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ControlsFreak


				

				

				
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joined 2022 October 02 23:23:48 UTC

				

User ID: 1422

ControlsFreak


				
				
				

				
5 followers   follows 0 users   joined 2022 October 02 23:23:48 UTC

					

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User ID: 1422

healthcare is very available and almost everyone can afford it

Regular reminder that "healthcare" is not a monolithic thing. It's usually a question of "how much healthcare". Bandaids and aspirin are "healthcare". So is a novel $1M treatment. There is a huge, huge spectrum in between. One could have access to and be able to afford vast swaths of types of healthcare, but some folks want to say, "...yeah, but if they don't also have this, then they don't have 'access to healthcare'." One simply cannot put everything in a single bucket and then make a judgment as to whether people have 'access' to that entire bucket. One must necessarily start thinking about types and gradations of healthcare.

One example I like to give is what the medical response "should" be to someone who has a bit of soreness in their wrist. Something feels "not quite right", but it doesn't necessarily have any other significant indications of anything major going on. For the vast majority of people, the answer should probably be some form of, "Maybe heat/ice/whatever (I don't actually know or care what details), maybe an OTC painkiller if you want. Come back if it gets worse or doesn't get any better after X weeks." But if you're an MVP quarterback and you're nearing the playoffs, they might want to do an MRI and this and that and this and that (again, don't know, don't care about the details). Determining any information about the likely progression, whether it's likely to get worse if they play in the next non-playoff game, maybe tailoring what you do in hopes to shave even a week or two off of the full recovery time is immensely valuable to them. What is the One Monolithic "Healthcare" in this situation, such that we should ask whether it is very available and almost everyone can afford it? There is no such thing.

The reason the opinion doesn't discuss the amendment as it would apply to anyone in the situation of a modern-day illegal immigrant is because such a situation didn't exist at the time the amendment was adopted.

Precisely. However, the concepts involved in the analysis existed. It's like in the oral argument in the violent video games case, where the question was basically posed to Scalia (I can't remember if it was another justice or what), some version of, "Do you want to know what James Madison thought about video games?" Scalia's response: "No. I want to know what James Madison thought about violence!" We can still consider the concepts of political allegiance/implied license/etc., as they apply to illegal immigrants today, even though they didn't have illegal immigrants then.

There might be an argument for this if the court hadn't ruled, but the court did rule

But they did not rule concerning how those principles come into play for anyone in the situation of modern day illegal immigrants. It just wasn't a question! You're heavily over-reading. I'm reminded of this old old exchange, where someone was heavily over-reading an opinion that simply did not consider an issue front-and-center, and thus, did not take the opportunity to really address it. That opinion may have still discussed principles which could have applied, but if one wants to be extra boneheaded, they could just imagine that it's implicitly settled. The extra fun part about that one is that we already had an opinion which clarified that, no, we didn't focus on that thing before. But we can still analyse it using the principles involved now that it's front-and-center.

you can't do this without overturning 130-year-old precedent.

In no way does one have to overturn the holding of Wong Kim Ark (that is, birthright citizenship for a resident alien) to say, "The Court in Wong Kim Ark acknowledged that the governing principles involve political allegiance and implied licenses, and since there was no such thing as a modern day illegal immigrant at the time, of course the Court did not find an exception for a category that they didn't even consider. But they obviously did not foreclose the question that they didn't even consider, and we'll proceed to analyze the current case using the same governing principles." From there, they'll inquire about the original meaning of 14A, including all the messiness of political allegiance/implied license, and we'll see what they come up with.

Let's clarify something directly. Do you reject the claim that the original meaning of 14A included some form of messiness about political allegiance/implied license?

If the amendment, at the time it was adopted, includes aliens, congress can't go back years later and create a new class of "illegal" aliens who aren't covered, any more than they can write in any other exemptions.

