We could easily support our current population and quite a bit more if we actually respected and shared our resources responsibly.
I think this is a monumentally bad argument. Statistically, you are typing this from a computer or smartphone, with internet access, and are probably part of the segment of humanity that consumes the most resources (as am I). You are saying that if we want to have 15, 20, 30 billion people, we can all just live like the most impoverished people in the world and it will be fine.
It's a quality vs. quantity problem. Maximizing human numbers means we must have very low per-person consumption to minimize impact. Maximizing quality of life means we can all eat/travel/live/consume how we want and the environmental impact will still be low (but with fewer people). I think that's far more desirable.
EDIT: to distill down the argument further - you support voluntarily decreasing your standard of living, so that we can grow the population more, for the benefit of.... ? Creating lives that have not yet been born and can't care?
Whatever you want, I personally do not want a decrease in my standard of living, and especially not to feed the capitalist machine that requires growth at all costs. I presume, if faced with a real and present choice of the same kind, most people would choose to uphold their standard of living instead of sacrificing, only so that more billions of people can be born. When is it enough? Do we really NEED 8B+ people? I wouldn't mind living in a world of <1B people where everyone has luxury and plenty without destroying the planet in the process. We can't get there, but the principle still holds. Put resources into solving the problem of elder care, and just let the population decline naturally.
I mean, I’ve always said that the population is a real problem with no good solutions. People are uncomfortable talking about it because there are no good solutions, but that’s no reason to pretend it doesn’t exist. But people act like even mentioning it is the same as proposing or supporting an unethical solution.
I agree with mostly everything you wrote in that, except to say that the problem is mostly manmade and is economic in nature.
Problem: demographic collapse causes a top-heavy (old-heavy) population pyramid whereby there aren't enough young people to take care of the aging population. This is a real problem that we should engineer ourselves out of. Maybe a higher % of the workforce is redirected to healthcare, in part by automating away bullshit jobs like fast food and retail workers. Maybe we make advances in automation/robotics/AI that allows some of the caregiving labor in hospitals and nursing homes to be done by machines instead of people (extending the productivity of the human labor). Those are problems we should be working towards solving, and plausibly could solve if the political and economic will were there. I hope Japan and South Korea get really far into solving this before it becomes a problem everywhere.
Problem: our entire economy is predicated upon infinite growth, and the nanoinstant that belief in future growth falters, the stock market and entire economy collapses in a way that makes the Great Depression look like a quaint blip. This is unsolvable. All of the wealthy, powerful, and political factions would revolt if anything threatened their prospects of unlimited future growth. The entire world economy is a ponzi scheme that requires new markets, new consumers, and perpetual growth even to exist at its current level. When you hear "growth is priced in", that's basically the fundamental corner we've painted ourselves into. The markets assume untenable growth now as the baseline, and if the mirage falters, the economy will tank shockingly quickly. This is the Faustian bargain of late stage capitalism.
As it stands, the population growth has peaked, and the population will naturally peak and then decline. Nobody needs to be killed or sterilized to make this happen - it will happen on its own. The reason seems to be rooted in the education level of women, and the availability of reliable birth control. As someone once eloquently put it: "the average woman would choose to give birth fewer than 2.1 times" (replacement rate).
As a final thought, I will never agree with people who assert that the "carrying capacity" of Earth is far higher than the present population - double or more. This entire premise is based on living like an impoverished person in India or Africa. They will freely admit that the "carrying capacity" is much lower if the baseline living standard is the middle class of developed countries. Most of North America and Western Europe is wildly rich by global standards (fact). I'm here to say that still higher standards are desirable and attainable, at low global impact with lower global populations. We should all be filthy, filthy resource-rich, and to deprive us of that because the Earth "should" have 10-20 billion humans is fucking bollocks.
It's like clockwork - you can almost set your watch by someone responding like that to pointing out the obvious that human population is straining global resources and making life worse for everyone.
I like to phrase it as this: who is the ecofascist? The person advocating for sustainable human population, or the person telling everyone we need to tighten our belts, give up meat, eschew fossil fuels and personal transportation, and live like a pauper in a cheap cookie-cutter dystopian apartment complex to prevent overconsumption? I would argue it's very much the latter.
Personal ethics aside (not everyone wants to eat meat and burn gas), everyone could live like a modern-day billionaire if there were fewer people. Everyone could have beachfront and slopeside property. Can't do that with 8.3 billion people. Isn't that the goal of fully-automated luxury gay space communism?
For a layperson, you are unbelievably, stubbornly confident in your incorrectness. You cannot possibly know the depths of your ignorance. I am an expert, and I will continue fixing the problems caused by bad international dentistry for a healthy fee. You don't need to believe it for it to be true, and your denial does nothing to change my daily reality in practice. Good luck.
With all due respect, you don't know what you don't know. In case you missed it, I am a US dentist. I spend every working day dispelling laypeople's misconceptions about dental work. What work they have, what work they need, benefits and drawbacks, etc. Your post hits on some of the many very common misconceptions.
Fortunately, there are plenty of ways to check the efficacy of medical procedures.
