Sarah Kliff says that maybe medical school debt isn’t the problem behind the absence of primary care docs. She cites a couple of reasons:

1. A program for medical student loan reimbursement had absolutely no applications.
2. Those with the largest student loans tend to actually go into primary care, rather than avoid it.

It might be overstated as a reason, but there are other factors going into what she’s taking about that should be addressed. Clancy took a pass on Arapaho’s student loan reimbursement program. It had nothing to do with being unworried about student loan debts. Rather, it was based on (a) the bureaucratic difficulty of signing up and (b) committing to the job for six years. She signed a three year contract, and there will be a financial penalty when she leaves early, so San Mateo’s more generous program might have been something we’d have signed on with when we didn’t sign on with Arapaho’s. But specific programs that offer reimbursement often do so precisely because they are among the most uncomfortable jobs. the jobs that someone is least likely to want to commit to. And the repayment is often backloaded. And you’re making payments in the meantime anyway and interest is accumulating. And the jobs will often pay less than you could make elsewhere, with the student loan reimbursement failing to account for the difference.

As far as the second thing goes, well, there it’s more complicated as well. My wife graduated in the top third of her class and didn’t have to go into primary care. But a lot of doctors who end up going into primary care do so with little choice. I suspect that these people are also those with the most amount of student debt. They couldn’t get into a state flagship (as my wife did) and end up going to an expensive (non-elite) private college. I don’t know this to be the case, but I think it’s a factor.

To me, the really pernicious effect that student loan debt actually doesn’t have all that much to do with the dearth of doctors willing to go into primary care, however. Rather, it has more to do with the medical culture itself. The desire to make as much money as early as possible in order to get out from under. This makes high-paying jobs that, on the face of it, are questionable. There were jobs that paid significantly more than the job Clancy took. She took a pass, but the ability to pay off student loans in a year is tempting nonetheless. And while you might tell yourself that it’s temporary, I think that once you’re making that sort of money, it’s hard to go back. It sets the pace for contributing to The McAllen Problem.

So what’s the solution? I’m not sure. Relieving student loan debt for doctors who want to go into primary care may help, but since such programs are often so back-loaded, I’m not sure how much of an effect they would really have. Since they’re not something you can really count on, I think a lot of docs would end up taking the enterprising course anyway.

Not that I wouldn’t mind someone stepping in and taking care of that for us.

David Feldman pushes back against the notion that college is a poor investment:

Okay, but the price tag is still very high; is it worth it? Absolutely. A college degree is an asset whose average value is $300,000 to $600,000 of extra lifetime earnings, measured in today’s dollars. And this value has risen steadily for the past 30 years. Your mileage may vary, depending on what you choose to study, but earning a college degree remains one of the best financial investments a person can make.

Nobody is saying that earning this degree is a guarantee of financial success. Even today, 18% of the college-educated workforce in prime working ages earns less than the median wage of a high school educated laborer. But in 1972, the figure was 30%. Think about that the next time someone claims that a college degree simply doesn’t pay off like it used to.

The “your mileage may vary” is understated here. It’s not just a matter of what you choose to study. It’s also a matter of who you are and where you go. People who go to some schools will make more than people who go to other schools. This is attributable to both the who and the where questions (because the who can determine the where). I am not sure where Feldman is getting his numbers, but it’s typically based on averages. And that’s problematic because the people who go to college are not the same people who don’t. Those who graduate and not the same as those who don’t. If anyone wants to point me to some numbers that are comparing apples-to-apples, I’d like to see them.

When we talk about who should and shouldn’t go to college, we should be talking about the borderline cases. Are the bottom quartile of those who go to college better off than financially than the top quartile of those who don’t? This is an overly simplistic way of putting it, since college admissions is inexact and the top quarter of people who miss out on college may well be smarter and more capable than the bottom quarter who go and even graduate. Of course, if those are the results, they are telling in their own way. So you might need to find more apples-to-apples comparisons. Though even that could be problematic because Person A may forgo college because they already have a great opportunity waiting for them while Person B is smart, has good grades, but doesn’t actually know anybody.

If I were to guess, I would say that even if you account for all of the variables, a college degree is still probably going to pay for itself over the course of a lifetime. This does not speak to the value of education, though. Rather, it speaks to (a) the networking opportunities available at college and more to the point (b) the credentialism. People with college degrees get to cut in front of a lot of lines. If everyone has a college degree, it negates the advantage.

