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Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @01:05PM (#38395578)
Their imagined future resurgence scenario -- someone in a lab gets infected, then travels abroad -- highlights one of the reasons developed countries need to help less developed countries: Out of enlightened self interest, not "charity" nor "the goodness of their hearts."

We currently are de facto breeding antibiotic resistant infections in places without adequate sanitation or water infrastructure and you can go from pretty much anywhere on the planet to pretty much anywhere else these days in 24 hours or less. When people from developed countries get sick while someplace else, they are often medevaced out to get them good care in a modern facility, thereby potentially exposing people in their country to whatever they have.

We need to do a better job of providing basics like adequate water infrastructure worldwide if we want to be free from such diseases in our cushy developed countries.

Re:Polio Is on the Brink of Eradication by iwontberude on Thursday November 23, 2023 @04:43PM (#38397908)
I had this realization when I was like 8 years old. It goes to show how undemocratic our governments are that we still cannot get the leaders, who are more insulated from the effects, to act on our vulnerability.
Re:Polio Is on the Brink of Eradication by boxed on Thursday November 23, 2023 @03:12PM (#38396999)
This is the same reason rich people should put a ton of their resources into basic science, tech, and health infrastructure.
Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @03:46PM (#38397339)
And since philanthropic approaches to such aspirations demonstrably do not work, we need extremely high taxes on the ultra wealthy.

Before the six-seven digit earning engineers here lambast me, I'm talking billionaires.

No one intelligent can/has yet looked me in the eye and told me earnestly: anyone with a billion + $ would have a single degree lower quality of life if their wealth was capped at 999 million

If you want empirics google "highest marginal tax rate 1950- present" and "infrastructure spending 1950- present".

Re:Polio Is on the Brink of Eradication by PoignardAzur on Thursday November 23, 2023 @04:37PM (#38397855)
> And since philanthropic approaches to such aspirations demonstrably do not work, we need extremely high taxes on the ultra wealthy.

Pretty bold to claim that government intervention post-taxes would work better than philanthropic fundations.

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @04:59PM (#38398043)
Is it bold? What percentage of all of our modern infrastructure is from the benevolence of philanthropists?? I am sure it's not zero, but I can't imagine it being a majority... But please enlighten me. For "billionaires know best what to do with all that wealth, they'll take care of us" sounds an awful lot like what sbf was preaching.
Re:Polio Is on the Brink of Eradication by PoignardAzur on Thursday November 23, 2023 @07:42PM (#38399522)
No, I agree that government investment in infrastructure is usually good.

My point is, when you're talking about investing in foreign developing countries, government programs will face the exact same failure modes as philanthropist-backed NGOs, with about as much accountability.

Re:Polio Is on the Brink of Eradication by robertlagrant on Thursday November 23, 2023 @05:17PM (#38398216)
This reasoning doesn't seem very sound. Infrastructure is far too broad, to the point of irrelevance. "Sounds like SBF" is also not reasonable.

How about this: the state is bad because it declares war and sends people to their deaths. Its projects often go astonishingly over budget, corruption is high in many countries, and its funding is unreliable, as it's prone to not keeping the promises of the people previously in charge.

That accurately describes almost every state that ever existed. If you have a similar list for all philanthropic institutions, that would be a good start in justifying your claim that philanthropy doesn't work, so we have to take the money and let the bureaucrats handle it.

Re:Polio Is on the Brink of Eradication by celticninja on Thursday November 23, 2023 @06:57PM (#38399197)
The state can do both good and bad things. Even in your war analogy, Russia (a state) can invade Ukraine and murder it's citizens, but Ukraine (a state) can defend it's citizens. USA can have no affordable healthcare for citizens, Sweden can have affordable healthcare for it's citizens.

A state can provide e.g safety or healthcare for millions, a philanthropist could not operate at that scale for a long time. Philanthropists also die on a shorter time frame than states and their successors may not want to continue to support the same things.

I don't think the claim was that philanthropy doesn't work. But it doesn't scale to the levels of what a state can achieve. And therefore it is an inefficient way to use the resources. For every billionaire philanthropist that builds a hospital wing there are 50 more who buy 2 yachts. Tax them all and you can build 51 hospital wings and they can all have a single yacht each.

Re:Polio Is on the Brink of Eradication by spit2wind on Thursday November 23, 2023 @06:00PM (#38398690)
It sounds like you view the state as bad. Even when that state is democratic?
Re:Polio Is on the Brink of Eradication by wegfawefgawefg on Thursday November 23, 2023 @07:05PM (#38399263)
The less average a citizen is, the less accurately the democratic function approximates their interests.

Additionally, our democratic function has strange domain mismatches were it has been overfit on unusual cases. Anyone who is more agency seeking than average will likely confront some vogonic laws and develop conflicting feelings.

try the book Everything I Want To Do Is Illegal.

Re:Polio Is on the Brink of Eradication by dghlsakjg on Thursday November 23, 2023 @10:22PM (#38400374)
Alternatively, the farther away you are from average when it comes to wealth and resources, the more the state can benefit you.

People in the bottom percentile are tremendously well served by many modern democracies, despite your assertion to the opposite.

If I’m going to be severely disabled (extremely far from average), I would much rather do it in a modern western democracy, instead of any other form of government.

Re:Polio Is on the Brink of Eradication by wegfawefgawefg on Friday November 24, 2023 @09:12PM (#38410521)
Those people will not be well represented by a democracy.

Blind people, cripples, and fetuses barely have a voter base.

You also need to specify in what direction someone is not average. (You meant below average). Wheras my point was just more general. Weirdos wont be represented, whether that means exentric inventor, amish orthodoxy, cripple, or homeless person.

I personally was responding to the other person who was asking why some people come to see the government as an enemy. Assuming they know that for some it is just culture, or indoctrination, I offered a relatable explanation for why an intelligent person might feel impeded by many laws.

I assume given their question they already know and believe democracies are better to live in than other forms of government lol.

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @05:32PM (#38398401)
>the state is bad because it declares war and sends people to their deaths

Wouldn't it make more sense to conclude war is bad, rather than states themselves?

>Its projects often go astonishingly over budget, corruption is high in many countries, and its funding is unreliable, as it's prone to not keeping the promises of the people previously in charge

All of this I agree with. But the solution isn't "less states" it's... Better states, surely? What am I missing here?

My point with the question about where a majority of our infrastructure comes from, (roads, schools, hospitals, water, electricity and sewage systems to specify as a start) the state or the benevolence of philanthropists was to demonstrate that there is quite a bit of evidence as to what structure is the better steward of societies, a bunch of rich guys, or a state with some mandate to do right by its constituents.

