Why YC went to DC • Hacker News Board

Re: Why YC went to DC

#231

Post by ceejayoz » Tue, Jun 04, 2024, 1:12 AM UTC

bumby wrote: post #206

luma wrote: post #169

Earlier quoted context omitted.

3) Medicare for all, starting today. Stroke of a pen I just fixed everything. > existing hospital infrastructure Hospitals already deal with medicare. > insurance companies Oh no the vultures in the system will go hungry whatever shall we do > citizens who don't want a single-payer system Buy premium insurance above and beyond the public option, same as every other modern industrialized country. If you don't like the…

Ignoring that a “stroke of the pen” is a dictatorial solution almost by definition… Considering Medicare/Medicaid are currently approaching $1T annually to serve less than 20% of the population how dues your stroke of the pen plan pay for the increase when everyone is enrolled? Hospitals are forced to accept Medicare, but in many cases this is at a loss, subsidized by private charges elsewhere. So you’ll need to find…

Medicare covers the most expensive part of the population.

The US spends 2-3x what the rest of the OECD spends per-capita, with about the same outcomes. Our system is the least cost efficient system in the entire developed world. It’s hard to see how Medicare-for-all could manage to do worse.

Re: Why YC went to DC

#232

Post by ec109685 » Tue, Jun 04, 2024, 1:12 AM UTC

zer00eyz wrote: post #105

dlkf wrote: post #94

Earlier quoted context omitted.

> It means that google doesn't have to aquire-hire your team, they can just poach all of them wholesale. Imagine a skilled worker taking a new job that pays better. What a nightmare scenario.

This isnt about workers. Let's say tomorrow that you find a better way to do search. It's going to crush google, and MS. You hire a team, smart people the VC's throw money at you. Everyone is happy. Your growing and the next darling of tech. Google comes in and offers to buy you out. You decline cause you know that they are blockbuster and your Netflix. In retaliation google hires all your staff, and sends them to th…

Imagine a world where employees can’t take a better offer, but a business could have their employees invent the next Google search, and then immediately fire all the workers that made that happen and hire cheaper ones to operate it.

That world sucks.

Re: Why YC went to DC

#233

Post by ceejayoz » Tue, Jun 04, 2024, 1:13 AM UTC

robertlagrant wrote: post #215

luma wrote: post #101

Why should healthcare be tied to employment? "Quit fucking around" and institute a national, single-payer plan that covers everyone, like every other modern industrialized country.

> institute a national, single-payer plan that covers everyone, like every other modern industrialized country The two (real, non-politicians are corrupt) downsides to contend with: - countries do this by limiting what they will spend; in the US you have access to unlimited treatment. E.g. in the UK the NHS will spend £30k for each good year it buys you - this one isn't fair, but the US is where health innovation hap…

> in the US you have access to unlimited treatment

This is a ludicrous claim.

Re: Why YC went to DC

#234

Post by noitpmeder » Tue, Jun 04, 2024, 1:14 AM UTC

mrb wrote: post #14

"This year, we’ll fund more than 500 companies out of 50,000 applications, and almost all of them are related to AI in some way." So, what this means: that in 2024, if you want to get VC capital, your startup must be related to AI.

Is anyone else depressed by that statistic? Is tech now eclipsed for the foreseeable future by AI?

Re: Why YC went to DC

#235

Post by pdonis » Tue, Jun 04, 2024, 1:16 AM UTC

yqx wrote: post #131

simonw wrote: post #13

This new essay by Jack Clark, who was at OpenAI when they made the decision not to release GPT-2 for safety reasons five years ago, feels relevant: https://importai.substack.com/p/import-ai-375-gpt-2-five-yea... > [...] history shows that once we assign power to governments, they're loathe to subsequently give that power back to the people. Policy is a ratchet and things tend to accrete over time. That means whatever…

I'm curious what history Jack Clark is referring to here. If I think of the last thirty years of policy in most of Europe and the US I'm thinking of a strong trend of deregulation and giving more powers to markets, removing international trade barriers and so on. That seems to be a dynamic opposite to the one the quoted article is suggesting.

