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Care Doesn't Scale

stevenscrawls.com

261–270 of 382 posts

Re: Care Doesn't Scale

#261

I'm surprised the article and non of the comments I've seen in this thread mention effective altruism, which in the framing of the article is an attempt to scale caring in some sense. The article helped me realize why so many people in the startup/tech/software engineering scene are drawn to effective altruism, it's a way to scale helping humanity in the best way possible. The effective altruism argument is that it's…

I think most people's problem with "effective altruism" is rather that some of its more prominent adherents end up defining "helping humanity" in very weird and rather counter-intuitive ways. Like that whole argument that we basically should care more about future humans than present ones because there's a lot more future ones.

Re: Care Doesn't Scale

#262

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…

Thanks for elaborating further what we mean by "scaling". Couldn't it be said that when organization acquire ranks, it is to solve coordination problems that arise with scale but that in this case, there isn't much that is solved by more organization ?

There's also a different kind of coordination problem.

The incentives of an organization - or at least of a corporation - are to make money and to continue to exist and to enrich and empower the people who control it. But employees' incentives are usually pretty different. Nurses usually get into nursing because they, at least to some extent, want to help people. Engineers get into engineering because they, at least to some extent, want to build something really good. Teachers get into teaching because they want kids to learn. And so on.

If you're the principal of a school, and your goal is for a teacher to teach, you don't have a coordination problem. Most teachers want to do that. But if your goal is for teachers to maximize standardized test scores, or to minimize the number of frustrated parent calls, etc, you do have a coordination problem, because your goals are misaligned with your employees'.

If you're the CEO of a tech company, and your goal is for your engineers to build good software, you don't have a coordination problem. Your engineers want to do that. But if your goal is to maximize conversions, or to ship faster, or to raise money, etc., you do have a coordination problem.

If you run a hospital, and your goal is for your nurses to care for patients, you don't have a coordination problem. But if your goal is to maximize profits, then you do.

It's usually these kinds of coordination problems that managers are, effectively, in charge of enforcing. Their job is not to help individual employees achieve individual employees' collective goals, it's to make employees feel (sometimes truthfully) like their goals are aligned with the organizational goals, or to use the threat of loss of income or work to force them into line.

Re: Care Doesn't Scale

#263
post #131

> There was some pain in that realization. So many of my utopian dreams—what if we could live in a society where everyone can get the food, the housing, the healthcare, the opportunities for growth that they deserve—come from a place of wishing that we could live in a world where people are cared for. I'd like to offer some comfort to the author on this score. Food, housing, healthcare broadly... while these are all…

> The food system is different from homecooked meals This is a good point, and everything I've heard from parents says that it's parents, not children, who identify home-cooked meals with care. Children notoriously prefer prepackaged industrially processed food over whole foods prepared with care and love. In order to feel cared for, all children need is to trust that the person caring for them will make sure they ge…

> at some point a child that is fed pancakes every day will gain the ability to look back and regret how they were raised

I regret nothing. Pancakes are and will always be great.

Re: Care Doesn't Scale

#264

Earlier quoted context omitted.

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?

> Have you ever been there and met the uniform mass persons? I was born in Eastern Europe in a society headed in this direction. I observed its transformation after the fall of the Berlin Wall. You felt the overarching power of the state from as early as the kindergarten. Signs of individuality were suppressed and all children were supposed to do things "the right way". When such an institution decided that a child "…

I grew up in the USSR, and in the kindergarten, our teacher actually tried to convince us that the correct 5 year old kid's answer to the question, "which person do you love the most?" ought to be Lenin, and not e.g. "mom".

That said, in practice, the quality of indoctrination was extremely variable for the same reason why it was variable for everything else - most people weren't really buying into it themselves, and so even if they were in a position where they were expected to indoctrinate, they did the bare minimum that was demanded of them, which usually wasn't very convincing. I didn't get to witness it as an adult, but according to my mother, by the time you were old enough for Komsomol, very few still had their rose-tinted glasses on.

Re: Care Doesn't Scale

#265
healthy society only work if most people are virtuous and take care of themselves and their families. The cost to care for the neglected and broken isn't sustainably if its more than a tiny percentage of the population.

Re: Care Doesn't Scale

#266
post #96

Earlier quoted context omitted.

Early Soviet Union did try to reshape family, but it went back on it eventually, seeing the value of the conservative family model in building social cohesion and loyalty.

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 would argue that the main reason why USSR changed so spectacularly circa WW2 is because Stalin was personally very socially conservative in many ways. It wasn't just religion during WW2 - the country reverted to traditional gender roles in general in many ways, banned abortion, made homosexuality illegal again etc. Most of the early extreme experiments that really didn't work out were already long abandoned by then.

Re: Care Doesn't Scale

#267

Earlier quoted context omitted.

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.

capitalism is so that strangers with no reason to cooperate can via the market. It should have nothing to say about you network or closer relations and how you interact. Altruism has a large place in life but in general it is directed to friends and family then your larger social groups.

Re: Care Doesn't Scale

#268
post #77

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 are assuming all family influence is good. There are lots of abusive families and poor parents, though.

In general people take care of their kids. In general the family is good you can always find edge cases.

Re: Care Doesn't Scale

#269
post #260

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…

To be fair, Buurtzorg doesn’t scale either, as they’re perpetually short staffed.

The other companies are also shortstaffed, all healthcare is at the moment, and the bureaucracy layers just keeps humming along ... Buurtzorg is however cheaper, and since you cannot scale the actual care that counts.

Re: Care Doesn't Scale

#270
post #152

Earlier quoted context omitted.

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…

I think it referred to the classic efficiency vs latency tradeoff. Like when emergency vehicles are always on standby, which is inefficient, but allows them to roll out without delay. Conversely privatised rail lines squeeze out every ounce of capacity from the infrastructure resulting in delays when something, anything goes even slightly wrong. I use this extensively when planning activities with my children. It's a…

I agree efficiency vs latency, but it's also "exploit vs explore" balance, work/life balance and more, leaving time for research, exploration, shooting the sh*t, decorating the office, buying christmas gifts at lunchtime, helping out co-workers etc.

I think "slack" is a much more general concept than efficiency vs latency. The slack itself allows low-latency response to emergencies but the activities that fill the slack time can be valuable in ways that often aren't legible to the org hierarchy.

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