Thursday, July 29, 2010

The microeconomics of heath care

Maxine Udall talks about the morality and microeconomics of heath care. Yes, some physicians accustomed to their privileges might leave the profession before health care reform becomes a reality. It's a free country: for every one who leaves there are a hundred who would happily take his place, either as physicians (once we remove the artificial limitations and rent-seeking from medical schools*) or as substitutes such as nurses or physicians assistants who can effectively treat many conditions.

*Not all strictures imposed by medical schools are artificial and pragmatically unjustified. But some clearly are, and serve only to artificially restrict the supply of physicians.

Everyone talks about the iron laws of economics until it's their professional privilege that's on the chopping block. I know whereof I speak: my own middle-class privilege was completely destroyed by economics. When I was young, it happened that I had real talent at computer programming. Then, the demand for people who could just turn the damn things on and make them do something far exceeded the supply, and those of us with demonstrated competence could make quite a bit of money. What we didn't do was artificially restrict the supply; by the time we clued ourselves in to how the capitalist system actually operates and started creating expensive and arbitrarily limited credentialing mechanisms, it was far too late: the invisible hand corrected the imbalance between supply and demand and for all but the most prestigious few, programming became a working class profession with working class wages. (And working class wages today ain't squat.)

1 comment:

  1. Yeah, the whole programming thing caught me, too. I saw the writing on the wall - that's a big part of why I went to law school.

    I was getting squeezed out of programming - I had no real credentials to speak of. I just taught myself to program - my B.S. was in film and video production. So when the projects started to dry up, my lack of "credentials" meant I couldn't get another. It did not matter in the slightest that I was a good programmer - much better than average. HR people don't know anything about that.

    With a law degree, at least, I figured I'd have the credential. I also figured it would be a lot harder to outsource law - not that it isn't done, but in the area I do, it really can't be. (Corporate and Big Law is another matter - but then I'd hate to do that anyway).


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