Name: 醫生工資過高嗎？醫療成本的真相 (Are Doctors Overpaid? The Truth About Healthcare Costs💊)
Uploaded: 2025-10-08T18:21:27.000Z
Duration: 11 min 13 s

程度副詞

Last year, health care spending in the US increased by 7.5% to a whopping $5 trillion, or in other terms, nearly $15,000 per person.

去年，美國的醫療保健支出增加了7.5%，達到驚人的5兆美元，換算下來，每人將近15,000美元。

轉承詞

Doctors are surely to blame because of their massive six figure salaries.

醫生們因為他們那驚人的六位數薪資，肯定是要為此負責。

Dr. Jubbal medschoolinsiders.com Healthcare is expensive, and someone's got to take the blame.

Dr. Jubbal medschoolinsiders.com 醫療保健很昂貴，總有人要為此負責。

But let's cut through the nonsense and look at the facts.

但讓我們釐清謬誤，檢視事實。

Physician services in the US Only make up a fraction of total healthcare spending, with estimates ranging anywhere from 8 to 14%.

在美國，醫師服務僅佔總醫療保健支出的一小部分，估計範圍從8%到14%不等。

But keep in mind, higher estimates lump physician services together, which includes additional costs beyond doctor salaries.

但請記住，較高的估計將醫師服務合併計算，這包含了醫生薪資以外的額外成本。

So if you cut physician salaries in half, it would only account for around 5% of total healthcare spending.

所以，如果將醫師薪資砍半，也只會佔總醫療保健支出的約5%。

And even if all physicians were to volunteer their time without any pay, about 90% of healthcare costs would go unchanged.

即使所有醫生都義務工作，不領薪水，約90%的醫療保健成本也不會改變。

那麼，到底是什麼在推高成本呢？

When you look at other top expenses in health care, hospital services and administrative costs each eat up approximately 30% of spending, and

當我們檢視醫療保健中的其他主要支出時，醫院服務和行政成本各佔了約30%的支出，

prescription drugs make up another 10 to 15% of spending.

處方藥則佔了另外10%到15%的支出。

These are also the areas that are increasing at a faster rate.

Total health care spending from 2022 to 2023 increased by 7.5% compared to a growth of 4.6% in 2022.

2022年至2023年，總醫療保健支出增加了7.5%，而2022年的增長率為4.6%。

Physician and clinical services, which includes much more than physician salaries, increased by 7.4%.

醫師和臨床服務（這包含了遠超過醫師薪資的項目）增加了7.4%。

But where we're seeing much more growth is in hospital care spending, which increased by 10.4%, and

但我們看到更多增長的是醫院照護支出，增加了10.4%，

retail prescription drugs, which increased by 11.4%.

以及零售處方藥，增加了11.4%。

But these data points don't paint the full picture.

但這些數據點並不能描繪出全貌。

The top people who profit from healthcare are big pharma and insurance companies.

從醫療保健中獲利最多的人是大型製藥公司和保險公司。

In the past two decades, the pharmaceutical industry has experienced significant growth, with revenue totaling over $1.6 trillion in 2023.

在過去二十年中，製藥業經歷了顯著的增長，2023年的總營收超過1.6兆美元。

For perspective, that's around the entire GDP of countries such as Mexico, Spain, Australia and South Korea.

作為參考，這大約等於墨西哥、西班牙、澳洲和韓國等國家的整體GDP。

Revenue doesn't paint the full picture because it excludes expenses.

營收並不能描繪出全貌，因為它排除了支出。

It's difficult to say, since each pharmaceutical company has different expenses and a different way of reporting.

這很難說，因為每家製藥公司的支出和申報方式都不同。

But it's safe to say that profits are still in the hundreds of billions of dollars a year.

但可以肯定的是，每年的利潤仍然高達數千億美元。

The 16 largest pharma companies alone, which earned $684 billion in 20, spent over $100 billion rewarding their shareholders.

