[programmertote]

Exactly the way it works in a SE Asian country I grew up. The private and public hospitals have price quotes on different procedures and it's for everyone to see. The comments above using Boglehead's quote as a justification of why medical pricing has a lot of variance is mostly a lie. My wife, who is a doctor trained in our home (SE Asian) country and is doing her residency in the US, and I were just laughing at the fact that it's much, much more expensive to get an X-ray here in the US than it is in our country (which costs ~$4 at most). Here, there's no price list for procedure as simple as taking an X-ray.

Hospitals, doctors, insurance companies and pharma companies are all scamming the US population. Every evening, my wife and I watch TV (WNBC to be exact) and we see many commercials from hospital networks, insurance companies and drug companies. This reminds us everyday that medicine and healthcare is commercialized to the max in this country and the only way from here is downhill. We both don't hope to retire in the US; when we grow old, we will go back to our home country and live there in the hope of getting much more affordable (and yet, of more or less similar quality) medical treatments.

[AtlasBarfed]

Have you seen radiologist salaries?

It's a scam, Jim.

There are four pigs at the trough of US health care:

Insurance Device/Drug Lawyers Doctors

Everyone points the finger at other people and desperately fight to maintain their bloated share of the bloating pie.

Unfortunately doctors are not your friends in hospitals. They are trying to get billing.

[bobthepanda]

This is also a side effect of how much medical education costs in the US, though. Education is so expensive that medical professionals have to have eye-watering salaries to have any hope of paying it off.

Of course, this is partially the fault of the AMA restricting medical school slots, but also is part of the general trend of tertiary education in the US being ridiculously expensive.

[travisoneill1]

And also partly the fault of the government paying whatever schools ask for in loans.

[programmertote]

Indeed! As she was applying for residency programs, my wife briefly entertained the thought of becoming a radiologist because boy, they made a load of money for 8am-2pm work! We both are 100% self-aware that healthcare industry has a lot of bad actors including doctors, pharma companies, hospital admins, lawyers and pretty much everyone involved.

If residents cry about 60+ hours/week of work during the first year residency, I don't pity them much. First of all, the hours aren't really that bad even for a hospital in metro NY area (speaking from my wife's residency experience so far). In our home country, residents have it worse; my wife had night float EVERY THREE DAYS over there. In the US, it's at most four times a month! Second of all, the "grueling hours" are for the first year of residency (in fact, during those hours, there's not much happening especially in night floats, so you can get decent sleep) and after that, things got much, much better. Sacrificing just one year and paying exorbitant exam/school fees--in the region of ~$250K total--to make $250K as starting salary is TOTALLY WORTH it. If any of the doctors complain that they are debt-laden, they are either fiscally irresponsible or are simply exaggerating. They can repay $250K debt + interest in less than 5 years if they really want to. Of course, it's much easier to use these (debt and hours/years sacrificed) as excuses to justify their pay.

If the doctors are true and honest, they should be advocating AMA to relax the residency and medical school requirements. No more than five years total (no undergrad necessary) is needed to treat garden variety problems. Then each specialty/fellowship can take however long it needs to take. But AMA and its leechers (KAPLAN, ECFMG, USMLE, FSMB, etc.) won't allow that because they make loads of money from exam and preparation fees. Everything about healthcare is business now and whether it is good or bad depends on one's moral compass (and how strongly one feels about capitalism).

[perl4ever]

"advocating AMA to relax the residency and medical school requirements"

People talk about the constriction of supply of doctors, but aren't NPs and PAs doing everything these days anyway?

[TheCoelacanth]

The crazy work hours for residents are basically a protectionist racket to keep wages for doctors high.

They don't serve any rational purpose in medical education and just serve as barrier to entry.

[sam36]

> Everything about healthcare is business now

https://i.imgur.com/t22Lg5Y.jpg

[roenxi]

> that medicine and healthcare is commercialized to the max

There are commercial problems but it isn't totally fair to call a system where nobody can tell you a price 'commercialised to the max'.

The problem isn't the commerce, the problem is that someone has set up a regulatory framework where people don't pay for services.

A perspective that could be important when it comes to American healthcare: insurance doesn't on average pay out more than people pay in. My understanding is traditionally insurance actually pays out exactly what people pay in and profits off the float. 'Having insurance' doesn't make anything more affordable for anyone, it is more like hiring someone else to track the savings for you and a few conveniences massaging risk through time.