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I don't think this proposal qualifies as "too big to manage." But I disagree with your examples. Freeing the slaves was necessary and proper, but far from imm

by stvswn 11y ago

I don't think this proposal qualifies as "too big to manage." But I disagree with your examples. Freeing the slaves was necessary and proper, but far from immune to the original argument. We screwed it up, big time (I don't mean to start a debate over this one, I think it's fairly uncontroversial that Reconstruction failed in some regards) -- in other words, we can simultaneously argue that sometimes massive policy proposals are correct but they almost always come up short of intention. "Ending slavery" couldn't be accomplished otherwise, but that doesn't meant that it was executed well. Ending Prohibition was the opposite of a "massive policy," as are some other popular deregulations (airlines, electromagnetic spectrum, encryption to name a few). This is the federal government deciding to stop doing something. It's not the case that anyone is arguing "the federal gov't never makes a good decision." Popular government-led programs are usually local or laissez-faire in nature. Public school systems, for instance. Or food stamps, which are relatively simple to execute. Or Social Security. The latter two have the feature that it's the individual's choice of how to spend the money. So national income is a good example of "welfare that isn't centrally planned," and in that regard I believe it has a chance at success. The reason I think it's possible is because you wouldn't need a panel of bureaucrats deciding how to distribute all of the welfare -- you'd simply need to distribute the debit cards or whatever.

dragonwriter 11y ago
> Ending Prohibition was the opposite of a "massive policy," as are some other popular deregulations (airlines, electromagnetic spectrum, encryption to name a few). This is the federal government deciding to stop doing something. It's not the case that anyone is arguing "the federal gov't never makes a good decision." Both establishing and ending prohibition were decisions made by the states collectively as overseers of the federal government, not decisions by the federal government; that's how the Constitutional Amendment process works. > Popular government-led programs are usually local or laissez-faire in nature. Social Security and Medicare seem notable counterexamples, neither is local, and neither is laissez-faire. > Or food stamps, which are relatively simple to execute. Or Social Security. The latter two have the feature that it's the individual's choice of how to spend the money. In both cases, I would say they aren't laissez-faire because of the fairly complex regulations determining who gets how much money; and, for food stamps, it also is not true that "it's the individual's choice of how to spend the money", as there are regulations as to what can and cannot be purchased with SNAP benefits.
- chimeracoder 11y ago
  > Social Security and Medicare seem notable counterexamples, neither is local, and neither is laissez-faire. Medicare and Medicaid are both a lot more laissez-faire than people realize. 40% of all Medicare patients are on Medicare Advantage plans - ie, plans that are privately managed by brand-name health insurers that sell private insurance. And this understates the number of Medicare patients who utilize private insurance in one way or another, because (a) Medicare Advantage patients represent a disproportionate amount of utilization of care by Medicare patients, and (b) some Medicare patients are eligible for dual-coverage (so they "have" Medicare, but they use a privately-purchased health plan for all of their actual medical needs). Incidentally, to address the original argument, Medicare Advantage patients are the ones who report higher satisfaction with their health care.
  - deleted 11y ago
    [deleted]
  - dragonwriter 11y ago
