eldavido

Great comment. They probably are closer than I originally said.

I totally agree on your point about professionalization. There might be a legitimate public benefit angle to it. But if you look hard enough, the distinction between a regulated profession (which ostensibly exists for public benefit) vs a union (which exists to advance its members interests) is fairly thin.

Since it is easier to track outcomes directly, it might be time to retire professions, or at least regulate them in a much finer-grained way, than just saying "Doctor" and letting someone do...anything...that falls under that huge "medical" bucket.

You're probably right.

More active antitrust may need to occur via regulation.

I'm just very skeptical of the sort of thinking that treats some abstract, not-very-realistic thing called "regulation" as a magic tool to solve all our problems.

No!

What we need is competition and choice to ensure companies are responsive to what people want.

I can't, for the life of me, understand why people think "regulation" will magic away all our problems. Here's what happens: a lengthy political process results in a bunch of laws getting passed. The large companies who have enough skin in the game to care send their lobbyists, who ensure the outcome of the process doesn't harm (and may even help) them.

Ordinary people like you don't have access to these meetings and by and large don't participate. All it ends up doing is helping the people who do participate, generally the larger firms, and the politicians who can say they "did something" to their constituents.

Plus, regulations are static. They don't get updated over time, in general, which means you get an entrenched group that favors the (regulated) status quo, actively blocking change.

"Regulation" gave us banking. It's 2021 and I still can't move money same day, because all of, I think seven banks started across the country in the past 6-7 years. I'm not even making this up--check for yourself.

"Regulation" gave us the healthcare system, with insurance companies chiseling up the United States into a bunch of local (state by state) markets, limiting competition across state lines.

"Regulation" gave us professionals -- doctors, dentists, lawyers, etc -- who systematically exclude competitors and overcharge their customers because they aren't exposed to the full force of competition and innovation.

Rather than the word "regulation", I would encourage anyone who wants this, to REALLY understand what they're asking for. Go deep. Understand how the process works, look for good and bad examples, and really study the process of how these things get passed, enforced (or not, when political winds change), used (and misused -- ever tried to build anything in San Francisco?), revised over time, and their costs and benefits.

What we need is competition, not just some abstract thing called "regulation".

I think the whole initiative process is horrible. But.

Your answer is right there in the declaration of independence: "to secure these rights, governments are instituted among men, deriving their just powers from the consent of the governed". Rather than going through the legislative process, the idea is that some things should be decided by the people directly.

The original intent of ballot initiatives (propositions) was to try to nullify special interest power over the legislature. If you think AB5 was special-interest legislation (it very clearly was) this might be the exact intended use of the ballot initiative process. For the popular vote to nullify what the special interest-controlled legislature wanted. And it worked.

An entirely separate question is what kind of questions should be decided by direct democracy in the first place. I think California goes too far in this regard, but I don't think the right answer is "none". Regardless of one's political beliefs, I think something on the scale of Brexit was put to the electorate in a direct vote, and probably with reason.

To some extent, you just need to look at the hard data: promotions and raises. See who's getting them. Whatever they're doing is what's actually rewarded.

It sounds cynical but I learned too late that a company's success is only incidental to your own success as someone who works there. If you think this is too negative, I'll just say I've seen a lot of "executives" run companies into the ground, then get great, high-paying jobs at acquirers, because they managed the politics well. It sucks but it's life.

Most tech management, especially young founders of VC-backed startups (vs. larger companies or owner-operated companies where the owners have a lot of skin in the game) is frankly pretty bad. It's just not celebrated or taken seriously the way it is in other industries, or fields (e.g. the military). I'm not saying this pessimistically, quite the opposite--I've seen a lot of bad management and I think there's better out there, but it does seem to be vanishingly rare.

Because the thread was about unions. Though you're right.

I think people who are really big "repeal citizens united" types need to realize that it cuts both ways.

Unions bring democracy to the workplace.

Democracy ensures some modicum of fairness, but is slow, inefficient, and can lead to very bad outcomes when dealing with highly technical questions. There's probably a place for big, large-scale political questions (who should be president, should we stay in the EU) to be decided by direct democracy, but I wouldn't want that for trade or monetary policy.

