…the most highly trained. Doctors salaries are on average in the middle of health care reimbursement. The big money goes to hospital administrators, according to this.
Patient-hours/Dr should in theory be larger when all factors of ACA are taken into account. No aspect of ACA appears to be directed at increasing the number of doctors or reducing the number of patient hours. The sole goal appears to have been universal coverage.
The ACA was by design intended to subsidize access to health care by increasing the cost to everyone who already could afford health care insurance. Yes, it tries to also contain costs via centralized cost-control regulations, but fundamentally it is a realization of the maxim "from each according to his ability [to pay] to each according to his need [for health care]."
Non-profit in the tax regulation sense only. Medicine has always been a service business - I don't think there have been too many times or places where it was ever successful as a selfless noble endeavor. But government has always been around to influence its exercise. Even the Code of Hammurabi had rules regarding payment to physicians:It is also interesting to note that according to these laws, both the successful surgeon's compensation and the failed surgeon's liability were determined by the status of his patient. Therefore, if a surgeon operated and saved the life of a person of high status, the patient was to pay ten shekels of silver. If the surgeon saved the life of a slave, he only received two shekels. However, if a person of high status died as a result of surgery, the surgeon risked having his hand cut off. While if a slave died from receiving surgical treatment, the surgeon only had to pay to replace the slave. This use of status to evaluate misdeeds does not seem to appear in other, similar "codes" however. [http://www.indiana.edu/~ancmed/meso.HTM]
Ancient Egypt had surprisingly good medicine - and even back then specialists were ranked higher in regard and presumably in compensation:There were professional divisions in ancient Egyptian medicine according to skill and experience. From lowest to highest rank there were:
Lay physicians
Supervisors of the lay physicians
Magic physicians (who treated people through religious rituals)
Caretakers of the Pharaoh's anus (yes that's right, and it was a high ranking position too!)
Specialists (like teeth, stomach, etc...)
Doctors worked in the temple as well as having a private practice if they chose. Their wages were paid through barter since there was no monetary system in ancient Egypt. [http://www.experience-ancient-egypt.com/ancient-egyptian-medicine.html]
I'd have been satisfied with tweaks to the U.S. laws that would have encouraged medical providers to advertise their prices. (Costs for services are currently hard for the patient customer to compare until after-the-fact, and insurance intermediaries pretty much undermine any possibility of that changing to allow traditional market forces to work properly.) Throw in plenty of publicly accessible customer rating systems and I'd expect the market to start to come into play.
