morphism
live long and prosper
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User ID: 2721
morphism
live long and prosper
5mo ago
I can’t answer for the user you’re replying to, but can for me.
Thanks!
The answer is immigration.
🤔 But — could you describe how immigration harms you personally?
I'm asking because the general argument against immigration is an indirect economic argument. The argument typically goes like this: The land can support a certain size of population. If more people come in, the land will not be able to produce enough food for everyone.
The trouble is just: This argument is precisely the Malthusean theory that my quote of Henry George refers to. And it is unfortunately not an accurate model of reality — it's not true. And hasn't been since 1879. 😅 After the invention of fertilizers, land size is not a big issue anymore — the economy now runs on goods and services that people produce for each other. Sure, immigrants lead to more consumption of goods and services — but in order to be able to buy these, they also need to work to produce them. In other words, "land" has been replaced by "labor" — and while an immigrant can, by definition, not bring the resource "land" with them, they can and do bring the resource "labor" with them anywhere they go.
morphism
live long and prosper
5mo ago
What will be the consequences?
For a thorough economic analysis, I recommend Patrick Boyle. The gist is that tariffs are redistributive: They take income from the household sector and transfer it to protected businesses — both within the US. Whether Canada will be thrown into a recession depends on how badly Canadian goods are demanded by US consumers.
The basic economic incentive for international trade is the same why we have different professions for people: by dividing labor, countries can specialize and be more efficient in producing particular good or service, making it cheaper for everyone. Yes, you can grow bananas in Canada, but it's just way cheaper to do it in warm climate. The flip side is that Canada will never gain the expertise needed to grow bananas, and will not have any bananas if the other countries close down shop. This is fine without bananas, but if you replace "banana" with "weapon", then some people start worrying about "natural security".
Up until now I've been more or less indifferent to Trump. While I find him personally and aesthetically unpleasant, the hysteria surrounding his every move – and especially the mainstream media's tendency to misrepresent him, often flagrantly – has sort of balanced things out for me. I confess I felt some cruel enjoyment watching people on the left (many of whom have done great harm to me and my loved ones) melt down both times he won.
This is not directly related to your questions — but I'm genuinely curious. How would you describe the harm that the left has done to you and your loved ones, and how would you say the mainstream media misrepresents Trump?
The reason why I'm asking is that I'm firmly anti-Trump — I have no hate for him, but I do believe that he will make the lives of almost everyone worse, including his own supporters, except for the direct beneficiaries of his authoritarian rule.
And I'm bringing this up with you because I'm curious why his own supporters would support him, even though he will harm them. Obviously, that doesn't make sense to me. 😅
Before I expand on that, I'd like to expound that my core value systems is humanism — essential, every human being is worth caring for. That includes you, every Trump supporter, all leftists, and people of all colors. However, it appears to me that Trump supporters do not necessarily see it the same way, and then it becomes a question of how much care I can afford for a human that is fine with harming me.
Now my quick rundown of Trump: The key tactic of populist figures is to deceive about the actual benefit of their policies. Will Trumps' tarrifs improve the lives of most American consumers? Judging by argument above, the answer is "no". Does Trump care? The answer is — "no". Why would he care? Why would he not lie to everyone? His good character? But he doesn't seem to have a good character? And will people be able to tell the difference? The answer is "no" — that's why the deception works. Most people do not understand well enough what effect tariffs have — and they will harm themselves if they belief they work while the reality is that they don't. It's the discrepancy between belief and reality that is the source of harm. And the populist strategy is to play exactly that: Tell people what they want to believe, reinforce it, throw new beliefs at the wall and see what sticks, without any regard for reality. Everyone who is in on that deception will win, everyone who is not will lose out.
As Henry George put it in his 1879 book "Progress and Poverty":
“A theory that, falling in with the habits of thought of the poorer classes, thus justifies the greed of the rich and the selfishness of the powerful, will spread quickly and strike its roots deep. This has been the case with the theory advanced by Malthus.”
morphism
live long and prosper
6mo ago
I don't believe that you have "sat down and done the calculation."
You are the one who does not seem interested in such a calculation. You cite some GDP figures and rest on your preconception that you're right. I'm not gonna bother discussing data against such attitude towards truth. (EDIT) For example, you make an assumption about me making a trip to Germany, which is factually wrong.
