Monday, June 23, 2008

Catching up with comments

I don't get too many comments here, and some of the ones I have received, particularly since I criticized the non-newspaper called Triblocal (see here and here), have been pretty scurrilous. Others have just been dim-witted. Most, however, have been interesting or thought-provoking, and I always like getting those (my post last week on libertarianism generated some very good comments; I shifted my view a bit, but still think libertarianism has some serious image problems that will continue to interfere with its viability as a major political force...as a party).

A while ago, I got into something of a dust-up on another site with someone named mcfnord (I'll assume for convenience that mcfnord is male - my apologies if I assume too much). While not a major contretemps, we did have a disagreement that, in my opinion, came from a too-idiosyncratic way of looking at the issues we were discussing, the danger of generalizing from one's own particulars.

I'm pleased to be able to moderate my views based on a comment received from mcfnord on my post of last week, Yes, you get it. Without getting into a lengthy rehash of what was said there, I contended that our future as a nation is going to be compromised by current trends and our failure to do anything about them, and how "we need to reconcile ourselves to a somewhat lesser life than we anticipated." If I had known that mcfnord was going to comment, I would have expected something other than his actual comment:
We've been living beyond our means throughout the last decade (or two), culminating in a negative savings rate and huge federal spending deficits, so yeah, like economists like to say: the unsustainable ends eventually. Factoring out the new advances in medical care, mostly in pharma, lowers both costs and quality of life, but there will be a massive nursing shortage. Time for skilled labor immigration? Don't tell Carrie!

I am probably in a minority saying things are going well for me as compared to my parents. I do believe there's a "dual income trap" that didn't exist in my parents' era, but my response is to live far below my means. Communities that require a lot of gasoline are suffering, and there will be changes. I don't understand her statements such as "as we fill up our gas tasks each day..." but I know vast swaths of this nation built their civilization on the stuff, and they are suffering. I ride a bicycle. I live in an environment where that's viable. So I fill my gas tank each month or so. I'm not sure what people expected from home prices when the historical trend is 1% since the Great Depression. We all rode a bubble, and of course that's not sustainable. But I'm not convinced things are so different in this era. In the end, how useful and accurate an indicator is "gloom"? Mondale asked in his campaign, "So we'll all flip burgers?" and it didn't turn out that way. A willingness to adjust to market conditions, work hard, retrain, and save liberally for the future will probably continue to result in sustainable first-world standards of living.

Let's put it another way: Monofuel dependency, deficit spending, credit card abuse, home equity reliance, a meat-heavy diet, and a hope that nothing will ever change: WAS IT EVER A GREAT IDEA?
My response:
And so we begin to see a kind of convergence in our thinking, mcfnord. For all that some might accuse me of peddling gloom, my primary contention is not that we are in a "malaise," but in a state of denial. We're refusing to accept the reality of our future, and, in our belief that the way we live is the acme of progress, we'll be very disappointed.

mcfnord, we should absolutely do all the things you're talking about, though I continue to believe there are structural problems with some of your remedies (retraining is too easily passed off as just another economic transaction, whereas I believe it to be a major relationship change - far more wrenching - but probably necessary).

And those things you correctly point out as weaknesses in our way of living are, unfortunately, perceived by many as among our strengths. When a president tells us to spend our way out of our national trauma surrounding 9/11, it is no wonder we see
spending psychosis. Stability has become the goal for many, rather than the flexibility to ride and enjoy change (but I do think we as a nation are rather glib about the potential negative effects of change).

You say that we can continue "in sustainable first-world standards of living." I'm not sure exactly what that will mean, especially if the trends toward income and wealth inequality increase, but I do know that that will represent a major shock to a country that expects excessive, luxurious first-world standards of living. It is true that not everyone needs a big-screen TV, but everyone thinks they do, and the change in mental frame that is needed will be wrenching in a nation that sees those things, things that are unfathomable to the vast majority of the world's population, as absolute necessities.