光是16家最大的製藥公司，在2020年賺了6840億美元，就花了超過1000億美元回饋股東。

And keep in mind that profits are something these companies can easily downplay after inflating their expenses, which includes paying CEOs millions of dollars in salaries, bonuses and stock options.

而且請記住，利潤是這些公司在誇大支出後可以輕易壓低的數字，這包括支付給執行長數百萬美元的薪資、獎金和股票選擇權。

With such a large and profitable industry, you'd expect the US to be leading the way in healthcare.

擁有如此龐大且有利可圖的產業，你可能會認為美國在醫療保健方面會處於領先地位。

And while the US Develops more drugs than any country, those same drugs cost an average of 278% more in the US when compared to other countries.

雖然美國研發的藥物比任何國家都多，但與其他國家相比，這些藥物在美國的平均價格卻高出278%。

The US pays 172% more for drugs than Mexico, 229% more for drugs than Canada, and

美國支付藥品的費用比墨西哥高172%，比加拿大高229%，而且

And on brand name drugs, the numbers get even worse.

而且在品牌藥品方面，數字變得更糟。

The US pays 422% more for brand name drugs across a comparison of 33 other countries.

在對照的33個國家中，美國支付的品牌藥品費用高出422%。

There's a powerful push, often fueled by big pharma and insurance companies, to paint doctors as the villains they want to deflect blame for rising costs and keep the public's focus away from their own profits.

一股強大的推力，常由大型製藥公司和保險公司推動，將醫生描繪成反派，目的是轉移人們對不斷上漲的成本的注意力，並讓公眾的焦點遠離他們自己的利潤。

And it's an easy story to buy into, with many doctor specialists making over half a million dollars a year.

這是一個很容易讓人相信的故事，因為許多專科醫生每年收入都超過五十萬美元。

Yes, while it's true that some specialties make an average of over $700,000 a year, there are also specialties, especially those focused on pediatrics, that make under $250,000.

沒錯，雖然有些專科的平均年收入確實超過70萬美元，但也有一些專科，特別是專注於兒科的，年收入卻不到25萬美元。

But still, clearing a guaranteed quarter million a year is still quite a bit of money.

不過，每年穩賺25萬美元仍然是一筆相當可觀的收入。

What's important to understand is the debt and opportunity cost of becoming a doctor.

重要的是要理解成為醫生的債務和機會成本。

Most physicians graduate with hundreds of thousands in student loans.

大多數醫生畢業時都背負著數十萬美元的學生貸款。

The average graduating medical student debt in the US is now over $250,000.

美國醫學院畢業生的平均負債現在超過25萬美元。

That's a massive financial burden that weighs heavily on a physician's shoulders for years.

這是一筆沉重的財務負擔，會讓醫生多年來肩上壓力沉重。

And keep in mind, this is the average, which means many doctors leave medical school with debt much higher than $250,000.

而且請記住，這是平均值，這意味著許多醫生離開醫學院時的債務遠高於25萬美元。

You might scoff at 250k of debt, thinking they'll be able to pay that off in a few years with a physician's salary.

你可能會對25萬美元的債務嗤之以鼻，認為他們可以用醫生的薪水在幾年內還清。

As humans, we didn't evolve to think in this long term logarithmic way.

作為人類，我們並非為了以這種長期的對數方式思考而演化。

We're much more interested in the here and now than in how small investments or debts compound over time.

我們對當下更感興趣，而不是小額投資或債務隨著時間的複利。

Consider investing that quarter million dollars over 43 years from college graduation age of 22 to retirement age of 65, at an annual return of 10%.

考慮一下從22歲大學畢業到65歲退休這43年間，以每年10%的回報率投資這25萬美元。

Compound interest would leave you with over 15 million dollars.

複利將讓你的資產超過1500萬美元。

That's the opportunity cost of becoming a doctor in America today.

