121–130 of 134 posts
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How awful which government projects go? Yeah the DMV is a thing, but so is NOAA and NASA.
Those are good orgs, but not really customer facing ones. Of those people interact with, I can't think of one people actually like. Social Security offices come to mind. And apparently the IRS is impossible to get ahold of, though luckily I've never need to.
"To catch up with other high-income countries, the administration and Congress would have to expand access to health care, act aggressively to control costs, and invest in health equity and social services we know can lead to a healthier population." The U.S. has the highest rate of people with multiple chronic health conditions... and the highest obesity rate... I think they are seriously missing something. Obesity…
That is why the problem is intractable. The very way of life, the lot sizes houses are on, the paved earth in all 4 directions are at the root of the problem, and there is no fixing that on a US wide scale. And people like that lifestyle, they like their individual, huge cars and huge (relatively) houses and huge parking lots and huge roads and huge food and drink portions. Trying to fight that in a democracy will ta…
Paved earth isn't a bad thing if you're opposed to car-centric lifestyles. Dense cities (like Manhattan NYC) are nothing but pavement outside the parks, but that's what you need if you want a walkable lifestyle. Lots of earth and grass everywhere means everything is so far apart you need to drive.
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> And people like that lifestyle, they like their individual, huge cars and huge (relatively) houses and huge parking lots and huge roads and huge food and drink portions. Do they like it or have they simply never had any choice in the matter and have never experienced anything else? The extremely high housing prices in the few dense walkable places seems to imply there is more demand than supply for such development…
Sure, some of them. But nowhere near the critical mass of voters needed to redirect entire infrastructure budgets away from prioritizing cars and large indoor spaces, to prioritizing public transit/walking/cycling and denser living. And this transition would take decades and cause a lot of pain in that time for eventual benefits the voting populace will never see, so it is a nonstarter.
Earlier quoted context omitted.
That is why the problem is intractable. The very way of life, the lot sizes houses are on, the paved earth in all 4 directions are at the root of the problem, and there is no fixing that on a US wide scale. And people like that lifestyle, they like their individual, huge cars and huge (relatively) houses and huge parking lots and huge roads and huge food and drink portions. Trying to fight that in a democracy will ta…
>The very way of life, the lot sizes houses are on, the paved earth in all 4 directions are at the root of the problem, and there is no fixing that on a US wide scale. Paved earth isn't a bad thing if you're opposed to car-centric lifestyles. Dense cities (like Manhattan NYC) are nothing but pavement outside the parks, but that's what you need if you want a walkable lifestyle. Lots of earth and grass everywhere means…
Earlier quoted context omitted.
A risk pool being split among multiple companies doesn't actually increase the average amount that each group would have to pay. For the group of 100 in your example, only one tenth of a person is going to have to get one tenth of the expensive treatment, so each one still has to pay 0.1. As long as each underwriter has a sufficiently large group to ensure that the average cost incurred by its members is sufficiently…
> For the group of 100 in your example, only one tenth of a person is going to have to get one tenth of the expensive treatment, so each one still has to pay 0.1 That makes no sense. It will be one person. Not a tenth. And also if that was true the private insurance would raise their quota to 1.9. And then deny treatment to that unfortunate person anyway because it’s cheaper to pay a lawyer to litigate the expensive…
Your lack of intuition about such a simple linear relationship should be extremely concerning to you. It suggests that you are approaching the question with an emotional attachment to a particular outcome that is blinding you to the extremely simple and intuitive correct answer.
There's a lot more to unpack here, but I don't have time to address it point by point. You are making a lot of assertions that seem much more reflective of left-wing ideology than actual conditions on the ground. You suggest that consumers demanding better is a solution to public systems that don't actually meet consumers needs, but the very nature of public goods ensures that no individual consumer will ever be in a position to make a demand that administrators will have to prioritize over competing demands from producers and public employees. The nature of democracy gives outsized influence public sector unions and interest groups that can then turn around and contribute a share of those benefits back to politicians campaigns. In contrast, a competitive market affords consumers to actually make demands with some weight behind them. A producer has to take a consumers demands into account lest that consumer simply take his business to a competing producer. The weight of the empirical evidence affirming this fundamental difference between public and private systems is completely overwhelming, and your resistance to the idea that capitalism is a far better system than socialism for the vast majority of goods suggests an emotional attachment to an ideology that has very intentionally been sold to the public in such a way as to make uncritical advocacy for that ideology very self-flattering to those very advocates.
I know that I didn't really address the middle part of your argument but let me assure you that those ideas are just as contrary to reality as any of the ideas that I chose to address. I might come back to those in a future post if I find myself with both the time and the inclination to do so.
Earlier quoted context omitted.
>The very way of life, the lot sizes houses are on, the paved earth in all 4 directions are at the root of the problem, and there is no fixing that on a US wide scale. Paved earth isn't a bad thing if you're opposed to car-centric lifestyles. Dense cities (like Manhattan NYC) are nothing but pavement outside the parks, but that's what you need if you want a walkable lifestyle. Lots of earth and grass everywhere means…
Yes, I meant more paved earth area per person.
I wonder if anyone has done an analysis comparing different nations and their per-capita road infrastructure maintenance costs. The US has to be the worst at this, and surely is a big drag on the economy.
