Taken as advertised, as a story about the upper-middle class transitioning into the ranks of the super rich, today's installment in the Times's "Gilded Paycheck" series is, to quote RMJ's cousin, "boring." But taken as a story about new fronteirs of accumulation in an already deeply commodified set of professions and workplaces - the university, (and the business school,) the hospital, the nexus where the twain meet, etc., - the tale seems - at least to my admittedly obvious prejudices - more gripping. What exactly, we wonder, is "health care investment management,"and why is it so lucrative - so much more lucrative than actually practicing medecine?
As for the section on philanthropy, the valorization of the reagano-machiavellian spirit here - make shitloads of money for yourself so you can give lots of it away later and thus replace the welfare state with voluntarist and extragovernmental structures, of course ignores the baleful effects of the privatization of the commons and commodification of life-worlds by which these folks are amassing their fortunes in the first place. It seems unlikely that "health care investment management" is a victimeless crime. That money has to come from somewhere, and that means someone else's work is involved and rendered invisible by this tale of ingenuity (or canny mediocrity, as Robert Glassman himself suggests) and excess. A study might be made (that's me pretending to be Gramsci) of the forms of labor central to this story but excluded in the times piece, included but not limited to the lives of the health care workers and "consumers" upon whose backs Glassman's fortune seems to have been built.
There were two (not so profound) things about the article that I found particularly irksome.
ReplyDeleteFirst, about the suggestion that the oncologist was horribly deprived because he didn't have large savings at 35: of course he hadn't put a ton of money away, because he'd only finished his training a maximum of 3 years earlier. For better or worse, that's how medical training works in this country - you accrue lots of debt, you finish your post-grad training while making a decent but not great salary, and then you start paying down your loans in a meaningful way. Maybe not ideal, but the delayed earnings (if not necessary the 100-200 k of loans) are inherent to a profession that requires 7+ years of post-college training.
Second, I hated the last paragraph or two, which implied that the case of the guy who'd worked his way up to a $42,000/year salary after six years with the same company - and then left to get an MBA - was somehow in a similar position to the other men (and they were all men, weren't they?) discussed in the article. He may well end up as another zillionaire if his entrepreneurial career goes well - but that doesn't change the fact that his starting circumstances (at a firm where, I'm guessing, his odds of ever making $100,000/year were pretty much nonexistent) placed him pretty solidly in the (squeezed) middle class, not the high-end professional stratum.
And yes, a little more attention to where the profits of healthcare investors and investment-managers are coming from, exactly, would certainly be welcome.
The notion that 42k and 150 k are analogous was ridiculous, but then so was the unexamined assertion that six figure salaries constitute some sort of middle ground, given how many millions of people in this country live below or straddle the poverty line, -- and how disproportionately feminized this population is.
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