Not disagreeing, but the US also has a doctor shortage for at least a decade that it is seemingly unable to fix.
At one point the AMA lobbied Congress for those funding limits but they reversed position on that years ago.
Resident doctors are doctors, exactly as junior SWEs are software engineers.
(UK doctors have for some reason long objected to 'junior' and recently become 'resident doctors' over exactly this. All the more confusing - throughout and still there's been 'Senior House Officers', because 'house' used to be what it was called, like US residency, doing house, there were junior and senior house officers, so why not just revert to that? Who knows, but now they're all resident doctors - and some of which are senior house officers - until they're registrars/consultants, and they're happier with that than junior doctors.)
One answer would be to raise GP salaries, but that's difficult, especially if you're self-funding residencies and already paying out the nose for specialists and other inflated expenses deemed necessary in modern healthcare systems. Kaiser California imports medical school graduates from abroad for their in-house residency programs, which is presumably cheaper than raising salaries to draw more US resident candidates.
Kaiser arguably points the way forward. As an HMO--a vertically integrated healthcare system--there's greater financial incentive to self-fund residencies. When insurers, hospitals, and doctors are all at arms length from each other, the financial incentives don't align very well, thus the "need" for outside funding (i.e. the government) of residencies.
Note that unfunded residencies are also a thing, where the resident is responsible for sourcing the funds for their salary and expenses.
They are usually paid several times less than people doing the same jobs in US.
But we wouldn't be starting from nothing. There's a large group of people who would lose income and who will lobby against that.
Also taxes are generally much higher in these countries as well.
> Taxes are usually higher, but not incredibly so
So again.. would you rather make 60k and pay 45% in taxes or make 100k and pay 35%?
> nowhere near what America spends
Sure, if you are above median higher will likely more than compensate the higher healthcare costs (unless you’re very unlucky of course).
https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?most_rec...
In other countries people become doctors because they want to heal others. Not because they want to become wealthy. In the US doctors spend half of their time haggling with the insurance companies.
I think the guaranteed respect and admiration that comes from the title is actually a more powerful draw. Don't get me wrong, the money is good, but on par with senior manager in any large tech firm. Doctor is a primal respect that technical roles do not carry.
You're not getting instant respect from mother in laws and pastors as an ATC.
You would if it was known to pay $500k/yr+
I have respect for lawyers, and i have respect for investment bankers (who make huge merger/acquisition deals work).
Many people believe investment bankers are a net negative for society.
In the case of lawyers, a necessary evil. I have respect for people, not a profession.
Frankly, while I acknowledge their necessity, I have a poor (default) view of both bankers and lawyers. I don't see them as bad people, but people in their professions do many bad things.
If my son brings a banker home as a prospective mate, well, let's say they're not earning status points from their profession.
You (may have) and I (do) have respect for people in tough jobs like see workers. Doesn't mean my mom wouldn't prefer I date a nice doctor. My point being that social respect does not come with your personal respect.
It's very much relevant to this conversation. Without specific negative factors like a "predatory" aspect, increasing earnings will increase prestige. ATC doesn't have those factors.
So yes it is irrelevant in the specific context of that sub-conversation. Which isn't to say that your point arguing why that might not be applicable to ATCs isn't also a relevant thing to say to being the conversation back to the main topic of this thread.
Being relevant to either of those is enough to make it overall be: relevant.
Also, secondary equity issuance is pretty non-controversial, and an important fund raising option for publicly-listed corporations.
And... uhm... software developers.
Banking? Sales?
> Outside of anti-capitalist circles ofc
Well that's quite the point. Maybe those circles are small in the US, but they aren't in most of the rest of the world.
Let me just say that if I called my parents and told them that I had gotten a well-paid job at, say, a hedge fund, they would not be impressed and would likely think less of me for it.
All of them. Respect is not commanded because you make lots of money or have a certain job.
Used to be. Not anymore. Nowadays many doctors act as a smartass business people.
I remember a former CEO who would come into work each day and let out a heavy sigh before unlocking his office door. I learned that he was trapped in the job until he retired for various reasons...most of his own making.
There's certainly a lot of paperwork that has to be done, but doctors aren't doing it.
