a form of power consolidation

October 11, 2024 Travis McCracken

The phenomenon I am trying to be referring to—where doctors and lawyers, despite their societal roles, often fail to confront the ethical dissonance between their outsized financial rewards and their broader social impact—is a key point in the critique of wealth consolidation among elites.

Data, the statistics, provides a clearer picture of how income and wealth inequality have intensified over the last few decades. While doctors and lawyers have seen significant income growth, the rest of society—especially the middle and lower classes—has experienced stagnation, reduced access to affordable services, and an inability to keep pace with rising costs. This growing divide highlights the disproportionate financial and social power held by professionals, exacerbating economic inequality and reinforcing their elite status at the expense of broader societal welfare.

Moreover, research into moral disengagement, pioneered by Albert Bandura, provides further insight. Professionals may engage in displacement of responsibility or diffusion of responsibility by attributing the inequalities in healthcare or the justice system to broader social or political factors, rather than their personal decisions to maximize profit(Council on Foreign Relations).

The Cognitive Dissonance of Wealth and Service

Doctors and lawyers occupy unique positions that allow them to control access to critical resources—healthcare and legal justice. These professions are licensed and regulated, meaning they are gatekeepers to services that most people cannot access without their mediation. The education, certification, and legal infrastructure that surrounds these professions have created a class of professionals who are (in terms of paper-thin at least) indispensable, allowing them to command outsized financial and social influence.

Cognitive dissonance occurs when a person experiences discomfort from holding two conflicting beliefs or values simultaneously. In the case of doctors and lawyers, their professional identity as public servants—dedicated to improving health or ensuring justice—conflicts with their financial behavior of accumulating wealth and often benefiting from an economically exploitative system. According to Leon Festinger's Cognitive Dissonance Theory, individuals are motivated to reduce this discomfort by either changing their behavior or adjusting their beliefs to justify their actions.

Wealth not only creates physical comfort but also psychological comfort. For doctors and lawyers, money can soothe the cognitive dissonance that arises when their professional ethics conflict with personal financial gain. Through self-justification, moral licensing, and system justification, they can maintain a narrative that portrays their wealth as deserved and ethical, while avoiding deeper reflection on the broader societal impact of their actions. Ultimately, wealth allows them to distance themselves from the inequalities they help perpetuate, fostering a form of moral blindness that shields them from the full ethical weight of their choices.

The idea that doctors and lawyers often make disproportionate returns for their time and effort, while extracting resources from the local economy, is an interesting critique of professional compensation and its effects on local economies.

This can be analyzed from multiple angles, especially when considering their roles in society and how their wealth is utilized.

Doctors and lawyers indeed belong to some of the highest-paid professions, often earning substantially more than the average worker. Their services are (?) crucial, but the financial compensation they receive often goes beyond what can be considered a proportional exchange for their time.

Given that their income is often reinvested in personal assets, such as real estate (inherently degenerative, typically), particularly in wealthy or warmer regions, this creates a cycle of economic extraction. Instead of circulating wealth back into the local economy—where they provide services—they may be pulling financial resources out, which can contribute to local economic stagnation.

For instance, consider how real estate investments, often made by professionals in wealthier areas, push up housing prices and reduce affordability for the general population. This can lead to increased inequality, where those who do not earn similar wages are priced out of their own communities. Additionally, wealth invested in out-of-area real estate means capital that could have stimulated local development and businesses is diverted to non-local markets, providing little direct benefit to the people from whom it was originally extracted.

This power is solidified through institutional and societal mechanisms: hospitals, universities, law firms, and courts all act as structures that perpetuate the authority of these professions. Over time, this system creates a consolidation of knowledge and power, leading to an elite class that can extract from the economy without needing to reinvest locally or contribute proportionally to the wider community's welfare.

a fascinating dynamic: the roles of doctors & lawyers in society (can indeed be seen) as a form of power consolidation

The notion that such professionals "should be kissing everyone's ass" can be interpreted as a call for increased social responsibility from high earners.

While their work often centers on helping others, the financial structures of these professions allow for outsized personal gains. As wealth accumulates, the discomfort they might feel from this conflict is often smoothed over by the material comforts and social status that come with money. This creates a two-faced narrative—one in which doctors and lawyers may publicly champion social good while privately benefiting from and perpetuating systems that exacerbate inequality.

The increasing concentration of wealth and power among professionals such as doctors, lawyers, and other high earners is part of a broader trend of rising income and wealth inequality. Over the past few decades, the share of wealth controlled by the top tier of earners—especially those in high-paying professions like healthcare and law—has expanded significantly, while much of society has seen stagnation or decline in economic mobility.

For instance, since the 1980s, the top 5% of earners—which includes many doctors and lawyers—have seen their incomes grow at a much faster rate than those of the general population. During the same period, the middle class has shrunk from 61% of adults in 1971 to just 51% in 2019, while upper-income households have grown from 14% to 20% of the population(Federal Reserve Bank of Richmond)(Pew Research Center).

