Interesting. Not long ago one of my daughters was in the pediatric ICU at a prestigious teaching hospital, and I noticed that both the attending physician and all of the residents I encountered were women. I wondered whether this was distinctive to pediatrics. I guess not.
One of Fleur's friends came to visit in the hospital room, and when she looked around and saw all the hott female residents, she asked, "What is this, the Charlie's Angels hospital?"
Q. sexist
A. law, politics, well, may be astronomy
Didn't this happen in the Soviet Union? Medicine became very feminized, and dropped way down in status? I haven't got a source, though.
Looking around my finance-y desk right now, and we're 40% women. It's too late!
Ex recto, but I think, like most other subdisciplines, medicine is well segregated by gender, and the ones which tend to attract a lot of women (pediatrics, objines) are correspondingly less prestigious.
As long as the AMA keeps doctors in short supply and the salaries are so high, something tells me this isn't a big worry.
Ob/gyn has suddenly become women's work. Because women are so much more sympathetic. hahahahaha
There's also the fact that a profession where women are equally represented is going to look like a profession with a hell of a lot of women in it. I haven't looked at med school stats nationwide, but the fact that there are some schools with more than half women doesn't mean that med students generally are more than half women; again, in a profession where half the practioners are women, sometimes you're going to be in a room where all the doctors are women.
ja, ja, linguistics is the most suitable profession for
the tender gender
Pediatric ICUs tend to be staffed by very intense women nurses. I tend to suspect that they are Catholics. I didn't have a lot of contact with the doctors, but they may be the same.
Both Cala and LB are right. In general, occupational sex segregation is pretty fine-grained, and the more precise the job description (e.g., going from "Doctor" to "Deputy director of pediatric oncology services") the more gender segregation you see.
You argue: if many women, then not prestigious.
The converse (and hence the inverse) are not true, at least- if a profession does not have women, it is not necessarily prestigious. I don't think I've ever heard of a used car saleswoman.
So looking for professions that remain all men (cf. 4, 8) doesn't mean they'll become prestigious.
You argue: if many women, then not prestigious.
It's a thing that has happened to professions in the past, is all.
the tender gender
I love me some bank.
Aren't lawyers approaching gender parity (at the young end, obvs)? Lawyer jokes aside, isn't law pretty prestigious? Certainly it's not the presence of women lowering the social status of lawyers.
This is not to put any doubt whatsoever onto the pink collar theory - it was just the first profession I thought of that is both prestigious and full of women.
SP: What used car saleswomen sell.
I've actually been surprised by Dr. Oops' coworkers as a transplant surgeon. There are more men than women, but not overwhelmingly so -- I couldn't give you percentages, but her being a woman isn't wildly unusual.
the ones which tend to attract a lot of women (pediatrics, objines) are correspondingly less prestigious.
I don't buy this. From what perspective do you think they're less prestigious?
The converse (and hence the inverse) are not true, at least- if a profession does not have women, it is not necessarily prestigious. I don't think I've ever heard of a used car saleswoman.
Whether the converse or the inverse is true is irrelevant. You'd have a point if the contrapositive weren't true.
Missed 16 on preview.
I think this
if many women, then not prestigious.
is broadly true, but I also think that this
So looking for professions that remain all men (cf. 4, 8) doesn't mean they'll become prestigious.
is an interesting point.
It seems that there are probably certain kinds of slop work where no one particularly wants to break gender barriers to enter - obviously garbage [man] is one example, but it's not just unpleasant/physical work - used car sales is probably a good example. I know that in the case of fields like waste, you see this incredibly insidious trend of jobs that are still male bastions gaining wages faster than those that have been opened up to women, even though both fields are traditionally comparable in prestige.
the ones which tend to attract a lot of women (pediatrics, objines) are correspondingly less prestigious
However you want to define prestige, they are certainly less well compensated.
Oh, and of course I was going to make a pedantic point about the phrasing in 16, but ben had already taken care of it.
Now I'm wondering what professions have declined in prestige as they become more gender-balanced, and whether the gender shift explained the prestige or whether some other factor explained both the prestige change and the gender balance.
We've got a college population where women are outperforming men in many ways. It's not surprising that women are getting into med schools in high numbers given how competitive admissions are.
However you want to define prestige, they are certainly less well compensated.
At this point, I think we need a big, fat data set.
Now I'm wondering what professions have declined in prestige as they become more gender-balanced, and whether the gender shift explained the prestige or whether some other factor explained both the prestige change and the gender balance.
I think the pattern alluded to tends to be one of flipping -- not increasing gender balance, but going from mostly male to mostly female. The examples I'm thinking of are mostly early 20th C -- secretary was an entry-level but on the ladder to prestigious position when it was all male, and then turned into a dead-end when it became mostly female; I think librarians did the same thing. I can't think of a more recent example.
22: There is clearly (to physicians) a hierarchy, although it's a little fuzzy. How it breaks down by gender lines, I'm not sure. But randomly ask a few thousand physicians if it's more prestigous to be attending in an ER or as a radiologist, or neurosurgeon, or cardiologist .... I'd be astonished if you didn't get pretty consistent results. Even within a subdiscipline: trauma surgeons, transplant surgeons, plastic, neuro --- these are not viewed equivalently.
I'm certainly no expert in the area, but the impression I have gotten from my M.D. friends is that sortation by speciality is more a function of personality type than gender, and the personality types are not always (though perhaps sometimes) correlated with gender.
Stereotypical examples: misanthropes go to anaesthesiology, the work-shy go to radiology, bleeding hearts go to primary care or pediatrics, the arrogant become surgeons, the greedy become plastic surgeons, etc.
Also, beyond the obvious (highly paid specialties more prestigious than lower paid general medicine), I'm not sure that the hierarchy of prestige is all that clear cut. Is a urologist more or less prestigious than an orthopedist?
28: there are clear patterns in compensation, too ... but this is somewhat complicated by malpractice.
In the health care professions, gender is the most powerful indicator of income. In 1983 when comparing male with female physicians, the women earned 81.6 percent of men's pay, while in 1999 this percentage dropped to 62.5 percent.(5) In a 2002 survey the median salary of male assistant professors was $75,000 and that of female assistant professors was $71,000. Male associate professors' median income was $97,000, that of their female counterparts $94,000, while male full professors earned $131,000 versus $114,000 for women.(6)
I think that as professional jobs become more gender-(and race- ) balanced, high status will shift to those jobs where success is less objectively predictable, like the arts. That women can do just as well as men on the MCAT or the California bar exam is undeniable; that women have as much intangible artistic genius as men, less so. It's an elaborate game of keep-away.
Even within a subdiscipline: trauma surgeons, transplant surgeons, plastic, neuro --- these are not viewed equivalently.
And, of course, you used to be able to trump the hierarchy by showing off your big, big dick. But that doesn't work for these newer doctors....
Dermatology - virtually no call, fairly high compensation, nice work week
Ophthalmology - virtually no call, very high compensation, nice work week
Emergency Medicine - no call, decent compensation, shift work
Pathology - virtually no call, fairly high compensation, nice work week
General Surgery - extremely long work week, lots of call, higher compensation, surgical
ENT (Ear-Nose-Throat) - longer work week, some call, very high compensation, surgical
Cardiology - extremely long work week, lots of call, high compensation, procedural
Anesthesiology - moderate to longer work week, some call, high compensation, procedural
Family Medicine - nice to moderate work week, some call, lower compensation - few procedures
Internal Medicine - moderate work week, some call, lower compensation - few procedures
Is a urologist more or less prestigious than an orthopedist?
