10 ms·

Some Thoughts on the Cost Disease

81 points by dsr_ 10y ago

dsr_ 10y ago
The key sentence, for me: "The pattern of Cost Disease seems to be related to things that inextricably require the unsubstitutable labour and attention not just of human beings but of human beings somehow comparable to the buyer."
- makomk 10y ago
  On a related note, you may have heard that Obama managed to push out the date that Medicare would run out of money by 11 years through the Affordable Care Act. He did this by declaring that henceforth, one of this things that requires the unsubstitutable labour and attention of human beings somehow comparable to the buyer - consultations with doctors - would henceforth go down in price at the same rate everything else. I have my doubts as to whether this is actually possible to do by decree.
- kalleboo 10y ago
  It doesn't explain the insane cost increases in the US though, if you follow the links on Cost Disease in the OP, there are sources that show only minor increases in salaries (the cost of labor) http://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ http://slatestarcodex.com/2017/02/09/considerations-on-cost-... It also doesn't explain that only the US has these insane cost increases. It all comes down to the weird political and regulatory climate in the US. You can't draw any conclusions on the broader human condition based on such an outlier country.
  - fanzhang 10y ago
    It's often cited that in Europe the sticker prices of both healthcare and education are lower. However that's because most of it is being subsidized by the state; it would be interesting to see whether the total societal costs are similarly rising everywhere for a comparable education or comparable healthcare (e.g. ER visit for broken arm).
    - Symmetry 10y ago
      No, the figures Scott cited include state subsidies. It's indicative that Britain, spending the same amount of money divided by total population, can provide healthcare to everyone for the same amount of money the US spends on Medicaid and Medicare for providing it for just the old and poor.
    - kalleboo 10y ago
      The "sticker price" in Europe is often zero. I don't think I've seen any international comparisons that don't include all the state costs. That said there are knock-on effects that aren't always well-explained - if higher education is free, doctors won't have student loans to pay off meaning they end up with lower salaries.
uiri 10y ago
Meta comment: "bc.ca" is one of those along with "co.uk", "co.jp", etc. where anyone can register a third-level domain underneath it. The domain for this submission really should be sooke.bc.ca
- schoen 10y ago
  The HN code should import and use the Public Suffix List or a library that can make use of it. https://publicsuffix.org/learn/ https://publicsuffix.org/learn/
  - teddyh 10y ago
    Yes. I suggested it two years ago: https://news.ycombinator.com/item?id=8911044 https://news.ycombinator.com/item?id=8911044
- ratatatsplat 10y ago
  canadian domains used to require you to register '(your-name).(city).(province).ca' unless you could prove you operated in more than one city, or in more than one province. sooke is a municipality, so in a perfect world, the domain for this submission should be ansuz.sooke.bc.ca.
jwatte 10y ago
The title of the blog is "people before ..." And the writer doesn't understand the social signaling of clothing? Like, at all? First, clothing is really personal, and funding a second skin that "suits me" and "fits me" requires much wider selection than a rack of time socks can supply. Second, anyone with a social job that depends on status, or who is in the marriage/mate market, or who works in a job that may wear on clothing but still needs to be presentable, will need more than a few hundred dollars a year for clothing budget. "The cost disease of the service sector" is a well known economic theory (I leaned it in economics 101 in the '90s) and the real insight should probably be that, as we get better at making stuff, the scarce resource becomes educated human time, but we are still locked in a value model that mainly measures "stuff." Once robots make all the stuff for basically free, we have to totally change how our society operates its economy. That's fairly close in time, yet nobody is really even making up the words we'll use to talk about the issue yet.
- nosuchthing 10y ago
  The article mentions a few: Post-Scarcity and Attention Economics. https://en.wikipedia.org/wiki/Post-scarcity_economy https://en.wikipedia.org/wiki/Post-scarcity_economy https://en.wikipedia.org/wiki/Attention_economics https://en.wikipedia.org/wiki/Attention_economics https://en.wikipedia.org/wiki/Late_capitalism https://en.wikipedia.org/wiki/Late_capitalism
- douche 10y ago
  Thank flying spaghetti monster I work in a profession where you can get by on free conference t-shirts and a couple new pairs of jeans a year.
  - Tycho 10y ago
    Why do you need new pairs of jeans every year? I don't think I've ever had to discard jeans except from growing out of them. They are made of tough material.
    - arjie 10y ago
guard-of-terra 10y ago
There exist some SF set in Strong Heaven, but it's mostly written in Russian :)
- throwanem 10y ago
  Here's a bit that is not: http://localroger.com/prime-intellect/ http://localroger.com/prime-intellect/ I found it not wholly unsatisfactory, although a bit rough in spots - on the other hand, it both prefigures and subverts the Rapture of the Nerds avant la lettre, so I'd be willing to excuse quite a bit more than is actually required. Definitely worthwhile, especially if you also found the whole "Singularity" thing grating.
