Kevin Meyer, in his post Leveraging the Solitude of Leadership, cites a lecture delivered at West Point by essayist William Deresiewicz…who started by describing his experience on the Yale admissions committee:
The first thing the admissions officer would do when presenting a case to the rest of the committee was read what they call the “brag” in admissions lingo, the list of the student’s extracurriculars.
So what I saw around me were great kids who had been trained to be world-class hoop jumpers. Any goal you set them, they could achieve. Any test you gave them, they could pass with flying colors. They were, as one of them put it herself, “excellent sheep.” I had no doubt that they would continue to jump through hoops and ace tests and go on to Harvard Business School, or Michigan Law School, or Johns Hopkins Medical School, or Goldman Sachs, or McKinsey consulting, or whatever. And this approach would indeed take them far in life.
That is exactly what places like Yale mean when they talk about training leaders. Educating people who make a big name for themselves in the world, people with impressive titles, people the university can brag about. People who make it to the top. People who can climb the greasy pole of whatever hierarchy they decide to attach themselves to.
But I think there’s something desperately wrong, and even dangerous, about that idea.
Dangerous how? Largely because of all that emphasis on hoop-jumping…
What we don’t have, in other words, are thinkers. People who can think for themselves. People who can formulate a new direction: for the country, for a corporation or a college, for the Army—a new way of doing things, a new way of looking at things. People, in other words, with vision.
A couple of weeks ago, a WSJ bookshelf piece titled The Price of Admission reviewed Little Platoons, by Matt Feeney, the theme of which is “a growing incursion of market forces into the family home.”
In the ambitious, competitive environments that Mr Feeney describes, year-round sports clubs and camps promote not joyful play or healthy exertion but ‘development’ and preparation for advancement to ‘the next level’–where the good, choiceworthy thing is always a few hard steps away. If there is a terminus to this process, it is admission to a good college, which is, for many of the parents Mr Feeney describes, the all-encompassing goal of child-rearing.
As a result, the most powerful and insidious interlopers in Mr Feeney’s story turn out to be elite college admissions officers. These distant commissars quietly communicate a vision of the 18-year-old who will be worthy of passing between their ivied arches, and ‘eager, anxious, ambitious kids’, the author tells us, upon ‘hearing of the latest behavioral and character traits favored by admissions people, will do their best to affect or adopt these traits.’
The emphasis on college admissions, especially ‘elite’ college admissions, has given enormous power to the administrators involved in this process–people who are ‘vain and blinkered’, in Mr Feeney’s words. They are also capricious:
Admissions officers once looked favorably upon students who captained every team, founded every club and spent every school break building homes in Africa and drilling for the SATs. Ambitious students and parents obliged, shaping family life in accordance to those preferences. In time, though, colleges found themselves deluged with résumé-padding renaissance students. Doing everything was no longer a sign of distinction, so admissions personnel changed the signals they were sending. “Now,” Mr. Feeney says, “instead of ‘well-rounded’ generalist strivers, admissions officers favor the passionate specialist, otherwise known as the ‘well-lopsided’ applicant.” Striving families are only too happy to comply.
I haven’t read Mr Feeney’s book, but at least as far as the college admissions process goes, I’d question whether it reflects ‘the intrusion of market forces’ into family life–if America was to go all the way to government ownership and control of those functions now performed by businesses, the malign effects of the admissions hoop-jumping described by the author would be just about the same.
In any case, people who are taught to center their lives and personalities around this admissions process, and the subsequent educational experience, are unlikely to be either first-class innovators or first-class leaders.
And, worse, the process makes them less likely to become thoughtful and courageous citizens. In the comments to this post, commenter OBloodyHell quoted Walt Whitman:
There is no week nor day nor hour when tyranny may not enter upon this country, if the people lose their roughness and spirit of defiance.
“Roughness and spirit of defiance” are not likely to be compatible with the admissions process…and the education…that are all too common in American universities today.
“What we don’t have, in other words, are thinkers. People who can think for themselves. People who can formulate a new direction: for the country, for a corporation or a college, for the Army””a new way of doing things, a new way of looking at things. People, in other words, with vision.”
Ugh. “thinkers..think…forumulate…DOING…looking…vision.”
Way too much about thinking, almost nothing about doing.
America, and any decent place worth considering, was built by dozens, hundreds, thousands, of people building a building, a business, etc., most of which fail, but the successes build up over time.
Thinking and formulating and vision give us stuff like Urban Renewal where there is one plan for a whole city, and when it fails, the place has been destroyed forever.
For any individual, it’s better–well, safer at least–to be a middle manager than an entrepreneur, but for a society that means stagnation and death.
I was reminded of this:
https://palladiummag.com/2020/07/27/harvard-creates-managers-instead-of-elites/
By a graduate from last year. The fact that she’s from New Zealand may give her a slightly different view of American academia from most of her peers.
“In effect, the system has stopped creating American elites altogether. If so, Harvard has failed in its institutional mission to educate “citizen-leaders.” In place of elite formation is a production line of professional strivers””albeit ones with relative wealth and a valuable social network. But this is no elite at all…”
Brian…what we most need is people who can combine *thinking* with *doing*…in many kinds of jobs and at all levels. The idea that we need a small group of ‘visionaries’/’geniuses’ to do the thinking, and everyone else just executes, is just wrong. There are endless problems to be addressed and opportunities to be exploited throughout an organization.
I spent about 8 years interviewing applicants to UC, Irvine medical school. I met some interesting kids. The admission office secretaries told me I was almost the only one who got the interview reports to the committee on time. I never learned if any of the kids I interviewed was accepted.
One was a Vietnamese girl who was working on a Masters in Biology at UCI. She told me she remembered being taken from her bed as a 9 year old and carried to a canoe that took her family to a fishing boat well offshore. They spent a year in a refugee camp in the Philippines. They were very lucky as at least half of those who did the same died.
Another was an Iranian-American girl whose parents were refugees from Iran and her father ran an nice cream store. When he had a heart attack, she dropped out of school and ran the store for a year.