Re:Polio Is on the Brink of Eradication by whakim on Friday November 24, 2023 @01:32AM (#38401166)
I agree that this is a bold claim. However, tax-deductible philanthropy is profoundly undemocratic, because it effectively amounts to everyone else subsidizing the philanthropic preferences of the ultra-wealthy. I think the onus is therefore on proponents of private philanthropy to prove its efficacy outweighs its democratic deficit.
Re:Polio Is on the Brink of Eradication by rpmisms on Thursday November 23, 2023 @04:27PM (#38397770)
So, the state should control any large enough corporation? Or there should be a ban on over $999m in cash? Or should the government just not waste the absurd amounts of money we already give them?
Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @04:32PM (#38397810)
>state should control any large enough corporation

Not necessarily, company could be broken down in to smaller, become employee owned in some part, could have some amount of stock become owned by an infrastructure fund or something. There's many ways to skin a cat

Re:Polio Is on the Brink of Eradication by wingworks on Thursday November 23, 2023 @04:55PM (#38397998)
I'd love for this to work, but in practise I feel the owner on the 999m will more likely stop investing in sed company when it reaches 999m and spin up a new company or some other loophole to get around it. (or if it's individual wealth, then they'll use trusts or some of the many other options available to them.)

If there are no options, you better believe they'll create them soon enough.

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @05:11PM (#38398178)
>or some other loophole to get around it. (or if it's individual wealth, then they'll use trusts or some of the many other options available to them

Completely agree, it will always be a cat and mouse game. But it's a worthy aspiration, and I'd argue the reason the wealthy have been the cat more than the mouse in the relationship with the state is due only to the budget disparity between them.

Start to shrink the disparity between the enforcement budget (think IRS special forces for the ultra wealthy) and the "avoid taxes" budget and the aspiration looks a lot more doable.

>owner of the 999m will stop investing

Maybe. Or maybe they'll get better and spending rather than hoarding and continuously need to replenish that stock.

Even if these "winners" of a more 'social capitalism' stopped gracing us with their genius, the surplus of wealth in endeavors like free stem schooling for everyone (that wants it) would surely make up for that loss??

Re:Polio Is on the Brink of Eradication by robertlagrant on Thursday November 23, 2023 @05:19PM (#38398257)
> Not necessarily, company could be broken down in to smaller, become employee owned in some part, could have some amount of stock become owned by an infrastructure fund or something. There's many ways to skin a cat

If you think taking money from paper billionaires is going to make a material difference to the US's $6 trillion spending each year, can you quantify how much are you expecting it to raise?

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @05:35PM (#38398419)
You're right that reducing spending, particularly the pentagon's blank check and the military budget is going to play a larger role but stop reading ahead! I can only push leftist politics one point at a time out here!
Re:Polio Is on the Brink of Eradication by robertlagrant on Thursday November 23, 2023 @07:14PM (#38399330)
Well, if you go after the actual problem and not just talking points, you'll know it's a lot bigger than the military. And that the US military is extremely important for the whole global house of cards to stay standing.

Glad to hear that limited government is now considered leftist politics. No more pork barrels for the Democrats?

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @07:36PM (#38399490)
Reign in unlimited military spending is not "limited government", it's "limited military". Making sure the pentagon stops "losing" trillions is not small government it's basic accountability. But you're right it's more than that. And the billionaires. But like I said, one point at a time! You've clearly read ahead of the class. And "no more pork barrels for democrats"? I said leftist, not democrat.

I still believe in state solutions to healthcare to start, since that's the topic at hand.

And yes, I know it's much bigger than the military and pentagon, but I can't exactly summarize Pikkety's Capital and ideology or the socialist manifesto by sunkara in a couple hn comments can I?

Re the "we're vital for the whole house of cards" to remain standing, lol.

What good have we done recently besides maybe funding ukraine? Were we keeping the house of cards standing in iraq? vietnam? Korea? points to latin america in general Need I go on? Iran? Were we keeping the cards up when we spent money arming the Mujahadeen?

Re:Polio Is on the Brink of Eradication by rpmisms on Friday November 24, 2023 @11:58AM (#38405895)
I mean, taxation is actually theft, even if you're stealing from the rich to give to the state. In order to justify that, you have to provide a lot of value, which we currently don't do. Angrily wanting to tax people more successful than yourself just makes you sound jealous, not optimistic. Cut the spending first, and then if the government is still in trouble, cut the spending more.

To control the hyper-rich, the solution is simple. Corporate tax breaks for your lowest paid employee's salary. The higher that floor, the less tax you pay. Incentivize prosperity, not taxation and slavery.

Re:Polio Is on the Brink of Eradication by dghlsakjg on Thursday November 23, 2023 @10:28PM (#38400399)
Military spending isn’t a binary. The US could probably spend significantly less, while still keeping the status quo.

The US military has not one, but three aerobatics teams spending over a hundred million per year total. To cite a single example of completely pointless spending

Re:Polio Is on the Brink of Eradication by robertlagrant on Friday November 24, 2023 @05:00AM (#38402250)
When I say it's a lot bigger than the military, I'm not meaning to exclude the military.
Re:Polio Is on the Brink of Eradication by boxed on Monday November 27, 2023 @04:27AM (#38430164)
Well.. no, we should all be less ignorant of how science, technology, and societies work. I have no idea how you got to your statement from mine.

States are ALSO absolutely HORRIBLE at doing this basic thing correctly. They waste enormous amounts of money doing worthless things and under-invest in infrastructure in ways that makes my eyes water. Same as the ultra rich really.

It's all about cultural stories. You have fallen into the base line left-right story so hard you replied to my comment with a non-sequitur. Literally it was nonsense, because your preconceived ideas of the solution space cannot even map what I was saying.

This is a war of ideas where currently sanity isn't only losing, it's not even in the game. The big players are Islam, Christianity, Communism, and Libertarianism/Laissez-faire capitalism. All of which are basically death cults in this context.

Re:Polio Is on the Brink of Eradication by weaksauce on Thursday November 23, 2023 @04:21PM (#38397709)
billionaires existing is an indictment on our greed and failures of our systems. nobody needs 1000+ million dollars.
Re:Polio Is on the Brink of Eradication by gwd on Thursday November 23, 2023 @04:29PM (#38397781)
You're confusing resources they have control over with resources for their own personal utilization. Money is power; not to force someone to do what they don't want to do, but to pay them to do what they're willing to do. When capitalism works well, it's because people who made "good" choices with their money-power were rewarded with more, and people who made "bad" choices were rewarded with less.

Warren Buffet doesn't have an extravagant lifestyle. He's been entrusted to make decisions about how to spend our economy's resources in part because he's made good decisions in the past.

Obviously it doesn't always happen this way; but the accumulation of wealth by itself isn't necessarily bad. It's bad when it can be accumulated by ways which destroy value for society rather than creating it; and it's bad when it can continue to be accumulated by doing nothing.

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @05:22PM (#38398295)
>You're confusing resources they have control over with resources for their own personal utilization

I don't know if they're as different as you portray in practice. I agree with the notion in theory, which is why I distinctly used "wealth" in my original comment and not "income".

>He's been entrusted to make decisions about how to spend our economy's resources in part because he's made good decisions in the past.

Sure, no one is saying don't aspire to a meritocracy when considering control of the state's purse strings.

