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Doctor Fees Major Factor in Health Costs, Study Says
New York Times ^ | September 7, 2011 | ROBERT PEAR

Posted on 09/08/2011 6:00:05 AM PDT by reaganaut1

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.

Such higher fees are driving the higher spending on doctors’ services, the study concluded.

Ms. Glied, an economist, was a Columbia professor before President Obama named her assistant health secretary for planning and evaluation in June 2010. She said the paper, based on academic research, did not reflect the official views of the administration or the White House.

But the journal said the findings suggested that, as policymakers struggle to find ways to restrain health spending, they might consider doctors’ fees. Doctors have generally been excluded from recent cost-cutting proposals because under existing law, Medicare, the federal insurance program for older people, will reduce their fees by 29.5 percent on Jan. 1. In addition, many states have frozen or reduced fees paid to doctors treating poor people under Medicaid.

(Excerpt) Read more at nytimes.com ...


TOPICS: Business/Economy; Culture/Society
KEYWORDS: doctors; healthcare
Liberals will convince themselves that if they cut Medicare and Medicaid reimbursement rates, doctors will work as many hours as before. When the doctors stop accepting Medicare patients and treat only the privately insured, liberals will try to force doctors to accept Medicare patients. When doctors quit practice altogether, what will the liberals do?
1 posted on 09/08/2011 6:00:09 AM PDT by reaganaut1
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To: reaganaut1

Insurance costs have been going up by double digits for years, yet doctor reimbursement rates don’t even keep up with inflation. Something doesn’t meet the smell test here.


2 posted on 09/08/2011 6:03:11 AM PDT by Kozak ("It's not an Election it's a Restraining Order" .....PJ O'Rourke)
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To: reaganaut1

From everything I’ve read, doctors lose money on Medicaid and Medicare, and have to wait months and months to get whatever the government decides to pay. Maybe they have to charge higher fees to everyone else to make up what they lose treating patients for the government.


3 posted on 09/08/2011 6:04:38 AM PDT by cbvanb
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To: reaganaut1
Doctors are paid higher fees in the United States than in several other countries

Maybe because they work in nice offices as opposed to banana shacks or alleys?

4 posted on 09/08/2011 6:05:00 AM PDT by Puppage (You may disagree with what I have to say, but I shall defend to your death my right to say it)
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To: Kozak
Sometimes the Obots demonstrate how crude and low class they are by suggesting that Americans should be satisfied with third-world standards of medical care.

This is one such instance ~ OF course we pay doctors more ~ TO GET THE BEST!

5 posted on 09/08/2011 6:06:05 AM PDT by muawiyah
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To: reaganaut1
When doctors quit practice altogether, what will the liberals do?

Blame it on Bush?

6 posted on 09/08/2011 6:06:54 AM PDT by unixfox (Abolish Slavery, Repeal The 16th Amendment!)
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To: Puppage
says a new study by two Columbia University professors, one of whom is now a top health official in the Obama administration.

Oh, ok then.

No bias or agenda here. Let's just move along, folks.

7 posted on 09/08/2011 6:07:05 AM PDT by Puppage (You may disagree with what I have to say, but I shall defend to your death my right to say it)
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To: Kozak

i’m not sure about Australia’s degree of government intervention
into the medical system

BUT I would expect this result. The more government interferes in
the free market,the lower the fees to the physician. This reduces quality
of physicians. Since physicians take 4 years college, 4 years med school,
3 years residence before they start earning their real wage, I would expect
a high salary. At least $100,000.

Milton Friedman would have a simple explanation.


8 posted on 09/08/2011 6:07:38 AM PDT by preamble
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To: reaganaut1
Here's a novel idea: How about getting the government and tort lawyers out of the business and let doctors decide how to best practice medicine and the free market decide how much to pay them?

Wanna bet costs drop significantly?

