Comment by kaitai

Your phrasing "something more productive in the private sector" is taken from the DOGE emails to federal employees. Note that in this sense "productive" means "makes money for corporations". If your utility function is different, these jobs are no longer more productive.

For a very concrete illustration, I know a Veterans Administration physician who got the DOGE emails. He's been underpaid by $50k-100k per year compared to private market rates, for the last twenty years. He is happy to take that discount because the mission of caring for veterans is something he cares about, and because he feels he can practice better medicine if his goal is patient outcomes rather than billable procedures. He also values the education and research priorities of the VA.

It is absolutely true that he would make a lot more money for a private provider maximizing procedures and billing.

But is that what we should be optimizing for as a society? Is that what you personally aim for from your doctors?