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Comment by Animats | Hacker News Reader

In the US, manufacturing and agricultural productivity did great. The result was manufacturing and agriculture dropping to around 10% of the work force.[1] Job growth is in low-productivity jobs. Largest area of growth is "healthcare support occupations".

This is the conundrum of productivity.

[1] https://www.bls.gov/emp/tables/emp-by-major-occupational-gro...

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So improvements in healthcare and the rapid surge in lifespans resulting from spending on medical care improvements so that more people could enjoy what they looked forward to for many years, a long, happy and healthy retirement, ruined America? This is the kind of perverse analysis that typically arises as an unwelcome emergent property of systems controlled by people facing inflexible deadlines to meet equally inflexible and arbitrary constraints and goals.

What long, happy, and healthy retirement? "Healthcare", like everything, is ironically named. It's actually sickness mitigation.

One of the things that economic demographers like to mutter about from time to time is that lifespan is going up, but healthspan is not. Women live longer than men, but approximately all of the extra is spent in a state of ill health.

I'm 75 years old, male, declining after being somewhat chronically ill for a long time, and I am still active socially and attending some organization meetings, exercising 10 hours/week, etc. AFAIK none of my male direct ancestors ever lived beyond 73. I have friends my age and considerably older, some of each sex, who are still climbing mountains and riding bicycles. When I was a kid, life expectancy was just flirting with 70, and the life insurance business was still implementing the change from the 1840's mortality table to the one that came out in 1941 -- that's how slowly things used to improve. About the time Medicare started, it looked like mortality improvement was slowing down, but that turned around for a few decades, allowing a much more significant gap between life expectancy and normal retirement age. Sorry, but YMMV.

In my childhood in the 1960s there were also many men in their seventies leading active lives as you describe - golfing, sailing, hiking and so on.

What there were not, was lots of people on oxygen or in wheelchairs or on dialysis or taking insulin daily. Lifespan is going up because we are keeping sick people alive for longer.

Do you think that those medical treatments disqualify anyone from living, or that many people receiving those treatments have not lived meaningful lives and done plenty of good work? The ideas that lead to thinking that we have too much healthcare are sustained by oligarchs of the medical industries who have raised the price of a vial of insulin from $1.48 during the 60's, 70's, and 80's to $275.00 now that bacteria make it much more economically than it was ever made before.

The article says (paraphrasing Thiel): "The world of bits (information technology) may have been on an upward trajectory, but the world of atoms (physical products) had been stagnant for decades."

It's not wrong, but also there's a strange sort of value judgment hidden within the phrasing, and maybe within yours as well. We seem to be saying that this sort of growth is bad, or at least inferior to the kind where more "Stuff" is made. The article even directly refers to healthcare as "unproductive." It doesn't FEEL unproductive to the people who get to live longer, happier lives.

It's built into the premise of productivity, which ultimately derives from Locke's "labor theory of property" - if you put labor into something, you have a claim on its ownership. Later philosophers studying trade and economy built this up to mean: "if we can increase the quantities of things that are legible as assets, optimizing their production on the balance sheet signals increased labor productivity". We've been awkwardly gluing that concept onto everything ever since and trying to measure things like teaching, wildlife management and "designed in California" electronics as productive activities.

Locke was thinking in agrarian terms, about how farmers work the land, or how many ships a nation has in its fleet - he was building off the mercantilism of prior centuries which was also balance-sheet driven, but in a pure trading sense, with no connection between labor/ownership. That connection was important to ushering in coherent industrial policy, since it expressed the idea of importing raw materials and then exporting finished ones at a profit - when you come up with new categories of asset to sell, or optimizations on existing ones, the economy provides more goods and services, it experiences a gain in material wealth. The real limitation is that it's too localized: commons goods are persistently attacked by it because they don't figure into the balance sheet.

This is a great point. I'm reminded of Lakoff's metaphors. I wonder if these primitive zero-sum views of the worlds economy mostly stem from folks inability to even conceive of a less physical metaphor for the mechanism of exchange.

Locke can be forgiven, but his modern disciples less so.

That may well be the case - but that’s not how the number called Productivity is measured.

At that point, people might be more productive if we stopped forcing them to get jobs in healthcare support occupations and let them do something more interesting with their time.

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