If the answer to this doesn't relate to the relative prestige of bunions and UTI, then I've lost all faith in humanity.
33: Those must be teaching salaries. They are small fractions of many attending salaries.
19: But the prestige is still not at all balanced within the profession. As I've mentioned before, I'm in a department where 70% of the associates are female, and less than 10% of the partners are.
39: Right, this is a different issue. It's also confounded a bit by age and typical progression through the profession. The gender mix of newly minted lawyers has to be compared to the mix of partners what, 15-20 years from now?
@28
Okay.
Family practice: $185,740
Gen peds: $185,913
Ob/gyn (inc gyn surg): $270,793
Gen surg: $327,902
Ortho surg: $436,481
CT surg: $460,000
Surgery being the most male specialties, with the most hazing by traditionalist docs. No, I don't have a data set for that.
objection, banks are boring
i'd never ask to love money-making mannequins
and yeah, linguistics are the best for reflexing chicks, especially to teach one's native language to
especially to non-natives
There is clearly (to physicians) a hierarchy, although it's a little fuzzy.
This is very true. My father told me, if you want to go into medicine, become a radiologist, because that's where the money is (this was when I was a kid; he was not a radiologist).
But this
How it breaks down by gender lines, I'm not sure.
appears to be the question at hand. Unfortunately, I've got to go pick up my daughters, so I'll have to pick this up later.
Didn't this happen in the Soviet Union? Medicine became very feminized, and dropped way down in status?
This is correct from what I could see while living over there for a couple of years.
40: A bit, but not as much as you'd think. Law schools have been 50/50 male-female for quite a while now.
As I've mentioned before, I'm in a department where 70% of the associates are female, and less than 10% of the partners are.
But this is where things get confusing, right? Leaving aside prestige vs. power (or pay), it's not entirely clear why that's true. As I recall, the best evidence is that wives and mothers are harmed and limited. That ends up being most women, but it isn't clear to me whether what's driving that is the behavior of the corporation or the behavior of the rest of life (which the corporation won't take into account).
Read, what is up with this "yeah, linguistics" thing? Are you punning, or what?
high status will shift to those jobs where success is less objectively predictable, like the arts.
Seriously? Oh yeah! But wouldn't this be a difficult shift; do high status jobs that are extremely low paying exist? Increasing the pay of artists is tricky partly because success is sometimes less objectively measurable as well as less predictable. How would this work?
45: Ah, I didn't mean it was a different number, just that you had to compare to their cohort. I didn't know what the fractions were like.
One question though, it's my understanding that law schools graduate a large number of people who will never work in this sort of situation. That seems to be possibly a confounding factor, too.
43: Yes, radiology is still up there. An acquaintance had a starting salary of around 400k. There are higer paid specialties (neuro surg. eg.) , but that's not a lot of people by comparison.
46: I'm not blaming the firm; the lifestyle explanations may be absolutely the correct ones. But we're not talking about explanations, just the facts relating to gender-segregation by prestige.
47: "punning" s/b "hallucinating"
Yeah, this trend of more women than men entering the health professions has been going for a while. It's particularly strong in dentistry. There is also a very disproportionate number of asian women among those future high-earners, which is why my mom keeps half-jokingly telling me to hang around the Northwestern Med school to find a wife (it's only a few blocks from my apartment, and very serious looking people surrounded by large books are a constant presence in local coffee shops).
It should also be noted though, that the much higher-earning specialties, such as oral surgery, orthodontics and endodontics in dentistry or orthopedic surgery and every other type of surgery in medicine, are still male-dominated even among the students.
I don't know what read's talking about, but linguistics is actually a pretty gender-balanced field.
the men are chasing the prestige, not the women chasing out the prestige.
As I recall, the best evidence is that wives and mothers are harmed and limited. That ends up being most women, but it isn't clear to me whether what's driving that is the behavior of the corporation or the behavior of the rest of life (which the corporation won't take into account).
As long as prestige is tied to being hardcore (to use the Grey's Anatomy term), won't this be a problem in every potentially prestigious field?
1 wins the thread; everything else is superfluous. Flippanter's been on a winning streak lately is my impression.
Of topic, but if Po-Mo Polymath would be so good as to drop me a line at snar/kout at gmail, I'd appreciate it.
Off. I've been awfully fat-fingered of late. Again, I blame Thanksgiving pie.
Haven't finished reading the thread yet but as far as professions that have become less prestigious as they've become more female, I think the #1 example would be psychology. I say this having two parents who are psychologists. Both my parents have noted the decline in the prestige of their profession over the course of their careers and correlate it, in part, from it being seen as a mostly male analytical dicipline to a mostly female touchy-feely dicipline.
54
good for linguistics, so hwy not to accept that medicine is becoming actually a pretty gender-balanced field also.
and be happy about it
While all the medical-knowing people are gathered, can anyone define the difference between "attending physician" and "physician [/doctor] in attendance"? I think they're pretty separate, but I'd like confirmation.
As long as prestige is tied to being hardcore (to use the Grey's Anatomy term), won't this be a problem in every potentially prestigious field?
This is something that I darkly suspect (rather than being willing to argue from data, to bring in a distinction from the other thread) of being a semi-intentional response to women entering the workforce on formally equal terms. In 1950, a high prestige lawyer could get home for dinner most nights, no problem -- if women had been high-prestige lawyers then, work-family issues wouldn't have been all that big a deal. Once women enter the high-prestige lawyer field, though, and are starting to try to manage work-family issues, suddenly working until midnight is a necessary part of the job. For everybody, not just women of course, but it ends up being a barrier.
This is, as I said, a dark suspicion, not something I'm going to defend, but it does float through my mind on occasion.
22: I don't buy this. From what perspective do you think they're less prestigious?
I don't have data handy, sorry, but I was at a talk a couple days ago about a single-payer medicine proposal. One speaker said that one among many problems with the current profit-based system is that hospitals devote more money and resources to specialists than to more common types of doctor like primary care physicians because even though specialists are needed less, they can charge more and their clients are more likely to pay. So a general practitioner or pediatrician may not be less prestigious than a cardiologist in some social sense, but (s)he probably makes less and is less likely to have hospitals fighting over him/her.
Haven't finished reading the thread yet but as far as professions that have become less prestigious as they've become more female, I think the #1 example would be psychology.
Maybe. But Psychology was hitting way above its weight for a long time, too. I'd expect a similar fall-off in prestige in economics sooner or later.
I think the prestige of doctors, in general, has already fallen. I really don't hear any of my arrogant-genius students saying they want to be doctors anymore. Unless they're immigrants.
My most brilliant student told me yesterday that he's getting an English degree, but plans to go to med school, and I nearly scoffed.
63- Aha, it's all women's fault when I have to work late.
The argument in 16 was superfluous, I was just trying to bring out the Benbot.
I think the prestige of doctors, in general, has already fallen.
But it's still quite high, speaking objectively. Doctors rose to the level of demigods over the 20th century, and that's now the baseline.