You can get x-rays, MRIs and all sorts of after-care examinations performed by your choice of trusted doctors and dentists if you are unsure of the quality of care you received.
Not all work can be evaluated, even with x-rays, as restorative materials often hide the most important details. MRI is irrelevant for dental. X-rays are just a tool, not the final word, and they can't reveal certain things. Bacterial ingress and leakage is, for all intents and purposes, invisible. Most docs (in both medicine and dental) are exceptionally reluctant to disparage another's work. It is considered unprofessional and unethical to bad-mouth another professional. That's just how we're trained.
A strong indicator will be how you feel after the procedure, which is why I include patient surveys in all of my posts about medical care abroad. Very importantly, other than the higher-rated equipment, expertise and report accuracy, patient satisfaction regarding care quality in Thailand is rated higher than in the US, for example.
This could not be further from the truth. Discomfort and success are completely different things. Some extremely high quality, ultimately-successful treatments will make you feel like shit afterwards. Often, post op symptoms are more closely a matter of chance than they are of quality. Patient satisfaction and surveys are complete worthless bullshit, as evidenced by hospitals' Press Ganey scores, etc. See Goodhart's law. Docs hate chasing patient satisfaction because it is so poorly correlated with actual quality care. Telling the patient "no, this will have a poor outcome" gets you bad reviews, while doing a slipshod job that is unlikely to last but looks superficially good gets you patient satisfaction. I see it CONSTANTLY. Smooth-talking, kind-seeming, gentle dentists whose skills and ethics are complete trash. Patients can't tell the difference. This is why so many people love Nurse Practitioners, who are poorly trained and often happy to act as a rubber stamp for what the patient is asking for, even if it is not in their best interests. People love "yes men".
Remember, Yelp and Google reviews are both astroturfed by business owners, and used as a weapon by disgruntled people and competitors alike. There's a local dentist office that's still under construction and it already has 30+ 5-star reviews in Google. Hasn't seen a single patient yet. I would not be too trusting of reviews in general.
You have taken your subjective experience and tried to use that to say the work is objectively good. That's not how any of this works.
Now could that work actually be good? It could be. This is not to say that all foreign dentistry is bad, but SO MUCH OF IT IS. I know because I see it. The fact of the matter is, patients generally don't know the difference between good and bad work. I see patients all the time who said some absolute basement-tier-garbage work was done by their previous dentist, who they adored.
Incorrect. This applies to most medical care destinations outside of the US; follow-up care is essential abroad and is usually presented in a contract and verbally confirmed with you before any diagnosis even takes place, let alone a procedure. You have access to all the documents and files your hospital abroad does and are also free to share those or ask your hospital to share the documents with other doctors and clinics of your choice.
Ask any orthopedic surgeon what they think of foreign procedure mills offloading post-op knee-replacement care to an unfamiliar doc in the country the patient is visiting from. This is a huge issue docs discuss in private - patients flying to wherever for cheap, substandard treatment and leaving them to manage the complications. It's a big issue in places like FL and NY, but also broadly everywhere.
Many treatments, you get essentially one chance to get it right, and fixing it is either impossible or 10x as much difficulty. Getting it right the first time is priceless. You can fuck up a tooth in an instant. Destroyed. Cannot be fixed. Some errors are invisible and don't hurt right away. Many infections are painless or hard to diagnose from typical x-rays. Many compromised teeth spend a few years feeling normal before they fall apart. I know this because I see it every day. I'm the one who gets to fix others' mistakes - if they can even be fixed.
As a practicing professional who spent the majority of my training seeing a high % of international dentistry, it's hard to watch.
Dental work is my most common healthcare experience abroad. I cannot recommend Thailand enough, especially for dental work, nothing but 5 out of 5 dentistry for me so far.
What it all boils down to is: how can you know the work done was good? You can't. You can know it looks good superficially. You can know the dentist was nice, or that their office was clean, and that the bill was low. You can't know if the work is actually good. You don't know if they are intentionally overlooking long-term health for doing what the patient/customer wants right now. You don't know if the materials or techniques would be considered substandard in the US. Yes, other countries often have a different "standard of care". I have seen ABYSMAL work from Asia and the Middle East. I have seen appalling work from Mexico, Central America, and Eastern Europe. Yes I also see bad work done by local US dentists - primarily those who advertise themselves as being some kind of affordable, emergency, or discount office -- but consistently the worst dental treatment I see is foreign. How do I know? I'm the one who has to fix it, if it can be fixed.
Dental tourism scares the hell out of me as a dentist in the US, but I understand why it appeals to people when quality care here is expensive. I have seen bad work from every country in the world, including the US, but the trend is you largely get what you pay for. The offices that accept every insurance under the sun are doing work at discounted fees, and usually cutting corners to do more of it. Medicaid? Pays less than the cost of providing the service unless serious corners are cut. Those are the US-side problems, but the dentists working for poverty wages in India are doing much worse things, on average.
Why is it often worse? With dental tourism you get no follow-up care. You also have no recourse if they fuck up your mouth. Good luck suing a dentist in Mexico or Thailand for malpractice. Turns out, the more financial incentive you have to practice high-quality care, the more you have to lose from fucking up and losing your license.