A third was an Iranian immigrant who had served in the Iran army during the war with Iraq. That involved working in an aid station caring for casualties and he decided he wanted to go to medical school. He made it over here and lived with his brother in San Jose. He worked nights at Sun Microsystems and went to college in the day. He graduated from San Jose State. He was worried that Americans might be prejudiced against him.
Those three I recommended for admission. I suspect the full time faculty had different criteria. I wanted to see some some history of difficulty and stress over come plus some experience with business. The last is probably obsolete because doctors no longer run small businesses. They are all, since Obamacare, employees.
Mike, I really like that take on stressful character formation as a predictor of productive achievement. If you want a society with dispersed leadership and creative results, then you need a lot of independently driven leaders. The so called elite institutions that provide erroneously preferred credentials to their hoop jumpers fall sadly short of moulding graduates into high character and creative leaders who can function outside their peer group. Wisdom and perspective is hardly high on their list of attributes to be encouraged. Networking and power point are much more highly prized. After all if you put on a slide it’s true, no?
Death6
I wonder how much the change from needing a business head to needing a bureaucratic one has affected the actual diagnosing, listening, creative choices of being a doctor? It used to be that the most conservative people in small communities tended to be the doctors – the experiential input Krauthammer talked about and the understanding their patients necessary to build loyalty as well as intelligent doctoring all made for people that were independent, didn’t want to be taxed a lot, and thought for themselves. Of course in small towns they could also be kind of cranks, but that has its up sides as well. Kennedy, your experience has been long and varied.
“The first thing the admissions officer would do when presenting a case to the rest of the committee was read what they call the “brag” in admissions lingo, the list of the student’s extracurriculars.
It almost sounds like the admissions committee values extracurriculars over scholastic achievement. Not to date myself, but back when I was applying to colleges, grades and SAT scores were the primary admissions criteria. Extracurriculars would play the role of a tie-breaker but wouldn’t be the primary criterion.
Brian wrote “Way too much about thinking, almost nothing about doing.
Good grief, Brian. I guarantee you that the engineers who designed the car you drive, the airplane you fly in, the cellphone you communicate with, and, yes, even the buildings you live and work in spent most of their on-the-job time *thinking* about all of those things.
What the original article was trying to say, and I agree with it, is that you don’t get innovation from the likes of Yale, Harvard business school, or your typical MBA. Thinking outside the box, to use a cliche, requires a different mindset, and the military needs officers who can exhibit that mindset quickly under very stressing circumstances.
We gave up a lot in making doctors employees instead of employers (small scale). Doctors are slowly sliding into an attitude that patients are a bother, not the source of income. This is a danger. I am increasingly concerned about competence of the doctors I see as a patient. I used to know all the doctors and could choose by talent and ethics. Most of the doctors I knew are retired or dead. A handicap of old age. We had a young Vietnamese internist who looked like one of my students. Sharp as a tack and very competent. About the time we moved to Tucson, he moved to Burbank. I don’t know why. I have had two internists in Tucson. One was an idiot with rude tattooed office staff. The one I have now is a Democrat (I can tell) and spends his time with me staring into his laptop. He is OK but opinionated and we agreed to disagree on some things. My wife had a pretty good internist (black from Jamaica) and he quit the group and went to concierge (cash) practice. I told her to sign up but she did not move fast enough and he is booked up.
If you are Medicare and can afford it (not very expensive), go to a cash practice. It might be about $200 a month (my wife’s guy) but it will be worth it. Primary care doctors are employees and resent Medicare. A bad combination.
Traditional medicine was a lot better but don’t ask Democrats. They want free stuff; worth every penny.
“We gave up a lot in making doctors employees”
Just a subset of the problem in making “employee” the default goal of literally everyone. We’ve ended up with a society that basically everyone a century ago would have said was a dystopian nightmare. People day by day traded power/liberty for money/security, and here we are.
What Brian said first above.
Death6
In Canada our single payer system produces mostly self employed Doctors. They employ a few people each, and the only Doctors I know that are employed work in Hospitals. All my Doctors have been self employed, often with a couple of others, that share reception and other staff.
Somebody doesn’t know that “single payer” means doctors are employees of government. Back about 25 years ago I was a consultant to the British NHS when Thatcher tried to modify the NHS single payer to make it more responsive to patients and primary care doctors. It was called “Fund Holding” and gave the GPs control of the budgets for certain diagnoses. For example, the NHS would figure out the average number of hip replacements in a certain population. The local GP could determine the best hospital and surgeon for his/her patients and send them there instead of always to the local district hospital. The doctors’ office staff had to learn how to do this. In teaching them, I learned quite a bit about the NHS and how it worked in real life. The result was better care and better communication between specialist and GP since the specialist could not ignore the GP and hope to get referrals.
When Labour came back in power, Fund Holding was ended.
LOL. No, single payer means exactly what it says. The government pays Doctors for services. They are independent business that provide our medical care. Instead of competing, for profit insurance outfits, we have a single payer.
Try to take it away from us and see what happens. Even Stephan Harper was not that dumb. ;)
Try to take it away from us and see what happens.
A laugh at ignorance. Take away free stuff from any inner city black and see what happens. Doctors in “single payer” programs are government employees. The GPs in the NHS demanded they be paid so much per subscriber to their panel. As a result, most GPs in England have other jobs at schools, factories, etc., that take precedence over their “Surgeries.” That means the the patients come last. Only market systems ensure good service.
The US could vastly improve Medicare by allowing “balance billing.” This would allow a doctor or other provider to charge more than the poor Medicare fee. Those who were willing to pay more for better care would follow. Those who wanted free care would stay. This is anathema to Democrats. At present, a doctor must drop Medicare to charge more. The fact that many are doing so should be a warning. In the example of Canada, those who could charge more left. That’s why so many Canadian docs are third world. The same for the NHS. A couple of years ago, 10,000 UK trained doctors were leaving.
Yes we do like our rather exceptional medical system. You are welcome to yours.
