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“Users want control” is a shoulder shrug
- collinmanderson 7y ago> I first started thinking about this during the debate over what would become the ACA. The rhetoric was filled with this idea that people want choice in their medical care: people want control. > No! People want good health care. If they don’t trust systems to provide them good health care, if they don’t trust their providers to understand their priorities, then choice is the fallback: it’s how you work the system when the system isn’t working for you. And it sucks! Here you are, in the middle of some health issue, with treatments and symptoms and the rest of your life duties, and now you have to become a researcher on top of it? But the politicians and the pundits could not stop talking about control.
- swagasaurus-rex 7y agoI would want to choice not to place my physical and financial health in the hands of profiteering insurers, but that's currently the only reasonable choice we (people in the U.S.) have.
- nostrademons 7y agoThat's not true. There are a significant number of non-profit health insurance companies, insuring a majority of the total market: https://www.firstquotehealth.com/health-insurance-news/non-profit-health-insurance https://www.firstquotehealth.com/health-insurance-news/non-p...
- ummonk 7y agoHaving not-for-profit tax status doesn't mean they aren't profiteering.
- nostrademons 7y agoIf you're worried about that you should be worried about government profiteering as well. Particularly since a very common failure mode of publicly-funded services is for the government to give the contract to friends of the bureaucrats who administer the program. If that's forbidden, a common failure mode is to give the administrator position itself (and usually, a fat salary) to friends of those in charge.
- maxxxxx 7y agoWhen you compare the US situation with other western countries your number one fear should be with US private insurances, private or not.
- username223 7y agoLet's put it in simple CRUD terms. Users want to: C - control when you collect it. R - read what you have on them, and know how you read it and/or share it with others. U - update it, e.g. when it is wrong. D - delete it. Most users just want non-hostile defaults, but all users should have CRUD-control.
- llamataboot 7y agoI'm not sure why this is downvoted - it's a little bit counter to the scope of the parent article, which applies to all sorts of design decisions, not just data retention and usage, but I would agree that this /is/ the base level of control over any data that a third party has from me and should be enshrined in law. It has been great to see Apple, for example, move more towards better awareness and defaults for C, but by and large the internet is still a mess of hostile defaults, opaque privacy statements, and no way to know that this weather app is selling your location to advertisers when they could've just asked you for your location, if they wanted to be a weather app.
- nostrademons 7y agoThe truth of "users want control" depends on how closely your users' preferences resemble each other with regards to the particular service you're providing. If you can make one set of choices that works for all users, then no, users don't want control. If you can't, then the users will be demanding that control whether you give it to them or not, and if you don't they'll go elsewhere. If you're small, you get to sidestep this distinction by defining your market carefully. Apple is one company that famously does not give users control. Is it true that PC users don't want control? No. That's why Windows has 80% market share in PCs and Android has 75% market share in mobile. But it's true of Apple customers, and in return for giving up control, they get a well-integrated user experience that's relatively bug-free, just works, and requires no extra thought on their part. You could look at dealing with hardware incompatibilities, avoiding crapware, integrating systems, and so on as services that Apple provides to its customers, and as a result they can charge a premium on their devices and make handsome profits. This model falls down for public policy, like privacy, because people have different priorities that lead to different tradeoffs. I will happily give Google my location if it helps me avoid traffic jams, something many HN readers object to. I will post semi-identifiable comments on Hacker News, because I've derived fairly significant benefit from comments here. I don't generally post pictures of my family on Facebook. I certainly don't document my every waking moment with Instagram. Many other people make different tradeoffs, and that's their right. It's debatable which bucket health care falls into - I suspect most people are in the "just make it work" camp until they dig into the details of exactly what experience and cost "just make it work" entails. I'll point out that the Apple experience for health care is completely possible with Kaiser Permanente and other managed HMOs, if you are willing to give up your choice of providers. Stay within their network and everything "just works", but then you have to stay within their network.
