You make too much money!

[Ree]

So, Dr. Faroohk, you are telling us that, if you had the same qualifications and abilities to run an operation that provides an essential service, had put in the necessary years of education and had the same expenses, and then, were able to start your own business, you would look at your overhead, and then operate at the minimum profit you could?

I am thinking no.

The point of running one's own business is to earn a decent living.
Sure, doctors should be in it to help sick people, but they should also be paid according to their abilities, and they should be able to earn a profit so they can have a nice life.

I do cake decorating on the side.
It's not an essential service, but it is a service for people who need a cake for a special occasion.
Right now, if I were to start my own business at what I charge people, I would be broke within the first year.
I feel guilty as heck charging more, though.
Unfortunately, the reality is, if I want to turn a profit, and benefit from the skills I have learned, and the talent I have, I have to charge people a lot of money.

If I want to better my life and have the good things, I can't be sitting back and thinking, "Oh dear, I can't charge $40 for this cake because they have a child who may need shoes soon."
I have to look at what it cost to make that cake and factor in my time, and go from there, thinking, "I can get $40 for this cake, and that will help pay my bills."

[Andara Bledin]

I strongly suspect that what the OP is most on about is the huge disparity in what the day-to-day worker makes versus the CEO or other upper management.

In 2007, the average CEO made $10,000,000. I can't even conceive of what I would do with ten million dollars. At my current rate, it would take me nearly 40 years to even make a tenth of that.

^-.-^

[Amanita]

I do leathercraft as a hobby, and while I may give a few price breaks to friends of mine, when I'm selling through a local store, I charge a decent price. Usually about $50 for one of my ornate spiked collars. (I don't do the plain black band with 10 spikes, or the single bondage ring, mine are more elaborate designs with tooling, unique hardware, and other interesting features)
That $50 is just what I charge, the store adds its own markup on top of that.

I remember when the store I sell through opened (It's a local Pagan/Goth store), and somebody complained about the prices, saying it was too expensive for Pagans to afford. I guess they forgot that:
-They're not dealing with Walmart and its volume discounts
-the store sells many imported goods, which cost money to bring into the country
-in the words of the proprietress "I sell wants, not needs".

Likewise, I justify selling my leather goods at a profit. I craft and sell wants, not needs. Nobody ever dropped dead due to lack of a steampunk styled collar or gothic wristcuffs.

On the other hand, we have another Pagan shop here in town, and one local Pagan is incensed that the place is run as a for-profit business. Like how dare the owners profit from the Pagan community that their business serves! I guess he forgets that this business is the primary source of income for the owners, and if they couldn't make a living from it, then they would not be doing it at all, and the Pagan community would then have no store serving them, period.

[protege]

If I want to better my life and have the good things, I can't be sitting back and thinking, "Oh dear, I can't charge $40 for this cake because they have a child who may need shoes soon."
I have to look at what it cost to make that cake and factor in my time, and go from there, thinking, "I can get $40 for this cake, and that will help pay my bills."

That's exactly it. You have bills to pay, it's not *your* problem that someone can't afford your product. With that said, should I complain to Tamiya (a plastic model manufacturer) that I can't afford their 1/12 scale Lotus 7 kit...which cost just under $360? If I did that, they'd give me the standard brush off (aka the "get lost") letter. Instead, I went for the cheaper 1/25 scale kit. It's not as detailed, but it'll fit in with my other sports cars better. I like my models as much as the next guy, but I refuse to pay silly prices for them.

Along those lines, some years back I picked up a 1/8 1932 Ford street rod for my collection. Now, 1/8 scale is pretty big (this '32 is just under 2 feet long) and are usually expensive. This one wasn't because it was in horrible condition. "Parts car" would be more accurate. Anyway, I thought that I could repair what I had, except for the body. At the time, I was going to see if I could find someone who could cast a resin shell for me. Those are currently selling for well over $100...if you can find one. Again, did I bitch? Nope. Instead, I did a deal with one of my fellow modelers. Seems he had a plastic '32 shell he was willing to send me. One Austin Mini kit I had lying around and some other parts, and the deal was done.

