Or to be less glib, that's a great question, and like many, not simple to answer well.
Mostly, it seems like a lack of positive reinforcement and role models (leading to self selection out at early ages), mixed with sexism in a a variety of forms (leading to lack of opportunities, or hostile environment and self selection out at later ages).
It's a choice, but it's not the same choice. When a woman signs up to be an engineer, she's signing up for long hours debugging segfaults, just like a man. But unlike a man, she's signing up to spend four years in school being one of the handful of women in her class, then entering a workforce with the likes of Uber, etc. There signing up for a life of awkward encounters with coworkers, supervisors who try to date female employees, limited support networks, etc.
> None of that stopped women from entering law, medicine, business, etc.
As to law, it didn't happen by magic. After openly excluding women into the 1970s, law schools and law firms made concerted efforts to increase the representation of women. Large law firms not only track demographic information for hiring and promotions, they disclose it to legal publications who report on it. These days much of it has become self reinforcing. Frat culture has a hard time surviving in an environment where a big chunk of the clients are women (a quarter of existing Fortune 500 CLOs and a third of new ones are women).
That's all true of tech as well. People should seriously ask why women aren't choosing tech careers, because the "old boys club" or "frat culture" explanation isn't at all unique to tech.
>There is not a stigma against "in tech". There was never a stigma against it, really.
Yeah. Traditionally all the cool kids were the math and computer whizes with glasses and pocket protectors - not the star football player. Yeah. Got it.
>And yes, men largely do get into stem fields because there is huge positive reinforcement and many positive role models.
Uh huh. Can you quantify that? Or did you just sit down and think really really really hard about it so it must be true.
>and many positive role models
Is that actually a real problem? Are you saying a white kid will be dissuaded from playing basketball, or even being an NBA fan because the best players are black?
In similar spirit, are you really trying to argue that a young girl will not be able to be inspired by Woz, or Jobs, or Elon Musk because they are men? What dystopian, ugly world are you living in?
I'm pretty sure the cool kids in my school did individual sports (golf, tennis, track), were in 2-3 AP classes, and aced their SATs. So that'd depend on where and when you are.
There's absolutely a stigma against not confirming to prevailing norms, which is a bit of a different discussion. Also the mess that is putting hundreds or even thousands of adolescents in a confined space with minimal oversight.
>Uh huh. Can you quantify that? Or did you just sit down and think really really really hard about it so it must be true.
Why did you get into it?
>Is that actually a real problem?
Yes. Though, representation generally is probably a better way to have said it. Though availability of role models and mentors with similar life experience is a factor as well.
>Are you saying a white kid will be dissuaded from playing basketball, or even being an NBA fan because the best players are black?
Fandom and participation aren't the same things, and while there's some overlap between former participation and later fandom in sports, it's far from 1 to 1.
I'm not sure if white kids would be discouraged due to lack of representation in the NBA. All other things being equal, yes, that's a likely outcome. But all other things are not equal. Race and sports in the US is an interesting topic in its own right.
>In similar spirit, are you really trying to argue that a young girl will not be able to be inspired by Woz, or Jobs, or Elon Musk because they are men?
Not at all. But a lack of representation has a few different impacts. At the personal level, individuals find it easier to identify with folks who they see as being like them. What exactly like them means varies, but the younger the child, the less abstract they tend to be. Second, parents and teachers are influenced by lack of representation, so it feeds back into a loop of lack of community encouragement, which doesn't help.
Really what I'm getting at, there is no 'structural racism' in this case. You cannot point at a law, or mandate, or policy that actively discriminates against an ethnicity, race, or gender. The best you can do is give some hand-wavy argument that 'unconscious biases' are driving racist actions without knowledge of the person - but what is a person supposed to do with that? They are racist in such a secret way that even they are unaware of it? Total garbage.
What is your explanation for the underrepresentation of black people and women in engineering besides structural racism and sexism? If the answer is "self selection," explain to me what could possibly cause women and black people to self-select out of high paying interesting jobs?
>What is your explanation for the underrepresentation of black people and women in engineering besides structural racism and sexism?