- floatingatoll 7y agoApple gives their users forms of control, but not necessarily the forms that HN commenters agree with. For example, this week I was explaining to someone how different the iOS (possible) and Android (impossible) processes are for finding and removing spying crap if you don’t know how to operate technology very well. I showed them Settings > General > Profiles on my phone, explained briefly that I’d opted in to them, and that they wouldn’t have that because they weren’t a developer. They had it! For a coupon email spam account. That they’d tried out a year ago and were now unable to completely remove. They removed it immediately. No, we can’t root iOS devices reliably (rarely at all), but in exchange, non-technical users gain control over their device to a degree that rootable devices make impossible. It’s not about whether you have control, it’s about whether you have the degree of control you desire, and whether that control provides the needs you desire. I, an advanced technical user, use iOS because I can prove efficiently that it’s unharmed. I consciously gave up a rooted device with a keyboard for it. I have a 50% typo rate and I miss a lot of things. But the need for safety is paramount, or else everyone protected by my MFA tokens is at risk from attacks so severe I can’t even fathom.
- jcrben 7y agoIt's unrealistic that an organization can predict exactly what users want. If you try to do that, it's like central planning of the economy. It just doesn't maximize people's happiness. However, if you give them lots of control and monitor choices, you can modify your defaults to improve that situation... but don't expect preferences to remain static.
- shstalwart 7y ago> ...and monitor choices, you... So... more telemetry. This user says no thanks.
- torstenvl 7y ago> Control is what you need when you want something and it won’t happen on its own. Err. Well. No, not usually. Usually it runs the other way. I want control because I specifically do not want you taking over my life, not because I disagree with the way you're taking it over. I don't want it to happen on its own. I can imagine the author in an automaker board room, arguing vehemently that if they only move from a ten-speed automatic transmission to a twelve-gear, the smoothness and low-end power will make it so nobody wants a manual transmission anymore. But that simply isn't the case. Freedom has inherent value. Simplicity and approachability have inherent value. People prefer to drive rather than fly or take a train because they want to be in the front seat - literally. Control has a value to it that far exceeds the mere pedestrian concern of whether your approach was good enough.
- contextfree 7y agoThat's called out in the article: "There are some cases when a person really does want control. If the person wants to determine their own path, if having choice is itself a personal goal, then you need control. That’s a goal about who you are not just what you get. It’s worth identifying moments when this is important ..."
- thatfrenchguy 7y agoI think this “a car give you freedom” American thing to be somewhat funny because to me it’s the opposite: a car is a huge investment, it costs you a ton of money per year, puts you down in one place (and thus prevents you from moving to another place easily), makes you mostly sit in traffic while going to work while contributing heavily to destroying the planet. I personally enjoy taking a train to where I’m going much more, especially in places where it’s convenient.
- praneshp 7y ago> makes you mostly sit in traffic while going to work Cherry picking this part of your argument: the last time I switched jobs this is what I told myself to rationalize commuting 50 mins one way (plus 15 mins last mile stuff). It works out _terribly_ if the mode of transport is not super reliable.
- microcolonel 7y agoI want you to stop telling me what I want, because it is sickening in its own right.
- strin 7y agoSometimes what users want is what users think of as a solution to their problem in the context they have. For example, users want better taxi services -> turns out ride-sharing is a better solution. Taxi service is a solution to the problem of getting point A to B.
- sfink 7y agoRide-sharing is a better taxi service. Or rather, the uber/lyft thing that is misnamed "ride-sharing" is a better taxi service. Better because of the experience of hailing a ride, and better because it is cheaper due to externalizing a bunch of costs onto the drivers and society. But not different.
- cryptokernel 7y agowho doesn't want control? Just leaving this here: Win a minimum of $10 in CoinCircle's Daily Competition https://coincircle.com/l/50VVxbObg3 https://coincircle.com/l/50VVxbObg3
- m463 7y agoI am reminded of a passage in the book "the subtle art of not giving a f*ck": "For a relationshipt to be healthy, both people must be willing and able to both say no and hear no. Without that negation, without that occasional rejection, boundaries break down and one person's problems and values come to dominate the other's." The problem is that users are not given the choice to say no.
