It’s quite obvious that making money has trumped ethics in US companies for a long time now.
Look what united healthcare does to its “customers” to make more money.[1]
Every last one of them should be rotting in jail, but that ain’t good for the ol GDP which is more important that peoples lives.
And why shouldn't it when there is zero negative ramifications for being completely fucking unethical?
It's like a video game where the more depraved your thinking is, the more money you make off it, and the rest of the characters sit around like NPCs and just let it happen. Well, maybe they don't, but when they pull a Super Mario Brothers trick the entire state apparatus is used to track them down and imprison them.
The people making obscene amounts of money give zero shits about that.
They live in private neighborhoods with private security guards and send their kids to private schools. Once they get enough money they fly on private jets and go to private islands to private parties that you're not invited to.
Simply put the consolidation of wealth in a very small percentage of the population always leads to outcomes like this. These people become completely disconnected from the reality that 98% of the rest of their country lives in.
You cannot build morals through legislation. Ultimately all systems rely on the individual to behave responsibly and morally. You cannot legislate your way out of that.
The collapse of collective consideration is a major reason the west is in decline. Championed by neoliberals without insight into history, it seems.
You can absolutely disincentivize unethical behavior through legislation though, whether they believe it at the core of their being or not. See slavery, murder, rape, robbery, etc. There will always be loopholes people can exploit, but that doesn't mean legislating away the larger ones doesn't have an effect.
Legislation on education curriculums can also have an impact on people's core morals, though that can be tough when even concepts like "share your toys" and "slavery was wrong" can be called indoctrination these days.
You can’t build a moral society without laws eliminating unethical parasitical business models either.
That is a very false and misleading dilemma.
Coordination matters. And coordination is too hard to do as a call for everyone to just be good.
If you live in a jungle of “free” actors (unconstrained by a need to compete constructively), the good path becomes unrealistic for everyone. And everyone but a few, have to work increasingly harder to pay off the damage of those few.
Or suffer the unrelenting undertow on their lives as highly rewarded parasitic behavior finances its own continued growth.
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What would a single chart of computing power devoted to commercial surveillance and feed manipulation, on hire to actors both good and bad, look like?
I can tell you, that the scrapbook and organic sharing aspects of the major social networks, even with non-surveillance personalized ads, would be profitable with a small fraction of the servers being used to optimize users for advertisers. If that wasn’t the enabled bar.
In the meantime, the leverage compounds as how do good actors who need to advertise compete without themselves feeding these highly centralized surveillance/manipulation machines? Even while they increasingly siphon off the margins of their revenue as real producers?
And how can direct competitors avoid becoming monsters? Whatever OpenAI’s natural good intentions, high or low: to compete with Google and Facebook in the consumer market they will also have no choice but to also start and innovate new ways of extracting surveillance/manipulation value from users.
Not just ads to cover natural costs, but s/m driven ads to keep up with the s/m margins and therefore investment by competitors they have to compete with.
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Without guardrails for everyone, everyone (at a practical level) is forced to be actively or passively complicit in increasing damage as a major growth industry.
Margins for profits in legally externalized negative outcomes are, by definition, better than for productive on-their-merits businesses.
I’m not arguing for a lack of regulation or a jungle. Far from it. But I’m pointing out that many people behave within the law but not in the spirit of it, for example.
Google exists, Facebook exists, both require intrusive advertising technology that has undermined democracy, led to large scale violence, etc. and it’s legal, and thousands of nerds make it happen.
Ah yes, human history is full of societies that never legislated morality. They always trusted in the individual. After all we all remember the nature of God's law and the ten commandments - Thou shalt follow your conscience.
Humanity is a largely defined by our exercise of legislating morality. For a lack of insight into history you should consult a mirror.
I didn’t say don’t legislate, I said it is not enough. The responsibility ultimately lies with the individual.
If I’m an academic and I want to pursue being a professor over helping a student, that’s my choice and no system will stop me. That’s why so many PhD students are endlessly screwed over by their supervisors so they can fuel their career.
Individual morality is what maintains institutions and the west has replaced that culture with selfish neoliberalism and now it is screwed.
This doesn't make any sense. Is it individual or up to the culture? You have a culture but it ultimately lies with the individual? So what was this culture before? How can the ultimate responsibility ever be displaced by any culture if it's up to the individual ultimately? Is your claim neoliberalism single handedly altered the nature of morality? You don't think something like students getting screwed can see improvements if legislated? Selfishness was invented within the last 100 years?
