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Comment by charlesdm | Hacker News Reader

I will bring up one point. The wages medical practitioners make are generally higher in the US. So the cost of medical care is higher.

I live in Belgium, mostly good and free healthcare (barring payment of a few euros here and there). I have 3 cousins who are (or are studying to become) doctors and while specialised doctors can make decent money (€75 -> 450k), they don't come anywhere close to what a US based doctor might be making.

Someone making between $1 to 2m in the US (e.g. certain surgeons) might "only" be making $300 - 400k here. And the quality level is exactly the same.

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This is not the reason US healthcare is costly. Canadian doctors do very well - there isn't much incentive to work south of the border. The reason US healthcare is expensive is because you have multiple payors and a ridiculously complex web of rules for everyone to navigate.

Wages certainly are a contributing factor to the cost of US healthcare. Canadian physician salaries are high by any normal standard, but still much lower than US salaries, especially when you get into specialties.

it has little to do with the pay of doctors and everything to do with health care administration costs, and insurance companies extracting as much profit as possible.

That's a good point, but not the only reason. The insurance industry extracts a big profit margin by just moving money from one risk pool to another, and that profit has to come from somewhere, so, costs go up. It's inevitable.

U.S. health insurers have an average profit rate of 3.1%. Does that sound massive to you?

That's their profit. We are all paying for their operating costs as well.

The whole healthcare provider<->insurer interface is hugely expensive.

http://www.commonwealthfund.org/publications/in-the-literatu...

Should healthcare be a for-profit venture?

That's the same as Amazon's!

If you were to break down the charges from a surgery, the portion that goes to the surgeons salary is rather small, and particularly the portion that might be the difference between EU and US salaries. I think differences in charges for things like prescription drugs make a much higher impact.

The other difference. Training in the US to become a doctor costs hundreds of thousands of dollars up to 1M. In your country it is free.

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