EDIT: This is "Work Reform", not "Fuck Everyone Who Has More Skills And Makes More Money Than Me", although you wouldn't know it from the types of responses sometimes. Quite frankly dentists are workers, whether employees or practice owners. They only earn what the work of their hands allows. They are not exploiting other workers to do the billable labor, because legally they cannot allow non-dentists to do the vast majority of billable work (there are small exceptions that account for a tiny % at most practices). They are not capitalists. The downvoters just hate the message and would rather shoot the messenger than listen to someone who knows from the inside.
All this boils down to is that there is nothing more expensive than first-world human labor. Without a doubt, nursing homes are increasingly run by sleazy profiteers, but the reason you can't easily do better (i.e. find a high-quality nursing home) is because it's simply expensive to employ enough people, who have sufficient skill and work ethic, to give the elderly care.
Yes, PE in healthcare is destroying the country in every imaginable way. The answer in this case is more complicated than get the for profit companies out of nursing homes, which is necessary but not sufficient to solve the problem. The scariest thought is that there may be no good solution.
See my other comment, but the situation was very different 20 years ago. Building a kit cost you a lot more in time than it did money. This is no longer the case.
Believe it or not, going back a few decades, personal flying (a real, certified, manufactured airplane, not a kit-built) was extremely middle-class attainable. I knew a couple of blue collar guys (would be age 70-80 now) who owned their own planes in the 80s.
Experimental aviation hung on a little longer and people were able to affordably build their own planes a couple decades after the price of a new Cessna or Piper got a bit steep. Like everything else, inflation, COVID, social media, and corporate greed ruined that too. Now Lycoming will charge you 50-100k for just an engine. Not including prop or actual plane. Even if you could build the plane part, the engine is unaffordable. Larger engines for a larger plane, or without a "builder" discount are even more eye-watering, they come with a years-long waitlist, and the quality control seems to actually be worse than historically. The price of engines has doubled in the last 5-6 years alone and they pump the price quarterly. Pure greed.
EDIT: to elucidate the greed part a bit more you can pin a ton of it on the rise of corporate jets, private equity rollups, opportunistic big-money flight schools, and market consolidation. If I want to build, buy, or rent a hangar at the local airport, I'm in competition with someone who can drop $5m on a turboprop and write it off as a business expense. These kinds of people aren't really hobbyists, and most of them have a hired pilot. Airports and airport services managed exclusively by private for-profit companies are implementing service fees that are meaningless to rich people flying in to see a sporting event, but keep out the riffraff hobbyists in their little bug smashers. The pursuit of profit is essentially elbowing-out people who are passionate about flying.
The demand for single-engine trainers is insatiable because there was a gold rush post-COVID when influencers sold the fantasy of flying yourself around in the backcountry, or dropping your boring tech job to become a sexy airline pilot. The number of new pilots per year increased about 2.5x, and they are all sharing the pool of airplanes that pretty much stopped being made in large numbers in 1979. Now instead of a new Cessna costing $100k (what you would expect, indexed for inflation) they cost $500k. Because Textron (owns Cessna, Lycoming, Beech, and Pipestrel) is a publicly traded company that must make line go up forever. And because they would rather sell one Cessna a year for a billion dollars than have to run a production line for something they don't care about. They prefer the margins and unit price on their bizjets.
Anyway, sorry for the rant, but I love general aviation flying and I hate what has happened to it.
I’m not sure how much either of these things cost, but I can tell you that these opportunities do not exist for any 10-12 year olds that I am exposed to.
Not anymore, but 20 years ago those things were extremely affordable. An old Cessna 150 was cheap as hell. The fact that her grandfather gifted it means he likely owned it for a long time and it would have been even cheaper going back a decade or two. I assume it was unairworthy or neglected meaning it would have had negligible residual value. Kits used to be cheap, too. Just a bunch of sheet aluminum with pre-drilled holes.
Like everything else, inflation, COVID, and social media ruined it. Building a kit in 2026 is extremely unaffordable for a middle class person.
I'm going to get into the weeds here as someone who has a lot of interest and experience with aviation:
It's easy to verify that she never earned a pilot certificate using the public FAA airman registry. She's listed as a student pilot.
The plane she's pictured with elsewhere in this thread looks like a homebuilt Zenith 601 (could be a similar variant) which may have borrowed the engine from the Cessna 150 mentioned in the Snopes article. This airplane is "experimental amateur-built", and building one is not a trivial amount of work. Notably, she does not have a repairman certificate for this plane (according to the airman registry), so either someone else is considered the primary builder (parent? grandparent?) or she never bothered to apply for the certificate. I was able to verify that her dad holds the repairman certificate. Not sure if that's because she was a minor at the time of completion or not.
Could be her academic interests and career took off before she could finish doing those hobby things, but as someone involved in experimental aviation, it looks a lot like she helped dad or grandpa build a plane. Whether she's intentionally taking credit for that, or being incorrectly assigned credit is a question I can't answer.