I really don't hear any of my arrogant-genius students saying they want to be doctors anymore.
What do they want to be?
The argument in 16 was superfluous, I was just trying to bring out the Benbot
This could be a fun game - how elaborate an argument can you make that is actually just a usage troll?
62: --- I interact with physicians in atypical ways, so I may be wrong about the destinction but as I understand the terminology the first is a job description (i.e. a `real', finally-finished-training, physician) , the second a relationship to a case.
Lawyers or economic theorists or political consultants.
I don't think the prestige of doctors has fallen. If I hear that someone is planning to become a doctor, I instantly have respect for that person. But my mental image of that person is not at all the kind of person who would make a good doctor - it's the kind of person who can stay focused enough on a goal to memorize enormous amounts of arbitrary information and withstand terrible sleep patterns and years of hazing and misery. Usually correlating with having poor social skills.
It does surprise me that so many women fit this description, though.
As for the contrapositive:
If prestigious, then not many women
link
When read a list of different occupations, 63% of respondents to the telephone poll said they feel firefighters have "very great" prestige, while 58% said doctors do. Other professions that were seen as having very great prestige included: nurses (55%), scientists (54%), teachers (52%) and military officers (51%).
I dunno man, I was on a different floor of the courthouse yesterday than I usually am, at a motion call, with a room full of about eighty lawyers, not that many of whom were women.
The place I've seen a lot of women in the Daley Center (court) is in Eviction court, 'cause they're all poor and getting throw out of their apartments.
It does surprise me that so many women fit this description, though.
Why? Lots of women have shitty social skills, you know.
69: I think in this country there has been a general devaluing of both education and the professions, from a `prestige' point of view, for many decades. Mostly sacrificed on the alter of entrepaneurialism and consumption.
Under this scheme, MD's become `merely' inhabitents of the upper economic reaches of salaried employees, but really nothing to respect like a `self-made' millionaire. Certain types (and only certain types) of lawyers and financial professionals avoid this disdain --- not because they are prestigous in their own right, but by proximity they are bathed in the holy light of big capital.
I really don't hear any of my arrogant-genius students saying they want to be doctors anymore.What do they want to be?
Architects!
Actually, the pinnacle of arrogant, godlike architect more or less coincided with that of the MD. Remind me to upload a photo of this church in New Castle, PA - it's a High Modernist, windowless brick box... with a giant, cyclindrical baptistry out front, complete with hemispherical tip. It's like St. Labs Goddamn Church. Some nameless architect in Small City, USA, apparently had the unquestioned authority to foist this on Good Catholics. Wright at least had talent.
Lawyers or economic theorists or political consultants.
Interesting. I knew tons of really smart premeds in college, but the school was the sort of place that attracts them.
Under this scheme, MD's become `merely' inhabitents of the upper economic reaches of salaried employees
Well, in a lot of ways, they are now. "Private practice" is a nebulous concept when every doctor's office is tied to a health care oligopoly that tells her where her patients get each kind of relevant care.
Both of the arrogant geniuses I know went into high finance.
m leblanc:
What kind of law do you practice?
79- Even some big names have problems. Actually, that's similar to Wright- didn't a lot of his fancy houses fall apart?
60: Both my parents have noted the decline in the prestige of [psychologists]
65 kind of says this, but doesn't this relate to the cratering of Freudianism as a credible theory/practice/whatever? I think that, for a lot of people, psychology=Freud=discredited. There's still an underlying acceptance of therapy that wasn't there long ago, but the idea that your psychologist will solve your problems with Superior Insight is pretty well by the boards.
Seems to me.
81: Sure, but at one point they were valued in greater society because of their education, or because of their profession itself. Now I think they are primarily valued by many people as having a good salary, and hence equivalently valued to anyone else making the same salary.
Wright- didn't a lot of his fancy houses fall apart?
To varying extents. If he'd been willing to accept just a bit more steel in his roofs, a lot fewer would sag, and waterproofing in general was art, not science, until about 25 years ago. But Fallingwater would be in, not above, Bear Run if not for a multimillion dollar reconstruction (there was a fundamental misunderstanding of the properties of concrete - no one knew about "elastic creep," which is just as alarming as it sounds).
Anyway, Gehry has no such excuses. Unlimited budget and a design that is a case study in making water go where it shouldn't.
MIT, being open to experimental architecture, has had this sort of bad luck before. There's an auditorium in the middle of campus -- a neat looking triangular section of a sphere's surface, touching the ground only at the corners. The story is that an architecture student did his thesis by proving that the dome was going to crack -- the department didn't accept it, and made him do another one before letting him graduate. A couple of years later, the dome cracked and the department apologetically awarded him another degree.
88: I'd love to know if that's true. The first half of the 20C was a heady time for architects, and there was a lot of exciting experiment. Experiments sometimes fail.
I'll google, but I'm 90% sure it's at least mostly true -- that is, the crack, predicted by a student thesis, and at least an apology all happened. I think the auditorium was Kresge?
Here's a picture, I'll look for the story.
Is the auditorium still there? Was it the place I remember by the playing fields, right across Massachussetts Ave from the main entrance to the endless hallway (building 14, I think?)?
Is the auditorium still there?
Yes.
91: Yep, that's the building I was thinking of. Weird, I didn't know it cracked, I wonder how much that cost to repair.
There's still an underlying acceptance of therapy that wasn't there long ago, but the idea that your psychologist will solve your problems with Superior Insight is pretty well by the boards.
But the Freudian psychoanalyst isn't even supposed to solve your problems with Superior Insight.
Well, I guess in that many people suppose that that's what they do, they are, in that sense, supposed to. But that's not the correct understanding.
Hrm. Maybe it is a legend -- I'm not finding the story by googling.
Dammit, it's Building 7 that I was thinking of (the great dome one). And it's "infinite corridor", not "endless hallway". My brain only ever remembers things as paraphrases, for some weird reason. Kind of annoying when I want to recall a direct quote.
This could be a fun game - how elaborate an argument can you make that is actually just a usage troll?
JRoth, you seem to misunderstand what is usage, what is form, etc, and what is a substantive mistake.
There was no error in usage in 16. The propositions that followed "converse" and "inverse" really were the converse and inverse of the proposition in question. The error was in the argument: the falsity of the converse or the inverse has no bearing on the falsity of proposition con- or inverted.
(You might say that, in an elaborate way, this is still a usage issue in that we only call certain things correct arguments or whatever. That would be silly, though.)
85: JRoth, I don't think that Becks is talking about therapists and psychoanalysts, the latter were in the U.S. psychiatrists exclusively until fairly recently. Not so in parts of Europe. I think that she's referring to the more experimental types of psychologists. B.F. Skinner was hugely respected. The people who brought you the SAT and a whole bunch of other standardized tests were all influenced by psychologists. Mathematical and analytical, not clinical.
The roof did crack (pdf), although I can't find anything about a student predicting it would do so.
Why? Lots of women have shitty social skills, you know.
That's just anecdotal. Whether it's genetics or environment, the fact is that few women have the poor social skills required by certain professions. It will be some time before gender equality is reached in this respect, if ever.
Of course, individual women should be judged entirely on the basis of the shittiness of their own social skills, and shouldn't be excluded from these professions because of their gender. But if gender equality hasn't been attained, we shouldn't assume that this is because of prejudice and discrimination.
