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> We are stumbling fools without systems and rules (organizations, institutions, laws, regulations, ...) to rely on. The wide masses yes - the 1% who is lookin

> We are stumbling fools without systems and rules (organizations, institutions, laws, regulations, ...) to rely on. The wide masses yes - the 1% who is looking to profit immensely from the upcoming chaos not. DOGE is not about trimming government costs, it is about allowing the large companies to rip off the masses without repercussions (e.g. the planned demise of CFPB or OSHA/DoL) and it is about preparing the transfer of what used to be government-provided services at cost or subsidised to privatised for profit enterprises where the 1% profit (e.g. the dismantling of public schools). The end game is obvious, neofeudalism: everything that the 99% do shall generate profit for the 1%. We shall own nothing and rent/pay for everything. It begins with five to six figures medical bills at birth and ends with our funeral costs.

chinathrow 2y ago
The rich are endangering their riches in this experiment. The pitch forks will have their field day eventually. 2014 https://www.politico.com/magazine/story/2014/06/the-pitchforks-are-coming-for-us-plutocrats-108014/ https://www.politico.com/magazine/story/2014/06/the-pitchfor...
- mschuster91 2y ago
  That's the insiduous thing we're seeing - when you have to work two jobs just to make rent on a dilapidated shack for a slumlord you don't have time to protest, and when your healthcare insurance depends on having a job (because there aren't charity-run hospitals around any more) you can't afford the risk getting fired for going on a strike, much less actual "direct action". On top of that, mass media controls the narratives way too hard - just look how fast Luigi Mangione got out of the news.
  - afavour 2y ago
    > just look how fast Luigi Mangione got out of the news. What news would there be? He was arrested and locked up, his court case hasn’t started. Should we have “Luigi still in jail” headlines?
    - mschuster91 2y ago
      I'd have expected a debate about healthcare cost and actual reforms resulting out of it because the momentum clearly was there, but hey, here we are... For a while, until he was caught, there was a debate beginning to form what drives someone to execute a healthcare executive on the street - but the day he got caught, the debate got suppressed and no one is talking about it anymore.
      - JumpCrisscross 2y ago
        > I'd have expected a debate about healthcare cost and actual reforms It was all show no thought. The big questions remain unanswered. Where are costs inflated between pharmaceuticals, providers, hospital administrators, insurance administrators and patients seeking unnecessary care? How do we reform insurance when most people hate our healthcare system while simultaneously liking their own coverage? Luigi didn't add anything substantive to the debate. Instead, his role was in facilitating venting. Someone still has to come up with an idea beyond "I hate this." > there was a debate beginning to form what drives someone to execute a healthcare executive on the street On Twitter, maybe. For most people, it was another Manhattan mental-health case murder. The chase and his good looks provided salacious intrigue, but only for so long as he was on the run.
        s1artibartfast 2y ago
        >The big questions remain unanswered. Where are costs inflated between pharmaceuticals, providers, hospital administrators, insurance administrators and patients seeking unnecessary care? Pharma costs are inflated by R&D costs and promotion. Insurance overhead is actually relatively lean, but base cost is primarily driven by cost of goods, and to a lesser extent admin. Provider costs are inflated by high legal and regulatory liability, shortage of qualified staff to offset liability, and high admin. At a the highest level, cost is driven by an inability to discover and set prices at market clearing rates. Manufacturer dont sell fixed price product into a market, but negotiate complex bulk deals with PBMs, pushing some prices up and others down. Similarly, hospitals/providers dont set prices at clearing rates, but negotiate 1:1 pricing, with some products above and below cost. Last, and I suspect most significantly, health plans cant meaningfully vary in provided care, only cost sharing. That is to say, a bronze plan must include the same medications and procedures at a gold plan, differing only in copay. This breaks the price feedback on COGs. (e.g. a generic only insurance plan is illegal, so name brands face reduced competition). If I were Medical Czar, I would look at banning preferential pricing/institutional rebates for goods and services. I would allow more heterogeneity in policies (e.g. generics only, no implants, limited oncology, ect). This would crush innovation, but also greatly reduce pricing as it moves from cutting edge, to 10 year old technology. Provider shortage is a tougher nut to crack, but I think it would require radically altering the residency program as it exists today and loosening requirements for other healthcare professionals.
  - scarab92 2y ago
    [flagged]
    - LightHugger 2y ago
