[1] https://jamanetwork.com/journals/jama/article-abstract/26132...
[2] https://hbr.org/2020/03/the-problem-with-u-s-health-care-isn...
Without NPs and PAs, I'm sure there would be a shortage of healthcare providers.
Well, guess what? I now also have rationed care. I have to wait six months just for a colonoscopy, plus I pay twice as much for the privilege!
Which obviously means we need 2-3x as many.
1 out of every 7 medical schools currently active in the US was founded in the year 2010 or after. That's a veritable bonanza in medical school creation, facilitated by the AMA.
The obvious one that comes up in every discussion is thinking that unions will protect their jobs from being outsourced to other countries. People like to layer various more palatable explanations on top of this to make it sound better, but when you ask them if the employees who receive the outsourced jobs should get the same union protections you usually get their real motivation: They want to keep the jobs local to their own market and exclude foreign labor supply in order to improve demand for their services (and therefore their leverage, and therefore their own wages)
It gets interesting when different demographics start imagining that their ideal union would protect them from other demographics: Commonly, older people like to think of unions that will protect them from losing their jobs to young people.
Then when I’m working with college students and they start discussing hypothetical unionization, they come up with ways to think the union will give them more jobs by protecting them from the old people “hoarding” the jobs. (Sorry, that’s the least likely outcome for a union)
What’s most interesting is that the people I know who are in unions (non-tech industries) don’t hide the fact that decreasing labor supply to increase their own demand is exactly what they expect from a union. The first time you hear someone complain that a non-union worker is “taking food off their table” by simply doing their job you realize that it’s not as simple as Unions versus Corporations like we’ve been led to believe. The Unions are advocating for the people in the union, not workers everywhere.
Bear in mind it's completely normalised for companies to charge higher prices in one market than another, and put barriers in place to make sure customers in the more expensive market can't just pay the lower price. So all the union is doing here is bringing it closer to a level playing field.
Even the cost of PPL, the lowest license on the path, is around $10,000 while the ultralight (European)/sport pilot (US) is over $6,000. From that you need CPL (commercial), multi-engine, complex aircrafts, instrument rating (bad weather or night) etc., that takes time and money most people cannot afford.
It can have its place, i.e. a way to balance bargaining power with the employer. It’s inherently anti meritocratic though.
In some cases it’s not about merit or about limiting supply however. In some cases it’s impractical to test someones work continuously, so instead it becomes honor based. That is, you are expected to go through an elite track and succeed in an exam once and then you are good for life unless you commit fraud or show gross incompetency.
https://freakonomics.com/podcast/is-professional-licensing-a...
(it has something to do with profit)
https://en.wikipedia.org/wiki/Latin_American_School_of_Medic...
A recent form of profit seems to be offering cheap treatment/medical tourism
https://www.cubamundomedico.com/en/university-of-medical-sci...
Seems impractical for USians, though.
When you try to build a society around human needs instead of capital needs, you end up with different priorities. It's that simple.
If anyone thinks they're making the big bucks and accumulating "soft power" by training a bunch of doctors then selling treatments to Americans for cheap, I'm not sure they can be helped.
I wondered about why there were almost always cuban medics, doctors, nurses etc. in action, when there has been some larger catastropic event in the world, and you could see them in the media.
Why is that, I thought? That doesn't fit being sanctioned by the US(and vassals), being poor in general, and so on.
That's how I became aware of ELAM.
And made up my mind the way I described. Can't help it :-)
I think the word for that is capitalist realism. You cannot imagine a motive beyond calitalist logic, but that doesn't mean nobody else can.
I'd feel offended if the YOU in "You cannot imagine a motive beyond calitalist logic, but that doesn't mean nobody else can." was addressed to me, personally.
Or was it just meant as a general description of the concept?
It's easy to have really good health outcomes at really low cost if you just fabricate the data. It's easy to export lots of doctors if you force them to work abroad, force them to pay most of their salary to the government and hold their families hostage to ensure compliance.
https://academic.oup.com/heapol/article/33/6/755/5035051
https://www.hrw.org/news/2020/07/23/cuba-repressive-rules-do...
Much less so to the doctors themselves, which frequently have to work in what amounts to conditions of indentured servitude. And they have no other option, as working as a domestic doctor in Cuba typically pays less than being a taxi driver.
To be honest, I'm not convinced of your explanation.