I love this talk about cost reduction and doctor salaries. Kudos to everybody. My thoughts are likely very biased considering I get a doctors salary but here are my comments on some of the topics above:
Doctors have the potential to make a high income. Not all doctors. Salaries range by geography and specialty. Some doctors make slightly over $100k while others can make over $1 million. In fact the average income for a physician is under $250k/yr which in my opinion is not to absurd for the education and work that they do (remember I am biased.) Don't forget because of our progressive tax code, making $250k/yr is not twice as good as make $125k/yr. Also doctors pay steep licensing and continuing medical education fees as well as malpractice insurance which lowers that income substantially. Also of note many physicians work well over 40 hours a week. It is not uncommon for 60-80 hour work weeks which allows them to make such a large income. Lastly most physician salaries have gone down comparative over the decades. Cardiologist don't make $800k like they used to. Actually the MACRA reimbursement model has a programed in rise in reimbursement that is below inflation. Which means compensation will continue to decrease as the years go by. I promise you it is not all roses for everyone.
I fully agree that the cost of becoming a doctor is outrageous. It is not uncommon to come out of residency with over $300k+ in school debt. Speaking of education. Many countries have medical school as part of undergrad and then they do a residency. This saves 4 years of education and debt as compared to the US. I'm sure physicians would be more amicable to lower wages if their education was fully funded. And BTW, because of the progressive tax code the interest rate on school loans is not tax deductible.
It is idiotic, but physicians are expected to live the "physician lifestyle." Therefor you can not judge how well a physician is doing financially by the car they drive or the latest vacation they went to. I know plenty of physicians who are broke despite driving a BMW to work every day. Very un-mustachian.
Someone brought up the AMA which in my opinion is a joke and in bed with CMS and lobbyists. They do not advocate for physicians and I refuse to give them money. I doubt anyone can get any positive leeway with that organization.
Regarding foreign doctors: The US has a very robust foreign trained doctor program. Currently 25% of our physician workforce is a foreign graduate. Many are Middle Eastern, Indian, Pakistani and Asian. The only time I have an issue with a foreign doctor is when their English is so bad that their patients have a hard time understanding them. It is rare, but it happens. You can't treat a patient if they can't follow your recommendations. More immigrant physicians would definitely help with the supply demand curve and the free market would lower their compensation naturally over time. For example doctors in NY and California are some of the lowest paid while working in Wisconsin or Alaska they can make a fortune.
TLDR, most docs do not make the crazy income described. This is especially true when considering the amount of overtime they work, their higher tax bracket, their school debt, their malpractice insurance, and all those licensing fees. Also, physician reimbursement has been on the chopping block for decades and continues to go down adding to the burnout and dissatisfaction of our physicians. In reality, to curb the cost of healthcare salaries will also have to go down, but so should education costs, licensing fees, malpractice insurance and maybe even taxes for those who provide unreimbursed care to the poor. I think we want our docs to be compensated well not obscene, but well enough so that bright young minds choose to do medicine instead of wall street.