Those numbers do seem to be a bit higher than the national salary averages for physicians [1]. However, physician pay only amounts to something like 8% of total health care costs [2]. I'm not saying that doctor pay at Vanderbilt isn't driving up their healthcare costs but this doesn't seem to be the whole story when it comes to national healthcare costs.
The structure is a messed up mix of the red tape and regulation of a government bureaucracy, monopolistic behaviour (try getting 3 quotes for a procedure like you would for a bathroom renovation), subsidies, freeloaders, and weird incentives.
The government has decided it's too stupid to run hospitals. But it's also decided that it needs to ensure both the supply of hospitals, and to maintain standards. So instead of just telling doctors what to do (and paying them enough to ensure a steady stream of high quality medical students) it tries to get all the red tape and subsidies right, while the private sector (hospitals and insurers) try to figure out how to outsmart the government and make the system more expensive.
The US government spends a similar amount (per captia or as a percent of GDP) as Canada on its public funding (Medicare, Medicaid, VA, and so on). But the US system is so fantastically inefficient (due to weird incentives and massive amounts of bureaucracy and profit seeking) that unlike Canada it can't even offer basic universal healthcare (despite spending an insane amount of tax dollars).
> The US government spends a similar amount (per captia or as a percent of GDP) as Canada on its public funding (Medicare, Medicaid, VA, and so on).
As of 2016, Canada's public spending was 7.4% of GDP, the US's was 8.5%; and the US per-capita GDP is higher, too, so I don;t think its really "a similar amount" per capita, and only loosely so per GDP. But, yeah, the big difference is that the US spends even more than the publicly spending in private healthcare spending, while Canada (like most other first-world countries) spends far less privately than the public share.
Reducing US healthcare costs sounds similar to reducing carbon emissions. Cuts need to come from everywhere because the system as a whole is inefficient. There's no single silver bullet.
to wit, as with teachers, i don’t mind doctors and other medical professionals getting paid well, but the AMA restricting supply to increase salaries is anticompetitive and wrong-headed. i also don’t mind medical devices, labs, and even drug companies getting a decent (but not exorbitant) return.
i’m less sympathetic to high administrator pay among medical networks, the whole medical records/billing industry, as well as the medical insurance industry. that feels like a very high tax burdened onto healthcare.
[1] https://www.merritthawkins.com/news-and-insights/blog/job-se...
[2] https://jacksonhealthcare.com/media-room/news/md-salaries-as...