Thread by @Neoavatara

Here is the funny part:

Cutting doc pay? IS THE EASY PART! 😂

Now, imagine cutting nurses pay 33%. Or Med techs. Or PAs. And all the ancillary staff, including secretaries and administrators.

All of their pay would have to drop.

Docs are the tip of the spear. Nothing more.

https://twitter.com/dylanmatt/status/1026545556733059072

When people talk about cutting reimbursements...people forget doctors and hospitals RUN BUSINESSES.

They aren't the only employees involved.

My group has SEVENTY ancillary staff. They'd all have to cut their pay too to make this work. Many would lose their jobs.

Do people think docs would take a 1/3 pay cut...and not pass that pay cut on to their staff?

Same with hospitals:you think you could magically maintain staffing pay at current levels, with a 40% cut?

Everyone downstream would take that pay hit...if they kept their jobs at all.

Cutting docs pay in 1/2 is one thing.

Cutting a secretary who makes $18/hour in half...how do liberals like the idea of that? Because that is what they are proposing.

The late, great Uwe Reinhardt spoke about this in length:

"Cutting doctors’ take-home pay would not really solve the American cost crisis."

query.nytimes.com/gst/fullpage.h…

"The total amount US pay their physicians collectively represents only about 20% of total national health spending. Of this total, close to half is absorbed by the physicians’ practice expenses, including malpractice premiums, but excluding the amortization of college...debt."

This makes the physicians’ collective take-home pay only about 10% of total national health spending. If we somehow managed to cut that take-home pay by, say, 20 percent, we would reduce total national health spending by only 2 percent..."

"... in return for a wholly demoralized medical profession to which we so often look to save our lives. It strikes me as a poor strategy."

And Uwe was not exactly a conservative leader on health care...but he did have immense common sense.

On a personal note? I've always expected some kind of horror show would come to health care.

That is why I am prepared.

I could literally quit tomorrow. Sure, I'd make a lot less money, but I'd survive. I can tell you that I wouldn't work my current hours for 1/2 the pay.

The trade off here would be would the cost reduction set off the reduction in productivity you'd see.

Because...I guarantee you'd see a massive reduction in productivity. There is no way you could maintain the high productivity rate in health care we have today.

For example: do you really believe nurses that made $100k a year (in one of the toughest jobs in the world!) would work that hard...making $70k?

Good luck with that.

Its not just us 'rich' doctors that would have to pay the price.

I haven't even talked about the WORST PART!

The worst part isn't that you would demoralize and cause dysfunction among HC professionals.

The worst part is...you'd probably wipe out 10-20% of hospitals that currently exist.

Many hospitals (especially those in rural areas and poor urban communities) are largely holding on by a thread as it is.

How would they fare under a system that cuts reimbursements 40%?

You don't need to be an economist to answer that question.

Of course, the govt wouldn't let that happen...so would provide subsidies.

Which is fine...except...there goes your cost savings.

In short, this points to one of the key things about the US health care systems' costs:

We are costlier because we pay our people more, and our hospitals are more expensive to run, than many hospitals around the world.

So what it comes down to is this entire concept is fine as far as a math problem goes.

As far as reality...consumers would have to quickly face a system that may be decent, but is not anywhere near the system they have today.

As always...everything is about trade offs.

And thanks to @TwitchyTeam for posting the whole rant!
twitchy.com/brettt-3136/20…