Even Surgeons Aren't Cutting It Anymore

It's pretty obvious the "fee for service" system doctors have enjoyed for decades, making many of them well-to-do and Republican in the process, is just about done for.

Not that health care is going to be cheaper thanks to the greedheads running both the hospitals and health insurance companies, but private practice doctors are going the way of home visits.

Another thing that will certainly happen is medical schools will no longer have limited spaces, which helped drive up doctors' annual salaries because the supply of doctors had been artificially limited, thus creating an artificial demand.

In other countries, there are still plenty of physicians, but they don't make the big bucks so many of them do here.

American physicians, worried about changes in the health care market, are streaming into salaried jobs with hospitals. Though the shift from private practice has been most pronounced in primary care, specialists are following.

Last year, 64 percent of job offers filled through Merritt Hawkins, one of the nation’s leading physician placement firms, involved hospital employment, compared with only 11 percent in 2004. The firm anticipates a rise to 75 percent in the next two years.

Today, about 60 percent of family doctors and pediatricians, 50 percent of surgeons and 25 percent of surgical subspecialists — such as ophthalmologists and ear, nose and throat surgeons — are employees rather than independent, according to the American Medical Association. “We’re seeing it changing fast,” said Mark E. Smith, president of Merritt Hawkins.

We all knew that was going to happen. Let's see: It appears we have a pattern here of the gutting of professions. Lots of legal work is being "outsourced" to other countries; teaching in all grade levels, including college, is under relentless assault; and now the medical profession, which seemed to be resistant to "globalization" and other neoliberal crap, seems to be headed toward the same fate.

After all, the pie is only just "so" big, and we can't allow the billionaires to share any more of that wealth and provide more crumbs from the crust to us peons.

The gradual removal of the medical profession from the high middle class or top five percent of income earners is far more likely than we ever get single-payer in this country. This despite more and more support for single-payer from many doctors.

The US Health Care System is a Mess

Not only because fewer people have access to it because of the lack of health insurance, but because of private health insurance, costs are through the roof.

The simple fact of the matter is the medical profession is going to have realize the gravy train they have ridden on for decades is just about done. There is no doubt someday there will be some kind of national health care plan, and that is going to cut on their profits. Well, that is too bad. They will soon not be able to make the extravagant salaries for which they have become accustomed.

Of course many doctors now are not making the big bucks, but fewer still won't be making them.

Ditto for the insurers. Ditto for the pharmaceutical manufacturers. Ditto for for-profit hospitals.

This insanity of overcharging for basic services has GOT to stop.

Whether directly from their wallets or through insurance policies, Americans pay more for almost every interaction with the medical system. They are typically prescribed more expensive procedures and tests than people in other countries, no matter if those nations operate a private or national health system. A list of drug, scan and procedure prices compiled by the International Federation of Health Plans, a global network of health insurers, found that the United States came out the most costly in all 21 categories — and often by a huge margin.

Americans pay, on average, about four times as much for a hip replacement as patients in Switzerland or France and more than three times as much for a Caesarean section as those in New Zealand or Britain. The average price for Nasonex, a common nasal spray for allergies, is $108 in the United States compared with $21 in Spain. The costs of hospital stays here are about triple those in other developed countries, even though they last no longer, according to a recent report by the Commonwealth Fund, a foundation that studies health policy.

That's because health care became a for-profit enterprise, not something that is a public good.

It needs to be seen as a public good, like police protection and education, and the profit motive needs to be scrapped.