"What they learned was that during office hours, half the time — a huge chunk — was allocated to desk work, like documentation in the electronic medical record (EMR), reviewing test results, handling medication requests, and filling out forms. What was remarkable was that even during office visits, doctors interacted with their patients for only half of the time; the rest was EMR and paperwork. As a matter of fact, for every hour of face-to-face patient time, another two hours were spent on desk work." [1]
The paper mentions that was the amount of time spent for doctors with "documentation support" (various forms of automation/streamlining) that would generally be absent in something like a primary care physician's office, meaning he'll be spending substantially more time on paperwork. The paper also (at a quick skim) did not mention out-of-office work, where doctors often spend even more time filling out paperwork. And there are also regulations meaning doctors themselves have to be the ones filling out much of this paperwork.
[1] - https://www.health.harvard.edu/blog/physicians-paperwork-and...
Not just that, but having a shortage means each ATC does more work which is inherently stressful.
But upgrading technology requires government administrative capacity. That's generally cheaper than outsourcing technology development to third parties, but does require a commitment to try to understand the thing you're managing.
Politicians don't hire competent administrators because they believe that building a solution yourself and buying a solution from a contractor are basically equivalent, which anyone on this website can tell you is not true. This is an easier problem to solve than most think, but it's not trivial. And it's really hard when you have clowns like Elon Musk purposefully destroying institutional knowledge for no good reason.
They genuinely cant. They can make a sorta kinda prototype of something that costs Google several million dollars.
There's a joke inside Google that Google infra makes easy things hard and impossible things possible.
Tell me you haven’t worked in aerospace without telling me you haven’t worked in aerospace. There is plenty of money sunk into all corners of the field but progress is slow because the risk of change is lives lost. At some point, the risk of not changing means more lives lost… and that’s when things will change.
… because of mismanagement, just like other large software rewrites that you are probably familiar with.
It’s the same problem - updating a complex system - except there’s no other vendor you can switch to.
ATC has human operators and people are non-deterministic and non repeatable and you can't just run a few tests and conclude it's fine.
The issues you're trying to stop may only occur once a month globally across all airports or something, and only be noticed once a year.
Money only does so much to improve your life. Stress is a way to shorten your life. Long term chronic stress literally makes you ill in ways that medicine can’t fix.
- Allow people to retire after a decade rather than several decades of work
- Allow (or require) people to only work part-time (eg 2 days a week, or 5 days of 2 hours a day, or...) while still earning a full time equivalent salary
- Allow a work day to be 10mins on, 50mins resting for every hour (requiring 6x as many staff), while paying as if the full hour was work
- Pay for therapy, stress-management lessons, etc.
- Pay for a professional cleaner at home, a part-time chef or lots of restaurant/takeaway meals, or whatever else helps to minimise the amount of work you need to do outside the job
- Probably other ideas that haven't come into my mind in the two minutes I've spent on the subject of how more money can help fight issues caused by stress
Another way would be investing in education (instead of dismantling it, or mixing it with religion and politics), making it more accessible so more people come out who are better equipped to take on "complex jobs"
You can see the list of criteria here: https://www.faa.gov/air-traffic-controller-qualifications
- Be under the age of 31
Well, they restrict the pool pretty harshly right from the start.
Education isn't just about changing the quantity of knowledge people have learned - a country with good free education, along with other things like mental health support, good parenting resources/education/support, etc. will lead to more people having the qualities needed to be ATCs despite not having learned them by going to specific "managing stress 101" classes.
(Edit: It's possible I misunderstood you and by innate qualities you literally just meant the things in their explicit requirements list like being under 31 and being a US citizen, if so apologies but I'll leave my comment here anyway.)
the people you might want mignt
1. always have a better option elsewhere and if your raise the offer, competitors will offer something even higher instead, beyond the pittances the government is willing to spend 2. never be willing to take on the job as specified - huge responsibility and risk of killing people, with long hours and no recognition 3. never finds out that the pay is high - nobody talks about it, or sells its existence as an option. 4. doesnt have a parent in the business to teach them what to do
raising the payment seems to fail a lot, even though its suggested naively all the time as the solution to all labour problems.
alternatives might be to increase outreach, immigration, enslaved prison workers, stronger unions to make the job more like what people are willing to work, etc
The extra expenses will also encourage actual fixes to the system like better automation or whatever to reduce costs.
