I actually think that this is just one example of many across a ton of disciplines where people like Nurses basically are forced to deal with costs and responsibilities offloaded onto them from above the responsibility chain. Resources are eaten up at the top of the chain to their benefit and costs are offloaded down the chain until it reaches people like Nurses at the end of the line who have to deal with it because there is nobody else to offload it to. There is no shortage of people wanting to be nurses (in some places it is extremely competitive), and there is a huge demand for nurses based on shortages everywhere, but somehow we are in a situation where nurses are overworked because they are short staffed.
I look at academia which is rife with money sloshing around, and see undergraduate classes are taught by grad students who make ~30k a year who are basically the Nurses of the academic world and treated like garbage. The justice system is dysfunctional, courts systems are overwhelmed and understaffed so criminals just enter and exit like a revolving door, and police is basically useless because the best they can do is taxi criminals into the system that automatically spits them out again, while they take the brunt of public criticism for how they are forced to deal with a problem that is mostly beyond their scope.
In all of these cases it seems like the bottom if falling out of these institutions, and the responsibilities have fallen on their respective janitors to deal with it when the solutions need to come from places that have been incentivized to create the mess in the first place.
"In any bureaucratic organization there will be two kinds of people:
First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.
Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.
The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization."
Nurses, teachers, charity workers, IEPs, game devs.
These are all jobs where people sign up for the job. Whether it’s altruism or genuine passion. They’re willing to compromise and put up with less pay and harder working conditions.
But because they’re willing to compromise, these people are pushed to their limit. With not only low pay and shit conditions, but higher-ups which actively exploit their altruism and passion. “If you don’t work, patients / children are going to suffer!” coming from the same beaurocracy which created the situation where a) they suffer or b) you work extra hours.
They’re being pushed past the limit in fact, which is why there’s now a nursing and teaching shortage despite these actually being popular fields. A lot of people want to work these professions, they just don’t want the jobs.
I think most startups (at least originally) did start out as ‘change the world’. When you find out that changing the world is kinda hard, ‘become filthy rich’ starts to sound like a good alternative.
As a startup person, I like the startups where the spiel is “Get filthy rich by changing the world” the most. As long as I get to partake in the riches.
I've had good rapport with those who are honest about their startups being businesses, as they're usually also the same types who understand that working for them is just a job, and that a job at a startup comes with its own risks, as well.
People that go out of their way to say that their startups have a higher mission make me uneasy. I don't know if they're just trying to convince others that they're running something other than for-profit businesses driven by expected returns on investment for investors, or if they truly believe it themselves. It's either borderline manipulation or delusion, and neither are something I want to hitch myself to.
> Surely there's got to be some non-Musk company that I can add to that list?
Biotech startups? Develop a cure for horrible disease X (save lives, give people a few more years with their families, etc–feels good?)–and then get rich selling that cure.
I think Blue Origin's messaging is in principle similar to SpaceX (Bezos wants to save the environment by moving manufacturing to orbit, etc.) It is just that SpaceX rather obviously delivers on that message, and has grown rich delivering; Blue Origin hasn't delivered much yet, and it is hard to grow rich prior to delivery–but maybe, give them a few more years, they'll finally get their act together, and they'll become more SpaceX-like.
It seems to be the case that if you give someone a bunch of money, they'll stop wanting to change the world for the better. There are thousands of billionaires who could each end hunger and homelessness but have chosen not to.
The resources available to nation states dwarf those of billionaires, and it’s they’re specific actual job to do it, yet they too have failed to end hunger and homelessness. Bill Gates has sunk untold billions into humanitarian aid and its a drop in the ocean.
As a regular person, I like startups where the spiel is "Have a fabulous life and be pretty comfortable while doing things that even after some serious devil's advocacy seem as if they might make the world a better place".
I was impressed when I met the founders of Gaikai (a zero-day network game distribution system later bought by Sony), and asked them what the goal was. Answer: "Buy an island". Honesty has its merits.
I had a VP at a large company who was sharing her background. When she talked about her failed start up she said "we did it cause we wanted to be MILLIONAIRES... and that didn't work out so here I am".
It was funny and personable. Still one of the better VPs I remember.
It's one way to do it, not the only or simplest one? And once someone had done it, they tend to transition a bit to exploitation mode because why not (they think)? Is my impression
Yeah - the problem is that "a dream fuffilling job" without major filtering like med or law school effectively has a "virtual compensation" from desirability of the job. We see the reverse for (potentially literally) shit jobs or in ill repute. The economy accounts for your feelings but it cannot care about them.
They become nurses because it's a relatively easy (two years at a CC) to become an RN, and the pay is pretty good.
It's easy on the body, compared to similar paid blue collar jobs, like union construction. And it seems better than office work.
Durning the AIDS crisis a lot of nurses--who could quit did. They quit because many were legitmetly scared.
Hospitals got worried, and told their marketing departments to throw out the word, "We need nurses!". Most smaller hospitals had a hard time keeping qualified egos (The Medical Doctor), and they couldn't be bothered besides doing just the bare minimum.
Let's not forget their are many classifications of nurses (RN, LVN, etc., and porely trained Candy Stripers, or cheap help, hospitals (especially union controlled) use instead of nurses. Some are not porely trained though, but nursing unions don't like competition. I'm not berating unions. Moneynot spent on help seems to go to administrators anyway.)