Sorry, but imo your argument is just bad. It's just griping about neoliberalism dressed up as some argument whose terms wouldn't even pass a type checker level of logical validation. And it's also boring. Neoliberalism is so easy to dunk on these days and yet you couldn't even manage to do it convincingly.
I was chatting with someone about the evils of capitalism. My position was that capitalism was viable as long as culture controlled capitalism. When culture capitulates to capitalism it's a death spiral.
When I speak with overseas friends there's often a sense of "of course" or "reasonable" moral lines in the relationship between their culture and where capitalism can't tread. That seems completely gone right now in the US, though it's been heading in that direction for decades. It was mediated by social constructs that have since been completely eradicated.
EDIT: Always interesting to watch comment points go up and then come down.
If I have any hope for the future of America it is that the upcoming generation finds 'Industrial Society and its Future', and instead of becoming radicalized, simply turns its back on tech fetishization.
Almost any reply mentioning that capitalism actually could have some problems on HN ends up being controversial. I can only assume some hate it and others worship it like a god.
In practice the system is such that 'everyone' doesn't really seem to include the people making a lot of money they are effectively outside the system the rest of us have to deal with.
> And why shouldn't it when there is zero negative ramifications for being completely fucking unethical?
Why is there a requirement for consequences to act moral? If I have to have a threat of punishment to be good, then I'm not being good and it's all transactional.
Because, "opt-in ethics" turns stronger ethical preference into a game theoretic disadvantage.
There are two populations: population A is those who prefer ethical behavior internally and would volunteer for it even if not compelled. Population B is those who don't prefer ethical behavior internally, wouldn't volunteer for it, and must be compelled to act ethically from without if they are to act ethically at all.
In a landscape that impartially disincentivizes unethical behavior, both A and B can coexist.
But in a landscape that DOES NOT impartially disincentivize unethical behavior, everyone acts the same as before—unless there's a benefit to acting unethically. In which case, A, those who prefer to be ethical for its own sake, will inevitably be outcompeted by B, those who engage in any behavior regardless of ethics, so long as that behavior confers advantage.
Enough of that on a long enough time scale and the voluntarily ethical population just disappears.
So, either we enforce ethical behavior (even on those who need no forcing), or we create an unethical free-for-all waiting to happen.
In some cases the "waiting to happen" stage can last a surprisingly long time. Centuries, maybe. But never, as long as B's exist and are free to act, without end.
One solution to this problem that was popular in certain ancient societies was, "Round up and execute all the B's." But A) that's not very ethical, so we can't do that without becoming B's ourselves; and B) you can't tell who is a B just by looking at them, or their skin color or race or eye color or religion or whatever; and C) B's have a maximal incentive to become those who decide who is to be executed for being a B, so the whole thing is prone to MASSIVE corruption.
So the thing Liberal societies have done is create systems where we punish BEHAVIOR rather than trying to classify people. And it works, as long as we do the "impartially disincentivizing unethical behavior" thing I mentioned before.
Typically the behavior is "Very slowly, then suddenly all at once". Which makes issues easy to ignore and by the time all at once happens there is no time to actually deal with it.
>Why is there a requirement for consequences to act moral?
See, most people don't want to murder and kill other people. For them we don't need to make laws saying murder is wrong and we'll hook your ass to ole'sparky if you proceed to do it.
For you, we do need to make that law so you have to think twice about carving people up like cantaloupes, and for dealing with those that do break the law.
A lot of law is the encoding of moral and ethical behavior. We didn't have the law, some people acted immoral, then we made the law to punish said behavior. For many people this pushed them away from the grey area between legal behavior that is immoral because if they act unethical new laws would be developed to punish them further (and people wonder why we have so many laws in the first place, quit acting like shitheads and we won't).
>then I'm not being good and it's all transactional.
Hurray, you've realized there is no god and the physical world we live in is built on cause and effect, thank you for catching up to the 20th century.
Cause: "you act good"
Effect: "I don't crack open your head and eat the tasty goo inside while screaming like a primate, since acting good allows us to build societies that have benefits for us all"
>Why is there a requirement for consequences to act moral? If I have to have a threat of punishment to be good, then I'm not being good and it's all transactional.
Morals are not universal; different people have different morals. Ancient Greece would not have batted an eye at relationships that we consider pedophilia. Slaves were kept in various societies over time, as recently as 6 generations ago, with varying levels of "morality" attributed to the practice.