You think I am so badly served by my long term Doctor, a Pakistani with a degree from the University of Edinburgh? ;)
“Doctors in “single payer” programs are government employees”
We all know this, Mike, even the troll. Best not to feed him.
So Doctors in Insurance Payer operations are insurance company employees?
The engineers “think”, the ditch diggers “do”. Not that I haven’t spent more than few hours contemplating the finer points of soil mechanics at the controls of an idiot stick.
Some are paid to follow policy, some to make it.
The recent engineering graduates I’ve come across seem to have spent their class time producing answers to esoteric, very narrow problems set by their teachers. If they have any experience with processing all the trade-offs a successful design takes, they got it from something like robot club or as an afterthought of some competition.
This is not new. In 1999, the bonfire pile being built at Texas A&M collapsed, killing 12 students that were doing the building. As the investigation unfolded, I saw that the “design” could never have passed even the most cursory engineering examination. This was no simple pile of wood, they were using heavy equipment to build a structure more than 100 feet tall with a very narrow base. Around the time the investigation came out, I asked an Aggie engineer I was working with how a school that prided itself on the quality of its engineering schools could have allowed something like this to happen. He didn’t know either. Apparently it was never considered to merit close examination.
PenGun said “You are welcome to yours.”
Judging by the large number of Canadians crossing the border to get health care, you are welcome to ours as well.
Canada works because it is next to the United States.
My point of course, was that you are complaining about Doctors being employees. Who employs them? Why is America losing its self employed Doctors?
I haven’t visited here for a long while but some things never change, PenGun is still wrong about everything, Bob Hodges has it exactly right, the Canadian Medical System still functions because it relies on the American system to deal with overflow issues. There were a number of news articles a few years back about BC having to fly expectant mothers to hospitals in Spokane because in the entire province there was not a single Neonatal bed free and neonatal beds in Alberta were also at near capacity. Spokane had spare capacity. Building spare capacity and not utilizing those resources 24/7 costs money but that’s the cost of living with a system which can provide you those services when you need them. Without Canadians shipping their surge of preemies to America, those preemies would die, maybe the mothers too. If Canada was completely surrounded by other countries using the same model of medical delivery, they’d be up Shite Creek and would have to massively increase spending and build more slack into their medical infrastructure.
Secondly, PenGun seems to think that Canadian physicians are not employees of the government yet these “small business operators”cannot set the price for the services they offer. There is no gov’t agency regulating Wal-Mart and mandating that prices be what the gov’t determines they should be, nor do restaurants have gov’t dictating price of meals they offer. If you can’t set a price for the time and service you provide, then you’re not really an independent actor.
If a nation, like Canada and even the US, can’t manage their society without DEPENDING on external inputs, like requiring Pakistan to train their physicians for them because the Canadian education system can’t train enough Canadians to do the job, then there is a rot in the way society is structured. This goes writ large for immigration – if your own people can’t produce enough children to fill the schools, to provide properly trained professionals to replace the retiring professionals, and you need to import people, then you have a dysfunctional society on your hands.
Turning back to the OP topic – these admissions officers are signs of a spreading rot. Universities have set themselves up as gatekeepers to a good life. Credentialism at toxic levels is what we’re seeing play out. Before I expand on this point I want to take a detour for a bit and use the detour to circle back to the point. The older I’m getting the more I’m becoming disillusioned with Adam Smith’s Invisible Hand perspective, which is operative in Western economies, profit maximization at all levels of the economy is certainly good for the entity which is maximizing profits, but the downstream effects are causing us all sorts of problems, such that society, viewed as a system, is ever more reliant on external outputs to function. When a family requires to income-earners to survive, thus limiting family size, this requires a constant inflow of immigrants to replace the children that were never born, most of those immigrants are of low human capital and destined to fill service jobs, service jobs which are booming because working people have less time to take care of their own cooking, lawncare, cleaning, raising children, etc. These immigrants are a net-negative for society but like any good ponzi scheme, the major negative cash flow arises towards the end of their working lives, so to finance them, we just import more low human capital immigrants. So this push to maximize profits affects society by lowering the percent of GDP going to worker income and boosting returns to capital, immigrants suppress wages, pushing more women into the workforce also suppresses wages, but profit is boosted. Now I come back to the admissions angle – profit maximization can also be implemented through industry consolidation. Within the lifetimes of most commenters here there used to be a path to the good life which came from a father passing on his business to his son. Howard Cunningham ran a hardware store somewhere in Wisconsin, if Ritchie’s journalism ambitions couldn’t be realized he could have come back and taken over his dad’s hardware store. There used to be over 20,000 banks in the US, this meant that there were 20,000 bank CEOS in America and for many of them, their families were controlling stockholders, so junior would take over after Dad retired and could have a good life without need of a credential bestowed from a group who’ve established a near monopoly on credentialing. Today with bank consolidation, there are no longer 20,000 Bank CEOs, nor are there that many independent hardware stores around, replaced by Home Depot and Lowes and Menards) so when those corporate executives are worrying about the future of their children, they can’t rely on passing on an inheritance of a good livelihood which would come from bequeathing the children the ownership of an ongoing business enterprise, no sirree, those corporate executives have to send their kids through the credentialing sausage machine and their kids have to compete for the credentials – the stakes in the game have now gotten very, very serious, because what absolutely scares the bejesus out of upper class parents is the prospect of massive downward mobility for their children. Actually no parent, of any SES strata, wants to see their kids doing worse than them, that’s antithetical to “the American Dream.” The problem here is that top leadership positions in society are diminishing at a time of population increase and an anti-meritocracy being foisted on society by universities who are trying to shape the leadership class demographics by using race and sex quotas. This leads to really bizarre outcomes, where credentials are a gateway to success for minorities and more competent people are overlooked for promotion because they’re White and male. So, we no longer have 20,000 Bank CEO positions to be filled, all of those people who would have been a small bank CEO are now drones in some larger banking enterprise and their kids have to enter the credential competition to have a shot at a good life, otherwise profit maximization on steroids is going to lead them into a life of some immigrant brought in to replace them at their job.
