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>What services are costing more now outside of healthcare? Infrastructure. Our (USA) costs are COMPLETETLY OUTRAGIOUS compared to the global standard. We're ta

by xxpor 6y ago

>What services are costing more now outside of healthcare? Infrastructure. Our (USA) costs are COMPLETETLY OUTRAGIOUS compared to the global standard. We're talking multiples. Things like the gateway project in NJ/NYC cost 4x what they should for a crappier outcome.

temp667 6y ago
This - I've looked at a number of projects. There's some kind of tipping point with public / govt infra projects at which point they just go crazy in terms of cost, it's like the make work / interia / rent extractors just tip out the get things done folks at some point. NY / SF, even germany for a bit with Berlin's airport. I look at what they did in the past (huge railroad bridges in 100 days) and even now with private money (Tesla in germany is going up fast and sports stadiums go up like weeds despite their scale) the contrasts are remarkable. Space Launch System is $20B with not a single flight. SpaceX comes along, get's no $1B/year base, get's paid a fraction of the "big players" - and has done 80+ F9 launches. Also - success academies in NY seems to have some pretty amazing results relative to local schools. I realize some confounding factors, but if I was a parent in NY - that would be the choice if I lived in an area they served.
- bumby 6y ago
  >Space Launch System is $20B with not a single flight. SpaceX comes along, get's no $1B/year base, get's paid a fraction of the "big players" - and has done 80+ F9 launches. You might be conflating Falcon 9 and Falcon Heavy. Falcon Heavy is a more applicable comparison to SLS. Falcon Heavy had one launch in '19 and two in '20. When it comes to infrastructure, I think there are a few confounding factors. 1) Our level of risk is lower. We no longer find it an acceptable risk to lose workers at the rates that were acceptable 100 years ago and 2) the systems are inherently more complex. Even so, we tend to oversimplify them when planning [1] [1] https://freakonomics.com/podcast/project-management/ https://freakonomics.com/podcast/project-management/
michaelcampbell 6y ago
Higher education also.
bnralt 6y ago
Indeed. Someone recently linked to an article that does a pretty good job of going over the massive infrastructure costs[1]. The U.S. also has relatively well funded education[2]. I think many of the comments here reflect one of the reasons we're in the situation we are in - the inability to consider that we might be able to do things better, even when there are plenty of examples from other countries to look at. To quote from the first article: > The answer, I believe, has to do with American incuriosity. Incuriosity is not merely ignorance. Ignorance is a universal trait, people just differ in what they are ignorant about. But Americans are unique in not caring to learn from other countries even when those countries do things better. I think there's a lot of truth in that; look at how almost all the discussions about healthcare ignore the successful systems in other countries. It goes beyond that, though. We shouldn't have to look at other countries to consider the possibility that we could be doing things better. But whenever it's suggested that we could make things better, there seems to be a lot of hostility to the idea and push back against it. [1] https://pedestrianobservations.com/2019/03/03/why-american-costs-are-so-high-work-in-progress/ https://pedestrianobservations.com/2019/03/03/why-american-c... [2] https://data.oecd.org/eduresource/education-spending.htm https://data.oecd.org/eduresource/education-spending.htm
- solarkraft 6y ago
  "But the other countries are smaller, so of course they're spending less in aggregate!" Is the one thing that seems to be enough to shut every discussion down for a certain political group.
  - twalla 6y ago
    Caring for a smaller, homogenous, less geographically distributed population is definitely different from a larger, heterogenous distributed population - and that's a valid criticism of attempting to wholesale copy other countries. I just wish that the criticism was used as a launching point for questions like "How can we overcome those challenges?" or "What parts of the system would potentially transfer well?" instead of the rhetorical blunt instrument it seems to have become.
    - 6y ago
J0_k3r 6y ago
main problem: if you are planning to open up a healthcare center in the united states you must prove that you will not compete with any others. thank government regulation
- genericone 6y ago
  I've never heard this reasoning before, are you saying the reason competitive healthcare services/pricing doesn't exist is because competing healthcare providers within a region are disallowed?
  - rogerbinns 6y ago
    https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need It has been law in many states starting in the 1960's. The original intention was to prevent too much competition which could skew incentives.
    - alistairSH 6y ago
      Yup. We basically built a worst-of-all-options* system in the US. It's not free market. And it's not fully socialized. * From the perspective of an average consumer. It's a brilliant system if you're in a position to profit off it. And it has resulted in the best health care in the world (for those who can afford it).
    - hyperdimension 6y ago
      I've heard of that requirement before (of course the artifical limiting of the numbers of doctors able to start practicing every year is somewhat a similar type of practice,) but I'd be curious to see what the original rationale for the Certificate of Need program was. Is '[too much] competition' not supposedly the bedrock of our Wonderful System of Market Capitalism?
  - deleted 6y ago
    [deleted]
mrkstu 6y ago
But that isn’t an American problem. Infrastructure buildout in AZ is done in an incredibly efficient and cost effective manner. Dallas is similar. Utah’s buildout for the Winter Olympics was amazing and inexpensive. Cali/NY/MA? Not so much.
- spenczar5 6y ago
  I haven’t seen that claim before. Do you have cites? I looked up Utah’s Olympics build. It cost $2.1 billion, and was 24% over budget. I don’t really know whether that’s efficient or not?
  - stjohnswarts 6y ago
    24% is a -low- number for overbudget. Talk to any civil engineer or look at city records, particularly in heavily regulated cities and famous NIMBY cities.
defterGoose 6y ago
Exactly. Things that affect everyone fairly equally are now just more expensive. Healthcare. Infrastructure. Housing. Higher education. It's great that our universities are capable of turning out transformative technologies like CRISPR, but it's arguably slowing down, and it's happening at a time when our basic assumptions about what education opportunities should be available to our children. And make no mistake, they're narrowing. Space travel may retrospectively look in a thousand years like an absolute necessity. But that will be from a perspective of inequality here on earth having exploded. And fewer people will be involved than our collectivity would like.
- deleted 6y ago
  [deleted]
srsQtho00 6y ago
Of course it’s because we’ve increased administrative costs by privatizing it into numerous bubbles of ownership who all believe they’re somehow entitled a bigger piece of the pie to divvy up. These are mathematical truths as much as any other, all documented in our theories of economics, government transfer of capital, etc. Does the public cost on the books matter when we’ll socially bail out the failures and all be left with a desiccated environment? Who benefits from that belief and agency around such semantics? Normalizing the real logistics around these things would streamline costs. But of course the gerontocracy demands we continue LARPing the story they’re normalized to. Figurative sacrifice & death is too scary, let’s just drag our grandkids off the cliff. They shoveled high this fiat pile of dollars! You will honor that or no healthcare! Our society is a joke.
imperfectcats 6y ago
Costs go up when the process gets complicated, especially when the complications are increasingly tangential to the activity. YIMBYism, environmental impact, indigenous land rights, historical considerations (preserving sites with historical value) all play a part in increasing costs in the west in building physical things. That is not an argument AGAINST these things. It may be a valid trade-off that we all accept. Or it may be a power grab by some department or group. It is tough to know generally speaking. That is true in all areas where costs are rising wildly - medicine, education, cost of building real estate in pre-COVID bay area, cost of infrastructure. Whether you think the trade-offs are justified will depend on your mood affiliation as much as anything else.