One quibble: we're talking about vast long-term trends here, and, while I'm no apologist for Walter Mondale, that we aren't all flipping burgers yet does not entirely invalidate the statement (not that I believe that we all will be, either, just that we haven't played it out long enough to determine anything).
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By the way, I recently received a comment from Anonymous asking my opinion of HR 5924. Since this was also alluded to, if indirectly, by mcfnord, I will give a somewhat abbreviated response. (For those without an encyclopedic knowledge of House bills, this provides for more visas for nurses.)

It's certainly possible that this comment is an attempt to find some inconsistency in my thinking. After all, I have expressed doubt about the attempts to increase the number of H-1B visas, most of which would be used to give software development jobs to foreign nationals. So, if I were to come out in favor of HR 5924, one could easily posit a "Gotcha" response (perhaps in tribute to the late Tim Russert).

First, I don't know and don't profess to know much of anything about the market for nurses. When I comment on the profession of software development, it comes from better than 20 years of experience in that profession, and it would be pointless of me to think that knowledge qualifies me to have an opinion on nursing.

Second, it seems almost trivial to point out that every market is different. I don't contend the market for CEOs should have the same rules as those for software developers any more than I see equivalence between, say, baseball players and teachers. There would be no necessary inconsistency if anyone saw the need for different policies and practices in the market for nurses than for software developers.

Third, what I do know tells me that there are differences. Nurses have seen a major upswing in their market power of late (as far as I know), commanding bigger salaries and better terms of employment; software developers and most other engineers have not (by the way, I'm not contending that nurses even now get what they merit; it's an incredibly difficult job and I have the utmost respect for them). If, after the upgrades to the compensation, we still don't have enough nurses to fill real needs, then it might be necessary to do something different.

Have we, however, exhausted other possibilities before we leap on the expedient of importing more nurses? Or is this just taking the easy, cheap way? Are hospitals and medical corporations funding scholarships for potential nurses to go to school? Is the well-known nursing instructor shortage being dealt with in some way?

I don't know the answers to any of these questions, because I am not plugged into the nurse labor market. One thing I do know: we should ask some very serious questions about the specific numbers in HR 5924, because we don't know where they came from. One of my biggest objections to the various H-1B visa "adjustment" bills floating around is that the numbers seem plucked out of nowhere - 130,000, 180,000, 195,000. I don't think anyone knows what the "right" number is, and I'd be very surprised if the nursing market yields any greater precision.

3 comments:

Anonymous said...

As comment to Androcass:

I think we've been in a state of denial since we threw out Carter in favor of Reagan. I know Reagan commands some respect from history for his Cold War wrangling, but Carter said of the oil crisis "put on a sweater" and he was right. SUV's were wrong, trying to claim the remaining oil unilaterally through force was wrong, oil-first energy policy is wrong, borrowing from the future for non-investments is wrong, and all of it is rooted in denial. So it's been denial-as-usual for most of my lifetime.

But nowadays I feel optimistic. I see changes, I hear people talking, and quite a few people in my 'hood are excited by the challenges. The era of denial is cracking and our country seems more open to compromise and new ideas. Alternative fuels have been percolating for years, but only in the face of a price vice grip can these ideas gain real traction. Efficiency suddenly matters. So it is with information technology: People can telecommute, advanced communication and freight-reduction systems can be implemented, but now it's all happening. Necessity is the mother of invention.

I tend to avoid talking about what "everyone" thinks, wants, expects, and does. Mostly because I really don't know, and also because I don't care. Maybe "everyone" is totally stupid. What matters is what I want, expect, and do. Of course if I save for the future, and if nobody else does, I guess I'll need to move to Ronpaulistan with my guns and off the zombies closing in on my vegetable garden. But seriously, there's this guy at work who rants on and on about the looming apocalypse of environmental and financial irresponsibility... he's so annoying! because i am much more interested in what i should do. let others see wisdom in my words, or not.

