Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Care Doesn't Scale

stevenscrawls.com

Post reply on HN
Print view View original

141–150 of 382 posts

Re: Care Doesn't Scale

#141

Post by potato3732842 »

Yawrehto wrote: post #103
MichaelZuo wrote: post #76

Earlier quoted context omitted.

Although it’s theoretically possible and theoretically economical for individual care ‘to happen’, it doesn’t in practice for the housing economy. If anything it’s decreasing year by year on average. Especially when you look at construction quality, the average quality of say new built condos in any major city has gone way way down since the 90s. Of course on average condo designs have on average gotten fancier with…

About housing: I have a few ideas as to why, weirdly none of which overlap with yours. 1) I think part of it is due to our ability to fine-tune the limits. Before, if a company wanted to pass an inspection, they had to be really confident. There were going to be some expenses that in theory they could have avoided if they were better capable of measuring where the line between 'safe' and 'unsafe' was. The end result…

1 is in large part a reflection of idiot proofing everything. Every party's judgement gets reduced down to some some quantitative stuff like wire gauges, stud spacing, etc, that even idiots with poor judgement can reliably assess. Instead of failures because people do shoddy work we instead get failures where people are dumbly building things they know won't last because it's easier to just let things be crappy than to try to get permission to deviate from the plan. Basically decision making authority is being abstracted away from the people who have actual context. This limits the screw-ups from people doing work below the minimum at the expense of preventing anyone from who would have done something better than the minimum from doing so.

Re: Care Doesn't Scale

#142

Post by vanderZwan »

If we're going to talk about how to "scale care" and how not to, then Buurtzorg has to be mentioned[0][1]. It's a Dutch home-care company that was started by nurses who basically got frustrated that managers got in the way of them doing their job. It operates by having a flat organization working with small teams of highly trained nurses, and trusting them to make the right decisions. The result is a low-cost provider of high-quality health-care.

So when the author says care "doesn't scale", they obviously mean "you need a one-to-one ratio of caretakers", which I fully agree with. But what they're also accidentally doing in the process is explaining why creating bigger teams with bigger hierarchies and structures does not appear to increase the efficiency of care.

Some projects do need big teams with hierarchies - even in healthcare. Effectively responding to a pandemic comes to mind. I suspect it's when the core problem to tackle most naturally breaks down like a tree - a hierarchy then mirrors the way the problem breaks down. For some projects, like general homecare, the efficiency sweet spot is a flat structure of autonomous individual teams, because it doesn't scale beyond those teams anyway.

And just like the author concludes, I find that there's something comforting about that.

[0] https://en.wikipedia.org/wiki/Buurtzorg_Nederland

[1] https://www.youtube.com/watch?v=SSoWtXvqsgg

Re: Care Doesn't Scale

#143

Post by CooCooCaCha »

Tade0 wrote: post #46

> But I wonder if part of that smaller focus comes from a deep realization that care doesn’t scale. My experience (and I believe it to be common) is that I'm really, really, really out of spare energy to care about anyone or anything else. Mind you, I'm in my best shape in years and I've explored my limits to find out they're actually way further than I originally thought, but still.

This is such an important point. Caring is often limited by the spare energy you have to care.

Care could scale, but we’d need the culture and societal changes to allow it to scale.

Re: Care Doesn't Scale

#144

Post by moolcool »

downut wrote: post #134
delichon wrote: post #123

It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages. Nobody but a beggar chuses to depend chiefly upon the benevolence of his fellow-citizens. -- Adam Smith Care doesn't scale but self-inte…

"...baker who gets up at 3 am..." But those 3am bakers are being exterminated by at scale corporate chains, no? Generalizes to just about anything that could reasonably be described using "artisanal". Social atomization inexorably spreads, and after thinking about it pretty hard for many years of travel putting eyeballs on "artisanal" processes I don't see any possibility of any other outcome. So we enjoy what is lef…

To complete the thought, the baker example is explicitly in opposition to OP's point. In the economy we exist in, a 3am artisan baker does so explicitly out of a care for craft and community.

