Setting prices by supply-and-demand and having insurance "pay for whatever is needed regardless of the cost" are incompatible. Insurance blocks the pricing cost signal back to the patient. Insurance also prevents better doctors that provide better service from charging more because the patients will pay for it.
An example: about 20 years ago I had just a major medical plan and I was at urgent care for a problem. After diagnosing the likely problem and prescribing the solution, they were about to run some tests "just in case." When I told them I would be paying for the tests due to the major medical plan, they explained that the tests didn't have any benefit, so we didn't run them.
I don't know of a real solution to these problems.
A partial solution is exposing some of the cost to the insured to create an incentive to save (like what I had when I was paying for the tests). At my company, we fully pay for a high-deductible plan AND a give company-funded contribution to a Health Savings Account that mostly covers the per-person out-of-pocket max. If the employee does not spend the HSA money (which is their money in their account), it can be used for retirement savings... so they have an incentive to save. But once someone hits the out-of-pocket max, there is no more incentive to save.
Patients must be incentivized to understand their care and question care that is unnecessary and wasteful. The partial solution you mention is the way to go, and if every employer adopted it, it will change the culture, and will at that point become a full solution.
Capitalist structures have a long history of pushing ownership of problems to the powerless individual, then exploiting information asymmetries (and actively obfuscating the truth that would allow for better informed decisions) for profit.
Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.
> Suggesting that the average person should be able to make medical decisions and override their health care provider’s recommendation is ridiculous.
The situation is similar to taking your out-of-warranty car to a dealer for repairs. Sometimes, you may suspect they’re not being completely honest with you. What do you do in that case? You get a second opinion before agreeing to a costly repair.
Sure, and that’s possible (at significant added cost) in a portion of cases. But not all - you might be on an operating table or in the middle of a psychiatric event, etc etc, where time does not permit second opinions, and if the system is set up to “gotcha” as a baseline, then only the most minor, time insensitive, situations will receive fair pricing.
> if the system is set up to “gotcha” as a baseline
This is what we have to change. When physicians and hospitals know that patients are scrutinizing care plans they will find a new fairer baseline. That cultural change will subsume older practices.
I'm willing to take a risk there because if my car craps out, I'll buy another.
Wish I can say the same about health. If the doctor who has my entire medical history recommends x procedure, yes I'm not going to risk potentially having irreversible damage to my body.
In my example in the grandparent post to yours, it was actually the empathy of the medical provider toward my paying the bill that prevented the unnecessary test.
Agreed that sometimes it is appropriate for insurance to say no.
After one round of physical therapy for tennis elbow, which made some progress but didn't completely clear up the issue, I got denied my insurer (not UHC) for the additional physical therapy that the PT recommended. The problem resolved itself on its own in a month without additional therapy. Seems like they may have been right that it wasn't medically necessary.
“But godliness with contentment is great gain, for we brought nothing into the world, and we cannot take anything out of the world. But if we have food and clothing, with these we will be content. But those who desire to be rich fall into temptation, into a snare, into many senseless and harmful desires that plunge people into ruin and destruction. For the love of money is a root of all kinds of evils. It is through this craving that some have wandered away from the faith and pierced themselves with many pangs.” — 1 Timothy 6:6-10 ESV
Here is the King James version, which I find it much more beautiful (from a literary point of view):
But godliness with contentment is great gain.
For we brought nothing into this world, and it is certain we can carry nothing out.
And having food and raiment let us be therewith content.
But they that will be rich fall into temptation and a snare, and into many foolish and hurtful lusts, which drown men in destruction and perdition.
For the love of money is the root of all evil: which while some coveted after, they have erred from the faith, and pierced themselves through with many sorrows.
Maybe but it makes much less sense to me. The meaning of “the love of money is the root of all kinds of evil” is very different to “the love of money is the root of all evil”. The former seems like a reasonable claim. The latter is surely untrue? I know of lots of evil acts NOT motivated by money or the love of money.
Here are a few key paragraphs from a sermon that has the most compelling explanation of that sentence that I've heard:
> When Paul said in 1 Timothy 6:10, “The love of money is the root of all evils,” what did he mean? He didn’t mean that there’s a connection between every sinful attitude and money — that money is always in your mind when you sin. I think he meant that all the evils in the world come from a certain kind of heart, namely, the kind of heart that loves money.