Null hypothesis. YOU are making an unsubstantiated claim. What is YOUR proof of this structural racism. And feel free to define your terms, because I have no effin clue what 'structural racism' is.
Here's an alternative explanation, people are influenced by the sub-cultures they are in and ideas that go viral in one sub-culture, may not go viral in another. In the early 1900s professional basketball was dominated by Jews. Why basketball? I don't know. It just happened to strike a chord with that specific population, in that specific time.
I'm not saying this is the reason, but what it is, is an example that YOU have to dismiss or account for to prove YOUR claim.
>If the answer is "self selection," explain to me what could possibly cause women and black people to self-select out of high paying interesting jobs?
An average salary for a radiologist is $350,000/year. Why aren't you a radiologist? I'll tell you why I'm not. I would rather shoot myself than spend the amount of time it takes to become a radiologist because I have no interest in it. I have no interest in memorizing massive amount of latin names and reading volumes of biology and anatomy text books. Similarly, if you don't love programming, programming is an insanely boring and tedious profession. You may sit in-front of a computer screen for days trying to find a bug that occurs sporadically under some very specific conditions. I find that fun, others who have no interest in it will want to shoot themselves too.
So to answer your question: "I don't know" but if your criteria is human irrationality, I can go on and on and on and on... Why are middle-class kids borrowing hundreds of thousands of dollars to go to private liberal arts colleges with no real hope of landing a job that will provide them an income to pay of those loans? Come to think of it, why do humanities degrees even exist? Why do people buy lottery tickets when investing the equivalent money will net them a significantly higher return rate?
Humans are not rational agents. We're driven by emotion.
We known several things as fact. We know overt and open oppression of black people happened as recently as the 1970s and 1980s. (I'd say it's still happening, but the fact that it did happen in the recent past is indisputable.) And we know that black households make only 60% as much at the median as white households. All I'm doing is suggesting a causal relationship between the two.
Since you reject my hypothesis, I'm asking you to suggest an alternative. And your alternative appears to be, "I don't know why, but for some reason black people just don't like money." Which doesn't make any goddamn sense. Sure individuals are different, but why would we expect groups of people to have such distinct preferences? To me your theory smacks of rationalization.
That's surely a factor, but there are many other factors that have to be considered: the stigma against "acting white", Democratic benefit programs that breed dependency and make wealth building almost impossible, violence, fatherless families [1]. The opportunities for success exist; now, it's up to people to work for success.
I reject your hypothesis on the basis that you have provided no evidence.
>I'm asking you to suggest an alternative
An alternative to what? Why there are less black people and women in tech than there are Asians and whites? I don't know. It could be any number of reasons and none of them may have to do anything with racism or misogyny. You can't just prove your assertion by saying "well i can't think of anything else it could be therefore racism must be the cause".
>And your alternative appears to be, "I don't know why, but for some reason black people just don't like money."
Your paraphrasing of a position I put forward is disgusting. It isn't at all what I said. At all.
You also missed my point. I'm not saying I believe my alternative. I have no evidence for it just like you don't have any for yours. I put it out there to demonstrate that there are potential alternatives that would need to be taken into account.
>Sure individuals are different, but why would we expect groups of people to have such distinct preferences
That's a good question. A type of question that one could study and get a Masters for or a PhD. Certainly there is plenty of precedent at least when it comes to tastes in movies, music and food. So why would you just dismiss it out of hand and blame racism?
> Mostly, it seems like a lack of positive reinforcement and role models
If one presupposes that men and women are literally just the same. As in they have the same distribution of proclivities and personality traits across their gender this would be the most logical conclusion to reach.
Because it is ambiguous goal which under any reasonable interpretation has massive consequences and major unintended side-effects. My favorite sport is basketball. What is the 'equality of outcome' in the context of the NBA? Is it that players are evenly distributed across gender lines? Across economic lines? Across national lines? Across racial or ethnic or religious lines? In our society, it would probably be understood that NBA should be proportionally represented by each identity group. So you should see 70% white players, 15% hispanic players, 12% black players, 5% asian players. Is that the right solution? But is the fact that black Americans dominate the league actually a problem? And what the heck are you supposed to do to fix it?
