I want to discuss why a single payer system for health care is better than insurance. I am not going to go into ethics or what people deserve. Instead, I am going to focus on value and efficiency.
First, it is important to fully understand what insurance is. On an individual level, insurance is a bet. The house bets that an event will not happen. The gambler bets that it will. For the customer, flood insurance is a bet that there will be a flood that causes more damage than the cost of the insurance. For the insurance company, it is a bet that such a flood will not happen. On a group level, insurance is a form of welfare. It is essentially a means for distributing costs (you have probably heard of distribution of wealth; well, insurance is a way to balance distribution of debt). When the insurance company looses a bet, the money used to pay for the losses comes from the money all of the other customers are putting into the pot. As gambling, insurance is no different from any other kind of gambling. The house always wins, and they want you to spend as much as possible, which is why they offer so many different options. As welfare, insurance is actually pretty awful. Imagine a welfare system where those administrating it constantly skim the poor box. This is more than just compensation for work. Insurance companies have CEOs, other extremely highly paid management, as well as shareholders who walk away with the house winnings. No well designed welfare system goes to such extreme efforts to avoid helping anyone, just to walk away with the unused funds.
In short, insurance makes extremely poor and inefficient welfare. It makes excellent gambling, at least for the house, but unless gambling is the whole point, insurance is actually pretty awful. Economically, there is one useful thing that insurance provides: jobs. Of course, paying people to spend 40 hours a week digging random holes would provide jobs as well, and those jobs might actually produce real value (good exercise for the employees, if nothing else). Work for the sake of jobs is just plain stupid. If work does not generate actual value, then it is not worth doing.
The better solution is real welfare. Real welfare is not gambling. Done well everyone wins. Real welfare minimizes work, to maximize the help it can provide. Real welfare does not have executives that are paid more in a month than most people make in a lifetime, and it does not have investors who ultimately get paid from the work of others.
It is very clear that our current health care situation in the US is unacceptable (despite Obamacare). Aside from reducing costs (which not even the government seems interested in), the only way to fix this situation is to spread the cost of health care out. Insurance is a very poor way of doing this, because insurance is more about gambling than welfare. Long term, the costs of insurance on the economy are far worse than the long term costs of welfare, despite the loss of jobs associated with eliminating health insurance companies. Economically, a single payer system is superior in almost every way to what amounts to mandated gambling.
Showing posts with label gambling. Show all posts
Showing posts with label gambling. Show all posts
07 August 2015
17 November 2014
Universal Pre-K
http://national.deseretnews.com/article/2750/navigating-the-research-on-universal-pre-k-overhyped-or-silver-bullet.html
I just read this, and I see so many flaws in the various arguments that I cannot resist writing about it.
First, the argument is about whether the Federal government should devote several billions of dollars to make preschool part of the education system. There is some evidence that poor children are likely to make more money and are less likely to get involved in crime when they grow up, if they attended a preschool. There is also, however, significant evidence that the cognitive benefits of preschool disappear within 2 years of starting elementary school. The cost to the country of doing this is around $15 billion. One side of the argument claims that universal pre-K is the best way to improve education and situation of the poor. The other side argues that the benefits are primarily temporary, and the cost will be more than the return. At this point, I don't actually care who is right. Perhaps we need more research, preferably done by people with mixed opinions, to avoid confirmation bias.
The first problem with universal pre-K is the cost. Our nation is already heavily in debt, and if we cannot prove that the investment will pay off, perhaps we should not do it. The second is reach. While the evidence shows that poor children can gain substantial long term benefits from pre-K, there is no conclusive evidence that middle and upper class children benefit at all. Those supporting universal pre-K say that it will not be taken seriously if it only targets poor people, and they cite Head Start as an example of this. While this is probably true, it is not, perhaps a valid excuse for spending many times what is necessary. What I hear them saying is, "We need to spend $15 billion to get people to take this seriously." That money would probably be more effective spent as a bribe to get the people to pretend to take it seriously than it would to use it to offer preschool to those whom it is unlikely to benefit.
There is also a lot of mud slinging going on in this debate, which makes it very difficult to determine what is fact and what is opinion. There is one study that "was likely underfunded" (yeah, I don't know what that is supposed to mean either) that showed kids who attended pre-K actually did worse in math and language than kids who did not. The "fact" that it might have been underfunded is used to discredit it. Likewise, another study showed impressive long term benefits from pre-K, at a price of $90,000 per child. While this study may have been valid, the price tag for those results is just not an option.