> Too much stress? I bet if you paid people so much money that they could work for 10 years and then either retire to a lower paying job, or retire entirely, people would deal with it.
I highly doubt that solving the problem with just money will get the right people.
A high salary becomes the goal in an of itself, and everything else falls to the wayside.
Do you really care about safety? Applicants may say they do, but only want to retire after 10 years and will lie through their teeth.
Money is a corrupting factor. I don’t like to take this side of the argument, since I want people to be paid fairly, but there’s something fundamental to seeing unpaid volunteers having the best intentions and most love for their craft
The other side of the coin is you won’t get the candidates you want if they can get the same money for less taxing jobs. Game theory 101.
Or pay people enough they can afford to work part time. A stressful job is less stressful if you only have to work 2 days a week.
No that's actually not true. Government jobs are soul crushing. The way the bureaucracy works, its all about social standing, politics, and seniority. In these jobs you trade your sanity for money, and they have a long reputation for being just like this which is why few ever apply.
No reasonably average intelligence person is going to do that unless they are absolutely desperate. Its a dead end job.
This was already addressed in the original post. Why write in this "spelling it out for you" style when they already addressed it?
> Do you know why people go through the pain of becoming a doctor? Because they make a lot of money when they get through the other side.
This is really reductive. There are multiple reasons:
- very stable employment
- very prestigious job, and has been for centuries. Conveys authority. Your family can boast that you're a doctor.
- very interesting tales come out of employment, and your family probably
- very easy to feel good about being a doctor - directly helping people etc
Not all of those for everyone, and they no doubt don't all turn out to be the case, but doctors apply for multiple reasons, and many of them aren't in high-paying areas at all. Doctors (in America, which I assume is what you're focusing in on) are paid well partly because they have high expenses in terms of liability insurance.
Reductive
-tending to present a subject or problem in a simplified form, especially one viewed as crude.
Stability of employment is something that traffic controllers could have, this is just a question of "working conditions" and solvable by money.
I really do not see why traffic controller could not feel good about being traffic controller. They do more "life saving" jobs then any of us on hacker news.
Identifiable tales are illegal, yes. That's not all tales. Surely you know a doctor and they've told you stories before?
I'm listing other reasons doctors like being doctors over just money. I don't know what the rest of your comment has to do with this.
You must know few doctors, or they must work in very boring locations.
> nor should have due to things being private by law
You wouldn't believe how amazingly easy to tell stories without any patient identifying details. Think of any of your best stories - could you tell them to me without providing me breadcrumbs about any identities? I bet you could with nearly every story you have to tell.
The supply of labor for a given job is related to the market price of the job. This is literally ECON 101.
(Econ 101 again: increased price -> reduced demand, i. e. fewer flights.)
things get complicated of course as the situation under analysis gets further and further from the ideal setup, as data gets more scarce, and so on.
but the job market is pretty darn close to the simple model, and this question is also close to the ideal (how much more price need to rise for supply to meet demand, we draw the graph based on data from other professions, and boom, there's our answer, if we want to get very fancy we can do various models to try to estimate the curves.)
Fact: Somewhere between 1X and 10X is a salary where we would have enough applicants.
It's objectively true.
Whatever prior assumptions prompt you to second guess this obvious, objective truth are ripe for reanalysis.
> at a certain point you are just going to be cannibalizing other talent pools
Nothing to do with raising pay causing/not causing more supply.
- Can you swim now?
- No.
- What if I give you money?
The notion that if you just pay enough, people who are otherwise qualified will do anything, is amazingly reductive. It's a super US-centric view, and not surprisingly, it does not have an amazing history of working out (especially compared to other mechanisms).
Given the people in question have good other options, why would they do this, even if you paid more?
In fact - plenty of smart people will take pay cuts for better qualify of life.
Example: Plenty of folks take pay cuts to work remotely from places they like more, and because they find it a better quality of life.
Not everyone is money driven, and the assumption that here is that the intersection of "money driven, capable of doing this job, etc" is large enough that increasing the amount of money will make the result larger.
It's totally non-obvious this is true.
