[mrtksn]

Isn't this a similar issue of doctors raised by taxpayers money doing hair transplant and cosmetic surgeries instead of working in much less profitable hospitals with sick people or European scientists and engineers risen by public education working in American tech companies or super rich people from all over the world buying all the homes in London which is valuable not because of its resources but because of the people there and now causing housing problems?

They all have the same issues:

1) Pricing that doesn't account for externalities.

2) Those who bear the consequences are not those who reap the benefits

[syntaxing]

In certain Asian countries, medical education is 100% covered but you must work at a public hospital for X years. I honestly think it’s very fair. If tax payers full funds your education, it should be mandatory to work in public services for X amount of years.

[hx8]

This is common for teachers in many US states too -- spend X years teaching where we need you the most and we cover your degree.

In the US a teaching degree might be $50,000, and medical degree might be $500,000. I'm not sure I want my state government covering half a million in education costs for one person... I know that we need doctors but I'd want to see some ROI numbers to justify such a high expense.

[nradov]

The National Health Service Corps (NHSC) Scholarship Program and Indian Health Service Scholarship Program will pay for medical school in exchange for agreeing to work in underserved areas for several years. Some states have similar programs. I'm not sure how you would even begin to calculate ROI for that.

https://www.congress.gov/crs-product/R44970

[hx8]

It's complex and imperfect, but in this situation the most direct ROI would be the cost of recruiting a newly graduated doctor by increasing the salary until someone accepts compared to the cost of providing the scholarship.

[gravypod]

There was an article posted on HN recently about the asymmetry in cost of providing an ambulance service vs the cost of the per-ride service. The cost of a medical degree, and the training on top of the degrees, may seem waaay too high but I am sure that when you need the service you want it to be there. I think if I break a leg, need an emergency surgery, etc I will be okay with $0.00001 of my taxes going into the pile needed for paying off those $500k loans.

[rogerrogerr]

At least in the US, the dudes who pick you up in the ambulance do not have medical degrees. They have various certifications that are far less than med-school levels of debt.

[gravypod]

I think part of this is the organization of the training. Cuba trains doctors for likely much less than $500k USD. Also, the training we give to a US solider is very expensive but we have "productionized" the process. The people who provide the training are employed by the military, the training is standardized, etc. Maybe a similar approach could work for other skills. Remember, our military trains surgical assistants and nuclear engineers! These are expensive degrees but they manage to do it.

[grogenaut]

One of the teachers I know had to pay for 7 years past their forgiveness date of 10 years teaching because of the student loan shenanagains in the early 202's and then the shutdowns. Luckily finally she got the loan closed ans is still waiting on the 10% back for paying over.

[carbocation]

That is essentially how it works in the US as well thanks to public service loan forgiveness for physicians.

[mrtksn]

Yep, that's common in many countries for doctors. Not much for anything else(maybe teachers too) and how much X is good enough is debatable.

Certainly common resources are very vulnerable to incorrect pricing and profiteering.

In the past there are many cases where local populations were deprived from their vital needs because some king/queen/sultan/khan etc needed that more.

[HDThoreaun]

There are programs that work this way in the US too. Most doctors arent interested because the pay cut you take working for the poor hospitals/military for a decade arent worth the paid off loan.

[hinkley]

What kind of plastic surgery are you looking to gatekeep?

Because I guarantee you the people who pointed out that plastic surgery was covered have ideas of what that should be.

Plastic surgery can include burn and emergency surgical scars (trauma surgeons are just trying to keep your insides in and your outsides out, and then they have to run to the next patient to do the same), and hair transplants can include head injuries or cancer surgeries in young people in addition to vain old men.

When we discuss things like this in political arenas, nuance goes out the window and you're contributing to condemning little girls to walk around with giant patches of missing hair and people to tolerate visible scars that will absolutely be used to illegally discriminate against them for jobs that would allow them to afford their own procedures.

[olelele]

He's talking about highly educated doctors taking jobs in private clinics instead of working in public hospitals for less.

[mrtksn]

Exactly. In countries with medical tourism this not only pushed the doctors to work for tourists instead of the local population that sponsored their education but also the brightest doctors to do things like botox, nose job or hair transplant because its incredibly lucrative. Fields that deal with stuff like cardiovascular deceases or children have become leftover fields where only the idealists and those who couldn't get into the cosmetic stuff specialize.

[mrtksn]

I think its obvious from the context what kind of plastic surgery, the vanity one.

