nvm0n1

It's silly to claim British companies were flouting employment law on a massive scale just a few years ago. That wasn't the case, especially as even pre-2017 legal costs were awarded to the winner and you can get a year's wages as winnings.

There's a big gap between the US and UK in this regard. The UK has and enforces the concept of an unfair dismissal as distinct from being fired due to discrimination. The US has the latter but not the former. In the UK you can't lay someone off if it would be unfair or if your dismissal process was unreasonable, where unreasonable can mean purely bureaucratic reasons like not following your own dismissal checklists.

In addition British employment tribunals are very worker friendly, resulting in frequent bizarre outcomes [1] like:

- "A worker who was absent for 808 shifts over a 20-year career – costing the firm an estimated £95,850 in sick pay – has won tribunal claims of unfair dismissal against his former employer." (employee won because employer didn't follow their own absence management procedures).

- "An office manager was discriminated against after she was told she was not allowed to work remotely from her son’s hospital bedside", deemed unfair because the boss "gave her views no credit" and "had a closed mind".

- "Worker unfairly dismissed for complaining about boss on Facebook, tribunal rules"

- An NHS worker who resigned won an unfair dismissal claim, because her workers had played a practical joke on her at one point and didn't like it when she complained.

- A lecturer accused of sending “aggressive” messages to colleagues was awarded £15,000 for unfair dismissal after an employment tribunal ruled there had not been a proper investigation into the allegations made against him, whilst also concluding that he had indeed sent aggressive messages.

The idea that this is a country that's "aggressively reduced safeguards for workers" will seem blinkered to the Americans on this site, who can be fired with zero notice and for any reason at all, with recourse only available if it can be proven to be sexism/racism/union organizing/etc. Winning huge awards because you weren't allowed to work remotely hardly exists there.

[1] https://www.peoplemanagement.co.uk/article/1747159/worker-ab...

Why does preventing cancer make less GDP than curing it? That would surely depend on how you're trying to prevent cancer. By prevent do you mean keeping a cancer somewhat under control?

> smoothly transporting oil without incident makes less GDP than spilling it.

Oil creates huge economic activity when used. It does no good spread over the ocean. The cleanup generates activity, but it's clearly far better for GDP to smoothly transport oil around than constantly lose it, if only because ships constantly sinking would cause people to transport things way less and so markets would be less efficient, yielding less wealth.

That's in a small town not Dublin proper, right? Gotta say that's a huge number of deliveries for a weekend in a place with only 30,000 people living there. Was that weekend during a special offer?

They aren't that similar. US has at-will employment, it's very straightforward. In the UK that's only true for a short period, then Euro-style worker protections start kicking in.

The US is self-sufficient in oil because it developed the tech to do fracking of the oil sands, it's nothing to do with Iraq.

> cancer patient is diagnosed, the GDP goes up. Is this how we measure economic progress?

Yes, obviously so! Diagnosing cancer early is one of the best ways to save someone from it. The cancer is there anyway, it's a natural occurrence. The economic activity that leads to and follows a cancer diagnosis is what economists call wealth: the things we do for each other than make each side mutually better off.

All the examples are like that. Nobody wants oil to spill, but accidents are a fact of life. The GDP created by mopping it up on the other hand leads to a cleaner environment, which is another form of wealth.

Indeed that's so, but it's not what I said. Those politicians want to dismantle the NHS because they believe that it will inevitably fail regardless of what they do, indeed that it already is failing, and that there's just no way to make that structure work, no more than the USSR could be made to work. That's not the same as wanting it to fail. Clearly life would be easier for them if it weren't the case as then they could avoid being blamed by voters for it.

The book doesn't say they want to replace the NHS with a US style system. Have you read it? I haven't but according to the Guardian - the least friendly and neutral reviewers imaginable - they argue for a French style system instead:

https://www.theguardian.com/politics/2012/aug/22/britannia-u...

Sometimes these are less fearsome than you might expect – Raab likes the French healthcare system; Truss admires the German economy – but often the foreign models cited are Asian

Observe: no mention of the USA. But it seems that the book must hardly mention health, given that healthcare isn't even mentioned on the Wikipedia summary of the book and the Guardian review mentions it only in passing.

