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Are healthcare workers paid too much?

Are healthcare workers paid too much?

January 27, 2010 | Richard Pizzi, Editor

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LAS VEGAS – Healthcare in the United States is becoming increasingly unaffordable, and one of the contributing factors may be the high salaries earned by healthcare employees.

Speaking recently at the Symposium on Payment Solutions for Healthcare Providers and Payers in Las Vegas, William Bertschinger, divisional chairman of finance at the Mayo Clinic, said healthcare labor costs are driving systemic inefficiency.

“Seventy percent of the high cost of healthcare is due to labor costs,” Bertschinger said. “There are too many full-time employees and too many employees paid at too high a rate.”

Bertschinger discussed data from the federal Bureau of Labor Statistics and the Kaiser/HRET Survey of Employer-Sponsored Health Benefits that showed the earnings of healthcare workers rising at a faster rate than overall U.S. workers and faster than overall inflation.

For instance, the overall inflation rate in 2008 was 29 percent higher than in 1999. U.S. workers’ earnings rose 34 percent over that same period, while healthcare workers’ earnings have risen 57 percent since 1999. Bertschinger noted that the upward trend in healthcare salaries has increased since 1999, with healthcare workers generally earning 1-4 percent more per year than non-healthcare workers.

“In order to cut costs in healthcare, we need to reduce the number of full-time employees, reign-in salaries, and stop increasing the fees we charge patients,” Bertschinger said.

Healthcare salaries are not usually mentioned as part of the overall affordability equation, Bertschinger said. He noted that even when healthcare executives have made hard decisions to cut full-time employees, the potential savings were not “banked,” but were simply redeployed to other areas of the budget.

A big part of the problem is the healthcare revenue cycle itself, Bertschinger claimed. Revenue cycle has the lowest patient satisfaction scores in healthcare, and the highest costs per patient – 70 to 90 percent of which are labor costs.

“The healthcare revenue cycle is not complex, it’s convoluted,” Bertschinger said. “We spend 5 percent of our total costs – or $120 billion – on the revenue cycle. That’s in addition to another $600 billion – or 25 percent – on administration. It’s really a sad state we’re in.”

A sea change in management philosophy is necessary to move healthcare toward systemic affordability, Bertschinger said.

“Leadership is the number one factor in changing the culture of healthcare,” he said. “Cost reductions will occur when there are fewer people providing services at fewer facilities, working at a much lower pay scale.”

Related Topics:
  • finance
  • Las Vegas
  • Mayo Clinic
  • United States
  • William Bertschinger

Reader Comments (28)Login to Post a Comment

poor-perso says:

March 06, 2010 | 7:03PM GMT

To all overpaid medical field workers

I noticed that most if not all of the comments to the author were from medical field workers and I would like to add a lowly common person's comment to the mix.
I wholeheartedly agree with the author about the high cost of medical treatment being mostly due to the outrageously high salary requirements of medical staff. This includes doctors, surgeons, and nurses. I'm sorry I can't feel sorry for you (medical staff) when I (single earner) am making a measley 26000 a year and can't afford a simple doctor's office visit. I know you guys work hard, study hard and deserve decent pay, but then again...so do I. I'm a professional in my field (NON-medical) but am not making 20.00+ hour pay.

Sincerely: From a dumb, uneducated peon making 13.00 a hour trying to provide for his family.

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kaferlily says:

February 09, 2010 | 12:44PM GMT

who is paid too much?

