Hmm, do you think most doctors in the U.S. are only in it for monetary rewards, and don't find any other part of the job rewarding? I don't think I want that doctor.
In any walk of life in a capital system, your pay is determined by how you serve people. Doctors serve the very basis of their patients' lives.
If you can put a price on that, it should be pretty darn high.
I don't know there's any reason doctors should get exceptionally high incomes (except that in the U.S. they have to pay back exceptionally high student loans for the first decade-ish, of course).
Depends on 'the good life' - we can't lift everyone up to live like a doctor, but it's easy to push doctors down so they live like everyone else.
>I don't know there's any reason doctors should get exceptionally high incomes
U.S doctor's incomes are probably influenced by the AMA cartel that keeps good candidates from earning medical degrees. After we bust the cartel, we can let the chips fall where they may. My hunch is that doctors would be paid more like veterinarians if the market were freer.
On some level, a job's compensation is tied to the challenge of the job. It's more difficult to perform good medicine than it is to be a cashier, we should expect doctors to be better compensated than cashiers.
If you don't think that doctoring should earn especially high incomes, then you have not seen a doctor work, and perhaps you've never been gravely injured.
I would say the success of being a doctor at all but it seems that to you success is purely a function of wealth. In that case these people could have left Cuba before using it's free education. It's highly hypocritical to use all the benefits of the Cuban system and then be upset when you also have to help pay into it.
>It may surprise you, but it is hard work to be a doctor.
Nope, I totally get that.
>with a government which was built on tricking peasant farmers into willing their land to a psychopathic dictator who killed everyone who got in his way.
Oh lord, put the overreaction away. How many words do you think I would have to change in this sentence to make it reflect America's founding relation between wealthy British WASPs and native americans?
>The conditions they work under have every feature of slavery, even if the clothes they put on look professional.
I understand you don't like communism but really the hyperbole man... and shame on you for trivializing slavery. These doctors all knew what the Cuban system was, they chose to use Cuba's excellent medical education program which is provided for free and which can only be provided, again, for free because it taxes it's citizens heavily and now that they have received that benefit, want to rescind on it's price.
>A 34 y/o American doctor, even if they are somehow still paying off school, had the personal opportunity to take on that burden.
Ah but how many Americans really get a shot at medical school?
In the most recent year for which quintile census data are available, more than three-quarters of medical students came from families in the top two quintiles of family income. [0]
And you should check that citation, Figure 2 is particularly damning. Essentially, these Cuban doctors face the reality that had they been born in the United States there is a significant percentage of them that never would have had a shot at attending medical school in the first place.
You could also take a look at the Wired article[1] that I found that linked from, it's about how poor American students are actually going to Cuba for education. In effect, Cuba that poor communist country is to a certain extent actually subsidizing vital parts of our healthcare system that happen to be less lucrative:
Most of the school’s American graduates go into family medicine, internal medicine, or pediatrics—all fields facing major doctor shortages and all fields on the low end of the doctor pay scale.[1]
Thanks Cuba!
>Every working person in Cuba, peasants, mechanics, and seamstresses alike, takes on the burden of training you as a doctor. Everyone, including the doctor, spends their entire life paying it off.
Can I just change the framing of this a little bit, tell me what you think:
Every working person in Cuba, peasants, mechanics, and seamstresses alike, chips in to train you as a doctor. Everyone, including the doctor, continues to chip in to train the next generation of doctors.
[0] https://www.aamc.org/download/102338/data/aibvol8no1.pdf
[1] https://www.wired.com/2016/03/students-ditching-america-medi...
It's pretty clear by that statement that you don't understand the government of Cuba or how it has been funded. Most Cubans don't pay taxes, and haven't since the revolution. Only recently have income taxes been put in place, and mostly that's for business owners and comes with significant write-offs.
>Ah but how many Americans really get a shot at medical school? In the most recent year for which quintile census data are available, more than three-quarters of medical students came from families in the top two quintiles of family income. [0]
Ok, so 75% of medical students come from families in the top 50% of incomes. That doesn't seem too absurd to me.
As to your Wired article, the statement that "In effect, Cuba that poor communist country is to a certain extent actually subsidizing vital parts of our healthcare system that happen to be less lucrative"
is a bit ridiculous, because that article mentions a total 100 doctors using the program over a 17 year period. Yes, Cuba may train 6 American MD's a year, (actually, more like 4 - not everyone graduates) but that isn't really subsidizing vital parts of our healthcare system, not in any meaningful way.
Fair, fair, it's communist not tax-capitalist. I shouldn't have said "tax."
