If we're going to talk about how to "scale care" and how not to, then Buurtzorg has to be mentioned[0][1]. It's a Dutch home-care company that was started by nurses who basically got frustrated that managers got in the way of them doing their job. It operates by having a flat organization working with small teams of highly trained nurses, and trusting them to make the right decisions. The result is a low-cost provider of high-quality health-care.
So when the author says care "doesn't scale", they obviously mean "you need a one-to-one ratio of caretakers", which I fully agree with. But what they're also accidentally doing in the process is explaining why creating bigger teams with bigger hierarchies and structures does not appear to increase the efficiency of care.
Some projects do need big teams with hierarchies - even in healthcare. Effectively responding to a pandemic comes to mind. I suspect it's when the core problem to tackle most naturally breaks down like a tree - a hierarchy then mirrors the way the problem breaks down. For some projects, like general homecare, the efficiency sweet spot is a flat structure of autonomous individual teams, because it doesn't scale beyond those teams anyway.
And just like the author concludes, I find that there's something comforting about that.
It is not from the benevolence of the butcher, the brewer, or the baker, that we expect our dinner, but from their regard to their own interest. We address ourselves, not to their humanity but to their self-love, and never talk to them of our own necessities but of their advantages. Nobody but a beggar chuses to depend chiefly upon the benevolence of his fellow-citizens. -- Adam Smith
Care doesn't scale but self-interest scales efficiently. The baker who gets up at 3 am generally does so because she cares about her close circle of loved ones, far more than the world at large. In this sense care and self interest are not in tension but amplify by constructive interference.
But those 3am bakers are being exterminated by at scale corporate chains, no? Generalizes to just about anything that could reasonably be described using "artisanal". Social atomization inexorably spreads, and after thinking about it pretty hard for many years of travel putting eyeballs on "artisanal" processes I don't see any possibility of any other outcome. So we enjoy what is left.
To complete the thought, the baker example is explicitly in opposition to OP's point. In the economy we exist in, a 3am artisan baker does so explicitly out of a care for craft and community.
Yes. Precisely so. As it happens, we've been friends with a "3am baker" for decades. We do not envy her life, but we do intensely enjoy her taste. Delighted to pay double for it.
True-ish. But try talking to some old folks, about the vastly reduced scale of such volunteer work since (say) the 1950's. That "voluntary unpaid" stuff would include religious organizations, civic groups, housewives, ...
It seems to me that capitalism discourages that behavior. If the system is setup to be transactional, and you can't rely on others reciprocating altruism if you need it; then it seems like engaging in altruism would be for suckers.
"The story, then, is everywhere. It is the founding myth of our system of economic relations. It is so deeply established in common sense, even in places like Madagascar, that most people on earth couldn’t imagine any other way that money possibly could have come about. The problem is there’s no evidence that it ever happened, and an enormous amount of evidence suggesting that it did not.”
That's not true, and only seems true because of highly selective examples.
Money can force people to work, out of the necessity of survival. What it buys is reliability. You can force a toilet cleaner to come to work day after day, and the toilets stay clean.
But human progress, social progress, economic growth, does not solely come from people grinding through their jobs. It comes from people 'giving it their all', look at the great scientists, Newton, Von Nuemann, all the people at bell labs etc. These people create titanic economic value in their wake, and they are motivated by passion, which heavily mixes altruism with self interest.
Indeed, the 'developed economies' are precisely the ones that also allow 'care' to scale, that's why we have social welfare, that's why we have free education.
Its that 'Care' doesn't scale, its that its impossible to centrally monitor and control. People in the third world work harder than the first world, and are 10% as rich, because no one in their societies care.
> There was some pain in that realization. So many of my utopian dreams—what if we could live in a society where everyone can get the food, the housing, the healthcare, the opportunities for growth that they deserve—come from a place of wishing that we could live in a world where people are cared for.
I'd like to offer some comfort to the author on this score. Food, housing, healthcare broadly... while these are all aspects of being "cared for" by society, they aren't all care in the individual sense you describe. The food system is different from homecooked meals; the housing economy is different from the handsome breakfast nook your family DIYed into their home. We can build systems which scale and make it possible and economical for individual care to happen.
> The food system is different from homecooked meals
This is a good point, and everything I've heard from parents says that it's parents, not children, who identify home-cooked meals with care. Children notoriously prefer prepackaged industrially processed food over whole foods prepared with care and love. In order to feel cared for, all children need is to trust that the person caring for them will make sure they get enough food when they need it. Food quality has nutritional consequences down the line, and at some point a child that is fed pancakes every day will gain the ability to look back and regret how they were raised, but it doesn't prevent a child from feeling cared for in the moment.
Often, it's the act of preparing the meal by hand rather than pressing a button on their hypothetical Food-o-matic that makes the biggest impact. We can certainly scale the provision of needs otherwise. I agree with the author on their assertions about what it means to care and actually connect with people.
I'm not talking about food preparation, but food systems. E.g. look up the concept of a food desert. Preparing a meal by hand is one thing; having access to quality affordable ingredients is another. A food desert is what you get when the system that would enable care is deficient.
And even in a "food oasis" with adequate quality, yes, if you yourself cannot prepare a meal, or have nobody to do that for you, that's a failure of a different kind.
I tend to consider food deserts just cheap/fast transportation or personal mobility deserts seeing as they tend to "lack" a whole bunch of other things in addition to food. They lack these things not because people can't get them, but because the cost in time or money of going whatever distance one needs to go to get them makes it not worth it. Food doesn't ship well or keep well in individual use volumes so it is particularly impacted.
Although it’s theoretically possible and theoretically economical for individual care ‘to happen’, it doesn’t in practice for the housing economy. If anything it’s decreasing year by year on average.
Especially when you look at construction quality, the average quality of say new built condos in any major city has gone way way down since the 90s.
Of course on average condo designs have on average gotten fancier with quirkier architecture, and building codes have gotten more complex, so maybe it’s not due to builders caring way less, but the end result is shoddy work either way.
Edit: And the average home buyer has no method of separating out all these confounding factors, so it boils down to a single congealed mess.
About housing: I have a few ideas as to why, weirdly none of which overlap with yours.
1) I think part of it is due to our ability to fine-tune the limits. Before, if a company wanted to pass an inspection, they had to be really confident. There were going to be some expenses that in theory they could have avoided if they were better capable of measuring where the line between 'safe' and 'unsafe' was. The end result was buildings that were more safe than strictly required. But now we can get closer to the line, and so buildings are engineered at the edge of safety.
2) Of course, survival bias plays a role here. Who remembers all the crappy buildings that just vanished? It's the same reason we look at old toasters or mixers or what-have-you and say things were so much better-made in the past - all the crappy cheap toasters, mixers, and houses are gone now.
3) Also, as extreme weather has happened more frequently, areas all over are seeing weather different than what they were designed for. Given that the average temperature in Oregon in July (the hottest month of the year) was typically around 65 degrees Fahrenheit[1]. For the past few years it has generally hovered in the upper 60s. The hottest temperature ever recorded in Oregon before 2021 was 107 degrees Fahrenheit[2], and typically there were one or two days a year that crossed one hundred degrees -- occasionally five, more often none. In 2021, it hit 116 degrees. Since 2021, there has not yet been a year without 4 or more days over a hundred. And, of course, this pattern is repeated all over the world. Houses are being built for one set of extremes and averages and getting another.
1 is in large part a reflection of idiot proofing everything. Every party's judgement gets reduced down to some some quantitative stuff like wire gauges, stud spacing, etc, that even idiots with poor judgement can reliably assess. Instead of failures because people do shoddy work we instead get failures where people are dumbly building things they know won't last because it's easier to just let things be crappy than to try to get permission to deviate from the plan. Basically decision making authority is being abstracted away from the people who have actual context. This seems the screw-ups from doing work below the minimum the expense of preventing anyone from who would have done something better than the minimum from doing so.
Maybe it doesn't in America. Nor here in Australia. Some European cities are showing that better is in fact possible by strongly supporting co-operative housing sectors which are better for residents. But that would break the American taboo against government intervening usefully in private markets for human rights (in this case, shelter).
Anyway, my advice to the author was that systems can enable care at scale. Not to say that our current systems do.
Edit: to be more explicit, I'm suggesting that some approaches to the housing sector in some parts of Europe amount to care that scales; society and governments have decided that housing is a right, and have enacted policies to approach that situation. Conversely, a "we don't care" approach also scales very well with the opposite outcome.
>We’re pretty limited when it comes to care. In any given moment, you can only really care deeply and individually for one person.
Absolutely. Society tends to assume that people are interchangeable units and that 'care' is a commodity which can be dispensed evenly as if from an industrial nozzle in a food factory. So we have 'care homes', 'daycare', 'care packages'. We are enjoined to be more 'caring'.
But the reality is that love, which is what we're really talking about, is dyadic.
i.e. between two individuals. That's how it works and how it effects its magic.
A patchwork of dyadic connections is what we may hope for and build.
Yes, it points to how hard & expensive any government attempt to backstop the traditional parental model of care actually is.
The earlier the intervention the better.. and consistency is also incredible important. But you can spend incredible amounts of money just to get a slightly worse outcome than what was going to happen on its own. As a wealthy society we must do something to help those in need, especially children who are in the situation of no fault of their own. But it's not clear our current methods work.
You can also generalize this problem to the healthcare industry as a whole. Costs go up much faster than the rest of the basket of goods & services citizens pay for, and they don't understand why.
The underlying reason is that - care doesn't scale. You are essentially (directly or indirectly) paying for someone's (doctor, nurse, etc) time. We have not gotten much better at making care more time efficient in the field, and in many cases it has gotten worse (more paperwork/electronic record entry time/etc). Everything else we buy is the product of using automation to replace labor, making labor more efficient, or making labor cheaper (offshoring / simplifying so less training is needed / etc).
There was a story on HN a while ago that I can't seem to remember the title of.
It was something along the lines of "The optimal amount of slack in an organization is not zero", or something like that.
The argument was that, since it's impossible to plan for every eventuality, you need a certain amount of slack capacity in order to retain some flexibility.
And that by always using 100% capacity, we end up dysfunctional.
I think the same is true for our personal lives.
But the endless treadmill of self-optimization, side-hustles and ever more commitments leaves us unable to cope.
