Doctors' earnings, or about (not) looking into pockets

This fact had already been known for several weeks, and the topic had come up in many discussions - including on doctors' social media. And the tone of most of the statements could have been disturbing, even if one takes into account the fact that the medics speaking out are by no means representative of their community. However, two approaches prevailed. First, to cast doubt on the rumor, allegedly spread by the media (in an extreme version, as part of a sponsored - not sure by whom, implicitly by the MZ, by politicians - action against doctors). Second, one that can be summarized by travestying a classic: - That money was simply due to him. Because perhaps that's the market value of this doctor's work and no one has anything to do with it, or perhaps it's simply a percentage of the value of the procedures this doctor performed. And besides, in the US, doctors in this specialty earn millions of dollars and no one has a problem with that. And if doctors can't earn (by default - any amount), they will leave.

This is a summary of the main themes raised by the "defenders of the invoice," probably unwittingly doing great damage to their own environment. Because it is obvious (the president of the medical self-government says this openly) that the public system is not governed by market mechanisms, or at any rate should not be. If only because a huge part of the demand for doctors' work is dependent on regulations - if these, as the Health Ministry announces, are loosened (deregulation in the area of, for example, on-call staffing is already announced for the beginning of the year), demand will decrease. It is also clear that the basis of contracts should be an hourly rate, not a "percentage of procedures." This one can elevate the earnings of a narrow part of doctors - and the vast majority of specialists have no chance to earn a fraction of the chimney amounts, despite having even higher qualifications and working even harder. The fact that it is difficult to compare the Polish system (about 7 percent of GDP of total health spending) with the United States (more than 17 percent of GDP, correspondingly higher, of course) is not even worth talking about. As is the fact that in the lion's share of EU countries, to which those leaving "for bread" could possibly go, there are maximum rates, calculated as a multiple of the national average (four or five times). This is money that is absolutely satisfying, paid for one-time work, with a simultaneous - enforced - ban on taking on additional work. In Poland, formal restrictions are lacking and the amount of doctors' salaries is derived from many, very many, factors.

The tone of the statements made by the doctors' self-government (as well as union organizations) is, of course, quite different - and it should be the point of reference, although between "should" and "is" the line is very fluid and the mood is, as a rule, at the bottom. Doctors, to put it bluntly, are outraged by politicians' statements, which they see as an attempt to manipulate facts and divert attention from the real problems of the health care system. In this atmosphere, it can be difficult to have a discussion rather than a dispute. The demand to talk about specific data (the president of the Supreme Medical Council reminds us that he had already requested such data from the AOTMiT some time ago) on the structure of contract doctors' salaries seems to be a step in the right direction. A hard reference point is always better than insinuations or anecdotal examples. And it is worth confronting.