The key to your example and your "accumulation of wealth by itself isn't necessarily bad" notion is the reason I didn't say "no organization" should have more than 999m. I was strictly referring to excess personal accumulation of capital. Which harms us all.

Like I said, no one's quality of life is going to get worse if personal wealth were capped at 999m, but I can think of infinite ways to make a lot of people's quality of life better with the money we'd have in such an organization of the economy.

>and it's bad when it can continue to be accumulated by doing nothing

I don't even know if I agree with this. A state fund that earns interest and spends that interest makes sense. I think the key is the first case you note where it's bad.

Re:Polio Is on the Brink of Eradication by scotty79 on Friday November 24, 2023 @01:25AM (#38401127)
The problem is that people who have more aren't necessarily smarter. Musk is a posterboy for that. So they really don't deserve the power that money awards them and we can't just blindly believe money to be a proxy for someone's decision making prowess.

It's still the same primate but now it's got a gun.

Re:Polio Is on the Brink of Eradication by gwd on Friday November 24, 2023 @04:25AM (#38402038)
> So they really don't deserve the power that money awards them and we can't just blindly believe money to be a proxy for someone's decision making prowess.

I think we basically agree on this. The question is whether a flat policy of "nobody can ever control more than a billion dollars" has any justification, either pragmatically or ethically. "Wow that's a lot" and "Maybe they aren't actually very smart" aren't really that well founded.

Re:Polio Is on the Brink of Eradication by scotty79 on Friday November 24, 2023 @05:38AM (#38402514)
Basically by splitting the money among many people you increase the odds that by sheer accident somebody does something smart with a part of it. When it's in a single hand it's devoted to single persons whims.
Re:Polio Is on the Brink of Eradication by boxed on Monday November 27, 2023 @08:24AM (#38431998)
You confused money with control of companies again. If you just randomly split the control of companies into many people you don't get more decisions, you get LESS decisions as you get boards that are gridlocked and paralyzed by indecision due to having basically hundreds or thousands or even tens of thousands of "bosses" who are all screaming different things.

This is how you end up the management class of people who do basically nothing and collect huge bonuses for it, running companies into the ground slowly by not making them taking any risks/not trying to do anything.

Re:Polio Is on the Brink of Eradication by scotty79 on Tuesday November 28, 2023 @08:31AM (#38445491)
> you get boards that are gridlocked and paralyzed by indecision due to having basically hundreds or thousands or even tens of thousands of "bosses" who are all screaming different things

Often that's exactly what prevents bad ideas and gives a chance for good ideas to flourish. The actual strength of democracy is not that it allows to make more decisions, but that it prevents making decisions unless they seem good to a lot of "bosses". At least that's how it works in multi-party democracies. Systems of governance that concentrate a lot of power in single hand may have a good run from time to time when the supreme leader accidentally has a good idea and can move fast with it, but they fail miserably over the long term because they have no safeguard against bad decisions which are way more frequent.

There's nothing unique about capital and its derived power that suddenly makes concentrating it in one hand any less harmful then it is with armies, countries and nations.

Doing nothing is the best course of action more often than any other sort of action. Economy loves stability so it can stably grow. Some amount of disruption is necessary for the development but it's really hard to tell if the billionaires capital reinforces or suppresses the right kind of disruption.

Re:Polio Is on the Brink of Eradication by wegfawefgawefg on Thursday November 23, 2023 @07:00PM (#38399217)
Ive heard tax evasion rates were much higher historically, and that though tax rates were considersbly higher and taxes more complicated, many people simply did not pay. The simplification of taxes and reduction may have resulted in a larger amount of collected taxes.

Do you suspect if taxes were set to 99% that people would honestly pay them? To me it seems like a solution to two equations intersecting. Find the number that maximizes willing participation (a decreasing function of rates) and maximizes tax revenue (an increasing function of rates).

Re:Polio Is on the Brink of Eradication by anonymouskimmer on Thursday November 23, 2023 @07:20PM (#38399372)
With appropriate funds to the revenue services it's easier to flag and investigate likely tax evasion these days than in days of yore.
Re:Polio Is on the Brink of Eradication by scotty79 on Friday November 24, 2023 @01:19AM (#38401096)
> Do you suspect if taxes were set to 99% that people would honestly pay them?

Truly rich have most of their money in assets like real estate and companies. And goverment through laws is in control of what it even means to own those things. Government could make a law that when any company goes public 20% of shares are a tax.

Re:Polio Is on the Brink of Eradication by GuB-42 on Thursday November 23, 2023 @07:13PM (#38399323)
Since we are talking about health, the ultra wealthy are still human beings, they get sick and die like the rest of us.

And they want to stay healthy and live long, also like the rest of us.

It means it is in their own selfish interest to invest loads of money into health, because that is what will help them achieve that goal.

But again, their body is much like our bodies, so every advance in medicine that can help them live longer will ultimately help us live longer. Maybe at first, only the wealthy will be able to get these state of the art treatment, but processes will improve, patents will expire, and sooner or later, they will be available to all of us.

This is one instance where there is no real need to "tax the rich", research is good for all of mankind, the rich are not taking away knowledge from the poor. This is in contrast to natural resources, like land. If the rich want to build their manor on some good spot, the poor that live there will have to leave. But if a cancer treatment is found for the rich, it will not take away a cancer treatment for the poor, in fact, that's the opposite, as it is likely that a few years after, the poor will also get the rich treatment.

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @07:47PM (#38399558)
This notion that medical inventions are the benevolent gift of billionaires' ability to accumulate wealth is just wrong. What medical advances were made by the process you imagine in this comment? Maybe if brian johnson's blood magic from his son works I'll cede a single point here.

Science is a communal, collective effort, more evidently than anything else I can think of. To need to say that here of all places is really unfortunate

To try and act like taxing the rich is incompatible with medical advancement is just wrong. In the 50's and 60's we still made advancements and google the top marginal tax rate then. Do you think research would even slow down if rich people were capped at 999m? Seriously?

Re:Polio Is on the Brink of Eradication by boxed on Friday November 24, 2023 @06:25AM (#38402833)
> This notion that medical inventions are the benevolent gift of billionaires' ability to accumulate wealth is just wrong.

No one said that. We are saying that billionaires do NOT do that, and because they don't, they are flaming idiots. Literally killing their own children, and often hastening their own personal deaths.

Re:Polio Is on the Brink of Eradication by HALtheWise on Thursday November 23, 2023 @09:25PM (#38400096)
> And since philanthropic approaches to such actions demonstrably do not work...

It baffles me that you chose to share this comment on, of all things, a post about the eradication of Polio, which was primarily funded by the Bill and Melinda Gates Foundation in a _clear_ example of a "philanthropic approach" working quite well. If I had to identify one organization that has contributed the _most_ to positive changes in public health infrastructure in the last decade it would be them, above any governments, churches, or other non-billionare organizations.

Reaching back further, many/most top universities have billionaires to thank for their existence (Stanford, Carnegie Mellon, etc.), the widespread existence of public libraries is mostly due to Andrew Carnegie, and a lot of tech/science innovation comes from for-profit companies primarily controlled by or funded by billionaires.

