This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
Do the math. When do similar high education fields start cracking a million? I'm not talking about a partner at McKinsey or a top level google engineer. I'm talking an average person in consulting, finance, or tech making low six figures. Way way earlier if they aren't spending like an idiot. Compound interest is a hell of a drug and physician don't start getting compensated until into their 30s and have a done of debt.
Yes 4.5% is a lot of money in real dollar terms but it is a drop in the bucket in terms of percentage and you know it. It's politically popular sure, but there is so much admin bloat, insurance nonsense and regulatory bullshit which is way easier to target and a much larger slice of the pie. Salaries are empirically not the problem.
And said salaries are what's propping up the system. Doctors do almost all of the revenue generation and work stops without them.
People do not understand how bad working in healthcare is. Nursing are being offered six figure for 36 hours a week of work and they are just refusing to do it.
No other job asks you to do things like work 100 hours a week, 24 hours straight, get sued even when you did everything right with regularity etc etc. If you halved salaries then a lot of specialties would die on the spot. Nobody is going to procedural work or surgeries of any kind in the U.S. under that model. Nobody is doing radiology etc etc. Being a doctor in the U.S. requires too much sacrifice.
As always the problem is not a doctor shortage it's an allocation shortage. That's the issue we have right now. Because we won't pay to get people to do the things we need (primary care and rural medicine). Cutting salaries is the opposite of the solution. And we don't need to theorize what would happen if you just increased the supply. We already did that with mid levels. They made the problem worse.
It's interesting you ask this. Of course, the average person working in consulting, finance, or tech will never make six figures.
There are more than 22 drops in a normal bucket (100%/4.5%). I agree that 4.5% isn't a silver bullet for solving American health care costs, but it's a start, and American physicians would still make twice as much as their European counterparts under this new regime.
I think this is simply detached from reality. The average American orthopedic surgeon makes $573k / year per here. Are you really suggesting that nobody would do it for just $286k / year? I assume people would still be falling over each other to compete for the spots.
You seem to be suggesting that the law of supply and demand doesn't apply to health care, i.e., that there's some bank shot argument whereby we should expect increasing the number of doctors to increase the costs of the services they provide. Can you make this case more explicitly?
You kidding me? Starting salaries in many jobs in those fields are six figures these days.
Same with the other post, I just don't think you have any idea what you are talking about.
Sure, I don't doubt that many of the people you think about in consulting / finance / tech at even 2nd-rate places like Accenture / Deloitte / Oracle will make six figures as starting salaries.
Still, statistics show that the average American working in the consulting, finance, or tech industries will never make six figures - even if we restrict attention to the college educated. I think you're just really out-of-touch to not recognize that.This is wrong. Maybe I'm the one who's out of touch. The median American salaries in tech and finance are both around $100k, suggesting that most people will attain them at some point. The median consulting salary is still lower than $100k.More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
Husband to a US physician here and I have to say that this comment and some of your previous ones strike me as very accurate based on my observing her med school / residency / fellowship and placement experiences. They can’t pay people enough to work in underserved areas. $500k a year is good money but not necessarily worth it to live in a cultural desert full if resentful unhealthy poor people, boring food, bleak weather, etc. some doctors HAVE to choose their specialty for financial reasons, etc.
People underestimate how bad working in healthcare is. Admin and regulatory bloat is the worst it is in any field. Perks are thin on the ground, the chair in my office during residency was older than I was, I frequently had to talk half a mile to the hospital at 4am, etc. Some people work a 24 hour shift every 4 days for years. You can get sued for anything. During residency if you quit or get fired your career is over.
It sucks. The pluses make it worth it, but they get eroded year after year and that includes the compensation.
Many doctors will tell kids interested in medicine not to do it. And that's with said salaries as they are.
People don't get it.
All those terrible things are true for British and French doctors too and they make like $100k a year.
Citation needed.
Labor protections are much better in other Western countries. Less hours, less call. Protections against getting fired etc. U.S. doctors work twice as much as other countries, especially during training.
Much of what of what makes being a doctor in the U.S. bad is related to our healthcare system - charting requirements, regulatory requirements, insurance bullshit, malpractice environment.
You also have hundreds of thousands of less debt and a much greater social safety net during training and after training in Britain and France.
Also: Nurses make more than 100k in the U.S. a good chunk of the time, and we still have a nursing shortage with those salaries. You want doctors to make less than nurses?
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link