ControlsFreak
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User ID: 1422
ControlsFreak
33m ago
Both can be used in the appropriate time/place. Your plumber didn't seem to have any problems with a quote and then a revision for additional work.
ControlsFreak
3hr ago
The same problem applies to bonuses, of course, unless the pay without the bonus, minus personal costs (such as paying tuition yourself) is market rate.
This is truly wild. Especially because you're getting into situations where it going to be essentially impossible to determine "market rate"; especially because in many places, the bonuses and tuition reimbursement plans are, themselves, part of the market rate. One example would be the financial industry, where bonuses are a huge part of compensation, to the point that for many folks, it hardly makes sense to talk about a market rate without them. Additionally, if you have two job offers that are otherwise all equally the same, but one offers a tuition reimbursement program (either in a standard form or in your Made It Worse form), that one may be preferred, thus making that type of comp part of the market rate. As is the case with most situations where people want to imagine that they know a magic "natural value" for something, you probably don't. The market is constantly deciding how much these different compensation schemes are worth, and you can't magically detangle it from your intuitions about "market rate".
ControlsFreak
4hr ago
The big thing the employer can do is make the working conditions for your job worse
Sure, and in contracts, counterparties can do things to make, e.g., the negotiating conditions worse. Or to make the subject of negotiation worse. Pages have been filled in the M&A world about the problem of merger targets "getting lazy" with managing their business, letting things start to fall apart, or paying out questionable outlays that perhaps you would have fought against. There's all sorts of harmful stuff they can try to do; that's the source of a variety of standard contract clauses that are used to try to mitigate their effects in advance.
You also haven't responded to deferred/annual bonuses. Honestly, it seems like you just don't like that they can change your working conditions at all. That's fine; it's annoying. It's not at all unique to things like tuition reimbursement with a clawback. Let's put it another way; let's hypothesize that they've heard your complaint; you don't like clawbacks, but you're fine with bonuses. They can "fix the glitch" by just structuring it differently. In the before days, you'd pay the tuition when it was due, submit your receipts, and they'd reimburse you immediately, subject to a year-long clawback or whatever. Now, in the after days, they'll promise future reimbursement; you just pay your tuition yourself, and after a year, you'll get a "bonus" if you're still there. Congrats; you made it worse.
ControlsFreak
6hr ago
the prkdpa didn't fix this problem any more than
Well, of course it didn't fix all of the problems with pricing in the industry. The industry has amazing lobbyists. All they could do is fix the one very very narrow problem of insurance companies banning doctors from telling patients they could get their meds cheaper without using insurance. Similarly with the anti-kickbacks. The laundry list of exceptions is phenomenal, and it's questionable whether they even conceptualized the problem correctly in the first place.
I'm generally skeptical of regulation. It's usually ineffectual, produces unintended outcomes, and gets ground up by lobbying efforts to protect entrenched interests. It would be my last resort as a tool to improve price transparency in medical services. However, at this point, I'm pretty much out of other ideas for how to accomplish it. If you have any, I'm all ears. Absent that, I am at the point where I would support as minimally-scoped of a regulation as is possible to say some version of, "You just have to give them a good faith price estimate for services that you're planning to do before you do them (subject to the caveat of situations where informed consent is otherwise infeasible)."
ControlsFreak
10hr ago
I don't understand why people would expect medicine to be any different.
You had said:
[a plumber...] quoted to replace it
The medical industry currently is different. They refuse to do this part. At all. You can make it not any different. You just have to start giving some quotes/estimates. It's not all that hard; even a plumber can do it. Why can't you? Do we need to tack on some plumber school at the end of medical school or something?
ControlsFreak
10hr ago
There isn't something comparable for most contracts that have penalties.
I don't believe this part. There's literally all sorts of shit that can be stopped (FYI, you actually mean "stopped", because you clearly don't mean "prevented") if you exit other contractual relationships. Perhaps you could start describing some items in the class of things you're thinking about in the employment context, and then we can check to see if there is anything comparable elsewhere. Without any examples (or, I guess, some conceptual description of this class), it's kinda hard to believe.
ControlsFreak
20hr ago
by no means binding if unexpected things come up
Literally no one is asking for this. They still give you the estimate, anyway, with what they do know. You can do at least that much, too. You can be better than a shitty, druggy, probably criminal contractor.