- draw_down 7y agoThe perfect situation is you make strong choices instead of delegating everything to users, and you make the right choices. Next worse is delegating to users. The worst is you make strong choices and those choices don't work for your users. Which is all a way of saying that the stakes are high, and there are worse things than giving people the choice. It's a cop out if you can do better, but if you can't do better, then the alternative is worse. But here's the catch: how do you know whether you can do better, and whether you have?
- johnrob 7y agoI just saw ads on that blog post. I thought that was odd given the context. I went back to see again, and they were not there anymore. Is one of the included script tags up to no good?
- ianbicking 7y ago:( Probably Disqus, I turned off ads but it looks like they've turned them back on for free accounts. I'd change comment providers, but doing it for new posts while leaving Disqus on old posts is beyond my energy level.
- anbop 7y agoOK, users don’t want control. I’ll start a Netflix with only one movie because they don’t want control over what they watch.
- throwaway66666 7y ago> For instance, we say “users want control over their privacy,” but what people really want is some subset of: > To avoid embarrassment > To avoid persecution > … sometimes for doing illegal and wrong things > To keep from having the creeping sensation they left something sitting out that they didn’t want to > They want to make some political statement against surveillance > They want to keep things from the prying eyes of those close to them > They want to avoid being manipulated by bad-faith messaging ----------- You forgot the two most important ones. Users want their privacy because. A) they do not trust you. B) They expect that everything they do, will be used against them. (eg providing an email address will result to receiving spam. Providing personal details to advertisers using them etc). C) Info they leak, is leaked out forever. Today that might be ok, but circumstances might change tomorrow. It is a bit dishonest to say that users want privacy because they want to do illegal things. Or that they want to make a statement against surveillance. Wanting privacy is not a statement, it is an end-goal on its own. Yes I am missing the point of the article but I had to point the above out.
- mankyd 7y agoA feel like your A & B are covered by the last and second points. A) they do not trust you. Hence, they want to avoid manipulation in bad faith. B) They expect private details to be used against them. Hence, they want to avoid persecution. C, however, is an interesting point bearing further discussion. It's something that a developer can't address directly except to not have whatever private data is under consideration in the first place.
- dkarl 7y agoI agree, software developers are easily responsibility-shamed and the most insidious form of this is to tell them users want their employers to be in complete control of data and experience. There's a kernel of truth, of course, which is that most users are happier to be unaware of when their privacy is at stake. Educating users about the consequences of using your product is always more of an effort than not educating them. That's the real responsibility that shouldn't be ducked, but for companies it's better to convince developers that "responsibility" means the cheaper route of keeping users in the dark.
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- reshie 7y agoyou have to define control first. personally i think it is a dev to users in the form of options but you have to create options that will get the most need and has mostly the most following for the most part. with advanced users almost on par with developers some times a light hackable modular design is better.
- hawaiian 7y agoAs a user of services, I do want control. Whether my privacy needs are met is not good enough unless mathematically guaranteed, and even then there are social/integration features that may add side channels that require control. An example of such a feature would be Signal requesting your contact list to find out whom, among your friends, is also using Signal (which isn't too horribly an anti-pattern in this case because the app still works without read access to your contacts). Why? Because I want to be able to revoke access to any of several specific details about me or my device based solely on whether I feel like it. As soon as this is taken for granted, it is devalued and users lose leverage. Then the conversation during development becomes whether a proposed new feature is "worth" an encroachment on user privacy.
- rb808 7y agorelated tweet from @SwiftOnSecurity yesterday. "The difference between Excel and a database is if they use Excel they don't have to talk to your elitist ass." Too true
- barce 7y agoI did a thought exercise and replaced users with pilots in light of the Boeing 737 Max crashes. Pilots wanting control is not just a shoulder shrug.
