Scott Alexander discusses the ethical dilemma of writing doctor's notes for back pain as a psychiatrist, leading to reflections on 'bullshit jobs' and procedural inefficiencies in the economy. Longer summary

Scott Alexander discusses the ethical dilemma of writing doctor's notes for patients with back pain, despite being a psychiatrist. He explores the pros and cons of writing such notes, and shares his strategy of radical honesty. This leads him to reflect on David Graeber's concept of 'bullshit jobs' and how much of the economy might consist of similar procedural rituals that don't add real value. The post highlights the tension between following procedures and providing practical help, and questions why profit-focused companies would engage in such seemingly inefficient practices. Shorter summary

Scott Alexander examines the phenomenon of cost disease, where costs for basic services like education and healthcare have increased dramatically without corresponding improvements in quality or wages. Longer summary

Scott Alexander explores the concept of cost disease, where costs for essential services like education, healthcare, and housing have increased significantly over the past few decades without corresponding improvements in quality or wages. He presents data showing how these costs have risen much faster than inflation, while worker salaries in these fields have remained stagnant or even declined. Alexander considers various potential explanations for this phenomenon, including market failures, increased regulation, lawsuit fears, and changing risk tolerance. He argues that this cost disease is a major factor behind many current political and economic debates, and expresses concern about its impact on living standards and economic progress. Shorter summary