ControlsFreak
20hr ago
Absolutely correct. The correct lens to look at this through is informed consent. Patients must be reasonably informed of the known costs/risks/benefits of medical procedures at the point when they give consent. Prices are part of costs, so they need to be reasonably informed of them when they give consent.
Of course, when they're lights out and cut open and something happens, there is no opportunity to inform them of the medical costs/risks/benefits, so we reasonably say that in such situations, it is acceptable to proceed anyway. All you need to do is import the exact same considerations to the question of when you can skip informing them of pricing information. If you feel ethically comfortable not getting informed consent for the medical costs/risks/benefits, sure, go ahead. Otherwise, when you're informing them to a reasonable extent about the medical costs/risks/benefits, you also need to inform them to a reasonable extent about prices. Just tell them what you're planning and what you know about that plan.
ControlsFreak
20hr ago
h-What? Leaving a job doesn't save your dog if your employer shoots your dog, either. This makes no sense to me.
ControlsFreak
20hr ago
the opposite complaint would be that doctors and pharmacies are banning insurance companies from offering cheaper alternatives, but I think I get what you mean
I chuckled. But anyway, what I meant (as you probably know) is the insurance company banning doctors/pharmacies from using more expensive alternatives. Dubbed "step therapy" or "fail first", the insurance companies were saying that you had to have the patient try a cheaper alternative first, and only if/when that didn't work would they cover the more expensive drug. I'm sure there are nuanced arguments on both sides of this, and I don't have a dog in that fight. Probably sometimes one approach is good; probably sometimes the other approach is good. Not worth getting involved from the outside.
insurance companies banning doctors from telling patients they could get their meds cheaper without using insurance.
I agree that lack of price transparency here was a problem. At a cursory look, I would agree with the goals of the Patient Right to Know Drug Prices Act that they cite, which fixed this problem. All we need to do is take that same name, swap in "Medical Services" for "Drug" in the title, and perhaps we can work out a text that can fix more of this price transparency nightmare.
ControlsFreak
1d ago
How about deferred bonuses? ...how about just annual bonuses, where you typically expect a significant sum, such as in the financial industry? I'm really trying to figure out the nature of your problem.
...how about penalty clauses in many other contracts? When you're doing M&A, you often agree to something like, "...and if I pull out of the deal for anything other than [acceptable reasons], then I'll have to pay you a penalty." In real estate or other transactions, people often put money down in the same sort of way, basically just pre-paid. Are all these things absolutely terrible, because then the counterparty will just arbitrarily harm them? Why have they stuck around so long, even when there are sophisticated (and possibly well-capitalized) parties on both sides of the transaction?
ControlsFreak
1d ago
I'd say I'm certainly open to hearing ideas and possibilities
Great! That brings us back to about:
Let's start with just the basics...
You now seem to have agreed with one of the specific proposals I mentioned (HCTs). How about the rest of the specific basics I mentioned, before we get into yet more specifics?
I think even you could agree that you shouldn't further delay things in order to try to swing an election. Moreover, you shouldn't even threaten mandates in order to justify performing so poorly, much less actually implement them.
These should be pretty easy points of agreement, and it's always good to try to generate some nice easy agreement early on to show mutual positive sentiment and likely compatibility of underlying goals/schemas between interlocutors.
It's the insurance companies who ban pharmacies and doctors from talking about the price of medication and offering cheaper alternatives.
Can you provide citation/further reading on this? A brief search actually turned up basically the opposite complaint (in multiple articles that were clearly founded on pro-doctor propaganda advocacy), so I'm definitely interested if the surface internet has it all wrong and no one has been talking about these secret bans.
ControlsFreak
1d ago
I'm not actually asking about an ideal system for handling pandemics. I don't think that's possible.
That's a hell of a thing to drop this far into a conversation about pandemics.
if you were making a system for all pandemics, you'd have to handle Covid, plus Aids, plus Ebola, plus everything else that's come down the pike, plus whatever the next pandemic may be, which none of us can predict.
Do you honestly think there are no differences between conceptual schema or patterns of behavior/regulation that can be applied across different flavors of pandemics? There are no better or worse ways of doing things in advance?
We can get to the rest of your comment in a bit, but we really ought to stop here for a second, because if I'm hearing what I think you're saying, most of the rest of the discussion might be pointless.
