this is continuation of the line of thought in my previous thread, about practicing medicine without American license in international waters.
Now, let’s consider an alternative approach to dealing with overly restrictive legal regime - organized crime. In many ways a gang operates (or at least can operate) as a mini-state, enforcing standards of behavior and, by threat of violence, preventing people from “cheating” against the pre-agreed rules.
So let’s consider this setup. There is a big customer base of poor Latinos, many of whom cannot afford American healthcare prices and probably cannot get at least some of the procedures done “for free”. Perhaps dental procedures would particularly fit the bill. There are also powerful gangs operating in their communities that can easily enforce rules like “you don’t rat on our medics to la Migra or the AMA, and you don’t sue them for malpractice either”. So they could bring in medical personnel from Mexico and have them work covertly servicing the trusted locals.
Well, so this sounds eminently sensible to me. Why do you think such things aren’t happening already? Or do you think they are in fact already happening but nobody told the Anglos?
I’m assuming it’s because medical schools aren’t really a big recruiting ground for Latino gangs. There aren’t that many doctors in the Latin Kings.
Also, beyond that, if I’m a gang leader, and I have to choose between selling coke and heroin or providing medical care to poor people who can’t afford legitimate doctors, I’m thinking the coke/heroin sales probably give me a better bottom line.
In my neighborhood there are a lot of poor latinos and lots of “cheap” doctors offices that work on a cash basis. 40 dollars a visit I think is typical. These doctors have lots of samples. Heck, a lot of these people quality for low-income assistance which includes some form of socialized insurance. No need for black market medicine.
Oh, I just watched a documentary about pain management clinics in Florida run by criminals. Essentially they hook up with a doctor who writes Oxycontin prescriptions to everyone. Due to the lack of regulation in Florida and the large margin on these drugs and an addicted customer, it becomes profitable and worth the effort. A small clinic that gives vaccinations and antibiotics? Not so much.
As mentioned above, I imagine Mexican doctors are pretty happy practicing medicine and making money in Mexico. They probably are not in the kinds of desperate financial situations that motivate people to leave their country. And, if they wanted to come to the United States, they’d probably do what it takes to be a legit doctor in America and make some real money.
You don’t have to put a doctor through school nor pressure them. There are always people in every profession who get in over their heads and need cash.
This includes doctors, dentists, well pretty much anybody.
You can simply bribe them. People who “overextend” themselves will fall for it.
My doctor only charges me $50.00 for an office visit, he’s Latino and his office is in the St Elizabeth’s Hospital in Chicago’s Humboldt Park, so I am 99% sure he’s legit, but who knows.
I had a temp job and I worked in a bail bonds office, just doing the clerical stuff and one thing that shocked me is how quickly people will rat each other out or do you a favour if you slip them twenty bucks.
I wouldn’t rat my friends out for $20.00 but believe me, virtually everyone did.
If people need money they’ll take the easy way out and if caught it becomes “Oh I got conned, I’ve always been a respectable member of the community.” They get a slap on the writst, don’t do it again, and the pushers move to the next doctor who charged too much on his Visa bill
Criminal organization in general, and especially gangs in particular, are very, very far from rational. Think about how important blood feuds and honor are - gangs don’t make decisions based on an analysis of expected returns vs. projected costs.
Actually, there is quite a bit of literature, such as Gang Leader for a Day, that illustrates how gangs operate on solid business principles. The top gang leaders are successful businessmen who are far removed from the day-to-day business of the streets. Lesser leaders act as middle management. I mean, drugs work on the principle of supply and demand, too. The gangs that make the smartest decisions will end up on top.
In most cases, the blood feuds and honor are there to provide fuel for the low-level street soldiers who maintain a gang’s right to run criminal enterprises on certain territory, etc. Much like the Vietnam war certainly wasn’t about “let’s kill some gooks!”, but that sort of rhetoric might be used to fire up the troops before a battle that serves a larger political goal. Indeed, according to the book above one of the main duties of a mid-level gang leader is to reign in the passions of the low-level thugs in order not to upset the careful balances that have been negotiated at the highest levels.
You’d have to be pretty down on your luck medical professional on either side of the border that after the strenuous push ups to become a doctor the best you can manage is to be a gang doctor. I can see a medical school washout doing this, but a real doctor would have better options in almost any conceivable situation than working for a gang. Plus think about it from rhe consumer’s end. Even poor people care about their health. Unless you are being sought by the popo’s almost any emergency room is better bet than a wanna be doc. Many will never pay anyway.
The doctor whom I believe is most responsible for my addiction problems wasn’t (to my knowledge) connected to a pain management clinic; he simply had a pharmacist on his staff. He would write prescriptions for damn near anything a patient might request and his pharmacist would fill those prescriptions at reduced rates. Sort of a one stop shopping experience, if you know what I mean. And my medical insurance paid for most of it. That doctors house was eventually bombed in what everyone believed was a drug deal gone wrong, although that was never proven.
My wife is a dentist from Mexico. One of her sisters is also a dentist, and one of her brothers is a physician (kind of a chief of medicine for a branch of his state government). As a consequence, a large number of our in-Mexico friends are dentists and doctors. Trust me, they all live very, very well, and they have no reason to leave Mexico for something “better” in the United States.
There are however many “dentists” who serve the immigrant community in Texas. They are typically not professionally trained in dentistry, and are certianly not licenced, though some have a certain level of training as say, dental assistants and whatnot. I wouldn’t be surprised if many of these illegal dentistry operations had connections with the Mexican and Costa Rican mobs in some way or another. It has gotten so bad that here in Texas we have actual Dental Police who are fully licenced peace officers that are tasked with shutting down illegal dentistry operations.
I lived in Miami for 10 years. My memory betrays me, but I seems to me that if I had $1000 for every time I heard/read about a black market dentist being busted (usually in an unassuming suburban house), I’d be able to retire @ 40.
Which is just a needlessly obtuse way of saying that I remember lots of unlicensed dentistry being busted in Dade county. I imagine for every one that was caught, a dozen more existed.
I find the criticism of my idea based on “Mexican dentists live very well” dubious. Global labor market is a numbers game. Some live well, some don’t. They don’t have to be Mexican. They can be from somewhere else, somewhere where the salary of a dentist is less than what can be earned by working in a “barrio” for “cheap” by American standards. The key point here is not the who lives how well, but rather the basic principle of violating licensing rules in this particular area (dentistry or medicine) using the unique characteristics of the Latino community. I mean, it’s not like they don’t have plenty of experience in violating other rules, like the rule about how many unrelated people can live in a single apartment
I would suppose there is an underworld medical industry, but presume it would be more based around old-country medicine men doing treatments not recognized by medical science.
I thought he came to the opposite conclusion. I haven’t read the book, but I’ve read his and Levitt’s paper “An Economic Analysis of a Drug Selling Gang’s Finances”, and they conclude, “The gang engages in repeated gang wars and sometimes prices below marginal cost. Our results suggest that economic factors alone are unlikely to adequately explain individual participation in the gang or gang behavior.”
For routine care, I think the low-income uninsured resort to either legitimate low-cost clinics or emergency rooms. There’s really not much room for a “black market” to develop that would make any kind of profit.
What I have heard of, usually when their work goes horribly awry, is an elective surgery black market that deals in things like silicone injections, sex-change operations, and amputations for apotemnophiliacs. I suspect that these businesses operate at such a low volume that they too are insufficiently profitable to interest organized crime.
I’m thinking gangs as in general organized crime. Finding the tools of the trade, especially drugs, for an illegal medical practice may put the proprietors in business with local crime syndicates.
