This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
The AMA would probably fight against most versions of single payer, and pretty heavily. If the proposal was "single payer and doctors are now going to be subject to the standard federal pay schedule", I don't think anything could prepare you for the fury that would be unleashed to prevent it from passing. Mayyyybe they could accept "...and we'll make a new, separate, special pay schedule (which can be changed separately from the standard schedule) for doctors, who are special," but there's just absolutely no way that the US government will actually have the political will to bulk force doctors to take a 3-8x pay cut.
Thousands of physicians are already public servants. They work for the public health service, the veterans administration or they're members of the armed forces. Other agencies employ them too (e.g. State dept, Indian Health Service). They receive special rates and do pretty well for themselves. They certainly make less than if they ran a successful practice, but not everyone is interested in those sorts of headaches and risk. And there are other tangible (loan forgiveness) and intangible (training, travel, work-life balance) benefits to working for the government beside the pay.
note that public doctors work immensely less because they get paid less - if you work for the va it isnt uncommon to see 1/2 or 1/3 the patients.
that would likely spread across the whole economy
More options
Context Copy link
More options
Context Copy link
That’s nothing new. The BMA (British Medical Association) was the most aggressive and chief lobbyist against the formation of the NHS in the 1940s. Doctors hate single payer because it drives down physician pay. That is precisely a reason to do it.
I mean teachers pay is politically radioactive in the US and doctors are roughly as sympathetic.
No, it’s different. Public school teachers are paid relatively averagely given years in the workforce and levels of education; a few make $130k but that’s a small minority in the highest paying districts in the country. They are paid toward the bottom of the most common ‘public service professions’ pay scale (cops, nurses, local government workers), especially in red states. In blue states, particularly rich ones in big cities with very high private sector salaries where the ‘we support underpaid teachers’ sentiment is most common they are paid slightly better, but so are the NYPD and nurses who work in Manhattan.
Meanwhile, while Americans have a lot of respect for doctors, I’ve never heard the sentiment that they’re underpaid except from doctors. They might say underpaid ‘compared to’ dislikes groups like CEOs and bankers, but that is more about the latter than the former. “No, I believe my anaesthesiologist should make $900k a year instead of $600k - hell why not a million?” just isn’t really the kind of thing people are saying or thinking.
The perception that certain specialties are underpaid is pretty widespread in the social groups familiar with specialty pay breakdowns. Many Pediatricians and ID doctors make under 200k, and government agencies and other organizations have made costly decisions to encourage more people to become PCPs because the pay is noted to be too low.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link