I won't deny that billionaire philanthropy _sometimes_ doesn't work, but that's true for any system of building infrastructure that I can imagine, and is a far cry from your claim that philanthropy is demonstrably an ineffective way to solve public infrastructure problems.

I'm curious if there are other processes you see as being historically more effective, either overall or per-dollar, at producing effective public health outcomes than philanthropic organizations? If so, I'd definitely like to find ways to give them more resources.

Re:Polio Is on the Brink of Eradication by tga_d on Thursday November 23, 2023 @10:30PM (#38400413)
Saying the eradication of Polio "was primarily funded by the Bill and Melinda Gates Foundation" is a vast overstatement. Less than a third of the main organization's funding came from the Gates Foundation, and outside of funding, a lot more of the effort was from your run-of-the-mill local civil health organizations, community outreach programs, etc.. There's no solid evidence that billionaires made such programs successful, especially given that the polio eradication effort has notoriously been mired by repeated setbacks.

It's also a vast overstatement to claim "most top universities have billionaires to thank for their existence" or that "the widespread existence of public libraries is mostly due to" Carnegie libraries. Most top universities in the world are public institutions, and public libraries existed long before Carnegie (there was never a point in American history where most public libraries were Carnegie libraries, let alone in other countries).

Re:Polio Is on the Brink of Eradication by mptest on Thursday November 23, 2023 @10:11PM (#38400319)
Ok, so first off happy thanksgiving. I'm drunk at this point so forgive my probable incoherence.

while there's some validity in the notion that philanthropists do good occasionally, a better question is would their good more effective than a state solution? I don't have a ton of evidence on hand right now, but highways, the whole new deal america stuff pretty clearly did more for infrastructure than any philanthropist. In the terms of stuff like the gates foundation, at the end of the day I'm a utilitarian. They do good I'm happy.

All I'm sayin is a more egalitarian state might have achieved the goal quicker had they any rich guys' will to solve it.

At the end of the day I don't have the evidence off hand but everything I've read points to the state as the source of modern amenities but admittedly I'm biased towards tech and leftism and I'm no expert. I haven't exactly read ayn rand. I've read stuff like pikkety and sunkara.

In the cases where billionaires do good I ask, Couldn't a state with that same will do more?

Re:Polio Is on the Brink of Eradication by southernplaces7 on Tuesday November 28, 2023 @04:32AM (#38444040)
>And since philanthropic approaches to such aspirations demonstrably do not work, we need extremely high taxes on the ultra wealthy.

Here you're just shoehorning in a specifically ideological posture in the context of a complex situation that's completely irrelevant to your fixation. Government spending today is enormous in the developed countries and among intergovernmental organizations. In the context of existing health research spending there's vastly more than enough money at least available inside government budgets even as they are for increasing that health spending. Just by reducing several gargantuan military budgets, many governments could easily increase health spending without some arbitrary new punitively huge tax on billionaires. The two things are literally unrelated in cause.

In any case, the revenue you'd generate from this billionaire tax you propose would be much less stable or bountiful than you think or is possible through much less antagonistic alternative means, and this revenue tax from basically forbidding billionaires would probably decrease too, because after all, billionaires, generally being protective of their assets in very sophisticated ways, would find ways to circumvent it. Thus just from a practical standpoint, stable funds for medical research would be much better obtained from reasoned, non-punitive incentives and tax schemes complemented by certain budget cuts for absurd outlays that governments often spend ridiculously wasteful amounts on as is.

>No one intelligent can/has yet looked me in the eye and told me earnestly: anyone with a billion + $ would have a single degree lower quality of life if their wealth was capped at 999 million

No, your hypothetical billioniare wouldn't live any less materially good a life by having just under a full billion dollars, but certain incentives that do also contribute to good things in the economic and developmental world could be destroyed by this prohibition. Also, simply, you might with this tax also badly and pointlessly disincentivize pharmaceutical companies when you could have just tolerated high profits and encouraged them to help with medical generosity in other ways. Remember after all that within health spending, a vast and very useful part of its percentage is sustained by a properly incentivized private sector that it would be stupid to burn just for the sake of cheap anti-capitalist ideological notions.

>If you want empirics google "highest marginal tax rate 1950- present" and "infrastructure spending 1950- present".

Seriously? you're comparing the speed of progress in medical infrastructure and related spending during the 50's with today?

You do realize that part of a reduction in gains could simply be because, oh I don't know, the easier problems and projects having been already handled with older, simpler methods and now the harder problems steadily dominating, requiring much more complex solutions with slower progress and higher cost...

Re:Polio Is on the Brink of Eradication by renegade-otter on Thursday November 23, 2023 @04:46PM (#38397925)
Alas, spending their untold riches to make the government better is not in vogue. Never has been.

Instead, their mission is to gut governments, "burn it all down" for the sake of eradicating those cursed regulations, in the name of making the government "more efficient". In reality it just means "get those pesky bureaucrats out of my way of making even more money with immoral, destructive, and even illegal ways".

Instead we get "effective altruism" which basically means - "my mission is to get as rich as possible in unholy ways, and if you are lucky enough to be within the gravity field of the pet causes I happen to be a fan of, then you get some money".

You cannot find a worse way of a civilized way of distributing money to those in need. It's ineffective by definition.

People need to remind themselves once in a while that the world like this already existed. A bunch of feudal lords running around, trying to get favors with the king. Most people suffered, and rivers of blood were spent to shed that kind of system to create, you know, a civilization.

So stop worshipping the ultra-rich - they are the most destructive anti-civilization force were are dealing with right now, unleashing their wrath if they are not adored enough, stewing in anger and grievances.

And no, I am not saying Capitalism is bad. Sure, greed is good and all that, but running amok and without any oversight, it leads to no good.

Re:Polio Is on the Brink of Eradication by Danjoe4 on Thursday November 23, 2023 @05:39PM (#38398458)
I mean, I sympathize with the "burn it all down" attitude because the (US) government needs to be culled. Education costs exploded in the last 50 years because the government got involved. Fiscal irresponsibility is the new normal because the government will get involved to bail out the banks; why not give out credit like candy? Housing costs are insane because governments get involved via zoning to artificially reduce supply. US military spending today is (inflation adjusted) almost as high as during WW2. Federal government spending is 37% of our annual GDP which is almost certainly slowing our economic growth.

Someone needs to take an axe to the US fed. If we reduce federal spending by 75%, do you honestly think that would be a bad thing?

The US has produced all the innovation and prosperity and our government was founded on the principle of "fuck the government". Government overgrowth is the problem.

Re:Polio Is on the Brink of Eradication by habinero on Thursday November 23, 2023 @08:40PM (#38399871)
It's 23% of GDP, not 37%. [0]

Anyone who says "we need to cull the feds" doesn't understand what we actually spend money on.

25% of our spending is Social Security, and 20% is the military. That's 45% right there.

Old people vote. Social Security is going nowhere. You literally can't cut the budget by 75%.

