This article from Scott Alexander may be the most important secular thing I’ve read recently. It’s about cost disease. In so many areas of modern life, things cost multiples of what they used to. Sometimes the service has improved slightly. Sometimes the service has gotten worse.
In public education, the scores are flat for decades. The costs have gone up 3x.
College is even worse. A degree is worth much less than it used to be. The cost of a degree has rocketed.
Health care. 5x cost increases, slight improvements in lifespan.
Housing. Costs are way up. Houses have gotten bigger, but commutes have also gotten longer.
You need to read the whole thing. A lot of instant explanations are false.
We are in the middle of a national malaise. The reason we got Trump is that our elites don’t know how to fix the problem, don’t even reliably know what the problem is, show little interest in fixing the problem, and repeatedly lie about the problem.
On education: while I believe that a lot of the rise in cost is bureaucratic and program bloat, a different perspective is that given the demographic changes over the last few decades, and given the cultural collapse of the family and of bourgeois values, maintaining the same scores for only 3x the cost may be better than it looks.
The same may apply in part to medical care. Demographic, familial, and values collapse means more lawsuits and more randomness in the delivery and receipt of medical care, which evokes a response of more rules and procedures and control–which makes a system less flexible and more expensive. The same factors may lie behind the shift to expensive private rooms in hospitals. The last two times my wife gave birth, we were probably the only married people on the floor. Everyone else was tatted up with rotting teeth. The nurses looked a lot more tired than they had before–they told us they had to lock the snack cabinet now, because patients’ boyfriends had taken to stealing it. They also had to watch while the new mothers ate their hospital delivered meal, to make sure the boyfriends didn’t eat it instead.