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A bunch of commenters here have gotten fixated on two questions: (a) "meritocracy" and what it means or should mean and (b) whether the value of top colleges de

by abeppu 6y ago

A bunch of commenters here have gotten fixated on two questions: (a) "meritocracy" and what it means or should mean and (b) whether the value of top colleges derives mainly from being exclusive. I think an interesting / illustrative case is the AMA as the credentialing authority for medical schools. An association of people in the profession, who have a clear interest in the supply of doctors being low, has a clear lever by which to restrain the future supply of doctors. Independent of which specific people get in and how, for the country overall, most of us would probably be better off if more people got into med school, if there were more med schools, and there were just more doctors working a decade from now. The important question isn't just who should get the seat, but which policy choice gives us a better health care system. I'm guessing the same is true for other areas, but it's just less clear. Rather than asking "who gets to go to the best schools", more interesting is "what policies at the best schools give us a country we want to live in a generation from now?" or "what choice yields the greatest benefit, not just to the student, but to society?" And if schools don't want to make choices from that perspective, if they want to operate like luxury brands whose goods are valued mostly because they're rare ... then maybe they shouldn't get tax exemptions around their endowments, or public funds, or the respect and esteem of a population that thinks they serve some higher, refined purpose.

mikeyouse 6y ago
The AMA doesn't restrict the number of people in medical school, you're thinking of residency slots, and they don't restrict that either. They're in favor of expanding the number of residencies available since everyone knows there is a shortage of doctors. The restriction comes from funding since it's all Federal dollars to pay for the training. https://www.ama-assn.org/press-center/press-releases/ama-builds-efforts-expand-funding-graduate-medical-education-0 https://www.ama-assn.org/press-center/press-releases/ama-bui... Congress, and more specifically right now, the Republican Senate is the only thing holding up funding tens of thousands of more slots (the bills are cosponsored by ~130 congresspeople, of which 100+ are Democrats and by 17 Senators, of which 15 are Democrats) https://www.congress.gov/bill/115th-congress/house-bill/2267/cosponsors?searchResultViewType=expanded https://www.congress.gov/bill/115th-congress/house-bill/2267... https://www.congress.gov/bill/115th-congress/senate-bill/1301 https://www.congress.gov/bill/115th-congress/senate-bill/130...
- wonder_er 6y ago
  If the parent's comment is true, I wouldn't trust the AMA to market itself honestly. Ditto for legislative solutions. There's too much conflict of interest, susceptibility to lobbying, non-representation of marginalized groups or those who would be doctors but are not because of troubling practices, etc. From Mises.org[0] To accomplish the twin goals of artificially elevated incomes and worship by patients, AMA formulated a two-pronged strategy for the labor market for physicians. First, use the coercive power of the state to limit the practices of physician competitors such as homeopaths, pharmacists, midwives, nurses, and later, chiropractors. Second, significantly restrict entrance to the profession by restricting the number of approved medical schools in operation and thus the number of students admitted to those approved schools yearly. AMA created its Council on Medical Education in 1904 with the goal of shutting down more than half of all medical schools in existence. (This is the Council having its 100th anniversary celebrated in Chicago this weekend.) In six years the Council managed to close down 35 schools and its secretary N.P. Colwell engineered what came to be known as the Flexner Report of 1910. The Report was supposedly written by Abraham Flexner, the former owner of a bankrupt prep school who was neither a doctor nor a recognized authority on medical education. Years later Flexner admitted that he knew little about medicine or how to differentiate between different qualities of medical education. Regardless, state medical boards used the Report as a basis for closing 25 medical schools in three years and reducing the number of students by 50% at remaining schools. The article is thoroughly footnoted. One might take exception with specifics, but it seems hard to argue that the above is not approximately correct. [0]: https://mises.org/library/100-years-medical-robbery https://mises.org/library/100-years-medical-robbery Edit: I see the downvotes, but don't see the justification. I know Mises is an often-unpopular resources, but the above article is well-researched. If there are problems with the line of reasoning, I'd love to hear your perspective on it.
  - MereInterest 6y ago
    Though I can believe there being a preference toward reducing competition, their argument is weakened by including homeopaths as maligned groups. Homeopaths are not competitors with physicians, as that would imply that homeopaths provide medical treatment. At best, homeopaths provide a placebo. At worst, they actively poison customers (e.g. belladonna teething tablets) and prevent them from seeking out actual medical care.
wonder_er 6y ago
My simple upvote is too small of a token to reflect how strongly I agree with everything in this comment.