- nhumrich 7y agoI mean, it is. If the plane could fly itself correctly, and know how to fix this problem without their intervention, then yes, they dont need or even care about control.
- laughinghan 7y agoHow about a thought exercise where you replace users with the customers of the Boeing 737 Max flights---the passengers? They don't want control. They want to be flown somewhere without dying.
- nhumrich 7y agoTrue. People didnt care about who had their data until the data started being used unethically. But now these unethical practices are so common, they are considered ethical. We used to print books with everyones name and number in the city. You would give your phone number out freely. But now, people keep their phone number hidden because its abused more then its actually used these days.
- Causality1 7y agoFrankly I'd settle for control of the hardware I paid good money for. Root access on my android devices. Full control over Windows Update without having to boot into Linux and rip DLLs straight out of the system folder.
- phkahler 7y agoUsers dont want plugins or extensions. They want features that are missing from the product.
- jancsika 7y ago> People don’t want to lose their data, but having personal control over your data is a great way to lose it, or even to lose control over it. I don't think "personal control" implies that nobody else has full access to one's data. If that were true then NDAs would be useless. The idea of users "wanting control" simply means they want ubiquitous software to work like the best parts of ubiquitous social structures they've grown up with that aren't the internet. That is: facilitate personal growth and self-expression in a framework where individual failures and oversights don't accumulate to create a goddamned international environmental hazard. For example-- I'd bet there are a lot of Youtube posters who would love the following two features: 1. Painlessly upload videos that assert their opinionated world view at that moment in time. 2. Have people find it without plugging into a recommendation rabbit hole of contention that reframes their content as yet another rusty nail in a goddamned international environmental hazard. > But if, as technologists, we can’t map functionality to desire, it’s a bit of a stretch to imagine everyone else will figure it out on the fly. And one level above that-- if you don't have a legal framework where it's against the law to put cocaine in soft drinks then mapping functionality to desire will often be an unethical endeavor.
- 3xblah 7y agoHow does he know what users want? I presume by the term "user" he means someone is not one of the authors or who cannot1 themselves modify the software as they wish. As a user, I do not ever recall being asked what I wanted by anyone at Mozilla nor have I ever heard of any other user being asked. 1 I could modify Firefox but the compile process requires more time and resources than what I consider reasonable.
- ianbicking 7y agoMozilla uses telemetry in their products to try to understand what Firefox users want. We only use telemetry to improve our products (which is directly related to understanding user desires), and we have a data review policy to ensure we are collecting data in an attempt to improve things for those people we collect data from. Additionally Mozilla regularly surveys samples of its user base, and conducts in-depth interviews of the public to try to understand desires.
- 3xblah 7y agoAre the dates, detailed methods and raw results of the "surveys" and "in-depth interviews" made available to the public?
- rgoulter 7y ago"try and understand underlying motivations whenever you see 'want control of X'" is neat point. I'd think "if the system satisfies all the desires, people don't need autonomy" and "people need control/power, because systems inevitably fail" are two contrasting viewpoints.
- mochomocha 7y agoI'll offer a contrarian opinion. A lot of the issues raised recently in our industry around privacy or algorithmic bias come from the fact that as an industry tech has the hubris to believe that it knows better than its users what is best for them. Under the pretense of simplicity and scalability, we think that every individual behavior and tastes can be reduced into a one-size-fits-all product and business model, sprinkled with machine learning to give the illusion of a product experience tailored to different people, when in fact it is only mildly so. And I'm saying this as someone building machine learning models for a living.
- solipsism 7y agoYou see it as hubris. I see it as earnestly trying to build amazing things but failing.
- deleted 7y ago[deleted]
- zoeysaurusrex 7y agoI agree with you here. The majority of the people involved are trying to do something good. I’d wager the egomaniacs are a much smaller percentage than those who want to build better things.
- benj111 7y agoAre they not functionally equivalent? I suppose morally there's a difference, but that's just us and our biases.