I think it referred to the classic efficiency vs latency tradeoff. Like when emergency vehicles are always on standby, which is inefficient, but allows them to roll out without delay. Conversely privatised rail lines squeeze out every ounce of capacity from the infrastructure resulting in delays when something, anything goes even slightly wrong.
I use this extensively when planning activities with my children. It's a fun challenge because they're both too young to tell the time, much less read, which are constraints one does not normally encounter in their work life.
It was the same problem for JIT supply chains falling apart during COVID.
It's very hard to sell slack to management and so in "well run organizations" it ends up trending towards zero. And then everyone is surprised at the resulting catastrophes.
I can't help you with the title, but with another paragraph from that story, should you want to find it.
Paraphrasing from memory:
> When you are in a major Chinese city you may street sweepers sitting on the side walk chitchatting. The first thing you may think of it as waste that could be eliminated. But it also acts as a buffer.
Things that scale can have a big multiplier, so to say. The problem is, more often than anticipated, that multiplier, rather than being large, ends up being considerably less than one.
Whereas work that doesn't scale always has a multiplier of 1, so its always useful.
This is ultimately a dichotomy between having the family unit or "the state" as the central point of governance. Many totalitarian regimes looked at newborns as "belonging to the state". The result is a unified mass person who dresses, thinks and acts in predictable ways.
The more power, personal connection and influence parents have over their children, the more diverse society will become.
> Have you ever been there and met the uniform mass persons?
I was born in Eastern Europe in a society headed in this direction. I observed its transformation after the fall of the Berlin Wall.
You felt the overarching power of the state from as early as the kindergarten. Signs of individuality were suppressed and all children were supposed to do things "the right way". When such an institution decided that a child "systematically misbehaves", it was able to take the child away from its parents in another orphanage-like institution that was supposed to teach them good socialist manners. Eventually some of them would end up seriously harassed, physically-ill and sent to an anonymous grave in the backyard of that institution.
Totalitarian regimes often uphold traditional values like family as a means of control, promoting unity and loyalty to the state-yet they’ll redefine these values whenever it suits their ideology.
That's not really true. Marxism-Leninism famously sought to abolish the family and the Soviet union performed quite a few experiments in communal rearing of children in it's early years.
The reason why totalitarian regimes end up promoting traditional values relations is that to them the only imperative superior to ideology is survival.
There is a reason the Soviet Union backed off from it's repression of religion in the middle of WW2.
Early Soviet Union did try to reshape family, but it went back on it eventually, seeing the value of the conservative family model in building social cohesion and loyalty.
Expressed differently: they tried to abolish the family, found that doing so created more problems then they solved, and backed off in order to avoid tearing their country apart.
They discovered that in some things doing nothing is better than doing something, but Westerners of all political stripes (both for or against authoritarianism) chronically make the mistake of assuming that everything that a totalitarian state does is done with some grand plan in mind rather than them just flailing about to find a centralized policy that kinda-sorta works.
Your comment reminds me a lot of modern speculation about China's grand plans. Sometimes a government chooses not to touch something because they learned from bad experience that they'll break it if they do, not because they're playing 4D chess manipulating it behind the scenes.
You’re describing the extremes on a spectrum, but you only go to one of the extremes, which exposes your bias.
And it’s a false dichotomy to begin with, since shifting more care work towards society doesn’t equate to a path toward totalitarianism. You’re conflating socialism with totalitarianism. Understandable, but misguided.
Frankly, your whole premise is based on a capitalist narrative that keeps workers in their place because individual care work is so inefficient—it drains energy that could otherwise be channeled into organizing worker councils to balance out the power now disproportionately held by banks, IT corporations, political parties, and the military-industrial complex.
I’m aware that I may come across as an arrogant prick in this comment. I wish I had more time to craft a friendlier response with more sources and explanation, but I simply don’t. I need to work to feed my children and their mother, but anyway, here’s a reading list for anyone who’s interested:
"Capitalist Realism: Is There No Alternative?" by Mark Fisher - Fisher discusses how capitalism has permeated every aspect of life, including care work, and critiques the idea that alternatives like socialism lead to totalitarianism.
"Workers of the World: Essays Toward a New History of the Working Class" by Philip A. H. G. D. Van der Linden - This collection explores the historical context of labor movements and the importance of organizing against disproportionate power structures.
"The Care Crisis: What’s Wrong with Care and How to Fix It" by the Institute of Public Policy Research - This report outlines the societal implications of care work and its impact on worker organization.
"Wages for Housework" by Silvia Federici - Federici argues for the recognition and compensation of domestic labor, linking it to broader struggles against capitalist exploitation.
Then I'm completely lost on how it is relevant to an article that specifically mentions the care of orphans as its central example for how care does not scale.
I think the idea is that many totalitarian systems treat every child as an orphan, in some cases taking them physically away from their parents and then have people look after the children as a job. Hence the comparable situation.
And, of course, all such systems I've ever read about do not care about the practical limitation of 1 caretaker per 1 child. I believe youth services in the Netherlands, for example, has 1 caretaker (effectively available to the child) per 15 children, or 7 or 8 if they're trouble. Does this work? No, of course not. They don't care. The kids grow up caring for nobody, probably because effectively nobody cares for them. One person watching 15 children can only hope to prevent disasters, if that, they cannot provide decent attention to children. By the standards of this article, there's probably 2 people who work in the same "group". If there's a third one, they will be shared between at least to groups. So 2 to 2.5 per 15 children ... comes to one parent figure per 7 children, which is a third to a fourth of the care children would receive in even a huge family, and much less than in a small family.
> I think the idea is that many totalitarian systems treat every child as an orphan
This idea is just wrong. Wrong isn't strong enough, it's conterfactual. At most some of them treated female bodies as owned by the state. I do not remember any example of totalitarian society where a child of a political opposant would be treated the same as any military child. Maybe Salazar? But even then, it was so corporate-aligned I doubt children from owners were treated the same as children from workers at anytime.
Working well with a three one ratio does not scream scaling to me.
The when you have more need than care workers it falls apart, with no way to scale it besides hiring more out of a pool that may not exist at the price you were paying the previous ones.
If you think in terms of supply and demand, if they are already have the curves met, additional demand is going to scale more than linearly because you need more people at a higher pay.
Which is quite remarkable, because up until less than a century ago when women “entered the workforce” virtually every woman who had ever lived somehow managed to care for her 3+ children.
Incidentally, large families do scale sublinearly with respect to the parents. The reason why is that even with merely natural spacing by the time they have a fourth child, the oldest is in a position to provide significant assistance. Every mother with a large family that I’ve spoken to confirms that the difficulty peaks with the third child and then plateaus.
It is remarkable. I have one child, and it is by far the hardest thing I've ever done - far harder than any job I've had. It doesn't help that both parents are working full time. Maybe parenting has changed recently and we are too hands-on, but I can't imagine having 2, much less 3+ running around. Even if one of us stops working to raise the kids full time, it's way more taxing, physically and mentally, than working a white collar job and paying for child care.
The comment comes from reading the article, then wondering how can societies make things scale? We make things scale by delegating our concerns to people who know and care more about specific outcomes, and helping them to make the differences that are required. Scale comes from people learning that things around them matter and that they are responsible for making them good.
What exactly is the evidence, and how is it not exactly centralisation? All the advances in care that I can think of (those that actually unburden more humans from having to give their life to care) are brought to us by some sort of centralisation.
No. Centralization isn't needed to scale, it's just needed to exploit scale. Exploitation has become so commonplace it's replaced everything as the primary "desirable metric". I'm writing this comment on a platform founded on the idea of exploitation being a desirable metric.
Try giving everyone housing without centralized production of things like nails, screws, siding electrical wire...
Decentralizization is fine sometimes, but a single huge nail factory is going to beat thousands backyard forges in (average/95th percentile) quality and especially in prices.
I'd argue that centralization allows a scale that otherwise wouldn't have been possible, but at the cost of added fragility and externalized costs.
We produce way more corn in the US today than we could without a centralized industry, but we do so by subsidizing the hell out of an industry that is driven only by how much volume of corn is produced. Nutritional quality of the food produced is ignored, damage to the land is ignored, damage to the broader environment is ignored, etc.
We grow a small amount of corn on our land. We absolutely don't have as high or consistent yields as an industrial farm, but we also don't spray any poisons on the land and if the soil health was being negatively impacted we would know it pretty darn fast. Rain water from the corn patch runs down into the pond our cows drink from, another reason we wouldn't use poisons on the land. All of these are considerations one will likely make at a smaller scale that just won't happen with a centralized system driven by one or two primary goals (currently that's just money).
yeah centralization is a proxy for trust and stability, it adds some friction on the edge to give you that benefit
i also think that ultimately no single system is best and that regular renegotiation about the amount of central vs decentral is key (something we should help people be better at)
Care is not something that is magically performed by the state or money.
At some point someone has to physically wash and feed the elderly in the retirement homes.
If past governments or cultural environments messed up demographics, states might end up with a significant fraction (Germany already has 22% aged 65+) of the population in need of that care, which requires another significant share of the population to just do that instead of producing actual stuff.
This will either get ugly in one way or another or we will need scalable tech solutions.
I don't think anyone's talking about forcing, or slavery.
Foreign workers are improving their lot (and that of their families back home). In a world where they don't have the same economic opportunities in their home countries, and the locals don't want to do those "shit jobs", it's a win win.
Even talking about shit jobs is pejorative. Foreign workers don't just pick fruit, they're also essential talent in healthcare and other critical areas.
Why is that? Do you think shit jobs don't exist? You think wiping other old people's asses is NOT a shit job? Are you lining up for these kinds of jobs yourself or did you work and study hard to not have to do them because you knew those jobs are shit and are usually given to the lowest underclass class of people who don't have better options due to various factors?
> Foreign workers don't just pick fruit
I never said such thing. The thread I replied was about importing workers for elderly care.
You're trying to project some things I didn't say onto me.
They're promised path to citizenship and an ok money. Then they discover that they work for an agency that takes away big chunk of their money. They can not change the employer since they'll be deported etc. etc. And the worst part is that at the end they still have to leave the country.
Actually... they kinda can? If they don't work, they get deported back. Also they are in debt to the agency that got them here. It's a hair above modern slavery the way it currently works, especially in EU countries with more... lax standards than Germany.
lol, nice joke, how many illegals has Germany for example deported? Deporting people in the EU is a huge hassle and the source countries often don't want to cooperate in taking back people. You'll have to murder someone to actually get the authorities in the EU go through the hassle of deporting you, but refusing to work shit jobs isn't enough to get you deported, just have your welfare access cut off.
