ControlsFreak
No bio...
User ID: 1422
ControlsFreak
3yr ago
Right, in America, you can have non-government-approved candidates... but if you try to run one, we'll investigate him and his associates to the ends of the earth and charge whatever ticky tack crimes we can concoct while claiming that he's "mentally incapable" of discharging the duties of the office, so we can also remove him that way, too.
ControlsFreak
3yr ago
I know this is already dead and buried... and that @firmamenti already pretty much explained why... but we have now gotten the NYT response. No surprise, it's "Republicans pounce". They're banking on their readership not actually reading the report. They just refuse to even acknowledge all the stuff in there that demonstrates how differently the FBI treated claims touching the Clinton campaign from those touching the Trump campaign. If they just close their eyes and ignore the screen for half the movie, it's no wonder they see a different movie. They get their zingers in. "In fact, Mr. Durham said he agreed that the F.B.I. should have opened a preliminary investigation." See! It's all bullshit, what these right wing nutjobs are saying! Of course, completely hidden in this sentence is the distinction between types of investigation, one of the major points of the Durham report. If you didn't read the report or you're not otherwise familiar with this, you'll never notice. They're not explicitly lying. They're just totally ignoring the entire discussion about how they shouldn't have immediately opened a full investigation, how a preliminary investigation wouldn't have justified many of the investigatory steps they took, how thinly the whole shebang was predicated, how an unbiased preliminary investigation would have almost certainly quickly noticed, "There's literally nothing here," and then been quickly closed, how a proper response that was trying to protect American elections and elected officials would have been to provide defensive briefings to Trump rather than the obscene exercise of doing everything possible to malign him for possibly being the victim of a foreign influence campaign... or critically, how this all goes down differently when it is blue politicians at risk.
Of course, again, as already said by @firmamenti, everyone on the right already knows all this, so there's not much that needs to be said here. The only culture war things of interest is the response. How partisan actors continue with their tactics of "not lying" and memoryholing "inconvenient truths". I spent a lot of time paying close attention to the developments of this story back when it was happening in real time in 2016. I know specific media people who know this topic in great detail. The real culture war story is seeing their silence. Usual Suspect Numero Uno, Benjamin Wittes; where is his comment on the Durham report? I've been looking, even went to his new Mastodon. Best I can tell, there isn't one. If you can get away with just squeezing your eyes shut and not watching the painful parts of the movie, you're going to.
ControlsFreak
3yr ago
I guess what we've really learned from this conversation is that you're not self-employed! Can you even try to explain how your claim was supposed to work?!
ControlsFreak
3yr ago
Oh wait, you're offering overtime pay for while I'm just sitting on a train playing on my phone?! (Maybe I'll even sleep during that time.) This is an even sweeter deal. I will definitely take this job for a few years, bank all the extra cash money, and then fook off. I've worked essentially two full-time jobs in the past, which is doable for a period of time. Didn't even get that sweet OT pay for sitting on a train. This is a wayyyy better deal.
ControlsFreak
3yr ago
Do you have any job openings? I'd like to work for you. I'm looking forward to receiving your formal offer letter!
On a totally irrelevant, tiny little matter, I happen to have a three hour and fifty nine minute commute each way. I expect the standard compensation still, but it appears that all I can provide for you is two minutes worth of work each day.
ControlsFreak
3yr ago
You are 100% correct. I'll try to edit for clarity.
ControlsFreak
3yr ago
The way I see it, any entity holding an initial stake in automation will become wildly wealthy in real terms.
Do you think this jives with the 'quote' that has been bandied about lately: "We have no moat; no one does"? Whose stake in automation is able to be protected? Like, say, if suddenly autonomous robot lawnmowers turn the corner and become good enough to be generally "good", that doesn't seem to so much accrue to the general group of people who have a stake in "automation". Instead, it probably accrues to people who are already making lawnmowers. Maybe to people who have lawn care businesses also, as folks might find it more affordable to pay a small fee for their company's autonomous lawnmower (which can be run nearly nonstop, not sitting in the garage useless for 99% of the time)? It seems more like automation is just a general upskilling across a variety of industries, like advances in math or engineering principles or corporate finance would be.
Any organized competitive activity will certainly require a set of rules (and will inspire a corresponding set of rules lawyers). Those rules almost always include some element of eligibility ("This is a human running race; horses cannot enter; humans aided by segways cannot enter...").