- Symmetry 10y ago
  There's some that was written in Scotland too.
im3w1l 10y ago
"As the only thing that can be expensive in the final Strong Heaven, attention predictably gets more expensive in a culture that moves more and more toward general post-scarcity. " So the world's first profession would also be its last. How fitting.
zkms 10y ago
I feel like a nontrivial root cause of cost disease is USian land use restrictions that make real estate pathologically expensive. The devastating effects of bad zoning policies end up severely driving the cost of real estate -- and real estate prices, both for housing and business/industry, end up affecting a whole lot of operational expenses for both employees and corporations (which then in turn affects prices). (It's not just simply "regulatory burden" in general (except maybe healthcare) as explained in http://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ http://slatestarcodex.com/2017/02/09/considerations-on-cost-... -- there's hella many industries and services and goods affected by cost disease, and the regulatory burdens too much to be a root cause -- real estate / housing costs is a more likely common cause)
- JumpCrisscross 10y ago
  > USian Is this a regional thing (Assuming it's a synonym for American. Google tries to correct me to Usain Bolt, then brings up a page of Usian Bolt typos.)
  - CalRobert 10y ago
    USian is a term adopted by English speakers who wish to more clearly distinguish between things related to the United States (the political entity), and things related to the Americas (the geographical entity(ies)). Motivations can range from a desire for precision in speech to a recognition that claiming the term "America" for one country, when in fact it is two continents with dozens of countries, isn't terribly considerate. People from Canada, Mexico, and Chile can all legitimately say they are "American", just like both Germans and Spaniards are "European", but using the term extensively to mean "people or matters related to the US" makes this less viable. Note that in Spanish the term Estadounidense (note the similarity to "Estados Unidos") exists, though I don't know how much it's used. Of course, it's an uphill battle, especially when you consider that the official name for Mexico is Estados Unidos Mexicanos.
    - deleted 10y ago
      [deleted]
marchenko 10y ago
This article also hints at one of the reasons why humans chafe at economic inequality, and a rising tide lifting all boats is not enough to produce utopia: there are some resources - desirable reproductive partners, status, land (esp. near others of high status) - which do not become more widely available as prosperity increases. The pursuit of these goods can even become more immiserating in a society with large differences in relative status, as the coveted attention of others flocks to global superstars rather than local stars. The author shows that these approximately zero-sum goods can be largely reduced to "attention".
- meric 10y ago
  And if we assume attention is valuable, while everything else is valueless, we've been pretty good at destroying what's valuable for what's valueless in the past century. Some of us pour our attention into games and movies instead of sharing it with those close to us. Some of us pour our attention into hour long commutes where we spend our utmost effort not to give attention to anyone near us - it might make them uncomfortable. Some of us pour our attention on those who already have a lot of it, who cannot possibly return it to us - famous youtube personalities, celebrities, porn stars even. We spend our time fine-tuning our processes to be as "efficient" as possible, from the queue in the supermarket, to the queue in the fast food restaurant, to reduce our shopkeepers and waiters to mere actors following a script efficiently, and in some cases, completely replace them with machines. We make our workplace a place where colleagues gather for majority of their lives, but make it difficult to form enduring long term friendships. We spend lots of time worrying about economic inequality but much less time about attention inequality. The only relevant policy we do have is subsidised psychologic care. It's inhumane to deny human food, that's why we provide welfare. It's inhumane to neglect a child's need for parental love, which is why we place orphans in foster homes (not perfect). And what about adults, what do we do about attention inequality in terms of family, friendship, and sexual partners? We just sort of leave it up to them to figure it out, and then when we read about suicides in the paper, we write a comment "if you feel this way please seek help immediately". This is a summary of what I find wrong about modern society, and I have no solution besides enjoying the giving of time to those close to me when they ask for it. We've become a lot more efficient trading away our attention for physical goods that don't really matter to us except to trade in a zero sum game for more attention.
jaggederest 10y ago
I think it's interesting to think about it in terms of a shift of the theory of value from subjective to objective: considering things like education in terms of objective value, you can just total up their cost in hours of people's lives, rather than trying to consider them purchased on a market. Or, if you prefer, fixing the basis for pricing on the effort involved rather than the exchange value.