The other point is that in a free society, you cannot guarantee equality of outcome because people are going to make personal choices that will be magnified and influenced by whatever sub-culture they are immersed in. Professional basketball in the early days was over-represented by Jews, because it just so happened that interest in the game went viral in that sub-culture.
Tech has an over-representation of men because it grew out of a particular nerd sub-culture. There's nothing wrong with doing outreach to get non-traditional sub-groups developing an interest in programming, just like there's nothing wrong with the NBA running clinics in China to get Chinese kids into basketball. But it's not racism that the demographics are the way they are! In a free society you should expect that!
> So you should see 70% white players, 15% hispanic players, 12% black players, 5% asian players. Is that the right solution? But is the fact that black Americans dominate the league actually a problem? And what the heck are you supposed to do to fix it?
Arguably yes. The NBA itself is an irrelevantly tiny portion of the economy. But it creates a huge pressure on African American kids to focus on being successful through sports instead of academic pursuits.
What do you mean "arguably yes"? What are we losing by having blacks be over-represented in the NBA?
>But there is a huge pressure on African American kids to focus on being successful through sports instead of academic pursuits.
BY WHO??! Who are these individuals who are pressuring black kids to focus on sports instead of academics?!? I have never met such a person.
Professional Hockey is dominated by White Canadians and Russians. Baseball is over-represented by Latino/Hispanic players. Asians, who are 5% of the US population, account for almost 25% of all Physicians. Which industry has this perfect ratio of races that should serve as a model for us all. And you conveniently side-stepped the issue of 1) why it is race/ethnicity where proportionality should be prioritized over (for example) religion, and 2) is it even reasonable to expect that such a ratio to be achievable in a society where people are free to choose and 3) what the heck is the actual gain to society if it is versus the cost of brainwashing people to want things they don't actually want.
>How much do you know about the personal experiences of African American teenagers?
How much do you? How much do middle-class black Americans in New York know about the personal experiences of poor black teenagers in rural Louisiana? How much do you know of the personal experiences of second generation Polish Americans in Chicago? Or recent Chinese immigrants in San Francisco? Or poor White Protestants in Appalachia.
My point was based on personal experience. You're the one who said you don't know anyone encouraging black kids to pursue success through sports. How is that opinion supposed to carry any weight if you wouldn't be in a position to know about it even if it were happening?
This thinking is exactly the problem. "There are a lot of people with dark skin in basketball, your skin color is looking like theirs, therefore your path to success must be basketball". But the solution you seem to be implying is even worse - "ok, we succeeded in convincing you your skin color determines your path in life. Congrats to us. But now we'll close this path for you because we already have too many people looking like you there, so no success for you, sorry". Both ways of thinking are idiotic and both if followed can ruin people's lives. We need less of that, not more.
Great. Now convince all the black teenagers living in the same segregated neighborhoods black people lived in a century ago (because it was illegal for them to live in the other side of this or that road) that skin color doesn't determine their path in life.
I can't, of course. But it's not about me, is it? It's about how to fix it. And I think getting out of "race determines everything" mentality is part of fixing it, regardless of what I personally can or can't do. Yes, there was a lot of harm and injustice done to black people in the US in the past, and some of it continues even to this day. It must be fixed. I haven't seen an instance of concentrating on racial quotas fixing it though. I don't think racism can be fixed with racial quotas.
Because it reduces people to a set of identity classes that fill respective identity checkboxes. I.e. if it happens that on conference there is 10 good presentation submitted from class X but only 2 from class Y, and the quota is half-half, you would either reject 8 good presentations or add 8 crappy ones, just to fill identity checkboxes and achieve equality of outcome. Or cancel the conference altogether.
The true equality would be when the conference organizers see 12 good presentations, and don't even think to dig into what identity class they represent (unless the conference is specifically organized to represent identity classes). When did you last seen statistics about hair color or eye color of conference presenters? How about blood type? Maybe AB- people are underrepresented? You get the idea.
If green eyed people had been systematically oppressed until recently and still made a fraction of the money brown eyed people do as a result, you'd see statistics about eye color at conference presentations.
