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Care Doesn't Scale

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Re: Care Doesn't Scale

#371

Post by m3t4man »

jimbokun wrote: post #207
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...

I disagree. Frustration wouldn't come from having to care for 10-30 people, but from inadequate systems that would fail to facilitate effective care for this many people simultaneously.

Id bet if there was a reliable and effective means for 1 person to take care of 10-30 people, it wouldn't be a problem.

In summary, imho, the problem here isn't capacity to emotionally care for this many people, but means of taking care. I think the problem is we don't collectively invest enough resources (both material and cognitive) to figure out how to do something like this well.

Re: Care Doesn't Scale

#372

Post by rachofsunshine »

flappyeagle wrote: post #300
rachofsunshine wrote: post #262

Earlier quoted context omitted.

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…

> Your engineers want to do that This is not true, I can confidently say, most of the time. Engineers generally want to build software they think is a good trade off between fulfilling the spec and not being too hard to build. This does not generally translate to good software. It’s not a detriment of character or anything like that. They’re just lazy like most people are

I'm generalizing, obviously, but I think most engineers would rather not build horribly tech-debt-y things all else equal. Yes, there are some business-minded engineers, but just looking at my own data set of job seekers, people seeking code quality far outnumber people seeking rapid product iteration.

Re: Care Doesn't Scale

#373

Post by rachofsunshine »

miki123211 wrote: post #299
rachofsunshine wrote: post #262

Earlier quoted context omitted.

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…

Then there's also the "rat-race" aspect. If you're focused on teaching, building or caring instead of test scores, conversions and profits, you're going to lose customers and opportunities. Parents choose schools with better test scores, not schools with better teaching. Customers use products with better conversions; this is literally what the word "conversions" means. If you focus on making your employees happy ins…

Yeah, my post was not intended to be a value judgment.

Personally, I think it's somewhere in between. Yes, some degree of "actually make things people want" is an essential component of a business...but I think the amount of "required evil" is usually overblown.

If markets were so ruthlessly competitive that no one could afford to be not-evil, no one would be making a profit. Every company would be barely surviving and profits would be minimal. The fact that profits exist - indeed, are much greater than they have been in the past - means that markets are NOT that ruthlessly competitive, at least not between actors with comparable access to capital resources.

Every dollar of profit a company makes is a dollar they could afford not to make and still survive. And given that the feasibility curve of profits level of evil is likely pretty convex, choosing not to make $1 likely pays out many dollars of not-being-evil externalities.

Re: Care Doesn't Scale

#374

Post by tightbookkeeper »

lucideer wrote: post #366
tightbookkeeper wrote: post #359

Earlier quoted context omitted.

> by definition This an empirical argument about nails. Are you just saying that to emphasize your confidence? > cut nails I just googled and there are literally dozens of brands of this product. Even so this preference appears to be a niche opinion of artisan woodworkers, not a failure mode of furniture and construction. > The switch to wire was a detail of the manufacturing processes, not of consumer demand Yes it…

> Are you just saying that to emphasize your confidence? [...] people like to reminisce about hand made goods. [...] I guarantee we can find a supplier of many varieties of decorative nails A nested HN thread is likely not the best place to go into great detail on the precise practicalities of trade work, & I know I can't expect any given commenter to become an expert in a possibly niche topic just to engage in discu…

Decorative was my word to summarize your “catalog if 30 styles of nails”

> but this level of dismissiveness is a little difficult to reckon with

Let me summarize the key economic points that I feel have been dismissed: - any kind of nail you want, you can buy right now. - You can also buy nails of higher quality than anything that’s existed in preindustrial time - popularity of which kind of nail is driven by demand

Re: Care Doesn't Scale

#375

Post by afpx »

bumby wrote: post #218
drivingmenuts wrote: post #212

Earlier quoted context omitted.

Most healthcare organizations in the US are profit-oriented, sometimes to the detriment of the patients. That is why we have large, unwieldy organizations surrounding the very few people that actually do hands-on healthcare. There’s also the issue of liability – it can be pretty litigious in the US, and companies are frequently wanting to limit their liability, which means having the paperwork to back up their decisi…

> Most healthcare organizations in the US are profit-oriented According to the American Hospital Association, less that 20% are for-profit [1]. I'm sure all are extremely budget-conscious, but that's not the same as being profit-driven. It seems to me that the US optimizes for quality to the detriment of cost and, more recently, access. [1] https://www.aha.org/statistics/fast-facts-us-hospitals

I couldn't find the 20% in your reference, but is it talking specifically about hospitals? I can believe that only 20% of hospitals are for-profit. But, if I do a maps search for all 'healthcare organizations' within 10 miles, the vast majority are for-profit.

Also, of the groups of ambitious hustlers that I know nearby, many are looking to get into running healthcare clinics because there's so much profit to be made.