Right here is the great big "if". Clearly, at the time it was adopted, political allegiance had something to do with it. At the very least, something about the "implied license under which they enter" had something to do with it. (All of this is clearly expressed by the Court prior to 1965.) Wong Kim Ark did not address the question of the original meaning of the amendment concerning anyone who is in the situation of a modern day illegal immigrant. I, for one, am excited to find out from the Court whether or not the amendment, at the time it was written, considering those factors that are expressly relevant, does or does not include illegal immigrants. I don't know! I don't think anyone knows! I think it's a huge open question! ...and I think, given the nature of this most recent comment, you've now come off the idea that it is just trivial, open-and-shut, by following Wong Kim Ark. It's not. It's messy. It's very very messy.

Sounds more like "not so much a surplus", then. ...what would you say a "surplus" is?

I'm very confused. I have it on good authority that:

There is actually a surplus of residency spots. Yes you heard me.

I'm becoming more and more of the opinion that approximately every use of the words 'shortage' or 'surplus', by anyone who is not an economist, is mostly self-serving BS to argue for some form of gov't protection/handout for their industry.

if the child was being abused by their illegal immigrant parents, would the courts do anything about that?

...

In addition to that, illegal immigrants are regularly charged with crimes under state and federal law. Which, I would think, means they are 'subject to the jurisdiction'?

The question has never been solely about the ability to arrest someone (or to "do anything about that"). They were able to arrest John Elk when he was on non-tribal US land.

This is not to say that the correct answer is the other way, either. It is only to say that it is abundantly clear that things like "can you arrest a person" are not the sole determinant. The case law is extremely clear that what they called "political allegiance" has something to do with it. It's super messy once you get into that, but the fact is, one has to get into that if they want to take the case history remotely seriously.

a close reading of Wong Kim Ark makes it crystal clear that there is no universe where this is necessary.

It really, really doesn't.

When the court mentions the classes that are exempt under the jurisdiction clause, they aren't listing examples of possible exemptions; they're listing the exemptions themselves. That's it. You don't get to add to the list.

Let's take a look at the text. The Court actually helpfully asks whether there are other exceptions. They cite The Schooner Exchange v. M’Faddon:

The reasons for not allowing to other aliens exemption “from the jurisdiction of the country in which they are found” were stated as follows:

When private individuals of one nation spread themselves through another as business or caprice may direct, mingling indiscriminately with the inhabitants of that other, or when merchant vessels enter for the purposes of trade, it would be obviously inconvenient and dangerous to society, and would subject the laws to continual infraction and the government to degradation, if such individuals or merchants did not owe temporary and local allegiance, and were not amenable to the jurisdiction of the country. Nor can the foreign sovereign have any motive for wishing such exemption. His subjects thus passing into foreign counties are not employed by him, nor are they engaged in national pursuits. Consequently there are powerful motives for not exempting persons of this description from the jurisdiction of the country in which they are found, and no one motive for requiring it. The implied license, therefore, under which they enter can never be construed to grant such exemption.

Yes, there are indicia in the opinion that go the other way, too. But it's definitely a not clear and complete bright line. What was "the implied license under which [illegal immigrants] enter"? Some see also. Yes, there is an intense debate, and the Court may now foreclose it, but it is definitely not just a trivial bright line rule that obviously and conclusively follows from Wong Kim Ark, with absolutely no possibility for any other exceptions.

That would be the one. Thanks!

I vaguely recall one of our resident military folks (maybe it was Hlynka, which would be sad) who had a fantastic post about some stories or lessons or what-have-you, and it had a line that stuck with me about one of the most important lessons of leadership: "Never give an order that will not be followed."

It's a multi-agent environment (Hlynka watch, even if Hlynka didn't make the above-referenced comment), and it's exceedingly difficult to force people to follow such an order. You end up having to go pretty over the top on it, which really ends up causing problems. And even if you don't, the mere giving of an order that will not be followed displays that you are completely out of touch with the reality on the ground. Whether or not that reality is "good", you are out of touch with it. Subsequent orders will absolutely be interpreted through a lens of, "...yeah, but this guy's out of touch and doesn't have a clue about how things work or what's going on."

Not every person with significant risk factors knows they have significant risk factors.

...

it is a known problem that people are willing to be lazy about their personal health in a way that they aren't with say their personal finances

All have been informed that this is how this person views you. They are not interested in speaking to any intelligent, rational individual with the means and conscientiousness to care for their personal health. Instead, everything they say is tailored to their perception of the lowest common denominator member of the general public.

