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Any industry can only have a shortage for slightly longer than it takes to recruit and train. I've heard about the nursing shortage for more than four decades.

Any industry can only have a shortage for slightly longer than it takes to recruit and train. I've heard about the nursing shortage for more than four decades. It can't take more than six years to fix. Although recently, a lot of nurse pay has finally risen dramatically.

alphazard 3y ago
You can have a shortage for other reasons. In a perfectly liquid labor market (which only exists in theory), you can also have shortages. The canonical example is a price ceiling. If the government comes in and says that you can't pay more than x dollars for a thing, then some people willing to pay x dollars will not get the thing. That's a shortage because they wanted to pay the market price (in this case a government fixed price), but they couldn't obtain the good. In cases of shortages, methods of discrimination other than price must be used to decide who gets the goods, and who goes without. Without a price ceiling, the price would increase so that the quantity demanded becomes equal to the quantity supplied. Basically a bunch of people deciding they would rather something else because the good is too expensive.
jltsiren 3y ago
Sometimes the market itself is the reason for the shortage. The value of the work itself may be high enough to justify paying the market rate, but the employer may not be able to capture enough value to pay that. Maybe positive externalities are a large part of the value. Or maybe the industry buying the goods/services consists of larger companies with more negotiating power than the industry providing them. You see both in healthcare. Patient health is an externality, because the patient is not the customer. The insurance provider is. And insurance providers tend to be larger than healthcare providers.
- Maxion 3y ago
  And a similar issue exists in Europe where most healthcare is paid for by the government. The value goes to the individual, but the costs paid for by the governemnt. Locally in Finland the situation is way more perverse, without going into too much detail the money to pay for hospitals and higher level care comes from a different pool than what goes to GPs and local clinics. The second pool has been underfunded for years, causing many local clinics and GPs to refer patients (particularly old patients and those with multiple ailments) to hospitals and higher level care as the lower level care doesn't have the money to hire enough staff. This, in turn, puts patients into a higher level of care than necessary, causing not only increased costs on a per patient level, but on a system level. Not to mention the fact that a whole heap of elderly people are lonely, and simply visit the 'doc cause they're nice to chat to and they don't really pay for the visit. If you'd fund / develop more programs to e.g. have school and daycare kids do things with retired people, you'd probably have fewer lonely old pepople. If you'd better fund the local clinics, there's less need for more expensive higher level care.
  - Adverblessly 3y ago
    > And a similar issue exists in Europe where most healthcare is paid for by the government. > The value goes to the individual, but the costs paid for by the governemnt. A healthy, productive, individual produces a lot of value that is captured by the government in the form of taxes. The government also runs a very differential pricing scheme where the individuals with higher salary get more of their value captured, though they do "lose out" on not being able to refuse low value service or provide better service to high value individuals. (Not to say that the government necessarily does a good job of managing healthcare, just that they do get to capture some of the value produced there)
refurb 3y ago
That analysis ignores people who get trained but just don’t want to do the job for whatever amount of money. They’d be happy to take less money just to not do the job. I hear that happens a lot with nurses.
- hellotheretoday 3y ago
  Classic “every job is equivalent to my office job” kind of analysis. “I couldn’t possibly fathom the idea that if a job had a very comfortable wage it still wouldn’t be worth doing because my frame of reference is moving between various offices for meetings and occasionally checking my emails.” When I worked inpatient psychiatry we were very underpaid and constantly understaffed. Later in my career when I was involved in the admin side of things we did increase pay a bit which helped but we had a kind of cynical joke that even if we could pay 6 figures to the entry level direct care staff we’d still have staffing issues. At the end of the day it’s a job where you have constant exposure to bodily fluids, loud noise, and sudden violence. It was often chaotic; staff quitting on day 1 was so common that we eventually made it policy to do a facility walkthrough during interviews so that people were well aware of what job entailed so we’d waste less money on training. Even then it still happened with some regularity.
Tangurena2 3y ago
The howls of "nursing shortage" are made to entice youngsters into the field in order to drive down wages. When wages drop, people quit to do other things, so wages rise. When wages rise, the media shouts "nursing shortage" from the rooftops. As a career, nursing suffers from a huge amount of burnout and COVID led to large numbers of medical professionals being physically attacked for failing to apply horse dewormer as the purveyors of "alternate facts" kept claiming was a magic cure. Many in the medical profession saw friends & coworkers die from COVID, so the sharp wage increase in recent years was an attempt to mitigate a shortage.