Corporate consolidation is (maybe) good for the consumer, but it unquestionably good for the stockholder, but what’s good for the stockholder is not actually a synonym of what is good for a healthy society. Heck, we can even tie this back to PenGun’s views – Single Payer is consolidation to the ultimate degree4 – government becomes the setter of prices for medical services and often times writes laws to criminalize the offering of medical services at prices higher than those set by government – (using laws (gov’t violence) to reduce competition. We saw with the Irish Potato Famine what happens when consolidation (in that case no variety in potato varieties) gets too extreme.
Let’s ask PenGun how he feels about Canada’s impending merger of Shaw and Rogers, two of his nation’s largest cable providers – he loves big centralized organizations which stamp out competition, so is he happy to have consumer choice reduced?
The problem here is the admission officers are gatekeepers to the good life, which they shouldn’t be, and the criteria by which they admit is increasingly arbitrary and divorced from metrics which can predict effective leadership or even net positive contributions to society. Obama was an Affirmative Action beneficiary his entire career. He became a community organizer and used that position to extract hard earned wealth from banks that he threatened on behalf of his organization, and so on for his entire career – the man never created any wealth in society, his entire focus in private life was wealth extraction and that’s the philosophy he brought into government. Wealth extraction is not a sustainable way to run a society, even you do kill the Golden Goose, yet the Gatekeepers were extremely happy to have used their gatekeeping power to elevate that man, and others like him (lots of the elite are finding their ways into the NGO sector) (this is an entirely different kettle of fish from past generations where some privileged kids would go work at Art Galleries and publishing, supported by their parent’s money) – these NGO folks are extracting money from government in order to run their do-gooder schemes.
The credential system creates brutal competition and is creating adverse effects, elevating the stupid, the useless and the mediocre over the competent and we can’t always count on the Peter Principle to put a stop to the rise of the incompetents (see, Clinton, Hillary – failed at every position she held and was continually elevated up the ladder.)
Which is the “better” way to live – below your means and build up a nest-egg, living at the level of your means, or living beyond your means? If you’re spending every dollar you earn (or spending borrowed money on top of what you earn) then you are enjoying a good lifestyle for as long as you can sustain your income flow. What happens though when the income drops or stops?
This same dynamic is at work with folks who work in large corporations – they have income and status and it’s almost all tied to their job, there is nothing to bequeath to their kids, so what happens when they get fired or laid off?
When I’m reading financial news and my industry news I see the ups and downs of people’s careers. Founders who get bought up seem to pop up in new enterprises quite frequently but corporate superstars who rose to prominence by climbing the career ladder seem, from what I am seeing, to have a hard time replicating their earlier success.
Steve Jobs co-founded Apple, then NeXT, then Pixar, the back at Apple was instrumental in resuscitating the company with the iPod, iPhone, IPad. What happened to John Scully?
So what’s my point? Parents want to ease the path for their kids. Many would like to pass on something which can help their kids have a good life, but employees have a harder time passing on “Means” which can sustain a good life, and if you’re a C-suite executive somewhere you’re, ultimately, still an employee, you can’t pass on a “means” of good living to your kids, the best you can do for them is to send them to the right schools, prepare them with the right connections, and send them out to compete for a spot at the right university where the credential will open doors (to employee jobs) for them. Everything (or so it seems) depends on the credential. What happens though if you’re a high-flying VP and your company gets bought out and you get pushed out of your job? For a lot of these people, they never again reach the same height in a new corporate environment. Their status was the equivalent of living at their means, meanwhile some small-time property developer who owns a few apartment buildings and has built himself a landbank of property he, or his heirs, can develop in the future when the time is right actually has something he can pass onto his kids, removing the pressure for the kids to play the credentialling game. Same with the guy who own a restaurant or a small chain, he can bring his kids into the business and pass it to them, his mind resting easy that they inherited a lifestyle from him. Some lefties may model this as privilege, unearned privilege, and yup, that’s exactly what it is and all parents would like to be in a position to help their kids in this way.
The folks who live below their means and build up a nest-egg, they have something to pass to their kids, those who live at their means do not. Those who are business owners, or property landlords, can pass that on to their kids, those who are employees have no “means” or “job” that they can pass to their kids, so the credential game becomes a brutal cage-match to insure a good outcome for their kids, see stories of parents battling for prestigious pre-school slots for their toddlers.
1) David, thanks for the shoutout. I’ve been carrying that quote around (I have a VERY large collection of them) for about 35-40 years…. But THAT one struck me as very important. I think my own personal experience with schools, where I was very much told to sit still and be quiet and go with the flow, while having no interest in doing anything like that, made it strike home. I think for the last 50+ years (probably since Horace Mann reared his ugly head, actually — He’s my own personal candidate for time-machine removal from the gene pool) the schools have been aiming to beat that “Spirit of Defiance” out of Americans. They seem to have come dangerously close, judging from the response to Covid. :-(
2)
}}} He was worried that Americans might be prejudiced against him.
Listens too much to liberals. The only reason most Americans have any problems or concerns with any Muslim has to do with the tendency to shout “Allahu Akbar!” and blow themselves up… or shoot up a Colorado supermarket… Or march around demanding the beheading of someone who insults Allah**. Islam seems to be very… “encouraging”… of that kind of behavior.
** Allah seems to be a remarkably weak version of God, if Allah needs his believers to protect him… As a Christian, I think, if you actually offend Him, He doesn’t need ME to do jack shit about it. He can make a piano fall on your head from the blue sky if He chooses. Yahweh is not much different. When a group of juveniles mocked His prophet, Elihu, taunting him, Elihu cursed them. So God sent two bears to maul forty-two of them. Message: “Don’t fuck with My Man.”. So Allah seems to come off as kind of a wimp, when he needs his people to defend his “honor”.
3)
}}} It almost sounds like the admissions committee values extracurriculars over scholastic achievement. Not to date myself, but back when I was applying to colleges, grades and SAT scores were the primary admissions criteria. Extracurriculars would play the role of a tie-breaker but wouldn’t be the primary criterion.