Has anyone ever dealt with a call center? You know that feeling of, "Motherfucker, I am intelligent and experienced enough to know that I don't need your script; I need a capable person who is willing to have a rational discussion about my very non-standard problem"? Have you ever just hung up and called back until you found such a person? Or tried to use tricks to escalate your way to finding such a person?

It is a pretty valuable skill to be able to assess another person's capability and perspective. Yes, this is the case even when you are trying to interact with someone because you actually need a person with greater knowledge and experience than yourself. The person you're talking to could secretly be the most knowledgeable person, able to effortlessly solve your problem, but if corporate is mandating (and effectively enforcing) that they read from a script instead, it is important to be able to understand this and seek out alternatives. It's no different if that mandate comes from inside the house, and there's just something about their worldview that is equally constraining.

Many doctors (apparently this one) are unfortunately like that. I had an experience once with a doctor-adjacent specialist. I knew approximately nothing about his specialty, but I very quickly learned that his entire specialty was built around one type of procedure. Literally everything else he did was to determine whether you would be a good candidate for that procedure and/or what minor variants might be involved. Yes, there was still a lot of value in getting his consultation, but it was also important to understand what he is about, what his perspective is, the way in which his every thought is shaped. He would be very valuable in one very specific way and approximately useless for anything outside of that lane.

Common investment advice is to take deep consideration of heterogeneity. "How do you differ from most of the market?" Statistics being what statistics are, there are many things in which you may not substantially differ. So, I would not give anyone mass advice as to how they should or should not invest. Similarly, I wouldn't give anyone mass advice as to how they should or should not interact with doctors like these. Just be aware of what it is that you're dealing with, be knowledgeable about your own self, and good luck out there.

for a business in the USA. Who gets the tax money?

If the US wants that tax money? The US clearly and obviously can do this right now (and in many ways, they do), without an AI involved.

When a worker has no useful skills he gets laid off permanently, and either subsists on a dole or goes hungry.

For many of the periods you're talking about, the vast majority of the population was actually doing subsistence farming. Obviously, this was not a nice life, especially given their level of tech, with even extremely rudimentary advances still on the horizon. They were much more at the mercy of things like weather patterns. While going off to work the land had downsides, it was an alternative. If a bunch of folks basically had to go off and do that, they could again trade with one another, coming from a baseline of ideas/tech that they could generate in-community that is significantly higher than what was possible at those times.

take up all the resources, desirable land, etc

This is the part where they're operating in your country, and so you can do stuff like taxing them. Unless it's also like the paperclip maximizer in that we assume that any attempt whatsoever to do things like that results in them just casually killing you. My point is that then you have a different problem. You have a, "AI-haves killing people problem," not a, "AI-have-nots just starve because they're unable to produce/consume sustenance-level calories (or stuff worth sustenance-level calories).

Similar if it's, like, China who gets AGI/ASI and they start conquering and to conquer in order to take up all the resources, desirable land, etc. You don't have a "AI-have-nots just starve" problem. You have an AI warfare-and-killing-people problem.

Yeah, if the AI is doing stuff inside the country, that's like "establishing a business presence". Then, you can just tax whichever entity to your heart's delight.

This highlights one of my favorite contradictions about the "AI will result in everyone starving because there are no jobs" doomerism. To make it work, you need some weird, strong separation between the AI-haves and the AI-have-nots. They're, like, totally isolated, and no trade is possible, because the AI-have-nots are supposedly worthless or something. Thus, why the AI-haves are supposedly buggering off to some island tax haven or something. But then, if there's literally no trade happening between these two groups, one has to ask, "Why wouldn't there be trade within the group of the AI-have-nots?" The only answer I can think of is that pretty much the vast majority of their wants and desires are already being fulfilled by some other mechanism. But that, of course, leaves us decidedly not in an "all the AI-have-nots are starving to death or something" situation.

Nah, you have to make friends in the government first. Generally, the way this works is that you and your fellow rodent groomers get together and decide that you want to form a cartel. You can't call it that, and you can't act too overtly anti-competitively at this stage. Instead, you're just a 'trade association' that wants to promote rodent grooming. Alone, it's hard for you to have much of a marketing budget, but if you get together and each kick in a little bit, you can market occasional fade cuts for little Mickey to a much wider audience. Yes, you're not personally capturing all of the benefit of the advertising, but maybe there aren't that many of you, so you can capture enough to make it worth kicking in to the club.

