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PaperclipPerfector  16d ago (text post)   30780 thread views

Culture War Roundup for the week of December 2, 2024

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To emphasize: name another business that is forced to work for free and is prohibited by law from closing unprofitable businesses segments

Don't need to. That does not in any way prevent you from giving a price. You know that it doesn't. You know that you can do it. You've basically admitted such by your responses and non-responses.

You are right of course that people will attempt to solve the problem by increasing regulations

You have an opportunity in front of you. Perhaps you'd like to respond to the questions I asked rather than not responding.

where else in modern America do you see costs kept down by using indentured servants? The closet thing to Residency

This is hilarious, given that you were just defending a claim about residency slots that looked extremely poor upon even a cursory look at the entire data you linked to. Maybe your industry is like other industries from an economic point of view when it comes to cartel behavior restricting supply. Like, economists know how systems like this lead to abuse, and perhaps if we stopped restricting supply and truly opened it up to competition, where if one hospital was known for abusing their residents or even paying them poorly or whatever, they would likely have other competing options. You might not be such a unique industry, impervious to literally all traditional analysis, as you think.

But yeah, you know there are atrocious problems. You can keep making bad arguments, pointing to data that you know doesn't show what you say, avoiding answering questions, choosing to be less helpful than we know you can be, etc. And one set of results will flow from that. There is another way, and hopefully another set of results to go with it.

EDIT: There are indeed many different dysfunctions in the medical industry, and one can always say, "Well, we can't spend time focusing on X, because there's also A, B, C, D, E, F that cause weird problems, too." That results in just spinning wheels and nothing ever gets done. When someone later suggests, "Here's an idea that can improve D," you will again say, "But we can't spend time on D, because there is also A, B, C, X, E, and F."

For IoT, I had originally suggested that people just focus on one thing, a little thing. You had to figure out a way to get default passwords out of the industry. It had to be done. It absolutely could be done. But it had to be done. Instead, we got the same distraction tactics, the same Obvious Nonsense claims that it was actually impossible, etc. We saw the results that followed.

I think it is plausible to start with one thing (I suggest just providing prices), especially one that we all know is actually, totally possible. There is no real reason why it cannot be done. If you adopt the mindset that it must be done, it must be the first step to changing the mindset of the rest of the culture, you at least have a chance of success. It requires admitting that there is dysfunction, admitting that the mindset needs to change, admitting that the old mindset and the old dysfunction was fundamentally built on lies, and here is one very straightforward, very easy way to demonstrate that it was built on lies and that we're going to have to call out those lies if we're going to have any hope at broader change.

Giving prices is possible. It will not break other things. It will not make other problems any worse. In some cases, it might not matter much; in other cases, it will. But it is an easy first thing that you can do to break the cycle of lies built upon lies and give us any hope of an alternative solution to something like the haphazard, chaotic mess of additional regulation. Not doing something like this is simply resigning to whatever other, possibly incoherent, change will come. The same dysfunctional mindset will persist, and I, for one, would have little hope that anything will be fixed anytime soon if we can't even do one little thing.

Let's go back to basics. We can estimate the price of a given surgery prior to providing it but that estimate is misleading due to the frequency with which it is wrong, often to the degree of orders of magnitude. You might say "yes you can give me an average that's an estimate" another person might say "an estimate is only meaningful if it is reasonably correct."

In my experience people get pissed if they ask how much it is going to cost to renovate their kitchen and they get a bill for 3 million dollars instead of the initially stated 30,000.

So

  1. Estimates cannot be provided in the same way they can be in most other industries due to an intrinsic excess in variability secondary to the complications involved in human health.

  2. Giving estimates reduces bargaining power with insurance companies and is therefore disincentivized.

  3. Estimates have no value to patients because your insurance is going to be paying not you.

Please pick one or more of these you disagree with and explain why.

Let's go back to basics. You already gave a vastly better answer. Did you forget what you said two days ago?

Dawg I have no idea what you are saying, I've been consistent in my messaging with you which is that this stuff is hard and complicated.

You don't seem to want to engage with any of the most important details here which include things like "medicine is not like other fields, maybe it could be but it is not allowed to be - and we have evidence of this!" and "the specific cost is not relevant in any practical sense."

You appear to have forgotten your answer from two days ago. I suggest you go back and re-read your prior comments.

You have made this accusation multiple times, I have consistently maintained that it is fundamentally unknowable (because it is) if you loosen your definitions of knowable you can know some things about it. Additionally, it ultimately is not relevant and not our job, but we do know some things about it anyway.

If you think you "got me" in some way you will need to clarify.

This tack is not helpful, unlike last time I've tried to give examples of things you don't know and would need to know in order to understand the complexity at hand, but you need to actually engage with them. Every example I've given you about how healthcare is not like a car repair shop has been ignored.

Can you remember what your answer was two days ago?

If you think you "got me" in some way you will need to clarify.

Yes. Please see above. Thank you.

If you had a lottery-type game as an option that you could consider playing, and they said, "The payout is $5k with about probability p, and the payout is $1.5M with probability 1-p," would you say that the payout is "fundamentally unknowable"?

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