Think of american doctor as a cadillac, and of his russian colleague as a cheap ford truck.

Back in the 20ies the american idea was that everyone is entitled to a car, while the russian idea was, everyone is entitled to healthcare. This is how our countries developed it. You can't put the same amount of work and care into a ford truck, like in a caddilac. You can't pay a mass doctor as much as he gets where healthcare is rather luxurious.