22 votes

Topic deleted by author

14 comments

  1. [14]
    skybrian
    Link
    The hook is about billionaires, but apparently they want to do it by nationalizing a lot of industries. (Or turning them into worker co-ops.) This seems like taking a tough problem and making it...

    The hook is about billionaires, but apparently they want to do it by nationalizing a lot of industries. (Or turning them into worker co-ops.) This seems like taking a tough problem and making it much harder and more unlikely to happen.

    If we took it seriously, we’d want to plan for it and build political consensus, and ideally test it out at a smaller scale. Maybe at a state level? An example of that is California’s plan to manufacture and sell insulin. Hopefully it works out, but it will be years before we find out how it did. If it’s a success, it could be used to justify trying again with some other important medicines. (It would take a long time to do all medicines, let alone all products, though.)

    We can look to other countries for examples, but just because it worked somewhere else doesn’t mean it would work for us. And results seem mixed? For a long time Americans would point to the UK as doing health care better than us, but I don’t think UK health care is doing so well lately?

    I have doubts that the US could nationalize Walmart, for example, without ruining it. By that I mean it either wouldn’t have the selection and low prices that their millions of customers rely on, or it would lose money. The employees would probably do better, though.

    I’m not sure anyone really takes nationalization seriously, though, as a thing that could actually happen in the US? It seems like a Congress that passed a law like that would have to be unrecognizably different? Now you have three enormous problems.

    This is a rhetorical move, tying something people care about to other huge changes that Jacobin also wants.

    I think if you want to actually solve a problem, you have to go the opposite way, figuring out how to solve it without having to change a lot of other difficult things. Worldwide consensus on fixing the ozone layer was done without transforming entire industries. New refrigerators work about the same as the old ones did. Things changed for manufacturing and repair of AC systems and someone who works on them could tell you how the new rules work, but It’s not radical change.

    7 votes
    1. [8]
      0x29A
      (edited )
      Link Parent
      In discussions/hearing from some others, my (only lightly-informed) view of UK healthcare is that it's only doing poorly because the political factions in the UK that want it to fail have...

      In discussions/hearing from some others, my (only lightly-informed) view of UK healthcare is that it's only doing poorly because the political factions in the UK that want it to fail have purposely underfunded/gutted it, ensuring its failure, but then blame the system itself for failing even though it would have been fine without their purposeful destruction. I hate that political tactic- it costs real human lives, health, time, and more, all just simply for an unnecessary agenda.

      Though I do agree that things that work elsewhere will have a tough time working in the US in some cases, sometimes due to our sheer size and structure, but mostly due to tradition and our screwed up "American culture" that just seems to slam the door on good ideas all the time just because of who we unfortunately are (hyper-individualist, etc). I don't know how to fix that, or at least not on any sensible time-scale.

      My honest belief is that we need radical change, and need to change things even when that means changing a lot of other difficult things simultaneously. That's idealistic, though... which is why it often feels rather hopeless here.

      10 votes
      1. post_below
        (edited )
        Link Parent
        You're exactly right that, to a large degree, it's a cultural problem. Yeah it's a catch-22. You fix it with education and a better social safety net. That gives you more open-minded, secure...

        You're exactly right that, to a large degree, it's a cultural problem.

        I don't know how to fix that, or at least not on any sensible time-scale.

        Yeah it's a catch-22. You fix it with education and a better social safety net. That gives you more open-minded, secure people who then naturally create a culture with more rational values and priorities. Which then elects different legislators.

        But of course you can't do that when capitalism has created so much opposition, in both legislation and culture, to those ideas.

        So instead I think the practical solution is for government to reign in capital a bit. That's still politically imaginable, for now. I think the first step there is already happening in terms of changing perspectives about wealth and corporate power driven by the slow disappearance of the middle class.

        It's anyone's guess whether it will be too little, too late, or not. The Market is a large beast.

        Edit: typo

        8 votes
      2. [3]
        stu2b50
        Link Parent
        Those are fundamentally related, though. Part of the argument for the private sector is that it has self equialization. If there is some innovation that you don't implement, a competitor will...

        In discussions/hearing from some others, my (only lightly-informed) view of UK healthcare is that it's only doing poorly because the political factions in the UK that want it to fail have purposely underfunded/gutted it, ensuring its failure, but then blame the system itself for failing even though it would have been fine without their purposeful destruction.

        Those are fundamentally related, though. Part of the argument for the private sector is that it has self equialization. If there is some innovation that you don't implement, a competitor will implement it and either you have to or die and give your marketshare up to those competitors. Have a overly complicated processes? Same thing.

