Before you know what you’re doing, you don’t know what you’re doing. And other people see it. That’s why being a newbie on the job can be such an excruciating experience: if not in reality, at least in the imagination.
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Explorations Outside
In most cases, lower inequality and higher GDP per capita were associated with higher levels of flourishing…. And then there's Slovakia and Slovenia: more equal, less affluent, and not yet flourishing. And then there's Russia…
When you're hot and sweaty and there's no relief, it's hard to have the energy or inclination to pursue challenging goals. Or just to get stuff done.
“…Happiness was linked to being a taker rather than a giver, whereas meaningfulness went with being a giver rather than a taker. Higher levels of worry, stress, and anxiety were linked to higher meaningfulness but lower happiness." Baumeister, Vohs, et al. (2013). "Some key differences between a happy life and a meaningful life."
In other words, rats make choices based on what they want and what they consider possible. They imagine the future, weigh the relative merit of different actions, seek additional information if needed, choose what to do, and then act. They are agents with desires and goals.
Most people accept that merit should be rewarded and bad behavior punished, but that doesn't tell us much. The difficult question is: how much? Part of the answer to that is: according to the rules of a legitimate system. And what makes a system legitimate?
…if we're around someone who's "higher" than us on a dimension that matters (e.g., wealth, looks, personality), the degree to which we feel good or bad about it depends (in whole or part!) on whether we feel we have what it takes to get where they are.
…what one considers fair or equitable is partly based on whether a person’s allotment is deserved - that is, earned by virtue of personal qualities or actions. Deservingness isn't just about what a person is or does, though. It's also about the broader social and economic context: the rules of the game that dictate which qualities or actions are rewarded.
I care about outcomes, not motivation. Greed is good as long as greed delivers.
But the California system uses a rigid, top-down approach that disincentivizes labor-saving innovations in nursing care. That's because California hospitals would still be stuck with the same minimum RN:patient ratios even if ways were found to reduce time spent on some nursing tasks (e.g., documentation).
It looks like job stress has gone up a bit over the years, while work hours and satisfaction with work load and level of RN staff levels haven't changed much since the implementation of AB 394. Kinda disappointing when you think of the added expense of all those extra RNs and RN hours. This is not at all to say that nurses haven't benefited from the implementation of strict staffing ratios. It just doesn't look like the benefit has been all that great. And then you've got to ask if it's worth it. Because there are costs to these extra costs.
“The basic takeaway from the analysis was that there is variation in quality from hospital to hospital, but that variation it is not correlated with for-profit status.” Maybe For-Profit Hospitals Aren't So Bad, Harvard.edu Blog
US healthcare spending is almost twice that of the other developed countries. Pharmaceuticals and medical goods (e.g., medical supplies and devices) are a relatively small part of that difference. If we knocked off, say, $200 a year in drugs and medical goods, we'd hardly make a dent in overall US healthcare spending – which is approaching a per capita average of $10,000 a year.
First we've got to get a handle on what the US actually spends on healthcare. According to the Centers for Medicare & Medicaid Services (National Health Expenditures 2016 Highlights - CMS.gov), US healthcare spending reached $3.3 trillion in 2016, or $10,348 per person. That represents 17.9% of the gross domestic product (GDP). For comparison, the “Comparable Rich Country” average for healthcare spending was $5169 per person in 2016 (10-12% of GDP, depending on the specific country).
Problems are problems because they conflict with desired outcomes. Exploring a problem space may start with the desired outcome (universal but affordable health care!) or with a "problem-alert": the sense that something is wrong. Part of exploring a problem space is refining, clarifying, or figuring out what the desired outcome is. Part of that process is refining, clarifying, or figuring out what the actual problem is.
There are things I care about… I want the biosphere to survive, relatively intact. I want every human to have a home… The list goes on. There's no way to justify the list. No first principles that can withstand scrutiny.
...ideologues tend to exaggerate societal problems, the better to justify their Big Solution. Big Solutions need to be justified when they require painful sacrifice (the darkness before the dawn), as they often do. That pain had better be worth it. Hence: Big Solutions need Big Problems.
Even when we think we're doing the right thing as an "end-in-itself", there is an implicit assumption that the world will turn out better (at least in the "long term") if we simply focused on the action itself, consequences be damned. Basically, it's a heuristic that resolves a lot of ethical dilemmas. We need heuristics because life is complicated; we can't think through everything.
On second thought, all research is desire-driven. Because behavior is necessarily goal-driven and you don't have goals without wanting something to happen and wanting is desire and doing science is a behavior. But some desires are more conducive to scientific progress than others. Like the desire for reality not to make fools of us.
Suppression of alternative points of view is immoral, because it prevents movement towards a better understanding of the truth. Species evolve through competing variations within changing environments. Nothing works for long (except for crocodiles).