- calimac 7y agoHubris is a wonderful adjective for the arrogance now main stream in the industry.
- citrablue 7y agoPerhaps I am thinking too narrowly, but I think the algorithm-driven approach is much less hubris than someone at the company making a decision. These models reflect what users do -- isn't that much more democratic than employees deciding? There is an orthogonal argument that this is also harmful to some people's aspect, but "give the people what they want" doesn't seem like it's reductive. Especially when it seems like people in our society can be clustered and have some clear groupings occur.
- cryptonewo 7y agoIn coincircle I control everything. They have the right team for creators and developers. https://coincircle.com/l/zH5hmt4s1S https://coincircle.com/l/zH5hmt4s1S
- envolt 7y ago> People want good health care. If they don’t trust systems to provide them good health care, if they don’t trust their providers to understand their priorities, then choice is the fallback. Applies to any settings page with too many options.
- arendtio 7y agoHaving control is just the least common denominator. Sure, in the end, people want other things and control is just a basic tool to reach a goal, but as long as we are not 100% sure what they want we will hold them back on their way to reach their goal if we take away their control. - First, give users control (enable them to reach their goal, whatever that might be). - Second, reason about what their goals are and make those easy to achieve (reduce friction, without taking the control away).
- stakhanov 7y ago...kind of reminds me of a slogan by "Die Partei", a political party -slash- set of comedians that runs in German general elections as a platform for political comedy. The slogan goes "We'll do it right!" -- Laugh about it for a moment. Then think about why it is so funny. Then stop laughing when it dawns on you how f*ing terrifying it is that this is where society is headed.
- scraegg 7y agoIn fact it is actually mutliple things, depending on the situation. I think the people Ian is talking about really exist. But I don't think it applies to health care. In health care it's actually a cost saving effort by politicians not unskilled providers trying to hide their lack of knowledge, i.e. reason (5) not reason (1). Therefore educating them or the public is also not an helpful action. More reasonable would be to try to figure out the cause of lack of funds and how to counter it, or if there is no way back to help people along the way, e.g. by writing an article about how to find and read research papers oneself as a previous user of a social health care system. If you don't believe it or don't understand what I mean, read on: 1) In software dev "Product Owners" who have no idea of their job (or simply see that nothing happens and therefore have better things to do in their life than focus all their energy on their job) say that to have some kind of goal to work towards. True. That's probably also where Ian got this idea from. In this situation it's not unreasonable to do that because if he can't even act like he would have a goal he could not stay in that leadership position. 2) Users also really want control when they can't trust the actual service provider. And that doesn't just mean incompetent providers. It also means providers with goals that compete with the users. E.g. many countries now try to figure out how they can do nextgen_after_4g without Huawei, because they fear the political goals that might stand behind Huawei. In this situation it's also not unreasonable to want control. 3) A third reason is people who know the user's situation better than the user (e.g. IT security experts) and who want to help the users. In that case they will basically do the reason (2) fight for the users without much help from the users. It's a naive but admirable position to take. Not unreasonable. 4) Some people act like they would do reason (3) but actually just try to play games with the users on the user's cost. Anti-Vaxxers are such a group of people. Or the nationalist political grups we saw rise up a few years ago. They take an existing fear of uneducated users, escalate that to unreasonable sizes and then act like they would offer some help in exchange for money or votes. 5) Politicians and highest level corp leaders will say "users want control" when they have an area where they were providing a service in the past that the user come to expect, but for political or market reasons they can't provide that for much longer. So they act like someone else would want it. If they stand there in front of the camera in their $5000 suit, $200 hair cut, and their $3000 wrist watch nobody would believe them if they would simply say "all right guys, there is no more money for that service, let's pull our belts tighter". The only practical alternative I've seen is what the new Pope is doing. But that really needs a fanatic who can live an asketic life style which simply is not for most people. If most people can choose between a $5000 suit and a $2 self-knitted, itching rope then most people would choose option 1. So either you need to put one of a very small number of people in a leadership position and defend them there (which will cost you a lot as well), or you need to accept that "users want control" is the strategy the existing leadership is driving. Imo the best approach is to think about how to deal with reality instead of hoping or fighting for a reality that can't exist. But I can even see the reasons for why one rather dies dreaming than live in reality. ;-)
