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Feb. 1, 2019 - Real Coffe - Scott Adams
07:57
Episode 398 Scott Adams: Reframing Healthcare as a Question of Systems Versus Goals
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Alright, let's try this again.
Now, with the third microphone.
Because my microphones keep breaking for some reason.
But I hope you can hear me.
This is going to be a single topic periscope.
And it's going to be on the topic of looking at healthcare and maybe a little bit about the wall.
In terms of systems versus goals.
Now, if you have read my book, How to Fail at Almost Everything and Still Win Big, you know that I talk about the limitation of having goals.
One of the problems is you don't know exactly what you want all the time.
Sometimes there might be multiple things that make you happy.
And it might limit your, let's say, your imagination for different solutions that could be even better than what your goal was.
So let me show you what this looks like in terms of healthcare.
Let's go to the whiteboard.
Alright, so here's a system for getting more health care.
The system is that you build walls and you improve competition, which the administration is doing.
Now, why do you need walls to have capitalism?
And of course, if you have capitalism, that makes you money and that creates wealth that can buy you health care, as well as other things.
So the question is, why do you need walls to For capitalism to work.
Well, here's a little economics lesson.
Capitalism can only work if you can protect wealth.
Period. If you can't protect wealth, you can't have capitalism.
So there's a reason that banks have walls, and that vaults exist, and that you have to show your ID when you're using your credit card, etc.
The entire capitalist system depends on being able to protect any wealth that gets created until it can be used by the people who created it.
If you create wealth and then other people can have it, if they want it, Then you can't really have capitalism for very long.
So I would argue that the border security is part of the system of protecting your assets because there is no other way to have capitalism.
It's not the only thing you're protecting.
You also have banks with walls.
You have buildings and offices that have security.
But in all cases, you can't have capitalism unless you also protect the assets.
And right now, if people can walk across the border in huge caravans and potentially take advantage of other people's assets directly or indirectly, then you're chipping away at capitalism.
So capitalism, we know, works.
And we saw today that Secretary Azar, if I'm pronouncing it right, Health and Human Services, has announced some new changes and regulations that would allow you to get your pharmaceutical meds cheaper.
And it's just a tweak with the law and with transparency and with kickbacks.
But there's also a broader set of plans that they have that I haven't looked at in great detail.
But they're actually doing a lot of work in terms of making sure that the market is more competitive.
So if you'd like to dig into that, there's a press release from Health and Human Services today.
That tells you all the things they're doing to maximize competition.
So you could say this isn't as good as you would like it, and you'd be on safe ground.
But all I'm going to say is that it's a system in which you can understand all the moving parts, and they're all well understood.
There's nothing controversial about this.
Alternative to this system, and again, I'm overgeneralizing, is goals, where you have Medicare for All, but you don't really know how to get there.
Because even, as you've seen, Howard Schultz and Mike Bloomberg, both Democrats, and they both said, yeah, but we don't know how to get there.
So there's no system that To get to the goal.
There are also goals of being kind and caring.
That's great. I love that goal.
I even like health care for everybody.
I love that as a goal.
And I like fairness.
If we could all agree what it was, which is impossible.
But in concept, I'd like a fair world where everybody is kind and everybody has health care.
But I don't know how to get there.
Except this way. So if anybody can come up with a system that can deliver these three things, you know, a system that would give me kindness to all the people who deserve it, Medicare for all or some version of universal health care, and fairness, if I could get that, I'm all over it.
I would support that in a heartbeat, but I need to know what the system is.
How can you get there?
Because raising taxes obviously won't do it.
So the thing that I wanted to add to this Is the notion that if you're looking at the wall in isolation, it's easy to get caught up in, gosh, is this just us being mean and not letting people over who have desperate problems and are just trying to make a better life, etc. And you could have great empathy for the people who are coming across illegally, and I do, but that doesn't make it a system.
It's still just sort of getting by and not really building a system.
Now, one of the things that I'm amused by the news is that apparently there was some gigantic fentanyl bust, and it happened when they checked the truck that was coming through one of the legal ports of entry.
And so some folks who are anti-wall said, well, here you go, it's the biggest bust yet.
And they weren't trying to go through some border area with no wall.
They went right through the main place and then they got caught.
To which I say, there's probably a good reason that they went that way.
And that good reason is, they had a big truck and you can't really take a truck over a rocky mountain or through a stream or over a wall.
They went where they went because we're doing a pretty good job of systematically closing off the other places.
Now, it's sort of an infinite whack-a-mole problem, but just because you found some people going through the easiest place doesn't mean you shouldn't close off the other places that they could go if they don't like that place.
So you want to make it as hard as possible in as many ways as possible so you can catch as many people as possible.
And... And that's your best solution.
All right. So you can still be against walls and all that, but it helps to keep a framework that one of these plans for, at least for healthcare, It involves a system that we know works, and it involves walls.
Walls around banks to protect assets, walls around homes to protect assets, and walls around countries to protect assets.
If you're not protecting your assets, you can't have capitalism.
So you're seeing some of the Democrats try to have it both ways.
They're trying to have it that they like capitalism, But they don't like protecting assets.
Can't have it both ways.
And that's all I wanted to add for now.
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