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mrtksn 2 hours ago

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 an hour ago | parent | next [-]

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 an hour ago | parent | next [-]

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.

gravypod 31 minutes ago | parent | next [-]

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.

nradov 35 minutes ago | parent | prev [-]

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 9 minutes ago | parent [-]

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.

carbocation an hour ago | parent | prev | next [-]

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

mrtksn an hour ago | parent | prev [-]

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.

hinkley 2 hours ago | parent | prev | next [-]

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 an hour ago | parent | next [-]

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

mrtksn an hour ago | parent [-]

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 2 hours ago | parent | prev [-]

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

hinkley an hour ago | parent [-]

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.

jubilanti an hour ago | parent [-]

[flagged]

protocolture 20 minutes ago | parent | prev | next [-]

>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 6 minutes ago | parent [-]

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.

s1artibartfast an hour ago | parent | prev | next [-]

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 an hour ago | parent [-]

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

s1artibartfast an hour ago | parent [-]

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 an hour ago | parent | next [-]

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 an hour ago | parent [-]

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 an hour ago | parent | prev [-]

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?

grantoz 29 minutes ago | parent | prev [-]

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