EDIT: I found a youtube video of her talking about building the plane with photos of her working on it. It's quite possible she did most or all of the work, but I'm basically certain she is not a licensed pilot. She did a student solo in the plane at 16 (must be 17 to get a license) and must have dropped out of flying sometime after that.
The airplane itself is easy to look up by the tail number: N5886Q. Flightaware suggests it hasn't flown in 4.5 years, which is sadly typical of experimental airplanes. Many people love to build them but grow bored with flying them. The data could also be an error and it hasn't flown in even longer than that. Maybe her dad aged out.
It's worth noting that Americans also must spend that income in a similarly-inflated market, so it doesn't much matter what their salary would be worth in, say, Uganda. I think any such comparison of global wealth runs into these sorts of issues.
Someone earning in the global top 10% may not be able to afford a house locally. Someone earning in the top 30% may not be able to afford rent and food at the same time in their locale. It makes the percentile meaningless.
What's far less dense with better public transit than NYC? The most popular example of no-car city design I see is Amsterdam, which is 1/2 the density of NYC, but still 15x the density of where I'm from (not even close to a rural area). I think robust public transit at 1/15th the density of Amsterdam and 1/30th the density of NYC is a pipe dream.
In these lower density places, maybe you luck out and you're walking or biking distance to work. If you change jobs do you have to move instead of hopping in the car and commuting a bit further? In circumstances like these, transit can't possibly serve every origin and destination efficiently, and personal vehicles can offer efficient point to point.
Fuckcars is made up of people with little life experience who think they have all the answers, and people who fetishize city living and think it's normal or healthy for humans to live at a density like NYC (and fuck you if you disagree). They're oversimplifying to the point of meaninglessness, and handwaving away the problems.
The free market is never going to address Climate Change. We need to force corporations to see pollution as a bad thing. By heavily taxing any sort of pollution created.
I'll just start by saying we're in agreement on this. The market doesn't price in externalities. But to your first point, it's literally the market (i.e. people) deciding they aren't willing to pay 10% more for manufacturing that costs more but reduces pollution.
If there are two competitors in a market, company A and company B:
Company A produces a product using the cheapest legal manufacturing that pollutes more, and company B does the same thing but cleans up their act for a 10% increase in cost, company B's market share will shrink, and they will eventually fail or be absorbed by a wildly successful company A. This is people voting with their wallets, and the companies are behaving rationally. We're essentially vilifing companies for responding to consumer behavior in aggregate. Obviously this is addressed through legislation and regulation which creates a level playing field for all competitors with environmental regulations everyone adheres to equally.
I feel like this point is missing the big picture: people create the demand, and companies supply what the market demands. Like or hate "the free market", this is essentially what it is. If there were magically 1/10th the number of humans on the planet, we would expect those companies to have 90% less emissions. It's not that some of these companies aren't bad actors, and have actions that are at times immoral, it's that they are amoral actors in a market economy that is only responsive to consumer demand.
The example I like to give is that companies' race to the bottom on quality. They're responding to human behavior, where if an item on Amazon is $6, and another very similar item is 10 cents cheaper, the cheaper item will sell 100x more. This is a brutal, cutthroat example of human behavior and market forces. It leads to shitty products because consumers are more responsive to price and find it hard to distinguish quality, so the market supplies superficially-passable junk at the lowest possible price and (with robust competition) the lowest possible profit margin.
I certainly agree based on my previous statement that income is not wealth, but I was trying to make two points and mixed the messages.
One is that amounts of money that were once considered an unbelievable amount for income or wealth - say $100k and $1m - have now been eroded by inflation to fairly modest money. In the 70s or 80s, having a million meant never working again. Earning 100k a year when a house cost $50k was huge money, and might lead to wealth quickly, if one bought several houses with it.
Another point I'd like to sneak in is that there's almost no modern equivalent to that kind of employed income. On paper, inflation puts it at 400k - so maybe today's equivalent of a surgeon - but the 50k house now costs $500k-1m. Notional inflation being 4x, while the critically important things have gone up 10-20x means that something harder to quantify is broken, and upward mobility isn't working the way we expect. The same opportunities don't exist. We are less likely to turn income into wealth over time than at points in the past, and so the tendency of people to erroneously think high income = wealth may have a reasonable basis in history that has never been less true today.
Edit: and it's not just houses, it's the stock market. The advent of the internet and e-commerce resulting in tech stock growth 1995-today is a phenomenon not likely to be replicated in any other area. We may be running out of growth to be had. The ability to get 10-20x your money over 30-40 years of investments is probably gone, and with it the prospect of comfortable retirement for even relatively high earners.
I've seen this on Reddit before: Six figures means you're rich, because that was true in the 80s, right? Obviously people don't have a clue that 40 years of inflation has made that middle class.
Also: income is not wealth, and the willful lack of understanding on that point blows my mind. A person who is wealthy can live an upper middle class lifestyle or better without ever having to work again. A person who has respectable income may have minimal wealth, or even mountains of debt (student loans, mortgage, etc). A person who makes 100k could be a few months unemployment away from losing their house or lease, while a person with "wealth" may not have to work at all.