> Now what does it mean to love money? It doesn’t mean to admire the green paper or the brown coins. To know what it means to love money, you have to ask: What is money? I would answer that question like this: Money is simply a symbol that stands for human resources. Money stands for what you can get from man, not from God! (“Everyone who thirsts, come to the waters. He who has no money come buy and eat!” Isaiah 55:1.) Money is the currency of human resources.
> So the heart that loves money is a heart that pins its hopes, and pursues its pleasures, and puts its trust in what human resources can offer. So the love of money is virtually the same as faith in money — belief (trust, confidence, assurance) that money will meet your needs and make you happy.
> Therefore the love of money, or belief in money, is the flip side of unbelief in the promises of God. Just like Jesus said in Matthew 6:24 — you cannot serve God and money. You can’t trust or believe in God and money. Belief in one is unbelief in the other. A heart that loves money — banks on money for happiness, believes in money — is at the same time not banking on the promises of God for happiness.
> So when Paul says that the love of money is the root of all evils, he implies that unbelief in the promises of God is the taproot of every sinful attitude in our heart.
I get what you're saying, but as someone completely unfamiliar with the Bible but familiar with the common phrase, "Money is the root of all evil", I agree that the GP's original statement is much clearer.
> For the love of money is a root of all kinds of evils.
This reads not that money itself is the root of evils, or even that a desire for money ensures you live a sinful life.
To me this reads that money, as a motivator, can be a catalyst to dip into immoral practice. If someone wants riches but cares not about how they acquire it, they may steal, they may start wars, they may con others, etc. But someone who uses their desire of money as a catalyst for bringing world change via a new product, service, knowledge, is well found in their desires and implementation, as they are making the world better while achieving their goals.
The contrast in translations completely alters the takeaway for me.
> But someone who uses their desire of money as a catalyst for bringing world change via a new product, service, knowledge, is well found in their desires and implementation, as they are making the world better while achieving their goals.
For what it's worth – and I think it is a worthwhile thing to note – I do not believe that Jesus would condone this.
To Christ, the root of "well-founded" behavior is the golden rule – treat others as you would want yourself to be treated. This comes from the Sermon on the Mount.
Capturing value (a requirement to satisfy the desire for money) from exchange with your customers is not how you would want to be treated, as a customer. If you become wealthy from this exchange, you are violating the Golden Rule.
This sentiment is corroborated elsewhere, with another a famous saying of his that's often "explained away" but should probably be taken seriously.
> It is easier for a camel to pass through the eye of a needle than for a rich man to enter the kingdom of God.
Martin Luther (of Lutheranism) has some interesting writings/interpretations on this subject [1], if you're interested.
Edit just to make it clear in a TLDR; the severity of the "money is the root of all evil" translation is warranted. I'd interpret the "all kinds of evil" translation as "every kind of evil", rather than "many kinds of evil" (which is how we colloquially interpret 'all kinds' in contemporary english).
Thank you for the response and the links. It's an interesting perspective on life, but I'm not sure I'm totally sold.
> 17And as he was setting out on his journey, a man ran up and knelt before him and asked him, “Good Teacher, what must I do to inherit eternal life?” 18And Jesus said to him, “Why do you call me good? No one is good except God alone. 19You know the commandments: ‘Do not murder, Do not commit adultery, Do not steal, Do not bear false witness, Do not defraud, Honor your father and mother.’” 20And he said to him, “Teacher, all these I have kept from my youth.” 21And Jesus, looking at him, loved him, and said to him, “You lack one thing: go, sell all that you have and give to the poor, and you will have treasure in heaven; and come, follow me.” 22Disheartened by the saying, he went away sorrowful, for he had great possessions.
Here we do see the commandment for this rich man to rid himself of his possessions, but the command instructs him to take the proceeds and give it to the poor.
In selling his goods, does the man not capture value from his customers? He does so, and then is able to transfer the value freely to those who have none.
