Let the Poor be Poor!

Andrew Atkin:

One of the nastiest things you can do to poor people--believe it or not--is not let them be poor. That is, force them to invest their resources in ways that you think is best for them, yet not what they think is best for them.

Housing is our great modern example. Auckland council outlawed the use of sleeping capsules, because in their 'superior wisdom' they decided that poor people should not be allowed to live that way. How nice. 

But there's a problem with that. People who wish to sleep in capsules are probably not rich, and if they're single and want to share a room with others, in exchange for saving say an extra $100 a week, then those capsules could have been great for them (they won't hear their roommates snoring). But again, that option was taken away by bureaucrats who decided that they know their priorities better than they do.

-A lot of it is image. Auckland council doesn't like poor people looking poor, because it makes their failure to provide affordable housing too naked. They would rather reduce the overt image of poverty, even if they make people existentially poorer for it.

Another example. I have a friend who several years back flatted with someone that she liked as a person but hated living with (to the point of tears), and she did so because she had no other choice due to costs. As a consequence she lived in poverty. Her basic need for privacy was badly undermined. She needed her own space and she couldn't have it. One [theoretical] option for her would have been freedom-camping close to work, in a nice setting in a good caravan. That would have been far better and much cheaper for her at that time. But no. That option was (and is) not allowed to be practical due to local regulations. She was not allowed to be poor so she had to be poorer - just like with my capsule example. 

When it comes to housing we have a national emergency in New Zealand. We've created true poverty and on social and material levels. We can do so much today to remove the hardest edge of the housing crises by simply relaxing regulations, so as to allow New Zealander's to build temporary alternatives that work for them personally - especially if they have little money.

A good idea amongst others is to create new camping zones that make caravan living easy and private. How? Just create designated park-up areas on the city fringe, in nice settings, coupled with electronically-locked pay-to-use showers, toilets and wash-house for people who might need it, and allow strong social controls to be established to keep "difficult" people out. 

It would also provide a lot of supply relief for housing. That would impact the entire rental market for everyone - reducing costs. When you don't have children, caravans and campervans can be surprisingly livable. And there are tens of thousands of Auckland renters with no kids.

Also, let people put simple China-import cabins on their properties, front or back of the house, classed as mobile homes, to expand the capacity of existing rentals without creating undue overcrowding.

Work with alternatives - don't suppress them. Let the poor be poor until we sort the construction cost of housing out. Surely this makes better sense? Better than forcing them to live in their cars or give up all disposable income, at least.

Why I am not a Conservative

Andrew Atkin:

Go back to the age of Spartans, and look at their conservative society for their time. By today's standards it was profoundly sick. Extreme violence was celebrated and even demanded. Their men would enter manhood by stealthily murdering an innocent slave; children proved their strength by withstand ritual whippings without passing out; wives were justly claimed by forceful abduction; homsexuality was compulsory - and on.

Sparta was a society made up of people akin to a MS-13 type gang, and worse. Their culture of child abuse was horrific and the people were, as they could only be, made partially insane from traumatic abuse.

Yet it worked. They survived for a long time. And with strict adherence to traditions they managed to continue on for hundreds of years. High death rates--as they were at the time--were balanced with high birth rates. 

Hence the systems, doctrines, and traditions of ancient Sparta were successful. So who am I to judge? Well I'm not judging, but I can see ancient Sparta for what it was. It was a waring society culturally evolved to deal with conditions of extreme hardship - and relentless barbarians at the gate. They made a god out of violence and brutish masculinity, ultimately because they had to. Awful conditions dictated it.

However, that kind of survival code comes at a cost. Spartans were deeply neurotic and therefore unfeeling. Their existence was emotionally numb, as it only can be when you're living in a severely repressed state. So they were alive - but hardly living. 

So, when would be the right time for Spartans to challenge their traditions and ask themselves if there's a better way to be? They should do it when times are peaceful - when the old codes and traditions can be seen as out of date. And when they take this position, I would say they go from being conservative to progressive. (I say 'progressive' in the real meaning of the word - not the modern Leftist meaning). 

The point behind my observation of Sparta, is that it's not ideal simplistically presume that traditional ways are best because they "worked" and are therefore "proven". Some societies that are surviving should nonetheless not be surviving - that is, in their existing form. 

