On average, patients thought that surgeons should receive $18,501 for total hip replacements, and $16,822 for total knee replacements. Patients estimated actual Medicare reimbursement to be $11,151 for total hip replacements and $8,902 for total knee replacements. Seventy per cent of patients stated that Medicare reimbursement was “much lower” than what it should be, and only 1% felt that it was higher than it should be.
In reality, surgeons get paid on average $1,378 for a total hip and $1,430 for a total knee. Thus patients were off by an order of magnitude in their estimates! The disconnect in public knowledge seems extreme.
In short, patients — the most important part of all of health care policy decisions — have absolutely no clue how much doctors get paid. They think we get paid (or, at least, deserve to) about 10 times more than we actually do!
For some reason, there is very little transparency about cost structures in healthcare. No wonder that patients have unrealistic ideas about what docs get paid. They see a 50-100K total bill, so they guess that the docs must be geting a substantial part of it.
A while ago I tried to find info about how Medicare is funding it's parts A and B over time. I was unable to find that data. Another claim is that Medicare is run with a 4% overhead. Maybe that is true, but how high are the costs after the funds get handed over to the commercial companies that do the actual hands on administering of the program?
Another item -- I am convinced that the skyrocketing increases in costs over the last several years are related to the fact that hospitals are taking over outpatient primary care. But - so far, the data is nowhere to be seen. |