I have been a nurse for over 25 years. My salary maxed out years ago and, in fact, I now make less per hour, not only in real 2010 income but also in terms of inflation than I did even 5 years ago. I am not given monetary or even verbal reward for my experience or education. Rather I am considered expendable -- no more than a cog in the corporate wheel that is US health "care". Now there's an oxymoron. It is much less expensive to replace me with a new grad or patient care technician. Those who suffer are the patients, who are tended by inexperienced and overworked bedside nurses who are thrown into the endless cycle of the nursing shortage without time to develop crucial assessment skills. Facilities prefer to orient a revolving door of new staff rather than retain experienced and dedicated nurses. They dangle recruitment incentives to nurses at the entrance while pushing expert nurses out the exit. When these new nurses earn their bonuses, they jump to the next carrot at the next facility and the cycle continues. The system does not reward nurses who stay at the bedside. The big salaries are earned at the top of the food chain by those who prefer to hire consultants to look for solutions rather than ask those who actually do the work.

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moneill says:

February 08, 2010 | 12:08AM GMT

Who is going to work if you cut salaries?

i can tell you right now, for anyone who's never been to a walgreens at 5:30pm... if you start cutting pharmacist salaries in order to make up for overall healthcare costs, beware. I know too many pharmacists that only work at Walgreens for the money. It definately isn't for the patient care they are able to provide in that busy setting. if that starts to go away you'll have a hard time finding community chain retail pharmacists, and a really hard time finding good ones.

think about it. if you start cutting the salaries of health care professionals, that pay at least $100,000 to go to school and for doctors, more. and invest 6 to 10 yrs of their lives for schooling, you're going to start losing quality.

not to mention if you cut jobs and make them even busier...Plus, do we really want to lose more jobs...

it doesnt take a brain surgeon to figure this out. pun intended. i know for a fact that pharmacist salaries were driven by demand. there's a reason why there's a walgreens on every corner now and there werent 10 yrs ago. more people want meds. high demand = high cost. think about it. if everyone who ever got an upset stomach just took tums instead of running to their doctor for nexium, charging their insurance for the MD visit, then charging their insurance for the RX, just to get home and not take the medication correctly. (guaranteed that 90% of people on nexium arent taking it compliantly and therefore decreasing effectiveness.)

if you want healthcare costs to go down, your choices are:
1. increase competition btwn insurance companies, allowing them to sell across state lines.
2. start demanding that your employeer drops you from your group enrolled insurance at work and give you the difference they pay in premiums. they'll say "no" of course, but if enough people start doing it...
3. stop running to the doctor every time you get a hiccup.
4. support caps on litigation against health professionals. yes, it sucks when something goes wrong w/ your medical treatment, but is it worth 10x as much as you'll make in your life regardless? cover the needed medical treatment. cover psych costs and help them get re-established in life, but limit the ridiculous pain and suffering millions.
5. tell your congressmen/rep that you want people on medicaid drug tested on a regular and random basis. if they're going to reap the benefits of my hard work, the least they can be is not sitting at home doing something illegal. i'd lose my job for doing drugs and getting caught. shouldnt they at least lose the free ride? basically they are getting paid...so it is like a job for them...
6. require people to have a real emergency to use the ER. sorry, but i have access to see what people are admitted to the ER for. you'd be shocked at how many are: "sore throat," "back pain," "cough/fever." oh, and how many of them got a ride to and from the ER in an ambulance b/c they called 911 about their "emergency." oh, and they dont have to pay for it either, you've got that one covered. wait til morning and see the doctor or use a clinic if you really need a doctor... not the er.
7. start paying CASH for your doctor visit. buy a catastrophic insurance plan that will cover you in case of a stroke or MI and then pay cash for everything else. call around and ask the doctors if they give a cash discount. you'd be surprised at how many will be willing to take on an patient that will pay for their visit up front and they dont have to mess w/ the insurance paperwork. if you dont see the MD often, this could save you over the course of the year anyway. although, you will then be branded as an "un-insured" american and therefore be part of the people we're all supposedly trying to "save" now.
8. think about real solutions instead of buying into the class-warefare rhetoric thats been going around lately. sorry, rich people provide jobs to everyone else. i will stand by this until i get a knock on my door from a homeless guy who's offering me a 40hr/week + 401K package. until then i will either choose to work for someone who's richer than i am or will venture out on my own business and try to become that rich guy. economics and capitalism work so long as our brains are turned on too.

