You’ve seen your health insurance premiums go up year after year. You’ve heard the blame game — drug companies, hospital administrators, insurance executives. But there’s one group that’s conspicuously absent from the conversation: your doctor.
Here’s the uncomfortable truth: We don’t have a healthcare cost crisis. We have a provider compensation crisis, and we’re not allowed to talk about it.
American doctors earn two to three times more than their counterparts in other wealthy nations. An orthopedic surgeon in the US makes over $500,000 a year on average. In Germany, the same surgeon earns around $180,000. Are American surgeons three times more skilled? No. They’re just three times more expensive — and we all pay for it.
But here’s where it gets personal. You’ve probably blamed the system, but you’ve never blamed the people. Because those people saved your life, or your parent’s life. They’re heroes. And heroes shouldn’t be criticized for their compensation.
Yet the math doesn’t lie. Physician compensation accounts for roughly 20% of total US healthcare spending — that’s over $1 trillion annually. And the reason it’s so high isn’t market forces. It’s policy. The American Medical Association and Congress have colluded for decades to keep the supply of doctors artificially low. Medical school enrollment is capped. Residency slots are funded by Medicare, and that number hasn’t kept pace with population growth. We don’t have a shortage of talent. We have a shortage of supply — and that shortage is a deliberate choice.
Take it from a provider I interviewed last year. ‘I know I’m overpaid,’ a surgeon told me. ‘But would you turn down $500,000 if the system offered it to you?’ He’s right. Doctors are rational actors in a rigged game. The fault isn’t their greed — it’s our collective refusal to examine the supply side.
Meanwhile, nurse practitioners and physician assistants also earn far more in the US than anywhere else. Even registered nurses top global charts. The pattern is clear: we pay more because we restrict who can practice. And we restrict who can practice to protect the incomes of those already in the club.
This is the part that makes people angry. Because it’s not just about doctors. It’s about a system that protects incumbents at the expense of everyone else. Every time you pay a premium, every time you skip a checkup because it’s too expensive, you’re subsidizing a policy that limits the number of people who can treat you.
So what’s the solution? It’s not to slash doctor salaries overnight. Good luck convincing a lobby that powerful to take a pay cut. But we can do something radical: change the supply. The cure for high healthcare costs isn’t more insurance — it’s more doctors.
Double the number of residency slots. Fund more medical schools. Allow foreign-trained doctors to practice without jumping through a dozen hoops. Let nurse practitioners and physician assistants practice to the full extent of their training. The AMA will fight this tooth and nail. But that’s exactly why we need to do it.
You might be thinking: will this lower quality? No. The evidence from other countries shows that more doctors actually improves access and outcomes. The US already has the most expensive system in the world with middling results. We can do better.
Let’s be clear: doctors deserve to be well-compensated. But they don’t deserve a system that treats them like royalty while making healthcare unaffordable for millions. The people we trust to heal us shouldn’t be the reason we can’t afford to get healed.
Your doctor’s salary is the hidden tax you pay every time you get sick. It’s time to stop pretending otherwise.
FAQ
Q: But doctors work hard and have huge student debt; shouldn't they be paid well?
A: Yes, doctors should be well-compensated. But the US pays double or triple the global average for similar training and outcomes — a difference driven by supply restrictions, not skill. Increasing supply would lower the extreme outlier pay without making doctors poor.
Q: So what can I actually do about this?
A: Advocate for policies that expand medical training slots and residency funding. Support legislation to increase the number of doctors. For routine care, consider seeing a nurse practitioner — they're equally effective and less costly.
Q: If we increase the number of doctors, won't quality drop?
A: Quality isn't tied to scarcity. Countries with more doctors per capita often have better health outcomes. The US actually has fewer doctors per capita than most developed nations — and worse outcomes. More doctors means shorter wait times, less burnout, and better care.