> If I think of the last thirty years of policy in most of Europe and the US I'm thinking of a strong trend of deregulation and giving more powers to markets

That's been the PR spin, but it's not actually true. It's a smoke screen to help governments avoid actual accountability.

For example, the crash of 2008 was blamed on too much market and not enough regulation, but in fact it was the opposite: regulatory thumbs on the scale, for example the US government wanting to encourage home ownership and skewing the mortage market and the money supply and requiring lenders to accept more default risk, and governments implicitly giving a "too big to fail" guarantee to large financial institutions and then being extremely arbitrary in when that implicit guarantee was broken. A true free market would never have produced such a thing.

> removing international trade barriers and so on.

Globalization of trade has been going on for much longer than the last 30 years. If anything, the last 30 years have seen more of things like trade wars (for example between the US and China) and other disruptions to smooth international trade.

Re: Why YC went to DC

#236

Post by bumby » Tue, Jun 04, 2024, 1:18 AM UTC

ceejayoz wrote: post #231

bumby wrote: post #206

Earlier quoted context omitted.

Ignoring that a “stroke of the pen” is a dictatorial solution almost by definition… Considering Medicare/Medicaid are currently approaching $1T annually to serve less than 20% of the population how dues your stroke of the pen plan pay for the increase when everyone is enrolled? Hospitals are forced to accept Medicare, but in many cases this is at a loss, subsidized by private charges elsewhere. So you’ll need to find…

Medicare covers the most expensive part of the population. The US spends 2-3x what the rest of the OECD spends per-capita, with about the same outcomes. Our system is the least cost efficient system in the entire developed world. It’s hard to see how Medicare-for-all could manage to do worse.

I agree with the population part. But more nuance is that a huge part is the last few weeks of life because of cultural aspects regarding protecting life by all means necessary.

However, they’re a saying in healthcare that you can optimize for quality, access, or cost but you only get two.

The US system is largely focused on optimizing for quality and access (although I admit the latter isn’t necessarily done well and generally relies on reactive care). So to open up access further, you’d probably need to address the other two levers, and I’m not seeing anyone discuss that. There’s also the disproportionate amount of R&D done by the US which effectively subsidizes the rest of the world to help keep their costs down. All that to say, none of the simple solutions bandied about really talk about those effects, let alone how to manage them.

Re: Why YC went to DC

#237

Post by bumby » Tue, Jun 04, 2024, 1:19 AM UTC

ryandrake wrote: post #228

bumby wrote: post #206

Earlier quoted context omitted.

Ignoring that a “stroke of the pen” is a dictatorial solution almost by definition… Considering Medicare/Medicaid are currently approaching $1T annually to serve less than 20% of the population how dues your stroke of the pen plan pay for the increase when everyone is enrolled? Hospitals are forced to accept Medicare, but in many cases this is at a loss, subsidized by private charges elsewhere. So you’ll need to find…

Come on--obviously OP meant a "stroke of the pen, held by duly elected representatives". Nothing dictatorial about that. We currently can almost get enough of those representatives in office to do it (and a president to sign it), if it weren't for things like the electoral college, gerrymandering, and grossly unequal representation in the Senate, things that currently give disproportionate power to the "team" that ha…

I meant it as an executive order, which is really the only stroke of a pen that would work. Otherwise you’d have to build the political capital to get enough representatives to sign on, and that’s exactly the non-simple task I was alluding to. Those are the same reps who make the rules you’re complaining about, and the same ones who can’t agree on a budget when we don’t have a massive increase in Medicare entitlements. Maybe I’m too cynical, but pretending like there’s the political capital to do it just in the horizon feels like a pipe dream to me. I’m old enough to remember politicians talking about a single payer system in the 1990s and yet here we are.