One theory as to why benefits are observed is that preschool provides more social interaction than the home, improving the social skills of the children at an age where it makes a bigger difference. Perhaps (though it is not stated), middle and upper class children have more opportunities to gain social skills at 4 years old than lower class children? If this is not true, then this theory does not account for the discrepancy between lower class children and middle/upper class children. (Supposedly, poor families are actually having fewer children than middle and upper class families now, so maybe social interaction at home can have the same benefits, so long as there are several children.) Regardless, if this is true, we don't need to bother spending $15 billion extra on this. It is already proven that the benefits of the learning go away fairly quickly. If the social interaction is the key, then we could eliminate low income pre-K programs like Head Start and instead provide government funded day care, and it would be far cheaper. Day care provides a very similar social setting, and day care workers don't cost as much as trained educators. In fact, without the learning part attached, and presented as an aid to poor families where both parents work, it would be taken far more seriously than a preschool program justified primarily by limited and unreliable data.
One proponent of universal pre-K asks a question that is stupidly obvious. Discussing some of the problems with programs specifically targeting poor people, Steven Barnett asks, "Why would we do that? Why not just make it open to everyone?" The painfully obvious answer is $15 billion. I guess he just didn't think of that one. In addition to this, there are multiple claims that the $15 billion to $20 billion already being spent on low income preschool programs is being spent poorly. Not everyone agrees with this, but given the state of the rest of our education system, it is hard to believe that significant improvements are not possible.
Ultimately, the situation is complicated. Obama and other proponents of the idea seem to be prepared to throw huge amounts of money at in, just in case it works. There is evidence that it could be beneficial, but there is no evidence that it will be. None of the most influential studies mirrored the reality of the situation well enough to actually trust. The less influential studies all seem to be affected by many uncontrolled factors, as there is really no consensus between them. Studies targeting the middle and upper classes are unlikely to ever be conducted, because no one seems to care. What I see this as is a giant $15 billion experiment that will affect children all around the U.S., to see whether universal pre-K will help them or harm them. Maybe the potential for harm is not that high, but the price tag certainly is. $15 billion is enough money to pull over 1 million Americans out of poverty entirely. This would dramatically reduce the need for a preschool system designed to help poor children, and it would likely do far more for them than preschool ever could.
I don't care who is right in the debate over benefits, but I am opposed to spending huge amounts of money on things that have such a high risk of failure. Instead of arguing over what the data means, maybe we need to spend a fraction of that money doing more research, where the situations are closer to what they would be if universal pre-K was made available on the proposed budget. I might not care about who is right, but I certainly do not want our government to gamble even more money on huge social experiments that have a limited probability of paying off.
I just read this, and I see so many flaws in the various arguments that I cannot resist writing about it.
First, the argument is about whether the Federal government should devote several billions of dollars to make preschool part of the education system. There is some evidence that poor children are likely to make more money and are less likely to get involved in crime when they grow up, if they attended a preschool. There is also, however, significant evidence that the cognitive benefits of preschool disappear within 2 years of starting elementary school. The cost to the country of doing this is around $15 billion. One side of the argument claims that universal pre-K is the best way to improve education and situation of the poor. The other side argues that the benefits are primarily temporary, and the cost will be more than the return. At this point, I don't actually care who is right. Perhaps we need more research, preferably done by people with mixed opinions, to avoid confirmation bias.
The first problem with universal pre-K is the cost. Our nation is already heavily in debt, and if we cannot prove that the investment will pay off, perhaps we should not do it. The second is reach. While the evidence shows that poor children can gain substantial long term benefits from pre-K, there is no conclusive evidence that middle and upper class children benefit at all. Those supporting universal pre-K say that it will not be taken seriously if it only targets poor people, and they cite Head Start as an example of this. While this is probably true, it is not, perhaps a valid excuse for spending many times what is necessary. What I hear them saying is, "We need to spend $15 billion to get people to take this seriously." That money would probably be more effective spent as a bribe to get the people to pretend to take it seriously than it would to use it to offer preschool to those whom it is unlikely to benefit.
