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PaperclipPerfector  2d ago (text post)   1252 thread views

Wellness Wednesday for January 15, 2025

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My mom got a free amount of money towards glasses through Medicare, and it was use it or lose it, so she ended up getting glasses worth several hundred dollars for no reason right as the money was about to expire. She was pretty happy about it, too.

From "Against Tulip Subsidies" by Scott Alexander:

Americans take eight years to become doctors. Irishmen can do it in four, and achieve the same result. Each year of higher education at a good school – let’s say an Ivy, doctors don’t study at Podunk Community College – costs about $50,000. So American medical students are paying an extra $200,000 for…what?

Remember, a modest amount of the current health care crisis is caused by doctors’ crippling level of debt. Socially responsible doctors often consider less lucrative careers helping the needy, right up until the bill comes due from their education and they realize they have to make a lot of money right now. We took one look at that problem and said “You know, let’s make doctors pay an extra $200,000 for no reason.”

And to paraphrase Dirkson, $200,000 here, $200,000 there, and pretty soon it adds up to real money. 20,000 doctors graduate in the United States each year; that means the total yearly cost of requiring doctors to have undergraduate degrees is $4 billion. That’s most of the amount of money you’d need to house every homeless person in the country ($10,000 to house one homeless x 600,000 homeless).

I want to be able to say people have noticed the Irish/American discrepancy and are thinking hard about it. I can say that. Just not in the way I would like. Many of the elder doctors I talked to in Ireland wanted to switch to the American system. Not because they thought it would give them better doctors. Just because they said it was more fun working with medical students like myself who were older and a little wiser. The Irish medical students were just out of high school and hard to relate to – us foreigners were four years older than that and had one or another undergraduate subject under our belts. One of my attendings said that it was nice having me around because I’d studied Philosophy in college and that gave our team a touch of class. A touch of class!

This is why, despite my reservations about libertarianism, it’s not-libertarianism that really scares me. Whenever some people without skin in the game are allowed to make decisions for other people, you end up with a bunch of elderly doctors getting together, think “Yeah, things do seem a little classier around here if we make people who are not us pay $200,000, make it so,” and then there goes the money that should have housed all the homeless people in the country.

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