Comment by dasil003 | Hacker News Reader

Comment by dasil003 | Hacker News Reader

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The problem is that stuff isn't what makes people happy. Sure if you give a poor person money they'll be happier, but that effect doesn't work for the middle class and above where people generally want a little more than they had before, and a little more than their neighbor. Of course a lot of people realize that material wealth won't make them happy, but that's an individual philosophical point that doesn't carry a lot of weight when you feel comparatively disadvantaged.

The real problem you have to solve then, is not the quantity of stuff, but the allocation of stuff. This is very difficult one to solve, especially in America, because of the deep puritanical culture. It's going to get a lot worse too as robotics, software and automation lead to ever greater consolidation of wealth. This is where capitalism starts to break down as economies of scale push us towards something resembling a feudal society, but the problem is we don't have any other system that people are ready to accept as "fair".

The problem is wealth affects happiness more than it used to because of things like health care. Give yourself a nice middle class healthcare plan. Give me wealth. If we both get cancer I have a lot more options and more ways to guarantee the highest level of care. Wealth makes happiness if it enables you to stay alive.

Likewise with opportunities for raising children - there are lots of ways to help children thrive with wealth, but it's not what i would consider the classical "material need".

I disagree with you, because there are countries on earth where wealth doesn't play as big of a role in happiness as it does in the American culture. Take Sweden for example, where I'm from, where literally every citizen has access to top-tier healthcare & education that's free (funded through taxes), 16 months paid parental leave, among many other nice things. This while still being very liberal (although social democratic) and one of the world's most developed countries in terms of technology, energy, transportation and taking care of the environment.

Over here happiness can be found without being wealthy, and generally you don't have to worry about your financial status as much because you'll always have access to top-tier healthcare, education and benefits if things goes south at some point, no matter what.

If you get what appears to be a routine cancer in Sweden, does an entire team of leading oncologists meet together in a room to fully review your diagnosis and discuss what additional cutting edge techniques you might benefit from?

Do they apply machine learning to help you that is so good 30% of the time it suggests actionable ideas that the oncologist didn't notice or even know about?

In Sweden if you have hepatitis C, do they give you the gold standard treatment that costs $70,000 US for 90 days of pills, or do they give you the older cheaper option?

Today, you get all of that and more if you have enough money.

I did live in Canada for a while, and noticed it was very common for the wealthy to bypass lines and access higher quality care by paying for private treatment out of pocket.

The reality is not many governments have the resources to afford the best possible care for all people in all situations. And innovation makes it worse. There is always something newer, better, more expensive.

You have to understand that this is a cultural difference between Sweden and the US, and Canada is more like Sweden but far from the same. In Sweden, the culture of things like the best possible healthcare and education is not a "premium" thing like it is in the US, over here it is seen as a basic human right to have access to the best possible healthcare and education no matter what your financial status is.

Thanks to this culture, ideas like making a profit off of peoples health issues is frowned upon and therefore medicine for example is not even close to as expensive as it is in the US. It's the same with the 16 months parental leave, it's considered a basic human right to be able to spend more time with your newborn if you want to, without impacting your finanical status as much.

Of course there is always something better available if you've got the dollar for it, but the Swedish healthcare is generally very good. I've had an uncle done heart surgery, a friend with brain tumour and both are healthy as horses now and they didn't have to spend any money.

I should also mention that the Swedish people is generally very healthy thanks to our laws and EU directives surrounding food and medicine standards. Overall the quality of food is better here than in the US, due to new chemicals has to be proven that they are not harmful to your health, while in the US new chemicals has to be proven that they are harmful to your health before it can get banned (so all new chemicals are banned by default, and allowed when proven otherwise). Additionally, antibiotics and other harmful medical treatment for livestock is banned in Sweden, so the resistance towards antibiotics is generally lower here as well. The reason I mention this is because it goes hand-in-hand with our government-funded healthcare. We invest a lot in making the people healtier overall.

This is a cultural difference, and the reason I stress that so much is because I don't want you to mistake this for a socialistic country, like so many do, because Sweden is very liberal overall.

It sounds like a great place to live and I appreciate the difference of culture you describe.

However, you didn't answer my three real life questions, which I take to mean most people wouldn't get those benefits.

The people there who decide what is allowable treatment are optimizing for a certain cost/benefit ratio. While wealthy people only optimize for quality of life and longevity.

The reason I didn't answer those question is because I am not a doctor and personally don't have any experience with any of those particular cases. I'd love to answer each of your questions point blank, but I just don't have an answer to them.

But the point of my response is that there are cultures in the world where healthcare and education isn't a problem for your happiness, because your citizenship has those benefits covered. I do however fully agree with you that it is as you say in the American culture, and many others.

That's not true in all countries. In France no matter what your wealth is, when you get a long-lasting disease like cancer you get 100% coverage from the public healthcare for that and can be cured in high quality hospital.

Now if you're extremely rich you might be able to get a famous surgeon that middle class doesn't have access to, or get a new treatment only available in foreign countries, but at the end of the day I don't think it's going to have a huge impact on your chances of survival because what you get from healthcare is already really good.

I think it is true in almost all countries. Please see my reply above to Svenskunganka's comment.

I'd be willing to bet most wealthy people in France have occasion to pay out of pocket beyond the healthcare they could get for free from the government.

I'm not quite sure what your point is.

Yes, there is always something better that only the wealthy may afford-but that doesn't mean the baseline level of care for most people can't be improved. People don't expect the world's best surgeon to work on them.

And either way-the care for most Americans isn't necessarily better than Canadian or Swedish care, many rankings are significantly worse while costing the most.

I know one thing-if I had health care covered, I'd be more willing to start a business or take a break from work. That would make me happier.

The point is that being very wealthy can in fact improve happiness. This is contrary to conventional wisdom that once basic needs are covered, any additional money only serves to keep people running on the hedonistic treadmill.

To support this argument I cite real world scenarios where the difference between your loved ones living and dying could possibly come down to how much money you have.

Distributing things equally is not possible. For example, if you need heart surgery, who gets the best surgeon? For another, who gets the dwelling with the nicer view? Even parents who try to treat their kids equally soon realize it is an impossible task.

Note that the comment you replied to didn't mention distributing things equally. Just noted that allocation is the problem that needs to be solved.

Not speaking to you in particular, but many people seem to equate any talk of redistribution to the extreme case of absolute equal distribution. But I've never seen anyone rationally arguing for that case. In reality, what most people seem to want involve some concept of 'fairness' in deciding who gets what, or minimums to what people should get just for being a part of society, or perhaps sane limits to the deviations between bottom, middle, and top.

So, yes, the questions you ask are exactly the questions we need to solve. How do we decide who gets the best surgeon, and who gets the trainee? How do we decide who gets a mansion with a view and who gets a closet with thin walls, if that? Most people seem to think that the way we are doing it now isn't ideal, so what is ideal, and how would we get there?

Your questions are unresolvable, because the person who gets the worst heart surgeon is inevitably going to agitate that the system is inequitable and unfair.

It isn't solvable in a binary way, certainly, but we can potentially find an optimal solution that at least reaches a level of fairness that the vast majority of people are comfortable with. Yes, you're always going to end up with some people unhappy with their lot, but there's a huge gray area between not pleasing everyone and not pleasing anyone (aside from a very few very lucky people).

If the most benefit for the most people is your criteria, historically a free market coupled with enforcement of basic rights has done the best.

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