The big problem I see with democracy, in general, is that it's highly susceptible to special-interest takeover. When a small group stands to gain disproportionately from a particular outcome, they will lobbby--HARD--to get that outcome. Even when doing so might be so harmful to the overall system, that it collapses, even if they get what they want.

The US analog is the SEIU/AFSCME organizing so hard that the entire government of a state, like Illinois, becomes beholden to what they want.

How did AB5, the TNC bill, pass, when it was overwhelmingly not supported by drivers and the electorate didn't want it, either? Teamsters pushed their agenda. Hard.

Unions will make no bones about running an employer, government, or other organization absolutely into the ground in the name of advocating for their members' interests. They do not care about taxpayers, customers, or any other constituency other than themselves and their members. And when it all falls apart, they'll just go to the next state/company/etc. and run the same playbook, over and over. It's very harmful. Some things need to be outside the reach of democracy/the masses.

I was arguing with a doctor friend recently about the AMA. He's on team New York Times, "knows" the Koch brothers are Satan incarnate, "knows" Trump owes Russian oligarchs money, etc.

It just didn't register that the AMA is the sixth-biggest spending organization on DC lobbying [1], right behind Blue Cross Blue Shield (an insurer) and the American Hospital Association.

People worry about the NRA and all kinds of other stuff. They should really get mad about how outrageously the medical industry lobbies (as do the realtors), and how much they've managed to extract from ordinary Americans. It's an utter coup of PR that people aren't rioting in the streets about this. Everything about the medical industry -- licensing, high physician salaries, etc. is rigged to be good for insiders.

[1] https://www.opensecrets.org/federal-lobbying/top-spenders

I never said anything about loans.

What I'm suggesting is food stamps. Everybody can pay cash. If you can't, you get government assistance in the form of a cash-like subsidy that can be spent anywhere food is sold.

It's a fast, efficient way of ensuring universality of care while benefiting from the market discipline you get from having a (mostly) competitive, cash market. Not to mention, there is no insane "food insurance" bureaucracy. You swipe the card at the checkout line and you're good.

I'm less convinced. The NHS, Britain's version of this, is constantly underfunded, and has long wait times for a variety of procedures. The Economist writes about this frequently.

https://www.economist.com/britain/2018/06/28/the-three-myths...

The main thing I take on faith is that people are different and one-size fits all solutions don't produce good outcomes. We have different car brands, grocery stores, non-health insurance companies, package delivery companies, retailers, and housing options. Some people want fast and cheap. Others want to drive an hour to save a few bucks.

This isn't some technical academic point. Without a range of choices, you actually can't know what people truly want. So things don't get better. People can't signal what's truly important by voting with their wallet.

> If we want to benefit from market forces here, it's probably much more effective to have large (or single) payers who understand what the standard of care should be, and can encourage price competition from providers.

I don't get this at all. There are so many markets where complex, highly-paid specialists do work customers might not understand: estate/trust lawyers, auto repair, even dental care. We don't have nearly the same problems as in medicine due to this culture of treating doctors like God. They aren't. They're just a person doing a service, just like a chef or a guy painting a house.

What actually bothers me most about this whole thing is that nobody is willing to get serious about the tradeoffs their system entails. Health care in the US is failing right now. Companies are trying to stay beneath ACA limits because health insurance would crush them. My premiums are $380/month as a healthy, 36-year old nonsmoker with no rare conditions. That is INSANE. There's ever-more incentive to keep people off of W2 employment because premiums have gotten so out of control. If you take the current system, where bankruptcies are the norm, this monster is devouring almost 20% of our GDP, and every time I go to the doctor it's a major hassle, I'll come out and say that yes, maybe I'd prefer to fix that even if someone can't get a $150,000 drug anymore.

>aside: Singapore is a weird case and probably not a good comparitor for most healthcare systems.

Umm...why not? You can't just hand-wave that away.

It's simple: waste. Everywhere.

There is no incentive for doctors to be efficient so they aren't. They order too many supplies, do too many procedures quickly (when doing them slowly would be fine, and cheaper, etc).

Price discipline is like gravity. It affects everything. In most American businesses subject to market forces, there is an enormous push to optimize every single little bit of the business to control costs.

