[hurryskurry]

Medicare rate and the reality of using Medicare are separate issues though

For me the issue is that if you had something like a hernia it would essentially cost less to fly to Europe, have the surgery, and stay a couple of weeks than to pay out of pocket in the US. And many European healthcare systems tend to rank better than the US.

So it seems that the procedure can be done for less, maybe even for less than Medicare costs; the "dollar store quality" doesn't seem to come from the inexpensiveness.

[throwayEngineer]

Then your issue is likely with the extraordinary wages of Physicians in the United States.

The American Medical Association is the 3rd biggest lobby in the United States.

Physicians/surgeons in Europe do not make 300k/year.

[coredog64]

It’s not just doctors though. It’s doctors, nurses, PAs, hospital admins, etc. Everyone in that chain is going to have to take a pay cut* to get prices down to where the rest of the American public feels it’s fair. We’re also going to have to change the way we design hospitals and remodel current ones: US hospitals are built and staffed for private rooms. That’s going to have to give way to wards, with private rooms being reserved for medical necessity.

*The staff that manages insurance payments etc. will lose their jobs.

I’m not making a value judgment, just stating facts. This is going to be a tough row to hoe once politically attractive groups start mobilizing members to fight the change.

[hurryskurry]

I agree that physicians wages may be part of it. The AMA keeps a tight control on how many physicians are produced to keep fees high, but physician incomes haven't really been increasing. Doctors, I believe, generally make less now adjusting for inflation than they did in the 90s, which I've heard described as like some kind of golden age or something.

[Gatsky]

This isn't really the issue. I live in a country where physicians/surgeons make more than that on average, and we have pretty good free healthcare.

As always, singling out some part of a hugely dysfunctional system for criticism is quite unhelpful.

[conanbatt]

This is part of it , but physician salaries are 10% of the spending. This could be fixed by laxing licensing laws, allowing doctor immigration and reducing the cost of education.

But only one of many reforms needed.

[mercutio2]

I’m not sure where you got the number 10% from. Perhaps you’re dispatching heavily on the word “salary”, when most doctors and surgeons operate as small businesses, and don’t earn much income directly as salary?

Doctor plus nurse compensation dominate every chart I’ve ever seen of US medical spending.

People like to imagine it’s all the fault of insurance companies, pharmaceuticals, and malpractice; those are collectively a tiny fraction of US spending. It’s mostly labor costs.

The US is rich, health is a good with infinite demand. It’s hard to reduce costs in that context.

[conanbatt]

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

This one shows 20%, though when you say clinical services you include nurses, mid levels and medical assistants, though it doesnt explain how much of the hospital spending goes to providers, so higher.

Also, add that the amount of debt physicians graduate with, does not make it a very healthy career, particularly in primary care (where you could do most of cost control).

PCP's have high burnout and suicide rates, work 50+60hour weeks until their 50's , etc. There is nuance to the analysis of provider spending.

In any case, i can assure you there are plenty of marginally useless rank-file employees that exist thanks to the current regulatory framework.