People don't become filthy rich working full time for six figures. The wealthy (~$20-50m net worth and up IMO) are people who made their money with something other than labor - through investments and things that the government doesn't really classify as normal income.
Edit: It's like the saying goes: nobody makes a billion dollars. They take a billion dollars. If you tax the wealthy on income, you collect very little tax, because it's not classified as income. Meanwhile you're going to tax an engineer or physician who probably have hefty student loans and work their asses off full time, at the highest marginal rates because we don't or can't tax wealth.
Edit2: we've got minimum wage internet trolls who think an employee software engineer is basically a cigar chomping capitalist because they make over the median wage. The middle class has shrunk and maybe you're not in it. Get a clue, dumbasses.
I think this is a monumentally bad argument. Statistically, you are typing this from a computer or smartphone, with internet access, and are probably part of the segment of humanity that consumes the most resources (as am I). You are saying that if we want to have 15, 20, 30 billion people, we can all just live like the most impoverished people in the world and it will be fine.
It's a quality vs. quantity problem. Maximizing human numbers means we must have very low per-person consumption to minimize impact. Maximizing quality of life means we can all eat/travel/live/consume how we want and the environmental impact will still be low (but with fewer people). I think that's far more desirable.
EDIT: to distill down the argument further - you support voluntarily decreasing your standard of living, so that we can grow the population more, for the benefit of.... ? Creating lives that have not yet been born and can't care?
Whatever you want, I personally do not want a decrease in my standard of living, and especially not to feed the capitalist machine that requires growth at all costs. I presume, if faced with a real and present choice of the same kind, most people would choose to uphold their standard of living instead of sacrificing, only so that more billions of people can be born. When is it enough? Do we really NEED 8B+ people? I wouldn't mind living in a world of <1B people where everyone has luxury and plenty without destroying the planet in the process. We can't get there, but the principle still holds. Put resources into solving the problem of elder care, and just let the population decline naturally.
I agree with mostly everything you wrote in that, except to say that the problem is mostly manmade and is economic in nature.
Problem: demographic collapse causes a top-heavy (old-heavy) population pyramid whereby there aren't enough young people to take care of the aging population. This is a real problem that we should engineer ourselves out of. Maybe a higher % of the workforce is redirected to healthcare, in part by automating away bullshit jobs like fast food and retail workers. Maybe we make advances in automation/robotics/AI that allows some of the caregiving labor in hospitals and nursing homes to be done by machines instead of people (extending the productivity of the human labor). Those are problems we should be working towards solving, and plausibly could solve if the political and economic will were there. I hope Japan and South Korea get really far into solving this before it becomes a problem everywhere.
Problem: our entire economy is predicated upon infinite growth, and the nanoinstant that belief in future growth falters, the stock market and entire economy collapses in a way that makes the Great Depression look like a quaint blip. This is unsolvable. All of the wealthy, powerful, and political factions would revolt if anything threatened their prospects of unlimited future growth. The entire world economy is a ponzi scheme that requires new markets, new consumers, and perpetual growth even to exist at its current level. When you hear "growth is priced in", that's basically the fundamental corner we've painted ourselves into. The markets assume untenable growth now as the baseline, and if the mirage falters, the economy will tank shockingly quickly. This is the Faustian bargain of late stage capitalism.
As it stands, the population growth has peaked, and the population will naturally peak and then decline. Nobody needs to be killed or sterilized to make this happen - it will happen on its own. The reason seems to be rooted in the education level of women, and the availability of reliable birth control. As someone once eloquently put it: "the average woman would choose to give birth fewer than 2.1 times" (replacement rate).
As a final thought, I will never agree with people who assert that the "carrying capacity" of Earth is far higher than the present population - double or more. This entire premise is based on living like an impoverished person in India or Africa. They will freely admit that the "carrying capacity" is much lower if the baseline living standard is the middle class of developed countries. Most of North America and Western Europe is wildly rich by global standards (fact). I'm here to say that still higher standards are desirable and attainable, at low global impact with lower global populations. We should all be filthy, filthy resource-rich, and to deprive us of that because the Earth "should" have 10-20 billion humans is fucking bollocks.
It's like clockwork - you can almost set your watch by someone responding like that to pointing out the obvious that human population is straining global resources and making life worse for everyone.
I like to phrase it as this: who is the ecofascist? The person advocating for sustainable human population, or the person telling everyone we need to tighten our belts, give up meat, eschew fossil fuels and personal transportation, and live like a pauper in a cheap cookie-cutter dystopian apartment complex to prevent overconsumption? I would argue it's very much the latter.
Personal ethics aside (not everyone wants to eat meat and burn gas), everyone could live like a modern-day billionaire if there were fewer people. Everyone could have beachfront and slopeside property. Can't do that with 8.3 billion people. Isn't that the goal of fully-automated luxury gay space communism?
Yes, but what about Bubb Rubb?
Keep pushing to advertise it and I'll have more work, thanks.
For a layperson, you are unbelievably, stubbornly confident in your incorrectness. You cannot possibly know the depths of your ignorance. I am an expert, and I will continue fixing the problems caused by bad international dentistry for a healthy fee. You don't need to believe it for it to be true, and your denial does nothing to change my daily reality in practice. Good luck.
