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Comment by throwayEngineer | Hacker News Reader

The Physician takes for granted that his profession has a monopoly on perscriptions and declaring medical necessity.

>Laughably some consider me rich

I know the article is supposed to hate on the 0.1%ers, but since Physicians always say this crap about their income, it's important to know Healthcare costs are terrible because he is paid so well.

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Doctors are way overpaid. The barriers to entry to become a physician are un-necessarily high, and I have a suspicion that that's by design. You only need a moderate amount of intelligence to learn and apply medicine. If the barriers to entry were lowered, then physician salaries would fall precipitously as supply would outgrow demand.

Disclaimer: I'm married to a doctor. That said, I agree with your point that they are over-paid, but I absolutely don't agree with the idea that you only need a moderate amount of intelligence to work as a physician. A slight majority of my friend group is physicians, both through my spouse's education and work and through a collegiate friend group that mostly went into medicine. While I have many, many complaints about the medical profession and many of the people who work at it, they are, virtually without exception, extremely intelligent people. The ones who weren't washed out at some point in the 4 years of university and subsequent 8-12 years of training. Some of the barriers to entry are excessive, but most of them are there because being a doctor is incredibly difficult.

I didn't mean that to across the way it did. I know some doctors, and they are extremely intelligent people, but it's a selection bias due to the high educational requirements required to get into med school. I think my point is that you don't need to be extremely intelligent to learn or apply medicine. I'd say medicine is on par with engineering, but the requirements to become an engineer are way lower than the requirements to become a doctor.

That's their argument, that the barriers to entry are too high. Obviously people who've successfully navigated those barriers will be inteligent and capable, but perhaps we could lower the average skill and knowledge level of doctors by 10% but reduce costs by 50% (by having more people into the profession) and therefore being able to provide appropriate care to more people and detect conditions earlier. This could make for a net-positive result in terms of overall health in society. Similarly, if you use technology to supplement a human doctor, you should likely be able to train doctors less and achieve similar outcomes.

I personally think health care costs are inflated by middlemen like insurance companies.

https://www.cms.gov/Research-Statistics-Data-and-Systems/Sta...

As far as I can tell, insurance companies are the only player in the system providing a check against the providers. The consumer has no idea what they're buying, so you need another similarly educated professional (employed by the insurance company) to vet the provider's charges. Insurance companies also have to spend 80% of their premiums on healthcare.

A small correction: In the US, Nurse Practitioners are able to write prescriptions. These are nominally under the authority of a supervising doctor, but in practice their scrips are mundane and approved with minimal scrutiny.

You can easily look at physician income over time to see that this isn't true. However, hospital administration and billing have shot up considerably over the last few decades.

Says the software developer that makes about as much as a doctor for writing Jenkins pipelines or something else essentially valueless to most people.

Most software devs aren't even close to doctors in terms of salary.

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