IMO, capturing value through voluntary transactions isn't robbing the counterparty. In fact, you may be treating them exactly as they wish to be treated. For example, I am quite happy to buy a phone for $700. It would take me far more than $700 to make my own phone, so the trade is really quite good for me. And I don't mind that some of the $700 goes to paying the people that did create the phone. Both parties are left better off.
Assumingly my employer feels the same about me, and we trade time for money. With the money, I can support myself and use the surplus to give freely to others.
I don't see any of this as a bad thing. But if I did rent out a house that was mold infested, knowingly, and refused willfully that fix it, that would be a violation of the golden rule.
> In selling his goods, does the man not capture value from his customers?
No, because selling goods is not the same thing as capturing value. Jesus is not asking for the man to first accrue wealth and then distribute it, he's asking the man to liquidate his wealth and distribute them. The implication is that the man developed his wealth through value capture.
> I don't mind that some of the $700 goes to paying the people that did create the phone. Both parties are left better off.
This unfortunately omits the many other parties involved in the supply chain, who are exploited and whose exploitation is carefully elided or hand-waved away by the phone vendor.
You're not exploiting them, though. Even the vendor has plausible deniability – because local governments have "different norms" around worker safety. And hey, they have money now that they didn't have before! So don't look too closely, OK?
You're a point of negative pressure (demand) in the system, that collectively keeps the whole system in balance. It's difficult to wrap our brains around and difficult to accept, which (IMO) makes its informed maintainers worse than a petty criminal.
Of course, capturing value through voluntary transactions does not necessarily rob the counterparty. But in today's complicated global economy, it's unfortunately insufficient to look at your transactions in isolation to know that you're not robbing somebody by proxy, or becoming an accessory to a robbery.
To put it in relief: is money laundering a violation of the golden rule, even if you capture no value from said laundering?
I don't think it was possible to investigate the entire supply chain even before the modern era. I go to a farmer and buy some crops, or barter with them. Who's to say they don't have slaves, or don't have good working conditions, etc.?
How does an economy work under your system? I must create demand somewhere. I need food. I need clothes. I need shelter. Amd I want things. Eventually I'll need to trade, and that trade will benefit both parties by making them both better off. But by becoming better off, some value was captured: I value what I purchase equal to or more that what I gave up. The concepts of marginal costs and revenue come into play here. Under your system, do I have to abstain from all trade if my marginal revenue exceeds my marginal cost? How do I scale?
> Who's to say they don't have slaves, or don't have good working conditions, etc.?
This is what social norms are for, and we have done it forever. The modern era has made this exponentially more difficult.
> Eventually I'll need to trade, and that trade will benefit both parties by making them both better off.
Yep yep, totally fine if you're not exploiting anybody.
> But by becoming better off, some value was captured: I value what I purchase equal to or more that what I gave up.
As long as you're creating value throughout the chain, you're doing just fine.
> Do I have to abstain from all trade if my marginal revenue exceeds my marginal cost?
This is actually an interesting question! The Luther piece touches on this a lot (where is the line between "Usury" and "Commerce"?). The answer he arrives on is no, you don't need to abstain, and that division of labor is not Usury.
The point is not to avoid profit, it's to avoid breaking the golden rule – there's no hard cutoff around how much profit is "too much" profit, but a rule of thumb that's often quoted (for whatever reason) is around 30% – i.e. if you see a gross profit that's consistently at or above that number, there's usually exploitation happening somewhere.
> How do I scale?
The answer depends on what we mean by scale. Revenues? Profits? Headcount? Volume of throughput?
Recently introduced a friend to Desiring God. Changed their whole perspective on Christianity. Took things back to basics for them, here’s what Jesus actually said, here’s what the Bible actually teaches, no sensationalism, let’s calm down and dive deep.
Here are some favorites of mine, bookmarked and ready to reread whenever I feel the urge.
If you're looking for clear, unambiguous moral guidance, then sure, you have a point. For me it's more about how it sounds, the poetry of it all, and less about guiding my life, my spiritual life or my morality.
Please don’t do this, there are many people and stories that speak to this. Now it looks like you’re claiming this for one particular religion, when it’s completely unrelated to religion.
Wisdom/Insight/Life Advice wherever it comes from is always valuable. It is up to you to tease out the kernel of knowledge from the chaff of religiosity.