When I still built models for people, I got to deal with all sorts of complaints. People would bitch about having to either supply the kit (or have me buy one), the cost of some of the materials...or simply because it took "too long." Sorry folks, it's not my fault that most kits are boxes of raw castings, nor is it my fault that said castings need cleaned up. You want something that looks like shit, or something that looks awesome? I don't sell shit

[muses_nightmare]

I find it strange when people talk about doctors and healthcare in the same terms as every other business. It's really not the same thing, healthcare is an essential service, not the same as something like a bakery or department store. And yes, doctors train for years and pay a lot of money to go to school, but the attitude that they deserve to make a ton of money by making it so people can't afford to even go for a basic doctors visit seems, just, wrong to me.

I can't imagine living in a place where anyone would have to put off going to the doctor because it will cost them an arm and a leg, and a place where people justified that cost in one way or another.

[AdminAssistant]

Well, muses, you have the luxury of living in a country enlightened enough to provide those basic services for all citizens.

[linguist]

I find it strange when people talk about doctors and healthcare in the same terms as every other business. It's really not the same thing, healthcare is an essential service, not the same as something like a bakery or department store. And yes, doctors train for years and pay a lot of money to go to school, but the attitude that they deserve to make a ton of money by making it so people can't afford to even go for a basic doctors visit seems, just, wrong to me.

I can't imagine living in a place where anyone would have to put off going to the doctor because it will cost them an arm and a leg, and a place where people justified that cost in one way or another.

I'll second what AA said, and add that it goes beyond the amount of schooling (and the hundreds of thousands of dollars in debt that puts doctors in at the beginning of their careers), it's also all the related costs of running a successful practice. Running a medical practice is hugely expensive. Not only do doctors have to carry insane amounts of insurance (upwards of $1 million in many cases), there's also the costs of hiring skilled staff (nurses, technicians, office assistants, etc.) as well as equipment costs. A well-equipped practice can have millions of dollars in equipment (an MRI machine alone costs in the $1-3 milliion range, plus the additional cost of constructing a suite to house it).

On top of all that, there's the fact that most doctors, essentially, are on call 24-7. Even in private practice, most doctors have answering services who will call them with patient concerns after hours, and the really good doctors will often give patients they have long-term relationships with their own private numbers to call them directly. Two years ago I was hospitalized, and my wife called my doctor at 3am just to let her know what was going on. She was at my bedside within the hour. She even cancelled a vacation to oversee my treatment through to the end (and I was in the hospital close to a month). My mom's OB/GYN told her while she was pregnant with my brother that he had not had a vacation or any real time off in over 8 years, because he didn't want to be gone or unreachable when one of his patients delivered. Doesn't this kind of dedication deserve compensation?

Additionally, I don't know of any doctor who isn't willing to work with patients who are unable to pay, up to writing off their charges all together. Unfortunately, doing so doesn't relieve the doctor of the expenses of treating those patients, and so they have to raise costs on the patients who can pay.

[DrFaroohk]

And I don't have a problem with covering costs. That's awesome. But these people aren't living on food stamps either (not that they should have to). They might not make as much as a stock broker or something but many of them are still pretty well loaded and I just ask - do they have to be? Do they have to be loaded? Some of these guys live a million dollar lifestyle. Whatever their expenses are, jesus....if your business costs 10 million a year to run, why do you have to charge people 20 million for your services?

It's rather frustrating, I've mentioned this several times and no one notices. Was my wording not clear? I don't understand. I'm not concerned with their expenses - covering expenses isn't an issue. Of course cover your expenses! I just question the profit margin.

[Ladeeda]

I can't imagine living in a place where anyone would have to put off going to the doctor because it will cost them an arm and a leg, and a place where people justified that cost in one way or another.

I live in America, and haven't been to the doctor for 18 months, since the health insurance for my last job ended after I got laid off. I only spent the $25 copay because it was an infection. I dashed to the dentist before that insurance ended as well, because I knew I wouldn't be able to go again unless I ended up in a miracle job with dental insurance, or that paid enough for me to visit the dentist. Not on birth control, since I can't afford it on my own (and I'm single), haven't' been to the ob/gyn since an STD scare: too expensive. I have a job, so can't NOT pay at Planned Parenthood, and no doctor I know of would write off the cost of a visit because someone's too poor to pay for it.

