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by grandalf 3601 days ago
I typed the comment in haste and so did not emphasize any of the differences. I think the main difference has to do with which of the entity's behaviors are regulated internally vs externally. This influences whether we consider failings to be incompetence or corruption, but it scarcely matters, since there is no chance for consumers/citizens to simply choose another option.

What sorts of contaminants in drinking water are harmful? How much contamination is too much? What tradeoffs are important when determining that?

Chlorine causes cancer, but it is added to the water supply to prevent bacteria growth while the water is in transit to buildings and residences. Those closest to the treatment facility get over-chlorinated water, and (assuming enough has been added) those furthest away get bacteria-free water.

Fluoride is also sometimes added to water, but it too can cause health problems. How much is reasonable, what is the right tradeoff between the dental health benefits of fluoride and the harms? Who is to decide this?

In Flint, the pipes began leaching harmful chemicals into the water supply, but the officials ignored reports of the problem. Why weren't citizens quickly aware that the water entering their homes (and bodies) was poisonous? Because the public trusts government to do a good job and not to be corrupt.

Public health standards dictate whether an old person gets stents or a coronary bypass operation or neither. There are age limits that apply regardless of health, because of the average health of people of certain ages.

In all cases, public health guidelines are fraught with tradeoffs that inflict intentional harm, usually to conserve resources, etc.

The problem is that the public believes these guidelines to be in their individual best interest. Th public also believes that water deemed safe by regulators is actually safe to consume over the long term, when it may not actually be.

Is it safe to ride in a car with seatbelts and no airbags? Is it safe to drink city water for municipality X for 20 years? How many people will die due to not having an airbag? How many due to low level contamination in the water? Someone is making this judgment call on behalf of everyone, but due to the need to preserve their political authority, the tradeoffs and weaknesses of the approach are not surfaced. They can't say "buy a home water filter" because then they are discriminating against people too poor to do so.

How many poor people live in buildings with water pipes that were grandfathered into code compliance but still create health risks? How much health risk is "reasonable" to prevent the landlord from having to replace pipes?

Similarly, regarding net neutrality, how many startups can never succeed because the "net neutral" latency is too high for the service they wanted to build?

Many of these things are minor, but across the whole spectrum of imperfectly regulated things, are all exposed to significant risk and harm. It's the things we don't tend to focus on (like what constitutes safe water) that are the most likely to harm us, and when we're grieving because a grandparent is sick we are not likely to be thinking about the standard of care that made him/her ineligible for a therapy that had a 1 in 5 chance of extending his/her life by a few years.

Institutions desire power and authority, and they often start out by doing some sort of useful service. But they are easily corrupted. One hallmark of tyranny is the creation of a top down idea of the "greater good". We must be vigilant to prevent our trusted institutions from embodying this sort of tyranny, even on issues that seem inconsequential or minor.