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Mark Cuban offers to fund former 18F employees

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Re: Mark Cuban offers to fund former 18F employees

#411

Post by consumer451 »

modeless wrote: post #331
consumer451 wrote: post #174

Earlier quoted context omitted.

> The difference is private companies that accumulate too much waste and useless things can fail and be replaced. The US healthcare system is evidence that this is an overly simplistic view. In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, and we work to decrease it. In a for profit healthcare insurance system, every dollar not spent on patient care is consi…

If you think the US healthcare system is a good example of something that isn't driven by pervasive regulation, this is exactly the kind of "what the hell is water" problem I was talking about.

Let's say there were no regulations. None at all.

Wouldn't the largest private health insurer just buy up all the smaller ones, and then how exactly would competition work?

Re: Mark Cuban offers to fund former 18F employees

#412

Post by cmrdporcupine »

HideousKojima wrote: post #284
cmrdporcupine wrote: post #130

Earlier quoted context omitted.

It's funny to me to see this kind of thing labelled as "communist" considering that classical Marxist theory itself actually has a very cynical (and determinist) view of the state and does not in fact see the state as performing this "civic" role at all. Old school dogmatic Marxists see the state as nothing more than the coordinating arm of capitalism, or a "relief valve" for it, and Lenin spoke openly about its comp…

>Old school dogmatic Marxists see the state as nothing more than the coordinating arm of capitalism, or a "relief valve" for it, and Lenin spoke openly about its complete destruction in State And Revolution. And yet every single time Communists (Lenin included) have gotten into power...

Sure, and that speaks at least partially to the incorrectness of the classic theory of the state in those branches of Marxism.

(I don't throw the baby out with the bathwater though. There are theoreticians who have added a lot more nuance here, especially Poulantzas)

Re: Mark Cuban offers to fund former 18F employees

#413

Post by consumer451 »

tmoertel wrote: post #209
consumer451 wrote: post #174

Earlier quoted context omitted.

> The difference is private companies that accumulate too much waste and useless things can fail and be replaced. The US healthcare system is evidence that this is an overly simplistic view. In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, and we work to decrease it. In a for profit healthcare insurance system, every dollar not spent on patient care is consi…

> In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, and we work to decrease it. That’s cute. But the reality is often closer to this version: In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, so we give it to ourselves and find a way to call it patient care.

> In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, so we give it to ourselves and find a way to call it patient care.

Can you share some significant real-world examples of this happening?

Re: Mark Cuban offers to fund former 18F employees

#414

Post by thedufer »

epistasis wrote: post #398
thedufer wrote: post #314

Earlier quoted context omitted.

I would assume they're pointing at the comment at the top of this thread ("They built / manage login.gov?") rather than the article itself.

I guess that's why I'm confused, which facts are not straight or were corrected?

18f built but did not then manage login.gov. It was handed off elsewhere. The implication of them managing it was that disbanding 18f left login.gov ownerless (or at least handed off to some group that knows nothing about it) which does not seem to be the case.

Re: Mark Cuban offers to fund former 18F employees

#415

Post by luckylion »

surgical_fire wrote: post #409
luckylion wrote: post #353

Earlier quoted context omitted.

It depends on what you consider government functions, but I'd be cautious as well. And while the German's government eventual recognition that fax machines are no longer the state of the art is an extreme case, I believe it's exemplifies the problem. Private companies, both large and small, have done that much earlier. Those profits they're chasing above all else are a powerful driver for innovation and optimization.

> Those profits they're chasing above all else are a powerful driver for innovation and optimization. They are also a powerful driver for exploitation both of employees and of the general public. Be careful with what you wish for. I certainly prefer dealing with a public sector that still operate on fax machines but that still may fundamentally work for the public good (as inefficient as it may be), than with a corpo…

> They are also a powerful driver for exploitation both of employees and of the general public.

Yes, but you'll always have that. An average person working for the government, be that as an employee or as an official, will optimize their work load and try to do the minimum amount required. That's individually much less of a problem than that greedy CEO you envision, but it adds up in large numbers and becomes a problem if not corrected - and there's no strong incentive to correct it when you play with the infinite money hack enabled.

Human nature has to be taken into account either way. It's just a lot easier when you acknowledge that it exists. Massively oversimplified: that's why the Soviets had to build walls to make it hard for their people to leave and murder those who tried. You can ignore human nature, but human nature won't ignore you.

Re: Mark Cuban offers to fund former 18F employees

#416

Post by tmoertel »

consumer451 wrote: post #413
tmoertel wrote: post #209

Earlier quoted context omitted.

> In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, and we work to decrease it. That’s cute. But the reality is often closer to this version: In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, so we give it to ourselves and find a way to call it patient care.

> In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, so we give it to ourselves and find a way to call it patient care. Can you share some significant real-world examples of this happening?

Sure. In many parts of the United States, regional hospital systems have captured their local markets through consolidation and exploitation of their non-profit status. They then offer their own health insurance plans to provide access their own hospital systems, sometimes even denying access to other insurance plans. So when these insurance plans spend on patient care, they are, in effect, paying themselves at rates they have strong influence over.

For example, in western Pennsylvania, there is UPMC. According to court documents, UPMC acquired 28 competitors between 1996 and 2018. According to the Pennsylvania Attorney General's office, in 2011 UPMC announced it would stop accepting patients insured by its competitor, Highmark. This prompted the PA government to "enter into consent decrees with both UPMC and Highmark to protect access to care." Which, again according to the Pennsylvania Attorney General's office, UPMC continued to violate. This has lead to, among other things, a recent antitrust lawsuit supported by the US Justice Dept. [1] [2]

[1] https://www.attorneygeneral.gov/upmc/

[2] https://www.wesa.fm/health-science-tech/2024-10-03/justice-d...