The H1-B and Schedule A (the old name for the nursing visas) frequently go hand-in-hand, but they are completely different markets, worthy of separate consideration. In addition to visas, HR 5924 provides for grants to fund American training facilities. The average age of an American nurse is mid-40's, and now they're retiring, just as boomers get old and need care. It's been called a category-5 hurricane across the entire country in terms of damage.

The market differences are rather substantial: People want local medical care, but I don't suppose they care where their software is made or maintained. Resisting software immigration causes immediate offshoring of jobs, whereas resisting medical immigration causes suffering and cost increases here. The interest groups have divided among predictable lines: Hospitals claim the demand is serious, while nurse unions downplay it. I'm not sure how they do that straight-faced. The nation imported nurses for many years under the old Schedule A program, but wages still rose faster than inflation during that time. Isn't that indication enough that we're being driven by a demographic tidal wave, and not just labor market hiccups? Few debate the nursing shortage. Instead, the matter of "comprehensive immigration reform" derailed all "piecemeal" immigration legislation when the Congressional Hispanic Caucus (24 members) withdrew support for all piecemeal legislation, in favor of their CIR agenda. It's believed that this summer is the last opportunity to pass HR 5924, because more labor activity related to rights for illegal immigrants is scheduled for the fall.

I got involved in all of this when my friend the registered nurse with two degrees from American universities and could not accept the job offered to her. I had to convince her that America isn't stupid, just slow sometimes, and that she shouldn't just rush off to Canada or Australia. I've offered to loan her a large sum of money to partially fund her master's studies, starting in September. Her admission to the MSN program makes my political advocacy less urgent, because Congress is likely to act in time. But I've learned a lot from my dip into political advocacy, and generally believe now that skilled labor immigration is a net-win for the nation. People don't care where their software is written, but they do care about taxes collected from corporations and individuals.

I was offered two well-paying jobs today. Absolutely true. When will the erosion by immigrants shrink my pie, and won't they just work and pay income tax elsewhere, if they cannot here? How about we sell them an American education, and then send them home immediately to compete against Americans while enriching their country of origin! What a plan!

Anonymous said...

The nursing shortage is, in part, the result of "monopoly capitalism"
which HR 5924 has the intent and purpose to promulgate.
What is "monopoly capitalism'?
In "monopoly capitalism", capital is exported from a nation instead of the finished products of the country produced by a nations own workers.
What is "capital"?
Capital is money, labor, and industry.
With regard to "high tech" workers and nurses, labor is exported through "outsourcing" and unjust immigration policies which deprive a nations workers of their jobs, decrease salaries, and have an adverse affect on working conditions.
"Monopoly capitalism" tends to concentrate both wealth and political power in a few individuals and entities.
"Monopoly capitalism" tends to destroy "true capitalims" which is characterized as having "free enterprise and competition".
"Monopoly capitalism" tends to impoverish the general citizenry (in this case, high tech workers and nurses.).
Economic theorists assert that "monopoly capitalism" is the last stage of capitalism before some form of socialism replaces the same.
If we are to maintain our standard of living and our individual freedoms, we must address the adverse affects and causes of "monopoly capitalism" inclusive of opposing HR 5924.

Anonymous said...

Then it's astonishing how jobs for registered nurses will grow 23 percent by the end of this year, faster than the average for ALL OTHER OCCUPATIONS, according to the Bureau of Labor Statistics, obviously a conspiracy-oriented group. About half of the RN workforce will reach retirement age in the next 15 years.

Meanwhile, you claim there are jobless RN's manning the bread lines right now.

HR 5924 (1) sets aside a mere 20,000 employment-based visas in each of the next three years for foreign-educated registered nurses and physical therapists; (2) provide funds to help U.S. nursing schools expand the domestic supply of nurses; and (3) establish a three-year pilot program aimed at keeping U.S. nurses in the workforce.

During periods where these visa set-asides were in place, wages still rose and openings still went unfilled. Where's the monopoly? This is a demographic explosion of retiring people and a clear shortage of skilled labor. This is not a conspiracy.

Androcass, you must admit at least that there are some real crazies associated with the opposition to skilled labor immigration. You aren't one, but they're out there.

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