No. Look, if you sit down and actually do the calculation, the combination of GDP, prices, salaries doesn't add up as you claim — and that's before asking the question of which quality of service you're getting.
EDIT: And the statement "salaries are higher, therefore prices must be higher" cannot even be a causation — if anything, it's the other way round: higher prices cause higher salaries (assuming that the workload stays the same). But why should prices for each specific medical procedure or diagnostic in the US be higher? Do they add magic sprinkles to it, so that the health outcome is phenomenally better than in Germany? Price and value are two fundamentally different things, and the question is whether the US offers a good price for the medicine stuff.
morphism
live long and prosper
7mo ago
Well, you know what they say about anecdotes and data. Germany spends about 12% of its GDP on healthcare, and that percent has steadily gone up over time. The US spends 17%, which is certainly higher but not massively so
But comparing GPD is not the same as comparing prices.
Prices for medical procedures in Germany are regulated by the Gebührenordnung für Ärzte (GoÄ), which is publicly visible. For example, the typical cost of a duodenoscopy (optical inspection of the gastrointestinal tract just after the stomach) is ~ 200 EUR. This is the price that a person would pay if they decide to get this procedure out of their own pocket (I have friends who have done this).
I don't know a good source for prices in the US, but let me take this New York based thing as an example. They list an upper endoscopy at $975. That's a 4-5x price difference compared to the price in Germany!
In addition, in Germany, this price is almost always covered by insurance, which is mandatory for everybody. In Germany, it is unheard of for people to go bankrupt due to a health expense. In the US, that's very different — people regularly go broke due to medical costs and ask for monetary support online.
If your figures about GDP are correct, this implies that the US performs dramatically less procedures than Germany. This can be due to efficiency, which I doubt, or due to 4-5x reduced level of care.
morphism
live long and prosper
7mo ago
OK, but you can't just run a large organization with no administration. Some of those administrators do useful work!
Sure. But administrative costs can easily blow 10x for checking rule B that would be unnecessary if rule A did not exist.
Total unemployment spending is like $10 billion a year, and that's mostly just benefits.
Care to cite a reference for this? What percentage is spent on the administration of those $10 billion?
Likewise, you can't just approve any grant that a scientist asks for. It actually seems reasonable that scientists would spend a lot of time proposing different ideas, and then have a separate agency deciding which ones are worth doing.
If you look at the source that I indicated, you will find ample evidence that the current system is dysfunctional, despite it "seeming reasonable". The gist is this: a) You need scientist time to check grants, which could be spent on doing science instead, and b) as science is inherently unpredictable, finding out which ones are doing is actually hard and the separate agency currently mostly fails at that task.
most of the countries that do comparable service at lower cost are also countries with much lower salaries overall, so that goes back to the point about "just lower salaries." Generally the countries with more money, like Switzerland, also spend more on healthcare.
I once took a breadth test in Germany, and a breadth test in the US, close in time. The Germany one is 50 EUR, the US one was $1020. That's a 20x difference, and I don't think that this can be explained by salaries alone.
morphism
live long and prosper
7mo ago
Oh, and here are more big issues for private health care, second-order effects:
- Timely treatment is cheaper than delayed treatment — due to increasing complications as the medical problem festers
- Effective treatment keeps people in the workforce
The issue with health problems is that it is usually cheaper to fix them early and thoroughly, rather than spend money peacemeal and end up with a complex operation to save the patient's life at the end. It's more efficient to do a the stitches today, than to deny care only to amputate the entire arm in two weeks.
On the second point, when a medical insurer is forced to keep paying for a patient that was taken out of the workforce by their illness, the insurer has an incentive to pay for early interventions, because the patient can still contribute to the insurance while they are working. If the patient can't work, they don't generate income for the insurer.
morphism
live long and prosper
7mo ago
I think we're all hoping that there's some big pot of money being totally wasted. […] But I'm not sure that's the case.
It's never as simple as an obviously frivolous budget. However, here are at least two systemic issue that are large sources of inefficiency:
- Information asymmetry. Doctors can and will prescribe treatments that are medically not quite necessary, but where the patient is fundamentally unable to tell the difference. This is actually a problem in Germany.
