Opinion | The curious case of the overpaid American physician

America’s extreme medical meritocracy has created a shortage of doctors.

Shahab Khan, Opinions Columnist

The U.S. does not have enough doctors, and the shortage is contributing to the high costs patients pay when they go to the hospital.

In the mainstream debates surrounding our health care systems, the problem overlooked by both proponents of private and single-payer health care systems is the supply of doctors and their high salaries. These salaries end up contributing significantly to the financial costs patients face.

To solve this problem, U.S. medical schools and doctors’ associations need to make the medical field more accessible to a wider array of students. That way, we will be able to alleviate supply constraints, leading to a decrease in salaries and thus, overhead costs for patients.

Compared to other industrialized countries, the U.S. ranks near the bottom in supply of doctors — only 2.6 doctors per 1,000 patients. In contrast, most major economies in the European Union, such as Germany and France, have nearly double the number of doctors we have per 1,000 patients.

Furthermore, the Association of American Medical Colleges projects that the U.S. will be short 139,000 doctors by 2033. This is largely due to high barriers of entry such as an incredibly limited number of spots in medical school and regulations that protect physicians from competition in the form of nurse practitioners and immigrant doctors.

Along with the complicated workings of our private insurance system, the shortage of U.S. doctors is the best elucidation to why they are overcompensated compared to their European counterparts. For example, doctors earn $138,000 in the UK compared to the $316,000 U.S. doctors make.

Even if the U.S. were to establish a system in which Medicare were the sole insurer in the market, overall health care costs would still exceed those of fellow industrialized nations because of the high salaries to which U.S. doctors are accustomed.

In a single-payer health care model, the U.S. government would have monopsony power over doctors, which could allow them to dictate the wages that doctors receive.

However, the supply curve for the number of doctors in the labor market is elastic. This means that the quantity of doctors in a market is responsive to changes in wages. In other words, if the U.S. monopsonist used its market power to decrease the wages doctors received, then less people would want to become doctors, exacerbating the current shortage.

As a result, the monopsonist would be disinclined to use its power to decrease salaries and pass the burden of that salary on to patients and taxpayers.

Now, many students on the pre-med track would object to my characterization that they are only interested in becoming doctors for the money. But if the wages of doctors were to suddenly plummet, I think many STEM majors would reconsider the years of difficult schooling.

Omar Mustafa, a sophomore at the UI studying human physiology on the pre-med track, said that because of the degree of difficulty and the intense competition of getting into medical school, many prospective pre-med majors drop out of the program, thus robbing the health care system of potential talent.

To alleviate these problems, there are myriad solutions we can take to increase the supply of doctors in the U.S. medical schools could accept more students into their programs with only 21,622 being accepted into medical school this past year.

The rest of the union should follow the lead of states like Iowa and allow nurse practitioners to open up general practices to compete with doctors.

These recommendations will make up for the shortage of doctors we have in the current system and drive down costs for patients in a future single-payer system.

Columns reflect the opinions of the authors and are not necessarily those of the Editorial Board, The Daily Iowan, or other organizations in which the author may be involved.