If doctors don't earn much more than baristas, why would I even bother putting myself through the hell that is medical school, free or not? I could skip it all and make almost as much pulling espresso shots. It makes no sense.
Why would I want to stand behind an espresso bar all day making cups of coffee for other people? That's not something I personally find challenging or intellectually stimulating and so if given the choice between my current profession and that at the same rate of pay I'd happily stick with what I love.
Hell, if the choice was barista or retrain as a physician for the same rate I'd take a stab at medicine even though it's only marginally interesting to me because it involves more of a chance of working on the types of problems I enjoy solving.
On the flip side, I'm sure there are lots of people that find the coffee business more attractive than medicine. That's great, they should absolutely pursue that. The freedom for people to do the things that they truly enjoy as work is something that we should be promoting and finding better ways of enabling.
Sweden 38.7
Iceland 34.6
Denmark 34.2
Finland 29.1
United Kingdom 27.7
United States of America 24.2
http://kff.org/global-indicator/physicians/
(You can click the boxes in the panel on the left to generate easy comparisons)
Data supposedly taken from WHO stats:
http://www.who.int/gho/publications/world_health_statistics/...
The jobs you'll have trouble filling are the ones that are shitty but get paid big bucks in the US, like oil field workers. Those guys are there entirely for the nice paycheck.
I'd also argue that a civil engineer is an entirely different beast from the actual laborers, who I was referring to. My understanding of a CE in that scenario is more of a planning and overseeing role (correct me if I'm wrong about that).
You'd ordinarily be right, but as an interesting quirk of how things are run out where my Father is he's down in the trenches with the rest of them :)
That's not entirely true. The United States military is one example of an organization that will pay for your medical school in exchange for some of your time. My wife is a physical therapist in the Army and this is how it worked for her. The Army paid for her school and she earned a 1.5x service obligation for the time she spent in school. It was a three-year school so once she finished, she owed 4.5 years of Active Duty service. On top of the school cost itself, they paid her as an active duty officer while she was in school, plus they paid for our housing and subsistence allowance for our family. All in all, she made about $75-80K a year to get her degree, then $100K+ once she was done with the school. It's not some front lines combat thing, either. She works in a normal clinic like most PTs, treating Soldiers and civilian family members and retirees. She's in it for a career so she will receive a retirement pension after 20 years (how many civilian docs in the US get that?), plus lifetime healthcare for her and me and our children until they turn 18.
It's truly an incredible deal for us, and it's available to anyone with the grades to get into medical/dental/PT/OT/etc. school and who can pass a physical and fitness test.
Do you really value money that much, that it would guide major life decisions (like how you spend your life)?
If I am backstopped by a home and food near my family and they are too, I won't be as motivated by riches. The entire reason I even need money is to buy a home and to build retirement funds... anything else is a toy (and in Western countries is probably trivially cheap compared to housing).
What that means is that I have much more freedom to do whatever I want to do. If I want to be a bin man or a doctor or a truck driver or a car salesman... whatever; I have much more autonomy to follow my dreams in a system that does not mean I live paycheck to paycheck doing half of those jobs.
Right now, I don't have a home, and so it is basically irrational (given that I don't want to be nomadic and leave my family behind) for me to take lower paying jobs ever. This is really a stupid situation to be in; it means that capitalism almost decides what I spend my entire life doing without me having that much free choice (choosing to be poor is not a valid choice).
Look, I appreciate what you all are saying and your noble intent--I just don't see this working in the US at all. The "American dream" of hard work as a path to wealth and comfort is practically built into the DNA of every new immigrant upon landing in our country.
a) The unskilled will choose to clean airports anyway. They can't get a job as a doctor and they want to buy toys (TV, smartphone, holiday, etc). Equivalent salary does not mean that jobs are just as accessible - academic positions tend towards min wage, but the working classes aren't scrambling for those because they are locked out via credentials or lack of education in general.
b) If clean airports require exploiting the poor (basically, relying on the fact that people will starve and die or suffer mental illness if they don't do it), then maybe we shouldn't have clean airports.
I think that part of what makes some jobs so crap is the fact that employers know that their employees are reliant. Senior management jobs are cushy precisely because people have FU money and can just leave. This should be expanded.
Whether or not this means doctors educated in the US are superior and make fewer mistakes than those that are not, I do not know.
The intern year is pure hell everywhere as far as I know but that's after you graduate even you want to qualify as a doctor. A year when working a mere 60 hours basically qualifies as a week off and people commiserate over the length of time they've gone without sleep.
All that said outside surgery the hours appear to be mostly hazing. Between lessened fatigue and poorer continuity of care reducing doctors' hours is a wash when analysing fatalities and medical errors. This does not hold for surgery. Reducing intern's working hours clearly results in more patient deaths in surgery. Feel free to check on google scholar.
After that statement, I'll assume you don't know what you're talking about or you're in some odd part of the planet where nursing is taught on the job.
Around here, nursing requires years of training. Psych, biology, pharmacology and I don't know what. We have different level of nursing qualifications, with the longest being a nurse practitioner, capable of legally prescribing medication.
It is a field regulated by the same governing body as doctors, and is not trivial in any way.
