This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
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Transnational Thursday is a thread for people to discuss international news, foreign policy or international relations history. Feel free as well to drop in with coverage of countries you’re interested in, talk about ongoing dynamics like the wars in Israel or Ukraine, or even just whatever you’re reading.
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Often, when we look at disincentives for childbearing, we think of them in terms of opportunity costs for the individual. But if children are cumulatively being considered a societal good, we should also weigh the cumulative opportunity costs to the individuals as a societal tradeoff. It seems to me that Ron Hosh's substack (of "luxury belief" fame) generally lives up to its tagline of "general incoherence," but he raised this point/question in this post. The kids have to come from somewhere; what tradeoff(s) should society make?
Teenage pregnancy? Major tradeoff against developing the human capital of the parents and, thusly, the parents' ability to develop the human capital of the children. (And, if you want to follow the HBD line of inquiry, you might hypothesize dysgenic selection effects.)
College students? Lesser tradeoff than above, but same general issue.
20-something professionals? We're taking human capital out of the economy, just after investing in its development, rather than trying to maximize its compound interest.
Hosh also brings up geography and sexual orientation (same-sex couples using IVF is a thing), though I don't think the tradeoffs here are as clear.
Have any of you thought about this? My answer to "Which couples should be having more children" is "All the couples who don't have as many children as they want" which I don't think cleaves cleanly enough across any demographic to give a more clear tradeoff than the subsidies required to support the children not-conceived out of financial concern. But others here are more open to social engineering than I am.
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Post your project, your progress from last week, and what you hope to accomplish this week.
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Let's chat about the National Football League. This week's schedule (all times Eastern):
Wed 2024-12-25 1:00PM Kansas City Chiefs @ Pittsburgh Steelers
Wed 2024-12-25 4:30PM Baltimore Ravens @ Houston Texans
Thu 2024-12-26 8:15PM Seattle Seahawks @ Chicago Bears
Sun 2024-12-29 1:00PM Atlanta Falcons @ Washington Commanders
Sun 2024-12-29 1:00PM Carolina Panthers @ Tampa Bay Buccaneers
Sun 2024-12-29 1:00PM Indianapolis Colts @ New York Giants
Sun 2024-12-29 1:00PM Arizona Cardinals @ Los Angeles Rams
Sun 2024-12-29 1:00PM Denver Broncos @ Cincinnati Bengals
Sun 2024-12-29 1:00PM Green Bay Packers @ Minnesota Vikings
Sun 2024-12-29 1:00PM New York Jets @ Buffalo Bills
Sun 2024-12-29 1:00PM Tennessee Titans @ Jacksonville Jaguars
Sun 2024-12-29 1:00PM Las Vegas Raiders @ New Orleans Saints
Sun 2024-12-29 1:00PM Los Angeles Chargers @ New England Patriots
Sun 2024-12-29 4:25PM Dallas Cowboys @ Philadelphia Eagles
Sun 2024-12-29 8:20PM Miami Dolphins @ Cleveland Browns
Mon 2024-12-30 8:15PM Detroit Lions @ San Francisco 49ers
Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.
Transnational Thursday is a thread for people to discuss international news, foreign policy or international relations history. Feel free as well to drop in with coverage of countries you’re interested in, talk about ongoing dynamics like the wars in Israel or Ukraine, or even just whatever you’re reading.
The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
-
Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
-
Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
-
Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
This thread is for anyone working on personal projects to share their progress, and hold themselves somewhat accountable to a group of peers.
Post your project, your progress from last week, and what you hope to accomplish this week.
If you want to be pinged with a reminder asking about your project, let me know, and I'll harass you each week until you cancel the service
Let's chat about the National Football League. This week's schedule (all times Eastern):
Thu 2024-12-19 8:15PM Cleveland Browns @ Cincinnati Bengals
Sat 2024-12-21 1:00PM Houston Texans @ Kansas City Chiefs
Sat 2024-12-21 4:30PM Pittsburgh Steelers @ Baltimore Ravens
Sun 2024-12-22 1:00PM Arizona Cardinals @ Carolina Panthers
Sun 2024-12-22 1:00PM Detroit Lions @ Chicago Bears
Sun 2024-12-22 1:00PM New England Patriots @ Buffalo Bills
Sun 2024-12-22 1:00PM New York Giants @ Atlanta Falcons
Sun 2024-12-22 1:00PM Tennessee Titans @ Indianapolis Colts
Sun 2024-12-22 1:00PM Philadelphia Eagles @ Washington Commanders
Sun 2024-12-22 1:00PM Los Angeles Rams @ New York Jets
Sun 2024-12-22 4:05PM Denver Broncos @ Los Angeles Chargers
Sun 2024-12-22 4:05PM Minnesota Vikings @ Seattle Seahawks
Sun 2024-12-22 4:25PM Jacksonville Jaguars @ Las Vegas Raiders
Sun 2024-12-22 4:25PM San Francisco 49ers @ Miami Dolphins
Sun 2024-12-22 8:20PM Tampa Bay Buccaneers @ Dallas Cowboys
Mon 2024-12-23 8:15PM New Orleans Saints @ Green Bay Packers
This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
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Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
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Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
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Be as precise and charitable as you can. Don't paraphrase unflatteringly.
