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Medicaid problems in Indiana

Marvin the Martian

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First, the link below does accept that ACA can account for some of the Medicaid issues Indiana is facing. Simply put, too many people need Medicaid.

In 2010, when the Affordable Care Act was passed, Indiana spent 0.57% of our total state GDP on Medicaid, and 969,000 Hoosiers were enrolled. Last year, we spent 1.13% of our GDP on Medicaid and enrolled 1.96 million Hoosiers. For every one new job created in Indiana since 2010, we’ve had more than two new people enroll in Medicaid.​
But there is another problem driving this, Hoosiers are falling behind the rest of the country in pay:

Hoosier workers are getting relatively poorer. In 2000, our factory workers earned the national average salary for their work. Overall, Hoosier workers earned about 93% of the national wage. The current Hoosier factory worker now makes about 89 cents for every dollar earned by factory workers nationwide and the average Hoosier worker earns less than 84 cents for every dollar earned nationwide.​
So why are we falling behind? Why did factory workers in Indiana go from 93% of national average to 89%? Why do average Hoosiers make 89% of the national average?

Looking at other sources, this has Indiana salaries behind Illinois, Michigan, and Ohio and tied with Kentucky.

The link on Medicaid in Indiana:

 
First, the link below does accept that ACA can account for some of the Medicaid issues Indiana is facing. Simply put, too many people need Medicaid.

In 2010, when the Affordable Care Act was passed, Indiana spent 0.57% of our total state GDP on Medicaid, and 969,000 Hoosiers were enrolled. Last year, we spent 1.13% of our GDP on Medicaid and enrolled 1.96 million Hoosiers. For every one new job created in Indiana since 2010, we’ve had more than two new people enroll in Medicaid.​
But there is another problem driving this, Hoosiers are falling behind the rest of the country in pay:

Hoosier workers are getting relatively poorer. In 2000, our factory workers earned the national average salary for their work. Overall, Hoosier workers earned about 93% of the national wage. The current Hoosier factory worker now makes about 89 cents for every dollar earned by factory workers nationwide and the average Hoosier worker earns less than 84 cents for every dollar earned nationwide.​
So why are we falling behind? Why did factory workers in Indiana go from 93% of national average to 89%? Why do average Hoosiers make 89% of the national average?

Looking at other sources, this has Indiana salaries behind Illinois, Michigan, and Ohio and tied with Kentucky.

The link on Medicaid in Indiana:

The majority of increases are from Obamacare (600,000). Thanks Obama. Also, since 2010, the Hispanic population has increased 200k. They rely on Medicaid at a higher percentage, which makes sense, since a large portion of them are immigrants. Importing unskilled workers have negative consequences when you have large safety nets. Of course the article doesn’t point this out, because it’s not the correct narrative, but @twenty02 gets his cheap Columbian nanny, with big beautiful…………. She’s so hot. For the record, I choose bankrupting the state it they all look like her.


Nbc Sophia GIF by America's Got Talent
 
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The majority of increases are from Obamacare (600,000). Thanks Obama. Also, since 2010, the Hispanic population has increased 400-500k. They rely on Medicaid at a higher percentage, which makes sense, since a large portion of them are immigrants. Importing unskilled workers have negative consequences when you have large safety nets. Of course the article doesn’t point this out, because it’s not the correct narrative, but @twenty02 gets his cheap Columbian nanny, with big beautiful…………. She’s so hot. For the record, I choose bankrupting the state it they all look like her.


Nbc Sophia GIF by America's Got Talent's Got Talent

Don't most immigrants, those without refugee status, have to wait 5 years to get on Medicaid?

It seems that Hoosier wages being in a race to the bottom is likely to contribute as much to the problem.

To get Medicaid and CHIP coverage, many qualified non-citizens (such as many Lawful Permanent Residents, also known as LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after getting "qualified" immigration status before they can get Medicaid and CHIP coverage.​
 
Don't most immigrants, those without refugee status, have to wait 5 years to get on Medicaid?

It seems that Hoosier wages being in a race to the bottom is likely to contribute as much to the problem.