NLips 10y ago
The whole chicken / beef thing has been misunderstood by the author - chicken was never the expensive alternative to beef. The author seems to have been masively misled by the (false) quote of Hoover "a chicken in every pot and two cars in every garage". Hoover never said this. My best reading of the history seems to be: 16th century: (Henry IV) "If God keeps me, I will make sure that no peasant in my realm will lack the means to have a chicken in the pot on Sunday!" 1928: (Hoover) "The slogan of progress is changing from the full dinner pail to the full garage." 1928: (Republican campaign flyer) Title "A Chicken for Every Pot", text includes "Republican properity has... put the proverbial 'chicken in every pot'. And a car in every backyard, to boot." It's clear that in 1928 chicken wasn't an the indicator of wealth that the author things; it was (as the flyer says) proverbial.
- Symmetry 10y ago
  According to the charts in The Rise and Fall of American Growth we've gone from eating 3 times as much beef as chicken in 1800 to eating 60% more chicken than beef. This[1] shows that since 1960 beef has gone up in price by a factor of 2 relative to chicken. So all the evidence I could find supports the author's conclusion even if I don't have any data on relative meat prices going back to 1900 or so. If you've got some data that actually contradicts the authors claim about food prices I'd love to see it but given the congruency I found I'm willing to accept their claim. [1]http://www.nationalchickencouncil.org/about-the-industry/statistics/wholesale-and-retail-prices-for-chicken-beef-and-pork/ http://www.nationalchickencouncil.org/about-the-industry/sta...
- NLips 10y ago
  For reference, the 'smell test' that lead to me thinking twice about this is the energy cost. Small animals don't have to live as long to reach full size, so you don't need to spend as much energy (food) keeping the existing mass of the animal alive while it's growing new mass. That's why (very roughly) the cost of common farmed meat is normally chicken -> pork -> beef.
  - vilhelm_s 10y ago
    It seems the main reason chicken was expensive was that it was seasonal and labor-intensive. Someone on reddit writes: > Chicken, and eggs, were until the mid-20th century, a seasonal food. Chicken more than a year old is very tough, requiring hours of roasting or boiling to get a fairly tasteless end result. Most chickens lay their eggs in the spring and summer, petering out over the year. Old recipe books will have different instructions for "December" versus "April" eggs, given the quality of the yolks, which didn't used to be the uniformly pale color that industrial eggs look like now. So when the eggs would hatch, the young males would be culled and eaten right away by households, but the variety of cuts were few and the market to sell chickens incidental. Let's fast forward to the twentieth century. Unlike cows and pigs, who are irregular but large, chickens resisted the assembly line innovations of industrial production because they were irregular and small, which means they needed lots and lots of labor to process them. (https://www.reddit.com/r/AskHistorians/comments/1o72to/how_did_chicken_beef_and_pork_become_the_three/ccqd3fu/ https://www.reddit.com/r/AskHistorians/comments/1o72to/how_d...)
skywhopper 10y ago
Health care is a pretty simple one to explain. In addition to the fact that technology doesn't bring massive productivity increases to a field that requires human-to-human interaction, the fact is that health care today is a much much more extensive undertaking than it was 50 years ago. We have much better drugs, much better treatments, and much better diagnosing tools. There's also the paradox that better health care means longer lifespans which means greater health care expenses. When chronic conditions can be managed instead of quickly becoming terminal, that's a win, but it also means that the health care costs for that human go way way up. There's corruption, rent-seeking, patent abuse and monopoly effects, too, of course, not to mention a balkanized health insurance market. But the basic fact is that we get a lot more from health care industry than we ever did in the past, so you'd expect that that portion of the economy would be much bigger than it ever was.
- 3pt14159 10y ago
  Plus a large portion of the public in America doesn't pay for healthcare directly (they either get employer-based health insurance or declare bankruptcy) so it distorts incentives while retaining the profit motive. Furthermore American society is seemingly setup to avoid exercise and healthy foods at any cost. The Japanese are just as wealthy, older, and they smoke more, but they have better health outcomes and they spend almost a third per capita on healthcare. Chile spends about a ninth on healthcare and their average life expectancy is a full year more than the USA. On top of all of this is the fact that people can get into debt at 1% interest. Hard to be cost-conscious when dear old gran needs a $20k (only $50 per month!) treatment to live another three months. Same thing happened to education.
  - deleted 10y ago
    [deleted]
  - specialist 10y ago
    Key part about that distortion is that it hides the rent seeking.
    - 10y ago
lmm 10y ago
> Yes, that's Haruhi Suzumiya. But it's also someone in a much older franchise you might have heard of. Let's not be coy. Does the author mean God here? Or something else?

