5 ms·

Based on our experience, this is at the very least, not wrong. My stepmother required, hospice, and and the worker was definitely helpful, but also very clinic

Based on our experience, this is at the very least, not wrong. My stepmother required, hospice, and and the worker was definitely helpful, but also very clinical, and somewhat hurried. There was not very much explanation or opportunity to ask questions. Fortunately, for us a relative, who was a nurse, from a separate side of our family, came for a few days, and was profound source of comfort for my stepmother and all of us. I haven’t thought about this for a little while, but what I’m struck by is that this is a problem that may never “scale” successfully from either a government or entrepreneurial standpoint. What a family needs are a couple of humans that have been through this before to just sit with them and answer questions and reassure them that everything‘s OK. We’ll never be able to make that cost effective. In the best cases, this was a role historically filled by others in the community, though I imagine throughout a lot of history, it is just been a very difficult experience.

AlbertCory 4y ago
"Scale" would mean to place ads for a low-paid, depressing job, and then hire people who last, on average, four months; use lots of software; get slick marketers; and raise venture capital to address this large, untapped market. So no, I don't want a scalable solution to hospice care, thanks.
- couchand 4y ago
  Scale, here, could also mean decommodifying our time so that we feel more free to spend it with those we love.
  - badpun 4y ago
    How many people genuinely care about their parents' wellbeing and how many are just happy to ship them to a facility, provided it mets a minimal standard of care? It's an earnest question - I wonder what the proportions are.
    - deleted 4y ago
      [deleted]
    - matthewdgreen 4y ago
      My wife and I have two sets of parents facing these issues and want to help take care of them. The main blocker is that neither one will move to our city, and we've tried repeatedly. The thing people often miss about caring for older people is that they have preferences too: preferences that often get stronger with age.
  - AlbertCory 4y ago
    I don't know what that means, exactly, but I'm fairly sure that when they're pitching it to investors, it means the business model.
pj_mukh 4y ago
Controversial Opinion: Elder Care/Hospice + Childcare + A lot teaching is "infrastructure" and should probably be done on Debt spending. It should be marginally cost optimized in that it should not give in to consultant + contractor + admin bloat driven cost diseases, but worrying about cost "effectiveness" here seems to be defeating the point, as you laid out in your example.
- yamtaddle 4y ago
  Given we seem to be all-in on "our economic system rewards you greatly for being highly mobile, and punishes you—potentially greatly—for sticking around somewhere with family roots" I'm inclined to agree. We should either modify our economy so that's not (at least, to such a high degree) the case, or treat elder care and child care as the costs—to society, not individuals—of doing business that way.
  - kiba 4y ago
    I don't think that's necessarily true. Freedom of movement is restricted by housing supply.
- pirate787 4y ago
  Much of the federal spending on these categories is deficit spending.
- nivenkos 4y ago
  Ongoing costs should never be met with debt spending. Just raise taxes to compensate - wealth tax, land value tax, capital gains tax, property tax, sin taxes, etc. - all of which help to push money into useful parts of the economy too.
- PuppyTailWags 4y ago
  There's a sociology (yeah yeah I know the criticisms) podcast recently that pointed out this was actually a decision made through following economic frameworks of efficiency. Before this framework was in place, social good programs were actually run by social workers and similar people who had personal careers in the thing they were running. A lot of our golden age of government regulation and robust social programs and the like were when agencies were run by actual folks in that career, social programs run by social workers, environmental programs run by scientists... An example they used was the EPA during the ozone crisis. The EPA tried to set something like "we should set maximum allowable ozone to a level where 95% of americans wouldn't be affected" vs the economists at the time arguing they should look at the marginal cost of saving american lives and go for the efficient tradeoff between lives and economic production of more ozone.

AlbertCory 4y ago

"Scale" would mean to place ads for a low-paid, depressing job, and then hire people who last, on average, four months; use lots of software; get slick marketers; and raise venture capital to address this large, untapped market. So no, I don't want a scalable solution to hospice care, thanks.

couchand 4y ago
Scale, here, could also mean decommodifying our time so that we feel more free to spend it with those we love.
- badpun 4y ago
  How many people genuinely care about their parents' wellbeing and how many are just happy to ship them to a facility, provided it mets a minimal standard of care? It's an earnest question - I wonder what the proportions are.
  - deleted 4y ago
    [deleted]
  - matthewdgreen 4y ago
    My wife and I have two sets of parents facing these issues and want to help take care of them. The main blocker is that neither one will move to our city, and we've tried repeatedly. The thing people often miss about caring for older people is that they have preferences too: preferences that often get stronger with age.
- AlbertCory 4y ago
  I don't know what that means, exactly, but I'm fairly sure that when they're pitching it to investors, it means the business model.

pj_mukh 4y ago

Controversial Opinion: Elder Care/Hospice + Childcare + A lot teaching is "infrastructure" and should probably be done on Debt spending. It should be marginally cost optimized in that it should not give in to consultant + contractor + admin bloat driven cost diseases, but worrying about cost "effectiveness" here seems to be defeating the point, as you laid out in your example.

yamtaddle 4y ago
Given we seem to be all-in on "our economic system rewards you greatly for being highly mobile, and punishes you—potentially greatly—for sticking around somewhere with family roots" I'm inclined to agree. We should either modify our economy so that's not (at least, to such a high degree) the case, or treat elder care and child care as the costs—to society, not individuals—of doing business that way.
- kiba 4y ago
  I don't think that's necessarily true. Freedom of movement is restricted by housing supply.
pirate787 4y ago
Much of the federal spending on these categories is deficit spending.
nivenkos 4y ago
Ongoing costs should never be met with debt spending. Just raise taxes to compensate - wealth tax, land value tax, capital gains tax, property tax, sin taxes, etc. - all of which help to push money into useful parts of the economy too.
PuppyTailWags 4y ago
There's a sociology (yeah yeah I know the criticisms) podcast recently that pointed out this was actually a decision made through following economic frameworks of efficiency. Before this framework was in place, social good programs were actually run by social workers and similar people who had personal careers in the thing they were running. A lot of our golden age of government regulation and robust social programs and the like were when agencies were run by actual folks in that career, social programs run by social workers, environmental programs run by scientists... An example they used was the EPA during the ozone crisis. The EPA tried to set something like "we should set maximum allowable ozone to a level where 95% of americans wouldn't be affected" vs the economists at the time arguing they should look at the marginal cost of saving american lives and go for the efficient tradeoff between lives and economic production of more ozone.