With all due respect, you don't know what you don't know. In case you missed it, I am a US dentist. I spend every working day dispelling laypeople's misconceptions about dental work. What work they have, what work they need, benefits and drawbacks, etc. Your post hits on some of the many very common misconceptions.
Not all work can be evaluated, even with x-rays, as restorative materials often hide the most important details. MRI is irrelevant for dental. X-rays are just a tool, not the final word, and they can't reveal certain things. Bacterial ingress and leakage is, for all intents and purposes, invisible. Most docs (in both medicine and dental) are exceptionally reluctant to disparage another's work. It is considered unprofessional and unethical to bad-mouth another professional. That's just how we're trained.
This could not be further from the truth. Discomfort and success are completely different things. Some extremely high quality, ultimately-successful treatments will make you feel like shit afterwards. Often, post op symptoms are more closely a matter of chance than they are of quality. Patient satisfaction and surveys are complete worthless bullshit, as evidenced by hospitals' Press Ganey scores, etc. See Goodhart's law. Docs hate chasing patient satisfaction because it is so poorly correlated with actual quality care. Telling the patient "no, this will have a poor outcome" gets you bad reviews, while doing a slipshod job that is unlikely to last but looks superficially good gets you patient satisfaction. I see it CONSTANTLY. Smooth-talking, kind-seeming, gentle dentists whose skills and ethics are complete trash. Patients can't tell the difference. This is why so many people love Nurse Practitioners, who are poorly trained and often happy to act as a rubber stamp for what the patient is asking for, even if it is not in their best interests. People love "yes men".
Remember, Yelp and Google reviews are both astroturfed by business owners, and used as a weapon by disgruntled people and competitors alike. There's a local dentist office that's still under construction and it already has 30+ 5-star reviews in Google. Hasn't seen a single patient yet. I would not be too trusting of reviews in general.
You have taken your subjective experience and tried to use that to say the work is objectively good. That's not how any of this works.
Now could that work actually be good? It could be. This is not to say that all foreign dentistry is bad, but SO MUCH OF IT IS. I know because I see it. The fact of the matter is, patients generally don't know the difference between good and bad work. I see patients all the time who said some absolute basement-tier-garbage work was done by their previous dentist, who they adored.
Ask any orthopedic surgeon what they think of foreign procedure mills offloading post-op knee-replacement care to an unfamiliar doc in the country the patient is visiting from. This is a huge issue docs discuss in private - patients flying to wherever for cheap, substandard treatment and leaving them to manage the complications. It's a big issue in places like FL and NY, but also broadly everywhere.
Many treatments, you get essentially one chance to get it right, and fixing it is either impossible or 10x as much difficulty. Getting it right the first time is priceless. You can fuck up a tooth in an instant. Destroyed. Cannot be fixed. Some errors are invisible and don't hurt right away. Many infections are painless or hard to diagnose from typical x-rays. Many compromised teeth spend a few years feeling normal before they fall apart. I know this because I see it every day. I'm the one who gets to fix others' mistakes - if they can even be fixed.
As a practicing professional who spent the majority of my training seeing a high % of international dentistry, it's hard to watch.
What it all boils down to is: how can you know the work done was good? You can't. You can know it looks good superficially. You can know the dentist was nice, or that their office was clean, and that the bill was low. You can't know if the work is actually good. You don't know if they are intentionally overlooking long-term health for doing what the patient/customer wants right now. You don't know if the materials or techniques would be considered substandard in the US. Yes, other countries often have a different "standard of care". I have seen ABYSMAL work from Asia and the Middle East. I have seen appalling work from Mexico, Central America, and Eastern Europe. Yes I also see bad work done by local US dentists - primarily those who advertise themselves as being some kind of affordable, emergency, or discount office -- but consistently the worst dental treatment I see is foreign. How do I know? I'm the one who has to fix it, if it can be fixed.
Dental tourism scares the hell out of me as a dentist in the US, but I understand why it appeals to people when quality care here is expensive. I have seen bad work from every country in the world, including the US, but the trend is you largely get what you pay for. The offices that accept every insurance under the sun are doing work at discounted fees, and usually cutting corners to do more of it. Medicaid? Pays less than the cost of providing the service unless serious corners are cut. Those are the US-side problems, but the dentists working for poverty wages in India are doing much worse things, on average.
Why is it often worse? With dental tourism you get no follow-up care. You also have no recourse if they fuck up your mouth. Good luck suing a dentist in Mexico or Thailand for malpractice. Turns out, the more financial incentive you have to practice high-quality care, the more you have to lose from fucking up and losing your license.
EDIT: This is "Work Reform", not "Fuck Everyone Who Has More Skills And Makes More Money Than Me", although you wouldn't know it from the types of responses sometimes. Quite frankly dentists are workers, whether employees or practice owners. They only earn what the work of their hands allows. They are not exploiting other workers to do the billable labor, because legally they cannot allow non-dentists to do the vast majority of billable work (there are small exceptions that account for a tiny % at most practices). They are not capitalists. The downvoters just hate the message and would rather shoot the messenger than listen to someone who knows from the inside.
