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My take is that saying the problem is birth rates is misguided. Surely we have enough labor to provide for the elderly, why can’t our economy be structured to get this labor to the people who need it?


We don’t. That really is the answer. Look at unemployment rates. They basically can’t go much lower.


Do we have enough labor? At least in the US there has been a shortage of elderly care workers. And even if we didn't, what does it mean, concretely, to structure the economy to get the labor to those who mean it?


The US's problem with healthcare workers isn't because nobody wants to do it, its because of not the great wages for a career that many don't just inherently enjoy doing on top of high educational costs and limited positions for trainees. The not great wages cuts prospective workers, caring for old people in general is not super attractive and cuts potential workers, the limited spots for residency cuts many qualified people who had the drive and intelligence and the money to become healthcare workers, and the high educational costs kills even more potential workers before they even try putting a step into the healthcare industry.

A truthful ad for working in an old folks home in the US would be, "slightly over median wages, but with inflexible and unreliable schedules, rampant industry wide exploitation of workers and their rights, likely multiple ownership changes of your place of business, caring for potentially deranged and violent individuals, high non-refundable monetary investment up-front, no guarantee of residency availability"


Correction to myself, I believe we have more than enough people to provide the labor.

I really don't mean to get into the nitty gritty details - I'm not an economist and I'm not providing solutions, just stating what I see as the problem. I believe that we have enough resources, and there are issues getting those resources to where they need to go.

Example: Assume we do have a shortage of elderly care workers. Why is this the case? Could this be fixed by increasing their wages? Then that implores the question of who is paying for these increased wages, which is the question I'm not answering and I don't know enough to answer.

I just don't really believe that keeping the birth rates high is the answer to this economic problem. It might be a solution, but it's more of a band-aid than truly facing the issue. If you have a inefficient engine you can either figure out how to produce more gasoline (babies), or you can figure out how to produce a more efficient engine.


> least in the US there has been a shortage of elderly care workers

Well yeah, because it's difficult, taxing, often traumatic work that pays the same as any other nursing job with a higher QoL and social status. And even then they're pushing out all the actual nursing staff that pays well in favor of MAs/CNAs who get paid like shit.


But at current unemployment rates, raising pay to get more workers into elderly care is just poaching them creating shortages in other places. I always say that the demographic challenges ahead of us are not about a shortage of dollars but about a shortage of humans.


I don’t ever expect everything to be perfectly efficient or even close to it, but how many jobs are there that really truly matter? A job “mattering” is binary either, a doctor is probably essential, and an artist isn’t, but it still matters.

I personally don’t think wages always correspond to how essential a job is, but for the sake of the argument let’s pretend that wages match the necessity of a job, its difficulty, educational requirements, etc.. In this case, I’d expect that we would see people move to jobs that are more essential than their prior job. I think this is more complex that just “poaching”.




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