THE STASH OCTOBER 1, 2009
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Just a quick coda to my earlier post about the debate Megan McArdle and I had over Obamacare and doctor shortages. At one point in our back-and-forth (about 2:35 in) Megan claimed that people would choose not to become doctors if salaries started to fall post-health care reform. The idea was that, unlike other countries, where doctors make up for what they lose in salary with the social prestige of doctoring, in this country we're all about money--social status be damned.
I argued in response that the ability to bathe doctors in social prestige isn't exactly a fixed feature of one's national character--it's not that Americans are genetically incapable of it, or that Europeans naturally excel at it. If doctors made slightly less money, but the system were seen as better for patients overall, the social prestige of doctoring might rise a bit and compensate them for the loss of income.
At this point, Megan came back with:
We don't have a unified culture. There's no--Sweden can talk about having a Swedish culture, and to some extent a Swedish status hierarchy and Swedish values. That's just not true of America. Everyone's participating in about 97 different subcultures. So you can invent your own status hierarchy, but you can't get everyone to buy into the idea that we should pay our doctors $60,000 a year and then all love them a lot because they're doctors.
I guess Megan's point is that Sweden has a more discernible status hierarchy because it's a much more homogeneous country. And it sorta sounds plausible (though I still think most people are inclined to respect doctors regardless of whether or not they belong to the same subculture--all the more so if they're satisfied with their health care).
But then, a day or two after all this, I stumbled across this item from Matt Yglesias:
An interesting fact about Sweden is that an extremely high proportion of its population is foreign born. It’s not the highest in the world—Canada and Australia take the crown—but the foreign-born are a larger proportion of the population than in the United States.
A large number of those immigrants are from other European countries, but apparently Sweden has one of the world’s largest Assyrian populations.
Hmmm. It turns out even Sweden doesn't have a Swedish culture.
4 comments
Sweden just got ranked 'best country for asylum' - sorry forget the source. just try reading any Swedish newspaper and you can see a country without any national identity, just nostalgia for what they thought they were. about the idea of social prestige versus net worth? do American doctors actually believe that Americans hold them in high regard because they make money? no wonder there are so many bad doctors.
- K2K
October 1, 2009 at 9:50pm
"An interesting fact about Sweden is that an extremely high proportion of its population is foreign born." Yes, and many of the are Arabs who brought with them a culture of Jew hatred which has now spread to the rest of the country. Not that the Swedes were ever in love with Jews.
- jacksondyer
October 2, 2009 at 10:49am
If you want to start paying doctors $60K/year I think you'll need to take a look at the cost of medical school and malpractice insurance. One guesses that the $160Kish that primary care providers make isn't cutting it primarily on account of these two culprits, hence the present and totally understandable flight of doctors from that practice area. Another worry I'd have here is that people get green in the eyes when they think about taking money away from the guy getting it because they think the money will go back to them. So, i.e.: we think we'll pay less for health care, but get better service, because we pay doctors less (sorry - can you explain to me again how that works? ... but for sake of argument ...) and we are able to convince ourselves of this fairly sloppy line of argumentation because we assume ourselves to be the beneficiaries. But in the great movement of these things ... system changing to pay doctors less, money they are not paid goes ... where, ... where exactly? ... I kind of doubt that after the machinery of change takes its affects that healthcare CUSTOMERS are going to find themselves with thicker pockets full of unspent cash. To the contrary: I wouldn't be surprised if the doctors got paid less, and some administrator, bureaucrat, executive, consulting organization, fees-funded regulatory agency or investor got the money instead. But you and me, the customer/patients? I'd personally rather keep paying the doctor thank you.
- dcwood10
October 2, 2009 at 2:31pm
Trying to be fair, something that no longer applies to Sweden, the widespread condemnation of Jews and Israel in Sweden seems to be self-generated by the trade unions, who, until recently, owned the majority of shares in Aftonbladet newspaper, which offers a view into Sweden that is completely at odds with the now false image of Sweden as a tolerant, neutral, 'role model for the world'. How can a country where Aftonbladet has such high circulation be anything but a poorly educated, self-absorbed nation fuelled by rumours, lies, and hate? Who knows whether Swedish doctors are actually admired for their secret organ harvesting of asylum-seekers? (note to Sweden: freedom of speech applies to rhetorical questions)
- K2K
October 3, 2009 at 10:22am