(I went to school with nursing students. Most were divorced. Most were around mid 30's. This was in the 90's. Now nursing is a good path to middleclass for immigrants.)
"They become nurses because it's a relatively easy (two years at a CC) to become an RN, and the pay is pretty good."
That is no longer the case and many now require 4 year bachelor programs to be hired as RN nurses. My wife has her bachelors in nursing and runs an ER and the hiring requirements includes a bachelors degree in nursing and not a 2 year degree.
Leo Laporte would have him on a variety of his TWIT podcasts from time to time. I considered once coming up with a drinking game where you'd drink every time Jerry would have a sentence that included, "..when I wrote about...", but I realized you'd kill yourself.
That wasn't as apparent when he was a BYTE columnist for many years but boy his website sure turned into "old man yells at clouds" although he did have serious health issues in his later years.
As somebody with experience at NASA, this made me chortle. I would NOT characterize the average civil servant that I worked with as "devoted to the goals of the organization." That includes the lowest level field organizations. Unfortunately, for the average employee, it eventually gets treated like any other job.
It's possible this dichotomy works in theory only. Being generous, it's possible they just disagree about the goals of the organization.
That’s the point. The second group, those who only care about the existence of the organisation, and the power/money it provides to them, have taken over at NASA.
As a result only those who act to increase the power/wealth at the expense of all else, such as the original goals of the organisation, get promoted and hang around. The end result, an organisation that achieves very little, and consumes huge amounts of resources, full of people who really don’t care about the fundamental goals of the organisation.
Ok, I see your point and think you're right. The quote distinguished between scientists/technicians and management. I met many in the former group who cared little about the goals of the organization, but to your point, they had been within the organization a long time.
I don't think the technician/management dichomoty is a good proxy. There are people from both groups who care about the goals more than the organization, but they not the people being given power.
Anyone who has visited planet earth and spent time here is well aware of that. The task is to prevent these people from taking and holding power.
Note that the strict formulation of this law (ie. "in _every_ case..") is profoundly anti-democratic in that it assumes no democracy can ever exist or function. Of course, I hope your household provides a good counter example (if not, then you should seek outside support).
Anyway, for those of us who still believe in democracy, it has long been recognised that the cost of it is that everyone has to be a adult who takes responsibility for basic things in life like maintaining the social fabric of the institutions you belong to in order to prevent them from being taken over by sociopaths.
So the question is, will we support medical professionals in doing this? In the UK, before COVID, when junior doctors went on strike to try and remedy the situation, the media denounced them as enemies of the people and they were completely crushed by the state (with the help of their own professional organisations like the BMJ). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4902702/
>The task is to prevent these people from taking and holding power.
And for that I completely blame the 'right' thinking, honest, hardworking nerd types - even when given the reins to power they will often not take it, because it is uninteresting work, compared the cool gadget/problem they are working on.
> There is no shortage of people wanting to be nurses (in some places it is extremely competitive), and there is a huge demand for nurses based on shortages everywhere, but somehow we are in a situation where nurses are overworked because they are short staffed.
why is this such a common story across pretty much every single industry? There's more people in the country than 10, 20, 30 years ago. More customers, more money. Why do they think they can handle more work with less workers whose salary is less when adjusting for inflation?
Owners and operators have learned that they can keep the lights on by running their businesses with skeleton crews and, at the same time, reap the rewards of lower costs as profits.
Covid was also used to exploited the issue further and as an excuse for horrible service and skeleton crews.
During covid Business owners saw that the consumer was willing to take it so they will continue to run on skeleton crews as long as the consumer takes it.
Sure the consumer will complain but they are still using their money to buy from skeleton run places.Partly because most industries nowadays are Oligarch control and what one does the other does as well and the consumer has lost their control of the marketplace.
We are living in a world where the big guys have the majority control of the market place and the market want's skeleton crews.
This is seen across the board in all big business run industries. However with nursing, especially in the ER and the ICU that are now running a skeleton crew the consequence is your health and even your life. Until the big healthcare providers,insurance industry, hospitals, doctors , etc start to get sued over low staffing as the cause of death nothing will change and they know how to document to prevent such a case.
I don´t know much about nursing specifically but it is actually interesting to account for how many customers served per employee and how many there are at the bottom of the organization. If you are earning next to nothing and are doing 200 widgets per minute a 10 fold salary increase wouldn't change the cost of the product per customer. If there also is a large profit margin the desire to keep wages down is more of a fetish than the sensible choice it is at the other end of the spectrum.
Depending on the type of job you also get a different "product" depending on how much you pay and you might not be able to measure it. Employees cut corners in the least visible way and do not brag about extra effort if they are paid well enough.
This[0] was a fun read.
>Nursing care services are the most intensely used hospital services by acute hospital inpatients yet are poorly economically measured
[...]
>Nurses are an anomaly in the current inpatient billing system. Rather than bill for the actual services provided to the patient or the amount of time spent providing nursing care, the cost of nursing is embedded into the line item for room and board, which is the same fixed cost for every patient receiving the same level of care within a particular institution. In other words, all patients cared for on a given unit are billed the same room and board charge regardless of the actual amount of nursing care the patient utilized during that hospitalization.
> If you are earning next to nothing and are doing 200 widgets per minute a 10 fold salary increase wouldn't change the cost of the product per customer. If there also is a large profit margin the desire to keep wages down is more of a fetish than the sensible choice it is at the other end of the spectrum.