Which brings to my mind an analogy that might be useful to get more left-leaning folks thinking about the topic differently: the special olympics/paralympics. I have no idea what rules they use, but I am 100% confident that they must have some set of eligibility rules. At some point, people sat down and said, "No, your specific condition does not qualify you to participate in the special olympics/paralympics." Any such set of rules is invariably going to have edge cases. (It's invariably going to inspire a set of rules lawyers, too.) There are going to be people who think it's unfair that they're not allowed to compete. There are going to be people who think it's unfair that someone else is allowed to compete. I think everyone can be aboard the train this far.
First off, I cannot possibly fathom someone on the left agreeing to a proposed rule of, "Anyone who self-identifies as 'special' is automatically eligible." This at least gets them into the right ballpark and out of the bailey.
Then, the motte about burden-of-proof shifting. The much harder position to crack is the claim, "We just need you to provide extensive peer-reviewed evidence that this person would have a competitive advantage." Here is where they set up a hundred foot wall and say, "If you can't crack this, we're back to the bailey of self-identification." However, again, let's go back to the special olympics/paralympics. There is an absolute myriad of specific situations/conditions that someone might think should qualify them for the special olympics/paralympics. It would be an utterly impossible standard to say, "Whelp, if you can't bring metareviews of peer-reviewed research showing that this particular condition, experienced by like 100 people on the planet (99 of which aren't competitive in the sport in question), does not unfairly situate them with respect to the other competitors, then you have to just go back to accepting everyone who self-identifies as 'special'."
Perhaps I'm wrong. If anyone here is "pro self-identification in women's sports" and also "pro self-identification in special olympics/paralympics" on the same grounds of requiring this type of peer-reviewed evidence, I'm all ears.
As an interesting note, I learned recently that the best bench pressers in the world, by the typical measure used, are all in the special olympicsparalympics. This is because the typical measure used is a ratio of weight lifted to bodyweight (or essentially this using weight classes). And, well, the people who max out this metric are all some form of leg amputee or other condition that results in extremely underdeveloped legs. They don't get the same "leg drive" strength that other lifters get, but the simple fact that they're not "wasting" bodyweight on a part of the body which isn't that useful for the bench press is more than enough to make up for it. I imagine that powerlifting federations don't have to go out of their way to exclude these people, because they probably are just happy doing what they're doing and have no need to jump into a powerlifting meet. Powerlifters are supposed to squat and deadlift, too, which they just can't do, so they probably don't bother, because all they'd be accomplishing is putting their name at the top of the bench board and everyone else being annoyed, mentally ignoring them, thinking, "Well, of course, there's that guy, but I set the real top bench number." Politics is dumb, though, and I sort of view the whole drive to require trans eligibility as politically-motivated; it would be akin to a political movement to do something dumb like try to wreck powerlifting federations with amputees just because your politics tells you to be an asshole.
ControlsFreak
3yr ago
At least in the Pauline epistles (specifically, 1 Corinthians 7) the New Testament pretty unequivocally suggests that it's better to just be celibate
I believe it says "good", not "better".
ControlsFreak
3yr ago
A huge confounder now is omnipresent surveillance. With cameras on every doorstep, every vehicle dash, every corner store, etc., it's bloody difficult to physically move to a place to murder someone without a camera catching you, your car, something. It's not always enough, but it is absolutely an incredible deterrent, at least to people who have other "regular life" equities that are a least a little bit important to them in comparison to the prospect of going to prison for most of the rest of their life.
I also wonder if the rise in surveillance is actually contributory to the rise in mass shootings. This is a completely fresh thought for me, so I'm just sort of throwing it out there. (Also, it's a small percentage of the overall issue, so the whole rest of this is pretty much just an aside.) The initial thought is just that omnipresent surveillance probably makes it vastly more difficult to be the type of serial killer we had decades ago (and presumably long in the past, too). You just can't bank on being undetectable by, like, picking up random victims at highway rest areas or whatever. Those rest areas have cameras now. The highways have automated license plate recognition, and they can correlate plates that were on the road near multiple incidents. Cell phones are constantly telling the telcos where you are, and that will also correlate you near multiple incidents. You can probably start trying to scheme your way through each one, but there are more and more and more. Many pieces of data, and you'd have to be incredibly meticulous to work your way through each problem in order to rack up a big body count over an extended period of time.