- stakhanov 7y agoIt's not about knowing better, it's about actual conflict of interest. Think about how much of the internet runs on advertising dollars. This leads to a situation where much of the internet serves the interests of people trying to maximize profits when selling stuff over the interests of people wanting to be well-informed about stuff they buy and looking for the best possible deal. -- When you search for "usb stick", of which there are gazillions, in an online store, which one will you be shown on page 1? The best product at the best price? Or the product made by the person who payed them to show their product first? (advertising expenses that they'll have to recoup by making that stuff more cheaply or selling it more expensively) Think about how copyright owners instrument digital rights management to try to maximize monetization of content over allowing users to make good use of rights in copyrighted material that they already possess. -- If you're 70 years old, and you're into the beatles, you probably paid for that music at least four times. You bought a record when it came out, buying the right to listen to that music for the rest of your life. But for some reason, you paid for buying that right a second time when it came out on CD. A third time when you bought an MP3 download. A fourth time as part of a subscription package that you now have. -- The development of the technology did not serve the interests of the user. Otherwise, a RW-medium like minidisc would have won over CDs, allowing you to maybe record from vinyl to minidisc. "Copy Protected" CDs would have never happened but instead ripping-friendly CDs would have been produced because this was what would have been in the user's interest. And streaming would have happened on the basis of making micropayments when streaming stuff you don't already own instead of turning everything into a subcription package. Think about how insurance companies might use the information gathered by the surveillance system which is the internet. People THINK that when they are the ones paying for a computer, for an internet connection, etc that they are paying for technology that should now serve THEIR interests. The fight for user control is the fight to actually make that happen. And a fight it is. It's not a given that technology is made to serve the user's actual interest.
- scarface74 7y agoIf you're 70 years old, and you're into the beatles, you probably paid for that music at least four times. You bought a record when it came out, buying the right to listen to that music for the rest of your life. But for some reason, you paid for buying that right a second time when it came out on CD. A third time when you bought an MP3 download. Why would you buy an MP3 download if you already had the CD? The most popular MP3 player at the time - the iPod was used with iTunes that it made it very easy to rip your own CDs. There was a way to rip CDs in Windows 2 decades ago. A fourth time as part of a subscription package that you now have. If you didn’t want the benefits of having access to all the music out there and just wanted your own library, you still wouldn’t need a subscription service. In the case of iOS, you could pay a one time fee of $25 for Apple Match and you would have up to a year to use it. With Apple Match, it will match all of the music in your library no matter where you obtained it and count it as purchased song that you can redownload from iTunes DRM free. The development of the technology did not serve the interests of the users. The user has a choice between subscription music that has DRM, purchased music that is DRM free, or easy to use software that lets you convert physical CDs. Otherwise, a RW-medium like minidisc would have won over CDs, CD-RWs were already backwards compatible with CDs. I was burning CDs using a parallel port CDRW in the late 90s. allowing you to maybe record from vinyl to minidisc. You’ve been able to take a record player, connect it to the audio in Of a computer, record the audio and burn it to a CD. I’m sure there were standalone boxes that let you do it. ”Copy Protected" CDs would have never happened but instead ripping-friendly CDs would have been produced because this was what would have been in the user's interest. Copy protected CDs were really never a big thing. And streaming would have happened on the basis of making micropayments when streaming stuff you don't already own instead of turning everything into a subcription package. People wanted subscriptions and not micropayments.
- arno_app 7y agoHow can you trust a system you don't control or see how it uses your data? With this premise the main claim becomes invalid imo while I agree with your point what users desire but I still think control and sovereignty are major points
- gnode 7y agoFor me, control in technology does not mean being able to go and press buttons in a maze of options. Control means being able to use an ad-blocking plugin in a browser written by an ad-tech company, to use off-brand ink in a printer, or to use a government API with a program written to optimize my taxes.