There is also a lot of mud slinging going on in this debate, which makes it very difficult to determine what is fact and what is opinion. There is one study that "was likely underfunded" (yeah, I don't know what that is supposed to mean either) that showed kids who attended pre-K actually did worse in math and language than kids who did not. The "fact" that it might have been underfunded is used to discredit it. Likewise, another study showed impressive long term benefits from pre-K, at a price of $90,000 per child. While this study may have been valid, the price tag for those results is just not an option.
One theory as to why benefits are observed is that preschool provides more social interaction than the home, improving the social skills of the children at an age where it makes a bigger difference. Perhaps (though it is not stated), middle and upper class children have more opportunities to gain social skills at 4 years old than lower class children? If this is not true, then this theory does not account for the discrepancy between lower class children and middle/upper class children. (Supposedly, poor families are actually having fewer children than middle and upper class families now, so maybe social interaction at home can have the same benefits, so long as there are several children.) Regardless, if this is true, we don't need to bother spending $15 billion extra on this. It is already proven that the benefits of the learning go away fairly quickly. If the social interaction is the key, then we could eliminate low income pre-K programs like Head Start and instead provide government funded day care, and it would be far cheaper. Day care provides a very similar social setting, and day care workers don't cost as much as trained educators. In fact, without the learning part attached, and presented as an aid to poor families where both parents work, it would be taken far more seriously than a preschool program justified primarily by limited and unreliable data.
One proponent of universal pre-K asks a question that is stupidly obvious. Discussing some of the problems with programs specifically targeting poor people, Steven Barnett asks, "Why would we do that? Why not just make it open to everyone?" The painfully obvious answer is $15 billion. I guess he just didn't think of that one. In addition to this, there are multiple claims that the $15 billion to $20 billion already being spent on low income preschool programs is being spent poorly. Not everyone agrees with this, but given the state of the rest of our education system, it is hard to believe that significant improvements are not possible.
Ultimately, the situation is complicated. Obama and other proponents of the idea seem to be prepared to throw huge amounts of money at in, just in case it works. There is evidence that it could be beneficial, but there is no evidence that it will be. None of the most influential studies mirrored the reality of the situation well enough to actually trust. The less influential studies all seem to be affected by many uncontrolled factors, as there is really no consensus between them. Studies targeting the middle and upper classes are unlikely to ever be conducted, because no one seems to care. What I see this as is a giant $15 billion experiment that will affect children all around the U.S., to see whether universal pre-K will help them or harm them. Maybe the potential for harm is not that high, but the price tag certainly is. $15 billion is enough money to pull over 1 million Americans out of poverty entirely. This would dramatically reduce the need for a preschool system designed to help poor children, and it would likely do far more for them than preschool ever could.
I don't care who is right in the debate over benefits, but I am opposed to spending huge amounts of money on things that have such a high risk of failure. Instead of arguing over what the data means, maybe we need to spend a fraction of that money doing more research, where the situations are closer to what they would be if universal pre-K was made available on the proposed budget. I might not care about who is right, but I certainly do not want our government to gamble even more money on huge social experiments that have a limited probability of paying off.
10 July 2014
D&D for Old Folks
I have had a strong opinion on D&D and similar role playing games for some time. Unlike popular opinion, my opinion is not a negative one. Pen and paper role playing games, like Dungeons and Dragons, can be highly educational. When played in groups (group play is typical), they also improve interpersonal skills like communication and team work. When played properly (role playing as opposed to pure hack and slash), they also help participants to look at things from other points of view. No computer game can compete with a face to face, pen and paper RPG.
There are some potential problems with role playing games like D&D. Occasionally, we hear stories about people who have become hopelessly addicted to the game. On even more rare occasions, we hear stories about someone doing something stupid that could be linked to their D&D game. These almost always get blown out of proportion (these are nearly always mentally unstable people, and there has never been any evidence that D&D caused the poor behavior), but addiction is a valid concern. Thankfully, there is no evidence that D&D or any other pen and paper RPG is any more addictive than similar video games. In fact, because pen and paper RPGs require scheduling play time around the schedules of several people, most groups play only once a week to once a month (the exception is high school groups which sometimes play 5 days a week during lunch periods and tend to have higher addiction rates as a result). People who play computer RPGs tend to play at least several days a week for a few hours, and many play several hours every day. Addiction to computer games in general has become a big enough problem to get specialized attention from the medical field. Addiction to pen and paper RPGs is so uncommon that people make a big deal about it when cases are discovered. (Ok, so part of the reason for this is that more people play computer RPGs, but the point still stands.)
