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Anecdotal stories are just anecdotal stories. I know plenty of GPs who don't make six figures, and I know plenty who make around $120,000 - 150,000. The issue of medical expenses goes WAY beyond physician salaries, which constitute a relatively small percentage of medical costs.

Let's take the breast cancer scenario of this thread. When a patient presents to their GP or OBs office for a check-up/exam etc. there has to be an office, a receptionist, a nurse, equipment etc., and malpractice insurance, all expenses part and parcel of that initial visit.

If the patient gets referred for a mammogram there are the costs for the mammography equipment, the radiology tech, the secretaries etc. who administrate the mammography facility, insurance costs, transcription costs, and the radiologists fee for reading the mammogram.

The patient gets referred to a surgeon or oncologist who also has to pay an office staff, rent on an office, equipment costs, malpractice insurance, etc. If surgery is recommended there will have to be a panel of pre-screening labs obtained, involving expensive equipment and technical staff (e.g. chem panels, CBC, coags, CXR, CT or MRI for staging, ECG etc.). Depending on the age of the patient and risk factors surgical clearance may be required (this is driven in part by fear of lawsuit should the patient have a myocardial infarction etc. during surgery because of undiagnosed coronary disease etc.). This clearance may involve a stress test with nuclear imaging (more equipment, more technicians etc.).

Once cleared from surgery and admitted to the hospital there are the people who work in admitting that have to be paid (filling out insurance forms etc.), transport personnel, the people who clean the rooms, the kitchen staff, etc. The patient will have to be seen by an anesthesiologist before surgery to make sure there are no surprises, and they may want further consults. The nursing staff needs to be paid, as well has the nursing assistants.

The surgery itself involves an anesthesiologist, a primary surgeon and possibly a secondary surgeon, scrub nurses, OR techs, and lots of other support staff. There are people who clean and sterilize the instruments. The costs of disposable sterile drapes etc., and the costs of other surgical disposables (e.g. suture, medications etc.).

The tissue that is removed is sent to the pathology lab where technicians prepare the tissue for analysis, and then the tissue must be examined by a pathologist to determine if the margins are clear and if the lymph nodes are free of cancer. There may be several special stains done, and genetic analysis of the tissue. The post-op course will involve 1 on 1 nursing in the post-op area, probably ICU time, lots of labs and dressing changes, meds, etc. etc. This is a very conservative depiction of what's involved, and doesn't even touch on the costs of running the hospital physical plant. And yes, there are the surgeons fees as well.

There are no easy answers, and we need to have an honest, informed, open discussion of the potential options.