I am no Christian, but i found Robert Alter's The Wisdom Books: Job, Proverbs, and Ecclesiastes quite interesting and would advice you to a study of the same.
He is sharing a quote from a religious book, it makes sense to cite it, no? If they quoted the Qur'an, a Buddhist Sutra, a piece by Kahlil Gibran, or a quote by Adam Smith, I would all expect a citation to be honest.
A few comments around we see a quote by Rick Roderick, and one by the Beatles. I don't see why this is fundamentally different and deserves critique.
Quoting a religious/ideologist book is inherently different to quoting an individual author or a non-religious/spiritual text, because the act of quoting itself is part of a tradition of (in this case evangelical) propagation of the religion/ideology.
We can pretend to see contemporary bible-quoting as a secular thing, but in these cases history matters.
For instance, in the above quote in the part "It is through this craving that some have wandered away from the faith and pierced themselves with many pangs." it is obvious that the quoted passage goes beyond a non-religious moral text and veers into religious moral judgement.
Furthermore, quoting a passage does not isolate you from the whole of the work, as you would probably take offense to me quoting WWII dictators even if the quote makes sense for the topic in isolation.
What I'm saying is all quite obvious and on the nose behavior by religious (or ideologist) people, who absolutely view quoting as a religious/ideologist act as described above.
I'm confused at what you are trying to say. As far as I can tell, it appears you are saying something like "don't quote religious texts in a way that makes them look like they have any claim on moral authority". And it appears to me that you are saying "moral authority", in this case, is a-religious and should not be related to any particular religion.
Well, fundamentally moral authority is a misguided idea, morals don't flow from an authority, morals are constructed and transformed over time by society. Taking your morals from an authority directly is itself immoral, as they don't have a foundation of human rights or empathy but rather are based on arbitrary ancient writing of arbitrary ancient writers.
I'm saying quoting religious texts without religious context (like you say, morals are not inherently religious) is not a secular act and can not be separated from the religion because of the history around quoting religious texts. Quoting religion in a moral discussion introduces religion into a discussion where religion is not necessary, and could even be harmful.
That's not to say you should never do it, but doing it is not the same as quoting any other text or other author. Again I'm not sure why this is controversial, regardless of the other comments quoting Hitler or Mao's red book in a moral discussion would very much be very weird if there is no reason to introduce any of his writing.
> Taking your morals from an authority directly is itself immoral, as they don't have a foundation of human rights or empathy but rather are based on arbitrary ancient writing of arbitrary ancient writers.
Where do you think should morals come from? A more precise question would be "where does human morality arise from?" Or even more fundamental, "why is it wrong to do one thing and not another?".
Given what you've said about religion and moral authority, I am genuinely curious to know your answers to these questions.
However, its quite simple to resolve. The gist of it is: if you need a deity holding judgement over you to distinguish right from wrong, you are probably a psychopath.
> as you would probably take offense to me quoting WWII dictators even if the quote makes sense for the topic in isolation.
Of course I wouldn't take offense to that. I will accept wisdom wherever it is to be found, even if it's from Hitler himself. I care about the merit of ideas, not the merits of their sources.
This text sits at the wellspring of Western culture, such as it is. You don't need to accept any metaphysical claims that it makes in order to appreciate its wisdom.
There is nothing wrong with drawing on the values that a text carries without necessarily agreeing with it in its entirety. This quote captures the point of the post above quite well.
The book "Principles for Dealing with the Changing World Order: Why Nations Succeed and Fail" by Ray Dalio compares the rise (and decline) of the American "world empire" to prior world empires. The two most recent are the U.K. and the Netherlands.
The same things that are happening now have happened before -- just not in our lifetimes. The history and his analysis is quite instructive.
The book was refreshing in its objectivity, lack of political bias, and clarity of writing. I've given copies to several friends.
It's pretty clear from his analysis and the data that the U.S. is in a decline of global influence.
> The book "Principles for Dealing with the Changing World Order: Why Nations Succeed and Fail" by Ray Dalio compares the rise (and decline) of the American "world empire" to prior world empires.
