4 ms·

The purpose of a system is what it does. It's functionally isomorphic to a black box where I make a deposit, every time it denies someone medical treatment I g

The purpose of a system is what it does. It's functionally isomorphic to a black box where I make a deposit, every time it denies someone medical treatment I get back monetary reward and I can withdraw my deposit at any time. If we ask ourselves, "Should this black box exist?" I cannot reasonably expect people to say, "Yes." Yet, here we are.

kube-system 2y ago
> The purpose of a system is what it does. As if systems always do as intended? If that were the case, my code would never have downtime! The interactions between intent and results in any sufficiently large system is inherently complex.
- kelseyfrog 2y ago
  That's the opposite of what the phrase means. https://en.m.wikipedia.org/wiki/The_purpose_of_a_system_is_what_it_does https://en.m.wikipedia.org/wiki/The_purpose_of_a_system_is_w... If a system constantly fails to do what it was intended to do, then we should consider that what it does in reality is its true purpose. Basically this is functional structuralism.
  - kube-system 2y ago
    I understand what it means. I think it is a silly maxim, because it is unnecessarily reductive. Employer sponsored healthcare insurance wasn't ever intended to be a good system for providing healthcare to people, it was popularized as a workaround for employers to raise wages during the Stabilization Act of 1942. Everything that has changed since then has been incremental changes for differing reasons. The idea that a huge system like this even has a single "intent" is ridiculous. It is made up of thousands of different actors, each in different situations with different intents and interests.
    - kelseyfrog 2y ago
      Purpose != intent. Besides, no one is saying there is a single intent so refuting that point doesn't exactly a counter.
      - kube-system 2y ago
        Colloquially, no, they are synonymous. https://www.merriam-webster.com/dictionary/purpose https://www.merriam-webster.com/dictionary/purpose https://www.merriam-webster.com/dictionary/intent https://www.merriam-webster.com/dictionary/intent
        kelseyfrog 2y ago
        But we aren't talking colloquially, we're talking about within the maxim. I'm trying to give you the benefit of the doubt, but it feels like you're doubling down in order to prove a point.
        kube-system 2y ago
        The maxim, applied here, is an obtuse oversimplification of the problems with the health insurance system, and the barriers to changing it. Yes, if we could wave a wand and delete the fact that it ever happened, that would be ideal. But the problem is more difficult to solve now, because we have the problem of the health insurance system, and the problem of drastic systematic and economic change.
        kelseyfrog 2y ago
        In my experience, choices to label opposition as either reductive or overly complex are largely rhetorical. They don't pass the validity test. Perhaps we should ask borrow the "magic wand" that seems to exist for every other country. Maybe they can lend us theirs since that's apparently how realistic a system that does not bankrupt people is. Sadly, it doesn't seem equally possible or realistic to build a system where CEO's aren't revenge murdered.
enoch_r 2y ago
> It's functionally isomorphic to a black box where I make a deposit, every time it denies someone medical treatment I get back monetary reward and I can withdraw my deposit at any time. If we ask ourselves, "Should this black box exist?" I cannot reasonably expect people to say, "Yes." Yet, here we are. I am honestly extremely baffled about what your mental model here is. When UHC doesn't deny a claim, who is paying for that treatment? You can't just look at one side of the ledger when deciding whether the system is doing good or bad! They deny some claims and they pay for others! You're leaving out the whole second half!
- kelseyfrog 2y ago
  I omitted it because it doesn't change the calculus. If the child were brought up into the sunlight out of that vile place, if it were cleaned and fed and comforted, that would be a good thing, indeed; but if it were done, in that day and hour all the prosperity and beauty and delight of Omelas would wither and be destroyed.
  - deleted 2y ago
    [deleted]
  - kube-system 2y ago
    According to who? It changes the calculus for me. I pay my health insurance because it covers the services I need. I could absolutely opt out if I wanted to, but I don't.
    - kelseyfrog 2y ago
      Except we're not talking about the choice of being a customer or not. We're talking about the design choices of the system.
      - kube-system 2y ago
        The system wasn't designed. There were no design choices. The entire thing is a legacy result of expectations and costs that all started snowballing from the moment FDR decided wage caps were a good way to stop inflation. We're not in the situation we're in because anyone thought it was a good idea. We got here incrementally over ~80 years.
avalys 2y ago
Without the black box, no one gets any medical treatment at all!
- kelseyfrog 2y ago
  Except every other country is able to function without the black box :/
  - kube-system 2y ago
    Most countries do have private health insurance, even if they also have more robust public options.
    - kelseyfrog 2y ago
      But we're talking about our inability to avoid the box. The existence of public options in other countries has no bearing on that.
      - deleted 2y ago
        [deleted]
      - seanhunter 2y ago
        Your argument would be stronger if your black box mental model wasn’t so obviously exaggerated. I live in the UK where we have universal healthcare that is free at the point of need. We also have private healthcare. In most countries in Europe both private and public healthcare exist side by side. Per capita spending on healthcare (across the private and public provision) in the UK is a tiny fraction of what it is in the US and outcomes in terms of quality adjusted life years and measured in individual life expectancy and patient outcomes for given conditions were significantly better than the US last time I checked (which is admittedly a while ago). The US healthcare system is definitely expensive and delivers a poor outcome, but you’re not convincing when you try to make a pastiche of the system that paints it as purely bad and say that health insurance simply should not exist for pure moral reasons.
tetnis 2y ago
off topic but what is the difference between functionally isomorphic and isomorphic?
- seanhunter 2y ago
  Isomorphic in normal use means corresponding in form[1], so functionally isomorphic means “functions the same as” whereas there are other types of isomorphisms, so for example minerals form groups which are considered isomorphic because their crystal structure is somewhat different but equivalent. They’re not functionally equivalent they are structurally similar. [1] In mathematics the meaning is somewhat stronger. In maths, two things are isomorphic if they cannot be distinguished in terms of structure in a particular context.
  - tetnis 2y ago
    ok, i default to the math meaning and try to interpret the english meaning.
seanhunter 2y ago
I never thought I would be defending health insurance providers yet here we are. Do you honestly, after reflection, think this comment is fair? They don’t only deny healthcare to people - if that was true no-one would pay them money because having healthcare would be no different to not having healthcare. Therefore they are not functionally isomorphic to a black box that collects money when it denies medical treatment. If you want to make a mental model and then ask questions of the model you should have the confidence to make your model robust enough to approximate the “other side” of whatever argument exists on the topic.

