[HN Gopher] Care Doesn't Scale
___________________________________________________________________
Care Doesn't Scale
Author : surprisetalk
Score : 271 points
Date : 2024-10-25 15:00 UTC (3 days ago)
(HTM) web link (stevenscrawls.com)
(TXT) w3m dump (stevenscrawls.com)
| tehabe wrote:
| This is one reason why we have a state, which collect taxes and
| can provide those services.
| dannyobrien wrote:
| well, except for the fact that, as the article states, it
| doesn't scale. Or rather, it scales poorly: the quality of care
| provided by a nation state is going to differ in degree and
| quality compared to the 1:1 care that humans probably need (and
| certainly traumatised humans).
|
| I'm not sure this comes as a surprise to anyone except for
| those who have had no interaction with state-provided social
| services. I'd also say that a level of care that does not reach
| to that 1:1 standard is still appreciably better than _no_
| care, which may be what one might otherwise receive.
|
| The open question is can we work out better, decentralized ways
| of providing support that take advantage of the new social
| technologies that we've developed since the construction of the
| modern state and its welfare services in the late 19th and 20th
| centuries.
| worldsayshi wrote:
| Care doesn't scale, but a lot of activities around care
| should be scalable. A caregiver can be helped so they can
| spend as little time as possible on auxiliary tasks like
| admin or logistics.
| zeroCalories wrote:
| I don't think there is any contradiction here. Government
| care can work, but it simply cannot benefit from economies of
| scale. Gonna need to double the income tax to pay for elders
| that have been abandoned by their children.
| Uvix wrote:
| You mean the elders who failed to take care of themselves,
| assuming someone else would do it for them.
| em-bee wrote:
| which has been the norm for as long as humanity existed
| bccdee wrote:
| That's how getting old works, yes. You lose the ability
| to take care of yourself and begin to depend on others.
|
| Do you really think infirmity is something that can be
| avoided with _the right grindset?_
| zeroCalories wrote:
| He means that they messed up by investing in their
| children and providing them a good life instead of
| putting everything in an index fund. They didn't realize
| the rug pull they were about to eat.
| tehabe wrote:
| Just because the government does something, doesn't mean it
| has to be centralised. Eventually the care has to be given
| from one human to another human. On the other hand, it
| shouldn't matter where you live to receive care or how good
| the care is.
|
| And the week in which private companies will be able to
| provide this, is the same week which has two Tuesdays.
| KeplerBoy wrote:
| Care is not something that is magically performed by the state
| or money. At some point someone has to physically wash and feed
| the elderly in the retirement homes.
|
| If past governments or cultural environments messed up
| demographics, states might end up with a significant fraction
| (Germany already has 22% aged 65+) of the population in need of
| that care, which requires another significant share of the
| population to just do that instead of producing actual stuff.
|
| This will either get ugly in one way or another or we will need
| scalable tech solutions.
| Gare wrote:
| Or importing even more foreign workers. Which I'm not
| strictly against, but does come with it's own set of
| challenges.
| FirmwareBurner wrote:
| _> Or importing even more foreign workers._
|
| Except you can't force foreign workers to do shit jobs the
| locals don't want. They're not slaves.
| ImPostingOnHN wrote:
| They don't need to be forced. They come here willing to
| do those jobs. After all, they're not slaves.
| FirmwareBurner wrote:
| Exactly. They come willingly but you can't force them to
| wipe your old age ass once they're here.
| Gare wrote:
| Actually... they kinda can? If they don't work, they get
| deported back. Also they are in debt to the agency that
| got them here. It's a hair above modern slavery the way
| it currently works, especially in EU countries with
| more... lax standards than Germany.
| FirmwareBurner wrote:
| _> If they don't work, they get deported back._
|
| lol, nice joke, how many illegals has Germany for example
| deported? Deporting people in the EU is a huge hassle and
| the source countries often don't want to cooperate in
| taking back people. You'll have to murder someone to
| actually get the authorities in the EU go through the
| hassle of deporting you, but refusing to work shit jobs
| isn't enough to get you deported, just have your welfare
| access cut off.
|
| Plus they can also claim asylum once they get here to
| escape their slave drivers and not get deported.
|
| _> especially in EU countries with more... lax standards
| than Germany_
|
| Germany already has lax standards on that regard. Many
| there are raking in huge profits by bringing in these
| vulnerable workers and having them work in terrible
| conditions.
| Gare wrote:
| > lol, how many illegals has Germany for example
| deported? Deporting people in the EU is a huge hassle and
| the source countries often don't want to cooperate in
| taking back people.
|
| > Plus they can also claim asylum once they get here to
| escape their slave employers and not get deported.
|
| You are confusing two groups of people. One group
| consists of illegal migrants, usually from MENA countries
| that claim asylum and are a hassle to deport back.
|
| Migrant workers usually come from southeast Asia (India,
| Nepal, Philippines..) and there is no problem sending
| them back because those countries are considered safe.
| Also they got families back home, their motivation is not
| really to stay here long term but to earn a decent amount
| of money (from their perspective). And despite sometimes
| poor treatment and shitty jobs, EU is a much better place
| to work than gulf countries.
| ImPostingOnHN wrote:
| I fear you might have stopped reading halfway through my
| post. Continue reading after the word "willing":
|
| _> They come here willing to do those jobs._
|
| Someone willing to do a job means you don't _need_ to
| force them to do it. After all, they aren 't slaves.
| FirmwareBurner wrote:
| No, I read what you wrote and I meant what I said. Let me
| explain again: people are willing to do anything, even
| jobs they dislike, just to get a visa. That doesn't mean
| they'll want keep doing that shitty job once they get the
| visa and can start looking for workarounds. Otherwise
| there wouldn't be a shortage of staff in those sectors if
| all workers would stick around for long.
| abraae wrote:
| I don't think anyone's talking about forcing, or slavery.
|
| Foreign workers are improving their lot (and that of
| their families back home). In a world where they don't
| have the same economic opportunities in their home
| countries, and the locals don't want to do those "shit
| jobs", it's a win win.
|
| Even talking about shit jobs is pejorative. Foreign
| workers don't just pick fruit, they're also essential
| talent in healthcare and other critical areas.
| FirmwareBurner wrote:
| _> Even talking about shit jobs is pejorative._
|
| Why is that? Do you think shit jobs don't exist? You
| think wiping other old people's asses is NOT a shit job?
| Are you lining up for these kinds of jobs yourself or did
| you work and study hard to not have to do them because
| you knew those jobs are shit and are usually given to the
| lowest underclass class of people who don't have better
| options due to various factors?
|
| _> Foreign workers don 't just pick fruit_
|
| I never said such thing. The thread I replied was about
| importing workers for elderly care.
|
| You're trying to project some things I didn't say onto
| me.
| FpUser wrote:
| This does not always happen but it happens often:
|
| They're promised path to citizenship and an ok money.
| Then they discover that they work for an agency that
| takes away big chunk of their money. They can not change
| the employer since they'll be deported etc. etc. And the
| worst part is that at the end they still have to leave
| the country.
|
| So yeah maybe not technically but they're slaves.
| intended wrote:
| This is not the same thing.
|
| The state is ideally suited to manufacture public goods, more
| efficiently than private enterprise.
|
| That means armies, judiciaries, policing municipalities,
| governance amongst others.
|
| They address issues like management of the commons.
|
| This does not translate into scaled care - care for orphans
| (from the article) still needs large numbers of skilled
| manpower, which is in short supply across the world.
|
| These services are also often underfunded, since they are not
| really a first class citizen for voters.
|
| Voters today, are also deeply targeted by emotional campaigns
| and identity campaigns, since that is the current political
| state of the art.
|
| The state can be efficient, but some things don't scale unless
| they are also resourced correctly.
|
| Such services will also be amongst the first to cut, since "X
| will render it obsolete", is a promise as old as time, and
| aren't directly tied to overall societal survival.
|
| Compared to something like defense / emergency funding
| tehabe wrote:
| My argument is, that care is a public good. There will never
| be a situation in which care can fund itself. To fund care is
| a political decision and when the decision is made to to not
| fund it or leave to a market or private enterprises it will
| fail, because private enterprises need something which will
| eventually scale.
| jimbokun wrote:
| Doing it by a state does not make it magically scale in any way
| shape or form. You still need something like one-to-one or one-
| to-a-few for care work to be effective. Trying to provide it
| through the government does absolutely nothing to change this
| fact.
| aniviacat wrote:
| > In any given moment, you can only really care deeply and
| individually for one person.
|
| What does this imply, that two parents cannot care for three
| children? I disagree.
| michaelmior wrote:
| I don't think it's implying that at all. Whether or not you
| agree with the statement, it's referring to a specific moment.
| Most parents will have many moments with their children.
| plaidfuji wrote:
| No, they go on to say
|
| > With four kids, the kids can feel like kids; if there were
| forty kids, they'd probably feel like they were cattle.
|
| The point of the article is that you'll never achieve economies
| of scale (10, 100, 1000x) for situations that require
| individualized attention, no matter how much engineering effort
| you put into it.
|
| At least with today's technology...
| paulryanrogers wrote:
| The quiver full movement is certainly testing the limits.
| watwut wrote:
| I would argue that they found it and that kids are not
| getting that individual attention they need.
| paulryanrogers wrote:
| Worse, the elder kids are forced into parenting their
| younger siblings.
| themaninthedark wrote:
| I don't know how many kids the Quiver Full families have
| but are they any different from Amish families?
|
| Are the kids not getting enough individual attention
| something from an outside perspective or from the kids
| perspective?
| closewith wrote:
| No, because normal healthy children do not require 24/7 care,
| even as newborns.
|
| Children in care do, partly because of the circumstances that
| led to them being in care, but mostly because the State in
| general is not willing to accept the same risk profile as
| individual parents.
| mrweasel wrote:
| I think it comes down to the many meaning of the word "care"
| in English. The state is certainly willing to accept way
| greater risk than the individual parent, in many
| circumstances. If we take something like daycare, which I
| presume is included in "care", then it's typically four
| children per adult until the age of 4, in schools it goes
| down to 20+ children per one adult, where at home it might be
| more than two adults per child (but also less obviously).
|
| The risk profile is different, if you have a newborn in
| hospital, then that child may have their parent present at
| all times, plus staff, but it might also be one or two nurses
| and an on-call doctor for any number of babies. In some sense
| the potential risk is greater, but it's also more
| professionally measured.
| closewith wrote:
| >The state is certainly willing to accept way greater risk
| than the individual parent, in many circumstances.
|
| I don't think that's true.
|
| > If we take something like daycare, which I presume is
| included in "care", then it's typically four children per
| adult until the age of 4, in schools it goes down to 20+
| children per one adult, where at home it might be more than
| two adults per child (but also less obviously).
|
| That's a much lower care ratio than parents accepted before
| regulation, so I think you're arguing against your own
| point here.
| mrweasel wrote:
| Those ratios are heavily debated in Denmark for being
| absolutely terrible. Parents have been complaining for
| years that the ratio of especially children for 4 to 6
| are awful (typically 7 children per adult).
|
| They might be a improvement in other countries, but they
| are considered a move in the wrong direction here,
| because they are worse than previously.
| dbingham wrote:
| No, it's saying that _in any moment_ you can only focus deeply
| on, and thus care for, one other person. And if you have to
| care for multiple people, then you have to shift your focus
| moment to moment.
|
| As a parent, can confirm. To give an example, it's really hard
| to hold and comfort two crying kids at the same time. When the
| toddlers are melting, they really want your whole attention and
| don't want to share it. If they're melting because they got in
| a fight with each other, it really takes an adult per toddler
| to help calm them.
|
| That doesn't mean I can't love and care deeply for both kids,
| it just means you can only implement that caring with one at a
| time.
|
| I think he's generalizing the point a bit and not all
| situations are like that. But it's close enough to accurate to
| be valid. Care doesn't scale.
