Sales reps make so much because they bring in so much more than they cost. It makes perfect sense for the business to keep retaining them. This is the same in every sector and industry.
> Sales reps make so much because they bring in so much more than they cost.
Almost. Engineers also bring in so much more than they cost.
The real question is if the money they bring in scales with the amount you're paying them. The reason salesmen can make so much money is because you can just pay them mostly on commission and take on practically zero risk of overpaying them. You can't do that with engineers.
Why not? Salespeople must have rules for assigning proportional commissions from joint sales. Why not assign proportional commissions to the engineers responsible for the product sold?
Because for product development, the time from starting a project until scalable revenue is very long. Granted, even the sales part can sometimes takes months, even years. But the engineer's work starts much before the sales work begins.
Engineers who want a bigger piece of the eventual profits start companies.
How do you know which engineer(s) are responsible? Maybe Alice and Bob both worked on the product but Bob spent all day on HN and Alice did all the work. And what about Charlie who joined after feature completion but fixed a couple of major bugs and closed a security hole that would have bankrupted the company had it been left open?
It's just unwieldy compared to the salespeople case.
It's just as complex with salespeople. What about Alice and Bob visiting the customer together for two presentations and then Bob closes the deal on the third presentation he does alone. What if Alice lives in Kansas and meets Charlie the Customer in Europe on vacation, should the European sales guy Marco get a piece of the action?
imho this is not the key point. it is just so much easier to measure their performance. without good engineering a sales rep can't sell anything for long...
The key point is that this is nothing specific about health care nor that it's somehow broken/rotten.
And sales is usually more important unless it's a highly technical situation. There are plenty of terribly engineered but extremely popular products. The important part of staying in business is getting people to buy it.