So, if you're a wannabe serial killer, but it's just too darn exhausting to think through how you can pull off more than a few before getting caught by the panopticon, maybe you just get funneled toward not doing it over an extended period of time. You don't do them individually, carefully, one-by-one, always hoping to not get caught on the next iteration. Instead, you give up on observability and simply try to get all your desired killing in as quickly as possible in one big streak.
In any event, I'm not sure we've experienced a combination of panopticon with decentralized law enforcement. Would probably result in some weird incentives.
ControlsFreak
3yr ago
I would also note that there may be some weird timing effects, too. I've heard through the grapevine about companies who are doing major layoffs while also being about to post some record annual profit numbers. The profit numbers are heavily influenced by things that happened early in their fiscal year, but their projections for the next 6mo-1yr are bad (thus the layoffs).
I think this is right, and I think the usual justification for why it would be beneficial in increasing output is often related to situations with significant fixed costs and small marginal costs. Buying a plane/operating a flight has significant fixed costs and low marginal costs. Another standard example is a drug company selling a pill in Africa for a tenth of the price they sell it for in America. Drug development has high fixed costs, while production of the pills often has low marginal costs. The key question is, "Would not being able to price discriminate lead to market exit?" In the drug case, if a company couldn't price discriminate between America/Africa (i.e., they had to choose one price everywhere), they're simply not going to sell drugs in Africa. They're going to exit the market. If an airline can't price discriminate at all, then some routes are going to become unprofitable, and they're just not going to offer the flights (and not buy the aircraft to fly the routes). I think this is essentially your idea that they're willing to sell African pills/cheap flights conditional on being able to price discriminate with other transactions. But in both of these cases, I think it's important to note that the price they're willing to give to the "poorer" folks is still above the marginal cost of production. This is obviously true, because otherwise they wouldn't sell a seat to a poorer person or a pill to an African, even with price discrimination.
A couple other salient differences between these examples are 1) monopoly power, and 2) the nature of the price discrimination. On (1), the drug example really only applies to drugs that are patented (and thus, the producers have monopoly power). For example, some countries don't respect patents of US drug companies, and those consumers get generic pills at the (low) marginal cost of production. Once a regular drug goes off-patent, no one really argues for the benefit of price discrimination, because everyone ends up enjoying paying the (low) marginal cost of production! Both in the US and Africa! (Remember, both sets of consumers were paying above the marginal cost of production during the period of monopoly + price discrimination.) The point of difference here is that while airlines have some significant regulatory and other barriers to entry, the market for air travel is much more competitive than that of a patented drug. Part of the question really boils down to how much "cartel-like" control one actually thinks universities/hospitals/whatever actually have. (We could probably argue about this another time; is a pretty rich conversation.)
Concerning (2), I think there is a significant difference in the nature of the price discrimination. Drugs in US/Africa is in a meaningful sense, I think, targeted at general income patterns by regional area. That is short of the very individualized income data that universities/hospitals are able to use. The price discrimination will be a little "less perfect". Moreover, I think that there is a conceptual difference between a company simply being able to look at incomes (whether abstracted over a region or individualized) as opposed to traditional means of price discrimination. Like I mentioned in the OP, all companies want to price discriminate. They want to know incomes. They want to know everything that is going to correlate with willingness-to-pay. But usually, they have to fall back on some other sort of weak correlate. "Vacation travelers tend to book further in advance than business travelers, and the latter tend to have higher willingness-to-pay." "Retirees are more able to view a 2pm matinee at the theater on a week day, and they tend to have lower willingness-to-pay." It may in some sense be correlated with income, but they're actually targeting something else. I also think it's meaningful if the method involved includes actually giving people a different product. Sure, selling a business class ticket for $2k may help make it profitable to run a flight that also includes some $100 seats, but they have to at least, like, try to make that business class seat better in some way. Some incentive for the person to choose to pay $2k rather than just, "Whelp, we magically know your income, so you're gonna have to pay more for the same thing, because fuck you, that's why."
