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>I understand you don't like communism but really the hyperbole man... and shame on you for trivializing slavery. These doctors all knew what the Cuban system w

>I understand you don't like communism but really the hyperbole man... and shame on you for trivializing slavery. These doctors all knew what the Cuban system was, they chose to use Cuba's excellent medical education program which is provided for free and which can only be provided, again, for free because it taxes it's citizens heavily and now that they have received that benefit, want to rescind on it's price. It's pretty clear by that statement that you don't understand the government of Cuba or how it has been funded. Most Cubans don't pay taxes, and haven't since the revolution. Only recently have income taxes been put in place, and mostly that's for business owners and comes with significant write-offs. >Ah but how many Americans really get a shot at medical school? In the most recent year for which quintile census data are available, more than three-quarters of medical students came from families in the top two quintiles of family income. [0] Ok, so 75% of medical students come from families in the top 50% of incomes. That doesn't seem too absurd to me. As to your Wired article, the statement that "In effect, Cuba that poor communist country is to a certain extent actually subsidizing vital parts of our healthcare system that happen to be less lucrative" is a bit ridiculous, because that article mentions a total 100 doctors using the program over a 17 year period. Yes, Cuba may train 6 American MD's a year, (actually, more like 4 - not everyone graduates) but that isn't really subsidizing vital parts of our healthcare system, not in any meaningful way.

frgtpsswrdlame 9y ago
>It's pretty clear by that statement that you don't understand the government of Cuba or how it has been funded. Fair, fair, it's communist not tax-capitalist. I shouldn't have said "tax." >Ok, so 75% of medical students come from families in the top 50% of incomes. That doesn't seem too absurd to me. Top 40%. It does seem absurd to me, did you look at Figure 2 that I linked? That is the inversion of a meritocracy. >As to your Wired article, the statement that "In effect, Cuba that poor communist country is to a certain extent actually subsidizing vital parts of our healthcare system that happen to be less lucrative" is a bit ridiculous, because that article mentions a total 100 doctors using the program over a 17 year period. Yes, Cuba may train 6 American MD's a year, (actually, more like 4 - not everyone graduates) but that isn't really subsidizing vital parts of our healthcare system, not in any meaningful way. But totally true! 100 doctors here working in geographic areas that don't normally attract doctors and/or fields that don't attract doctors. It may not be super large but I bet you there are some Americans out there who are very happy (any may not even know it) that Cuba invested in our doctors when we wouldn't.
- ameister14 9y ago
  >Fair, fair, it's communist not tax-capitalist. I shouldn't have said "tax." It's not just that. Powerful central governments don't function on the idea of everyone chipping in, they function on the idea that they can oversee the use of resources and allocate them in the best possible way. Normal people don't get a say in terms of resource allocation and don't get a say in who makes up the central government, so they aren't 'chipping in' in a meaningful way, as that implies it was their choice. >Top 40%. It does seem absurd to me, did you look at Figure 2 that I linked? That is the inversion of a meritocracy. I am not surprised by the news that 75% of doctors come from families that make over $50,000 a year. To become a doctor, you need to go to college, which costs money, then go to medical school, which costs more. During that period you must also not need to provide for your family so there's also a significant opportunity cost. That said, the fact that this rate is increasing may be cause for concern, as noted in the article. Frankly, there is also another significant issue: the idea that you can become a doctor at all as a realistic goal, which I think is also a barrier - many people don't believe it is possible for them when it actually is. As for the 100 medical students, I bet a lot of those doctors did not return to the United States to practice medicine, as they would have to do their residencies here to get licensed.

frgtpsswrdlame 9y ago

>It's pretty clear by that statement that you don't understand the government of Cuba or how it has been funded. Fair, fair, it's communist not tax-capitalist. I shouldn't have said "tax." >Ok, so 75% of medical students come from families in the top 50% of incomes. That doesn't seem too absurd to me. Top 40%. It does seem absurd to me, did you look at Figure 2 that I linked? That is the inversion of a meritocracy. >As to your Wired article, the statement that "In effect, Cuba that poor communist country is to a certain extent actually subsidizing vital parts of our healthcare system that happen to be less lucrative" is a bit ridiculous, because that article mentions a total 100 doctors using the program over a 17 year period. Yes, Cuba may train 6 American MD's a year, (actually, more like 4 - not everyone graduates) but that isn't really subsidizing vital parts of our healthcare system, not in any meaningful way. But totally true! 100 doctors here working in geographic areas that don't normally attract doctors and/or fields that don't attract doctors. It may not be super large but I bet you there are some Americans out there who are very happy (any may not even know it) that Cuba invested in our doctors when we wouldn't.

ameister14 9y ago
>Fair, fair, it's communist not tax-capitalist. I shouldn't have said "tax." It's not just that. Powerful central governments don't function on the idea of everyone chipping in, they function on the idea that they can oversee the use of resources and allocate them in the best possible way. Normal people don't get a say in terms of resource allocation and don't get a say in who makes up the central government, so they aren't 'chipping in' in a meaningful way, as that implies it was their choice. >Top 40%. It does seem absurd to me, did you look at Figure 2 that I linked? That is the inversion of a meritocracy. I am not surprised by the news that 75% of doctors come from families that make over $50,000 a year. To become a doctor, you need to go to college, which costs money, then go to medical school, which costs more. During that period you must also not need to provide for your family so there's also a significant opportunity cost. That said, the fact that this rate is increasing may be cause for concern, as noted in the article. Frankly, there is also another significant issue: the idea that you can become a doctor at all as a realistic goal, which I think is also a barrier - many people don't believe it is possible for them when it actually is. As for the 100 medical students, I bet a lot of those doctors did not return to the United States to practice medicine, as they would have to do their residencies here to get licensed.