        Government systems have to do things. If the cost of living increases and doctors need higher pay, the government needs to actively raise it. If the internet comes about, they need to actively decide to make websites.

        Bad governments are inevitable just as humans are inevitably fallable. There is no way to never have Tories come in at some point and wreck things. You have to make them resilient in the face of that.

        For the NHS, I think the US has become a red herring. Yes, the US has worse Healthcare on average, but the vast world has quite a few more countries than just the UK and US. Some of the best Healthcare systems in the world that on a wide variety of metrics perform waaay better than the NHS are public/private mixtures, like Germany and Japan.

        From "Von der Last zur Chance – Der Paradigmenwechsel vom Gesundheitswesen zur Gesundheitswirtschaft"

        an almost totally regulated health care market like in the UK would not be very productive, but also a largely deregulated market as in the United States would not be optimal. Both systems would suffer concerning sustainable and comprehensive patient care. Only a hybrid of social well-balanced and competitive market conditions created a relevant optimum

        5 votes
        1. [2]
          rosco
          Link Parent
          Doesn't monopoly or even consolidated capital disrupt that though? If you can buy and bury innovation then competition doesn't matter and the "best outcome" is simply the one with the most capital...

          Part of the argument for the private sector is that it has self equalization. If there is some innovation that you don't implement, a competitor will implement it and either you have to or die and give your marketshare up to those competitors.

          Doesn't monopoly or even consolidated capital disrupt that though? If you can buy and bury innovation then competition doesn't matter and the "best outcome" is simply the one with the most capital behind it.

          3 votes
          1. stu2b50
            Link Parent
            Yes, those are market failures. Healthcare is a market that tends towards local monopoly due to large barriers of entry. That’s why the German model of healthcare is not pure market nor pure...

            Yes, those are market failures. Healthcare is a market that tends towards local monopoly due to large barriers of entry. That’s why the German model of healthcare is not pure market nor pure government mandate - it’s both, to create incentive alignment, make sure the markets are competitive, and to ensure an minimum level of care and affordability is kept.

            It’s certainly has had its challenges in the last few decades but by most metrics has fared significantly better than both the NHS and certainly the US’s healthcare system.

            3 votes
      3. [2]
        skybrian
        Link Parent
        If it's political fighting that's doing it, I think that still counts as a risk, though? It can happen again. We probably should expect more of it, particularly in the US. And of course private...

        If it's political fighting that's doing it, I think that still counts as a risk, though? It can happen again. We probably should expect more of it, particularly in the US.

        And of course private businesses fail all the time, too, like Bed Bath & Beyond just recently. Walmart is an extreme success (at some things) and you wouldn't expect that normally.

        5 votes
        1. 0x29A
          (edited )
          Link Parent
          Sure, I don't think my post implied a lack of risk in de-privatization. Political change is a risk for any system, for any change. It feels like a given. I just absolutely oppose the privatization...

          Sure, I don't think my post implied a lack of risk in de-privatization. Political change is a risk for any system, for any change. It feels like a given.

          I just absolutely oppose the privatization of various industries (absent extreme regulation), such as healthcare. I definitely lean more towards co-op ideas than nationalization, only because state-owned can be a bad thing when the state itself is bad (oppressive, etc). I also lean towards extreme regulation, especially surrounding competition/monopoly/consumer protection, but in many aspects.

          5 votes
      4. NaraVara
        Link Parent
        From a policy design perspective, though, political capture by hostile factions in society should be part of your threat model there. We can't just say "if only the cool and realistic...

        In discussions/hearing from some others, my (only lightly-informed) view of UK healthcare is that it's only doing poorly because the political factions in the UK that want it to fail have purposely underfunded/gutted it, ensuring its failure, but then blame the system itself for failing even though it would have been fine without their purposeful destruction. I hate that political tactic- it costs real human lives, health, time, and more, all just simply for an unnecessary agenda.

        From a policy design perspective, though, political capture by hostile factions in society should be part of your threat model there. We can't just say "if only the cool and realistic implementation we have isn't perpetually under attack by greedy assholes. . ." because it's simply the nature of how the world works that the cool things we have will always be under attack by greedy assholes. We need real plans to harden against that instead of wishing it away.

        A good example of such hardening would be the US Social Security System. It's basically protected by an extremely powerful lobby that makes it a third-rail of American politics. But more importantly, it's an extremely simple program to implement that isn't easily fucked around with. There's a deterministic formula. All they do is send out checks. The eligibility criteria is extremely basic and easy to assess. There is no imaginary fat to cut there. Administration costs are too low.