Doctors are prohibitively expensive, so I'm just hoping I don't get cancer or a broken leg or anything. Rather not have to try and set it myself.

[linguist]

It's rather frustrating, I've mentioned this several times and no one notices. Was my wording not clear? I don't understand. I'm not concerned with their expenses - covering expenses isn't an issue. Of course cover your expenses! I just question the profit margin.

You apparently didn't pay attention to the part where I said it goes beyond covering expenses. There's also the fact that the truly dedicated are on call 24-7, leaving them little to no time for a personal life. There's a reason that the burnout and divorce rate among medical professionals is as high as it is. This doesn't deserve compensation?

Also, this just occurred to me. The costs of education continue beyond the initial medical school. Doctors are required to complete so many hours of continuing education per year in order to maintain their certification and licenses. Continuing education expenses are paid for out of their own pockets, as are the costs of repaying their student loans. To pay such out of the profits of the business (which are supposed to be put back into the business if the corporation is set up properly) is unethical if not illegal.

[Ree]

It's rather frustrating, I've mentioned this several times and no one notices. Was my wording not clear? I don't understand. I'm not concerned with their expenses - covering expenses isn't an issue. Of course cover your expenses! I just question the profit margin.

I caught it.
I am asking, if the shoe was on your foot, are you saying you would charge the bare minimum and keep to the smallest profit margin possible?

I really have to wonder.

[muses_nightmare]

I am asking, if the shoe was on your foot, are you saying you would charge the bare minimum and keep to the smallest profit margin possible?

Correct me if I'm wrong DrFaroohk, but I don't think that's what he was saying. I think the main point is that the profit margins are huge, they don't have to be making the bare minimum but they don't need to gouge people in order to live million dollar lifestyles, and it's not the same as running a regular business, it's an essential service, unless there is no such thing as an essential service in the US?

[Greenday]

Other than specialists, I don't know too many doctors living in the million dollar lifestyle.

[Racket_Man]

I can't imagine living in a place where anyone would have to put off going to the doctor because it will cost them an arm and a leg, and a place where people justified that cost in one way or another.

welcome to the US healthcare system.

bacause of the current system and lack of insurance for the last 10 years or so I have not really been to a doctor for quite sometime.

higher income jobs prior to 10 years ago I have had yes did have decent insurance but the costto us employees kept going up (and up)

now the "minimum wage" job I have now does "offer" health coverage (at a cost of $1300 per year) BUT has sever spending limits, sever payout $$$$ restrictions and very little coverage for the premeiums paid.

just as an example. several months ago I did a trip to the ER with a kidney stone problem. could not get rid of it for some reason. that cost me just over $5100. if I would have had my company's insurance it still would have cost me, at minimum, $4500 out of pocket. even if I had wanted to go to my GP who could refer to me a Uriologist who would have performed a procedure, I would have STILL had to pay like 95% out of pocket.

let me give you a rundown of the $$$'s I spent to go to the ER

in the ER the 2 CAT scans they did set me back $2000. the ER doctor cost me $500. the Radiologist who looked at my CAT scans cost me $700. jsut walking into the ER cost me $1300. drugs and labs cost me $500. the ER room was the cheapest charge at $150 for the 4 hour stay.

finally I passed just part (note I said part) of the stone (have pictures to confirm the shear size of this boulder that formed causing me soooo much pain)

10 years ago I had the same thing happen minus the CAT scan. the size of the stone was about the same (and about 2 week later I was able to pass it with lots of trouble and much blood letting) back then my total cost was only around $1500.

and people wonder why there is soo much debate and wailing about healthcare and the associated costs??????

[DrFaroohk]

It seems now like the main argument is that since I personally might do the same thing, it's ok...

since when has that ever been a good argument? I've NEVER been able to use that. "Well you do it too! He's done it too! You would do it in my shoes!" I've never been allowed to do that, why is it allowed now?