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Finding a way to just give needy people money, and then have them participate in the same system as everyone else, seems much simpler than trying to build 2 sys

Finding a way to just give needy people money, and then have them participate in the same system as everyone else, seems much simpler than trying to build 2 systems in 1. Granted there are plenty of problems in getting for-profit medicine to work for people with average income, but assuming you could wave a magic wand and solve those problems...

derefr 9y ago
The problem as it stands is that no agent in the system sees an incentive to do so, because the people having problems are invisible to their preference functions. Consider the aphorism "the squeaky wheel gets the grease." Why is this an aphorism? Because squeaky wheels are annoying. If the people who use the wheels have to hear them squeak, they'll soon oil them. So if you hear a squeaky wheel (for example, on a shopping cart), that's usually because the people with the oil don't ever have to get close enough to hear that squeak. Proposals like Basic Income, or even welfare, basically translate to "greasing all the wheels on a regular schedule, whether you've heard them squeak or not"—i.e., fixing problems that aren't actually bothering you personally. It's nearly impossible to incentivize anyone to do that. My proposal here is more in terms of "ensuring when manufacturing wheels that they will squeak as loudly as possible when they've begun failing." You want to solve the shopping-cart case, where the person with the oil isn't the person who has to use the cart. And the best way to do that is to ensure that the customers will be too irritated by the squeaking to actually use the carts; and therefore the carts will go disused; and therefore the customers will complain to the cashiers that there are no carts, and people will buy less than they would with a cart, and revenue will go down, and some stakeholder will notice, and gather information, and figure out that it's that all the carts are squeaking horribly, and so oil them. Or, in other words, you want the squeak of "people not getting treated because they don't have the money" to be loud enough to actually make it all the way up to the hospital's CFO, where the squeaking will cause cost-cutting; and even further, to the city surrounding the hospital, where the squeaking will cause donating. In fact, if you oil the carts regularly, you might not realize that your wheels are badly-made and are rusting prematurely; or that your parking lot needs a regular dust-blower-ing; or whatever else. Sensitive components—canaries in coal mines, or people with no money in poor health—show you where your system is weakest. If you eliminate them (by just providing UBI, or even just public healthcare), you eliminate the chance to observe where your system fails. In a country with more money than it knows what to do with, this is probably a sensible approach—it has fewer people suffer over the short term, after all, at the expense of a bloated, bureaucratic medical system. But if you're trying to figure out how to cut those costs, you need the squeaking.

derefr 9y ago

The problem as it stands is that no agent in the system sees an incentive to do so, because the people having problems are invisible to their preference functions. Consider the aphorism "the squeaky wheel gets the grease." Why is this an aphorism? Because squeaky wheels are annoying. If the people who use the wheels have to hear them squeak, they'll soon oil them. So if you hear a squeaky wheel (for example, on a shopping cart), that's usually because the people with the oil don't ever have to get close enough to hear that squeak. Proposals like Basic Income, or even welfare, basically translate to "greasing all the wheels on a regular schedule, whether you've heard them squeak or not"—i.e., fixing problems that aren't actually bothering you personally. It's nearly impossible to incentivize anyone to do that. My proposal here is more in terms of "ensuring when manufacturing wheels that they will squeak as loudly as possible when they've begun failing." You want to solve the shopping-cart case, where the person with the oil isn't the person who has to use the cart. And the best way to do that is to ensure that the customers will be too irritated by the squeaking to actually use the carts; and therefore the carts will go disused; and therefore the customers will complain to the cashiers that there are no carts, and people will buy less than they would with a cart, and revenue will go down, and some stakeholder will notice, and gather information, and figure out that it's that all the carts are squeaking horribly, and so oil them. Or, in other words, you want the squeak of "people not getting treated because they don't have the money" to be loud enough to actually make it all the way up to the hospital's CFO, where the squeaking will cause cost-cutting; and even further, to the city surrounding the hospital, where the squeaking will cause donating. In fact, if you oil the carts regularly, you might not realize that your wheels are badly-made and are rusting prematurely; or that your parking lot needs a regular dust-blower-ing; or whatever else. Sensitive components—canaries in coal mines, or people with no money in poor health—show you where your system is weakest. If you eliminate them (by just providing UBI, or even just public healthcare), you eliminate the chance to observe where your system fails. In a country with more money than it knows what to do with, this is probably a sensible approach—it has fewer people suffer over the short term, after all, at the expense of a bloated, bureaucratic medical system. But if you're trying to figure out how to cut those costs, you need the squeaking.