It depends on what portion of the cost of production is materials vs capital costs vs labor. You're presuming that labor is a small portion of the cost of production, which is probably true if you're selling them for $10. If it's an extremely low cost item, like plastic washers, labor can still be a significant part of the production costs. It also depends on whether you carry that down the supply chain, since part of your material cost is someone else's labor costs.
> Nursing care services are the most intensely used hospital services by acute hospital inpatients yet are poorly economically measured
This doesn't strike me as utterly insane. Most treatment prices should include the cost to have a nurse deliver it. The tiers of rooms should roughly approximate the amount of nursing care required outside of treatments. It's not perfect, but it might be better on the net than having nurses spend more time on the patient chart to add billing items.
I.e. it might be overall better to not have a specific line item for "rolled patient over to prevent sores" that the nurse has to enter in, and then billing has to argue with insurance about whether a roll was needed or not. It might be cheaper for everyone to figure out the average cost of providing nursing per tier, add a profit margin, and charge everyone that.
I'm not saying it is better, but it seems at least plausible.
> If there also is a large profit margin the desire to keep wages down is more of a fetish than the sensible choice it is at the other end of the spectrum.
I'm consistently surprised by misunderstandings of supply and demand.
There is a labor market. It's relatively free, all things considered. Sometimes companies conspire to keep prices down (see: high tech antitrust lawsuit/settlement) but usually the thing that keeps wages low isn't business owner collusion it's the availability of workers accepting work with a low wage.
Sure, all things being equal business owners would like to pay less for labor. They'd also like to pay less rent, less for insurance, lower taxes, etc. And sometimes they want to pay less than anyone is willing to accept, and sometimes instead of raising wages they rant about it on Twitter or in opinion pieces or whatever.
>usually the thing that keeps wages low isn't business owner collusion it's the availability of workers accepting work with a low wage.
But if you have a labor shortage and low wages at the same time, that means that workers accepting work with a low wage aren't available, but the employers are keeping wages low anyway. (And in this context, poor working conditions amount to "low wages" because they decrease the value of the job to the employee.)
In capitalism, "labor shortage" means "the employers had better pay their employees more, or else they won't have the employees to compete against other employers who will pay more".
I don't think we disagree, but what you describe is not necessarily a result of collusion -- maybe the business just doesn't work with higher-paid workers (i.e., product costs more than market is willing to pay) and scales with number of workers, in which case the owner might take whatever workers they can get at cost X, but can't hire any at cost X+1.
Only a profit-averse business owner would turn away revenue-exceeding-costs work merely because it involves paying workers more -- that business will likely not last super long unless there are special circumstances in play.
I think 'we have to exploit our workers to stay competitive' is a bigger argument against capitalism than 'I choose to exploit my workers because it gives me more profits'.
Because they really can in many cases from more automation, better tools, and better processes and understanding. The demand also doesn't neccessarily increase linearly with the population.
in many cases there is room for automation. I'm not quite confident we are at the level of an Auto-Doc assisting/replacing nurses yet, though. Nurses being thrown into multiple duties for 1.5x standard full time work seems to suggest that one or all of the above factors are not being met.
>The demand also doesn't neccessarily increase linearly with the population.
for elastic goods, no. But medicine is about as inelastic a product as you can get.
> academia which is rife with money sloshing around
In the academia that contains money sloshing around, the only grad students teaching are the ones who want to.
In the academia that doesn't contain money sloshing around, it's a different story.
But the truth is, no one in academia is making bank from academia directly -- not the grad students, certainly, but also not the adjuncts, or even the professors. You have to look higher up the chain (or, I guess, laterally?) for that. (Yes, there's the caveat that some faculty make good use of their prestigious affiliations or professional connections to increase income from outside of academia.)
I don't disagree nurses DESERVE to be paid more (I'm not sure if the economics bear out but they're certainly as WORTHY as many other professions), but wouldn't the fact that these nurses continue to work in nursing despite considering leaving bolster the argument even further that they are receiving adequate compensation?
Staying when you want to leave indicates there's enough compensation to 'make it worth it' at least versus whatever shitty alternatives you have. Leaving when you want to stay, to me, would be a much bigger indicator that nurses who want to stay in the profession can't because of wage/benefits/conditions issues.
> Staying when you want to leave indicates there's enough compensation to 'make it worth it' at least versus whatever shitty alternatives you have. Leaving when you want to stay, to me, would be a much bigger indicator that nurses who want to stay in the profession can't because of wage/benefits/conditions issues.
I think the conclusion of this sort of economic thinking is basically: Give your employees just enough money that they can keep they keep their head above the water but not enough to flourish, and just enough pressure/responsibility that they don't have energy to do anything else, but not too much that they have a complete mental breakdown that leaves them with the conclusion that they should leave your industry at any cost.
When you spent a lot of time and money into a specialized and demanding career, I imagine it practically very difficult to actually change your career, even if it's killing you. It's probably even worse if you have familial obligations. You likely do not have time or energy to better your situation after hours, and if you quit, you potentially resign yourself (perhaps) to many years of destitution while you accumulate the necessary knowledge to do something else. I would not be surprised if many people just bear bad conditions because the cost to do anything else worth one's time is simply too high.
