Now we are in a situation where a handful of unelected business men have more power over our lives than the elected government.
I don't know that I've been brainwashed, but living most of my life in Chicago & Los Angeles, I've seen a lot of bloat, corruption, & massive inefficiency.
Many of friends lost their homes in the Palisades & Altadena fires. If it weren't tragic, it would be laughable the challenges they've faced in rebuilding. Several have kids about to enter high school. A dilemma they face is should they both building a house for their teenage children or assume they'll be off to college -- knowing it could be 3+ years until they're have a permanent home again.
In Chicago, I watched the mayor sell of all the parking meters for a fraction of their value. In Los Angeles, I'm watching them struggle to complete the people mover at LAX, a project years later & billions over budget.
This doesn't make me anti-government.
I see the need for it & I want it work well.
But comments like this make me frustrated that people would rather close their eyes & try to gaslight people, rather than acknowledge the problems & talk about how we fix them.
I feel our country is split between one side that doesn't want the government to do anything, even when it works, and another side that wants the government to do everything, even when it fails.
It's not clear to me where someone in the middle goes.
Our current ideology is so skewed toward “gov bad” that the first step toward moderation is acknowledging that it’s possible for government to do things well in the first place.
To what extent is this due to the public nature of the organisations and to what extent is it just the size of them? Are private organisations of similar sizes free from such bloat, corruption and inefficiency?
I feel like people often give "businesses" a pass on this. Government projects that are over budget, especially IT-related ones are widely and publicly bemoaned, but this isn't that much different from such projects in private enterprises (although the moaning remains more within the company itself).
Right, but if someone’s point is that bloated government should be replaced by lean, efficient companies, then it does matter whether they are actually lean and efficient.
The classic "government can't do anything right"-trope is quite strong and influences voting and policy making. My hypothesis is that the reality is closer to "cooperating with many many people in big organisations is very very hard to do efficiently".
No, it isn't. Life without health insurance (in some form) is awful.
> I suspect that a better system would look a lot more like removing the insurance component of it in more contexts, and having more medical procedures paid for out of pocket at point of use by ordinary people - which is something I try to do right now anyway when I can.
Getting cancer is like winning the shit lottery and you're effectively saying that people should just "save for if that happens or die of they don't". The fucked up health insurance system in the US makes medical bankruptcies a thing. Your idea here turbocharges that.
More importantly, you ignored the main point in my reply. Please respond to this:
"It's more about making a fair assessment of whether servicing a market via private or public enterprises is more or less efficient. What you mention is a comparison between different markets, not a fair comparison of the same market run either publicly or privately.
[...]
The classic "government can't do anything right"-trope is quite strong and influences voting and policy making. My hypothesis is that the reality is closer to "cooperating with many many people in big organisations is very very hard to do efficiently"."
COBRA is always an option when you leave a job and don't have another one lined up that will give you another insurance plan without a gap.
Yes, it's annoying to have to make the switch in general to a new employer's plan, since your existing slate of doctors might not be covered by your new plan, deductibles reset, and you have to navigate a new-to-you bureaucracy.
> I wish I could just pay for ordinary health care in a way completely unrelated to my job and that my job had nothing to do with
You can, you just aren't going to like the price tag. ACA marketplace plans are open to everyone, even if your employer offers health insurance. You can always decline the latter and sign up for your own plan. Depending on where you live, you might be able to get a barebones plan for as low as $350/mo, but in some markets your cheapest option could be hundreds of dollars more. And that's going to be a HMO-type plan with a high deductible, so you'll be paying out of pocket to the tune of thousands of dollars for anything other than preventative care, and your choice of providers will be limited. If you want something similar to what an established tech company offers (for example), you'll be paying north of $1k/mo in most situations.
(Source: our COBRA just ran out a couple months ago, we don't have jobs that offer health insurance, and I went down this rabbit hole and spent hours researching options.)