I agree that drug companies charge a lot for medications. Some times it is warranted. By the time the drug comes on the market they may have been working on it for 15-20 years and have spent millions in production already. To top it off, another company is using their info to make a generic that will be able to come out in a year b/c it took so long to produce the drug. But, if we want new drugs for diseases we can't currently treat...if we want people researching cures for cancer, etc. Who do you think is going to do that?

If you think healthcare costs too much, quit using the healthcare system. Go to school yourself to know how to treat yourself and then research how to make the medication to treat yourself and how to dose the medication, etc.

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kcparsons says:

February 02, 2010 | 12:01PM GMT

Thank you Mr. Bertschinger!

My sincere thanks to the divisional chairman of finance at the Mayo Clinic for offering up such opinions. The "commoditization" of healthcare is in line with his opinions and would be further supported by the rise in "medical tourism" that causes paying customers to go to other countries for cheaper procedures. I am also grateful for the firestorm of comments from providers with alternative views. As a physician who made progressively less the last few years of clinical practice, despite no decrement in patient load, I can say that ins. contract discounts for procedures and E&M codes, shrinking Medicare payments and roll backs in workers comp and medicaid payments are already accomplishing what Mr. Bertschinger proposes, if he is talking about physicians. Now I spend time hanging out with the incoming generation of medical students who are just beginning the process I started in 1966. I finished medical school with zero debt and a paid off automobile. But in eight years my young colleagues will have more than $100,000 in debt, and they will be looking for places to practice where they can have a decent life style (what better definition for "delayed gratification?") and enough left over to cover their student loans. By the way, does Mayo Clinic pay off the loans of the faculty they hire? Ask a mid-career physician if he or she would do it all over again, if they had known then what they know now? Their answers would make engineering and business schools look much more attractive to the "best and brightest" that we need to be recruiting to our medical schools today and tomorrow.

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justin98 says:

February 02, 2010 | 10:54AM GMT

Are Healthcare Workers Paid Too Much?

As an executive search consultant specializing in healthcare and the Mother of an Oncology Nurse who cares for very sick and/or dying patients, I cannot disagree more with Mr. Bertschinger's comments. I also cannot imagine a hospital that runs on part-timers (with no, or reduced benefits available) who are not paid a living wage, but, yet,are expected to be knowledgeable of, and proficient with, the latest technologies, protocols and pharmaceuticals. Who would want a job like that? And who would want to be that person's patient? Not I, in either case.

If Mr. Bertschinger's comments are reported correctly here, I have to believe he has spent too many years in a financial silo and has probably never been the recipient of quality healthcare, provided by the hands of a smart, well-trained nurse, nurse practitioner, etc. who loves what he/she does for a living. There is a lot of waste in healthcare, but don't blame it on the people who are taking care of patients.

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monicadard says:

February 02, 2010 | 8:41AM GMT

Salary cuts.

Yes, I agree with Mr. Bertschinger and perhaps the salary cuts should begin on his level. Let's face it the people who DIRECTLY deliver healthcare services are the individuals who should be making those salaries. Far too often healthcare facilites are way too top heavy and maybe it is time to trim the fat. I am certain Mr. Bertschinger salary is much more that the labor intensive bedside nurse position.

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keithmock says:

February 02, 2010 | 8:39AM GMT

A disconnect between the CFO suite and the bedside?

There has to be an explanation of the reason behind such a monumental disconnect between the thought processes in Mr. Bertschinger's mind and the realties of the bedside delivery of healthcare. No one can take his comments seriously if they have any idea of what is transpiring in the delivery of healthcare today. Technological advances at the time of increasing acuity of patients is causing an increase in the need of even more highly trained professional staff. To answer the question posed by the title of this article is to reply "No! Professional staff in today's modern healthcare system is underpaid, not overpaid. We need to find better ways to compensate professional staff or we are not going to be able to deliver high quality care. Mr. Bertschinger's comments are either misstated or just completely ignorant based on the realties of today's healthcare delivery issues.