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> For the group of 100 in your example, only one tenth of a person is going to have to get one tenth of the expensive treatment, so each one still has to pay 0.1 That makes no sense. It will be one person. Not a tenth. And also if that was true the private insurance would raise their quota to 1.9. And then deny treatment to that unfortunate person anyway because it’s cheaper to pay a lawyer to litigate the expensive…
It does make sense. A smaller group will have a correspondingly smaller number of people who will end up needing treatment, so the expected value for an individual's cost doesn't actually depend on the number of people in the group, just the probability that any specific person will end up requiring treatment and the cost of the treatment. Maybe you are confused because you chose a specific example wherein the expect…
In my example 10 people out of 1000 required the treatment. If it's 100 people, then 1 will need it. You must have misread.
> Your lack of intuition about such a simple linear relationship should be extremely concerning to you
That's very condescending and a bit ironic. I think you should apologize.
> much more reflective of left-wing ideology
"Left" means different things in different places. In my country, a big chunk of the people on the "right" feel the same way you feel about the army, but about healthcare. Which is that some things like life-threatening problems are too important to let personal gain interfere. More on that in a second.
> actual conditions on the ground
I am writing this from the ground. My son just got treated by our public health system twice this week - the last one today. (His pediatrician was on strike today, actually. That is a bit inconvenient for us but it is fine. It's not life or death). My sister in law got diagnosed with cancer and got treatment for it. This is reality that I am telling you is happening right now. Not a theoretical thing that I am imagining might work on a communist country. It exists, and it works.
For the life-threatening cases at least. It is not perfect - there's sometimes long waiting lists for non-life-threatening ones. That is where private health plays a role. Those who don't want to wait, or want a private room in the hospital, can pay for it.
But if you are poor and you get cancer you don't necessarily die. Your family doesn't have to beg in gofundme for your treatment, nor they are left bankrupt. Which is absolutely a reality in the US.
> The nature of democracy gives outsized influence public sector unions and interest groups that can then turn around and contribute a share of those benefits back to politicians campaigns. In contrast, a competitive market affords consumers to actually make demands with some weight behind them.
I prefer referring to people as people. Or, citizens, in the context of a country.
Perhaps that is where our difference of opinion comes from. I don't see a country as a business. So naturally its people are not "consumers". Poor people may not be able to consume much, but they are still people.
On buying public administrators: in my country, lobbying consists in "having meetings with politicians". It does not mean "giving presents" or "contributing to campaigns". That is called bribing, and is against the law. Again, not a perfect system by any means. There's plenty of corruption, as well as other problems. One of them, and one of the places where I do agree with you, is that that interest groups (especially those sponsored by the extremely wealthy) still have much more levers to pull than the average person.
Where I differ with you is in how to fix this. You propose that "people vote with their wallet". The problem with that is that the money that consumers use to vote with their wallet eventually goes into the pockets of the ones funding the interest groups that eventually make laws against them. This is a problem both in my country and in the US. It gets worse with inequality, which is getting worse everywhere, but especially in the US.
My proposed solution is simply that there's other things besides the consumer-producer relationship. This doesn't necessarily imply a communist regime or an anarchist revolution. It just means Europe, man.
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It does make sense. A smaller group will have a correspondingly smaller number of people who will end up needing treatment, so the expected value for an individual's cost doesn't actually depend on the number of people in the group, just the probability that any specific person will end up requiring treatment and the cost of the treatment. Maybe you are confused because you chose a specific example wherein the expect…
> Maybe you are confused because you chose a specific example wherein the expected number of treatments required is less than one? In my example 10 people out of 1000 required the treatment. If it's 100 people, then 1 will need it. You must have misread. > Your lack of intuition about such a simple linear relationship should be extremely concerning to you That's very condescending and a bit ironic. I think you should…
Earlier quoted context omitted.
> Maybe you are confused because you chose a specific example wherein the expected number of treatments required is less than one? In my example 10 people out of 1000 required the treatment. If it's 100 people, then 1 will need it. You must have misread. > Your lack of intuition about such a simple linear relationship should be extremely concerning to you That's very condescending and a bit ironic. I think you should…
Ok, I see where the problem is. The 10 people requiring the 100 treatment in your example will cost 1000. That's one dollar per person, not one tenth. For the group of 100, 1 person will require the 100 treatment and it is still 1 dollar per person. You very obviously made a mistake and I incorrectly assumed it was in your calculation of the costs for the second group. The underlying point is still the same though, a…
But yeah, focus on purposely misinterpreting my arguments all you want. Have a nice day.
Earlier quoted context omitted.
Ok, I see where the problem is. The 10 people requiring the 100 treatment in your example will cost 1000. That's one dollar per person, not one tenth. For the group of 100, 1 person will require the 100 treatment and it is still 1 dollar per person. You very obviously made a mistake and I incorrectly assumed it was in your calculation of the costs for the second group. The underlying point is still the same though, a…
The cost of 100 is the cost of the whole treatment system. That includes doctors, nurses, medical equipment etc. For a capacity of around 10 cases. But yeah, focus on purposely misinterpreting my arguments all you want. Have a nice day.