maketheworldworkbetter

Statistically informed ideas on how to make the world work better.

Category: Health

Salaries for doctors and teachers: should we pay more to get better health care and education?


Mindful Stew recently had a nice post suggesting that we should pay teachers more – much more, perhaps as much as $100,000 per year. The basic premise is that we lose a lot of talented teachers because we don’t pay them enough and they go into other, more lucrative professions. Perhaps paying teachers more would thus be a good long-term investment in education.

At the same time, I’ve been reading T.R. Reid’s The Healing of America, a book comparing the US medical system to others from around the world. The unsurprising but crystal-clear conclusion is that Americans pay a lot for very bad medical care. And a lot of this a lot is for doctors’ salaries. In many countries with much better medical systems (France or Japan for example) doctors make half or one third of what doctors in the US make, and yet they still attract good doctors.

So I found myself wondering: If I agree so strongly with Mindful Stew (and I do), how can I also agree so strongly with the implicit conclusion of Reid, that doctors should be paid much less in the US? This post is about how these ideas can be reconciled.

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My hypocritical reasons for celebrating today’s health care ruling

Today the US Supreme Court upheld the constitutionality of Obama’s health care law. Like many non-conservatives, I was overjoyed by this news. At the same time, I recognize that many on the right are dismayed.

However, when I ask myself (honestly) why I am overjoyed, the answer is not what I would hope. Fortunately, it is not because those on the right are dismayed. But it is also not because now lots of people will have good health care, or because there will be fewer horror stories emerging about those without coverage. Yes, I believe these things will result, and I am glad about them in a rational kind of way. But my emotional response comes because the US government has affirmed in a certain way that it reflects my values. I think we are all subject to this kind of emotional bias, something important to recognize.

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The science behind “Everything in moderation”

We’ve all the heard the famous quote “Everything in moderation, including moderation” (attributed variously to Oscar Wilde, Horace Porter, and Petronius), and it probably strikes most of us as good advice. Of course, we can’t apply it too broadly: certain things are better in less than moderation (cyanide and genocide, for example) while others should be taken in more than moderation (walks in the woods and Cirque du Soleil performances come to mind). But is there any real reason to believe the principle is more than an old wives’ tale?

Yes, in fact. Emerging research (including mine, self-congratulatory back pat) is increasingly showing both the evolutionary and physiological bases for this principle, at least in regards to diet and exercise. Let’s look at this from three perspectives:

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