To get Medicaid and CHIP coverage, many qualified non-citizens (such as many Lawful Permanent Residents, also known as LPRs or green card holders) have a 5-year waiting period. This means they must wait 5 years after getting "qualified" immigration status before they can get Medicaid and CHIP coverage.​
From 2010 to 2024 the Hispanic population increased around 200k, which accounts for about half of Indiana's population growth during the time period. My best guess is that accounts for a majority of the wage decreases. I'll also add Marv there are other factors, but the majority of the increases are Obamacare and immigration.

Edit: My numbers were off in the 1st post. It's 200k (one said 400k but I think it's from 2000).
 
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From 2010 to 2024 the Hispanic population increased around 200k, which accounts for about half of Indiana's population growth during the time period. My best guess is that accounts for a majority of the wage decreases.

Edit: My numbers were off in the 1st post. It's 200k (one said 400k but I think it's from 2000).
And iu soccer recruits white Stl kids who play kickball. Weird
 
From 2010 to 2024 the Hispanic population increased around 200k, which accounts for about half of Indiana's population growth during the time period. My best guess is that accounts for a majority of the wage decreases. I'll also add Marv there are other factors, but the majority of the increases are Obamacare and immigration.

Edit: My numbers were off in the 1st post. It's 200k (one said 400k but I think it's from 2000).
And that may be, but does that explain Indiana's wage decline which also makes a difference. More people making less money makes more people eligible. Other states have immigrants.
 
Hicks has a fetish about college degrees -- as if the student debt crisis doesn't exist or has some kind of alternative explanation.

College has never been the right choice for everybody. And that's never been truer than it is today -- as the cost to obtain a degree has diverged from the monetary value of possessing one. If college was truly worth what it costs for anybody and everybody, we wouldn't have a student debt crisis -- because the acquired education would have resulted in enough income for borrowers to afford their payments.

College is a great investment for people who are getting worthwhile degrees that actually do open the doors to enough income to justify the cost. But it's a terrible burden for most of those who get the other kind.

So colleges and universities need to rethink their business models. They should start by doing honest estimates of the NPV of each degree they offer. And the tuitions for these programs should reflect that number. All degrees are not worth the same amount of money to possess. So why do they all cost the same amount of money to obtain?

This would mean that universities would be losing money on low-value degree programs. And they'd face the choice to subsidize them or cut them loose. Rightsizing is often unpleasant, but it's extremely healthy. But it's important to realize that these losses already exist. They just show up in the form of distressed student debt.
 
Hicks has a fetish about college degrees -- as if the student debt crisis doesn't exist or has some kind of alternative explanation.

College has never been the right choice for everybody. And that's never been truer than it is today -- as the cost to obtain a degree has diverged from the monetary value of possessing one. If college was truly worth what it costs for anybody and everybody, we wouldn't have a student debt crisis -- because the acquired education would have resulted in enough income for borrowers to afford their payments.

College is a great investment for people who are getting worthwhile degrees that actually do open the doors to enough income to justify the cost. But it's a terrible burden for most of those who get the other kind.

So colleges and universities need to rethink their business models. They should start by doing honest estimates of the NPV of each degree they offer. And the tuitions for these programs should reflect that number. All degrees are not worth the same amount of money to possess. So why do they all cost the same amount of money to obtain?

This would mean that universities would be losing money on low-value degree programs. And they'd face the choice to subsidize them or cut them loose. Rightsizing is often unpleasant, but it's extremely healthy. But it's important to realize that these losses already exist. They just show up in the form of distressed student debt.

I do agree that there is an issue with overvaluing degrees. But at the same point, if we measure income from degree earners and non-degree earners, I suspect non-degree is losing ground.

One issue is that so much of factory work is automated that many jobs don't pay what they once did. Sure, a Cummins does well. But a lot of other factory jobs are no longer solid middle class.
 
And that may be, but does that explain Indiana's wage decline which also makes a difference. More people making less money makes more people eligible. Other states have immigrants.
I agree other states have immigrants, but who is migrating matters. If it's a majority of low skilled/low wage workers, it's going to put downward pressure on wages and increase the amount of people eligible over time. I don't think it accounts for all the decline (in wages), but I would bet it's the largest percentage of the decline.
 
