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19 comments
Taylor Nichols, MD :verified: replied to Carl T. Bergstrom

@ct_bergstrom would be curious to discuss this in the context of healthcare and health system collapse because this fails perfectly or maybe parallels exactly what is happening in healthcare right now.

Prasad Jallepalli, MD, PhD replied to Taylor Nichols, MD :verified:

@Tnicholsmd @ct_bergstrom As an economy, we continue to underfund services that are not only societal goods in "normal" times but critical and essential in times of stress (which are all-too-common).

Resilience and robustness require surplus capacity.

Carl T. Bergstrom replied to Prasad Jallepalli, MD, PhD

@jallepap @Tnicholsmd

Yes. And I think what's so interesting to me about this example is that it's not a matter of underfunding resilience. It's a matter deliberately engineering fragility because it turns a profit most of the time.

Thank you. This is helping me so much to clarify my own thinking.

costrike replied to Carl T. Bergstrom

@ct_bergstrom @jallepap @Tnicholsmd it's like what's been done to our medical system. Engineering things thus is great for maximizing returns, but not so great for dealing with unusual spikes in demand.

Taylor Nichols, MD :verified: replied to Carl T. Bergstrom

@ct_bergstrom @jallepap I think that’s exactly right. We find and run emergency departments on the thinnest possible level of resilience to maximize profits for all involved. But we fund other emergency services via government funding to have optimal staffing at all times (fire, EMS, etc). I truly cannot fathom why others couldn’t possibly imagine this also being a good idea for medicine.

Jim Vernon replied to Carl T. Bergstrom

@ct_bergstrom You can edit the link in your original post.

Edit

Test

Carl T. Bergstrom replied to Jim

@jimvernon Not without orphaning every followup post and response.

Jim Vernon replied to Carl T. Bergstrom

@ct_bergstrom I just edited mine and it still shows your reply.

Crystal Steltenpohl replied to Carl T. Bergstrom

@ct_bergstrom @jimvernon Edit and "delete and redraft" are different. If you're posting through an app, it may not have the edit function yet, but I think most servers have it on the web client.

Carl T. Bergstrom replied to Crystal

@cnsyoung @jimvernon Thank you. It's not present on the web client for fediscience.org but I sure would love to have access to such for situations like this.

Crystal Steltenpohl replied to Carl T. Bergstrom

@ct_bergstrom Interesting -- it's there for me on the browser (I'm also on fediscience) but it's not on Tusky (Android app)

Crystal Steltenpohl replied to Crystal

@ct_bergstrom Anyway also wanted to say this sounds like it's needlessly frustrating and I'm sorry your family (and so many others) are having to deal with it. Travel is stressful outside of holidays but it seems especially shitty when companies pull this stuff during times when people would at the very least probably prefer to be on the phone with the families they're trying to visit or something rather than on hold/reconnecting with a service agent.

Leigh Honeywell replied to Carl T. Bergstrom

@ct_bergstrom in government service design I’ve seen this referred to as “rationing by friction” eg this fantastic thread on the bird site by @allafarce: twitter.com/allafarce/status/1

But yes it’s very much deliberate. One of my new years project ideas is actually to lobby the 🇨🇦 gov to mandate that airlines offer call-backs; there’s no excuse at this point to not, and the human cost is so high.

Carl T. Bergstrom replied to Leigh

@leigh @allafarce

Precisely. "Rationing by friction" is a great term. This is a major issue in (1) research grant applications and (2) journal submissions.

And wonderful about your idea for lobbying CA.

Stuart Marks replied to Leigh

@leigh @ct_bergstrom @allafarce Good term, “rationing by friction.” Happens in corporations too. If a department wants to ban something but they know they can’t get away with it, they allow it but require a VP signature. Still too much of it happening? Require a senior VP or an executive VP signature instead.

Cavyherd replied to Leigh

@leigh @ct_bergstrom @allafarce

Predicted "excuse": "But the staff shortages... 😫"

Jim Vernon replied to Carl T. Bergstrom

@ct_bergstrom Edit comment aside, I thought I was going to disagree with your take on corporate customer service, but you make a good point about being able to automate much of it. So much of what we call in for could easily be done by the customer instead of an agent.

Yogthos replied to Carl T. Bergstrom

@ct_bergstrom you can actually edit the original post

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