It also cues your organization up for a failure cascade. You don't have workers who want to stay, you have workers who are forced to stay. As soon as they can leave, you're not going to lose "1 or 2" you're pretty likely to use a substantial plurality since whatever changed probably changed for all of them at the same time. Can your organization survive with 50% of the staff giving 4 weeks notice at the same time?
That conclusion would be fallacious, although many on both sides believe it. For one it ignores both growth potential and relative costs. High productivity workers can and do utterly dominate in ways which more than make up for it. And miserable employees are mercurial in quality at best relative to happy and motivated ones.
I recall hearing about one desert conflict "gratuitous" allocation of several times the prior typical water per day resulted in outsized military performance. I think it may have been the Six Day War. But Silicon Valley is basically the exemplar of that business model as they specifically go with a very high COL area in the world's richest country instead of mass outsourcing. Even assuming that the actor is a heartless and selfish bastard what truly matters first is net profit.
It is the same fallacious false economy seen both among slaveowners and the Soviet Union. That the labor is free or already paid for so don't worry about its efficiency.
The caring professions are quite a special case. The worse things get, the more carers care.
They are not like computer programmers who can make an industrial process be 10,000x faster. They cannot magically care 10,000x more, no matter how relaxed and comfortable they are.
Furthermore, as they are pushed closer and closer to failure, the collapse in patient care standards does not result in a collapse in profit. People aren't going to not seek medical treatment, it's a basic human need, sometimes a life or death need.
So we're back to the question: does that mean they should be exploited and milked of all their caring, at the same time the standard of care collapses, because the economic incentives reward that?
And that is fundamentally a moral/humanitarian question in which you have to make an adult moral judgement.
Employers are going to pay the minimum wages they can in order to retain sufficient workers. They obviously aren't going to voluntarily pay extra just so that employees can flourish.
There are a lot of jobs openings available to someone with an RN certificate and some experience. Unemployment in that group is close to zero. They don't all work in direct patient care roles.
It looks like you accidentally "did a communism" by arguing for nationalizing health and putting patient-care considerations above market considerations :)
Communism never has worked and never will work. We should just set legal minimum standards for patient care quality. Hospitals can then do whatever they need to comply with those standards, including setting nurse wages at whatever the market dictates.
Thanks Ayn Rand, a more astute reader might see the meme phrase, the scare quotes, the smiley, and see the obvious humorous intention :)
But I'll go ahead and explain the joke. There is a long history of the private sector using the spectre of communism (or socialism, or "big government" or "nanny state") as a canard to prevent sensible policies eg. anything that would improve patient care, even if it were at minuscule costs and will use that canard to justify lobbying aggressively to prevent it. And if they cannot obstruct legislative action then they switch to defunding the state bodies which enforce the regulations as an exercise in "cost cutting" because "the state is wasting your hard earned taxes!!" etc.
Hope you have a better rest of your day.
Edit: I mean, once you have set a regulation, and established a body to police it, you have already interfered with the market, so even what you are suggesting could be described as having "done a communism"
>Edit: I mean, once you have set a regulation, and established a body to police it, you have already interfered with the market, so even what you are suggesting could be described as having "done a communism"
Exactly, remove regulations from health care. I'm dead serious. Regulatory burden on nurses and health care workers are insane. It's completely plausible the net effect would be far more people saved than lost, due to greater access to healthcare and lower burdens to achieving outcomes.
Which specific regulations would you propose to remove? Everyone loves the idea of reducing regulatory burden but they always fail to give specifics.
For example, hospitals spend a lot of money complying with CMS reporting rules on iatrogenic harm such as bed sores and secondary infections. Should they stop doing that?
I love it. Libertarians and similar always like to say "communism sucks, can not work, can never work, is a completely broken model"... when the reality is that 1) they _dislike_ the model (which doesn't make it broken), and/or 2) that communism, like many systems, works well, until annoying corrupt humans wanting money, power or both start interfering with the ecosystem.
The second point is entirely accurate. It's one of the major factors that makes communism, socialism, untenable in many ways.
What's hilarious / frustrating is how these same people think that humans in a libertarian utopia won't be corrupt, won't want for money and power, and as a result, "Sure, remove all regulation - the market will get more efficient! It certainly won't end up like the railroads in the 19th century, or something out of an Upton Sinclair novel!"
I choose free markets BECAUSE everyone is corrupt, not the other way around. Regulators, who are third parties to the transaction beholden to neither those seeking health care nor those offering it, are the most susceptible to corruption. Regulators need eliminated to reduce corruption, amongst other things.
Never the supplier using ill gotten capital from predatory business practices to lobby or perpetrate regulatory capture.
Nope, it's always those pesky regulators sticking their hands out. Never those Captains of Industry! Paragons of Humanity and Unquestionable Beings of Moral Fiber and Impeccably Ethical Manner!
What part of that didn't you understand? Where did I say the captains of industry aren't corrupt. I said "everyone."
The consumer has the power to voluntarily spend or not spend with a particular health care provider for the vast majority of health care decisions. Their providers are beholden to the customer.
The regulator, on the other hand, is not beholden to the customer this way. The regulator, are typically integrated as part of government and thus not only are they unbeholden to the customer but they also are part of the same entity as men with guns who can use violence to achieve their ends. They are nearly always unelected and only in the loosest sense does the customer have any control -- no one seriously votes for their senators / representative based on who they approve of in say the FDA (can 99% of voters even name a single regulator in say the FDA?) -- that vote is dominated by other even more important issues you need your representative for. These regulators are effectively an ultimate source of corruption, backed by guns and only in the most tangential sense accountable to consumers but with wide latitude to control industry in ways that harm the consumer.
