Historian Bret Devereaux on his blog wrote about the status quo coalition which is a somewhat related idea; he has a similar bit about how returns from development outpace returns from conquest in the modern era, making modern wars of conquest not economically worthwhile.
The fight for 25. Linked archive because it's registration lapsed.
I think that this somewhat old (ca. 2015) essay series on exploding costs in Healthcare in the US is interesting and worth reading.
The TL;DR is that there has been a plethora of outsourcing of core functions of healthcare-related companies, at the same time as more healthcare has been able to be provided through the march of technology. The US and larger companies have attempted to solve the issue by requiring more and more 'accountability' (which requires paperwork, man-hours, and ultimately employees to be paid).
When one company employs specialists in finding obscure reasons to deny coverage of claims to patients due to paperwork errors in their Byzantine medical coding system (which are coded by medical coding specialists), and another company employs specialists in appealing the denied coverage and proving the patients should be covered after all - all of those people's paychecks are ultimately coming out of insurance premiums, and making the system cost more. As more companies proliferate in the system, they all try to push the costs of the system onto each other - but since the costs will all ultimately get paid by someone in the end, the net result is that there is a huge amount of paperwork and people employed in thrashing out who exactly is responsible for each and every expense.
Still, though, you get a better sense of the details by reading the whole thing, so I recommend doing that.
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A tumblr post I quite enjoyed:
I generally agree about your fourth point: More than a decade ago, one of the better professors I had at university was an English teacher; she was young enough and new enough to not have been worn down by the grind yet. A large part of the grade for her class was in the exam portion, where we were given ~4 hours of proctored exam time to (mostly) write several short essays in person by hand, without electronics. We were allowed copies of the literature involved and no other aids, and basically given "choose 3 topics from this list of 10 to write essays about", where the topics were things like "compare [work A]'s [element x] to [Work B's]." etc. I imagine she could simply load more of the final grade on that final exam, and the similar but shorter midterm, rather than homework essays, and still be able to assess/grade students' abilities in the era of ChatGPT.
Instead, it largely seems like universities have mostly tried nothing, and are all out of ideas. The remarkable fatalism I've been seeing about it is amusing.
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