How much health insurers pay for almost everything is about to go public

How do you account for case-based charges?

It's not that doctors resent people improving their health, it's that people are wary of their healthcare services existing in a for-profit system- these types of scams play to the paranoia and fear that people associate with medical establishments selling treatments rather than establishing preventative health. Basically it boils down to the sentiment people generally have that doctors benefit from sick people because they make money from people being sick.

Anecdotally, I remember growing up in Brazil and we were taught in school about human anatomy and all sorts of health issues and how nutrition, immunization, proper hygeine, etc. helped prevent being sick... as well as home remedies for simple illness. But here in the US people seem to seek some authority to provide solutions, and these scam pseudo-medical ads play to this and fill the gap where state medicine and folk knowledge would otherwise be.

Spouse of a third year resident here. My wife has volunteered at several primary care (i.e. generic doctor) clinics in Manhattan and nearby area (Queens, Astoria, Brooklyn and even in Boundbrook, NJ). These are all owned by the doctors. She worked in all kinds of operations of a clinic from billing, sending prescription, taking patient history, etc.

Back-of-the-napkin calculation based on my wife's experience -- if you are a primary care (generic) doctor in a highly populated area and you see ~40 patients a day and each patient pays $100/visit.

$100 * 40 patients * 22 days per month of work * 12 months = $1056000 (about $1 million USD)

We are using $100/patient/visit and that's being very conservative. Most of these doctors would encourage the staff/volunteers who do the billing to put as many relevant billing codes as possible in the system (e.g., if someone comes in with a cough, they'll try to bill for anything related to cough symptom although they already knew it's just for seasonal allergy). This is necessary also because a lot (not all) of the patients are on medicare/aid and the reimbursement from medicare/aid is not as good as the ones from the private insurance companies. The cost of the labor is mostly just one assistant or at most two for ~$20-$30/hour max. Not sure about the insurance cost (but we assume that it would cost ~$20-$30K/year for malpractice insurance?) and renting the clinic (some docs do own the clinic). All in all, we believe that having your own practice can net you a lot more than what you'd make by working as an attending/hospitalist at a hospital (on average, hospitalists make between $250K-$300K/year, which is still commendable).

But if you live in a rural area, which tend to have smaller population density, then you are probably better off working for a hospital because as a hospitalist, you can make close or a little more than $300K/year as a general doctor. My wife knows a couple of doctors in Palmdale, CA, who work as hospitalists in two hospitals (6 days a week alternating between two hospitals; the days start at around 9am and ends around 3-4pm). They rake in ~$600K/year from salaries (not including bonuses). A friend of mine just completed his residency and got an offer from a hospital near Dyersburg (Tennessee) for $300K/year salary with $40K sign-on bonus. The specialists earn more of course: https://www.whitecoatinvestor.com/how-much-do-doctors-make/. A cardiologist friend of mine told me that he got an offer from a hospital in Montana that pays $800K+/year.

Just wanted to share what I know about how much the doctors can make in the United States.

I would think that hospitals could create price schedules similarly to how other businesses do.

Although I imagine this gets really messy when dealing with Medicare and with the mandate to treat everyone regardless of their ability to pay. I'd expect those arrangements would need to change to make this work.

I feel a bit silly pontificating about this. Hopefully someone who really understands the topic will weigh in.