Now, to get to the point. I have had this idea for over 10 years, but I have not really had time to do much about it. I just read an article that reminded me of it and gave me a very good reason to discuss it here. This article discusses seniors that gamble out of boredom. Evidently, a significant percentage of U.S. seniors gamble because they do not have anything better to do. Some claim they do it for the social interaction, however, upon observation, it is found that almost no social interaction takes place in the casinos aside from lunch time. The rest of the time is spent gambling on very non-social machines. The gambling itself offers no social interaction. All of the social interactions occur during the trips to and from the casino and during meals. In most cases, according to studies funded primarily by the gambling industry (red flag), most seniors gamble responsibly. The problem I see is that they think they are spending their money on a social experience, but they are not getting the actual experience. Besides the false advertising (casino ads typically show groups of people having positive social experiences, when in reality most gamblers are sitting at a machine, ignoring everything else), these people are craving social experience, but they are not getting what they need. In the article, one person is quoted as lamenting that her generation did not invent something better for seniors to do than squander their money gambling. She is wrong. Her generation (or maybe the one directly before her) did invent something superior to gambling.
Most older people choose to gamble out of boredom. When people get old, fun physical activity becomes difficult and painful, so the normal things younger people do for fun are either painful or even outright dangerous for older people. The current older generation is not very computer literate, and thus the computer games with good long term value can be very difficult for them to learn. They also grew up during a time when most social interaction was face to face, and they prefer that to the impersonal online interactions found in computer games. My solution is Dungeons and Dragons (or any other pen and paper RPG).
Dungeons and Dragons allows people to try new things by proxy. An 80 year old man may not have the physical capacity to travel much, but in an RPG, he can role play a 20 year old youth with very good stamina and strength. Through his character, he can experience things and places that he cannot experience in person due to his age. Even further, he can experience things through his character that no one can experience in real life. Though it is often frowned upon, women can play male characters and men can play female characters (it also tends to be more difficult to role play characters that are a different gender from the player). Further, addiction is less problematic for older people, in some degree, because they tend to be less susceptible to addiction, and because gaming addiction is far less likely to interfere with their lives.
Note that not all pen and paper RPGs are based on a fantasy environment. A D&D-like modern RPG system exists called Modern D20. Shadowrun is another RPG system that is futuristic (the genre is often called cyberpunk). There are also superhero RPGs, anime RPGs, steampunk RPGs, and nearly any other kind of RPG you can think of. And if you are worried about claims of a certain RPG being evil and demonic, the involvement of any brand of supernatural power (good or evil) is up to the DM (who hosts the game) and the players. (D&D has some seriously evil monsters, however, it has a selection of monsters so large that the DM must chose a subset of them to use in the game. In fact, a game heavy on role playing and light on combat might not include any of the fantasy monsters available for the game.) Ultimately, the direction and content of the game is up to the DM and the players. If they are really set on gambling, they could even play a game where their characters go on a casino road trip (a good setting for this might be the 1800s, when much of gambling was done face to face with a dealer and other players). At least this way, the money squandered would be fake.
Old people, especially those in elderly care homes, do not have much to do with their time. They often suffer from extreme boredom. Many have taken up gambling as a hobby, because they think it will provide social interaction that they crave. Unfortunately, it does not, and it costs money than many elderly people cannot afford to lose. Role playing games are less addictive and far cheaper than gambling. They offer a wide variety of possible social interactions. They provide good mental stimulation and experiences that can not be had any other way. With a good DM, even the learning curve is quite shallow (players tell the DM what their characters do, and the DM explains what happens in response; the DM can handle most of the rules). I think that we could solve this gambling problem for elderly people by offering face to face, pen and paper role playing experiences.
