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Given how hamstrung regulators are these days thanks to a pro-corporate Congress, it doesn't say much other than that the government we've elected has chosen no

Given how hamstrung regulators are these days thanks to a pro-corporate Congress, it doesn't say much other than that the government we've elected has chosen not to control costs.

nickff 10y ago
When was the last time a regulator (or government agency) admitted to failing because of incompetence, stupidity, or bad luck? It seems they are eternally underfunded and understaffed, and never make mistakes. I consider myself and my associates to be quite diligent and intelligent, yet every one of us is sometimes at fault when we fail.
- colechristensen 10y ago
  The NTSB/FAA does a _great_ job of regulating. Aircraft have the beneficial property of being immune to bullshit. Mistakes, incompetence, and corruption lead very directly to planes falling out of the sky which is a very public and costly failure. They're great because they have to be _and_ being great leads to success. You can, with solid engineering, completely understand and prevent failing. There aren't any act-of-God accidents. How and when aircraft fail is designed from the start; when they do fail there is always a cause and it's always fixable. You can read plenty of NTSB reports about accidents (and they take mistakes which don't actually result in harm very seriously too) and they really do point out incompetence and stupidity. The most important part is that it isn't about blame or prosecution, it's about finding, fixing, and preventing problems. Revenge against people who screw up intentionally or not isn't helpful, making it impossible to screw up is.
  - nickff 10y ago
    All of the airplanes that crash were approved for production by the FAA. I am not sure how you would measure the failure rate of the NTSB, other than by looking at the number of repeated failures, which is tough, as many incidents are one-offs, or can be categorized as distinct without being substantially different. In any case, one could regard the FAA's primary failure being that the airliner market is a duopoly. The FAA and its counterparts have helped make it so expensive to develop and approve new aircraft that only two companies can do it, and even they only design one new airplane every ten-twenty years. Bombardier, which is a large and established aircraft manufacturer could afford to develop an airliner, but not to get it approved; this results in slow progress, high prices, and little competition. It would be interesting, if impossible to know how safe aircraft would be if Boeing and Airbus were granted an unregulated monopoly. I would guess their aircraft would be very safe and expensive (as they currently are), just like 'Ma Bell's service was in the days of its monopoly.
    - colechristensen 10y ago
      Every mistake, every crash is a failure and there are remarkably few of them. Mistakes happen and the mistake is always in not predicting the failure correctly. And there's quite a bit of competition; Boeing and Airbus are integrators, they don't build all of the parts and there are plenty of parties competing for the various parts. Likewise they both make the largest aircraft exclusively, but as you get smaller you add more and more alternatives to the mix. You're also wrong about no new models. They release updates and changes all the time. Completely new planforms just aren't needed. The basic design is fundamentally unchanged and doesn't need to be changed. There's just nowhere to go. Only small iterations of improvement.
      - nickff 10y ago
