2 ms·

> most people (in the US, anyway) view doctors as a magical priesthood that is worth any cost. The alternative is, if you don't incentivize someone financially

> most people (in the US, anyway) view doctors as a magical priesthood that is worth any cost. The alternative is, if you don't incentivize someone financially to spend a decade studying medicine, they won't or they will immigrate to somewhere where they can. This is what my SO did when leaving Vietnam - her med school tuition was around $6k/yr in a country where median household incomes are $2-3k per year (and more like $1.5k for her parents, being tenant farmers) and she'd end up working for $700-800/mo working 70 hour weeks and best case $2k/mo in 5-7 years. Unsurprisingly, she chose to leave just like the rest of her peers, because you can't even buy a house in a tier 4 city in Vietnam without spending $100k anymore, let alone a HCMC or Hanoi where the jobs are actually located. Similar story for my cousin in India as well - he's attending a T5 AIIMS and is looking at 10 years of medical education (an MBBS doesn't cut it in 2025 anymore - you need an MD as well now) in order to get a $15k starting salary, but he is also lucky that his parents are both doctors. If he was not from that background he would have probably attempted the USMLE as well and leave. Both India and Vietnam are seeing a significant medical exodus, as is the UK, South Korea, and other countries where this kind of penny pinching sentiment is rife. HNers harp about layoffs and offshoring, but seem to only care about stagnating wages for themselves in high wage industries with no barriers to entry, relatively chill work cultures, and no risk of legal liablity. What do you guys want? Barefoot doctors and aryuvedic treatment?

BrawnyBadger53 1y ago
The wage of medical staff is independent to the cost of drugs
ceejayoz 1y ago
> This is what my SO did when leaving Vietnam - her med school tuition was around $6k/yr in a country where median household incomes are $2-3k per year and she'd end up working for $700-800/mo working 70 hour weeks and best case $2k/mo in 5-7 years. Unsurprisingly, she chose to leave just like the rest of her peers, because you can't even buy a house in a tier 4 city in Vietnam without spending $100k anymore. I mean, people in the US pay $250k+ tuition, median income $65k/year, work $35k/year for a while, and eventually make something like that $250k/year. A house in many US markets is $300-500k. It's pretty much the same balance between each item, just more zeroes on the end of each number.
- alephnerd 1y ago
  > It's pretty much the same balance between each item, just more zeroes on the end of each number You cannot compare the poverty or material condition between the two. Personal access to tap water, personal bathrooms, not having to pay a bribe to get ID, public services, school meals, public schools the actually have some sort of services, and other stuff Americans take for granted are not available to the vast majority of Vietnamese, Indians, and others in the developing world. My SO literally had to pay a $5k bribe/speed money to get her diploma from her university otherwise she'd have to work as an unlicensed doctor for 2 years. The rent for an illegal 1 bedroom hovel in D3 in Saigon with a tap water connection and personal bathroom goes for $250-550/mo - that's literally the monthly wage for most residents in Saigon You really cannot compare even the worst life in the US with the life the silent majority faces in developing countries
  - ceejayoz 1y ago
    > You really cannot compare even the worst life in the US with the life the silent majority faces in developing countries Sure, but your example cites someone who expects to be making the median annual salary every month within a few years, right? In both places, there's a hefty up-front investment for a much-better-than-average earning employment opportunity.
    - alephnerd 1y ago
      > Sure, but your example cites someone who expects to be making the median annual salary every month within a few years No. This is someone who spent $50k in debt just to end up earning the same salary ($700-800/mo) if she worked in a factory sowing clothes (which give free dormitory housing vs paying $200-400/mo in rent like non factory workers do), working in the unregulated vice industry in Singapore, UAE, of Korea, or doing nails under the table while overstaying their B2 visa in East San Jose - like a number of my SO's peers who didn't make it into a degree program that leads to you becoming a doctor, dentist, bureaucrat, or engineer. Spending 8-10 years of education just to end up earning a similar amount as a factory worker makes people who devoted so much time and effort angry, and why you see a significant exodus of medical professionals in developing countries to developed countries, becuase they are not remunerated enough. Remunerating people less only exacerbates brain drains. And note how this is specifically medical professionals - other white collar roles pay less and are much more competitive or difficult to land a job in VN Saying the median American has a life comparable to the median Vietnamese is TRULY out of touch.
labcomputer 1y ago
> The alternative is, if you don't incentivize someone financially to spend a decade studying medicine, they won't or they will immigrate to somewhere where they can. People already have plenty of incentive to become doctors. We just don't let them. Medical schools collude to limit the number of medical students each year (under the guise of preventing having "too many" doctors). Medical schools have ridiculous selection criteria, like picking the candidates who earned an "A" in physics instead of a "B", or who came from a rich enough family that they could perform many hours of volunteer community work (mostly because the low quotas make it otherwise impossible to select candidates without literally rolling dice). You know what? I think tech workers aren't paid enough. There isn't enough incentive to become a tech worker. We should limit how many people can study CS each year with strict quotas. It should be illegal for a person to program a computer unless they have a CS degree from an accredited school (one in on the quota system) and have passed an exam. Practicing programming without a license (or practicing from a foreign country with a local license) should be illegal, punishable by time in jail. Finally, programmers should have access to computer tools (like encryption) which will be illegal for the rest of the population to possess, and be given the benefit of the doubt if/when they misuse them. Do you see how ridiculous this sounds?
- alephnerd 1y ago
  The difference is a SWE who merges faulty code or causes a production outage is NOT legally liable. If a patient faces a complication or (god forbid) passes away, you as a medical practitioner are held legally liable and can lose your license and potentially even your freedom.

