6 ms·
Planning and predicting highly variable systems is hard. Long-range interventions are especially risky given the possibilities for unexpected consequences and a
by bruce511 3y ago
Planning and predicting highly variable systems is hard. Long-range interventions are especially risky given the possibilities for unexpected consequences and also the long lead times in fixing the problems.
Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.)
As the article points out, the concept of central planning is orthogonal to who is providing the service. With heath care there are a range of national strategies (from fully private to fully public), and the impact of central planning (or lack thereof) can be seen across the board.
So one should be careful of concluding that this is a party-political issue. It seems unrelated to left-right politics, and rather the result of central planning, predicting and modelling.
- whitemary 3y ago"Communist" Cuba has 64 physicians per 10K population, which is 2nd in the entire world for physicians per capita. https://en.m.wikipedia.org/wiki/List_of_countries_and_dependencies_by_number_of_physicians https://en.m.wikipedia.org/wiki/List_of_countries_and_depend... During the pandemic, they were sending droves of doctors to Europe. They offered to assist in NYC but Trump turned them away as our population dwindled. Famously, when a British cruise ship with ill passengers aboard was denied by ports in Florida, Cuba took them in and saved many lives.
- alehlopeh 3y agoWhat’s with the scare quotes around communist? Sure they have a lot of doctors. And how many of those doctors are allowed to do business as a private practice? Or how many would be allowed to change careers if they wanted to? How many are allowed to spend their income at fancy places, where the currency they get paid in isn’t even accepted? Hate to break it to you, but “your” worldview is incredibly, laughably, misinformed.
- the_mar 3y agoI’m not a fan of communism, but your worldview about it is also misinformed. People are allowed to change careers under communism: source I was born in USSR, my mother had many careers in the 70s and 80s. I’d give you the inability to work for a private practice, that is true, but I am not entirely convinced it’s all that beneficial to society. Lastly, Cuba can have some things better than the US, it doesn’t necessarily mean communism is a superior type of system. It just means that even a broken clock can show the right time
- whitemary 3y agoAccording to a Marxist definition of communism (classless society) neither Cuba or the Soviet Union are or were communist.
- NemoNobody 3y agoWell, you're right but it's think that despite the definition Marx coined, or the government he imagined, Communism has evolved and so has the definition. The countries that tried Communism did so differently but with many similarities and all still had/have social classes. A classless society only works theoretically - those that have tried to implement such societal changes have been unable to realize that goal practically. Practical application matters most. It may not be so much that modern Communists have failed to implement Marxist government but rather that Marx failed by focusing so solely on social class. Inequality is the problem - it eats away at a society and its people. True equality is impossible and honestly not even desirable. Absolute equality doesn't mesh well with individuality. I don't need to own the same things that everyone else does, live in the same size house or drive comparable cars - it's OK that people have nicer things than I do. It's not OK that everyone I know works hard their entire lives and others don't have too. It's not OK that I know several people that have died bc they were avoiding medical care they knew they needed due to the expense. It's not OK that everyone I talk to under 25 all seem to want to skip college and go work wherever - they are not lazy, they are certain that our future is uncertain. Why have goals that can't be reached? I'm fine with classes as long as all classes have the same MINIMUM quality of life. Society should never limit the individual but should rather empower them to live well, as such, the only limits on maximum wealth I would impose would come after several billions have been added to an account - it does the society that generated that wealth no good if it simply sits an account and gets bigger. Gates, Zuck, Mush, Bezos and other super rich are examples of our societal failure to regulate OUR economy well enough to prevent the greediest of us all from taking all of OUR collective wealth. This is what Marx missed. This is why his definition/ideology didn't work out - also why so many have failed. There will always be owners and workers, rich and poor, good and bad people - this is why government exists. How can a government eliminate the reason it exists? To be frank, it was kinda stupid to think that paying everyone the same, trying to treat everyone the same, taking away ownership and attempting to equalize access to possessions would transform society into a paradise. tl;dr: The definition of Communism has changed since Marx because everyone that tried Marx failed miserably and had to make due - today Communism is what they are doing now and isn't at all like Marx proposed.
- bruce511 3y agoAgain, it's best not to align planning to political methodologies. Cuba has success stories. That isn't a vote for communism. Equally, another "communist" state (China) is doing very well and while there is a lot of planning there, there is also a lot of free-market. Again, not a vote for communism. I use communist in quotes here because Chinese communism is different to communism as practiced in the USSR. Just like capitalism is different in the US compared to say Switzerland. There are (literally) hundreds of political systems, and we find it helpful to lump them together under broad names, but that can lead to a misunderstanding of the actual system. Incidentally some planning is necessary- but it remains hard. Cuba planned for, and got, a fantastic heath system built around primary health care. Cuban doctors are well respected, and are exported all over the world. Cuba also got a lot wrong, and saying they got something right is not an endorsement of all ideas Cuban.