I skipped over the "HCT/RCT debate" question because I honestly have no clue what that is. A few google searches didn't provide much insight. What is this debate?
HCT is Human Challenge Trials; RCT is Randomized Controlled Trials. I do kinda sorta think that you might just not be very exposed to any of the debates going on about how to improve our systems for the possibility of new pandemics. I guess I'm not sure why you would be, given that you seem to think that it's pointless to even try. I guess I'd just wonder which came first. Did you decide that it was pointless to try, and thus never went and learned anything about what factors might be considered? Or is it just that you have no idea what factors might be considered, and so you concluded that it must be pointless to try?
ControlsFreak
2d ago
Do those differences show up with different billing codes when you send them over to insurance? If so, how is that difference expressed in the content of the billing codes?
ControlsFreak
2d ago
I hate to say it, but people probably shouldn't torrent movies or other IP. The analogy there would be more if this contractor's truck was in the street, maybe he was working on a neighbors house, and the redditor went and swiped a few screws from it. Then, when the contractor noticed, he threatened to sue the guy for OneBillionDollars.jpg. Like, okay, buddy. Silly, yes. But kind of different in kind. Perhaps one could make other analogies to try to make it somewhat more sympathetic, like if the contractor was working on the neighbor's house, and the neighbor swiped the screws and gave them to the redditor. I get that there are complications here, but I think it's really just a different type of thing.
Debt collection should mostly be premised on the validity of a previously-agreed-upon debt. That's usually the first line of defense - "Prove that I owe this debt." When done above-board, the debt collector can produce a document that the debtor signed that specifically authorized the terms of the debt. Things get sketchier as the underlying facts get sketchier. Usually, how sketchy it gets depends on how sketchy the original transaction was. The extreme end of sketchy for underlying debts would be, "We refused to give them a price, just did the service, and then unilaterally made up a price." (Yeah, I guess even more extreme would be that they just didn't even do the service or just totally made up the whole thing, but that would probably be better categorized as obvious outright fraud rather than "sketchy".) I guess if the conclusion is that routine practice in the medical industry is akin to the sketchiest versions of underlying debts that are claimed by debt collectors, that's damning with faint praise.
ControlsFreak
2d ago
There was a wild post on r/RealEstate yesterday. It's already been deleted.
Hello,
I'm a young owner of a few rentals - I got lucky young starting a marketing business that worked.
We've been having some wind here lately and it partly ripped off some siding on the side of my house that's way to high for me to reach with a ladder. I look online and call a dude with good reviews - I think he's a solo gig. He pulls up within an hour of calling him and he's like "Oh, no big deal!". I watch him get out his ladder, get up there, screw these screws into the siding that are literally going into nothing (i think he did it so it looked like he was doing something), he pushed the siding back into the trim, and got down. Literally up there for 2 minutes. He said "Okay I'll go to my truck and get a quote"
He ends up coming back to my door like a half hour later and he claims his service call is $3000 and the screws were $5.
I kind of just look at him and I'm like "hahaha how much do I owe ya?"
Him: "$3005. I accept all forms of payment"
Me: "You're joking right? You told me on the phone your service call was $75."
Him: "We never talked sir. You must have talked to some other siding guy"
Me: "If I talked to someone else, how would you have known to come over right away and do my siding?"
Him: "Uhhh.. I mean.. Like I use a contracting app that gave me this job. My rate is $3000"
Me: "I'll give you $100 just to leave. I'm not doing this, that's crazy"
Him: "Maybe I should call the police. Should we do that?"
Me: "Go right ahead but it's a civil manner"
Him: "This is theft of services. If you don't pay, I'm pressing charges and you're going to jail"
Me: "I can promise you if you keep up this immoral scam like behavior you're going to end up in jail"
Him: "I just got out of prison, no sweat off my brow"
Me: "Doesn't surprise me with that prison tat on your neck"
Him: "Look kid you gonna pay me or not"
Me: "No"
Him: "You'll be hearing from my lawyer kid. Hope mommy and daddy can pay for it"
Me: See ya later!
I'm 25 but look 20. I've had people try to charge me crazy prices for things or take advantage of me but this was nuts and criminal (not literally but you know what i mean - just not right). Why are there people out there like this?
There's obviously a good chance that it's a totally fake story. I'd basically assume that it is. I don't even really care if there's even a 0.1% chance that it's actually true; it doesn't really matter.