At some point, everyone's kicked in enough money that you start thinking about what the most effective use of that money is. You look at the market trends, the providers involved, etc., and perhaps that money isn't best used for broad industry advertising of services. Instead, you might think that it's best to use that money to hire some professional lobbyists who waltz into the state capital, shake hands, pass around goodies, make buddies, and impress upon them that you have a group of individuals who just might happen to be thinking about where they'd like to allocate their campaign contributions. Conveniently, they also point out that there seems to be some minor problems with some shady, low-cost rodent groomers lurking in the underworld. Since your trade association really cares about the quality of the industry, you'd be more than happy to help root out the problems. All the politicians need to do is let you. It costs them nothing; you're going to do all the work of taking care of the situation. And oh by the way, you'd be very grateful, wink wink, something something, campaign contributions. It definitely doesn't hurt if you can get a couple prominent trade association members elected into office.

Then, they pass a law, promoting how they're going to rid the scourge of seedy rodent groomers, so the public can have full faith and trust that they're getting a good one. The law sets up a Board, and the qualifications for this Board are obviously that they need to be decorated and awarded by your trade association, since you're the experts in determining who is fantastically qualified. They may even directly appoint a bunch of your leadership to the Board right off. Then, you can fly, ye formerly caged bird! You can invent all sorts of barriers to entry suitable training qualifications, most of which require payment to members of your trade association. Then, you can haul randos into your kangaroo court for brushing Mickey's hair this way instead of that way, for that may look too much like a fade and constitute unlicensed rodent grooming. You now have all the power you could have wanted, directly handed to you with the authority of the policy powers of the State. Just try not to look too outlandishly anti-competitive, and make sure to heavily heavily emphasize any possible examples of an unlicensed individual doing anything that could have hurt Mickey in any way.1 You've gotta market fear now. The more scared people are of anything going wrong, the more leeway they'll give you to put in place any silly rule that will drive out any competition you might think could be useful in some way.

1 - As seen in the linked comment, it's not even really necessary that it was actually unlicensed people who caused the harm. The vast vast majority of people who were hurt by the drug that kicked off one of the whole shebangs in the medical industry had taken it under the direction of a government-licensed doctor.

Good call! I hadn't made this connection, myself, though now I see that there are quite a few works making that comparison as well. I was curious about why we would have the transition from guilds->unions->boards, and it seems that the leading hypothesis for the two arrows are the Industrial Revolution and the transition to a service economy. That is, in the guild days, there was mostly a patchwork of small, independent producers, who banded together to rent-seek. As mass production took off, the economics were in favor of larger firms (now you could build cars and sell a bunch of them across the nation or internationally) where workers were mostly trained in one specific task on an assembly line, so guilds started to fall, while unions began to rise. Then, as we've transitioned toward services, they're again more of a patchwork of small, independent providers, who, unsurprisingly, band together to rent-seek.

Medicine is an especially egregious case, as we've seen significant consolidation in that sector. It's less about small independent providers, as the doctors here are apt to point out that larger conglomerates are taking over and many doctors are now employees of a hospital system rather than just running their own little business. So I'm not surprised that a brief search indicates that doctors' unions are significantly on the rise. Of course, they don't have the same sort of mass production scale, as they are still fundamentally a service product rather than a good, so I think it's less likely that the guild power of licensing is going to disappear to any meaningful degree, especially not in comparison to the historical decline in guild power in the good production arena. Instead, we're going to get the worst of both worlds - obscenely licensed and unionized. The academic papers I've found say that they have empirical evidence that these schemes do intersect and provide the most rent-seeking. It's like the anti-Reece's peanut butter cup - two awful tastes that taste awful together. I had sort of thought that the medical industry was reaching a breaking point and that changes would have to occur... but now, I'm sort of getting the feeling that it's going to get a whole lot worse before there's any hope that it'll get any better.