81 points by dsr_ 10y ago

dsr_ 10y ago

The key sentence, for me: "The pattern of Cost Disease seems to be related to things that inextricably require the unsubstitutable labour and attention not just of human beings but of human beings somehow comparable to the buyer."

makomk 10y ago
On a related note, you may have heard that Obama managed to push out the date that Medicare would run out of money by 11 years through the Affordable Care Act. He did this by declaring that henceforth, one of this things that requires the unsubstitutable labour and attention of human beings somehow comparable to the buyer - consultations with doctors - would henceforth go down in price at the same rate everything else. I have my doubts as to whether this is actually possible to do by decree.
kalleboo 10y ago
It doesn't explain the insane cost increases in the US though, if you follow the links on Cost Disease in the OP, there are sources that show only minor increases in salaries (the cost of labor) http://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ http://slatestarcodex.com/2017/02/09/considerations-on-cost-... It also doesn't explain that only the US has these insane cost increases. It all comes down to the weird political and regulatory climate in the US. You can't draw any conclusions on the broader human condition based on such an outlier country.
- fanzhang 10y ago
  It's often cited that in Europe the sticker prices of both healthcare and education are lower. However that's because most of it is being subsidized by the state; it would be interesting to see whether the total societal costs are similarly rising everywhere for a comparable education or comparable healthcare (e.g. ER visit for broken arm).
  - Symmetry 10y ago
    No, the figures Scott cited include state subsidies. It's indicative that Britain, spending the same amount of money divided by total population, can provide healthcare to everyone for the same amount of money the US spends on Medicaid and Medicare for providing it for just the old and poor.
  - kalleboo 10y ago
    The "sticker price" in Europe is often zero. I don't think I've seen any international comparisons that don't include all the state costs. That said there are knock-on effects that aren't always well-explained - if higher education is free, doctors won't have student loans to pay off meaning they end up with lower salaries.

