But think of it: fundamentally insurance is a finite pool that insures against finite losses. Home owners insurance, for example, only pays out at most what the replacement value of your home is, and car insurance only pays out at most what is the replacement value of your car.
This model clearly breaks down--even in government-run "single payer" systems (such as the example I gave about British health care) when you come up against the potentially unbounded cost of a major medical emergency.
After all, what is the replacement value of a human being? $100,000? $1 million? $10 million?
What that strongly suggests to me is that as a society we place more value on preserving human life regardless of cost, regardless of the fact that this cannot properly be handled in a free market environment.
And by definition in the edge cases where the free markets break down is where society should step up and socialize costs.
This isn't a matter of "privatizing the losses"; the breakdown has to do with the potentially unbounded cost of health care for an individual due to circumstances that cannot be properly predicted. For example, I know someone who needs nearly continuous care for the simple reason that she was unfortunately in a car accident that wasn't her fault. Allowing her to die because it's too expensive to let her live is not an option, and assuming that corporations are boundless fonts of endless money is absurd--and penalizing an insurance company because it is unable to cover an unexpected multi-million dollar loss (because as a society we don't want her to die) doesn't really fit the notion of insurance as covering a finite (and maximum) amount.
Thus, door 'C': socialize high-cost patients.
We already do something akin to this with Medicare; the whole point of Medicare was to cover the expenses of the elderly rather than having those expenses covered by private insurance. (And the structure of Medicare is pretty similar to what I'm proposing, with Medicare effectively serving as a back-stop against private supplemental insurance. We just think of Medicare as the base-line insurance and supplemental insurance as covering the 'gaps', when in some sense it's really the other way around.)
Because currently no mechanism exists to force a corporation to take action.
My hypothetical above was premised on the idea that if we were to listen to our emotions and demand that a corporation not leave the health care business simply because it was unprofitable--and after all there are lives to save--that we would create a mechanism which would effectively exempt corporations from folding.
And note if the only way I can exit a business is to zero out millions in assets I own, that's a pretty hefty burden being placed on me.
I would think the solution would be quite the opposite: subsidize the ramp-up costs for generic drug manufacturers so that when drugs fall out of patent they can be easily manufactured by other drug makers.
My understanding is that there are essentially two classes of drug manufacturers--those which make patented compounds, and those which make generics. Patented compounds tend to be very expensive because it can cost billions to bring a new compound to market, largely because of the cost to get FDA approval for the compound--so by default patented compounds will be extremely expensive so that those profits can be used to pay off the R&D costs and subsidize future R&D costs for future compounds. Generics, on the other hand, are cheap because they are not paying for R they're just paying to make the compound.
The real problem, of course, goes around the high R&D costs for creating new compounds. And it is there where, if I were King For A Day, I would concentrate my efforts, by ramping up government funding of research efforts by providing more grant money to universities for basic R&D research into newer compounds, and I would also see if I couldn't reduce the regulatory overhead for obtaining FDA approval.
Like soylent green, companies are made of people.
And a "company" is just a legal fiction by which a group of people can hold property and IP rights without those property rights being held by any single individual, so that the company can continue to operate when there are changes in personnel.
So if you insist on making a company continue to operate even when it is no longer profitable--as was in my example--then at some level that company still must contain people: a company without any people cannot function except as a passive property owner.
Which means at some level, the practical outcome of requiring a company to actively do something implicitly would make it illegal for that company not to have people working for it--and would require the owners of that company to be active participants, even if only in the management of that company's activities.
Which is a long way of saying that you are effectively requiring someone to act against his will and work for the company without being able to quit--which is akin to slavery.
Are you saying healthcare should be handled by the government because healthcare is not always profitable?
This goes to a major complaint I have about the way we seem to be approaching health care in the United States: it's always an "either/or" proposition. Either the entirety of 1/6th of the economy in the United States can be handled by free markets, or the entirety cannot. There is never any consideration that perhaps one part isn't profitable under the current rules and needs a rule tweak, or that a small part doesn't work under free market rules and should be socialized but the rest should use free market rules.
Take, for example, discussions about the unprofitability of Emergency Room operations. I've seen the fact that hospitals who run an ER are required to treat anyone--and thus wind up treating the uninsured for minor ailments as a suggestion that the entire health care system is broken and so we need single payer.
But does anyone in the debate consider the possibility that ER visits only represent a very small percentage of the overall costs to the health care system? Does anyone consider the possibility of perhaps just socializing the costs for ER visits--by using taxpayer dollars to implicitly insure the uninsured who use an ER, while leaving the rest of the system alone?
Or take the fact that it is profitable for insurance companies to dump high-expense patients who run up large insurance-paid health care bills due to things like cancer. "Oh, we must switch to single payer, otherwise insurance companies will dump expensive patients and leave them to die." (Never mind that in Great Britain, they are implicitly dumping expensive older patients by pushing them onto the Liverpool Care Pathway without their consent. Bean counters are bean counters regardless of if they work for the government or for private corporations.)
But did anyone consider the possibility of the government backstopping insurance companies for high-expense patients, by (for example) putting a cap on the amount of money an insurance company must pay out in the lifetime of an individual (call it $1 million)--then when you hit that cap, the money beyond that cap comes from the government, filtered through the insurance company? That is, we socialize costs for expensive patients, while privatizing costs below the cap.