Take a look at societies that have arranged marriages for example. They're often highly successful in the 'stable' sense of the word, but on a human level they are tragic. Sure they achieve their stability, but only by violating the natural process of mate-selection. Hence, behind the winning tradition is a losing reality. An ideal society should never need arranged marriages that threaten to drive so many people into a silent misery. And for the long term, it is failing strategy as there will be a compromise on the genetic health of the offspring, which may become pronounced over time.

To a degree, I believe that traditional (conservative) western society--though well worth celebrating on many levels--still has a way to go. And this is why I'm as much a progressive and as a conservative. The difference between myself and a common conservative, is that I have a background in understanding how child abuse, child neglect, and common mistakes that we all make with children today affect the mental make-up of our society at large, and how that ultimately affects the entire operational structure of our society over time.

Hence, I do not want to see New Zealand back to a 'good old days' that never really were. At least not on all levels. We can do much better I believe and go much further forward [my blog is filled with assertions on how things can be improved]. However, progressive change must be done with calm thinking and a respect for why our traditions were established in the first place. It's insane of course to remove an old pillar without first understanding why it's there.

So I am not a conservative. I am a cautious progressive.

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-Note, progressive's should not to be confused with regressives, the latter of which often call themselves progressives. Bluntly, the extreme-leftist ideologists of today are our modern regressives, and they are pathetic. They don't respect tradition nor wish to understand it or build from it. They're mis-educated and under-educated and operate more like vandals than builders. As it seems to me at least, they're driven more by anger and frustration than objective insight. 

Thoughts on dramatically improving the health system

Andrew Atkin:

Competition is not about creating winners and losers. It's about driving innovation and raising standards. 

Probably the best thing to focus on is of course poor health prevention. 

The ultimate success of an idealised health system would be for it to no longer be needed. We can move a lot further in that direction.

This comes back to the basics. We should be making sure people can live well without undue stress, and a key part of this is making sure the cost of healthy living is not too high. Also important is focusing on good childcare, and minimising child abuse and neglect as much as we practically can (Traumatic childhood stress gets internalised and leads to health problems later. In fact early abuse may be the No.1 toxin our health system exists to accommodate, other than nasty accidents and old age. Good video here).

Diagnosis.

Another focus should be early diagnosis. Obviously the sooner a condition is recognised the easier it is to deal with. Respecting that nearly all diagnosis begins with self-diagnosis (you go to the doctor because you first know something is wrong), it makes sense to work with and expand on the process...

An idea is to develop systems that facilitate better (easier) self-diagnosis. For example, if someone is worried that their mole might be cancerous, then rather than waiting to be worried about it enough to bother to see a doctor, the individual could instead quickly take a photo on their cellphone and upload it for analysis, to be seen by a specialist who reviews these things. The specialist can then make the call as to whether another professional should look further, or when.

(Note, through the online process we can greatly concentrate the productivity of otherwise very expensive health professionals, as those professionals can spend less time mucking about with communication inefficiencies, and less time doing low-level work that can then instantly be delegated to others).

Developing quick, user-friendly self-diagnosis facilities could be an important focus. With modern smartphones a well-developed app could be extremely useful for preliminary diagnosis, and save a lot of unnecessary grief.

Information and health records.

New Zealand should have everyone's health records uploaded into the cloud, accessible by any professional once given the patients authority to access it.

My recently deceased father, for example, had difficulties getting the health information that he obtained from Hastings hospital transferred over to Wellington hospital, which created silly delays and costs. We need to standardise health information into master cloud files, and I must say it's surprising that this (obvious) modernisation has not already been done.

Another advantage of having everyone's health records in a standardised format is research. We can quickly search database's to identify correlations, to help us recognise where causes of health problems are (or might be) coming from. Correlations are not causes of course, but they can certainly give us good clues.

Further, it allows access to expert second-opinions, for accurate diagnosis to be efficiently conducted. This is very important. GP's don't know everything and make errors with diagnosis and treatment all the time. Giving them an online back-up review option, that's rapid and efficient, would probably be invaluable.

Improving quality and reducing costs:

Is it really necessary for a specialist doctor to spend 10 years in university to diagnose and deal with your skin condition? Of course it isn't. Most of what they have studied will be redundant to that end. Yet we pay big money to these professionals, and because only those with a vast medical education are allowed to do the job - due to the licensing system.

Is there a better way? I believe so. One model is to move to a system of fully private hospitals that are directly market-accountable...