101: The vast majority of female physicians I know have similar social skills to the vast majority of male physicians I know, for whatever that's worth.
Ack, everyone says I'm wrong!
Ben, I picked the word "usage" to be broad - I wasn't necessarily saying that was the best description of SP's sin, nor did I mean that a shaggy dog story with a subtle typo wouldn't count in the contest.
As for psychologist:
- I know Freudianism didn't promise miracles; I was talking about popular perception, which is the foundation of prestige.
- I know nothing about Becks' parents, but I wouldn't think of experimental psychologists as ever having had a lot of prestige, so I assumed they were doing something else. Apologies if I misconstrued.
It seems that there are probably certain kinds of slop work where no one particularly wants to break gender barriers to enter - obviously garbage [man] is one example
Crew that picks up ours has had an older black guy and a young woman for about five years now.
So, to be clear: by "usage," I really just meant "shit for ben to be pedantic about." And I only said it because SP had disavowed the presence of any content in 16.
104: I once worked with a crew of (hott) women drywallers - it's funny how many construction jobs are actually perfectly gender-neutral (ie, never require extraordinary strength, etc.) yet have essentially zero women. I mean, I know it's an ultra-sexist industry, and so forth, but the pay is good - they're very desirable jobs. And with specialization (99% of jobs over $1M are done by general contractors who sub out virtually all of the work), you could easily be in a specific trade without the general construction background that comes from male-training paths.
Women of the World, Spackle! You have nothing to lose but your lungs (to silicosis).
106: Especially since a lot of contracts to such people are from government agencies that favor female-owned businesses. Or so I think, knowing nothing about the topic except anecdotes from people I don't like very much.
I don't buy this. From what perspective do you think they're less prestigious?
By what subdiscipline is expected to draw the best and brightest and hardest working, mostly. The fields with easier (i.e., only mostly insane) hours tend to attract women, and some options are considered the soft options from the stereotypes already mentioned.
Hrm. Maybe it is a legend
"Too good to check" is the journalist's stockphrase for such anecdotes.
I also think that the prestige of doctors has fallen to the extent that there's lots of other ways to make money that don't involve destroying yourself and then having people sue you.
I spackled drywall once on a Habitat build. It is hard.
Skilled, but not all that muscle intensive. I've only done drywall once, but it's fun -- turning a room with exposed studs and no walls into a perfectly normal looking room is neat.
108: this socialization happens other places, i.e. chemical engineering (`soft', `fem engg') vs. electrical engineering (`hard').
"Too good to check" is the journalist's stockphrase for such anecdotes.
Print the legend.
And I only said it because SP had disavowed the presence of any content in 16.
Tell it to the marines, pal:
Oh, and of course I was going to make a pedantic point about the phrasing in 16, but ben had already taken care of it.
Maybe now that women are doctors, we'll get some national health care passed, and they can get hired as adjuncts, same as what happened when women started getting PhDs.
106:
Construction work is very desirable? Really? Is it one of those plumber-type situations where secretly they all make >100K/year?
chemical engineering is supposed to be 'soft'? In what alternate universe is that?
You're just a great big girly girl, Nathan. Your a chem engineer, right?
high status will shift to those jobs where success is less objectively predictable, like the arts.
Paging the Guerilla Girls.
Also, can we please get rid of the word "objectively" when talking about this stuff? Especially when it's being used to talk about test scores? Thank you.
117: Given the hourly wages of the tradespeople, 40-50k would be my expectation of the typical. Of course, good business sense and quality craft could bring in a fair bit more.
You are stuck with the vaguaries of the construction industry, though, which is incredibly cyclical. If you're at the top end, you'll always have work, but there are a lot of people who enter the field for a couple years then have to leave just as quickly when the jobs dry up and all the contractors only need a third as many crews.
I'm the electrical engineer type that 113 implied should be looking down their noses at chem-e people. I do no such thing; they'd kick my ass and then inject it with something creatively and painfully toxic.
The vast majority of female physicians I know have similar social skills to the vast majority of male physicians I know, for whatever that's worth.
Also true IME. Skimming the thread, I still don't see a good argument for increased women's participation leading to diminished status of medicine, or certain medical specialties. Physicians vs. surgeons represents a special case, I think; there's been hostility between the two fields since before women entered med school in any significant numbers (I'm not sure how it correlates to compensation, but I think highly specialized surgeons have always earned a lot more). The physician's stereotype of surgeons incorporates many typically male-identified characteristics &mdash mechanical inclination; aggressive, non-collaborative, daredevil tendencies &mdash and there seems to be some truth in it, at least as far as some surgical specialties are concerned.
The stereotype of orchestral conductors, who at the highest levels are almost exclusively male, is similar.
Just to troll for a second, MDs will lose prestige not when they are all female, but when they become civil servants via UHC.
Even some big names have problems.
Michael Graves' iconic Portland Building is another case in point.
MDs will lose prestige not when they are all female, but when they become civil servants via UHC
Of course, just like has happened with judges, military officers, firefighters, and the like.
Nice try, TLL. Say, did you know they have waiting lists for hip replacements in Canada?
Just to troll for a second, MDs will lose prestige not when they are all female, but when they become civil servants via UHC.
I first read that as UFC.
"Enter the octagon! The winner receives eternal glory! The loser, a government pay scale."
Presidenting has really gone downhill since this country took it public sector.
118- Chem E. generally requires less grad school than many science fields (straight chem, EE.) Grad school is where you really get your antisocialization.
Anyone with any interest in architecture or Portland Oregon should read Jesus' link.
In April of 1979, the city of Portland, then in the midst of a building boom and with a new mayor in charge eager to establish a new identity for the city as one of the foremost cultural centers in the nation
It actually worked, but "foremost" is an enormous reach. It went from almost nowhere to somewhere in the middle of the pack.
I wouldn't mind a government pay scale, government health care, and a government pension.
I suppose that in a way I have government car insurance.
124: ime, physicians have more prestige (and less money) in several countries that have UHC.
KR, those professions you named have always been civil servants, therefore whatever prestige they have has already been factored in. MDs had previously been independent. But people already complain about foreign trained doctors. UHC will be a convenient excuse for the world's ills. (Excuse the pun).
Firemen have decidedly not always been civil servants.
124: I doubt they'll lose prestige (after all, it's still about Saving People's Lives), but I wonder what changes would have to be made to encourage people to become doctors once the salaries are fixed low compared to what they are now. The delays in Canadian medicine, such as they are, aren't due to rationing, but due to a shortage of doctors.
Maybe now that women are doctors, we'll get some national health care passed, and they can get hired as adjuncts, same as what happened when women started getting PhDs.
I think that this has sort of happened in the UK (warning: my BS in this area comes only from reading the blog of a GP called nhsblogdoc), but I think that most GPs are in something like private practice with partners. If you want to get really ambitious, you hire locums who work part-time (basically as adjuncts) so that you can have more patients without doing that much more work. That can happen without UHC, of course. I think it is partly caused by the weird compensation structure in the UK which recently started paying GP's huge sums for meeting specific targets. It turns out that the decent ones were already doing these things, but now they spend 20 minutes filling out a form saying that they did them, and they get lots more money. GPs have started costing much more than the Government anticipated.