This force simply doesn't exist in healthcare.

I realized over the past few years that there is no "natural" price for anything. It's 100% set by competition.

Economic research confirms this. Mergers result in higher prices due to less competition.

What we need is way, way, WAY more competition in healthcare. 10x as many providers, 10x as many clinics, with prices posted on the wall. When they start losing business, they'll notice.

I see this argument a lot.

The trouble is that emergency care isn't what drives the majority of healthcare spend. What does is actually chronic conditions: dialysis, diabetes, autoimmune disorders, chronic weight conditions.

That's what we need to worry about.

And if there was a real market here, you wouldn't need to shop around because all the people that do, would enforce some level of price discipline on the market.

Think about it. For any good sold at, say, Wal-Mart, say Gatorade, there are some people that want it a LOT, even NEED it, while others are more on the fence. There's only one price on the shelf and it's calculated to get a lot of people buying. So in effect, the people who are more indifferent (want it less) are actually doing a pretty significant service to the people who want it a lot, by guaranteeing the price will be set low for everyone.

There's no reason something like this can't apply in healthcare.

Also a fiscal conservative, I completely agree single-payer would be much better than what we have now.

What I think would be best though, is to eliminate medicare/medicaid, hand people cash, and get out of the way.

The high-order problem with medicine isn't coverage or insurance. It's price. There are only two ways to get price under control: meaningful competition, or government price controls (e.g. single payer). Single payer would end up like public schools: one choice for everyone, probably OK quality, but not great.

I think we could do so much more here if we just created a cash market and handed people money. It's what Singapore does. It would let doctors compete on -- even discover -- what actually matters to consumers -- wait times, when procedures take place, even how comfortable the office is. I would much rather have a market with choice and variety than one that straitjackets everyone into a one-size-fits-all system that might work for some but probably won't for others.

I know people are going to worry about rare (expensive) conditions not being covered, and this is indeed a problem. I don't have an answer to this. One good thing about competition though, is that it drives innovation. Provider prices will absolutely be set based on what they know people can pay. If people can't pay as much, the only thing for them to do is drop prices.

It's funny. In a community where people are so focused on innovation, and startups, and choice, I see a lot of support for a national single-payer scheme. I would much rather take the collective energies of this community and apply them to innovation in this market, with meaningful choice and competition. Medicine needs more of a startup mindset. And for those roasting me about how it's different/dangerous/risky: what we have today is KILLING us, economically.

There are degrees of democracy (as I think your comment rightly points out).

Maximum democracy in this case might be, the RFCs are written by anyone, work on features is started when people vote to start it, and there is widely distributed veto/filibuster power.

A bit less democracy might be that the maintainers select the ten proposals they feel are best, and put them to a vote for people to choose.

I just read a really good book on this topic called "10% Less Democracy". I'd highly recommend it. It shows how "maximum democracy" usually isn't the best setting, at least for governments. Their proposal for tax is interesting: write a 4-page bill in Congress that outlines the % of income to be collected, and maybe some amount each decile should pay, and an unelected tax body (like the IRS) figures out how to make that happen, as cheaply and transparently as possible.

This is a really thoughtful comment.

"Process weight" is a good concept I wished more people understand. Building released-to-web software without hardware, big teams, long-term API support, etc. should really have almost no process, except for maybe high-level prioritization of features/functional areas (which a small-company CEO or PM can do). Reflecting on my own experience, it's the micro-management of most development processes that kills me -- 45 minute stand-ups where I'm arguing over whether something will take 2 or 4 hours. I honestly don't know and the powers that be just can't accept that. "How do you not know how long doing that will take!?!"

I think most teams would be capable of this, it's just that the people signing the checks get really, really uncomfortable with the apparent lack of accountability.

One of my best friends was high up in the M1 project (don't want to get too specific, but he works at Apple).

I am not surprised about the M1 performance numbers at all. Granted, I have a degree in this area (silicon design) and many friends in the industry. But it's the sort of thing where if you're paying any attention, it's just inevitable.