- oytis 7y agoAs a control freak I don't agree. I feel uncomfortable even with good solutions I don't understand and have no control over. I think a lot of Linux users like myself have chosen it because of that in the first place. And the same holds for privacy even more. I'll prefer encryption on my machine with my keys to the best permission model in the cloud.
- psychoslave 7y agoMost users want to take back control when the default behavior stands in the way of their current workflow. So the best scenario is the default configuration is handy for basic uses, and the behavior can be tweaked extensively when needed.
- ajuc 7y ago> For instance, we say “users want control over their privacy,” but what people really want is some subset of: > (...) > To avoid persecution > (...) That's like saying "drivers don't want safe cars, they just don't want to die in a car accident". Will you stop making safe cars, then? If not - how is that an useful information? I understand it wasn't the main point of the article, and I might even agree with the main point in general (I'm not sure, there are exceptions), but that was bad example.
- fareesh 7y agoTrue, but also possible that users want control.
- dboreham 7y agoLost 5 minutes to wondering what other thing you can shrug...
- norswap 7y agoAs a counterpoint, if you give users control, you don't have to figure exactly what they want. They can also get creative. And in some cases that is exactly the right approach.
- Eric_WVGG 7y agoThe economist Theodore Levitt said “consumers don’t want to buy a quarter-inch drill, they want a quarter-inch hole.”
- LaGrange 7y ago> Making the claim “users want control” is the same as saying you don’t know what users want, you don’t know what is good, and you don’t know what their goals are. Yup, that's exactly what I'm saying. There might be overriding concerns coming from _community_ needs (which is where arguments for things like ACA and other public healthcare come from, actually, and why I might not give a user a particular configuration option), but while I might know better what a platonic ideal of a user wants, what any particular user wants _I do not_ unless I ask them.
- vorpalhex 7y agoNobody ever has your best interest in mind except yourself. You can throw all the money in the world at healthcare, you can make it free, and you should still get a second opinion and be involved as a direct agent in your health choices. Humans are agents, that is to say, they have agency. There is no single optimum outcome for all people - there may be an optimum for a business (the most profit), a healthcare provider (the least amount of getting sued) or other entities, but there is no single best outcome for agents. Given that no system can give the best outcome for all people, the system shouldn't even bother but instead empower people to make their own outcomes. The problem is that sometimes people choose bad outcomes - but that is also an expression of agency.
- sfink 7y agoSure. But only giving users control, in the form of being able to choose between the available providers, does not solve the problem by itself. Say you sprain your pinky finger and your insurance covers two doctors: Donald Drugmeister who can afford to pay his office staff only by pushing the latest offerings from Pfizer, and the excellent surgeon Carl Cutter who will decide your root problem is in some organ that needs to be removed. You may feel vast relief that you're able to choose Donald over Carl, but in actuality you'd be better off going to your mom who will give you an ice pack (not covered by your insurance!) and kiss you on the forehead. The US healthcare system, at least, cannot be fixed simply by handing over all control to the patients. That'll just end up with even more strenuous efforts by the pharmaceutical companies to convince of us, the non-medically astute population, of the necessity for various drugs that they happen to make money off of. And even more antibiotic overuse and unnecessary procedures. I think having choice of doctors is part of the solution, as is having a pretty high degree of control over what procedures and drugs are used in each personal situation. But if the only fix on offer is to allow more control over the choice between mediocre or bad options, then we're all screwed. (And the less privileged are even more screwed than the rest of us.) I agree that the system shouldn't even bother to guarantee the best outcome for all people, but I don't think empowering people to make their own outcomes is going to get us very far.
- vorpalhex 7y ago
- Data_Junkie 7y agoReminds me of when Gordon Ramsey tried to explain to a clueless "chef" not to just give endless options. " Well why are you here then ? "