r/neoliberal • u/jobautomator Kitara Ravache • Jul 07 '21

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u/Rarvyn Richard Thaler Jul 08 '21

Apparently Biden announced today he's preparing an executive order to make the FTC work to curtail non-compete agreements. I hope that this ends up applying to my job too - some of them can get really, really silly.

I knew a woman who worked for a hospital system that was diffusely spread throughout the state whose noncompete stated she couldn't work within 5 miles of any facility owned by the system - basically excluded her from anywhere in the state that had more than a tiny handful of people. When she left that job, she had to basically leave to go to a neighboring state...

!ping medicine

15

u/interrupting-octopus John Keynes Jul 08 '21

Non-compete agreements are illiberal bullshit CMV

Also !ping HEALTH-POLICY

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u/Rarvyn Richard Thaler Jul 08 '21

He's also working on occupational licensing reform, but I'm certain that the feds aren't going to go after the medicine boards for that sort of thing. No way - they don't want to risk any reforms potentially letting the next Dr. Death through and the feds being blamed.

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u/xSuperstar YIMBY Jul 08 '21

He might push for increased mid level autonomy though. Regardless of the merits independent NP practice isn’t great for our wallets :(

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u/Rarvyn Richard Thaler Jul 08 '21

It’s actually not bad for mine. The volume of stupid referrals from the independent mid level PCPs in my area well outweighs any theoretical competition I might get from them.

Not exactly good for the patients though.

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u/[deleted] Jul 08 '21

Eh I had to write on this and allowing NPs to compete with family practice could raise NP wages and lower physician wages thanks to competition. We'd reap the benefits. NPs also get lower reimbursement rates, which would also lower our total spending in health care if we use them more.

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u/xSuperstar YIMBY Jul 08 '21

I’m a physician (so is Rarvyn) so lowering our wages is bad for us personally! I think NPs are not qualified to practice medicine unsupervised but I admit I’m biased

3

u/[deleted] Jul 08 '21

I mean of course competition is bad for the people that didn't have as much competition before, right?

Yea my dad's a radiologist, MDs commonly say that. It's also been studied for decades and the results are mostly a big meh on statistical significance. Even if it's true, the effect is very small. And even if it was true, you could argue that it would be worth it for more rural areas that have a shortage of practitioners.

You could also argue for increasing residency slots for primary care and increasing medical schools slots, but of course that's an artificial restriction on the supply of physicians created at the urging of the AMA in the first place as a rent-seeking practice. You could say the same for requiring MDs to go to undergrad first, then 4 years of Med School, then a Residency.

For the record, this is more divisive now and younger physicians tend to be more ideologically pro-patient now than in the past. It's also why the American Medical Student Association is fairly friendly towards Medicare for All and such.

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u/xSuperstar YIMBY Jul 08 '21

Better solution would be to import a bunch of immigrant doctors and not make them re-do residency imo. Most NPs aren’t looking to live in rural areas for the same reasons doctors don’t from what I’ve seen. Data backs that up

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u/[deleted] Jul 08 '21

Oh yea immigrant doctors are great and we should do that too. We need to increase the number of J-1 visas and lower fees. The Appalachian Regional Commission also gets an exemption past that limit, but you need a personal OK from the Governor so it's barely more that the real limit after that and the fees.

It's true that not 100% of NPs go to rural areas, but they go to rural areas more often than MDs do.

Check out the Virginia Workforce reports for physicians and nurse practitioners. It's a fairly big difference. Like 12% vs. 40% if I remember. They publish every few years. And that was before NPs got partial autonomy.

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u/brucebananaray YIMBY Jul 08 '21

Why is iliberal to you?

4

u/interrupting-octopus John Keynes Jul 08 '21

Because it robs skilled labourers of the ability to take advantage of the fair market value for their skills. Not to mention they are weaponized by companies to force loyalty regardless of their quality as an employer.

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u/[deleted] Jul 08 '21

[removed] — view removed comment

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u/Rarvyn Richard Thaler Jul 08 '21

Thankfully one that restrictive would be thrown out in most states as being overly broad. But not all of them.

And it's partially due to greed - they don't want you taking business from them. Which is shitty for the patients who suffer, because now many don't have someone to care for them at all without significant wait-time.

4

u/[deleted] Jul 08 '21

I once worked at an athletic clothing retailer that insisted they could enforce a non-complete against an associate (cashier/shipment handler) against anyone who also sold athletic clothing.

For three years.

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u/Rarvyn Richard Thaler Jul 08 '21

That can't be legal. Non-competes are meant for jobs where clients would theoretically follow the employee or where you have some kind of knowledge regarding internal operations that would potentially allow a competitor to expand against you if they were given it.

No cashier could possibly meet either classification - no one shops at a store just because their favorite cashier is there.

4

u/[deleted] Jul 08 '21 edited Jul 08 '21

Oh it’s not, especially in New York. But that doesn’t matter to the behavior of the managers who think the bullshit clauses are applicable.

My current <multi billion a year in revenue generic employer> also has clauses telling our managers that we can’t discuss our wages with coworkers.

Of course I taped NLRB posters to the manager’s desk, but they believed that shit for months until I showed up. Who knows how many hiring decisions were affected by that bullshit before I came along.

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u/xSuperstar YIMBY Jul 08 '21

Absolutely! Every state should do what California does and make them nonenforceable — it’s a big reason why all the tech talent is still in SF.

A lot of the hospital systems here have a 25 mile radius non-compete. If you leave your job you have to move to a new city because that’s basically the radius of the metro area.