9 ms·

People Are Dying Younger Because America Keeps Failing the Bad-Break Test

84 points by benevol 10y ago

oconnore 10y ago
Why didn't Janet Foy just learn to code and launch a startup?
- omginternets 10y ago
  Yeah those pretty much always make people rich.
golemotron 10y ago
It would be interesting to compare and contrast how societies with strong family and extended family bonds do on the bad-break test. In the US and Western Europe a strong individualist ethos has led to societies where government is the fall back for individual and immediate family misfortune. It's not ideal.
- benevol 10y ago
  > It's not ideal. ...if your government does not allow for solid social security and health care.
- CalChris 10y ago
  > In the US and Western Europe a strong individualist ethos has led to societies where government is the fall back for individual and immediate family misfortune. I don't understand this. Can you explain?
- pessimizer 10y ago
  I agree; but it's important to remember that even in societies with strong, cohesive extended family bonds, there are large numbers of people who lack family, or people whose families are mostly abroad (immigrants) who are really in trouble when the state abdicates due to the assumption of a family safety net. I'm of the opinion that governments (or any large institutions and networks of institutions, including powerful families and corporations) have an interest in breaking up families, because relationships between peers create a power base that competes against them. I don't think that it's a coincidence that governments tend to be fought over on one side by a party representing traditional large institutions, and on the other a party representing social interest/minority protection organizations and employee unions.
- mikeash 10y ago
  Nothing is ideal, but having government as the fallback seems better than having family as the fallback. Falling back on family only works if some of your family has enough resources to help, and that's not always the case.
  - nickff 10y ago
    The big advantage is that family (and community) usually cares about you, whereas bureaucrats care most about following rules. Because of this, family can usually do more than just give you a few cheques.
    - Retra 10y ago
      What, condolences and sympathy? That's not better than a few checks.
      - pessimizer 10y ago
        Work, generally. It's a network of people that will vouch for you (with little or no evidence of your worth), or simply employ you.
        deleted 10y ago
        [deleted]
        Retra 10y ago
        Oh, it's that easy? I can just ask my poverty-stricken family to bootstrap me out of my poorness because they'll hire me to do the jobs they don't have? I'm the highest-paid person in my family. You think I can go to my boss and say "Hire my brother, he's been a gas-station attendant for 6 years. Probably he's a great programmer." It's easy to not be poor when you come from a family with wealth and hiring power. If you are poor, it's probably because you don't have either. You'd think that would be obvious.
    - mikeash 10y ago
      What about all the people whose families don't care about them?
thechao 10y ago
Many people vote against their own self interest---universal healthcare, larger tax credits to the poor, cash welfare---because they think "if I can't afford $15000 to give to the Feds, no one can". This is partly an innumeracy problem; but, partly, I think it's the fact (naturally) those who are taxed the most can mutually align their interests with those who are taxed the least: they both say the same words, but for entirely different reasons: one is because they can't; the other because they wont.
- ArkyBeagle 10y ago
  $15k every year is a stupendous amount of money to nearly everyone in the US. There exist people in large numbers for whom this would change their lives quite radically. No innumeracy there. We all live with a lot of "s'posed ta-s" and we just won't get to 'em all.
- deleted 10y ago
  [deleted]
- paulddraper 10y ago
  I don't think the cost is as significant as the ineffectiveness of the effort. If I thought universal health care, more progressive taxes, and cash welfare worked without solving more problems than they create (without causing stagflation, unemployment, loss of personal liberty), I would support them. But I don't so I won't.
  - thechao 10y ago
    We already have universal health care---we just choose to do it in the most expensive possible way (emergency health care), rather than in a less expensive way (urgent, chronic, terminal). I don't know about the rest; although, the EITC (the closest thing we have to cash welfare for non-family citizens in Texas) was actually a pretty important part of my income for the five years when I lived below and near the poverty line.
    - paulddraper 10y ago
deleted 10y ago
[deleted]
lucidguppy 10y ago
This is why real education is so important. The government wants gullible and apathetic citizens. They got what they wanted. To bad it will destroy the US. We need longer school days to help 2 income families, we need year round schools as well (yes we'll have to buy air conditioning for summer school).
- maxerickson 10y ago