Re: Mark Cuban offers to fund former 18F employees

#417

Post by FireBeyond »

kierangill wrote: post #229

I’ve seen a lot of positivity surrounding login.gov on HackerNews. I’ve never used the service and am unfamiliar with the quality of its implementation. Many commenters here point to login.gov as an example of the US government shipping good software. [1] 1. From the end-user’s perspective, what makes this a quality service? Is it simply better than other government alternatives, or does it compete with equivalent mo…

> Many commenters here point to login.gov as an example of the US government shipping good software.

Maybe. But in some ways, my experience with it was a heaping turd (registering my identity for the IRS):

"Scan the front and back of your Driver's License."

[upload scan of front of DL @ 200DPI]

"Unable to find a face in the image you uploaded."

[upload scan of front of DL @ 300DPI]

"Unable to find a face in the image you uploaded."

Huh. Maybe I'll try with a lower resolution.

[upload scan of front of DL @ 72DPI]

"Thank you, now please upload the back of your Driver's License."

Hmm, 72DPI worked for the front, so...

[upload scan of back of DL @ 72DPI]

"Unable to read a barcode in the image you uploaded."

[upload scan of back of DL @ 200DPI]

"Unable to read a barcode in the image you uploaded."

[upload scan of back of DL @ 300DPI]

"Thank you for verifying your Driver's License".

Re: Mark Cuban offers to fund former 18F employees

#418

Post by austin-cheney »

ctxcode wrote: post #236
austin-cheney wrote: post #169

Is there any evidence that government teams are more wasteful or less productive than commercial alternatives? How does spinning a government team into a government contract of a commercial vendor save the government money?

Private companies are required to do a good job and balance spending to stay alive. Goverment agencies can do the most horrible job for enormous amounts of money and just keep going.

First of all that isn't evidence of anything and explains how we got in this pickle to begin with... people making shit up.

Secondly, private companies don't have to do a good job. They have to turn a profit, which could be exploitative and not necessarily legal.

Third, government agencies have budgets and audits like many public companies but not private companies. If a government agency exceeds its budget it is essential bankrupt.

Finally, if a government agency fails an audit people can be fined, fired, or even prosecuted. Government agencies are always audited, unlike many commercial companies that are only audited according to regulation and/or cause of investigation. Many of the people recently fired by DOGE are auditors that were preventing the very kind of behavior you suggest of government.

Re: Mark Cuban offers to fund former 18F employees

#419

Post by surgical_fire »

luckylion wrote: post #415
surgical_fire wrote: post #409

Earlier quoted context omitted.

> Those profits they're chasing above all else are a powerful driver for innovation and optimization. They are also a powerful driver for exploitation both of employees and of the general public. Be careful with what you wish for. I certainly prefer dealing with a public sector that still operate on fax machines but that still may fundamentally work for the public good (as inefficient as it may be), than with a corpo…

> They are also a powerful driver for exploitation both of employees and of the general public. Yes, but you'll always have that. An average person working for the government, be that as an employee or as an official, will optimize their work load and try to do the minimum amount required. That's individually much less of a problem than that greedy CEO you envision, but it adds up in large numbers and becomes a probl…

> Yes, but you'll always have that. An average person working for the government, be that as an employee or as an official, will optimize their work load and try to do the minimum amount required.

Except that is not really my observation of someone that dealt with the public sector extensively in multiple different countries.

More often than not I dealt with people that were really trying to do a good job and were helpful to an extent.

Yes, there are lazy people that just want to coast (as if those don't exist in the private sector) and there is a level of corruption (also let's pretend that there's no corruption in the private sector). But that is definitely not the majority, especially in countries that more or less work.

> That's individually much less of a problem than that greedy CEO you envision, but it adds up in large numbers and becomes a problem if not corrected

Again, I disagree. The profit seeking and inherent greet of the any corporation creates a fundamental adversarial condition that is unsolvable. What is good for a corporation tends to almost always be bad for the general public. And there is no incentive to place constraints on the greed of corporations besides government regulations.

> Massively oversimplified: that's why the Soviets had to build walls to make it hard for their people to leave and murder those who tried. You can ignore human nature, but human nature won't ignore you.

You mention the Soviet Union as an example of a government that worked against the people, ignoring plenty of good examples in different countries.

And I am not really the one ignoring human nature when you are essentially willing to surrender the public good to relentless greed. Greed only begets more greed. You would do well to remember that

Re: Mark Cuban offers to fund former 18F employees

#420

Post by consumer451 »

tmoertel wrote: post #416
consumer451 wrote: post #413

Earlier quoted context omitted.

> In a not for profit healthcare insurance system, every dollar not spent on patient care is considered waste, so we give it to ourselves and find a way to call it patient care. Can you share some significant real-world examples of this happening?

Sure. In many parts of the United States, regional hospital systems have captured their local markets through consolidation and exploitation of their non-profit status. They then offer their own health insurance plans to provide access their own hospital systems, sometimes even denying access to other insurance plans. So when these insurance plans spend on patient care, they are, in effect, paying themselves at rates…

Wow, that appears to be pure corruption. Thanks for sharing.

I wonder if there are examples of this type of thing happening in places outside the USA, like Western Europe for example.

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