kube-system 2y ago

> The purpose of a system is what it does. As if systems always do as intended? If that were the case, my code would never have downtime! The interactions between intent and results in any sufficiently large system is inherently complex.

kelseyfrog 2y ago
That's the opposite of what the phrase means. https://en.m.wikipedia.org/wiki/The_purpose_of_a_system_is_what_it_does https://en.m.wikipedia.org/wiki/The_purpose_of_a_system_is_w... If a system constantly fails to do what it was intended to do, then we should consider that what it does in reality is its true purpose. Basically this is functional structuralism.
- kube-system 2y ago
  I understand what it means. I think it is a silly maxim, because it is unnecessarily reductive. Employer sponsored healthcare insurance wasn't ever intended to be a good system for providing healthcare to people, it was popularized as a workaround for employers to raise wages during the Stabilization Act of 1942. Everything that has changed since then has been incremental changes for differing reasons. The idea that a huge system like this even has a single "intent" is ridiculous. It is made up of thousands of different actors, each in different situations with different intents and interests.
  - kelseyfrog 2y ago
    Purpose != intent. Besides, no one is saying there is a single intent so refuting that point doesn't exactly a counter.
    - kube-system 2y ago
      Colloquially, no, they are synonymous. https://www.merriam-webster.com/dictionary/purpose https://www.merriam-webster.com/dictionary/purpose https://www.merriam-webster.com/dictionary/intent https://www.merriam-webster.com/dictionary/intent
      - kelseyfrog 2y ago
        But we aren't talking colloquially, we're talking about within the maxim. I'm trying to give you the benefit of the doubt, but it feels like you're doubling down in order to prove a point.
        kube-system 2y ago
        The maxim, applied here, is an obtuse oversimplification of the problems with the health insurance system, and the barriers to changing it. Yes, if we could wave a wand and delete the fact that it ever happened, that would be ideal. But the problem is more difficult to solve now, because we have the problem of the health insurance system, and the problem of drastic systematic and economic change.
        kelseyfrog 2y ago
        In my experience, choices to label opposition as either reductive or overly complex are largely rhetorical. They don't pass the validity test. Perhaps we should ask borrow the "magic wand" that seems to exist for every other country. Maybe they can lend us theirs since that's apparently how realistic a system that does not bankrupt people is. Sadly, it doesn't seem equally possible or realistic to build a system where CEO's aren't revenge murdered.

