Human physiology is complicated and on the surface, any job can seem simple if you have no understanding of what is happening. While a large portion of the time, the surgeries go smoothly, sometimes it doesn’t and it can go downhill fast. In that moment, you want an anesthesiologist that can quickly and thoroughly think through a patients medical history, what drugs they’re on at home, the current surgery, variant anatomy, what drugs they’ve given so far, etc to decide on the correct next drug to give or action to take. That takes training and experience.
See here https://www.commonwealthfund.org/publications/issue-briefs/2...
Physician salaries are a driver, but the far bigger portion lies with insurance’s take, and the administrative costs required to respond to insurance shenanigans.
https://www.healthsystemtracker.org/brief/what-drives-health...
It calculates US's spending on healthcare to be 87% higher than "Comparable Country Average", and attributes only a 10 percentage point of the price increase to "administration" costs, as opposed the report you linked which estimates 30 percentage points.
US: $438k/yr Australia: $203k/yr UK: £112k/yr
That seems like a big difference to me.
Sure premiums will go up, but the conversation should then shift to why does a 15 min ambulance ride cost $5,000 instead of fighting about whether or not an insurance company is going to cover it.
Because the insurance company is basically the only entity who has skin in the game.
>Sure premiums will go up, but the conversation should then shift to why does a 15 min ambulance ride cost $5,000 instead of fighting about whether or not an insurance company is going to cover it.
And the response if this is all covered would be "who cares? my insurance is covering it anyways". The patient doesn't have any incentive to choose a cheaper hospital, because he won't see any of the savings.
What I'm talking about is capping the costs of a supporting doctor for a surgical procedure. From my quick research, there is no significant cost basis for surgery running longer than planned besides the anesthesiologist's time. So the doctor would make $400k instead of $500k per year.
Here is some perspective. The anesthesiologist's bill for my wife's colonoscopy in 2023 was $2k. This is a routine procedure that takes less than an hour. Also, the place was just filled with patients and there was one guy handling them all.
ACA needs 2 sequels before anything resembling a market can emerge.
It's an explicit pro-big business tax policy that hurts businesses that aren't big enough to afford the paperwork and HR involved with administering insurance and other benefits, and also to prevent people from being able to easily compare compensation offers from various employers.
Are there any countries in the world where they've replaced anesthesiologists with nurses? What's the data on outcomes for that look like?
I don't think it's unreasonable to put a cap on the cost of one of highest paid healthcare specialties.
Of the surgeries I've been involved in as a patient or family member, the anesthesiology bill does not seem proportional to the work they do. I mean they do some calculations for the amount of drugs to put you to sleep and then monitor your vitals. Seems like something a responsible and well-trained nurse could do.