A little over a week ago, I talked about Alex Tabbarok's review of a new book, "The Licensing Racket", which does a deep dive on occupational licensing, specifically when the boards that control the licensing process are, themselves, controlled by licensed professionals within that industry.

I just listened to the author, Rebecca Haw Allensworth, get interviewed on the Short Circuit Podcast. It's worth a listen, above and beyond the snippets that Alex pulled from her book. She very intuitively conveys exactly how these things function and why. She literally just started going to their meetings (often the only non-industry-insider present), watching what they did, listening to what they talked about, and getting a sense for how they actually functioned in the real world. I want to point out a couple things that I didn't really bring out in my prior comment.

First, just another anecdote. Some handyman installed a Ring camera. He just bought the camera at Sam's Club. They're designed to be super easy to use; meant to be pretty much just plug-and-play by consumers. His great sin was that he put on a business card that he could install Ring cameras. For this, he was dragged in front of a licensing board for installing security systems. "This could be competition." When some people on the staff suggested that they could be lenient, because after all, he only did it once, the response from the board was, "...that we know of." Maximum fine. You have to scare anyone else who could even think about competing with you.

Anyway, everyone is aware that, right in everyone's face, there is a huge conflict of interest with these boards. The author says that industry folks talk about how they can totally manage it. "Hats", they call it. When you sit on the board, "you take your industry professional hat off and put on your board member hat". Of course, it's easy to say that; it's much harder to actually do it. They find themselves constantly coming down extremely hard on anything that smells like competition, but when it comes to one of their own, when their people are actually harming consumers, they suddenly find mercy and leniency. As mentioned before, they play the two-step of, on the one hand, playing up the super scary dangers of unlicensed people (i.e., people who haven't paid their dues to the cartel) doing anything, while on the other hand, saying that it's soooo critical that people have access to their services (like medical care, where there is a 'shortage'), that they just have to keep bad professionals out there harming consumers. "Better to have a butcher for a doctor than no doctor," but god forbid a foreign doctor or anyone who hasn't paid their dues to their particular cartel. Their own will get second, third, and fourth chances. When they actually need to dive in to a complaint, they only meet once every month or two, so they'll spend one day every month or two working on it, and if it's a case that needs five days of work, eh, they'll get around to figuring it out within a year, maybe. Even when they know it's a bad professional causing harm to consumers; even saying things like, "We know he'll be back again." The author says that often times, these folks don't get stopped by the board; only the most egregious cases get stopped - and those often get stopped by criminal proceedings in actual courts of law! In the meantime, they're out there taking patients and prescribing...

In the interview, they draw comparisons to labor unions. Obviously, both have the tangible impact of raising wages for their profession. She cites one of Morris Kleiner's books, saying that union membership has gone from super high in the 1950s all the way down to where it is today... but licensing goes in the exact opposite direction - super low in the 50s, way up to being quite significant today. That said, everyone knows and acknowledges that unions are self-interested; the overt point is to vindicate the interests of its members. They get a seat at the table with management to hash out a relationship. It's expected to be somewhat adversarial, and there are a bunch of rules governing how that interaction is supposed to work. But licensing boards aren't like that. Instead, we basically just declare that the 'union' is actually the government. They're in charge of the whole shebang. They essentially 'make law' in the area. It's an entirely new way of organizing labor in society, and it just sort of happened, quietly, while everyone smiled and trusted that a "Board of experts" was looking out for them.

Which is why there is only one guiding light holding them back via anti-trust action - North Carolina State Board of Dental Examiners v. FTC. The board was sending cease and desist letters to folks offering teeth whitening in malls. You know those things that you can just buy at Costco and do at home? Yeah, they were basically just selling it and maybe helping folks put it on. They were "practicing unlicensed dentistry". The Supreme Court acknowledged that when a state licensing board is primarily composed of active market actors, they are not immune from anti-trust regulation unless they're being actively supervised by the State. Of course, we haven't made most of these boards become actively supervised by the state; the union/cartel still controls most of them. They just make sure they have a cartel union Board lawyer present when they're making decisions, who sometimes tells them that they shouldn't do certain things that could attract too much anti-trust attention (apparently, they do really often want to do stuff that would be egregiously anti-competitive, so these lawyers still have to tell them no reasonably often). Of course, how one thinks about the strength of these constraints depends significantly on how one views the anti-trust mechanisms in government. In my estimation, you have to be pretty overtly egregious, and do so by policy, for them to rouse into action.

