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I trust Walmart because its really in their best interest. If you are in a poor area on the 1st of the month, you know exactly why they would not screw this on

I trust Walmart because its really in their best interest. If you are in a poor area on the 1st of the month, you know exactly why they would not screw this one up. I grew up with Indian Health Services (and the 3 operations to correct a poorly done root canal) have taught me that a group with a profit interest is probably going to do a better job than a disinterested government agency.

toomuchtodo 9y ago
I can understand where you're coming from. I would say that we should be building processes and systems that enable those who are interested in delivering results to achieve roles in positions of power in government, while disempowering empire builders and self-interested parties. To your anecdote, would you not trust the US Health and Human Services to deliver national healthcare if the team behind Watsi was in charge? Because that is quite literally what they're doing; building a transparent [1] and ruthlessly efficient [2] healthcare management system for third world citizens. Cleary, YC believes they can do it [3]. I also believe it can be done. [1] https://usenotion.com/watsi/transparency/ https://usenotion.com/watsi/transparency/ [2] https://venturebeat.com/2017/02/07/y-combinator-and-watsi-launch-study-to-see-how-technology-can-fix-healthcare/ https://venturebeat.com/2017/02/07/y-combinator-and-watsi-la... [3] https://blog.ycombinator.com/yc-research-universal-healthcare/ https://blog.ycombinator.com/yc-research-universal-healthcar...
- protomyth 9y ago
  No, I wouldn't trust US Health and Human Services because the government cannot manage to serve a much smaller population through Indian Health Service without racking up years of tragedy and mismanagement. If they cannot succeed with a smaller group then why would I trust them with a bigger group?
  - toomuchtodo 9y ago
    Because a government will always be more accountable than a for profit entity. Everyone gets a vote. Anyone can run for office.
    - dragonwriter 9y ago
      One of the big problems with US government institutions aimed at the Native American population like IHS is that the population they serve is small and diffuse so that it has basically zero electoral power and can impose no accountability.
    - anoncoward111 9y ago
      This, unfortunately, is wrong in the USA. The IHS is not staffed by elected officials. The Native Americans who need our help, and do not receive it from the government IHS, do not have any way of democratically bringing about a more efficient team to run their health services. The ONLY solution therefore must be a private one.
      - dragonwriter 9y ago
        > The IHS is not staffed by elected officials. It's accountable to elected officials in Congress and the White House, OTOH, those elected officials are not in any meaningful sense accountable to the population served by IHS. > The ONLY solution therefore must be a private one. The structural problems with IHS incentives and accountability don't mean that there is a better private solution, and private services to Native American communities often are poor, too, because private industry isn't really all that interested in solving problems for people that have very little money to pay for the solution.
    - protomyth 9y ago
      People can bring a class action suit against a private company, but the government is much harder and often impossible to deal with in court. The Department of Interior proved that fairly well with their continued incompetence even in the face of a court system. > Everyone gets a vote. Yes, but its a majority game. Heck, look at all the diversity news on HN or the diversity reports by tech giants. See any mention of enrolled members of Native American tribes? See any VC funding to solve the smaller problem (might have been a nice place to test all that basic income stuff)? Heck, Google can block one of the tribal community colleges in Google Voice and no one gives a solitary damn. No, government is less accountable than any private group. After all, they can get away with doing things like this when questioned: https://www.youtube.com/watch?v=TcgGoAcDXvQ&feature=youtu.be https://www.youtube.com/watch?v=TcgGoAcDXvQ&feature=youtu.be
  - deleted 9y ago
    [deleted]

toomuchtodo 9y ago

I can understand where you're coming from. I would say that we should be building processes and systems that enable those who are interested in delivering results to achieve roles in positions of power in government, while disempowering empire builders and self-interested parties. To your anecdote, would you not trust the US Health and Human Services to deliver national healthcare if the team behind Watsi was in charge? Because that is quite literally what they're doing; building a transparent [1] and ruthlessly efficient [2] healthcare management system for third world citizens. Cleary, YC believes they can do it [3]. I also believe it can be done. [1] https://usenotion.com/watsi/transparency/ https://usenotion.com/watsi/transparency/ [2] https://venturebeat.com/2017/02/07/y-combinator-and-watsi-launch-study-to-see-how-technology-can-fix-healthcare/ https://venturebeat.com/2017/02/07/y-combinator-and-watsi-la... [3] https://blog.ycombinator.com/yc-research-universal-healthcare/ https://blog.ycombinator.com/yc-research-universal-healthcar...

protomyth 9y ago
No, I wouldn't trust US Health and Human Services because the government cannot manage to serve a much smaller population through Indian Health Service without racking up years of tragedy and mismanagement. If they cannot succeed with a smaller group then why would I trust them with a bigger group?
- toomuchtodo 9y ago
  Because a government will always be more accountable than a for profit entity. Everyone gets a vote. Anyone can run for office.
  - dragonwriter 9y ago
    One of the big problems with US government institutions aimed at the Native American population like IHS is that the population they serve is small and diffuse so that it has basically zero electoral power and can impose no accountability.
  - anoncoward111 9y ago
    This, unfortunately, is wrong in the USA. The IHS is not staffed by elected officials. The Native Americans who need our help, and do not receive it from the government IHS, do not have any way of democratically bringing about a more efficient team to run their health services. The ONLY solution therefore must be a private one.
    - dragonwriter 9y ago
      > The IHS is not staffed by elected officials. It's accountable to elected officials in Congress and the White House, OTOH, those elected officials are not in any meaningful sense accountable to the population served by IHS. > The ONLY solution therefore must be a private one. The structural problems with IHS incentives and accountability don't mean that there is a better private solution, and private services to Native American communities often are poor, too, because private industry isn't really all that interested in solving problems for people that have very little money to pay for the solution.
  - protomyth 9y ago
    People can bring a class action suit against a private company, but the government is much harder and often impossible to deal with in court. The Department of Interior proved that fairly well with their continued incompetence even in the face of a court system. > Everyone gets a vote. Yes, but its a majority game. Heck, look at all the diversity news on HN or the diversity reports by tech giants. See any mention of enrolled members of Native American tribes? See any VC funding to solve the smaller problem (might have been a nice place to test all that basic income stuff)? Heck, Google can block one of the tribal community colleges in Google Voice and no one gives a solitary damn. No, government is less accountable than any private group. After all, they can get away with doing things like this when questioned: https://www.youtube.com/watch?v=TcgGoAcDXvQ&feature=youtu.be https://www.youtube.com/watch?v=TcgGoAcDXvQ&feature=youtu.be
- deleted 9y ago
  [deleted]