Mount Sinai Hospital's cardiac catheterization lab — which apparently gives some patients "emergencies by appointment" so Medicaid will cover catheterizations for patients who show up at the emergency room — is the subject of a Bloomberg News article. The article reports that Samin Sharma, the director of interventional cardiology at the hospital, was paid $4.8 million by Mount Sinai in 2012:
Kenneth Davis, Mount Sinai's chief executive officer, bemoaned the "obscene levels" of pay for interventional cardiologists at a conference this summer, where he said a starting pediatrician at the hospital "is going to earn 40 times less" than a top cath-lab specialist. Mount Sinai officials declined to clarify the CEO's statement, or to make Davis or Sharma available for this article.
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Across New York City, cath-lab patients are especially likely to get stents, according to Medicare data compiled by the Dartmouth Atlas of Health Care. In the U.S., doctors perform about 480 stent procedures for every 1,000 times they do a visual scan for blockages in patients' arteries, the data show. In Manhattan, it's 584 per 1,000; in Brooklyn, 632. All five city boroughs have rates above the national average. They're also higher than average for the number of stent procedures per 1,000 Medicare enrollees; for example, Brooklyn, at 14 per 1,000, is 84 percent higher than the national rate.
New York's rates are driven by a "surplus" of cath labs seeking patients, a competition that spurs usage of hospitals' facilities and doctors' expertise that's unrelated to patients' needs and distorts the market for heart procedures, Marmur said. "The pendulum is way out of whack," he said. "It drives up the cost of health care for everyone."
When even the hospital CEOs say the amount the doctors are getting paid is "obscene," what are the taxpayers footing the bill for these procedures via Medicare and Medicaid supposed to think? I understand all the counterveilling arguments. These interventional cardiologists perform life-extending miracles. They train for 15 years at long hours and low pay before they start earning the big bucks. We want high salaries for them to attract highly skilled and dedicated hardworking professionals to the jobs. Do you really want someone earning a Post Office-style salary messing with your heart? Government contractors in other industries, such as defense and investment banking, also are highly compensated. The doctors pay their share of taxes, too (though the hospital is a non-profit).
But the Bloomberg article may be a signal of a political backlash brewing on this topic. The tax reform plan put forth recently by the chairman of the House Ways and Means Committee, Republican Dave Camp, included a 25 percent surtax on individual executive compensation of $1 million paid by non-profits. That would apply to all non-profits, regardless of whether they are government contractors and regardless of whether they are in the healthcare industry or in some other industry.
