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Care Doesn't Scale

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Re: Care Doesn't Scale

#201

Post by jimbokun »

geysersam wrote: post #60
bluetomcat wrote: post #8

This is ultimately a dichotomy between having the family unit or "the state" as the central point of governance. Many totalitarian regimes looked at newborns as "belonging to the state". The result is a unified mass person who dresses, thinks and acts in predictable ways. The more power, personal connection and influence parents have over their children, the more diverse society will become.

A false dichotomy some would call that. Children can be raised in units different from the current western perception of "the" family unit. Besides, what countries are you talking about? Have you ever been there and met the uniform mass persons?

Did you read the article?

"Care" doesn't scale. You can't just replace "the family" with some industrialized system of raising children and get the same results. Not being able to scale "care" and make it more efficient is almost tautological, really.

> Besides, what countries are you talking about?

North Korea? Former Soviet Union?

At the very least appearance of conformity was ruthlessly enforced and even private conversations were infiltrated to detect dissent.

Re: Care Doesn't Scale

#202

Post by steveBK123 »

jimbokun wrote: post #196
hedvig23 wrote: post #177

Earlier quoted context omitted.

It's pretty simple no, the model that is reasonable and antifragile is within our grasp, a model that includes degrees of error more than it reifies hewing towards 0 carrying costs. It's more the good will and good faith across the board to use that known simple math, as sneaky monkey minds in our midst see that if they defect they can win some edge in the short term (and again, a better model shows the true utility…

It's aligning the incentives of top management with the slightly longer term outcomes. If stock grants are based on this quarter's performance, "slack" seems much less important.

Exactly, if you get rewarded for the 5% improvements annually but are out before the once-a-decade near death experiences.. you end up with more Intels, GMs, Boeings, etc.

Re: Care Doesn't Scale

#203

Post by jimbokun »

kubb wrote: post #127
lolinder wrote: post #110

Earlier quoted context omitted.

Expressed differently: they tried to abolish the family, found that doing so created more problems then they solved, and backed off in order to avoid tearing their country apart. They discovered that in some things doing nothing is better than doing something, but Westerners of all political stripes (both for or against authoritarianism) chronically make the mistake of assuming that everything that a totalitarian sta…

I don’t think they ever tried to “abolish family”. Where are you getting this stuff? It sounds like bad history lessons. They did stuff like legalizing divorce, or collectivization of parenting.

You really want to go to bat for the Soviet Union?

Re: Care Doesn't Scale

#204

Post by bunderbunder »

bumby wrote: post #157
vanderZwan wrote: post #142

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 provide…

Your reply seems focused on size, but this line caught my attention: > trusting them to make the right decisions. I'm wondering if trust isn't the real issue. For example, wouldn't a large high-trust organization be able to provide good care? Or is there something intrinsic to scale (e.g. diffusion of responsibility) that makes "high-trust" and "large organization" incompatible?

Paperwork. I swear, it's paperwork.

My mom is a (retired) preschool teacher. By the end of her career, she was working for a school affiliated with a large chain, and maybe 1/3 of her time was spent on filling out all the paperwork required by management. That was time she absolutely was not spending with the kids.

My dad is a (retired) doctor. Similar story there. His hospital ultimately ended up associated with a regional health care network, and the paperwork load ultimately got so bad that they ended up having to hire additional staff dedicated to help the actual health care providers fill out all the paperwork so that they could spend more time actually providing health care.

I switched primary care providers over this a few years back. I had a great doctor, but her practice got bought up by one organization, which then got bought up by another, and over time working with her office became a huge bureaucratic quagmire. I switched to a different clinic that's still local (although also chain with multiple locations), and everything's easier again.

The same thing happens at my own job, software. The bigger a company I'm at, the more of my job consists of filling out paperwork about the work I'm doing, rather than doing the actual work.

tl;dr: It's communication that doesn't scale.

Re: Care Doesn't Scale

#205

Post by jimbokun »

peepee1982 wrote: post #62
bluetomcat wrote: post #8

This is ultimately a dichotomy between having the family unit or "the state" as the central point of governance. Many totalitarian regimes looked at newborns as "belonging to the state". The result is a unified mass person who dresses, thinks and acts in predictable ways. The more power, personal connection and influence parents have over their children, the more diverse society will become.

You’re describing the extremes on a spectrum, but you only go to one of the extremes, which exposes your bias. And it’s a false dichotomy to begin with, since shifting more care work towards society doesn’t equate to a path toward totalitarianism. You’re conflating socialism with totalitarianism. Understandable, but misguided. Frankly, your whole premise is based on a capitalist narrative that keeps workers in their…

"because individual care work is so inefficient"

The whole point is scaling "care work" is almost oxymoronic. Care is only quality care when there are a small number of carers per those being cared for. To make it "efficient" is to turn children, the addicted, the disabled, and the elderly into cattle.

> "Wages for Housework" by Silvia Federici - Federici argues for the recognition and compensation of domestic labor, linking it to broader struggles against capitalist exploitation.

This reveals one of the poorly hid secrets of progressive ideology. Progressives LOVE Capitalism and want to spread it to encompass every human interaction. Caring for your own home, your own children, anything someone might do for a friend or a loved one MUST be turned into a financial transaction with an explicit contract.

Re: Care Doesn't Scale

#207

Post by jimbokun »

k__ wrote: post #107

I assumed the opposite. Knew a women who worked 100% as foster mom. Had 3 children at a time, age 6 to 13. Everything was well organised. It seemed to me, child care can work pretty well of it's your main job and you get paid by the state.

3 children.

If it's 10, 20, 30, this doesn't work. This is the entire point, that care work does not scale like manufacturing or farming or software or entertainment or...

Re: Care Doesn't Scale

#208

Post by theamk »

amanaplanacanal wrote: post #186
theamk wrote: post #93

Earlier quoted context omitted.

Try giving everyone housing without centralized production of things like nails, screws, siding electrical wire... Decentralizization is fine sometimes, but a single huge nail factory is going to beat thousands backyard forges in (average/95th percentile) quality and especially in prices.

Yet somehow houses were still well built before the huge nail factory existed. Which means it is not required.

Sure, it's not required to build _some_ houses, but it's required for scale.

Backyard forges are OK if you have few hundred million people, most of them in farming, with most families living in a house with a a single room. But you cannot build New York on without large factories.

Re: Care Doesn't Scale

#210

Post by jimbokun »

tehabe wrote: post #2

This is one reason why we have a state, which collect taxes and can provide those services.

Doing it by a state does not make it magically scale in any way shape or form. You still need something like one-to-one or one-to-a-few for care work to be effective. Trying to provide it through the government does absolutely nothing to change this fact.
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