There are some potential problems with role playing games like D&D. Occasionally, we hear stories about people who have become hopelessly addicted to the game. On even more rare occasions, we hear stories about someone doing something stupid that could be linked to their D&D game. These almost always get blown out of proportion (these are nearly always mentally unstable people, and there has never been any evidence that D&D caused the poor behavior), but addiction is a valid concern. Thankfully, there is no evidence that D&D or any other pen and paper RPG is any more addictive than similar video games. In fact, because pen and paper RPGs require scheduling play time around the schedules of several people, most groups play only once a week to once a month (the exception is high school groups which sometimes play 5 days a week during lunch periods and tend to have higher addiction rates as a result). People who play computer RPGs tend to play at least several days a week for a few hours, and many play several hours every day. Addiction to computer games in general has become a big enough problem to get specialized attention from the medical field. Addiction to pen and paper RPGs is so uncommon that people make a big deal about it when cases are discovered. (Ok, so part of the reason for this is that more people play computer RPGs, but the point still stands.)
Now, to get to the point. I have had this idea for over 10 years, but I have not really had time to do much about it. I just read an article that reminded me of it and gave me a very good reason to discuss it here. This article discusses seniors that gamble out of boredom. Evidently, a significant percentage of U.S. seniors gamble because they do not have anything better to do. Some claim they do it for the social interaction, however, upon observation, it is found that almost no social interaction takes place in the casinos aside from lunch time. The rest of the time is spent gambling on very non-social machines. The gambling itself offers no social interaction. All of the social interactions occur during the trips to and from the casino and during meals. In most cases, according to studies funded primarily by the gambling industry (red flag), most seniors gamble responsibly. The problem I see is that they think they are spending their money on a social experience, but they are not getting the actual experience. Besides the false advertising (casino ads typically show groups of people having positive social experiences, when in reality most gamblers are sitting at a machine, ignoring everything else), these people are craving social experience, but they are not getting what they need. In the article, one person is quoted as lamenting that her generation did not invent something better for seniors to do than squander their money gambling. She is wrong. Her generation (or maybe the one directly before her) did invent something superior to gambling.
Most older people choose to gamble out of boredom. When people get old, fun physical activity becomes difficult and painful, so the normal things younger people do for fun are either painful or even outright dangerous for older people. The current older generation is not very computer literate, and thus the computer games with good long term value can be very difficult for them to learn. They also grew up during a time when most social interaction was face to face, and they prefer that to the impersonal online interactions found in computer games. My solution is Dungeons and Dragons (or any other pen and paper RPG).
Dungeons and Dragons allows people to try new things by proxy. An 80 year old man may not have the physical capacity to travel much, but in an RPG, he can role play a 20 year old youth with very good stamina and strength. Through his character, he can experience things and places that he cannot experience in person due to his age. Even further, he can experience things through his character that no one can experience in real life. Though it is often frowned upon, women can play male characters and men can play female characters (it also tends to be more difficult to role play characters that are a different gender from the player). Further, addiction is less problematic for older people, in some degree, because they tend to be less susceptible to addiction, and because gaming addiction is far less likely to interfere with their lives.
Note that not all pen and paper RPGs are based on a fantasy environment. A D&D-like modern RPG system exists called Modern D20. Shadowrun is another RPG system that is futuristic (the genre is often called cyberpunk). There are also superhero RPGs, anime RPGs, steampunk RPGs, and nearly any other kind of RPG you can think of. And if you are worried about claims of a certain RPG being evil and demonic, the involvement of any brand of supernatural power (good or evil) is up to the DM (who hosts the game) and the players. (D&D has some seriously evil monsters, however, it has a selection of monsters so large that the DM must chose a subset of them to use in the game. In fact, a game heavy on role playing and light on combat might not include any of the fantasy monsters available for the game.) Ultimately, the direction and content of the game is up to the DM and the players. If they are really set on gambling, they could even play a game where their characters go on a casino road trip (a good setting for this might be the 1800s, when much of gambling was done face to face with a dealer and other players). At least this way, the money squandered would be fake.
Old people, especially those in elderly care homes, do not have much to do with their time. They often suffer from extreme boredom. Many have taken up gambling as a hobby, because they think it will provide social interaction that they crave. Unfortunately, it does not, and it costs money than many elderly people cannot afford to lose. Role playing games are less addictive and far cheaper than gambling. They offer a wide variety of possible social interactions. They provide good mental stimulation and experiences that can not be had any other way. With a good DM, even the learning curve is quite shallow (players tell the DM what their characters do, and the DM explains what happens in response; the DM can handle most of the rules). I think that we could solve this gambling problem for elderly people by offering face to face, pen and paper role playing experiences.
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