UHC will be a convenient excuse for the world's ills.
I agree entirely. That doesn't mean that it won't be much better than what we've got. It'll be sort of like feminism that way.
118: Not in an absolute sense, but in the spectrum of engineering disciplines. I taught engineers a bit at a school with a big, high profile engineering faculty. The demographic shift between bio & chem programs (more female students) and ee and mech (fewer) was very obvious.
I don't know how well that generalizes, having only taught engineers at one place.
137: The shortage of docters in Canada may be mostly due to being next to the US.
[Drywalling is] skilled, but not all that muscle intensive
Except that it requires moving large stacks of heavy sheets of drywall, and because it's piecework, there's a very strong incentive to bust ass. It's hard work. Trades like that also involve a lot of day labor, at least around here, and that's pretty much all male.
Firemen have decidedly not always been civil servants
Thank you again, Ben Franklin.
141: That's true, too. A lot of the criticisms just don't generalize easily: doctor shortages, whether the U.S. would be able to subsidize prescriptions, &c.
Also, I'm not sure where all the people are in the U.S. that never have to wait to see a doctor because all the gasping over waits for non-emergency treatment times in UHC countries have to be coming from people who have never actually scheduled anything non-emergency. (The wait's even longer if you don't have insurance!)
That doesn't mean that it won't be much better than what we've got
I, for one, am sick of writing the god damn check to Blue Cross every month. I have to read Obama's plan by that Harvard guy. He seems pretty smart and in tune to the pitfalls of regulatory capture, agency issues etc. that are the devil in the details.
I'm pretty much convinced the actual waiting in Canada is not systemically worse than in the US, with some particular blips in elective and semi-elective surgeries that show up badly.
Overall, it (canadas) is a better system but there are some real questions of how to get something like it to fit here, without wholesale adoption (unlikely). Devil in the details, and all.
145: We crossed `devil in the details', which was amusing. I'm convinced the real stumbling blocks here are athe insurance and malpractice industries, both of which are out of control.
I am convinced that most small employers would be in favor of adopting a UHC if it was explicit that Worker's Comp would be folded into the system. I mean if the treatment is covered, who cares how it happened? You would still need OSHA, to help keep those costs down.
KR, those professions you named have always been civil servants, therefore whatever prestige they have has already been factored in.
Can you name a single Democratic elected official who has proposed that all doctors become civil servants? For that matter, in how many countries besides the UK and Cuba are the doctors state employees? These are red herrings.
MDs had previously been independent.
How many doctors today are truly independent anymore (i.e. not at least affiliated with a provider group that negotiates with insurers)?
this socialization happens other places, i.e. chemical engineering (`soft', `fem engg') vs. electrical engineering (`hard').
Chemical engineers considered soft. That isn't my experience at all. Civil engineers maybe. But Chemical engineering is hard and we electrical engineers know this.
Not to imply that civil engineering is easy, it just doesn't seem to garner the same amount for respect from other engineers.
TLL, have you done the math on health insurance costs for owners of small businesses (themselves and their employees) vs. probable tax burden for same under UHC? I want to convince my dentist that her belief that UHC will cost her more than she's paying now is wrong.
Well, on the glorious day that UHC dawns on America the obesity epidemic will become job one. You will have to pry my double bacon cheeseburger from my cold, fat, dead hand.
Nah, chem engineers are pussies, and Willie is a weenie bend-over-backward liberal.
The soft bigotry of low expectations: "Sure we respect you chemical engineers. You're so intuitive and sensitive! So what if you don't have linear left-brain high IQ? Not everybody has to be 'intelligent', whatever that means. We all have our own unique talents!"
152 is not meant with a trace of seriousness, right? 'Cause that argument is just too dumb for a smart fellow like TLL to make, even half-jokingly.
B, do I look like a public policy wonk or something? Get some smarty pants think tank to gin up those numbers for your dentist.
154. Only that I think that some genius will want to partially fund UHC with a "fat tax", the way we pay for kid's health care in CA with a tobacco tax. And don't get me started on Grandma's new heart valve after age 75. Details will matter alot.
151
Well if you cover people who aren't covered now and give better coverage to some people who are already covered it is going to cost somebody more. Why do you believe it won't be your dentist?
Seriously, people claming ChemE is "soft?" They don't get to ignore a lot of the unpleasant parts of Navier-Stokes, at least in grad school.
James don't you know anything? The only people it will cost will be the insurance company execs who will lose their billion dollar salaries. It won't be UHC that drive up the dentist's tax bill, it will be "other stuff".
157 assumes a number of things that probably are not correct. It is almost certainly possible to deliver better coverage to more people for less total cost than is currently incurred, because the system just isn't very efficient. Practical implimentation, as well as getting there from here, are seperate questions.
150: Hey, I wasnt' making the judgement (or calling it `fem engg') -- nor do I believe it. Just reporting what I've seen, and what various students would imply.
159: c'mon TLL, you can troll better than that.
In all seriousness sb, tax bills will go up with or without UHC. If a UHC plan is adopted, people will blame it. Somehow the notion of "fungible" escapes many who are otherwise able.
Hey, maybe it'll make her tax burden go up, I don't know. I'd be surprised, though, because I assume that the health-insurance costs for a small employer with like half a dozen or so employees are extremely high; much higher than they would be if those employees were part of a state- or nation-wide pool. Duh.
Of course, even if it does raise her taxes, I still think that's a selfish and short-sighted argument on her part. But since it's the one she's given, I'm curious to find out if it's true or if it's just the kind of reactionary assumption Shearer's making and (I assume) TLL is pretending to endorse.
163: Exactly.
This is also the dentist who bitches, mind, about how her taxes pay for other people's kids to go to school, and then in the next breath complains about how much she's paying in student loans. Also, she's younger than I am, owns a business and a house, and says she carries no debt. What she's bitching about I have no idea.
163: well, sure ... the upward tendency is true (part of the problem with trusting pol's to fix a broken system, even if it's know how to do it, too) . I was objecting to the dismissive characterization of insurance vs. UHC, when in fact insurance is a big part of the problem in our current system.
the problem with trusting pol's to fix a broken system
Amen and hallelujah to that, brother. Flirting with the analogy ban, if Canada decided to get back in the power projection business, would it adopt the Pentagon plan? I think not. But the sticker shock would be similar to what we as a nation are looking at with UHC. As bad as our system is, I am afraid that once Congress gets ahold of it it will be much worse. But then I look at Medicare and wonder if it isn't possible.
164
"Hey, maybe it'll make her tax burden go up, I don't know. I'd be surprised, though, because I assume that the health-insurance costs for a small employer with like half a dozen or so employees are extremely high; much higher than they would be if those employees were part of a state- or nation-wide pool. Duh."
Being in a bigger pool is helpful only if the bigger pool is on average healthier than the pool you are in. I would guess that she and her employees are on average healthier than the general population. And of course there is the additional cost of providing subsidized coverage to people who can't currently afford it.
What she's bitching about I have no idea
And you have a PhD in the subject, and everything!
TLL: the problem is, Canada for various reasons manages ok without force projection capabilities (lets not derail the thread). However, the US health care is manifestly broken, and it's getting worse over time, not better. This will not go away by itself.