Barring something unforeseen, Clancy and I will likely be encouraging our children to go to college. To some, this would make us hypocritical skeptics of universal college education. Actually, it means that we live in the real world. It’s reconciling ourselves to the system we have. A system that says everybody should go to college. It means contributing to a perpetuation of the system, but not supporting it on any ideological level.

Before I start with this story, a personality tick of the Redstone Gazette: The Gazette has a tendency to mention the salaries of public officials in articles where the public official is important. I’ve never really seen that before, but the paper does it with such regularity that I think it is part of some policy (or something one of their main writers or editors simply wants done). It would be an interesting angle for a conservative paper in a conservative place, but Redstone is pretty heavily blue and the newspaper’s editorial staff is, as near as I can tell, no different. An interesting thing about this policy is that it can be oddly helpful at times. Knowing that the county executive gets paid more than the mayor, but that the city councilmen get paid half of what the county commissioners do, helps put things in perspective when it comes to who is running for what. But it’s a little weird to read, in the middle of an article about the schools, “Superintendent Davis, who gets paid $75,343 a year, announced…”

Anyhow, today there was an article about the city courts being so backlogged that they are on the verge of running up against “speedy trial” requirements and will start having to dismiss charges. This goes back to a previous story involving former Judge Mike Balasevic. Balasevic, who I was informed made $63,455 a year, resigned very suddenly last year. I was also informed that he had a part-time job with the school district as a janitor, making $11,575 a year (okay, I’m making the specifics up, but those are the ballparks). He was resigning as judge, but not janitor. This was an unbelievably weird article to read, because I’d never heard of a city judge working as a janitor, and quitting one job while holding on to the other… what the hell?

I should have seen the next part coming: Federal indictment. Bribery, of a pretty crass nature. They had him having taken roughly $14,000 a couple of years back (making more from corruption than cleaning). He’d later to at least ten bribes at a few hundred dollars a piece (and a few requests that the defendant put up a yard sign for his re-election). He plead guilty to a single count and received probation and $5k restitution. Anyhow, everything apparently screeched to a halt while this was going on until they found a replacement. Hence, defendants about to go free.

As far as I know, he still has that janitor job. I’ve never actually seen him at the schools. A teacher that I have substituted for more than once is named Mrs. Balasevic. I assume a relation of some sort, but I’m not going to ask (Mrs. B has actually offered to write me a letter of recommendation if I shift to subbing down here in Callie).

Dr. Manhattan writes about how our Special-Ed system favors the rich.

Louisiana is trying to revolutionize schools. They took advantage of Katrina and did a remarkable job improving the New Orleans school district (yes, even accounting for demographics). But the NO school system is very expensive and we need to find out what, if anything, we can scale.

More on cops and cameras.

The Washington Post had a good op-ed piece on how we might make adoption easier across state lines. If Clancy and I have trouble with our second (or, heaven forbid, our first), adoption remains a possibility. Given our preference for lowpop states, this is a potential issue for us.

You may have heard about Diane Tran, an honors student from Texas who was sentenced to jail for missing school due in large part to having to take care of her family. I wrote about it here. Well, the judge is trying to defend himself thusly: “I’m not mean. I just wasn’t doing my job!”

How dogs may have made humans thrive while neanderthals didn’t.

Bakadesuyo: Are we fundamentally the same person from childhood to adulthood?

When I was young, I was told that exercise was good for me and that rest was good for me. I thought that was great, because it gave me the choice between the two. I chose rest every time! So a new study suggests that exercise might be bad for you. I love science!

Josh Barro writes on how we can get the Internet Sales Tax right. I’ve written on the subject here before. I think Barro’s plan is actually quite good. The real sticking point here is local taxes, where it is a burden for online retailers to have to conform. His streamlining idea would take care of it.

We’ll see if I get around to writing a post on this, but for now, Slate writer Emily Shire asks if being a 29 year old should qualify as an accomplishment. The answer is, if it’s by choice, yes. Shire attempts to be value-neutral in her analysis, but it’s steeped with judgment. The main problem here is that she doesn’t want to grant Lolo Jones any plaudits when her goal is the result of sexual attitudes that Shire disapproves of.

I’m not intending to pick on Nancy Pelosi by linking to this, wherein she suggests $1m a year is “middle class.” Rather, I point to this article because it really does bring out the populist in me. It’s not healthy the extent to which we are governed by people with life experiences and expectations so different from our own. Pelosi is hardly unique, in this regard.

