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Another one! I keep hearing this over and over again. Can you PLEASE explain how these things won't scale from a few million people to a few hundred million peo

by gspr 6y ago

Another one! I keep hearing this over and over again. Can you PLEASE explain how these things won't scale from a few million people to a few hundred million people? Of course there are some things that only work in very tiny places, like the prince of Liechtenstein inviting all citizens to a garden party at his place – and some things that only work in very big places, like a manned lunar program. But why wouldn't things like hospitals and schools scale well for the range "a few million" (Sweden in your example) to "a few hundred million" (the US in your example)? Sorry that I'm getting all worked up here, but I feel like a crazy person for being presented with this argument over and over and not grasping even a fraction of it! Nobody says "oh, those things from Sweden won't scale to Germany (10x)", but for some reason this conversation keeps getting shut down with "oh, those things from Germany can't possibly scale to the US (4x)". Above I'm only talking about population, because surely you don't actually mean that "small physically" has a positive effect on hospitals, schools and housing? If we were discussing transportation infrastructure, sure, but…

roenxi 6y ago
> But why wouldn't things like hospitals and schools scale well for the range "a few million" (Sweden in your example) to "a few hundred million" (the US in your example). Different climates, industries, demographics and educational achievement change what diseases/health issues are present and how they are dealt with in the community. That sort of thing varies wildly in a population of 10s-100s of millions spread over a large geographic area. A sparse rural population has different healthcare needs than an urban one, for example. Coordinating that sort of thing across a continent isn't that helpful. State level administration makes more sense than trying to coordinate a policy across a continent. What is cross-continent coordination supposed to win anyone anyway? It just makes the politics harder to manage. > Nobody says "oh, those things from Sweden won't scale to Germany (10x)", but for some reason this conversation keeps getting shut down with "oh, those things from Germany can't possibly scale to the US (4x)". I'm happy to say that; there will be things Sweden is doing that are completely different to what Germany does because of scaling. Plus the fact that they have different laws and legal systems. Although I suspect neither of us speaks Swedish or German, so it would be hard to settle that one decisively. > because surely you don't actually mean that "small physically" has a positive effect on hospitals, schools and housing? I mean exactly that. Australia faces similar issues where West Australia has a decidedly different culture to the east coast states and it doesn't make sense to try and coordinate housing policy between them. We don't coordinate hospitals either for that matter, although there may have been some push towards a nationalised education standard.
- gspr 6y ago
  > Different climates, industries, demographics and educational achievement change what diseases/health issues are present and how they are dealt with in the community. I'm sorry, I'm not buying this without some source that shows that Americans need more healthcare than Swedes due to those factors. > A sparse rural population has different healthcare needs than an urban one, for example. Sure, but the US is 82% urban, Sweden is 88%, Germany 77%, France 81%, Norway 83%, Denmark 88%, Finland 85%, Switzerland 74% – I can go on [1]. All very much in a comparable range. [1] https://www.cia.gov/library/publications/the-world-factbook/fields/349.html https://www.cia.gov/library/publications/the-world-factbook/... > State level administration makes more sense than trying to coordinate a policy across a continent. Fine. Many public hospitals in Germany and Switzerland – two countries with federal systems – are run at the equivalent of the state level. > What is cross-continent coordination supposed to win anyone anyway? It just makes the politics harder to manage. I'm not claiming that the US would have some gain in these areas for being huge! I'm merely questioning your claim that "it won't scale". > I'm happy to say that; there will be things Sweden is doing that are completely different to what Germany does because of scaling. This is incredibly vague. Of course there are "things done differently". That's not an argument for why the US can't do a version of the same. > Plus the fact that they have different laws and legal systems. Why is this relevant? That's like saying "the flags are very different". > Although I suspect neither of us speaks Swedish or German, so it would be hard to settle that one decisively. I can understand Swedish just fine, and rudimentary German. Even if I couldn't, the legal, healthcare and educational systems in both countries are well-described in English language sources. > Australia faces similar issues where West Australia has a decidedly different culture to the east coast states and it doesn't make sense to try and coordinate housing policy between them. I'll perhaps grant that the housing situation may be extremely different from place to place, and coordination can be hard, but I still don't understand an iota of what you mean when it comes to healthcare and education.
  - roenxi 6y ago
    > Sure, but the US is 82% urban https://en.wikipedia.org/wiki/Urbanization_in_the_United_States https://en.wikipedia.org/wiki/Urbanization_in_the_United_Sta... Alaska is substantially larger than any of the European countries you listed, and is not very urban. > I'm merely questioning your claim that "it won't scale". Given how badly the US has mucked it up? With that level of technology sophistication, social dynamism and money? Pretty solid evidence that it can't be done. It got stuck in the morass that is politics at the US Federal level. > Why is this relevant? That's like saying "the flags are very different". European countries are coordinating healthcare at the equivalent level of a US state and it is working. The US has made moves to coordinate at the Federal level and it is not. The separate legal systems indicates that these are highly independent policy-wise. > I still don't understand an iota of what you mean when it comes to healthcare and education. Healthcare is similar to housing. Sickness is location-specific and population-specific. For education the arguments take a slightly different flavour; but boil down to different industries have different educational needs and a one-size-fits-all educational system will either systematically under- or over- educate students in different cities with different industry needs/opportunities.
corporateslave5 6y ago
Have we ever seen it scale?