[0] https://fiscaldata.treasury.gov/americas-finance-guide/feder...

Re:Polio Is on the Brink of Eradication by naremu on Thursday November 23, 2023 @06:02PM (#38398700)
It's comments like these that make wanting a better world feel like a truly thankless, sisyphean task.

All I can say without wasting too much of my own personal time is: in the world of federal spending you suggested

> US military spending today is (inflation adjusted) almost as high as during WW2.

would be unchanged, if not exacerbated (to continue exerting military/police control on a populace who's tax dollars aren't returned to them in the form of non-private, non-profit entities but now live in literally Bladerunner)

and the privately owned companies that lobbied to have that considerable amount of society's tax dollars spent on their products will certainly not be displaced. See also: basically every other industry

Sometimes I'm jealous of the uber wealthy not because they have nicer bathrooms or destroyed entire generation's qualities of lives and the reliable longevity of the future...but because of how many people seem eager to step up to bat for them, for nothing more than a thin veneer of "yeah well, fuck that other guy, amirite?"

Our social instincts are still tied to old institutional forms. Individuals with economic empires without borders seem to escape our otherwise commonly more organized criticisms.

This makes it painfully easy to get people to rally against "the state", but rallying against the vague, shadowy amalgamation/political party of wealth concentration proves elusive, I suppose. Like rallying against feudalism as a whole. Where do you start or end is the only real question.

Re:Polio Is on the Brink of Eradication by IX-103 on Thursday November 23, 2023 @08:45PM (#38399898)
"Education costs exploded in the last 50 years because the government got involved"

You do realize that the reason costs have increased is that State funding for public Universities has been significantly cut over that period? This "government can't do anything right" attitude has been a major driver in this increased cost?

Yes, the availability of some grants and guaranteed loans to people barely old enough to sign contracts did't help, but the big driver of the cost increases is the reduction of public funding. State funding for secondary education has been continuously reduced in the name of lower taxes and "fiscal responsibility".

As for Federal spending, it depends on how you slice it. If you count Social Security and Medicare and other "entitlements"* then SS and Medicare are huge.

If you don't, then the Military is the biggest expenditure. That's a little misleading though, since a large amount of basic and applied research is funded through the military (such as through DARPA and other agencies). If we reduce here we'd need corresponding increases elsewhere to avoid starving basic research. There are some expenditures that are wasteful there (I'm not sure how well the F-22 will handle the shift to drone warfare), so we could back there if we wanted to.

Funding for many other agencies is actually too low to accomplish their stated mission. We either need to reduce the scope of what they are legally required to do or increase funding. For the IRS, one thing we could do is to simplify the tax code to make audits less expensive. Similar changes could be made for the INS.

As for wastefulness, if you compare the government to private companies to implement the same standards, government is always cheaper. The only way private companies get cheaper is to provide less or offset the cost in some other way (unexpected externalities). The real reason expenses are so high is that the government is big -- it provides services to every person in the US and many others around the world. It covers a large number of markets from healthcare, security, finance, etc. There is literally no company comparable to the Federal government in totality. But if you compare just the pieces you still find government usually comes out ahead.

*"Entitlements" really should be considered contractual obligations and treated separately from the budget -- after all, would we allow a private company to include disbursements from their pension fund as part of their budget? Fuck no, that's a separate pile of money that doesn't belong to you. The entire framing around "entitlements" is designed to trick people out of their money.

Re:Polio Is on the Brink of Eradication by boxed on Friday November 24, 2023 @06:23AM (#38402819)
> US military spending today is (inflation adjusted) almost as high as during WW2.

Not in % of GDP.

Re:Polio Is on the Brink of Eradication by claytongulick on Thursday November 23, 2023 @05:19PM (#38398251)
> stewing in anger and grievances

It seems as if the targets of your ire are not the only ones in the stewpot.

Re:Polio Is on the Brink of Eradication by HALtheWise on Thursday November 23, 2023 @09:37PM (#38400151)
> spending their untold riches to make the government better is not in vogue. Never has been.

Isn't this just lobbying/political contributions? That definitely happens, but I think I'm generally more in favor of keeping the government and laws somewhat isolated from the influence of money, and keeping philanthropic organizations as a separate category from government agencies.

For the most part, private organizations (especially nonprofits) seem mostly willing to operate within the bounds of the laws as currently written, and government organizations like the CIA and NSA and military seem much less perturbed by commiting physical violence to achieve their aims. There are maybe some exceptions, but I can think of a lot more examples of governments being toppled by the CIA than by nonprofits (unless you count the Taliban and ilk as charities, which seems like a stretch).

Re:Polio Is on the Brink of Eradication by boxed on Friday November 24, 2023 @06:21AM (#38402805)
Well you totally missed the point. Calm down dude.
Re:Polio Is on the Brink of Eradication by thephyber on Friday November 24, 2023 @01:37AM (#38401187)
Polio would already be eliminated if not for extremely superstitious people and religious governments.

Coordinating the public health efforts across all countries is incredibly difficult and expensive work that requires constant investment and upkeep. Teaching people to be skeptical of the superstitions that were passed down and to look for real, reproducible evidence is what produced all of the benefits of The Enlightenment and continues to pay off.

Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @01:28PM (#38395862)
We must collectively understand the reason why some countries stay "developing". The reason is very simple - the rate of population growth exceeds the rate of infrastructure development by large margin. You can make large investments and build everything for 1 million people, but after two decades there are now 2 million people and then 4 and then 8. Africa started out with 200 million people After the WW2 period. In the beginning of this century there were around 800 people. Now there are 1.5 billion people. The rate of population growth is just unbearable. And Africa is here just an example. The same problem affects also India and other places.
Re:Polio Is on the Brink of Eradication by andrewmutz on Thursday November 23, 2023 @01:59PM (#38396188)
That's not the reason that nations stay "developing". Nations stay "developing" due to extractive economic and political institutions that prevent economic growth. Great book about the topic by economist Daron Acemoglu ("Why nations fail").

The reason that countries that have high population growth tend to be poor is because when a country gets rich its people have fewer children. The high fertility rate does not cause the poverty, instead its the other way around: the poverty causes the high fertility rate.

Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @03:49PM (#38397364)
I can't agree with this unfortunately. While getting rich further lowers the fertility rate then there is a certain threshold that must be first exceeded to get rich (relatively speaking of course).

There must be a feedback loop that incentivizes to get better education, to get better productivity to get richer. Raising a child is expensive, raising a highly educated child is very expensive. If you have 8 children then you can barely feed them unless you are very rich indeed. Even if you manage to provide good education for few of your children then the larger part of them continues the poverty loop. Breaking out of poverty requires breaking of this loop.

It should be very obvious - if your economy grows 5% but your population grows 10% then everybody is getting poorer as the growth per capita is negative. The same applies for everything, education, sanitation, food production. If you capacity to provide any of them is lower than the population growth then the amount of the poor continues to increase.

Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @04:02PM (#38397501)
And providing more basics, like improved agriculture, education and essential infrastructure like clean water access, is a better means to combat that issue than sending in surgeons to play hero and have a feel-good moment without making any real difference in the root causes that led to someone needing surgery.
Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @04:45PM (#38397920)
Current problem in Africa is that their capacity to produce food, while it is increasing relatively fast, doesn't increase enough to keep up with the population growth. This is why Russia can play with the grain shortage to begin with.
Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @04:48PM (#38397944)
I don't think we really disagree per se. Not sure why you seem so adversarial.

And Russia is probably not playing with the grain shortage. They had an agreement in place to let the country they are at war with sell grain because it's so critical.

It's probably more complicated than that and a tangent.

Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @05:06PM (#38398129)
No, I don't think that I provided a counter argument but rather a supplementary one. Population growth rate is a huge problem that hinders capacity to provide enough aid.

Russia certainly used the risk of hunger as a weapon to increase political pressure on Ukraine on the international level. Fortunately that attempt didn't play out and Russia was instead pressurized to make concessions. But they stopped the agreement the same moment they thought that it is not beneficial for them anymore. But this is just a side topic and was given as an example how the African incapacity to keep up with the population growth has wider geopolitical implications.

Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @07:02PM (#38399236)
Ah, so it's me. Thank you.

There was a time when HN was more conversational than it typically seems these days. It gets hard to assume someone is making conversation rather than making an argument when the default seems to be the latter.

Re:Polio Is on the Brink of Eradication by BariumBlue on Thursday November 23, 2023 @01:48PM (#38396092)
The Malthusian argument is incorrect and I disagree with the concept of physical infrastructure being the end-all-be-all. Japan, South Korea, Germany, as well as the USSR had explosive growth after WW2 not because they had massive existing infrastructure, but because of social systems & processes that enable a reliable, stable, productive society.

If the societies are fragile (vulnerable to drought, markets, or violence), or rotting (corruption, superstition, tribalism), even great infrastructure can make for subpar growth.

An analogy I always think of are Wadis (dry riverbeds); in very dry places with little rainfall (like Hudaydah in Yemen / Saudi Arabia), when it DOES rain, the dry dirt riverbeds don't soak up any water and transport it all out in flash floods - but it IS possible (and has been done) to invest in the land's ability to hold that water rather than purge it. Similarly, in a "always-developing" society, there'd have to be a investment in the people to ensure they can benefit from solutions to their issues.

Re:Polio Is on the Brink of Eradication by epicureanideal on Thursday November 23, 2023 @01:52PM (#38396116)
I don’t think they’re making a Malthusian argument. It’s about the difference in the rate of change or two variables, not the absolute carrying capacity of a set of resources as in the Malthusian argument.
Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @01:47PM (#38396075)
Malawi is one of the countries mentioned in this article as a source of polio outbreaks. A famous singer has invested millions in hospitals there and they still lack adequate water infrastructure. I imagine their post operative stats are probably not great. Getting surgery in a modern hospital and going home to inadequate clean water and inadequate nutrition likely actively fosters post operative infections.

Population growth tends to stop with adequate education plus reproductive rights for women. Development isn't just about infrastructure. It's also about culture, education, developing the local population so they can sustain a more developed society.

My recollection: water.org was started by a man who went to Africa with a medical charity, concluded that a lot of the health issues they were treating were directly caused by lack of clean water, decided we should fix that.

We already invest in other countries, just not necessarily wisely. Advanced surgery being brought to primitive conditions is more about people wanting to feel heroic than about really improving things.

Re:Polio Is on the Brink of Eradication by harshalizee on Thursday November 23, 2023 @03:44PM (#38397319)
Also forgot the part where India and North/West African regions were incredibly wealthy in the past and were basically strip mined by colonialism. It's been only 50 years or so that they're trying to catch up.
Re:Polio Is on the Brink of Eradication by OfSanguineFire on Thursday November 23, 2023 @05:42PM (#38398492)
West Africa was never "incredibly wealthy". Yes, before Europeans it was part of long-range trading routes with the Muslim world, but empires were feudalistic and only a tiny elite had access to that trade-related wealth, while the vast majority of the population was barely surviving through subsistence farming and pastoralism, just like so many do today, or hunting and gathering.
Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @06:38PM (#38399017)
Lets also not forget the slavery and slave trade that was practiced in Western and Northern Africa.
Re:Polio Is on the Brink of Eradication by epicureanideal on Thursday November 23, 2023 @01:51PM (#38396107)
Although some might be interpreting the previous poster as having some bad motives for saying what they’re saying, it does seem to be objectively true that population growth in developing countries is absolutely huge. If the population level had remained the same as 50 years ago the level of development would be much higher. But of course the population growth rate is declining so standards of living should hopefully start to catch up.
Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @04:49PM (#38397955)
Yes and no. This is my argument indeed that if the population growth stayed lower then a lot more people would have been able to rise above the poverty level (or even much higher).

UN prediction for Africa is that they fall close to the reproduction threshold for the end of century. Until that the poverty trap will continue. It also means that by that time now 4 billion people require their needs satisfied instead.

But the population growth has been huge and exponential. From 200 million to 4 billion in 150 years is an incredible amount of growth.

Re:Polio Is on the Brink of Eradication by teddyh on Thursday November 23, 2023 @02:17PM (#38396363)
> why some countries stay "developing". The reason is very simple - the rate of population growth exceeds the rate of infrastructure development

Opinions are divided: <https://www.youtube.com/watch?v=xP8CzlFhc14#t=3m>

Re:Polio Is on the Brink of Eradication by genman on Thursday November 23, 2023 @04:40PM (#38397881)
Yes, the communist argument - everybody else is at fault but not myself. Yet the communist paradise, the 1/6 of all the land with incredible riches stayed poor and finally collapsed.
Re:Polio Is on the Brink of Eradication by teddyh on Friday November 24, 2023 @05:35AM (#38402480)
That argument has nothing to do with communism. At most, it could be seen as anti-capitalist. As I understand it, the argument is that some so-called “underdeveloped” country is actually rich in natural resources, but foreign companies have come in and extracted the vast majority of the wealth, given some resources only to a select elite, as essentially bribes, and the large masses of people get nothing, and so remain poor. Even though the wealth extracted, had it remained in the country, would have made the country on the same level, or even higher, than the so-called “developed” countries. I can see no argument for communism here.

If anything, the argument is a nationalistic one, and nationalism have traditionally been associated with the right, not the left.

Re:Polio Is on the Brink of Eradication by genman on Friday November 24, 2023 @09:48AM (#38404490)
You have to know the history to understand why this argument is communist.
Re:Polio Is on the Brink of Eradication by teddyh on Saturday November 25, 2023 @09:06PM (#38418582)
I don’t see how this invalidates the argument itself. I mean, who cares if evil communists have made that argument. Does that make the argument wrong?
Re:Polio Is on the Brink of Eradication by jona-f on Thursday November 23, 2023 @03:13PM (#38397010)
You're coming off rather paternalistic to me. At least in my circles calling countries "developed" and "less developed" is frowned upon. Might even be called racist. People would now probably rather call it "privileged" and "less privileged", but in my opinion it's the same paternalistic thing.