That's one of the points in favor of capitalism. Most people are not innately good (even "normal" people). The goal of capitalism in theory is to cajole them into acting good by linking helping a customer with monetary benefits.
This sounds like goal post moving. Not much different from the people that say "We've just not tried the right kind of communism yet, I'm sure it will work next time".
Real world behaviors and markets are far more complex than a dogmatic market ideology.
You could change the society and laws. Right now this is of course not quite possible, but people can change that. Get rid of the oligarchs in the USA, for instance.
> And why shouldn't it when there is zero negative ramifications for being completely fucking unethical?
This is at the crux of everything in America. There are zero punishments for corporations and executives but there are bureaucratic lock ins for "customers".
And the answer is not merely regulation. Why shouldn't I be able to switch health insurance at ANY time? If I am unsatisfied with United Healthcare, I should be able to get anything else right away. Why impose laws on me?
The reason insurance companies have specific sign-up windows and enrollment periods is because the insurance model breaks down if anyone could switch at any time.
If someone could get the cheapest plan when they're healthy and then go switch to the best plan as soon as they started getting sick with something, everyone would do exactly that.
Insurance companies are required to accept patients regardless of pre-existing conditions, so there has to be something counter-balancing that to prevent people from only getting good insurance when they plan to use it.
Health insurers are required to accept all insureds without pricing the insured’s risks. It would increase premiums a lot if people could bounce around, as it would make already difficult to forecast medical loss ratios even more volatile.
This really is a problem only the government can solve, by continuously auditing coverage decisions at random, and sufficiently penalizing the companies that understaff at best, and intentionally deny or delay payment at worst.
Currently, years might go by until CMS audits the company, and even then, there are no consequences. Try arguing for a higher budget for more $400k doctors and $200k pharmacists in this environment.
The current situation is because one company can lower premiums by reducing quality of service, all the other ones have to also, and the buyer rarely buys on anything but price since it’s usually a third party buying it, like an employer.
> Health insurers are required to accept all insureds without pricing the insured’s risks. It would increase premiums a lot if people could bounce around, as it would make already difficult to forecast medical loss ratios even more volatile.
It's almost as if there is nothing insurance-like about US health "insurance" but the name.
Picture health insurance models laid on top of your car. Imagine your car gets totaled:
Your insurer says, "Hey, we're going to pay out $25,000 for your vehicle. So you have a $1,000 deductible, so that's $24,000, and then your copay for a total loss is $2,000, so that brings us down to $22,000. For total losses, your coinsurance as your contribution for your vehicle coverage is 20%, which is $5,000, so here's a check for $17,000. Buttttt... that's only if you're buying a Hyundai, otherwise the vehicle is out of network and you'll get a check for $8,500 instead."
US health insurance premiums are not insurance-like, as they are mostly a tax due to the forced wealth redistribution.
US health insurance coverage is very insurance-like, due to the out of pocket maximum.
Determining auto insurance coverage is very simple, because fixing/replacing cars is simple.
Determining health insurance coverage can't be simple, because fixing bodies is not simple. It's unknown what will and will not fix issues, how to even measure if there is an issue, and what will cause more issues and the cost/benefit of that fix.
The people who can fix the issue are a lot more rare and in demand than the people who can fix automobiles.
Also, the medicine is patented, and the seller of the medicine wants to be able to charge different prices to different buyers, hence all the games.
> US health insurance coverage is very insurance-like, due to the out of pocket maximum.
Well, other than that whole "out of network" thing...
> Determining health insurance coverage can't be simple, because fixing bodies is not simple. It's unknown what will and will not fix issues, how to even measure if there is an issue, and what will cause more issues and the cost/benefit of that fix.
Don't disagree - but that doesn't make what we have more "insurance-like".
I mean for most auto and home insurers, the "negotiated price" is a pretty loose thing. My insurer might ask for a quote from someone in their "preferred network" but I can get a quote from anyone I want to do the work, and if it's within x% of the preferred quote, it's automatically approved, otherwise someone from the insurer calls them and asks about the different pricing, and I've generally got that approval within 24-48 hours. (Which has also worked in my favor - with an auto glass claim, their repairer was insistent that third party glass would work fine, despite the HUD, but the other was able to demonstrate to the insurer that OEM glass was required).
Mostly this all boils down to "the healthcare industry in the US needs to be comprehensively revamped in any one of several different ways or methodologies, but likely won't be".
> but I can get a quote from anyone I want to do the work, and if it's within x% of the preferred quote, it's automatically approved,
It would be the same in healthcare if quotes were for 4 and low 5 figures with no future costs.
