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.
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.
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/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.
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
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.
We would probably disagree as to the causes and alternatives to this oligarchic structure, but I don't want to go down that rabbit hole at the moment.
What I am saying is that when you look at the problems with the medical profession, there is more at play here than the self-interest of billionaires. You talk at high levels about the impact of inequality on overall government policy, but not everything that goes wrong with an industry is a result of government policy, let alone policies favored by the wealthy. Medical research is fraught with issues of reproducibility. Government regulations artificially restrict the supply of healthcare. Technological advancement means that many people can now live sedentary lives, and it's adversely affecting health outcomes.
What the politics of inevitability does is that it teaches you to narrate in such
a way that the facts which seem to trouble the story of progress are disregarded.
So in the politics of inevitability, if there is huge wealth inequality as a
result of unbridled capitalism, we teach ourselves to say that that’s kind of a
necessary cost of this overall progress. We learn this dialectical way of
thinking by which what seems to be bad is actually good.
And, of course, that applies to foreign affairs as well. When we look at
countries that are not making the quote-unquote “transition” to democracy the way
we expect, you know, we find excuses. We imagine that the general trend is going
to our direction in some deep way. And then we fail to notice, what has been the
case for the last 15 years or so, that the world is actually moving in a very
pronounced and easily observable way away from democracy.
But the way that things are breaking now in the U.S. is that our politics of
inevitability, which we’ve held to in the last 25 years, basically this idea that
“since communism ended in 1989 there are no alternatives,” basically this idea
that “technology must lead to enlightenment,” this idea that “the market must lead
to democracy.” Those ideas have now come back to clobber us. Neither of them ever
had any foundation. Both of them are highly persuasive to a lot of people and
that’s lead to some consequences, which are very dangerous for the rule of law and
indeed for democracy. Believing that, for example, more market means more
democracy means that you don’t regulate things that you really need to regulate,
like offshore wealth or anonymous transactions or shell companies. And that
creates a world, a gray zone of capitalism where, for example, a Donald Trump can
begin close relationships with Russian oligarchs. If you believe that technology
automatically leads to progress, then you don’t watch very carefully as certain
kinds of social platforms lead people into a politics of “us and them” and destroy
a sense of common factuality. The story that you’re telling yourself the whole
time about how “the market or tech have to lead toward enlightenment and
democracy” dulls your mind to what’s actually happening until you reach the point
that we’ve reached now.
It is not positive government policy that is the problem but government failure to act because the government operates on behalf of money (oligarchy), not on behalf of us (democracy).
If not the government, where do you think a solution comes from?
None of that big wall of text seems to directly address anything I actually said.
> It is not positive government policy that is the problem but government failure to act because the government operates on behalf of money (oligarchy), not on behalf of us (democracy).
The only thing worse than pedantry is wrong pedantry. Your attempt at correcting me here is wrong because The absence of the kinds of policies you would like to see is still policy.
In other words, not everything that goes wrong with an industry is the result of the government not doing what you wish it would do.
And to be more specific, even those things that go wrong because of government policy are not necessarily caused by oligarchic influence.
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.
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.
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.