Yes everyone is corrupt, including the 'captains of industry' and even the 'consumer' but regulators make things massively worse. Regulators create an amplification effect of corruption.
Many can't afford to not work due to debt/rent/child support payments. If you don't pay rent you lose the apartment and the weekend parenting time. Miss the child support payments which were being taken from paycheck and child support enforcement takes driver license and starts process to take the car that is in your name.
That's actually my point. IF they are able to meet their obligations in nursing and their job is literally such a superior option to all the alternatives that they don't have 'optionality' then it's a weird flex to be angry at your one best(least bad) option that actually pays your rent and child support. Be angry that the alternatives aren't as good as the nursing gig you have.
I definitely feel for those paying child support, because 'imputed income' means you must pay at whatever rate the judge thinks you can make the best money at. You can never take a more relaxing lower paying job, because it will result in your imprisonment. Those people really have no future in the US -- their only option to throttle back their income is suicide, leave the country, or wait to go to jail. I blame society for the existence of these debtor's prisons, not nursing employers.
Seems you understand the more income -> more support trap. Mandatory overtime is considered in support calculations. That sets high water mark so going back to 40/hours week does not lower payments. I learned the hard way, and last employer I regularly sent email to boss thanking them for opportunity to work voluntary overtime. I would subpoena the boss's response of 'yes' for evidence in child support hearing to only use 40/hours week. The courts and county child support enforcement are wicked and liars.
Yes that never made the slightest sense to me. As someone married with a kid, when I get a raise or bonus it goes to my retirement -- not as a change in quality of life for a child who already has food/shelter/education. The kid still gets the same amount now as when I made significantly less. The idea that a kid needs more money because you worked overtime is quite possibly one of the dumbest ideas I've ever heard. At best it's simply backdoor alimony.
But the counter to that is, just because you work a minimum wage job and can't afford much child support, doesn't mean that what you can afford is enough to raise the child well. I expect it's very hard to say "the child needs _this_ much in order to be raised well" and then scale up from 0 to that amount as the parent makes more money. But you also can't just decide how much the child needs and then make the parent pay that much no matter how much they make. So the compromise is to base the amount paid on the amount the parent makes, and not really cap it. This has the benefit of allowing low earning parents to pay less, at the cost of high earning parents paying more (than is really needed).
>But you also can't just decide how much the child needs and then make the parent pay that much no matter how much they make.
This is basically how it works when you're married, though, at least in my family. Whether I'm unemployed or my work life is booming, the child cost the same for me as when I'm not. During bad times I liquidate my engineering tools / spend from savings / go into debt / sell my vehicle to take care of my kid if needed. On the flip side during the good times the extra money goes into investments and retirement. The amount I need to take care of the kid is fixed, with the amount I spend having virtually nothing to do with the amount I make. My level of personal real spending has changed very little since I got my first near minimum wage job after leaving home at 18; and definitely not linearly with my salary (at best I eat out more now, but that's because I'm busier making money). When the kid came they've always been a relatively fixed cost -- or at least unaffected by our salaries.
My kid would not be effected the slightest, better or worse, for my wage unless I was stuck below ~$12/hr for an extended time, so maybe it would make more sense to take a variable amount up to say $12/hr and then just a fixed price after that.
>doesn't mean that what you can afford is enough to raise the child well
Really depends. Some children grow up in situations where money is scarce but nonetheless have fulfilling childhoods that lead them towards success. It's also worth noting parents who can provide other things in lieu of money -- such as a homestead where they grow their own food and build their own house is perfectly acceptable in a marriage but somehow not acceptable as part of child support enforcement. It doesn't make sense.
>This has the benefit of allowing low earning parents to pay less
Again this is an odd choice. When I am making nothing, I still contribute half to the family costs. When I'm making 6 figures, my half stays the same. Both my wife and I have a deal where we pay half the costs. That way there is no resentment that someone is paying more just because they make more. It happens to be my wife makes significantly more money than me, but we still pay 50/50 costs of child and other bills with the remainder going into our own unshared accounts. It would be extraordinarily selfish and greedy of me for me to demand my wife to pay more simply because she makes more money, yet if we divorced this is precisely what the judge would order in many states. No matter how nasty the divorce I would simply return her share of her savings along with anything over half for spending of the child -- to not do so would make me a vile and greedy person who cowardly uses the violence of the state to unjustly take from others.
In our case the cost of the child is about 6-8% of our current salaries; so as you can see from child support calculators, about half of the money calculated by child support worksheets would be entirely for the lolz of the judge.
>So the compromise is to base the amount paid on the amount the parent makes
Unfortunately this isn't how it works, as above alluded. Once you make a certain amount it becomes your 'imputed income'. Once you set the precedent you can earn a maximum, the judge expects that to be your income you're capable of. You pay based on that higher amount whether you relax back to a lower paying job or not. In this way you're set up into a trap where if you try to get a higher paying job to save up to pay off years of child support, you're stuck in an even more fucked position and meanwhile if your kid is like mine and has a relatively fixed cost then the rest is bled off as backdoor alimony as a reward to your ex-spouse for divorcing you.