Define "recently. Neither women nor blacks nor catholics nor jews have been systematically oppressed in the US in my lifetime, or yours, or most of the potential presenters. If you are conservative about it you can claim discrimination up until the 1960s - which is 50 years ago, hardly "recently".
> Neither women nor blacks nor catholics nor jews have been systematically oppressed in the US in my lifetime
If you are ever so slightly open-minded about it you could consider black Americans to still be systematically oppressed by the criminal justice system. Read a bit about the criminalisation of marajuana, sentencing procedures, the industrial prison complex etc..
Equality of outcome as a goal is terrible because it's the enemy of equality of opportunity. "Everybody is denied their agency" would be equal, perhaps, but isn't part of any feminist vision I choose to align myself with.
You can absolutely underpay your employees, sell goods to employees of others firms who do not, and profit. There is a clear benefit to a single company doing this.
It is not clear the benefit is greater than increasing wages, but that's another thing.
But if everyone does this, to the point that there are not enough potential consumers for the majority of products, then there is no benefit to lowering wages. You can't sell anything to anyone.
Parent post is not arguing about underpaying, but the feasibility of increasing wages. The idea is that if we treat all companies and their employees as one grand company, then the company will have to sell everything to its employees in order to get revenue, but that revenue will have to be distributed to the employees as wages, in full, in order for everything to be bought. That leaves no margin for profit.
The answer to the question lies in what is missing from the equation: the existence of stockholders. They are potential customers too. You don't need to sell everything to just employees, that means you can underpay them and still be sustainable as long as stockholders buy things too.
But there are limits to how many things a customer wants to buy. Once the stockholders' needs are satiated, the rest of the profit won't be spent. At that point, in order for businesses to be sustainable, this balance has to be redistributed as increase in wages.
This sounds kind of like one of those games where the Nash equilibrium leaves everyone with fewer points than they'd get if they all cooperated in the right way.
There may be something to that.
I have to say, though, paying my employees more so that my competitors have to pay their employees more so that their employees will buy more stuff from me sounds like a pretty dubious business strategy. And one that certainly won't work at all if there's enough of a labor surplus, because my competitors can keep their wages low and still find employees even if I'm paying an order of magnitude more.
>>>I live in the Netherlands, a very open-minded country with same-sex marriage, equal rights and were women seem to me to be even slightly more dominant over men (but this is just my perception).
I can't comment on the present social climate or attitudes in NL generally, but the history seems pretty similar. Sufferage at about the same time, anyway.
Anyway, think about who is offending and being offended. No is being beaten in the streets for saying, "Actually, I think Bill Maher is the height of comedy."
Also, holding a sign that, explicitly or implicitly says, "I am inherently superior to you, and I fervently hope you will all die and come to ruin, what are you going to do about that, huh, <expletive>?" seems unlikely to be well received anywhere in the world.
No, this stuff doesn't belong in HN, I don't accept it; this isn't tumblr.
Nobody is complicit of anything just for existing. At risk of invoking Godwin's law, that's exactly what the nazis said about every jew, including children.
> About not being able to sail through life without ever having to.
Yeah, let's not pretend you aren't a person who's had so much privilege that the biggest thing you think to fight about online is the diversity quota about some conference in an emerging (bad, but that's IMO) technology.
The instant someone steps in to make comments defending the status quo -- when the status quo is obviously deeply flawed -- they become complicit irrevocably and beyond any hope of later denial.
> The instant someone steps in to make comments defending the status quo -- when the status quo is obviously deeply flawed -- they become complicit irrevocably and beyond any hope of later denial.
Counterpoint: no, it doesn't. Because, being against racism against white people or sexism against men is not the same as being in favor of racism against non-white people or sexism against women. You're doing a false dichotomy.
> Like you just did with your comment.
Good thing I'm not in the USA and I'm not white, then. Now you'll tell me I have "internalized racism."
I'm also gay, facing actual discrimination because I can't even get legally married in my country.
And none of that makes retaliating to racism and sexism with racism and sexism ok. Nor it does retaliating homophobia with heterophobia, of course.