| triceratops wrote:
| Two parents, all alone, without a community around them. Yeah
| it's near-impossible.
| ersiees wrote:
| I think this is also interesting to keep in mind when thinking
| about the changes to the job market that are possible due to
| technology (e.g. AI).
|
| Most of care will not be automated any time soon. And it is a
| huge part of the economy.
| johanneskanybal wrote:
| Yes this was my first thought too.
|
| Nice to see this post on HN.
| bluetomcat wrote:
| This is ultimately a dichotomy between having the family unit or
| "the state" as the central point of governance. Many totalitarian
| regimes looked at newborns as "belonging to the state". The
| result is a unified mass person who dresses, thinks and acts in
| predictable ways.
|
| The more power, personal connection and influence parents have
| over their children, the more diverse society will become.
| dqv wrote:
| What? What does this have to do with orphaned children?
| rgrieselhuber wrote:
| It's not a reference to orphans.
| dqv wrote:
| Then I'm completely lost on how it is relevant to an
| article that specifically mentions the care of orphans as
| its central example for how care does not scale.
| spwa4 wrote:
| I think the idea is that many totalitarian systems treat
| every child as an orphan, in some cases taking them
| physically away from their parents and then have people
| look after the children as a job. Hence the comparable
| situation.
|
| And, of course, all such systems I've ever read about do
| not care about the practical limitation of 1 caretaker
| per 1 child. I believe youth services in the Netherlands,
| for example, has 1 caretaker (effectively available to
| the child) per 15 children, or 7 or 8 if they're trouble.
| Does this work? No, of course not. They don't care. The
| kids grow up caring for nobody, probably because
| effectively nobody cares for them. One person watching 15
| children can only hope to prevent disasters, if that,
| they cannot provide decent attention to children. By the
| standards of this article, there's probably 2 people who
| work in the same "group". If there's a third one, they
| will be shared between at least to groups. So 2 to 2.5
| per 15 children ... comes to one parent figure per 7
| children, which is a third to a fourth of the care
| children would receive in even a huge family, and much
| less than in a small family.
| orwin wrote:
| > I think the idea is that many totalitarian systems
| treat every child as an orphan
|
| This idea is just wrong. Wrong isn't strong enough, it's
| conterfactual. At most some of them treated female bodies
| as owned by the state. I do not remember any example of
| totalitarian society where a child of a political
| opposant would be treated the same as any military child.
| Maybe Salazar? But even then, it was so corporate-aligned
| I doubt children from owners were treated the same as
| children from workers at anytime.
| kubb wrote:
| Totalitarian regimes often uphold traditional values like
| family as a means of control, promoting unity and loyalty to
| the state-yet they'll redefine these values whenever it suits
| their ideology.
| username332211 wrote:
| That's not really true. Marxism-Leninism famously sought to
| abolish the family and the Soviet union performed quite a few
| experiments in communal rearing of children in it's early
| years.
|
| The reason why totalitarian regimes end up promoting
| traditional values relations is that to them the only
| imperative superior to ideology is survival.
|
| There is a reason the Soviet Union backed off from it's
| repression of religion in the middle of WW2.
| kubb wrote:
| Early Soviet Union did try to reshape family, but it went
| back on it eventually, seeing the value of the conservative
| family model in building social cohesion and loyalty.
| lolinder wrote:
| Expressed differently: they tried to abolish the family,
| found that doing so created more problems then they
| solved, and backed off in order to avoid tearing their
| country apart.
|
| They discovered that in some things doing nothing is
| better than doing something, but Westerners of all
| political stripes (both for or against authoritarianism)
| chronically make the mistake of assuming that everything
| that a totalitarian state does is done with some grand
| plan in mind rather than them just flailing about to find
| a centralized policy that kinda-sorta works.
|
| Your comment reminds me a lot of modern speculation about
| China's grand plans. Sometimes a government chooses not
| to touch something because they learned from bad
| experience that they'll break it if they do, not because
| they're playing 4D chess manipulating it behind the
| scenes.
| kubb wrote:
| I don't think they ever tried to "abolish family". Where
| are you getting this stuff? It sounds like bad history
| lessons.
|
| They did stuff like legalizing divorce, or
| collectivization of parenting.
| jimbokun wrote:
| You really want to go to bat for the Soviet Union?
| kubb wrote:
| Not really, just the notion that trying to abolish family
| is somehow the hallmark of totalitarianism doesn't seem
| like sound reasoning, and indeed it isn't confirmed by
| historical examples.
| bccdee wrote:
| > the only imperative superior to ideology is survival
|
| I think it's more that well-meaning ideologues are easily
| replaced by self-serving pragmatists in post-revolutionary
| turmoil. There were plenty of Marxists in Russia vying for
| power, in the early days. Lenin didn't win based on
| ideological purity; he won based on political strength. And
| say what you will about Lenin--he did have beliefs and he
| did have a real ideology. Stalin only cared about Stalin,
| and he claimed to believe whatever was convenient for him
| in the moment.
| geysersam wrote:
| A false dichotomy some would call that. Children can be raised
| in units different from the current western perception of "the"
| family unit.
|
| Besides, what countries are you talking about? Have you ever
| been there and met the uniform mass persons?
| bluetomcat wrote:
| > Have you ever been there and met the uniform mass persons?
|
| I was born in Eastern Europe in a society headed in this
| direction. I observed its transformation after the fall of
| the Berlin Wall.
|
| You felt the overarching power of the state from as early as
| the kindergarten. Signs of individuality were suppressed and
| all children were supposed to do things "the right way". When
| such an institution decided that a child "systematically
| misbehaves", it was able to take the child away from its
| parents in another orphanage-like institution that was
| supposed to teach them good socialist manners. Eventually
| some of them would end up seriously harassed, physically-ill
| and sent to an anonymous grave in the backyard of that
| institution.
| jimbokun wrote:
| Did you read the article?
|
| "Care" doesn't scale. You can't just replace "the family"
| with some industrialized system of raising children and get
| the same results. Not being able to scale "care" and make it
| more efficient is almost tautological, really.
|
| > Besides, what countries are you talking about?
|
| North Korea? Former Soviet Union?
|
| At the very least appearance of conformity was ruthlessly
| enforced and even private conversations were infiltrated to
| detect dissent.
| peepee1982 wrote:
| You're describing the extremes on a spectrum, but you only go
| to one of the extremes, which exposes your bias.
|
| And it's a false dichotomy to begin with, since shifting more
| care work towards society doesn't equate to a path toward
| totalitarianism. You're conflating socialism with
| totalitarianism. Understandable, but misguided.
|
| Frankly, your whole premise is based on a capitalist narrative
| that keeps workers in their place because individual care work
| is so inefficient--it drains energy that could otherwise be
| channeled into organizing worker councils to balance out the
| power now disproportionately held by banks, IT corporations,
| political parties, and the military-industrial complex.
|
| I'm aware that I may come across as an arrogant prick in this
| comment. I wish I had more time to craft a friendlier response
| with more sources and explanation, but I simply don't. I need
| to work to feed my children and their mother, but anyway,
| here's a reading list for anyone who's interested:
|
| "Capitalist Realism: Is There No Alternative?" by Mark Fisher -
| Fisher discusses how capitalism has permeated every aspect of
| life, including care work, and critiques the idea that
| alternatives like socialism lead to totalitarianism.
|
| "Workers of the World: Essays Toward a New History of the
| Working Class" by Philip A. H. G. D. Van der Linden - This
| collection explores the historical context of labor movements
| and the importance of organizing against disproportionate power
| structures.
|
| "The Care Crisis: What's Wrong with Care and How to Fix It" by
| the Institute of Public Policy Research - This report outlines
| the societal implications of care work and its impact on worker
| organization.
|
| "Wages for Housework" by Silvia Federici - Federici argues for
| the recognition and compensation of domestic labor, linking it
| to broader struggles against capitalist exploitation.
| marcosdumay wrote:
| > shifting more care work towards society doesn't equate to a
| path toward totalitarianism
|
| There are plenty of reasons to believe that yes, it does.
| This is something that is almost completely unknown (except
| on the extremes).
|
| And history has those two coupled in very complex, hard to
| understand ways.
| jimbokun wrote:
| "because individual care work is so inefficient"
|
| The whole point is scaling "care work" is almost oxymoronic.
| Care is only quality care when there are a small number of
| carers per those being cared for. To make it "efficient" is
| to turn children, the addicted, the disabled, and the elderly
| into cattle.
|
| > "Wages for Housework" by Silvia Federici - Federici argues
| for the recognition and compensation of domestic labor,
| linking it to broader struggles against capitalist
| exploitation.
|
| This reveals one of the poorly hid secrets of progressive
| ideology. Progressives _LOVE_ Capitalism and want to spread
| it to encompass every human interaction. Caring for your own
| home, your own children, anything someone might do for a
| friend or a loved one _MUST_ be turned into a financial
| transaction with an explicit contract.
| fph wrote:
| You are assuming all family influence is good. There are lots
| of abusive families and poor parents, though.
| AnimalMuppet wrote:
| He is (or perhaps he's ignoring that issue). But when a
| totalitarian government is abusive, it affects _all_ the
| families, not just the bad ones.
| plaidfuji wrote:
| This is a pretty big realization and one that resonates strongly
| with me. As an engineer, parenting can be frustrating, of course
| for the usual reasons, but also because you realize there's
| really no way to "hack" it.
|
| I feel like we as a society need to acknowledge that this
| probably applies to childcare, teaching, health and elder care to
| a large extent. That no matter how much _private sector
| ingenuity_ you apply to some field, there is a hard upper bound
| to how much efficiency you can achieve. Cost savings basically
| just require making hard choices about who gets what.
| sokoloff wrote:
| I think some of the healthcare changes during my lifetime have
| increased efficiency and been fine (maybe even good) for
| patients.
|
| I used to have my vitals taken by the doctor. Now, that's a
| nurse. Used to get vaccine shots from the doctor, now a nurse.
| I feel like docs used to do blood draws, now a nurse. All of
| that is good, IMO. Doctors may not like the 20 minute blocks,
| but overall I can get the same care at a lower total cost and
| the nurses are probably better at the job they do twice as
| frequently than the doctor whose head might be somewhere else
| during the "boring parts".
|
| I suspect aspects of this apply to teaching (why does every
| calc teacher need to give the lecture? Why not have the top 1%
| of them in that skill record lectures with excellent production
| quality/editing and have students watch those?)
|
| Yes, there are upper bounds, but I think even +50% or +100%
| might be possible with minimal (or in the calc case, negative)
| losses. Those efficiencies can really matter when someone else
| has to pay the bill.
| potato3732842 wrote:
| >I used to have my vitals taken by the doctor. Now, that's a
| nurse. Used to get vaccine shots from the doctor, now a
| nurse. I feel like docs used to do blood draws, now a nurse.
| All of that is good, IMO. Doctors may not like the 20 minute
| blocks, but overall I can get the same care at a lower total
| cost and the nurses are probably better at the job they do
| twice as frequently than the doctor whose head might be
| somewhere else during the "boring parts".
|
| The statistical you is paying statistically much more than
| the historical equivalent. The situation is far more complex
| than that. There's a million variables here. Changes in
| services rendered, changes in outcomes, relative wage
| differences, more parties taking a cut of any given
| transaction, more "make work" prior to rending specialized
| care, etc, etc.
|
| Outcomes are better than they were 40yr ago but is that
| because of the changes or despite them?
| watwut wrote:
| > Used to get vaccine shots from the doctor, now a nurse. I
| feel like docs used to do blood draws, now a nurse.
|
| Weren't these always done by nurses? The doctor would do the
| determination of what you get, but nurse being the one
| executing these is something that was here for decades.
| __MatrixMan__ wrote:
| I question your teaching comment. Sitting there and receiving
| a lecture is a rather small part of learning (varies per
| student). For the rest of it you're going to find that class
| size is by far the biggest determiner of success.