Well it depends what you think the purpose of economies is. One idea is that human beings are just a type of animal, and the economy is a social system which is supposed to incentivize the kind of behaviours that you want humans to do. If you want humans to be nurses, then the economy had better reward that.
Another interpretation is that the economy is a tool for exploiting people. For example, human beings are inherently of the opinion that human decency is good, they want to be functioning members of society, they care about the wellbeing of others, and if they are paid crap and treated like garbage, they will endure that, even to the point of great personal cost, emotional distress, mental illness, alcoholism, and even death. But as long as they don't quit, then everything is fine.
People don't 'switch careers' when they've spent years getting good at it. What they do instead is sit around posting on HackerNews and fucking the dog in all sorts of other ways.
Do you realize the irony of it all? This place gets like 1/10th the traffic on weekends. That's not a coincidence.
Are you familiar with the US? I don't see how you can in good faith argue that if people don't like what they have to do and/or what they get paid for it, they can just go do something else.
There's also the consideration that nurses don't leave, because they can see that patient care standards are not good, and they worry that if they leave, their colleagues will be forced take up the slack, employers won't replace them (since the colleagues took up the slack), and they will reward themselves for having found a way to "improve efficiency."
There are, of course, onlookers who are unable to even perceive the moral dimensions that normal human beings take for granted. Perhaps they were beamed down from the mothership just yesterday? The prevalence of psychopathy among human beings cannot be as high as it would appear from the average internet message-board, can it?
I am not really specifically making an argument on their salaries, I guess I am saying that Nurses are in the position where they have the least leverage in the system so they end up bearing a lot of the responsibilities that should be held elsewhere while having a disproportionate amount of resources allocated to them.
In healthcare I get the feeling that a lot of workers feel stuck in that there are many patients and people depending on them, and to leave would sort of be like abandoning them while increasing the burden on ex-cowoerkers.
> Staying when you want to leave indicates there's enough compensation to 'make it worth it' at least versus whatever shitty alternatives you have
Not necessarily. The "transaction costs" of switching careers are huge. If you want to make comparable money to nursing, you probably need training in something else, which likely requires a period of low or no income, possibly years of schooling or other training, etc.
It's hard to switch careers after 30 -- not always impossible, but certainly hard to revert back to the lifestyle of a 20-something for some time. People may stick it out despite unhappiness.
America is full of terrible jobs now. Just terrible. There has been a degradation of job quality with outsourcing, amazon, you name it. This may be why nurses don't leave.
But hasn't that always been the case, where 80% of the jobs were unsatisfactory in some way or another. Be it pay, conditions, co-workers, management/boss, hours, commute time, etc... Not just America, but most industrialized countries.
At what point in time did America have better jobs? A lot of people may reference the glory days of 70s and 80s manufacturing, but those jobs went from bad to good with the power of unionization. There was no free lunch.
This reads too much like a generalization of the standard complaints about management and their stupid meetings, the basic thesis of that web comic that was neither funny nor true, Dilbert.
The criminal justice system may be overwhelmed, but its reaction certainly isn't to just let criminals "exit like a revolving door". The US is still incarcerating people at 10x the rate of other wealthy countries.
Nurses being overworked is simply due to there not being enough nurses. It matters little if there's too much bureaucracy somewhere, or if too much money is spent on pharmaceuticals (about twice as expensive as anywhere else) or if doctors make too much money or if the US has a uniquely unhealthy population.
>Nurses being overworked is simply due to there not being enough nurses.
yes but this begs the obvious question of "why?", which either leads to the immediate thoughts of
1. not enough people want to be nurses
2. companies don't want to hire more nurses
I'm assuming #1 is false, so #2 is the go-to conclusion, at least on the high level. I'm sure I'm missing some more nuanced #3/4/5 explanations, but it does seem to ultimately come down to money that isn't being spent (be it maliciously or simply due to not having the budget).
The obvious #3 is "nurses are doing too much non-nurse stuff" which relates to both #1 (job is annoying and not what I want to do) and #2 in a way (they are not hiring non-nurses and/or investing in equipment, tools, etc).
I was introduced to the Dilbert comic strip while working in the Bay Area in the '90s. Customer's rep literally pulled me aside and asked how I could work for my boss. Said "this is your boss!"
Not just America but pretty much everywhere. I'm Finnish, and when I read about problems of American nurses it all seems pretty much identical to what is going on in my country, except maybe for some legal problems. Low pay, angry patients, lack of resources and bad IT seem universal.
The government is one of the few places where you can get a job in your twenties and retire comfortably in your 60s having made a decent, but certainly not outstanding, amount of money with consistent raises and cost of living adjustments.
What some people will call government waste - other people will call ethical employee treatment... sure there are a lot of other sources of inefficiency outside of your comment - but complaining about overpaid government bureaucrats is essentially advocating for the same race-to-the-bottom that has stagnated wages in large parts of the labour pool.
Please don't conflate State Public Employee retirement systems with State Teacher retirement systems. They each have their own rules.
The teacher retirement systems I know of have rules like (age + years_worked)>=80 ==> full pension benefits.
Retiring after 20y will earn you a smaller monthly and is only possible (under that rule-of-80 above) if you start teaching at age 40. Teachers are much more likely to retire after 25+y (age_start=30, age_retire=55).