A more striking illustration of income inequality comes from the Economic Policy Institute, which reports that between 1979 and 2020, the top 1% of earners in the U.S. saw their incomes increase by over 179%, while the bottom 90% experienced just a 28% growth in their earnings. Meanwhile, CEO pay (which shares characteristics with elite professionals like doctors and lawyers) grew by 1,322% during the same period, further highlighting the disproportionate rise of elite incomes relative to the rest of society.

Studies in social psychology indicate that wealth can reduce empathy and increase moral disengagement. Research published in the Proceedings of the National Academy of Sciences found that people in higher socioeconomic classes are less likely to engage in empathetic behaviors, such as offering help to others, than their less wealthy counterparts(Federal Reserve Bank of Richmond). The study suggests that as wealth increases, so does psychological distance from others' suffering, which helps explain why some professionals in lucrative fields may not feel compelled to address the inequalities their wealth perpetuates.

This aligns with the concept of economic detachment, where individuals who grow wealthier tend to feel less connected to the broader social issues affecting lower-income populations. Wealth serves as a buffer that shields them from the realities of poverty, healthcare access, or legal inequities, allowing them to rationalize their role in an increasingly unequal society.

The Harvard Law Review reports that legal fees have increased by 60% in the last two decades, disproportionately affecting middle- and low-income individuals who cannot afford adequate legal representation. Similarly, healthcare costs in the U.S. have skyrocketed. The Kaiser Family Foundation found that the average family health insurance premium rose by 55% between 2010 and 2020, while wages only grew by about 27%, compounding the economic burden on working- and middle-class families while bolstering the earnings of healthcare providers(Pew Research Center)(Council on Foreign Relations).

Looking beyond income, the Federal Reserve data shows that the top 1% of Americans now own over 40% of the nation's wealth, while the bottom 90% hold less than 30%. This trend has intensified since the 1980s, driven in part by professionals in highly compensated fields like law, healthcare, and finance. The Gini coefficient, a measure of inequality, has steadily risen, reflecting a growing concentration of wealth and power(Council on Foreign Relations).

Doctors and lawyers often invest in high-value assets such as real estate, further extracting wealth from the economy. According to Zillow and Urban Institute reports, real estate speculation by wealthy professionals has contributed to the surge in property values, pricing out middle and lower-income families. In California, for example, the median home price has increased by 240% from 2000 to 2020, largely driven by high-income earners. These investments displace local populations and contribute to housing crises, showing how wealth circulates out of the general economy and back into the pockets of an elite few(Pew Research Center)(Council on Foreign Relations).

While professionals in law and healthcare have seen their compensation grow, median wages for middle-class workers have stagnated. The Pew Research Center found that from 1970 to 2018, the median income for middle-class households grew by just 49%, while upper-income households saw a 64% rise, contributing to the shrinking share of middle-class income relative to upper-class households (falling from 62% in 1970 to 43% in 2018)(Pew Research Center).

Given that their education and career success is often subsidized by society—through public universities, government grants, and infrastructure—they may indeed have a moral or ethical duty to give back to the communities that enabled their success. This could take the form of reinvestment into local projects, philanthropy, or supporting policies that address wealth inequality.

Self-Justification and Moral Licensing

Many professionals in these fields reduce their cognitive dissonance through self-justification or moral licensing. This means they rationalize their wealth by emphasizing the importance of their work and its societal benefits, such as saving lives or defending human rights. This form of justification allows them to maintain a positive self-image while continuing behaviors that contribute to wealth inequality.

Moral licensing refers to the phenomenon where individuals feel entitled to act in self-serving ways after performing a morally good act. For instance, a doctor who justifies their high earnings by pointing to the lives they save may feel licensed to invest in speculative real estate without acknowledging the societal harm it may cause through gentrification and displacement(Pew Research Center).
Self-justification can also be seen in the way high earners deflect responsibility. Research has shown that individuals who benefit from an unfair system often engage in system justification—the psychological tendency to defend and rationalize the status quo, even when it perpetuates inequality(Oxford Academic). For example, wealthy professionals might argue that their high earnings are deserved because of their extensive education and skill, minimizing the reality that structural inequalities allow them to accumulate wealth at the expense of others.

Another argument is that the compensation for these professions is not inherently tied to their social benefit. While doctors and lawyers perform valuable work, especially in life-saving and justice-related fields, their financial returns may not align with the broader social value provided. For example, a doctor or lawyer working in an underserved rural area likely provides greater benefit to the community than one practicing in an affluent urban center, but the latter is typically rewarded more financially. This disparity challenges the assumption that market compensation always reflects societal benefit.

These professions—whether we view them as rule-keepers, gatekeepers, or even "controllers"—wield immense power over essential aspects of our lives: health, justice, and wealth. The education, certification, and legal infrastructure that surrounds these professions have created a class of professionals who are (paper thin) indispensable, allowing them to command outsized financial and social influence.