The tantalizing thing about Medicare is that it gives an image about what is actually possible, in this actual country. Not that I trust Congress not to fuck it up, but it just seems so ... plausible.
And of course there is the additional cost of providing subsidized coverage to people who can't currently afford it.
This again assumes facts not in evidence. The reason that people currently cannot afford it has little to do with fundamental costs. Also, there is no reason to assume as a starting point that dentists employees (secretary, dental hygenist or two) are anything but in average health.
171
"... Also, there is no reason to assume as a starting point that dentists employees (secretary, dental hygenist or two) are anything but in average health."
Employed people as a group are healthier than unemployed people. And small right wing employers who provide health insurance will try to hire young healthy people.
168: Perhaps not a crazy assumption if you see that the demographics of the uninsured are largely healthy young adults whose jobs don't provide it. Insurance companies love healthy young adults because they don't really use a lot of health care. They're also a really hard to group to convince that they need to purchase health care.
Second thing to consider is that we already pay for the uninsured through higher premiums. The emergency room that treats the guy who didn't have insurance and wound up with pneumonia has to pass on the costs somehow.
172 ... and people are, on average, employed.
And small right wing employers
as opposed to small left wing employers, who will mostly employ smoking couch potatoes.
You're thinking about this fairly superficially, James.
165: she says she's out of debt, but has student loans to pay?
smoking couch potatoes
That'll cause a fire if you don't move it, quick.
175: A lot of people pay their student loans as slowly as possible because of the low interest rates. That's my guess, anyway.
how about
1950
MD+dick= double status
2007
MD+dick= single status
thus, status is lower now. but its not like what you guys are saying.
And small right wing employers who provide health insurance will try to hire young healthy people.
You know this as an objective fact because....?
175: Consumer debt, I meant. Obviously she has a mortgage to pay as well.
Employed people as a group are healthier than unemployed people.
Gee, I wonder why.
175
"as opposed to small left wing employers, who will mostly employ smoking couch potatoes."
The employer in question was described as right wing and selfish. I think perhaps naively that some small left wing employers treat their employees better than they have to for idealistic reasons.
Small businesses are exempt from providing health insurance (other than competitive advantage, often substantial.)
Shearer seems to be operating with the assumption that the only people who aren't insured are poor unemployed cancer-ridden smokers or something, but that's just not true.
181: Ah, ok. You're still wrong in broad brushstrokes, but I missed the fact that `small right wing employer' was coming from earlier comments.
However, treating your employees better probably leads to better health outcomes. Your putative greedy employer will seek to externalize costs as much as minimize them, so as long as they don't have to foot the bill (i.e. at will employment, etc) they don't care. You're still making a number of strong assumptions that may not hold up at all, and certainly don't hold without careful evidence.
179
"You know this as an objective fact because....?"
It is in their selfish interest to do so. They may also look for excuses to fire employees who starting incurring a lot of medical expenses. Of course this is not true of all small right wing employers but it is a good bet.
It is in their selfish interest to do so.
This is also probably so oversimplified as to be unreliable. People aren't making decisions like this on one axis, and it's a big jump to say that even if it's a goal, it's not trumped by other goals (e.g. what if other desireable to this employer characteristics correlate with poorer than average health). James, you know this stuff --- you know these are complicated systems, and yet you assert very simplistic things about them. Why?
Everyone always does what is in his or her selfish interest, or in the interest of his or her genetic success.
For instance, I wrote the above comment because i thought it would play a role in impressing the chyx, thereby increasing the likelihood of my having viable offspring. (Or any at all.) And now I'm writing this comment for similar reasons.
185
"This is also probably so oversimplified as to be unreliable. People aren't making decisions like this on one axis, and it's a big jump to say that even if it's a goal, it's not trumped by other goals (e.g. what if other desireable to this employer characteristics correlate with poorer than average health). James, you know this stuff --- you know these are complicated systems, and yet you assert very simplistic things about them. Why?"
Of course these are complicated systems. That doesn't mean you can't make useful simple statements about them. The art of modeling is to construct simplified versions of complex systems which still preserve interesting aspects of the way the larger systems behave. I believe my simplified statements are in fact useful. This may be wrong in a particular case but it is not impossible. Pro football games are complicated but one can usefully speak of a home field advantage.
I do think that historically employed people were thought to be of above-average health. That is why insurers were keen to provide group health and life insurance. Now it's desirable, because it allows you to avoid some of the adverse selection issue. People who are really sick often can't work.
The employer in question was described as right wing and selfish.
Not by me, she wasn't.
But the sticker shock would be similar to what we as a nation are looking at with UHC. As bad as our system is, I am afraid that once Congress gets ahold of it it will be much worse.
Gah. For the love of christ, pick any country on the planet with a generous UHC system, and they spend less per citizen than we do.
The U.S. has plenty of money. I keep harping on this, but it bears repeating. If this country would return to Clinton era tax levels along with the closing of the more egregious loopholes, and spend "only" 100 billion on the military, everyone could have a pony. Seriously.
I love you gswift. You can be president, even despite your ideas about guns.
People who are really sick often can't work.
And often they can, but companies don't have a way to fit them in with the rest of the cogs. My mom's cousin had diabetes, lost one leg below the knee, lost the other leg below the knee, had some bipolar episodes. She was the most useful and popular volunteer her church had ever had. I think Medicaid paid for her health care.
191 is correct. Why is war the only thing that gets funded at infinite levels?
And why not increase the amount of GDP spent on healthcare, now that healthcare finally actually works? In terms of Maslow's hierarchy of needs, healthcare should always be a top priority, since we'll always need it.
Clinton era tax levels along with the closing of the more egregious loopholes, and spend "only" 100 billion on the military
It depends on the loopholes. And 100 billion doesn't buy what it used to. You're talking about a rethinking of priorities, which is all well and good, but probably not politically viable, at this time. Somethings gotta give, and it ain't gonna be the carriers.
Why is war the only thing that gets funded at infinite levels?
Because war is the fundamental business of the nation state. Health care for the citizenry, not so much, but certainly a well deserved afterthought.
Because war is the fundamental business of the nation state.
Talk about begging the question.
And 100 billion doesn't buy what it used to.
Unless you're implying 100 billion isn't enough hardware and people to defend the country, I don't give a shit.
You're talking about a rethinking of priorities, which is all well and good, but probably not politically viable, at this time. Somethings gotta give, and it ain't gonna be the carriers.
It's not viable because nobody harps on it. (Democrats, I'm looking at you worthless fucks)
I love you gswift. You can be president, even despite your ideas about guns.
I'm a uniter, laydeez.
Arguably TLL isn't begging the question, but rather defining "nation state."
194: I absolutely agree Ned. I shoudl perhaps say that many people who aren't working have a lot of health problems, more than many of the people whoa re working. In the same vein, poorer people tend to be sicker than the more affluent. Whether poverty causes poor health or people in poor health are not able to earn as much is not entirely clear. I suspect that, if one defiens these terms broadly enough, both are probably true.
He's running from a formal definition of "nation state" to a decision on policy questions. (In fact, he's picking up a definition of "nation state" most used by anti-state anarchists and militarist imperialists).
Defense at some necessary level may be the state's bottom line, but if you look at actual states (now or historically), very few have militarized at our level, and they aren't examples to follow.
