Doctor Fees Major Factor in Health Costs, Study Says

[onpatrol98]

By ROBERT PEAR
Published: September 7, 2011

WASHINGTON — Doctors are paid higher fees in the United States than in several other countries, and this is a major factor in the nation’s higher overall cost of health care, says a new study by two Columbia University professors, one of whom is now a top health official in the Obama administration.

“American primary care and orthopedic physicians are paid more for each service than are their counterparts in Australia, Canada, France, Germany and the United Kingdom,” said the study, by Sherry A. Glied, an assistant secretary of health and human services, and Miriam J. Laugesen, an assistant professor of health policy at Columbia.

The study, being published Thursday in the journal Health Affairs, found that the incomes of primary care doctors and orthopedic surgeons were substantially higher in the United States than in other countries. Moreover, it said, the difference results mainly from higher fees, not from higher costs of the doctors’ medical practice, a larger number or volume of services or higher medical school tuition.

http://www.nytimes.com/2011/09/08/us/08docs.html?_r=1&ref=politics

[WhiteTara]

1. Doctor's fees are high because of the incredible premiums

charged for malpractice insurance. Some have to quit practicing because of insurance premiums. Just another fake attack by TPTB.

[dkf]

7. Is malpractice insurance related in anyway to tort reform or are they completely separate?

[WhiteTara]

9. Hand in glove.

Of course the insurance companies want to cap what the claimant can be awarded, but the real problem is the cost of malpractice insurance.

[jberryhill]

14. It's related to not having national health insurance

Do you know what is the largest cost component of awards sought by malpractice plaintiffs?

The cost of corrective and/or continued healthcare and rehabilitative therapy.

It's a circular problem, not a linear one.

The SINGLE most important thing that would reduce malpractice insurance is a national health insurance system.

[slipslidingaway]

15. Exactly! n/t

[eridani]

19. Here, yes. In sane, civilized countries, no.

In Japan, malpractice insurance comes automatically with the monthly medical association fee, at $100. Journal included. Malpractice fees vary from $1000 to $3000 a year elsewhere.

So why do people in those countries not sue their doctors all the time? Because health care is a guaranteed human right in those countries, and therefore people aren't looking for deep pockets to help pay extra large health care expenses from bad outcomes, or even actual malpractice.

[jberryhill]

21. Correct, and...

Consider the fact that from the moment your doctor touches you, the doctor's malpractice insurance becomes the primary coverage in the event that something goes wrong.

So, if your health insurer determines that there are consequences from malpractice, and the doctor's malpractice insurer says it wasn't, then you become a pawn in a proxy suit by your insurer against the doctor's insurer, in order to establish who should cover you from then on.

It's the same thing that goes on between auto insurers and health insurers.

People don't realize that most lawsuits aren't really filed in order to establish some legal point between the parties, but are motivated by a contest between insurance companies over who is going to pick up the tab for something.

[dflprincess]

2. At least doctors provide a service

unlike the health insurance companies that "our" elected representatives are so anxious to protect.

[leftstreet]

3. Ah Doctors...come take your place under the bus

Big Insurance and Big Pharma are in the driver's seat

[Firebrand Gary]

4. Physicians pay is not the problem, the problem IS malpractice insurance.

AND profit margins for medical groups and hospital facilities.

[Go2Peace]

17. What is unclear about physician pay being double? That's net *after costs*

http://www.medpagetoday.com/PracticeManagement/Reimbursement/28391

"The average income of a primary care physician practicing in the U.S. is $186,582; Australian and French primary care doctors earn about half of that.

U.S. orthopedic surgeons earned about $442,450 per year, followed by the $324,138 earned by British orthopedic surgeons. French orthopedic surgeons are at the low end and earn about $154,380 annually."

[Mojorabbit]

18. I found it weird they would pick primary docs

instead of plastic surgeons, cardiologists, neurologists as those are the ones making huge bucks. No one has anything to say when CEOs who probably have less education make ten times this much.
Yes, they are going to throw the docs under the bus nexct.

You have seen it done with teachers and all manner of union jobs that used to generally be considered high prestige and important to society. Firefighters and Police jobs also under seige.
It is kind of freaky. My brother in law makes more than my husband who is a family doc and he has no where near the responsibility nor hours my husband puts in. He works for a food service company...

[Cassandra]

24. Other countries pay for medical schools.

[SmileyRose]

5. Doctor fees could be higher for all I care.

I don't begrudge a doctor (a WORKER) the option to get the most money for their labor that they can. It does bother me quite a bit that the doctor who tells me my health and well being depends on a diagnostic test that costs $6000 actually owns the machinery and the facility it will be done at.

[tblue37]

6. In addition to high premiums for malpractice insurance, most doctors

owe enormous amounts in student loans, because unlike other civilized countries, we do no subsidize their training.

My daughter left medical school owing $212,000 in student loans, and that is not at all uncommon! If she is not going to be able to earn fairly decent wages, then how will she pay off those loas?

She just finished her ER residency this year (and has started a second residency).

During residency, doctors do not make much money, so they usually have to defer their loan payments until they complete their residency. During that time, those huge amounts are accruing interest, so they ultimately have to pay even more.

Medical school is no walk in the park, and neither is residency. Add the huge loans and malpractic insurance premiums to that, and I think I can see why doctors charge high fees.

[onpatrol98]

8. Now that is definitely the truth...

[dkf]

10. Chicken and egg...they charge so much because they know the doctors will be earning a lot.

[BadgerKid]

13. Not unlike businesses, passing costs on to consumers. n/t

[Dreamer Tatum]

23. No, malpractice insurance is high due to the cost of litigation. nt

[eridani]

20. +10 n/t

[applegrove]

11. When you walk around the grounds of a hospital in Canada you see some pretty

fancy cars owned by doctors. They are not hurting here in Canada.

[KT2000]

12. I know - let's make enemies

out of everyone working person on a rotating basis. even numbered Mondays: Teachers odd numbered Mondays: postal workers even Tuesdays: nurses
odd Tuesdays: doctors etc. etc. even and odd Wednesdays: all government workers etc. etc.

[physioex]

16. Actually....

The biggest factor is the for profit corporations that control the systems and management pay......

[amborin]

22. the Obama admin has used flawed studies before;

they relied on a super flawed Dartmouth study concerning medical care for the elderly

ny times reported on that both before and after it was revealed to be flawed