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"If supply-demand is in the Nurse's favor, then don't they get more leverage on what QOL and wages they can demand?"

I have a family member who works in public health and is trying to staff nursing positions. She has something like a $400k budget to hire 4 nurses at $100k each (let's say). She is unable to fill the positions because cost of living in her area has gone up so much. She'd rather have 2 nurses at $200k each instead of zero nurses, but she's simply not allowed to do that. She's trying to change policy but it's a massive uphill battle.

Power's concentrated very high up in health care, and it's exercised through the use of rigid policies. It certainly seems like nurses should command higher wages, but the bureaucracy has become very effective at preventing basically anything from changing quickly.

> 'leave nursing' and then what

When we got married, my wife (Physicians Assistant) made handily more than I did. $140k to my $82k midwest, software development job.

10 years later, she makes $130k (after cutting hours back) and I make $4-500k as a software engineer in the midwest. The two markets crossed drastically

Where are they going?

For us, home.

$500K as a software engineer? That's the very tip of the unicorn's horn. My friend works as a CEO of a (smallish) software company and makes half that.

This forum almost certainly skews heavily towards people in Silicon Valley or working at Bay Area companies. AKA the very highest earning people in tech.

It's the difference in working at a public company that offers RSUs and bonuses vs working for a startup. Your base salary will be somewhat similar, but startups can't compete on total compensation.

> I make $4-500k as a software engineer in the midwest

This is a massive outlier though. In your case, the exception proves the rule.

The rule: "The 1% of Nurses that found a partner in the US top 1 percentile will be able to quit their job."

OK fair, but let's say that making $250k as a senior/experienced software engineer these days is fairly middle of the road. It's still double.

(I managed a team where post-Covid, 3 left to make >$500k, 2-4 round up the $3250-$425k range. It sure _feels_ average)

$250k is only middle of the road for a senior engineer in places like The Bay where the majority of jobs are at big, successful public companies.

Outside of that, $250k is pretty much top of the like for a SWE.

Exactly. I don't know if anyone under an architect or director can get over 200k here. Still, you can support a family on 150.

It is a fairly common problem. We extrapolate our perceptions of the world from our peer groups. I had to suppress my urge for saying I am underpaid at $200k, because my non-tech (still STEM) MIT & Harvard grad-student room-mates would get annoyed at me. That's how messed up our circles can get, when STEM grad students MIT and Harvard are the poor ones. We live within many nested bubbles.

$250k still puts you in the top 2 Percentile of the US. So, while double the nurses would get to retire cuz of rich husbands, 98% would still be in the same pickle.

I feel like either you might be massively out of touch or this is a most not-so-subtle totally unverifiable flex ever.

I'm reminded of that episode of Arrested Development. "I mean it's just one banana Michael, how much could it possibly cost? $10?" "You've never actually set foot inside of a grocery store before, have you?"

> Nursing is a well paying

Only in a vaccuum. It pays far worse than other jobs at the same rate given the effort and stress the job entails.

> don't they get more leverage on what QOL and wages they can demand ?

Sure, but it needs to get far worse. The hospitals are only going to budge once walkouts are organized. But that can't happen without strong unions, most nurses just need to pay the bills which is why they continue to put up with it.

I'm not sure you understand who has the leverage. The hospitals can let healthcare deteriorate far beyond current expectations. They still get paid in the end. The environment for patients and nurses will only get worse.

> don't they get more leverage on what QOL and wages they can demand ?

Following up on this apart from my reply above, my observation is instead of raising pay they simply let roles languish. It's bizarre.

But then again it feels like that's what happens when nursing/AP care is treated as a cost center. It seems like they aren't concerned with addressing a market as much as keeping cost/income the same as it has always been.

What I read here instead is that the American people is fine with deteriorating healthcare, and will not regulate the industry, nor burst into a walkout of their own.

I find it cheaper to fly back to Europe and pay out of pocket (uninsured) for anything non-trivial along with my flight ticket than pay for California services. Only two things I miss: a) nicely decorated clinics and nurses taking my vitals and information instead of the doctor b) heart attack or stroke chance while reading the bill.

(Of course, I have the advantage of having people to stay with. Perhaps, Airbnb will start offering health services that way soon.)

/s

Seriously, we need to start looking as health care for its value as health care and not a money grab; we pay enough taxes to have a hospital running without the fear of profitability I believe -- in California at least.

Honestly, unless they're not in the midst of fighting a serious illness, most Americans just want to be sure that they have access to better healthcare than the people below them in the socioeconomic ladder. They're fine with healthcare deteriorating, as long as it deteriorates at least as much for the guy below them.

Now, if a serious illness comes along, some people do wake up and realize it's not a f*cking game. But certainly not all.

That’s such bullshit.

People here just have inherently less trust in the government providing good services. It has nothing to do with people below them on the socioeconomic ladder. People prefer the devil they know. That’s it.

Well you got my opinion right at least. Distrust in the government is exactly why I have always opposed government administrated Universal Health Care. Deregulation and elimination of most health insurance still looks like the best path, but things are getting bad and at this point I would support anyone willing to try a radical change.

Of course, Medicare already exists. It just only covers the retired and disabled. And while it has its flaws, it at least covers all Americans over age 65. And it's amazing the ferocity with which conservative retirees will defend their government-administered health insurance.

> It pays far worse than other jobs at the same rate given the effort and stress the job entails.

Depends on location. Most professions I know with that much effort and stress get paid a lot less than $100K, which is the median nurse pay in my area. Amazon pays a lot less.

Not sure what you're responding to.

My point is that you can get a BA and go sit at a decently cushy desk job for 60k-80k/year in many parts of the US. Nursing might pay a bit more but at much greater cost to one's health.

> Amazon pays a lot less.

Yes, I wasn't comparing nursing to jobs with much lower wages.

One difference is that you don't need a Bachelor's degree for nursing. Associate's degree suffices.

…in limited areas. Most higher paying nursing jobs are requiring bachelors degrees as of about 5 years ago.

I was thinking the same as your first point. I'm a career military officer and know a lot of military families[1]. My observation is that the spouses who are doctors and nurses are the only ones who can reliably find middle-class employment. Becoming a nurse is much easier than becoming a doctor, and pays much better than other common things like retail, food service, house cleaning, and photography (probably more of a hobby).

[1] The labor participation and employment rates for military spouses (especially when adjusted for age and education) are so low that they're almost off the charts. The causes are frequent cross-country moves to economically struggling locations, and an extreme need for flexible schedules (e.g. for when service members get deployed and spouses become de facto single parents). Medicine seems to be unique in that it's everywhere, always hiring, and often allows for part-time employment.

Health care is far from a free market for labor, IT, etc. It's one of the most heavily regulated and dysfunctional sectors of our economy. The normal incentives like supply and demand don't work the way they would in other industries.

> Not to be mean, but 'leave nursing' and then what ? Nursing is a well paying middle-class job without a lot of transferable skills to other professions.

Whelp, that the whole point. When you have a good paying job and people are leaving in droves for ??? anything else, maybe even teaching or staying home. That's a bad sign.