Reviews | The curious case of the overpaid American doctor

America’s extreme medical meritocracy has created a physician shortage.


The United States does not have enough doctors and the shortage contributes to the high costs patients pay when they go to the hospital.

In the mainstream debates surrounding our healthcare systems, the issue overlooked by both proponents of private, single-payer healthcare systems is the supply of physicians and their high salaries. These salaries end up contributing significantly to the financial costs that patients face.

To solve this problem, medical schools and medical associations in the United States must make the medical field more accessible to a wider range of students. In this way, we will be able to alleviate supply constraints, resulting in lower salaries and therefore overhead costs for patients.

Compared to other industrialized countries, the United States ranks lower in terms of physician supply – just 2.6 physicians per 1,000 patients. In contrast, most of the major economies in the European Union, like Germany and France, have almost double the number of doctors we have per 1,000 patients.

In addition, the Association of American Medical Colleges predicts that the United States will run out of 139,000 physicians by 2033. This is in large part due to high barriers to entry, such as an incredibly limited number of places in the hospital. medical schools and regulations that protect physicians from competition in the form of nurse practitioners and immigrant physicians.

With the complicated operation of our private insurance system, the shortage of American doctors is the best explanation for why they are overcompensated compared to their European counterparts. For example, doctors earn $ 138,000 in the UK, compared to $ 316,000 in the US.

Even if the United States were to establish a system in which Medicare would be the only insurer in the market, overall health care costs would still exceed those of other industrialized countries due to the high salaries that American doctors are accustomed to.

In a single-payer health care model, the U.S. government would have monopsony power over physicians, which could allow them to dictate the salaries physicians receive.

However, the supply curve for the number of physicians in the labor market is elastic. This means that the quantity of doctors in a market is sensitive to changes in wages. In other words, if the American monopsony used its market power to lower doctors’ salaries, then fewer people would want to become doctors, which would exacerbate the current shortage.

As a result, the monopsony would be reluctant to use its power to lower wages and shift the burden of that wages onto patients and taxpayers.

Now, many pre-med students would object to my characterization that they are only interested in becoming doctors for the money. But if doctors’ salaries suddenly collapsed, I think many STEM majors would reconsider the tough years of schooling.

Omar Mustafa, a second year UI student studying human physiology on the pre-medical path, said that due to the degree of difficulty and the intense competition to enter medical school, many applicants pre -medicals are dropping out of the program, depriving the health system of potential talent.

To alleviate these issues, there are a myriad of solutions we can adopt to increase the number of physicians in U.S. medical schools who could accept more students into their programs, with only 21,622 accepted into medical schools. last year.

The rest of the union should follow the lead of states like Iowa and allow nurse practitioners to open general practices to compete with doctors.

These recommendations will address the physician shortage we have in the current system and reduce costs for patients in a future single-payer system.


Columns reflect the views of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.


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