> I don't have a grand theory of how best to reform the entire American health insurance system, but I'm in favor of doing so
I'm with you there. What we have sucks. We (or our employers, which we end up paying for indirectly) pay much more for care than people in other developed nations with socialized medicine, and our outcomes are not meaningfully better, or at least not anywhere near better enough to justify the added cost.
> more medical procedures paid for out of pocket at point of use by ordinary people - which is something I try to do right now anyway when I can
That's good that you're able to, but in the absence of an insurance system, and no state-supported subsidy, healthcare would be something only a relatively privileged few would be able to afford in the US.
While our private insurance system does cause inefficiencies that raise the price of care, eliminating it won't solve enough of the cost problem to matter.
I don't think there are better options than some sort of single-payer, government-subsidized healthcare system. Those systems do of course have their flaws (some of them quite significant), but they tend to provide care to everyone more or less equally, with generally good outcomes, and completely avoid the problem of people facing a choice between foregoing needed care and bankruptcy.
Government has the major focus of taking money, and largely spending it arbitrarily. It’s inarguable that the US Federal Government is bloated, corrupt, and vastly inefficient. Despite taking in $trillions in revenue every year, the US has $40 trillion in debt. That’s utterly inexcusable, and heads should roll.
Getting back to the discussion about private enterprise, would you characterize Amazon as bloated, corrupt, and inefficient, despite being an effective monopoly? I would not, though I’ll admit I have no data on the corruption aspect…
Highly debatable. Not making a profit on paper (or moving it to low tax-environments) is a great way to dodge paying taxes. Innovation is a side effect of competition, not of profit-seeking. Plenty of examples of oligopolies and monopolies where innovation ground to a halt in favor of siloization, buying up competitors, dark patterns, regulatory capture, etc.
The right way too look at this is that the organisation of private industry creates a selection pressure on "making money" (not profit!), with the minimum being "able to cover costs" and thus stimulates evolution of strategies to do so. Like in biological evolution, there are many, many pathological situations that can occur.
> Government has the major focus of taking money, and largely spending it arbitrarily.
This is false. The US is a bad example because it has an incredibly corrupt political system, especially since Citizens United. In general in most modern developed democracies spending by the government is supported democratically to a very large extent. That is not to say that 80% of citizens support each bit of spending, but for 95% of the things where money is spent by the government, a majority agrees that money needs to be spent there. The word "arbitrarily" is definitely not warranted.
> would you characterize Amazon as bloated, corrupt, and inefficient, despite being an effective monopoly?
Don't know, yes, and don't know.
For corruption, I think it is necessary to determine how it would even look like for Amazon. Corruption in government is often "favoring entities friendly to the people making the decisions over objectively better options". I'd argue that that is wholly accepted in private enterprises and even encouraged. A "quid pro quo" in private enterprise is just "a business deal" or "customer relations". "Nepotism" is just "helping your friends out". Etc. I would assume that things like that are very, very common within Amazon.
With regard to bloated/inefficient: This is incredibly hard to make definitive statements on without having worked there and having a lot of intimate knowledge, so I'll refrain from doing so. I think it is, but I don't know.
If the goal of the USPS was to turn a profit, then serving rural addresses is inefficient and the jobs and infrastructure to do so is bloat. Luckily that’s not the goal of the USPS.
I hesitate to mention Mamdani in this forum but it seems like he has done a lot to make NYC’s government “more efficient” in many ways. But also many people disagree on who that government should primarily serve.
I feel that a lot of government spending on roads is inefficient and would be better spent on transit systems. Many people disagree with my values tho.
(At least the Democrats seem to be more open to actually taxing to make up for shortfalls, unlike Republicans.)
> would you characterize Amazon as bloated, corrupt, and inefficient, despite being an effective monopoly?