Plus they can also claim asylum once they get here to escape their slave drivers and not get deported.
>especially in EU countries with more... lax standards than Germany
Germany already has lax standards on that regard. Many there are raking in huge profits by bringing in these vulnerable workers and having them work in terrible conditions.
> lol, how many illegals has Germany for example deported? Deporting people in the EU is a huge hassle and the source countries often don't want to cooperate in taking back people.
> Plus they can also claim asylum once they get here to escape their slave employers and not get deported.
You are confusing two groups of people. One group consists of illegal migrants, usually from MENA countries that claim asylum and are a hassle to deport back.
Migrant workers usually come from southeast Asia (India, Nepal, Philippines..) and there is no problem sending them back because those countries are considered safe. Also they got families back home, their motivation is not really to stay here long term but to earn a decent amount of money (from their perspective). And despite sometimes poor treatment and shitty jobs, EU is a much better place to work than gulf countries.
well, except for the fact that, as the article states, it doesn't scale. Or rather, it scales poorly: the quality of care provided by a nation state is going to differ in degree and quality compared to the 1:1 care that humans probably need (and certainly traumatised humans).
I'm not sure this comes as a surprise to anyone except for those who have had no interaction with state-provided social services. I'd also say that a level of care that does not reach to that 1:1 standard is still appreciably better than no care, which may be what one might otherwise receive.
The open question is can we work out better, decentralized ways of providing support that take advantage of the new social technologies that we've developed since the construction of the modern state and its welfare services in the late 19th and 20th centuries.
Just because the government does something, doesn't mean it has to be centralised. Eventually the care has to be given from one human to another human. On the other hand, it shouldn't matter where you live to receive care or how good the care is.
And the week in which private companies will be able to provide this, is the same week which has two Tuesdays.
Care doesn't scale, but a lot of activities around care should be scalable. A caregiver can be helped so they can spend as little time as possible on auxiliary tasks like admin or logistics.
I don't think there is any contradiction here. Government care can work, but it simply cannot benefit from economies of scale. Gonna need to double the income tax to pay for elders that have been abandoned by their children.
The state is ideally suited to manufacture public goods, more efficiently than private enterprise.
That means armies, judiciaries, policing municipalities, governance amongst others.
They address issues like management of the commons.
This does not translate into scaled care - care for orphans (from the article) still needs large numbers of skilled manpower, which is in short supply across the world.
These services are also often underfunded, since they are not really a first class citizen for voters.
Voters today, are also deeply targeted by emotional campaigns and identity campaigns, since that is the current political state of the art.
The state can be efficient, but some things don’t scale unless they are also resourced correctly.
Such services will also be amongst the first to cut, since “X will render it obsolete”, is a promise as old as time, and aren’t directly tied to overall societal survival.
Compared to something like defense / emergency funding
My argument is, that care is a public good. There will never be a situation in which care can fund itself. To fund care is a political decision and when the decision is made to to not fund it or leave to a market or private enterprises it will fail, because private enterprises need something which will eventually scale.
So, maybe interesting in the context of "creating scalable structures of aid and care", one of the big points I think that makes scaling hard is how much complexity gets pushed onto a central administrator. You have societies like certain Basque communities (see https://scholarship.claremont.edu/cgi/viewcontent.cgi?articl... ) where households are literally arranged in circular patterns, and there are obligations of care and service between you and your "first neighbor", "second neighbor", and so on, chains of dependencies moving clockwise and counterclockwise through the circle, allowing a potentially very large structure that still allows you to mostly interact with a small number of "near neighbors".
Quoting directly from the article:
"THE GIVING OF BREAD
Until the 1960’s, a fundamental circular exchange was the giving of blessed bread. Each household regards its neighbor to the right as its first neighbor
(The directions right and left are as viewed from the center of the circle so that right is clockwise and left is counterclockwise.)
The giving of bread took place weekly and was thought of as being given from first neighbor to first neighbor. That is, each Sunday a woman from one particular household, call it H_i, bought two loaves of bread to the church where it was blessed and partially used in a church ritual. Then, before sunset, a portion of the bread was given by H_i to her first neighbor, namely to H_{i+ 1}. The following week H_{i+1} was the bread-giver and H_{i+2} the bread-receiver. Thus, the giving (and receiving) of bread moved around the circle serially, taking about two years to complete one cycle of about 100 households. While each household was both a giver and receiver of bread, this mode differs from simple reciprocity; only if there were a total of two households would H_i and H_{i+1} directly reciprocate as each other’s first neighbor."
This reminds me of Clay Christensen's talk: How Will You Measure Your Life?[0] He compares how most people define success by how high up the hierarchy they get, against the individual effort of making a positive impact on the people around you.
> Scale isn’t bad, at least not necessarily. Industrial is perfectly capable of being better than custom. Sometimes the YouTube video is more helpful than the private tutor.
This is not true; consider the argument that there is always a loss of quality in scaling. Industrial maybe better than average custom, but is always worse than best customs. Broadcast lecture is almost always worse than a tutor whose discourse is customised to student's current knowledge. (The word guru (literally, one who leads towards light) is wrongly translated to teacher, for which the word in sanskrit is shikshak.)
I agree the average tutor is better than the average lecturer. But if I watch a YouTube lecture, then I might have access to the best lecturer in the world, or at least a 99%ile lecturer, e.g 3blue1brown. This only works because of the scale -- it wouldn't be possible for millions to get access to tutors this good 1 on 1.
but can you argue with them for an indeterminate period of time in earnest dialogue until the idea goes CLICK inside your head? You cannot, and so the value is much lessened because that critical access isn’t present.
I don’t think that holds for everything. Industrial 3nm chips are probably better than whatever you would get if people tried to DIY this. Lots of things get better with scale: materials, precision machinery, process efficiency, power generation.
But there’s also plenty of things that don’t work this way. Care is one of the most extreme things that does not.
I think the argument is that someone with the knowledge to make 3nm chips could probably know how to make some very cool yet very expensive chips, but since they target a lot of people they probably make choices that would satisfy more people but maybe not as well
Interesting maybe, but also one that lacks sources. It is entirely possible that this passed by me and I just didn't catch the thing mentioned in the blog post. But, I also can't find much in the way of any reference to it online. Not even a hint using various search terms and combinations as mentioned in the blog post.
It very much gives the impression of it being a story made up as a vehicle for the main point they are trying to make.
Whats much more important, empathy doesn't scale. Care can be established. But no one will ever know about its quality. I know what I am talking about, I visited a k12 school for the blind, and have a mentally unstable mother. Nobody ever asked me if I am happy/content at home. They all assumed my mother is doing her best. My life only started when I managed to escape from every kind of care. Institutionalized care is the worst, because its lacking empathy the most...
This is a pretty big realization and one that resonates strongly with me. As an engineer, parenting can be frustrating, of course for the usual reasons, but also because you realize there’s really no way to “hack” it.
I feel like we as a society need to acknowledge that this probably applies to childcare, teaching, health and elder care to a large extent. That no matter how much private sector ingenuity you apply to some field, there is a hard upper bound to how much efficiency you can achieve. Cost savings basically just require making hard choices about who gets what.
I think some of the healthcare changes during my lifetime have increased efficiency and been fine (maybe even good) for patients.
I used to have my vitals taken by the doctor. Now, that’s a nurse. Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse. All of that is good, IMO. Doctors may not like the 20 minute blocks, but overall I can get the same care at a lower total cost and the nurses are probably better at the job they do twice as frequently than the doctor whose head might be somewhere else during the “boring parts”.
I suspect aspects of this apply to teaching (why does every calc teacher need to give the lecture? Why not have the top 1% of them in that skill record lectures with excellent production quality/editing and have students watch those?)
Yes, there are upper bounds, but I think even +50% or +100% might be possible with minimal (or in the calc case, negative) losses. Those efficiencies can really matter when someone else has to pay the bill.
>I used to have my vitals taken by the doctor. Now, that’s a nurse. Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse. All of that is good, IMO. Doctors may not like the 20 minute blocks, but overall I can get the same care at a lower total cost and the nurses are probably better at the job they do twice as frequently than the doctor whose head might be somewhere else during the “boring parts”.
The statistical you is paying statistically much more than the historical equivalent. The situation is far more complex than that. There's a million variables here. Changes in services rendered, changes in outcomes, relative wage differences, more parties taking a cut of any given transaction, more "make work" prior to rending specialized care, etc, etc.
Outcomes are better than they were 40yr ago but is that because of the changes or despite them?
> Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse.
Weren't these always done by nurses? The doctor would do the determination of what you get, but nurse being the one executing these is something that was here for decades.
No, it's saying that _in any moment_ you can only focus deeply on, and thus care for, one other person. And if you have to care for multiple people, then you have to shift your focus moment to moment.
As a parent, can confirm. To give an example, it's really hard to hold and comfort two crying kids at the same time. When the toddlers are melting, they really want your whole attention and don't want to share it. If they're melting because they got in a fight with each other, it really takes an adult per toddler to help calm them.
That doesn't mean I can't love and care deeply for both kids, it just means you can only implement that caring with one at a time.
I think he's generalizing the point a bit and not all situations are like that. But it's close enough to accurate to be valid. Care doesn't scale.
> With four kids, the kids can feel like kids; if there were forty kids, they’d probably feel like they were cattle.
The point of the article is that you’ll never achieve economies of scale (10, 100, 1000x) for situations that require individualized attention, no matter how much engineering effort you put into it.
I don't think it's implying that at all. Whether or not you agree with the statement, it's referring to a specific moment. Most parents will have many moments with their children.
No, because normal healthy children do not require 24/7 care, even as newborns.
Children in care do, partly because of the circumstances that led to them being in care, but mostly because the State in general is not willing to accept the same risk profile as individual parents.
I think it comes down to the many meaning of the word "care" in English. The state is certainly willing to accept way greater risk than the individual parent, in many circumstances. If we take something like daycare, which I presume is included in "care", then it's typically four children per adult until the age of 4, in schools it goes down to 20+ children per one adult, where at home it might be more than two adults per child (but also less obviously).
The risk profile is different, if you have a newborn in hospital, then that child may have their parent present at all times, plus staff, but it might also be one or two nurses and an on-call doctor for any number of babies. In some sense the potential risk is greater, but it's also more professionally measured.