Re: Care Doesn't Scale

#376

Post by peepee1982 »

jimbokun wrote: post #205
peepee1982 wrote: post #62

Earlier quoted context omitted.

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,…

I didn’t advocate for "scaling" care work in any way. The point is that care work needs adequate support and funding—not efficiency measures to turn it into a production line. Right now, schools and childcare services are chronically underfunded, with too few teachers and caregivers for the number of children needing attention. Meanwhile, parents with limited support systems work full-time just to make ends meet, only to watch a large portion of their income go straight to childcare costs.

The conservative approach you’re defending offloads all responsibility to the individual and the nuclear family, which means that in reality, women often end up trapped in unpaid care roles, increasingly dependent on their spouses' income. That’s not freedom, nor does it offer any dignity or choice; it’s a conservative agenda dressed up as “individual responsibility,” which only entrenches inequality and dependence within families.

And let’s address this twisted notion that anyone who wants state-funded support for care services somehow thinks of people as "cattle." It's laughable—except it’s also insulting. So, to put it bluntly: go fuck yourself for even suggesting that. Care, when adequately supported and dignified, recognizes people’s humanity rather than ignoring it.

As for the accusation that progressives want to monetize and commodify every human relationship, look at who benefits from the status quo. Conservatives would rather sacrifice people’s well-being to "traditional values," while keeping corporate interests safe from any pressure to reinvest in the society they profit from. I don’t see any corporate executives or capitalists hesitating to send their own kids off to private schools and exclusive care, expecting other people’s children to manage with nothing.

So let’s be clear: asking for social investments in care isn’t “capitalist.” It’s about making sure people aren’t left to fend for themselves, and about affording everyone—children, the elderly, those with disabilities, and the rest of us—a dignified life. And if that offends the conservative agenda, then good.

Re: Care Doesn't Scale

#377

Post by reallycare_mark »

evolve2k wrote: post #364
vanderZwan wrote: post #348

Earlier quoted context omitted.

Yes, and the actual nurses also have more job satisfaction and their patients are happier too, so the quality also improves. The main explanation given for that is that compared to solutions that require a lot of time spent on administrative work, these nurses get to focus on the actual care work, and have more personal time with the patients, meaning a bond of trust can be established. Which is also an important asp…

Imagine if we had an openly adoptable Buurtzorg model along side open source software used for adminstration. With the power resting with the carers the non-care admin work could be collectively automated through the open source model.

I'm actually working on the software part of that, in the UK. It isn't open source yet (mostly because we can't afford the level of comfort we need about data security, given that this is very sensitive data) but that remains the intention.

But even with open-source software, there will still be the issue of how highly regulated the care industry is. There are significant variations even within the UK, and indeed, there are even inconsistencies between inspectors of the same regulator.

But below the level at which regulation kicks in, care work is—for some people—the most rewarding (not financially!) type of work and arguably will be one of the last professions to be replaced by AI (though there is plenty of work on robots).

Re: Care Doesn't Scale

#378

Post by intended »

tightbookkeeper wrote: post #287
intended wrote: post #105

Earlier quoted context omitted.

This is not the same thing. The state is ideally suited to manufacture public goods, more efficiently than private enterprise. That means armies, judiciaries, policing municipalities, governance amongst others. They address issues like management of the commons. This does not translate into scaled care - care for orphans (from the article) still needs large numbers of skilled manpower, which is in short supply across…

> The state is ideally suited to manufacture public goods, more efficiently The government does not provide a more efficient military or education. It compels individuals to pay for something which is in the collective good, but not their personal interest.

> The government does not provide a more efficient military or education

This is news to me, or a novel use of economic terminology.

Source?

Re: Care Doesn't Scale

#380

Post by tightbookkeeper »

intended wrote: post #378
tightbookkeeper wrote: post #287

Earlier quoted context omitted.

> The state is ideally suited to manufacture public goods, more efficiently The government does not provide a more efficient military or education. It compels individuals to pay for something which is in the collective good, but not their personal interest.

> The government does not provide a more efficient military or education This is news to me, or a novel use of economic terminology. Source?

I'm assuming this is a question in good faith.

Economists argue markets are efficient because of the incentive structure they place on actors. There is a plethora of writing about government inefficiencies due to not having these. It the most distilled form: they are insulated from both positive and negative consequences of behaving efficiently.

Due to this, government entities have a unique set of traits, but efficiency tends to not be one of them. But who cares? Efficiency isn't always the goal. When it comes to making laws, efficiency isn't the goal, long term values are more important.

The post office was created with full knowledge that it would be a net loss, but it was felt to be institutionally important to have universal access to communication across the nation. Now that this is an antiquated method of communication, and there is a market for the remaining services, it is mostly an inefficient make-work program for a well organized voting block.

Now you I can imagine all the distopian problems of a private military, but I'm going to guess efficiency is not one of those (The US Gov believe Blackwater saves them money, btw).

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