<<this is a complex issue and pat answers, on either side, do not do justice to it.>>
We live in a complex society. Many abstract models apply. If we go looking for the free market, we can find it. If we look at segments of our society, we (each from his/her own viewpoint/model) can find "unfairness", etc. One way of looking at this debate about fairness and physicians, etc. is that we live in a political economy. That is different than a truly free market. We levy taxes and reallocate income. The Clinton health care is an effort to say "Hey this aspect of the free market has run amok, and we are going to fix it." The political economy is dynamic. Taxes and income reallocations and laws that we pass today, we repeal tomorrow. We tinker with capital gains, health care, etc. all the time. The political economy imperfectly, dynamically balances voting power, "special interests".
There is a consensus that physicians should be well paid at this point in our society, as we want bright young minds to choose that path. There is considerable debate about what well paid is. Should the market determine it, or should we control it? The problem gets complex, as if and when we politically control it, bright young minds get to weigh in with their reaction to that political control. If, for example, Wall Street analysts make on average ten times the new administered wage for physicians, then what is the new balance? Then the political process probably revisits the issue and asks itself if the new balance is optimum.
We do this all the time. We want bright young minds to choose careers in education and vote to increase teachers' salaries.
Anyway, I am rambling. It is indeed complex. It is also dynamic. Individuals get to choose their path. They get to decide what is fair. They get to vote. They get to exercise their interest, "special" or otherwise. And sometimes the political economy gets to decide what is in the (imperfectly determined) "national interest" at a given time. Nothing stops the debate and the struggle or the ever-changing balancing mechanism. And nothing stops individuals from trying to cope with the ever changing landscape and its rewards and frustrations.
|