  I really disagree. We need education metrics that reward schools for achieving outcomes with less classroom hours, not ever expanding classroom hours. We need to stop pretending that a single curriculum can serve people that are and people that are not interested in college equally well. I think inexpensive child supervision is a good thing to make available to people that want to work, but damn anyone to hell that wants to tie it to education.
- ArkyBeagle 10y ago
  I don't think the government WANTS gullible and apathetic citizens. I think they get them anyway. I don't know that a government anywhere WANTS anything except continuation. I see that as an ... (mis)anthropic principle thing. These things are entangled, in a chicken-or-egg manner. If for some reason that is opaque to us, people are naturally gullible and apathetic, then won't a leadership that reflects that preference emerge? We expect to be the boss ( the seat of final authority) and be led at the same time.
- mjn 10y ago
  All else equal, education is good, but education isn't going to make everyone into healthcare policy wonks, nor is that necessarily a good use of everyone's time. Which... is a problem when the programs are designed so that you more or less have to be a healthcare policy wonk to understand them. Obamacare is unpopular in part because it's incredibly complex. On the political side that makes it an easy target, because you can blame everything on it, and some of that will stick. But it also makes it unpopular for substantive reasons, in that people really hate the experience of interacting with it. You rarely get people who like Obamacare; its supporters, at best, think it's less bad than what was there previously. I follow the area pretty closely, am quite left-wing politically, clearly think it's better than the alternative, and nonetheless when I was signing up for a marketplace plan last year, even I found the experience frustrating and complicated. You need to understand a pretty big range of things to just understand the baseline terminology and market setup: the subtleties of in-and out-of-network coverage (did you know that in-network hospitals can have out-of-network doctors?), the different kinds of deductibles, out-of-pocket maximums, the subsidy schemes, etc. Then you have to learn how to read the policy documents of each plan in light of this new terminology you've learned, and compare them in order to act as an informed market participant. The healthcare.gov marketplace gives a few tools to try to simplify comparisons, but the overall experience is still overwhelming, and I'm not even sure whether I made a good choice in the end. I think there's a good argument that simpler, universal programs are actually an easier sell. Centrist Democrats view policy-wonk type programs as "more moderate", because they contain various means-testing and market mechanisms, and believe this will make them an easier sell than universalist entitlements, which are seen as too left-wing. But I'm not sure that's actually true, if you take into account that people really fucking hate policy wonks and their programs, while universalist entitlements like Social Security and Medicare are popular. Frank Pasquale makes that argument at a bit more length here, arguing that of the two early 20th century traditions that the Democrats to some extent inherit, populism and progressivism, they've erred too much in the direction of the latter, promoting "technocratic alliance between corporate and government experts". https://balkin.blogspot.co.uk/2016/11/rebuilding-health-care-policy-from.html https://balkin.blogspot.co.uk/2016/11/rebuilding-health-care...
deleted 10y ago
[deleted]
nananuno 10y ago
And the dems solution to the opioid crisis was to ignore unemployment everywhere but in the coastal states :^)
princetontiger 10y ago
The USA has already started a long-term decline. Peak was 1998/1999 if you go by peak productivity and real GDP/capita. Unfortunately, not much can be done. We're in a situation similar to that of the British Empire prior to 1915.
- rch 10y ago
  I see what you're saying, but the British didn't have metrics like 'broadband access' to work with. Hopefully we can do better.
  - benevol 10y ago
    The internet was supposed to be that new tool to save or even boost democracy. What's been happening lately is the opposite: mass surveillance and using the data to manipulate the population.
- ArkyBeagle 10y ago
  The British Empire was completely and totally infeasible at the time. This was largely and widely known, at least in the U.S. I had grandparents who were born around 1900, give or take, and the dominant idea about Europe and Britain was that it was corrupt, that the principle seat of corruption as the royal system and that they could go to hell in their own way. It took Considerable Doing ( and a lot of John Wayne movies ) to sell WWII to the mothers of America. And you know what? One grandmother had one son of five serve in WWII and two serve (in Germany) after. One in the early '50s, the other in the '60s. The sort of American Exceptionalism that emerged after WII was ( I would say ) completely unknown prior.
- pessimizer 10y ago
  That was a stock bubble. The peak was somewhere between the end of WWII and 1980, when we decided to start funding the country through a continuing trade deficit.
  - prodigal_erik 10y ago