      Your use of the word "innocent" there is doing a lot of heavy lifting. He did not have a day in court, and what he did was indirect. However, a lot of people consider the supposedly "innocent" guy that got killed a mass murderer. Whether or not you agree with that assessment, it seems like you don't understand a few links in the chain there or are otherwise playing dumb. It is very reasonable for people to not care about the death of someone who is widely considered a mass murderer whether or not our legal systems have caught up to this sentiment. In a perfect world that CEO would have spent his entire life rotting in jail, his ill gotten fortunes completely stripped and his name as infamous as other mass murderers. We live in an imperfect world where people like him get defended by weirdos online though. It's not good that he got assassinated. Assassinations like this are a symptom of a failing justice system doesn't deal with human waste like Brian Thompson on it's own. If society widely considers someone like him a mass murderer he should be behind bars. But there's a pretty huge inequality between the ruling class and the poors these days, so the justice system has stopped working for the everyman. It's a natural result of cascading inequality, it will keep happening at an increasing rate if our civilization doesn't start holding people accountable for their crimes.
      - scarab92 2y ago
        [flagged]
        digdugdirk 2y ago
        Touché. Would you disagree with a more factual "mass-suffering profiteer"?
        LightHugger 2y ago
        If one of your family members was killed because of Brian Thompson using an bot to auto deny valid medical claims, among hundreds of thousands of others, you'd consider him a mass murderer too. Do you have an argument about why you think what he did wasn't mass murder? Do you not like the specific term, do you think he should have been prosecuted but disagree with the wording, what's your actual position or are you just going to make vague irrelevant platitudes? (Left right politics isn't even relevant to this issue either)
  - BoxFour 2y ago
    > On top of that, mass media controls the narratives way too hard - just look how fast Luigi Mangione got out of the news. People say this a lot, but it seems just as likely to me that the media is simply reflecting what we care about. Coverage fades because, broadly speaking, people have moved on from the story. Even more "intellectual media" like the Atlantic has moved on from it. I get that it’s uncomfortable to acknowledge, but an equally plausible explanation is that the public is far more interested in Blake Lively’s lawsuit than in Mangione or the state of healthcare in the U.S. Yes, it’s a symbiotic relationship, but I think people are often too eager to blame a shadowy cabal rather than recognizing that it’s often just a reflection of what society actually values. Probably because, as stated, dismantling mass media seems like something that could possibly happen while changing the entirety of a nation is essentially impossible.
  - DennisP 2y ago
    Healthcare doesn't depend on a job, and I don't understand why this rhetoric continues. Except in certain red states that refused federal funds, anyone below a certain income gets Medicaid and anyone above it can get ACA insurance, complete with a subsidy based on your income. Preexisting conditions are irrelevant. Republicans might make big changes but this has been the situation since Obama.
    - harimau777 2y ago
      Everyone I know with ACA plans can't actually afford to go to the doctor because the copay is too high.
- bix6 2y ago
  Almost 10 years later and still no pitchforks?
  - scarab92 2y ago
    We're seeing a significant rise in left-wing conspiracy theories though, which is not a great sign for the future.
    - SauciestGNU 2y ago
      Conspiracy theories? Can you elaborate?
      - Jensson 2y ago
        There are a lot of conspiracy theories around Trump and Musk etc. Just remember that not all conspiracy theories are wrong, but there being so many popular ones from the left now is not a good sign regardless if they are right or wrong.
        tim333 2y ago
        There's probably a lot of conspiring going on with those guys, just a question of the details.
        Jensson 2y ago
        That is still a conspiracy theory, some conspiracy theories are right as I pointed out. So everything I said was right, the people who responded to me validated it, they think there are conspiracies! That means there are a lot of conspiracy theories, I explicitly noted that I didn't say they were right or wrong.
        lwhi 2y ago
        Trump and Musk are working according to their own fickle natures and whims. All anyone can do is guess and imagine, because of this. Everyone has to be a theory. Reason is extinct.
- JumpCrisscross 2y ago
  > rich are endangering their riches in this experiment The history of modern revolutions is that the rich are fine. Hell, even in the French Revolution, most of the aristocracy fled with their lives and moveable riches. In the intervening centuries, mobility of both people and wealth has substantially increased.
- 7speter 2y ago
  Pitchforks effectiveness comes into question when the rich has a sophisticated surveillance system backed by ai.
tremendoussss 2y ago
I think if you looked at the history of the global economy and geopolitics since 1970 or 1900 pre Federal Reserve, I think you could make an argument that the dystopia that you're worried about already exists.
- gcr 2y ago
  The point is that it’s worth fighting, not whether the end goal is attainable.
- insane_dreamer 2y ago
  Yes but there are still degrees of existence.

