Physicians tend to partner up with other professionals, like lawyers, bankers and CPAs when they start their own private practices. Many established physicians ARE going broke and filling for bankruptcy after getting drawn too deep into the business side of medicine. Instead of keeping focus on patient treatment, many physicians have their entire life savings linked to the profitability of their practice, which has more to do with negotiating the best deals for insurance reimbursement, malpractice insurance, building leases, utilities, and capital expenses such as X-ray, EKG, or sonogram machines. The bankers and lawyers structure things so they have the lion's share of ROI while the physician is personally exposed to the most liability. Then they have lawyers, bankers, limited partners, and shareholders pressuring them to be more "profitable", which means cutting face time with patients from 15 minutes to 10 minutes, prescribing drugs from suppliers that will pay back "incentives", referring to other specialists and facilities that offer kickbacks, separating physician fees from facility fees to juice more from insurance, performing more tests than necessary to defend against liability while receiving more reimbursement from insurance and medicare, performing sneaky out-of-network or uncovered services on unsuspecting patients with deep pockets, and more frequently flat-out defrauding medicare, medicaid, and private insurance companies.
Patients and physicians both would benefit from either a single-payer system like the UK and Canada have, or a maybe a public-private system like Australia has, where those willing to pay more direct or willing to buy commercial insurance can be treated by private physicians rather than publicly employed physicians, just like we have public and private schools in the US. In the US we actually have a shortage of physicians, especially if we are going to start covering care for more of our poor and working class. Yet many excellent candidates are not admitted to medical school because only the cream of the cream were selected. There are also many qualified physicians educated in Europe and Asia that cannot EVER practice in the US simply because they didn't get their degree here. Direct government investment in programs to train and certify physicians without forcing them into hundreds of thousands of dollars of unforgivable student loan debt would be a benefit to aspiring physicians and patients alike. Direct government assumption of financial liability and discipline of physicians would free physicians to earn an honest and comfortable living while providing patient care that serves the interest of the patient.
Gradually shortening the terms of pharmaceutical patents and finding more cures and treatments through non-profit, grant-funded, university research would help to substantially lower the family burden when it comes to the cost of care. At the end of the day it is the scientists putting in 80-120 hours each week that makes cures possible, and even those scientists working for Big Pharma are not raking in the dough compared to the executives, lawyers, and pharma sales reps. Scientists are not paid any less at the University level so the argument of profit incentive is rather mute.
