# Access to medical care or "Do you really want a doctor who can't afford a Ferrari?" **URL:** \ **Category:** In My Humble Opinion\ **Created:** [May 8, 2017, 5:23am UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115 "2017-05-08T05:23:41Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [May 9, 2017, 4:06pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/61 "2017-05-09T16:06:49Z")
> [@Jophiel](#): > > True but misleading. Earning MW+1¢ qualifies you to be “earning more than minimum wage” and, without a MW, the floor drops out. “Oh, you’ll start at $1/hr but get a raise in 120 days of 3¢”. “Hooray, I’m making $1.03/hr! I’m not minimum wage!” Hell, setting the floor at a buck allows companies to say “We’ll hire you for 5x minimum wage!” and put people to work for under the current wage. Today’s wages and salaries are set around a floor based on MW – someone makes $12/hr because they’re “worth” more than the minimum floor for labor. Drop the floor and you drop wages. The idea that we would do away with minimum wage and continue paying retail workers $11/hr is incredibly naive. > > Given that we’ve had government programs and protections in place for many decades now, your question is really more of a defense of that intervention than a defense of capitalism itself. We have fewer workers at the bottom because we have protections in place to keep them from hitting there. Your contention that all compensation is based around the minimum wage is easily testable. Simply see if any increases in the minimum wage correspond to sudden jumps in the amount of wages paid for all workers. Obviously the answer is no, ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [May 9, 2017, 4:08pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/62 "2017-05-09T16:08:23Z")
> [@Jophiel](#): > > TGiven that we’ve had government programs and protections in place for many decades now, your question is really more of a defense of that intervention than a defense of capitalism itself. We have fewer workers at the bottom because we have protections in place to keep them from hitting there. Can I interest you in an [anti-tiger rock](https://www.youtube.com/watch?v=xSVqLHghLpw)? ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [May 9, 2017, 4:10pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/63 "2017-05-09T16:10:53Z")
> [@puddleglum](#): > > Your contention that all compensation is based around the minimum wage is easily testable. Simply see if any increases in the minimum wage correspond to sudden jumps in the amount of wages paid for all workers. Obviously the answer is no, Sudden? I never said sudden. Does raising minimum wage cause other wages to rise over time? Yes, of course. You can’t get away with paying your shift manager as much as your entry worker. Will lowering it cause other wages to diminish over time (if only by laying off more expensive employees and hiring in cheaper ones)? Of course it will. Saying that it has to happen “suddenly” is a strawman. ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [May 9, 2017, 4:12pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/64 "2017-05-09T16:12:19Z")
> [@puddleglum](#): > > Can I interest you in an [anti-tiger rock](https://www.youtube.com/watch?v=xSVqLHghLpw)? Oh, is that a Simpsons clip!? How cute! Or, you know, we can look at actual history and see how working class conditions fared prior to those labor laws or how working class people fare in nations without protections. But hey! Simpsons! ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [May 9, 2017, 4:29pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/65 "2017-05-09T16:29:05Z")
> [@puddleglum](#): > > Luckily we have a class of people who are fully informed and rational that can make the decisions for people, we call them politicians. You so funny. 😛 ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [May 9, 2017, 4:37pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/66 "2017-05-09T16:37:16Z")
> [@Jophiel](#): > > True but misleading. Earning MW+1¢ qualifies you to be “earning more than minimum wage” and, without a MW, the floor drops out. US median household income is almost $52K a year. Why is it not closer to $16K, or something closer to MW+1¢? Why, in other words, hasn’t income dropped closer to the current floor? Regards, Shodan ---
**Author:** ![RickJay](https://avatars.discourse-cdn.com/v4/letter/r/bb73d2/32.png) [@RickJay](https://boards.straightdope.com/u/RickJay)\ **Post date:** [May 9, 2017, 4:42pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/67 "2017-05-09T16:42:08Z")
> [@constanze](#): > > I want a doctor who choose his field not in order to make Money Hand over fist, but in order to care for his patients. > > If he owns a Ferrari\*, that means he is interested more in Money and Status than in his patients. > > How would I know, even if I were a millionaire, that he will do what’s best for me, and not what’s best for him? Honestly, none of this has a damn thing to do with good medical care. I really don’t give a shit what my doctor got into medicine for, and given that my doctor got into medicine 25 years ago, it hardly means anything now. If your doctor likes fancy cars, that has no bearing at all on whether or not she’s a good doctor. None. The doctor who drives a Honda might just have expensive tastes in boats. ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [May 9, 2017, 4:44pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/68 "2017-05-09T16:44:00Z")
> [@Shodan](#): > > US median household income is almost $52K a year. Why is it not closer to $16K, or something closer to MW+1¢? > > Why, in other words, hasn’t income dropped closer to the current floor? Already answered. Specific labor is valued at X% over the floor. You can’t pay your lead cashier the same as your entry cashier or else no one would want the extra work of being lead cashier. Likewise, it’s not worth 4x the wages of an entry cashier to be the lead cashier. It doesn’t settle closer to the floor if the floor itself doesn’t move but will absolutely drop if the floor is lowered. Let me ask you directly: If the minimum wage was abolished (Fed/State/Local) next week, do you think, a year later, that Walmart cashiers would make the same hourly wages on average as they do now? ---
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [May 9, 2017, 5:03pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/69 "2017-05-09T17:03:31Z")
> [@Jophiel](#): > > Let me ask you directly: If the minimum wage was abolished (Fed/State/Local) next week, do you think, a year later, that Walmart cashiers would make the same hourly wages on average as they do now? I would expect them to continue the current upward trajectory we see in areas currently only paying the fed minimum. ---
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [May 9, 2017, 5:09pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/70 "2017-05-09T17:09:41Z")
> [@Ruken](#): > > I would expect them to continue the current upward trajectory we see in areas currently only paying the fed minimum. That should be areas where only the federal minimum is in effect, since Walmart doesn’t pay anyone that. In areas where the local wage is high, like $15/h, I’d expect it to go down. Assuming they have any stores there. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [May 9, 2017, 5:20pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/71 "2017-05-09T17:20:28Z")
> [@Jophiel](#): > > It doesn’t settle closer to the floor if the floor itself doesn’t move but will absolutely drop if the floor is lowered. Why hasn’t it settled closer to the floor? Your allegation is that wages seek the lowest possible level, and are only prevented from falling further by MW laws. Why haven’t wages sought the lowest possible level? None of the rest of your post addresses the question. Regards, Shodan ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [May 9, 2017, 5:24pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/72 "2017-05-09T17:24:54Z")
Ironically, Walmart increased wages recently in its efforts to stave off unionization, another product of the early 20th century in response to how well capitalism was working. Add in there things like OSHA, environmental protections, protections for employees suing employers and later anti-discrimination laws. And, again, this was after that period where capitalism was on the “We should literally own human beings as property because it’s cheaper than hiring workers” kick. Sure, capitalism does a bang-up job of protecting the worker left to its own devices so naturally it’s the best source for healthcare 😃 ---
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [May 9, 2017, 5:30pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/73 "2017-05-09T17:30:27Z")
> [@Jophiel](#): > > Ironically, Walmart increased wages recently in its efforts to stave off unionization Cite that this has anything to do with unions? ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [May 9, 2017, 5:30pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/74 "2017-05-09T17:30:46Z")
> [@Shodan](#): > > Why hasn’t it settled closer to the floor? [Already](http://boards.straightdope.com/sdmb/showpost.php?p=20194107&postcount=57) [explained](http://boards.straightdope.com/sdmb/showpost.php?p=20194305&postcount=68). I literally talk about how wages can not, as a whole, collapse to a certain level. If you’re not understanding it, I apologize but I can’t explain it any clearer than that. ---
**Author:** ![Jophiel](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jophiel/32/66_2.png) [@Jophiel](https://boards.straightdope.com/u/Jophiel)\ **Post date:** [May 9, 2017, 5:32pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/75 "2017-05-09T17:32:54Z")
> [@Ruken](#): > > Cite that this has anything to do with unions? No thanks. Walmart won’t say “The unions scored a partial win” in response to the decades long fight but if you want to work on the belief that they’re unrelated since Walmart hasn’t explicitly said it, I’m okay with that. ---
**Author:** ![iamthewalrus\_3](https://avatars.discourse-cdn.com/v4/letter/i/258eb7/32.png) [@iamthewalrus\_3](https://boards.straightdope.com/u/iamthewalrus_3)\ **Post date:** [May 9, 2017, 5:44pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/76 "2017-05-09T17:44:51Z")
I want a world where everyone can afford a Ferrari. But we should maybe start by making sure everyone can afford not to die of preventable and treatable diseases. ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [May 9, 2017, 6:21pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/77 "2017-05-09T18:21:47Z")
> [@Jophiel](#): > > Already answered. Specific labor is valued at X% over the floor. You can’t pay your lead cashier the same as your entry cashier or else no one would want the extra work of being lead cashier. Likewise, it’s not worth 4x the wages of an entry cashier to be the lead cashier. It doesn’t settle closer to the floor if the floor itself doesn’t move but will absolutely drop if the floor is lowered. > > Let me ask you directly: If the minimum wage was abolished (Fed/State/Local) next week, do you think, a year later, that Walmart cashiers would make the same hourly wages on average as they do now? If minimum wage was set to $50 dollars an hour, what would happen to the wages of heart surgeons? ---