chinathrow 2y ago

The rich are endangering their riches in this experiment. The pitch forks will have their field day eventually. 2014 https://www.politico.com/magazine/story/2014/06/the-pitchforks-are-coming-for-us-plutocrats-108014/ https://www.politico.com/magazine/story/2014/06/the-pitchfor...

mschuster91 2y ago
That's the insiduous thing we're seeing - when you have to work two jobs just to make rent on a dilapidated shack for a slumlord you don't have time to protest, and when your healthcare insurance depends on having a job (because there aren't charity-run hospitals around any more) you can't afford the risk getting fired for going on a strike, much less actual "direct action". On top of that, mass media controls the narratives way too hard - just look how fast Luigi Mangione got out of the news.
- afavour 2y ago
  > just look how fast Luigi Mangione got out of the news. What news would there be? He was arrested and locked up, his court case hasn’t started. Should we have “Luigi still in jail” headlines?
  - mschuster91 2y ago
    I'd have expected a debate about healthcare cost and actual reforms resulting out of it because the momentum clearly was there, but hey, here we are... For a while, until he was caught, there was a debate beginning to form what drives someone to execute a healthcare executive on the street - but the day he got caught, the debate got suppressed and no one is talking about it anymore.
    - JumpCrisscross 2y ago
      > I'd have expected a debate about healthcare cost and actual reforms It was all show no thought. The big questions remain unanswered. Where are costs inflated between pharmaceuticals, providers, hospital administrators, insurance administrators and patients seeking unnecessary care? How do we reform insurance when most people hate our healthcare system while simultaneously liking their own coverage? Luigi didn't add anything substantive to the debate. Instead, his role was in facilitating venting. Someone still has to come up with an idea beyond "I hate this." > there was a debate beginning to form what drives someone to execute a healthcare executive on the street On Twitter, maybe. For most people, it was another Manhattan mental-health case murder. The chase and his good looks provided salacious intrigue, but only for so long as he was on the run.
      - s1artibartfast 2y ago
        >The big questions remain unanswered. Where are costs inflated between pharmaceuticals, providers, hospital administrators, insurance administrators and patients seeking unnecessary care? Pharma costs are inflated by R&D costs and promotion. Insurance overhead is actually relatively lean, but base cost is primarily driven by cost of goods, and to a lesser extent admin. Provider costs are inflated by high legal and regulatory liability, shortage of qualified staff to offset liability, and high admin. At a the highest level, cost is driven by an inability to discover and set prices at market clearing rates. Manufacturer dont sell fixed price product into a market, but negotiate complex bulk deals with PBMs, pushing some prices up and others down. Similarly, hospitals/providers dont set prices at clearing rates, but negotiate 1:1 pricing, with some products above and below cost. Last, and I suspect most significantly, health plans cant meaningfully vary in provided care, only cost sharing. That is to say, a bronze plan must include the same medications and procedures at a gold plan, differing only in copay. This breaks the price feedback on COGs. (e.g. a generic only insurance plan is illegal, so name brands face reduced competition). If I were Medical Czar, I would look at banning preferential pricing/institutional rebates for goods and services. I would allow more heterogeneity in policies (e.g. generics only, no implants, limited oncology, ect). This would crush innovation, but also greatly reduce pricing as it moves from cutting edge, to 10 year old technology. Provider shortage is a tougher nut to crack, but I think it would require radically altering the residency program as it exists today and loosening requirements for other healthcare professionals.
- scarab92 2y ago
  [flagged]
  - LightHugger 2y ago
    Your use of the word "innocent" there is doing a lot of heavy lifting. He did not have a day in court, and what he did was indirect. However, a lot of people consider the supposedly "innocent" guy that got killed a mass murderer. Whether or not you agree with that assessment, it seems like you don't understand a few links in the chain there or are otherwise playing dumb. It is very reasonable for people to not care about the death of someone who is widely considered a mass murderer whether or not our legal systems have caught up to this sentiment. In a perfect world that CEO would have spent his entire life rotting in jail, his ill gotten fortunes completely stripped and his name as infamous as other mass murderers. We live in an imperfect world where people like him get defended by weirdos online though. It's not good that he got assassinated. Assassinations like this are a symptom of a failing justice system doesn't deal with human waste like Brian Thompson on it's own. If society widely considers someone like him a mass murderer he should be behind bars. But there's a pretty huge inequality between the ruling class and the poors these days, so the justice system has stopped working for the everyman. It's a natural result of cascading inequality, it will keep happening at an increasing rate if our civilization doesn't start holding people accountable for their crimes.