Part of the reason why people likely believe that it's fake is that it sounds like absolutely outrageous behavior by the contractor. Something that no one would put up with. Something that would shock the conscience if it actually happened and there was a recording of the interaction or something.
So what's weird is that this is the standard modus operandi in the medical industry. It's just the way things are done. Yes, if you have insurance, then instead of telling you to your face that they're charging a ridiculous made up number after the fact, they tell your insurance provider the same thing. But the basic fact pattern is absolutely the same.
I'm definitely not going to go all Kulak and say that since this routinized obscenity shocks the conscious, everyone needs to start going around murderin'. But it absolutely is a routinized obscenity that should shock the conscience. Perhaps my crazy pills are significantly less potent than his, but they appear to still be crazy pills.
Lawyers can debate the legalese of "consent to treat" forms and what they do and do not allow, but it simply cannot be plausible that we will have a functional medical industry when it is the one and only industry that is allowed to simply refuse to provide you a price prior to authorizing work and then go on to just make up whatever the hell inflated price they want after the fact.
Correct. There are all sorts of dysfunctions that happen in business. Generally, the businesses with more of those dysfunctions fail more. None of those are what you had implied by "the company gets to harm you in arbitrary ways". Now, you're saying that there's just a background of some companies harming people in arbitrary ways, which has nothing else to do with the topic at hand. Presumably all of those things occur regardless of whether you get a degree paid for by the company. Do you think that somehow choosing to not get a degree paid for by the company stops those three things? If so, how?
...would you even dismiss giving someone a raise on the same grounds? "Eh, raises seem sus, because then they can arbitrarily harm you by slightly less than that much..."
ControlsFreak
2d ago
They can, but a) it makes it more expensive for them, and thus somewhat less likely and b) it provides you with some form of protection/compensation.
ControlsFreak
2d ago
if the old company paid a third party vendor for classes or other training
This is almost always the case. Or, as @phailyoor mentioned, continuing education/advanced degrees. They're often doing things like tuition reimbursement programs.
This definitely creates some messed up incentives, because if you can, say, "partner" with a separate training company who is really just doing the stuff you'd be otherwise doing, then you can implement clawbacks for things you couldn't otherwise. Might cost a bit more up front, but you might be able to make it back on the employee retention. And I'm sure some big companies would be happy to set up basically fake "separate" training companies that aren't really separate and dare you to try to prove it.
ControlsFreak
2d ago
On the topic of people getting mad and yelling at the government for every bullshit thing they see (including the decisions they choose), but us mostly ignoring them when they're being dumb, this week's Short Circuit summarized a hilarious case thusly:
Firearm instructor purchases a Glock pistol modified to prevent its safety from re-engaging after firing a round. Yikes! He drops the gun during training, it shoots, and he loses a leg. The instructor sues Glock arguing, inter alia, that the gun is unreasonably dangerous. Tenth Circuit: Glock's warning and testing instructions adequately warn that modified guns may cause unintentional discharge.
Hlynka-watch. Multi-agent environment.
Employees think about their situation and make choices, too. If they think you're starting to treat them worse, they'll definitely start looking. Decent chance they'll get someone to pay off the clawback, or at least enough of a raise to overcome whatever delta is left.
Plus, when you start treating them poorly, it's not just a direct monetary thing. It's an emotional thing, which is often highly valued alongside money. That is, say that they would owe you $10k. You imagine that you're going to only arbitrarily harm them by $5k somehow. But their resentment is worth $7k to them, so they'd even be willing to eat the $10k and make a lateral move elsewhere. (In the same vein, good will and belief that they know you are a decent employer compared to the unknown elsewhere is a huge reason why people often stay at companies even if they think they could eek out a bit more money elsewhere.)
On top of that, they're likely to be less productive, which is a pure harm for the employer. Especially with only a year clawback (I don't know why, but it does seem like clawbacks tend to be only 1yr, while incentives are more likely to vest in 3yrs). Pretty much as soon as they get a whiff of you treating them more poorly in that time, it's easy for them to go into "coasting" mode, start looking for other work, and think, "I'm only going to stay here until the 1yr mark if I can find any other offer." I know of one guy (not where I work) who I don't even think was treated badly, wasn't even training-related, but he got a signing bonus with a 1yr clawback, dropped his resignation on exactly the one year and one day mark. I have to imagine that a good chunk of that time, he was hardly even trying to contribute to the company. He knew what his plan was, and he went through the motions that he had to go through.
