Is there such a thing as a poor doctor?

Published 11:47 pm Wednesday, February 19, 2003

By By Lloyd Albritton
I hear a lot people complaining these days about the mega-incomes of sports stars and movie stars. Not me! When I consider the huge revenues generated by the entertainment industry, I do not see anything wrong with industry stars negotiating all they can get from their masters. If they were not worth that much money I don't believe they'd be getting it. I think the corporate bigwigs only agree to pay the big bucks because the stars draw them in-the big bucks, that is. And that's OK by me. The fact that they can afford to pay such huge salaries and bonuses to their stars implies that the money is there for them to pay. If ownership and management has to pay out more, it only means that they will pocket less. Since all these people are presumably filthy rich anyway, before and after the bonuses, why should it matter to me how they split up the loot? I just don't care! When ticket prices get so expensive that I can't afford them anymore, I will care, and I'll quit buying tickets. If enough of my fellow sports and movie fans share this same sentiment, there will be less loot for the moguls to split up and they will be forced to lower their ticket prices, their salaries and their bonuses. This is nothing but your basic supply-and-demand stuff.
Now can we talk about the health care industry for a moment? According to the Department of Labor's Bureau of Labor Statistics, the top 20 highest-paying professions in the U.S. are:
(1) Surgeons
(2) Obstetricians and gynecologists
(3) Anesthesiologists
(4) Internists
(5) Pediatricians
(6) Psychiatrists
(7) Family and general practitioners
(8) Dentists
(9) Chief Executives
(10) Airline pilots, copilots and flight engineers
(11) Podiatrists
(12) Lawyers
(13) Optometrists
(14) Computer Information Systems Managers
(15) Physicists
(16) Air Traffic Controllers
(17) Petroleum Engineers
(18) Nuclear Engineers
(19) Judges
(20) Marketing Managers
You will note that the top eight job titles in the above list are doctors. Movie stars and athletes are not even in the top 20!. Doctors work long, hard hours and their educational requirements are extensive (and expensive!) and most doctors are possessed of an exceptional intellect. Doctoring also incurs a lot of business overhead. All those modern buildings and medical equipment doctors need to practice their craft do not come cheap, and neither do nurses and other medical staff. Outrageous malpractice insurance premiums have also become a significant cost of being a doctor.
Still, these are all business costs. The above report reflects net personal income, that is, what the doctor takes home in his pocket at the end of the day. This report also reflects The Law of Supply-and-Demand. I have seldom visited a doctor's office that was not filled with waiting patients and I have never heard a patient demand to know in advance what the visit was going to cost. If I owned a business with a lobby filled with waiting customers who never questioned my price, I would charge a lot for my services too. In fact, I'd keep raising my prices until my customers started to balk.
The cost of a hospital stay these days is also mind-boggling. Again, I am not ignorant of the high cost of hospital equipment and staffing. When medical professionals explain to me all the reasons why hospitals cost so much, it seems to make sense, but afterward I still find it hard to grasp that all the various tools and instruments a hospital requires should be so expensive. For example, does it really cost that much to manufacture a kidney dialysis machine? And what about those infamous fifty-dollars aspirins we hear so much about?
Pharmaceutical manufacturers are also raking in profits that would shame the corner dope peddler. Our government has long favored pharmaceutical manufacturers with protective patents on new drugs, a long period when they can legally charge outrageous prices on the premise of recovering their research and development costs.
There are 285 million people in America today. According to Dr. Mark Pauley, a research associate at the University of Pennsylvania Wharton School of Business, forty million Americans are not covered by health insurance. Dr. Pauley's research indicates that about half of these uninsured people, i.e., 20 million, can afford health insurance premiums, but elect to spend their hard-earned money in other ways. The remaining 20 million uninsured represent just 7% of the population.
This might explain why there has not been much urgency on the part of government to address this social issue. The problem is further softened by the fact that, despite the horror stories we have all heard, uninsured patients are not left out in the cold streets to die in this country, but will generally receive about half the health benefits of an insured person-at no cost to them. Dr. Pauley further opined that the number of uninsured Americans can only increase as more and more people throw up their hands in frustration and choose to forego the extraordinarily high and increasing cost of health insurance, which is usually accompanied by reduced policy benefits.
I believe America does indeed have the highest quality of health care in the world. But, as the cost of this superb health care system continues to escalate, it begins to mirror our legal system, where all men are deemed equal, but some are more equaler than others. Health care should not be a social luxury, but should be just as much an American right as police and fire protection and the public highways and byways. We simply cannot continue to base our entire health care system on greed and avarice and the inalienable right of doctors and pharmaceutical and insurance executives to be rich. When the current seven percent of the uninsured population grows to, say 20-30 percent, then the problem of unaffordable health care costs will no-doubt demand a solution. As long as Americans continue to voluntarily pay these ungodly high insurance premiums without complaint, there seems no compelling reason for the medical services industry to fix anything. When, however, enough people choose to say, "No more!" and drop out of the insurance pool, health care providers will be forced to adjust their prices and their living standards, just like the rest of us have to do in times of financial crises..
Lloyd Albritton is a columnist for the Atmore Advance. Your comments are invited at or by calling (850)384-6676.

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