The idea that the Tories hate the NHS for ideological reasons and want the US system is a common idea on the British left, but that's not what they really think. What they really think is that the NHS is a lost cause and a European health insurance model would work better. They also think a US style economy would be beneficial. Given that the US is now a lot richer than the UK and their economy is motoring ahead, it seems the book's prediction of a "slide into mediocrity" has come true. The ultimate determinant is wealth - given enough of a gap, a poor Britain will always have worse outcomes than a rich USA regardless of how healthcare costs are paid.

Kinda odd phrasing from Nolan there. "The rise of companies over the last 15 years bandying about words like ‘algorithm,’ not knowing what they mean in any kind of meaningful, mathematical sense."

That's a description of scriptwriters and journalists. Tech companies know well what they mean when they say algorithm, especially what they mean mathematically. It's the non-tech class that talks about algorithms as if they are magical spells of mind control which is why they think that "Meta’s contribution to genocide in Myanmar" is a real thing and why they are shocked that Threads, being a social network, uses a "purely algorithmic feed" (emphasis in the article).

"as AI systems go into the defense infrastructure, ultimately they’ll be charged with nuclear weapons"

The logic of MAD is simple that's why it's a three letter acronym. Nukes could be put under automated control for decades now and AI wouldn't change anything about what those control systems would do. Detect a pile of nukes heading your way from Russia/China -> fire back. No fancy schmancy AI needed for that!

“When I talk to the leading researchers in the field of AI they literally refer to this right now as their Oppenheimer moment,” Nolan said. “They’re looking to his story to say what are the responsibilities for scientists developing new technologies that may have unintended consequences.”

So much more exciting than the banality of the truth: neural networks are useful algorithms but not nuclear weapons. Not even close.

Given one of the primary justifications for not leaving the EU was to retain access to unlimited cheap labor for the NHS, it isn't easy to blame low medical worker wages on Brexit. If you want medical staff to make more money, removing their primary source of competition is a quick way to do that.

In practice of course Brexit has done no such thing as the immigration rules in the UK are still optimized for mass immigration, as the Conservatives are so much not xenophobic that they prefer to enrage their own voter base than restrict immigration by even small amounts.

As for healthcare spending, the massive jump in NHS spending during the pandemic more than consumed the former EU contributions. The EU funds did indeed go to the NHS and then a lot more on top. If the UK was still paying in, then inflation would be even worse.

Switzerland has a massive foreign-born population compared to other places - their largest city is something like 30% foreign - yet very few problems caused by that even though those people often don't learn the local dialects or not even German/French at all. If it were actually a xenophobic society (spelled with PH not F in English) then they'd be having race riots all the time.

In practice Switzerland is one of the more accommodating societies in the world. Most Swiss people don't move far from where they grow up though, so often still have friends from school. It isn't a culture oriented towards chatting with strangers or making new friends at the drop of a hat, but that's not the same thing as xenophobia. Swiss who move abroad then back after many years experience the same difficulties with making new friends.

"Getting worse" can be relative. If progress in your country had stopped in 1920 then it would be fair for people who lived there to think things had got worse over the past 100 years when they look to America and see how people live there.

I don't think the UK has ever had a government that actually wanted the NHS to fail. Even the most right wing conservatives realize they're stuck with it and that voters will be happier if it works better. They have very few levers to achieve that. Private sector involvement is one but not a very powerful one given that the NHS killed off the private health sector in the UK and ensures it can't regrow to any kind of meaningful capacity. To the extent it grew in the last few years that's only because the NHS is now in the stages of advanced collapse, failing to provide even the most basic services you'd expect and therefore for some paying twice is the only way to get healthcare at all.

I also really doubt there are many in government or politics who want a US style system. The US has a strange system replicated nowhere else (much like the UK). The way healthcare is tied to the employer there is a legacy of socialist economics during WW2. To try and stop inflation wage controls were implemented so companies started to compete via non-wage benefits, like bundled health insurance. Then for reasons I don't know it was made tax-exempt, so the tax system incentivized workers to demand healthcare through their employer instead of paying it themselves. And then legal changes and union campaigns cemented that system. Part of why US healthcare is so expensive is the sheer number of layers between the people who use it and the act of paying for it. It's very much an accident of history born in the war, and not a model to obviously replicate.