(1) Intel has been a mess for a while. Multiple canceled high-profile projects (not announced publicly), some high-profile process technology missteps, and frankly...they just feel kind of rudderless. A lot of my more career-minded friends have jumped ship. There just doesn't seem to be a concrete goal they're pursuing. They've had what, three CEOs in the last few years?

(2) Apple's semiconductor team is really good. REALLY good. It was a Steve Jobs-level initiative that started with the acquisition of PA Semi and they've assembled a lot of the best people in the industry.

(3) Apple sells something like 10-100x as many phones as computers each year. This means there's much, much more scope for high-budget R&D on the phones. And in this case, they took a lot of what they learned about system-on-chips, which are used in phones, and brought it back to PCs.

(4) It's pretty obvious the architecture of PCs was overdue for a bit of a rethink. Just look at a PC mainboard. There's all kinds of shit on there, lots of clocked digital electronics, BIOS chips, memory controllers, real-time timers, a giant energy-eating PCI bus, etc. If you stop and think about it, we've probably reached the point where the whole thing needed to be repackaged into a single part. With the exception of overclockers and hardcore gamers, most people don't upgrade their CPU, or memory, so right there, you can remove a bunch of clunky edge connectors and all their bus logic. This means the whole thing can run on fewer synchronous clocks, which dramatically improves power efficiency and also (I'm not sure about this, but it stands to reason) performance. There's also a completely unified memory model--one giant flat RAM between CPU and GPU--so no schlepping all the things back and forth from GPU to CPU memory. Huge performance improvement right there, just by eliminating stupid legacy bullshit we don't need anymore.

As a software guy, it's like they just ripped out a bunch of legacy stuff and got rid of all the unnecessary and complex silicon.

No less important, there was a movement in academia about ten years ago toward using FPGAs (basically reprogrammable silicon) to do various special-purpose tasks like image processing, DSP, and GPU. Custom silicon is way more efficient (both power and performance) than general-purpose CPU silicon. If you look at the M1 design, they bundled a bunch of custom stuff into a single package, so that rather than having a CPU, you get a CPU, memory controller, GPU, image processor, etc. on a single piece of silicon.

(5) And finally, they did a bunch of sensible things with the ARM CPU that anyone with an undergraduate degree in computer engineering wouldn't be surprised by. I read something about large reodering buffers and a few other things.

I'm not in any way minimizing this achievement. It is a very big deal. But like a lot of what Apple does, it's just a realtively straightforward idea, executed to a very, very high level of excellence by a very good team. And it's interesting how all these little 5% improvements here, there, and everywhere culminated into a much larger, qualitative degree of excellence. It all feels very "Apple".

I've given this a lot of thought and pretty much concluded government needs to get out of the retirement game. Not saying this as a libertarian or any kind of principled statement, simply looking at what happens time and again. We need to switch to 401(k)-style DC plans or something similar where the funds have to be contributed today and are beyond the reach of politics.

The incentives to game the system are just too strong. Whether incorrect discount rates, systematic underfunding, whatever, people always treat the pension assets as a "big pot of money" for today's emergency, and use it for the pet project du jour.

I even see this at my condo association. We have a replacement fund to stay on top of long-term replacement liability. We can't even balance that. What chance does a large government, with many stakeholders, have of getting this right?

The pensions payouts are simply outrageous. Do the math, you'll see a 60-70% final value pension on 100k salary (60-70k/year) with a 3% cost of living increase (standard in Illinois) is worth 1.8-2.0 million dollars (25 years @ 3.5% discount rate). This is equivalent to having nearly 2 million dollars saved in a retirement account and when you retire, buying an annuity with credit quality equivalent to a promise from a major government (not a junk bond which may become insolvent).

Anyone who thinks that's "fair" really needs a reality check. 600k pensioners in Illinois [1], many of them living out of state, and the ones that live in-state aren't even taxed on their pension income. They also don't have to pay for health insurance. This is simply insane. There's really no other word for it. This needs to be indexed to private benefits or otherwise tethered to reality.

Sidenote. We need a rethink of public service in this country (US). The old bargain of "you get paid less working for the government but the benefits and job security are better" needs to go. Everyone receiving this $2 million entitlement is going to say, well, I work for the government so I deserve my "better benefits". It shouldn't matter if you work private or public sector. There needs to be some equivalence otherwise you get Illinois, where politician after politician promises great treatment to AFSCME and SEIU and to nobody's surprise, no real attempt is ever made to fix this broken system.

