> Yes, probably. This rule likely needs a sibling regulation reducing the capacity of collectors to collect on medical debt in ways that financially impair the consumer.
But if we did that, then medical debt would become even less valuable to collectors, and hospitals will struggle to sell off unpaid accounts.
They’d have to make up the difference elsewhere, and raise prices further.
This regulation seems well meaning but it’s just beating around the bush that our healthcare system is way too expensive and there’s no politically feasible solution.
> then medical debt would become even less valuable to collectors, and hospitals will struggle to sell off unpaid accounts
Medical debt is already heavily discounted given its abysmal collection rates. Papering over that by pretending something that trades at pennies is worth face value strikes me as a useless fiction to continue propagating.
> have to make up the difference elsewhere, and raise prices further
Medical debt trades at a nickel to a dime on the dollar [1]. This isn’t a meaningful difference.
What’s the politically infeasible but effective solution in your opinion? I’m having trouble coming up with something that doesn’t create an additional cost elsewhere.
> What’s the politically infeasible but effective solution
Proper published pricing, for starters. If the price isn’t properly published and price wasn’t agreed upon ex ante, the bill should be dismissible. (It’s technically the law, but compliance is miserable.)
There is no reason for the richest profession in the nation to require taxpayer funding for their graduate education.
Most people pay for college.
Why are we using taxes to pay for rich people's college?
EDIT: Rate limited and replying to 'FAANG Workers make the same as doctors':
"You didn't include any numbers.
You also decided to choose the most elite workers living in a high cost of living area to compare to.
Not fair! Not fair! There is a bit of malice to do such an unequal and unfair comparison.
If we look at reality, you are never going to have the moral high ground. The wages are not-market rates, its due to lobbying/artificial scarcity that benefit the members only. The majority lose and the richest profession gets richer.
I hope people can see past the pretty paint you were able to place over reality. "
Probably close to half of doctors make less money than the average person working at FAANG.
Medical school is outrageously expensive.
If you think people are going to put up with the misery of being a doctor, delay any wages until 34, basically live a lower middle class life until 50 while paying of medical school debts, and then barely be in the top 10% after that - you're gonna have a really bad pool of people signing up to be a doctor.
We absolutely do not need to be making medical school EVEN MORE expensive.
> Probably close to half of doctors make less money than the average person working at FAANG.
I feel like comparing doctors as a whole to the subset of software engineers who are at FAANG is not really apt.
> delay any wages until 34
What?
Out of HS at 18, BS at 22, MD at 26.... then what? At least 2 years of residency (PGY1, 2) and you're 28. And then what are you doing for the next SIX years before you're earning wages? Uhhh.
> lower middle class life until 50 while paying of medical school debts
I work as a paramedic, and have multiple provider friends, from family practice, to EM to anesthesiology. While the anesthesiologist is 40 and already owns a book store, and multiple homes, none of the others are wallowing in the "lower middle class". You can pay a lot of student loans at the $300-350K EM residents make in this area.
> barely be in the top 10% after that
I think you're exaggerating on top of exaggeration.
The top 10% line would be at $86K/year.
Let's be more real. Public Health pays the lowest physician salary, averaging at $249K/year. That already puts you in the 2%.
Cruise on up the ladder and Gastro, Cardio, Ortho and Plastics all are north of $500K.
Yes, there is malpractice insurance, and it's not negligible (and some networks will provide allowances to providers for this). But it's also fairly linear to specialty and income, and often not as much as assumed. Obstetrics, as expected, is the highest, at ~$42K (with average salaries of $390K), family practice averages around $10K, and even my anesthesiologist friend is only paying around $13-15K/year.
> It does not put you in the top 2% if you have a tax rate of ~45%
The top 2% pays tax, too. They're still in the top 2% of income, by definition. And that tax rate is more like 35%, less if married.
After that student loan you're still taking home ~$11K/month.
Other professions with higher pay also have student loans, you don't get to say "doctors are different and aren't in the income bracket you think they are because loans".
Length of residency depends on specialty, but is generally at least 3 years and can be 7+. Some physicians also have to complete an additional fellowship before they can really practice independently.
There is a real shortage of residency program slots. Every year some students graduate from medical school with an MD but are unable to practice medicine because they don't get matched (some of those do get matched the following year). The most effective thing we could do to increase the supply of physicians (and reduce their wages) would be to get Congress to allocate more Medicare funding to expanding residency programs.
That comment represents a fundamental misunderstanding of graduate medical education (residency). It is not college. Residents have already graduated from medical school with an MD/DO degree. They paid for medical school in the same ways as any other students (sometimes including tax funding). Many of them have >$200K in student debt by the time they graduate.
Residents are employees of teaching hospitals. They aren't really students. They're more like post-docs in academia. Even though hospitals can recoup some of the expenses of their residency programs by charging patients for care delivered by residents, overall residency programs operate at a financial loss. The funding has to come from somewhere. Lowering already low wages for residents to close the gap and thus forcing them to take on even more debt is no solution. We all benefit from having more physicians so I fail to understand the objection to subsidizing residency programs with taxes.
As an aside, I’ve always wondered - residencies famously overwork newly minted doctors - they’re allowed to work up to 80 works, and for incredibly low salaries considering the education level required.
