I just read a comment on an Uber fundraising page for a lady with cancer. It said, “Uber should provide healthcare for all drivers instead of doing gofundme pages!”
I’m not here to debate whether or not that would be better, but rather to point out a phenomenon of sacrifice-blindness.
My friend sent me an article today about a kid falling out of a window on LSD. She doesn’t like that I do LSD. I told her that LSD was really safe and that more people fall out of windows on alcohol. She said,
Frequently we point out things that are Good Ideas Motivated by Goodness, such as:
*Everyone should have access to health care
*Nobody should fall out of windows
*Avoid war no matter what
*Jobs should pay enough to cover all basic financial needs
*Terminal illnesses should be researched and cured
*Nobody should be racist
*Our culture should be protected from criminals
*We shouldn’t have our freedom infringed
*Provide the homeless with housing
*We need more after-school programs
*Employers should provide medical benefits to employees
I don’t disagree with the desires expressed by all these things, and I suspect almost nobody would. If I could press a button and magically everybody gets health care without any cost to anybody, I absolutely would.
And I don’t mean to make this an argument against the individual ideas expressed. Whether or not universal healthcare should be instituted is a whole different idea. What I am arguing is to eliminate sacrifice-blindness.
I am on a birth control that puts me at significantly increased risk for stroke. A few years ago I would have never considered taking this birth control, because “avoiding all things that increases health risk is a Good Idea Motivated by Goodness.” Good health was paramount above everything.
But really? Above everything? Even all the positive benefits the birth control pill gave me? By blindly accepting this rule of Goodness, I failed to consider what I was sacrificing to follow this rule – medication that would improve my quality of life. And once I stopped to actually consider the practical results of the options I was facing, my choice changed.
Preserve Human Life No Matter What is a frequently touted Good Idea Motivated by Goodness, but we don’t act according to it. We drive our families around in cars, putting them at risk of car accidents and death. Realistically speaking, the law we follow is more like Preserve Human Life As Long As It’s Mostly Convenient For Us.
And this is fine. Outlawing LSD to preserve safety might be a Good Idea Motivated by Goodness, but it ignores the sacrifice made for this – human autonomy in their own safety and all of the benefits of LSD.
Now, you can look at this evaluation and make a choice, and I’m not going to tell you you’re wrong. If you’re fully aware of all of the things you are sacrificing in order to gain “nobody falls out of a window,” then I cannot blame you, and now our discussion switches to one of personal value.
With the example of Uber and medical benefits – would it be a Good Idea to make Uber provide benefits to its employees independent contractors? Yes. But what would we be sacrificing in order to make this happen? Would this raise the cost of Uber, making Lyft a better option and putting Uber drivers out of business? Or making it less affordable for poor people in communities to have easy transportation? Or raise the barrier of entry for people who want to be Uber drivers, thus reducing the number of potential income sources that a desperate person might need to feed their family? Would requiring Uber to give out healthcare actually end up hurting poor communities the most? Maybe. Maybe not. Maybe even if it did, it would still be worth it. But whatever our final choice, let’s not be sacrifice-blind.
I find that in the majority of political discussions I see, parties from all sides engage in sacrifice-blindness in pursuit of touting Good Ideas Motivated by Goodness. I suspect that if everyone knew exactly what would be sacrificed if their idea was actually perfectly implemented, people would agree with each other much more often.
>I suspect that if everyone knew exactly what would be sacrificed if their idea was actually perfectly implemented, people would agree with each other much more often.
Only if they cared. The people arguing aren’t trying to maximize global utility, they’re just engaging in theatre. The commenter on the Uber-cancer page felt outraged and was looking for any reason to express that outrage.
This gets even worse when passed through the filter of internet commentary. Even if 99.9% of people understood the concept of tradeoffs, their most likely reaction would be to just say nothing, leaving the conversation dominated by the 0.1% of people who least understand the issue.
Thomas Sowell argues the same in Knowledge and Decisions. People ignore trade-offs. This is a good point.
If it’s at all feasible for you, you’d probably get a lot out of a few introductory-level philosophy and economics classes, as far as sharpening your perspective on questions like these, like if there’s an extension school nearby. Philosophy classes that aren’t super-narrowed down to one philosopher or field of logic or whatever are pretty much tailored to bringing the history of ideas to bear on questions like yours.
I don’t think my ideas are original, but I hope I’m phrasing them in a succinct way that’s easy for people to understand. If my rephrasing itself is unoriginal, could you point me towards where the phrasing existed previously?
A closely related concept is sacred values, ones that people feel Must Be Upheld at all costs. Example is the person saying ‘one person falling out of a window is one too many’.
Just about the health care system… In Europe most countries manage to have an universal health-care system which is cheaper for the citizens and for the government than the US health system. In fact the US heath system is the most expensive (both for government and citizens) and inefficient in the western countries.