9 posted on 09/08/2011 6:08:52 AM PDT by Zakeet (If it ain't broke, the Wee Wee will fix it until it is)
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To: reaganaut1
Most of the fees go to malpractice insurance which the lawyers cause. Tort reform laws would probably cut medical costs in less than half. Get rid of the Pharmapirates and see prices of health care be quite reasonable.
10 posted on 09/08/2011 6:08:52 AM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: reaganaut1
“..what will the liberals do?”

They will be very happy ...as all that money will be available for them to play with in their bureaucracy. Basically ObamaCare works out to be a jobs program for DC bureaucrats

11 posted on 09/08/2011 6:10:17 AM PDT by mo
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To: reaganaut1
There's always going to be finger pointing -- it's true, doctor's fees are a small part of health care costs. But so are drug costs, hospital costs and insurance costs. And all of the major participants -- the AMA, drug companies, hospitals, and insurance companies supported Obamacare. (Except patients!)
12 posted on 09/08/2011 6:12:56 AM PDT by Sooth2222 ("Suppose you were an idiot. And suppose you were a member of congress. But I repeat myself." M.Twain)
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To: reaganaut1

Just remember, for every doctor who qualified out of medical school with an “A” or “B” average grades, there are several who just got in under the line and barely made it, but yet as lousy as they are, are still called doctors. If the “good” ones quit, we are left with the ones that do not know their right from their left hand and you will pay for it in the long run.


13 posted on 09/08/2011 6:14:26 AM PDT by RetiredArmy (EVERY knee shall bow and EVERY mouth shall say: Jesus Christ IS LORD!!!!)
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To: reaganaut1

Yeah right. My good friend and back surgeon pays more than $250,000 per year for his medical malpractice insurance, although he has never had a claim. Think of that $1,000 every working day before you have seen your first patient. I’m sure countries with socialized medicine disallow tort claims against their government doctors. The only small ray of sunshine that socialized medicine is that it would bring mass bankruptcies of personal injury lawyers.

I’d sooner believe this study if it was conducted by Cuda’s health ministry and published by The Star Weekly.


14 posted on 09/08/2011 6:14:57 AM PDT by deltabean (Born free, die free.)
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To: reaganaut1

Would YOU want to be operated on by a doctor who qualified for food stamps?


15 posted on 09/08/2011 6:17:15 AM PDT by Buckeye McFrog
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To: reaganaut1
They cost more because they are better.

People come here from around the world to get the best care.

But the purpose of Obamacare is not health care.

The purpose is to kill off all the old white people ASAP to accelerate their replacement by illegals.

16 posted on 09/08/2011 6:21:50 AM PDT by E. Pluribus Unum (Palin is coming, and the Tea Party is coming with her.)
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To: reaganaut1
When doctors quit practice altogether, what will the liberals do?

They will work hard to ultimately implement a comprehensive 'lifelong employment preparation program’ (LEPP) at the federal level which will include, but not be limited to:

1) Mandatory ‘aptitude’ tests for all children at various stages of their state-run primary and secondary education/indoctrination.

2) .Secondary school which assigns each student a required course of study based on results of primary-level aptitude tests.

3) ‘Free’ mandatory college education or vocational/technical training, with courses of study dictated for each individual, based on results of secondary-level aptitude tests.

4) State-mandated professions/fields of employment for all. No one will be allowed to seek or accept employment in any area outside their state-mandated profession/trade.

Does that sound about right?

17 posted on 09/08/2011 6:22:02 AM PDT by WayneS (Enlightened statesmen will not always be at the helm. -- James Madison)
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To: mountainlion
Tort reform laws would probably cut medical costs in less than half.

This brings up an interesting argument....

First....let's start with: true, actual, effective tort reform is enacted.

Does it follow that: medical malpractice insurance companies will pass the cost decreases DIRECTLY to the insured in the form of radically decreased premiums (say....over 80% decrease)?

And if so, will the doc then pass along this radical cost decrease in his overhead directly to patients in the form of drastically lowered medical bills for them to pay?

I've a sibling who is in the medical community. When I posed this argument to him, his response was "fat chance".

So...tho tort reform is needed, perhaps the cost savings from it won't even reduce down to patient level??

