In a country absolutely pwn3d by special interests, what are the chances that we will see any reform whatsoever when one of the most powerful (and, hypocritically, most bent on self-interest) lobbies in the world (AMA) pulls the strings of every lawmaker? All your diseases are belong to us.

I think if we have Edwards or Obama as president, we’ll get at least SOME progress towards a sane system. Edwards, in particular, has a very ambitious trojan horse plan (see other blog item) that could well get passed, though it’d be a tough fight.

Also, I’m not sure I buy the idea that physician salaries in the universal-care countries are so terribly low. Sure, they don’t have surgeons getting paid half a million a year, but a lot of doctors here don’t make that much either, and those that do often have extremely high costs to deal with, as well. Replacing pay-for-procedure with pay-for-outcome (discussed by the Brit in SiCKO), and creating a no-fault malpractice system, would help fix things on that side…

Actually, the article goes into the salary issue — apparently French doctors get tax breaks, and also don’t have to pay for malpractice insurance. The article can be read to say that that the combined value of these perks is equivalent to $90,000 in salary. A friend of the family is a doctor in France and seems rather poorer than one would expect a doctor to be, but certainly not poor, and it’s not clear how much of that poverty comes from the fact that he lives in Paris, an extraordinarily expensive city. Based on what I know of my friend’s experiences, his purchasing power is about equivalent to that of an American with a BA living in a large city. That’s low, but not disastrous. And providing a higher salary is a solvable problem; even if we can’t, then we only have a system that screws the doctors, rather than the system that we have now, which so far as I can tell screws everyone, even the doctors who trade high salaries for high debt, long hours, and annoying insurance-related paperwork.