Bringing it back to universities (maybe I'll do healthcare another day), I think they are remarkably more cartel-like than most people understand. They control the accreditation boards that determine who is allowed to sell education. They control processes that require universities to "show a need" for opening up a new program even within an existing university (at least sometimes)! They went knives out in regulatory processes against for-profit colleges, MOOCs, etc. (notwithstanding other legitimate concerns that may exist with those things). You should hear the stories of various tech people/billionaires/etc. who have tried to go after the academia cartel. They give up, because the cartel is stronger than you think. We've bolstered it by subsidizing demand and restricting supply. That's the first problem. Then, I don't think there's any real charge that they will exit the market if they can't price discriminate. While their marginal costs are pretty low, their fixed costs don't really correlate with market exit in the same way that say, not buying a plane to fly a route or not bringing a drug to market does. They have no natural analog to simply not selling drugs in Africa if they're unable to price discriminate. And finally, they've always been able to "price discriminate" by offering a different product. Business class seats are like living in the fancy new dorm building. I don't know that anyone really cares about it that much. Those consumers are genuinely getting additional consumer surplus out of the deal. It is specifically the, "We've magic'ed (by force of government) into existence a new way to just take the surplus from you, not by giving you something else you want or by providing more things to more people, but because we vaguely threatened 'poor people' enough that the gov't now tells us how much money you make," that is a problem.
No one would accept this in any other industry that hasn't already been mammothly screwed up. No one thinks that when you go to the grocery store, or go to buy a TV, a refrigerator, or car, or anything else, that you should first have to just give them all your financial information so that they can tailor your price. Everyone realizes that if the starting point is one of those regular, well-functioning, competitive markets, there would be no benefit to such a thing; it would be a pure transfer of surplus from consumers to producers. Everyone realizes that apples/TVs/refrigerators/cars are already sold at the marginal cost of production, and that adding income-based price discrimination isn't going to magically make producers sell them below the marginal cost of production to poor people. It's only after we have completely screwed up a market that this starts even being a thinkable proposition.
ControlsFreak
3yr ago
Now do food.
Suppose there is a food cartel that has gained sufficient market power that they could restrict output, raise prices, and profit according to standard monopoly theory. If you are in a position where you can't afford food, you're going to go without food or you're going to be saddled with food debt. If the food cartel perfectly price discriminates, then you can get food for exactly your willingness-to-pay (i.e., you have basically nothing left for any other aspect of the Good Life).
This is the threat that the cartel issues in order to get you to be willing to have the government come in and hand them the tools to price discriminate perfectly. But that's all it is. It's a threat. Blackmail. From their position of market power.
You're right that once we've gotten ourselves into such an abhorrent situation with the food cartel, maybe it's an appealing trade-off. But hot damn is the vastly better deal to break the food cartel, create a competitive market, watch the price of food fall to the marginal rate of production, and see everyone eat plenty of cheap food and have money left over for, like, flatscreen TVs or whatever.
This is sort of the point of my OP. We see this progression of reasoning happening over and over again in all these domains where the gov't comes in; they subsidize demand, restrict supply, create a de facto cartel, completely destroying the competitive market. Then, when your back is against the wall and all seems lost, they issue the threat. "Just let us take all the surplus now; it'll be epsilon better for the poorer part of the population." And they're right! It is epsilon better for the poorer population (and significantly worse for the richer part of the population).
The real problem is that you put yourself in such a vulnerable position to such a threat. That you let the gov't subsidize demand, restrict supply, and set up a de facto cartel. The first best solution is to undo all of that shit. The second best solution is to observe on the internet how the same dynamic that results in this threat seems to keep materializing over and over again. A distant third is to just give in to the threat, trading what's left of consumer surplus for the richer part of the population in exchange for an epsilon improvement for the poorer part of the population.
ControlsFreak
3yr ago
I think the easy answer here is not to set up a monopoly/cartel in the first place.
However, once you have set up a weak cartel, then give the individual components of the cartel reason to defect from the cartel. Cartels want to restrict output, exactly in line with your example (1). But they can struggle to enforce the restriction internally, since individual members have an incentive to reduce the price. One member could charge 6 and make more individual profits. The hope is that defections build on defections, and the result is the competitive equilibrium of everyone charging 2. (In most cases, the supply curve will be upward sloping instead of constant, so they will still capture some surplus.)
However, if we hand each member the ability to perfectly price discriminate, there is much less incentive to defect. Each member of the cartel simply presents each potential buyer with the price that is their individual willingness-to-pay. At best, you have little mini-competitions where each member considers, say, the buyer who values the good at 5, and presents them with a price of 5-ε. The members of the cartel might haggle a bit over who chooses the biggest epsilon for each individual, but none have much of an incentive to deviate much. Instead, I think we would predict exactly what we see universities do in practice - "competing" primarily on non-price factors. Prestige. Name brand. Exclusivity. That helps them maximize their chances to get those 10 and 9 buyers, selling to them at 9.9 and 8.9. The lower tier universities might offer them prices of 9.8 and 8.8, respectively, since they also know their willingness-to-pay, but they're offering a product that is actually valued lower. If each university offers individual prices that are pretty darn close to the individual willingness-to-pay, adjusted slightly for perceived quality, then consumers are going to make slightly different estimates of value, different members of the cartel will "win" a different set of the customers, and so each buyer will get some surplus, but not much. Mostly noise. It's just an entirely different ballgame when every member of the cartel has quite good information concerning each individual's willingness-to-pay.