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Don't imply that someone said something they did not say, even if you think it follows from what they said.
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Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
About a month ago, as I was browsing twitter, I stumbled upon the following article by Cathy Young:
https://www.theunpopulist.net/p/the-making-of-the-maga-hoax-about
At the time, talk about pet-eating Haitian immigrants was all over twitter. Donald Trump had just referenced it in the latest presidential debate, and his his running mate, J.D. Vance had tweeted about it. It was fascinating how the story played out. Every day, I would see a new story that supposedly validated the claim. Also every day, I would find that an earlier story had been debunked. Either it wasn’t about a Hatian, wasn’t about an immigrant, wasn’t in Springfield, or wasn’t about a pet getting eaten. The article seemed like it would be an interesting read.
Early on in the article, I came across the following paragraph:
It started with an X hatefest I happened to catch at the outset. On Sept. 7, a full three days before the debate, I saw left-wing-crank-turned-right-wing-loon Naomi Wolf share a post from misinformation superspreader End Wokeness (an account that may be run by far-right troll and Pizzagater Jack Posobiec), containing what seemed like an obviously made-up story: “ducks and pets” in Springfield, Ohio being gobbled up by Haitian migrants. The evidence: an anonymized Facebook post about a “neighbor’s friend’s daughter” who had seen her lost cat being carved up by the Haitians next door. I decided to post a sarcastic comment, unaware that I was wading into a dumpster fire.
Nothing about this paragraph is factually incorrect as far as I know, but something in there caught my eye: “Misinformation superspreader End Wokeness”
I am familiar with the End Wokeness twitter account. They’re pretty prominent on twitter, and they are not exactly what I would call trustworthy. I can understand why they might be described as an misinformation superspreader. That characterization isn’t entirely wrong, but even so, it put me on alert.
I think what I’m sensitive to is the way this pattern judges a thing at the same time it’s introduced. It wants me to make up my mind about who End Wokeness is before I’ve had the chance to evaluate them and come to my own conclusion.
When I see that pattern, it always puts me on alert. I’m so sensitive to it, that it sticks out like a sore thumb even in articles that I’m predisposed to agree with (like this one). “Misinformation superspreader” isn’t the only example of it here; “hatefest” “left-wing-crank-turned-right-wing-loon” and “far-right troll” are all examples of this pattern.
Furthermore, it’s trying to persuade me of something without being an actual argument. It’s like when a movie plays sinister music just to let me know that a character supposed to be bad. If I didn’t already know who End Wokeness was, I shouldn’t just take Cathy’s word for it that they’re a misinformation superspreader. Any writer can introduce someone with whatever label they want to, regardless of whether or not it’s accurate.
It also indicates bias. It makes Cathy seem predisposed to be against them. With an introduction like that, it seem unlikely that she would give them a fair shake. It may be that they don’t deserve a fair shake, but I still need to get my bearings as a reader. I can’t always be expected to already know who they are, and I need a way to validate their trustworthiness for myself.
Right-wing publications do this too. I think that Cathy herself would be sensitive to it in these cases. Take this passage for instance:
Just when you think the barrel-bottom standards at Politico cannot get any more bottomer or barreler, the disgraced outlet publishes talking points from a man who is not only facing murder charges, but who is alleged to have tried to commit one of the worst crimes imaginable: assassinating an individual who represents the will, hope, and future of tens of millions of Americans — and I would say the same about Kamala Harris had she been a target.
Does that seem like a reliable narrator to you? Do you think they’ll accurately present what the Politico really said? I know I wouldn’t trust them after reading the above paragraph. You can read the full article here.
I’m sure this sort priming is persuasive to some people. That’s probably why It’s so common. Still, it makes me feel skeptical, and I think for good reason. When I get skeptical like this, I’ll occasionally have the patience to go thorough the article, validating and double-checking the whole way through. Most of the time, however, I’m not that motivated, and I will probably decide the article isn’t worth engaging with.
