Noam Scheiber reports on our Bloggingheads back and forth, where in response to his argument that we could compensate doctors with prestige rather than money, I said:
We don't have a unified culture. There's no--Sweden can talk about having a Swedish culture, and to some extent a Swedish status hierarchy and Swedish values. That's just not true of America. Everyone's participating in about 97 different subcultures. So you can invent your own status hierarchy, but you can't get everyone to buy into the idea that we should pay our doctors $60,000 a year and then all love them a lot because they're doctors.
I guess Megan's point is that Sweden has a more discernible status hierarchy because it's a much more homogeneous country. And it sorta sounds plausible (though I still think most people are inclined to respect doctors regardless of whether or not they belong to the same subculture--all the more so if they're satisfied with their health care).
But then, a day or two after all this, I stumbled across this item from Matt Yglesias:
An interesting fact about Sweden is that an extremely high proportion of its population is foreign born. It's not the highest in the world--Canada and Australia take the crown--but the foreign-born are a larger proportion of the population than in the United States.
A large number of those immigrants are from other European countries, but apparently Sweden has one of the world's largest Assyrian populations.
Hmmm. It turns out even Sweden doesn't have a Swedish culture.
I could be wrong--I'm certainly no expert on Sweden--but my understanding is that Sweden has a very high immigration rate because of its extraordinarily generous asylum policy. However, these immigrants are not particularly well assimilated, and are not really the people who become doctors in Sweden. Indeed, the non-Western immigrants to whom Matt refers seem to have a horrifically high unemployment rate. Second generation immigrants, particularly those who are not from Northern Europe, appear to have severe lagging income gaps with ethnic Swedes. As Michael Moynihan said a while back:
[T]he plurality of the foreign-born in Sweden are Finns and Finlandsvensk-Swedish-speaking Finns-who are very much a part of the Nordic welfare tradition. This will soon change, with the influx of asylum-seekers from the Middle East, and we'll soon see how much stress this puts on the "Swedish model." That said, and as Geier seems to concede but not comprehend, the remaining 87 percent are native-born Swedes with, for the most part, a common cultural, religious/irreligious, social, and political heritage. This is, obviously, not the case with native-born Americans, a patchwork of ethnicities and religious affiliations. (Incidentally, I am an American-born permanent resident of Sweden.)
My impression is that the ethnic Nordics who have a higher probability of finding jobs as skilled professionals do in fact think of themselves as participating in a common Swedish culture in a way that is just not comprehensible in the United States. They talk about being Swedish in the way that an individual American might talk about being Jewish, or a Harvard grad.
In America, it's not just that we have a high percentage of immigrants right now; it's that all the previous generations of immigrants also created their own subcultures, as did the regional divides between north/south/west, the endlessly multiplying religious divides, and so forth. It's generally harder to substitute status for income outside of relatively closed and homogenous cultures, which is why small towns rely on volunteer firemen, and cities don't.