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I have nothing against private charities but see them only as a complement to state-run programs. The social improvement that comes from people having healthcar

I have nothing against private charities but see them only as a complement to state-run programs. The social improvement that comes from people having healthcare/education/etc requires that the vast majority of people have it, not some, and not even a simple majority. I view it somewhat similarly to herd immunity through vaccination. When you have a 95% vaccinated population, diseases can be eliminated. When you have a 50% vaccinated population, it's of course good for those 50%, but doesn't provide the same global benefits. Is some of the welfare money wasted due to inefficiency? Yes, of course. But for a task of this scale, which has to provide benefits to everyone in the country, I only trust the state with it, and not a private entity. Can I opt out of the system? No, but freedom isn't a single variable you can straightforwardly optimize for. In this case, I believe the infringement on individual freedom through taxation results in considerably higher total freedom when considering all individuals in the society.

beaconstudios 8y ago
see, I don't think the state is very good at dealing with issues like this because from such a high viewpoint, the state can either apply a one-size-fits-all policy, or provide a localised but drastically oversimplified strategy for specific regions that will require more overhead for managing the many regional subdivisions. Providing for social healthcare is a good thing (at least within the context of how our nation states currently operate), but I think it should be devolved down to local authorities with perhaps a state-level overseer to monitor their performance. I'm of the strong belief that central management at scale is unilaterally inferior to decentralised and devolved decision-making that can more effectively take local variables into account. > But for a task of this scale, which has to provide benefits to everyone in the country, I only trust the state with it, and not a private entity. Trusting the nation state and trusting a private (presumably either commercial or charitable) entity are not the only two options. The charity and taxation options can both occur at a local authority, or a community, level.
- ACS_Solver 8y ago
  Too much centralization is definitely bad (for an extreme example see the Soviet economy that was centralized to a ridiculous extent). But government doesn't have to mean centralized, to take the Swedish system once again, the healthcare is handled at a regional level, within the national legal framework. This does take local variables into account, which is important - different parts of Sweden can actually have significant differences in the medical situation. It's still state-run in the important sense that the legal mandate comes from the state. This is a major advantage over private initiatives in my opinion. To take a simple example, say there's a legal requirement that people who cannot use their legs are entitled to receive a wheelchair. When that's the law, it means the government (regional, local, whatever applies) has to make it happen, even when it's inconvenient or expensive. When it's a charity or a private initiative, it might not have enough money/incentive/commercial interest/insert reason here to cover everyone. Admittedly my views on centralized vs. regional governance aren't sophisticated due to my background. I live in a country of 10 million, which isn't too big globally, and I moved here from a very centralized country of 2 million where devolved decision making only makes sense in truly local issues.
  - beaconstudios 8y ago
    that seems reasonable to me. To recontextualise it in software terms, the requirement comes from the state but the solution comes from the local level. As long as the requirement isn't overly prescriptive (e.g. "people who can't use their legs are entitled to a wheelchair" vs "local authorities must invest 50M SKR in departments X, Y and Z") that's a good solution. My aversion to the idea of a central state (though I don't have a proposed solution to this) is that because there is no antagonist to push back on poorly thought out requirements, states trend towards centralised prescriptive solutionising which I believe to be the root cause of the problem with centralisation. A classic example was the Soviets as you mentioned earlier, with their economic planning committee (Gosplan) explicitly telling factories how much steel to produce and who to send it to. It's one of those problems that pops up in different areas like software development and management practices too. Markets are good at preventing this because they separate the requirements (the customers) from the solution (the producers) and provide a Darwinian process to optimise for the best performers, but markets have their own problems and inefficiencies that make them a poor fit (like markets' tendency to ignore customers with unique or rare requirements, meaning people with rare diseases or multiple problems get rejected or priced out by medical markets). There are market-oriented solutions that libertarians propose, such as evening out costs through medical insurance, but markets will always leave cracks people can fall though (such as those who cannot afford insurance, or immigrants with pre-existing health conditions) and introducing state mandates into the market often fundamentally break the market itself (see: US health insurance market). State legislation leaves cracks too when written badly, so neither is a perfect solution in practice. I don't have a solution to these problems because I think they're rooted in patterns of thinking rather than systemic design, but they're interesting to think about.

beaconstudios 8y ago

see, I don't think the state is very good at dealing with issues like this because from such a high viewpoint, the state can either apply a one-size-fits-all policy, or provide a localised but drastically oversimplified strategy for specific regions that will require more overhead for managing the many regional subdivisions. Providing for social healthcare is a good thing (at least within the context of how our nation states currently operate), but I think it should be devolved down to local authorities with perhaps a state-level overseer to monitor their performance. I'm of the strong belief that central management at scale is unilaterally inferior to decentralised and devolved decision-making that can more effectively take local variables into account. > But for a task of this scale, which has to provide benefits to everyone in the country, I only trust the state with it, and not a private entity. Trusting the nation state and trusting a private (presumably either commercial or charitable) entity are not the only two options. The charity and taxation options can both occur at a local authority, or a community, level.

ACS_Solver 8y ago
Too much centralization is definitely bad (for an extreme example see the Soviet economy that was centralized to a ridiculous extent). But government doesn't have to mean centralized, to take the Swedish system once again, the healthcare is handled at a regional level, within the national legal framework. This does take local variables into account, which is important - different parts of Sweden can actually have significant differences in the medical situation. It's still state-run in the important sense that the legal mandate comes from the state. This is a major advantage over private initiatives in my opinion. To take a simple example, say there's a legal requirement that people who cannot use their legs are entitled to receive a wheelchair. When that's the law, it means the government (regional, local, whatever applies) has to make it happen, even when it's inconvenient or expensive. When it's a charity or a private initiative, it might not have enough money/incentive/commercial interest/insert reason here to cover everyone. Admittedly my views on centralized vs. regional governance aren't sophisticated due to my background. I live in a country of 10 million, which isn't too big globally, and I moved here from a very centralized country of 2 million where devolved decision making only makes sense in truly local issues.
- beaconstudios 8y ago
  that seems reasonable to me. To recontextualise it in software terms, the requirement comes from the state but the solution comes from the local level. As long as the requirement isn't overly prescriptive (e.g. "people who can't use their legs are entitled to a wheelchair" vs "local authorities must invest 50M SKR in departments X, Y and Z") that's a good solution. My aversion to the idea of a central state (though I don't have a proposed solution to this) is that because there is no antagonist to push back on poorly thought out requirements, states trend towards centralised prescriptive solutionising which I believe to be the root cause of the problem with centralisation. A classic example was the Soviets as you mentioned earlier, with their economic planning committee (Gosplan) explicitly telling factories how much steel to produce and who to send it to. It's one of those problems that pops up in different areas like software development and management practices too. Markets are good at preventing this because they separate the requirements (the customers) from the solution (the producers) and provide a Darwinian process to optimise for the best performers, but markets have their own problems and inefficiencies that make them a poor fit (like markets' tendency to ignore customers with unique or rare requirements, meaning people with rare diseases or multiple problems get rejected or priced out by medical markets). There are market-oriented solutions that libertarians propose, such as evening out costs through medical insurance, but markets will always leave cracks people can fall though (such as those who cannot afford insurance, or immigrants with pre-existing health conditions) and introducing state mandates into the market often fundamentally break the market itself (see: US health insurance market). State legislation leaves cracks too when written badly, so neither is a perfect solution in practice. I don't have a solution to these problems because I think they're rooted in patterns of thinking rather than systemic design, but they're interesting to think about.