    > Medicare and Medicaid are both a lot more laissez-faire than people realize. You seem to be using "laissez-faire" to mean "private businesses are involved, regardless of the degree of government regulation". This is an unusual use of the term. > 40% of all Medicare patients are on Medicare Advantage plans - ie, plans that are privately managed by brand-name health insurers that sell private insurance. And very significantly regulated -- in who they are sold to, what they must cover, and various other things -- by the government, as well as the premiums being subsidized by the government. This is not "laissez-faire" by any normal definition. > And this understates the number of Medicare patients who utilize private insurance in one way or another, because (a) Medicare Advantage patients represent a disproportionate amount of utilization of care by Medicare patients, and (b) some Medicare patients are eligible for dual-coverage (so they "have" Medicare, but they use a privately-purchased health plan for all of their actual medical needs). And it overstates the degree to which any of this is "laissez-faire", because not only is Medicare Advantage in general not "laissez-faire" as discussed above, but some Medicare Advantage plans are even more regulated as Medicaid/Medicare managed care plans (Dual-Eligible Special Needs Plans) into which beneficiaries eligible for both Medicaid and Medicare are either made eligible or outright assigned into by state Medicaid rules. Also, dual coverage does not mean they use a privately-purchased health plan for all their actual medical needs. Ignoring Medicaid/Medicare dual eligibility (where Medicare is primary and Medicaid potentially pays for costs not covered by Medicare), dual coverage with Medicare results in either Medicare being the primary payer and the other payer being secondary and potentially paying costs not covered by Medicare or Medicare being secondary to the other payer. [0] It doesn't mean either Medicare or the other plan is used exclusively. [0] https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview/Medicare-Secondary-Payer/Medicare-Secondary-Payer.html https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Re...
chimeracoder 11y ago
> Freeing the slaves was necessary and proper, but far from immune to the original argument Yes, the abolition of slavery in the US is actually the perfect proof of OP's argument, that sweeping, panacea-like proposals are rarely effective in achieving the desired end-goal. We should have executed a strategic plan for reintegrating freed slaves into society, providing them with the means to succeed and overcome the unbelievably disastrous impact that centuries of the slave trade had on their lives. This is in addition to the abolition of slavery, not instead of it. Instead, we used a very blunt tool (the abolition of slavery) and followed it up with.... nothing[0]. Unsurprisingly, we are still feeling the effects of this massive failure today. [0] Reconstruction, in many ways, did more harm than good, because it gave people the impression that the work had been done and 'was over', when in reality it was a band-aid sloppily placed over a gaping, septic chest wound.
- mikeash 11y ago
  Ending slavery was extremely effective. Millions of people gained freedom and human rights overnight. The result was a vast improvement in their situation. Was it perfect? No. Could it have been done a lot better? Clearly. But your proposals for doing it better involve even more intervention! The original argument was that policy changes should be kept small, incremental, and evolutionary, or that they should be done at the state level.
  - chimeracoder 11y ago
    > Ending slavery was extremely effective. Millions of people gained freedom and human rights overnight. The result was a vast improvement in their situation. Yes, it was 'extremely effective' if you stop the clock on Jan 2, 1863, and don't look at what actually happened in the long run afterwards. People gained some basic freedom overnight, but that's only a small piece of what needed to be done, and that remaining part... never actually happened. So while it was a success in 1863, it was not a success in 1870, or 1900, or 2000, at which point the targets for 'success' were considerably higher. There was no plan for executing Reconstruction, no process for evaluating its success or failure, no strategy for providing the support needed to have it occur successfully. It was assumed that the initial step taken would solve all the problems, and that no additional incremental steps would need to be taken beyond that. > But your proposals for doing it better involve even more intervention! Yes, and in this case (abolition of slavery and the reintegration of freed slaves into society), more intervention is exactly what I'd advocate was necessary.
mikeash 11y ago
I don't see how freeing the slaves isn't a counterargument. Yes, it was messy and got screwed up badly, but it was still vastly better than leaving it up to the individual states to figure it out. And I don't see why ending prohibition doesn't qualify. It's a massive new policy that was enacted nationwide. Just because that policy was eliminating an existing ban doesn't make it "not a policy."