- ch4s3 3y agoCuba actually has a terrible health system that lacks even basic medical supplies like aspirin and antibiotics[1]. The state department and in the past MSF have called their medical missions modern day slavery[2][3]. There are also a lot of questions about the quality of Cuban medical training[4]. [1]https://cuba.miami.edu/business-economy/a-close-look-at-cubas-health-care-system/ https://cuba.miami.edu/business-economy/a-close-look-at-cuba... [2]https://www.reuters.com/article/us-usa-cuba-trafficking/u-s-says-cuban-medical-missions-are-trafficking-doctors-idUSKBN1WC00X https://www.reuters.com/article/us-usa-cuba-trafficking/u-s-... [3] https://www.hrw.org/news/2020/07/23/cuba-repressive-rules-doctors-working-abroad https://www.hrw.org/news/2020/07/23/cuba-repressive-rules-do... [4] https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909-019-1661-4 https://bmcmededuc.biomedcentral.com/articles/10.1186/s12909...
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- Tanjreeve 3y agoThe first three articles are various flavours of FUD and vague assertions of coercion of the usual kind of "flood the field" BS everyone is used to from MSM. The fourth link you provided "asks questions" but then the actual conclusion is that their trainings fine and people are spouting FUD and they'll need some extra focus on country specific problems. """ Results South African students trained in Cuba have had beneficial experiences which orientate them towards primary health care and prevention. Their subsequent training in South Africa is intended to fill skill gaps related to TB, HIV and major trauma. However this training is ad hoc and variable in duration and demoralizing for some students. Cuban-trained students have stronger aspirations than those trained in South Africa to work in rural and underserved communities from which many of them are drawn. Conclusion Attempts to assimilate returning Cuban-trained students will require a reframing of the current negative narrative by focusing on positive aspects of their training, orientation towards primary care and public health, and their aspirations to work in rural and under-served urban areas. Cuban-trained doctors could be part of the solution to South Africa’s health workforce problems. """
- ch4s3 3y agoI'm not sure how they could have assisted with anything, they basically have no medical supplies[1][2][3][4]. And before you bring it up, no medical supplies aren't covered by the embargo, they get a special exemption since the 90s. [1] https://havanatimes.org/cuba/medicine-shortages-a-challenge-to-public-health-in-cuba/ https://havanatimes.org/cuba/medicine-shortages-a-challenge-... [2] https://www.reuters.com/world/americas/cuban-diaspora-sends-medicines-alleviate-dire-shortages-2021-08-12/ https://www.reuters.com/world/americas/cuban-diaspora-sends-... [3] https://www.sabcnews.com/sabcnews/south-african-medical-students-in-cuba-lament-lack-of-support-from-government/ https://www.sabcnews.com/sabcnews/south-african-medical-stud... [4] https://cuba.miami.edu/business-economy/a-close-look-at-cubas-health-care-system/ https://cuba.miami.edu/business-economy/a-close-look-at-cuba...
- codersfocus 3y agoThere's a US law that says any ship that docks with Cuba can't dock with the US. Considering that modern shipping relies on big ships making many port calls, this law restricts Cuba's access to stuff like medical supplies.
- ch4s3 3y agoYou can still sell food and medicine[1]. There’s a regular liner service and DHL takes packages to Cuba. [1] https://2001-2009.state.gov/p/wha/rls/fs/2001/fsjulydec/2612.htm https://2001-2009.state.gov/p/wha/rls/fs/2001/fsjulydec/2612...
- toast0 3y agoThere was a time where supplies was the issue, and I doubt Cuba could help there. But there was also a time when medical labor was the issue, and Cuban doctors could have helped with that.
- ch4s3 3y agoProbably not. They definitely wouldn’t have had training with modern medical equipment, which isn’t available in Cuba. Also we take a dim view here on slave labor which is the most accurate way to describe the Cuban medical mission.
- codersfocus 3y agoThe thing is, not all of those doctors work in Cuba. The government rents them to neighboring countries to make money.
- pessimizer 3y agoThis is definitely true, but enough work in Cuba to give them a higher life expectancy than the US.
- badpun 3y agoSome of those physicians (mostly young and female) take second jobs as prostitutes, because their baseline pay makes it hard to survive.
- gadflyinyoureye 3y agoWhat? I would like some evidence of that.