|
| I wonder how the best teacher in the world teaching 5 classes
| of 40 would stack up against 200 people chosen at random from
| a pool who had already passed that class working 1:1 for 1 hr
| per day. Probably the ideal case is somewhere in the middle,
| but the point is that it's allocation of the teacher's time,
| and not production quality, that's the bottleneck when it
| comes to scaling teaching.
| sokoloff wrote:
| Sorry/thanks; your feedback is fair/adopted.
|
| I meant to expand that to clarify that other aspects
| (supporting students as they work to _apply_ the lectured
| material) would /must be done 1:1 in person, but the core
| lecture can/should be delivered by those with particular
| skills in that area and that we could apply extra effort to
| editing/production value.
|
| My son's calc class is taught via watch the lectures
| online/at-home and then apply them in class and at-home via
| exercises. The only difference from what I proposed is that
| the same teacher pre-recorded the lectures, which seems to
| a practical solution but not an inherently necessary
| constraint (and there are likely thousands of calc teachers
| making average quality such videos).
|
| But absolutely a personalized teacher must be available 1:1
| for at least part of the overall process.
| nsbshssh wrote:
| Unless one lets go of ego. The human being is perfectly
| engineered to raise its young. We are automota of reproduction,
| for millions of years.
| furyg3 wrote:
| This is why avoiding the need for care, while never totally
| achievable, is always the most scalable solution.
| cobbzilla wrote:
| Yes, also simultaneously why (some) smaller companies can offer
| exceptional service unmatched by larger competitors.
|
| I am reminded of the PG startup advice to "do things that don't
| scale", this seems to be one of those cases.
| jasfi wrote:
| This could be at the core of "do things that don't scale".
| moolcool wrote:
| Is that a world you want to live in?
| czbond wrote:
| Yes - to me the OP means solving issues ahead of time....
| create the vaccine 1x or treat the virus causing the issue
| millions of times.
|
| I have spent enough of this year injured due to my own
| adventure sport aggressive mis steps. I was MUCH less
| productive during this period than before or now due to
| injury.
|
| Had I not needed to deal with that, is the most productive
| self and that has a exponential effect society.
| moolcool wrote:
| But you're not just a productivity machine though, and as
| such, you surely yearn to give and receive care in
| different ways.
| jimbokun wrote:
| Not possible for raising children. Or caring for the elderly
| until we perfect an immortality elixir.
| lynx23 wrote:
| Whats much more important, empathy doesn't scale. Care can be
| established. But no one will ever know about its quality. I know
| what I am talking about, I visited a k12 school for the blind,
| and have a mentally unstable mother. Nobody ever asked me if I am
| happy/content at home. They all assumed my mother is doing her
| best. My life only started when I managed to escape from every
| kind of care. Institutionalized care is the worst, because its
| lacking empathy the most...
| taylorius wrote:
| I think in the future, descendants of today's LLM models and some
| future version of Tesla's Optimus could create a paradigm shift
| in how care is given.
|
| I'm hopeful that when I get old, and inevitably come to need some
| help with living, that such a solution will be available.
| Eisenstein wrote:
| I would like the option to die painlessly before I end up
| needing a robot to change my diaper.
| alamortsubite wrote:
| > I would like the option to die painlessly before I end up
| needing a robot to change my diaper.
|
| My dad has Parkinson's and needs a human to change his
| diaper. If he had the option of a robot, I bet he'd take it.
| Not a painless die now option, though. As I write, where he
| is it's 8 o'clock in the morning and he's watching an old
| Larry David and eating an ice cream cone while my mom gets
| ready for them to go to breakfast.
| jen20 wrote:
| That's the idea of an option. Great if it works for him,
| but having spent a lot of time with Pieter Hintjens (of
| AMQP and ZeroMQ fame) before he chose the time of his own
| passing from recurrent cancer, the notion that this is not
| allowed in order to appease religious zealots is simply
| barbaric.
| alamortsubite wrote:
| I'm not sure you replied to the right post, but religious
| zealots don't watch Larry David.
| worldsayshi wrote:
| Let's then hope that the LLM solution is FOSS so that relatives
| and the one being cared for can be in control of the service
| and avoid enshittification.
| HKH2 wrote:
| Exoskeletons should be able to help old people balance etc.
| davidclark wrote:
| This hypothetical bot can provide supportive actions - feeding,
| cleaning - but it can't provide "care" in the way that people
| truly need.
| moolcool wrote:
| I think this is a gross and psychopathic vision of the future.
| Tell your grandmother that you're going to automate away her
| need for human connection. What a terrible indignity. I hate my
| industry.
| taylorius wrote:
| Psychopathic? I think that's a ridiculous statement. No-one
| said anything about automating any human connection. I can
| tell you that my wife is a full time carer for her parents,
| and though she does it willingly and with love, it exerts a
| great toll on her, both physically, and mentally. So if we're
| going to far-too-easily use words like "psychopathic" - I
| could just as well say that ignoring that cost is
| psychopathic. Knowing what her role as a carer has cost her
| in terms of quality of life, I would never want to subject my
| children to the same. That is entirely different to
| maintaining human connection with older relatives.
| moolcool wrote:
| > No-one said anything about automating any human
| connection
|
| Maybe I was inferring the wrong thing, and if so I
| apologize, but the context of this comment was invoking
| LLMs and humanoid robots in a discussion about how "care
| doesn't scale". Like of course automation and technology
| should do things to make the lives of the elderly easier,
| but I would not classify any action done by a machine as
| "care". My dishwasher is a great convenience, but I would
| never classify my relationship with it as one of "caring".
|
| > Knowing what her role as a carer has cost her in terms of
| quality of life, I would never want to subject my children
| to the same
|
| Of course that's a problem. The answer though, IMO, is
| creating a society where we value elder care more, and have
| more programs to provide human support and connection to
| the elderly. I strongly feel like this isn't something
| which we can or should automate away.
| taylorius wrote:
| Perhaps it is a question of the different meanings the
| word care can take. Care in its normal everyday usage is
| indeed a natural human emotion, however this was not the
| subject of my post.
|
| "Carers", are people who perform functions for people
| unable to do them themselves. Whether they "care" or not
| for their charges is not directly relevant (though often
| they are relatives, and certainly do care for, and love
| the people they are helping very much). Not always though
| - consider a "care home", which is essentially a dumping
| ground for the old and inconveniently frail. Having seen
| the inside of a few such places, I very much do not want
| to end up in one.
|
| Enter the Robots, and technologies such as the LLM. In my
| imagination, a robot equipped with some facility with
| language, could act as an assistant for an elderly
| person, allowing them to maintain their independence for
| much longer without a human carer. This is not a
| replacement for human connection with their loved ones,
| but it is a replacement for putting them in a care home,
| or having ones own children spend part of their lives
| unable to have a job, or a normal social life, due to
| complex care requirements of some relative.
|
| For what its worth, I doubt we disagree too much, I think
| it was a misunderstanding. However I'm interest to hear
| your thoughts.
| moolcool wrote:
| > For what its worth, I doubt we disagree too much, I
| think it was a misunderstanding
|
| I think so as well-- I'm glad you replied.
|
| We certainly agree on the problem of bad care homes.
| We've all seen and heard the horror stories, and it's
| really unacceptable what's going on at a lot of these
| places. The question is, would unscrupulous care homes
| buy a robot and re-task workers with providing more
| social care to residents, or would they simply lay off
| the workers?
|
| For a pretty large chunk of the population, care workers
| are the only source of regular human interactions. As
| such, I would make the argument that the necessity for
| these tasks to be completed by a human is, in many cases,
| a feature, not a bug.
| wazoox wrote:
| This has been well-known for ages and is a major subject of
| feminist studies. Care jobs are mostly feminine, and don't scale,
| and this dichotomy plays a big role in the overall wage gap.
| kome wrote:
| yep, super important contributions but hardly understood or
| studied in mainstream economics
| moolcool wrote:
| Say it louder for the people in the back.
|
| There's a million examples of tech utopianists walking head-
| first into ideas and even entire disciplines they previously
| dismissed as irrelevant or outdated.
| kome wrote:
| I have what I think it's a very good article on the economy of
| care - making exactly this point and others, but it's in the
| dungeon of peer review for more than one year. And the reviewers
| do not even answer my emails.
| nsbshssh wrote:
| Can it just be published on arxiv?
| auggierose wrote:
| But then nobody cares.
| nsbshssh wrote:
| So... caring doesn't scale?
| fph wrote:
| But you can submit the same paper both to Arxiv _and_ to a
| peer-reviewed journal, in most fields.
| baoluofu wrote:
| I would be keen to read it if you're happy to share?
| api wrote:
| A lot of what makes society and politics so hard comes from the
| fact that humans have among the most demanding offspring of any
| living creature. This starts with pregnancy and birth which is a
| life threatening medical condition with a high mortality rate
| without modern medicine. We can't reproduce and raise our
| children without dedicating gigantic amounts of energy to it,
| causing an inherent tension between the need to do so and the
| desires of both individuals and entities like corporations and
| states that want claim to that labor.
|
| If we laid eggs and our young were viable more quickly our
| politics would be orders of magnitude simpler. It would basically
| be the politics of twenty somethings, but for everyone.
|
| On the plus side, it's probably why we have among the longest
| life spans of any land mammal. Grandparents helped with child
| rearing, so societies with longevity probably did a better job
| raising children.
| jimbokun wrote:
| That is partly true due to biology. But it's partially
| culturally inflicted.
|
| In previous decades kids were allowed to do much more
| unsupervised. And the pressure to prepare for high stakes
| college admissions from early ages was much less extreme.
| fieldcny wrote:
| The premise is wrong, you can care for more than one other person
| at a time.
|
| People have children, in this world we can only care about our
| spouse or one child?
|
| Hardly.
| dagw wrote:
| Depends on what you mean by "care for". Calling your parents a
| few times a week to make sure they're doing OK and dropping by
| on the weekend doesn't take too much time and effort. But as
| people get older they need more and more care. Caring for one
| person with dementia or other similar problems that comes with
| aging is for all intents and purposes a full time job.
| crabmusket wrote:
| I agree with you, but I read the article as saying you can't
| care deeply about more than one person at literally the same
| instant. Your attention is directed to one or the other.
|
| But I think even that's not literally true e.g. the social
| worker could make dinner for all four kids at once. And
| probably converse with all four of them while doing it!
|
| But, I think I agree with the broader point that care doesn't
| _scale_ , even if it does scale slightly greater than 1.
| moolcool wrote:
| Did you read the article? He addresses this point specifically.
| kang wrote:
| > Scale isn't bad, at least not necessarily. Industrial is
| perfectly capable of being better than custom. Sometimes the
| YouTube video is more helpful than the private tutor.
|
| This is not true; consider the argument that there is always a
| loss of quality in scaling. Industrial maybe better than average
| custom, but is always worse than best customs. Broadcast lecture
| is almost always worse than a tutor whose discourse is customised
| to student's current knowledge. (The word guru (literally, one
| who leads towards light) is wrongly translated to teacher, for
| which the word in sanskrit is shikshak.)
| api wrote:
| I don't think that holds for everything. Industrial 3nm chips
| are probably better than whatever you would get if people tried
| to DIY this. Lots of things get better with scale: materials,
| precision machinery, process efficiency, power generation.
|
| But there's also plenty of things that don't work this way.
| Care is one of the most extreme things that does not.
| karrieberrie553 wrote:
| I think the argument is that someone with the knowledge to
| make 3nm chips could probably know how to make some very cool
| yet very expensive chips, but since they target a lot of
| people they probably make choices that would satisfy more
| people but maybe not as well
| kang wrote:
| for eg, asic custom designed for an application is better
| than a generalised industrial chip
| durumu wrote:
| I agree the average tutor is better than the average lecturer.
| But if I watch a YouTube lecture, then I might have access to
| the best lecturer in the world, or at least a 99%ile lecturer,
| e.g 3blue1brown. This only works because of the scale -- it
| wouldn't be possible for millions to get access to tutors this
| good 1 on 1.
