Healthcare in the United States.

The insurers have somehow created which ensures their survival at a real cost. Attempts to rationalize the system have failed because of the focus on getting everyone health insurance rather than health care (admittedly among other reasons).

It doesn’t help that politicians continue to propose dead-in-the-water alternatives. The last round of “Medicare for All” included a lot of provisions that were very unpopular when you asked people about them directly, such as taking away people’s existing private insurance.

This a common theme in politics: Actually solving the problem might remove enthusiasm for your candidate or party, so instead they propose things with no realistic chance of passing. Their business is being front and center in public discourse, not quietly fixing things.

EDIT: I’m getting downvoted because a comment below is denying this part of the bill, so I’m adding the exact text here:

> SEC. 107. PROHIBITION AGAINST DUPLICATING COVERAGE. (a) IN GENERAL.—Beginning on the effective date described in section 106(a), it shall be unlawful for— (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or (2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.

The comment below is incorrect. The bill would have made people’s existing insurance plans illegal to offer.

This is not correct. There was no prohibition on private insurance. Rather, all would have been required to participate in the public plan to spread the risk. That's the only way it could work. If someone wanted to also pay for a private plan, that was allowed.

So that's not true.

They had to prohibit overlapping coverage in order to make sure that all private practice physicians accepted the medicare system, which has lower reimbursement rates than private insurance. You can pay for more coverage, because that doesn't compete with the public system, but you cannot pay for private insurance that may lead to lower access for publicly insured persons.

Yes, I did not read closely enough. You referred to new medicare for all plans, while I responded recalling similar false accusations against Obamacare. Some of these new proposals do not allow duplicate plans. Nevertheless, I don't think this particular objection makes them DOA. I believe this is an objection that could be overcome with discussion.

No, this is incorrect. Here is the actual section from the bill:

> SEC. 107. PROHIBITION AGAINST DUPLICATING COVERAGE. (a) IN GENERAL.—Beginning on the effective date described in section 106(a), it shall be unlawful for— (1) a private health insurer to sell health insurance coverage that duplicates the benefits provided under this Act; or (2) an employer to provide benefits for an employee, former employee, or the dependents of an employee or former employee that duplicate the benefits provided under this Act.

You could technically also buy extra insurance for… something extra, but your existing insurance plan would have become illegal.

This was a huge sticking point, despite how many people try to deny it or downplay it.

I'm honestly curious what the real meat of the objections to this were (I never heard much about this sticking point). Why would you want duplicating coverage anyway? Is it not strictly better for any consumer to only be paying for the extra coverage you want on top of the public coverage?

I didn't say I had objections to it. I said it was unpopular with the general public when you told them the details.

This is an example of a situation where people dislike the system but when you ask them about it they like their part of the system.

For example, people generally have an extremely low opinion of Congress, but on average they like their own Congress person.

You get similar results when you poll people about healthcare and health insurance: People generally hate the health insurance system, but if you start talking about taking away their health insurance or their doctor and replacing it with an unknown system, they get upset.

> Why would you want duplicating coverage anyway? Is it not strictly better for any consumer to only be paying for the extra coverage you want on top of the public coverage?

Duplicating coverage is superfluous if you assume the new plan would be better in every way and you give up nothing in the process, obviously.

However, the fear is that upending the entire system would require people to give things up and replace it with unknowns. There's a good chance that some people would be forced to be reassigned to different doctors under a centrally-planned system, or that access to things would be reset and need to be re-determined under new guidelines.

If this doesn't make sense, consider a situation where someone got special approval for off-label coverage of a drug (happens all the time) but the new government insurance had stricter guidelines about which conditions could be treated with which drugs (to keep cost down). Those people could lose access to medications or treatments that were covered privately.

We tend to think of "Medicare for All" type plans as being without downsides, but when you get into the details of changing the entire health care system out and banning the old ways, it's inevitable that some people would start losing things they liked. And that's where people get upset.

To be fair, there was a log of disingenuous fear mongering around the notion of "the government is getting rid of your insurance".

It would be extremely difficult to get an accurate idea of what the general public thinks about a measure before certain interests get involved with publicizing FUD.

> fear mongering around the notion of "the government is getting rid of your insurance

But that’s literally what the bill said.

Why is it “fear mongering” to state the effects of a bill? People truly didn’t like this idea.

Because it's being disingenuous. The insurance isn't getting removed, just like "the HVAC tech is removing heating" is not a coherent statement if the tech is just replacing your furnace. You might have opinions about the performance of the new furnace, but saying that the heating is going to be removed is simply untrue beyond discussing the logistics of that change.

I don't think you understand what people disliked about the idea.

They understood that it was being replaced. Nobody ever pretended like health care was going away and being banned. People weren't assuming that. That would be nonsensical.

People thought the bill was going to be about a Medicare option for all, but then it came out as forced Medicare for all. People didn't like that.

It wasn't fear mongering, people just didn't like that. It's demonstrably unpopular, and this isn't news to anyone who has been paying attention.

Your error is assuming that everyone is a rational actor and is doing the research to make an informed decision.

This is simply not the case and it's naive to think otherwise.

