1. The FDA (and to a lesser extent regulatory agencies generally) being extremely over-reluctant to approve things, because of the misaligned incentive that heavily punishes approving something that ends up being bad, but doesn't generally punish failing to approve something that would have been good. For the greater public good, individuals within the organization would have to take on substantially more personal risk, with little to no corresponding personal gain.
2. Much lumber and other treated wood is treated with formaldehyde, a carcinogen, which then vaporizes back out of the wood over time, causing a health risk. The EPA regulates the allowed quantity of formaldehyde emission, but the limits, while they prevent acute poisoning, leave a substantial carcinogenic effect. The costs (an increased level of cancer in some people, likely dozens of years later) are diffuse and hard to notice, so there is no great incentive for the EPA to reduce the requirement, and formaldehyde is a useful treatment, so the companies themselves have no incentive to unilaterally reduce their use of formaldehyde. Thus, people who work with wood and those in newly constructed wooden structures bear an increased risk of cancer.
3. Schools starting at times much earlier than the window of wakefulness for teenagers. It's likely that the knowledge diffusion problem has some impact (I do not have good information about how many school administrators don't know the science, vs how many are just ignoring it), but even with appropriate knowledge diffusion, a degree of incentive misalignment remains, where the people who suffer the most (the students) have nearly no power to enact the policies, while the adult administrators, with their earlier circadian rhythm, bear no personal cost from the schedule. Likely the combination of both leads to the current state of affairs persisting, as there is some incentive for the administrators to use better schedules, as students would be able to perform better on tests when properly awake.
4. Ongoing overfishing of ocean fish. Each individual fishery (and, at a higher level, each country) would prefer a world where everyone fishes a sustainable amount, rather than overfishing and crashing the fish populations that they all rely upon, but without a centralized enforcement mechanism, they have no way of ensuring that the other fisheries (or countries) go along with them in cutting back on fishing, so unilaterally doing so would simply make them get out-competed by others.
5. The lemon problem. Someone is selling their used car, and they know that it works fine, but they have no real way to cheaply, credibly give that information to prospective buyers. Pretty much any assurances that the seller could give the buyer could also be given by someone with a lemon, as long as that lemon works at least some of the time, so the information can't reliably propagate, and the used-car market remain inefficient, with the uncertainty effectively being a tax on all transactions.
6. Countries building up their militaries. Most of the use of sizable militiaries is fighting against other militaries (and as a deterrent against such), so they are overall a negative-sum game. If countries all agreed to cut back their militaries, they would (for the most part) all benefit, but due to the competitive nature, there is a strong incentive to not cut back. Even if a cutting-back deal were arranged, there would be a strong incentive to merely produce the appearance of cutting back, while maintaining as much capacity as possible, as doing so would lead to an advantage against their newly-weakened rivals. Thus, the combination of the multipolar nature (hindering cooperation in the first place) and the difficulty of credibly demilitarizing puts an upward pressure on military expenditure.
7. The "race to the bottom" problem. Using companies producing widgets as an example, each company might wish to fairly pay their workers, maintain a safe work environment, and not pollute the environment. However, other companies can gain an edge by sacrificing things in favor of producing more widgets (e.g. hiring more workers at cheaper wages). Thus, the principled company must make similar changes, or get outcompeted. This can continue until the companies have all sacrificed everything they can in favor of more productivity, even if all of them would have preferred to peacefully coexist with comfortable work conditions.
8. Doctors being overly cautious in treatment. Similarly to the first example, the incentives punish positive mistakes much more heavily than negative ones. In this case, any deviation from what is considered to be the "proper" way of dealing with a case subjects the doctor to risk of being sued for malpractice in a way that sticking to the "proper" method does not, even if the deviation would have been a net positive in expectation for the patient. On a similar note, severe problems as a result of treatment gain much more than proportional negative attention relative to minor problems, so doctors have an incentive to avoid even small chances of severe negative results, in the process causing much larger amounts of harm to patients through large amounts of small harms (e.g., the doctor's more at risk if one patient gets a stroke than if a thousand get headaches).

EDIT: For some of these, the end-state is not especially stable by itself. In those cases, central enforcement would likely be the most realistic way to stabilize it.

Apparently (link to tweet), most countries have straightforward automated systems for tax collection, requiring minimal user input. Obviously, this setup saves everyone the pain of filling out confusing tax forms.

But the US has confusing tax forms because intuit (the company behind turbo tax), successfully lobbies to keep the current system in place, so that they can charge people for the service of helping them fill out their confusing taxes.

People being held against their will and drugged at long-stay psychiatric hospitals. Psychiatric hospitals profit from keeping their patients looked up instead of them getting their freedom back. Drugs given to calm the patients can make it easier to interact with the patient for the hospital even when the drugs aren't increasing the likelihood of recovery for the patients.