It's funny you should bring this up in the context of healthcare. Amazon acquired One Medical a few years ago. Within no more a year, One Medical got so much worse. Harder to book appointments, wait times increasing, and care team not responding to in-app messages as quickly. (And sometimes being significantly less helpful than they used to be; e.g. "you don't need a recommendation or a referral for a general surgeon since you're on a PPO; just look through UCSF Health's directory and pick one". And this, after I specifically asked for a recommendation, twice. Not to mention most of UCSF's departments will turn you away without a referral, regardless of what kind of insurance you have.)
So I don't know if Amazon is bloated, corrupt, or inefficient, but Amazon acquiring what used to be a genuinely useful medical group made it much, much worse, and I assume that was all in the name of "minimizing costs".
One Medical, I had before/after Amazon and was never that impressed. They had nice offices and a good booking system, but the GPs were a couple notches above webmd IMO.
Been working for more than 20 years in corporations and I've seen the same.
I'm very familiar with New York politics, and I watch in slow motion while enormous amounts of money disappear into government salaries and pensions, programs that go nowhere, and corruption where no one is held accountable. I can give examples of any of these but the school system is one - it's the highest per-pupil cost almost anywhere in the U.S. but has some of the lowest standardized scores. The last two mayors were corrupt, one with his wife who received almost 2B on a program that went unaccounted for (look up ThriveNYC), had a friend in the ferry system that he funneled money to; the mayor after that was a borderline banana republic leader in terms of corruption.
On the other hand, look at construction costs. We know that despite the supposed high costs of doing business in Europe, and the high costs of places like Japan, that building subway/metro infrastructure costs 3-4 times in New York what it costs in Tokyo, London or Paris. Why is that?
So I have two theories to explain what's overall going on here:
1. Local government. I think local government was a great idea in 17th century philosophy; in practice look at how efficient countries like Japan and France are at providing healthcare and excellent infrastructure. And how much cheaper they do it. Those are strong, central governments without layers to worry about. In the U.S., you have NIMBY community councils, cities, counties, states and the federal government, all with a say in it. Then you have lawsuits, organizations that span states, etc. And those people are elected officials who have no interest in what happens to US in 10 or 20 years. They care about their election cycle and terms. In my opinion, local government is evil as a result of what I see here compared to overseas.
2. Others have said it - the influence of big business. What is illegal in those other countries as bribery or undue influence in electoral process, is legal, a 1st Amendment right and called "lobbying" in the U.S. This is why the Democrats will talk a big talk about identity politics to get elected, but they can't talk about a Medicare for All to get elected, because their sponsors block it (unless you're a fringe politician like what just happened in Michigan).
The NYC subway is one of the few (the only one?) to run 24/7, and it is one of the largest in the world. Construction is expensive because the operators choose to make it expensive. Digging giant new tunnels under existing skyscrapers also isn't exactly easy.
Yeah there's corruption and waste, but not to the order-of-magnitude level.
The costs of running the NYC subway are no more unique than any other large city, some argue shutting down/starting up would be just as expensive.
The subway daddy[1] was my last straw at having any hope that it would be fixed in my lifetime, it is clear the people running it do not want any part of NYC subway "fixed".
[1] https://en.wikipedia.org/wiki/Andy_Byford#New_York_City_Tran...
Also, in the US, there are a lot of forces who see the government straight-up as the enemy and want to have it as dysfunctional as possible. It's where "starve the beast" and DOGE comes from.
1. Your government clearly is dysfunctional
2. You have been brainwashed into thinking that government is bloated, corrupt and inefficient.
If I believe that government is dysfunctional... then surely that belief is informed by the observation that my government is bloated, corrupt and inefficient, not due to brainwashing?
Very possible they were right. Hell, I'd agree it's true of the US gov today. If the message was "the government is currently bloated and corrupt, let's fix that" that's great. Today though the message is "government is inherently bloated and corrupt by it's very nature, and therefore unfixable, let's burn it all down" which is not true and actively harmful to democracy.
They're the source of all of decades of nonsense about "small government" and "inefficiency" and "rational markets."