    It was the late 1960s and early 1970s, when our trading partners got their bombed-out domestic industries back in working order after a decade or two of producing junk.
nradov 10y ago
Yes this is part of the reason, but people are also dying younger now due to obesity. We are literally digging our graves with our teeth.
- deleted 10y ago
  [deleted]
throw2016 10y ago
Something changed in our global and economic system at the turn of the 70s. The late 70's and early 80's were really a high point for global utopianianism. Since then the balance of power between the people and the state has shifted towards the latter at quite an incredible speed over the last 30 years. Concentration of tremendous wealth in the hands of large corporations and a few individuals and the seeming impotence of the political system to keep them in check has always been a recipe for disaster. The amount of money spent by the state for instance on surveillance just gets millions more 'uniforms' vested in the state. Security deparments keep getting beefed up. And money being throw around by think tanks into the academic sector, especially economics, and cultivating the mainstream press with all of them parroting a similar message and ideology all point towards a fundamental regression of democratic principles. Just the amount of double speak over the last 5 years is astounding. Sometime arrogance presumes control but its only a shaky interlude before things completely unravel.
Animats 10y ago
Drugs. Deaths from opioid overdoses are up by a factor of 4 in the last fifteen years. That's huge. Is becoming a druggie a "bad break", though? Losing a job, an injury, or an illness is a true bad break. Becoming a druggie is self-inflicted. Do druggies deserve tax-funded support? With limited resources, shouldn't tax money be spent primarily on people who had a bad break that wasn't their fault? We can usually bring people back from a broken bone or a lost job. Druggies, not so much. [1] https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroin-deaths-surpass-gun-homicides-for-the-first-time-cdc-data-show/?utm_term=.ae3ae435f16b https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroi...
- deleted 10y ago
  [deleted]
- pessimizer 10y ago
  It's incredibly coincidental that our resources always seem to be limited to exactly the amount we need to help people who don't deserve what's happening to them according to the particular ideology of the people who happen to be controlling our resources at the time, and no more. It's as if they were dividing us by our own interests, and encouraging us to morally condemn and attack people on the other side.
- Scalestein 10y ago
  I don't think many people 'choose' to become so dependent on drugs that they cannot function in society and fatally overdose. A doctor prescribing opiates for an injury without a plan for cessation and withdrawal is a very common path to opiate addiction and overdose. I would absolutely classify this as a 'bad break'. The path out of opiate dependence is so difficult and our society does very little to assist. Saying "i'm addicted to drugs and in a downward spiral" and having society respond in a manner that will actually help you out of the situation is not currently a reality. [1] http://www.pbs.org/wgbh/frontline/article/veterans-face-greater-risks-amid-opioid-crisis/ http://www.pbs.org/wgbh/frontline/article/veterans-face-grea...
- tomjen3 10y ago
  The rest are downvoting you, but that is a really relevant problem. Sometimes you have injure or some other surgery and you get opiods to deal with the (possible severe) pain - and you get addicted and then cut of. Your fault? Sometimes opiods are even prescribed for chronic pain, but then you need larger and larger dosages. The amount of normal people who just inject heroin on a lark some morning is probably less than ten. Most slide into it, and a lot of them are mentally ill.
johan_larson 10y ago
The harsh-truth line for situations like this is that these people have been living beyond their means. Right living doesn't just mean that you can cover your expenses day to day. It also means that you have set enough aside to deal with the inevitable occasional hurdles life sets before you. If you can't deal with an illness or a job loss or a serious car repair, you only think you're doing all right, and a hard rain is gonna fall. Looking at that paragraph, I think it is basically true. Yes, you should set something aside for contingencies. But is it the whole truth? It is well known by now that people, even clever people, tend to discount the future heavily, to the point of unreason. It seems to me this is a case where some sort of institutional intervention is called for, to fight our own worst impulses.
- maxsilver 10y ago
  > The harsh-truth line for situations like this is that these people have been living beyond their means. You (should) have set enough aside to deal with the inevitable occasional hurdles life sets before you. That would require people to not be poor. With exploding 200%+ rise in costs of rent / healthcare / education / childcare / etc, it's no longer feasible to expect people to be saving lots of money for rainy days -- not because they are bad people without the responsibility or fortitude to plan for the future, but because there's literally no money for it.