Lots of people want to be able to pay to get faster treatment, or pay for better doctors if they can.

> Why would you want duplicating coverage anyway?

What I have works. It doesn’t for everyone. But it does for me.

If I’m too busy to read a thousand-page bill, it’s rational to default to the status quo. (Also, Americans like competition. Banning duplicate coverage sounds like ruling out the competition.)

No one is going to get elected for solving a problem everyone today is going to be dead to see the results of.

Although we all might agree that this is necessary, people usually tend to vote for people who promise "real" solutions. As in, short term solutions to problems we've been carrying for decades (which obviously requires policies that also take decades to cement).

I recall an interview where the interviewers were asking the politician if their plan for health coverage would raise everyone's taxes, to which they responded yes - of course they would. The interviewers tried to move forward with that, but the politician then notes that this would also mean that everyone stops paying for their current health insurance - and thus quite a lot cheaper.

> the politician then notes that this would also mean that everyone stops paying for their current health insurance - and thus quite a lot cheaper.

Unfortunately, not so simple:

1) Health insurance is already required to pay out at least 90% of your contributions, so even a hypothetically perfectly efficient replacement could only eliminate 10% of costs, all things equal.

2) The government run system would realistically be expensive to run, like any program covering all Americans. Many of those private insurance costs would just be transferred to a government-run operation. In theory it should be more efficient to have single payer, but it would also be extremely expensive in the short term to build and overhaul the system.

3) The actual cost savings wouldn’t come from operational efficiency (not the government’s strongest ability) but from forcing prices down because nobody would have any choice but to accept the government insurance. They were going to drive costs down by forcing doctors and hospitals to take lower payments and, as unpopular as it is to say, by limiting the types and amounts of treatments available to people.

> 1) Health insurance is already required to pay out at least 90% of your contributions, so even a hypothetically perfectly efficient replacement could only eliminate 10% of costs, all things equal.

All things remaining same, yes. But all things won't remain same because the incentives would be completely different. The 10% rule has incentivized the entire industry to raise their prices so that 10% will be worth more each quarter. Private insurance would rather have insulin at $1000/mo instead of $10/mo so that they can take $100 instead of $1 and they would rather collect $2000/mo in premiums than $200/mo. Medicare, on the other hand, can and should negotiate prices down: https://www.cms.gov/inflation-reduction-act-and-medicare/med...

These points assume that costs would stay the same and there's no overhead in the existing insurance system.

Single-payer could be cheaper and more efficient simply by returning the massive profits of health insurers directly to taxpayers. Part of high cost for healthcare in the USA is the huge number of middlemen.

Do they have massive profits? It says here that they have very low profit margins of about 3%

https://content.naic.org/sites/default/files/inline-files/he...

Contrast that with the average of all industry profit margins at ~10% and with SaaS type firms of ~80%.

If you want to improve US healthcare costs by getting rid of the profit margin of insurers, it's probably a bad idea. You wouldn't notice the impact.

> The government run system would realistically be expensive to run, like any program covering all Americans. Many of those private insurance costs would just be transferred to a government-run operation. In theory it should be more efficient to have single payer, but it would also be extremely expensive in the short term to build and overhaul the system.

The government is already the largest health insurer in the country, and providers can't turn them down. There's no system to overhaul.

The idea of "Medicare for all" is actually very simple - if you do not have private market health insurance, you can opt in to the health insurance the government already provides for about 65 million people.

> The government is already the largest health insurer in the country, and providers can't turn them down.

This is completely false. Many providers don’t accept Medicare or Medicare.

I don't know where you’re getting the idea that Medicare/Medicaid can’t be turned down by private practices.

> The idea of "Medicare for all" is actually very simple - if you do not have private market health insurance, you can opt in to the health insurance the government already provides for about 65 million people.

Again, that’s not what the “Medicare for All” bill actually said.

People just assumed it was an optional thing, but the bill said something else entirely.

Your post is a great example of how people had their own ideas about how things work or would work under new bills, but when you actually read the details it’s a different situation altogether.

I’m also amazed at the confidence with which people will deny the basic facts of “Medicare for All”, as evidenced by many comments in this thread. I posted an actual excerpt from the bill above, yet people are still trying to argue that it said something else.

You are misinterpreting the text of the bill you keep quoting. As well as equating the notion of Medicare For All as a policy with one attempt to pass it that failed.

While sure, providers could choose to not accept Medicare, practically all do because the people that need the most healthcare are all on it. That would be akin to not treating anyone over the age of 65.

> You are misinterpreting the text of the bill you keep quoting.

I don't think I am. You haven't provided any specifics and your claims above were easily disproven, so I'm not sure what you think I'm doing wrong.

> As well as equating the notion of Medicare For All as a policy with one attempt to pass it that failed.

See above: My parent comment was specifically talking about the Medicare for All bill. You are the one trying to substitute a different concept into the discussion.

> While sure, providers could choose to not accept Medicare

This is the exact opposite of what you claimed two comments up.

This discussion is a perfect example of what I'm talking about: When it comes to these discussions, people like to substitute their own facts and pretend like we can just ignore the reality of of what goes into bills. Once you start looking at actual legislation these things aren't as popular as people think because it doesn't match their imaginary ideal.

