Yes, Doctors get paid a set amount of money. They can then choose to charge over that amount and patients can decide which Doctor that they want to see based on what fees the Doctors are charging.
This is not remotely how it works outside of Medicare which doctors typically avoid like the plague because the returns are too low. What you're ignoring is the regulations being placed upon healthcare providers - in terms of Malpractice Insurance among all the other regulatory costs ON top of operational costs if it's their own private practice. It's driving all healthcare providers, generally, to be a volume-profit business. You really can't imagine how ridiculous it all is.
Then enter corporate healthcare - where they do their utmost, as all corporations do, to do one-size-fits all healthcare. Where doctors are essentially mercenaries dealing with a whole different kind of bureaucratic morass on top of the standard regulatory garbage.
Because under the auspices of "lives mattering" - somehow the financial demands have eclipsed the need for actual healthcare. That's the dirty secret. The very needs of the bureaucracy in feeding the bureaucracy in order to turn profit, fueled by institutionalized insurance requirements because of the intensely litigiousness nature of US culture, has turned into insurance extortion - most doctors are under the financial barrage from the jump.
Your overly simplistic view of "how it should work" - hasn't been that way since Horse-and-Buggy days, when Doctors would take a basket of apples for treating you for the "vapors". I'm not suggesting it shouldn't or couldn't be that way... but we'd be living in an entirely different reality to get there.
Do they produce those papers in Journals like the British Medical Journal? Or is it only in other lesser known American journals?
Producing papers is only part of the equation. I mean... people are *paid* to do research. That's their job. Reverse your position - it means that the EU are not paying *as much* - they don't need to - because we're already doing it. The real scam is in the amount the "evil" pharmaceutical companies are putting into research and the rest of the world simply gets the formula and starts mass-producing knock-offs. Then those pharmaceutical companies are branded evil cocksuckers because they're jacking up prices to offset their costs and losses, which ultimately fucks *us*.
The biggest joke of all is those newly fucked people point to those very nations that exacerbate the fucking and say "Look how cheap their healthcare is!"... Well shit that "falls off the truck" do tend to be cheaper. You just don't get to decide when it arrives. Same principle.
The Drug Companies do not get paid below market cost because, by definition, the money that they get paid must be Market cost so therefore no subsidy. Its not rocket science man, the US is not subsidising anyones medicines, they are just getting ripped off.
I have no idea what you're talking about. Pharmaceutical companies spend on average 17% of their profits on pure R&D. Compared to other industries - like the Military, which is about 3%. Let that sink in. The *average* singular drug development cost is ~$3-billion dollars and takes YEARS to go through trials. All of that is *upfront* costs. How many businesses have to fork out billions of dollars for the *chance* at turning a profit?
And the reality is that most drugs fail. Then it's back to the drawing board... Couple that to the patent-laws which are the only things holding up these pharmacorps, because it's the only economical way for the R&D to be offset. The idea is based purely on the notion the company can find the one drug that can impact a huge problem and net a profit. When you see people getting fucked for high prices - it's usually some asshat company jacking up prices on established medications to fund some other thing they're doing (which is pretty gross... but common for newer pharmacorps).
And we haven't even spoken about the regulatory hoops and flim-flams that they jump through at extra costs. Are they part of the problem? Sure. Are they the only problem? Not even close.
Putting the government in charge of your healthcare... and I'm saying this as a government healthcare employee - is a *disaster* waiting to happen.