Originally Posted By: mechanicx
I don't know want point you are trying to make but the health professions' pay and many others are not really marketed based because of insurance or other indirect payer schemes. Say what you want but the ADA and AMA are the ultimate unions. They completely control supply and demand of workers in so many ways and at some many levels.
It is not mandatory that doctors be a member of the AMA. The people who control state licensing for doctors control supply and demand, not the AMA.
To a lesser degree, the state boards who control who can offer medical school curriculum also control the supply of doctors. For example in my state, if you wish to set up a new medical school somewhere where one doesn't already exist, you must gain permission from the Texas Higher Education Coordinating Board. (
http://www.thecb.state.tx.us). Medical schools have been established in Lubbock and El Paso in recent years in order to address a perceived market demand for more doctors in those markets.
The argument about insurance distorting the market, I agree with you there. Doctors are continually marking things up to see if the insurance will increase the fraction of the billed amount that they actually pay.
For example, I recently dated a pediatrician, who said that her group of doctors billed around $200 for a 15 minute visit whereas the insurance company actually paid $60. It's a big shell game, and when Joe Sixpack goes in with no insurance, they attempt to bill the same $200 that they know the insurance companies only pay $60 on. There's not enough transparency, and too much distortion going on.
Thankfully there is a growing retail market for medical services springing up. If they don't want to price themselves out of the marketplace they will have to charge reasonable fees to their cash and carry customers.
Quote:
Labor supply and demand does not apply when there is offshoring and bringing in foreign workers.
Sure it does. There are difficulties with offshoring company operations in areas such as IT, which I speak of because I am most familiar with it. The outsourcing vendors promise you the world, and promise it to you more cheaply than you're doing it now.
But...you have problems with communications, in that you're talking often over Internet links, to people in different timezones, who's native language is often not English.
Management is not directly in control of the people who are working with your critical data, they report to someone at the outsourcing company. Who is holding those people's feet to the fire on following company procedures, and delivering project deliverables on time?
For that reason it is critical that you have a good customer relationship manager from the outsourcing company, someone who has the wherewithal to work the corporate machinery at that company. Some who can kick [censored] and take names, and then report the results back to you with a smile.
There's a cost associated with all this, and that cost is directly comparable to what it cost to run the [censored] thing ourselves in house. THAT is where your competitive labor market comes into play vs. outsourcing. In our case, it costs us 50% MORE to outsource our server environment. We'd love to back out and hire back people to run it ourselves, but it's a 7 year contract with the parent company so in the end it's up to them. We can't just unilaterally back out as a division, no matter how much we might love to.
US workers should be given an opportunity to sharpen their pencils before this offshoring is going on. However, if they have been and they still don't see the writing on the wall then things might not go their way.
guess that's it for now....