A very interesting post by Arnold Kling at the EconLog. He very concisely defines the economic differences between entrepreneurs and workers:
As Taleb points out, there are safe professions where you charge by the hour, so I might call them Billers. As a Biller, your earnings tend to have a high floor but a low ceiling. Think of an accountant.
What Taleb calls scalable professions are ones where you are not limited by what you can charge for an hour. Recording artists, professional baseball players, entrepreneurs, corporate CEO's, and financial speculators enjoy scalability. But, as Taleb points out, they have to compete in tournaments where there are a few winners and many losers. So we can call these sorts of people Players.
Both Wallstreet and the technology industries have done an amazing job in not only delineating between "players" and "billers", but also rewarding "billers" (via outsized bonuses and stock options). That is not the case in the healthcare industry. Although, there are certain specialty physicians that garner tremendous compensation, the bulk of the "billers" just get a standard salary that is not tied to performance. IThat leads to tremendous inefficiencies because compensation focused "billers" are constantly jumping around for the highest paying job. Also, "billers" not so focused on money are stagnated, never realizing the potential rewards had they been rewarded like "billers" on Wallstreet and Silicon Valley. I can see that structure leading to "billers" looking at their profession as "just a job" and not really being motivated to innovate and foster change. Just look at the (lack of) progress in the healthcare industry as it lags significantly behind finance and technology in the last decade.