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That's always an excuse to not pay market rates. If you really need doctors NOW, bump up the rates as high as they will go. At some point you will either run o

That's always an excuse to not pay market rates. If you really need doctors NOW, bump up the rates as high as they will go. At some point you will either run out of money, or you'll find a doctor somewhere in the world willing to take the 12 hour plane to move to the UK for the 1 million pound an hour wage you're offering them.

bell-cot 3y ago
Or you don't literally run out of money...but it still doesn't work out so well - https://en.wikipedia.org/wiki/Hyperinflation_in_the_Weimar_Republic https://en.wikipedia.org/wiki/Hyperinflation_in_the_Weimar_R... Also worth keeping in mind - there's a big difference in "market rate" between "well-treated doctor in a well-functioning health system" and "relentlessly over-worked doctor in a wretchedly crumbling health system". And even if paid well above "market rate", the latter position will attract far fewer applicants who really care about patient welfare and outcomes. And suffer considerably higher turn-over.
- highwaylights 3y ago
  I do see your point, but the fall of the Weimar Republic isn’t a great comparison. Ultimately, it still boils down to “I think you should be limited to making X for doing job Y, because I don’t believe it should be worth as much as job Z, which is clearly prestigious enough to be worth 2X.” Market forces are a surprisingly efficient means of separating perceived and actual value for pretty much anything, even with some fairly sizeable warts.
  - bell-cot 3y ago
    > of the Weimar Republic isn't a great... Yes and no. A nation like the UK can afford to pay any one doctor millions of pounds. But that solution scales poorly to a national level. And worse if you try to scale it to all the other sorts of essential workers. And when an extremely large, complex system is wretchedly mismanaged - paying the guys in the trenches 10X does not fix that. For example, many of the UK's public buildings were built with "RAAC", and are at risk of collapse: https://www.theguardian.com/uk-news/2023/sep/04/raac-crisis-who-knew-what-when-crumbling-concrete-england https://www.theguardian.com/uk-news/2023/sep/04/raac-crisis-... Meanwhile - a rather large number of HNer's seem to disagree with you about the virtues of those "efficient market forces" when it comes to health care. Perhaps discuss it with them here? - https://news.ycombinator.com/item?id=37398504 https://news.ycombinator.com/item?id=37398504
hathchip 3y ago
No. Doctors who qualified in a different country cannot simply start working. They have to do expensive and time consuming training to convert their credentials. This is partly because it's very important your doctor has appropriate language skills and understands the local system - and partly because local trade associations of doctors insist on it to protect their own jobs.

bell-cot 3y ago

Or you don't literally run out of money...but it still doesn't work out so well - https://en.wikipedia.org/wiki/Hyperinflation_in_the_Weimar_Republic https://en.wikipedia.org/wiki/Hyperinflation_in_the_Weimar_R... Also worth keeping in mind - there's a big difference in "market rate" between "well-treated doctor in a well-functioning health system" and "relentlessly over-worked doctor in a wretchedly crumbling health system". And even if paid well above "market rate", the latter position will attract far fewer applicants who really care about patient welfare and outcomes. And suffer considerably higher turn-over.

highwaylights 3y ago
I do see your point, but the fall of the Weimar Republic isn’t a great comparison. Ultimately, it still boils down to “I think you should be limited to making X for doing job Y, because I don’t believe it should be worth as much as job Z, which is clearly prestigious enough to be worth 2X.” Market forces are a surprisingly efficient means of separating perceived and actual value for pretty much anything, even with some fairly sizeable warts.
- bell-cot 3y ago
  > of the Weimar Republic isn't a great... Yes and no. A nation like the UK can afford to pay any one doctor millions of pounds. But that solution scales poorly to a national level. And worse if you try to scale it to all the other sorts of essential workers. And when an extremely large, complex system is wretchedly mismanaged - paying the guys in the trenches 10X does not fix that. For example, many of the UK's public buildings were built with "RAAC", and are at risk of collapse: https://www.theguardian.com/uk-news/2023/sep/04/raac-crisis-who-knew-what-when-crumbling-concrete-england https://www.theguardian.com/uk-news/2023/sep/04/raac-crisis-... Meanwhile - a rather large number of HNer's seem to disagree with you about the virtues of those "efficient market forces" when it comes to health care. Perhaps discuss it with them here? - https://news.ycombinator.com/item?id=37398504 https://news.ycombinator.com/item?id=37398504

hathchip 3y ago

No. Doctors who qualified in a different country cannot simply start working. They have to do expensive and time consuming training to convert their credentials. This is partly because it's very important your doctor has appropriate language skills and understands the local system - and partly because local trade associations of doctors insist on it to protect their own jobs.