by stvswn 11y ago

dragonwriter 11y ago

> Ending Prohibition was the opposite of a "massive policy," as are some other popular deregulations (airlines, electromagnetic spectrum, encryption to name a few). This is the federal government deciding to stop doing something. It's not the case that anyone is arguing "the federal gov't never makes a good decision." Both establishing and ending prohibition were decisions made by the states collectively as overseers of the federal government, not decisions by the federal government; that's how the Constitutional Amendment process works. > Popular government-led programs are usually local or laissez-faire in nature. Social Security and Medicare seem notable counterexamples, neither is local, and neither is laissez-faire. > Or food stamps, which are relatively simple to execute. Or Social Security. The latter two have the feature that it's the individual's choice of how to spend the money. In both cases, I would say they aren't laissez-faire because of the fairly complex regulations determining who gets how much money; and, for food stamps, it also is not true that "it's the individual's choice of how to spend the money", as there are regulations as to what can and cannot be purchased with SNAP benefits.

chimeracoder 11y ago
> Social Security and Medicare seem notable counterexamples, neither is local, and neither is laissez-faire. Medicare and Medicaid are both a lot more laissez-faire than people realize. 40% of all Medicare patients are on Medicare Advantage plans - ie, plans that are privately managed by brand-name health insurers that sell private insurance. And this understates the number of Medicare patients who utilize private insurance in one way or another, because (a) Medicare Advantage patients represent a disproportionate amount of utilization of care by Medicare patients, and (b) some Medicare patients are eligible for dual-coverage (so they "have" Medicare, but they use a privately-purchased health plan for all of their actual medical needs). Incidentally, to address the original argument, Medicare Advantage patients are the ones who report higher satisfaction with their health care.
- deleted 11y ago
  [deleted]
- dragonwriter 11y ago
  > Medicare and Medicaid are both a lot more laissez-faire than people realize. You seem to be using "laissez-faire" to mean "private businesses are involved, regardless of the degree of government regulation". This is an unusual use of the term. > 40% of all Medicare patients are on Medicare Advantage plans - ie, plans that are privately managed by brand-name health insurers that sell private insurance. And very significantly regulated -- in who they are sold to, what they must cover, and various other things -- by the government, as well as the premiums being subsidized by the government. This is not "laissez-faire" by any normal definition. > And this understates the number of Medicare patients who utilize private insurance in one way or another, because (a) Medicare Advantage patients represent a disproportionate amount of utilization of care by Medicare patients, and (b) some Medicare patients are eligible for dual-coverage (so they "have" Medicare, but they use a privately-purchased health plan for all of their actual medical needs). And it overstates the degree to which any of this is "laissez-faire", because not only is Medicare Advantage in general not "laissez-faire" as discussed above, but some Medicare Advantage plans are even more regulated as Medicaid/Medicare managed care plans (Dual-Eligible Special Needs Plans) into which beneficiaries eligible for both Medicaid and Medicare are either made eligible or outright assigned into by state Medicaid rules. Also, dual coverage does not mean they use a privately-purchased health plan for all their actual medical needs. Ignoring Medicaid/Medicare dual eligibility (where Medicare is primary and Medicaid potentially pays for costs not covered by Medicare), dual coverage with Medicare results in either Medicare being the primary payer and the other payer being secondary and potentially paying costs not covered by Medicare or Medicare being secondary to the other payer. [0] It doesn't mean either Medicare or the other plan is used exclusively. [0] https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview/Medicare-Secondary-Payer/Medicare-Secondary-Payer.html https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Re...

chimeracoder 11y ago

> Freeing the slaves was necessary and proper, but far from immune to the original argument Yes, the abolition of slavery in the US is actually the perfect proof of OP's argument, that sweeping, panacea-like proposals are rarely effective in achieving the desired end-goal. We should have executed a strategic plan for reintegrating freed slaves into society, providing them with the means to succeed and overcome the unbelievably disastrous impact that centuries of the slave trade had on their lives. This is in addition to the abolition of slavery, not instead of it. Instead, we used a very blunt tool (the abolition of slavery) and followed it up with.... nothing[0]. Unsurprisingly, we are still feeling the effects of this massive failure today. [0] Reconstruction, in many ways, did more harm than good, because it gave people the impression that the work had been done and 'was over', when in reality it was a band-aid sloppily placed over a gaping, septic chest wound.

mikeash 11y ago
Ending slavery was extremely effective. Millions of people gained freedom and human rights overnight. The result was a vast improvement in their situation. Was it perfect? No. Could it have been done a lot better? Clearly. But your proposals for doing it better involve even more intervention! The original argument was that policy changes should be kept small, incremental, and evolutionary, or that they should be done at the state level.
- chimeracoder 11y ago
  > Ending slavery was extremely effective. Millions of people gained freedom and human rights overnight. The result was a vast improvement in their situation. Yes, it was 'extremely effective' if you stop the clock on Jan 2, 1863, and don't look at what actually happened in the long run afterwards. People gained some basic freedom overnight, but that's only a small piece of what needed to be done, and that remaining part... never actually happened. So while it was a success in 1863, it was not a success in 1870, or 1900, or 2000, at which point the targets for 'success' were considerably higher. There was no plan for executing Reconstruction, no process for evaluating its success or failure, no strategy for providing the support needed to have it occur successfully. It was assumed that the initial step taken would solve all the problems, and that no additional incremental steps would need to be taken beyond that. > But your proposals for doing it better involve even more intervention! Yes, and in this case (abolition of slavery and the reintegration of freed slaves into society), more intervention is exactly what I'd advocate was necessary.

mikeash 11y ago

I don't see how freeing the slaves isn't a counterargument. Yes, it was messy and got screwed up badly, but it was still vastly better than leaving it up to the individual states to figure it out. And I don't see why ending prohibition doesn't qualify. It's a massive new policy that was enacted nationwide. Just because that policy was eliminating an existing ban doesn't make it "not a policy."