This is a phenomenon I’ve been meaning to write about for some time. I don’t have anything against Cathy young, but when I read the article, the pattern really just jumped out at me, and it seemed like a good anchor point for this article. It’s an even more interesting case due to the fact that it’s an article that I essentially agree with, which means my aversion to it was pure sensitivity to the pattern, and not bias against the content itself.
Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
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Transnational Thursday is a thread for people to discuss international news, foreign policy or international relations history. Feel free as well to drop in with coverage of countries you’re interested in, talk about ongoing dynamics like the wars in Israel or Ukraine, or even just whatever you’re reading.
Noah Smith has entered the debate:
So the fundamental reason your health care costs so much is not that the health insurance companies are lining their pockets. And it’s not that insurers are an inefficient mess. It’s that the actual provision of America’s health care itself just costs way too much in the first place.
The actual people charging you an arm and a leg for your care, and putting you at risk of medical bankruptcy, are the providers themselves. The smiling doctor who writes you prescriptions and sends you to the MRI and refers you to a specialist without ever asking you for money knows full well that you’re going to end up having to wrangle with the insurance company for the cost of all those services. The gentle nurse who sets up your IV doesn’t tell you whether each dose of drugs through the IV could set you back hundreds of dollars, but they know. When the polite administrative assistants at the front desk send you back to treatment without telling you that their services are out of your network, it’s because they didn’t bother to check. The executives making millions at “nonprofit” hospitals, and the shareholders making billions on the profits of companies that supply and contract with those hospitals, are people you never see and probably don’t even think about.
Excessive prices charged by health care providers are overwhelmingly the reason why Americans’ health care costs so cripplingly much. But they’ve outsourced the actual collection of those fees to insurance companies, so that your experience in the medical system feels smooth and friendly and comfortable. The insurance companies are simply hired to play the bad guy — and they’re paid a relatively modest fee for that service. So you get to hate UnitedHealthcare and Cigna, while the real people taking away your life’s savings and putting you at risk of bankruptcy get to play Mother Theresa.
So the way to make our health care system affordable is not to browbeat insurers, in the hope that they will be able to reduce their profits and pay for us to have cheap health care. Insurance companies simply do not have the power to do that, even if you threaten to shoot them. What we need is to reduce costs within the actual medical system itself...
He jumps in to the comments to add:
They [providers] don't know the exact costs, but they have a general idea, they know the costs are very high, and they typically don't talk to patients about those costs when prescribing services to them. This is understandable, given that talking about costs would make patients less comfortable while receiving care, and one of doctors' main jobs is to make patients feel comfortable. But there's basically no point in the process of receiving care at which patients could make a decision based on cost.
Incentives matter, and patients aren't automata who are unable to follow incentives, as much as some doctors would like them to be. They can understand pricing concerns/risk, and they're coming from a wide variety of financial situations. A recent NYT op-ed admits as much:
One of my first lessons as a new attending physician in a hospital serving a working-class community was in insurance. I saw my colleagues prescribing suboptimal drugs and thought they weren’t practicing evidence-based medicine. In reality, they were doing something better — practicing patient-based medicine. When people said they couldn’t afford a medication that their insurance didn’t cover, they would prescribe an alternative, even if it wasn’t the best available option.
As a young doctor, I struggled with this. Studies show this drug is the most effective treatment, I would say. Of course, the insurer will cover it. My more seasoned colleague gently chided me that if I practiced this way, then my patients wouldn’t fill their prescriptions at all. And he was right.
Of course, the op-ed is doctor-apologia, working as hard as possible to finger point at insurance companies and only admitting a possible problem of lacking clear and reasonable pricing when it comes to drugs; after all, patients and their insurance companies pay pharmacists and drug companies for drugs, not doctors. They can't see that there could be a similar problem for their own services (insert Upton Sinclair quote). But they admit that patients can and do make decisions based on their understanding of prices and risk. Yet, when it comes to their own services, this is absurd to them. Surely they know better than the patient, and the patient should just do what they say; cost doesn't matter.