Straight to Nazis, huh? I'm not talking blood and soil here. I'm talking about benefiting from structural inequalities that favor certain groups over others.
And to the degree one benefits, and takes that for granted, and perceives the calling out of those benefits as a form of persecution, then yes, there's a degree of complicity.
But no one's saying (well, not anyone on HN, anyway, and not most people on Tumblr) that white people or me should be persecuted. Just that they shouldn't be accorded undue advantages to the direct detriment of others.
> I'm talking about benefiting from structural inequalities that favor certain groups over others.
Still arguing about complicity just out of existence. Last time I'm replying to you because you won't understand, but at least now my comment is just as visible as yours.
> And to the degree one benefits, and takes that for granted, and perceives the calling out of those benefits as a form of persecution, then yes, there's a degree of complicity.
Again, calling out unfair benefits is not bad. Attacking the people directly based on their race and sex is. But you do you and keep pretending I'm doing the first, it's the only way you can avoid the cognitive dissonance of your narrative after all.
> Just that they shouldn't be accorded undue advantages to the direct detriment of others.
Yeah, no, this isn't what's being argued here, again. Nobody should have inherent advantages over anyone else, that's a non-starter, it's obvious.
What I and the others you replied to here is calling out is a direct snub on a group of people because of their race and sex. If you don't see that as racism or sexism (or are selectively pretending that those aren't bad things) doesn't matter: It is racism/sexism and they're bad things.
Let's imagine someone organizes a conference and every single speaker ends up being a black woman. The organizers proceed to postpone it because it isn't "diverse" enough.
Now you'll tell me that you'd think they did the right thing and that you won't consider that a snub. And I sure will believe that.
As I knew, this is what you hope starts happening. So don't pretend that what you want is diversity, it was patently obvious from your first statement that it isn't what you want, and your backpedaling in every single reply didn't work.
Glad you're back to your original intent, though, it's honest.
Ridiculous. I think about it all the time. I mentor early-career black and female employees right now, and sponsor on-campus events for groups like NSBE. So don't sit here and assume that because I have a problem with our discussion about equality now means that I don't think about equality, don't support it, or somehow I "sail through life". Did you grow up in a poor family of high school dropouts? Did you go fight in a stupid war so you could do something with your life besides drugs? Did you nearly fail out of college multiple times because you didn't learn how to study when you were younger? Did you struggle from depression for your whole life?
This is the exact kind of bs response that I was expecting from somebody who doesn't really understand what's going on besides whatever the latest outrage article they just read said they should be outraged about.
To clarify, it's not about you. Poor word choice? My bad.
The sailing through life bit was specific to the context of being untroubled by the need to examine ones relative privelege or lack of, and the structures affecting same.
Not to imply that not having to think a out these things means life is automatically easy. You can still get cancer, get hit by a bus, etc.
----
You say that if people were not so quick to call out perceived racism or sexism things would be better.
I say if people were not so quick to be personally insulted when perceived racism and sexism are called out, things would be better.
Is there evidence of that? Not clear from the discussion of the list how much diversity of thought there was. Also, generally, the amount of diversity in thinking that is possible when you are talking about a conference for the discussion and promotion of a single technology cant be that much in the first place.
If you were going for discrediting calling something "a white-sausage party" as if it were a bad thing isn't racist by linking that, you failed.
The very first definition in your own link on racism:
> : a belief that race is the primary determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race
Inherent inferiority, I'd assume, fits within that mind frame.
As for sexism, the second definition.
> : behavior, conditions, or attitudes that foster stereotypes of social roles based on sex
Now you'll start thinking of ways to complaint to the dictionary so that those definitions can be changed in a way that it's only about "minorities", I'm sure.
I'm not sure how saying that a non diverse group is inferior to a diverse group is equivalent to saying that the specific elements making up the non diverse group is inferior?
Like, saying all-white is inferior to mixed is not the same as saying white is inferior.
Also, do recall usages b and c, and that they are important to consider, and specifically see my third link for better explanation of how.
> I'm not sure how saying that a non diverse group is inferior to a diverse group is equivalent to saying that the specific elements making up the non diverse group is inferior?
