Managed Care

One reason our health care costs so much

We pay docs more — sometimes very much more — than other countries do

Primary care physicians (PCPs) in the United States earn the highest incomes — higher than in five other developed countries, reports a new study in Health Affairs. But that scale is relative, given the costliness of the overall U.S. health care system, the researchers caution. Lead author Miriam J. Laugesen, assistant professor of health policy and management at the Mailman School of Public Health at Columbia University, says, “All countries are struggling with the growth of health care costs but it’s the higher fees ... that public and private payers paid that is significant.” PCPs in the United States were paid an average of 27 percent more by public payers for an office visit, and 70 percent more by private payers for an office visit, in comparison with the average paid in the other countries.

The study also reviewed earnings of orthopedic surgeons. Researchers found a similar pattern, with specialists in the U.S. earning the highest pretax incomes, net of expenses.

Physician earnings in six countries, 2008

Note: All earnings figures were converted to U.S. dollars and adjusted for purchasing power parity and then converted to 2008 dollars using the U.S. Consumer Price Index.

Source: Laugesen MJ, Glied SA. Higher fees paid to U.S. physicians drive higher spending for physician services compared to other countries. Health Aff. 2011;30(9):1647–1656

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