U.S. Physician Pay at Issue in Health Care Reform Debate
Many health care economists maintain that the "partisan fight" over whether to "force cuts in prescription drug prices and insurance company profits" to expand health insurance to more U.S. residents is a "distraction from a bigger problem: the relatively high salaries paid to American doctors, and even more importantly, the way they are compensated," the New York Times reports.
Salaries for U.S. physicians are two to three times higher than salaries for physicians in other industrialized nations.
According to surveys conducted by medical practice management groups, U.S. physicians on average have annual salaries of $200,000 to $300,000, and specialists on average have annual salaries of more than $400,000. Physicians in Europe in 2002 on average had annual salaries of $60,000 to $120,000, according to a survey conducted in 2004 by the British government.
In addition, most U.S. physicians "are paid piecemeal, for each test or procedure they perform, rather than a flat salary," which provides them with "financial incentives to perform procedures that further drive up overall health care spending," the Times reports. Physicians also receive limited reimbursements for preventive care and "cognitive services," such as research into alternative treatments or advice provided to patients that does not involve medical treatment.
Alan Garber, a practicing internist and the director of the Center for Health Policy at Stanford University, recommends that U.S. physicians receive flat annual salaries, as well as bonuses based on the health of their patients.
Peter Bach, a pulmonary physician at Memorial Sloan-Kettering Cancer Center and a former senior adviser to CMS, said, "I don't have a view on whether doctors take home too much money or not enough money. The problem is the way they earn their money" (Berenson, New York Times, 7/29).