Why should I put much stock in historical analysis done by a "American billionaire investor and hedge fund manager" [1]? My gut feel that someone like that probably has so much other stuff on his plate that the analysis would be in many ways superficial, and such a person likely has enough status that large numbers of people would indulge his pretensions at being a polymath even if it's not actually true.
The heat flux through the walls depends on the temperature of your apartment and your neighbor's apartments -- not on if your thermostat is on or off. So even if you leave your thermostat on at 19° you still benefit. And you have no obligation to turn your thermostat up.
The argument for theft would have to assume that there is a "right" temperature to set. Personally I would be sweating in a t-shirt if I had the heating set to 22C, which would be the only way to prevent the cooling in the example.
As others have pointed out, it's a happy coincidence that the equilibrium is at a point that GP is happy with. If it were higher they would have to actively cool their apartment which can be seen as a cost, sort of comparable to dumping trash on someone's property forcing them to pay to deal with it.
Five Dysfunctions of a Team completely was absolutely revolutionary for me and my team. It's not about MBTI at all, but MBTI is just a tool it mentions to help with dysfunction one.
Here are the five dysfunctions:
The foundational dysfunction is a lack of trust -- trust defined as belief that your skill weaknesses and deficiencies will not be used against you. So people conceal weaknesses and don't ask for help from each other, etc.
This leads to fear of (healthy, productive) conflict -- you don't hash things out, but rather any meaningful discussion gets suppressed. Creates an environment where back-channeling and politics thrive, etc.
This leads to lack of commitment -- the team has not really had heathy, productive conflict/discussion so they don't buy into decisions. There is ambiguity about direction and priorities.
As mentioned - I have read the book, and I'm not opposed to the some of the ideas in the book. However, the endorsement of MBTI is just really damn hard for me to swallow.
> MBTI has the predictive value of horoscopes, more or less
My understanding of MBTI is that it's not supposed to be predictive, but it helps you understand a different person's preferences or view-point. Preferences don't necessarily predict behavior.
Understanding the J vs P preference difference was revolutionary early in my marriage. I'm P and my wife is J, and our different preferences on that dimension helped explain much of our conflict. And understanding her preference helped me be more considerate and loving to her. MBTI helped me understand her (not predict her).
When I read a description of an MBTI type for someone I know really well, about half of it rings true -- but then reading and talking through it together sparks a great conversation where we learn a lot about each other.
The book does recommend using a qualified MBTI coach/trainer, so that it's not mis-used.
I'm assuming the predictive power is in relation to fact the MBTI has been shown to have low repeatability in the test results, which undermines its ability to predict the actual personality of the individual in question.
This interested me enough to read some of that chapter. Here are a few quotes that give more context:
> Traditional operations teams and their counterparts in product development thus often end up in conflict, most visibly over how quickly software can be released to production. At their core, the development teams want to launch new features and see them adopted by users. At their core, the ops teams want to make sure the service doesn’t break while they are holding the pager. Because most outages are caused by some kind of change—a new configuration, a new feature launch, or a new type of user traffic—the two teams’ goals are fundamentally in tension.
...
> The use of an error budget resolves the structural conflict of incentives between development and SRE. SRE’s goal is no longer "zero outages"; rather, SREs and product developers aim to spend the error budget getting maximum feature velocity. This change makes all the difference.
...
> ...the decision to stop releases for the remainder of the quarter once an error budget is depleted might not be embraced by a product development team unless mandated by their management.
An example: about 20 years ago I had just a major medical plan and I was at urgent care for a problem. After diagnosing the likely problem and prescribing the solution, they were about to run some tests "just in case." When I told them I would be paying for the tests due to the major medical plan, they explained that the tests didn't have any benefit, so we didn't run them.
I don't know of a real solution to these problems.
A partial solution is exposing some of the cost to the insured to create an incentive to save (like what I had when I was paying for the tests). At my company, we fully pay for a high-deductible plan AND a give company-funded contribution to a Health Savings Account that mostly covers the per-person out-of-pocket max. If the employee does not spend the HSA money (which is their money in their account), it can be used for retirement savings... so they have an incentive to save. But once someone hits the out-of-pocket max, there is no more incentive to save.