| hprotagonist wrote:
| but can you argue with them for an indeterminate period of
| time in earnest dialogue until the idea goes CLICK inside
| your head? You cannot, and so the value is much lessened
| because that critical access isn't present.
| MichaelZuo wrote:
| You can't do that for the average lecturer either...
| assuming it's a normal college lecture room with hundreds
| of students.
|
| Nonetheless the 99th percentile lecturer is still better
| than the 50th percentile tutor in most cases.
| bccdee wrote:
| Do you always need that kind of prolonged argument whenever
| you learn a new concept?
|
| > _Sometimes_ the YouTube video is more helpful than the
| private tutor.
|
| University lectures work like that. First the general
| lecture, which has 300 students and is not interactive.
| Then the tutorial, where students who want extra help can
| consult individually with a TA. Attendance for tutorials
| was typically much lower in my experience, because a lot of
| students thought the lecture was plenty and wanted to spend
| the time on something else.
| kang wrote:
| Except the argument is university lecture (classroom
| structure) doesn't work. A personal tutor might be able
| to teach a concept to all their students, whereas not
| everyone in a classroom passes. Your argument about
| sufficiency can be made about books and is not relevant
| here.
| bccdee wrote:
| > A personal tutor might be able to teach a concept to
| all their students, whereas not everyone in a classroom
| passes.
|
| Why are you convinced that personal tutors are so much
| more effective? I'd expect the average student to be
| slightly better-served by having a personal tutor, but
| not by much. After all, personal guidance _is_ available
| from TAs when necessary--my point is that it typically
| _isn 't_ necessary.
| james-bcn wrote:
| I think this post on the same blog is much more interesting:
|
| 'Small Village' of Supposedly-Deceased Intellectuals Found Alive,
| Thriving at Caribbean Resort
|
| https://stevenscrawls.com/bucket-bump/
| paulryanrogers wrote:
| An interesting thought experiment
| jasfi wrote:
| Probably, without any sources or anything related online it
| seems to be fiction.
| creesch wrote:
| Interesting maybe, but also one that lacks sources. It is
| entirely possible that this passed by me and I just didn't
| catch the thing mentioned in the blog post. But, I also can't
| find much in the way of any reference to it online. Not even a
| hint using various search terms and combinations as mentioned
| in the blog post.
|
| It very much gives the impression of it being a story made up
| as a vehicle for the main point they are trying to make.
| james-bcn wrote:
| Yes I think it's made up. But it's not obvious that it is.
| Which makes me doubt the blog as a whole.
| Tade0 wrote:
| > But I wonder if part of that smaller focus comes from a deep
| realization that care doesn't scale.
|
| My experience (and I believe it to be common) is that I'm really,
| really, really out of spare energy to care about anyone or
| anything else.
|
| Mind you, I'm in my best shape in years and I've explored my
| limits to find out they're actually way further than I originally
| thought, but still.
| avhception wrote:
| There was a story on HN a while ago that I can't seem to
| remember the title of.
|
| It was something along the lines of "The optimal amount of
| slack in an organization is not zero", or something like that.
|
| The argument was that, since it's impossible to plan for every
| eventuality, you need a certain amount of slack capacity in
| order to retain some flexibility. And that by always using 100%
| capacity, we end up dysfunctional.
|
| I think the same is true for our personal lives.
|
| But the endless treadmill of self-optimization, side-hustles
| and ever more commitments leaves us unable to cope.
| nielsole wrote:
| I can't help you with the title, but with another paragraph
| from that story, should you want to find it. Paraphrasing
| from memory:
|
| > When you are in a major Chinese city you may street
| sweepers sitting on the side walk chitchatting. The first
| thing you may think of it as waste that could be eliminated.
| But it also acts as a buffer.
| ghgr wrote:
| I think you might be referring to this comment:
| https://news.ycombinator.com/item?id=41952570
| hprotagonist wrote:
| https://www.bitsaboutmoney.com/archive/optimal-amount-of-
| fra...
| AnimalMuppet wrote:
| I found the book _Margin_ by Richard Swenson to be helpful.
|
| TL;DR: Pretty much what you said, but he labeled it "margin"
| instead of "slack". But yeah, you need some.
| steveBK123 wrote:
| It was the same problem for JIT supply chains falling apart
| during COVID.
|
| It's very hard to sell slack to management and so in "well
| run organizations" it ends up trending towards zero. And then
| everyone is surprised at the resulting catastrophes.
| hedvig23 wrote:
| It's pretty simple no, the model that is reasonable and
| antifragile is within our grasp, a model that includes
| degrees of error more than it reifies hewing towards 0
| carrying costs. It's more the good will and good faith
| across the board to use that known simple math, as sneaky
| monkey minds in our midst see that if they defect they can
| win some edge in the short term (and again, a better model
| shows the true utility and total harmed effect) and then
| it's a race to the bottom and a world of basically the
| prisoners dilemma. Making that thinking anathema in human
| culture should be the focus. I don't know that a grass
| roots effort could out-compete existing networks of power
| and influence, nor that a total reset of players is
| possible either.
| jimbokun wrote:
| It's aligning the incentives of top management with the
| slightly longer term outcomes. If stock grants are based
| on this quarter's performance, "slack" seems much less
| important.
| steveBK123 wrote:
| Exactly, if you get rewarded for the 5% improvements
| annually but are out before the once-a-decade near death
| experiences.. you end up with more Intels, GMs, Boeings,
| etc.
| adamc wrote:
| Tom DeMarco wrote a book about this some years ago, called...
| "Slack".
| Tade0 wrote:
| I think it referred to the classic efficiency vs latency
| tradeoff. Like when emergency vehicles are always on standby,
| which is inefficient, but allows them to roll out without
| delay. Conversely privatised rail lines squeeze out every
| ounce of capacity from the infrastructure resulting in delays
| when something, anything goes even slightly wrong.
|
| I use this extensively when planning activities with my
| children. It's a fun challenge because they're both too young
| to tell the time, much less read, which are constraints one
| does not normally encounter in their work life.
| Self-Perfection wrote:
| I find this article a nice exploration of slack concept in
| personal lives
|
| https://www.neelnanda.io/blog/38-slack
| CooCooCaCha wrote:
| This is such an important point. Caring is often limited by the
| spare energy you have to care.
|
| Care _could_ scale, but we'd need the culture and societal
| changes to allow it to scale.
| tripper_27 wrote:
| hey, I hear you. Modern America is full of voices demanding you
| give them care/attention.
|
| Every.
|
| Single.
|
| Thing.
|
| It is overwhelming. See following comments on the need for
| slack/margin in capacity. Well, we also need it in emotional
| demands. Yet every commercially-moderated interaction in our
| society seems to be optimizing for making us care more about
| it, because that increases their revenue.
| moolcool wrote:
| I really resent how our collective attention has been so
| commoditized. Advertising lies at the core of so many of our
| problems, and I'm not sure how we can come back.
| gaussiandistro wrote:
| So, maybe interesting in the context of "creating scalable
| structures of aid and care", one of the big points I think that
| makes scaling hard is how much complexity gets pushed onto a
| central administrator. You have societies like certain Basque
| communities (see
| https://scholarship.claremont.edu/cgi/viewcontent.cgi?articl... )
| where households are literally arranged in circular patterns, and
| there are obligations of care and service between you and your
| "first neighbor", "second neighbor", and so on, chains of
| dependencies moving clockwise and counterclockwise through the
| circle, allowing a potentially very large structure that still
| allows you to mostly interact with a small number of "near
| neighbors".
|
| Quoting directly from the article:
|
| "THE GIVING OF BREAD
|
| Until the 1960's, a fundamental circular exchange was the giving
| of blessed bread. Each household regards its neighbor to the
| right as its first neighbor
|
| (The directions right and left are as viewed from the center of
| the circle so that right is clockwise and left is
| counterclockwise.)
|
| The giving of bread took place weekly and was thought of as being
| given from first neighbor to first neighbor. That is, each Sunday
| a woman from one particular household, call it H_i, bought two
| loaves of bread to the church where it was blessed and partially
| used in a church ritual. Then, before sunset, a portion of the
| bread was given by H_i to her first neighbor, namely to H_{i+ 1}.
| The following week H_{i+1} was the bread-giver and H_{i+2} the
| bread-receiver. Thus, the giving (and receiving) of bread moved
| around the circle serially, taking about two years to complete
| one cycle of about 100 households. While each household was both
| a giver and receiver of bread, this mode differs from simple
| reciprocity; only if there were a total of two households would
| H_i and H_{i+1} directly reciprocate as each other's first
| neighbor."
| paulryanrogers wrote:
| Strange definition of "one to one". It sounds more like 4-to-1 to
| me.
| dagw wrote:
| There are 4 workers taking turns looking after 4 kids. So while
| at any given time 1 worker is looking after 4 kids, you need 4
| workers to cover all the shifts. Thus one-to-one
| paulryanrogers wrote:
| That's a very odd framing. So it works out to one worker per
| one shift/day? Wouldn't that be true if there were 10 or 20
| kids yet still 1 worker per shift?
| cj wrote:
| 4 people taking care of 4 kids 24/7 in 24 hour shifts. From
| article:
|
| > To get that individualized care, though, they had four social
| workers and four children. One-to-one. [...] But you couldn't
| stray that far from one-to-one without changing the nature of
| the experience, without industrializing it to the point that
| individual care is lost.
|
| I don't think you need the ratio of worker:child to be 1:1 in
| order to provide 1:1 care.
|
| The alternative might be 20 social workers taking care of a
| group of 20 kids. It's the same ratio of workers to kids, since
| no 1 worker will get to deeply know individuals in the group.
|
| I agree 1:1 is confusing and not totally accurate but it's fine
| for illustrating the point.
| paulryanrogers wrote:
| Well 1-1 care for any given child at an average of 25% of the
| time. Which for social work is probably better than most
| alternatives, yet not as good as having a parent per one or
| two kids.
|
| Anyway, I don't mean to nit pick. Everyone has to know their
| limits, and I'm sad to admit that I found I can barely handle
| two kids with two adults. And families managing 5+ kids
| strike me as over natural+healthy limits, unless they've a
| large extended family (who have capacity to help).
| moolcool wrote:
| This is a semantics argument which doesn't really challenge his
| central point.
| paulryanrogers wrote:
| It muddies the point, because having 1 worker at a time
| (watching 4 kids) isn't really 1-to-1. And doing 24h shifts
| means kids have a different caretaker quite often, which
| complicates conflict resolution and other things that may
| span days.
|
| Regardless, it's probably the best they can do and likely far
| better than orphanages with 20+ kids per adult. So the core
| message about scaling does stand. Even if the ratio described
| is actually worse and less scalable.
| crabmusket wrote:
| > There was some pain in that realization. So many of my utopian
| dreams--what if we could live in a society where everyone can get
| the food, the housing, the healthcare, the opportunities for
| growth that they deserve--come from a place of wishing that we
| could live in a world where people are cared for.
|
| I'd like to offer some comfort to the author on this score. Food,
| housing, healthcare broadly... while these are all aspects of
| being "cared for" by society, they aren't all care in the
| individual sense you describe. The food system is different from
| homecooked meals; the housing economy is different from the
| handsome breakfast nook your family DIYed into their home. We
| _can_ build systems which scale and make it possible and
| economical for individual care to happen.
| MichaelZuo wrote:
| Although it's theoretically possible and theoretically
| economical for individual care 'to happen', it doesn't in
| practice for the housing economy. If anything it's decreasing
| year by year on average.
|
| Especially when you look at construction quality, the average
| quality of say new built condos in any major city has gone way
| way down since the 90s.
|
| Of course on average condo designs have on average gotten
| fancier with quirkier architecture, and building codes have
| gotten more complex, so maybe it's not due to builders caring
| way less, but the end result is shoddy work either way.