Hence my original point: Politicians have an incentive to keep these concepts as far from reality as possible, because it allows people to cling to their own idealized versions of what it would look like. The closer you get to reality, the more people realize that tradeoffs and compromise are necessary in the real world.

Most establishments in the United States.

Obamacare was an absolute unfiltered gift to the insurance companies and to this day I can’t understand how no one saw this or cared.

Yea… things were going to get better when more people were being ripped off.

My first thought was of the 2 major US political parties and their mission of promising things they have no intention of ever doing to get votes so they can win elections, take away more of our freedoms and redistribute more wealth from the many to the few. TurboTax is also a great example though.

This is quite independent of the US. The state functions purely to protect the interests of the dominant class. In the US, the dominant class happens to be capital owners, but that's true in most of the world these days.

>> the 2 major US political parties and their mission of promising things they have no intention of ever doing

> This is quite independent of the US.

Happens less in electoral systems where the 2nd party can become 3rd overnight. Politics become less rigid.

Multiparty systems can become completely deadlocked as well. Belgium has had complete deadlocks because nobody can form a coalition, Israel had five elections in three years for similar reasons, Britain was effectively deadlocked under Theresa May, and Canada has had outright minority governments.

I also wouldn’t describe US politics as “rigid” just because we have the same two parties, because each party has different factions and some of the most powerful factions were either marginal or completely nonexistent a couple decades ago.

The biggest problem with the U.S. system isn’t that there are only two parties (that’s a problem, just not the biggest one). It’s that both parties need to agree in order to pass anything (due to the senate filibuster), which as far as I know is unique among democracies.

I'm not saying that to say that the us is any better, but simply for context for what happens when you don't need all the parties to approve:

France effectively has that by way of the infamous 49.3. the majority party coalition can effectively force all others to accept a law, without ever presenting it for a vote.

The caveat is that the other parties can start a vote of no confidence and dissolve the government with a simple majority, but in reality this never happens because dissolving the government over [pension reform, the budget, insert issue here] is disproportionate.

The current government's lack of caring about their voter base because of the Overton windows shifting to the right has obviously aggravated this.

The filibuster is just a product of the Senate rules and could be changed at any time. There's no incentive to do so now because the Democrats currently control the Senate but they couldn't pass anything even without the filibuster because the Republicans control the House. I suspect it's going to happen with the next trifecta.

I tend to agree, but then I look at Europe and I say, who is the ruling class here? In the US it's obvious that corporations run everything, but that doesn't seem to be the case in western Europe.

I won't say this is a good representation of every european country, but in France, basically two bilionary own all mainstream private press media, the rich class basically built Macron to push their agenda, and most important laws anyway come from Europe transpositions where only those that can build a perpetual lobby service can push a topic into a directive.

So yes obviously Europe is a paradise of direct democracy where every citizen bloom thanks to a social structure made to help each of them thrive and reach the best version of themselves acting everyday for an harmonious society free of any anxiety about future that promise only bright shiny days for the masses and their children.

Just because they occasionally legislate USB-C chargers doesn't make them bastions of socialism, lol.

I know they're not socialist, but they're also not clearly dominated by giant corporations the way the US is. Who is the ruling class then?

Means & motive are still largely governed by whether you own things for a living or work for a living. The pay to exist vs get paid to exist dynamic is alive and well over there and the debates are all quite familiar. After all they invented the rules and we just copy-pasted them with a few small modifications. The ownership class just isn't as dominant as it is in the US at the moment, for better and for worse.

Is it possible that they pass USB-C charging and data privacy laws in Europe because the companies affected are primarily American companies not European companies?

Likewise, I imagine they pass anti-fossil fuel laws because there aren't really any major fossil fuel producing countries in Europe besides Russia which is both a pariah and the continent's gas station.

Not countries producing but there's huge oil companies based in Europe (BP, Shell, Total)

https://en.m.wikipedia.org/wiki/List_of_largest_oil_and_gas_...

That's because western europe is the ruling class.

All of the people of western Europe are the ruling class? LOL I doubt any of them feel that way. What are they ruling exactly?

> The state functions purely ...

any sentence that starts this way is just walking straight into its own falsity.

No human system as complex as "the state" ever functions "purely" to do anything. Instead, it's a venue in which different interests and power levels sometimes compete and sometimes cooperate, sometimes achieving goals and often not.

Yes yes and the other is the saviour of the democracy and humanity, while preserving equity.

Either you're new on this planet or just lying to yourself - all parties are marching against same goal, they just keep the distraction going so people are interally conflicted instead of paying attention.

> if you squint, maybe they're kinda the same.

> all parties are marching against same goal

Clearly you’re both in agreement.

Not really a helpful comment in either content or tone. Biden and Trump are marketedly different in both major policies and governing competence, and it doesn't help the discourse to say that they're just "marching against the same goal."

Neither is your comment. If you polled Americans I think more would say both parties are full of shit than would take one parties line like you are.

