doesn't factor in nearly as much as most people think, at least in terms of actual dollars. Now, the discussion of whether fear of malpractice suits encourages doctors to overtest and overprescribe is another topic altogether and may well factor in significantly to the cost of healthcare.

The only docs who would feel direct effects of malpractice insurance are those who are working in smaller practices where their "salary" is what is left over after the practice pays all the bills. Personally, I work for a large physician group and my malpractice insurance is included in the costs to our practice and has nothing at all to do with my personal salary. I might be in a unique situation though.

[red-beard]

The other assumption here is that people go into medicine JUST because doctors make big bucks. In fact, most of the doctors I know didn't go into it for that reason.

But, after they get "medicared", the doc's will unionize and we'll start having stikes...

[artplumber]

Originally Posted by red-beard

The other assumption here is that people go into medicine JUST because doctors make big bucks. In fact, most of the doctors I know didn't go into it for that reason.

But, after they get "medicared", the doc's will unionize and we'll start having stikes...

You know, although you jest, but it would be the right thing to do. If public servants (which is what MD's would become under a single payor system, foot on the neck scenario) MD's should be able to do it too. Furthermore, since education is required that is prolonged and frequently not at the cost of the government, it would be interesting to see what sort of retirement benefits etc could be wrangled from the government, especially since the firefighters/police etc are getting 90% of their base salaries + full healthcare in perpetuity in Cali.

[tabs]

Forty six cents of every USD spent this year by BAMA is going to be borrowed....

[jyl]

Are doctors in the UK inferior to doctors in the US? I see from the chart posted that they make 1/2 the money.

Quote de jyl

I had thought doctors in other countries made less money, so that doesn't surprise me.



In the US, my guess is that if the avg hospital doc made $100K, there would be a significant doctor shortage, given the cost of medical school and the length of training needed. Is that true? If so, how does it work in those other countries? Is there a doctor shortage, and why or why not?

No shortage. Quality of medical school applicants decreases dramatically, though. After the Iron Curtain fell, this country would not honor medical diplomas from many eastern European nations. In many cases postal workers made more than doctors. Hardly the way to recruit "the best and the brightest".

[Moses]

Originally Posted by jyl

Are doctors in the UK inferior to doctors in the US? I see from the chart posted that they make 1/2 the money.

No, but they have a shorter and decidedly more affordable pathway to medical practice.

[Rick Lee]

In Germany universities are free and students get stipends from the state for room and board. So, if you graduate with zero debt, you can definitely get by on a smaller salary, confiscatory taxes notwithstanding. I've heard from a few doctor friends in Germany that nurses and even hospital cleaning crews can make more money than the doctors. I don't know why they bother unless it's just out of a sense of great medical curiosity or some hope of making it big many years later. Joeaksa and I had a mutual doctor friend in Germany who was the boss of a large clinic and made very big bucks. But he paid his dues in his youth and was older than my folks.

[Nathans_Dad]

Originally Posted by jyl

Are doctors in the UK inferior to doctors in the US? I see from the chart posted that they make 1/2 the money.

No they are not inferior, but the entire system in the UK is different. Malpractice systems are different, care systems are different, education costs are different.

Look at what is considered a good standard of living in the UK. People live in much smaller houses and get along with much less than the average US citizen.

I appreciate your attempts to continue to rationalize bringing socialized medicine to the US, but until you change the entire US culture, the result will simply be that the people you want to become doctors (the intelligent, compassionate, hardworking people) will see that they can make much more with much less stress, less legal risk, and an easier schedule in other professions.

[Tobra]

Originally Posted by Nathans_Dad

The only docs who would feel direct effects of malpractice insurance are those who are working in smaller practices where their "salary" is what is left over after the practice pays all the bills. Personally, I work for a large physician group and my malpractice insurance is included in the costs to our practice and has nothing at all to do with my personal salary. I might be in a unique situation though.

I am a solo practioner, so your first scenario describes me; my overhead is about 55-60%, it was less in Texas, go figure. I think the trend is toward multiple doctor practices, multi-disciplinary groups, allows you to capture more market share, spread out expenses and get economies of scale, all that crap they taught me in economics.

Healthcare on this planet is at the level it has attained due in large extent to the US system. If we go to nationallized plan, where will the Canadians go to get their heart bypasses? What new medications will be developed, new surgical devices, wound care products, a lot of progress in medical technology is driven by the profit motive.

One thing is for certain, I have spoken to enough of my colleagues to know that there will be a problem with it.

I am talking to the Emergency Medicine Committee on the 28th about it. Set that up as an improve patient care, diminish length of stay sort of thing. The more i think about it, the more I am convinced that if they don't call while the prospective patient is in the ED, they won't be getting treated by a podiatrist.

[jyl]

Originally Posted by Nathans_Dad

I appreciate your attempts to continue to rationalize bringing socialized medicine to the US, but until you change the entire US culture, the result will simply be that the people you want to become doctors (the intelligent, compassionate, hardworking people) will see that they can make much more with much less stress, less legal risk, and an easier schedule in other professions.

Are there aspects of the US healthcare system that could be changed to permit US doctors to have the same take-home/net income and the same schedule/stress/life quality as they do today, while receiving substantially lower gross revenue? Put another way, what can be done to substantially lower US doctors' costs of doing business?