|
| Edit: And the average home buyer has no method of separating
| out all these confounding factors, so it boils down to a single
| congealed mess.
| crabmusket wrote:
| Maybe it doesn't in America. Nor here in Australia. Some
| European cities are showing that better is in fact possible
| by strongly supporting co-operative housing sectors which are
| better for residents. But that would break the American taboo
| against government intervening usefully in private markets
| for human rights (in this case, shelter).
|
| More from a recent report by Australia's business council of
| coops and mutuals: https://bccm.coop/australia-urged-to-look-
| to-europe-for-solu...
|
| Anyway, my advice to the author was that systems _can_ enable
| care at scale. Not to say that our current systems _do_.
|
| Edit: to be more explicit, I'm suggesting that some
| approaches to the housing sector in some parts of Europe
| amount to care that scales; society and governments have
| decided that housing is a right, and have enacted policies to
| approach that situation. Conversely, a "we don't care"
| approach also scales very well with the opposite outcome.
| MichaelZuo wrote:
| 'Society and governments' can also 'decide' that the Sun is
| revolving around the Earth... so decisions and policies on
| paper cannot be fully credible by themselves...
|
| What is the actual tangible evidence that the
| aforementioned issues are avoided?
| Yawrehto wrote:
| About housing: I have a few ideas as to why, weirdly none of
| which overlap with yours.
|
| 1) I think part of it is due to our ability to fine-tune the
| limits. Before, if a company wanted to pass an inspection,
| they had to be really confident. There were going to be some
| expenses that in theory they could have avoided if they were
| better capable of measuring where the line between 'safe' and
| 'unsafe' was. The end result was buildings that were more
| safe than strictly required. But now we can get closer to the
| line, and so buildings are engineered at the edge of safety.
|
| 2) Of course, survival bias plays a role here. Who remembers
| all the crappy buildings that just vanished? It's the same
| reason we look at old toasters or mixers or what-have-you and
| say things were so much better-made in the past - all the
| crappy cheap toasters, mixers, and houses are gone now.
|
| 3) Also, as extreme weather has happened more frequently,
| areas all over are seeing weather different than what they
| were designed for. Given that the average temperature in
| Oregon in July (the hottest month of the year) was typically
| around 65 degrees Fahrenheit[1]. For the past few years it
| has generally hovered in the upper 60s. The hottest
| temperature ever recorded in Oregon before 2021 was 107
| degrees Fahrenheit[2], and typically there were one or two
| days a year that crossed one hundred degrees -- occasionally
| five, more often none. In 2021, it hit 116 degrees. Since
| 2021, there has not yet been a year without 4 or more days
| over a hundred. And, of course, this pattern is repeated all
| over the world. Houses are being built for one set of
| extremes and averages and getting another.
|
| [1] https://www.ncei.noaa.gov/access/monitoring/climate-at-a-
| gla...
|
| [2] https://projects.oregonlive.com/weather/temps/
| potato3732842 wrote:
| 1 is in large part a reflection of idiot proofing
| everything. Every party's judgement gets reduced down to
| some some quantitative stuff like wire gauges, stud
| spacing, etc, that even idiots with poor judgement can
| reliably assess. Instead of failures because people do
| shoddy work we instead get failures where people are dumbly
| building things they know won't last because it's easier to
| just let things be crappy than to try to get permission to
| deviate from the plan. Basically decision making authority
| is being abstracted away from the people who have actual
| context. This limits the screw-ups from people doing work
| below the minimum at the expense of preventing anyone from
| who would have done something better than the minimum from
| doing so.
| lesuorac wrote:
| Heh, I know somebody that was really annoyed their
| builder wouldn't install conduit since it wasn't in the
| code or something and their gripe was "but its better
| than code".
| NBJack wrote:
| Often, it's the act of preparing the meal by hand rather than
| pressing a button on their hypothetical Food-o-matic that makes
| the biggest impact. We can certainly scale the provision of
| needs otherwise. I agree with the author on their assertions
| about what it means to care and actually connect with people.
| crabmusket wrote:
| I'm not talking about food preparation, but food systems.
| E.g. look up the concept of a food desert. Preparing a meal
| by hand is one thing; having access to quality affordable
| ingredients is another. A food desert is what you get when
| the system that would enable care is deficient.
|
| And even in a "food oasis" with adequate quality, yes, if you
| yourself cannot prepare a meal, or have nobody to do that for
| you, that's a failure of a different kind.
|
| https://en.wikipedia.org/wiki/Food_desert
| potato3732842 wrote:
| I tend to consider food deserts just cheap/fast
| transportation or personal mobility deserts seeing as they
| tend to "lack" a whole bunch of other things in addition to
| food. They lack these things not because people can't get
| them, but because the cost in time or money of going
| whatever distance one needs to go to get them makes it not
| worth it. Food doesn't ship well or keep well in individual
| use volumes so it is particularly impacted.
| dkarl wrote:
| > The food system is different from homecooked meals
|
| This is a good point, and everything I've heard from parents
| says that it's parents, not children, who identify home-cooked
| meals with care. Children notoriously prefer prepackaged
| industrially processed food over whole foods prepared with care
| and love. In order to feel cared for, all children need is to
| trust that the person caring for them will make sure they get
| enough food when they need it. Food quality has nutritional
| consequences down the line, and at some point a child that is
| fed pancakes every day will gain the ability to look back and
| regret how they were raised, but it doesn't prevent a child
| from feeling cared for in the moment.
| tripper_27 wrote:
| > Children notoriously prefer prepackaged industrially
| processed food over whole foods prepared with care and love.
|
| Let me fix that for you:
|
| Children notoriously prefer heavily marketed food in
| attractive packaging which is designed/optimized for
| addictiveness and immediate gratification.
| lesuorac wrote:
| Eh, if you dumped a container of sugar into a home cooked
| meal they'd like it more than packaged food.
| tripper_27 wrote:
| if you'll forgive my prior snark, some people successfully
| involve the children in the cooking. When this is done, the
| children seem to prefer the home-cooked because they are part
| of the cooking and they are part of the feeding/providing to
| others.
|
| Don't underestimate the human desire to provide value to the
| tribe, it runs deep in the evolutionary make-up.
| theamk wrote:
| Pretty sure no amount of participation in cooking can make
| children start liking food with specific tastes, like
| eggplants or celery. If they like it - great! I they don't
| like it, but parents do - well, _that_ kind of home-cooked
| food will never be liked.
|
| (Unless you process them so much, and add so many spices,
| that they no longer have any original taste.. but by that
| point they are at "pre-packaged" level of cooking)
| KittenInABox wrote:
| Children notoriously prefer consistent meals over diverse
| ones, home cooked or not. The issue with serving blueberries
| for example is that each blueberry is different. My mother
| home-cooked for me a boiled egg and rice porridge every
| morning, and it was that consistency that associated me with
| care.
| jimbokun wrote:
| > Children notoriously prefer prepackaged industrially
| processed food over whole foods prepared with care and love.
|
| In most cases, this is probably due to the care givers
| training their children to prefer that kind of food because
| they don't make many home cooked meals.
|
| I don't even know if it's true, though. When I was a kid, the
| best food in the world were the home made meals my
| grandmother made, especially on the holidays. Remember as a
| teenager telling my Grandma her meals were better than any
| restaurant I had ever eaten at, and meaning it in all
| sincerity.
| AStonesThrow wrote:
| [flagged]
| dang wrote:
| Could you please stop posting flamewar- and ideological-
| battle-style comments to HN? Your account has been doing
| it repeatedly, unfortunately, and it's not what HN is
| for.
|
| https://news.ycombinator.com/newsguidelines.html
| rightbyte wrote:
| Dunno. My wife was reeeeally tryhard with our first child
| feeding him only home made food from the age of 1 to 2.
|
| He though industrial food was awesome as soon as he was
| exposed to it.
|
| (Obviously bad sample size)
|
| I think it is something about the perfect homogeneous
| product they like. Or how the taste even out between
| different ingredients on the shelf.
| hardlianotion wrote:
| Care does scale and the human race is evidence of that. It is
| centralisation that doesn't scale well.
| bryanrasmussen wrote:
| but centralization is in many ways the thing that is needed to
| scale all sorts of other things.
| lucideer wrote:
| No. Centralization isn't needed to scale, it's just needed to
| _exploit_ scale. Exploitation has become so commonplace it 's
| replaced everything as the primary "desirable metric". I'm
| writing this comment on a platform founded on the idea of
| exploitation being a desirable metric.
| theamk wrote:
| Try giving everyone housing without centralized production
| of things like nails, screws, siding electrical wire...
|
| Decentralizization is fine sometimes, but a single huge
| nail factory is going to beat thousands backyard forges in
| (average/95th percentile) quality and especially in prices.
| amanaplanacanal wrote:
| Yet somehow houses were still well built before the huge
| nail factory existed. Which means it is not _required._
| theamk wrote:
| Sure, it's not required to build _some_ houses, but it's
| required for scale.
|
| Backyard forges are OK if you have few hundred million
| people, most of them in farming, with most families
| living in a house with a a single room. But you cannot
| build New York on without large factories.
| lucideer wrote:
| This isn't true though. Neither in theory nor in
| practice. A broad set of individual product quality has
| consistently declined throughout the industrial era - not
| least, infamously, one of your own examples: nails.
|
| Many products have increased in quality due to factors
| unrelated to centralised production: new scientific
| research, intensive r&d, internal standardisation efforts
| - but centralised production tends instead to produce
| demonstrable reductions in individual quality. We're
| living in an age of unprecedented consumer waste due to
| this phenomenon. Planned obsolescence is a relatively
| recent term (& while it may not be real in terms of being
| intentional it's definitely true in terms of increases in
| obsolescence-rates).
| agumonkey wrote:
| yeah centralization is a proxy for trust and stability, it
| adds some friction on the edge to give you that benefit
|
| i also think that ultimately no single system is best and
| that regular renegotiation about the amount of central vs
| decentral is key (something we should help people be better
| at)
| _heimdall wrote:
| I'd argue that centralization allows a scale that otherwise
| wouldn't have been possible, but at the cost of added
| fragility and externalized costs.
|
| We produce way more corn in the US today than we could
| without a centralized industry, but we do so by subsidizing
| the hell out of an industry that is driven only by how much
| volume of corn is produced. Nutritional quality of the food
| produced is ignored, damage to the land is ignored, damage to
| the broader environment is ignored, etc.
|
| We grow a small amount of corn on our land. We absolutely
| don't have as high or consistent yields as an industrial
| farm, but we also don't spray any poisons on the land and if
| the soil health was being negatively impacted we would know
| it pretty darn fast. Rain water from the corn patch runs down
| into the pond our cows drink from, another reason we wouldn't
| use poisons on the land. All of these are considerations one
| will likely make at a smaller scale that just won't happen
| with a centralized system driven by one or two primary goals
| (currently that's just money).
| jstummbillig wrote:
| What exactly is the evidence, and how is it not exactly
| centralisation? All the advances in care that I can think of
| (those that actually unburden more humans from having to give
| their life to care) are brought to us by some sort of
| centralisation.
| intended wrote:
| This comes across as a comment on the headline and not the
| article.
|
| The article had a very specific circumstance it built upon -
| how much human time time it takes to help kids.
|
| This doesn't scale, in the context of the article.
|
| Your statement would translate into a point on economics and
| organization, than individual care.
|
| This still obscures the fact that many critical functions don't
| scale.
|
| I would add that these tend to be under resourced in favor of
| things that do scale.
| hardlianotion wrote:
| The comment comes from reading the article, then wondering
| how can societies make things scale? We make things scale by
| delegating our concerns to people who know and care more
| about specific outcomes, and helping them to make the
| differences that are required. Scale comes from people
| learning that things around them matter and that they are
| responsible for making them good.
| intended wrote:
| Ok.