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I agree other states have immigrants, but who is migrating matters. If it's a majority of low skilled/low wage workers, it's going to put downward pressure on wages and increase the amount of people eligible over time. I don't think it accounts for all the decline (in wages), but I would bet it's the largest percentage of the decline.

So we have more low skilled immigrants coming to Indiana than does, say, Kentucky. According to that USA today article their average salary is about the same. That wasn't true years ago.

Indiana isn't successfully bringing in better jobs. I do not know why, but it would be good to figure it out.
 
But at the same point, if we measure income from degree earners and non-degree earners, I suspect non-degree is losing ground.

Probably. But does it make sense to look at "degree" as a monolith? And shouldn't all of this take into account the net value -- meaning that costs of college (whether financed by loans or otherwise) are deducted?

In other words, a Bachelors in Engineering from Purdue is virtually always going to be worth what it costs to obtain. A degree in Classical Civilizations from IUB, probably not.

What grinds my gears (h/t Peter Griffin) is that Hicks couches all this in a premise that we should be spending more on education. I'm fine with that, to the extent that the investment actually makes sense.

But everybody's going to have to realize that many "education" investments do not make financial sense. And we need to adjust how we approach these things to correct for that. If a degree isn't a good investment for an individual, why would it become a good investment if it's being paid for by taxpayers?
 
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Probably. But does it make sense to look at "degree" as a monolith? And shouldn't all of this take into account the net value -- meaning that costs of college (whether financed by loans or otherwise) are deducted?

In other words, a Bachelors in Engineering from Purdue is virtually always going to be worth what it costs to obtain. A degree in Classical Civilizations from IUB, probably not.

What grinds my gears (h/t Peter Griffin) is that Hicks couches all this in a premise that we should be spending more on education. I'm fine with that, to the extent that the investment actually makes sense.

But everybody's going to have to realize that many "education" investments do not make financial sense. And we need to adjust how we approach these things to correct for that. If a degree isn't a good investment for an individual, why would it become a good investment if it's being paid for by taxpayers?
He does not that K-12 spending is also down, as a percentage.

We could up funding for STEM as the Lilly CEO wants


It will be tough to get as many line workers as we used to have and overall paid what Ford and GM pay. While they pay a lot, go to YouTube and watch videos of car assembly. There aren't many humans involved.

I don't know how Indiana does better at getting higher paying jobs. But we need to.
 
He does not that K-12 spending is also down, as a percentage.

He does. And I'm good with that -- so long as we're certain that additional funding is what's necessary to improve outcomes. I'm skeptical about that as a universal thing. But it certainly can be the case.

We could up funding for STEM as the Lilly CEO wants

I'm 100% behind this -- because I suspect that STEM will virtually always have a very high batting average of paying off...for the student, for their future employers, for the state, etc.

It will be tough to get as many line workers as we used to have and overall paid what Ford and GM pay. While they pay a lot, go to YouTube and watch videos of car assembly. There aren't many humans involved.

Couldn't agree more. FWIW, I agree with a lot of what Hicks wrote. I just don't think that "college degree" is the answer. Because, again, if it was, we wouldn't have the student debt crisis we have. But we do have it.

I don't know how Indiana does better at getting higher paying jobs. But we need to.

Yes, we do. But putting good money after bad would actually set us farther away from that goal.
 
He does. And I'm good with that -- so long as we're certain that additional funding is what's necessary to improve outcomes. I'm skeptical about that as a universal thing. But it certainly can be the case.



I'm 100% behind this -- because I suspect that STEM will virtually always have a very high batting average of paying off...for the student, for their future employers, for the state, etc.



Couldn't agree more. FWIW, I agree with a lot of what Hicks wrote. I just don't think that "college degree" is the answer. Because, again, if it was, we wouldn't have the student debt crisis we have. But we do have it.



Yes, we do. But putting good money after bad would actually set us farther away from that goal.

Nice conversation Crazed. I don't want to tout the education part because I don't know how much it is the problem. I just see it as a problem. It seems to me Indiana has a mindset of "move to Indiana, we have low wages" and that doesn't exactly attract better jobs. Yes, a WalMart greeter job is better than no job, but there is nothing wrong with the state trying to do better than that.
 