>Ok, so 75% of medical students come from families in the top 50% of incomes. That doesn't seem too absurd to me.
Top 40%. It does seem absurd to me, did you look at Figure 2 that I linked? That is the inversion of a meritocracy.
>As to your Wired article, the statement that "In effect, Cuba that poor communist country is to a certain extent actually subsidizing vital parts of our healthcare system that happen to be less lucrative" is a bit ridiculous, because that article mentions a total 100 doctors using the program over a 17 year period. Yes, Cuba may train 6 American MD's a year, (actually, more like 4 - not everyone graduates) but that isn't really subsidizing vital parts of our healthcare system, not in any meaningful way.
But totally true! 100 doctors here working in geographic areas that don't normally attract doctors and/or fields that don't attract doctors. It may not be super large but I bet you there are some Americans out there who are very happy (any may not even know it) that Cuba invested in our doctors when we wouldn't.
It's not just that. Powerful central governments don't function on the idea of everyone chipping in, they function on the idea that they can oversee the use of resources and allocate them in the best possible way. Normal people don't get a say in terms of resource allocation and don't get a say in who makes up the central government, so they aren't 'chipping in' in a meaningful way, as that implies it was their choice.
>Top 40%. It does seem absurd to me, did you look at Figure 2 that I linked? That is the inversion of a meritocracy.
I am not surprised by the news that 75% of doctors come from families that make over $50,000 a year. To become a doctor, you need to go to college, which costs money, then go to medical school, which costs more. During that period you must also not need to provide for your family so there's also a significant opportunity cost.
That said, the fact that this rate is increasing may be cause for concern, as noted in the article. Frankly, there is also another significant issue: the idea that you can become a doctor at all as a realistic goal, which I think is also a barrier - many people don't believe it is possible for them when it actually is.
As for the 100 medical students, I bet a lot of those doctors did not return to the United States to practice medicine, as they would have to do their residencies here to get licensed.
They're not chipping in, they don't have a choice in the matter. I think Cubans would rather have a better basic quality of life, than spend so much of their income training doctors who probably won't even operate near them, and who are used basically as indentured servants by the government, a government which pockets most of the money (as evidenced by the mansions and secret wealth of the despots).
They do have a better basic quality of life. That's exactly what they already have. Cuba is not a rich country like the US, so of course the direct comparison without historical context will mislead you. If they opened up free capitalism style trade with other nations, they would be slaves on foreign owned farms and foreign owned factories instead of the government (using this thread's definition of slavery, of course). If they opened up capitalism style free trade internally, some people would get very rich and the majority of people's lives would be much much worse off. The income inequality would skyrocket.
You're suggesting that they're poor because they're communist. That's not the case. They're poor because they're an ex colony whose never became rich from wars, imperialism, natural resources, etc.. And when you consider that and the US trade embargo, they've done amazingly well.
I'd like you to back that up. Right now, the private sector in Cuba (for example, taxi drivers with private licenses) is rich by Cuban standards. A taxi driver with a private license can make several times more in a day than a doctor makes in a month. Participation in the black market also contributes to quality of life.
The most successful common people in Cuba are those who engage with the freest markets.
But to blame Cuba's poverty on communism is wrong, it's a result of being excluded from trade. And I really wish you could pull back from the slavery hyperbole. They're not indentured servants. I work at a corporation, I make a bunch of money for the corporation that they pocket and then I get a tiny piece back, am I an indentured servant? What about my debt? Am I an indentured servant? Come on, just pull back on the rhetoric a bit and let's hash this out. And no one likes the hoarded wealth of secretive and bad people but that exists in America just like it does Cuba.
Every nice thing (or thing that looks like it was once nice) you see in the picture was produced by capital markets; and it looks like the 1940s because because the capital markets stopped functioning in the 1940s.
Succeed at what? What success do they gain from being a doctor in a country which prevents them from being rewarded for it? Their returns are fixed by the government, and even when they're working overseas (earning way more money) the government is kind enough to even it out.
It may surprise you, but it is hard work to be a doctor. These folks are basically forced to work however long is required by the state in a country where they're probably not even allowed on the internet, with a government which was built on tricking peasant farmers into willing their land to a psychopathic dictator who killed everyone who got in his way.
The conditions they work under have every feature of slavery, even if the clothes they put on look professional.
A 34 y/o American doctor, even if they are somehow still paying off school, had the personal opportunity to take on that burden. Every working person in Cuba, peasants, mechanics, and seamstresses alike, takes on the burden of training you as a doctor. Everyone, including the doctor, spends their entire life paying it off.