Every job has monetised by regulating every job to have a certification or license. Many years ago, you could become a nurse by doing a program of 'on the job training's. Now you gotta pay 000s to study for the certificate, and then 000s to keep your registration up to date. Even healthcare assistants - give showers, make beds etc, have to do a course before working. Crazy shit.
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And to make matters worse, once certified you can lose your license if you don’t toe the official line of whatever the current thing of the day is. A very exquisite slave plantation