Well, I’m pretty sure, at the level of some of these, that there’s very little difference between their scholastic metrics. I recall that, for my own class of 600 graduates, they had to go back to like 5th grade to find ANY difference in their grades. Now take the valedictorian and salutatorian products of the 26,727 high schools in the USA. Are there really all that many differences in their transcripts? And my example was back in the 1970s — with “grade inflation”, I suspect there’s little difference between the top 5 to 10 graduates of many moderately large high schools.
4)
}}} Primary care doctors are employees and resent Medicare.
What the hell? Are you saying that government run health care is a bad idea? You… you… you… RACIST!!?!?!
:-P
Yes,
/irony off
in case that wasn’t obvious.
}}} In Canada our single payer system produces mostly self employed Doctors. They employ a few people each, and the only Doctors I know that are employed work in Hospitals. All my Doctors have been self employed, often with a couple of others, that share reception and other staff.
In CANADA, all your freaking doctors have quit working by November, and can’t TAKE any more patients because they are only allowed a certain number.
That’s not what “self-employed” means, Penitent.
}}} Try to take it away from us and see what happens. Even Stephan Harper was not that dumb.
Yeah, that’s why Canadians are constant medical tourists, when they can afford to be… LOLZ.
}}} A laugh at ignorance. Take away free stuff from any inner city black and see what happens. Doctors in “single payer” programs are government employees.
Exactly.
}}} So Doctors in Insurance Payer operations are insurance company employees?
No, because, if they don’t like the way an insurance company operates, they can refuse to accept that insurance company’s clients. Which leads to major bitching by those clients when they can’t see their doctor (yeah: “If you like your doctor, you can keep your doctor”… except…. *no* OC doesn’t do anything of the sort)
That’s one of the benefits of market solutions. If you don’t like one solution, there are others out there looking to gain you as a customer.
Government systems are “single payer”. This is called a “Monopsony”, and it’s just as bad as “Monopoly”, because in both cases, “You don’t like the deal? Tough. Where else are you gonna go?”… Only it’s WORSE than a monopoly or a monopsony, because in actual market systems, those are unstable, and sooner or later they are broken, either by internal forces or external ones, like new competition. When it’s The Government, they’re There To Help, and that usually means, “Do Vut Ve Vant Or Else Zer Wil Be Conzequenzes!!”
MCS – Don’t want to hijack the quite interesting post itself, but wanted to say something directly to you about your comment.
I don’t know a lot about it, but did do an old post on the Aggie Bonfire collapse. I am too lazy to find a way to get you the whole article, but one of Jonathan’s arguments was that the Faculty Senate (which he was on at the time it collapsed and which issued a report he had a major hand in writing) had thought they’d control the increasing size of the fire by limiting the size of the base, ignoring the fact that it is human nature of young Aggies to build bigger than the year before which made for a towering but not very well based configuration. (Academics often fail to consider human nature.) The potential liability and insurance has meant there has never been another one on campus – somewhat sad given the long, long tradition. But certainly not as sad as the memorial on campus to those who died. There is one done off-campus, which, of course, produces further problems but I don’t think it is nearly as large.
A&M has always prided itself on turning out leaders honed by projects on campus that are totally student run – when that is a lecture series or a simple bonfire or a Science Fiction program, the risks aren’t so great and it probably does make for learning in a different way. But as the corps has less and less been the center of campus culture, some institutional memory has been lost. Jonathan’s article also (as I remember) traced back a century’s worth of Battalions (the student newspaper) and noting slow rises, falls, and then slow rises again in the number of complaints about student drinking as they built it. That year was on the upside and alcohol was, I think, another of the contributors. (It looks like his article was at one time a pamphlet form on Amazon so you’d think it would be more available.)
Jonathan is really a great guy married to an exceptional woman – we met him his first year here when he started courting her.
Tango Man…interesting & thoughtful comment, thanks.
One problem with family businesses is that the kids may have interests that lie in totally different directions…or, alternatively, may *want* to run the business but have questionable competence or worse. And non-family-members working in the business are likely to feel that their opportunities are limited.
Regarding the reduction in the # of top leadership positions in America, there are certainly less *local* and locally-owned businesses…but there may actually be *more* businesses with national or international scope..
So no one will tell me what the problem is with self employed doctors in the US. The only reason I said anything, was all the lamenting about this. As I said our doctors are usually self employed and provide health care under our Federal/Provincial national health care system. That is a single payer system and benefits from many economies because of this. Our medical insurance is nation wide and we pay into it as long as we have an income. It takes care of every citizen in the country which we rather like.
As a racist group you really do not see the benefit of multicultural societies. My doctor is a Canadian and has been most of his life. We have Canadians from all over the world and our country is actually a multicultural one. The University of Edinburgh is one of the best medical schools on the planet and I am extremely well served by my doctor.
The point of the Canadian medical system is that lack of money should not affect medical outcomes. We like it like that, and the rich can go where they want.
}}} What happened to John Scully?
First off, Scully was an exec at Pepsi before taking over Apple, and basically ousting Jobs.
Second, he was in charge of the policies that, long term, screwed Apple, drove it into the tank.
https://www.wired.com/1997/11/es-apple-2/
Apple was literally DEAD as a major company, until Jobs came back and saved its ass with the iPod and then the iPhone.
And then they followed through and made the same stupid mistakes with the iP that they made with the Mac, of going for short-term, high-end profits and ignoring the lower end market… so they’ve captured an ever-decreasing market share, and sooner or later, they’ll slide under, unless Jobs comes back to save them again, and frankly, if he manages that, well, we’ve got bigger portents to fry.
Back in the 80s/90s there were companies on the verge of creating “Macintosh clones”, which would have provided a low-end entry for mac people. It would have been very beneficial to Apple, as it would provide market share they did not have to support in any regard, and would provide a “feed-in” as people became able to upgrade to an actual mac.
THEN apple made its infamous lawsuit for “look and feel” against Microsoft.
Needless to say, this led to the end of all discussion of Mac clones.
And thus apple killed itself.
