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Considerations On Cost Disease | Slate Star Codex
[via: https://meaningness.com/metablog/post-apocalyptic-health-care ]

"IV.

I mentioned politics briefly above, but they probably deserve more space here. Libertarian-minded people keep talking about how there’s too much red tape and the economy is being throttled. And less libertarian-minded people keep interpreting it as not caring about the poor, or not understanding that government has an important role in a civilized society, or as a “dog whistle” for racism, or whatever. I don’t know why more people don’t just come out and say “LOOK, REALLY OUR MAIN PROBLEM IS THAT ALL THE MOST IMPORTANT THINGS COST TEN TIMES AS MUCH AS THEY USED TO FOR NO REASON, PLUS THEY SEEM TO BE GOING DOWN IN QUALITY, AND NOBODY KNOWS WHY, AND WE’RE MOSTLY JUST DESPERATELY FLAILING AROUND LOOKING FOR SOLUTIONS HERE.” State that clearly, and a lot of political debates take on a different light.

For example: some people promote free universal college education, remembering a time when it was easy for middle class people to afford college if they wanted it. Other people oppose the policy, remembering a time when people didn’t depend on government handouts. Both are true! My uncle paid for his tuition at a really good college just by working a pretty easy summer job – not so hard when college cost a tenth of what it did now. The modern conflict between opponents and proponents of free college education is over how to distribute our losses. In the old days, we could combine low taxes with widely available education. Now we can’t, and we have to argue about which value to sacrifice.

Or: some people get upset about teachers’ unions, saying they must be sucking the “dynamism” out of education because of increasing costs. Others people fiercely defend them, saying teachers are underpaid and overworked. Once again, in the context of cost disease, both are obviously true. The taxpayers are just trying to protect their right to get education as cheaply as they used to. The teachers are trying to protect their right to make as much money as they used to. The conflict between the taxpayers and the teachers’ unions is about how to distribute losses; somebody is going to have to be worse off than they were a generation ago, so who should it be?

And the same is true to greater or lesser degrees in the various debates over health care, public housing, et cetera.

Imagine if tomorrow, the price of water dectupled. Suddenly people have to choose between drinking and washing dishes. Activists argue that taking a shower is a basic human right, and grumpy talk show hosts point out that in their day, parents taught their children not to waste water. A coalition promotes laws ensuring government-subsidized free water for poor families; a Fox News investigative report shows that some people receiving water on the government dime are taking long luxurious showers. Everyone gets really angry and there’s lots of talk about basic compassion and personal responsibility and whatever but all of this is secondary to why does water costs ten times what it used to?

I think this is the basic intuition behind so many people, even those who genuinely want to help the poor, are afraid of “tax and spend” policies. In the context of cost disease, these look like industries constantly doubling, tripling, or dectupling their price, and the government saying “Okay, fine,” and increasing taxes however much it costs to pay for whatever they’re demanding now.

If we give everyone free college education, that solves a big social problem. It also locks in a price which is ten times too high for no reason. This isn’t fair to the government, which has to pay ten times more than it should. It’s not fair to the poor people, who have to face the stigma of accepting handouts for something they could easily have afforded themselves if it was at its proper price. And it’s not fair to future generations if colleges take this opportunity to increase the cost by twenty times, and then our children have to subsidize that.

I’m not sure how many people currently opposed to paying for free health care, or free college, or whatever, would be happy to pay for health care that cost less, that was less wasteful and more efficient, and whose price we expected to go down rather than up with every passing year. I expect it would be a lot.

And if it isn’t, who cares? The people who want to help the poor have enough political capital to spend eg $500 billion on Medicaid; if that were to go ten times further, then everyone could get the health care they need without any more political action needed. If some government program found a way to give poor people good health insurance for a few hundred dollars a year, college tuition for about a thousand, and housing for only two-thirds what it costs now, that would be the greatest anti-poverty advance in history. That program is called “having things be as efficient as they were a few decades ago”.

V.