They pretended to be liberal, and they were fervently anti-communist.
But they've always been primarily about the protection and promotion of private monopoly and aristocratic privilege. And influences like von Mises were more than fascist-adjacent.
See the Mont Pelerin Society for a partial history.
[1]: https://archive.org/details/whithersocialism0000stig_i9j5/pa...
But sure, socialist ideology is pure evil...
Step 2: Start hiring their crew members to government positions to later aid them in acquiring licenses for industries they want to monopolize.
Step 3: Pass some regulation that your buddies can easily comply with but nearly impossible for everyone else to comply with.
Result is a bloated government that spends a ton of money to seemingly achieve nothing, except serve your oligarchy.
Now blame the poor and welfare state. So you can keep more of the taxes.
Deregulate so your buddies who are now running monopolies can spend less.
Give more contracts to new buddies to share the spoils from aforementioned taxes you kept more of.
So on, so forth.
Oh, remember to keep telling the public about communism and how big governments are bloated and point at the one you designed as evidence that it’s inevitable.
For example, I find it very annoying to have to fill out time cards or such, and other people find it very annoying to have any demands whatsoever on their time outside of core working hours. If we had to have a political debate about which is the one true working model, we'd get pretty worked up about it, and if I lost I'd go away bearing a pretty strong grudge about the daily annoyance that was inflicted on me against my will. Instead, there's some companies that do it one way and some that do it the other, and we self-sort between them according to our preferences.
Which is, imo, one of the primary reasons of the stagnation of US society over the past 50 years.
We are at all time lows for internal migration. This reduces dynamism drastically. People used to chase economic and social opportunity. Sometimes multiple times through a well lived life.
The whole point of states was you could relatively trivially pull up stakes and move for better opportunity. Once people decided that was impossible (and historically speaking, it's actually less risky than ever before) things really went to shit.
Overall and in generally speaking terms: US citizens have chosen comfort over every other metric when it comes to every single daily decision they make in aggregate.
And realistically, they don't require a monopoly. If there are 1000 competitors but they all have the same evil ideology at the helm, the result is identical. Your choice is now "flee the country".
Except, wait no. Those companies have the entire western world by the balls. Want to avoid extreme surveillance from Google? Maybe there's a forest somewhere you can forage in.
We live in a representative democracy. We all have a choice in who we vote for, what polices we support. In addition, we have checks and balances in place to prevent the consolidation of power. The government is not "one thing", it's hundreds of things working together.
Now, the system is not perfect, and I never claimed it to be. But compare this to how corporations functions. Corporations function as totalitarian dictatorships. You cannot vote. You have no influence. And they make decisions unilaterally, regardless of how harmful or stupid said decision may be.
The arm in which we control corporations IS the government. It IS regulation. The only reason you're not working 80 hours a week and dying young is because of the government. Now, again, that doesn't mean the government is perfect. But those regulations were protested for and voted in by people just like you and me, and I think that's good. So sue me.
That is not the only arm we control corporations with, corporations even die sometimes for doing the wrong thing. And voting internally is not the only way to change a corporations behavior. I think talking about them being a dictatorship is confusing the aspects we're talking about.
I don't know when I said the government and corporations were the same thing when monopolies, but I still hold one is much more destructible than the other when they are properly separated (they aren't).
I don't think markets and capitalism solve everything. I would say when democracy and capitalism are both working well (not right now) their combo is awesome.
I don't think placing all blame on corporations is productive because it's a misdiagnosis. I am more afraid of the ratchet effect than I am of Google, but they both scare the shit out of me.
Edit- I admit my original comment wasn't very good, I apologize.
I think, though, when we see many (all?) corporations exhibiting the same bad behavior, and said bad behavior materially negatively affects the population, that's a sign we have a gap in legislation. We shouldn't, and really can't, play wack-a-mole with corporations individually with individual actions. We should fix it upstream.