It's the world that has changed. Launching into a relatively open world wide web is fundamentally different to breaking into the consolidated platforms of today. Startup culture was at its peak in the PG days today it's closer to a nadir.
"As long as we live in a world where fiat currency and nation states dominate transactional and regulatory environments"
Do you think that world will ever end? What will that look like? Will the very, very early stages look something like this?
Cryptocurrencies were not developed as a get rich scheme, nor as a tool for energy efficiency, corporate profits nor so many of the rubrics we use to judge them today.
The idealists that authored the crypto world imagined replacing the fiats of current rulers. Considering how rare a thing that is in history their early, chaotic form of decentralization isn't doing so badly judged on its own merits.
this community has been reactionary to bitcoin since day 1. crypto is a generational shift, more so than web 2.0 and the glory days of hacker news. the audience here is predominantly the pre-crypto generation, much like slashdot is the voice of the dot com generation.
we all need skepticism in our arsenal and that is what you can expect here, brilliant at times but hn is simply not the voice of this moment. you will be frustrated if you forget this rather than accepting it.
Its unclear who "you" means, most people on earth can actually buy antibiotics without this. Also unsure as to how you define what is "responsible" for them.
If you have accurate test results that show you need medicine and can obtain it without a gatekeeper then you don't "need" to go to a doctor. That's one hell of a payoff.
Couldn't one say being the forum it is at this moment - when the world is online and commercial pressures abound - is something more than what you imply.
there seems a fundamental incongruence between a market based decision mechanism and a singular fiat decision. prediction markets are valuable because of their ability to absorb complex and dynamic information. while they point to a consensus it is a fleeting one by definition.
for theoretical examples the 2 presented are especially awkward and seem fated to trip over themselves not because of the mystic beauty of self reference but rather because they are the wrong tools for the job.
perhaps to start thinking this way its better to remove legacy institutions and things like government bail outs and ceo pay as a priori conditions.