uiri 10y ago

Meta comment: "bc.ca" is one of those along with "co.uk", "co.jp", etc. where anyone can register a third-level domain underneath it. The domain for this submission really should be sooke.bc.ca

schoen 10y ago
The HN code should import and use the Public Suffix List or a library that can make use of it. https://publicsuffix.org/learn/ https://publicsuffix.org/learn/
- teddyh 10y ago
  Yes. I suggested it two years ago: https://news.ycombinator.com/item?id=8911044 https://news.ycombinator.com/item?id=8911044
ratatatsplat 10y ago
canadian domains used to require you to register '(your-name).(city).(province).ca' unless you could prove you operated in more than one city, or in more than one province. sooke is a municipality, so in a perfect world, the domain for this submission should be ansuz.sooke.bc.ca.

jwatte 10y ago

The title of the blog is "people before ..." And the writer doesn't understand the social signaling of clothing? Like, at all? First, clothing is really personal, and funding a second skin that "suits me" and "fits me" requires much wider selection than a rack of time socks can supply. Second, anyone with a social job that depends on status, or who is in the marriage/mate market, or who works in a job that may wear on clothing but still needs to be presentable, will need more than a few hundred dollars a year for clothing budget. "The cost disease of the service sector" is a well known economic theory (I leaned it in economics 101 in the '90s) and the real insight should probably be that, as we get better at making stuff, the scarce resource becomes educated human time, but we are still locked in a value model that mainly measures "stuff." Once robots make all the stuff for basically free, we have to totally change how our society operates its economy. That's fairly close in time, yet nobody is really even making up the words we'll use to talk about the issue yet.

nosuchthing 10y ago
The article mentions a few: Post-Scarcity and Attention Economics. https://en.wikipedia.org/wiki/Post-scarcity_economy https://en.wikipedia.org/wiki/Post-scarcity_economy https://en.wikipedia.org/wiki/Attention_economics https://en.wikipedia.org/wiki/Attention_economics https://en.wikipedia.org/wiki/Late_capitalism https://en.wikipedia.org/wiki/Late_capitalism
douche 10y ago
Thank flying spaghetti monster I work in a profession where you can get by on free conference t-shirts and a couple new pairs of jeans a year.
- Tycho 10y ago
  Why do you need new pairs of jeans every year? I don't think I've ever had to discard jeans except from growing out of them. They are made of tough material.
  - arjie 10y ago

guard-of-terra 10y ago

There exist some SF set in Strong Heaven, but it's mostly written in Russian :)

throwanem 10y ago
Here's a bit that is not: http://localroger.com/prime-intellect/ http://localroger.com/prime-intellect/ I found it not wholly unsatisfactory, although a bit rough in spots - on the other hand, it both prefigures and subverts the Rapture of the Nerds avant la lettre, so I'd be willing to excuse quite a bit more than is actually required. Definitely worthwhile, especially if you also found the whole "Singularity" thing grating.
Symmetry 10y ago
There's some that was written in Scotland too.

im3w1l 10y ago

"As the only thing that can be expensive in the final Strong Heaven, attention predictably gets more expensive in a culture that moves more and more toward general post-scarcity. " So the world's first profession would also be its last. How fitting.

zkms 10y ago

I feel like a nontrivial root cause of cost disease is USian land use restrictions that make real estate pathologically expensive. The devastating effects of bad zoning policies end up severely driving the cost of real estate -- and real estate prices, both for housing and business/industry, end up affecting a whole lot of operational expenses for both employees and corporations (which then in turn affects prices). (It's not just simply "regulatory burden" in general (except maybe healthcare) as explained in http://slatestarcodex.com/2017/02/09/considerations-on-cost-disease/ http://slatestarcodex.com/2017/02/09/considerations-on-cost-... -- there's hella many industries and services and goods affected by cost disease, and the regulatory burdens too much to be a root cause -- real estate / housing costs is a more likely common cause)

