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I think primary care workers are generally underpaid and specialists are generally overpaid. That said there's a lot of variation in the data. If you look at some studies of why the US spends more than other countries on healthcare without better outcomes, the difference in prices between the US and other systems is a significant driver. Labor (particularly physicians), drugs and administration costs more here than elsewhere [1]. It's true doctors go through a lot of training, but I'm not terribly sympathetic to stories of a surgeon not being paid enough. Family practice, primary care I'd be more inclined, but even there we spend more than most countries it seems. [EDIT] I'm less sure on what the "blue collar" healthcare workforce (health aides, etc.) wages looks like, I would totally buy that many are underpaid. Administrative costs are a terrible drag, and I say that knowing that currently I am personally paid by administrative costs. We could bring them more in line to the international norm, but we'd still be substantially more expensive because administrative costs are still not the bulk of total expense. Drugs are an interesting story because the US effectively subsidizes international drug costs [2]. Also, drugs are a way to stop way more expensive interventions (better to take a $100K drug that cures Hepatitis C than get a liver transplant that will cost far more than that and won't give as good quality of life), so maybe in some ways we should spend more there if the treatments are worthwhile. That said there are disturbing pricing trends in the industry that are clearly exploitative. In summary, what nationalized systems buy you is fewer administrative costs (good), price controls on medical services (maybe good, but necessarily docs get paid less down the line), price controls on drugs/devices (maybe good, but maybe trade-offs in developing treatments that are less expensive than other interventions). All of the parties involved will be fighting this "efficiency", some more justifiably than others. Who knew healthcare could be so hard? [1] https://www.hsph.harvard.edu/news/press-releases/labor-pharm... [2] https://www.vox.com/science-and-health/2016/11/30/12945756/p... |