Because Scully, stupidly, thought that market share wasn’t any more important in computers than it was in soft drinks, and that Apple keeping control of the high-end-high-profit end of the market was enough.
But as the Wintel box became prevalent, fewer and fewer devs were developing for the Mac, so, even at best, the software you WANTED took a year to get ported to the Mac from Wintel. Or it wasn’t ported at all, if the company thought the market wasn’t worth the effort. When Adobe switched to initial development of Photoshop on wintel boxes instead of doing macs first, the writing was already on the wall. Mac was dead. It was just a shambling zombie company, waiting for its market share to drop too far. Because, as Apple knew with the iPhone, you don’t buy the box for the box, you buy the box for what it does. And if the mac couldn’t run software people wanted, what good was it?
And apple has ceded the lower-end market for phones, again, to Others, and, trust me, they’re now dead men walking. It might be another 10-15 years, but they aren’t going to last forever. Not without some radical restructuring of their business model to not depend on iPhone profits.
A suspicious person might conclude most of the reason to exclude Huawei is to protect Apple. Huawei phones are head and shoulders above pretty well all other cell phones, and its not like there are actual security reasons, to ban them.
Many good points made above. What happened to small banks was Dodd-Frank. At least as I understand it.
The points about physician employees is missed, as usual by the troll. Medicare bans balance billing and even bans providing medical care for LESS than the Medicare allowance. At one time I had a woman who had no insurance and who had had breast cancer doing my house cleaning to pay for her surgery. That was her business but Medicare would have punished me if they found out about it.
Quite a few doctors, mostly older with kids educated, etc, are dropping Medicare and all insurance to practice for cash. That is returning to the model of small business where the patient is the customer and not a cost. Canadian doctors, like NHS doctors, may employ a few staff but they are not independent. Thatcher tried to give them some independence but Labour ended that as soon as they recovered power.
One of the drivers forcing doctors into employee status is the Obamacare requirement for EMR. It is expensive and poorly designed. Since it is expensive, many docs are allowing their practices to be bought up by hospital groups in return for providing the EMR. They end up being controlled as employees.
I agree that ending the Mac clones was a bad mistake. I still use Macs and the Macbook Air seems to be an effort at keeping them affordable.
My wife’s internist, black Jamaican, went to “concierge” practice in January and I encouraged her to sign up but she waited too long and he is all booked up with a long waiting list.
Mike K…I know a guy who owned a small bank (jointly with his brother), but after Dodd-Frank the compliance costs got to be just too much, so they sold the bank and are now doing other stuff…investments in startup and still-private companies, for the most part.
I might add a bit about the Jamaican internist and his plans, as I understand them.
He plans to charge $200 a month and has a panel of 400 patients. That would provide $80,000 a month to run his practice. I don’t know what his rent is but $5,000 a month would not be unusual and he probably has 4 employees. Cash practice drops overhead by a lot as there is no need for an insurance billing operation. No doubt the group of which he was an employee provided that service at what cost I don’t know.
There is nothing like signing the front of paychecks to teach you economics.
A cash physician does not affect his patients’ ability to use Medicare for hospital expenses. The busiest hip replacement surgeon in Newport Beach, before I moved, was cash only and charged what Medicare allows for the surgery. The difference was that he did not have to deal with the Medicare bureaucracy.
Ginny,
The bonfire collapse was nothing more or less than an engineering failure. There is no possible way that it could have been considered stable or safe as it was built. It was not some impromptu pile of wood. There were cranes and steel cables to try to bundle the logs. They had a plan, it was just unbelievably bad.
There should have been many people on campus that could have explained in detail just how bad the proposed plan was, yet none of them seem to have been consulted. Building a structure more than 100 feet tall is the essence of a project that requires careful planning from the start. Careful planning should be the essence of what they should be teaching in the engineering schools. The tragedy is the dead and injured students. The scandal is that they were allowed through some combination of ignorance, arrogance and blind neglect to be anywhere near such a travesty.
The subsequent banning of the bonfire is very much on topic. Much easier to ban it than to go about the process of keeping it safe. Of course, no one learns anything from what they haven’t done. Ap designers probably don’t pay much attention to things like safety factors, they can always issue a new version. You’d hope whoever designed the next bridge you pass over isn’t just waiting to see what fails so he can correct it next version.
PenGun
As a racist group you really do not see the benefit of multicultural societies
The drawbacks are far greater than imaginary benefits. If multiculturalism was so damn great then political parties in the 50s and 60s would have ran on the platform of erasing the White culture and replacing it with multiculturalism, extolling the benefits of making non-Whites “protected classes” and giving them more rights than those given to the Canadians whose ancestors built that country, they would have told the voters how wonderful it would be to have their right to free association raped and how wonderful it would be to have government force them into unwanted associations with these foreigners that are brought into the country and given greater rights.
You don’t need government coercion to force a parent to love his/her child, parental love is a phenomenon which sells itself, the benefits are obvious. You don’t need government coercion to force people to buy a car instead of using public transit, the benefits, for most people, are self-evident. If multiculturalism and anti-discrimination laws are so damn wonderful, then parties would have run on that platform and received the “consent of the governed” but that’s not what happened in ANY Western nation, diversity was imposed without receiving the consent of the governed and there has been a massive degradation of values, community, culture and lifestyle in order to accommodate the toxicity which flows from diversity.
My doctor is a Canadian and has been most of his life.
HAHA! If you put a hamster into an empty aquarium, the hamster doesn’t suddenly become a fish. If I moved to Japan or China, I wouldn’t suddenly become Japanese or Chinese.
The point you can’t evade is that this massive change was never implemented via ASKING for the consent of the people. In a very real sense, all Western nations which implemented multiculturalism went through a silent coup – leaders fundamentally changed their countries against the will of the people who inhabited those countries at that time, the leaders destroyed the nation which gave rise to the country and through which a State came into being. They preserved the State and destroyed the nation. As an apologist for multiculturalism, you have to answer for a great evil. This is best illustrated by efforts people like Richard Gere make to preserve Tibetan culture and the Tibetan people from Chinese “multiculturalism” or how extraordinary precautions are taken with “Forgotten Tribes” found in the Amazon, to insure that their cultures are not destroyed by exposing them to the modern world. In these situations folks understand the evil and work to prevent evil being done by people like you, who would support the Chinese erasing the Tibetan people and their culture.
