3 ms·

> Then you come to a situation where you have to make a trade-off: some must die in order for others to live. I mean, in a wrongful death case, nobody is going

> Then you come to a situation where you have to make a trade-off: some must die in order for others to live. I mean, in a wrongful death case, nobody is going to die for anyone to live. The healthcare thing is more nuanced, and is part of the problem with any sort of centralized decision-making around it. On an individual level it's not usually any sort of tradeoff -- your choices don't make anyone else live or die except in imaginary fantasies. For governments they do have to make the choice AND THAT IS EXACTLY THE PROBLEM. Governments have been dominated by the pursuit of efficiency against metrics and avoiding any responsibility for outcomes because it's a "science". If more people are dying than should be dying, then you just spend more in accordance with your principles; this is the way that the NHS (for example) was designed to run, until the 1970s, when this obsession with deference to "experts" and pursuit of metric-driven efficiency (not just in England but in most other countries too) drove it to become a managerial culture and alienated the entire workforce associated with the program.

cryptonector 6y ago
> The healthcare thing is more nuanced, and is part of the problem with any sort of centralized decision-making around it. On an individual level it's not usually any sort of tradeoff -- your choices don't make anyone else live or die except in imaginary fantasies. [...] Really? What about your choices regarding people you have power of attorney over, or, say, minors whose guardian you are? Should a family bankrupt itself to pay for treatment for a child whose life expectancy with treatment is only a few years anyways? Should a family bankrupt itself to pay for an elderly member's care who has no assets left and little life expectancy? These are difficult decisions to make if you should ever have to, and god forbid you ever have to. But they do come up in real life, and implicitly or otherwise, people do put a value on life.

cryptonector 6y ago

> The healthcare thing is more nuanced, and is part of the problem with any sort of centralized decision-making around it. On an individual level it's not usually any sort of tradeoff -- your choices don't make anyone else live or die except in imaginary fantasies. [...] Really? What about your choices regarding people you have power of attorney over, or, say, minors whose guardian you are? Should a family bankrupt itself to pay for treatment for a child whose life expectancy with treatment is only a few years anyways? Should a family bankrupt itself to pay for an elderly member's care who has no assets left and little life expectancy? These are difficult decisions to make if you should ever have to, and god forbid you ever have to. But they do come up in real life, and implicitly or otherwise, people do put a value on life.