by gspr 6y ago

roenxi 6y ago

> But why wouldn't things like hospitals and schools scale well for the range "a few million" (Sweden in your example) to "a few hundred million" (the US in your example). Different climates, industries, demographics and educational achievement change what diseases/health issues are present and how they are dealt with in the community. That sort of thing varies wildly in a population of 10s-100s of millions spread over a large geographic area. A sparse rural population has different healthcare needs than an urban one, for example. Coordinating that sort of thing across a continent isn't that helpful. State level administration makes more sense than trying to coordinate a policy across a continent. What is cross-continent coordination supposed to win anyone anyway? It just makes the politics harder to manage. > Nobody says "oh, those things from Sweden won't scale to Germany (10x)", but for some reason this conversation keeps getting shut down with "oh, those things from Germany can't possibly scale to the US (4x)". I'm happy to say that; there will be things Sweden is doing that are completely different to what Germany does because of scaling. Plus the fact that they have different laws and legal systems. Although I suspect neither of us speaks Swedish or German, so it would be hard to settle that one decisively. > because surely you don't actually mean that "small physically" has a positive effect on hospitals, schools and housing? I mean exactly that. Australia faces similar issues where West Australia has a decidedly different culture to the east coast states and it doesn't make sense to try and coordinate housing policy between them. We don't coordinate hospitals either for that matter, although there may have been some push towards a nationalised education standard.

gspr 6y ago
> Different climates, industries, demographics and educational achievement change what diseases/health issues are present and how they are dealt with in the community. I'm sorry, I'm not buying this without some source that shows that Americans need more healthcare than Swedes due to those factors. > A sparse rural population has different healthcare needs than an urban one, for example. Sure, but the US is 82% urban, Sweden is 88%, Germany 77%, France 81%, Norway 83%, Denmark 88%, Finland 85%, Switzerland 74% – I can go on [1]. All very much in a comparable range. [1] https://www.cia.gov/library/publications/the-world-factbook/fields/349.html https://www.cia.gov/library/publications/the-world-factbook/... > State level administration makes more sense than trying to coordinate a policy across a continent. Fine. Many public hospitals in Germany and Switzerland – two countries with federal systems – are run at the equivalent of the state level. > What is cross-continent coordination supposed to win anyone anyway? It just makes the politics harder to manage. I'm not claiming that the US would have some gain in these areas for being huge! I'm merely questioning your claim that "it won't scale". > I'm happy to say that; there will be things Sweden is doing that are completely different to what Germany does because of scaling. This is incredibly vague. Of course there are "things done differently". That's not an argument for why the US can't do a version of the same. > Plus the fact that they have different laws and legal systems. Why is this relevant? That's like saying "the flags are very different". > Although I suspect neither of us speaks Swedish or German, so it would be hard to settle that one decisively. I can understand Swedish just fine, and rudimentary German. Even if I couldn't, the legal, healthcare and educational systems in both countries are well-described in English language sources. > Australia faces similar issues where West Australia has a decidedly different culture to the east coast states and it doesn't make sense to try and coordinate housing policy between them. I'll perhaps grant that the housing situation may be extremely different from place to place, and coordination can be hard, but I still don't understand an iota of what you mean when it comes to healthcare and education.
- roenxi 6y ago
  > Sure, but the US is 82% urban https://en.wikipedia.org/wiki/Urbanization_in_the_United_States https://en.wikipedia.org/wiki/Urbanization_in_the_United_Sta... Alaska is substantially larger than any of the European countries you listed, and is not very urban. > I'm merely questioning your claim that "it won't scale". Given how badly the US has mucked it up? With that level of technology sophistication, social dynamism and money? Pretty solid evidence that it can't be done. It got stuck in the morass that is politics at the US Federal level. > Why is this relevant? That's like saying "the flags are very different". European countries are coordinating healthcare at the equivalent level of a US state and it is working. The US has made moves to coordinate at the Federal level and it is not. The separate legal systems indicates that these are highly independent policy-wise. > I still don't understand an iota of what you mean when it comes to healthcare and education. Healthcare is similar to housing. Sickness is location-specific and population-specific. For education the arguments take a slightly different flavour; but boil down to different industries have different educational needs and a one-size-fits-all educational system will either systematically under- or over- educate students in different cities with different industry needs/opportunities.

corporateslave5 6y ago

Have we ever seen it scale?