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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.
Isn't the issue with this that there's a raft of externalities. If ongoing citizenship were assigned at 21 on the basis of productivity it'd work, but the natives who got outcompeted don't suddenly phase out of existence. Especially in our current system where they will be supported regardless meaning the immigrant not only needs to be better they've also gotta be sufficiently better to deal with the increased social bill created by taking the native Born's job?
Typically throughout history, automation and immigration displacement just leads to other jobs being done or even created. Work exists to do something someone wants, whether it is the work of mowing the lawn so you can have cut grass or the work of clicking on a spreadsheet so you can optimize portfolios or whatever.
So until we run out of people's wants, jobs can't really dry up in the long term. There can be temporary issues, especially with older workers who won't/can't shift gears so easily but otherwise the total amount of production in the world just goes up because instead of just having a person do X with their time, a machine does X and the person does Y different thing.
Think of it this way, you live in the past and before you have to leave for some event, you have enough time to either clean the dishes or beat the carpets down to get the dirt out of them. You can only choose one, so your production is 1. A machine that does the dishes for you allows you to beat the carpets down instead, making a production of 2 before you leave. If you have a machine that does both, you might come up with another task like hauling some wood for the fire and get a productivity of 3.
If we ever get to a point where jobs aren't really a thing you can get anymore in the long term due to AI, then what do you even want a job for at that point? That would be a world where pretty much all people's wants that can be fulfilled are already fulfilled. That we're at productivity of googol^3 or whatever and there's nothing else to do for yourself or others.
I'd argue that a lot of modern jobs in the Western service economy are just clustering awkwardly into makework on the side of vast surpluses that aren't necessarily reactive to extra peons. If the international competition was coming in for widget creation and Interational expertise could guarantee 6 widgets per hour instead of 5 for a domestic person, sure. The modern scenario seems a lot more along the lines of 'specious laptop job exists, foreigner is willing to do some combination of working for less/exaggerating qualifications more and little marginal benefit is derived by society.'
Your examples are all conspicuously physical realworld activities that can be tied easily to an actual output. In the real world, especially the sort of skilled professional laptop job reality that most Mottizens are living in, a lot of jobs are more sinecures for being on the right team/time and place than they are productive organisms. Handing those out to foreigners is literally insane behavior.
Yeah I've never bought the "bullshit jobs" sort of idea. If people are willing to pay to have you do something, then clearly they must think you are bringing them value somehow. Not every single individual job is necessarily worth it, businesses are run by people who make mistakes and miscalculations too but overall there must be some sort of value somewhere or else why would they pay? I doubt the modern job is actually just corporate charity to the employees.
I think this sentiment is more that our work has become so abstract and intangible that it's harder for us to measure. This probably does increase the error rate a bit, but it also means people don't realize how they're being productive in the same way.
I'd wager I'm in the upper percentile of Mottizens for lifetime earnings due to a early startup lottery hit and in yhe vast majority of my jobs at larger corporations my function had a lot more to do with managerial largesse and posse-forming than anything resembling an output. Even if the title were somehow associated to something resembling productivity how the individual actually contributes in a larger business is pretty damned tenuous.
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What about the things that are not so easily quantified in economic models?
eg:
But it all together and this might make for an ugly sort of cyber-feudalism, where a rich few control all the wealth and the vast underclass can only find work in humiliating servant type roles for the rich.
If there are wants and needs unmet then there's either still work to be done in meeting those or it's a deeper issue that just happens to intersect with how we currently work, but is fundamentally different from it. I don't know how exactly we're going to solve these deeper problems of the human condition.
It could be as silly as everyone willingly living in VR where their virtual AI neighbors are just slightly worse off than them, the neighbor husband and wife are slightly less attractive, the kids are slightly more misbehaved, etc. And maybe we intentionally pull back automation in some less important fields just so people can feel good working a few hours every day.
Otherwise for status and power over others, it's impossible for everyone to be winners no matter what because it's entirely based around having other people be losers. Just not solvable there. It's why I really do worry that we're gonna have a permanent AI enforced underclass slave society that exists not because of economic usage, but so the AI overlords in control of the Killbots can feel good about themselves. They will be forced into work not because they're more productive than the automation, but because there must be a loser to suffer.
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