It's all pretty crazy to hear. Whatever role you thought licensing boards were doing, they're not doing that. They're doing the absolute bare minimum to protect consumers and the absolute maximum to protect their own interests. Why wouldn't they? Incentives do what incentives are. The system is what the system does. It doesn't do what you thought it might do, no matter how much you might hope that it did.

I am now worried because I am beginning to see the checks and balances waver.

What are two examples of actually illegal behavior that you think the checks and balances are wavering on?

Most sufficiently large medical group/hospitals could open a residency and self-fund. However they don't. Because docs make money from seeing patients. Teaching a trainee takes away from seeing patients.

And the medicare funding issue is squarely out of our hands. For literally decades, medical associations and prospective/current residency programs have been asking for more funding for more slots.

All of this comes after the standards have been chosen in a way designed to allow you to play this exact game. What game are you playing here? The "we won't train people to the standard that we've selected unless you pay us more money" game. Everyone who isn't a doctor (as you clearly are) can tell that this game is just extortion.

Would unlimited free visas for indian/chinese phds be beneficial?

I don't know. What do you think? Why?

Very likely looking to buy a new (to me, at least) car in the next few months. Weirdly, I have almost no starting criteria on which to begin my search. It really will be mostly a Point A to Point B thing, and while I'm not opposed to any features/bells/whistles, I find myself mostly apathetic. Just not really aware of what really nifty features might be out there now that can genuinely provide value. Almost certainly want something <10yrs old, good chance I'd be amenable to something <5yrs old. Last car I bought was 4yrs old at the time, and it's still in pretty great condition after an additional decade. It was near the end of a model run that was still just "basic car, engine makes it go", not a bunch of computers and wiz-bang gizmos in the cabin. I grew up too poor to ever think about buying new, but I know that was almost a better deal in the market for some window in time not too long ago. I have more means now and am not completely opposed to it; it will depend completely on the shape of the market once I really dive in.

Anyway, with that background, I'd like to at least try to focus in on one Small-Scale Question for this Sunday. Any resources for how to find a relatively-recent car that isn't constantly spying on you? Any little communities out there that curate some lists for cars that spy less on you out of the box or have how-to guides for lobotomizing cars that can be lobotomized?

The president is the chief executive. Among other things, can view all classified material in the nation, can he not?

Classification is a construct by and for the power of the Presidency as Commander-in-Chief. It is specifically for national security information that the President has determined (or someone to whom he has delegated such power to has determined) would be detrimental to national security. Your statements are absolutely correct when it comes to information for which classification is the only barrier to releasing it to someone.

...but classification isn't the only restriction on sharing information. I haven't dug into this lawsuit at all, so I don't know what the specifics here are about, but I'll conjecture that there are statutory requirements on other types of information that don't give the President unilateral authority to share it. I'd have to double-check, but I think, e.g., restrictions on sharing individuals' tax information may restrict the President as well. That is, Congress could (maybe did) pass a law that prevents the President from, say, personally choosing to release his political opponent's tax records to the press. In this case, classification would have nothing to do with it. I don't think there would be an Article II argument that such a statutory restriction would be an unconstitutional impingement on the Executive power.

Alex Tabarrok reviews "The Licensing Racket" in the WSJ:

Governments enact occupational-licensing laws but rarely handle regulation directly—there’s no Bureau of Hair Braiding. Instead, interpretation and enforcement are delegated to licensing boards, typically dominated by members of the profession. Occupational licensing is self-regulation. The outcome is predictable: Driven by self-interest, professional identity and culture, these boards consistently favor their own members over consumers.

Ms. Allensworth conducted exhaustive research for “The Licensing Racket,” spending hundreds of hours attending board meetings—often as the only nonboard member present. At the Tennessee board of alarm-system contractors, most of the complaints come from consumers who report the sort of issues that licensing is meant to prevent: poor installation, code violations, high-pressure sales tactics and exploitation of the elderly. But the board dismisses most of these complaints against its own members, and is far more aggressive in disciplining unlicensed handymen who occasionally install alarm systems. As Ms. Allensworth notes, “the board was ten times more likely to take action in a case alleging unlicensed practice than one complaining about service quality or safety.”