You could do some actual field science and ask a physician in a Nordic country why they chose to go to medical school. Whatever their reasons, the system works for them; there are no reports of doctor shortages in Denmark.
Also, something I noticed while living in Norway for a few years, it's much more common to make big career changes mid life. Their system is quite supportive of this and allows you to maintain a reasonable lifestyle while you do. It's a really good system IMO.
If your calling in life is to pull espresso shots, I think you should pull espresso shots.
If you simply say everyone should make the same regardless of skill, then you diminish the value of both the skill, and the effort used to master the skill.
If you're just talking about the peons trading labor for money, then yes, more or less.
But there's another class of folks, and my anecdotal evidence is that they're freaking everywhere, overflowing with unearned wealth. I'm nobody from nowhere and I know many of these people, and they'd be screwed if they had to go through what I have.
The veneer of meritocratic capitalism in America should be at the breaking point IMO. But this is a vulgar place so I'm probably wrong.
The argument for capitalism is not about equality, but relative mobility compared to other systems. That mobility creates incentive and thus growth.
Fair enough. Let's call it all equal then.
>The argument for capitalism is not about equality, but relative mobility compared to other systems.
The argument for socialism (or socialism-like endeavors) is about equality; when societies are more equal, 'relative mobility' is less important, because the place you're in is less likely to be so horrible that you're dying to get out of it.
False. The AMA lobbying activities were not successful and in fact they have been trying to expand. The limiting factor is residency.
A principal of a high school makes more than most tenured professors. Why would anybody want to go through a Ph.D., job hunt and seven years of working like a dog in the hope of getting tenure when they could do an M.Ed. (laughably easy for anyone sane contemplating a doctorate) and have job security three years post qualification?
First, doctors make more, way more. I'm born and raised in Europe and while wage inequality is smaller, it's not equal.
For example, for a GP here in the Netherlands about 30% are salaried and make between 60k and 80k or so. The rest are mostly independent (have their own (co) practice) and make between 100 and 150k. (all euros).
Meanwhile a Barista makes about 20k.
So there's definitely a significant gap here. The difference is that in the US the gap tends to be slightly bigger, and the tax slightly lower at the higher end of income.
Another difference is that education is highly subsidised: my college received about 12k or so per year for my tuition, 10k straight from the government, and 2k from me, and I - and everyone else - got a 2k a year loan from the government which is turned into a 100% gift if you graduate. I use this gift to pay my remaining 2k tuition fees, so tuition is totally free. I still borrowed because studying full-time leaves me not enough time to work to pay for a little over $1k a month on rent, food, insurance etc. But that debt is very small and also provided by the government at currently about 1.5% (it's always very low, don't think it ever beats inflation).
This basically creates an incentive to become a doctor, without a risk of lifetime crushing debt. It also creates an opportunity for people to choose what they love to do. Money plays a role, obviously, and this is how market inefficiencies are kept in check, but it's not the sole factor.
Now being a doctor obviously sucks in terms of working pressure. But there's still plenty of incentive to become one, but not enough incentive to work 80 hours a week like you may see in the US where you want to make mad bank because if you don't your student debt will crush you. I dare say it brings a bit of life/work balance to doctors, of whom as I gather live a pretty stressed and shitty life professionally.
You'll quickly find though that if indeed studying is cheap, if indeed you can make a living as a barista to fall back on, you may as well pursue what you actually like to do, and for most people that's not pulling espresso shots. A system like that makes quite a bit of sense.
As for the barista making just 20k... it seems low but the cool thing about large parts of Europe is that it's very affordable on low wages. For example if I didn't have so much equity (more than 30k or so) I would get a roughly $300 subsidy from the state for my $1000 rent. My insurance is just $90 or so, but the state pays me $80 for it. Primary, secondary and tertiary education was all de facto free and I was able to study at some top institutions in the world (both here and North America and Asia, without paying more). As a starting entrepreneur I get tons of tax cuts and barely pay tax right now, and if I lose my job I don't get silly foodstamps, I get like 80% of what the Barista makes as long as I show I'm applying for jobs. Yet there's plenty of incentive for me to strife and do better, up to a certain (quite high) point when taxes scales are such that it makes little sense working more hours, but doing more productive or valuable work is still very rewarding, which results in a very decent work life balance, health etc.
In short, while Europe is very far from perfect, and while some countries have an easy position (e.g. Norway, resource rich, or the Netherlands, small and manageable), there is this tendency of Europeans to look at the US and think 'wtf?' when it comes to social and economic equality, work life balance, wage gaps, taxes, healthcare insurance, food stamps etc, which seem to be very poorly designed in the US, despite a tremendous amount of economic and sociological wisdom produced by American academia that ostensibly goes unnoticed by policy makers.
1) the assumption that intelligence can actually be measured (in which case it's really just "analytical intelligence"), 2) the assumption that other types of intelligence are less important, 3) the fact that you can't even measure creativity, period.
I have a 148 IQ (and I'm a programmer- of COURSE I have high analytical intelligence) and I have been consistently humbled by the "less intelligent."
You don't need to measure anything like intelligence or creativity to arrive at someone's market worth. Just measure, or estimate, the value of their output.
So: how much value are they creating that other humans are prepared to pay for?