**Author:** ![puddleglum](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/puddleglum/32/137_2.png) [@puddleglum](https://boards.straightdope.com/u/puddleglum)\ **Post date:** [May 9, 2017, 6:29pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/78 "2017-05-09T18:29:34Z")
> [@Jophiel](#): > > Sudden? I never said sudden. Does raising minimum wage cause other wages to rise over time? Yes, of course. You can’t get away with paying your shift manager as much as your entry worker. Will lowering it cause other wages to diminish over time (if only by laying off more expensive employees and hiring in cheaper ones)? Of course it will. Saying that it has to happen “suddenly” is a strawman. How long does it take? From 1982-1990 the minimum wage did not go up at all. During that same time the total wages in the economy went up 70%. From 2004 to 2012 the minimum wage rose three times from 5.25 to 7.25 and total wages in the economy went up 30%. That is the exact opposite of what your model predicts. ---
**Author:** ![Ruken](https://avatars.discourse-cdn.com/v4/letter/r/f475e1/32.png) [@Ruken](https://boards.straightdope.com/u/Ruken)\ **Post date:** [May 9, 2017, 6:46pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/79 "2017-05-09T18:46:41Z")
I wonder if credibility exhibits a Doppler effect. At least we’re getting our lulz this afternoon. Does anyone else miss that “my post is my cite” guy? > [@Ruken](#): > > Cite[…]? > [@Jophiel](#): > > No thanks. 😃 ## How about you give what you wrote just one more hard thought and let us know if you still believe it. In case you’re interested, union affiliation stats are available from BLS. Because data. Back to the OP, I’m wondering what it means to afford a Ferrari and whether most physicians can afford them. I don’t even know how much one costs and wouldn’t recognize one if I couldn’t read the label, so I checked. Searching for ferrari pricereturns “Ferrari car prices range from $188,425 and go upwards of $400,000.” My 15-year-old Honda could use an upgrade, but that’s certainly more than I’d like to spend on a vehicle. But I could. It would be dumb, i.e. eating into and forgoing future retirement savings. Maybe we should look at a typical household. BLS [tells us](https://www.bls.gov/news.release/cesan.nr0.htm) the typical $70k/year (pre-tax) household spends about $4k/year on vehicle purchases, or less than 6% or their pre-tax income. People who buy Ferraris probably don’t get normal car loans, but until we learn more let’s say the cost is spread over five years. For the cheaper cars, that’s about 40k/year, or 10x what the typical household spends on cars. More random googling tells me median physician pay is \<$190k. I don’t think a Ferrari is a good choice for the typical physician. Which is probably why my close physician friend drives a Hyundai. She could probably do it if she wanted, but kid/husband/house/etc. But you’ll always find a few who really like fancy cars and who make those a priority. At \<$200k, the net present value of medical school is lower than I expected. We’re talking about reasonably smart and hard-working people who could command a decent wage elsewhere. So they’re forgoing wages entirely for four years. Then earning low wages as residents and (optional) interns. And that’s before we get to tuition. And once they do start earning the big bucks, they’re taxed at a high rate. The math varies by specialty, obviously. Wages vary, as does training time and career length. Does anyone know what portion of medical costs goes to physician wages? I’m getting wildly different numbers from random googling ([8%](https://www.jacksonhealthcare.com/media-room/news/md-salaries-as-percent-of-costs/), [20%](https://economix.blogs.nytimes.com/2008/11/14/do-doctors-salaries-drive-up-health-care-costs/?_r=0)). Maybe we pay way too much here compared to other countries, but I would expect high costs here even if we cut physician wages in half. ---
**Author:** ![constanze](https://avatars.discourse-cdn.com/v4/letter/c/f9ae1b/32.png) [@constanze](https://boards.straightdope.com/u/constanze)\ **Post date:** [May 9, 2017, 7:00pm UTC](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115/80 "2017-05-09T19:00:25Z")
> [@RickJay](#): > > Honestly, none of this has a damn thing to do with good medical care. I really don’t give a shit what my doctor got into medicine for, and given that my doctor got into medicine 25 years ago, it hardly means anything now. Replacing “expensive car” with “expensive boat” doesn’t change the main argument: if your doctor is more interested in making money in order to buy espensive stuff, then how do you know he won’t choose the most expensive treatment, instead of a cheaper one that’s better for you? Or just bill you for completly unneccessary procedures? > [@](#): > > If your doctor likes fancy cars, that has no bearing at all on whether or not she’s a good doctor. None. The doctor who drives a Honda might just have expensive tastes in boats. That argument was made by the author of the article, the implication that “Good doctor = high income = expensive toys”, which is obviously a faulty metric. Remind me of that old joke: A couple moves into a small town, and go around looking for a new house doctor (GP in the US?). They notice that at each doctor’s practice, several balloons are flying, so they ask a resident “Excuse us, what’s the meaning of the balloons?” The resident says “Well, by local law, each doctor must fly a balloon for each patient that died under his care”. “Oh, thank you” the couple says. So they walk and see one practice with 20 balloons, the next one has 15, and then they see one with only 5 balloons! So they enter and say “We want to become patients at this practice” and the doctor says “Wonderful! You know, considering that I opened this practice just 2 days ago, there are sure a lot of people coming!” [Previous page](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115.md?page=3) [Next page](https://boards.straightdope.com/t/access-to-medical-care-or-do-you-really-want-a-doctor-who-cant-afford-a-ferrari/786115.md?page=5)