A relative of mine works for a state level LEO targeting financial crimes - they've spoken often about how "smaller government" advocating politicians have repeatedly hamstrung the organization when it tries to go after large corporations. They've still managed to do good work going after smaller scale offenders that fleece investors - but I wouldn't put the blame on those employees for doing work you don't find useful... it's mostly up to politics.
That's the whole point. Powerful proponents of small government want to do anything and everything with no consequences. They've duped a lot of less-wealthy suckers into believing that having fewer public services will benefit them somehow, and/or that the only thing standing in the way of personal success is the government. They talk a lot about figures like word count in legislation and other easy to understand concepts (even to folks with low education).
Any govt office, focusing on the US here, seems to have a huge back log and understaffed like the IRS, Immigration services, DMV etc. For e.g. earliest appointment I can get is perhaps a month or two out. A huge backlog and understaffed makes a case of overworked employees. Surely, they are doing work, and so I can only think that by "they do too little useful work", you mean that the work itself that they do is of little use. Are they? Seems like getting my driver's license or tax refund is pretty useful, no?
It's actually not sure that they are doing work. There are backlogs because the employees and management are slow, inefficient, and don't make changes that would be made by a private organization either staying up to date or being replaced by a competitor.
(There are complexities and counter-examples that moderate this generally true statement.)
Defund the organisation to point of total chaos and near-collapse. Blame employees for collapse in work quality.
Here are some more generally true statements:
Increase profits and improve efficiency by cutting out maintenance tasks and firing the people who do them. Blame accidents or outages on employees, customers, bystanders.
People die? Company goes bust? Who cares? Even if there are consequences, the executives/officials to blame have already taken the money and moved on to the next thing. You can't prosecute them or get the money back (unless they were stupendously dumb and got directly involved and stayed on 'til the bitter end and centres of power were so affected that prosecutors can't ignore it: see Theranos, Enron, etc.).
Even without governments being overthrown, government agencies get deeply reorganized fairly often; often for reasons of politics rather than efficiency, but nevertheless.
We don't share preconceptions (I see multiple problems at multiple levels of public org charts, and in the electorate), but I see and appreciate why you might have that priority.
While I myself am frustrated with the bureaucracy and inefficiencies of govts, but I am not sure if its entirely fair to compare a govt with a private company/org - at least based on the scale they operate on and the profit motive, which make it very different.
> It's actually not sure that they are doing work.
> (There are complexities and counter-examples that moderate this generally true statement.)
Guess, based on that I cannot really have a counter argument here :)
From what I understand, queueing theory would say a backlog that doesn't go away but also doesn't keep growing means you're staffed to just barely keep up on average.
It's not given that the queue backlog is staying even, but you would also have to factor the externalities of better or worse performing offices into the queueing analysis. Slower government workers have consequences like the public giving up and bothering to add to the queue, and occasionally, lawsuits due to failure to perform a required task, legal cases being a less desirable budget spend than bureaucratic staffing.
Parents point is that there must be slack in a system in order to have a stable queue size.
But slack can also be perceived as waste, which can be cut.
And if your budget is cut, you are likely to see that slack as "first thing on the copping block" with the consequence that the queue begins to expand. But most systems have natural buffers which delay catastrophic failure. By that point there have been elections, you have retired, etc. and someone else is left holding the bag.
At that point you can blame the organisation for being "slow", or "inefficient", and then you can cut it's funding further, or destroy it outright or maybe outsource it to the private sector.
Then the private sector can drive profits by asset stripping and cutting safety or vital maintenance work, then when the whole system collapses, you can hold the taxpayer hostage by demanding a bailout of the, presumably vital, service (or you can renationalise it), and the whole cycle starts again.
Welcome to our planet, enjoy your stay, it's likely to be a brief one :)
Ah, if that was their only point, then I should have pointed out that a better operating department can achieve a lower waiting time with the same degree of slack. I understand the utilization rate tradeoff and that's not the issue.
I'm glad you've enjoyed writing your comments--like your style. :)
Ah sorry, slightly misinterpreted, my understanding was that without slack you cannot stabilize queue sizes which makes OP incorrect(?)
Yeah, more efficient nodes can delay that effect, but it seems that in real world system the existence of buffers means that consequences are delayed in ways that have significance (across careers, elections, etc) and those factors tend to dominate.
yw, nice that anyone reads it, without that i'd just be another mad shouty bloke on the internet, maybe i still am :)
I've worked public and private sector and know plenty of people in both and I've not noticed a huge difference in the number of people just coasting vs those who really try to make a difference.
What makes you think government is that much worse than the private sector in this regard?
> What makes you think government is that much worse than the private sector in this regard?
Sure a lot of people coast in the private sector, hiding in the corners of their organizations. But if the business allows too much of that to happen, they go bust. In government, they just go get a tax increase.
They do not go bust, they just find ways to bilk their employees, or customers, or the general public, or they find a way to make the government nanny them by shredding regulations or what not.
You seem to think that people cannot escape the consequences of their actions, and that consequences arrive swiftly and fairly. But I should think a quick look around the world we actually live in will disabuse you of that notion in short order. Especially when it comes to gigantic centres of power with vast reserves of cash and well protected revenue streams.
And if you've worked in any tech company, you've probably already seen that the people who coast do not "hide in corners" they make up an entire class, called "management", especially "middle management", they're front and centre because they have no productive work to do so they can devote the majority of their time to extravagant displays justifying their existence and their elevated positions and compensation.