18 posted on 09/08/2011 6:23:55 AM PDT by Logic n' Reason (The stain must be REMOVED (ERADICATED)....NOW!!)
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To: Kozak
It's the cost of hospitalization, not the cost of the "doctors' bills."

A simple thing--pay your own office visits. You pay your own cabfare, groceries, haircuttings. You'd see the doctor's basic office visits price drop quickly because of paperwork reductions. You'd see docs happy to accept a lower fee for the convenience and the increase in their own productivity.

But hospitalization is not so easy. People take the infrastructure that is a hospital for granted, and don't understand all the maintenance, admin, nursing, tech, recovery room, beds, machinery...that's big $$$.

It's rich...these tenured parasites telling docs they're greedy for charging $100 for a $35 office visit, when the other $65 goes to support tenured parasites in one way or another, including the most pernicious of parasites...the trail lawyer.

Why not just pay the doc $35 and dispense with the rest?

19 posted on 09/08/2011 6:25:52 AM PDT by Mamzelle
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To: preamble

These economists are making the case for price controls, a fundamental element of government control of any industry, especially health care. The market should determine the appropriate prices for health care services including doctor fees. These economists are comparing US medical care to government controlled health care having price controls. Some have argued that supply control has enabled high doctor fees in the US. I support reducing artificial restrictions on supply of physicians. Price controls will only bring shortages. Other countries have physician shortages especially at the specialist level. In addition, physicians game the system to bypass the price controls using tactics like forcing patients to come for multiple visits when a single visit would suffice.


20 posted on 09/08/2011 6:27:26 AM PDT by businessprofessor
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To: reaganaut1

Hey you stupid doctors who voted for and support der Fuehrer. You’ve been tagged by democrats as the cause of all their supposed woes with our health care system. Hope you all like the idea of being government employees, being told what to practice and when and where you will practice and how you will practice medicine. Morons.


21 posted on 09/08/2011 6:32:59 AM PDT by RJS1950 (The democrats are the "enemies foreign and domestic" cited in the federal oath)
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To: reaganaut1

American bureaucrats and college professors are more highly paid in the U.S. than their counterparts overseas, too. Pay cuts for these people need to be on the table!


22 posted on 09/08/2011 6:34:07 AM PDT by GadareneDemoniac
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To: reaganaut1

Notice they don’t factor in the cost of Malpractice ins.

Are the Taxpayers going to pick up the premiums for this ins. If not Docs will just stop accepting new patients.


23 posted on 09/08/2011 6:34:59 AM PDT by Marty62 (Marty60)
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To: reaganaut1

The authors had better be careful what they wish for. As doctors fees go down, older physicians will have a greater incentive to leave the profession. The physician population is already old; 40% of physicians are obver 55 years old. Numerous surveys have indicated that many physicians will leave the profession if 0bamacare is implementated. Because it takes 4 years of med school and 4-8 years of residency to train a physician (depending on speciality), medical schools will not be able to make up the shorfall any time soon. Meanwhile some 30 millions uninsured are expected to be newly covered under obamacare. It doesn’t take a genius to see that access and quality will be drastically reduced.


24 posted on 09/08/2011 6:37:53 AM PDT by grumpygresh (Democrats delenda est)
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To: reaganaut1; Mrs. B.S. Roberts

Let’s see..who exactly is telling us ALL ABOUT the evils of medicine in the USA? Professors of nothing worth knowing. Politicians. Bureaucrats seeking to justify their salaries. Armies of lawyers defending their “Awards”. Union Officials. Truck drivers. And millions of people not qualified to put a band-aid on a boo-boo.
Have any ACTUAL DOCTORS, those with REAL, LIVE patients posted their opinions.
When I have a medical issue, I want to see a doctor, not some know-nothing who can accomplish nothing.


25 posted on 09/08/2011 6:42:11 AM PDT by CaptainAmiigaf (NY TIMES: "We print the news as it fits our views")
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To: Logic n' Reason
Malpractice companies would have to change with competition. To say that the whole medical industry is corrupt is painting with too wide of a brush. Doctors do have compassion and actually do work for some that can not afford Dr. fees. Insurance companies do have to be competitive and even Farmers Group has a class action law suit for overcharges.
26 posted on 09/08/2011 6:58:12 AM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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To: grumpygresh

If your scenario is correct, and I think it is, look for the regime to panic and begin “crash training” doctors just as they did in the USSR.