Pay cuts are not important; profit is! If I get paid 100 less, and spend 90 less because of no commuting, I'm gaining more than before.
I make less working remotely in a LCOL area than I would in the HCOL area where my office resides. The differential in COL, though, is so high that I'm saving a lot more. In other words, I'm making less but I'm building more wealth.
Most of the money that goes into living in a HCOL area and commuting to office is just pure waste to satisfy the egos of upper managers who want to preside over a big floor of workers.
If every part of the US became equally expensive and convenient for work, VHCOL areas like the Bay Area would still be immediately oversubscribed for reasons unrelated to work.
The Bay Area has arguably the best climate (cool Mediterranean) of any major city, unique proximity to a diverse set of outdoor recreation (Big Sur, Napa, Yosemite, Tahoe just to name a few), and all the desirable amenities of a major metro area.
That’s not to say you can’t have a perfectly happy life in other areas if you have different preferences, but the cost of living is ultimately a market, driven by the aggregate preferences of all people.
I think you are right.
Do you have other ideas on what constraints can be relaxed?
You can't say it doesn't work until you've raised the median salary in the field and observed the effect. Managers and bean counters aren't willing to do this so it will never happen.
I knew, of course, this would be the response. But i'm not sure why, in the history of the world, people assume we haven't tried paying people more in various fields, and that "managers and bean counters aren't willing to do it".
It's amazingly silly.
It would take you less than 60 seconds to find at least 100 studies on this, across tons of fields.
The next thing that happens is that when you point out studies (and there are plenty good and bad), they will start arguing with any study that doesn't support their already preferred position, rather than trying to ever spend time considering alternatives.
There are nearly infinite studies on infinite fields and the results are fairly mixed.
Certainly not the amazingly positive expected value that constantly gets paraded around.
Some of y'all are so money driven you just can't possibly contemplate that not everyone is driven by money.
The complaints in the article were all about too many hours. More pay, more workers, less hours.
I didn't see anything about not liking the job. At least not in the article.
There are nearly infinite studies in infinite fields on this, and despite claims here, the results are mixed at best.
Certainly not the utopia consistently predicted.
I'm sure someone will next just say it's not enough money, rather than bother to read any of the studies and whether they tried to account for this or not, or ...
I'm going to ignore those comments, since it doesn't seem like a discussion anyone wants to learn anything in.
If you want to push your preferred position, that's sort of silly. There is no winning or losing here. If you want to actually learn something, happy to discuss it for real.
Why is money the only thing to do here? Why do you assume that is the driver, despite tons of data suggesting it's simply not the only driver?
Can you please, please, take like 10 minutes, and go read any of the 1000's of studies on this, and then make some reasoned argument that is more than just what you are doing now, which is:
A. I think money is the only thing that matters and refuse to present any evidence that it is.
B. I will also claim that we never try it, despite it actually having been tried.
C. When someone takes the time to show me that we do try it, i will simply, without any further evidence, claim we aren't offering enough.
This sort of discussion is just kind of silly to have.
You know what - great, you figured it out. The real problem is that we just aren't paying enough. That's the only problem. It's not that the qualifications are too high, or the job as is is too stressful, or anything else ....
You have, without any data, evidence, etc, figured out the one simple and true solution to a very complex problem that lots of people have spent lots of time trying to puzzle through.
You won hacker news! Congrats!
I actually hope they offer an infinite amount of money to ATC controllers, so we stop having this particular reductive variant pop up in discussions.
It's fine if you want to argue money matters, i even believe money does matter. I just don't think it's the only thing that matters, nor do i believe you can solve a complex problem like this by just taking a single variable in that complex system and pushing it to the extreme.
The most likely outcome seems to be you increase the rejection rate from 90% (which is what it is now) to 99.99999%, given how the process actually works right now.
Plenty of people in the US have finical goals, and providing them a means to more quickly reach their goals will motivate them. Will you convince everyone to apply to a job with more pay? No, but you really just need to convince a few more qualified people.
Yep, I dropped to a 4-day week prorated (so a 20% cut, a little less if you consider that changed my position with respect to tax boundaries, for 20% less work) a while back, to deal with family health issues and my own burn-out. As things are fixing up I'm considering keeping to this routine despite the fact the extra money would be useful – the extra time is _very_ nice too.