alphazard 3y ago

You can have a shortage for other reasons. In a perfectly liquid labor market (which only exists in theory), you can also have shortages. The canonical example is a price ceiling. If the government comes in and says that you can't pay more than x dollars for a thing, then some people willing to pay x dollars will not get the thing. That's a shortage because they wanted to pay the market price (in this case a government fixed price), but they couldn't obtain the good. In cases of shortages, methods of discrimination other than price must be used to decide who gets the goods, and who goes without. Without a price ceiling, the price would increase so that the quantity demanded becomes equal to the quantity supplied. Basically a bunch of people deciding they would rather something else because the good is too expensive.

jltsiren 3y ago

Sometimes the market itself is the reason for the shortage. The value of the work itself may be high enough to justify paying the market rate, but the employer may not be able to capture enough value to pay that. Maybe positive externalities are a large part of the value. Or maybe the industry buying the goods/services consists of larger companies with more negotiating power than the industry providing them. You see both in healthcare. Patient health is an externality, because the patient is not the customer. The insurance provider is. And insurance providers tend to be larger than healthcare providers.

Maxion 3y ago
And a similar issue exists in Europe where most healthcare is paid for by the government. The value goes to the individual, but the costs paid for by the governemnt. Locally in Finland the situation is way more perverse, without going into too much detail the money to pay for hospitals and higher level care comes from a different pool than what goes to GPs and local clinics. The second pool has been underfunded for years, causing many local clinics and GPs to refer patients (particularly old patients and those with multiple ailments) to hospitals and higher level care as the lower level care doesn't have the money to hire enough staff. This, in turn, puts patients into a higher level of care than necessary, causing not only increased costs on a per patient level, but on a system level. Not to mention the fact that a whole heap of elderly people are lonely, and simply visit the 'doc cause they're nice to chat to and they don't really pay for the visit. If you'd fund / develop more programs to e.g. have school and daycare kids do things with retired people, you'd probably have fewer lonely old pepople. If you'd better fund the local clinics, there's less need for more expensive higher level care.
- Adverblessly 3y ago
  > And a similar issue exists in Europe where most healthcare is paid for by the government. > The value goes to the individual, but the costs paid for by the governemnt. A healthy, productive, individual produces a lot of value that is captured by the government in the form of taxes. The government also runs a very differential pricing scheme where the individuals with higher salary get more of their value captured, though they do "lose out" on not being able to refuse low value service or provide better service to high value individuals. (Not to say that the government necessarily does a good job of managing healthcare, just that they do get to capture some of the value produced there)

refurb 3y ago

That analysis ignores people who get trained but just don’t want to do the job for whatever amount of money. They’d be happy to take less money just to not do the job. I hear that happens a lot with nurses.

hellotheretoday 3y ago
Classic “every job is equivalent to my office job” kind of analysis. “I couldn’t possibly fathom the idea that if a job had a very comfortable wage it still wouldn’t be worth doing because my frame of reference is moving between various offices for meetings and occasionally checking my emails.” When I worked inpatient psychiatry we were very underpaid and constantly understaffed. Later in my career when I was involved in the admin side of things we did increase pay a bit which helped but we had a kind of cynical joke that even if we could pay 6 figures to the entry level direct care staff we’d still have staffing issues. At the end of the day it’s a job where you have constant exposure to bodily fluids, loud noise, and sudden violence. It was often chaotic; staff quitting on day 1 was so common that we eventually made it policy to do a facility walkthrough during interviews so that people were well aware of what job entailed so we’d waste less money on training. Even then it still happened with some regularity.

Tangurena2 3y ago

The howls of "nursing shortage" are made to entice youngsters into the field in order to drive down wages. When wages drop, people quit to do other things, so wages rise. When wages rise, the media shouts "nursing shortage" from the rooftops. As a career, nursing suffers from a huge amount of burnout and COVID led to large numbers of medical professionals being physically attacked for failing to apply horse dewormer as the purveyors of "alternate facts" kept claiming was a magic cure. Many in the medical profession saw friends & coworkers die from COVID, so the sharp wage increase in recent years was an attempt to mitigate a shortage.