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First, the link below does accept that ACA can account for some of the Medicaid issues Indiana is facing. Simply put, too many people need Medicaid.

In 2010, when the Affordable Care Act was passed, Indiana spent 0.57% of our total state GDP on Medicaid, and 969,000 Hoosiers were enrolled. Last year, we spent 1.13% of our GDP on Medicaid and enrolled 1.96 million Hoosiers. For every one new job created in Indiana since 2010, we’ve had more than two new people enroll in Medicaid.​
But there is another problem driving this, Hoosiers are falling behind the rest of the country in pay:

Hoosier workers are getting relatively poorer. In 2000, our factory workers earned the national average salary for their work. Overall, Hoosier workers earned about 93% of the national wage. The current Hoosier factory worker now makes about 89 cents for every dollar earned by factory workers nationwide and the average Hoosier worker earns less than 84 cents for every dollar earned nationwide.​
So why are we falling behind? Why did factory workers in Indiana go from 93% of national average to 89%? Why do average Hoosiers make 89% of the national average?

Looking at other sources, this has Indiana salaries behind Illinois, Michigan, and Ohio and tied with Kentucky.

The link on Medicaid in Indiana:

2 Words Republican Government. They create nothing but for the rich. You guys have trump now be careful what you ask for.
 
The majority of increases are from Obamacare (600,000). Thanks Obama. Also, since 2010, the Hispanic population has increased 200k. They rely on Medicaid at a higher percentage, which makes sense, since a large portion of them are immigrants. Importing unskilled workers have negative consequences when you have large safety nets. Of course the article doesn’t point this out, because it’s not the correct narrative, but @twenty02 gets his cheap Columbian nanny, with big beautiful…………. She’s so hot. For the record, I choose bankrupting the state it they all look like her.


Nbc Sophia GIF by America's Got Talent's Got Talent
You are so quick to pick on POC but there are more white folks on welfare. Most of the counties in central and southern Indiana are poor.
 
It may be all just correlation, but at the same time Indiana has become less educated it has also become poorer. We need more college educated people and we need them to stay and work here.
 
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So colleges and universities need to rethink their business models. They should start by doing honest estimates of the NPV of each degree they offer. And the tuitions for these programs should reflect that number. All degrees are not worth the same amount of money to possess. So why do they all cost the same amount of money to obtain?

Why? We don't make businesses do this when they are releasing products into a market where willing buyers are eating them up.

I guess I should say, the public colleges and universities might be forced to by legislative action but how would we convince private colleges from doing the same. LIke, "Hey guys, why don't you stop making all this money and give everyone a break?"

Doesn't happen much is what I'm saying. I guess if we could convince enough of the states to take action (thinking regionally here) maybe the privates have to follow suit. But I think you're living in a dream state if you believe the colleges/universities are going to do it unprompted. Maybe once enrollments dip in a meaningful way.
 
It may be all just correlation, but at the same time Indiana has become less educated it has also become poorer. We need more college educated people and we need them to stay and work here.
I would agree we need more educated people. I'm not sure college needs to be the educator for many.

Killed off those unions though didn't we? They served no purpose, oh wait.
 
You are so quick to pick on POC but there are more white folks on welfare. Most of the counties in central and southern Indiana are poor.
Wait wait wait……I know you hate white ladies, but I was hoping beautiful Latinos is something we could both agree on. Come on, Big Willy, they got some junk in the trunk.

Hip Hop Booty GIF
 
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I would agree we need more educated people. I'm not sure college needs to be the educator for many.

Killed off those unions though didn't we? They served no purpose, oh wait.
I have plenty of criticism for current colleges. From cost to ROI on certain degrees. Don’t get me started on every campus apartment having granite countertops. It’s not for everybody.

But sacrificing Purdue engineers for tradesmen is not a path to prosperity. Sure, the trades are a great career for a lot of people. They should do that. But we need a highly educated workforce to prosper. Carmel is Carmel for a reason. And I HATE Carmel as every southsider does.

Edit: I don’t have statistics but I’d wager a fair sum that college educated folks are not driving up our Medicaid costs.
 
I have plenty of criticism for current colleges. From cost to ROI on certain degrees. Don’t get me started on every campus apartment having granite countertops. It’s not for everybody.