Not only does healthcare easily reach into the 5, 6, and 7 figures, but the health insurance company is also on the hook for myriad known and unknown issues caused by the initial costs.
> It would be the same in healthcare if quotes were for 4 and low 5 figures with no future costs.
I mean, this is somewhat the same in auto, too. Is one of the reasons you're recommended to go through insurance even if involved in an accident and the other party offers to give you cash for the initial quote - it's quite common that they start repair work and find other issues because they hadn't removed components or panels to give you a quote. Got cash from someone? Now you have to go back and say "Well, I know the quote said $1,500, but they took off the back quarter panel and found other issues and now it's $3,800..."
That being said, ICD codes, one of the cornerstones of billing, are predicated around "encounters", and certainly not "future costs".
> is also on the hook for myriad known and unknown issues caused by the initial costs.
There's a pretty huge asterisk to all that. Health insurers are adept at neatly sidestepping any obligations. They've fought and won many many times over in court on similar issues, "Insurer is denying me care and I'm going to die/suffer serious issues as a result!" Insurer's response, which has been held in court many times over? "We're not denying you any care at all, we're just declining to accept financial responsibility for it. You're free to get that care and be directly billed."
>There's a pretty huge asterisk to all that. Health insurers are adept at neatly sidestepping any obligations
This might sidestep some obligations, rightly or wrongly. They clearly do not sidestep "any" obligations. The amount of money spent on healthcare claims (medical loss ratios) is public information, available in their SEC filings. It is required to be 80% or more by law.
Every state government has an insurance regulator that also has to approve insurance prices, which are based on the cost of claims. The regulator is not going to let an insurer increase premiums just for profit.
Also, the non profit and for profit insurers have similar premiums, with the for profit insurers having ~3% profit margins or less, indicating a highly competitive market where the revenue is barely covering costs.
Shareholders aren't making any money either (10 year returns lag SP500):
Finally, the fact that Buffett/Dimon/Bezos tapped out on creating a competitor should really drive home how little the profit potential is in health insurance, and any less "sidestepping" of obligations would lead to higher premiums.
I worked in EMS. United battled a bunch of civil suits years ago where they had denied HEMS transports (helicopter transport) from accident scenes due to "lacking pre-authorization". For a car accident.
What would that even look like?
"This is John, I'm a paramedic working on one of your patients who was hit by a truck. We would like to fly him to the trauma center due to extensive multisystem trauma but we need your authorization. His name? Hang on, let me find his wallet. No, that's Smythe, S-M-Y-T-H-E, sorry, I know, it's a bit loud with the jaws of life in the background... Uhh, sure, I guess I can hold for a nurse consult..."
> Look what united healthcare does to its “customers” to make more money.
Hold short. They already lost a CEO to an act of revenge at the end of '24... and still didn't think that maybe they should stop, reflect on themselves and cut down on the BS before the next CEO catches a bullet?
I'm not sure if it's audacity, ignorance or stupidity that's at play here.
US Nurses are more and more using an "uber for nursing" apps which buy US credit data to change the rates they offer nurses - the more debt they have, the lower rates they get because they are judged to be more desperate.
This is exactly the sensational take (devoid of nuance and information) that we should collectively push back against. You should read the actual guardian article that Vice links to and investigate the actual reality.
If you actually look at the data, the vast majority of expenditures in medicine are the last few months of life. Paying ~500K to 1M to extend life ~6 months so you can spend the time hooked up to tubes and passing in and out of consciousness to deal with the pain is NOT HUMANE.
Facebook had zero ethics to start with. It's worked out very well for them so far so there's no surprise that they're keeping with a winning formula. It falls on governments to step in and tell them that enough is enough. Until that happens, don't expect them to start to act ethically on their own.
Making money and other types of material gratification has trumped ethics, notions of virtue and honor, and responsibility towards posterity in the general US population, the US ruling class, and US elites.
Ascribing this to just "US companies" is a cop-out or a cope. The US is in complete social collapse across the entire spectrum of society.
I am coming at this from a right-wing perspective.
There are few unambiguous bad actions by US tech companies. Certain people just hate them for various reasons that have more to do with their size/success than their actions.
Facebook in particular has been a scapegoat for years now.
Every last one of them should be rotting in jail, but that ain’t good for the ol GDP which is more important that peoples lives.
[1] https://www.vice.com/en/article/unitedhealths-alleged-plan-t...