這就是現今在美國成為一名醫生所付出的機會成本。

It's a much different story for doctors who train in other countries, such as in Europe or Australia, who might make less than American doctors, but

對於在歐洲或澳洲等其他國家接受訓練的醫生來說，情況就大不相同了，他們可能賺得比美國醫生少，但

they don't train for as long or have hundreds of thousands of dollars of debt to contend with after graduating.

他們的訓練時間較短，畢業後也不必面對數十萬美元的債務。

medical student graduates with that amount of Debt Some students have their education paid for by their parents, and

醫學院的學生畢業時都背負這麼多債務。有些學生的教育費用是由父母支付，而

top students have the potential to earn merit based scholarships that can cover the majority of the cost of medical school.

頂尖學生有潛力獲得績優獎學金，足以支付大部分的醫學院學費。

By the way, merit based scholarships are how I got all of my medical school tuition paid for and I did this by leveraging multiple acceptance offers.

順帶一提，績優獎學金就是我獲得所有醫學院學費補助的方式，我透過爭取多個錄取通知來達成。

These are the advanced tactics myself and the team at Med School Insiders can teach you through our medical school admissions consulting services.

這些就是我和Med School Insiders團隊，能透過我們的醫學院入學諮詢服務教導你的進階策略。

Learn more@medschoolinsiders.com and remember, it's not just $250,000 or more of debt, it's also the interest that comes with it.

請到medschoolinsiders.com瞭解更多，並記住，這不僅是25萬美元或更多的債務，還有隨之而來的利息。

And what's more, doctors can't begin making any significant debt in their debt until after they complete residency.

而且更重要的是，醫生在完成住院醫師訓練之前，根本無法開始償還任何可觀的債務。

During residency, which can last anywhere from three to seven years, depending on the specialty, doctors only make an average of $67,000 while their debt continues to accumulate interest.

住院醫師訓練期間，根據專科不同，可能長達三到七年，醫生平均只賺取67,000美元，而他們的債務卻持續累積利息。

While this may sound like a good amount of money, it comes with working long, difficult hours.

這聽起來可能是一筆不少的錢，但伴隨而來的是長時間、高強度的工作。

Depending on the specialty, residents can work upwards of eight 80 hours a week, meaning at times they're essentially paid less than minimum wage.

根據專科不同，住院醫師每週的工作時間可能超過80小時，這意味著有時候他們的時薪甚至低於最低工資。

Despite the Accreditation Council for Graduate Medical Education limiting resident work hours in the US to a maximum of 80 hours weekly on average over a given month, there are numerous accounts of residents exceeding these thresholds.

儘管美國的醫學教育認證委員會規定住院醫師每週工作時間平均上限為80小時，但有許多報告指出住院醫師經常超出這個時數。

I covered the use of residents as cheap labor over on the khemajubal MD channel.

我曾在 Dr. Jubbal 的 YouTube 頻道上探討過住院醫師被當作廉價勞力的問題。

Doctors are overworked, plain and simple.

醫生就是工作過度，非常簡單。

The US has fewer doctors per patient compared to many other developed countries.

與許多其他已開發國家相比，美國每位病人的醫生人數較少。

According to the aamc, the United States will face a physician shortage of up to 86,000 physicians by 2036.

根據AAMC的數據，到2036年，美國將面臨高達86,000名醫生的短缺。

So the next time you hear someone blaming doctors for sky high healthcare costs, point them to the facts.

下次聽到有人怪罪醫生造成醫療保健費用飆漲，就請他們檢視事實。

Physicians are not the problem, they're part of the solution.

醫師不是問題，他們是解決方案的一部分。

They are on the front lines taking care of their patients despite the system stacked against them.

他們在前線照顧病人，儘管體制對他們不利。

Even though physician compensation rose by 14% from 2017 to 2022, when you account for inflation, their real compensation decreased by 6%.

