Medical professionals and their insurers frequently suggest that the high cost of medical care in this country is due to frivolous medical malpractice cases. Former Congressman and former Secretary of Health and Human Services Tom Price claimed that limiting medical malpractice cases would save consumers “hundreds of billions of dollars” every year. Needless to say, there is great disagreement about the role medical malpractice cases play in medical spending in this country. A clearer culprit for the cost of medical care in the United States is, according to a recent Politico article, high doctor salaries.
The author is a think tank director. He points out that Americans pay twice as much for comparable medical care than citizens of any other industrialized country and don’t get as much for it in terms of patient outcomes. He claims that we spend $100 billion more every year than we should because American doctors earn so much more than their counterparts in other modern, industrialized nations.
The much higher salaries are due to a couple of factors. The first is that doctors control the supply of doctors. Doctors have made sure that only those who have completed an accredited residency program in the United States may be licensed to practice medicine here. By limiting the number of slots in residency programs, doctors have made sure that there will be a perennial shortage of doctors and no price competition to attract patients.
A second factor is that we produce far more specialists than we do general practitioners when it is general practitioners whom we need most desperately, especially in underserved rural areas. This means that many procedures, which could and should be performed by a generalist, are instead performed by specialists, who charge substantially more for the procedure than would a generalist. Fewer specialists would also be good for doctors, who often incur large amounts of debt while participating in specialty residency programs.
The author points to a number of trends which may make care more affordable and available in the future, including the use of nurse practitioners and laws which allow foreign-trained doctors to practice medicine under the supervision of licensed doctors. He also suggests ways to increase the supply of doctors and thereby to lessen the economic clout which drives high physician salaries.
While we like our doctors and value the good care we receive from them, their salaries could be lower without being unfair to them and at the same time make things better for the rest of us.
Physicians, stop blaming high medical costs on the patients whom you injure. You are a far greater driver of high medical costs than these injured patients.
