I have observed the devolution of medicine over the past 30 years. Anyone who is not independently wealthy would be ill-advised to choose a career in medicine as the exepense to achieve it is becoming more difficult each year to pay off. Physician salaries in the U.S. continue to decline, and although they are the highest in the industrialized world, those who promote universal health care want to level the playing field among physician salaries.
With tuition and expenses running upward of $60K per year for the 4 years of medical school, and salaries for medical residents ranging from $30-35K per year for the 3-7 additional years of training post medical school, it is easily seen that an overwhelming debt is difficult, if not impossible to pay back. If one graduates from medical school with a $250K debt, and cannot pay but minimal interest payments during residency, the debt load could be substantial when the physician finally has some earning power i.e. $200K plus. It is difficult to start a family and buy a house under these circumstances, especially while working 60-80 hours per week.
Universal health care sounds terrific for those who have no medical coverage, but wait until you have the wonderful things like prioritization and waiting lists. There will no longer be "instant gratification" as Americans are used to. If you need an MRI scan, get in line and wait your turn. Likewise with cancer treatment and other medical necessities. The system is based upon the premise that while you are waiting in line, you will die and someone else will jump ahead.
I discouraged my own children from considering medicine, and interestingly enough, my daughter makes as much money with fewer hours and responsibility working as a retail pharmacist than some of my physician colleagues.
Thank you so much for your essential and illuminating post, which encapsulates the entire debate in a meaningful way with a few well-chosen words.
The debt load incurred by medical students is unconscionable and un-American, as the specter of such a mammoth financial debt will surely turn away many of the best and brightest students, whose only failing is that they don't happen to come from wealthy families. I'm not sure what the answer is, as I reject the notion of additional taxpayer funding of higher education and prefer Capitalist reforms whenever possible. My feeling is that at least a partial solution would involve Tort law reform and the reduction of legal exposure and associated lawsuits in the medical professions, but as long as the likes of John Edwards populate the litigious landscape I doubt that relief will occur anytime soon. I'm thinking that such reforms might at least slow down the escalating costs in medicine, which will inevitably trickle down to all areas of healthcare, including education.
As to "Universal Healthcare", my great wish is that some of it's most vocal proponents here in the USA would live for awhile (it may take them a generation or two) in any of the nations featured toward the right of your excellent chart. They would find your words to be true, and that they had chosen something far different than the Socialist Utopia that their ignorance had suggested.
It seems that a significant number of doctors in the UK are echoing many of your sentiments, as outlined in this FR thread:
Great Britain Morale terrible among doctors (poll of NHS Docs69% wouldn't recommend MD career)
The story of your daughter is surprising, as I wasn't aware that the earning levels of Pharmacists was at the level of some MD's.
Thank you again for your insightful post.....there's nothing quite like a truly informed perspective such as yours.