“Oh, you washed out of teacher college? OK, you’re a doctor now!”


27 posted on 09/08/2011 6:58:31 AM PDT by Buckeye McFrog
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To: Puppage

Maybe you should have read the rest of the article — Last I knew none of these countries had banana shacks or alley health care - although we do have some of that here, specially if you are poor..

On average, primary care physicians in the United States received $186,582 in pretax income a year, compared with $95,585 in France and $92,844 in Australia. When it came to orthopedic surgeons, there was a similar disparity, with US surgeons taking in an average of $442,450 a year, compared with $154,380 in France, $208,634 in Canada and $324,138 in the UK.


28 posted on 09/08/2011 6:58:35 AM PDT by darwin666
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To: darwin666
On average, primary care physicians in the United States received $186,582 in pretax income a year, compared with $95,585 in France and $92,844 in Australia. When it came to orthopedic surgeons, there was a similar disparity, with US surgeons taking in an average of $442,450 a year, compared with $154,380 in France, $208,634 in Canada and $324,138 in the UK.

Guess that sorta explains whey the best French, Aussie and Canadian doctors are all working here. The ones left back home are all earning less because they are the "AA" ball players.

Sort of like how the Pittsburgh Pirates did not have the money to re-sign Barry Bonds and Bobby Bonilla, so we all ended up having to watch guys like Emil Brown and Kevin Polcovich fumbling around on the diamond.
29 posted on 09/08/2011 7:03:27 AM PDT by Buckeye McFrog
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To: reaganaut1

So what do they earn after taxes, and more importantly, after having paid their enormous malpractice insurance fees to protect against greedy trial lawyers and their scamming clients?


30 posted on 09/08/2011 7:08:59 AM PDT by meyer (We will not sit down and shut up.)
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To: reaganaut1

They lost me at “a survey conducted by two Columbia professors”. Nuff said.


31 posted on 09/08/2011 7:10:18 AM PDT by Georgia Girl 2 (The only purpose of a pistol is to fight your way back to the rifle you should never have dropped.)
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To: reaganaut1
When doctors quit practice altogether, what will the liberals do?

Same thing National Socialists always do - load 'em in boxcars and send them to "camp".

32 posted on 09/08/2011 7:10:25 AM PDT by meyer (We will not sit down and shut up.)
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To: darwin666
On average, primary care physicians in the United States received $186,582 in pretax income a year

So what? They've earned it, IMHO. Our healthcare system has issues, no doubt, but it's the very best in the world.

33 posted on 09/08/2011 7:12:04 AM PDT by Puppage (You may disagree with what I have to say, but I shall defend to your death my right to say it)
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To: Zakeet

We also need to consider loosening the stranglehold the AMA has on the production of new doctors, and the regulations on who is allowed to practice medicine.
For example, a lot of medical work could be handled by Nurse Practitioners.


34 posted on 09/08/2011 7:14:37 AM PDT by Little Ray (FOR the best Conservative in the Primary; AGAINST Obama in the General.)
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To: RJS1950

If you think your doctor is a moron you should look for a new one.

This article if filled with misinformation. A real moron is someone who believes everything they read in the New York Times.

Insurance, Medicare and Medicaid have been limiting reimbursement for physicians. They may send a bill for $100 but sometimes only get reimbursed $17. or less from the government or insurance company. Add to the mix the millions of illegals and the underclass who pay nothing for their health care. Our high health care costs are subsidizing them.


35 posted on 09/08/2011 7:31:43 AM PDT by ladyjane
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To: Little Ray
For example, a lot of medical work could be handled by Nurse Practitioners

That's already the case, along with Physician Assistants.

