I get the impression that the real problem with health care specifically is that we are keeping sicker people alive longer with more effective (and expensive) treatments, and this increased cost is not being reimbursed by valuable work done by those sick people. In simplistic economic terms it is not cost-effective to keep a certain class of people alive or healthy. Is that analysis evil? I think so; automation will almost certainly put 99% of unmodified humans into that class at some point in the future. The practical effect is perhaps what we are seeing; Walmart and McDonalds can't afford to pay enough money to keep their minimum wage workers as healthy as a Silicon Valley tech worker or a NY banker, and the difference in achievable healthcare outcomes between a low income worker and a high income worker has increased significantly in the last 50 years. Remember when cancer and heart disease and even diabetes used to kill people (rich or poor) quickly and cheaply?
Guaranteed basic income or minimum wage aren't sufficient on their own to solve the problem. Total production efficiency (or at the very least medical/health care efficiency) has to increase at a rate equal to or above the rate that medical treatments and medical technology advance. When automation unemploys people from McDonalds and Walmart they will still get sick. at roughly the same rate, and with the same diseases. The total cost of providing healthcare will not go down, barring increases in efficiency, and the cost of welfare would increase. Given those assumptions it seems like the best action is to allow McDonalds and Walmart to continue to employ people at existing, sustainable wages and leave them on welfare, and implement as much of basic income or increases in minimum wage that the rest of the economy can bear to prepare for widespread automation, and focus heavily on automating medical care to improve its efficiency.
I get the impression that the real problem with health care specifically is that we are keeping sicker people alive longer with more effective (and expensive) treatments, and this increased cost is not being reimbursed by valuable work done by those sick people.
Does that have anything to do with Walmart or health care for workers?
Note: Originally posted in Discussion, edited to take comments there into account.
Yes, politics, boo hiss. In my defense, the topic of this post cuts across usual tribal affiliations (I write it as a liberal criticizing other liberals), and has a couple strong tie-ins with main LessWrong topics:
The issue is this: recently, I've seen a meme going around to the effect that companies like Walmart that have a large number of employees on government benefits are the "real welfare queens" or somesuch, and with the implied message that all companies have a moral obligation to pay their employees enough that they don't need government benefits. (I say mention Walmart because it's the most frequently mentioned villain in this meme, but others, like McDonalds, get mentioned.)
My initial awareness of this meme came from it being all over my Facebook feed, but when I went to Google to track down examples, I found it coming out of the mouths of some fairly prominent congresscritters. For example Alan Grayson:
Or Bernie Sanders:
Now here's why this is weird: consider Grayson's claim that each Walmart employee costs the taxpayers on average $1,000. In what sense is that true? If Walmart fired those employees, it wouldn't save the taxpayers money: if anything, it would increase the strain on public services. Conversely, it's unlikely that cutting benefits would force Walmart to pay higher wages: if anything, it would make people more desperate and willing to work for low wages. (Cf. this this excellent critique of the anti-Walmart meme).
Or consider Sanders' claim that it would be better to raise the minimum wage and spend less on government benefits. He emphasizes that Walmart could take a hit in profits to pay its employees more. It's unclear to what degree that's true (see again previous link), and unclear if there's a practical way for the government to force Walmart to do that, but ignore those issues, it's worth pointing out that you could also just raise taxes on rich people generally to increase benefits for low-wage workers. The idea seems to be that morally, Walmart employees should be primarily Walmart's moral responsibility, and not so much the moral responsibility of the (the more well-off segment of) the population in general.
But the idea that employing someone gives you a general responsibility for their welfare (beyond, say, not tricking them into working for less pay or under worse conditions than you initially promised) is also very odd. It suggests that if you want to be virtuous, you should avoid hiring people, so as to keep your hands clean and avoid the moral contagion that comes with employing low wage workers. Yet such a policy doesn't actually help the people who might want jobs from you. This is not to deny that, plausibly, wealthy onwers of Walmart stock have a moral responsibility to the poor. What's implausible is that non-Walmart stock owners have significantly less responsibility to the poor.
This meme also worries me because I lean towards thinking that the minimum wage isn't a terrible policy but we'd be better off replacing it with guaranteed basic income (or an otherwise more lavish welfare state). And guaranteed basic income could be a really important policy to have as more and more jobs are replaced by automation (again see gwern if that seems crazy to you). I worry that this anti-Walmart meme could lead to an odd left-wing resistance to GBI/more lavish welfare state, since the policy would be branded as a subsidy to Walmart.