>The state is certainly willing to accept way greater risk than the individual parent, in many circumstances.
I don't think that's true.
> If we take something like daycare, which I presume is included in "care", then it's typically four children per adult until the age of 4, in schools it goes down to 20+ children per one adult, where at home it might be more than two adults per child (but also less obviously).
That's a much lower care ratio than parents accepted before regulation, so I think you're arguing against your own point here.
Those ratios are heavily debated in Denmark for being absolutely terrible. Parents have been complaining for years that the ratio of especially children for 4 to 6 are awful (typically 7 children per adult).
They might be a improvement in other countries, but they are considered a move in the wrong direction here, because they are worse than previously.
Not only does care not scale, but the fact that other fields do scale is one of the sources of "cost disease" [0]. If software engineering is thousands of times more scalable than teaching, caring for children, injured or elderly people then all of those other jobs will need to pay more to prevent everyone quitting to become a software developer.
This has been well-known for ages and is a major subject of feminist studies. Care jobs are mostly feminine, and don't scale, and this dichotomy plays a big role in the overall wage gap.
There's a million examples of tech utopianists walking head-first into ideas and even entire disciplines they previously dismissed as irrelevant or outdated.
I think in the future, descendants of today's LLM models and some future version of Tesla's Optimus could create a paradigm shift in how care is given.
I'm hopeful that when I get old, and inevitably come to need some help with living, that such a solution will be available.
I think this is a gross and psychopathic vision of the future.
Tell your grandmother that you're going to automate away her need for human connection. What a terrible indignity. I hate my industry.
> I would like the option to die painlessly before I end up needing a robot to change my diaper.
My dad has Parkinson's and needs a human to change his diaper. If he had the option of a robot, I bet he'd take it. Not a painless die now option, though. As I write, where he is it's 8 o'clock in the morning and he's watching an old Larry David and eating an ice cream cone while my mom gets ready for them to go to breakfast.
That’s the idea of an option. Great if it works for him, but having spent a lot of time with Pieter Hintjens (of AMQP and ZeroMQ fame) before he chose the time of his own passing from recurrent cancer, the notion that this is not allowed in order to appease religious zealots is simply barbaric.
Let's then hope that the LLM solution is FOSS so that relatives and the one being cared for can be in control of the service and avoid enshittification.
What most don't understand is that the economy IS us caring for each other. When you go to a restaurant when you are hungry, or a store to get what you need, or a hospital when you get sick, you are getting care. Virtually most people are taking care of other people. And yes it doesn't scale because it takes all of us to care for each other.
> What most don't understand is that the economy IS us caring for each other.
But when those businesses we seek care from scale, the system is no longer closed.
A portion of the care I give or receive is siphoned off and sent to shareholders or a wealth business owner. When caring happens through capitalism, a portion of our care is depleted with every transaction.
Q: How many Silicon Valley software engineers does it take to change a lightbulb?
A: They will refuse to change the lightbulb, claiming it "doesn't scale" unless the "lightbulb problem" is fixed globally ;)
In seriousness, enjoyed this article and it's a wise realization. I think the world would be a better place if more people take the time to be a good person to the people around them, rather than focusing so much on big picture issues.
Depends on what you mean by "care for". Calling your parents a few times a week to make sure they're doing OK and dropping by on the weekend doesn't take too much time and effort. But as people get older they need more and more care. Caring for one person with dementia or other similar problems that comes with aging is for all intents and purposes a full time job.
I agree with you, but I read the article as saying you can't care deeply about more than one person at literally the same instant. Your attention is directed to one or the other.
But I think even that's not literally true e.g. the social worker could make dinner for all four kids at once. And probably converse with all four of them while doing it!
But, I think I agree with the broader point that care doesn't scale, even if it does scale slightly greater than 1.
4 people taking care of 4 kids 24/7 in 24 hour shifts. From article:
> To get that individualized care, though, they had four social workers and four children. One-to-one. [...] But you couldn’t stray that far from one-to-one without changing the nature of the experience, without industrializing it to the point that individual care is lost.
I don't think you need the ratio of worker:child to be 1:1 in order to provide 1:1 care.
The alternative might be 20 social workers taking care of a group of 20 kids. It's the same ratio of workers to kids, since no 1 worker will get to deeply know individuals in the group.
I agree 1:1 is confusing and not totally accurate but it's fine for illustrating the point.
There are 4 workers taking turns looking after 4 kids. So while at any given time 1 worker is looking after 4 kids, you need 4 workers to cover all the shifts. Thus one-to-one
A lot of what makes society and politics so hard comes from the fact that humans have among the most demanding offspring of any living creature. This starts with pregnancy and birth which is a life threatening medical condition with a high mortality rate without modern medicine. We can’t reproduce and raise our children without dedicating gigantic amounts of energy to it, causing an inherent tension between the need to do so and the desires of both individuals and entities like corporations and states that want claim to that labor.
If we laid eggs and our young were viable more quickly our politics would be orders of magnitude simpler. It would basically be the politics of twenty somethings, but for everyone.
On the plus side, it’s probably why we have among the longest life spans of any land mammal. Grandparents helped with child rearing, so societies with longevity probably did a better job raising children.
I have what I think it's a very good article on the economy of care - making exactly this point and others, but it's in the dungeon of peer review for more than one year. And the reviewers do not even answer my emails.
> Adults often come to see small-scale solutions to major problems as childish. Yeah, you could make a couple of sandwiches for the hungry—but there are billions of people who need better access to food. Maybe your effort is better spent working on solutions that can scale.
Much of this essay is baffling to me.
From 2022 to 2023 the fed funds rate was jacked up. The aim of doing this was to, among other things, drive up unemployment, so that more working class people working in supermarkets and the like would become unemployed, and to increase food scarcity for their families. The rate rise affects us as well, with tech hiring somewhat dead since late 2022.
Looking abroad - the International Criminal Court charged Netanyahu, Israel fires on and invades UN bases in Lebanon, Israeli television broadcasts Israeli soldiers raping in Sde Teiman (go look on YouTube for the footage) as rabbis and Knesset MPs swarm to defend them. Gazan children starve as European countries block weapons being sent to Israel. In the US, Biden sends troops abroad and Israel weapons to further the slaughtering, which has spread to the West Bank, Yemen, Syria, Iran and Lebanon. Also, the US vetoes at the UNSC effectively help block Gazan children being fed as they starve. Kamala Harris backs Biden and vows to continue arming and funding Netanyhu doing this, and Trump is even more belligerent. So Americans elected the person enabling this and over 98% who vote will vote for a candidate doing this.
It is not a lack of care or attention to Gazan children, Americans, or 98% of those who vote are paying attention to Gazan children and are trying to starve them - or at least are willing to trade a specific tax cut or whatnot to enable their starvation.
There's nothing about lack of individual or scaled care - the vast majority of Americans work for the opposite - to continue the famine.
Going back to the point of scale - the <2% of people not voting for candidates arming Israel and continuing the Gazan famine are working together as a mass movement and at scale and many for as the essay mentioned "socialism", because this <2% has to coordinate and work together against the 98% who are actively pursuing the famine in Gaza, or who are neutral about it and willing to trade support for it for a tax cut and such.
Gazan children don't starve because Americans don't pay individual or scaled attention to Gazan children. They starve because 98% of Americans will vote for someone who works to starve them. It is what the vast majority of Americans are and what America is. And works for domains outside Gaza - like unemployment and the fed funds rate mentioned.
If we're going to talk about how to "scale care" and how not to, then Buurtzorg has to be mentioned[0][1]. It's a Dutch home-care company that was started by nurses who basically got frustrated that managers got in the way of them doing their job. It operates by having a flat organization working with small teams of highly trained nurses, and trusting them to make the right decisions. The result is a low-cost provider of high-quality health-care.
So when the author says care "doesn't scale", they obviously mean "you need a one-to-one ratio of caretakers", which I fully agree with. But what they're also accidentally doing in the process is explaining why creating bigger teams with bigger hierarchies and structures does not appear to increase the efficiency of care.
Some projects do need big teams with hierarchies - even in healthcare. Effectively responding to a pandemic comes to mind. I suspect it's when the core problem to tackle most naturally breaks down like a tree - a hierarchy then mirrors the way the problem breaks down. For some projects, like general homecare, the efficiency sweet spot is a flat structure of autonomous individual teams, because it doesn't scale beyond those teams anyway.
And just like the author concludes, I find that there's something comforting about that.
[0] https://en.wikipedia.org/wiki/Buurtzorg_Nederland
[1] https://www.youtube.com/watch?v=SSoWtXvqsgg
"...baker who gets up at 3 am..."
But those 3am bakers are being exterminated by at scale corporate chains, no? Generalizes to just about anything that could reasonably be described using "artisanal". Social atomization inexorably spreads, and after thinking about it pretty hard for many years of travel putting eyeballs on "artisanal" processes I don't see any possibility of any other outcome. So we enjoy what is left.
To complete the thought, the baker example is explicitly in opposition to OP's point. In the economy we exist in, a 3am artisan baker does so explicitly out of a care for craft and community.
Yes. Precisely so. As it happens, we've been friends with a "3am baker" for decades. We do not envy her life, but we do intensely enjoy her taste. Delighted to pay double for it.
The countless hours of voluntary unpaid work by many people shows don’t act only for their own benefit
True-ish. But try talking to some old folks, about the vastly reduced scale of such volunteer work since (say) the 1950's. That "voluntary unpaid" stuff would include religious organizations, civic groups, housewives, ...
You need time for that.
It’s true that first you care for yourself but after survival is secured many people care for others without profit concerns.
But if you need more time to satisfy your own needs you have less time for others.
It seems to me that capitalism discourages that behavior. If the system is setup to be transactional, and you can't rely on others reciprocating altruism if you need it; then it seems like engaging in altruism would be for suckers.
"The story, then, is everywhere. It is the founding myth of our system of economic relations. It is so deeply established in common sense, even in places like Madagascar, that most people on earth couldn’t imagine any other way that money possibly could have come about. The problem is there’s no evidence that it ever happened, and an enormous amount of evidence suggesting that it did not.”
"Debt", David Graeber
This is only true to an extent. Self-love only goes so far.
That's not true, and only seems true because of highly selective examples.
Money can force people to work, out of the necessity of survival. What it buys is reliability. You can force a toilet cleaner to come to work day after day, and the toilets stay clean.