JumpCrisscross 10y ago
> USian Is this a regional thing (Assuming it's a synonym for American. Google tries to correct me to Usain Bolt, then brings up a page of Usian Bolt typos.)
- CalRobert 10y ago
  USian is a term adopted by English speakers who wish to more clearly distinguish between things related to the United States (the political entity), and things related to the Americas (the geographical entity(ies)). Motivations can range from a desire for precision in speech to a recognition that claiming the term "America" for one country, when in fact it is two continents with dozens of countries, isn't terribly considerate. People from Canada, Mexico, and Chile can all legitimately say they are "American", just like both Germans and Spaniards are "European", but using the term extensively to mean "people or matters related to the US" makes this less viable. Note that in Spanish the term Estadounidense (note the similarity to "Estados Unidos") exists, though I don't know how much it's used. Of course, it's an uphill battle, especially when you consider that the official name for Mexico is Estados Unidos Mexicanos.
  - deleted 10y ago
    [deleted]

marchenko 10y ago

This article also hints at one of the reasons why humans chafe at economic inequality, and a rising tide lifting all boats is not enough to produce utopia: there are some resources - desirable reproductive partners, status, land (esp. near others of high status) - which do not become more widely available as prosperity increases. The pursuit of these goods can even become more immiserating in a society with large differences in relative status, as the coveted attention of others flocks to global superstars rather than local stars. The author shows that these approximately zero-sum goods can be largely reduced to "attention".

meric 10y ago
And if we assume attention is valuable, while everything else is valueless, we've been pretty good at destroying what's valuable for what's valueless in the past century. Some of us pour our attention into games and movies instead of sharing it with those close to us. Some of us pour our attention into hour long commutes where we spend our utmost effort not to give attention to anyone near us - it might make them uncomfortable. Some of us pour our attention on those who already have a lot of it, who cannot possibly return it to us - famous youtube personalities, celebrities, porn stars even. We spend our time fine-tuning our processes to be as "efficient" as possible, from the queue in the supermarket, to the queue in the fast food restaurant, to reduce our shopkeepers and waiters to mere actors following a script efficiently, and in some cases, completely replace them with machines. We make our workplace a place where colleagues gather for majority of their lives, but make it difficult to form enduring long term friendships. We spend lots of time worrying about economic inequality but much less time about attention inequality. The only relevant policy we do have is subsidised psychologic care. It's inhumane to deny human food, that's why we provide welfare. It's inhumane to neglect a child's need for parental love, which is why we place orphans in foster homes (not perfect). And what about adults, what do we do about attention inequality in terms of family, friendship, and sexual partners? We just sort of leave it up to them to figure it out, and then when we read about suicides in the paper, we write a comment "if you feel this way please seek help immediately". This is a summary of what I find wrong about modern society, and I have no solution besides enjoying the giving of time to those close to me when they ask for it. We've become a lot more efficient trading away our attention for physical goods that don't really matter to us except to trade in a zero sum game for more attention.

jaggederest 10y ago

I think it's interesting to think about it in terms of a shift of the theory of value from subjective to objective: considering things like education in terms of objective value, you can just total up their cost in hours of people's lives, rather than trying to consider them purchased on a market. Or, if you prefer, fixing the basis for pricing on the effort involved rather than the exchange value.

NLips 10y ago

The whole chicken / beef thing has been misunderstood by the author - chicken was never the expensive alternative to beef. The author seems to have been masively misled by the (false) quote of Hoover "a chicken in every pot and two cars in every garage". Hoover never said this. My best reading of the history seems to be: 16th century: (Henry IV) "If God keeps me, I will make sure that no peasant in my realm will lack the means to have a chicken in the pot on Sunday!" 1928: (Hoover) "The slogan of progress is changing from the full dinner pail to the full garage." 1928: (Republican campaign flyer) Title "A Chicken for Every Pot", text includes "Republican properity has... put the proverbial 'chicken in every pot'. And a car in every backyard, to boot." It's clear that in 1928 chicken wasn't an the indicator of wealth that the author things; it was (as the flyer says) proverbial.

