Are doctors' salaries the biggest problem in health care?

The good news for American families is that median income grew 30 percent between 1999 and 2009, according to a new study from the RAND Corp. The bad news: Health costs rose even faster, leaving many families worse off. Why are health costs rising so fast? A second study, from Columbia University, suggests that the biggest factor is doctors' pay. An American primary care doctor earned an average of $186,582 in 2008 (before taxes but after expenses), while the corresponding figure in France was $95,585. American doctors with lucrative specialties — like, say, orthopedic surgery — can earn an average salary well above $400,000. As U.S. citizens and policymakers struggle with skyrocketing health costs, should we take a scalpel to physician fees and salaries?

We can't afford doctors' greed: The upshot of this study is that "greedy American doctors are taking all of our health care money, because they can," says Hamilton Nolan at Gawker. That certainly helps explain why health care is so damned expensive here, but not why primary care physicians picked the very same day this study came out to demand a raise from Medicare. Here's an idea: "Instead of giving primary care doctors a raise, how about we give specialists a pay cut?"

"Doctors overpaid, says study; 'Give us a raise,' say doctors"

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This is just the American way: The difference between what U.S. and other Western doctors earn is "eye-popping," says Julie Rovner at NPR. But don't be too quick to pin the blame on doctors: The "sure-to-be-controversial study" suggests that all "top intellectual talent" earns more in the U.S. than in other countries. So it could be that "the only way to pay doctors less is to lower salaries for [all] the top-paid people in society," and that seems unlikely.

"Pay for U.S. doctors is tops"

And our mess of a system is bigger than doctors: Our outrageously costly health care system has "a lot of moving parts," says Erika Stutzman in the Boulder, Colo., Daily Camera, and doctors aren't the only ones who "enrich themselves at a cost to the system as a whole." Sperm banks, drug companies, insurance companies, and hospital administrators share the blame. What's worse: Our health care costs are the highest in the world, but they don't even come close to buying us the world's best health care.

"Big dollars, little sense"