4 ms·

He mentions the impact of globalization, but I think that it's a much bigger deal than he makes of it. For work that can easily be offshored (manufacturing, sof

He mentions the impact of globalization, but I think that it's a much bigger deal than he makes of it. For work that can easily be offshored (manufacturing, software dev, phone/online support, creative work, etc.) the obvious corporate response to unionization it to move shop. OTOH, for professions that can't easily be offshored (medical, local services such as fire/police/utilities, education, etc.), many are still heavily unionized. Some of the unions are non-traditional - for instance, the AMA (American Medical Association) effectively serves a role as a Doctors' union even though they don't advertise themselves as such. They control training into the profession, they are the sole arbiter of who can practice the profession, and they generally work to suppress supply below the level of demand (and therefore drive up wages). OTOH, software is already being offshored at a rapid pace (I really doubt whether I'd recommend that my children go into the profession), and I think that labor organization would only serve to accelerate that. Having said that, it probably could prevent some of the more egregious benefit erosions that plague our industry ("unlimited" vacation, anyone?) ... which would be nice while it lasted.

chimeracoder 8y ago
> Some of the unions are non-traditional - for instance, the AMA (American Medical Association) effectively serves a role as a Doctors' union even though they don't advertise themselves as such. They control training into the profession, they are the sole arbiter of who can practice the profession, and they generally work to suppress supply below the level of demand (and therefore drive up wages). None of this is true. The AMA does not control training in the medical profession. That's determined by the number of residency positions available, which is capped by the AAMC, not the AMA. However, removing the cap wouldn't increase the number of positions, because those are funded by Medicare. The AMA does not control who can practice the profession either; only 25% of practicing physicians even belong to the AMA. (The AMA is also not a union because it does not invoke a monopoly claim over the members of a bargaining unit, which is something that basically every union in the US does - and conversely, something which basically no unions outside the US claim - but that's all a separate matter).
- vonmoltke 8y ago
  > That's determined by the number of residency positions available, which is capped by the AAMC, not the AMA. The number of Medicare-funded residency positions available is capped by the AAMC. Nothing but an unwillingness to do so is stopping more institutions from opening non-Medicare-funded residency billets.
  - chimeracoder 8y ago
    > The number of Medicare-funded residency positions available is capped by the AAMC. Nothing but an unwillingness to do so is stopping more institutions from opening non-Medicare-funded residency billets. Yes, except the fact that it's unprofitable to do so. Residency positions, contrary to popular belief, generally lose money, which is why the government subsidizes 75% of their costs in the first place. The reason we don't have more doctors is because the funding isn't there. It has nothing to do with the AMA, as OP claimed.
- danjayh 8y ago
  The AMA might not control it directly, but like any good union, they are politically active and have members on the relevant controlling bodies... https://www.forbes.com/2009/08/25/american-medical-association-opinions-columnists-shikha-dalmia.html#7c6d0c7e42f2 https://www.forbes.com/2009/08/25/american-medical-associati... https://www.motherjones.com/kevin-drum/2013/11/its-doctors-who-control-number-doctors-america-not-government/ https://www.motherjones.com/kevin-drum/2013/11/its-doctors-w... When both Forbes and MotherJones can agree on something (maybe this is the only thing :) ), there must be some truth to it.
  - chimeracoder 8y ago
    > The AMA might not control it directly, but like any good union, they are politically active and have members on the relevant controlling bodies... The first article you link claims (with no basis) that the AMA was responsible for the current funding shortfall. The second article doesn't mention the AMA at all. In reality, the AMA has been pretty clear and consistent in advocating to increase funding for GME. https://www.ama-assn.org/education/gme-funding/save-graduate-medical-education https://www.ama-assn.org/education/gme-funding/save-graduate...

chimeracoder 8y ago

> Some of the unions are non-traditional - for instance, the AMA (American Medical Association) effectively serves a role as a Doctors' union even though they don't advertise themselves as such. They control training into the profession, they are the sole arbiter of who can practice the profession, and they generally work to suppress supply below the level of demand (and therefore drive up wages). None of this is true. The AMA does not control training in the medical profession. That's determined by the number of residency positions available, which is capped by the AAMC, not the AMA. However, removing the cap wouldn't increase the number of positions, because those are funded by Medicare. The AMA does not control who can practice the profession either; only 25% of practicing physicians even belong to the AMA. (The AMA is also not a union because it does not invoke a monopoly claim over the members of a bargaining unit, which is something that basically every union in the US does - and conversely, something which basically no unions outside the US claim - but that's all a separate matter).

vonmoltke 8y ago
> That's determined by the number of residency positions available, which is capped by the AAMC, not the AMA. The number of Medicare-funded residency positions available is capped by the AAMC. Nothing but an unwillingness to do so is stopping more institutions from opening non-Medicare-funded residency billets.
- chimeracoder 8y ago
  > The number of Medicare-funded residency positions available is capped by the AAMC. Nothing but an unwillingness to do so is stopping more institutions from opening non-Medicare-funded residency billets. Yes, except the fact that it's unprofitable to do so. Residency positions, contrary to popular belief, generally lose money, which is why the government subsidizes 75% of their costs in the first place. The reason we don't have more doctors is because the funding isn't there. It has nothing to do with the AMA, as OP claimed.
danjayh 8y ago
The AMA might not control it directly, but like any good union, they are politically active and have members on the relevant controlling bodies... https://www.forbes.com/2009/08/25/american-medical-association-opinions-columnists-shikha-dalmia.html#7c6d0c7e42f2 https://www.forbes.com/2009/08/25/american-medical-associati... https://www.motherjones.com/kevin-drum/2013/11/its-doctors-who-control-number-doctors-america-not-government/ https://www.motherjones.com/kevin-drum/2013/11/its-doctors-w... When both Forbes and MotherJones can agree on something (maybe this is the only thing :) ), there must be some truth to it.
- chimeracoder 8y ago
  > The AMA might not control it directly, but like any good union, they are politically active and have members on the relevant controlling bodies... The first article you link claims (with no basis) that the AMA was responsible for the current funding shortfall. The second article doesn't mention the AMA at all. In reality, the AMA has been pretty clear and consistent in advocating to increase funding for GME. https://www.ama-assn.org/education/gme-funding/save-graduate-medical-education https://www.ama-assn.org/education/gme-funding/save-graduate...