That you don't see it is framed as a question. Ok, look at it harder and come back to me when you have an actual answer instead of a question on your own reading capacity.
> Like, saying all-white is inferior to mixed is not the same as saying white is inferior.
Yes, it is, that's exactly what it is. I'd ask you which mental hoops led you to think it isn't but I know every single one of them will be a fallacy so I won't bother asking.
> Also, do recall usages b and c, and that they are important to consider, and specifically see my third link for better explanation of how.
You don't get to tell me which definitions to use. And I'm not reading some rant rationalizing why racism and sexism is good based on the target.
"I'm not sure how saying that a non diverse group is inferior to a diverse group is equivalent to saying that the specific elements making up the non diverse group is inferior[. Could you please clarify]?"
Thought it was implied. Sorry to be unclear.
>Yes, it is, that's exactly what it is. I'd ask you which mental hoops led you to think it isn't but I know every single one of them will be a fallacy so I won't bother asking.
You haven't added anything here, just restated your original thinking that I don't get.
Here's what makes sense to me:
1 + 1 = 2
1 < 2
1 = 1
>You don't get to tell me which definitions to use. And I'm not reading some rant rationalizing why racism and sexism is good based on the target.
It's not that there are more than one competing definition. There are several complimentary ones and ignoring the rest does not promote better discussion.
If you read the third link, that's so not an accurate assessment of it's contents.
No, no, you're doing a false equivalency. This is what you're saying:
1+1=2 but 2>2 if the second 1 is of a different race/sex/orientation/etc.
> It's not that there are more than one competing definition. There are several complimentary ones and ignoring the rest does not promote better discussion.
>Yep, that is good and I agree with that, I'll let it pass that i wasn't what you were saying earlier giving the context.
But it is what I said.
>But it still doesn't justify postponing/cancelling something just because it's "1", it's discrimination against that "1".
As to whether it is appropriate to postpone or cancel the event, I'd say that's up to the organizers, their goals, etc. If they specifically only want to put on a >=2 event, and they cannot, the justification seems adequate.
I'm not sure how, in that context, it equated to discrimination. I'd expect them to have cancelled regardless of the "1" in question, in this case.
>I'm not arguing that the definitions exist. I'm arguing your assessment that only using a particular one stifles discussion.
You said, if I understood correctly, that the definitions meaning "there are essential qualities applicable to all members of a group" was the only relevant definition for purposes of this discussion.
I said, no, the other definitions are complementary, and must be considered.
You said no, they should not be considered.
I am unclear on how this is not stifling to the discussion.
If the doctor can't effectively predict what benefit said scan or pill regimen will provide (50% chance of 10 year life extension,90% chance of 2 years...? not even getting into quality of life), how does the consumer make informed choices? This approach devolves to if you have money you get care, if not, you don't, regardless of need or efficacy. Similar to any other market.
There or some easy decisions to make in medical care (set the broken bone, stop the bleeding), but less so when it comes to areas driving price increases.
Adding layers is potentially problematic, as is removing them. Single payer and no-payer are attractive solutions due to ideological simplicity.
I wonder if a tax funded provision of care rationed similarly to the organ transplant system would be workable...
Most people who are paying that much for pills are retired middle class people trying to stay healthy into old age. Or alive for a few more years. But people should be able to pay for typical levels of healthcare. The fact that this isn't true is a question of economics and employment opportunities, not entirely problem with the "healthcare system" itself.
> There or some easy decisions to make in medical care (set the broken bone, stop the bleeding), but less so when it comes to areas driving price increases.
> Single payer and no-payer are attractive solutions due to ideological simplicity.
I agree with this first sentence more than the second. These decisions are never all that simple. And they are made even more complicated or perverse when you ignore that the best alternative for a bureaucrat (private or public) approving treatments is saying "no" and going home for a Scotch. The best alternative for the patient is saying "yes" and spending $300k and live another year in diapers.