197. Soup Biscuit didn't want to derail the thread, JE, but there won't be much of a nation state without war, or defense if you prefer. The borders weren't carved into a stone tablet at the UN in 1946.
anti-state anarchists and militarist imperialists
I'm bipolar that way
Yeah, TLL, but that doesn't mean that every war has to be fought, or that every aggression must be pursued, or that military needs must always be prioritized. Defense is a minimum requirement, not the primary function.
202: See, I'm not sure that statement necessarily *approves* of the policy question; I read it as merely explanatory. I happen to agree with it, as explanation (I'd add "imperialist nation-state", I suppose). As policy I completely disapprove and think that *shouldn't* be the primary role of a wealthy, highly secure nation-state, but I think it's undeniable that nation-states *do* act that way (unless they have even more powerful militaristic allies who free or forbid them from doing so).
"War is the fundamental business of the nation state" says more than "states must defend themselves or they won't be able to do anything else". One is a statement of purpose, one is a functional minimum. Empirically, states (even major states) vary widely in their degree of militarization. Right now the U.S. is upping the ante for everyone.
205. Couldn't agree more, JE. When you've got a big shiny hammer in your toolbox, nails look inviting. A smaller hammer might cause one to think about what one is trying to build.
207: The point isn't that "states must be able to defend themselves." (I'm not even sure I'd agree with that, actually.) The point is that the "nation state" is arguably defined by war.
So are you an anarchist or an imperialist, B?
The state is indeed defined by war, but that doesn't explain why military spending is prioritized over health spending. It's defined by war in the sense that that sets a minimum. Like saying that life is defined by breathing or digestion -- that doesn't mean that we should devote ourselves to taking in as much air as possible, or eating as much food as possible.
The historical trend of states to overmilitarize is something else which needs further explanation, and by and large, a bad example to avoid.
207. Actually I think that is the same thing. How one construes the meaning of "defend themselves" is in and of itself a policy debate, witness current events. And as a function of a percentage of GDP being spent on defense, I think that the US is a lot smaller than other countries, and is at historic lows.
http://en.wikipedia.org/wiki/Military_budget_of_the_United_States
But I am open to the idea that we spend too much on "defense", and that if we spent less we might make different foreign policy decisions.
Percent of GDP, yes, but absolute spending, no. And in the absence of a real external military threat (terrorism is something else.) And the neocons and national-greatness cons have been promoting increased militarization all along; they want the American mission to be world domination. Still to come, but foundations have been laid during the peacetime years between Vietnam and now (and since the USSR stopped being a factor. )
So are you an anarchist or an imperialist
I am to impose statelessness on other lands by force of arms. Because I know better than they do.
Militarists always present aggression as defensive. The poles and Czechs were threatening Germany, you know.
I'm neither.
The state is indeed defined by war, but that doesn't explain why military spending is prioritized over health spending.
Why not? Inasmuch as citizens and/or leaders are invested in the state *as* state, it's going to make sense that they're going to prioriize military spending over *everything* else.
Again, I think this is *wrong*, and it's not *my* idea of what a state should be; but I think it's a good explanation of why militarized states work the way they do.
#1: Money management
You need to be more specific. Client wealth management, which is a very person-to-person kind of business, relatively speaking, is already tilting female. I predict that men will remain overrepresented, however, in the sort of trading where you sit in front of a computer screen all day and don't have to interact with people much.
212. Well if McManus is right and economic doom is upon us, then maybe GDP will fall enough so that 12 carrier battle groups will seem a luxury we can no longer afford. Defend yourselves, ungrateful world.
Sure, and if you were invested in digestion *as* digestion, you'd be cramming food down your throat all day long.
There are lots of reasons why states tend toward militarism, but "because war is the fundamental business of the nation state" doesn't explain it.
I have never seen a historical study of the degree of militarization of various states in various circumstances, but there have been plenty of states which were satisfied with the minimal functional level, and if they didn't have powerful hostile neighbors they did fine.
211: Those countries spending a great % of GDP mostly includes countries like turkey, namibia, saudi arabia, and eitria.
Shit dude you got me scared now.
sometimes i think the best way for democrats to talk about military issues is only to just laugh at republicans for being pussies who are scared of countries that can't even build roads.
Saudi Arabia seems to use the military as a welfare system or pork barrel project. For all the money they spend, they don't have much of a military, at least if the first Iraq War is anything to go on.
Wait, wait, I got it! After women take all the high-paying jobs, the very act of working itself will be seen as "women's work" The true man will prove his manliness by staying home and disporting himself like a 18th-century European lord, while his wife goes out and engages in the unglamorous act of actually working for money.
crime/property seems like the fundamental definitions of states. fighting wars is secondary. health care is tertiary. I don't see how that applies to any person who doesn't think theres a good chance of the need to reconstruct nation states after the postapocalyptic anarchy.
That doesn't mean you can't make useful simple statements about them.
True. When will you start? There is a difference between making simple statements, and making simplifying assumptions that are possibly (or even probably) wrong on the face of them. In that case, you really need to provide some sort of reasoning behind those assumptions. Just asserting them is what is getting you in trouble. You tend to do this strongly.
For example, all available evidence suggests that a well implemented UHC could provide the same level of service we have now, at less cost, to the entire country. However, you made statements suggesting that the cost is fixed, and so adding extra people to coverage will neccessarily raise costs.
On the face of this, it is a silly assumption to make, because the US currently pays more for health care than any of the UHC systems one might use for a model. So when you say something like that, it looks like you are jumping off with a bad model to start with.
If, however, you said something like: ok, initially it looks like a UHC will reduce systemic costs, but I don't believe that because (any number of reasonable arguments), then you don't look like you're pulling things out of your ass.
I'm not even saying you are necc. wrong. I'm saying you've presented lousy support. I can't tell if it's because you aren't providing support for your model, or if it's because your model is really naive --- but the latter is what it kind of looks like from what you *have* provided.
220. You'll note Russia was dark. When Putin's battallions cut through the Great White North like a hot knife through butter, you'll sing a different tune. More to the point, a threat based defense posture makes more sense, but the lead times of the intelligence gathering through procurement mean we are always preparing for the wrong war. Also, consensus on "threat" is always difficult.
#19: Aren't lawyers approaching gender parity (at the young end, obvs)?
This is true, but if you watch some Ally McBeal on DVD, you can see that all their cases deal with sexual harassment, marriage, and other girly stuff.
222: I'd put that under "has a powerful militaristic ally that frees them up from military spending."
Anyway, I really don't want to argue about this, because for the umpteenth time it isn't an argument I *approve* of. Merely one that I think is comprehensible, and that doesn't, actually, imply that the person who says it thinks that this state of affairs is right, necessary, or inevitable.
226: oh i see. the fact that noone can identify a threat is a reason to increase funding.
229. "Known unknowns and unknown unknowns" yoyo, where ya been?
What the US could do with the money it saved if it wasn't maintaining an imperial stance and the military budget (let alone assets) it has is an interesting question, but I think quite different from what can be done within (or near) current health-care budgest, and really deserves a thread if anyone wants to bash it out properly.
For what it's worth, I don't think `what is defense' is quite as open a policy debate as TLL suggests. The policy debate is really `how do we sell aggression'. But that's also a different issue.