One place I worked, was a Big Company providing overpriced services to other Big Companies. There were loads of low skilled IT workers, taking too long, making mistakes. Adding a BA and/or PM to drive every project when a competent dev could've done it solo a few years ago. But when you keep getting issues, you keep adding process and now every job is 1000+ hours.
But eventually the work got done and we kept getting work because Big Companies buy from other Big Companies. You're not going to risk tendering to a 3 man office who gets it done faster, cheaper, better because if it doesn't happen questions will be asked. Unfortunately there are a lot of talented small businesses out there but they just don't get the work due to this.
Do that enough, and Big Corp gets overtaken by a smaller, nimbler company that does better. See the book "The Innovators Dilemma" for one aspect of this.
Which Big Corp though? The provider or the consumer? The dilemma is, this all feels like a bit of a Boy's Club where they all agree to just help each other and ignore the little people. Not always formally, it's just how things work out. They have an interest in maintaining the status quo and ignoring upstart-startups.
Of course, eventually yes it's impossible to ignore the value gap. But I've seen companies threaten to leave but keep paying the bills for many years because in a big company, it's not really anyone's problem in particular and it's easier to just keep going along to get along. One example we had was B2C email communications, there are so many cheaper more capable players out there but they just got us to do it because we did other stuff for them.
> this all feels like a bit of a Boy's Club where they all agree to just help each other
Come on. They often try to sue each other out of business, get the government to declare competition illegal, "cut off their air supply", "knife their baby", etc.
> because we did other stuff for them
There you go. Not because of the goodness of their hearts.
Big Companies today are not the same Big Companies of yesterday. There is constant churn at the top. The ones at the top today are all newish companies.
Companies go bust all the time. One of the corporations I've worked for simply disappeared (Data I/O). Corporations disappear all the time. Remember RCA? No? How about Kmart? Sears? Kodak? Tektronix? Novell? Lotus? Wordstar? AOL? Zilog? Myspace? Zenith? Curtis-Mathis? RCA was once the biggest corp in the world.
I've known people in every corporation I've worked for who accomplished nothing and were not managers. I was often given the job of trying to turn whatever they did into something useful. Everybody knew who they were. I remember one person, we'll call "Smith". "Smith" would check in code, and it was always so bad that someone else would have to redo the whole thing. After a while, the term "smith-code" became a generic term for code that was worse than nothing.
How bad can you be that your name becomes a generic term for useless work?
"Smith" eventually got laid off. The team was relieved.
Sure, I was imprecise, I mean, they do not necessarily go bust. And even if they do, it can be delayed by decades, even centuries, by techniques that are too numerous and well known to list here.
I've known a few Smith's in my time, one thing they all had in common was the protection of a manager who had no interest in the quality of Smith's work, as long as Smith would take his side in any disputes. When the consequences became too great, the manager would suddenly understand the problem and approve the minimum of changes to fix it, while taking credit for the work. Smith would not complain about this slight because he understood the nature of the transaction.
Edit: btw. congrats getting rid of your Smith, these people can be very difficult to dislodge. Presumably your guy did not have the protection of a manager.
None of those companies have gone bust though. RCA got purchased and integrated by/into GE, Kodak filed bankruptcy but still exists with a significant number of employees, Tektronix is currently a fortune 500 company, Novell is now owned by Micro Focus, Lotus was never that big of a company, but they still exist and are doing pretty poor but still sell cars, AOL still exists and is owned by Yahoo, MySpace still exists and is owned by an advertising company and the other 2 or 3 I've never heard of.
The Lotus that the GP refers to is probably Lotus Development Corporation / Lotus Software, the makers of the hugely popular Lotus 1-2-3 spreadsheet from the 80s. It's still around-ish: it was owned by IBM until 2017 then was sold to the Indian company HCL Technologies for $1.8 billion. Pretty good for a company thought to be two decades obsolete!
Zilog was the maker of the Z80 microprocessor that powered a huge number of games consoles and simple computers in the 80s. Also still around - its parent company was acquired for $750 million.
I had to look up Curtis-Mathis because it wasn't a thing in the UK.
And MicroPro / WordStar International does seem to be legitimately dead: acquired by SoftKey who were acquired by Mattel who have since gotten rid of all the associated brands.
Yeah, I know they didn't literally go bust, some company always winds up buying the remaining value in the company, as its trademarks and IP have value.
But in any practical sense, they ceased to exist. (I meant Lotus of 1-2-3 fame, not car fame.)
You're right, I thought I'd remembered they'd gone bust.
> part of an umbrella corporation
meaning their former glory is gone. When I was starting out Tektronix was a very big deal in computers and electronics. I haven't even heard their name in 20-30 years.
I look at academia which is rife with money sloshing around, and see undergraduate classes are taught by grad students who make ~30k a year who are basically the Nurses of the academic world and treated like garbage. The justice system is dysfunctional, courts systems are overwhelmed and understaffed so criminals just enter and exit like a revolving door, and police is basically useless because the best they can do is taxi criminals into the system that automatically spits them out again, while they take the brunt of public criticism for how they are forced to deal with a problem that is mostly beyond their scope.
In all of these cases it seems like the bottom if falling out of these institutions, and the responsibilities have fallen on their respective janitors to deal with it when the solutions need to come from places that have been incentivized to create the mess in the first place.