        There are plenty of opportunities for new models; Boeing wanted to make 3 new aircraft, and had to settle for 1 new and 2 upgrades. The 737 has been flying for almost 50 years, and Boeing still can't give it long enough landing gear to properly accommodate properly-sized turbofans because of the regulatory burdens. Bombardier thought there was an opportunity for a new single-aisle airliner, but hasn't been able to come up with the money to get a certificate. The fact that there are no new aircraft manufacturers coming on-line only proves that the regulators have created a duopoly.
    - lukeschlather 10y ago
      Looking around on the internet it sounds like the cost of the aircraft accounts for about 10% of the cost of a ticket. Frankly, airplanes sound downright cheap compared to the cost of staffing and fuel. Doesn't seem like the right place to start looking for cost-cutting measures.
      - nickff 10y ago
        If you want to understand how important new aircraft are, you need to take more factors into account, such as turn times, average numbers of transfers, etc. into account. The airlines have been moving away from the hub-and-spoke model, towards point-to-point for quite some time; aircraft CPM plays a significant part in this shift (as well as in slowing it down).
colechristensen 10y ago
Many people have strong support for a single payer system. Seeing this simple failure illustrates a risk in moving that direction. Who do you trust to do a better job keeping costs in control? The greed (or fiduciary duty) of an insurance company or the governance of bureaucrats? I trust the market more because the government has proved to be far more corruptible. There should be a government option for sure, but regulations should focus more on making the healthcare market healthy. * Open straightforward pricing * Removal of trademark protections for named drugs * Reducing patent terms, adding affordability conditions * Publicly funding research with open access requirements * Mandating manufacture of unpopular or poorly competitive drugs to get patent protections * Adding efficiency to approval and regulation process It seems all too obvious that a single payer system in America would get overrun with regulatory capture and skyrocket costs in sweetheart deals.
- DasIch 10y ago
  The US is the only first world country that has these problems. You don't need to come up with a fancy solution, just copy what another country does. It's not like it can get worse.
  - colechristensen 10y ago
    The US isn't the same as the rest of the first world (outmoded as that term is). A disproportional amount of research and medical industry happens in the US. In a way, many of the developed nations' medical systems are made possible by the American medical economy. We end up paying for more of the development and exporting our technology for as much as we can get. The cost structure wouldn't be the same worldwide if America switched. We have 50 states. Each one of them is capable of setting up a single payer healthcare system on it's own, yet none of them have. Not for lack of trying, but none have been successful. I don't think we should even have the national conversation at all until at least one state finds success implementing it themselves.
    - DasIch 10y ago
      There are a large number of medical companies outside of the US as well. Additionally governments encourage research in general through patents and subsidies and provide direct funding. Not to mention that a lot of research happens at universities. Additionally many of these companies are located outside of the US. Ignoring all of that just from a purely financial perspective, the amount of money spent on health care simply can't be explained through research, both in quantity and when it comes to the reality of what people actually pay for which treatments. Medical research doesn't explain why people think twice about calling an ambulance or go as far as taking a taxi or driving themselves or a loved one to a hospital in an emergency. If you do that in Germany, you'll get a lecture and will be considered an idiot who has unnecessarily endangered themselves.