But human progress, social progress, economic growth, does not solely come from people grinding through their jobs. It comes from people 'giving it their all', look at the great scientists, Newton, Von Nuemann, all the people at bell labs etc. These people create titanic economic value in their wake, and they are motivated by passion, which heavily mixes altruism with self interest.
Indeed, the 'developed economies' are precisely the ones that also allow 'care' to scale, that's why we have social welfare, that's why we have free education.
Its that 'Care' doesn't scale, its that its impossible to centrally monitor and control. People in the third world work harder than the first world, and are 10% as rich, because no one in their societies care.
> There was some pain in that realization. So many of my utopian dreams—what if we could live in a society where everyone can get the food, the housing, the healthcare, the opportunities for growth that they deserve—come from a place of wishing that we could live in a world where people are cared for.
I'd like to offer some comfort to the author on this score. Food, housing, healthcare broadly... while these are all aspects of being "cared for" by society, they aren't all care in the individual sense you describe. The food system is different from homecooked meals; the housing economy is different from the handsome breakfast nook your family DIYed into their home. We can build systems which scale and make it possible and economical for individual care to happen.
> The food system is different from homecooked meals
This is a good point, and everything I've heard from parents says that it's parents, not children, who identify home-cooked meals with care. Children notoriously prefer prepackaged industrially processed food over whole foods prepared with care and love. In order to feel cared for, all children need is to trust that the person caring for them will make sure they get enough food when they need it. Food quality has nutritional consequences down the line, and at some point a child that is fed pancakes every day will gain the ability to look back and regret how they were raised, but it doesn't prevent a child from feeling cared for in the moment.
Often, it's the act of preparing the meal by hand rather than pressing a button on their hypothetical Food-o-matic that makes the biggest impact. We can certainly scale the provision of needs otherwise. I agree with the author on their assertions about what it means to care and actually connect with people.
I'm not talking about food preparation, but food systems. E.g. look up the concept of a food desert. Preparing a meal by hand is one thing; having access to quality affordable ingredients is another. A food desert is what you get when the system that would enable care is deficient.
And even in a "food oasis" with adequate quality, yes, if you yourself cannot prepare a meal, or have nobody to do that for you, that's a failure of a different kind.
https://en.wikipedia.org/wiki/Food_desert
I tend to consider food deserts just cheap/fast transportation or personal mobility deserts seeing as they tend to "lack" a whole bunch of other things in addition to food. They lack these things not because people can't get them, but because the cost in time or money of going whatever distance one needs to go to get them makes it not worth it. Food doesn't ship well or keep well in individual use volumes so it is particularly impacted.
Although it’s theoretically possible and theoretically economical for individual care ‘to happen’, it doesn’t in practice for the housing economy. If anything it’s decreasing year by year on average.
Especially when you look at construction quality, the average quality of say new built condos in any major city has gone way way down since the 90s.
Of course on average condo designs have on average gotten fancier with quirkier architecture, and building codes have gotten more complex, so maybe it’s not due to builders caring way less, but the end result is shoddy work either way.
Edit: And the average home buyer has no method of separating out all these confounding factors, so it boils down to a single congealed mess.
About housing: I have a few ideas as to why, weirdly none of which overlap with yours.
1) I think part of it is due to our ability to fine-tune the limits. Before, if a company wanted to pass an inspection, they had to be really confident. There were going to be some expenses that in theory they could have avoided if they were better capable of measuring where the line between 'safe' and 'unsafe' was. The end result was buildings that were more safe than strictly required. But now we can get closer to the line, and so buildings are engineered at the edge of safety.
2) Of course, survival bias plays a role here. Who remembers all the crappy buildings that just vanished? It's the same reason we look at old toasters or mixers or what-have-you and say things were so much better-made in the past - all the crappy cheap toasters, mixers, and houses are gone now.
3) Also, as extreme weather has happened more frequently, areas all over are seeing weather different than what they were designed for. Given that the average temperature in Oregon in July (the hottest month of the year) was typically around 65 degrees Fahrenheit[1]. For the past few years it has generally hovered in the upper 60s. The hottest temperature ever recorded in Oregon before 2021 was 107 degrees Fahrenheit[2], and typically there were one or two days a year that crossed one hundred degrees -- occasionally five, more often none. In 2021, it hit 116 degrees. Since 2021, there has not yet been a year without 4 or more days over a hundred. And, of course, this pattern is repeated all over the world. Houses are being built for one set of extremes and averages and getting another.
[1] https://www.ncei.noaa.gov/access/monitoring/climate-at-a-gla...
[2] https://projects.oregonlive.com/weather/temps/
1 is in large part a reflection of idiot proofing everything. Every party's judgement gets reduced down to some some quantitative stuff like wire gauges, stud spacing, etc, that even idiots with poor judgement can reliably assess. Instead of failures because people do shoddy work we instead get failures where people are dumbly building things they know won't last because it's easier to just let things be crappy than to try to get permission to deviate from the plan. Basically decision making authority is being abstracted away from the people who have actual context. This seems the screw-ups from doing work below the minimum the expense of preventing anyone from who would have done something better than the minimum from doing so.
Maybe it doesn't in America. Nor here in Australia. Some European cities are showing that better is in fact possible by strongly supporting co-operative housing sectors which are better for residents. But that would break the American taboo against government intervening usefully in private markets for human rights (in this case, shelter).
More from a recent report by Australia's business council of coops and mutuals: https://bccm.coop/australia-urged-to-look-to-europe-for-solu...
Anyway, my advice to the author was that systems can enable care at scale. Not to say that our current systems do.
Edit: to be more explicit, I'm suggesting that some approaches to the housing sector in some parts of Europe amount to care that scales; society and governments have decided that housing is a right, and have enacted policies to approach that situation. Conversely, a "we don't care" approach also scales very well with the opposite outcome.
>We’re pretty limited when it comes to care. In any given moment, you can only really care deeply and individually for one person.
Absolutely. Society tends to assume that people are interchangeable units and that 'care' is a commodity which can be dispensed evenly as if from an industrial nozzle in a food factory. So we have 'care homes', 'daycare', 'care packages'. We are enjoined to be more 'caring'.
But the reality is that love, which is what we're really talking about, is dyadic.
i.e. between two individuals. That's how it works and how it effects its magic.
A patchwork of dyadic connections is what we may hope for and build.
Yes, it points to how hard & expensive any government attempt to backstop the traditional parental model of care actually is.
The earlier the intervention the better.. and consistency is also incredible important. But you can spend incredible amounts of money just to get a slightly worse outcome than what was going to happen on its own. As a wealthy society we must do something to help those in need, especially children who are in the situation of no fault of their own. But it's not clear our current methods work.
You can also generalize this problem to the healthcare industry as a whole. Costs go up much faster than the rest of the basket of goods & services citizens pay for, and they don't understand why.
The underlying reason is that - care doesn't scale. You are essentially (directly or indirectly) paying for someone's (doctor, nurse, etc) time. We have not gotten much better at making care more time efficient in the field, and in many cases it has gotten worse (more paperwork/electronic record entry time/etc). Everything else we buy is the product of using automation to replace labor, making labor more efficient, or making labor cheaper (offshoring / simplifying so less training is needed / etc).
> But I wonder if part of that smaller focus comes from a deep realization that care doesn’t scale.
My experience (and I believe it to be common) is that I'm really, really, really out of spare energy to care about anyone or anything else.
Mind you, I'm in my best shape in years and I've explored my limits to find out they're actually way further than I originally thought, but still.
There was a story on HN a while ago that I can't seem to remember the title of.
It was something along the lines of "The optimal amount of slack in an organization is not zero", or something like that.
The argument was that, since it's impossible to plan for every eventuality, you need a certain amount of slack capacity in order to retain some flexibility. And that by always using 100% capacity, we end up dysfunctional.
I think the same is true for our personal lives.
But the endless treadmill of self-optimization, side-hustles and ever more commitments leaves us unable to cope.
I think it referred to the classic efficiency vs latency tradeoff. Like when emergency vehicles are always on standby, which is inefficient, but allows them to roll out without delay. Conversely privatised rail lines squeeze out every ounce of capacity from the infrastructure resulting in delays when something, anything goes even slightly wrong.
I use this extensively when planning activities with my children. It's a fun challenge because they're both too young to tell the time, much less read, which are constraints one does not normally encounter in their work life.
It was the same problem for JIT supply chains falling apart during COVID.
It's very hard to sell slack to management and so in "well run organizations" it ends up trending towards zero. And then everyone is surprised at the resulting catastrophes.
https://www.bitsaboutmoney.com/archive/optimal-amount-of-fra...
Tom DeMarco wrote a book about this some years ago, called... "Slack".
I can't help you with the title, but with another paragraph from that story, should you want to find it. Paraphrasing from memory:
> When you are in a major Chinese city you may street sweepers sitting on the side walk chitchatting. The first thing you may think of it as waste that could be eliminated. But it also acts as a buffer.
I think you might be referring to this comment: https://news.ycombinator.com/item?id=41952570
I found the book Margin by Richard Swenson to be helpful.
TL;DR: Pretty much what you said, but he labeled it "margin" instead of "slack". But yeah, you need some.
This is such an important point. Caring is often limited by the spare energy you have to care.
Care could scale, but we’d need the culture and societal changes to allow it to scale.
Things that scale can have a big multiplier, so to say. The problem is, more often than anticipated, that multiplier, rather than being large, ends up being considerably less than one.
Whereas work that doesn't scale always has a multiplier of 1, so its always useful.
This is ultimately a dichotomy between having the family unit or "the state" as the central point of governance. Many totalitarian regimes looked at newborns as "belonging to the state". The result is a unified mass person who dresses, thinks and acts in predictable ways.
The more power, personal connection and influence parents have over their children, the more diverse society will become.
A false dichotomy some would call that. Children can be raised in units different from the current western perception of "the" family unit.
Besides, what countries are you talking about? Have you ever been there and met the uniform mass persons?
> Have you ever been there and met the uniform mass persons?
I was born in Eastern Europe in a society headed in this direction. I observed its transformation after the fall of the Berlin Wall.
You felt the overarching power of the state from as early as the kindergarten. Signs of individuality were suppressed and all children were supposed to do things "the right way". When such an institution decided that a child "systematically misbehaves", it was able to take the child away from its parents in another orphanage-like institution that was supposed to teach them good socialist manners. Eventually some of them would end up seriously harassed, physically-ill and sent to an anonymous grave in the backyard of that institution.
Totalitarian regimes often uphold traditional values like family as a means of control, promoting unity and loyalty to the state-yet they’ll redefine these values whenever it suits their ideology.
That's not really true. Marxism-Leninism famously sought to abolish the family and the Soviet union performed quite a few experiments in communal rearing of children in it's early years.
The reason why totalitarian regimes end up promoting traditional values relations is that to them the only imperative superior to ideology is survival.
There is a reason the Soviet Union backed off from it's repression of religion in the middle of WW2.
Early Soviet Union did try to reshape family, but it went back on it eventually, seeing the value of the conservative family model in building social cohesion and loyalty.
Expressed differently: they tried to abolish the family, found that doing so created more problems then they solved, and backed off in order to avoid tearing their country apart.
They discovered that in some things doing nothing is better than doing something, but Westerners of all political stripes (both for or against authoritarianism) chronically make the mistake of assuming that everything that a totalitarian state does is done with some grand plan in mind rather than them just flailing about to find a centralized policy that kinda-sorta works.
Your comment reminds me a lot of modern speculation about China's grand plans. Sometimes a government chooses not to touch something because they learned from bad experience that they'll break it if they do, not because they're playing 4D chess manipulating it behind the scenes.
I don’t think they ever tried to “abolish family”. Where are you getting this stuff? It sounds like bad history lessons.
They did stuff like legalizing divorce, or collectivization of parenting.
You are assuming all family influence is good. There are lots of abusive families and poor parents, though.
He is (or perhaps he's ignoring that issue). But when a totalitarian government is abusive, it affects all the families, not just the bad ones.
You’re describing the extremes on a spectrum, but you only go to one of the extremes, which exposes your bias.
And it’s a false dichotomy to begin with, since shifting more care work towards society doesn’t equate to a path toward totalitarianism. You’re conflating socialism with totalitarianism. Understandable, but misguided.
Frankly, your whole premise is based on a capitalist narrative that keeps workers in their place because individual care work is so inefficient—it drains energy that could otherwise be channeled into organizing worker councils to balance out the power now disproportionately held by banks, IT corporations, political parties, and the military-industrial complex.
I’m aware that I may come across as an arrogant prick in this comment. I wish I had more time to craft a friendlier response with more sources and explanation, but I simply don’t. I need to work to feed my children and their mother, but anyway, here’s a reading list for anyone who’s interested:
"Capitalist Realism: Is There No Alternative?" by Mark Fisher - Fisher discusses how capitalism has permeated every aspect of life, including care work, and critiques the idea that alternatives like socialism lead to totalitarianism.
"Workers of the World: Essays Toward a New History of the Working Class" by Philip A. H. G. D. Van der Linden - This collection explores the historical context of labor movements and the importance of organizing against disproportionate power structures.
"The Care Crisis: What’s Wrong with Care and How to Fix It" by the Institute of Public Policy Research - This report outlines the societal implications of care work and its impact on worker organization.
"Wages for Housework" by Silvia Federici - Federici argues for the recognition and compensation of domestic labor, linking it to broader struggles against capitalist exploitation.
What? What does this have to do with orphaned children?
It’s not a reference to orphans.
Then I'm completely lost on how it is relevant to an article that specifically mentions the care of orphans as its central example for how care does not scale.
I think the idea is that many totalitarian systems treat every child as an orphan, in some cases taking them physically away from their parents and then have people look after the children as a job. Hence the comparable situation.
And, of course, all such systems I've ever read about do not care about the practical limitation of 1 caretaker per 1 child. I believe youth services in the Netherlands, for example, has 1 caretaker (effectively available to the child) per 15 children, or 7 or 8 if they're trouble. Does this work? No, of course not. They don't care. The kids grow up caring for nobody, probably because effectively nobody cares for them. One person watching 15 children can only hope to prevent disasters, if that, they cannot provide decent attention to children. By the standards of this article, there's probably 2 people who work in the same "group". If there's a third one, they will be shared between at least to groups. So 2 to 2.5 per 15 children ... comes to one parent figure per 7 children, which is a third to a fourth of the care children would receive in even a huge family, and much less than in a small family.
> I think the idea is that many totalitarian systems treat every child as an orphan
This idea is just wrong. Wrong isn't strong enough, it's conterfactual. At most some of them treated female bodies as owned by the state. I do not remember any example of totalitarian society where a child of a political opposant would be treated the same as any military child. Maybe Salazar? But even then, it was so corporate-aligned I doubt children from owners were treated the same as children from workers at anytime.
I think this is also interesting to keep in mind when thinking about the changes to the job market that are possible due to technology (e.g. AI).
Most of care will not be automated any time soon. And it is a huge part of the economy.
Yes this was my first thought too.
Nice to see this post on HN.
I assumed the opposite.
Knew a women who worked 100% as foster mom.
Had 3 children at a time, age 6 to 13.
Everything was well organised.
It seemed to me, child care can work pretty well of it's your main job and you get paid by the state.
Working well with a three one ratio does not scream scaling to me.
The when you have more need than care workers it falls apart, with no way to scale it besides hiring more out of a pool that may not exist at the price you were paying the previous ones.
If you think in terms of supply and demand, if they are already have the curves met, additional demand is going to scale more than linearly because you need more people at a higher pay.
This seems more like a very skilled caregiver to me, I would be absolutely overwhelmed in this position.
Which is quite remarkable, because up until less than a century ago when women “entered the workforce” virtually every woman who had ever lived somehow managed to care for her 3+ children.
Incidentally, large families do scale sublinearly with respect to the parents. The reason why is that even with merely natural spacing by the time they have a fourth child, the oldest is in a position to provide significant assistance. Every mother with a large family that I’ve spoken to confirms that the difficulty peaks with the third child and then plateaus.
It is remarkable. I have one child, and it is by far the hardest thing I've ever done - far harder than any job I've had. It doesn't help that both parents are working full time. Maybe parenting has changed recently and we are too hands-on, but I can't imagine having 2, much less 3+ running around. Even if one of us stops working to raise the kids full time, it's way more taxing, physically and mentally, than working a white collar job and paying for child care.
Care does scale and the human race is evidence of that. It is centralisation that doesn't scale well.
This comes across as a comment on the headline and not the article.
The article had a very specific circumstance it built upon - how much human time time it takes to help kids.
This doesn’t scale, in the context of the article.
Your statement would translate into a point on economics and organization, than individual care.
This still obscures the fact that many critical functions don’t scale.
I would add that these tend to be under resourced in favor of things that do scale.
The comment comes from reading the article, then wondering how can societies make things scale? We make things scale by delegating our concerns to people who know and care more about specific outcomes, and helping them to make the differences that are required. Scale comes from people learning that things around them matter and that they are responsible for making them good.
What exactly is the evidence, and how is it not exactly centralisation? All the advances in care that I can think of (those that actually unburden more humans from having to give their life to care) are brought to us by some sort of centralisation.
but centralization is in many ways the thing that is needed to scale all sorts of other things.
No. Centralization isn't needed to scale, it's just needed to exploit scale. Exploitation has become so commonplace it's replaced everything as the primary "desirable metric". I'm writing this comment on a platform founded on the idea of exploitation being a desirable metric.
Try giving everyone housing without centralized production of things like nails, screws, siding electrical wire...
Decentralizization is fine sometimes, but a single huge nail factory is going to beat thousands backyard forges in (average/95th percentile) quality and especially in prices.
I'd argue that centralization allows a scale that otherwise wouldn't have been possible, but at the cost of added fragility and externalized costs.
We produce way more corn in the US today than we could without a centralized industry, but we do so by subsidizing the hell out of an industry that is driven only by how much volume of corn is produced. Nutritional quality of the food produced is ignored, damage to the land is ignored, damage to the broader environment is ignored, etc.
We grow a small amount of corn on our land. We absolutely don't have as high or consistent yields as an industrial farm, but we also don't spray any poisons on the land and if the soil health was being negatively impacted we would know it pretty darn fast. Rain water from the corn patch runs down into the pond our cows drink from, another reason we wouldn't use poisons on the land. All of these are considerations one will likely make at a smaller scale that just won't happen with a centralized system driven by one or two primary goals (currently that's just money).
yeah centralization is a proxy for trust and stability, it adds some friction on the edge to give you that benefit
i also think that ultimately no single system is best and that regular renegotiation about the amount of central vs decentral is key (something we should help people be better at)
Infrastructure is care at scale, as Deb Cachra would say: http://debcha.org
This is one reason why we have a state, which collect taxes and can provide those services.
Care is not something that is magically performed by the state or money. At some point someone has to physically wash and feed the elderly in the retirement homes.
If past governments or cultural environments messed up demographics, states might end up with a significant fraction (Germany already has 22% aged 65+) of the population in need of that care, which requires another significant share of the population to just do that instead of producing actual stuff.
This will either get ugly in one way or another or we will need scalable tech solutions.
Or importing even more foreign workers. Which I'm not strictly against, but does come with it's own set of challenges.
>Or importing even more foreign workers.
Except you can't force foreign workers to do shit jobs the locals don't want. They're not slaves.
I don't think anyone's talking about forcing, or slavery.
Foreign workers are improving their lot (and that of their families back home). In a world where they don't have the same economic opportunities in their home countries, and the locals don't want to do those "shit jobs", it's a win win.
Even talking about shit jobs is pejorative. Foreign workers don't just pick fruit, they're also essential talent in healthcare and other critical areas.
>Even talking about shit jobs is pejorative.
Why is that? Do you think shit jobs don't exist? You think wiping other old people's asses is NOT a shit job? Are you lining up for these kinds of jobs yourself or did you work and study hard to not have to do them because you knew those jobs are shit and are usually given to the lowest underclass class of people who don't have better options due to various factors?
> Foreign workers don't just pick fruit
I never said such thing. The thread I replied was about importing workers for elderly care.
You're trying to project some things I didn't say onto me.
This does not always happen but it happens often:
They're promised path to citizenship and an ok money. Then they discover that they work for an agency that takes away big chunk of their money. They can not change the employer since they'll be deported etc. etc. And the worst part is that at the end they still have to leave the country.
So yeah maybe not technically but they're slaves.
They don't need to be forced. They come here willing to do those jobs. After all, they're not slaves.