The point of the Canadian medical system is that lack of money should not affect medical outcomes.
This is some really woke-level of stupidity. Medical outcomes are often the product of medical resources which are employed to treat an ailment. Medical resources are finite and are rationed by cost. Canada’s PER CAPITA MRI machine infrastructure was about 1/4 of America’s per capita rate. Medical outcomes ARE affected by differing degrees of medical resources used to treat ailments. If a physician can offer better treatment with MRI information available than would be the case without MRI information, the medical outcomes will be changed.
Ask that Newfie Premier why he flew to NYC for medical treatment rather than using the Newfie medical system, where I might add, he would have been a VIP and even in places like Canada with their putrid equalitarian ethos, party apparatchiks always get special treatments.
I’m the author of the above comment.
Canada’s PER CAPITA MRI machine infrastructure was about 1/4 of America’s per capita rate.
You could ask Natasha Richardson about that MRI situation. Oh, wait…..
“HAHA! If you put a hamster into an empty aquarium, the hamster doesn’t suddenly become a fish. If I moved to Japan or China, I wouldn’t suddenly become Japanese or Chinese.”
Our country, like yours, is made up of various groups, who became Canadians/Americans as we developed the continent. All the people who are Canadians are the same to me. I don’t care about their racial background, what they look like, where they came from, as what they do as people, is what matters to me. I am not a racist.
Now I was raised all over the world, and my first real friend was so black he could hide in a shadow. I have perspective many do not because of this.
As we have universal health care, we have to look after all the people who are Canadians. We do not have the luxury of just treating those who can afford the treatment, so we have to make certain compromises. Not having a surfeit of MRI machines does not impact our ability to take care of our population in any real way. I have had MRIs whenever my doctor thought it was appropriate and there was no waiting.
Hateful and demeaning attacks on me are just funny, well I think so, but they do pollute your consciousness, and hate is not a good thing to cultivate.
The troll thinks truth is a Hateful and demeaning attack.
He is here to spread anger and hate. A lot of Canadians are jealous and angry. Especially as they have been taken over by China and the third world.
The level of medical rationing in Canada is ignored or not understood by many of the residents who are unsophisticated. The huge medical complex in Spokane is evidence that many Canadians are sophisticated. Spokane is hundreds of miles from another big city. Where do the patients come from for those big hospitals ? Guess.
Mike K.:
I’ve told this story before, but it is appropriate. In the late 1980’s we had a friend, a local pharmacist, who was a scuba diver and went to Victoria on Vancouver Island where she had a regular dive boat she would go to. It had a divemaster her age named Carl. Carl suffered from Crohn’s Disease. He would go to the Canadian medical system, and all they would do was give him the equivalent of Pepto-Bismol. They said that was the only treatment there was for Crohn’s.
Over time, our friend and Carl became close and she finally told him to get his a– down to Colorado and took him to a gastroenterologist she knew. Turns out that even back in those ancient days there were quite a number of alternative treatments that had been in use here for quite a while. It took a couple of visits to the states, but they soon had him on a common drug regimen that made his life a lot better.
In passing, they got a lot closer over time and got married. He came down here and went to school and became a Nurse Practitioner [not a Licensed Practical Nurse] but rather the equivalent of a Physician’s Assistant able to see and diagnose patients.
A bit later we heard about Carl’s mother. His family, like I understand Pengun does, lives in Port Hardy on the northern tip of Vancouver Island. She needed an MRI for diagnostic purposes. At the time in all of Canada there were only 4 medical MRI’s in the country, the westernmost of which was in Edmonton, Alberta. A little over 1000 miles and days of travel from Port Hardy. I will note there were a number of MRI’s on Vancouver Island, but they were for veterinary purposes only in veterinarian’s offices and could not be used on humans.
About that same time I got tired of an old injury to my knee. It had been aggravated fighting a felon. I live in a small town in the mountains of Colorado. Our hospital did not have an MRI. The nearest one was either 40 or 50 miles away in other hospitals depending on which way you went. However, a private company had one in a semi-trailer that made rounds of small town hospitals so they had access to one, one day a week.
I called the doctor Monday. He referred me to a local ortho specialist who I talked to [by phone] and got an order for an MRI when it came to the hospital on Wednesday. Got the MRI on Wednesday and saw the ortho on Thursday when he explained what he was going to do. . . on Friday. Surgery on Friday morning, home Friday afternoon to heal. It was all covered by my insurance and cost me nothing out of pocket. From the first call to my family doctor to specialist surgery, by way of an MRI, was 5 days. I think our pre-Obamacare system won.
Subotai Bahadur
All the people who are Canadians are the same to me. I don’t care about their racial background, what they look like, where they came from, as what they do as people, is what matters to me. I am not a racist.
Yeah, sure. I’ve run into hypocrites like you before and every single one of you hypocrites refuse my offer of personal enrichment, my plan to make you wealthier. I offer to sell a person’s home and then, as their authorized agent, I will insure that they purchase a home of identical square footage and identical lot/acreage size and can double, or more, their money. Seems that homes in ghettos go for a fraction of the cost of homes in non-ghettos, and because folks like you don’t see race as an issue, you should be happy living in a 96% Somali neighborhood in a house of identical size to the one you presently live in and reap beaucoup bucks. How come you communists don’t like “free” money?
Mike,
Canadians seem to suffer an inferiority complex with respect to America. While Americans point to numerous historical people and events and practices as characterizing America, the CBC polled Canadians and they couldn’t think of anything other than socialized medicine as being the glue which holds them together (thank Multiculturalism for that – the exact same process is taking place now in America with the erasing of “historically problematic” figures, practices, beliefs, history)
Subotai,
Lots of Canadians think they have a fine system, they suffer with their Pepto-Bismo remedies under the false belief that they’re receiving world-class healthcare on the cheap through the magic of socialized medicine, but then when the SHTF and they have a real health crisis in their life, that’s when they run into severe rationing and substandard care. That’s when they pay out of their own pocket in Spokane or book a flight to a Mexican private medical clinic.
