>> For one, doctors educational costs are astronomical in the U.S compared to other countries.
Doesn't this apply to all US educational costs (at the college level)? On the other hand doctors in the US seem to get paid a lot more than in, say, the UK.
> But I'm pretty sure they make far more in the US than anywhere else in the world.
Yea, but the opportunity cost of getting there is huge. At graduation, most doctors are in the ballpark of $1MM behind where they'd be if they went straight into a professional career.
Also, doctor's salaries only account for 8% to 20% of total healthcare costs.
>> Doctors are already paid absurd salaries in the US
>To put it in context, when I finish all my training, I will owe over $600,000.
> It's not the doctors being "paid absurd salaries" that makes medical care in this country expensive. It's lawyers - malpractice insurance can take upwards of 25+% of your income - and it's insurance companies, who have shareholders they are responsible to, and it's hospital administration, whose positions keep multiplying.
It's a red herring. If you compare physician compensation in the UK to the US, the costs of medical education are made up within the first ten years. Yes, even after malpractice insurance. Hospital administrators are also wildly overpaid, but there just aren't as many of them. Physician compensation as compared to foreign doctors, which get the same or better results, is just too large a piece of the pie to brush under the rug by pointing at other problems.
> Is grinding thru med school somewhat sacred? should they earn more than EEs? civil engineers? architects?
Everyone you mentioned should (and does in the US) earn more than 90k GBP. Nurses in the US (at least in California where they make 50-60$/h) earn the same as top pay grade specialty doctors in the UK according to that NHS payscale.
> yes, fixing noses or fake tits
No, there are many specialties which don't involve plastic surgery but make millions. Cardiologist, dermatologist, dentist, etc. Or if you're a surgeon and work at a big hospital, you can also make 500k+. All of these involve mitigating pain and suffering and saving lives.
Sorry you think plastic surgery is the only way to earn a good living in medicine.
> like almost everyone else. Newsflash - US is really expensive.
Compared to what, London? Amsterdam? Paris? The US isn't more expensive than anywhere else, and for a doctor working in the suburbs, it's way cheaper than any major city in Europe. Don't forget, health insurance for white collar workers in the US is cheap compared to their salary, and taxes are lower. Energy costs as well. And a 401k is a lot cheaper than paying progressive social security taxes that redistribute earnings.
At least the US doctor can afford a house, whereas the UK one will never buy one within an hour's drive of London in their lifetime.
> there are doctors making $500k/year living paycheck to paycheck.
Can you provide a source for that please ?
Also, it would be interesting to find how much of their expenses are paying back their insanely high tuition-fees.
> For example, the US has extremely high standards restricting who can practice medicine compared to the rest of world
Rest of the world, yes. Rest of the developed world, not at all. The major difference is that becoming a doc in the US is much more expensive than pretty much anywhere else. You could also argue it's proportionally harder because of the more numerous competitors. But on an absolute level of knowledge and capability no, it's not harder than say, in western european countries.
> Maybe medical school prices would go down with additional scale.
It seems like a bit of a chicken and egg problem. Medical school is already so expensive that the salaries are necessary in order for newly minted doctors to have the same disposable income after loan payments that, say, a programmer or chemical engineer who's 7 years younger has (4 years medical school + 3 years residency minimum). Who would make the sacrifices necessary to become a doctor, taking out massive loans, only for an income that won't sustain them comfortably?
> The US pays about twice per nurse or doctor in the system, and part of that is because the US pays nearly twice for most skilled work.
which is in turn because in the US an average GP comes out of medical school with $200k-300k of student debt that has to have interest serviced and paid off within some 10-20 year timespan. That cost ultimately ends up being borne by the patient and their insurance.
unfortunately the US is very resistant to the idea of education reform in general, very very resistant to student debt relief, and very very very resistant to student debt relief for "high earners" like doctors and lawyers, even when a huge chunk of that earn is going to debt service. But there is a shortage of doctors and we're doing everything in our power to make the path unattractive for new students. And this time the problem isn't even the AMA - the AMA agrees there is a problem and is onboard with expanding the pipeline... it's just not all that attractive a profession anymore when you can make equal/higher compensation (after considering the debt) in software or other fields.
doctors are still extremely well-paid professionals in other countries, but if we tackle the cost of education we can get our numbers down much closer to theirs. conversely if you push salaries too low then servicing $200-300k of student debt won't be realistic and the path becomes even less attractive.
medical care is probably the single most complex political problem in the US because it's basically at the nexus of every single social and political problem we have. doctors are too expensive... because they're trucking around a quarter million of student loan debt from our shitty education system. we spend way too much on end-of-life care and not enough on earlier care... because seniors vote. we have way too much overhead due to the multi-payer insurance system and the market-driven pricing system's overheads... and all those insurance companies are huge lobbyists too. Drug and device costs are out of control... because the US doesn't allow conditioning of regulatory approval on price negotiations, or reimportation from other countries, etc. It's just every single political problem in the US in a single field all at once and every hand is dipping into the till as much as they can get away with, and it's politically infeasible to slap the hands that are necessary to slap to actually get costs reduced.
>The entire system is flawed and opaque so it’s hard to know who is exploiting who.
Doctors are by far the highest paid career in the USA. Surgeons are paid enormous salaries. Its pretty clear who is winning.
I know there is a complaint that medical school is very expensive. If we offered free medical school for cutting salaries in half, I'm pretty sure doctors would prefer to keep as it is.
>have to earn very high pay to cover the (insane) cost of medical school and insurance.
Also opportunity cost for people capable to become physicians in the US have other options with competitive pay to quality of life at work ratio. Lots of ways to not spend one’s 20s memorizing stuff for step exams and then spend 26 to 30 being a slave during residency, and then maybe a fellowship or getting board certified, and at the end, you still have to deal with patients.
Alternatively, they could go for a job where they sit behind a computer and not deal with the general public and get to work from home when shit hits the fan.
> Doctors are well paid in the US but they are typically not rich.
What doctors do you know? My friends who are just getting out of residency and such are making a few hundred thousand a year. My college roommate’s father was an anesthesiologist making $800k/year.
Just because they don’t draw attention to themselves with ostentatious vehicles doesn’t mean they couldn’t afford to (the anesthesiologist only had a Porsche for each of his kids).
"The problem is American doctors are smug elitist's who believe they're worth half a million dollars a year and american society believes they're worth it too (possibly through watching too much medical dramas on television).
Every other country in the world treats theur doctor's as humanitarians who deserve an above average but honest wage."
After at least 10 years of schooling (plus the debt), grueling work, and 12+ hour work days for many years, doctor's deserve the high wage. When you first start out as a doctor, you don't get that much. It only happens after specialization.
Other countries also pay developers $5/hour and you forget to mention that the cost of living in many "other countries" is significantly lower.
I doubt that's the majority of the massive cost difference.
> For instance: Western european doctors do not need a 4-year bachelors degree just to _enter_ medical school.
Don't know where you are basing this but in France, Pharmacist is High School Diploma + 6 years or + 9 year depending on the specialty. So you get out at 24 or 27 year old (best scenario), I doubt that's longer in the US or otherwise there's a big problem there.
> Well, physicians have to be paid accordingly for their time and financial investment. Consider most are hundreds of thousands down in education debt and have been in training for almost a decade
> What is most baffling to me, as someone who isn't from America, is how expensive even the most basic tests are.
If you understand the former, then why is the latter baffling?
Doesn't this apply to all US educational costs (at the college level)? On the other hand doctors in the US seem to get paid a lot more than in, say, the UK.
reply