84 points by benevol 10y ago

oconnore 10y ago

Why didn't Janet Foy just learn to code and launch a startup?

omginternets 10y ago
Yeah those pretty much always make people rich.

golemotron 10y ago

It would be interesting to compare and contrast how societies with strong family and extended family bonds do on the bad-break test. In the US and Western Europe a strong individualist ethos has led to societies where government is the fall back for individual and immediate family misfortune. It's not ideal.

benevol 10y ago
> It's not ideal. ...if your government does not allow for solid social security and health care.
CalChris 10y ago
> In the US and Western Europe a strong individualist ethos has led to societies where government is the fall back for individual and immediate family misfortune. I don't understand this. Can you explain?
pessimizer 10y ago
I agree; but it's important to remember that even in societies with strong, cohesive extended family bonds, there are large numbers of people who lack family, or people whose families are mostly abroad (immigrants) who are really in trouble when the state abdicates due to the assumption of a family safety net. I'm of the opinion that governments (or any large institutions and networks of institutions, including powerful families and corporations) have an interest in breaking up families, because relationships between peers create a power base that competes against them. I don't think that it's a coincidence that governments tend to be fought over on one side by a party representing traditional large institutions, and on the other a party representing social interest/minority protection organizations and employee unions.
mikeash 10y ago
Nothing is ideal, but having government as the fallback seems better than having family as the fallback. Falling back on family only works if some of your family has enough resources to help, and that's not always the case.
- nickff 10y ago
  The big advantage is that family (and community) usually cares about you, whereas bureaucrats care most about following rules. Because of this, family can usually do more than just give you a few cheques.
  - Retra 10y ago
    What, condolences and sympathy? That's not better than a few checks.
    - pessimizer 10y ago
      Work, generally. It's a network of people that will vouch for you (with little or no evidence of your worth), or simply employ you.
      - deleted 10y ago
        [deleted]
      - Retra 10y ago
        Oh, it's that easy? I can just ask my poverty-stricken family to bootstrap me out of my poorness because they'll hire me to do the jobs they don't have? I'm the highest-paid person in my family. You think I can go to my boss and say "Hire my brother, he's been a gas-station attendant for 6 years. Probably he's a great programmer." It's easy to not be poor when you come from a family with wealth and hiring power. If you are poor, it's probably because you don't have either. You'd think that would be obvious.
  - mikeash 10y ago
    What about all the people whose families don't care about them?

thechao 10y ago

Many people vote against their own self interest---universal healthcare, larger tax credits to the poor, cash welfare---because they think "if I can't afford $15000 to give to the Feds, no one can". This is partly an innumeracy problem; but, partly, I think it's the fact (naturally) those who are taxed the most can mutually align their interests with those who are taxed the least: they both say the same words, but for entirely different reasons: one is because they can't; the other because they wont.

ArkyBeagle 10y ago
$15k every year is a stupendous amount of money to nearly everyone in the US. There exist people in large numbers for whom this would change their lives quite radically. No innumeracy there. We all live with a lot of "s'posed ta-s" and we just won't get to 'em all.
deleted 10y ago
[deleted]
paulddraper 10y ago
I don't think the cost is as significant as the ineffectiveness of the effort. If I thought universal health care, more progressive taxes, and cash welfare worked without solving more problems than they create (without causing stagflation, unemployment, loss of personal liberty), I would support them. But I don't so I won't.
- thechao 10y ago
  We already have universal health care---we just choose to do it in the most expensive possible way (emergency health care), rather than in a less expensive way (urgent, chronic, terminal). I don't know about the rest; although, the EITC (the closest thing we have to cash welfare for non-family citizens in Texas) was actually a pretty important part of my income for the five years when I lived below and near the poverty line.
  - paulddraper 10y ago

deleted 10y ago

[deleted]

lucidguppy 10y ago

This is why real education is so important. The government wants gullible and apathetic citizens. They got what they wanted. To bad it will destroy the US. We need longer school days to help 2 income families, we need year round schools as well (yes we'll have to buy air conditioning for summer school).