Canadians seem to suffer an inferiority complex with respect to America.
This is what you see with you-know-who. Canada had a great history of medical care back 120 years ago. Osler was Canadian. So were Banting and Best. Of course, MacLeod, a typical Canadian, stole the credit and Best was excluded from the Nobel Prize. Best went on to a distinguished career and MacLeod disappeared from history.
In 1972 the Nobel Foundation officially conceded that omitting Best was a mistake.
Yes, MCS, but I think the culture – e.g., the students take responsibility as a tradition – was not unimportant. And you are right, the consideration of what mentoring needed to be done and what level of expertise needed to be valued in the project would have helped. But the administrators (and I think the Faculty Senate) was completely resistant to it ever happening again. We live four or five blocks away and some a bit closer also worried about any flying sparks in a dry season – though I don’t think that was ever a problem. At that point, with the year of mourning, halting it was understandable. And of course the question is how much more mentoring needs to be done now than 100 years ago? The height and massive machines weren’t around then, of course, though the actual gathering of a bunch of wood to be burned in one night (and often in a couple of hours) would seem remarkably unchanged.
(Notice our friend was a cultural geographer, not an engineer, though that specialty does do more science than most of us in that kind of area.) The “conservatism” he values is different from some of ours, but it made him one of the few faculty that tried to understand the tradition (one of the guys from my husband’s dept. thought they should never have been allowed to do it because of the waste of electricity in the spotlights as they built it, many had little sympathy for the project at all). When a call went out to get students to replant trees (I think it was) after the great Bastrop fire, 97 of the students that showed up were Aggies, three were from other schools. The sense of personal responsibility and duty, of pleasure in work and working together, in physical tests is still one of its strengths.
While he got his paper published in the flagship journal of his profession, it wasn’t until a lot of critiques had gone back and forth. For instance, one complaint was that he used sexist language, referring to the students with male pronouns in discussing earlier bonfires – apparently unaware that it was an all male military school into the 60’s.
“Yeah, sure. I’ve run into hypocrites like you before and every single one of you hypocrites refuse my offer of personal enrichment, my plan to make you wealthier.”
This is Nigerian Prince level of BS. I know a bit about Nigeria as my father was sent there when I was 5 and I went along. He was a Captain in the British Army, many Canadian officers went into the British Army right out of RMC as the British had lost so many junior officers.
We had a compound with a house and a small village full of servants at the bottom of the garden. My best friend was the cook’s son Suli and we were quite a wild little pair back then. He showed me the bush and we were very good friends for several years.
Oh yeah. A great many Canadians think Americans are just dumb. I don’t know anyone who would want to live in America, so you have pulled the “inferiority complex” from the usual place, don’t get any on yourself. ;)
I don’t know anyone who would want to live in America, so you have pulled the “inferiority complex” from the usual place, don’t get any on yourself. ;)
We are quite happy to have you and your ilk stay in the frozen north. My grandmother headed south and married my grandfather in Illinois. The one good thing that Canada still has is the family history library in Toronto. I spent some time there about 20 years ago. I don’t know anyone who moved TO Canada. All I know are those who left.
Canadian immigrants living in the U.S. in 2016…..783,000
U.S. immigrants living in Canada in 2016…..253,700
This despite the fact that the U.S. population is approximately 9 times that of Canada.
https://www.migrationpolicy.org/article/canadian-immigrants-united-states-2016
https://canadaimmigrants.com/us-immigrants-to-canada/
Canadian medical anecdotes, FWIW:
In the late 90s I was president of a health care alliance in Lake Charles, Louisiana. We negotiated with doctors for better rates for our members and so I got to know many local doctors. Surprisingly to me, we had a number of fairly recently arrived Canadian doctors who had fled the Canadian system. Their reputation was excellent in the area. One told me that if it wasn’t for family ties, there wouldn’t be a Canadian doctor left in Canada. Hyperbole perhaps, but reflective of the way they and their friends felt.
My son taught English in Korea in the late 90s and met a Canadian girl who was also teaching there. They became engaged and when their contracts we fulfilled, they moved back, he to the Baltimore area and she to a small town in western Ontario. There was a waiting period of several months before all the necessary paperwork could be processed to allow her to immigrate to the US. During this period a very suspicious-looking mole was discovered on her leg. Her local doctor made an appointment for her to see a dermatologist in Toronto, but the wait time was about 6 months. She called my son to tell him about this, and he told her to leave immediately and drive to his place in Baltimore, which she did. He called his doctor, who called a dermatologist at Johns Hopkins and they got her in 2 days later. The mole was an advanced melanoma. They had it off 2 days later and radiation started that week. The Hopkins guy told her and my son that it would surely have metastasized had she waited even a couple months.
In about 2010, a friend of mine who was a pilot got laid off from his job with a “fractional ownership” airline and took a job with a medical-transport company. He was based in Idaho. The bulk of his flights were flying Canadians from the middle of the country to the US for treatment, and, as mentioned earlier, for deliveries in problematic pregnancies. Many were emergency runs.
Recently, a Canadian friend badly needed a knee replacement. It took 2 years after that recommendation to actually get it done.
The US system is far from perfect (and getting worse, IMO), but it certainly is superior to Canada’s.
“Recently, a Canadian friend badly needed a knee replacement. It took 2 years after that recommendation to actually get it done.”
Amazing. My Step Grandfather, a Goldman Sachs alumnus, was given one at 93, 4 years before he died, as he was still playing tennis. They judged he could use one and gave him one, just a few weeks after they made the decision.
Canadian immigrants living in the U.S. in 2016”¦..783,000
U.S. immigrants living in Canada in 2016”¦..253,700
I’d like to see a breakdown of who immigrated when, specifically, the numbers of Canadians who are recent migrants to the USA vs. Americans who went to Canada to avoid the draft.
Lots of troll anecdotes.