by xxpor 6y ago

temp667 6y ago

This - I've looked at a number of projects. There's some kind of tipping point with public / govt infra projects at which point they just go crazy in terms of cost, it's like the make work / interia / rent extractors just tip out the get things done folks at some point. NY / SF, even germany for a bit with Berlin's airport. I look at what they did in the past (huge railroad bridges in 100 days) and even now with private money (Tesla in germany is going up fast and sports stadiums go up like weeds despite their scale) the contrasts are remarkable. Space Launch System is $20B with not a single flight. SpaceX comes along, get's no $1B/year base, get's paid a fraction of the "big players" - and has done 80+ F9 launches. Also - success academies in NY seems to have some pretty amazing results relative to local schools. I realize some confounding factors, but if I was a parent in NY - that would be the choice if I lived in an area they served.

bumby 6y ago
>Space Launch System is $20B with not a single flight. SpaceX comes along, get's no $1B/year base, get's paid a fraction of the "big players" - and has done 80+ F9 launches. You might be conflating Falcon 9 and Falcon Heavy. Falcon Heavy is a more applicable comparison to SLS. Falcon Heavy had one launch in '19 and two in '20. When it comes to infrastructure, I think there are a few confounding factors. 1) Our level of risk is lower. We no longer find it an acceptable risk to lose workers at the rates that were acceptable 100 years ago and 2) the systems are inherently more complex. Even so, we tend to oversimplify them when planning [1] [1] https://freakonomics.com/podcast/project-management/ https://freakonomics.com/podcast/project-management/

michaelcampbell 6y ago

Higher education also.