|
| In that case i'll ask for a clarificaiton on the link. From
| the article it seemed quite a clear cut case about activity
| types that dont scale.
|
| Outsourcing the responsibility doesn't mean it scale, which
| seems contradicted by what you are saying. People learning
| that things matter and that they are responsible, doesn't
| change this does it?
| openrisk wrote:
| The article defines care "scarcity" rather narrowly, almost
| tautologically
|
| > In any given moment, you can only really care deeply and
| individually for one person
|
| Yes, but there are many moments in a day / one's life, and
| care is needed and appreciated at various levels of
| "deepness". Further, how much care (and what type) is needed
| depends _enormously_ on what society has managed to scale
| with the right organizational patterns etc.
|
| So in the end the question is: how much of this type of
| exclusive (and scarce) caring capacity does society really
| need? Mathematically, there are 8 billion exemplars of the
| species roaming the planet and 1:1 caring takes care (pun) of
| the 4 billion.
| bccdee wrote:
| Well, everyone's a kid for the first few years of their
| life, and children require a lot of care. The elderly
| require care. The unwell require care. Everyone wants care
| some of the time.
|
| We do have cultural institutions to do much of this work.
| Parents care for kids. Adults care for aging parents.
| Romantic partnerships exist so that people can reciprocally
| care for each other. Still, we have to fill in the gaps for
| kids without parents, seniors without kids, and sick
| people. The demand for therapy and sex work proves that
| people will pay a lot of money to be cared for, even when
| they don't need it to survive.
|
| > So in the end the question is: how much of this type of
| exclusive (and scarce) caring capacity does society really
| need?
|
| A lot, apparently.
| ForHackernews wrote:
| Not only does care not scale, but the fact that other fields _do_
| scale is one of the sources of "cost disease" [0]. If software
| engineering is thousands of times more scalable than teaching,
| caring for children, injured or elderly people then all of those
| other jobs will need to pay more to prevent everyone quitting to
| become a software developer.
|
| [0] https://en.wikipedia.org/wiki/Baumol_effect
| tmsbrg wrote:
| Q: How many Silicon Valley software engineers does it take to
| change a lightbulb?
|
| A: They will refuse to change the lightbulb, claiming it "doesn't
| scale" unless the "lightbulb problem" is fixed globally ;)
|
| In seriousness, enjoyed this article and it's a wise realization.
| I think the world would be a better place if more people take the
| time to be a good person to the people around them, rather than
| focusing so much on big picture issues.
| czbond wrote:
| I agree with your central point, but in my estimation, the
| entire world minus a very small percentage point only work on
| or care about small, short term solutions to problems.
|
| And that is fine. Engineers are not social & feelers with high
| individual level empathy scores. So let them/us build large
| scaleable solutions with the individual 1-to-1 personal
| interaction removed.
| mempko wrote:
| What most don't understand is that the economy IS us caring for
| each other. When you go to a restaurant when you are hungry, or a
| store to get what you need, or a hospital when you get sick, you
| are getting care. Virtually most people are taking care of other
| people. And yes it doesn't scale because it takes all of us to
| care for each other.
| anticorporate wrote:
| > What most don't understand is that the economy IS us caring
| for each other.
|
| But when those businesses we seek care from scale, the system
| is no longer closed.
|
| A portion of the care I give or receive is siphoned off and
| sent to shareholders or a wealth business owner. When caring
| happens through capitalism, a portion of our care is depleted
| with every transaction.
| moolcool wrote:
| It's an interesting conflict. As the businesses scales, small
| losses which would be acceptable in a smaller operation will
| scale as well. Maybe a mistake people make as they scale is
| being too quick to give up the extra couple french fries.
| jimbokun wrote:
| Non-paid human interactions exist.
| khaledh wrote:
| This reminds me of Clay Christensen's talk: How Will You Measure
| Your Life?[0] He compares how most people define success by how
| high up the hierarchy they get, against the individual effort of
| making a positive impact on the people around you.
|
| [0] https://www.youtube.com/watch?v=tvos4nORf_Y
| k__ wrote:
| I assumed the opposite.
|
| Knew a women who worked 100% as foster mom.
|
| Had 3 children at a time, age 6 to 13.
|
| Everything was well organised.
|
| It seemed to me, child care can work pretty well of it's your
| main job and you get paid by the state.
| rileymat2 wrote:
| Working well with a three one ratio does not scream scaling to
| me.
|
| The when you have more need than care workers it falls apart,
| with no way to scale it besides hiring more out of a pool that
| may not exist at the price you were paying the previous ones.
|
| If you think in terms of supply and demand, if they are already
| have the curves met, additional demand is going to scale more
| than linearly because you need more people at a higher pay.
| pschoeps wrote:
| This seems more like a very skilled caregiver to me, I would be
| absolutely overwhelmed in this position.
| User23 wrote:
| Which is quite remarkable, because up until less than a
| century ago when women "entered the workforce" virtually
| every woman who had ever lived somehow managed to care for
| her 3+ children.
|
| Incidentally, large families do scale sublinearly with
| respect to the parents. The reason why is that even with
| merely natural spacing by the time they have a fourth child,
| the oldest is in a position to provide significant
| assistance. Every mother with a large family that I've spoken
| to confirms that the difficulty peaks with the third child
| and then plateaus.
| ativzzz wrote:
| It is remarkable. I have one child, and it is by far the
| hardest thing I've ever done - far harder than any job I've
| had. It doesn't help that both parents are working full
| time. Maybe parenting has changed recently and we are too
| hands-on, but I can't imagine having 2, much less 3+
| running around. Even if one of us stops working to raise
| the kids full time, it's way more taxing, physically and
| mentally, than working a white collar job and paying for
| child care.
| KittenInABox wrote:
| I recall before we lived in nuclear families [somewhat
| recent phenomenon] communal raising was commonplace.
| Grandparents, aunts, uncles, neigbours, etc. would come
| help.
| jimbokun wrote:
| 3 children.
|
| If it's 10, 20, 30, this doesn't work. This is the entire
| point, that care work does not scale like manufacturing or
| farming or software or entertainment or...
| endoblast wrote:
| >We're pretty limited when it comes to care. In any given moment,
| you can only really care deeply and individually for one person.
|
| Absolutely. Society tends to assume that people are
| interchangeable units and that 'care' is a commodity which can be
| dispensed evenly as if from an industrial nozzle in a food
| factory. So we have 'care homes', 'daycare', 'care packages'. We
| are enjoined to be more 'caring'.
|
| But the reality is that _love_ , which is what we're really
| talking about, is dyadic.
|
| i.e. between two individuals. That's how it works and how it
| effects its magic.
|
| A patchwork of dyadic connections is what we may hope for and
| build.
| steveBK123 wrote:
| Yes, it points to how hard & expensive any government attempt
| to backstop the traditional parental model of care actually is.
|
| The earlier the intervention the better.. and consistency is
| also incredible important. But you can spend incredible amounts
| of money just to get a slightly worse outcome than what was
| going to happen on its own. As a wealthy society we must do
| something to help those in need, especially children who are in
| the situation of no fault of their own. But it's not clear our
| current methods work.
|
| You can also generalize this problem to the healthcare industry
| as a whole. Costs go up much faster than the rest of the basket
| of goods & services citizens pay for, and they don't understand
| why.
|
| The underlying reason is that - care doesn't scale. You are
| essentially (directly or indirectly) paying for someone's
| (doctor, nurse, etc) time. We have not gotten much better at
| making care more time efficient in the field, and in many cases
| it has gotten worse (more paperwork/electronic record entry
| time/etc). Everything else we buy is the product of using
| automation to replace labor, making labor more efficient, or
| making labor cheaper (offshoring / simplifying so less training
| is needed / etc).
| dflock wrote:
| Infrastructure is care at scale, as Deb Cachra would say:
| http://debcha.org
| jimbokun wrote:
| That strikes me as a complete non-sequitur. I have no idea what
| it might mean.
| erikig wrote:
| Her talk on "How infrastructure works" was eye-opening
| https://www.youtube.com/watch?v=oK6BRwwhgbo
|
| I'm having a hard time translating her points regarding how
| infrastructure serves and cares for the basic human physical
| needs (e.g water, clean air etc) and how it can serve social
| needs like child care or elder care.
| delichon wrote:
| It is not from the benevolence of the butcher, the brewer, or the
| baker, that we expect our dinner, but from their regard to their
| own interest. We address ourselves, not to their humanity but to
| their self-love, and never talk to them of our own necessities
| but of their advantages. Nobody but a beggar chuses to depend
| chiefly upon the benevolence of his fellow-citizens. -- Adam
| Smith
|
| Care doesn't scale but self-interest scales efficiently. The
| baker who gets up at 3 am generally does so because she cares
| about her close circle of loved ones, far more than the world at
| large. In this sense care and self interest are not in tension
| but amplify by constructive interference.
| croes wrote:
| The countless hours of voluntary unpaid work by many people
| shows don't act only for their own benefit
| bell-cot wrote:
| True-ish. But try talking to some old folks, about the vastly
| reduced scale of such volunteer work since (say) the 1950's.
| That "voluntary unpaid" stuff would include religious
| organizations, civic groups, housewives, ...
| croes wrote:
| You need time for that.
|
| It's true that first you care for yourself but after
| survival is secured many people care for others without
| profit concerns.
|
| But if you need more time to satisfy your own needs you
| have less time for others.
| harimau777 wrote:
| It seems to me that capitalism discourages that behavior.
| If the system is setup to be transactional, and you can't
| rely on others reciprocating altruism if you need it; then
| it seems like engaging in altruism would be for suckers.
| bell-cot wrote:
| True-ish. But in older-fashioned communities - long-term
| stable, extended families usually present, participation
| in many altruistic groups and activities are established
| norms, everybody's noses _not_ buried in web browsers and
| smart phones - there 's this thing called "social
| capital". And, as a generality, it's at least as
| important as the monetary kind.
| Eisenstein wrote:
| True-ish. But when you say 'older-fashioned communities'
| I have a feeling you are speaking through nostalgia or a
| rose-tinted view of an idealized past. Can you name some
| of these older-fashioned communities that exist today,
| and how they are different from the ones you are
| contrasting them to?
| lelandfe wrote:
| America's in-person group membership plummeted across the
| decades[0], but I don't know about overall volunteerism. It
| may just come in different forms. Anecdotally, here in NYC
| volunteer orgs are stuffed to the gills; spots to clean my
| local park fill up in days, finding any weekend activity on
| NY Cares can be hard.
|
| More concrete data are hard to find, AmeriCorps' only
| started in '02. We can look at volunteer rates across
| demographics[1] but it's likely true that volunteer hours
| drop off with age.
|
| [0] see: _Bowling Alone_ (needs a post-COVID update,
| though)
|
| [1] https://americorps.gov/sites/default/files/document/Vol
| untee...
| downut wrote:
| "...baker who gets up at 3 am..."
|
| But those 3am bakers are being exterminated by at scale
| corporate chains, no? Generalizes to just about anything that
| could reasonably be described using "artisanal". Social
| atomization inexorably spreads, and after thinking about it
| pretty hard for many years of travel putting eyeballs on
| "artisanal" processes I don't see any possibility of any other
| outcome. So we enjoy what is left.
| moolcool wrote:
| To complete the thought, the baker example is explicitly in
| opposition to OP's point. In the economy we exist in, a 3am
| artisan baker does so explicitly out of a care for craft and
| community.
| downut wrote:
| Yes. Precisely so. As it happens, we've been friends with a
| "3am baker" for decades. We do not envy her life, but we do
| intensely enjoy her taste. Delighted to pay double for it.
| ToucanLoucan wrote:
| I would argue that the killing of small businesses that
| care by chains that don't is that the vast majority of
| consumers are in a position where making even such
| choices as paying twice as much for a donut are luxuries.
| Salaries have been stagnant forever, with a boost during
| COVID but was then immediately undone with price gouging
| on the part of tons of essential-to-life industries. And
| do not come at me with inflation, it has been
| demonstrated, numerous times and is continuing to be
| demonstrated, as nothing more than profit seeking.
