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Care Doesn't Scale

stevenscrawls.com

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Re: Care Doesn't Scale

#41

Post by karrieberrie553 »

api wrote: post #37
kang wrote: post #29

> Scale isn’t bad, at least not necessarily. Industrial is perfectly capable of being better than custom. Sometimes the YouTube video is more helpful than the private tutor. This is not true; consider the argument that there is always a loss of quality in scaling. Industrial maybe better than average custom, but is always worse than best customs. Broadcast lecture is almost always worse than a tutor whose discourse i…

I don’t think that holds for everything. Industrial 3nm chips are probably better than whatever you would get if people tried to DIY this. Lots of things get better with scale: materials, precision machinery, process efficiency, power generation. But there’s also plenty of things that don’t work this way. Care is one of the most extreme things that does not.

I think the argument is that someone with the knowledge to make 3nm chips could probably know how to make some very cool yet very expensive chips, but since they target a lot of people they probably make choices that would satisfy more people but maybe not as well

Re: Care Doesn't Scale

#43

Post by potato3732842 »

sokoloff wrote: post #17
plaidfuji wrote: post #10

This is a pretty big realization and one that resonates strongly with me. As an engineer, parenting can be frustrating, of course for the usual reasons, but also because you realize there’s really no way to “hack” it. I feel like we as a society need to acknowledge that this probably applies to childcare, teaching, health and elder care to a large extent. That no matter how much private sector ingenuity you apply to…

I think some of the healthcare changes during my lifetime have increased efficiency and been fine (maybe even good) for patients. I used to have my vitals taken by the doctor. Now, that’s a nurse. Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse. All of that is good, IMO. Doctors may not like the 20 minute blocks, but overall I can get the same care at a low…

>I used to have my vitals taken by the doctor. Now, that’s a nurse. Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse. All of that is good, IMO. Doctors may not like the 20 minute blocks, but overall I can get the same care at a lower total cost and the nurses are probably better at the job they do twice as frequently than the doctor whose head might be somewhere else during the “boring parts”.

The statistical you is paying statistically much more than the historical equivalent. The situation is far more complex than that. There's a million variables here. Changes in services rendered, changes in outcomes, relative wage differences, more parties taking a cut of any given transaction, more "make work" prior to rending specialized care, etc, etc.

Outcomes are better than they were 40yr ago but is that because of the changes or despite them?

Re: Care Doesn't Scale

#44

Post by [deleted] »

dqv wrote: post #39
rgrieselhuber wrote: post #30

Earlier quoted context omitted.

It’s not a reference to orphans.

Then I'm completely lost on how it is relevant to an article that specifically mentions the care of orphans as its central example for how care does not scale.

[deleted]

Re: Care Doesn't Scale

#45

Post by dagw »

fieldcny wrote: post #28

The premise is wrong, you can care for more than one other person at a time. People have children, in this world we can only care about our spouse or one child? Hardly.

Depends on what you mean by "care for". Calling your parents a few times a week to make sure they're doing OK and dropping by on the weekend doesn't take too much time and effort. But as people get older they need more and more care. Caring for one person with dementia or other similar problems that comes with aging is for all intents and purposes a full time job.

Re: Care Doesn't Scale

#46

Post by Tade0 »

> 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.

Re: Care Doesn't Scale

#47

Post by crabmusket »

fieldcny wrote: post #28

The premise is wrong, you can care for more than one other person at a time. People have children, in this world we can only care about our spouse or one child? Hardly.

I agree with you, but I read the article as saying you can't care deeply about more than one person at literally the same instant. Your attention is directed to one or the other.

But I think even that's not literally true e.g. the social worker could make dinner for all four kids at once. And probably converse with all four of them while doing it!

But, I think I agree with the broader point that care doesn't scale, even if it does scale slightly greater than 1.

Re: Care Doesn't Scale

#48

Post by gaussiandistro »

So, maybe interesting in the context of "creating scalable structures of aid and care", one of the big points I think that makes scaling hard is how much complexity gets pushed onto a central administrator. You have societies like certain Basque communities (see https://scholarship.claremont.edu/cgi/viewcontent.cgi?articl... ) where households are literally arranged in circular patterns, and there are obligations of care and service between you and your "first neighbor", "second neighbor", and so on, chains of dependencies moving clockwise and counterclockwise through the circle, allowing a potentially very large structure that still allows you to mostly interact with a small number of "near neighbors".

Quoting directly from the article:

"THE GIVING OF BREAD

Until the 1960’s, a fundamental circular exchange was the giving of blessed bread. Each household regards its neighbor to the right as its first neighbor

(The directions right and left are as viewed from the center of the circle so that right is clockwise and left is counterclockwise.)

The giving of bread took place weekly and was thought of as being given from first neighbor to first neighbor. That is, each Sunday a woman from one particular household, call it H_i, bought two loaves of bread to the church where it was blessed and partially used in a church ritual. Then, before sunset, a portion of the bread was given by H_i to her first neighbor, namely to H_{i+ 1}. The following week H_{i+1} was the bread-giver and H_{i+2} the bread-receiver. Thus, the giving (and receiving) of bread moved around the circle serially, taking about two years to complete one cycle of about 100 households. While each household was both a giver and receiver of bread, this mode differs from simple reciprocity; only if there were a total of two households would H_i and H_{i+1} directly reciprocate as each other’s first neighbor."

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