Re: Why YC went to DC

#238

Post by dghlsakjg » Tue, Jun 04, 2024, 1:25 AM UTC

robertlagrant wrote: post #215

luma wrote: post #101

Why should healthcare be tied to employment? "Quit fucking around" and institute a national, single-payer plan that covers everyone, like every other modern industrialized country.

> institute a national, single-payer plan that covers everyone, like every other modern industrialized country The two (real, non-politicians are corrupt) downsides to contend with: - countries do this by limiting what they will spend; in the US you have access to unlimited treatment. E.g. in the UK the NHS will spend £30k for each good year it buys you - this one isn't fair, but the US is where health innovation hap…

I live in Canada and there isn’t a spending limit. The decision of how to treat is made by the doctor. The doctor is then paid. In my experience living on both sides of the border, you get far more care up here since there is no bullshit with finding a facility that accepts your insurance, and cost isn’t a consideration for doctors or patients.

People will occasionally travel to the states for drug/therapy trials not available in Canada, or for treatments that are not proven effective. These people will then loudly bitch about Canadian healthcare.

If you want the proof of it, remember that a huge majority of Canadians live close enough to drive to the US for health care, but don’t.

Re: Why YC went to DC

#239

Post by bumby » Tue, Jun 04, 2024, 1:25 AM UTC

ethbr1 wrote: post #223

bumby wrote: post #143

Earlier quoted context omitted.

> Better to simply create a system by which they're weeded out. I agree with this. It's really just another way to say there should be mechanisms to hold people accountable. > Which I guess dovetails with the military "up or out" process. I don't think the military does a great job of this. From what I could see, it only forces out the absolute absymal performers (e.g., those who can't pass a PFT or have multiple DUI…

I've less familiarity with it on the enlisted side, but there's also much stronger gating of promotions by competency tests there, right? On the officer side, especially in certain specialties, it's very much musical chairs... with an ever-decreasing number of chairs. (Which admittedly creates a lot of its own issues by setting up zero-sum, don't-help-your-competition scenarios and politics at the higher ranks)

>but there's also much stronger gating of promotions by competency tests there, right?

I think it heavily depends on the branch and what is considered “competence”. I remember meeting Airmen who could cite all the stats about weapons systems because that was on their test, but the couldn’t shoot. And Marines where it was the opposite. It’s also generally possible to get promoted by just hanging out, keeping out of trouble, and having reasonable fitness tests

Re: Why YC went to DC

#240

Post by pjmorris » Tue, Jun 04, 2024, 1:28 AM UTC

bumby wrote: post #206

luma wrote: post #169

Earlier quoted context omitted.

3) Medicare for all, starting today. Stroke of a pen I just fixed everything. > existing hospital infrastructure Hospitals already deal with medicare. > insurance companies Oh no the vultures in the system will go hungry whatever shall we do > citizens who don't want a single-payer system Buy premium insurance above and beyond the public option, same as every other modern industrialized country. If you don't like the…

Ignoring that a “stroke of the pen” is a dictatorial solution almost by definition… Considering Medicare/Medicaid are currently approaching $1T annually to serve less than 20% of the population how dues your stroke of the pen plan pay for the increase when everyone is enrolled? Hospitals are forced to accept Medicare, but in many cases this is at a loss, subsidized by private charges elsewhere. So you’ll need to find…

> Considering Medicare/Medicaid are currently approaching $1T annually to serve less than 20% of the population how dues your stroke of the pen plan pay for the increase when everyone is enrolled?

Most countries manage on ~12% or less of GDP, the US takes ~17% of GDP to pay for healthcare [0]. For example, the UK manages to cover everyone for about 12% of GDP. If the US adopted a plan as ubiquitous as the UK, in the same manner as the UK, it'd be cheaper than the current system. Expense seems to be correlated more with the presence of insurance than with the ubiquity of healthcare.

[0] https://ourworldindata.org/financing-healthcare