BrawnyBadger53 1y ago

The wage of medical staff is independent to the cost of drugs

ceejayoz 1y ago

> This is what my SO did when leaving Vietnam - her med school tuition was around $6k/yr in a country where median household incomes are $2-3k per year and she'd end up working for $700-800/mo working 70 hour weeks and best case $2k/mo in 5-7 years. Unsurprisingly, she chose to leave just like the rest of her peers, because you can't even buy a house in a tier 4 city in Vietnam without spending $100k anymore. I mean, people in the US pay $250k+ tuition, median income $65k/year, work $35k/year for a while, and eventually make something like that $250k/year. A house in many US markets is $300-500k. It's pretty much the same balance between each item, just more zeroes on the end of each number.

alephnerd 1y ago
> It's pretty much the same balance between each item, just more zeroes on the end of each number You cannot compare the poverty or material condition between the two. Personal access to tap water, personal bathrooms, not having to pay a bribe to get ID, public services, school meals, public schools the actually have some sort of services, and other stuff Americans take for granted are not available to the vast majority of Vietnamese, Indians, and others in the developing world. My SO literally had to pay a $5k bribe/speed money to get her diploma from her university otherwise she'd have to work as an unlicensed doctor for 2 years. The rent for an illegal 1 bedroom hovel in D3 in Saigon with a tap water connection and personal bathroom goes for $250-550/mo - that's literally the monthly wage for most residents in Saigon You really cannot compare even the worst life in the US with the life the silent majority faces in developing countries
- ceejayoz 1y ago
  > You really cannot compare even the worst life in the US with the life the silent majority faces in developing countries Sure, but your example cites someone who expects to be making the median annual salary every month within a few years, right? In both places, there's a hefty up-front investment for a much-better-than-average earning employment opportunity.
  - alephnerd 1y ago
    > Sure, but your example cites someone who expects to be making the median annual salary every month within a few years No. This is someone who spent $50k in debt just to end up earning the same salary ($700-800/mo) if she worked in a factory sowing clothes (which give free dormitory housing vs paying $200-400/mo in rent like non factory workers do), working in the unregulated vice industry in Singapore, UAE, of Korea, or doing nails under the table while overstaying their B2 visa in East San Jose - like a number of my SO's peers who didn't make it into a degree program that leads to you becoming a doctor, dentist, bureaucrat, or engineer. Spending 8-10 years of education just to end up earning a similar amount as a factory worker makes people who devoted so much time and effort angry, and why you see a significant exodus of medical professionals in developing countries to developed countries, becuase they are not remunerated enough. Remunerating people less only exacerbates brain drains. And note how this is specifically medical professionals - other white collar roles pay less and are much more competitive or difficult to land a job in VN Saying the median American has a life comparable to the median Vietnamese is TRULY out of touch.

labcomputer 1y ago

> The alternative is, if you don't incentivize someone financially to spend a decade studying medicine, they won't or they will immigrate to somewhere where they can. People already have plenty of incentive to become doctors. We just don't let them. Medical schools collude to limit the number of medical students each year (under the guise of preventing having "too many" doctors). Medical schools have ridiculous selection criteria, like picking the candidates who earned an "A" in physics instead of a "B", or who came from a rich enough family that they could perform many hours of volunteer community work (mostly because the low quotas make it otherwise impossible to select candidates without literally rolling dice). You know what? I think tech workers aren't paid enough. There isn't enough incentive to become a tech worker. We should limit how many people can study CS each year with strict quotas. It should be illegal for a person to program a computer unless they have a CS degree from an accredited school (one in on the quota system) and have passed an exam. Practicing programming without a license (or practicing from a foreign country with a local license) should be illegal, punishable by time in jail. Finally, programmers should have access to computer tools (like encryption) which will be illegal for the rest of the population to possess, and be given the benefit of the doubt if/when they misuse them. Do you see how ridiculous this sounds?

alephnerd 1y ago
The difference is a SWE who merges faulty code or causes a production outage is NOT legally liable. If a patient faces a complication or (god forbid) passes away, you as a medical practitioner are held legally liable and can lose your license and potentially even your freedom.