[Not sure how far into “smart” territory I'd be considered though :)]
There are three forms of pay cut: reducing pay for the same time spent working, reducing pay for the same work done (when pay is awarded piecemeal rather than by time), or indirectly by a reducing in work. Ask anyone on a zero-hours contract who unexpectedly gets a zero-hours week: it feels like a pay cut to them more than a joyful temporary freedom from work.
There are a number of companies experimenting with a 4-day working week with no change in pay or other conditions, some are finding the reduction in working time often doesn't reduce useful work output. A 20%-ish drop in income for a 4-day week is a pay cut when compared to that.
"The notion that if you just pay enough, people who are otherwise qualified will do anything, is amazingly reductive. ... It's totally non-obvious this is true."
But perhaps you were just responding to the narrower assertion that some people will be happy to trade money for more leisure time. Apologies if I misunderstood which point you were addressing.
This is true for individuals.
With a sample size large enough, the probability that no one will be up for it given the increased pay, is extremely low, tending to zero.
IE it's not particularly useful to say "we will pay 1 million billion dollars to anyone in the united states who wishes to be an air traffic controller" if you want good air traffic controllers.
It is more useful, for example, to take the people who wanted to do this, and you stopped from doing this before for dumb reasons, and offer them more money to go back to doing this.
Citation needed, because...
> IE it's not particularly useful to say "we will pay 1 million billion dollars to anyone in the united states who wishes to be an air traffic controller" if you want good air traffic controllers.
...if you're asserting that offering one quadrillion dollars as the salary for ATCs would not decisively solve the problem, that's insane and there can't be further discussion.
However, if your point is that this might be true, but the statement isn't useful, that's false too - it is useful to say this, because if true, then it means that there some function that describes the relationship between compensation and qualified applicants. And now that we've agreed that there is a function, we can then have a reasonable discussion about the inputs, and specifically the tradeoff between making the compensation higher vs. changing the way the training is structured and the artificial constraints on supply.
If you can say "to increase trained ATCs by 50% you can either make the salary $450k higher for 1k employees, or you can do a tech modernization that will cost $10M and keep your tech recent for the next decade" and provide a specific tradeoff between financial compensation vs non-salary factors, then you'll be able to have a logical argument about the two. And if the numbers are as skewed as in my example, you'll be able to convince the majority of logical people that increasing the salary is the suboptimal strategy.
If you think that, you aren't considering paying them enough money.
> Given the people in question have good other options, why would they do this, even if you paid more?
You ain't thinking about offering them enough money. Enough money means as much as it takes to make your offer better than any other option they have.
> In fact - plenty of smart people will take pay cuts for better qualify of life.
True, but also the same people will take quality of life cuts if you offer enough money.
Also, in general, the best way to improve one's quality of life is... through more money.
> Example: Plenty of folks take pay cuts to work remotely from places they like more, and because they find it a better quality of life.
Counterexample: add four zeros to the salary offered, and watch how many of them won't be happy to uproot and move with their whole family to your location within 24 hours.
> Not everyone is money driven, and the assumption that here is that the intersection of "money driven, capable of doing this job, etc" is large enough that increasing the amount of money will make the result larger.
This assumption is sound in theory and almost always true in practice, it's just rarely attempted, because you need to spend money, which people absolutely hate.
Almost all cases of skilled staff shortage can be solved with multiplying the payment by 2-10x (and convincing people you mean it - at the 10x end, people may start having doubts, precisely because it's so uncommon to see). Do that, and you'll have your competitors' staff jumping ship, and a wave of skilled applicants from abroad, committed to relocate if you let them. If the market for the skill is growing and you're able to sustain the pay bump, people will retrain and entrepreneurs will start schools for future candidates.
And yes, with that much extra money available, other entrepreneurs will try and pitch all kinds of software and hardware that will reduce your need for skilled labor, hoping you pay them instead.
Of course, 2-10x bump might make the whole endeavor stop making business sense on your end. It's often the case. But in this situation, saying there's shortage of labor is a lie. It's only a shortage at the price you're willing to pay.