We're still teaching children arithmetic in base ten. The objectively correct base is six.

I'm serious. This is not just my opinion. The base we choose had better be a whole number, but the size of the multiplication table we have to memorize goes up roughly quadradically in the size of our base (although there are regularities that can sometimes make this easier), so it has to be a fairly small whole number. There just aren't that many choices, and we've checked them all. Base six is optimal.

• The smallest four primes {2, 3, 5, 7} are either divisors or nearest-neighbors of six, which give the system a lot of nice properties, like easy divisibility tests.
• The single-digit addition and multiplication tables are much smaller. The 0's and 1's are trivial, so that leaves two 4x4 tables, but because these operations are commutative, there are only ten "facts" to memorize for each table, instead of the 36 facts per table required for decimal.
• More small-denominator fractions have a short or short-repeating seximal representation than in any other small base.
• You can easily count up to five-x five on your fingers, instead of just to ten.

So why aren't we all using seximal? The decimal system is, to put it mildly, extremely entrenched. We developed it before we knew better. Path dependency. Almost all of our books and devices show numbers in decimal. Our money is decimal. All of our metric prefixes are based on powers of ten. Everybody who's learned arithmetic already did so in decimal. If you want to talk to others about numbers, you pretty much have to do it in decimal. We've calibrated our numeric intuitions in decimal. Learning decimal is easier than learning decimal and seximal, so almost nobody learns seximal. Having two different bases in wide use seems like it would make us worse off, but that's what we'd have to go through, since there's no emperor of the world to accomplish it by fiat.

If we wrote numbers in two different bases for a while, we'd have to distinguish them somehow, but if we only tag the seximal, then it feels second-class. I think we'd be better off writing seximal using completely different symbols to minimize interference, like ٤٢ instead of ${42}_6$ or 0s42.

First past the post voting often leads to undesirable outcomes, as explained by Jameson Quinn in his voting theory primer. There are several newly designed voting methods which are likely to be improvements over the current system, but most have seen limited, if any, uptake.

Some factors blocking such a transition include:

• it's difficult to change political systems from the outside (e.g. few and infrequent opportunities to place referendum questions on election ballots)
• within a two-party system, both benefit from first past the post voting, as they know they have a ~50% chance of winning each election, so there is no incentive for them to change from within
• proponents of voting reform have not yet been able to coordinate on which method they recommend (i.e. establish a Schelling point)
• individual voters will have to be able to intuitively understand how the new method works and why it should lead to better outcomes for them to consider supporting it

I'm sure there are more that others might think of.

—Make More Land.

—American policing. There's tons of obvious problems with this, and the proposed solutions range from obvious and nearly universally agreed upon (reduce SWAT-style raids by >90%, end/drastically reform qualified immunity, abolish civil asset forfeiture, etc) to speculative and contentious. Such reforms generally don't match the incentives of the police themselves, and civil oversight is currently too diffuse and ineffective to impose reform. National authorities are incapable of any reform, and while a few state and cities have made small changes in the past year, the core issues will not be addressed anywhere in the near future.

—COVID vaccine distribution. Our society can reach better equilibria, as shown by the normal flu vaccine distribution and by the occasional stories where a freezer breaks down and all the shots are administered before they expire. Nevertheless our current system is a mess, no one feels they have responsibility for the mess, and there is no sign it will be fixed before the pandemic ends.

—Whatever made development of the F-35 fighter plane so much worse than the development of previous fighter planes.

—There are several cases in America (and presumably elsewhere, although I'm less familiar) where a relatively small, coordinated group successfully lobbies for laws which benefit themselves by imposing small costs on the country as a whole. Because the costs are so widely distributed, no one has a strong incentive to overturn these, and lawmakers have a moderate incentive to cooperate with the special interest group. The canonical examples include the artificial complexity of the tax code held in place by tax-preparation firms; ethanol subsidies supported by corn growers; and comically long copyright for artistic works, supported by media conglomerates (IIRC these expire 70 years after the death of the author!).

Passive investors should want companies they hold to not engage in zero sum games with each other (like advertising), but in practice best corporate governance practices spreading is often limited by the bandwidth of shareholder activists.

Drug expiration dates are probably far too conservative in most cases, with strict regulations forcing hospitals to discard medication that is likely still effective, and to go to the expense of replacing it, which makes medical care that much more expensive than necessary, and worse, they are still required to do so even during a shortage when replacements are not available, potentially costing lives.

The FDA allows manufacturers to extend expiration dates with further studies, but big pharma has little incentive to do so. Studies are expensive, and shorter expiration dates mean they can sell more drugs.

Stockpiles of medicines are important to the military, and the government also maintains stockpiles for emergency civilian use, but keeping these up to date given short expiration times is very expensive, so at the behest of the Department of Defense, the FDA undertook the Shelf Life Extension Program, which proved that many medications remain effective for years past their expiration date when properly stored, saving the government a lot of money on maintaining stockpiles. But hospitals are still required to throw these away.