maxerickson 10y ago
I really disagree. We need education metrics that reward schools for achieving outcomes with less classroom hours, not ever expanding classroom hours. We need to stop pretending that a single curriculum can serve people that are and people that are not interested in college equally well. I think inexpensive child supervision is a good thing to make available to people that want to work, but damn anyone to hell that wants to tie it to education.
ArkyBeagle 10y ago
I don't think the government WANTS gullible and apathetic citizens. I think they get them anyway. I don't know that a government anywhere WANTS anything except continuation. I see that as an ... (mis)anthropic principle thing. These things are entangled, in a chicken-or-egg manner. If for some reason that is opaque to us, people are naturally gullible and apathetic, then won't a leadership that reflects that preference emerge? We expect to be the boss ( the seat of final authority) and be led at the same time.
mjn 10y ago
All else equal, education is good, but education isn't going to make everyone into healthcare policy wonks, nor is that necessarily a good use of everyone's time. Which... is a problem when the programs are designed so that you more or less have to be a healthcare policy wonk to understand them. Obamacare is unpopular in part because it's incredibly complex. On the political side that makes it an easy target, because you can blame everything on it, and some of that will stick. But it also makes it unpopular for substantive reasons, in that people really hate the experience of interacting with it. You rarely get people who like Obamacare; its supporters, at best, think it's less bad than what was there previously. I follow the area pretty closely, am quite left-wing politically, clearly think it's better than the alternative, and nonetheless when I was signing up for a marketplace plan last year, even I found the experience frustrating and complicated. You need to understand a pretty big range of things to just understand the baseline terminology and market setup: the subtleties of in-and out-of-network coverage (did you know that in-network hospitals can have out-of-network doctors?), the different kinds of deductibles, out-of-pocket maximums, the subsidy schemes, etc. Then you have to learn how to read the policy documents of each plan in light of this new terminology you've learned, and compare them in order to act as an informed market participant. The healthcare.gov marketplace gives a few tools to try to simplify comparisons, but the overall experience is still overwhelming, and I'm not even sure whether I made a good choice in the end. I think there's a good argument that simpler, universal programs are actually an easier sell. Centrist Democrats view policy-wonk type programs as "more moderate", because they contain various means-testing and market mechanisms, and believe this will make them an easier sell than universalist entitlements, which are seen as too left-wing. But I'm not sure that's actually true, if you take into account that people really fucking hate policy wonks and their programs, while universalist entitlements like Social Security and Medicare are popular. Frank Pasquale makes that argument at a bit more length here, arguing that of the two early 20th century traditions that the Democrats to some extent inherit, populism and progressivism, they've erred too much in the direction of the latter, promoting "technocratic alliance between corporate and government experts". https://balkin.blogspot.co.uk/2016/11/rebuilding-health-care-policy-from.html https://balkin.blogspot.co.uk/2016/11/rebuilding-health-care...

deleted 10y ago

[deleted]

nananuno 10y ago

And the dems solution to the opioid crisis was to ignore unemployment everywhere but in the coastal states :^)

princetontiger 10y ago

The USA has already started a long-term decline. Peak was 1998/1999 if you go by peak productivity and real GDP/capita. Unfortunately, not much can be done. We're in a situation similar to that of the British Empire prior to 1915.

rch 10y ago
I see what you're saying, but the British didn't have metrics like 'broadband access' to work with. Hopefully we can do better.
- benevol 10y ago
  The internet was supposed to be that new tool to save or even boost democracy. What's been happening lately is the opposite: mass surveillance and using the data to manipulate the population.
ArkyBeagle 10y ago
The British Empire was completely and totally infeasible at the time. This was largely and widely known, at least in the U.S. I had grandparents who were born around 1900, give or take, and the dominant idea about Europe and Britain was that it was corrupt, that the principle seat of corruption as the royal system and that they could go to hell in their own way. It took Considerable Doing ( and a lot of John Wayne movies ) to sell WWII to the mothers of America. And you know what? One grandmother had one son of five serve in WWII and two serve (in Germany) after. One in the early '50s, the other in the '60s. The sort of American Exceptionalism that emerged after WII was ( I would say ) completely unknown prior.
pessimizer 10y ago
That was a stock bubble. The peak was somewhere between the end of WWII and 1980, when we decided to start funding the country through a continuing trade deficit.
- prodigal_erik 10y ago
  It was the late 1960s and early 1970s, when our trading partners got their bombed-out domestic industries back in working order after a decade or two of producing junk.