| Inflation _was a factor,_ yes. Greedy bastard
| corporations were another, IMO much larger, factor.
|
| The pandemic as a whole stomped the gas on an already
| running process of money being trapped in the hands of
| the uber rich, and if none of it is coming back down,
| then the amount of money everyone has to spend
| necessarily shrinks too. And this is not my usual pinko-
| commie-scum ass set of thoughts. This is a well
| understood principle that many economists have been
| banging on about for years now, because even those who
| believe capitalism is the best system, though I disagree
| with them on much, also understand that if all the damn
| money goes to the rich and stays there then the entire
| party ends REAL quick and probably violently.
| MisterBastahrd wrote:
| The 3am baker currently exists because the people who
| benefit the most from the exploitation of labor have the
| extra money to buy artisan products. My great grandfather
| had a bakery. He and my great grandmother would bake their
| product and my grandfather and his brothers would deliver
| the product to local businesses and homes.
|
| And then corporate breadmakers came in and made it
| impossible to compete from a price standpoint. Quality
| disappeared, and variety was subsequently crushed. The only
| people keeping his businesses open for a while were those
| who had fortunes that existed from owning a ton of land.
| They still wanted their oval loaves and fresh french bread
| and muffins.
| anonylizard wrote:
| That's not true, and only seems true because of highly
| selective examples.
|
| Money can force people to work, out of the necessity of
| survival. What it buys is reliability. You can force a toilet
| cleaner to come to work day after day, and the toilets stay
| clean.
|
| But human progress, social progress, economic growth, does not
| solely come from people grinding through their jobs. It comes
| from people 'giving it their all', look at the great
| scientists, Newton, Von Nuemann, all the people at bell labs
| etc. These people create titanic economic value in their wake,
| and they are motivated by passion, which heavily mixes altruism
| with self interest.
|
| Indeed, the 'developed economies' are precisely the ones that
| also allow 'care' to scale, that's why we have social welfare,
| that's why we have free education.
|
| Its that 'Care' doesn't scale, its that its impossible to
| centrally monitor and control. People in the third world work
| harder than the first world, and are 10% as rich, because no
| one in their societies care.
| bccdee wrote:
| > free education
|
| Public schools are notoriously uncaring. It's expensive
| private schools which can afford to have small class sizes,
| so the teachers can develop personal relationships with the
| students. "Care" in this context isn't just "doing something
| for someone's benefit"; it requires a caretaker's undivided
| attention, which is why it doesn't scale.
| blargey wrote:
| The quality floor of "reliable" work produced solely by
| economic self-interest is also quite vulnerable to misaligned
| incentives.
|
| If you don't provide the right balance of economic incentives
| for quality, the rational economic answer becomes "quiet
| quitting", and quality plummets. And maintaining that balance
| of incentives is also someone's job, which needs the right
| economic incentives to be done _well_ , so it's turtles all
| the way down (or up).
|
| In practice, it's an unstable, patchwork combination of care
| and economic incentives that keeps real-life institutions in
| working order.
| r14c wrote:
| > People in the third world work harder than the first world,
| and are 10% as rich, because no one in their societies care.
|
| typically they "care wrong" and the first world comes in and
| dismantles everything to keep raw resource prices at a price
| point that they like. advanced third world economies are a
| threat to first world prosperity.
| pkphilip wrote:
| This is only true to an extent. Self-love only goes so far.
| cnr wrote:
| "The story, then, is everywhere. It is the founding myth of our
| system of economic relations. It is so deeply established in
| common sense, even in places like Madagascar, that most people
| on earth couldn't imagine any other way that money possibly
| could have come about. The problem is there's no evidence that
| it ever happened, and an enormous amount of evidence suggesting
| that it did not."
|
| "Debt", David Graeber
| r14c wrote:
| Its wild to me how often people conflate "human nature" and
| culture. People who share a cultural background with Adam
| Smith may very well be accustomed to this self-interest-first
| way of seeing the world. People who would struggle to see
| other people's life ways as valid, because there's very
| little value in other people's perspectives. Especially if
| they involve practices that undermine profitability.
| bumby wrote:
| > _In this sense care and self interest are not in tension but
| amplify by constructive interference._
|
| Perhaps in a well designed system, but if self-interest can be
| derived at a cost to the collective good, that also scales
| rather efficiently and without such a wholesome outcome.
| bccdee wrote:
| I feel like you missed the point completely. Did you read the
| article at all? The social workers in the article are also
| professionals working for a paycheck. The operative difference
| is that a baker produces bread: If they can produce (say) 100
| loaves for 100 people in a day, you have a 1:100
| producer:consumer ratio, and with a bigger oven you could
| probably double that. Conversely, a social worker cares for
| children at close to a 1:1 rate, with one worker per child, and
| you can't do much better than that. Regardless of a social
| worker's motivations, their productivity is limited by the fact
| that they are _doing the labour of caring._
| tomjen3 wrote:
| Capitalism is a fantastic solution to the problem of biological
| wants and physical limitations.
|
| But that does not really change the issue that you need about
| 1:1 caregiver per child. It just means you get them much more
| effectively than any other system.
| empath75 wrote:
| People do depend a lot on the benevolence of the butcher and
| the brewer and the baker, because while regulation and
| inspections and laws and so on are there to stop out and out
| sociopaths from killing people in pursuit of profits, a lot of
| people that do their jobs are doing it because they think their
| job provides some value to the community at large, and they try
| to do it in a way that doesn't harm people.
| velcrovan wrote:
| Just want to add that so many freshman-level thinkers who are
| fond of this idea forget that democratically enacted regulation
| and oversight also count as self interest.
| vanderZwan wrote:
| If we're going to talk about how to "scale care" and how not to,
| then Buurtzorg has to be mentioned[0][1]. It's a Dutch home-care
| company that was started by nurses who basically got frustrated
| that managers got in the way of them doing their job. It operates
| by having a flat organization working with small teams of highly
| trained nurses, and trusting them to make the right decisions.
| The result is a low-cost provider of high-quality health-care.
|
| So when the author says care "doesn't scale", they obviously mean
| "you need a one-to-one ratio of caretakers", which I fully agree
| with. But what they're also accidentally doing in the process is
| explaining why creating bigger teams with bigger hierarchies and
| structures does not appear to increase the efficiency of care.
|
| Some projects _do_ need big teams with hierarchies - even in
| healthcare. Effectively responding to a pandemic comes to mind. I
| suspect it 's when the core problem to tackle most naturally
| breaks down like a tree - a hierarchy then mirrors the way the
| problem breaks down. For some projects, like general homecare,
| the efficiency sweet spot is a flat structure of autonomous
| individual teams, because it doesn't scale beyond those teams
| anyway.
|
| And just like the author concludes, I find that there's something
| comforting about that.
|
| [0] https://en.wikipedia.org/wiki/Buurtzorg_Nederland
|
| [1] https://www.youtube.com/watch?v=SSoWtXvqsgg
| cassepipe wrote:
| Thanks for elaborating further what we mean by "scaling".
|
| Couldn't it be said that when organization acquire ranks, it is
| to solve coordination problems that arise with scale but that
| in this case, there isn't much that is solved by more
| organization ?
| vanderZwan wrote:
| That sounds about right. If you watched the video then you
| also will notice that the further up the management chain we
| go, the more abstract the goals become compared to the most
| concrete ones that the nurses are dealing with. One could say
| that if most care work starts and ends with those concrete
| individualized issues, the cost of handling (or worse,
| _prioritizing_ ) abstract goals is far greater than the
| benefits that they add.
|
| Compare that to the pandemic response example I gave: that is
| the kind of challenge where there are concrete problems at
| individual, city-wide, national and international scale to
| tackle, and they're all interconnected too. So plenty of
| those coordination problems you mentioned.
| kartoffelsaft wrote:
| Honestly sounds like that's Conway's law, but in reverse.
| Instead of a project's setup mirroring it's organization, the
| organization mirrors what they see as the ideal project setup.
| That's something that I wish more teams were willing to
| recognize as the best approach; Conway's law isn't necessarily
| something to be worked around, it's a tool.
| bumby wrote:
| Your reply seems focused on size, but this line caught my
| attention:
|
| > _trusting them to make the right decisions._
|
| I'm wondering if trust isn't the real issue. For example,
| wouldn't a large high-trust organization be able to provide
| good care? Or is there something intrinsic to scale (e.g.
| diffusion of responsibility) that makes "high-trust" and "large
| organization" incompatible?
| vegetablepotpie wrote:
| Not OP, but orgs that scale usually rely on metrics. It's
| metrics that are easier to measure, not the one that measure
| system performance (i.e. lines of code written per day,
| points closed per sprint) that get selected. Then management
| lampoon workers for not meeting those metrics (they need to
| prove their doing something, and can't lose control),
| regardless of how the system is performing. So trust erodes.
| ToucanLoucan wrote:
| I honestly think most orgs would leap forward considerably
| (with some pain) by doing a severe reduction in middle
| management, basically making them prove why they are
| actually providing value, and removing them if they aren't.
|
| Tons and tons of middle managers do absolutely FUCK ALL in
| terms of delivering product, meeting goals, and serving
| customers.
| bumby wrote:
| I generally dislike middle-management as much as the next
| IC, but I think these types of arguments tend to ignore
| latent or low-probability risks.
|
| You see this all the time in discussions about quality or
| safety metrics. By definition, if those teams are doing a
| good job you won't see many quality or safety issues,
| which leads people to believe they are doing "FUCK ALL"
| and provide little benefit. Only in hindsight, after a
| low-probability but high risk event happens, does getting
| rid of them seem like a bad idea.
| skybrian wrote:
| It might be possible to do a better job at improving and
| discarding metrics? Shared recently:
|
| Goodhart's law isn't as useful as you think
| https://news.ycombinator.com/item?id=41956587
|
| Though, I'm not sure how well that applies to programming,
| let alone child care.
| bunderbunder wrote:
| Paperwork. I swear, it's paperwork.
|
| My mom is a (retired) preschool teacher. By the end of her
| career, she was working for a school affiliated with a large
| chain, and maybe 1/3 of her time was spent on filling out all
| the paperwork required by management. That was time she
| absolutely was not spending with the kids.
|
| My dad is a (retired) doctor. Similar story there. His
| hospital ultimately ended up associated with a regional
| health care network, and the paperwork load ultimately got so
| bad that they ended up having to hire additional staff
| dedicated to help the actual health care providers fill out
| all the paperwork so that they could spend more time actually
| providing health care.
|
| I switched primary care providers over this a few years back.
| I had a great doctor, but her practice got bought up by one
| organization, which then got bought up by another, and over
| time working with her office became a huge bureaucratic
| quagmire. I switched to a different clinic that's still local
| (although also chain with multiple locations), and
| everything's easier again.
|
| The same thing happens at my own job, software. The bigger a
| company I'm at, the more of my job consists of filling out
| paperwork _about_ the work I 'm doing, rather than doing the
| actual work.
|
| tl;dr: It's _communication_ that doesn 't scale.
| bumby wrote:
| > _The same thing happens at my own job, software. The
| bigger a company I 'm at, the more of my job consists of
| filling out paperwork about the work I'm doing, rather than
| doing the actual work._
|
| There's some irony here considering software has been
| promising for decades to help businesses scale information
| sharing.
| bunderbunder wrote:
| Oh, it has. The scale at which we share information has
| never been greater.
|
| Concrete example:
|
| 15, 20 years ago when we tracked user stories, the status
| of the sprint, etc., with sticky notes on a wall. We
| didn't have to record a lot of information on them
| because they only needed to track status at a high level.
| Details were communicated through conversations. That did
| mean that a lot of that information was tribal knowledge,
| but that was actually fine, because it was of ephemeral
| value, anyway. Once the work was done, we'd throw the
| sticky notes in the trash can and forget the tribal
| knowledge. Reporting out happened at a much higher level.
