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Comment by danboarder | Hacker News Reader

Being optimistic and positive on tech in the first place is the root issue here. This reminds me of my mom in medical school who became disillusioned when she experienced the corruption of the pharmaceutical industry and it's influence of the entire industry for it's own profit, not always in the interest of the patient. Being overly optimistic about an industry or field is in my view a worldview error, and a better approach is to be optimistic about one's own potential to contribute to the betterment of humanity, no matter the field. Also the understanding that there are and always will be bad actors should not dissuade one from being part of creating solutions, as one sees it. Being jaded and cynical will not help in the long run.

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> Being jaded and cynical will not help in the long run.

This sounds like it's better to work within the system rather than try to overthrow it. You need more than a little angst to completely reset cultural norms. Maybe you're optimizing for a local maxima instead of realizing the true potential of saying "fuck everything" and replacing it.

I'm mostly playing devil's advocate, not saying the correct response to all adversity is to plot a revolution. But my point is sincere - sometimes it is the best thing to burn it to the ground and start over. Private healthcare seems like a pretty good example of a system that should be abolished rather than massaged (assuming your goal is better healthcare at a more affordable price) and we have decades of data from our own country and others to corroborate that.

I think what you are saying is orthogonal to what they are saying.

You can be positive and optimistic about big scale societal changes that throw out all the established notions. Likewise, you can also be cynical and jaded about small scale changes that just aim to incrementally improve things.

Aiming for big changes doesn't necessarily imply you have to be cynical. In fact I think you're more likely to be able to achieve big changes if you're optimistic about them.

If you're willing to accept small changes as a win in a fundamentally broken system (in the sense the incentives aren't aligned and there is no real accountability feedback mechanism) then the problem is you aren't cynical enough to attempt something drastic. I'd actually go even further and argue it's a form of being brainwashed, usually as a byproduct of effective propaganda. Going back to the example of private healthcare - I don't fucking care about small incremental changes when the system itself is still structurally broken. We need more cynicism about the status quo so people say "fuck this" and replace it with something better. And it's not even a complicated or abstract idea - literally every other 1st world country has solved this problem and laugh about how broken healthcare is in the USA.

Most third world countries too.

The point is: what are you going to do if single-payer healthcare does not materialize in the US? You have many options; plotting a revolution, working for reform inside the system or impotently complaining on social media. What is actually workable for you?

The same goes for the article's author. Sounds like they're shocked—SHOCKED—that private companies are just out to make money, and don't actually have our best interests at heart. The real issue is that they bought into the fantasy in the first place. But now that the veil is lifted, how will it change your actual behavior in the real world? If it will have no effect, why let it get you worked up at all? If it will have an effect, go out and do it.

> But now that the veil is lifted, how will it change your actual behavior in the real world?

As the author said:

> Stop giving them your money, time and data as much as possible for you. They won't bring us closer to these ideals they promise.

It's not changing the world, but I just do what I can to not contribute to it. And if any alternatives do pop up I do try to support them, sometimes financially.

The internet's outskirts are emptier than ever with this centralization, but I have made the active choice to de-activate pretty much all the mainstream stuff and use extensions to minimize their ability to track me. So knowing this did change my behavior on how I interact with the internet.

I think people tend to think too much in terms of black and white. Jaded cynicism is sometimes a good response, and sometimes less so, and other times won't make too much of a difference or can go either way. The trick is to know how to balance it all.

Same story with "tear it all down" vs. "work within the system".

>a better approach is to be optimistic about one's own potential to contribute to the betterment of humanity, no matter the field. Also the understanding that there are and always will be bad actors should not dissuade one from being part of creating solutions, as one sees it. Being jaded and cynical will not help in the long run.

Easy to say this, but these two aspects contradict each other. You become jaded and cynical precisely because your potential to better humanity is locked down in beauracracy that has the opposite interest. One can only fight back so much against the tidal wave that was setup decades before you were born.

I'd even go so far to say that the ones who do rise to the challenge need to be jaded, and channel that into overcoming the wave. Being cynical means understanding a need to deeply understand every little action, no matter how simple and otherwise "objectively good" it is in the short run.

It's how you use that cynicism that matters, not the state of being cynical.

> This reminds me of my mom in medical school who became disillusioned when she experienced the corruption of the pharmaceutical industry and it's influence of the entire industry for it's own profit, not always in the interest of the patient.

That sounds like a story of its own. Would you care to share the story about the corruption she saw? We so often hear the stories about companies hiking prices for lifesaving medicine fo no apparent reason other than profit, but it would be interesting to hear what she saw from the inside?

Personal financial payments to physicians are a common marketing strategy used by the pharmaceutical industry. These payments include both cash (typically for consulting services or invited lectures) and in-kind gifts such as meals.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8315858/#:~:text=Pe....

The pharma and medical device companies sponsor the conferences that all our doctors attend every year.

Also trips to medical conferences abroad, at least in Europe.

Someone who's in medical school (or finishes and goes into medicine) isn't really "inside" the pharmaceutical industry and typically has a very, very poor understanding of how pharmaceuticals are developed and brought to market.

The most substantial corruption in the health/life sciences/medicine world is simple profit motive at hospitals, pharmacy benefit managers (PBMs), and insurers, and especially when those three entities combine into mega "pay-vidors" like UHG.

Tiny anecdote: I worked on the campus of a children's hospital. The pharma reps had parking right by the main entrance. The parents of sick children? Expensive, paid parking a mile away.

Here's a fun one that just happened recently. A doctor I know works for a giant conglomerate as a general practitioner. Recently the business development team realized that insurance will pay them to take pee samples for diabetes tests for every patient. Now every single time someone comes in the medical assistants are made to get a piss sample for a test that is totally worthless for most of these people as they have little risk of diabetes(far high chance of false positive than true positive). When the doctor told the medical assistants to stop he received an angry email from an MBA which became a huge pain in the ass. At the end of the day we have to remember that the only goal of a business is to make money and even if everyone inside that business is trying to do good the banality of evil tends to rear its ugly face. The MBA actually believed the policy was helping people here believe it or not.

You've got to separate the tech from human nature. Penicillin, modern medicine, travel, communication etc. are good. Greed corruption and self interest are a human thing irrespective of whether you have high tech or not. We may make some progress there but it's not really a tech issue.

> it's influence of the entire industry for it's own profit

I continue to be fascinated by how easy people priorities profit over doing the right thing. Sometimes they don't even stand to personally gain all that much, they do it for the benefit of some soulless company.

If you aren't actively making things worse for the general public I'll even let the sole focus on profit slide, but how can you justify to yourself going out and actively causing suffering.

Things like pensions are frequently refusing to invest in weapons manufacturers, because of the harm their products do, but why? At least they are honest about what they do and they can justify it.

It's easy for people who face no real threat themselves to pretend to take the moral high road by refusing to invest in weapons manufacturers. Not everyone has that luxury.

> Things like pensions are frequently refusing to invest in weapons manufacturers, because of the harm their products do, but why? At least they are honest about what they do and they can justify it.

Not to mention, their justifications are much more legitimate than anything advertising industry could come up with, and yet, marketing is a respectable occupation these days for some reason, and ad industry funds everything.

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