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Institutional corruption will not be solved by losing trust in the institutions. When the institution dies because nobody trusts it you don't all of a sudden ge

Institutional corruption will not be solved by losing trust in the institutions. When the institution dies because nobody trusts it you don't all of a sudden get good health care. So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity.

aj7 4y ago
Well put.
jjcon 4y ago
So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic. Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ - thats all just some billionaires faults? Sorry, I don’t buy it. The medical and pharmaceutical industries have been rotting for decades in the US and protecting them, “because it would be better for our healthcare system” is exactly the mentality that gets you into this mess to begin with. State the problem, state it clearly. Don’t shift blame around to invisible boogeymen.
- nemothekid 4y ago
  >So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic The FDA has never claimed obesity is purely genetic and it's own guidelines state multiple factors for obesity and stringent guidelines for the approval of drugs that target specific genetic disorders. >Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ This doesn't seem true at all, and seems like an extension of the "woke" boogeyman we see in undergrad. The problem with this kind of thinking is it's hard to assign anysort of motivation for these actions without sounding cartoonish. The FDA wants to say obesity is a purely genetic for what reason? Who is enriched when the FDA says this? Does the FDA get some kickback every time there's a new obese person? >State the problem, state it clearly. Don’t shift blame around to invisible boogeymen. The for-profit medical system has created a two-tier treatment system that is incentivized to protect profits over providing adequate care. This includes both providing poor treatment to those who cannot pay as well as providing ineffective treatment to wealthier americans in order to sell more expensive, patented drugs. Any political action to change this system is effectively stonewalled due to "invisible boogeymen" who all happen to have the same political interests in keeping current profitable system and are able to easily buy politicians to prevent any radical change from going through. The incentive is clear - to protect profit margins.
lliamander 4y ago
> Institutional corruption will not be solved by losing trust in the institutions. When the institution dies because nobody trusts it you don't all of a sudden get good health care. That's a fair point. "Burn it down" is not a good solution. The system, even while corrupted, still results in vastly improved outcomes relative to what people could expect 100-150 years ago. > So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity. I'm not going to say greed has nothing to do with it, but this is just such a reductive take that I don't think really even begins to address the multitude of perverse incentives going on with our healthcare system.
- hayst4ck 4y ago
  I was not being reductive. Money gets to vote on candidates before people do. Before any general election there is a primary, and to win the primary you do fundraising. People with money give politicians money with the implicit understanding that making anti-donor decisions will result in withdrawal of future money or (thanks to citizens united) unlimited contributions to their opponent. Money literally votes on political candidates before any person does. That is why we have a "democracy" more responsive to money than to the will of the average voter. Even if you look at it as a black box, Princeton did a study and asked if the legislation our politicians pass correlate most with the average citizen, interest groups, or the desires of rich people, the correlation was highest with rich people: https://scholar.princeton.edu/sites/default/files/mgilens/files/gilens_and_page_2014_-testing_theories_of_american_politics.doc.pdf https://scholar.princeton.edu/sites/default/files/mgilens/fi... Multivariate analysis indicates that economic elites and organized groups representing business interests have substantial independent impacts on U.S. government policy, while average citizens and mass-based interest groups have little or no independent influence. Here you can watch Harvard Law professor Lawrence Lessig talk about this issue: https://www.youtube.com/watch?v=PJy8vTu66tE https://www.youtube.com/watch?v=PJy8vTu66tE As wealth concentrates, it is able to purchase and corrupt further institutions. Bezos bought WaPo, Musk bought Twitter, I'm sure there are more examples. Do you think that is a form of power that is able to manipulate public opinion or government policy? Do you think ownership of a media outlet could help a person concentrate their wealth or fight being taxed? Even from a mathematical approach. If Billionaires are able to earn 5% year over year interest at minimal risk, while large swathes of people will never make enough to have a savings, what do you think the long term consequences of that will be? If inequality is increasing and never decreasing, what do you think the long term effects will be? What types of things cause inequality to decrease, are we doing those things? How much wealth has to concentrate before you are comfortable labeling it oligarchy? Here is Yale history professor and expert in European history Timothy Snyder talking about oligarchy, the rule of the wealthy few. "What is oligarchy?": https://www.youtube.com/watch?v=biZVrh821RA https://www.youtube.com/watch?v=biZVrh821RA In this video he explores what oligarchy is and what effect oligarchy (the state of extreme wealth inequality -- too many billionaires) has on social programs like healthcare, namely that there won't be social programs/investment in institutions.
rvcdbn 4y ago
If an institution is a net negative and it dies then we are better off immediately. Even if it’s not a net-negative and it dies we might be better off in the long term because something better replaces it.
tick_tock_tick 4y ago
> So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity. Don't you mean not enough billionaires? It seems like they are the only ones that can circumvent the political roadblocks to deliver things like cost plus drugs. There aren't that many of them nor are they involved in a lot of the industries plagued with these issues. Most issue are from regulator capture from honestly not even that rich of people.
nradov 4y ago
Help us out here. Let's say hypothetically we confiscate all wealth above $1B. How exactly would that improve average healthcare outcomes? Please take us through the causal chain step by step.
user3939382 4y ago
> Institutional corruption will not be solved I would just stop there. For over 10,000 years we've had two systems: one where a small group of very rich people control society and admit it, and one where they don't. The former was arguably better, at least it was honest.