But sacrificing Purdue engineers for tradesmen is not a path to prosperity. Sure, the trades are a great career for a lot of people. They should do that. But we need a highly educated workforce to prosper. Carmel is Carmel for a reason. And I HATE Carmel as every southsider does.

Edit: I don’t have statistics but I’d wager a fair sum that college educated folks are not driving up our Medicaid costs.
Well CG been kicking Carmel's ass for a few years so take solace. Kevin Wright is back in Indiana though.......so watch out.

Also, I think we need both. I'm not saying sacrifice Purdue engineers or IU Kelley grads, but we need more plumbers, welders, electricians, elevator contstructors, ditch diggers, machine operators,HVAC techs (besides COH) etc. Those jobs use to start as journeymen and became full members after TRAINING. Which was handled by the unions. And tehy were reasonably good at it.

I have several uncles who were tradesmen and ended up doing very well in life. Only one went to college (electrical engineering) and he still ended up building elevators. All ended up master electricians.
 
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Why? We don't make businesses do this when they are releasing products into a market where willing buyers are eating them up.

I guess I should say, the public colleges and universities might be forced to by legislative action but how would we convince private colleges from doing the same. LIke, "Hey guys, why don't you stop making all this money and give everyone a break?"

Doesn't happen much is what I'm saying. I guess if we could convince enough of the states to take action (thinking regionally here) maybe the privates have to follow suit. But I think you're living in a dream state if you believe the colleges/universities are going to do it unprompted. Maybe once enrollments dip in a meaningful way.

Keep in mind where the bulk of their students’ tuition money comes from.

The Feds can affect this pretty easily by altering their student lending standards.
 
Well CG been kicking Carmel's ass for a few years so take solace. Kevin Wright is back in Indiana though.......so watch out.

Also, I think we need both. I'm not saying sacrifice Purdue engineers or IU Kelley grads, but we need more plumbers, welders, electricians, elevator contstructors, ditch diggers, machine operators,HVAC techs (besides COH) etc. Those jobs use to start as journeymen and became full members after TRAINING. Which was handled by the unions. And tehy were reasonably good at it.

I have several uncles who were tradesmen and ended up doing very well in life. Only one went to college (electrical engineering) and he still ended up building elevators. All ended up master electricians.

I’m as big a proponent of skilled trades as you’ll find. And there is a growing need for kids to get into the trades - because most of them are still very top heavy in terms of median age.

But there are only so many of them to go around. And we’re taking in about 1 for every 8 or 9 applicants around here.
 
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Well CG been kicking Carmel's ass for a few years so take solace. Kevin Wright is back in Indiana though.......so watch out.

Also, I think we need both. I'm not saying sacrifice Purdue engineers or IU Kelley grads, but we need more plumbers, welders, electricians, elevator contstructors, ditch diggers, machine operators,HVAC techs (besides COH) etc. Those jobs use to start as journeymen and became full members after TRAINING. Which was handled by the unions. And tehy were reasonably good at it.

I have several uncles who were tradesmen and ended up doing very well in life. Only one went to college (electrical engineering) and he still ended up building elevators. All ended up master electricians.
I’m as big a proponent of skilled trades as you’ll find. And there is a growing need for kids to get into the trades - because most of them are still very top heavy in terms of median age.

But there are only so many of them to go around. And we’re taking in about 1 for every 8 or 9 applicants around here.
My uncle was an electrician. My dad went to Vietnam. I have no idea why but my dad didn’t get into the union. Was a contentious point of resentment he always harbored over his brother. I thought it was odd as fck to be that way but he was
 
My uncle was an electrician. My dad went to Vietnam. I have no idea why but my dad didn’t get into the union. Was a contentious point of resentment he always harbored over his brother. I thought it was odd as fck to be that way but he was
A lot of people just hate unions as a general rule. They’re well aware of it - and, honestly, don’t seem all that inclined to do much to improve their public image.

Those who say that they largely exist to serve the interests of their weakest members have a very good argument. They do - IMO because they’re so caught up in getting the biggest numbers they can get. They’ve lost market share and the clout that comes with it. So they feel obligated to operate in a defensive posture.