bnralt 6y ago

Indeed. Someone recently linked to an article that does a pretty good job of going over the massive infrastructure costs[1]. The U.S. also has relatively well funded education[2]. I think many of the comments here reflect one of the reasons we're in the situation we are in - the inability to consider that we might be able to do things better, even when there are plenty of examples from other countries to look at. To quote from the first article: > The answer, I believe, has to do with American incuriosity. Incuriosity is not merely ignorance. Ignorance is a universal trait, people just differ in what they are ignorant about. But Americans are unique in not caring to learn from other countries even when those countries do things better. I think there's a lot of truth in that; look at how almost all the discussions about healthcare ignore the successful systems in other countries. It goes beyond that, though. We shouldn't have to look at other countries to consider the possibility that we could be doing things better. But whenever it's suggested that we could make things better, there seems to be a lot of hostility to the idea and push back against it. [1] https://pedestrianobservations.com/2019/03/03/why-american-costs-are-so-high-work-in-progress/ https://pedestrianobservations.com/2019/03/03/why-american-c... [2] https://data.oecd.org/eduresource/education-spending.htm https://data.oecd.org/eduresource/education-spending.htm

solarkraft 6y ago
"But the other countries are smaller, so of course they're spending less in aggregate!" Is the one thing that seems to be enough to shut every discussion down for a certain political group.
- twalla 6y ago
  Caring for a smaller, homogenous, less geographically distributed population is definitely different from a larger, heterogenous distributed population - and that's a valid criticism of attempting to wholesale copy other countries. I just wish that the criticism was used as a launching point for questions like "How can we overcome those challenges?" or "What parts of the system would potentially transfer well?" instead of the rhetorical blunt instrument it seems to have become.
  - 6y ago

J0_k3r 6y ago

main problem: if you are planning to open up a healthcare center in the united states you must prove that you will not compete with any others. thank government regulation

genericone 6y ago
I've never heard this reasoning before, are you saying the reason competitive healthcare services/pricing doesn't exist is because competing healthcare providers within a region are disallowed?
- rogerbinns 6y ago
  https://en.wikipedia.org/wiki/Certificate_of_need https://en.wikipedia.org/wiki/Certificate_of_need It has been law in many states starting in the 1960's. The original intention was to prevent too much competition which could skew incentives.
  - alistairSH 6y ago
    Yup. We basically built a worst-of-all-options* system in the US. It's not free market. And it's not fully socialized. * From the perspective of an average consumer. It's a brilliant system if you're in a position to profit off it. And it has resulted in the best health care in the world (for those who can afford it).
  - hyperdimension 6y ago
    I've heard of that requirement before (of course the artifical limiting of the numbers of doctors able to start practicing every year is somewhat a similar type of practice,) but I'd be curious to see what the original rationale for the Certificate of Need program was. Is '[too much] competition' not supposedly the bedrock of our Wonderful System of Market Capitalism?
- deleted 6y ago
  [deleted]

mrkstu 6y ago

But that isn’t an American problem. Infrastructure buildout in AZ is done in an incredibly efficient and cost effective manner. Dallas is similar. Utah’s buildout for the Winter Olympics was amazing and inexpensive. Cali/NY/MA? Not so much.

spenczar5 6y ago
I haven’t seen that claim before. Do you have cites? I looked up Utah’s Olympics build. It cost $2.1 billion, and was 24% over budget. I don’t really know whether that’s efficient or not?
- stjohnswarts 6y ago
  24% is a -low- number for overbudget. Talk to any civil engineer or look at city records, particularly in heavily regulated cities and famous NIMBY cities.

defterGoose 6y ago

Exactly. Things that affect everyone fairly equally are now just more expensive. Healthcare. Infrastructure. Housing. Higher education. It's great that our universities are capable of turning out transformative technologies like CRISPR, but it's arguably slowing down, and it's happening at a time when our basic assumptions about what education opportunities should be available to our children. And make no mistake, they're narrowing. Space travel may retrospectively look in a thousand years like an absolute necessity. But that will be from a perspective of inequality here on earth having exploded. And fewer people will be involved than our collectivity would like.

deleted 6y ago
[deleted]

srsQtho00 6y ago

Of course it’s because we’ve increased administrative costs by privatizing it into numerous bubbles of ownership who all believe they’re somehow entitled a bigger piece of the pie to divvy up. These are mathematical truths as much as any other, all documented in our theories of economics, government transfer of capital, etc. Does the public cost on the books matter when we’ll socially bail out the failures and all be left with a desiccated environment? Who benefits from that belief and agency around such semantics? Normalizing the real logistics around these things would streamline costs. But of course the gerontocracy demands we continue LARPing the story they’re normalized to. Figurative sacrifice & death is too scary, let’s just drag our grandkids off the cliff. They shoveled high this fiat pile of dollars! You will honor that or no healthcare! Our society is a joke.

imperfectcats 6y ago

Costs go up when the process gets complicated, especially when the complications are increasingly tangential to the activity. YIMBYism, environmental impact, indigenous land rights, historical considerations (preserving sites with historical value) all play a part in increasing costs in the west in building physical things. That is not an argument AGAINST these things. It may be a valid trade-off that we all accept. Or it may be a power grab by some department or group. It is tough to know generally speaking. That is true in all areas where costs are rising wildly - medicine, education, cost of building real estate in pre-COVID bay area, cost of infrastructure. Whether you think the trade-offs are justified will depend on your mood affiliation as much as anything else.