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I understand your arguments, which in my view, "shift the blame", and in your view, "charge with at least some responsibility" to the government. The problem I

I understand your arguments, which in my view, "shift the blame", and in your view, "charge with at least some responsibility" to the government. The problem I see is that this sort of arguments, if accepted as OK/inevitable and universalized lead to a dilution of responsibility that would make no one fully accountable for any intentional wrongdoing: for example, if you pay for your car to be repaired at your regular car repair shop, but the mechanic knowingly used parts that were not certified or due to time pressure skipped standard checks, and you let someone drive your car a year later, and there is an accident that was caused as a consequence of that sloppy repair-work, do you share responsibility for your oversight? - You might argue you do; well, I would argue you don't.

unpolloloco 6y ago
The moral blame rests fully on the clinic, but the responsibility to fix the system rests fully on the government (in this case). It's really no different than a production line with a quality problem. You can yell and scream about the morality of the workers all you want, but you can't expect them to improve if you don't fix the system and incentives that cause the problems.
cloverich 6y ago
the reason the analogy doesn’t hold up is there isn’t a system there — that’s a set of actually individual choices. When you see systematic behavior, you need to look for the system to fix it. The problem with blame is it doesn’t get you far enough, even if it feels good or right. Finding and fixing incentives is the only way to systematically enact change. Whether it feels good or not.
- ggrrhh_ta 6y ago
  is the threat of punishment for wrongdoing not enough?
  - typomatic 6y ago
    Clearly not--when there is systemic rulebreaking, the point is that it's impossible to enforce the rules in a way that is "enough".
- ggrrhh_ta 6y ago
  btw, I think it is important to place the blame correctly and take whatever action is possible on the perpetrators to deter such behavior and at the same time patch systemic loopholes that are identified. They are not incompatible actions. If anything, they are complementary.
topkai22 6y ago
The government is not an individual- appropriate morality and responsibility at scale are different then as an individual. Additionally, if insurance / the government agrees to pay for a procedure that serves as a form of confirmation for the end user - after all, the department of health and human services approved the procedure! A better example would be if a Sr Director of a rental car company shifted sourcing of thier repair contractor. If the new repair contractor consistently did way more repairs then the rental company needed, should the director of fleet maintenance be held responsible? Absolutely.

unpolloloco 6y ago

The moral blame rests fully on the clinic, but the responsibility to fix the system rests fully on the government (in this case). It's really no different than a production line with a quality problem. You can yell and scream about the morality of the workers all you want, but you can't expect them to improve if you don't fix the system and incentives that cause the problems.

cloverich 6y ago

the reason the analogy doesn’t hold up is there isn’t a system there — that’s a set of actually individual choices. When you see systematic behavior, you need to look for the system to fix it. The problem with blame is it doesn’t get you far enough, even if it feels good or right. Finding and fixing incentives is the only way to systematically enact change. Whether it feels good or not.

ggrrhh_ta 6y ago
is the threat of punishment for wrongdoing not enough?
- typomatic 6y ago
  Clearly not--when there is systemic rulebreaking, the point is that it's impossible to enforce the rules in a way that is "enough".
ggrrhh_ta 6y ago
btw, I think it is important to place the blame correctly and take whatever action is possible on the perpetrators to deter such behavior and at the same time patch systemic loopholes that are identified. They are not incompatible actions. If anything, they are complementary.

topkai22 6y ago

The government is not an individual- appropriate morality and responsibility at scale are different then as an individual. Additionally, if insurance / the government agrees to pay for a procedure that serves as a form of confirmation for the end user - after all, the department of health and human services approved the procedure! A better example would be if a Sr Director of a rental car company shifted sourcing of thier repair contractor. If the new repair contractor consistently did way more repairs then the rental company needed, should the director of fleet maintenance be held responsible? Absolutely.