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There are several points that I don’t see being made in these discussions.

1. Layoffs would be less painful is major aspects of your life (read: health insurance or your visa) wasn’t tied to employment. Yes the layoffs would still hurt but it wouldn’t be such a catastrophe for the actual workers. This is a discussion for another thread but it’s at least worth mentioning here.

2. Unions could certainly provide some protection and security for affected workers. There’s obviously a lot of pluses and minuses about “US” unions but workers guilds, the AMA and bar associations show that there’s other ways for professionals to protect their employment while still providing training, certification, and quality workers.

3. The bigger issue seems to be lack of employee ownership in the company. Yes you can purchase stock on the market or through equity grants but they are an optional expense. If these laid off employees were earning actual vested stock from their start date they’d at least leave the company with some tangible asset and be in the same boat as these executives. If laying off workers is a good financial move for the company then at least they will get a softer landing. Employees will also have the same incentives as executives to boost stock prices and could flex their power to punish poorly performing executives. That last reason is likely why employees have to buy their way in instead of just getting stock as part of their comp. Obviously it isn’t as simple as giving away stock and hoping everything works out alright but you’d cut down on a lot of these discussions about executives not feeling the pain.




I'm on board with #1. #3 is tough because you'd have to offer lower salaries to make up for the expense of essentially pre-paying a severance package.

#2, however, is way off base. The AMA played a significant role in our current health system's mess. It recently backed off of some of its previous bad decisions (i.e. in 2019 it lobbied to remove the caps on medicare-funded residency slots that it had originally gotten put in place), but it still spends a ton lobbying on "scope of practice" laws that keep doctors overburdened and limited in supply.

Becoming a doctor in the US requires far more years of education than many other countries, drastically driving up salary requirements (how else do they pay for all of that schooling?), limiting supply and providing only comparable care.

The AMA managed to avoid what the bars failed- we didn't experience a glut of doctors like we did lawyers. Unfortunately, we're experiencing the flip side to that coin- doctor shortages may be good for doctors, but it is profoundly bad for everyone else.


It's similar with the BMA in the UK, but they've been less successful.

It's worked out well for the doctors in the USA though so you can't blame them.




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