And here is some on doctors incomes.
People want to avoid the real problems and talk about the financing. But the conclusion is simple and inescapeable. You need to reduce the amounts your pay (per hour, per pill, per syringe, per piece of new equipment).
I have helped prepare hospital budgets. The biggest costs are:
Doctors Salaries (even though they are a a surprising small proportion of the staff)
Other staff costs
Services (cleaning, disposal, maintenance)
Equipment costs (primarily reflected as depreciation though there is quite a bit of leasing going on)
and then way down we have
Outside the hospital, in clinical practices, you have 2-3 non-doctors per doctor, but the personnel cost is still 70-80% doctors (if you count nurse practicioners with the doctors) because the disparity in salaries is so high.
On the drugs side, the cost of production is a tiny fraction of the retail price. Actually so is the cost of research. Marketing and overhead are the big costs. And guess what? Most of those are income to people working for the pharmaceutical companies.
If you want to attack the cost you have to face the reality of where the costs are in the first place.
I can see lots of statistics showing that insurers have a 10-20% overhead (premium dollars not paid out as claims) but if the insurers did not provide the function of denying claims (!) the total costs would be higher. It is like to cost of the budget department. You can save money by eliminating the budget department, but you will end up spending ten times as much when costs get out of control everywhere else. People need to understand the position the insurance companies are in. They are paid by one group of people (primarily employers) and they pay out based on the behavior of two highly self-interested groups, patients and doctors, both of whom want more of everything and the best of everything.
As a loonie leftist, I have no more love for the insurers than for the pharmaceutical companies or the hospital companies. They all behave badly when they think they can get away with it.
I am 100% in favor of a single payer plan, but some strict regulation of private insurance with strong public option is fine with me. But people should understand that either this is going to mean even higher costs or lower payments to providers. Taking out some of the profit motive is going to mean fewer new drugs, fewer new procedures and less brilliant people going into medicine as a profession.
I think we also need LESS qualified doctors. The process for becoming a doctor in the US is too long, too rigorous and too expensive for the doctors themselves. So they demand a huge premium in pay compared with doctors in other countries. In some way the market is already taking care of this, by making care provided by nurse practicioners and physicians assistants a bigger feature of health care delivery.