nradov 10y ago

Yes this is part of the reason, but people are also dying younger now due to obesity. We are literally digging our graves with our teeth.

deleted 10y ago
[deleted]

throw2016 10y ago

Something changed in our global and economic system at the turn of the 70s. The late 70's and early 80's were really a high point for global utopianianism. Since then the balance of power between the people and the state has shifted towards the latter at quite an incredible speed over the last 30 years. Concentration of tremendous wealth in the hands of large corporations and a few individuals and the seeming impotence of the political system to keep them in check has always been a recipe for disaster. The amount of money spent by the state for instance on surveillance just gets millions more 'uniforms' vested in the state. Security deparments keep getting beefed up. And money being throw around by think tanks into the academic sector, especially economics, and cultivating the mainstream press with all of them parroting a similar message and ideology all point towards a fundamental regression of democratic principles. Just the amount of double speak over the last 5 years is astounding. Sometime arrogance presumes control but its only a shaky interlude before things completely unravel.

Animats 10y ago

Drugs. Deaths from opioid overdoses are up by a factor of 4 in the last fifteen years. That's huge. Is becoming a druggie a "bad break", though? Losing a job, an injury, or an illness is a true bad break. Becoming a druggie is self-inflicted. Do druggies deserve tax-funded support? With limited resources, shouldn't tax money be spent primarily on people who had a bad break that wasn't their fault? We can usually bring people back from a broken bone or a lost job. Druggies, not so much. [1] https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroin-deaths-surpass-gun-homicides-for-the-first-time-cdc-data-show/?utm_term=.ae3ae435f16b https://www.washingtonpost.com/news/wonk/wp/2016/12/08/heroi...

deleted 10y ago
[deleted]
pessimizer 10y ago
It's incredibly coincidental that our resources always seem to be limited to exactly the amount we need to help people who don't deserve what's happening to them according to the particular ideology of the people who happen to be controlling our resources at the time, and no more. It's as if they were dividing us by our own interests, and encouraging us to morally condemn and attack people on the other side.
Scalestein 10y ago
I don't think many people 'choose' to become so dependent on drugs that they cannot function in society and fatally overdose. A doctor prescribing opiates for an injury without a plan for cessation and withdrawal is a very common path to opiate addiction and overdose. I would absolutely classify this as a 'bad break'. The path out of opiate dependence is so difficult and our society does very little to assist. Saying "i'm addicted to drugs and in a downward spiral" and having society respond in a manner that will actually help you out of the situation is not currently a reality. [1] http://www.pbs.org/wgbh/frontline/article/veterans-face-greater-risks-amid-opioid-crisis/ http://www.pbs.org/wgbh/frontline/article/veterans-face-grea...
tomjen3 10y ago
The rest are downvoting you, but that is a really relevant problem. Sometimes you have injure or some other surgery and you get opiods to deal with the (possible severe) pain - and you get addicted and then cut of. Your fault? Sometimes opiods are even prescribed for chronic pain, but then you need larger and larger dosages. The amount of normal people who just inject heroin on a lark some morning is probably less than ten. Most slide into it, and a lot of them are mentally ill.

johan_larson 10y ago

The harsh-truth line for situations like this is that these people have been living beyond their means. Right living doesn't just mean that you can cover your expenses day to day. It also means that you have set enough aside to deal with the inevitable occasional hurdles life sets before you. If you can't deal with an illness or a job loss or a serious car repair, you only think you're doing all right, and a hard rain is gonna fall. Looking at that paragraph, I think it is basically true. Yes, you should set something aside for contingencies. But is it the whole truth? It is well known by now that people, even clever people, tend to discount the future heavily, to the point of unreason. It seems to me this is a case where some sort of institutional intervention is called for, to fight our own worst impulses.

maxsilver 10y ago
> The harsh-truth line for situations like this is that these people have been living beyond their means. You (should) have set enough aside to deal with the inevitable occasional hurdles life sets before you. That would require people to not be poor. With exploding 200%+ rise in costs of rent / healthcare / education / childcare / etc, it's no longer feasible to expect people to be saving lots of money for rainy days -- not because they are bad people without the responsibility or fortitude to plan for the future, but because there's literally no money for it.