But in general, your point is a good one. IIRC, many economists judge the value of price discrimination based on whether it actually increases total output. This is the reasoning behind statements like that of @FlyingLionWithABook:
This means poor people benefit greatly from price discrimination: they get goods or services they want at a price they are willing to pay when otherwise they wouldn't be able to afford it.
Would universities actually reduce output if they couldn't price discriminate so perfectly? I'm not sure. Their marginal costs are pretty low.
ControlsFreak
3yr ago
This entirely depends on the people involved. There are a surprising number of upper management folks who aren't true believers. I've advised some on how to approach things. They know how destructive the woke spiral is and how cancerous even a small number of the most vocal advocates can be. They want to be on a first name basis with the worst of the worst, because they want to know who to target when an opportunity arises to move people out of the business.
Obviously, the valence switches completely if they are a true believer or even a collaborator.
ControlsFreak
3yr ago
The panopticon, street crime
Uh, street crime is what the panopticon is for. People who live in bad neighborhoods know that surveillance works. While there can be other concerns with the panopticon, the entire raison d'etre of the thing is to get rid of that problem. If it's not being used to at least accomplish that, then you've got a hell of a raw deal with your local politicians.
ControlsFreak
3yr ago
This is pretty much true. Maybe in a sign of things looking slightly up for them, I did recommend publication for one Chinese paper this year, for the first time ever. It wasn't great, but it wasn't wrong. So, maybe they're starting to trend in the right direction?
ControlsFreak
3yr ago
Thanks for such positive feedback! It's really nice to hear that it resonated with people; when I first wrote it, I got no responses, so I actually figured that it had just fallen flat with the audience.
ControlsFreak
3yr ago
Concerning the @Esperanza post:
Pope Francis said that a man’s gayness was less important than whether “he searches for the Lord and has good will.”
No, he asked who was he to judge, forgetting his position. He could decide to make homosexual actions not a sin. It is within his power.
I've been seeing the question lately in a few places, most recently when Bryan Caplan did a podcast with Richard Hanania: how much "power" do people "in power" actually have? In the podcast, they talked about university presidents, but I've heard it discussed for all sorts of positions. The idea is that, to become a university president, you have to do so many things to please certain people, who have certain interests. To what extent do you need to continue pleasing them to remain university president? Even if you can't be formally kicked out of your role for a particular action, to what extent does your role require cooperation/acquiescence from a variety of stakeholders? If you spend all of your political capital accomplishing one thing that is incredibly controversial among your stakeholders, they may proceed to do everything they can to neuter every last shred of remaining power that you have until they can actually kick you out.
I imagine these constraints vary significantly across different positions of power, but as a non-Catholic, I would argue that the pope does not have the power to "decide to make homosexual actions not a sin", even within the Catholic church. The bulk of the power centers within the Catholic church are committed enough to the position that the bible means something, that one of the somethings that they can easily interpret the bible as meaning is that homosexual actions are sinful, and that this is supported by so great a weight of history and tradition that it would be near inconceivable for a mere pope to, on his own, without a long careful process of arguing for and convincing many stakeholders of his position, suddenly reverse course. They would feel as though a "foreigner" has somehow invaded their group, a spy, a saboteur, an enemy operative. They would view it as illegitimate, do all that they can to remove the invader or at least neutralize his further power until he can be removed. Then, they would go about reversing the decision to whatever extent their history and tradition allows them to. They will declare that it was not "conformable with Sacred Scripture and Apostolic Traditions" (to just copy the words from wikipedia).
In a different time, maybe the pope will gain such power. If the cultural memeplex continues propagating among enough of the rest of the leadership of the Catholic church, perhaps enough will get on board with whatever new argument arises to shift around their traditional position. Different levels of support (or even just apathy) across the leadership will require different expenditures of political capital by a hypothetical future pope, but I think that right now, it's not reasonably "within his power".