231. "Guns or Butter?" was how my sixth grade teacher put it. Of course now we should have heart healthy spread instead of butter, for the children.
we also have heart healthy guided missiles. those also seem to be for the children.
232: with something over 700 active foriegn bases, etc. though, it's not exactly an exersize in small change to think about possible worlds. The problem with force projection is, as you said --- if all you've got is a bloody great shiny hammer, you tend to look for nails everywhere.
Reducing to 25 percent of our current military spending, say 100-150 billion, is still a pretty damn beefy military budget by world standards.
http://www.globalsecurity.org/military/world/spending.htm
Small businesses are exempt from providing health insurance (other than competitive advantage, often substantial.)
As are large businesses. Employers aren't required to provide health insurance (except in one small state). They do it to the extent they do because they got stuck with it during WWII and employees demand it.
225
"For example, all available evidence suggests that a well implemented UHC could provide the same level of service we have now, at less cost, to the entire country. However, you made statements suggesting that the cost is fixed, and so adding extra people to coverage will neccessarily raise costs."
The virtues of a well implemented UHC are kind of irrelevant since there is little reason to believe we are going to get such a thing. The choice is probably going to boil down to expensive inefficient UHC or nothing. Given that choice I expect UHC proponents are going to end up supporting and possibly passing an expensive inefficient system.
"On the face of this, it is a silly assumption to make, because the US currently pays more for health care than any of the UHC systems one might use for a model. So when you say something like that, it looks like you are jumping off with a bad model to start with."
Two of the reasons the US pays more are we pay doctors more and we pay more for drugs. You think you are going to pass a bill that substantially reduces either of these expenses? Given the way the US political system works this is unlikely. Bills are passed by buying off every important affected group. It is hard for me to imagine this process reducing overall costs while improving coverage.
I thinks claims this can be done are basically BS, the same variety of BS as claims that taxes can be cut by eliminating waste and abuse.
To return to the original subject of the thread, here in the Netherlands the increase in wimmin lawyers over the past decade has recently been Viewed with Alarm, because this would threaten the prestige of the lawyering profession.
The virtues of a well implemented UHC are kind of irrelevant since there is little reason to believe we are going to get such a thing. The choice is probably going to boil down to expensive inefficient UHC or nothing. Given that choice I expect UHC proponents are going to end up supporting and possibly passing an expensive inefficient system [....] Given the way the US political system works this is unlikely. Bills are passed by buying off every important affected group. It is hard for me to imagine this process reducing overall costs while improving coverage.
Thanks, this is basically what I was looking for, and isn't at all what you said before. I don't agree it's impossible --- and what we have now is an expensive and inefficient system --- but this has a reason behind it. What I was objecting to was dismissing it with a transparently weak position.
This thread is dead enough I don't that getting into details about UHC etc. are worthwhile right now...
Bills are passed by buying off every important affected group. It is hard for me to imagine this process reducing overall costs while improving coverage.
Just because it's Republican SOP to pass bills this way does not mean that's how it has to be. Republicans love to run the government like shit and then hold up their incompetence as an example of why government can't be trusted to administer things like Social Security and health care. (and yet, should be trusted to go into foreign countries and magically pull functioning western style democracy out of their ass)
Anyways, addressing your cost problems isn't that tough Shearer, and can be done by basically extending things we already do.
1. For cities, use a VA style system with hospitals and clinics that are open to all, and like the VA, negotiate prices with the drug companies. For areas and/or people with less access to the public system, a Medicare type insurance could be a supplement to ensure everyone has good access.
2. Build more medical schools. A substantial increase the supply of doctors so that we don't have to pay them so damn much. Look everybody, market forces!
It is no great surprise that we can make the health care industry much more efficient. Look at how much money companies make in "Revenue Cycle Management."
It is simply amazing how much companies make when their job is to reduce the costs for hospitals. The people cutting the fat make tremendous amounts of money.
magically pull functioning western style democracy out of their ass)
Iraqi people: "Hey, this functioning western style democracy smells funny."
Just because it's Republican SOP to pass bills this way does not mean that's how it has to be. Republicans love to run the government like shit and then hold up their incompetence as an example of why government can't be trusted to administer things like Social Security and health care.
But seriously, this. If something's been done successfully in every other industrialized country in the world, you don't get to assert that it's obviously unworkable because it's not the sort of thing governments can successfully do. We might screw it up, sure -- the best laid plains of mice and men and so on. But assuming that governments just can't do this sort of thing with reasonable results is just idiotic.
I thinks claims this can be done are basically BS, the same variety of BS as claims that taxes can be cut by eliminating waste and abuse.
I'm not sure that this is right. But I think it's a real issue. And the only way we get UHC in the next five years is if we go into a significant recession. Which would really, really suck. I'll be happy with good-sized incremental steps.
It's genuinely odd how unembarrassed Americans are about not having a decently competent government—I mean believing it. The myth runs counter to our competitiveness about everything else, however trivial, and is a reversal in my lifetime.
The late Herbert Stein, sane father of toolish son, used to muse about this in his WSJ column. Why should we believe, he wondered in the late eighties, that the US military was exemplary and competent, but no other part of the government? Neither was remotely true, this Republican noticed.
240: Plus, increased coverage means less strain on resources like emergency rooms, and easier access to preventive care means catching conditions early when they're still treatable.
I guess the thread is revived!
I thinks claims this can be done are basically BS, the same variety of BS as claims that taxes can be cut by eliminating waste and abuse.
These claims may be wrong, rather than bullshit (and I don't believe this is the case), but they are most certainly not similar to the claim that taxes can be cut by eliminating waste and abuse (regardless of the truth value of that claim).
The main problem with the US healthcare system is that it is fundamentally badly designed. There are aspects of it that work very very well, but these are small --- overall it's terribly inefficient. So it simply isn't a matter of making what we've got work more efficiently. It's broken, and if we want real improvement, some fundamental changes need to be made. Implementing this is hard, yes. But not impossible.
It's genuinely odd how unembarrassed Americans are about not having a decently competent government
I think this mostly comes down to simple racism. At least, that's always been my perception.
we also have heart healthy guided missiles. those also seem to be for the children.
Brilliant.
It's genuinely odd how unembarrassed Americans are about not having a decently competent government--I mean believing it
Don't most people believe that thier own government is a joke? I know that British government is famously derided, and I get the sense that Candians tend to view their government with a significant level of bemused incredulity.
I think, like here, the parts that consistently work, without drawing attention to themselves, aren't thought of as part of "government."
The main problem with the US healthcare system is that it is fundamentally badly designed
It was designed at all, but piecemealed together as various needs arose. The countries with a functioning UHC mostly did so after WWII, when they kind of had a clean slate, and were thus able to actually design something. I think SCMT may be right, in that we will need some sort of catastrophe to get us to a "clean slate".
Don't most people believe that thier own government is a joke?
Yes, you're right. There's a wonderful story, almost a fable, in Magnus Enzensberger's Europe, Europe, about the unexpected and commonsense reform of the Italian Mint. Carlyle's Past and Present in the here and now.
251: agreed, but that is an issue of the practicality of implementation, not the fundamental question `are there better systems'. Also, the system is actively getting worse, which is a related issue.
Of course, the catastrophe may just be the functional collapse of health-care for a large number of people.