I wish I could convince them to attack the problem from the other direction: to grow their rolls (and coffers) by doing things necessary to gain market share. Lord knows I’ve tried. But the leaders are elected, which makes them politicians. And there’s simply no appetite among the people who show up to vote to take this approach.

It’s counterproductive as hell. But it’s futile to get them to see things any other way than they do.
 
A lot of people just hate unions as a general rule. They’re well aware of it - and, honestly, don’t seem all that inclined to do much to improve their public image.

Those who say that they largely exist to serve the interests of their weakest members have a very good argument. They do - IMO because they’re so caught up in getting the biggest numbers they can get. They’ve lost market share and the clout that comes with it. So they feel obligated to operate in a defensive posture.

I wish I could convince them to attack the problem from the other direction: to grow their rolls (and coffers) by doing things necessary to gain market share. Lord knows I’ve tried. But the leaders are elected, which makes them politicians. And there’s simply no appetite among the people who show up to vote to take this approach.

It’s counterproductive as hell. But it’s futile to get them to see things any other way than they do.
It’s an interesting thing. I really don’t know anything about them other than to witness my dad’s jealousy and resentment and to hear about the pros and cons from so many family members. My ex wife’s outlaw grandfather was an organizer for the chemical union. He was ferociously protective of it and liked to always tell me when we’d be pound beers about the “power of membership and brotherhood.” If they each kicked in a grand what they could do. Ha.

At 65 he beat me in arm wrestling. Not to brag but not a small feat
 
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A lot of people just hate unions as a general rule. They’re well aware of it - and, honestly, don’t seem all that inclined to do much to improve their public image.

Those who say that they largely exist to serve the interests of their weakest members have a very good argument. They do - IMO because they’re so caught up in getting the biggest numbers they can get. They’ve lost market share and the clout that comes with it. So they feel obligated to operate in a defensive posture.

I wish I could convince them to attack the problem from the other direction: to grow their rolls (and coffers) by doing things necessary to gain market share. Lord knows I’ve tried. But the leaders are elected, which makes them politicians. And there’s simply no appetite among the people who show up to vote to take this approach.

It’s counterproductive as hell. But it’s futile to get them to see things any other way than they do.

The parties were wearing slightly different ideological dresses at the time but the right won the PR battle over unions in the 80s. The laws then followed.

Ask anyone why the big three got decimated by the Japanese and most will tell you it was because of greedy, corrupt unions. Not bloated, brain-dead c-suiters. Not shitty design. No, it was American workers with similar skills bargaining collectively. The horror. The kicker is that the Japanese workers who beat us were also in unions.

Want to know how effective the PR campaign was? Say something positive about teachers' unions here. lol.
 
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The majority of increases are from Obamacare (600,000). Thanks Obama. Also, since 2010, the Hispanic population has increased 200k. They rely on Medicaid at a higher percentage, which makes sense, since a large portion of them are immigrants. Importing unskilled workers have negative consequences when you have large safety nets. Of course the article doesn’t point this out, because it’s not the correct narrative, but @twenty02 gets his cheap Columbian nanny, with big beautiful…………. She’s so hot. For the record, I choose bankrupting the state it they all look like her.


Nbc Sophia GIF by America's Got Talent's Got Talent
200.gif
 
…liked to always tell me when we’d be pound beers about the “power of membership and brotherhood.” If they each kicked in a grand what they could do. Ha.

I’ve lost count of the number of times I’ve heard that contractors are useless exploiters of their labor and that the men could and should just take over the industry as a collective.

What’s funny is that most startup contractors are tradesmen who decide to hang out a shingle. And each one of them, to a man, is disabused of this view the first time they have to make payroll and supplier payables with customers dragging their asses out for months.

Walk a mile in another man’s shoes…
 
I’ve lost count of the number of times I’ve heard that contractors are useless exploiters of their labor and that the men could and should just take over the industry as a collective.

What’s funny is that most startup contractors are tradesmen who decide to hang out a shingle. And each one of them, to a man, is disabused of this view the first time they have to make payroll and supplier payables with customers dragging their asses out for months.

Walk a mile in another man’s shoes…
Irony….
 
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