36 posted on 09/08/2011 7:41:49 AM PDT by Puppage (You may disagree with what I have to say, but I shall defend to your death my right to say it)
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To: reaganaut1
Doctors are paid higher fees in the United States

Note to the NYT's, everyone in the United States gets paid more then other countries! Of course this hurts women and children the most.....................asshxxxx

37 posted on 09/08/2011 7:52:38 AM PDT by Lockbox (`)
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To: reaganaut1

Don’t blame the doctors, only a small fraction of their fee is for salaries and normal overhead. Thebulk of the cash goes to insurance companies and lawyers. I personally know of at least 3 doctors and 1 dentist who no longer practice because of insurance premiums.


38 posted on 09/08/2011 8:05:55 AM PDT by BuffaloJack (2012 is the opportunity to get rid of Obama and his Empire of Lies.)
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To: reaganaut1

I wonder how malpractice insurance premiums compare, and what the courts in the foreign countries listed allow for limits on malpractice claims. This would seem to be a key part of the “net cost/net income” determination.


39 posted on 09/08/2011 8:18:16 AM PDT by NEMDF
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To: reaganaut1

Totally asinine, like all liberal tripe. Lawyers get paid a lot more in the US than in most other countries, but I don’t hear liberals jumping on that bandwagon.

Average physician reimbursement rates for a simple new patient visit are around $40 - $50 dollars. For advanced comprehensive new patient visits these numbers vary between $130 - $165. For return visits these numbers are $24-$35, and $100 - $125 respectively.

These numbers can vary a bit, dependent upon who the payer is, but these are the basic ranges. If you think running an office, with staff / nurse etc., paying malpractice, etc. is easy with these numbers, you haven’t thought enough about it. There’s no way, in my opinion, that you can do a good job with patients if you push them through with very short visits. It’s not fair to them, and it definitely doesn’t make you feel good as a doc. Thus, trying to make a profit by running a ridiculously high volume practice is not the answer.

As a doc, I don’t ever think of myself as better or brighter than other people in society, but I do believe that I made some pretty big commitments with my time and personal life over many years - including quite a bit of my youth - to become capable of doing a good job with patients. I’m very tired of being characterized as some sort of villain.


40 posted on 09/08/2011 9:35:43 AM PDT by pieceofthepuzzle
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To: ladyjane

You will note that it addressed doctors who voted for and who support his healthcare fiasco as morons. My doctor is the one assigned to me as my military healthcare provider and is great. What I said is a note of caution for all of those other doctors out there who do not support obama that they will be swept into this socialist scheme just as the moron doctors will.


41 posted on 09/08/2011 10:15:13 AM PDT by RJS1950 (The democrats are the "enemies foreign and domestic" cited in the federal oath)
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To: mountainlion
Malpractice companies would have to change with competition. Unprovable, but a hopeful dream.
To say that the whole medical industry is corrupt is painting with too wide of a brush. Doctors do have compassion and actually do work for some that can not afford Dr. fees. To use the term "doctors" without any idea of how many, what kind, or where they may be defeats the purpose of the argument. It trys to substitute "feelings" for facts.
Insurance companies do have to be competitive and even Farmers Group has a class action law suit for overcharges Uh...of course they do; they are "for profit" business entities. What these comments have to do with my original questions is beyond me....but thanks for the response anyway.
42 posted on 09/08/2011 10:21:27 AM PDT by Logic n' Reason (The stain must be REMOVED (ERADICATED)....NOW!!)
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To: reaganaut1

They’ll just import the doctors from India.


43 posted on 09/08/2011 10:24:42 AM PDT by dfwgator
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To: Logic n' Reason
You seem to be substituting feelings for facts also. You seem feel the whold medical system is corrupt. I know my doctor forgives many bills that poor people can not pay. you accused me of unprovable but hopeful dream... without any idea of how many and what kind. You have done the same with your statement of corruption. Farmers group was sued in a class action law suit so with changes in malpractice insurance they could also be sued over overcharging.
44 posted on 09/08/2011 10:43:14 AM PDT by mountainlion (I am voting for Sarah after getting screwed again by the DC Thugs.)
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