She finds similar patterns among boards that regulate auctioneers, cosmetologists and barbers. Enforcement efforts tend to protect turf more than consumers. Consumers care about bad service, not about who is licensed, so take a guess who complains about unlicensed practitioners? Licensed practitioners. According to Ms. Allensworth, it was these competitor-initiated cases, “not consumer complaints alleging fraud, predatory sales tactics, and graft,” where boards gave the stiffest penalties.

You might hope that boards that oversee nurses and doctors would prioritize patient safety, but Ms. Allensworth’s findings show otherwise. She documents a disturbing pattern of boards that have ignored or forgiven egregious misconduct, including nurses and physicians extorting sex for prescriptions, running pill mills, assaulting patients under anesthesia and operating while intoxicated.

In one horrifying case, a surgeon breaks the white-coat code and reports a fellow doctor for performing a surgery so catastrophically botched that he assumes the practitioner must be an imposter. Others also report “Dr. Death” to the board. But Ms. Allensworth notes, “at the time of the complaints to the medical board, [Dr. Death] was only one third of the way through the thirty-seven spinal surgeries he would perform, thirty-three of which left the patients maimed or dead.” The board system seems incapable of acting decisively and Dr. Death’s rampage is only ended definitively when he is indicted—the initial charges include “assault with a deadly weapon,” the scalpel—and eventually imprisoned.

This is reminiscent of my recent comments about imagining that we set up a licensing regime for grocery stores, under the pretext that we do need some training to ensure food safety... but that we let the grocery stores control the process. I predicted:

Grocery stores get the government to set up a licencing requirement to stock shelves, with some boilerplate reasoning about food safety or something. The thing is, the only way to get licensed is to get a grocery store to give you the mandatory years of experience. And, of course, they refuse to have such positions unless the government pays them for it. I would predict that there would be fewer grocery store employees, their pay would be higher, industry profits would be higher, government outlays would be higher, prices to the consumer would be higher, and service quality would decrease.

And sure, Tabarrok also agrees that we're not going to go to zero licensing for doctors. But he echos some of what I said here:

Let's put it this way - perhaps there is a "right" level of training for doctors, and perhaps there is a "right" level of training for grocery stores. Maybe the latter is much smaller than the former. Now, imagine we set up the system I described in my last comment for grocery store training. Do you think their incentives would lead to them selecting the "right" level of training?

Do we have any evidence that turning over control to them does actually have perverse incentives and results in not the "right" kind of controls (not necessarily in the patients' interests)? Back to Alex:

No system is perfect, but Ms. Allensworth’s point is that the board system is not designed to protect patients or consumers. She has a lot of circumstantial evidence that signals the same conclusion. The National Practitioner Data Bank (NPDB), for example, collects data on physician misconduct and potential misconduct as evidenced by medical-malpractice lawsuits. But “when Congress tried to open the database to the public, the [American Medical Association] ‘crushed it like a bug.’”

One of the most infuriating aspects of the system is that the AMA and the boards limit the number of physicians with occupational licensing, artificially scarce residency slots and barriers preventing foreign physicians from practicing in the U.S. Yet when a physician is brought before a board for egregious misconduct, the AMA cites physician shortage as a reason for leniency. When it comes to disciplining bad actors, the mantra seems to be that “any physician is better than no physician,” but when it comes to allowing foreign-trained doctors to practice in the U.S., the claim suddenly becomes something like “patient safety requires American training.”

We see this in industry after industry after industry that has captured the regulatory apparatus. Academia, real estate, the list goes on. Doctors are not some magic exception to perverse incentives. Alex and Ms. Allensworth disagree on possible solutions. There are hard problems here... but it's important to remember that there are, indeed, problems with the status quo. It's important to remember that we have a pretty good idea how these problems are manifested in terms of incentives. (No doubt someone can put a timer on for how long it will take a doctor to say that the solution involves putting doctors more in control of everything...)