        It's much harder to do healthcare like this because it's inherently a very complicated thing. You can't just make a deterministic decision one time and just run it on virtual autopilot for decades. It's always evolving. You can't get away with minor tweaks. There's lots of consequences to mismanagement that don't just come down to checks and approvals go out slower.

        5 votes
    2. [5]
      rosco
      Link Parent
      I think what often goes unmentioned in these discussions is that the riskiest parts of our economy are already nationalized. FEMA provides insurance in locations that are too risky for traditional...

      I think what often goes unmentioned in these discussions is that the riskiest parts of our economy are already nationalized. FEMA provides insurance in locations that are too risky for traditional insurance, in places like coastal Florida. Medicare insures the sickest and the elderly as they too are unwelcome by traditional medical insurance. And when it comes to innovation, particularly with pharmaceuticals, the expensive R&D costs are almost entirely supported by federal programs be it through NSF, NIH, DOD, or even state education programs.

      I don't think anyone is talking about nationalizing Walmart, even if they also get federal subsidies in the form of low income housing, food stamps, and their workers receive subsidized healthcare. Hell, even their produce and products are subsidized to hell. SpaceX and Tesla also aren't viable companies without government support of R&D and massive tax breaks. There isn't a sector that isn't effected by this. Their economic models don't make sense without government support, so the question is posed: Why should industries that require collective support not provide collective benefit. I believe nationalization gets proposed when the balance of cost and benefit are way out of whack.

      I’m not sure anyone really takes nationalization seriously, though, as a thing that could actually happen in the US? It seems like a Congress that passed a law like that would have to be unrecognizably different.

      I think the same could be said for regulation. I think regulation could take care of the ills seen within the consumer goods industry, but with new laws like the Proposition 22 in California that loosens those laws even further, I don't have high hope for that changing. Regulation even has the opportunity to fix the deregulation that we've seen in key industries like healthcare, banking, and housing. Healthcare was not for profit until it was deregulated by the Clinton administration. The banking industry got their greenlight in a similar era with the repeal of the Glass-Steagall Act and the passing of the The Commodity Futures Modernization Act which effectively deregulated their sector. Neither of these changes brought about benefits for the actual customers, it just allowed for consolidation of power/wealth within industries.

      6 votes
      1. [4]
        skybrian
        Link Parent
        This seems like a bad assumption? For example, the idea of a government contract is that the people benefit somehow when the contractor does its job. For Medicare, people benefit from health care....

        Why should industries that require collective support not provide collective benefit.

        This seems like a bad assumption? For example, the idea of a government contract is that the people benefit somehow when the contractor does its job. For Medicare, people benefit from health care.

        How much that's worth depends on what you compare it to, and the alternatives are often vague.

        1 vote
        1. [3]
          rosco
          Link Parent
          I'm not sure what you mean.

          I'm not sure what you mean.

          1. skybrian
            Link Parent
            For example, SpaceX delivers supplies and astronauts to and from the space station. It's paid for this, but it's not an act of charity, it's because the government deemed it worth doing. Also, I...

            For example, SpaceX delivers supplies and astronauts to and from the space station. It's paid for this, but it's not an act of charity, it's because the government deemed it worth doing. Also, I believe SpaceX is the low-cost provider of launch services, so arguably it's saving the government money, at least relative to other NASA contractors.

            We could talk about whether the US really needs a space station (I'm undecided on this) but as a transaction, both sides benefited, so it's unclear if we should call it the government supporting SpaceX or SpaceX supporting the government. It seems more like mutual benefit?

            Similarly, when Medicare pays for procedures, it's to benefit elderly people, and also people in the health industry get paid. This is mutual benefit, assuming the price is reasonable, there's no fraud, and so on.

            Figuring out who benefits more is often very complicated. It depends on what you look at. So, I don't think we can safely assume that industries that sometimes benefit from government programs don't provide collective benefit.

            7 votes
          2. streblo
            Link Parent
            I think the point being made is related to this: There is some perceived benefit, presumably at least indirectly collective, as part of every government contract, that's the reason it exists. For...

            I think the point being made is related to this:

            SpaceX and Tesla also aren't viable companies without government support of R&D and massive tax breaks. There isn't a sector that isn't effected by this. Their economic models don't make sense without government support, so the question is posed: Why should industries that require collective support not provide collective benefit.

            There is some perceived benefit, presumably at least indirectly collective, as part of every government contract, that's the reason it exists. For example a hypothetical government subsidy of a company doing hard-to-do soft plastic recycling doesn't need to put money directly into taxpayer pockets/government coffers for the public to benefit.

            Of course, it's reasonable to question the public benefit of a Space X or EV subsidy but I think that argument cuts both ways.

            5 votes