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> The alternative is, if you don't incentivize someone financially to spend a decade studying medicine, they won't or they will immigrate to somewhere where they can.

People already have plenty of incentive to become doctors. We just don't let them. Medical schools collude to limit the number of medical students each year (under the guise of preventing having "too many" doctors). Medical schools have ridiculous selection criteria, like picking the candidates who earned an "A" in physics instead of a "B", or who came from a rich enough family that they could perform many hours of volunteer community work (mostly because the low quotas make it otherwise impossible to select candidates without literally rolling dice).

You know what? I think tech workers aren't paid enough. There isn't enough incentive to become a tech worker. We should limit how many people can study CS each year with strict quotas. It should be illegal for a person to program a computer unless they have a CS degree from an accredited school (one in on the quota system) and have passed an exam. Practicing programming without a license (or practicing from a foreign country with a local license) should be illegal, punishable by time in jail. Finally, programmers should have access to computer tools (like encryption) which will be illegal for the rest of the population to possess, and be given the benefit of the doubt if/when they misuse them.

Do you see how ridiculous this sounds?

The difference is a SWE who merges faulty code or causes a production outage is NOT legally liable.

If a patient faces a complication or (god forbid) passes away, you as a medical practitioner are held legally liable and can lose your license and potentially even your freedom.

The wage of medical staff is independent to the cost of drugs

> This is what my SO did when leaving Vietnam - her med school tuition was around $6k/yr in a country where median household incomes are $2-3k per year and she'd end up working for $700-800/mo working 70 hour weeks and best case $2k/mo in 5-7 years. Unsurprisingly, she chose to leave just like the rest of her peers, because you can't even buy a house in a tier 4 city in Vietnam without spending $100k anymore.

I mean, people in the US pay $250k+ tuition, median income $65k/year, work $35k/year for a while, and eventually make something like that $250k/year. A house in many US markets is $300-500k.

It's pretty much the same balance between each item, just more zeroes on the end of each number.

> It's pretty much the same balance between each item, just more zeroes on the end of each number

You cannot compare the poverty or material condition between the two.

Personal access to tap water, personal bathrooms, not having to pay a bribe to get ID, public services, school meals, public schools the actually have some sort of services, and other stuff Americans take for granted are not available to the vast majority of Vietnamese, Indians, and others in the developing world.

My SO literally had to pay a $5k bribe/speed money to get her diploma from her university otherwise she'd have to work as an unlicensed doctor for 2 years.

The rent for an illegal 1 bedroom hovel in D3 in Saigon with a tap water connection and personal bathroom goes for $250-550/mo - that's literally the monthly wage for most residents in Saigon

You really cannot compare even the worst life in the US with the life the silent majority faces in developing countries

> You really cannot compare even the worst life in the US with the life the silent majority faces in developing countries

Sure, but your example cites someone who expects to be making the median annual salary every month within a few years, right? In both places, there's a hefty up-front investment for a much-better-than-average earning employment opportunity.

> Sure, but your example cites someone who expects to be making the median annual salary every month within a few years

No.

This is someone who spent $50k in debt just to end up earning the same salary ($700-800/mo) if she worked in a factory sowing clothes (which give free dormitory housing vs paying $200-400/mo in rent like non factory workers do), working in the unregulated vice industry in Singapore, UAE, of Korea, or doing nails under the table while overstaying their B2 visa in East San Jose - like a number of my SO's peers who didn't make it into a degree program that leads to you becoming a doctor, dentist, bureaucrat, or engineer.

Spending 8-10 years of education just to end up earning a similar amount as a factory worker makes people who devoted so much time and effort angry, and why you see a significant exodus of medical professionals in developing countries to developed countries, becuase they are not remunerated enough.

Remunerating people less only exacerbates brain drains.

And note how this is specifically medical professionals - other white collar roles pay less and are much more competitive or difficult to land a job in VN

Saying the median American has a life comparable to the median Vietnamese is TRULY out of touch.

"her med school tuition was around $6k/yr in a country where median household incomes are $2-3k per year and she'd end up working for $700-800/mo working 70 hour weeks and best case $2k/mo in 5-7 years"

I'm still not seeing the bad investment here.

> investment

To make an investment you need capital.

A $6k a year tuition is double the median household salary for most Vietnamese. And unlike in developed counties, student loans are essentially non-existent for the majority of the population. To get a loan, it means going to a tattooed snaggle tooth guy wearing a flower shirt who exchanges gold and foreign exchange, and getting a double digit monthly loan. Best case, you are lucky and have land you can mortgage or family abroad you can beg for remittances. Additionally, tuition is paid up-front - not monthly payment plans. Additionally, the universities didn't provide half of the materials needed like scalpels or gauze - that came out of pocket at US prices.

Additionally, for someone from the bottom half of society, like my SO's family, social security and public services are non-existent, so they are dependent on their children sending them $150-200/mo while their kids are paying $250/mo in rent and $100-150/mo in incidentals on best case a $700-800/mo salary.

If you are a woman from the bottom half of society, like my SO and her peers - it is almost impossible to afford 8-10 years of no cash flow. If you are an 18 year old woman in the Central Highlands or the Mekong Delta, immediately working in a factory with a subsidized dormitory and food means you can immediately start sending cash to family to help them out. Alternatively, earning $15k-$20k working in the "unregulated vice industry" in Singapore, South Korea, the UAE, and others starts looking extremely lucrative (usually referred to work there by that snaggle tooth guy I mentioned). Best case, you get an arranged marriage with someone in the diaspora in the US or become a "Viet Bu" in Malaysia or Singapore.

My SO was literally the only person from her social class at her medical school (Vietnam's equivalent of Harvard Med) - everyone else were the children of doctors, bureaucrats, diaspora Vietnamese, businessmen, MPS officers, and other crème-a-la-creme of Viet society.

For people in my SO's case who somehow even make it to medical school, they all try to leave to practice in Japan (which my SO did), Taiwan, South Korea, or the US as soon as possible becuase it is the only way they can even recoup the cost. And this is exacerbating the medical health crisis in much of Vietnam, because a rural government doctor in a village like my SO's (if they are lucky enough to even get a doctor) would earn a $100-200/mo government salary that is almost always late.

Like, there are massive issues in the US, but to even compare the that to those faced by the bottom half of a developing country is legitimately out of touch and actually insulting as it trivializes the pains billions of people face across developing countries.