All this boils down to is that there is nothing more expensive than first-world human labor. Without a doubt, nursing homes are increasingly run by sleazy profiteers, but the reason you can't easily do better (i.e. find a high-quality nursing home) is because it's simply expensive to employ enough people, who have sufficient skill and work ethic, to give the elderly care.
Yes, PE in healthcare is destroying the country in every imaginable way. The answer in this case is more complicated than get the for profit companies out of nursing homes, which is necessary but not sufficient to solve the problem. The scariest thought is that there may be no good solution.
See my other comment, but the situation was very different 20 years ago. Building a kit cost you a lot more in time than it did money. This is no longer the case.
Believe it or not, going back a few decades, personal flying (a real, certified, manufactured airplane, not a kit-built) was extremely middle-class attainable. I knew a couple of blue collar guys (would be age 70-80 now) who owned their own planes in the 80s.
Experimental aviation hung on a little longer and people were able to affordably build their own planes a couple decades after the price of a new Cessna or Piper got a bit steep. Like everything else, inflation, COVID, social media, and corporate greed ruined that too. Now Lycoming will charge you 50-100k for just an engine. Not including prop or actual plane. Even if you could build the plane part, the engine is unaffordable. Larger engines for a larger plane, or without a "builder" discount are even more eye-watering, they come with a years-long waitlist, and the quality control seems to actually be worse than historically. The price of engines has doubled in the last 5-6 years alone and they pump the price quarterly. Pure greed.
EDIT: to elucidate the greed part a bit more you can pin a ton of it on the rise of corporate jets, private equity rollups, opportunistic big-money flight schools, and market consolidation. If I want to build, buy, or rent a hangar at the local airport, I'm in competition with someone who can drop $5m on a turboprop and write it off as a business expense. These kinds of people aren't really hobbyists, and most of them have a hired pilot. Airports and airport services managed exclusively by private for-profit companies are implementing service fees that are meaningless to rich people flying in to see a sporting event, but keep out the riffraff hobbyists in their little bug smashers. The pursuit of profit is essentially elbowing-out people who are passionate about flying.
The demand for single-engine trainers is insatiable because there was a gold rush post-COVID when influencers sold the fantasy of flying yourself around in the backcountry, or dropping your boring tech job to become a sexy airline pilot. The number of new pilots per year increased about 2.5x, and they are all sharing the pool of airplanes that pretty much stopped being made in large numbers in 1979. Now instead of a new Cessna costing $100k (what you would expect, indexed for inflation) they cost $500k. Because Textron (owns Cessna, Lycoming, Beech, and Pipestrel) is a publicly traded company that must make line go up forever. And because they would rather sell one Cessna a year for a billion dollars than have to run a production line for something they don't care about. They prefer the margins and unit price on their bizjets.
Anyway, sorry for the rant, but I love general aviation flying and I hate what has happened to it.
Not anymore, but 20 years ago those things were extremely affordable. An old Cessna 150 was cheap as hell. The fact that her grandfather gifted it means he likely owned it for a long time and it would have been even cheaper going back a decade or two. I assume it was unairworthy or neglected meaning it would have had negligible residual value. Kits used to be cheap, too. Just a bunch of sheet aluminum with pre-drilled holes.
Like everything else, inflation, COVID, and social media ruined it. Building a kit in 2026 is extremely unaffordable for a middle class person.
I'm going to get into the weeds here as someone who has a lot of interest and experience with aviation:
It's easy to verify that she never earned a pilot certificate using the public FAA airman registry. She's listed as a student pilot.
The plane she's pictured with elsewhere in this thread looks like a homebuilt Zenith 601 (could be a similar variant) which may have borrowed the engine from the Cessna 150 mentioned in the Snopes article. This airplane is "experimental amateur-built", and building one is not a trivial amount of work. Notably, she does not have a repairman certificate for this plane (according to the airman registry),
so either someone else is considered the primary builder (parent? grandparent?) or she never bothered to apply for the certificate.I was able to verify that her dad holds the repairman certificate. Not sure if that's because she was a minor at the time of completion or not.Could be her academic interests and career took off before she could finish doing those hobby things,
but as someone involved in experimental aviation, it looks a lot like she helped dad or grandpa build a plane. Whether she's intentionally taking credit for that, or being incorrectly assigned credit is a question I can't answer.EDIT: I found a youtube video of her talking about building the plane with photos of her working on it. It's quite possible she did most or all of the work, but I'm basically certain she is not a licensed pilot. She did a student solo in the plane at 16 (must be 17 to get a license) and must have dropped out of flying sometime after that.
The airplane itself is easy to look up by the tail number: N5886Q. Flightaware suggests it hasn't flown in 4.5 years, which is sadly typical of experimental airplanes. Many people love to build them but grow bored with flying them. The data could also be an error and it hasn't flown in even longer than that. Maybe her dad aged out.
It's worth noting that Americans also must spend that income in a similarly-inflated market, so it doesn't much matter what their salary would be worth in, say, Uganda. I think any such comparison of global wealth runs into these sorts of issues.