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Roger T says:

February 02, 2010 | 7:56AM GMT

Overpaid?

Maybe at the VP level and above, but not at staff levels. I was a IT Auditor in a hospital system in a major East Coast city from 1998 thru 2003. My annual raise for all those years was 3% and I was told in advance that 3% was the absolute maximum allowable, no matter how good my performance was, and I did not get a raise when I moved from Banking to Healthcare.
The biggest improvement that the government could make in healthcare costs is to control malpractice costs. Many many costs are introduced to the system by defensive medicine. Looking at not what the patient needs but at what the patient's lawyer might be able to convince a jury what he/she feels "should" have been done to create a different outcome (with the benefit of 20/20 hindsight).
Insurance, everyone's favorite whipping boy has made some pretty stupid denials when looked at by hindsight, but the idea of pre-existing conditions is a valid actuarial cost calculation. Eliminate the denial of pre-existing conditions and EVERYONE ELSE'S COSTS WILL GO UP. All insurance does is spread the costs around. If the insurance company must take customers who already have say cancer, their cost structure WILL GO UP. a lot.
If you applied for an auto insurance policy the day after a major accident, would you really expect them to pay? Get real. That is just plain silly. Given that scenario, don't buy health insurance until you are sick. The more control Washington has over the healthcare system, the worse things will get. Remember the Social Security TRUST Fund, the Post Office. Picture a strongly unionized healthcare workforce, then think about the flexibility needed to run a hospital during a widespread emergency. Sorry, union work rules prevent you from using those nurses in the dept that needs them most. Too bad, so sad.

Roger T.

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euonymous says:

February 02, 2010 | 7:46AM GMT

Healthcare Costs

Mr. Bertschinger may be saying that 70% of Mayo Clinic's budgeted costs are related to personnel. That is quite different from saying that 70% of health care costs in general are personnel. 30% of all health care costs nationally are administrative according to federal and private statistics (including Mr. Bertschinger); that includes the entire health insurance industry and the administrative personnel at the Mayo Clinic who cope with the insurance industry. Medicare has a 3% administrative overhead, according to government statistics, by the way. My point being that there are more costs in the system than personnel and administration.

The health care revenue cycle is ridiculous. The entire health care system in this country is broken. We have excellent doctors, nurses and health care professionals struggling to work in a system that allows them increasingly less time to work with patients and demands increasingly more time addressing profit-related issues. Universal health care would not only be less expensive overall, it would put the United States on a par with other developed countries.

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herriottb says:

February 02, 2010 | 6:55AM GMT

I can agree to a point that

I can agree to a point that health care employees are over-paid. Who is to blame for this? As I re-call, the stipulations and regulations that are placed are caregivers provide role strain for qualified employees. For example, an LPN working at a facility can do 80% of the work, but the facility only allows that LPN to do 60%, therefor requiring more RNs to staff and higher wages to be paid. Most acute care facilities are fazing out the LPN that is substantially cheaper than the RN. Why is this? Working as an RN I have experienced this first hand it baffles me. Another reason that more caregivers are required is due to the high number of malpractice suits that are filed every year. I am sure it is cheaper to have more employees than to pay out some ridiculous amount of money in a lawsuit. Which brings up another point, the requirement of documentation takes so much time away from bedside nursing (we can thank the government's medicare/medicaid reimbursement requirements) that it requires the facility to have a lower patient ratio for the caregiver to accomplish all the necessary charting to one, avoid lawsuits and two, receive full reimbursement for services rendered. So instead of spouting off that health care workers are overpaid and there are too many of us, lets look at causes and find a solution other than cutting wages or firing employees. The last thing this economy needs is to lose more jobs!

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