Biden passed the most comprehensive climate law in US history. The most unbelievable part is that the law was nearly unchanged from what was written by climate experts. Usually bills start out looking good, then get frankensteined by the hundreds of stakeholders that want to cram their shit into it. For once, we got a pretty clean bill that will actually do good (based on the climate experts I've read).

Form your own opinions, but I had to mention real action that happened.

What comes to my mind are labor unions, the NAACP,as well as feminists and other identity groups.

They seem to follow a pattern of being really important for their time and place, but after winning the important, landmark victories, they stick around.

Now they have to start looking for, or creating, problems to solve, which often looks a lot like extortion.

Their base also becomes increasingly radical because all of the moderate people lost interest after the initial victories were won.

> What comes to my mind are labor unions, the NAACP,as well as feminists and other identity groups.

> They seem to follow a pattern of being really important for their time and place, but after winning the important, landmark victories, they stick around.

They stick around because union busting corporations, racists, and sexists don't just magically disappear or give up after they lose a battle.

If these groups were doing their job, those bad guys you mentioned should be gone by now, right? They used to make the history books with their accomplishments. What have they done for you lately?

> If these groups were doing their job, those bad guys you mentioned should be gone by now, right?

Wrong. By what magic do you think their opponents suddenly disappear or give up?

Martin Luther King said, "the arc of the moral universe is long". Progess is slow and subject to setbacks.

> They used to make the history books with their accomplishments.

Some areas of the country now want to ban the teaching of that history.

Forget racism and sexism for a moment: do you seriously think that the temporary existence of labor unions makes profit-maximizing corporations give up and give in to all of labor's demand for eternity, even after labor unions dissolved?

Do you feel the wars on drugs and terror will ever be won? I don't. I look at your wars the same way.

They'll drag on and on. Some people will get rich and powerful, but the people on whose behalf you're supposedly fighting don't really care about any of it.

They'd much rather have affordable healthcare and housing.

Get out of here with the "my team" / "your team" nonsense and the trolling in general. It's perfectly possible to make your point with reason and civility instead of cheap, shallow jabs, and if it isn't, well - probably not a point worth making.

> They'd much rather have affordable healthcare and housing.

The "wars" for affordable healthcare and housing will also drag on and on. Because guess what, there are opposing sides fighting against each other on those issues too, and neither side will magically disappear or give up when one side wins a temporary victory.

It's truly bizarre that you think longstanding social issues can just be "solved" once and for all (if you truly believe that and aren't just trolling).

"If Christian evangelists did their job, then the whole world should be Christian." Doesn't that sound silly? It turns out that there are a whole lot of non-Christians in the world who don't want to be Christians, and they're going to do their "job" too.

So you've now compared feminist movements to Christian evangelists. Do you think christian evangelists are important and deserve our attention even if the majority of christians don't care about them? How about feminists if women don't care about them?

> So you've now compared feminist movements to Christian evangelists. Do you think christian evangelists are important and deserve our attention even if the majority of christians don't care about them?

You seem to have completely missed the point of why I mentioned them. We've now compared many different organizations and social issues. What they all have in common is that there are longstanding competiting interests on both sides, and thus an advocacy group doing its "job" doesn't entail that the opposition magically disappears. An advocacy group hasn't failed to do its job if it doesn't wipe the opposition off the face of the earth, thereby rendering itself irrelevant.

"An advocacy group should disband after one significant victory" is really an incredibly inane suggestion that could probably only be made by someone who doesn't like the advocacy group in question and wishes they would disband regardless of successes or failures.

I'm just writing to call out your abrupt change of subject and avoidance to actually answer the person you replied to. Please be a better poster, if you have no answer, just don't reply.

> Some areas of the country now want to ban the teaching of that history.

This is not actually true, but the lie serves the purposes of activists seeking to justify their continued existence, so they keep telling it.

I'm not supportive of all opinions from the left-wing about race and whatnot, but it's clear that there is real pushback. Some people want to downplay the crime of enslaving Africans and highlight "American exceptionalism", complete with evangelical Protestantism and some degree of white supremacy.

>those bad guys you mentioned should be gone by now, right

I dont follow your logic. Isnt this a bit like saying if doctors were doing their job, cancer should be gone by now? If police does their job all crime is gone?

Scientists research cancer and are producing visible, measurable results. If they hadn't had any for the past 50 years, I'd say maybe they should change course.

Are you saying that the civil rights and feminist movements in the US have not had visible measurable results in the last 50 years? If so, you are wrong.

The fact that capitalists and misogynists have gotten too powerful means, to you, that we should abolish unions and feminism?

I don't think they're too powerful. Like I said, the major victories were won long ago and are in the history books.

The institutions that claim to fight those things are the ones who are the bad guys now. All the while, ignoring the real problems that everyone wants solved.

Wage slavery and misogyny *are* real problems that sane people want solved.

Yes they are still problems.

No, there hasn’t been newsheavy significant wins recently. There has, however, been newsworthy significant losses.

The idea that institutions should disappear because they’ve managed certain successes is utterly, bafflingly stupid. That’s especially the case as we are still current fraught with issues that these institutions exist to help with.