Oh goody! I get another opportunity to share this gem of a paper.

The data included domestic communications from American citizens

Yep. It's like if the gov't got a wiretap on Tony Soprano, and he called one of his kids' schoolteachers. One could say, "They're collecting the communications of schoolteachers!" But really, everyone knows that's bullshit. It's true, but it's bullshit. They're collecting Tony Soprano's communications.

You're the one trying to claim that this data doesn't include domestic communications, and the reason you have so much trouble answering this question in an earnest way is that the answer destroys your position.

Super ROFL to this. As shown above, I have literally no trouble answering this question. If Mike Flynn calls the Russian ambassador, yes, they collect Mike Flynn's call to the Russian ambassador.... because they collect all of the Russian ambassador's calls. Because he's a legit foreign intelligence target.

I'm going to trust Ron Wyden

So you trust him when he says that he asked Clapper to correct the public record and that he did not, in fact, put classified information in the public record, right?

It's incredibly easy to design a system that doesn't fail in this way - you need to go to a court and apply for a search or wiretap warrant, then you can start collecting information on a target.

They do this for any targets that are in the US or are otherwise US Persons. The question is about foreign targets who are in foreign countries, but happen to have comms that transit the wires of US companies. People who have never had Fourth Amendment protections. Putin Lackey #6528, lives in Russia, but emails some people in Syria who have GMails. Maybe he even emails some US citizen schoolteachers. The question has always been, "What is the right process to collect on this guy?" Notice that we're worlds apart from some ridiculous claim that they're just monitoring all domestic comms. You've already admitted that the thing I said was false is actually false. We're literally just talking process now.

lets someone use opposition research they know is false to spy on presidential candidates

They got a warrant for that. From a judge. So, it seems like your solution would not prevent this problem. I have heard discussions of solutions that would prevent this problem, but your solution is not one of them. You are just not a serious person on this topic.

A common criticism of AI slop is that it's not really that creative. It's mid. It only gives you a sort of average (let's set aside the question of whether you can make that sort of average still be approx academic tier average). That is still useful for at least one type of application - when an extremely obstinate commenter acts like their words don't mean things that regular, average people would think they mean. An example here, where someone basically just tried repeating a phrase, as if it was an argument on its own, as if saying it again made it mean something else that it didn't mean.

In these cases, it's useful to just ask the AI, "What does this mean?" It gives you a perfectly mid interpretation. A basic, what does this mean to a normal person? A "duh" check. An obviousness check. An easy way to point out, "If you want this to have some esoteric meaning, you need to put in a modicum of effort to justify that esoteric meaning (and explain it as though everyone is reading), because it doesn't mean that to anyone else."

Why do you have those forks marked 'for long pig only

Which forks are those? You have a citation for those markings, right?

part of the correct answer would be "Email, Video/voice chat, Photos, stored data, VOIP, file transfers, video conferencing, activity notifications, social networking details and special requests"

...for who? That answer will be precisely what I said. You get an even louder incorrect buzzer. Please educate yourself.

He didn't provide a correct, classified answer to them in a secure channel afterward

This is a lie. Note that when you quote the phrase

correct the record

he means, "Correct the public record". Which means putting classified information in the public record. Which is illegal.

The reason I bring up LOVEINT is that by virtue of the problem existing at all it shows that the warrant requirements aren't being applied and domestic communications are being collected - if the surveillance panopticon was functioning with the restrictions and rules that you are implying, it could never actually be a problem. But it is a problem, and the fact that it is means that the system is capable of abuse and is actively being abused.

There are strategies put in place to discover these things. When discovered, those people get fired and prosecuted. Can you design a system that "functions with the restrictions and rules"... with absolutely zero possible failures? If you can, you can make a bundle of money, because everyone wants this. Just give it to us. We'll pay you an insane amount of money.

Mind you, I'm not saying that SIGINT doesn't deserve to exist

Then just tell us how to do it better! Make tons of money by telling us how to magically design these systems!

the corrupt surveillance of the Trump campaign, including when he was President Elect, was far more serious

Perhaps. I've seen some serious suggestions for how to improve the systems that are in place. Do you have any? Or are you just bitching and lying about the facts that are in evidence?