In 1930, economist John Maynard Keynes predicted that his grandchildrens’ generation would have a 15 hour work week. At the time, it made sense. GDP was rising so quickly that anyone who could draw a line on a graph could tell that our generation would be four or five times richer than his. And the average middle-class person in his generation felt like they were doing pretty well and had most of what they needed. Why wouldn’t they decide to take some time off and settle for a lifestyle merely twice as luxurious as Keynes’ own?

Keynes was sort of right. GDP per capita is 4-5x greater today than in his time. Yet we still work forty hour weeks, and some large-but-inconsistently-reported percent of Americans (76? 55? 47?) still live paycheck to paycheck.

And yes, part of this is because inequality is increasing and most of the gains are going to the rich. But this alone wouldn’t be a disaster; we’d get to Keynes’ utopia a little slower than we might otherwise, but eventually we’d get there. Most gains going to the rich means at least some gains are going to the poor. And at least there’s a lot of mainstream awareness of the problem.

I’m more worried about the part where the cost of basic human needs goes up faster than wages do. Even if you’re making twice as much money, if your health care and education and so on cost ten times as much, you’re going to start falling behind. Right now the standard of living isn’t just stagnant, it’s at risk of declining, and a lot of that is student loans and health insurance costs and so on.

What’s happening? I don’t know and I find it really scary."
scottalexander  economics  education  history  politics  policy  prices  inflation  highered  highereducation  colleges  universities  bureaucracy  costdisease  healthcare  spending  us  government  medicine  lifeexpectancy  salaries  teachers  teaching  schools  regulation  tylercowen  poverty  inequality  litigation  litigiousness  labor  housing  rent  homes  subways  transportation  health 
january 2018 by robertogreco
'Adventure Playgrounds' a Dying Breed in the U.S. : NPR
"At so-called adventure playgrounds, kids are given hammers, nails, paint, scrap wood — anything they want, really — to make whatever they want. These playgrounds are popular in Europe, but in the United States liability issues have made them a dying breed. Kristin Wiederholt reports on the Berkeley Adventure Playground in Northern California."
2006  playgrounds  litigation  parenting  society  adventureplaygrounds  us  liability 
december 2013 by robertogreco
notes.husk.org. Should Jay have the right to claim the derived....
"“Should Jay have right to claim derived image isn’t fair use & ask for cease & desist? Yes. He’s not, as many are saying, a dick for his opinion. Should Andy have the ability to defend his stance that it is fair use. Of course. Should it take the kind of money that only either corporations or the very rich can easily afford to spend in order to get a judge’s ruling and find out? Definitely not. That’s the real problem here.”

James Duncan Davidson writing about The Maisel vs Baio Incident.

I strongly agree…Currently US (&, largely, UK) ration access to law on ability of both (sometimes prospective) litigant & defender to pay, rather than merits of case.

Another piece…mentions Shepard Fairey vs AP case (Obama Hope poster) would have made great case law. Instead…ended w/ out of court settlement. Shame.

(…another public service which has more demand than access—health care…UK largely rations through need, via NHS…US dependent on employment, age, & to nontrivial extent, mone)
andybaio  law  litigation  money  power  government  copyright  fairuse  2011  paulmison  corporations  corporatism  legalsystem  us  uk  helathcare  via:preoccupations  employment  age  settlements  outofcourtsettlements  shepardfairey  associatedpress  ap  obamahope  jamesduncandavidson  photography  ageism  agism 
june 2011 by robertogreco
Philip K. Howard: Four ways to fix a broken legal system | Video on TED.com
"The land of the free has become a legal minefield, says Philip K. Howard -- especially for teachers and doctors, whose work has been paralyzed by fear of suits. What's the answer? A lawyer himself, Howard has four propositions for simplifying US law."
broken  innovation  reform  health  law  simplicity  risk  authority  us  schools  medicine  teaching  learning  education  philiphoward  trust  constitution  values  principles  rules  ted  fear  freedom  lawsuits  gamechanging  fairness  playgrounds  passion  care  waste  money  productivity  decisionmaking  hiring  judgement  paralysis  dueprocess  rights  threats  government  litigation  recess  warnings  warninglabels  labels  psychology  society 
february 2010 by robertogreco

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