One wonders why the expiration dates were set so short to begin with, or not extended automatically through continued testing.

Scott mentioned another one recently:

I’ve had Uber drivers who were doctors back in their home countries. They’re stuck driving Ubers because the US insists that nobody - not British doctors, not Canadian doctors, nobody - can work in the US unless they repeat their last four years of training in an American hospital. American hospitals don’t have many training positions, and reserve the ones they do have for American med students, so most of them can’t do it. Meanwhile, my patients complain of having to wait months to get a desperately-needed appointment, and the hospitals just say “well, there aren’t enough doctors”. There are, they’re just all driving Ubers because of regulatory failure!

Hypnosis + anesthetics is likely better then just anesthetics when doing surgery. It means you need less anesthetics and there's decent evidence that it provides better wound healing. 

As a paper in a reputable anesthetics journal suggests:

Faster wound healing, earlier postoperative gastrointestinal recovery, and less nausea have been reported when hypnosis or positive suggestions were part of the perioperative management 

I have a friend who I knew from having attended hypnosis seminars together who worked as an anesthetic in a hospital who still didn't use hypnosis. It would have meant spending 15-30 minutes more per patient and the hospital was organized in a way to pressure him to do anesthetics as fast as possible. 

Instead of being able to do it, his job demoralized him enough to quit never wanting to work in a hospital again. 

The hospital doesn't profit from the faster wound healing enough to do the nonstandard thing of using hypnosis even when it has skilled personal. 

We should be teaching trigonometry and the unit circle in terms of tau instead of pi, that is, since the mathematically natural angle measure is radians (not diameters), we should express radians in terms of the ratio of the radius to the circumference, instead of the ratio of the diameter to the circumference, which adds a spurious factor of 2 everywhere.

The choice of pi in the first place was due to path dependency, and is now extremely entrenched. (Nearly?) all of our textbooks use pi and all our school graphing calculators have a pi button. Python, however, is more enlightened.

Sell medical care based on the calibrated likelihood of achieving the wished for medical outcomes.

This would allow treatments that can't be easily standardized (and thus studied with controlled studies) be brought based on their impact.

One is blame games. Many problems don’t have a clear cause. Pointing the finger creates stress and defensiveness that’s counterproductive to solving the problem and emotionally harmful, and also doesn’t help identify how to avoid similar problems in the future. It would be better not to even start. But the fact that each person anticipates being on the receiving end of a lot of unfair blame prevents them from not engaging.

1: Nuclear Power Currently we (the developed world except France) rely mostly on fossil fuels for energy with some usage of renewables. This has been the case since WW2. This is bad. It's bad because global warming and other kinds of pollution. It's bad because we rely either on coal, which is extra dirty, or oil and natural gas which largely comes from brutal autocracies and causes us to be needlessly involved in wars and influence battles. Renewables are coming but they're too inconsistent to be useful. until we have better energy storage tech.

None of this was necessary. We've had nuclear energy since the 1960's. It's cheap, safe and essentially limitless. France generates 70% of its energy from nuclear power and has done so for decades. As a consequence it has energy independence, low emissions, low energy costs and is generally better off. The only reason it's not mainstream in most nations is due to environmentalist movements campaigning against it and high profile nucler accidents leading to a public misconception of the risks of nuclear as compared to other power sources much the same way as people are more scared of terrorism than car crashes despite the latter being overwhelmingly more dangerous.

2: Immigration Canada and Australia do immigration well. They have points system. High skilled, probably beneficial to society immigrants can easily migrate with minimum paperwork.

In the Uk and USA, immigration is hell. Low skilled illegal migrants number in the millions. High skilled legal migrants have to fight through regulatory hurdle after hurdle to get into the country. This is bad.

It's not clear why immigration is so bad. Massive majorities of the public support points based migration systems. Nevertheless we have terrible systems which tolerate massive illegal migration but make legal migration unnecessarily difficult.

3: Corruption Private individuals and businesses can give money to politicians and parties. They usually do this because it's in their interest. This is colloquially known as corruption. There is massive support for ending this kind of practice. Almost everyone from elites to the public see it as bad. Still year after year it persists. In the US this may be because of the law imposing a barrier to reducing campaign contributions. In the UK or other european countries there's no such problem yet still nothing is done.

4: Education A lot of education is signalling. This is even more true of lower tier education. One memory that sticks with me is on my first day of a graduate schema another person telling my they studied airport management. I asked them why. They said just to get a job and that they'd learn nothing practical over those years.

The problem with education is a collective action/externality one. Education is good for individuals but imposes costs on others by inflating the level of signalling needed. Many people would be better off if they collectively decided to not waste years on useless degrees so they can apply to unrelated graduate schemes. Still, it's not possible to cordinate.