If people were spending their own money, they would also think about:
- grandkids that want to go to college
- underfunded soup kitchens in their neighborhoods
- not reverse mortgaging the family home they wanted to pass down to their loved ones
- going on a "farewell" cruise
And that's just one category of health care decisions. There are more mundane ones like "Should I try the generic treatment for a week to see if it helps? Or should I put $3k into the boutique one and save the hassle?" I wouldn't know how a (even highly qualified, well meaning) bureaucrat in Atlanta would make a better decision than the person getting treated.
> Most people who are paying that much for pills are retired middle class people trying to stay healthy into old age
What of all the people whose lifespan is cut early by disease? Getting cancer or some other serious disease at a young age just due to sheer dumb luck is less common, but still quite prevalent. Or let's just think about traffic accidents? It's just preposterous to me that people should ever have to worry about sudden illness or injury. If you're looking for bloat and overspending, why not slash the defense budget instead?
> The best alternative for the patient is saying "yes" and spending $300k and live another year in diapers.
Wait, wasn't this exactly what republicans criticized obamacare for? The accusation was that there were "death panels" that would decide whether it's "worth it" to put all that money into that one dying patient, or whether it's better spent elsewhere. So we don't like it when obamacare appears to be doing it, but now that obamacare is gone we want it?
> What of all the people whose lifespan is cut early by disease?
Actual insurance and government welfare programs are for things you can't otherwise save for. Let's not burn straw men, here.
> If you're looking for bloat and overspending, why not slash the defense budget instead?
That's fine, too. But paying for the healthcare of an entire country is far more expensive than even U.S. defense spending. And cutting defense spending doesn't address the structural problems of having party A pay party B to pay party C to produce good health in party D.
> The accusation was that there were "death panels" that would decide whether it's "worth it" to put all that money into that one dying patient, or whether it's better spent elsewhere.
I want the patient to be able to decide (for instance) that another year on the lam from the reaper isn't worth the high price tag. That only really works if the savings goes to what they want: family, charity, community, etc. and not back into the general fund of a government or corporation.
One issue here is that health care can get really complicated really fast. Which makes it quite a bit more difficult for many consumers to make an informed decision.
Because health care is complicated, in an idea world, there would be a layer to distill all of the complicated scientific information into simpler, scientifically sound recommendations. In theory, this is what your doctor should do. In practice, this system is currently broken in the United States. It is easy to demonstrate cases of over-treatment in the current medical system. (http://www.newyorker.com/magazine/2015/05/11/overkill-atul-g...).
If the consumer was paying for everything with full price visibility, would this change? I'm not sure. The problem here is a large amount of people would have no idea whether the prescription / test the doctor is requesting is worthwhile or bunk.
In fact, I think some of the over-treatment today is by "by patient request". One reason given for why doctors write antibiotic prescriptions for viral infections (which as we should know is scientifically useless and may in fact be harmful due to the potential of allergic reactions) is to make patients feel better by making it seem like something is being done. (http://ideas.time.com/2012/04/16/why-doctors-uselessly-presc...). The same probably goes for even more expensive cases (MRIs for most back pain cases, for instance).
Think of what we see in the "alternative medicine" market. There may be a few hidden undiscovered gems in that field, but in the majority of cases people pay sometimes a ton of money for what ends up being a rather expensive placebo effect at best (or harmful snake oil at worst). All of this both because medical science is difficult to understand (where glossy marketing is easy to understand), and also because in many cases medical science has unsatisfactory answers for people desperate to be healed.
I'm not saying that knowledgeable bureaucrats are completely correct (ideally the doctor and patient are making the informed decisions together, not the bureaucrats) but I can't see not having some layer that aims to eliminate the current perverse incentives in the system.
In my local calling area, the motives and reasoning were simpler. Some of us just wanted more TW2002 and LoRD instances. Some of us needed to cut the phone bill. And some of us did it to, well... 'do it' (cause there is nothing quite so attractive as power -_^).
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Or to be less glib, that's a great question, and like many, not simple to answer well.
Mostly, it seems like a lack of positive reinforcement and role models (leading to self selection out at early ages), mixed with sexism in a a variety of forms (leading to lack of opportunities, or hostile environment and self selection out at later ages).
But that's an oversimplification.