| We'd report status of projects in broad strokes by saying
| what big-picture features were done and what ones were in
| progress. We'd fill operations in on the changes by
| telling them how the behavior of the system was changing,
| and then let them ask questions.
|
| Nowadays, we put it all in Jira. Jira tickets are
| extremely detailed. Jira tickets live forever. Jira
| tickets have workflow rules and templates and policies
| that must be complied with. Jira rules make you think
| about how to express what you're doing in this cookie
| cutter template, even when the template doesn't fit what
| you're actually doing. Jira boards generate reports and
| dashboards that tell outside stakeholders what's
| happening in terms of tickets and force them to ask for
| help understanding what it means, almost like you're
| giving them a list of parameters for Bezier curves when
| what they really wanted was a picture. Jira tickets have
| cross-referencing features, which creates a need to do
| all the manual data entry to cross-reference things. Jira
| tickets can be referenced from commits and pull requests,
| which means that understanding what changed now means
| clicking through all these piles of forever-information
| and reading all that extra documentation just to
| understand what "resolves ISSUE-25374" means when a
| simple "Fix divide-by-zero when shopping cart is empty"
| in the commit log would have done nicely. etc.
|
| We communicate _so much more_ these days. Because we can,
| because we have all this communication technology to
| facilitate all that extra communication. What we forgot
| is that, while computers can process information at an
| ever faster pace, the information processing hardware
| inside our skulls has remained largely unchanged.
| bumby wrote:
| I think that highlights the issue I'm poking at. "Good
| communication" doesn't just mean a firehose of
| information at your fingertips. It means getting the
| right amount of information at the right time. Developing
| systems like the latter is much harder than the former,
| but they both get the same sales pitch.
| bunderbunder wrote:
| This is also where I really dislike a lot of this more
| recent push toward automating communication.
|
| One person deciding what needs to be said, to whom, and
| when, can have a LOT of leverage in the productivity
| department, by reducing the time that tens or even
| hundreds or thousands of other people lose to coping with
| the fire hose.
|
| Microsoft Copilot has been yet another downgrade in this
| department. Since it got adopted at my job, I've seen a
| lot of human-written 3-sentence updates get replaced with
| 3-page Copilot-generated summaries that take 10 minutes
| to digest instead of 10 seconds.
| ToucanLoucan wrote:
| At my company we are aggressively rolling out policies to
| forbid the use of AI. I'm one of the bigger folks behind
| it. I just see no benefits. I have no desire to debug AI
| generated code, I have no desire to read pages and pages
| of AI generated fluff, I have no desire to look at AI
| generated images. Either put the work in or don't.
| drivingmenuts wrote:
| Most healthcare organizations in the US are profit-oriented,
| sometimes to the detriment of the patients. That is why we
| have large, unwieldy organizations surrounding the very few
| people that actually do hands-on healthcare. There's also the
| issue of liability - it can be pretty litigious in the US,
| and companies are frequently wanting to limit their
| liability, which means having the paperwork to back up their
| decisions. Unfortunately, it also means they have to restrict
| their decision-making to a very small matrix.
| bumby wrote:
| > _Most healthcare organizations in the US are profit-
| oriented_
|
| According to the American Hospital Association, less that
| 20% are for-profit [1]. I'm sure all are extremely budget-
| conscious, but that's not the same as being profit-driven.
|
| It seems to me that the US optimizes for quality to the
| detriment of cost and, more recently, access.
|
| [1] https://www.aha.org/statistics/fast-facts-us-hospitals
| Kevguy wrote:
| But also be aware that non-profit does not mean non-
| profit-oriented. Just that any profit goes to executives
| [1] instead of toward community/charity services [2].
|
| [1] https://paddockpost.com/2021/06/10/executive-
| compensation-at... [2] https://www.healthaffairs.org/doi/
| 10.1377/hlthaff.2022.01542
| bumby wrote:
| I think there's an error in conflating "not for profit"
| with "charity". You could provide all care at cost and
| have zero charity care. That d doesn't imply all "profit"
| goes to executives, but rather to keep reimbursed or
| charged costs lower.
| Kevguy wrote:
| 1. Thanks for the nuanced view. I agree that zero charity
| care doesn't necessarily mean greedy execs.
|
| 2. In my mind keeping costs lower is a form of charity.
| Especially with something as frequently difficult to
| understand as health care costs.
|
| 3. Executives do deserve to make a fair amount for their
| skills and effort. I'm not sure myself what salary I
| consider it fair pay vs taking greedy advantage of not-
| for-profit status.
| rqtwteye wrote:
| Don't be fooled by the "non-profit" label. Many are as
| greedy as for-profit hospitals, except that the money
| goes to execs and their friends instead of shareholders.
| davidclark wrote:
| I don't think it's that they are incompatible by definition.
| I think the large organization is a result of low-trust.
|
| A trust-breaking event occurs, so a new form gets added, a
| compliance process is created with a new team monitoring,
| etc. etc. Have enough of those and you eventually get your
| typical, modern healthcare bureaucracy today.
| vanderZwan wrote:
| Well, Buurtzorg _is_ a large organization, it 's just that it
| does not have a large _hierarchy_. I suspect you 're really
| asking "high-trust" and "large hierarchy". In that case
| there's plenty of causes to point at. I'll just give a few of
| the top of my head
|
| First, note any organization that breaks into different
| departments (hierarchical or not), at least partially does so
| to let each department "abstract" away the other ones - if
| you don't have to worry about issues outside of your
| responsibility, you can focus more on yours. That is actually
| a form of trust.
|
| In the case of a hierarchy however, that means that each
| layer abstracts away the layers above and below, and since
| going up multiple levels in the hierarchy happens indirectly,
| the further away, the more abstract things become. So that
| often needs some kind of structure to regain the trust that
| is lost by dealing with abstract departments - leading to
| bureaucracy.
|
| On top of that, usually more power resides higher up the
| hierarchy. That means that without explicit structures to
| compensate for this, people lower in the hierarchy lack
| individual leverage to protect themselves against bad
| decisions made higher up, that may not even be malicious or
| intentional but just a consequence of the aforementioned
| abstraction.
|
| Of course, most structures that are created to fix this
| _typically are also abstract procedures_ , meaning they
| barely help with our instinctual _" I cannot attach a face to
| this"_ type of distrust. Bureaucracy can create _leverage_ ,
| but rarely creates trust. Which also explains that quite
| often, talking to someone in person can make such a
| difference in being allowed to "go ahead" or not. Because it
| can provide a more "natural" sense of trust that bureaucracy
| is supposed to provide but barely does.
| MatthiasWandel wrote:
| Things that scale can have a big multiplier, so to say. The
| problem is, more often than anticipated, that multiplier, rather
| than being large, ends up being considerably less than one.
|
| Whereas work that doesn't scale always has a multiplier of 1, so
| its always useful.
| feedforward wrote:
| > Adults often come to see small-scale solutions to major
| problems as childish. Yeah, you could make a couple of sandwiches
| for the hungry--but there are billions of people who need better
| access to food. Maybe your effort is better spent working on
| solutions that can scale.
|
| Much of this essay is baffling to me.
|
| From 2022 to 2023 the fed funds rate was jacked up. The aim of
| doing this was to, among other things, drive up unemployment, so
| that more working class people working in supermarkets and the
| like would become unemployed, and to increase food scarcity for
| their families. The rate rise affects us as well, with tech
| hiring somewhat dead since late 2022.
|
| Looking abroad - the International Criminal Court charged
| Netanyahu, Israel fires on and invades UN bases in Lebanon,
| Israeli television broadcasts Israeli soldiers raping in Sde
| Teiman (go look on YouTube for the footage) as rabbis and Knesset
| MPs swarm to defend them. Gazan children starve as European
| countries block weapons being sent to Israel. In the US, Biden
| sends troops abroad and Israel weapons to further the
| slaughtering, which has spread to the West Bank, Yemen, Syria,
| Iran and Lebanon. Also, the US vetoes at the UNSC effectively
| help block Gazan children being fed as they starve. Kamala Harris
| backs Biden and vows to continue arming and funding Netanyhu
| doing this, and Trump is even more belligerent. So Americans
| elected the person enabling this and over 98% who vote will vote
| for a candidate doing this.
|
| It is not a lack of care or attention to Gazan children,
| Americans, or 98% of those who vote are paying attention to Gazan
| children and are trying to starve them - or at least are willing
| to trade a specific tax cut or whatnot to enable their
| starvation.
|
| There's nothing about lack of individual or scaled care - the
| vast majority of Americans work for the opposite - to continue
| the famine.
|
| Going back to the point of scale - the <2% of people not voting
| for candidates arming Israel and continuing the Gazan famine are
| working together as a mass movement and at scale and many for, as
| the essay mentioned, "socialism", because this <2% has to
| coordinate and work together against the 98% who are actively
| pursuing the famine in Gaza, or who are neutral about it and
| willing to trade support for it for a tax cut and such.
|
| Gazan children don't starve because Americans don't pay
| individual or scaled attention to Gazan children. They starve
| because 98% of Americans will vote for someone who works to
| starve them. It is what the vast majority of Americans are and
| what America is. And works for domains outside Gaza - like
| unemployment and the fed funds rate mentioned.
| red_admiral wrote:
| Horizontal, not vertical scaling is what you need here.
|
| Even the college-socialists, at least when they're talking about
| climate change, realize that the best we can do individually is
| save a few bags of CO_2 here and there, but if everyone in the
| world did this then we'd have a fighting chance.
|
| Or consider the charity ads with lines like "if everyone reading
| this poster donated the cost of a cup of coffee a week ..."
|
| We can care deeply for one person, or perhaps two or four. We can
| look out for a couple of coworkers. We can cultivate 5 or so deep
| and meaningful friendships. If everyone did this then we'd have
| improved the world a lot, at scale.
| stonethrowaway wrote:
| > Software engineering as a field is made up of people who are
| very conscious of missed opportunities for scale [...]
|
| It amuses me to read these articles because it's so airy and
| nebulous that there is all this text that doesn't say much. I
| pretend it's another pg article instead to humour myself further.
|
| HN is perpetually being played by the storytelling of some minor
| event that the author saw - people taking care of orphaned
| children by some rotating number of adults - and is reaching
| conclusions "care doesn't scale" as if to educate us. It's like a
| TED talk, only even less structured. So all I'm reading is vain,
| egotistical puffery. There isn't really anything here other than
| the author thinking they can bring the tablets to us, the blind
| unwashed masses. It's not only software engineers who do this so
| I won't say it's a trait unique to them in any way, though I see
| software engineers trying to make grandiose life statements more
| often than not.
| m3kw9 wrote:
| Maybe one day with robots taking over some mundane care tasks, it
| can free more direct care work
| keeptrying wrote:
| "Care Doesn't Scale" is a fractal type of truth which essentially
| describes life but also is a steadfast warning of the underlying
| state of healthcare in general.
|
| Holistic 100% care doesn't exist - even for the rich.
|
| The only way to get optimal care is to pay for it with study.
| Even the richest in the world don't necessarily get the best care
| because care is a function of the present life situation of the
| practitioner - something no one can control 100% of the time.
|
| What is reassuring is that through a little study - you can
| refine the care provided by most nurses and doctors using your
| own curiosity at the point of interaction.
|
| Surprisingly the mistakes committed by nurses and doctors on
| somewhat healthy patients are easily fixed with some sembalance
| of attention.
|
| Study the first 2 years of med school. It's not hard but does
| take time. And then ask the pertinent quesitons during your time
| with the doctor. Understand the diagnosis and how they came to it
| - it's mostly simple and straight forward.
|
| 80% of the massive mistakes by doctors and nurses are fixable
| this way. Thats $800B ... 800 billion dollars - with a little
| study.
___________________________________________________________________
(page generated 2024-10-28 23:00 UTC)