By this definition no nation should need a police force after an initial period of unrest. After all, police is there to solve crime right?

Douglas Murray's book "The Madness of Crowds" explains this very succinctly. On the other side of the political aisle you could reference the pro-life-only voting block who now finds themselves trying to raise money on an issue that has been resolved (in their minds). "Dog Catches Car" is the headline for all of these issues.

I upvoted. I don't think you are entirely correct, but I think that you can go somewhere interesting from here.

Every position invites the opposite position to exist and gather power.

> extortion?

Yup: Looks like there is an industry with a standard operating pattern:

Form a public interest group. Find an issue, e.g., a claim of a big threat, some version of the old the sky is falling.

To put over the issue: For evidence for the threat, scientific is not necessary; anecdotal is sufficient. Celebrity endorsement can help.

Get the media hungry for content on-board: Have them gang up, pile on, form a mob, publish shocking content, get credibility for the group and the issue via one for all, all for one, write click-bait headlines. Then the media gets eyeballs and ad revenue.

The group gets publicity, credibility, donations, goes for legislation and appropriations which help the group, result in campaign contributions, maybe cushy jobs.

Make use of a fact of life in politics: One percent of the voters making a big noise can scare politicians more than the other 99% not much concerned.

I.e., there is "extortion" -- objecting to the issue can result in getting hurt.

But eventually too many of that 99% find reasons not to like the issue, and it dies.

Repeat with another group/issue.

I'm not sure why this was downvoted; it's entirely correct.

Any institution has, as its primary goal, to further its own life.

Why would institutions against $FOO (where $FOO is whatever your personal bogeyman is, such as racism or sexism) be any different?

It's (the original comment) a pretty myopic comment because the same point can be made about the institutions that perpetuate $FOO.

You're correct on a theoretical level. But in reality these are still very real issues. You don't even have to squint - just look at the Supreme Court and Dobbs v Jackson.

The fact that you think racial equality or feminism are "done" illustrates clearly that the problem isn't solved.

From the perspective of most people belonging to those groups, the major battles are all won and they have much bigger cocerns in their day to day lives. These groups know that, so they have to keep manufacturing outrage in order to stay relevant.

You don't stop fighting after the major battles are won. You fight until the the war is over.

As long as there are groups that continue to fight to reverse the gains that were hard won, one must continue to fight hard. Complacency risks society regressing. See: abortion rights.

Neverending wars are exactly what I want to avoid. Eventually both sides end up becoming the bad guys.

Really?

I am a gay man and I see increasing homophobic speech that stems from transphobia which most definitely isn't a "solved issue". This worries me.

Yes there was a battle in culture and politics that lasted decades for gay men, but as soon as you let go. You will see conservative groups pushing back. Because they're not gone, there is a long way for them to go as a lot of these ideas come from religious and conservative groups that will probably never go away.

Sorry, but the fight is not over. You don't see it because you're not a part of it it's as simple as that.

If you haven't taken the time to understand why people are still struggling then you can't come and say "well this is a done deal".

Societies move forward but they so with a constant push back. That's just how it is. Even today there is so much homophobia, transphobia, misoginy and racism being touted by people in our most powerful sitting positions that it's silly to think this is "made up" struggle for these groups to "stay relevant". I mean, homosexuals, transpeople, women and racial minorities are never going to go away so they're always going to be relevant.

I'm not denying anyone's struggle or their right to organize against it.

I'm saying that the groups in question are amplifying the problem 100x, with the goal of angering folks like yourself.

They are the arms dealer in a never ending war.

The groups organizing against trans people are amplifying the problem 10000000000x.

A recent example is [1]. Many anti-trans activists, including some that represent themselves as more polite, are actively engaged in a conspiracy to eliminate the notion of transgender experiences being a real part of humanity. This is obviously going to elicit a response from trans people like me, and our reaction is not just understandable but wholly legitimate. Why are you not focusing your attention on those people?

[1] https://genderanalysis.net/2024/01/still-dreaming-of-running...

If the "transgender experience" is males insisting that they have the right to impose themselves on any female-only space simply because they imagine themselves to be women, disregarding the boundaries and consent of actual women, then this experience should indeed be eliminated. If you are behaving in this way, please stop it.

And yet, you continue to use software and hardware that trans people have made significant contributions to, including quite likely (at least indirectly) some written by myself.

This is the great tragedy of open source software, isn't it? We keep laboring on things that make people's lives better, including the lives of the people who hate us. Sometimes I ask myself if focusing my career on FOSS always was a mistake.

> Even today there is so much homophobia, transphobia, misoginy and racism being touted by people in our most powerful sitting positions t

Is that really the case though? It seems like in many (most? nearly all?) cases we've gone from people saying things that are overtly and objectively racist / sexist / etc. to things that aren't but could be construed that way if you squint hard enough, and it's largely in the eye of the beholder to decide, and along with that we've seen the rise in assuming people's intent. Once you've crossed the bridge of assuming intent, then pretty much everything can be further "evidence" of the foregone conclusion.

I invite you to take the statements of the "people in our most powerful sitting positions" for any recent period of time (the past month, the past 6 months, whatever) and make a note of all the ones that you are sure are homophobic, transphobic, racist, or whatever and try to take a look at them with fresh eyes. Set aside for a moment what you are so "sure" about their intent and background and see how many you can find are actually and objectively bad, or if they are just "bad" in the sense because (a) they have a different view than you and/or (b) it's only bad because in your mind that person is already <whatever>-ist and so everything they say is just going to be viewed through that lens.

We're never going to say that e.g. racism is a completely solved problem, but the headway we've made over the past century or two is so incredible that from the 30,000 ft view we're relatively close, and the organizations that exist to combat it have largely outlived their purpose and, unfortunately, in many cases seem to exist mostly to fan the flames.

" Senator calls LGBTQ+ people 'filth,' says most don't want them here " >https://www.tahlequahdailypress.com/news/senator-calls-lgbtq...

So is this just bad because of a or b? Is it because their view is different, or because I'm not giving them enough credit?

How about the fact that three states are having to re-district because they have been using racial gerrymandering to reduce black votes right now?

Actually, I think this is a fantastic example of my point. He did not, in fact, call LGBTQ+ people filth, at least according to the quote in the article - the headline and the article clearly misconstrue what he said.

But let's pretend for a moment that he did say that. Is a state senator from Oklahoma one of the "people in our most powerful sitting positions"? With a sufficiently large population, we will be able to find people saying hateful things until the end of time - I don't dispute that at all. There will always be morons. But as you cast a wider and wider net to find people saying stupid things, you have to also take into account their proportion of the population. Even if he had really said that, he'd be part of a vanishingly small minority. Heck, the very fact that an article was written about what he not-quite said also shows how far we've come.

"We are a religious state and we are going to fight it to keep that filth out of the state of Oklahoma because we are a Christian state – we are a moral state"

Seems to me that he did, in fact, call LGBTQ+ people filth.

When later questioned about calling LGBTQ+ people filth, he answered: "I support my constituency, and like I said, we’re a Christian state, and we are tired of having that shoved down our throat at every turn. I’ll let my words [spoken here] speak for theirselves, but that is my statement, and I stand behind it, and I stand behind the Republican Party values, and that is my statement"

I get that you want there to be a bright line rule and that the only way for you to see that he said this was if he said it in a way that cannot possibly be construed as anything else, but that's not the reality of the english language. Since his statement was clarified further, I think we can all take it to mean what the headline says and agree that the bit of grace we might grant someone being misunderstood is run through.

> Is a state senator from Oklahoma one of the "people in our most powerful sitting positions"?

Actually, yes. If anything, recent legislation has shown that you underestimate the power of state government at your peril.

As to the "vanishingly small minority" - I'd say if 0.01% of people felt that way, it would be vanishingly small. The reality is, given Republican party platforms in multiple states, that closer to 21% of people feel this way. 21% is a minority, it's true, but it is not vanishingly small.

For example, 28% of the country believes gay marriage should be illegal, and 33% believe it is morally unacceptable to be a gay or lesbian person, according to Gallup: https://news.gallup.com/poll/1651/gay-lesbian-rights.aspx

> Seems to me that he did, in fact, call LGBTQ+ people filth.

I see that you are choosing to read it that way, but that is quite literally not what he said, and I don't agree with the assumptive leap that you took to get there. Is it possible he meant it the way you're choosing to interpret it? Of course it is. But it seems at least as plausible that he didn't (the fact that he said 'that' and not 'them' means he's probably referring to some sort of dogma or indoctrination or messaging, and not people), but you - and the author of that article apparently - are choosing to go with that particular interpretation anyway. If you can't see the rather large assumption you're making, to me that's a far bigger problem, because it all but guarantees a state of perpetual aggrievance.

Regarding the other stats, that is actually committing the common follow on mistake of lumping everyone together as the same. Again, let's pretend this rando really meant things the way you're choosing to interpret it. To go from there to implying that he is equivalent to everyone who is not on board with gay marriage is again a huge (and false) assumption that only serves to ratchet up your frustration / anger / whatever towards people who don't see the world the same way.

(And as an aside, if you are truly interested in making further progress on some of these issues instead of just being angry about them, you need those people as your allies and could probably win many if not most of them closer to your POV, but demonizing them by lumping them in with the tiny minority representing the worst of them all but guarantees that won't happen.)

>But it seems at least as plausible that he didn't

I do not believe that is true. Possible, perhaps. Plausible, much less at least as plausible? No. You're kinda making an unjustified leap to support your position here. The alternative meaning of his statement is that LGBTQ+ behavior is filth and that their advocacy for equal rights and safety was advocacy for filth. That is essentially the same as calling the behavior that makes them members of a subgroup filth, and so the subgroup is made up of filth as a requirement for membership. The fact is, though, that he was asked about his statement in the context of calling LGBTQ+ people filth and reiterated that his words stood as a Christian and Republican.

>Regarding the other stats, that is actually committing the common follow on mistake of lumping everyone together as the same. Again, let's pretend this rando really meant things the way you're choosing to interpret it. To go from there to implying that he is equivalent to everyone who is not on board with gay marriage is again a huge (and false) assumption that only serves to ratchet up your frustration / anger / whatever towards people who don't see the world the same way.

That's not really it - I implied that he was similar to about 20% of the population, which is about 2/3 of the population against gay marriage or who believe gay and lesbian people are sinning/immoral. These people advocate for their position. They do not want gay people to exist; they would prefer that sin be eradicated. It is not a stretch to say that people who openly state that their core beliefs are antagonistic to the existence of a group of people are similar to one another in terms of their general unwillingness to allow those people to exist peacefully and freely.

>And as an aside, if you are truly interested in making further progress on some of these issues instead of just being angry about them, you need those people as your allies and could probably win many if not most of them closer to your POV, but demonizing them by lumping them in with the tiny minority representing the worst of them all but guarantees that won't happen.

I don't think that's actually true. If you look at the history of the civil rights movement, at least in the US, it has not required the willing participation of out-and-out bigots to make forward progress. It has required the population that is not flatly bigoted to either take action or get out of the way, but nobody required the KKK to become the ally of the civil rights movement. Fortunately, as their behavior is less respected or allowed, they get less out of being members of their groups and most withdraw or change their behavior.

Are you generally taken in by con artists?

> The fact that you think racial equality or feminism are "done" illustrates clearly that the problem isn't solved.

Where are you going with this?

I mean, do any of those institutions formed solely for feminism (for example) actually have a metric for when they will be done?

Did they actually draw a line in the sand, saying "When we reach this point, we will dismantle the institution because at this point we will, happily, no longer be necessary?"

Because to all of us watching, they don't have a "done" metric. They don't have a goal, which when reached, will cause their existence to be unnecessary.

Their primary goal isn't "fighting for $whatever", it's to ensure the continued existence of the institution.

Sane people don't work that way - they have a goal in their mind, and once that is achieved they move on to a new goal.

I totally agree with that. In the past they may have had manifestos and explicit demands. You were either on board or you weren't.

Nowadays they seem to deal more in narratives.

seems to be related to continuous engagement versus living independently, somehow.. "crowded world" corollary?

I'm not sure what you think the goal should be. Do you imagine a world where racist policies end and never resume? We're a long, long, long ways from that so it seems premature to ask for organizations opposed to racism in government and business to close up shop, eh?

Tbh this comes across as related to the typical conservative argument that racism is over because we elected a black man president. That's not really what you're talking about, is it?

> Do you imagine a world where racist policies end

Yes. I don't, right now, see racist policies.

> and never resume?

Why does that matter? Can't a new institution form to fix the problem if it comes up again?

If society goes through (for example) 100 years of a totally racist-policy-free existence, why on earth would you argue that the institutions founded to oppose racist policies continue existing for that 100 years?

The challenge with metrics is Goodhart's law.

The way it applies to companies, we can state that <whatever>-ism is solved because we reached some metric. So I'm not sure we can close up shop on an <ism> issue after winning some policy or reaching some type of measurable threshold.

That said, what I'm really hearing in this conversation isn't actually that the -ism institutions need to go away. What I'm really hearing is that some folks are very fatigued and tired of being inundated with the -ism dialogue and the demand to spend any energy on it at all. This seems to be significantly true for the people not affected by a particular ism.

And on the side of the -isms, folks are saying, "We absolutely do not feel heard, you're not hearing us about my particular -ism! You can't ignore the badness of the -ism. listen to me! I will step up my activism!"

The reality of the matter is that the -isms aren't going to go away and change is going to be a generational process. For example, every significant founding woman of woman's suffrage died of natural causes (old age), and none of them got to see womens' voting rights pass in their lifetime. Now that women voting isn't even a question of debate and very obvious, no one is really debating in earnest whether women should be allowed to vote or not. That's just a ridiculous thing to consider.

If you want a metric for a measurable threshold of when the ism-issue should go away, it's when we reach a point where the ism-issue has reached a point of saturation where it's plain and obvious and has enough societal inertia not to be challenged. And if people decide to revive something like whether women should be allowed to vote, trust that there will be an opposing force that rises up to fight that.

The pandora's box of the internet and social media is that much of the learned-helplessness to accept that an -ism-issue is here to stay can actually be rallied against, and that change can come about from it. So I would expect that this is the new reality we live with. One can either fight for or against the ism, or ignore it and focus on their interest of choice.

Given you mention NAACP I'm assuming your comment refers to US-based organizations.

In that respect "feminists" won a landmark victory in 1973 that was just recently overturned in Roe v Wade. That's one example of the importance of "sticking around".

As all your examples are of groups leaning one particular way politically I'll proffer another example from other side.

Consider the NRA, presumably they don't need to exist as the 2nd amendment enshrines the right in our constitution.

As you may point out that right is under constant threat. Apply that same logic to the groups you're disparaging and you may better understand their purpose.

I don't feel any differently about the NRA. They're yet another group that's peddling a never ending culture war.

The "culture war" just resulted in the reversal of Roe v Wade denying millions of women with healthcare access. The current and previous presidents both called for depriving people of their constitutional 2nd amendment rights. Even if you specifically dislike the NRA their stated purpose is objectively needed.