[1] https://ballotpedia.org/Public_pensions_in_Illinois

I'm going to nitpick here a bit because I think it demonstrates a larger point.

Net neutrality is far from a "technocratic" issue. In many countries, media companies like facebook or Netflix do partnerships with mobile phone operators where the two agree that use of Netflix doesn't count against a user's quota. Netflix wins because they get more customer use, the operator creates a more compelling offering, and the customer wins because they get a better deal. This is called zero-rating and it flies in the face of net neutrality. There's also the fundamental issue of ownership - if someone owns the cables, why can't they set the rules? Especially in situations where ISPs can compete? And really, do you want yet another set of regulations set in stone, by a body like the FCC, that's vulnerable to regulatory capture in how it interprets and enforces net neutrality? Can you even define "net neutrality" in terms clear enough for a regulator to enforce?

Point being, it's not just about basic beliefs. There are substantive policy disagreements that don't arise purely from social differences. Sure, there are some people who just don't like transit. Maybe others think it's wasteful. Did you see New York spent 2.5 billion dollars to build less than two miles of subway recently? Reasonable people can disagree on whether that was a good use of money.

[1] https://www.nytimes.com/2017/12/28/nyregion/new-york-subway-...

"Don't study liberal arts. It's a huge waste of time."

Much bigger conversation I'm happy to have off-thread (email me). I agree with everything you've said.

I own an apartment building and the rent on a 1BR close to downtown is $875/month. Mind you, this is 2 blocks from a commuter rail station in a reasonable building that includes water and parking, in a city with a great park district, good schools, and plenty to do.

I didn't say you're living high on the hog--you're getting by. The household median income in Homewood is 57k. It's no Palo Alto, just a relatively modest town with reasonable local government and people who seem to care a lot. I like this.

Illinois is clearly on a fiscal crash course. I have no doubt about that and now that the fair tax was defeated at the ballot box, it's going to accelerate the insolvency. The state needs to get its pension obligations in line with its funding levels. Obviously that's going to take a decade. But I'm pretty convinced that this state's strengths (Chicago, great universities, lots of competent local governments) could make it bounce back. Especially seeing the direction a lot of other states like California are going, or San Francisco, a city that can't seem to balance its $13 billion annual budget after it increase 50% in the last 5-10 years. Any idiot can run Palo Alto, where the median household income is $140k. It takes a lot more to make a city with about 60% less income function.

Completely agree. Buttigieg (Mayor Pete) talked about this a great deal in his book. As a gay man, he recounted working with Mike Pence (Trump's VP) while Pence was governor of Indiana and he was mayor of South Bend. Talk about two guys you wouldn't expect to get along.

The key, as you pointed out, as did Buttigieg, is to identify areas where there are shared problems you can work together to solve. There's something about local government that seems to encourage this, in my opinion. Maybe you think gay people are awful and I go the pride march every year. Guess what, the water main is still leaking, and building permits take too long. Maybe we can just focus on working together to solve real problems, and accept that there are a range of social issues where we probably won't ever agree? And that's just fine?

I think we used to know how to do this in the United States, but something changed.

(Author here). I've been surprised that that's generally not the case.

Cities spend money on all sorts of things -- their own tax revenues, as well as grants from higher levels of govenment (state and local). If you look at the incentive structures of most local governments, their leadership wants to be seen as "doing something". This usually translates into big, tangible projects, particularly "infrastructure", that's "large" and that ordinary people can understand: bridges, malls, stadiums, etc.

Coming from venture tech, these projects are mind-bogglingly expensive. Even a mid-size office building costs millions to construct. 10-20 stories, big underground garages, easily into $xx or even $100 million, or more. These aren't pie-in-the-sky numbers, my wife is a practicing San Francisco architect. It costs $60-70 million to build a 200-unit "affordable" apartment building with ground-floor retail. That's like 5-10 mid-sized series As. Just to build a damn building.