enoch_r 2y ago

> It's functionally isomorphic to a black box where I make a deposit, every time it denies someone medical treatment I get back monetary reward and I can withdraw my deposit at any time. If we ask ourselves, "Should this black box exist?" I cannot reasonably expect people to say, "Yes." Yet, here we are. I am honestly extremely baffled about what your mental model here is. When UHC doesn't deny a claim, who is paying for that treatment? You can't just look at one side of the ledger when deciding whether the system is doing good or bad! They deny some claims and they pay for others! You're leaving out the whole second half!

kelseyfrog 2y ago
I omitted it because it doesn't change the calculus. If the child were brought up into the sunlight out of that vile place, if it were cleaned and fed and comforted, that would be a good thing, indeed; but if it were done, in that day and hour all the prosperity and beauty and delight of Omelas would wither and be destroyed.
- deleted 2y ago
  [deleted]
- kube-system 2y ago
  According to who? It changes the calculus for me. I pay my health insurance because it covers the services I need. I could absolutely opt out if I wanted to, but I don't.
  - kelseyfrog 2y ago
    Except we're not talking about the choice of being a customer or not. We're talking about the design choices of the system.
    - kube-system 2y ago
      The system wasn't designed. There were no design choices. The entire thing is a legacy result of expectations and costs that all started snowballing from the moment FDR decided wage caps were a good way to stop inflation. We're not in the situation we're in because anyone thought it was a good idea. We got here incrementally over ~80 years.

avalys 2y ago

Without the black box, no one gets any medical treatment at all!

kelseyfrog 2y ago
Except every other country is able to function without the black box :/
- kube-system 2y ago
  Most countries do have private health insurance, even if they also have more robust public options.
  - kelseyfrog 2y ago
    But we're talking about our inability to avoid the box. The existence of public options in other countries has no bearing on that.
    - deleted 2y ago
      [deleted]
    - seanhunter 2y ago
      Your argument would be stronger if your black box mental model wasn’t so obviously exaggerated. I live in the UK where we have universal healthcare that is free at the point of need. We also have private healthcare. In most countries in Europe both private and public healthcare exist side by side. Per capita spending on healthcare (across the private and public provision) in the UK is a tiny fraction of what it is in the US and outcomes in terms of quality adjusted life years and measured in individual life expectancy and patient outcomes for given conditions were significantly better than the US last time I checked (which is admittedly a while ago). The US healthcare system is definitely expensive and delivers a poor outcome, but you’re not convincing when you try to make a pastiche of the system that paints it as purely bad and say that health insurance simply should not exist for pure moral reasons.

tetnis 2y ago

off topic but what is the difference between functionally isomorphic and isomorphic?

seanhunter 2y ago
Isomorphic in normal use means corresponding in form[1], so functionally isomorphic means “functions the same as” whereas there are other types of isomorphisms, so for example minerals form groups which are considered isomorphic because their crystal structure is somewhat different but equivalent. They’re not functionally equivalent they are structurally similar. [1] In mathematics the meaning is somewhat stronger. In maths, two things are isomorphic if they cannot be distinguished in terms of structure in a particular context.
- tetnis 2y ago
  ok, i default to the math meaning and try to interpret the english meaning.

seanhunter 2y ago

I never thought I would be defending health insurance providers yet here we are. Do you honestly, after reflection, think this comment is fair? They don’t only deny healthcare to people - if that was true no-one would pay them money because having healthcare would be no different to not having healthcare. Therefore they are not functionally isomorphic to a black box that collects money when it denies medical treatment. If you want to make a mental model and then ask questions of the model you should have the confidence to make your model robust enough to approximate the “other side” of whatever argument exists on the topic.