Ohhhhh, no. It's "either/or." Because we're too stupid to think of anything more subtle than reshaping the entire industry to fit either in the mould of Ayn Rand or in the mould of Karl Marx.
This is a slippery slope to slavery, requiring people to do something against their collective will.
"if you are in the healthcare business..."
You know where this leads, don't you? "We've decided to exit the health care business because the requirements to manufacture drugs that are no longer profitable has left us an unprofitable company.
Well, you can't exit the healthcare business anymore.
What people seem to be missing in all of the comments above is that Amazon and Google are investigating not just using unmanned arial vehicles, but they are also investigating using computer-controlled unmanned arial vehicles: that is, arial vehicles that are not flown with a human operator. So questions about "line of sight" or the nature of the license a human operator holds ignores the whole point of their research.
Beyond this, in order for a company like Amazon to make drone deliveries profitable, we're not talking about a handful of these devices. We're talking about a whole swarm of them making tens of thousands or hundreds of thousands of trips a day in a congested area like Los Angeles, in and around the congested class B airspace of LAX, around the congested class C airspace around Burbank, Ontario and John Wayne, by helicopter traffic carrying police, news reporters and tourists, by student pilot traffic out in the San Fernando Valley.
(If a UPS driver makes 100 deliveries a day, as an article I recently read suggested, and assuming an out and back from a warehouse in El Monte takes on average an hour--half an hour each way--and assuming drone deliveries are handled during the same 10 hour window UPS driver operate--this implies it would take around 10 drones to replace that one driver, each making 10 deliveries a day. Multiply this by (as a guesstimate) 1,000 drivers in the Los Angeles area, and you're talking about 10,000 automated pilotless drones swarming the LA skies.)
I completely agree, thank you. Too often I've seen managers imply strongly that overtime is required, and on almost every project I've worked on, the overtime was only required because the projects were so poorly mismanaged in the first place.
What's sad is that so many IT projects are mismanaged that most people assume it's the norm.
It seems to me the real problem is separating drone traffic--including drones bought by amateurs and self-built drones--from passenger carrying aircraft. Meaning rather than sending commands causing drone traffic "swarms" to self-separate or to prevent them from flying outside of their desired area--which strikes me as problematic if you want ot use a drone to inspect a pipeline or inspect telephone wires (for example)--wouldn't it be better to simply create advisories to help separate drones from passenger airplanes?
For example, wouldn't it be better to simply advise drone operators to keep their aircraft 400' AGL (or lower) and keep them out of the approach corridors of various airports (and publish those locations and encourage drone manufacturers to provide maps), and pass laws which make it a potentially criminal offense to operate a drone above 400' or in a landing corridor unless your drone has a transponder, you're in constant contact with ATC (and are being actively separated by ATC) and the drone has the ability to land itself when communications with its operator is lost?
Yes, it'd be a bitch if two drones collide. But there you're just talking about property damage. What frightens me is some idiot with a DJI Phantom and a GoPro trying to get a close-up of a 737 carrying passengers as it attempts to land at LAX--and getting his toy sucked into the engine, taking that engine out and risking everyone on board and everyone on the ground.
I think the author's original focusing on C++ as an example of "worse is better" is a sad distraction. Clearly C++ was designed with the goal of being compatible with C. There are plenty of examples of languages which attempted to solve object-oriented programming but threw away backwards compatibility as a design goal: D, Java, and C# come to mind.
That said, I think he does have an interesting point about our unwillingness to sit down and carefully consider our response to problems as they arise during development--that we are constantly chasing incremental changes without considering the technical debt that arises. I've seen it particularly inside many of the companies I've freelanced to; they consider their software an asset rather than a depreciating liability, that must be preserved at all costs--even if that cost is increased technical debt that makes maintenance nearly impossible.
But the real source of the problem, in my opinion, is not a culture which thinks "worse is better." It may appear that way, because many companies engage in tradeoffs which, to the casual observer, seems like they really consider "worse" as "better." The real problem is that many corporations and many organizations don't necessarily reward competence, because they are often run by the incompetent. The Dunning-Kruger effect extends beyond self-assessment. Thus, they treat software as an asset rather than as a depreciating liability: management is unable to properly assess their internal processes and the value of the result. All that work, and we're supposed to throw it away?
The scary part is that to many of the organizations I've freelanced to, too much competence creates organizational friction. The places where I've done work who've ranked my work the best are exactly the places where I've "phoned it in", so to speak, only going a little bit above the call of duty. Go too much above the call of duty, pause everyone to have a considered response and to carefully do what is right, and you find yourself up against very powerful forces who, thanks to their inability to self-assess, push back hard.
"El Monte Tower, Piper five-niner-niner-seven-yankee, ready to go runway one-niner."
"Piper niner-seven-yankee, El Monte Tower, maintain runway heading, clear for takeoff runway one-niner."
"Piper niner-seven-yankee clear for takeoff."
I sorta miss El Monte and the Piper I was renting in Los Angeles...
Wind displaces coal and thus reduced the energy cost of caring for people with lung disease, but your measure misses that.
Actually that should be factored into the higher insurance and liability costs of mining and using coal, as well as motivates a drive to make coal safer.
For example, Duke Energy is facing a massive $10 billion dollar cleanup for spilled coal ash. That $10 billion will eventually be paid for by consumers of electricity generated by Duke in higher electric costs--which simply reflects the actual higher costs of coal than was originally estimated.
Meaning improper estimates do self-correct--unless government steps in and tips the scales, 'natch.