Point being, in my conversations with the city government, they all sort of know there's something going pretty right in these coastal cities -- many places would kill to have the tax base and jobs of a place like Austin, or San Francisco -- they really just don't know _how_ to facilitate that. So much city government is wrapped up in tangible infrastructure like business parks, highways, and shopping centers when the things I most need, as someone building a technology company, is a nice, walkable downtown, easy-to-lease commercial real estate (not landlords that require 10-year terms, 20 years of operating history, and AAA credit), a reasonably responsive government, fast broadband, a few decent coffeeshops and restaurants, and nice people. None of these things are especially expensive and given how dysfunctional a lot of the coastal cities have become, it's not hard for a lot of places to provide. They just need to know _how_.

(Original author here)

Fight vs. flight. How do you decide? I'm just a bit older than you (36 currently) and haven't figured it out yet.

Like, if I think the politics somewhere are a dumpster fire, or to use your analogy, growing crops in a salted field, how do I pick the battles I'll fight, vs. the ones where it's best to let go?

Offhand, I tend to think it's worth fighting for when the thing is very important to you personally, it's something only you can do (whether by dint of identity, skills, whatever), or the benefits are large. Probably not worth it when you don't have the patience (might take ten years but you only want to put in 5), the other side is too entrenched, or the upside isn't worth it. Would love to hear your thoughts on this.

I think it's actually a decent time to buy (saying this as I sit in a commercial building I recently purchased in a south suburb). The tax situation can't get much worse, it's almost mathematically impossible to pay all these pensions, it can only get better from here.

Whether or not the "fair tax" passes will be an important bellwether.

I'm currently building a company in the mold described in this article (slow and steady). So a couple of firsthand observations.

First, I think every business has a natural speed. There are some businesses that can be made to grow really fast. Others, no matter how much marketing spend/growth hacking you throw at it, just aren't going to grow quickly enough to be truly venture fundable. I've seen a lot of these businesses started and they flame out quickly when the founders raise a ton of VC, build this huge staffed-up company, end up with a cost structure their revenues can't support, then don't hit the growth numbers their funding requires. Fast forward 18 months, the company is sold for parts and everyone walks away with nothing (especially if there's a huge liquidation preference overhang). That said, I do think some types of business (esp with strong network effects) need VC.

Another major factor is whether the founders are craftspeople who enjoy making great products, or are more the kind of people who want to make as much money as quickly as possible and "exit".

I think the biggest obstacle I'm going to hit is hiring. These companies don't profile as traditional "hot" VC companies which will bring certain unique challenges around hiring. I'll figure it out.

Great article, thanks for sharing.

At what cost? $50/hr?

Yes and no.

Most companies I see using H1-Bs are startups looking for people to get technical work done as cheaply as possible. These are the same people who give employees 0.1% of a series A company and whine about how there's a "skill shortage".

When in truth, there is no "shortage" -- it's just that software engineering is one of the only (somewhat) high-end careers subject to absolutely no credentialing whatsoever, meaning, if you can get someone here (to the US) and they can do the work, great, they're hired.

Contrast this to the absurd coddling present in other professions. Doctors, dentists, lawyers, architects, etc. have massive barriers keeping people out, competition down, and in the end, prices of their services up.

It blows my mind what middling lawyers can charge: $300/hr or more for mediocre law work for my California HOA. These people have zero side projects, don't study a minute out of work, and work strict 8-hour days, with the expectation of earning $250k/yr or more mid-career. This is what the cream of the crop in our field earns (Google SWEs making 350k or so). The cream of the crop for layers make millions/year at places like Cravath or Orrick billing $1000/hr or more. Even my wife, an architect, is now billing out at $250/hr.

It blows my mind how underpaid software developers are, given how difficult the work, and the working conditions are, compared to other similarly demanding fields in terms of professional education, and raw intellectual horsepower required to do the job. A typical H1-B can be productive a few months after a good software education anywhere in the world, assuming they speak passable English. My best friend's sister-in-law, an Indian dentist, had to retake the last year of dental school before she could touch a single tooth in the US.

The biggest winners from the H1-B regime are high-skilled professionals in the US. Low-end labor doesn't care about any of this. They work for cash, and still pay sales and property tax (through rent) just like the rest of us, and all for absolutely zero government benefits.