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We're no stranger to the immigration hot button here; we all want some way to filter for attractive women and investment dollars where we live and less competition for labor, but the want for those things proves weaker than the iron laws of supply and demand for both. However, here's a problem in the immigration debate that I don't think has come up in discussion before: ladies and gentlemen and undecideds of the Motte: how do we fix the doctor shortage?
And I mean globally. The solution many places settled on after it became clear that it was difficult to impossible to train more doctors locally is to import them, but this simply moves the problem around and causes brain drain as market efficiencies mean doctors move where they can get paid more.
Accounting for inflation, apparently physician pay growth is lagging although I'm not sure if anyone has more up to date information on whether this is still the case.
The easy low effort swipe is to make it easier to qualify as a doctor, but doing so without lowering medical standards and/or quality of care seems more difficult. There's also the simple calculus where people are less willing to take on, in the US, large amounts of student debt and to commit to the many years of study it takes to become a qualified doctor. After which you can look forward to high stress, long hours, dealing with patients, and potential lawsuits. It's no surprise that people would rather hustle sneakers or crypto or streaming when the effort to do so is significantly less.
Previously, governments would subsidize medical training as they saw medical professionals as a necessary function. Now, why bother? If there are opportunities and more money to be made elsewhere, they'd just move elsewhere after being trained, which would be happy to take them. Is there a low effort politically achievable band-aid fix, like making mandatory provision of medical care within the country a necessary precondition of qualification? But that'd make the profession even less popular - if you're a Kenyan doctor, fuck staying in Kenya if you can get paid multiples of that elsewhere.
Disclaimer: I'm asking for entirely selfish reasons. Working on a new investment thesis after the last one turned out spot on although with limited rewards so far for being right. I foresee this problem getting much, much worse as doctors retire, populations trend upwards in age and require increased medical care.
Speak for yourself. While I obviously would prefer less competition for my own particular field, I want a meritocracy for other fields. If an immigrant is a better and/or cheaper home builder/chef/actor/professor/nurse/house cleaner/whatever than a native, I'd rather have the immigrant then. In the same way I'd rather have the better/cheaper robot than the worse human.
Well, automation is actually even better since while people tend to be a net positive generally, automation is generally even more efficient in the input vs output long term. It's why I don't worry about AI "taking our jobs" if all the work I could possibly do is automated then surely pretty much all the work I would want done for me is also pretty much automated then too right? A robot might take my job, but what need is a job when every material good I could want a robot gives. Control of natural resources matters more than anything else then.
If there was a magical way to carve out "meritocracy for everyone but me" it would be the optimal me orientated solution, but obviously that doesn't happen.
And many Americans agree with me, not in a culture war sense but in the business sense. Any of those jobs that gets "stolen" is another notch on the bedpost here. Whether it be high skilled work of lazy college grads losing to the extremely intelligent and hard working Asian programmers or the opioid addicted white trash dregs of society losing to the Hispanic guy who bothers to show up to work on time every day without a hangover, or the phone operators losing their jobs to automatic dialers, the decision is made by Americans everyday looking out for their businesses best interest.
I wish I could show you the face I made reading this comment.
I'm- I'm sorry, I have nothing to add to this. I mean, you're spot on, but seeing someone say it in plain language makes me even more cynical than I was previously.
I suddenly have no sympathy for anyone working in a creative field who cannot make art better than an AI.
Yeah I don't care at all about the artists losing their jobs being "stolen" by AI. If it's something you're passionate about, just do it on your own. You should be more worried that you won't have art supplies for your passion projects cause the AI overlords can take away your access to the world without means to resist their killbots.
Especially when it's clear that most of what they're making as a job isn't even something they want to make. I don't think many artists actually consider their life calling to be drawing the furry diaper porn for horny customers and generic boring corporate art style pieces for big companies right? So if anything, outsourcing all the work parts of art should be a plus for artists who want to make their passionate and personal pieces.
I for one do have sympathy for the artists.
Traditionally, automation improved job quality. Plowing the fields manually is back-breaking work, steering a farm tractor is a huge improvement over it. Likewise, multiplying numbers all day long was probably considered soul-crushingly boring by most of the human computers, and they would rather have a job dealing with fucking Microsoft Excel.
The obvious bottom job to automate would be the workers at Amazon warehouses. Sure, some would be upset until they found other work, but nobody would claim automation stole my dream job of fulfilling customer orders while peeing into bottles.
However, creative pursuits are actually the least intrinsically soul-crushing work there actually is. I imagine that there is competition between artists -- likely not everyone who would prefer to make a living drawing furry porn can earn enough, just like there is competition in pro sports, with a lot more people interested than the field can support.
Competition from AI art is a bit like allowing motorbikes in long-distance running. Suddenly you are not competing against your fellow humans any more. We are not yet in the stage where any kid could just spend 5k$ on a used bike and trivially win against the best human runner in the world for art, but this is clearly the way things are going.
Now, that would suck a bit if we were actually in a post-employment UBI stage where the artists would be free to spend their lives to make retro human-created art as a hobby, just as they might become chess grandmasters despite any kid with a mobile being technically able to defeat them. But we are not in that stage. Instead, we tell them 'why don't you work in an Amazon warehouse as a day job and make your now non-competitive art in your spare time?'
Yeah that's the main issue. First that there's no guarantee we have this sort of futuristic utopia where work doesn't exist (because it's all done by the robots) and we just pursue pleasure and "greater meaning" in our lives instead of a hell scape where most humans are deemed undesired by the AI overlord in charge of Claude Control Killbots, but also the transition period between now and then is going to be hella rocky and people will be hurt.
But this does happen, to a lesser degree, about other forms of work already. The solution the US seems to have is disability. We had a surge of disability applications during the long period of unemployment of the great recession for instance. We say "on you're too old to meaningfully adapt and find another job anymore, so we're essentially just gonna give you this as early retirement". One of the ways you can tell we do it as early retirement too is that the disability crisis we had in the early 2010s disappeared in the late 2010s/early 2020s, they all transitioned into normal retirement.
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