Given that they have this valuable resource for an incredibly low wage - where is all the money for residency going? Why do hospitals require such a large subsidy to fill the gap?
This isn’t an accusation that hospitals are misusing the money - I genuinely do not understand the costs that go into residency here.
That's a complex question with no clear answer. It varies between hospitals and by medical specialty. In my previous comment I oversimplified things a bit because whether a particular program operates at a profit or loss depends largely on cost accounting. How do the accountants allocate overhead and other indirect costs besides resident wages? There are some general accounting guidelines on cost allocation but ultimately it's open to interpretation.
You seem confused about how medical education works. The link I posted above is relevant in that it has some good general information about the costs of residency programs. You might want to read it as a starting point for correcting your misunderstandings.
Most teaching hospitals are non-profits, often owned by educational institutions or state/local governments. They don't "write off" expenses from an income tax perspective because they aren't subject to income tax in the first place. Cost accounting as a discipline is only loosely related to financial accounting or tax accounting.
As for corruption, there are probably ways the current system could be improved. But you haven't presented any evidence of widespread illegal activity.
I genuinely can't tell if you are malicious, or easy to convince. The line about the non profit was mindboggling. You know that is just a business structure? It has nothing to do with profits weirdly enough.
>But you haven't presented any evidence of widespread illegal activity.
Its an immoral activity to corner a market, take tax dollars, lower quality for consumers, and raise prices. Its not illegal.
> residencies famously overwork newly minted doctors - they’re allowed to work up to 80 works
Wait til you learn about EMTs and paramedics. EMTs can be making as low as $11/hr. And at the last ambulance service I worked at there was no upper cap on hours. The only restriction was you had to be off-duty for 8 hours after every SIXTY on-duty.
Car manufacturers forget about their cars infotainment systems as soon as they sell them. I just drove home on a road yesterday that was totally missing from my Toyota's built-in map. Even if they offer a map update, it's probably already out of date and they probably charge for it. I'm sure the speed limit data is going to be equally fresh and easy to update.
regarding the stat redfin uses: homeownership" is only counting those that are head of household (which is who is responding when filling out a census), e.g. if there are ~100 genZ's, consisting of 96 that live with their parents, 3 that rent, 1 that owns their own home, the stat just takes those last two numbers, ~1/4, and redfin then reports "26% of GenZs owned their own home".
Agree, The author of the post said he has been paying $2500/mo in rent, that is similar to the mortgage on a $450k house with 20% down. The problem is all the $450k houses are miles from where most young people want to live. I am not sure why they want to live in large cities and many suburbs have been abandoned. Probably has something to do with loss of manufacturing and other middle class jobs.
I know plenty of millennial homeowners that would not be able to afford todays prices at current interest rates. They bought before the covid bump (or earlier) and could barely afford it then. Had they rented instead they would probably be locked out of the housing market, at least until they got a significant pay increase or some sort of windfall.
Is it really a minus if Musk is upset? If he’s upset enough to leave, that seems like a potentially beneficial outcome.
There’s got to be some measurable number of people who are turned off from buying a Tesla because of his association, especially now that alternatives are available.
This assumes he cant sell and leave. It would be costly to him, but not impossible. Both sides have leverage in a situation of mutual assured destruction. I dont think it is accurate to only consider the leverage in one direction.
If I’m a shareholder, I don’t want an overly inflated stock price. I want a high stock price due to solid fundamentals. Tesla was temporarily extremely overvalued, but has since lost 60% of its market cap. It’s likely still overvalued compared with peers. It’s a car company, not a b2b SaaS company.
Put another way, which company is more likely to exist in 10 years: Microsoft or Tesla?
Not sure why you are down-voted. If you are an investor, you want a fair price when you buy. Think of going to a store, when there is a sale and prices are below value of a product, it's smart to buy. Same goes with stocks.
I get that the source is Nikkei Asia , and China is the only Asian country* on the list, but the headline and a good chunk of the article made the law seem like it was exclusively targeting Chinese nationals.
Well, they have the funds do they not? I don't think there's a class of wealthy real estate investors from DPRK eager to get into the condo market in South Florida. In that context it makes perfect sense to focus on China. Still, given the expansive jurisprudence on targeting specific races, and the general allergy we have in American politics to doing anything even adjacent to that idea, it would've been better to draft a more expansive policy for the bill.
Personally I think foreign real estate investment is bad, and should be severely dealt with. I don't think it's fair for rich foreigners to essentially park cash in American housing. That specific sense that this activity is wrong can be generalized into a better policy solution, where we don't have to pretend that it's only bad when the Chinese or the Russians or whoever does it. It's also bad for private equity to do this, but that's a separate topic.
Does it matter that only some of them are headquartered in the US? Presumably those other companies also sell drugs in the US?
I would think any company - regardless of where it’s headquartered - would seek to recoup R&D costs in a huge market like the US where prices aren’t capped by the government.
So your only option is to buy the modern day synthetic analogs - or illegally import the old stuff, which the FDA notes here it has the right to block, but may allow under exceptional circumstances.
But if we did that, then medical debt would become even less valuable to collectors, and hospitals will struggle to sell off unpaid accounts.
They’d have to make up the difference elsewhere, and raise prices further.
This regulation seems well meaning but it’s just beating around the bush that our healthcare system is way too expensive and there’s no politically feasible solution.
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