The time health care stops being a business, and the need for profit vanishes, it becomes much cheaper.
I assume most people already know this graph, but it is worth showing it again
http://theincidentaleconomist.com/wordpress/wp-content/uploads/2013/11/OECD-LE-Spending1.jpg
Life expectancy is more a reflection of culture, genetics, and lifestyle, than it is a reflection of the healthcare system.
While the U.S. system is crazy expensive and has plenty of problems, it has MUCH higher success rates in treating nearly every type of cancer & other life threatening diseases than all government run single payer systems.
I lived in two Scandinavian countries for several years each. There are plenty of health care horror stories over there that never receive media attention. It was quite a shock for me when I saw protesters in front of a cancer clinic in Stockholm who were diagnosed with cancer but refused treatment. Why? Because it had been determined that the clinic’s resources were better spent on younger patients. The protestors were left to die of the disease. You can save a lot of money if you just let the most expensive cases die off without any treatment at all.
Americans would be better served looking back at the health care system we used to have back in the early 1980s and earlier, before the rise of HMOs, than the mediocre-at-best government run systems of Europe. Back then we had the best health care in the world, and it was affordable.
Life expectancy is a reflection of health care and (specially) access to health care. The correlation is not spurious, is a well documented fact. US health care system nowadays is the least efficient in the world. It provides huge profits to health corporation, but horrific results to people. It is not a coincidence that US is the only outlayer of the western countries. US system favours corporate profits over health, and prevents many people to get the health care they need. Yes, maybe the best hospitals in the US are the best in the world, but 99% people never go to the best hospitals. What they need is the chance to go to a regular hospital whenever they need it, independently of their financial situation.
I have a hard time believing in that story. In the countries I know it would be a serious crime for any public hospital to deny any kind of necessary treatment to anyone. The hospital does not have the legal right to make that kind of decision. And if decided by the central government it would be an international scandal.
The “mediocre at best” systems of Europe are among the only ones that provide good health care to people non-rich people. Much better than the US system has ever done.
https://www.healthsystemtracker.org/chart-collection/mortality-rates-u-s-compare-countries/#item-mortality-rates-fallen-steadily-u-s-comparable-countries
https://en.wikipedia.org/wiki/List_of_countries_by_quality_of_healthcare
http://accesstohealthcare.eiu.com/wp-content/uploads/sites/42/2017/06/AccesstohealthcareinNorthAmerica.pdf
My admittedly very brief search for statistics supports the notion for cancer, but not exactly for all afflictions. Are you quite sure about those numbers? It seems that the US system is ONLY better at treating cancer, not for a lot of other diseases. I’ve heard this argument quite a lot (its more expensive in the US but way better quality) but I’ve never quite been able to find the numbers to support it. If you have those figures, I’d be interested to hear them.
But you do make a valid point; you can save a lot of money by having the expensive cases die off; in fact this number can even be expressed in the unit of measurement called the “qually” which represents the gain of 1 year of quality life in an individual. At a certain point you have to look at the total resources available as a collective.
The WHO seems like a credible source on the subject to me; the US does not score all that well on their metrics, number 37 of 191 isn’t great. ITs not terible either, but it is surpassed by many “Mediocore-at-best” european nations; at least on the notion of efficiency. I like a utalitarian perspective on this, I want the invested resources to benefit as many people as possible.
https://www.who.int/healthinfo/paper30.pdf
…and, my comments are getting caught in spam again. (Although, admittedly my comment was just a link to Policy Debates Should Not Appear One-Sided as relevant LW reference, so you don’t necessarily need to bother fishing it out.)
No worries, I approve each comment, it just takes me a bit to get around to it
Oh, OK, thanks! It’s just annoying because my comments seem to get caught in the spam filter rather than in moderation, so I wasn’t sure you’d even see it for approval without looking. Thanks again!
Relevant LW: http://lesswrong.com/lw/gz/policy_debates_should_not_appear_onesided/
I think this represents the difference between understanding an argument and using an argument. When using, you isolate the important points from the greater system, and ignore as much as possible to present an objectively good option. It’s common in politics because that is the entire point of politics.
The concept of “sacrifice-blindness” feels to me like a particular way of looking at an issue I wrote about a couple of (somewhat more unwieldy) blog posts on our tendency to ignore “gadflies”. In other words, we humans are lazy: we want to be able to settle on a position and argue for it via as easy an algorithm as possible, so we pay plenty of credence to some aspects of issues that we find comfortable (e.g. “health care for everyone is good”) while conveniently (often subconsciously) dismissing other possibilities (e.g. “the money for health care has to come from somewhere”, and so on). It certainly makes the task of convincing ourselves and others easier on us, but only at the price of making much less valid and rational assessments.
I think reason why debates are so bad is due to knowing what sacrifices are made for the good idea.
But in general I’m usually opposed to good ideas, even if I suggested the idea I will usually take the opposing side. I’m just against it.