Given how hamstrung regulators are these days thanks to a pro-corporate Congress, it doesn't say much other than that the government we've elected has chosen not to control costs.

nickff 10y ago

When was the last time a regulator (or government agency) admitted to failing because of incompetence, stupidity, or bad luck? It seems they are eternally underfunded and understaffed, and never make mistakes. I consider myself and my associates to be quite diligent and intelligent, yet every one of us is sometimes at fault when we fail.

colechristensen 10y ago
The NTSB/FAA does a _great_ job of regulating. Aircraft have the beneficial property of being immune to bullshit. Mistakes, incompetence, and corruption lead very directly to planes falling out of the sky which is a very public and costly failure. They're great because they have to be _and_ being great leads to success. You can, with solid engineering, completely understand and prevent failing. There aren't any act-of-God accidents. How and when aircraft fail is designed from the start; when they do fail there is always a cause and it's always fixable. You can read plenty of NTSB reports about accidents (and they take mistakes which don't actually result in harm very seriously too) and they really do point out incompetence and stupidity. The most important part is that it isn't about blame or prosecution, it's about finding, fixing, and preventing problems. Revenge against people who screw up intentionally or not isn't helpful, making it impossible to screw up is.
- nickff 10y ago
  All of the airplanes that crash were approved for production by the FAA. I am not sure how you would measure the failure rate of the NTSB, other than by looking at the number of repeated failures, which is tough, as many incidents are one-offs, or can be categorized as distinct without being substantially different. In any case, one could regard the FAA's primary failure being that the airliner market is a duopoly. The FAA and its counterparts have helped make it so expensive to develop and approve new aircraft that only two companies can do it, and even they only design one new airplane every ten-twenty years. Bombardier, which is a large and established aircraft manufacturer could afford to develop an airliner, but not to get it approved; this results in slow progress, high prices, and little competition. It would be interesting, if impossible to know how safe aircraft would be if Boeing and Airbus were granted an unregulated monopoly. I would guess their aircraft would be very safe and expensive (as they currently are), just like 'Ma Bell's service was in the days of its monopoly.
  - colechristensen 10y ago
    Every mistake, every crash is a failure and there are remarkably few of them. Mistakes happen and the mistake is always in not predicting the failure correctly. And there's quite a bit of competition; Boeing and Airbus are integrators, they don't build all of the parts and there are plenty of parties competing for the various parts. Likewise they both make the largest aircraft exclusively, but as you get smaller you add more and more alternatives to the mix. You're also wrong about no new models. They release updates and changes all the time. Completely new planforms just aren't needed. The basic design is fundamentally unchanged and doesn't need to be changed. There's just nowhere to go. Only small iterations of improvement.
    - nickff 10y ago
      There are plenty of opportunities for new models; Boeing wanted to make 3 new aircraft, and had to settle for 1 new and 2 upgrades. The 737 has been flying for almost 50 years, and Boeing still can't give it long enough landing gear to properly accommodate properly-sized turbofans because of the regulatory burdens. Bombardier thought there was an opportunity for a new single-aisle airliner, but hasn't been able to come up with the money to get a certificate. The fact that there are no new aircraft manufacturers coming on-line only proves that the regulators have created a duopoly.
  - lukeschlather 10y ago
    Looking around on the internet it sounds like the cost of the aircraft accounts for about 10% of the cost of a ticket. Frankly, airplanes sound downright cheap compared to the cost of staffing and fuel. Doesn't seem like the right place to start looking for cost-cutting measures.
    - nickff 10y ago
      If you want to understand how important new aircraft are, you need to take more factors into account, such as turn times, average numbers of transfers, etc. into account. The airlines have been moving away from the hub-and-spoke model, towards point-to-point for quite some time; aircraft CPM plays a significant part in this shift (as well as in slowing it down).

colechristensen 10y ago

Many people have strong support for a single payer system. Seeing this simple failure illustrates a risk in moving that direction. Who do you trust to do a better job keeping costs in control? The greed (or fiduciary duty) of an insurance company or the governance of bureaucrats? I trust the market more because the government has proved to be far more corruptible. There should be a government option for sure, but regulations should focus more on making the healthcare market healthy. * Open straightforward pricing * Removal of trademark protections for named drugs * Reducing patent terms, adding affordability conditions * Publicly funding research with open access requirements * Mandating manufacture of unpopular or poorly competitive drugs to get patent protections * Adding efficiency to approval and regulation process It seems all too obvious that a single payer system in America would get overrun with regulatory capture and skyrocket costs in sweetheart deals.

DasIch 10y ago
The US is the only first world country that has these problems. You don't need to come up with a fancy solution, just copy what another country does. It's not like it can get worse.
- colechristensen 10y ago
  The US isn't the same as the rest of the first world (outmoded as that term is). A disproportional amount of research and medical industry happens in the US. In a way, many of the developed nations' medical systems are made possible by the American medical economy. We end up paying for more of the development and exporting our technology for as much as we can get. The cost structure wouldn't be the same worldwide if America switched. We have 50 states. Each one of them is capable of setting up a single payer healthcare system on it's own, yet none of them have. Not for lack of trying, but none have been successful. I don't think we should even have the national conversation at all until at least one state finds success implementing it themselves.
  - DasIch 10y ago
    There are a large number of medical companies outside of the US as well. Additionally governments encourage research in general through patents and subsidies and provide direct funding. Not to mention that a lot of research happens at universities. Additionally many of these companies are located outside of the US. Ignoring all of that just from a purely financial perspective, the amount of money spent on health care simply can't be explained through research, both in quantity and when it comes to the reality of what people actually pay for which treatments. Medical research doesn't explain why people think twice about calling an ambulance or go as far as taking a taxi or driving themselves or a loved one to a hospital in an emergency. If you do that in Germany, you'll get a lecture and will be considered an idiot who has unnecessarily endangered themselves.