    - scarab92 2y ago
      [flagged]
      - digdugdirk 2y ago
        Touché. Would you disagree with a more factual "mass-suffering profiteer"?
      - LightHugger 2y ago
        If one of your family members was killed because of Brian Thompson using an bot to auto deny valid medical claims, among hundreds of thousands of others, you'd consider him a mass murderer too. Do you have an argument about why you think what he did wasn't mass murder? Do you not like the specific term, do you think he should have been prosecuted but disagree with the wording, what's your actual position or are you just going to make vague irrelevant platitudes? (Left right politics isn't even relevant to this issue either)
- BoxFour 2y ago
  > On top of that, mass media controls the narratives way too hard - just look how fast Luigi Mangione got out of the news. People say this a lot, but it seems just as likely to me that the media is simply reflecting what we care about. Coverage fades because, broadly speaking, people have moved on from the story. Even more "intellectual media" like the Atlantic has moved on from it. I get that it’s uncomfortable to acknowledge, but an equally plausible explanation is that the public is far more interested in Blake Lively’s lawsuit than in Mangione or the state of healthcare in the U.S. Yes, it’s a symbiotic relationship, but I think people are often too eager to blame a shadowy cabal rather than recognizing that it’s often just a reflection of what society actually values. Probably because, as stated, dismantling mass media seems like something that could possibly happen while changing the entirety of a nation is essentially impossible.
- DennisP 2y ago
  Healthcare doesn't depend on a job, and I don't understand why this rhetoric continues. Except in certain red states that refused federal funds, anyone below a certain income gets Medicaid and anyone above it can get ACA insurance, complete with a subsidy based on your income. Preexisting conditions are irrelevant. Republicans might make big changes but this has been the situation since Obama.
  - harimau777 2y ago
    Everyone I know with ACA plans can't actually afford to go to the doctor because the copay is too high.
bix6 2y ago
Almost 10 years later and still no pitchforks?
- scarab92 2y ago
  We're seeing a significant rise in left-wing conspiracy theories though, which is not a great sign for the future.
  - SauciestGNU 2y ago
    Conspiracy theories? Can you elaborate?
    - Jensson 2y ago
      There are a lot of conspiracy theories around Trump and Musk etc. Just remember that not all conspiracy theories are wrong, but there being so many popular ones from the left now is not a good sign regardless if they are right or wrong.
      - tim333 2y ago
        There's probably a lot of conspiring going on with those guys, just a question of the details.
        Jensson 2y ago
        That is still a conspiracy theory, some conspiracy theories are right as I pointed out. So everything I said was right, the people who responded to me validated it, they think there are conspiracies! That means there are a lot of conspiracy theories, I explicitly noted that I didn't say they were right or wrong.
      - lwhi 2y ago
        Trump and Musk are working according to their own fickle natures and whims. All anyone can do is guess and imagine, because of this. Everyone has to be a theory. Reason is extinct.
JumpCrisscross 2y ago
> rich are endangering their riches in this experiment The history of modern revolutions is that the rich are fine. Hell, even in the French Revolution, most of the aristocracy fled with their lives and moveable riches. In the intervening centuries, mobility of both people and wealth has substantially increased.
7speter 2y ago
Pitchforks effectiveness comes into question when the rich has a sophisticated surveillance system backed by ai.

tremendoussss 2y ago

I think if you looked at the history of the global economy and geopolitics since 1970 or 1900 pre Federal Reserve, I think you could make an argument that the dystopia that you're worried about already exists.

gcr 2y ago
The point is that it’s worth fighting, not whether the end goal is attainable.
insane_dreamer 2y ago
Yes but there are still degrees of existence.