The internal cognitive dissonance experienced by these professionals can often be numbed by the same system that creates it. As their wealth grows, so too does their ability to distance themselves from the ethical concerns surrounding their financial gains. For example:

Doctors in private practice may earn enormous fees for elective surgeries or consultations, yet participate in healthcare systems where millions lack access to basic care. Wealth can shield them from the stark realities faced by those outside their economic bubble.
Lawyers, especially in corporate law or high-profile criminal defense, can earn vast sums defending clients that contribute to the very social inequalities they may publicly decry. The prestige of success and financial rewards allows them to reconcile—or ignore—these contradictions.

Over time, wealth has a self-reinforcing effect: the more one has, the easier it becomes to justify further accumulation. Studies have shown that as people become wealthier, they may become less empathetic or socially aware(Federal Reserve Bank of Richmond)(Pew Research Center). The money acts as a psychological cushion, allowing professionals to engage in a selective narrative that focuses on their achievements and contributions while minimizing the broader systemic issues their wealth perpetuates.

This critique can be expanded to question the broader structure of compensation across industries. The rewards of various professions often don't align with their actual societal impact. For instance, teachers, social workers, or laborers might provide significant social value but are rarely compensated in proportion to their contributions, compared to high-earning professionals who operate in more extractive or speculative industries.

Billionaires, doctors, and lawyers alike often use their wealth to pursue long-term security, both literally and figuratively. In recent years, we've seen high-net-worth individuals pour vast resources into technologies aimed at extending human life—anti-aging treatments, genetic modification, cryonics, and other ventures aimed at defying mortality.

It is highly plausible that tech elites could dominate in the coming decades, but whether they will solidify their hold on power, and to what extent, depends on several factors. The convergence of technological advancements in AI, biotechnology, data control, and automation is already shifting power toward those who control these fields. However, the future is not guaranteed, as there are potential counterforces that could prevent full domination by the tech elites.

The pursuit of immortality, in a sense, is the ultimate expression of power consolidation. Billionaires and powerful individuals use their wealth not just to secure their own futures, but to potentially escape the very human limitations the rest of society faces. This mirrors the historical efforts of emperors, kings, and nobility who sought to solidify their legacies through grand monuments, dynastic succession, or alchemical quests for eternal life.

Historically, societies have been built on structures where those who control resources—whether land, labor, or knowledge—consolidate power over time. In feudal systems, this meant landowners and aristocrats. In modern capitalist societies, professionals like doctors, lawyers, and financiers play a similar role. They hold the keys to vital resources (healthcare, justice, capital) and are compensated disproportionately for their services, enabling them to accumulate wealth and influence.

The consolidation of power within these professions may not be as overtly hierarchical as in past centuries, but it is no less significant. Access to education and professional networks are restricted, ensuring that only those with certain privileges can enter these fields. Once inside, professionals benefit from protective regulations, high barriers to entry, and the social status that comes with their roles. This allows them to accumulate wealth at a rate unmatched by many other professions, perpetuating the cycle of inequality.

In this light, the professions of doctors and lawyers contribute to a kind of economic and social stratification. Like the aristocracies of old, they extract from the wider economy but may not reinvest in ways that benefit the broader society. Instead, wealth flows into speculative investments like real estate in warmer climates, further entrenching economic disparities.

In evolving societies, those in power—whether through wealth, expertise, or legal control—have often sought ways to maintain or extend their influence. This could be viewed as a modern form of feudalism, where instead of kings and lords controlling land, professionals control the systems that sustain life and order. And much like the monarchs of old, they use their accumulated power and wealth to distance themselves from the vulnerabilities of everyday life—whether through luxury lifestyles, political influence, or even the quest for immortality.

Doctors and lawyers, like the billionaires they serve, often enjoy not just financial rewards but the sense of being indispensable, of holding knowledge that others do not. This knowledge gives them power over life, death, and justice.

Two-Faced Narrative in Practice

This dissonance is most visible in how high-income professionals rationalize their contributions to society:

Justifying through philanthropy: Some wealthy doctors and lawyers attempt to ease the tension by engaging in philanthropy, but this often doesn't address the root causes of inequality. For example, while charitable donations might benefit specific causes, they often allow the donor to maintain control over how the funds are used, further consolidating power rather than redistributing it(Council on Foreign Relations).
Deflecting responsibility: There is also a growing narrative among the wealthy that suggests systemic issues—like rising healthcare costs or increasing legal fees—are outside their control, even though they are deeply enmeshed in the systems that create these disparities(Council on Foreign Relations)(Pew Research Center).

Ultimately, this is part of an age-old human story—those in positions of power seeking ways to transcend their limitations and exert control over an uncertain future. Whether through real estate empires, legal victories, or cutting-edge biomedical research, the pursuit of wealth and influence often carries with it the desire to outlast the natural cycles of life and death. In this sense, doctors, lawyers, and billionaires are simply playing out their roles in the evolving structure of power in human society, albeit on a modern stage.

These professions, while necessary, may indeed act as forms of power consolidation, extracting wealth and influence from their communities and, at times, seeking personal gain over the well-being of the societies they serve. This critique highlights the importance of considering the ethical responsibilities that come with such positions of privilege, and the need for systems that encourage reinvestment into the broader community to prevent widening inequality.