Think of this. You go to a private hospital to deal with your condition, and after your experience you make a report on the service. The government manages the surveys. You click on rankings (1 to 10) and make comments. This record then gets pooled into the statistics that allows the public to see median rankings and patient recommendations, for any given service provider. Giving the public direct and explicit transparency.

Depending on their relative rankings, different hospitals will be able to charge different rates. Hence, you've created the commercial incentive for hospitals to improve their services to maximise their bottomline. In a sector where there's so much room for innovation, this is surely a good idea.

The transparent competitive market is a powerful natural regulator. The market could, in turn, largely replace government regulation. The new regime can be: "You can do whatever you want, however which way you want, but you will be commercially accountable for your results".

Hospitals can then also be responsible for training their own staff. We can abandon the licensing system which helps to make health services unnecessarily expensive. For example, if a hospital thinks they can train a young woman on skin cancer diagnosis in 6 months, and without having her go to university, then we can let them do it and let them save themselves (and the nation) a small fortune. Remember the hospitals will be careful not to fail. The last thing they will want is bad patient reports reducing what they can charge.

Funding:

I think the ideal is for the government to subsidise funding, to cover the most basic costs. Fundamentally it should be an insurance system.

If you want to be served by a hospital with a higher ranking, then that will be more expensive and you will have the opportunity to pay an extra premium for that access.

No hospital should be allowed to drop below a certain level in terms of ranking and be allowed to operate. There should be a minimum national standard.

Also, it should be a 'self-abuser pays' system. If you badly disregard your health and become higher-risk, then you should be expected to pay that risk-difference. These payments should be compulsory for all citizens.

Conclusion:

I believe that the final result of these initiatives would be a smaller health sector and a healthier society. Providing increased life expectancy and increased quality of life. And we should see a health sector where everyone is properly covered.

In good time, due to the virtues of innovation and well-functioning markets, even the worst service providers of tomorrow would quickly become better than our best providers today.

-Note: 03-09-2019:

It would probably be a good idea to separate the service of diagnosis from treatment, as much as practicable. Naturally, you would not want over-diagnosis being incentivised to the end of selling an expensive treatment. Also, you would not want preventative treatment being under-represented to that end either.

A close focus on incentive-mechanics is very important.

Google's dithering is costing millions of lives - and counting.

Andrew Atkin:

Each year over 1 million lives are lost to human error on the roads, world over. That will quickly come down to 100,000 and less, as robotics takes over the driving.

Hence, every time we delay the deployment of driverless technology we cost lives. Each delayed year costs about a million lives, and about 5 million severe injuries.

This is why we shouldn't want to hold back driverless implementation. But we do, and actually quite drastically.

Here is the point. We can already win the critical safety advantages provided by driverless technology as the technology stands today. It's simply a matter of deploying single-seat vehicles that drive themselves to the next customer.

You can drive the car when you're in it, but it will be extremely safe regardless because the car operates with advanced anti-collision technology, inherent in a driverless-capable vehicle. 

Each driverless car would take 10 to 30 traditional cars off the road. Because they are highly economical (most cars would be 300 kg single-seaters) and convenient, the popularity and therefore deployment of these cars should be rapid.

We could have actioned the first stage of deployment 2 or even 3 years ago. But Google (or more specifically, Waymo) has chosen not to. Why?

I can only speculate. But think of this. If Google deploys an auto-send car-sharing system, the effect would be that auto companies go bankrupt overnight. Because the death of the private-auto as we know it would be written on the wall for all to see, and plainly. Who's going to buy a new car for $70,000 while knowing full well that they will struggle to sell it for even $5,000, in 2 years time? You don't have to collapse demand too much to induce a devastating glut, destroying sale prices.

This isn't a problem for countries like New Zealand that import (not make) automobiles. But for other countries it will be devastating to their trade economies, albeit in the short term. Maybe--and to stress I can only speculate here--political forces and financial interests are deliberately holding back driverless deployment because they're afraid that too much change, too soon, will hurt too many people (financially). 

This is all I can put it down to, because when it comes to driverless technology we seem to be hell-bent on playing dumb. It's just so obvious that we should be starting off with an auto-send car-sharing system using compact 'mini' cars, to catch the bulk of the demand. Again we could have done this years ago....and it's costing lives. Millions of them.

The included short video clarifies my argument: