I work with formerly homeless addicts in recovery. The economics of it are challenging. The program is funded by sober church people because our "customers" literally don't have money to vote with. I guess you could say that relapses are a "purchase" in which they have chosen substances over sobriety. Rehabs function as a form of voluntary friction, making sobriety the default, and substance use something you have opt into. We need to use other indicators of preference because money isn't available. But the leg room problem is difficult to solve because there's no market feedback to give the lie to stated preferences.
Healthcare is interesting. It is very high quality, very expensive in America. But we have insurance. Do we really want to pay for an unshared hospital room? If I were an insurance company, I'd offer the insured patient $100/day if they agreed to have a shared room, and I bet most people would take it and both patient and insurance company would be better off.
Roommates are a concern. Even just 20-30 years ago older people would complain about a hospital roommate either moaning all night in pain or watching loud TV as a flawed way to cope. People would say how it was so foolish to spend all the time and money on surgery for someone and not let them sleep at least as well as they could in a hospital to help them heal.
Hospitals could try pairing up only roommates who are likely to suffer less but efficiencies already send some easier patients (at least those with insurance) to either Urgent Care or outpatient surgery centers.
Private rooms means relatives, often a spouse, can stick around and advocate for the patient. The usual, to make sure each doctor gets the story straight, to watch for errors, and to go to the nurse's station when something goes wrong. People needed to do that if they wanted the best care even before Covid era staffing cuts.
More, better hospice might be better than roommates. Get people home who don't want to die in a hospital. It always seems like a lot of work for the family to get hospice arranged with a lot of time invested rather than money. We might need changes in employment law to deal with hospice being an often passive also a 24/7 situation. Obits that mention donations to the local hospice suggest that people value it even if the market connection is murky.
"People complain about this. It does destroy consumer surplus." Only if the airline has market power, e.g. monopoly. If airlines compete for the route, they will compete for each variant of seat too.
"An organization with an endowment so large it buffers against a need to retain a constituency is probably going to go off mission and maybe even go crazy to boot"
This problem is common enough to have a name: donor intent violation. Very common among grantmaking foundations and somewhat common among eds & meds (although with the latter, distorted markets contribute as much as endowments do).
That's an interesting point. I'm interested in you bringing out your last statement. I don't think we have access to money on some basic level, and some people are naturally very frugal. I think the market is a meaningful way to connect with some larger community, but I do wish there were better forces which were more linked to us. The only things I pay more for are things that are beyond better quality that the extra buck or two doesn't come close to the savings made by higher quality (e.g. dishwasher soap, laundry detergent). I still want more legroom, though. Some airlines have them so close it pinches you if someone leans back. The marketplace sorta selects against frugality.
As someone who has been a leader in the military, business and the church, people always complain about leaders and leadership but very few are willing to step up and be a leader because with it comes all the complaints. They all have “great” ideas or solutions but don’t want to do anything about it. As a former boss of mine used to say, “Nothing is impossible if you don’t have to do it yourself.”
Tbh, I'm not sure we have a culture that sorta has "becoming a leader" integrated. It's sorta the wild west sometimes, and a lot of cultures privilege social conformity over working hard or taking charge. I stopped wearing nice clothes to interviews on the west coast because it comes off badly (and not impressive as in TX).
I work with formerly homeless addicts in recovery. The economics of it are challenging. The program is funded by sober church people because our "customers" literally don't have money to vote with. I guess you could say that relapses are a "purchase" in which they have chosen substances over sobriety. Rehabs function as a form of voluntary friction, making sobriety the default, and substance use something you have opt into. We need to use other indicators of preference because money isn't available. But the leg room problem is difficult to solve because there's no market feedback to give the lie to stated preferences.
Healthcare is interesting. It is very high quality, very expensive in America. But we have insurance. Do we really want to pay for an unshared hospital room? If I were an insurance company, I'd offer the insured patient $100/day if they agreed to have a shared room, and I bet most people would take it and both patient and insurance company would be better off.
Roommates are a concern. Even just 20-30 years ago older people would complain about a hospital roommate either moaning all night in pain or watching loud TV as a flawed way to cope. People would say how it was so foolish to spend all the time and money on surgery for someone and not let them sleep at least as well as they could in a hospital to help them heal.
Hospitals could try pairing up only roommates who are likely to suffer less but efficiencies already send some easier patients (at least those with insurance) to either Urgent Care or outpatient surgery centers.
Private rooms means relatives, often a spouse, can stick around and advocate for the patient. The usual, to make sure each doctor gets the story straight, to watch for errors, and to go to the nurse's station when something goes wrong. People needed to do that if they wanted the best care even before Covid era staffing cuts.
More, better hospice might be better than roommates. Get people home who don't want to die in a hospital. It always seems like a lot of work for the family to get hospice arranged with a lot of time invested rather than money. We might need changes in employment law to deal with hospice being an often passive also a 24/7 situation. Obits that mention donations to the local hospice suggest that people value it even if the market connection is murky.
"People complain about this. It does destroy consumer surplus." Only if the airline has market power, e.g. monopoly. If airlines compete for the route, they will compete for each variant of seat too.
"An organization with an endowment so large it buffers against a need to retain a constituency is probably going to go off mission and maybe even go crazy to boot"
Example 1: The Ford Foundation
This problem is common enough to have a name: donor intent violation. Very common among grantmaking foundations and somewhat common among eds & meds (although with the latter, distorted markets contribute as much as endowments do).
That's an interesting point. I'm interested in you bringing out your last statement. I don't think we have access to money on some basic level, and some people are naturally very frugal. I think the market is a meaningful way to connect with some larger community, but I do wish there were better forces which were more linked to us. The only things I pay more for are things that are beyond better quality that the extra buck or two doesn't come close to the savings made by higher quality (e.g. dishwasher soap, laundry detergent). I still want more legroom, though. Some airlines have them so close it pinches you if someone leans back. The marketplace sorta selects against frugality.
As someone who has been a leader in the military, business and the church, people always complain about leaders and leadership but very few are willing to step up and be a leader because with it comes all the complaints. They all have “great” ideas or solutions but don’t want to do anything about it. As a former boss of mine used to say, “Nothing is impossible if you don’t have to do it yourself.”
Tbh, I'm not sure we have a culture that sorta has "becoming a leader" integrated. It's sorta the wild west sometimes, and a lot of cultures privilege social conformity over working hard or taking charge. I stopped wearing nice clothes to interviews on the west coast because it comes off badly (and not impressive as in TX).