6 ms·

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/20

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.
        JumpCrisscross 2y ago
        If you had to pick one policy that maximises impact and messagability, what would it be?
        s1artibartfast 2y ago
        I dont know that they work well in isolation, as there are multiple market failures at play. If I had to pick one, I would say heterogeneity of insurance plans as most fundamental. Consumers must have some exposure to cost savings or liability for downward price pressure exerted and inferior substitutes to be selected. People will never pick a $20 treatment over a $20,000 unless they have skin in the game, even if it is 99% as effective. I think this has to be instituted at a insurance policy level for a number of reasons. Charges are stochastic and in the future, while policy premiums are predictable and immediate, allowing consumers to see cost or savings across the entire policy and pre-commit. Measurability is tough on this because it amounts to allowing inferior treatment, and I dont think this could be papered over, even if it brings down the price of all care and allows more treatment in aggregate. Uniform pricing is much better on the messaging. It is adjacent to collective bargaining, just mediated by a market instead of a technocrat. It can be sold to the left as an attack shadowy rentseekers. It can be sold on the right as a free market reform. On the pragmatic front, it can It has a transparent pricing angle, where you could see prices, which current transparency legislation seems to fail. I also think there is a lot of negative will pent up about negotiated pricing and the idea of companies paying drastically lower prices than an individual because they can throw their weight around when bargaining.
    - dragonwriter 2y ago
      > I'd have expected a debate about healthcare cost and actual reforms resulting out of it because the momentum clearly was there No, it wasn't; if the momentum was there, the debate would have been self-sustaining and not dependent on new news events relating to Mangione to sustain it. > but the day he got caught, the debate got suppressed and no one is talking about it anymore. The debate didn't get suppressed and didn't need to be; the “debate” in the major media wasn't a real debate, it was just a way to stretch attention to Mangione news for a few more commercial breaks, and once there were no more news events for it to leverage for that purpose, it was abandoned by the same people who had been driving it. And, to the extent that there were people engaging in social media and elsewhere who saw the debate as genuine, they didn't need to be suppressed, as they never had momentum, they just mistook cynical commercial manipulation for opportunity.
  - s1artibartfast 2y ago
    This is the failure mode of the anarcho-liberal awareness premise. "Awareness" is almost never the limiting factor to policy change. This is why awareness based movements such as occupy, BLM, and climate protests go nowhere. Everyone is aware of climate change, police brutality, or inequality. Organized opposition with leverage and a compelling alternative is the bottleneck. Awareness isn't a policy position and doesn't advance debate. Luigi did not have a thesis capable of changing minds. I dont know and haven't seen a single example of someone having their mind changed. Just people more fired up on their priors.
    - harimau777 2y ago
      Wasn't the thesis that can change minds behind Luigi basically "If we don't fix the system then this could happen to me"?
      - s1artibartfast 2y ago
        I dont think that is a policy proposal, nor do I think it is compelling to the voters and policy maker that would need to implement the change. My point is that acting out until someone else comes up with a solution and someone else implements it almost never works. You have to change minds en masse.
- 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.

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.
      - JumpCrisscross 2y ago
        If you had to pick one policy that maximises impact and messagability, what would it be?
        s1artibartfast 2y ago
        I dont know that they work well in isolation, as there are multiple market failures at play. If I had to pick one, I would say heterogeneity of insurance plans as most fundamental. Consumers must have some exposure to cost savings or liability for downward price pressure exerted and inferior substitutes to be selected. People will never pick a $20 treatment over a $20,000 unless they have skin in the game, even if it is 99% as effective. I think this has to be instituted at a insurance policy level for a number of reasons. Charges are stochastic and in the future, while policy premiums are predictable and immediate, allowing consumers to see cost or savings across the entire policy and pre-commit. Measurability is tough on this because it amounts to allowing inferior treatment, and I dont think this could be papered over, even if it brings down the price of all care and allows more treatment in aggregate. Uniform pricing is much better on the messaging. It is adjacent to collective bargaining, just mediated by a market instead of a technocrat. It can be sold to the left as an attack shadowy rentseekers. It can be sold on the right as a free market reform. On the pragmatic front, it can It has a transparent pricing angle, where you could see prices, which current transparency legislation seems to fail. I also think there is a lot of negative will pent up about negotiated pricing and the idea of companies paying drastically lower prices than an individual because they can throw their weight around when bargaining.
  - dragonwriter 2y ago
    > I'd have expected a debate about healthcare cost and actual reforms resulting out of it because the momentum clearly was there No, it wasn't; if the momentum was there, the debate would have been self-sustaining and not dependent on new news events relating to Mangione to sustain it. > but the day he got caught, the debate got suppressed and no one is talking about it anymore. The debate didn't get suppressed and didn't need to be; the “debate” in the major media wasn't a real debate, it was just a way to stretch attention to Mangione news for a few more commercial breaks, and once there were no more news events for it to leverage for that purpose, it was abandoned by the same people who had been driving it. And, to the extent that there were people engaging in social media and elsewhere who saw the debate as genuine, they didn't need to be suppressed, as they never had momentum, they just mistook cynical commercial manipulation for opportunity.
- s1artibartfast 2y ago
  This is the failure mode of the anarcho-liberal awareness premise. "Awareness" is almost never the limiting factor to policy change. This is why awareness based movements such as occupy, BLM, and climate protests go nowhere. Everyone is aware of climate change, police brutality, or inequality. Organized opposition with leverage and a compelling alternative is the bottleneck. Awareness isn't a policy position and doesn't advance debate. Luigi did not have a thesis capable of changing minds. I dont know and haven't seen a single example of someone having their mind changed. Just people more fired up on their priors.
  - harimau777 2y ago
    Wasn't the thesis that can change minds behind Luigi basically "If we don't fix the system then this could happen to me"?
    - s1artibartfast 2y ago
      I dont think that is a policy proposal, nor do I think it is compelling to the voters and policy maker that would need to implement the change. My point is that acting out until someone else comes up with a solution and someone else implements it almost never works. You have to change minds en masse.
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.