aj7 4y ago

Well put.

jjcon 4y ago

So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic. Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ - thats all just some billionaires faults? Sorry, I don’t buy it. The medical and pharmaceutical industries have been rotting for decades in the US and protecting them, “because it would be better for our healthcare system” is exactly the mentality that gets you into this mess to begin with. State the problem, state it clearly. Don’t shift blame around to invisible boogeymen.

nemothekid 4y ago
>So when the US FDA is shilling for obesity drugs, says that being obese isn’t a lifestyle problem but is purely genetic The FDA has never claimed obesity is purely genetic and it's own guidelines state multiple factors for obesity and stringent guidelines for the approval of drugs that target specific genetic disorders. >Medical schools are lowering/removing certain standards for admission under the guise of ‘equity’ This doesn't seem true at all, and seems like an extension of the "woke" boogeyman we see in undergrad. The problem with this kind of thinking is it's hard to assign anysort of motivation for these actions without sounding cartoonish. The FDA wants to say obesity is a purely genetic for what reason? Who is enriched when the FDA says this? Does the FDA get some kickback every time there's a new obese person? >State the problem, state it clearly. Don’t shift blame around to invisible boogeymen. The for-profit medical system has created a two-tier treatment system that is incentivized to protect profits over providing adequate care. This includes both providing poor treatment to those who cannot pay as well as providing ineffective treatment to wealthier americans in order to sell more expensive, patented drugs. Any political action to change this system is effectively stonewalled due to "invisible boogeymen" who all happen to have the same political interests in keeping current profitable system and are able to easily buy politicians to prevent any radical change from going through. The incentive is clear - to protect profit margins.

lliamander 4y ago

> Institutional corruption will not be solved by losing trust in the institutions. When the institution dies because nobody trusts it you don't all of a sudden get good health care. That's a fair point. "Burn it down" is not a good solution. The system, even while corrupted, still results in vastly improved outcomes relative to what people could expect 100-150 years ago. > So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity. I'm not going to say greed has nothing to do with it, but this is just such a reductive take that I don't think really even begins to address the multitude of perverse incentives going on with our healthcare system.

hayst4ck 4y ago
I was not being reductive. Money gets to vote on candidates before people do. Before any general election there is a primary, and to win the primary you do fundraising. People with money give politicians money with the implicit understanding that making anti-donor decisions will result in withdrawal of future money or (thanks to citizens united) unlimited contributions to their opponent. Money literally votes on political candidates before any person does. That is why we have a "democracy" more responsive to money than to the will of the average voter. Even if you look at it as a black box, Princeton did a study and asked if the legislation our politicians pass correlate most with the average citizen, interest groups, or the desires of rich people, the correlation was highest with rich people: https://scholar.princeton.edu/sites/default/files/mgilens/files/gilens_and_page_2014_-testing_theories_of_american_politics.doc.pdf https://scholar.princeton.edu/sites/default/files/mgilens/fi... Multivariate analysis indicates that economic elites and organized groups representing business interests have substantial independent impacts on U.S. government policy, while average citizens and mass-based interest groups have little or no independent influence. Here you can watch Harvard Law professor Lawrence Lessig talk about this issue: https://www.youtube.com/watch?v=PJy8vTu66tE https://www.youtube.com/watch?v=PJy8vTu66tE As wealth concentrates, it is able to purchase and corrupt further institutions. Bezos bought WaPo, Musk bought Twitter, I'm sure there are more examples. Do you think that is a form of power that is able to manipulate public opinion or government policy? Do you think ownership of a media outlet could help a person concentrate their wealth or fight being taxed? Even from a mathematical approach. If Billionaires are able to earn 5% year over year interest at minimal risk, while large swathes of people will never make enough to have a savings, what do you think the long term consequences of that will be? If inequality is increasing and never decreasing, what do you think the long term effects will be? What types of things cause inequality to decrease, are we doing those things? How much wealth has to concentrate before you are comfortable labeling it oligarchy? Here is Yale history professor and expert in European history Timothy Snyder talking about oligarchy, the rule of the wealthy few. "What is oligarchy?": https://www.youtube.com/watch?v=biZVrh821RA https://www.youtube.com/watch?v=biZVrh821RA In this video he explores what oligarchy is and what effect oligarchy (the state of extreme wealth inequality -- too many billionaires) has on social programs like healthcare, namely that there won't be social programs/investment in institutions.

rvcdbn 4y ago

If an institution is a net negative and it dies then we are better off immediately. Even if it’s not a net-negative and it dies we might be better off in the long term because something better replaces it.

tick_tock_tick 4y ago

> So if you believe that our medical institutions are corrupted, anger at the institution itself is misdirected. The corruptive force is billionaires and the measurement for the level of corruption is wealth disparity. Don't you mean not enough billionaires? It seems like they are the only ones that can circumvent the political roadblocks to deliver things like cost plus drugs. There aren't that many of them nor are they involved in a lot of the industries plagued with these issues. Most issue are from regulator capture from honestly not even that rich of people.

nradov 4y ago

Help us out here. Let's say hypothetically we confiscate all wealth above $1B. How exactly would that improve average healthcare outcomes? Please take us through the causal chain step by step.

user3939382 4y ago

> Institutional corruption will not be solved I would just stop there. For over 10,000 years we've had two systems: one where a small group of very rich people control society and admit it, and one where they don't. The former was arguably better, at least it was honest.