[hinkley]

I think it's obvious from 'all nuance is lost' that it does not matter, at all. You're inviting collateral damage, as I already said.

[thin_carapace]

the grandparent commentor provided examples to illustrate 1 idea. you took one of those examples and showed how it could be used to illustrate another idea. thats fair enough. in your second comment you continued drilling this point without expounding upon it and without referring to the original topic. hence it seems you aren't interested in the overall conversation, rather whatever point you are trying to make. im not trying to be pejorative here, it is legitimately my perspective that the only thing you added to the conversation was collateral damage itself, by annoying someone enough for them to get muted.

[hinkley]

Okay, fair enough. But once we stop doing things entirely because we are jealous of how some people use it, everything gets a bit dimmer.

I'm all for pricing externalities in. There are some obvious ways to do that with plastic surgeons on scholarships. There are ways to do that with natural resources and power generation and distribution. There's also perhaps space for making deals with the government where load shedding occurs in the data centers, not unlike how the power companies deal with foundries and such.

(what was this about getting muted?)

[thin_carapace]

not sure if you have enabled dead comments or not, somebodys comment was killed for calling you pedantic. anyway nose jobs and skin grafts are both done by a plastic surgeon; one of these procedures saves lives and the other doesn't. the argument is that the taxpayer should prioritize life saving over vanity projects. accusations of jealousy make it seem as though you have missed the point entirely, whether intentionally (which would make the muted person correct) or not

[protocolture]

>Pricing that doesn't account for externalities.

Water and power are priced by third parties, if they aren't passing some cost on to datacenters thats not the fault of datacenters.

>Those who bear the consequences are not those who reap the benefits

Super broad statement that cannot be meaningfully tested. Your power goes up, but your ISP has more and better peers, your emergency services have redundant vxc's between redundant sites, your steam games are cached more locally, your data is hosted in country rather than overseas and hundreds of other little benefits. A lot of which would cause greater whinging if they suddenly evaporated.

[mrtksn]

It's not important whose fault it is, I am sure that the datacenter people believe that they got such a good deal and everything is peachy.

[protocolture]

It does matter. Screeching about datacenters when you cant get your polity to price energy correctly is not an issue with datacenters.

[mrtksn]

It’s not important who’s fault it is, it’s probably the politicians who were looking for short term gain that they can present as creating jobs or maybe even taking bribes to issue permits. It’s not that important who’s personally to blame.

[protocolture]

Politicians wouldnt make more or less jobs by pricing power correctly.

If there was suddenly a bunch of people angry at plumbing because pipes had become expensive, and I found myself having to defend the dual benefits of fresh water and sewerage removal, I would likewise try and identify the root cause of pipes being expensive before crazed internet commentators tried to rip up important infrastructure.

[s1artibartfast]

The common thread in your examples is the idea of entitlements.

Either entitlement to the doctors/engineers labor or a house one doesnt own.

I dont think externalities is the most useful model for thinking about this because it is easy to construct a more favorable hypothetical. That doesnt mean one is entiteled to it.

[slowin]

You are entitled to a benefit from your tax dollars being spent. Otherwise, it's just theft.

[s1artibartfast]

No, no you arent. Money given without strings attached is just that. Claiming ownership of another humans labor is called slavery.

It might be evidence that you or your government isn't benefiting you with its spending. That doesnt put obligation on the recipient.

[slowin]

My taxes aren't "money given without strings attached". They are payment for services that benefit myself and others in the community. They're not a free gift for the government to hand out, that's theft.

[s1artibartfast]

Sure, I agree with that. I just think that is a problem to take up with your government. It doesnt mean a doctor or engineer owes you.

[wat10000]

Does the same reasoning apply to student loans? Is the lender engaging in slavery by claiming entitlement to a portion of the student’s future labor?

[s1artibartfast]

No, student loans are not slavery for two reasons. First, the borrower agreed and signed a contract. Second, the debt owner is the one calling it due.

This is substantially different than expecting control on how debt free doctors or engineers spend their time or what jobs they work.

The crux of this is that externalty price analysis is only useful when bounded by real harms and property rights. Otherwise, anyone can call anything they dont like an externality: If my employee quits for a better job- Externality! If a woman wants to go home to their family instead of having sex with me - Externality!

[wat10000]

The doctors would also have agreed and signed a contract. And the debt owner i.e. the state is calling it due.