ControlsFreak
3yr ago
Can you give some examples, particularly in the field of media, entertainment, data generally?
The earliest recorded historical case-law on the right to copy comes from ancient Ireland. The Cathach is the oldest extant Irish manuscript of the Psalter and the earliest example of Irish writing. It contains a Vulgate version of Psalms XXX (30) to CV (105) with an interpretative rubric or heading before each psalm. It is traditionally ascribed to Saint Columba as the copy, made at night in haste by a miraculous light, of a Psalter lent to Columba by St. Finnian. In the 6th century, a dispute arose about the ownership of the copy and King Diarmait Mac Cerbhaill gave the judgement "To every cow belongs her calf, therefore to every book belongs its copy."[1] The Battle of Cúl Dreimhne was fought over this issue.
Literally went to war for it.
For a long time, things in media/entertainment/data weren't easily infinitely copyable. Text was hard/expensive to reproduce. With the rise of the printing press, making it much easier, we see the rise of formalized copyright law. Old plays, musical scores? They were physical objects. You could literally just keep a hold of the physical objects. Performances were ephemeral and literally uncopyable. Hell, the oldest known chess masters claimed exclusive rights to the list of moves they played.
This would be a more attractive argument, if we didn't see the history of copyright extensions in perpetuity.
I am 100% on your side that in perpetuity is a bad policy. That has literally nothing to do with your original argument, which was from first principles arguing that no such possible policy could make any theoretical sense.
As a general matter, I also reject your insistence that the debate is only concerning music/art/theatre/writing. The first principles argument you made was broader than that. We have good reason to reject your overly broad first principles argument. If you would like to make a different first principles argument such that those principles distinguish between those categories and, say, general trade secrets, I'm all ears.
ControlsFreak
3yr ago
People often spend considerable effort preventing people from carrying off their possessions, and expend similar effort trying to encourage people to carry off their ideas.
...except for the cases where they do the opposite and try to prevent people from carrying off their ideas.
ControlsFreak
3yr ago
If FC agrees with you, then IP is essentially as primitive as (nonI)P. The whole shebang about it being an emergent property of our brain holds for IP, just the same. All we can do is attempt to work around this reality as best we can, just the same. Most importantly, his entire second paragraph seems to be based on a false premise.
This is, of course, IF FC agrees with you.
Personally, I agree with you. I think that prior to socially-agreed-upon law protecting physical property, brains held that some sliver of atoms in the universe were theirs, and they did what they could to preserve their personal possessions. They hid them, they fought others off who wanted to take them, etc. The socially-agreed-upon law worked around this as best we could, trying to make a credible promise that you didn't have to go to extreme measures all the time. That, in fact, you could loan your neighbor your ax, and if he didn't return it to you, the rest of the group would agree that he had wronged you. People could share more freely, given some contextual rules.
Same as IP. Before patent/copyright protection, you do still see some innovation in technology, and you see that people went to extreme measures to hide and protect the ideas which they believed they "owned" that they felt were most valuable. They didn't ever just share their ideas, and often, when they sold physical goods made using those ideas, they would even distort it from the optimal instantiation specifically to make it more difficult for someone else to "take" their ideas. You still see this on the international scene, where IP isn't socially-agreed-upon. For example, most militaries sell equipment to other countries, but they hobble the technology that goes into those products for export, specifically to prevent other countries from "stealing their ideas". Maybe patent/copyright law isn't the best law that could be socially-agreed-upon, but it has reason behind it. "How do we do our best to work around the fact that people want to hoard their best ideas?" Well, we'll give you limited time exclusive use, but in exchange, you have to share your idea publicly. It has to be published in a regularized format, to serve both as a mechanism of society knowing which specific idea is to be protected and as a mechanism to ensure that the idea is eventually shared to the benefit of everyone. Just the same as with physical property, people can now share their ideas more freely, since they have some contextual rules governing that sharing.
ControlsFreak
3yr ago
No matter where or when they are, people are always going to consider some small sliver of all existent objects and territory "theirs", and all we can do is attempt to work around this reality as best we can.
Do you think that there is anything primordial in people that causes them to always consider some small sliver of all the ideas in the universe "theirs"?