- Administrative costs. A system with complex rules for who gets denied care and who does not will need accountants who check these rules. This is busywork that could be spent on simply actual care. I have no estimates how this affects that health care sector, but I bet that it's substantial. But I know of at least two other sectors where this problem occurs:
- Checking unemployment benefits vs universal basic income
- Science funding. I can't find the estimate, but for some grants, at least 50% of the work goes into writing the grant, not doing the actual research.
In the end, money is just "liquefied" work that people do for other people. Not all of that work is useful towards the goal of meaningful health care, and not all of these people are paid the same amount of dollars per hour of useful work, rightfully or wrongly.
We could perhaps make an argument for cheaper, but worse, health care.
Well, the fact that countries other than the US have health care systems which deliver comparable service, but at significantly lower cost indicates that a large chunk of money is spent ineffectively.
morphism
live long and prosper
7mo ago
I agree that more transparent price information would improve the market, but that does not yet imply that the market is fit for purpose.
It's a question of market design. Markets have a specific purpose — optimize the allocation and procurement of scarce goods using decentralized decision making, but depending on circumstances, not all of them are effective at this purpose. This topic is closely related to auction theory, where e.g. a second-bid auction is better than pay-as-bid auctions.
The main troubles with market design in health care are:
- Inflexible demand. A person who is sick generally cannot abstain from buying the good "healthcare".
- Information asymmetry. Doctors can generate demand by recommending procedures that are not quite necessary or more expensive than necessary, but the patient does not have a chance of being informed enough to know the difference.
Due to these issues, a "free market" will lead to perverse incentives; other market designs are better at solving the optimization problem. And yes, market design = regulation.
morphism
live long and prosper
1yr ago
people are still having to pay more for goods and services than they did previously; their money is worth less and they are poorer now than they were previously.
This is actually intended by the Federal Reserve — the typical inflation target is 2%. The reasoning behind this is that money is only useful if it is spent for goods and services — people who make the goods and perform the services will only do so if there is demand for it, and the inflation gives a little nudge to spend money rather than hoard it. Put differently, spending money is equivalent to soliciting work from other people. No spending, no working.
As a counterpoint, the creators of cryptocurrencies typically think that this is a terrible line of reasoning, and therefore created their own money.
it becomes more plausible to me that there is an underlying emotional component that is either modulating the symptoms, or leading to some of them.
I'm afraid, but this is a logical non-sequitur.
- The "weirdness" of a physical symptom does not logically imply that it has an emotional cause. Counterexample: People with rabies panic when presented with liquids to drink. I would say that this symptom qualifies as "weird" — unfortunately, the disease is still deadly virtually all of the time.
- Even if the symptom is an emotion, such as irrational fear, this does not imply that the cause is emotional. Counterexample: 1) Rabies as above, 2) Depression can be caused by continued ingestion of fructose during fructose malabsorption.
Even more afraidly, I have to point out that current notions of an "emotional cause" have no basis in science — even though there are codified in popular diagnoses, such as F45 ("somatform disorder") in ICD-10.
Specifically, the problem with F45 is the following:
F45 postulates that the inability to detect a physical cause implies the presence of an emotional cause.
But "absence of evidence is not evidence of absence". As Ioper already points out, the physical cause may be unknown and a) there exists no current test for it. In practice, b) the doctor is "too lazy" to test for it.
In fact, the postulated criterion for presence of "emotional cause" is unscientific — by definition, a criterion which is scientific must be falsifiable. Here, this means that there must exist an experiment which is able to reject the hypothesis that XY is the "emotional cause". No such experiment has ever been put forward for F45. (If you know of any such experiment, please do write a reply to this post.)
As for your "weird" symptoms: Mast cell diseases, such as mastocytosis, MCAD or hereditary alpha tryptasemia are known to cause "weird" symptoms.
(This fact is useful, but strictly speaking unnecessary for rejecting F45.)
That's a fair point. But there is a difference between being "anti-murder" and being "anti-immigration", because "murder" is obviously violating the bodily integration of a person, whereas it's more difficult to argue that "immigration" is harmful on a personal level — that's what I wanted to hone in on by using the word "personally", though missed the mark by being too specific on the interlocutor.
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