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Politics and Economics
…Thus, if you want to understand why these procedures cost so much, follow the reimbursement rates. For instance, in 1997 Medicare raised reimbursement rates in certain parts of the country. On average, areas with a 2 percent increase in payment rates experienced a 3 percent increase in care provision. Physicians charge what they can, and then some.
Given that old people consume way more healthcare than anyone else, why do other rich countries spend so much less on healthcare than the US, when the US has comparatively fewer oldsters? Something is very wrong with this picture. What is all that money going? … A lot is paying for outpatient care and administration, which alone account for half of US healthcare expenditures
What does this actually mean, though? That permanent housing be available at the snap of one's fingers, anywhere in the US? Not realistic. Maybe in Finland, but not here. There is no basic right to live in the community of one's choice. Small town USA is off the hook here.
Unfortunately, residential hotels are becoming a relic of the past. For instance, San Francisco had 65,000 residential hotel units in 1910; today there are only around 19,000 units. If we really want to get serious about reducing urban homelessness in the US, we need to bring back residential hotels. Of course, I'm talking new, improved residential hotels, with support services available to all residents.
…For instance, single resident occupancy (SRO) rooms are just 80 square feet, enough for a bed, dresser and little else. San Francisco’s largest SRO hotel has 248 units. It would take 30 such SRO hotels to house the city’s current homeless population. That’s a lot of new buildings taking up a lot of valuable real estate in a city that doesn’t come close to meeting the housing needs of its low- and middle-income workers.
Homeless advocates are coalescing around a "housing first" approach to ending homelessness. The idea is to transition homeless people to permanent housing as soon as possible, ideally within a matter of weeks. Formerly homeless tenants would receive ongoing needs-based support, contributing a portion of their income to the cost of housing and services.
The big coastal cities, such as Los Angeles and New York, have contributed the most to this increase in homelessness. A large majority of the US homeless are individuals without children (e.g., 92% in San Francisco) and most are mentally ill, physically disabled, and/or abuse various substances.
Label creep: a gradual broadening of a category, often changing its meaning.
“Members of the public with the highest degrees of science literacy and technical reasoning capacity were not the most concerned about climate change. Rather, they were the ones among whom cultural polarization was greatest.” Kahan, Peters et al (2012)
For example, someone uninterested in higher education may not feel all that deprived compared to college graduates. Nor is it likely that a college undergrad would feel anger and resentment towards all those graduate students at her school if she considers the system for getting into graduate school to be fair and reasonable, expects to be a graduate student herself one day, and believes people who don't get accepted into graduate school have only themselves to blame.
We perceive social justice through a prism of intervening considerations, like how much:
...people have control over their circumstances
...luck figures in life outcomes
...the rules of the game are fair
...people deserve what they get.
…survey evidence showing the number of Americans endorsing anthropogenic climate change fell during the Great Recession, between 2007 and 2009. The authors' basic theory is that when people sense economic threat, they are more likely to value order and stability, which motivates them to justify the existing economic system and downplay evidence suggesting the system itself is a problem.
There's something about psychologizing that's invalidating. As if psychology was the science of human error. But does it have to be so? Humans are pretty good at tracking reality, thanks to biases and heuristics that work well most of the time. Error can be an ally in the search for truth.
In the bad ol' days of bureaucratic communism, psychiatrists contributed their diagnostic services to the state to help rein in trouble-makers. Take "sluggish schizophrenia", a diagnosis characterized by “pessimism, poor social adaptation and conflict with authorities” and frequently used to facilitate the psychiatric incarceration of political dissenters in the USSR and Eastern Bloc countries. Thanks to sluggish schizophrenia, the Soviet Union had three times as many schizophrenic patients as the US.
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?
Wealth is usually calculated as what the household owns that can be cashed in for future spending. But shouldn't external sources of future spending be counted as household wealth as well? Why not count the value of investments into which other entities pay but the household collects, like government- or employer-funded pensions? For example, the median pension benefit for newly retired teachers in California is $40K a year. That works out to $1 million over 25 years.
For instance, inequality was associated with higher happiness in countries where people felt they or their children were going places. Well-dressed rich people reminded them of their own possibilities, not of something they can never have because the system is rigged. In these countries, exposure to the good fortune of others wasn't depressing or an occasion to rage against the machine. It was inspirational: an occasion to double-down on one's resolutions. Okay, that's simplifying a bit, but you get the point.
…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.
Average profit margins for insurance companies have hovered around 3% for years. That's not wasted money, though; in our current healthcare system, insurance companies play a vital role: they rein in providers who are prone to over-treat and over-test.