Exactly. They come willingly but you can't force them to wipe your old age ass once they're here.
Actually... they kinda can? If they don't work, they get deported back. Also they are in debt to the agency that got them here. It's a hair above modern slavery the way it currently works, especially in EU countries with more... lax standards than Germany.
>If they don't work, they get deported back.
lol, nice joke, how many illegals has Germany for example deported? Deporting people in the EU is a huge hassle and the source countries often don't want to cooperate in taking back people. You'll have to murder someone to actually get the authorities in the EU go through the hassle of deporting you, but refusing to work shit jobs isn't enough to get you deported, just have your welfare access cut off.
Plus they can also claim asylum once they get here to escape their slave drivers and not get deported.
>especially in EU countries with more... lax standards than Germany
Germany already has lax standards on that regard. Many there are raking in huge profits by bringing in these vulnerable workers and having them work in terrible conditions.
> lol, how many illegals has Germany for example deported? Deporting people in the EU is a huge hassle and the source countries often don't want to cooperate in taking back people.
> Plus they can also claim asylum once they get here to escape their slave employers and not get deported.
You are confusing two groups of people. One group consists of illegal migrants, usually from MENA countries that claim asylum and are a hassle to deport back.
Migrant workers usually come from southeast Asia (India, Nepal, Philippines..) and there is no problem sending them back because those countries are considered safe. Also they got families back home, their motivation is not really to stay here long term but to earn a decent amount of money (from their perspective). And despite sometimes poor treatment and shitty jobs, EU is a much better place to work than gulf countries.
well, except for the fact that, as the article states, it doesn't scale. Or rather, it scales poorly: the quality of care provided by a nation state is going to differ in degree and quality compared to the 1:1 care that humans probably need (and certainly traumatised humans).
I'm not sure this comes as a surprise to anyone except for those who have had no interaction with state-provided social services. I'd also say that a level of care that does not reach to that 1:1 standard is still appreciably better than no care, which may be what one might otherwise receive.
The open question is can we work out better, decentralized ways of providing support that take advantage of the new social technologies that we've developed since the construction of the modern state and its welfare services in the late 19th and 20th centuries.
Just because the government does something, doesn't mean it has to be centralised. Eventually the care has to be given from one human to another human. On the other hand, it shouldn't matter where you live to receive care or how good the care is.
And the week in which private companies will be able to provide this, is the same week which has two Tuesdays.
Care doesn't scale, but a lot of activities around care should be scalable. A caregiver can be helped so they can spend as little time as possible on auxiliary tasks like admin or logistics.
I don't think there is any contradiction here. Government care can work, but it simply cannot benefit from economies of scale. Gonna need to double the income tax to pay for elders that have been abandoned by their children.
You mean the elders who failed to take care of themselves, assuming someone else would do it for them.
which has been the norm for as long as humanity existed
This is not the same thing.
The state is ideally suited to manufacture public goods, more efficiently than private enterprise.
That means armies, judiciaries, policing municipalities, governance amongst others.
They address issues like management of the commons.
This does not translate into scaled care - care for orphans (from the article) still needs large numbers of skilled manpower, which is in short supply across the world.
These services are also often underfunded, since they are not really a first class citizen for voters.
Voters today, are also deeply targeted by emotional campaigns and identity campaigns, since that is the current political state of the art.
The state can be efficient, but some things don’t scale unless they are also resourced correctly.
Such services will also be amongst the first to cut, since “X will render it obsolete”, is a promise as old as time, and aren’t directly tied to overall societal survival.
Compared to something like defense / emergency funding
My argument is, that care is a public good. There will never be a situation in which care can fund itself. To fund care is a political decision and when the decision is made to to not fund it or leave to a market or private enterprises it will fail, because private enterprises need something which will eventually scale.
So, maybe interesting in the context of "creating scalable structures of aid and care", one of the big points I think that makes scaling hard is how much complexity gets pushed onto a central administrator. You have societies like certain Basque communities (see https://scholarship.claremont.edu/cgi/viewcontent.cgi?articl... ) where households are literally arranged in circular patterns, and there are obligations of care and service between you and your "first neighbor", "second neighbor", and so on, chains of dependencies moving clockwise and counterclockwise through the circle, allowing a potentially very large structure that still allows you to mostly interact with a small number of "near neighbors".
Quoting directly from the article:
"THE GIVING OF BREAD
Until the 1960’s, a fundamental circular exchange was the giving of blessed bread. Each household regards its neighbor to the right as its first neighbor
(The directions right and left are as viewed from the center of the circle so that right is clockwise and left is counterclockwise.)
The giving of bread took place weekly and was thought of as being given from first neighbor to first neighbor. That is, each Sunday a woman from one particular household, call it H_i, bought two loaves of bread to the church where it was blessed and partially used in a church ritual. Then, before sunset, a portion of the bread was given by H_i to her first neighbor, namely to H_{i+ 1}. The following week H_{i+1} was the bread-giver and H_{i+2} the bread-receiver. Thus, the giving (and receiving) of bread moved around the circle serially, taking about two years to complete one cycle of about 100 households. While each household was both a giver and receiver of bread, this mode differs from simple reciprocity; only if there were a total of two households would H_i and H_{i+1} directly reciprocate as each other’s first neighbor."
This reminds me of Clay Christensen's talk: How Will You Measure Your Life?[0] He compares how most people define success by how high up the hierarchy they get, against the individual effort of making a positive impact on the people around you.
[0] https://www.youtube.com/watch?v=tvos4nORf_Y
> Scale isn’t bad, at least not necessarily. Industrial is perfectly capable of being better than custom. Sometimes the YouTube video is more helpful than the private tutor.
This is not true; consider the argument that there is always a loss of quality in scaling. Industrial maybe better than average custom, but is always worse than best customs. Broadcast lecture is almost always worse than a tutor whose discourse is customised to student's current knowledge. (The word guru (literally, one who leads towards light) is wrongly translated to teacher, for which the word in sanskrit is shikshak.)
I agree the average tutor is better than the average lecturer. But if I watch a YouTube lecture, then I might have access to the best lecturer in the world, or at least a 99%ile lecturer, e.g 3blue1brown. This only works because of the scale -- it wouldn't be possible for millions to get access to tutors this good 1 on 1.
but can you argue with them for an indeterminate period of time in earnest dialogue until the idea goes CLICK inside your head? You cannot, and so the value is much lessened because that critical access isn’t present.
You can’t do that for the average lecturer either… assuming it’s a normal college lecture room with hundreds of students.
Nonetheless the 99th percentile lecturer is still better than the 50th percentile tutor in most cases.
I don’t think that holds for everything. Industrial 3nm chips are probably better than whatever you would get if people tried to DIY this. Lots of things get better with scale: materials, precision machinery, process efficiency, power generation.
But there’s also plenty of things that don’t work this way. Care is one of the most extreme things that does not.
I think the argument is that someone with the knowledge to make 3nm chips could probably know how to make some very cool yet very expensive chips, but since they target a lot of people they probably make choices that would satisfy more people but maybe not as well
I think this post on the same blog is much more interesting:
‘Small Village’ of Supposedly-Deceased Intellectuals Found Alive, Thriving at Caribbean Resort
https://stevenscrawls.com/bucket-bump/
Interesting maybe, but also one that lacks sources. It is entirely possible that this passed by me and I just didn't catch the thing mentioned in the blog post. But, I also can't find much in the way of any reference to it online. Not even a hint using various search terms and combinations as mentioned in the blog post.
It very much gives the impression of it being a story made up as a vehicle for the main point they are trying to make.
Yes I think it's made up. But it's not obvious that it is. Which makes me doubt the blog as a whole.
An interesting thought experiment
Probably, without any sources or anything related online it seems to be fiction.
Whats much more important, empathy doesn't scale. Care can be established. But no one will ever know about its quality. I know what I am talking about, I visited a k12 school for the blind, and have a mentally unstable mother. Nobody ever asked me if I am happy/content at home. They all assumed my mother is doing her best. My life only started when I managed to escape from every kind of care. Institutionalized care is the worst, because its lacking empathy the most...
This is a pretty big realization and one that resonates strongly with me. As an engineer, parenting can be frustrating, of course for the usual reasons, but also because you realize there’s really no way to “hack” it.
I feel like we as a society need to acknowledge that this probably applies to childcare, teaching, health and elder care to a large extent. That no matter how much private sector ingenuity you apply to some field, there is a hard upper bound to how much efficiency you can achieve. Cost savings basically just require making hard choices about who gets what.
Unless one lets go of ego. The human being is perfectly engineered to raise its young. We are automota of reproduction, for millions of years.
I think some of the healthcare changes during my lifetime have increased efficiency and been fine (maybe even good) for patients.
I used to have my vitals taken by the doctor. Now, that’s a nurse. Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse. All of that is good, IMO. Doctors may not like the 20 minute blocks, but overall I can get the same care at a lower total cost and the nurses are probably better at the job they do twice as frequently than the doctor whose head might be somewhere else during the “boring parts”.
I suspect aspects of this apply to teaching (why does every calc teacher need to give the lecture? Why not have the top 1% of them in that skill record lectures with excellent production quality/editing and have students watch those?)
Yes, there are upper bounds, but I think even +50% or +100% might be possible with minimal (or in the calc case, negative) losses. Those efficiencies can really matter when someone else has to pay the bill.
>I used to have my vitals taken by the doctor. Now, that’s a nurse. Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse. All of that is good, IMO. Doctors may not like the 20 minute blocks, but overall I can get the same care at a lower total cost and the nurses are probably better at the job they do twice as frequently than the doctor whose head might be somewhere else during the “boring parts”.
The statistical you is paying statistically much more than the historical equivalent. The situation is far more complex than that. There's a million variables here. Changes in services rendered, changes in outcomes, relative wage differences, more parties taking a cut of any given transaction, more "make work" prior to rending specialized care, etc, etc.
Outcomes are better than they were 40yr ago but is that because of the changes or despite them?
> Used to get vaccine shots from the doctor, now a nurse. I feel like docs used to do blood draws, now a nurse.
Weren't these always done by nurses? The doctor would do the determination of what you get, but nurse being the one executing these is something that was here for decades.
> In any given moment, you can only really care deeply and individually for one person.
What does this imply, that two parents cannot care for three children? I disagree.