Why not let others sort out there own problems while you take care of your own. Then work together on global problems like this one on equal terms.

Also, instead of helping, stopping the exploitation would suffice. All this charity and "helping" is a public charade so people like you can keep ignorant about what's really going on.

Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @03:16PM (#38397043)
If you must insult me, the word you are looking for here is maternalistic.

Please and thank you.

Re:Polio Is on the Brink of Eradication by jona-f on Thursday November 23, 2023 @03:36PM (#38397221)
I did not mean to insult you, i actually tried to make an argument. Nor was I looking for maternalistic. That's a different thing and i meant the negatively connoted one. Also reading again I realize I went too far saying all the helping, which is an unfortunate generalization, surely, being compassionate is a good thing.
Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @03:55PM (#38397430)
I'm a woman. It's pretty well established that lack of rights and education for women is a root cause of high birth rates and other negative factors being discussed here.

"Paternalistic" implicitly assumes I'm male and that's kind of a problem if we are wanting to treat all people with respect as a baseline means to make the world a better place.

We absolutely shouldn't be interfering in a colonial sort of fashion, but the reality is that "not interfering at all" is not a realistic goal. The only way you get that is by not interacting at all and that amounts to calling for not trading with poorer countries which is an excellent means to ensure they remain poor and can't develop.

The reality is we already do interfere and often in ways that make the people going in to "help" feel good more than really helping. Real help does, in fact (as you suggested), require one to have some kind of baseline respect for people that many people lack generally.

I will suggest that if you think maternalistic has positive connotations but paternalistic has negative, you should spend some time examining your implicit assumptions about men, women, parenting roles, etc and wonder exactly why you think the female-coded version of that word is not negative but the male-coded version is.

FWIW: I'm an environmental studies major (as background for wanting to do urban planning) and I'm far from ignorant. If you weren't intending to insult me, leading with calling me paternalistic and ending with saying "...so people like you can keep ignorant..." seriously fails to achieve the stated intentions.

Re:Polio Is on the Brink of Eradication by codezero on Thursday November 23, 2023 @04:12PM (#38397616)
I’m pretty sure they were using the term to refer to the concept of paternalism: https://en.m.wikipedia.org/wiki/Paternalism

not as a gendered term targeted at you.

Re:Polio Is on the Brink of Eradication by constantly on Thursday November 23, 2023 @04:15PM (#38397637)
Just a heads up: paternalism or being paternalistic is a concept unrelated to the user’s gender. It means advocating for action that limits a groups freedom or autonomy. Maternalism has a different meaning. You being one gender or another has no bearing on whether it was the correct word for the argument. It wasn’t quite the right word, condescending would probably have been better given the context of their phrases.
Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @04:18PM (#38397687)
Thank you. I stand by my opinion that gender issues are a factor in global poverty, so someone insisting the cure for such is to respect people and not think you know what's best for them should find gender-neutral terms to make that point in line with their stated values or at least check the gender of the individual they are attacking and insulting (in violation of HN guidelines) and use gender appropriate insults if they insist on getting personal.
Re:Polio Is on the Brink of Eradication by constantly on Thursday November 23, 2023 @04:52PM (#38397975)
Totally agree with your statement that gender issues are a factor in global economics, and that we should strive to use gender-neutral phrasing whenever practical.
Re:Polio Is on the Brink of Eradication by Danjoe4 on Thursday November 23, 2023 @05:26PM (#38398326)
The euphemisms are insufferable
Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @05:44PM (#38398518)
I'm actually not someone big on insisting we say "humankind" instead of "mankind" or similar. I did check the link talking about paternalism and I can understand where the practice of using the word that way comes from, but it implicitly smears fatherly behavior and implicitly reinforces an assumption that men have political and economic power and women don't.

Gendered language is kind of a thorny issue for the English language. Not all languages are like English. Japanese and Farsi default to gender-neutral pronouns and cultures that default to calling people by their family name instead of their given name also sidestep a lot of these issues.

The US had a women-only baseball league during World War II and someone said (or somewhere I read) that it was the era of radio broadcasts and baseball defaults to referring to players by their last names, so listening to a game of baseball with women-only was experientially nearly identical to listening to men's baseball:

"And Smith is up to bat and knocks it out of the park for a home run, winning the game!"

It's probably a fiercely fought battle with English because it's the default lingua franca for the world and doesn't play well with a lot of cultures that feel forced to use it. Various proposals for fixing it come from interest groups rather than arising naturally in an emergent fashion and strike people as unnatural, top-down solutions to a problem they personally may not have, so see no reason to pursue.

/off-topic tangent, oops, because linguistics and social issues are both interests of mine

Re:Polio Is on the Brink of Eradication by constantly on Friday November 24, 2023 @08:45AM (#38403874)
There’s no reason you can’t address a mixed-gender group as something like “hey everyone” or “hey folks” rather than something like “hey guys” or “hey gentlemen.” It’s just common courtesy we should feel a duty to perform it as members of a society, in my humble opinion. The point I was making a couple replies up was that some terms aren’t fungible, like paternalism and maternalism, because also they seem superficially to be different genders for the same topic, they mean totally different things, so we should use paternalism to mean what it means, despite the gender connotation.
Re:Polio Is on the Brink of Eradication by theduder99 on Thursday November 23, 2023 @04:14PM (#38397625)
stop misgendering me!!!
Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @04:42PM (#38397903)
Nah, my personal policy is to ignore that in most cases. If you aren't insulting me while lecturing me that the cure for what ails this world is genuine respect for others, I generally interpret that as "DoreenMichele fits in with this overwhelmingly male forum and her behavior doesn't just scream I'm a woman."

You would know that if you read my blogs. I wrote a long and detailed blog post about that once.

Re:Polio Is on the Brink of Eradication by ClassyJacket on Thursday November 23, 2023 @04:08PM (#38397571)
"Why not let others sort out there own problems while you take care of your own."

Literally the entire point of the comment you were replying to was to explain why you help others sort out their problems.

Re:Polio Is on the Brink of Eradication by hpenvy on Thursday November 23, 2023 @04:25PM (#38397749)
TIL it's paternalistic to give people in 3rd world countries free things that they like.
Re:Polio Is on the Brink of Eradication by robertlagrant on Thursday November 23, 2023 @05:10PM (#38398164)
> We currently are de facto breeding antibiotic resistant infections

For my understanding, if no one else's: are there a lot of places without decent water, but with antibiotics? What's causing that strange inconsistency?

Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @05:21PM (#38398276)
In a global assessment for 103 countries, after accounting for type of governance, education, economy, health care spending and community infrastructure, it was concluded that reducing antibiotic consumption alone would not control resistance. Independent of antibiotic consumption, poor infrastructure (e.g. sanitation), poor governance (e.g. corruption) and low health expenditure were all associated with higher rates of resistance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7782542/

Re:Polio Is on the Brink of Eradication by akdor1154 on Thursday November 23, 2023 @05:19PM (#38398256)
Anecdotal, but most towns in Vietnam you'd want to boil your water, and if you want antibiotics you go to the pharmacy, pay about $2, and get some.