The UK system is likewise rather dysfunctional thanks to WW2. Years of wartime propaganda followed by a victory convinced Brits that the government must be very good at things, and of course this was an era in which socialist economics was taken seriously across society. So on victory the UK immediately voted in a Labor government that nationalized many industries including the entire healthcare system, with Bevan famously dividing and buying off doctors who realized it'd be a bad idea by "stuffing their mouths with gold". Governments have attempted to use the same strategy to solve its problems ever since, yet have never been able to predict or control costs in the way a business would need to. Even in its very first year, costs were double what was predicted. This is very far from the original belief that GDP improvements from the NHS would be so great it would effectively pay for itself.

Maybe. There's a lot of noise in these measurements. A lack of error bars doesn't mean a lack of errors. For many years activist orgs and newspapers liked to claim the UK was at the rock bottom of EU healthcare spending, that it spent far below other nations. When new accounting standards came in that tried to unify the way healthcare spending was measured between nations, overnight the UK went up to be about the middle of healthcare spending. The reason was, social care spending hadn't previously been reported as healthcare spending in the UK whereas in other places it was. Standardizing that fixed the disparity.

There are still big sources of error in these numbers. It's not obvious, but spending on IT systems and hospitals (capital investment) isn't included in these numbers, yet these have sucked up a lot of NHS spending over time especially in the form of large failed IT projects, and capital expenditure on hospital buildings has often been done "off the books" in the UK using PFI schemes.

Unfortunately the ideological basis of the NHS means that many people feel a nearly moral obligation to argue its failings are always about money, especially Brits who work in the healthcare world themselves. It's a risk free strategy. To criticize the way the NHS is actually structured or operates would come dangerously close to wrongthink.

Alternative hypothesis: it's hard to define what "smart" and "dumb" mean, and the metrics they're using are optimizing for a different definition than what other people are using.

For example if their definition of "smart" means refusing to answer questions on delicate or specialized topics, then in some way they've made the model smarter but in ways they made it dumber.

The Swiss system works well. It at least isn't in crisis like many of the others.

Your study doesn't actually say that. You'd expect their comparison to be with other developed countries given how it's worded, but in reality:

The UK had the lowest healthcare expenditure per capita relative to our comparator countries (UK, $3825 (£2972; €3392); study average, $5700), although this was roughly in line with the average healthcare expenditure of the OECD member states ($3854) and the EU member states

So the UK spends about the same as other EU and OECD countries. It only spends less compared to a set of hand-picked "comparator countries" which are: Australia, Canada, Denmark, France, Germany, the Netherlands, Sweden, Switzerland, and the USA.

That's a remarkably cherry-picked list. If you average such a small list then the mean will be dominated by healthcare spending in the USA. To get better and less cherry-picked data you can turn to the ONS. See Figure 1 (2017) here:

https://www.ons.gov.uk/peoplepopulationandcommunity/healthan...

The UK is around the same level as Finland, New Zealand and other developed countries.

This chart really makes it obvious how they picked their "comparator countries": all the countries that spend the most on healthcare. That isn't surprising. It's hard to get a more biased source on British medical spending than the British Medical Journal. Of course academics specializing in healthcare will claim the UK doesn't spend enough on healthcare.

Integrated healthcare systems in other countries like Kaiser can balance patient flows between hospitals and care homes. This is something that in theory the UK should be good at given it's also an integrated system, but the dysfunction caused by trying to have the government centrally plan everything means it doesn't work in practice. The issue isn't under-funding, the UK social/healthcare system has plenty of money relative to peers.

Beyond general disorganization the UK system shoots itself in the foot regularly. Care homes are bottlenecked by labor cost, so their solution was:

1. Raise the minimum wage, thus increasing care prices and ensuring more people can't afford to pay for it even though there's lots of available labor.

2. Fire huge numbers of carers because they didn't want to get vaccinated, even though the vaccines weren't reducing transmission and their elderly tenants were multiple-vaccinated anyway.

(2) was especially damaging because care homes were one of the few sectors that had vaccine mandates in the UK, so people have now learned that if they go to work at care homes then they will be forced to take experimental medical things even if they don't want to or if it doesn't seem to make sense. That's a big downside to a job that already had few upsides.

Do all doctors need that much or is it just the homogenizing effect of licensing? You could argue that programmers need many years of schooling and apprenticeship to become useful if you set the bar of utility at the same place Google used to, but in reality most people can be useful way before that. Also self-learning makes a big difference but isn't recognized by the medical licensing system.