No, it's saying that _in any moment_ you can only focus deeply on, and thus care for, one other person. And if you have to care for multiple people, then you have to shift your focus moment to moment.
As a parent, can confirm. To give an example, it's really hard to hold and comfort two crying kids at the same time. When the toddlers are melting, they really want your whole attention and don't want to share it. If they're melting because they got in a fight with each other, it really takes an adult per toddler to help calm them.
That doesn't mean I can't love and care deeply for both kids, it just means you can only implement that caring with one at a time.
I think he's generalizing the point a bit and not all situations are like that. But it's close enough to accurate to be valid. Care doesn't scale.
No, they go on to say
> With four kids, the kids can feel like kids; if there were forty kids, they’d probably feel like they were cattle.
The point of the article is that you’ll never achieve economies of scale (10, 100, 1000x) for situations that require individualized attention, no matter how much engineering effort you put into it.
At least with today’s technology…
The quiver full movement is certainly testing the limits.
I would argue that they found it and that kids are not getting that individual attention they need.
I don't think it's implying that at all. Whether or not you agree with the statement, it's referring to a specific moment. Most parents will have many moments with their children.
No, because normal healthy children do not require 24/7 care, even as newborns.
Children in care do, partly because of the circumstances that led to them being in care, but mostly because the State in general is not willing to accept the same risk profile as individual parents.
I think it comes down to the many meaning of the word "care" in English. The state is certainly willing to accept way greater risk than the individual parent, in many circumstances. If we take something like daycare, which I presume is included in "care", then it's typically four children per adult until the age of 4, in schools it goes down to 20+ children per one adult, where at home it might be more than two adults per child (but also less obviously).
The risk profile is different, if you have a newborn in hospital, then that child may have their parent present at all times, plus staff, but it might also be one or two nurses and an on-call doctor for any number of babies. In some sense the potential risk is greater, but it's also more professionally measured.
>The state is certainly willing to accept way greater risk than the individual parent, in many circumstances.
I don't think that's true.
> If we take something like daycare, which I presume is included in "care", then it's typically four children per adult until the age of 4, in schools it goes down to 20+ children per one adult, where at home it might be more than two adults per child (but also less obviously).
That's a much lower care ratio than parents accepted before regulation, so I think you're arguing against your own point here.
Those ratios are heavily debated in Denmark for being absolutely terrible. Parents have been complaining for years that the ratio of especially children for 4 to 6 are awful (typically 7 children per adult).
They might be a improvement in other countries, but they are considered a move in the wrong direction here, because they are worse than previously.
Not only does care not scale, but the fact that other fields do scale is one of the sources of "cost disease" [0]. If software engineering is thousands of times more scalable than teaching, caring for children, injured or elderly people then all of those other jobs will need to pay more to prevent everyone quitting to become a software developer.
[0] https://en.wikipedia.org/wiki/Baumol_effect
This is why avoiding the need for care, while never totally achievable, is always the most scalable solution.
Yes, also simultaneously why (some) smaller companies can offer exceptional service unmatched by larger competitors.
I am reminded of the PG startup advice to “do things that don’t scale”, this seems to be one of those cases.
This could be at the core of "do things that don't scale".
Is that a world you want to live in?
This has been well-known for ages and is a major subject of feminist studies. Care jobs are mostly feminine, and don't scale, and this dichotomy plays a big role in the overall wage gap.
Say it louder for the people in the back.
There's a million examples of tech utopianists walking head-first into ideas and even entire disciplines they previously dismissed as irrelevant or outdated.
yep, super important contributions but hardly understood or studied in mainstream economics
I think in the future, descendants of today's LLM models and some future version of Tesla's Optimus could create a paradigm shift in how care is given.
I'm hopeful that when I get old, and inevitably come to need some help with living, that such a solution will be available.
This hypothetical bot can provide supportive actions - feeding, cleaning - but it can’t provide "care" in the way that people truly need.
I think this is a gross and psychopathic vision of the future. Tell your grandmother that you're going to automate away her need for human connection. What a terrible indignity. I hate my industry.
Exoskeletons should be able to help old people balance etc.
I would like the option to die painlessly before I end up needing a robot to change my diaper.
> I would like the option to die painlessly before I end up needing a robot to change my diaper.
My dad has Parkinson's and needs a human to change his diaper. If he had the option of a robot, I bet he'd take it. Not a painless die now option, though. As I write, where he is it's 8 o'clock in the morning and he's watching an old Larry David and eating an ice cream cone while my mom gets ready for them to go to breakfast.
That’s the idea of an option. Great if it works for him, but having spent a lot of time with Pieter Hintjens (of AMQP and ZeroMQ fame) before he chose the time of his own passing from recurrent cancer, the notion that this is not allowed in order to appease religious zealots is simply barbaric.
Let's then hope that the LLM solution is FOSS so that relatives and the one being cared for can be in control of the service and avoid enshittification.
What most don't understand is that the economy IS us caring for each other. When you go to a restaurant when you are hungry, or a store to get what you need, or a hospital when you get sick, you are getting care. Virtually most people are taking care of other people. And yes it doesn't scale because it takes all of us to care for each other.
> What most don't understand is that the economy IS us caring for each other.
But when those businesses we seek care from scale, the system is no longer closed.
A portion of the care I give or receive is siphoned off and sent to shareholders or a wealth business owner. When caring happens through capitalism, a portion of our care is depleted with every transaction.
Q: How many Silicon Valley software engineers does it take to change a lightbulb?
A: They will refuse to change the lightbulb, claiming it "doesn't scale" unless the "lightbulb problem" is fixed globally ;)
In seriousness, enjoyed this article and it's a wise realization. I think the world would be a better place if more people take the time to be a good person to the people around them, rather than focusing so much on big picture issues.
The premise is wrong, you can care for more than one other person at a time.
People have children, in this world we can only care about our spouse or one child?
Hardly.
Depends on what you mean by "care for". Calling your parents a few times a week to make sure they're doing OK and dropping by on the weekend doesn't take too much time and effort. But as people get older they need more and more care. Caring for one person with dementia or other similar problems that comes with aging is for all intents and purposes a full time job.
I agree with you, but I read the article as saying you can't care deeply about more than one person at literally the same instant. Your attention is directed to one or the other.
But I think even that's not literally true e.g. the social worker could make dinner for all four kids at once. And probably converse with all four of them while doing it!
But, I think I agree with the broader point that care doesn't scale, even if it does scale slightly greater than 1.
Did you read the article? He addresses this point specifically.
Strange definition of "one to one". It sounds more like 4-to-1 to me.
4 people taking care of 4 kids 24/7 in 24 hour shifts. From article:
> To get that individualized care, though, they had four social workers and four children. One-to-one. [...] But you couldn’t stray that far from one-to-one without changing the nature of the experience, without industrializing it to the point that individual care is lost.
I don't think you need the ratio of worker:child to be 1:1 in order to provide 1:1 care.
The alternative might be 20 social workers taking care of a group of 20 kids. It's the same ratio of workers to kids, since no 1 worker will get to deeply know individuals in the group.
I agree 1:1 is confusing and not totally accurate but it's fine for illustrating the point.
This is a semantics argument which doesn't really challenge his central point.
There are 4 workers taking turns looking after 4 kids. So while at any given time 1 worker is looking after 4 kids, you need 4 workers to cover all the shifts. Thus one-to-one
A lot of what makes society and politics so hard comes from the fact that humans have among the most demanding offspring of any living creature. This starts with pregnancy and birth which is a life threatening medical condition with a high mortality rate without modern medicine. We can’t reproduce and raise our children without dedicating gigantic amounts of energy to it, causing an inherent tension between the need to do so and the desires of both individuals and entities like corporations and states that want claim to that labor.
If we laid eggs and our young were viable more quickly our politics would be orders of magnitude simpler. It would basically be the politics of twenty somethings, but for everyone.
On the plus side, it’s probably why we have among the longest life spans of any land mammal. Grandparents helped with child rearing, so societies with longevity probably did a better job raising children.
I have what I think it's a very good article on the economy of care - making exactly this point and others, but it's in the dungeon of peer review for more than one year. And the reviewers do not even answer my emails.
Can it just be published on arxiv?
But then nobody cares.
But you can submit the same paper both to Arxiv and to a peer-reviewed journal, in most fields.
So... caring doesn't scale?
> Adults often come to see small-scale solutions to major problems as childish. Yeah, you could make a couple of sandwiches for the hungry—but there are billions of people who need better access to food. Maybe your effort is better spent working on solutions that can scale.
Much of this essay is baffling to me.
From 2022 to 2023 the fed funds rate was jacked up. The aim of doing this was to, among other things, drive up unemployment, so that more working class people working in supermarkets and the like would become unemployed, and to increase food scarcity for their families. The rate rise affects us as well, with tech hiring somewhat dead since late 2022.
Looking abroad - the International Criminal Court charged Netanyahu, Israel fires on and invades UN bases in Lebanon, Israeli television broadcasts Israeli soldiers raping in Sde Teiman (go look on YouTube for the footage) as rabbis and Knesset MPs swarm to defend them. Gazan children starve as European countries block weapons being sent to Israel. In the US, Biden sends troops abroad and Israel weapons to further the slaughtering, which has spread to the West Bank, Yemen, Syria, Iran and Lebanon. Also, the US vetoes at the UNSC effectively help block Gazan children being fed as they starve. Kamala Harris backs Biden and vows to continue arming and funding Netanyhu doing this, and Trump is even more belligerent. So Americans elected the person enabling this and over 98% who vote will vote for a candidate doing this.
It is not a lack of care or attention to Gazan children, Americans, or 98% of those who vote are paying attention to Gazan children and are trying to starve them - or at least are willing to trade a specific tax cut or whatnot to enable their starvation.
There's nothing about lack of individual or scaled care - the vast majority of Americans work for the opposite - to continue the famine.
Going back to the point of scale - the <2% of people not voting for candidates arming Israel and continuing the Gazan famine are working together as a mass movement and at scale and many for as the essay mentioned "socialism", because this <2% has to coordinate and work together against the 98% who are actively pursuing the famine in Gaza, or who are neutral about it and willing to trade support for it for a tax cut and such.
Gazan children don't starve because Americans don't pay individual or scaled attention to Gazan children. They starve because 98% of Americans will vote for someone who works to starve them. It is what the vast majority of Americans are and what America is. And works for domains outside Gaza - like unemployment and the fed funds rate mentioned.