From a utilitarian standpoint doing human challenge trials for the covid vaccines would have been preferable to ecological / uncontrolled trials (for instance, we would have clearer data, today about the optimal dosage, which translates into maximizing the number of successful vaccinations from a given batch of the vaccine). 

My current understanding for why the US didn't do human challenge trials comes down to the incentives of the decision makers: they are likely to experience some backlash, especially if something goes wrong, but they don't gain accolades or other rewards for the massive upside.

An EY category #3 example from emergency medical services (EMS) in the USA

>How things are currently, and why that's bad.
When someone tells a public safety access point (PSAP) that there might be a problem, the dispatcher generally sends an ambulance at a minimum. Then, the city or ambulance provider takes the nearest obvious patient(s) to the emergency room. The resulting EMS bill is often extremely high as well as the ER bill. Sometimes, the providers are not in-network and the patient must pay in full even if there was not a true emergency.

>How they could be instead, and why that's better.
The PSAP could pre-commit to only sending certain types of units when a set of criteria are met. And, if none of the criteria are met for a public safety response, then the patient could be given self-care instructions ranging from watchful waiting to calling the patient's doctor. If a crew is sent to the scene, then the crew could send the patient to the most appropriate place (ranging from "stay home for a week" to "Uh oh, you really do need an emergency room."). This would result in greatly reduced spending by the PSAP, public safety agencies, ambulance providers, hospital, patient, and other healthcare-related entities. The patient would also have better outcomes due to decreased financial stress, decreased risk of iatrogenic infections, etc.

>What's blocking the transition from 1 to 2.
A public safety agency/ambulance provider is only paid when they transport a patient to the emergency room because that's what all the insurance companies have agreed to do.

If a hospital dares to tell an ambulance provider that they can send patients to another type of location, the hospital will lose money.

If an ambulance crew does not transport a patient to an emergency room, the crew takes on liability for practicing unconventional medicine.

Dispatchers are generally not permitted to send anything less than an ambulance and a fire engine. Sometimes, ambulances are only provided at the most costly level (ALS). The crew may even be required to go lights and sirens as a matter of policy despite the increased risk of death and injury. But if a city does not do a "full response", then it is on the hook if anyone complains about reduced responses (aka political fallout) and there may be legal liability for the reduced response. Dispatchers are also often not RN or MDs. So they may not be permitted to definitively diagnosis or recommend treatment outside of a very narrow set of pre-defined situations.

For what it's worth, Coronavirus disease 2019 has forced many cities to change their practices because there are not enough units. CMS has also had on-again-off-again efforts to send patients to alternate destinations (e.g. https://www.cms.gov/newsroom/fact-sheets/emergency-triage-treat-and-transport-et3-model) but many such programs eventually end and the local city must find alternative grant funding in the long-term. As usual, the necessary know-how has existed for decades (e.g. https://en.wikipedia.org/wiki/Medical_Priority_Dispatch_System#Response_Determinant).

April 25, 2021 Update: Today, there is a New York Times article talking about the closure of ambulance services in rural America. As the article says, the situation was entirely foreseeable (article reasonably claims that the direct proximate cause was lowered patient transport volumes from Coronavirus disease 2019).

This is a thing I've heard unofficially from a guy in the industry, but I'm not sure how big of a problem it basically is. I mean, I think it's a big deal, but I would not care to quantify it.

In Ukraine, we have a separate branch of research institutions dedicated to agriculture, forestry, fishery etc. I mean, we've got universities where there's some science being done; the Academy, where most of it happens; and several "applied" branches like the above-mentioned Academy of Agrarian Sciences. The "applied" people are generally not well-integrated into the whole community, which is a problem in itself. One day I took part in an agrarian conference (I was looking for possible collaborations), and this guy showed me a sample of wheat they were working on. He said they have to keep producing new varieties, ever better varieties. Which means in practice that they don't actually go all out to breed superwheat, they just keep making it incrementally super.

And I just hate this - local culture? Official requirements? I mean, if only they were actually acknowledged as researchers by the overall community (heck, if they were acknowledged as researchers by their own authorities). People would be working, ridiculous expectations would be laughed at, things would be moving along!

Because when they say Lysenko had left a legacy, this is what it looks like.

dating on dating apps (I think) men sends messages or tries to match with as many people as possible to increase their chances of talking to someone. women receives a lot of messages/potential matches so they get more selective. which in turns creates less matches per message sent for men, which reacts by sending more messages

this is from what I read and from my experience and experience of people I talked to. also, it looks like there is still a big heterosexual dynamics in this case (this might not apply to all dating apps but I guess it must apply to the big ones). I stayed a big vague in the description since I have seen different reasons for every of those points (that are not necessarily contradicting each other though: they could be additive)