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Speaking of high costs of higher ed - and healthcare

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The Cheesehusker, Trade Warrior

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Jun 30, 2019, 9:20:38 PM6/30/19
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There's a really interesting book out getting a ton of buzz by Alex Tabarrok of Marginal Revolution fame called "Why are the prices so damn high?? He and his coauthor, Helland from Claremont, focus on why labor intensive service industries like health care and higher ed are going up in cost

Bloat, they feel, makes up less of an issue than most think - this is a biggie - a very biggie - but what's understated is the so-called "Baumol Effect" they feel is the biggest driver. Simply put, labor productivity has not kept pace in these fields - and thus pay to skilled labor has had to go up to retain labor - plus, we're buying more of this labor.

Here's a pretty good review - which discusses a lot of this - as well as parts the reviewer feels they overlook - primarily the hidden effects of gov't regs

https://www.econlib.org/why-the-prices-are-so-damn-high-a-deeper-look/

dotsla...@gmail.com

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Jun 30, 2019, 9:28:45 PM6/30/19
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What skills do you believe are necessary between say image tech and brain surgeon?

I promise the field is narrower than you think.

Mia with his sorta kinda bullshit non-science likely last forever tho lol.

Cheers.

The Cheesehusker, Trade Warrior

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Jun 30, 2019, 9:34:46 PM6/30/19
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On Sunday, June 30, 2019 at 8:28:45 PM UTC-5, dotsla...@gmail.com wrote:
> What skills do you believe are necessary between say image tech and brain surgeon?
>
> I promise the field is narrower than you think.

Not sure I understand your question - much less how it pertains to the above?

Other than both are highly skilled and well compensated professionals - whose salaries of part of the reason health care costs are as they are (that's an "is" - not making a good/bad statement there)

michael anderson

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Jun 30, 2019, 9:41:24 PM6/30/19
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I'm not sure what an image tech is....does dot mean radiology tech? If so, I don't know how well compensated they are. It's not a bad job but the ones I know make like 55k for full time work. the brain surgeons I know of who don't work for UAB but rather at my hospital in pp have a salary that starts with at least a 1 and maybe even a 2 I would guess.

nothing but respect for both though...I couldn't do either

michael anderson

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Jun 30, 2019, 9:44:23 PM6/30/19
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On Sunday, June 30, 2019 at 8:28:45 PM UTC-5, dotsla...@gmail.com wrote:
hey that lakehouse didn't pay for itself :)

On a related note one of the things I find most fascinating about psychiatry is that there is a lot more of the unknown than in some other fields...there is a ton of evidence base and known pathophys too, but the part that is still missing makes it cooler imo. Some of my med students otoh get frustrated with that aspect


>
> Cheers.

michael anderson

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Jun 30, 2019, 9:52:42 PM6/30/19
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> https://www.econlib.org/why-the-prices-are-so-damn-high-a-deeper-look/\

has pay to skilled labor really gone up though? I don't mean physicians(I think our salaries have actually dipped a bit each decade relative to inflation no? but the more numerous fields- nursing for example? It doesn't seem like RNs make more in 2019 than they did in 1999 for example? The ones I work with who have been around forever don't seem to feel that way....

It just seems like there is so many more tests to order and things to do now and drugs to prescribe and everything.....i'm obviously not an economist though and know little about it.

The Cheesehusker, Trade Warrior

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Jun 30, 2019, 9:56:21 PM6/30/19
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yes AND there are more of them too

Service industries like labor and higher ed are productivity constrained - in manufacturing, you see incredible drops in manhours per widget - but a doc still has only so much time to see a patient - you're simply not going to see a 10X improvement in patient pass thru. What gains we can see would simply be licensing issues - but medicine is still a one on one biz which takes time be it a full doc or a LPN at WalMart

michael anderson

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Jun 30, 2019, 10:05:14 PM6/30/19
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well we have seen more use of NPs and PAs however. this does allow us in many fields technically to 'see' more(at least sign off on) more patients.

the thing is they don't reduce costs really though. Because the code still comes out about the same(we get some of it and they get some of it...imagine a dime if I see a patient myself but if she sees the patient and I supervise her seeing them we each get a nickel)

The Cheesehusker, Trade Warrior

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Jun 30, 2019, 10:12:58 PM6/30/19
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It does reduce costs a smidge - but not as much as productivity gains are seen elsewhere - and the reduction tends to be on a per patient basis - b/c the doc is then freed up to see other patients - so his load stays exactly the same

michael anderson

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Jun 30, 2019, 10:19:10 PM6/30/19
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I know when I am working inpatient wih an np I see more patients total. Like tomorrow the np is there. I'll see more total patients tomorrow than Tuesday when she is in outpt clinic.

A lot of our providers(including me) don't really like to work with nps. But if we refuse to we'll get paid less. So there is that....

michael anderson

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Jun 30, 2019, 10:29:12 PM6/30/19
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Also, one of the big factors driving up the cost of labor in my field(probably less so in more lucrative fields) is the govt itself. We are now offering just over 300k for someone *just done with residency* for a 40 hr week, vacation, full health care(we pay it all), 401k we fund, no weekends. We pay all licensing, cmes, etc

This person doesn't even have to be board certified yet(they wouldn't be). It can be someone that literally just graduated residency last week(they finish in june). no experience needed.

And yet we can't find takers because the VA jobs are so cush…..so that's very much driving up salaries in some areas.

Michael Press

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Jun 30, 2019, 10:43:17 PM6/30/19
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In article <cf03f72e-ec10-4c60...@googlegroups.com>,
The reason is that industry and wealth creating jobs were stolen
and moved to other countries. The goal was to make the USA
a country of people selling apples to each other on the street corners.

--
Michael Press

Michael Press

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Jun 30, 2019, 10:55:51 PM6/30/19
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In article <c0aaea3a-a0c7-458d...@googlegroups.com>,
Any field is like that for the adventurous.

Even though the special theory of relativity is over a hundred
year old, many are unprepared to open themselves to some of the
consequences hence leaving themselves attempting to resolve
unresolvable "paradoxes." Same with wave mechanics.

"The views of space and time which I wish to lay before you have
sprung from the soil of experimental physics, and therein lies
their strength. They are radical. Henceforth space by itself, and
time by itself, are doomed to fade away into mere shadows, and
only a kind of union of the two will preserve an independent
reality"---Hermann Minkowski

--
Michael Press

J. Hugh Sullivan

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Jul 1, 2019, 11:14:01 AM7/1/19
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On Sun, 30 Jun 2019 18:28:43 -0700 (PDT), dotsla...@gmail.com
wrote:

>What skills do you believe are necessary between say image tech and brain surgeon?

One is often a matter of life and death - the other might help a
little when used by the surgeon.

Hugh

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