- badpun 3y agoHere's a (part of) PhD thesis covering this subject: https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1166&context=shss_dcar_etd https://nsuworks.nova.edu/cgi/viewcontent.cgi?article=1166&c... It speaks about how, since most people in Cuba have roughly equal (equally low) salaries, prostitution is present in all strata of society. Example citation from the link; a prostitute speaking: "We're all on a survival plan, no matter who you are, if you're a doctor, a philosopher, a teacher, we are all pretty much the same, we make the same money, 20 or 30 cuc a month is not enough at all."
- DSingularity 3y agoI feel like we are going too far. Central planning in presence of hostile adversaries unrestricted by any ethical systems failed. And by what measures has “free market” has proven itself as successful? You can come up with your measures of success and others will propose measures of shortcoming. Others will even dispute the claim the American-led west is anything different from a centrally planned set of cooperating economies.
- cscurmudgeon 3y agoWhat are those adversaries and why were they unrestricted ethically?
- bruce511 3y agoCentral planning, in this context, is not the same as political philosophy. So be careful not to conflate the two. Central planning does happen in free-market economies all the time, at various levels. An HOA for example is a hyper-local example of central planning. The larger the scale the stronger the lever, and hence the more variable the result. The "free market" brings all kinds of its own oroblems of course - I'm not arguing for the elimination of planning - but long-range planning at national scales, is hard.
- NemoNobody 3y agoHaha, I love "Central Planning" is viewed as a bad thing by most normal Americans - like the commies are the only ones doing it. It takes a huge amount of "Central Planning" for our economy to function - as its fundamentally based on the concept of delayed gratification. Those concepts are very very similar. Any American that has worked and budgeted towards any financial goal should be able to see that for what it is... essentially the same thing.
- cscurmudgeon 3y agoPlanning isn't the problem, planning to the point of forcing others is the problem. USSR stooped so low as to plan vacations of its workers: where they could go and with whom they could go. https://daily.jstor.org/workers-of-the-world-take-pto/ https://daily.jstor.org/workers-of-the-world-take-pto/ Not all central planning is the same. An American budgeting their finances is not the same as USSR deciding what the entire country should do during their vacations.
- scythe 3y ago>Central planning on resources has been especially rife with failed examples (the USSR being the all-in poster child.) This assertion is greatly exaggerated. It's certainly true that the centrally planned economy of the USSR didn't grow as quickly as peer countries with similar levels of economic development. The typical contrast is the much faster growth of Japan versus the Soviet Union in the late twentieth century. (Even the computer knows the story; my phone's predictive text got the countries right!) But the Soviet Union nonetheless grew. Its growth rate was similar to that of the United States, but starting from a lower level (missing out on catch-up growth). It was the contradiction between the government's insistence that the planned economy would outperform the West versus the reality of the situation that led to a death spiral of political dysfunction and "alternative facts". Even though the system was not efficient, it wasn't disastrous by itself, only suboptimal. It's a standard prediction of economic theory that lower risk tolerance comes at the cost of some expected return. But in the case of fields like education and medicine, we might have a lower risk tolerance and be willing to tolerate lower growth to achieve it. In this case, the government stopped subsidizing medical schools. That would seem like what the libertarians want, but the outcomes were not good. Blaming central planning per se doesn't seem like the answer.
- bruce511 3y agoClearly there are multiple factors in play, and it is simplistic of me to pin all the failings of the USSR on central planning. (Which is the essence if my root post, planning is hard and only one small part of the political environment.) Clearly geographical, climate, and population dynamics (Not to mention war damage) of the US , USSR and Japan post WW2 are enormously varied. >> the government stopped subsidizing medical schools That's part of it, yes. The other part and perhaps more damaging part, is the moratorium on creation of new schools, and the measures to actively reduce the ability of hospitals to offer residency positions. Given a finite money supply the feds have to pick winners and losers for receiving money. However introducing policy, beyond money, has more impact on outcomes. The libertarians would argue that the policies caused the shortage, not the lack of money. (As evidenced by the US citizens training outside the country.)
- lr1970 3y ago> But the Soviet Union nonetheless grew. Its growth rate was similar to that of the United States, but starting from a lower level (missing out on catch-up growth). ... Even though the system was not efficient, it wasn't disastrous by itself, only suboptimal. I am sorry but it is total BS. I grew up in late USSR and can attest that its economy was in free fall. Central planning was one big demotivator and major contributor to the economic disastor. There were no incentives whatsoever to do your job well. Social mobility, career growth depended on factors outside of your direct control. Productivity was a fraction of what it was in the West. Bottom line -- any attempt on economic central planning first has to solve the problem of motivating productivity of human free agents. Otherwise it will fail in a similar way as Soviet Union did.
- profsummergig 3y agoIt is troubling that people trained similarly (to the people who made the forecasting blunder in the article) and given similar powers, are involved in forecasting in other significant domains: climate, war, inflation, etc.