雖然從 2017 年到 2022 年，醫師的薪酬上漲了 14%，但若考慮通膨，他們的實質薪酬卻下降了 6%。

Physicians are getting less and less for doing the same amount of work, and

醫師們在做相同工作的情況下，得到的卻越來越少，而且

in many cases more work due to understaffed hospitals and the additional administrative burdens of the electronic health record.

在許多情況下，由於醫院人手不足以及電子病歷增加的行政負擔，他們的工作量還更多。

Yet pharmaceutical profits are consistently on the rise.

然而，藥品業的利潤卻持續上漲。

Remember that $1.6 trillion industry we mentioned earlier?

還記得我們之前提到的那個 1.6 兆美元的產業嗎？

Look, the US healthcare system is a mess.

聽著，美國的醫療保健體系一團糟。

The prioritization of profits over people in the US Healthcare system has led people to anger, disillusionment, and

美國醫療保健體系中將利潤置於人民之上的做法，已經讓民眾感到憤怒、幻滅，以及

in the case of Brian Thompson, the CEO of UnitedHealthcare, even murder.

以 UnitedHealthcare 的 CEO Brian Thompson 為例，甚至涉及謀殺。

Check out my assessment of the United Healthcare scandal over on The Kevin Jubbal, MD channel.

歡迎到 The Kevin Jubbal, MD 頻道收看我對 United Healthcare 醜聞的分析。

In that video further discuss the benefits of a single payer healthcare system.

在那部影片中，我會進一步討論單一支付者醫療保健系統的好處。

There are many, many different factors contributing to high healthcare costs.

有非常非常多不同的因素導致醫療保健費用高漲。

But instead of scapegoating doctors, let's be honest about what's really going on.

但與其把矛頭指向醫生，不如誠實面對真正的情況。

The idea that doctors are rolling in dough and driving up costs is a myth, plain and simple.

醫生們大把撈錢並推高成本的想法，簡直就是個迷思。

We need a healthcare system that works for everyone, not just for insurance companies.

我們需要一個對每個人都有效的醫療保健體系，而不僅僅是保險公司。

Fee for service care puts an emphasis on profits and speed of care over the well being of patients.

論量計酬的照護方式，將利潤和照護速度置於病患福祉之上。

Value based care, on the other hand, ties reimbursement to the quality and effectiveness of the care provided.

相較之下，價值導向的照護則將給付與照護的品質和成效連結。

This results in more emphasis on preventive care, chronic disease management and patient engagement, and

這使得預防保健、慢性病管理和病患參與受到更多重視，

in the long term, reduced healthcare spending.

長期下來，也能降低醫療保健支出。

While there are clear pros and cons to both fee for service and value based care, which we covered in this video right up here, working towards an effective value based model is one solution for US Healthcare.

雖然論量計酬和價值導向的照護各有優缺點，我們在這支影片裡有詳細介紹，朝向有效的價值導向模式努力，是美國醫療保健的一種解決方案。

Single payer systems like the ones used in Canada and the uk, which spend far less per capita, are another option.

像加拿大和英國採用的單一支付者系統，人均支出較少，也是另一種選擇。

These implementations of a single payer system are riddled with problems, but there are benefits.

單一支付者系統的這些實施方式雖然問題叢叢，但也有其益處。

A single payer owns the patient and their outcome for life, so that single payer is incentivized to get on top of any health issues to limit long term costs.

單一支付者終身擁有病患及其照護結果，是以單一支付者有動機去處理任何健康問題，以限制長期成本。

With the current US healthcare system, insurance companies aren't motivated to optimize that person's health long term because they know there's a strong likelihood that person will have moved on to another insurance company before they develop something like diabetes or heart disease.

在目前的美國醫療保健體系下，保險公司沒有動力去優化病患的長期健康，因為他們知道，在病患罹患糖尿病或心臟病之前，很可能已經轉到另一家保險公司了。

It's the next insurance company's problem.

這變成下一家保險公司的問題了。