by abeppu 6y ago

mikeyouse 6y ago

The AMA doesn't restrict the number of people in medical school, you're thinking of residency slots, and they don't restrict that either. They're in favor of expanding the number of residencies available since everyone knows there is a shortage of doctors. The restriction comes from funding since it's all Federal dollars to pay for the training. https://www.ama-assn.org/press-center/press-releases/ama-builds-efforts-expand-funding-graduate-medical-education-0 https://www.ama-assn.org/press-center/press-releases/ama-bui... Congress, and more specifically right now, the Republican Senate is the only thing holding up funding tens of thousands of more slots (the bills are cosponsored by ~130 congresspeople, of which 100+ are Democrats and by 17 Senators, of which 15 are Democrats) https://www.congress.gov/bill/115th-congress/house-bill/2267/cosponsors?searchResultViewType=expanded https://www.congress.gov/bill/115th-congress/house-bill/2267... https://www.congress.gov/bill/115th-congress/senate-bill/1301 https://www.congress.gov/bill/115th-congress/senate-bill/130...

wonder_er 6y ago
If the parent's comment is true, I wouldn't trust the AMA to market itself honestly. Ditto for legislative solutions. There's too much conflict of interest, susceptibility to lobbying, non-representation of marginalized groups or those who would be doctors but are not because of troubling practices, etc. From Mises.org[0] To accomplish the twin goals of artificially elevated incomes and worship by patients, AMA formulated a two-pronged strategy for the labor market for physicians. First, use the coercive power of the state to limit the practices of physician competitors such as homeopaths, pharmacists, midwives, nurses, and later, chiropractors. Second, significantly restrict entrance to the profession by restricting the number of approved medical schools in operation and thus the number of students admitted to those approved schools yearly. AMA created its Council on Medical Education in 1904 with the goal of shutting down more than half of all medical schools in existence. (This is the Council having its 100th anniversary celebrated in Chicago this weekend.) In six years the Council managed to close down 35 schools and its secretary N.P. Colwell engineered what came to be known as the Flexner Report of 1910. The Report was supposedly written by Abraham Flexner, the former owner of a bankrupt prep school who was neither a doctor nor a recognized authority on medical education. Years later Flexner admitted that he knew little about medicine or how to differentiate between different qualities of medical education. Regardless, state medical boards used the Report as a basis for closing 25 medical schools in three years and reducing the number of students by 50% at remaining schools. The article is thoroughly footnoted. One might take exception with specifics, but it seems hard to argue that the above is not approximately correct. [0]: https://mises.org/library/100-years-medical-robbery https://mises.org/library/100-years-medical-robbery Edit: I see the downvotes, but don't see the justification. I know Mises is an often-unpopular resources, but the above article is well-researched. If there are problems with the line of reasoning, I'd love to hear your perspective on it.
- MereInterest 6y ago
  Though I can believe there being a preference toward reducing competition, their argument is weakened by including homeopaths as maligned groups. Homeopaths are not competitors with physicians, as that would imply that homeopaths provide medical treatment. At best, homeopaths provide a placebo. At worst, they actively poison customers (e.g. belladonna teething tablets) and prevent them from seeking out actual medical care.

wonder_er 6y ago

My simple upvote is too small of a token to reflect how strongly I agree with everything in this comment.