Symmetry 10y ago
According to the charts in The Rise and Fall of American Growth we've gone from eating 3 times as much beef as chicken in 1800 to eating 60% more chicken than beef. This[1] shows that since 1960 beef has gone up in price by a factor of 2 relative to chicken. So all the evidence I could find supports the author's conclusion even if I don't have any data on relative meat prices going back to 1900 or so. If you've got some data that actually contradicts the authors claim about food prices I'd love to see it but given the congruency I found I'm willing to accept their claim. [1]http://www.nationalchickencouncil.org/about-the-industry/statistics/wholesale-and-retail-prices-for-chicken-beef-and-pork/ http://www.nationalchickencouncil.org/about-the-industry/sta...
NLips 10y ago
For reference, the 'smell test' that lead to me thinking twice about this is the energy cost. Small animals don't have to live as long to reach full size, so you don't need to spend as much energy (food) keeping the existing mass of the animal alive while it's growing new mass. That's why (very roughly) the cost of common farmed meat is normally chicken -> pork -> beef.
- vilhelm_s 10y ago
  It seems the main reason chicken was expensive was that it was seasonal and labor-intensive. Someone on reddit writes: > Chicken, and eggs, were until the mid-20th century, a seasonal food. Chicken more than a year old is very tough, requiring hours of roasting or boiling to get a fairly tasteless end result. Most chickens lay their eggs in the spring and summer, petering out over the year. Old recipe books will have different instructions for "December" versus "April" eggs, given the quality of the yolks, which didn't used to be the uniformly pale color that industrial eggs look like now. So when the eggs would hatch, the young males would be culled and eaten right away by households, but the variety of cuts were few and the market to sell chickens incidental. Let's fast forward to the twentieth century. Unlike cows and pigs, who are irregular but large, chickens resisted the assembly line innovations of industrial production because they were irregular and small, which means they needed lots and lots of labor to process them. (https://www.reddit.com/r/AskHistorians/comments/1o72to/how_did_chicken_beef_and_pork_become_the_three/ccqd3fu/ https://www.reddit.com/r/AskHistorians/comments/1o72to/how_d...)

skywhopper 10y ago

Health care is a pretty simple one to explain. In addition to the fact that technology doesn't bring massive productivity increases to a field that requires human-to-human interaction, the fact is that health care today is a much much more extensive undertaking than it was 50 years ago. We have much better drugs, much better treatments, and much better diagnosing tools. There's also the paradox that better health care means longer lifespans which means greater health care expenses. When chronic conditions can be managed instead of quickly becoming terminal, that's a win, but it also means that the health care costs for that human go way way up. There's corruption, rent-seeking, patent abuse and monopoly effects, too, of course, not to mention a balkanized health insurance market. But the basic fact is that we get a lot more from health care industry than we ever did in the past, so you'd expect that that portion of the economy would be much bigger than it ever was.

3pt14159 10y ago
Plus a large portion of the public in America doesn't pay for healthcare directly (they either get employer-based health insurance or declare bankruptcy) so it distorts incentives while retaining the profit motive. Furthermore American society is seemingly setup to avoid exercise and healthy foods at any cost. The Japanese are just as wealthy, older, and they smoke more, but they have better health outcomes and they spend almost a third per capita on healthcare. Chile spends about a ninth on healthcare and their average life expectancy is a full year more than the USA. On top of all of this is the fact that people can get into debt at 1% interest. Hard to be cost-conscious when dear old gran needs a $20k (only $50 per month!) treatment to live another three months. Same thing happened to education.
- deleted 10y ago
  [deleted]
- specialist 10y ago
  Key part about that distortion is that it hides the rent seeking.
  - 10y ago

lmm 10y ago

> Yes, that's Haruhi Suzumiya. But it's also someone in a much older franchise you might have heard of. Let's not be coy. Does the author mean God here? Or something else?