Someone earning in the global top 10% may not be able to afford a house locally. Someone earning in the top 30% may not be able to afford rent and food at the same time in their locale. It makes the percentile meaningless.
Agreed, but social media has become an echo chamber for fuckcars and good luck reasoning with them.
What's far less dense with better public transit than NYC? The most popular example of no-car city design I see is Amsterdam, which is 1/2 the density of NYC, but still 15x the density of where I'm from (not even close to a rural area). I think robust public transit at 1/15th the density of Amsterdam and 1/30th the density of NYC is a pipe dream.
In these lower density places, maybe you luck out and you're walking or biking distance to work. If you change jobs do you have to move instead of hopping in the car and commuting a bit further? In circumstances like these, transit can't possibly serve every origin and destination efficiently, and personal vehicles can offer efficient point to point.
Fuckcars is made up of people with little life experience who think they have all the answers, and people who fetishize city living and think it's normal or healthy for humans to live at a density like NYC (and fuck you if you disagree). They're oversimplifying to the point of meaninglessness, and handwaving away the problems.
I'll just start by saying we're in agreement on this. The market doesn't price in externalities. But to your first point, it's literally the market (i.e. people) deciding they aren't willing to pay 10% more for manufacturing that costs more but reduces pollution.
If there are two competitors in a market, company A and company B:
Company A produces a product using the cheapest legal manufacturing that pollutes more, and company B does the same thing but cleans up their act for a 10% increase in cost, company B's market share will shrink, and they will eventually fail or be absorbed by a wildly successful company A. This is people voting with their wallets, and the companies are behaving rationally. We're essentially vilifing companies for responding to consumer behavior in aggregate. Obviously this is addressed through legislation and regulation which creates a level playing field for all competitors with environmental regulations everyone adheres to equally.
I feel like this point is missing the big picture: people create the demand, and companies supply what the market demands. Like or hate "the free market", this is essentially what it is. If there were magically 1/10th the number of humans on the planet, we would expect those companies to have 90% less emissions. It's not that some of these companies aren't bad actors, and have actions that are at times immoral, it's that they are amoral actors in a market economy that is only responsive to consumer demand.
The example I like to give is that companies' race to the bottom on quality. They're responding to human behavior, where if an item on Amazon is $6, and another very similar item is 10 cents cheaper, the cheaper item will sell 100x more. This is a brutal, cutthroat example of human behavior and market forces. It leads to shitty products because consumers are more responsive to price and find it hard to distinguish quality, so the market supplies superficially-passable junk at the lowest possible price and (with robust competition) the lowest possible profit margin.
I certainly agree based on my previous statement that income is not wealth, but I was trying to make two points and mixed the messages.
One is that amounts of money that were once considered an unbelievable amount for income or wealth - say $100k and $1m - have now been eroded by inflation to fairly modest money. In the 70s or 80s, having a million meant never working again. Earning 100k a year when a house cost $50k was huge money, and might lead to wealth quickly, if one bought several houses with it.
Another point I'd like to sneak in is that there's almost no modern equivalent to that kind of employed income. On paper, inflation puts it at 400k - so maybe today's equivalent of a surgeon - but the 50k house now costs $500k-1m. Notional inflation being 4x, while the critically important things have gone up 10-20x means that something harder to quantify is broken, and upward mobility isn't working the way we expect. The same opportunities don't exist. We are less likely to turn income into wealth over time than at points in the past, and so the tendency of people to erroneously think high income = wealth may have a reasonable basis in history that has never been less true today.
Edit: and it's not just houses, it's the stock market. The advent of the internet and e-commerce resulting in tech stock growth 1995-today is a phenomenon not likely to be replicated in any other area. We may be running out of growth to be had. The ability to get 10-20x your money over 30-40 years of investments is probably gone, and with it the prospect of comfortable retirement for even relatively high earners.
I've seen this on Reddit before: Six figures means you're rich, because that was true in the 80s, right? Obviously people don't have a clue that 40 years of inflation has made that middle class.
Also: income is not wealth, and the willful lack of understanding on that point blows my mind. A person who is wealthy can live an upper middle class lifestyle or better without ever having to work again. A person who has respectable income may have minimal wealth, or even mountains of debt (student loans, mortgage, etc). A person who makes 100k could be a few months unemployment away from losing their house or lease, while a person with "wealth" may not have to work at all.
People don't become filthy rich working full time for six figures. The wealthy (~$20-50m net worth and up IMO) are people who made their money with something other than labor - through investments and things that the government doesn't really classify as normal income.
Edit: It's like the saying goes: nobody makes a billion dollars. They take a billion dollars. If you tax the wealthy on income, you collect very little tax, because it's not classified as income. Meanwhile you're going to tax an engineer or physician who probably have hefty student loans and work their asses off full time, at the highest marginal rates because we don't or can't tax wealth.
Edit2: we've got minimum wage internet trolls who think an employee software engineer is basically a cigar chomping capitalist because they make over the median wage. The middle class has shrunk and maybe you're not in it. Get a clue, dumbasses.