Why should the "relative value" (lenght, complexity, etc.) of a procedure determine how much the doctor gets paid? This is quite contrary to a "free market" system. Normally, how much work/effort it takes to do something is not determinative -- but rather how much demand there is relative to supply. For example, digging ditches by hand takes great effort but that doesn't necessarily mean that ditch diggers get to demand high wages. Likewise, translating ancient texts can be an exceptional mental challenge -- but archeologists and historians don't necessarily get paid based on "how hard they work" either. The idea that people should get paid depending on "how hard they work" has long been ridiculed by most capitalistic economists. Labor - mental or physical - has no intrinsic value. It is only the demand for the result that gives something value. In theory. While a demanding job might have an effect on the supply side of the supply/demand relationship, the demands of the job do not per se equate to higher compensation. Any system where the seller gets to set the price irrespective of demand is suspect.