What's causing it? The free market is working great to build the systems to get drugs to people. In fact if a pharmacist refused to give out antibiotics when they weren't needed, the pharmacist would probably just go out of business because the customer would just head up the street to the next guy.

The free market is not so hot at building expensive infrastructure like safe water in a tropical biome, that requires government involvement (not meaning to rag on SE Asian governments: building this stuff is difficult even if your country has been stable for the last 100 years, which is a luxury they haven't been lucky enough to have)

Re:Polio Is on the Brink of Eradication by peyton on Thursday November 23, 2023 @11:39PM (#38400678)
I dunno if safe drinking water is a great example. There are many success stories both of public and private provisioning.

It’s not rocket science. You need to:

1. Build, operate, and maintain wastewater treatment plants

2. Require everyone send their wastewater to a treatment plant

Vietnam has a neat loophole for 2. where if you simply generate too much wastewater for your zone’s plant to handle, you don’t have to send it to the plant. That’s more a policy decision with a side of administrative corruption that’s unrelated to who’s handling the infra.

Re:Polio Is on the Brink of Eradication by troupo on Friday November 24, 2023 @02:57AM (#38401577)
> Build, operate, and maintain wastewater treatment plants

You'd be surprised at how difficult this is in shitty countries.

First, wastewater plants are rather expensive. Maintaining them is also both expensive and required. And you don't get bonus points for doing the right thing.

My home city of Chişinău, Moldova has a population of about 800 000. The whole city stank of feces for almost two years (and districts close to the sewage treatment facility for much longer than that) because no one cared to maintain the old Soviet-built facility.

Only when you could smell (and almost taste) shit over 20km away, did they scramble to do something (ask for more money from IMF/EU, steal most of it, ask for more money, implement a patchwork solution that barely holds)

Re:Polio Is on the Brink of Eradication by otherme123 on Friday November 24, 2023 @03:34AM (#38401765)
It's a well known problem in economy: the tragedy of the commons.

In a free market, even the river or the sea has an owner (might be a group of people), so you cannot throw your waste on a river that is not yours. But currently rivers are "common" or public property, so the state cannot limit who polutes the rivers unless they provide an alternative. In rich countries, such alternatives exist. In poor countries they just dump waste in public/common rivers.

Re:Polio Is on the Brink of Eradication by hnbad on Friday November 24, 2023 @05:37AM (#38402503)
It's a self-imposed problem however. The economical system requires every interaction to be transactional and disincentivizes activities outside the economical system itself. This leads to transactional relationships supplanting those which previously provided mutual benefit.

In poor countries rivers used to be maintained by the community because of a shared interest in them. This works fine in a gift economy. But in a transactional free market economy the communal river is an externality because it isn't privately owned, which requires outside intervention to create a financial incentive (either via subsidies or regulations/fines).

The tragedy of the commons is not a natural law, it's an emergent property of the economical system. There are three remedies: privatization of the commons (which has its limits unless you literally want to commodify every atom in the biosphere), state intervention (which is how most functional mixed market systems approach it) or changing the system (which goes against the interests of those currently benefiting from it and may as well lead to a worse system than a better one).

EDIT: For sake of clarity: creating a gift economy alongside a transactional free market economy is extremely difficult in an open system. They keep being reinvented in peer groups (e.g. buying "rounds" of drinks among friends without keeping tabs on who spent how much) but they rapidly break down when exposed to a transactional system because "freeloading" becomes an optimal move without the "honor system" enforced by social pressure (e.g. your peers thinking you're taking advantage of them and no longer inviting you to drink with them or having a stern word with you).

Re:Polio Is on the Brink of Eradication by danielheath on Thursday November 23, 2023 @08:07PM (#38399692)
Flint, Michigan?
Re:Polio Is on the Brink of Eradication by dralley on Thursday November 23, 2023 @05:17PM (#38398220)
Yes, absolutely. Proper water infrastructure is both difficult and expensive to develop, and requires constant maintenance.

Antibiotic pills are cheap and easy to distribute.

Re:Polio Is on the Brink of Eradication by quickthrower2 on Thursday November 23, 2023 @07:39PM (#38399510)
From an engineering point of view decent water may be overkill. Just send shitty water down the pipes and filter it on premises. Putting to one side “ooh that sounds disgusting / what poor people do” emotions, is there any downside?

Probably the main one is the cost of RO but if that cost can be got down it might work.

Re:Polio Is on the Brink of Eradication by danielheath on Thursday November 23, 2023 @08:08PM (#38399698)
It's much, much cheaper to make the water supply for a city clean at the source than it is to install several million water filters.
Re:Polio Is on the Brink of Eradication by nl on Thursday November 23, 2023 @10:31PM (#38400420)
> but with antibiotics? What's causing that strange inconsistency?

There are a number of reasons, but one that hasn't been mentioned so far is the heavy use of antibiotics in food production: https://ourworldindata.org/grapher/antibiotic-usage-in-lives...

Re:Polio Is on the Brink of Eradication by klyrs on Friday November 24, 2023 @01:55PM (#38406951)
Antifungals, too! That lethal highly-resistant C. Auris didn't happen naturally.
Re:Polio Is on the Brink of Eradication by vikramkr on Thursday November 23, 2023 @11:16PM (#38400594)
Lot easier to ship pills than to clean and ship water
Re:Polio Is on the Brink of Eradication by finite_depth on Thursday November 23, 2023 @06:36PM (#38399003)
If only we had some sort of massive example that had killed literally a million Americans. Then maybe we'd learn.

Oh well. Maybe when that happens.

Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @06:56PM (#38399182)
You are apparently shadow banned. I have vouched for your comment with some trepidation hoping you will clarify what incident or issue you mean.
Re:Polio Is on the Brink of Eradication by anonymouskimmer on Thursday November 23, 2023 @07:29PM (#38399443)
It's visible now, so your vouching worked. It seems obvious to me GP is writing about COVID-19. The US CDC lists estimated US deaths from COVID at currently 1,153,910.

But we've had plenty of other examples in living memory, with influenza currently averaging about a million deaths in the US every 30 years.

Re:Polio Is on the Brink of Eradication by finite_depth on Thursday November 23, 2023 @09:29PM (#38400117)
Yeah, I'm aware. Happens to all my comments.

And as the other poster correctly guesses, this was a sarcastic reference to covid.

Re:Polio Is on the Brink of Eradication by DoreenMichele on Thursday November 23, 2023 @10:12PM (#38400322)
Thank you.
Re:Polio Is on the Brink of Eradication by klyrs on Friday November 24, 2023 @01:51PM (#38406902)
I assume a more cynical scenario: there's no way that governments haven't stockpiled a variety of horrible diseases (and their vaccines) for use in biological warfare. It isn't acceptable today, but what if somebody else moves first?