Sunday, February 8, 2009

"You Can't Always Get What You Want..."

I have seen it speculated in many places that the field of healthcare is where all the action is going to be in the future. The argument always put forth is that the boomers will all be getting on in years, and since there are so many of them there will be a lot of demand for medical care. Sorry, I have to disagree. Now, I wouldn't argue that one was a fool to pursue medicine or nursing. It's never a bad idea to learn new things and acquire technical skills, even if the field doesn't pan out the way you had thought. Expanding your knowledge base is always a good idea, at least as long as the skills are somewhat relevant to some kind of pursuit. I wouldn't advocate memorizing the 1913 New York City phonebook, but you get the idea. And as long as there is any demand, there will be demand for medicine. So there will be some demand for these skills. But we need to make one thing clear, and just so the boomers understand this, I'll use the prophetic words of one of their greatest icons, the Rolling Stones:
You can't always get what you want.
The whole healthcare-is-the-future-of-everything line of thought seems to subscribe to the dogma that the boomers "always get what they want." Why? I want a lot of things. Lots of folks out there want a lot of things. There is always demand. There are people in Zimbabwe who want medical care, possibly more than said baby boomers. I'm sure they would like advanced western medicines to treat their ailments. They can't get that. Instead, they have to settle for shamans and witchdoctors, or whatever sparing care they can get, and that's just the way it is. Clearly, we don't always get what we want. Human beings satisfy their needs within an economy. Markets are where people meet to exchange goods and services. It's not just about money. That is only the intermediary. What we have to ask ourselves is: what are boomers going to trade for medical care? Why will the medical profession serve them? What do they have to offer, over and above those unfortunate Zimbabweans? Their 401(k) holdings? Give me a break. Retirement holdings will be wiped clean by the stock market crash and the following inflation. There will be nothing left. So, what are the boomers going to ante up? I suspect the future is going to look a lot different than most people expect. There are really two possibilities for the boomers: go back to work and produce something that people want, or demand that government fill in the gap to buy what boomers can't afford once their retirement accounts are wiped out, at the expense of everyone else. I suspect the outcome will be a little of both. This means that for most people, there is to be no retirement other than death. It also means ever greater government burdens on present workers, which means America begins to look more and more like the third world. And the medical profession in the third world is far from stellar. I suppose it beats rummaging through garbage by leaps and bounds, but the reality is that third world doctors do not live like kings. It's not a bad gig, all things considered; they get by better than most. But it's far from a prosperous life on easy street. What I'm trying to say is that getting a medical degree is probably not a stupid thing to do, (unless, of course, you pay too much for it) but it is not going to save you, either. Don't get your hopes up. As always, just my humble opinion. Of course, there is the possibility that the government goes completely tits-up, in which case we Americans get to see what freedom really looks like. I suspect most of us won't like it one bit. All of which begs the question: given these dire predictions, what is going to be the most lucrative profession going forward? That one is easy: Gangster. In closing, I leave the reader with the lyrics of that Rolling Stones anthem, which looks to be the most appropriate theme song for the new American century: You can't always get what you want You can't always get what you want You can't always get what you want But if you try sometimes you just might find You just might find You get what you need I hope that last line proves to be as true as the first three.

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