Timeshares are on sale… for a penny. There’s a condo unit near my parents house where they can’t give the condos away because the maintenance fees alone are $1200 a month in a part of the country where people are not accustomed to paying that much in rent for an unroomy dwelling.

Abigail Pesta asks if teens should be jailed for sex offenses. Well some, but not the sex offenses she’s talking about. Mothers of sons that have found themselves on the hook are the perfect advocates for this issue, which really has no home base of support.

The FBI is apparently worried about the effect the transition to IPv6 will have on their investigations. It’s coming closer and closer. I know what IPv4 and IPv6 are, but need to read more about how I might be affected.

While talking to a fellow Leaguer in Las Vegas, he talked about stopping in Fort Beck – in Deseret where I used to live – and getting completely unacceptable Mexican food. This came as a bit of a surprise to me because I found the Mexican food there to be very acceptable. As he described it, I was pretty sure that he stopped at Taco John’s. Taco John’s is big on putting tater-tots in everything. Then again, so are other places within Idaho and the states around Idaho, so it’s hard to say for sure.

Anyhow, Gustavo Arellano has an article about Mexican food in the US and how American it is:

The most popular restaurant in town that day was Taco John’s. I didn’t know it then, but Taco John’s is the third-largest taco chain in the United States, with nearly 500 locations. But what lured me that morning was a drive-through line snaking out from the faux-Spanish revival building (whitewashed adobe and all) and into the street. Once I inched my rental car next to the menu, I was offered an even more outrageous simulacrum of the American Southwest: tater tots, that most Midwestern of snacks, renamed “Potato Olés” and stuffed into a breakfast burrito, nacho cheese sauce slowly oozing out from the bottom of the flour tortilla.

There is nothing remotely Mexican about Potato Olés—not even the quasi-Spanish name, which has a distinctly Castilian accent. The burrito was more insulting to me and my heritage than casting Charlton Heston as the swarthy Mexican hero in Touch of Evil. But it was intriguing enough to take back to my hotel room for a taste. There, as I experienced all of the concoction’s gooey, filling glory while chilly rain fell outside, it struck me: Mexican food has become a better culinary metaphor for America than the melting pot.

Back home, my friends did not believe that a tater tot burrito could exist. When I showed them proof online, out came jeremiads about inauthenticity, about how I was a traitor for patronizing a Mexican chain that got its start in Wyoming, about how the avaricious gabachos had once again usurped our holy cuisine and corrupted it to fit their crude palates.

In defending that tortilla-swaddled abomination, I unknowingly joined a long, proud lineage of food heretics and lawbreakers who have been developing, adapting, and popularizing Mexican food in El Norte since before the Civil War. Tortillas and tamales have long left behind the moorings of immigrant culture and fully infiltrated every level of the American food pyramid, from state dinners at the White House to your local 7-Eleven. Decades’ worth of attempted restrictions by governments, academics, and other self-appointed custodians of purity have only made the strain stronger and more resilient. The result is a market-driven mongrel cuisine every bit as delicious and all-American as the German classics we appropriated from Frankfurt and Hamburg.

I’m all about equal opportunity. I love actual Mexican food. I love Tex-Mex. I love the bastardizations of Taco Bell and Taco John’s. We have a Taco John’s here in Callie, but not a Taco Bell. TJ’s is more expensive, but has better ingredients. If you don’t mind the tater tots. Which are actually not bad tater tots, especially if they’re right out of the pan. If you can deal with the incongruity of a tater tot infused burrito.

I was reading an article about Hewlitt-Packard and a sentence jumped out at me. The wording made me think that Lenovo had purchased Dell. My eyes shot wide open and I went googling and discovered that no, this bizarre thing had not happened. What happened was not that Lenovo had taken over Dell, but rather that they overtook Dell as the #2 computer seller in the world. I actually have mixed feelings about this. On the one hand, I’m all about the Thinkpad. On the other hand, Dell is an American company and I tend to root for American companies in the international marketplace (even if I don’t purchase their products).

In any event, it listed the top five makers in order: HP 17.7%, Lenovo 13.5%, Dell 11.6%, Acer 10.6%, ASUS 6.2%.

It seemed to me that Apple was missing from this. And bizarre that Lenovo was actually #2. And shouldn’t Toshiba be on there? Then I realized that this was the world market, so I looked at the US market: HP 28.9%, Dell 21.9%, Apple 12.9%, Toshiba 8.4%, Acer 7.4%.