This all just follows the same dynamics everything else in the economy does. If you believe employment is a special case where this doesn't apply, you're still not imagining paying enough money :).
You really just assume everyone, at their core, is money driven enough. So to you, everything is about whether they are beign offered enough money. You even use the amazingly circular reasoning that if you discover them saying no, it just means you weren't trying to pay them enough.
There is apparently no limit to this, and anything gets solved by more money. This of course, can't possibly be disproven, since you will just say to increase the limits.
Meanwhile, as I've said, this is an intensely researched thing. I have yet to see a single person constantly pushing the infinite money angle make any reasoned argument, backed up by any study or data.
As I've said, plenty of studies have explored the effect and limits of giving more money on happiness, on recruitment, etc, on tons and tons and tons of fields.
Rather than just making reductive arguments that don't really get us anywhere, why don't you make a reasoned one?
also consider, just for a second, the possibility that not everyone is this money driven. Seriously.
"Enough money means as much as it takes to make your offer better than any other option they have."
That doesn't always exist. That's the whole thing about not everyone being money driven.
The original claim was this:
> Only 10% of applicants are physically and mentally qualified? Sounds like you need more applicants? Want to attract more applicants? Offer more compensation.
You then dishonestly moved the goalposts:
> There are plenty of jobs that you can't pay people enough money to want to do.
> The notion that if you just pay enough, people who are otherwise qualified will do anything, is amazingly reductive.
Maybe before accusing people of being reductive, you should respond to the actual point being made instead of moving the goalposts.
> As I've said, plenty of studies have explored the effect and limits of giving more money on happiness, on recruitment, etc, on tons and tons and tons of fields.
None of which you have linked. Go ahead, link a study that says that even offering an unbounded amount of money isn't enough to get enough applicants within the amount of time it takes to go through the training pipeline.
Would you mind listing 2 or 3 examples? All the jobs that I do not want to do that I can think of, are actually poorly compensated.
So, you're claiming that there's empirical evidence that supports your claim. Please link it.
I have had some experience with family, girl friends, friends and med-students. And it was definitely not the primary reason any one of them chose that path.
I don’t think money is a strong enough single motivator for med-school or any other long term hard study/job.
Don't underestimate just how high-stress these jobs are and what it does to you. People quit these kinds of jobs for 2 reasons
1) They can't deal with the stress mentally, or don't want to.
2) They were not smart enough to choose option 1 and their body just physically gives up and they are no longer capable of performing their job as an ATC.
Or the passive visual skin color test (Brigida vs Buttigieg 2021 lawsuit).
That'll be about 4,120 qualified ATC applicants that won't be coming back: would you come back if a sizable class-action award is forthcoming?
If that was the plan (to lock up and away FAA ATCs, to inflate supply-demand, that's a shrewd economic move, but I don't think so).
I feel like this could be counterproductive. If people retire after 10 years instead of after 30 years, you now have to hire 3x the amount of people over time.
Is it realized it almost happened in the recent helicopter / aeroplane crash. As it was said the helicopter was used for moving VIPS ....
Except that when money was on the table, Reagan fired them. ATC is remote from most people's day-to-day awareness unless planes hit each other, but medical help that's held back is really in-your-face.
Granted, that's decades in the past. No way anyone would jump in and try to gut the public service like that today [1].
[1] sarky.
Only 10% of applicants are physically and mentally qualified? Sounds like you need more applicants? Want to attract more applicants? Offer more compensation.
The training and onboarding is incredibly long? Sounds like a doctor? Do you know why people go through the pain of becoming a doctor? Because they make a lot of money when they get through the other side.
Technology hasn't changed is a political problem due to lack of... money. There isn't an issue with new technology, there's an issue with the government refusing to invest in upgrading the technology. Canada doesn't have this issue and they're far smaller than the US.
Too much stress? I bet if you paid people so much money that they could work for 10 years and then either retire to a lower paying job, or retire entirely, people would deal with it.
I do absolutely, 100% think that this is a problem that can easily be solved with money.
I also think our politicians will flounder around making excuses about how the problem is unsolvable because it doesn't directly help their chances of re-election.
The first time a plane goes down carrying a dozen congress critters and their families, you can bet there will magically be money in the banana stand.