To reorient the discussion back on topic, the Sharky Principle is often weaponized by those who don't understand the ongoing endangerment of our basic rights. Even with immediate relevant examples like Dobbs v Jackson. Though it may be broadly applicable across organizations it's important to pick good examples.

> The "culture war" just resulted in the reversal of Roe v Wade denying millions of women with healthcare access.

I don't really think it's accurate to describe abortion as "healthcare access". Whatever your views on the topic may be, the situation is more complex than that.

It really is that simple. Women are at severe risk now if they develop certain normal conditions which are mathematically certain to happen to a number of people every year, but now they have to leave to free states (if they can) or plead with a court system to get life/fertility-saving healthcare because the medical treatment is an abortion. Anyone doing IVF especially has to worry about that because there are more situations which can go wrong with elevated risk of death or loss of fertility. It’s not even directly reproductive care: some things like chemotherapy have the risk of complications due to pregnancy during treatment, which has numerous documented cases where treatment was delayed waiting for proof that someone isn’t pregnant because state law prohibits an abortion if that happens.

There’s another aspect which again really is that simple: the liability risk of having some theocrat second-guess their medical expertise means that hospitals are closing obstetric departments and doctors are leaving repressive states. Reduced access guarantees that people who would have had medical care a few years ago do not today.

https://www.idahostatesman.com/living/health-fitness/article...

This is in fact the first example in the article.

That's literally the first example in TFA.

Teach for America?

The Friendly Article

There’s a lot of businesses like this that rely on “complexity” or “fragmentation” of existing systems, particularly in the US where laws and standards differ across all states. Another example is a business like Segment—-they profit off of the complexity and incompatibility of other companies’ products, and would likely oppose or delay an open standard.

Avalara is another one

Charities too.

I think the more archetypal example is that _treating_ a disease is a lot more profitable than _curing_ a disease -- would the Epipen manufacturer ever develop and market a allergy _vaccine_ that cured an allergy with a one time shot?

One of the most successful drugs in recent times was one that actually cured a previously chronic and not curable disease. It was also a controversial one because it was very expensive. But Solvadi, which cured Hepatitis C was certainly a huge commercial success and shows that the whole idea that pharma companies are never incentivized to cure diseases instead of treating them is just wrong.

Nice example, but one exception doesn’t disprove a trend.

What trend? In which cases specifically are companies avoiding to create a cure that would be possible and promising?

What trend? You need to show evidence of cures being suppressed many times to indicate any kind of trend.

Any trend. I’m not making a claim—simply a logical statement. Those making claims need to show evidence.

This is one reason it's essential to have a free enterprise system, where anyone can take on such problems.

Free enterprise is not a necessary precondition for research. You'll note how much of the last 50 years of technological advancements were direct or indirect results of government funded research programs.

If it's too free, nobody will do the research because they'll get scooped by copycats while everyone will claim to have a cure because they'll already have the customer's money by the time their fraud is discovered. Freedom is a good default and a good guiding principle, but it's a terrible absolute principle.

Or a system that removes profit from the equation. From the article, I don't think any one bureaucratic system is immune from the effect.

In the tech sector, we see many examples of the disruptor opening a temporary wedge to either get acquired by the dominant player or becoming the new hegemonist.

A system where it's not profitable to solve problems won't do much problem solving.

This is just taking the rational consumer model, forgetting it's just a model and treating it as a fact of life, and then inventing corollaries from it. Plenty of people find intrinsic value in solving problems without there needing to be a profit. See, e.g. Open Source Software, The Apollo Program, Academia, the BBC.

And that only works for problems that are cheap to solve. Most aren't.

You are replying to a post that references exceptionally expensive efforts. The inflation adjusted cost of the Apollo Program was hundreds of billions of dollars[1]. By what measure is that cheap? Maybe I'm missing intended sarcasm?

[1] https://www.planetary.org/space-policy/cost-of-apollo

The Apollo Program, Academia, and the BBC all pay their workers, which makes it profitable for them to do the work.

I get your point: These are not for profit enterprises and they still get important work done.

I'm making a different point: People don't work for the benefit of others without being rewarded.

Open Source Software is not a bad counter example. I think there are rewards in the joy of programming, making a name for yourself, and a few other things, but I'll concede that there is some nuance there.

Spoken like a true Ferengi.

Why would this happen when it's more profitable not to?

How do you make profit not doing something?

Right now I'm not doing billions of things, and don't see a cent is coming in!

Or the carbon/nuclear industries' PR campaigns to foment support to maintain their subsidies and keep them away from solar + wind.

Indeed, however at least TurboTax has competition so that the experience, while unnecessarily complicated, is not as unpleasant as it could be. I have recently been thinking about this as I have just filed my taxes, which, in the country I am living in, can be done only using the government's website. This website is dreadful. It hasn't changed since the early 2000s at the latest, provides no help or guidance, contains typos, and even requires that you manually copy a number from one page to the next. I also don't think the tax system is noticeably easier than the one in the USA (where I used to live) even though there is no direct analogue of TurboTax lobbying for complexity (although there probably are still accountant lobby groups).