That struck me as reasonable but for one thing: I never see HP’s anywhere!. Okay, that’s an exaggeration, but I see far more Thinkpads than HP’s out there. The workplace? Everywhere I’ve worked, just about, has gone with Dell. Maybe the home desktop market is where HP does well. But it’s just weird that they are so significantly on top and they’re maybe the fifth or sixth name that comes to mind when I think of computer brands.

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Ramesh Ponnuru takes on Trans Secretary Ray LaHood on cellphones and cars. I’m not saying that there isn’t a hazard, but the roads have never been safer. Not that we can’t be safer still, but some perspective would be nice.

I haven’t run across the new Batman-inspired flavor(s?) of Mountain Dew, but look forward to it. I’m running low on my previous promotional brands. I have to agree with ComicsAlliance that they are showing off a pretty sad Batman.

There is an argument for police seizures, but unfortunately it is undermined by how they work and the incentives involved.

Gabriel Rossman has some of the best writing on IP and piracy going on right now. Filling in for McArdle, he explains exactly why HBO won’t let you get Game of Thrones without cable. It’s an insight into some of the problems with vertical and horizontal integration. At the same time, though, these shows need capital. Take away the bundling, and the result might not be that you can get Game of Thrones for a “reasonable” subscription rate, but that Game of Thrones doesn’t get made.

Longtime readers know that I have long believed that China’s imminent threat to our domination is over-wrought. So naturally I approved of this article.

No doubt many read about the new study suggesting that long commutes are bad for the heart and nodded, pining for increased density. I still maintain, of course, that the easiest way to cut down on commutes is to move employers out rather than people in. If I recall, some studies have suggested that density itself is bad for the heart, too.

An interesting profile on WWE wrestler The Rock. He’s apparently created a niche for himself in rescuing troubled franchises. He also made a couple shrewd choices about his career trajectory along the way.

The Atlantic has a neat analysis of what those modem sounds mean. I actually had modem sounds as the ringtone on my last phone. Clancy hated it, but I never doubted if it was my phone ringing. Modem sounds on TV did fool me once or twice.

Last week, at the League, Nob Akimoto linked to to a story about a girl getting tossed in jail for skipping school:

A judge threw a 17-year-old 11th grade honor student from Willis High School in jail after she missed school again.

Judge Lanny Moriarty said last month Diane Tran was in his Justice of the Peace court for truancy and he warned her then to stop missing school. But she recently missed classes again so Wednesday he issued a summons and had her arrested in open court when she appeared.

Tran said she works a full-time job, a part-time job and takes advanced placement and dual credit college level courses. She said she is often too exhausted to wake up in time for school. Sometimes she misses the entire day, she said. Sometimes she arrives after attendance has been taken.

It’s tempting to chalk this up as a clear abuse of judicial discretion and leave it at that. It’s tempting because it is an abuse of discretion, but we really shouldn’t leave it at that. We should instead be asking ourselves why there was a crime for which the judge could do this. We should be asking ourselves what kind of pressures exist to make this a crime, and perhaps lead the judge to believe what he did was okay. (more…)

My trip down to Vegas took me through Real-Life Utah. There were some things that jumped out at me as worthy of note:

They’re combating Fatigued Driving in a constructive way. This is an issue that’s important to me because back when I was a full-time college student and had a full-time job and was writing at one paper and editing another, I got into two of these. I have also long worried about the hours my wife has worked and works and the toll it takes on her alertness. Anyhow, they have designated turn-off spots for fatigued drivers. This is good because if you are tired and pull over, you never know if you’re going to get ticketed (especially in a place that craves order like Utah). Letting you know it’s okay to do so, and where, is immensely helpful.

A good public/private partnership. In addition to public rest areas, they have also apparently worked things out with some way stations wherein they double as public rest areas. I guess the state pays these places some money and in return the restrooms are public, well-kept, and you won’t get hassled for loitering. This is an all-around win and I prefer these places to the actual rest areas and regular gas stations because if I want to buy something, I can (more than at a public rest stop), but I feel under no obligation to (as I do at a gas station).

Petting zoos. How family-friendly is Utah? Family-friendly enough that one of the gas stations had a petting zoo attached. With zebras.

Utah has 80mph speed limits. The signs all let us know that it’s experimental. They’re also heavily enforced. I’m not sure if that’s because of concern that drivers will take that as a license to go over 100 or because drivers already have. The end result is that on the way back, when the speed limit was 75 I drove 80 and when the speed limit was 80 I drove 80. Still, it’s a start.