Re: Care Doesn't Scale

#145

Post by ativzzz »

User23 wrote: post #138
pschoeps wrote: post #124

Earlier quoted context omitted.

This seems more like a very skilled caregiver to me, I would be absolutely overwhelmed in this position.

Which is quite remarkable, because up until less than a century ago when women “entered the workforce” virtually every woman who had ever lived somehow managed to care for her 3+ children. Incidentally, large families do scale sublinearly with respect to the parents. The reason why is that even with merely natural spacing by the time they have a fourth child, the oldest is in a position to provide significant assista…

It is remarkable. I have one child, and it is by far the hardest thing I've ever done - far harder than any job I've had. It doesn't help that both parents are working full time. Maybe parenting has changed recently and we are too hands-on, but I can't imagine having 2, much less 3+ running around. Even if one of us stops working to raise the kids full time, it's way more taxing, physically and mentally, than working a white collar job and paying for child care.

Re: Care Doesn't Scale

#146

Post by adamc »

avhception wrote: post #61
Tade0 wrote: post #46

> But I wonder if part of that smaller focus comes from a deep realization that care doesn’t scale. My experience (and I believe it to be common) is that I'm really, really, really out of spare energy to care about anyone or anything else. Mind you, I'm in my best shape in years and I've explored my limits to find out they're actually way further than I originally thought, but still.

There was a story on HN a while ago that I can't seem to remember the title of. It was something along the lines of "The optimal amount of slack in an organization is not zero", or something like that. The argument was that, since it's impossible to plan for every eventuality, you need a certain amount of slack capacity in order to retain some flexibility. And that by always using 100% capacity, we end up dysfunction…

Tom DeMarco wrote a book about this some years ago, called... "Slack".

Re: Care Doesn't Scale

#147

Post by downut »

moolcool wrote: post #144
downut wrote: post #134

Earlier quoted context omitted.

"...baker who gets up at 3 am..." But those 3am bakers are being exterminated by at scale corporate chains, no? Generalizes to just about anything that could reasonably be described using "artisanal". Social atomization inexorably spreads, and after thinking about it pretty hard for many years of travel putting eyeballs on "artisanal" processes I don't see any possibility of any other outcome. So we enjoy what is lef…

To complete the thought, the baker example is explicitly in opposition to OP's point. In the economy we exist in, a 3am artisan baker does so explicitly out of a care for craft and community.

Yes. Precisely so. As it happens, we've been friends with a "3am baker" for decades. We do not envy her life, but we do intensely enjoy her taste. Delighted to pay double for it.

Re: Care Doesn't Scale

#148

Post by croes »

bell-cot wrote: post #140
croes wrote: post #129

Earlier quoted context omitted.

The countless hours of voluntary unpaid work by many people shows don’t act only for their own benefit

True-ish. But try talking to some old folks, about the vastly reduced scale of such volunteer work since (say) the 1950's. That "voluntary unpaid" stuff would include religious organizations, civic groups, housewives, ...

You need time for that.

It’s true that first you care for yourself but after survival is secured many people care for others without profit concerns.

But if you need more time to satisfy your own needs you have less time for others.

Re: Care Doesn't Scale

#149

Post by harimau777 »

bell-cot wrote: post #140
croes wrote: post #129

Earlier quoted context omitted.

The countless hours of voluntary unpaid work by many people shows don’t act only for their own benefit

True-ish. But try talking to some old folks, about the vastly reduced scale of such volunteer work since (say) the 1950's. That "voluntary unpaid" stuff would include religious organizations, civic groups, housewives, ...

It seems to me that capitalism discourages that behavior. If the system is setup to be transactional, and you can't rely on others reciprocating altruism if you need it; then it seems like engaging in altruism would be for suckers.

Re: Care Doesn't Scale

#150

Post by moolcool »

taylorius wrote: post #16

I think in the future, descendants of today's LLM models and some future version of Tesla's Optimus could create a paradigm shift in how care is given. I'm hopeful that when I get old, and inevitably come to need some help with living, that such a solution will be available.

I think this is a gross and psychopathic vision of the future. Tell your grandmother that you're going to automate away her need for human connection. What a terrible indignity. I hate my industry.
Post reply on HN