This is the biggest reality. I remember that around the time of Obergefell, I was taking neuroscience classes and also sitting in on some queer theory classes. The former was relevant to my professional work/interests, and the latter was me just seeing this strange movement brewing and wanting to discover if there was any there there (spoiler: there wasn't really). In any event, my queer theory prof made a point of declaring agnosticism concerning whether sexual orientation was biologically determined (and one of our first readings was an article titled "What's wrong with be(com)ing queer?"). Around the same time, I was seeing in neuroscience some actual science on the topic of pair bonding/infidelity, what was there, what was really lacking, and just what sort of things were considered scientific evidence in the general area.
So, in that context, I'm sitting in a bar, having a drink with my friends. The topic comes up somewhat related to the whole homosexuality/gay marriage thing. I just ever so gently wonder if mayyyyyybe we don't have settled science telling us that sexual orientation is biologically determined, that mayyyyyybe we don't have some set of utterly conclusive scientific experiments demonstrating that people are "born that way" (of course, it could totally be true, but maybe it just hasn't been shown conclusively). Lemme tell ya, for people who are usually pretty rigorous about logical, scientific arguments, the looks on their faces were more, "How could someone even entertain the possibility," than, "Oh, well clearly you're just not aware of these three papers which conclusively show..." In one moment, one experience, I viscerally knew that they had not been reasoned into their position on homosexuality, like at all. It's hard to feel this in your bones without experiencing it, but when you do, you won't forget it. These positions are not being taken because of objective logic and reason. There are other forces at work.
Drug prices have always been a tiny part of it. The big ones are the obvious cartel-like behavior, restricting the supply of trained doctors and approved facilities. But one of the biggest issues is still price transparency. It's what makes this market feel different to people. Compare to complaints that housing is "unaffordable". Well, the market for housing is abundantly transparent. In most places, people can just go look at the market prices, and they'll see a spectrum of prices from quite high to remarkably low. And they'll notice that when folks complain about "unaffordable housing", they really mean that they just want newer, nicer, bigger housing in better locations for less money. Moreover, because the market is transparent, they can see just how much local government housing policy can restrict/enable supply, pushing prices up/down. So the movement has rightly been able to focus on the underlying issue of restricted supply.
In healthcare, the shell game of price hiding is so advanced, people can't even notice what's going on. The process is, "People go about normal life; sometimes, that involves going to the doctor; poof! Some amount of money is gone. How much? Who knows? Maybe nobody can know." That's what's plaguing the PBMs - everything is predicated on playing "hide the paper". If they keep everyone in the dark about what the numbers mean, they can play four square all the way home to piles of money. And it's what's plaguing the hospitals, too. Of course they want to charge high "facility fees"; these are almost certainly hidden fees! Hidden fees rub a lot of people the wrong way. They feel like when you're in one of those countries where the guy acts like because you touched his product, the culturally-mandated thing is that you've already bought it and have to pay for it. What's the price? You didn't know, could be anything! But you're either a sucker for the paying the number he pulls out of his ass or you're a dick for arguing back.
Healthcare is entirely about hiding every fee possible. So while many people may have experienced a healthcare purchase that turned out to be a little cheaper than their wild-ass guess of what it might be, they've probably also experienced the opposite. And you know they're going to 1000% remember the time they felt they got screwed over wayyyyy more, even if they thought they got okay deals most of the rest of the time. People want a "deal" 100% of the time. They want some amount of "consumer surplus". That's kind of the definition. We turn down buying stuff every day that doesn't give us consumer surplus; we don't say those things are "unaffordable". They just don't bring me, personally, sufficient value right now. But for every single trade I willingly engage in, even if I don't think I got a "great" deal, I think I got more value than I spent. To have a transaction... and then to find out later that it was more expensive than you thought... enough more expensive that, had you known, you wouldn't have agreed to the transaction in the first place? That pisses people off. That makes people say that healthcare is "unaffordable". (That is probably what causes people to go bankrupt; most people don't willingly engage in many transactions that they know will bankrupt them; they have to be blindsided into it.)
I'm becoming more and more obstinate on this point for healthcare. The shell game is too entrenched. The "let's force prices onto the internet" tack didn't work. They're still too good at making it impossible to understand or impossible to access/figure out at the time that you need it. Nobody's going to be sitting in a doctor's office, trying to decide what to do, and say, "Gimme a second, I need to look up on the internet what the price is here and at other locations and.... oh shit, I need to write a JSON parser to figure that out?" Nah. At this point, I can't imagine there's anything we can do besides simply mandate that every single provider of healthcare services must give every single patient a written price prior to performing the service. (Assuming, of course, they're conscious, etc.)
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