Harming people in arbitrary ways is usually negative sum, and any business that lets too much of that creep in is likely to end up doomed sooner or later. You would really need a surprisingly good business case for how you're actually going to extract additional value by treating them poorly during something like a clawback period.
ControlsFreak
3d ago
I am, however, sensitive to there being actual shortages in certain occupations that we can't just wait 10 years until there are enough qualified people available.
I'm... less sensitive to this. I think these things almost never happen. Especially because very few occupations really take ten years to ramp up production unless there are significant restrictions in place (the occupation that comes closest in terms of number of years would be doctors, but when there are problems there, the absolute most likely explanation is supply restrictions). For the most part, we should probably just let the price system operate.
As mentioned in the linked comment, it is inherently a political decision as to whether the supply curve should be purely the domestic one or the world one. This is not necessarily an easy choice. You ask Bryan Caplan and he'll take gainz from trade every time; you ask the unions, and they'll take domestic salaries every time. But I think that we should just be honest that that is the political decision to be made, not hiding a political decision inside what would inevitably be a political determination of whether there is a "shortage".
In other words, hiring foreign workers should be more expensive than hiring native workers.
I sort of reject the idea that you can accomplish this by government fiat. Supply curves slope upwards. If the "current price" to hire a domestic employee is $X, but the gov't only allows you to hire a foreign employee for $X+Y, then just look back to the domestic supply curve. You could hire more domestic employees for $X+Y, which would bring the "equilibrium price" of hiring domestic employees up to $X+Y. Which, first, if the price mechanism is actually operating domestically, you don't actually want to do, because the market has already cleared. Second, if our plan is to always make it more expensive to hire foreign workers, it in turn requires the government to bring up the cost of hiring a foreign worker to $X+Y+Z. Rinse and repeat. Like, mayyyyyyybe someone could define a sense of "if the (I don't know) "medium run" supply curve has elasticity below some threshold, then..." but good luck estimating it or having a usable definition of "medium run" to use for your estimation.
If bringing over a single foreign worker requires a $25,000 nonrefundable application fee, legal fees, and no guarantee that the sponsored immigrant won't jump ship to a company that offers him more money, you're not bringing him over unless there really is a shortage and you're confident you can keep him.
I think this would be equivalent to just saying that we're going to choose the world supply curve... but with a tariff. It would essentially require adopting the meaning of "shortage" to be "with respect to the world supply curve". Of course, the tariff would still cause a ""shortage"" (not to be confused with "shortage") with respect to the world market clearing equilibrium that would be obtained without the tariff.
ControlsFreak
3d ago
Labor laws are such that you can’t insist that people you train stick around long enough to pay back at least the cost of the training.
Agreed with @Botond173. You can absolutely do this. Well, not "insist", but you can include either clawback provisions (retrospective "if you leave within X years, you have to pay us back for the training", which they have to agree to when they sign up for the training program) or delayed comp that only vests after some number of years (prospective, acknowledging that they're worth more now, but you only have to actually pay it out if they stick around for X years). They're both pretty common.
Sounds fine to me! Maybe not even strictly necessary to put numbers to all the things. Again, it's just informed consent, just like medical costs/risks/benefits. You can say that there are risks in anesthesia, that unknown complications can happen, and if they do, you'll do what you can (where the actions and price are yet unknown). However, in some cases, where it's a "routine" complication, you can advise a little better. One doctor in these forums suggested that there are some procedures where they know that something happens about 1% of the time, that they plan for it, that they know what they're going to do if that happens (e.g., "If we see X, we're going to remove Y also"). In those cases where you have reasonably known specifics with reasonably known, planned actions, what you do is inform the patient. You can likewise inform them with reasonable information about likely costs of that relatively-known event and following actions. I think people would be perfectly happy with that.
All of this is getting into what is a common situation in hospitals, but is relatively rare for individual patients and in terms of total patient interactions with medical billing. It's kind of an edge case, though it is important to put some thought into. I think people would be pretty fine with a variety of practices concerning informed consent in these edge cases if the industry started getting the basics done on the much more vast world of much more numerous, much simpler services.
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