But as Noah points out, they "know", but they don't know. They "don't bother to check". They give every excuse imaginable to avoid the topic. And some of this is understandable! As Noah points out, they just want to focus on the medicine; they want to make the patient feel comfortable with the medicine; medicine is sacred and money is profane, so never the two shall meet. Doctors don't want to know. They're happy to sit back and say that they're prohibited by law to consider their costs in providing recommendations, but conveniently forget to be patient-based, not remembering that patients can and do make such decisions. But patients can only do this in a reasonable way when they're properly informed before making decisions. Without information, it's generally fear that rules the day, be it fear of medical issues or fear of medical expenses. Some doctors want to not know so much that they can't even identify the names of the relevant numbers in the billing/insurance process that might be involved in the decision-making process. This is perfectly fine, of course; they shouldn't have to spend all their time becoming intimately familiar with the details of how each of their patients' insurance works.
It's hard for me to come to any conclusion other than that providers shouldn't be bothered to know those details. Instead, there is an extremely simple solution that takes one small step toward what Noah wants - providers just need to inform patients of what they know about the pricing for suggested courses of actions before those courses of action are taken. We need to create a point in time where patients can have the relevant information with which to make a decision that takes their own understanding of their own finances into account. I have suggested that providers simply provide the price that they will be billing insurance and their negotiated rate. The negotiated rate gives the patient a good idea of what to expect if the procedure is covered. Sure, the provider doesn't know the rest of the details of the insurance policy (deductibles, co-insurance, out-of-pocket max, etc.), which are important for estimating things like out-of-pocket costs - again, they shouldn't. But the patient can know these things. The only information the patient is missing is the information that the providers refuse to give them. In addition to the negotiated rate, it would be nice to have the full bill amount, so the patient can consider the risk of an insurance denial (and perhaps have a conversation about this risk or gather more information). Then, they at least have some idea of how much they could be nominally on the hook for if there is an insurance snafu.
I am generally anti-regulation, but the good doctors here at TheMotte have convinced me that there is no way that we are going to persuade them on this point with reason, so I am reluctantly throwing in my support for as minimally-scoped regulation as we can come up with, just as much as it takes to cast off the excuses and actually get numbers in front of patients at a point in time where they can use those numbers to make decisions. Hopefully, someone can get this idea to people like Noah, so they can consider advocating for something like this rather than tired ideas he gave like having the gov't "play hardball" to negotiate prices. He seems open to ideas:
There are probably other ways to foster competition and increase efficiency in the medical care system.
Indeed, there is, and it's right in front of your eyes. It's the natural conclusion of your request in the comments for what NYT would call "patient-based medicine".
The Wednesday Wellness threads are meant to encourage users to ask for and provide advice and motivation to improve their lives. It isn't intended as a 'containment thread' and any content which could go here could instead be posted in its own thread. You could post:
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Requests for advice and / or encouragement. On basically any topic and for any scale of problem.
-
Updates to let us know how you are doing. This provides valuable feedback on past advice / encouragement and will hopefully make people feel a little more motivated to follow through. If you want to be reminded to post your update, see the post titled 'update reminders', below.
-
Advice. This can be in response to a request for advice or just something that you think could be generally useful for many people here.
-
Encouragement. Probably best directed at specific users, but if you feel like just encouraging people in general I don't think anyone is going to object. I don't think I really need to say this, but just to be clear; encouragement should have a generally positive tone and not shame people (if people feel that shame might be an effective tool for motivating people, please discuss this so we can form a group consensus on how to use it rather than just trying it).
This thread is for anyone working on personal projects to share their progress, and hold themselves somewhat accountable to a group of peers.
Post your project, your progress from last week, and what you hope to accomplish this week.
If you want to be pinged with a reminder asking about your project, let me know, and I'll harass you each week until you cancel the service
Let's chat about the National Football League. This week's schedule (all times Eastern):
Thu 2024-12-12 8:15PM Los Angeles Rams @ San Francisco 49ers
Sun 2024-12-15 1:00PM Cincinnati Bengals @ Tennessee Titans
Sun 2024-12-15 1:00PM Dallas Cowboys @ Carolina Panthers
Sun 2024-12-15 1:00PM Kansas City Chiefs @ Cleveland Browns
Sun 2024-12-15 1:00PM Miami Dolphins @ Houston Texans
Sun 2024-12-15 1:00PM New York Jets @ Jacksonville Jaguars
Sun 2024-12-15 1:00PM Baltimore Ravens @ New York Giants
Sun 2024-12-15 1:00PM Washington Commanders @ New Orleans Saints
Sun 2024-12-15 4:25PM Buffalo Bills @ Detroit Lions
Sun 2024-12-15 4:25PM Indianapolis Colts @ Denver Broncos
Sun 2024-12-15 4:25PM New England Patriots @ Arizona Cardinals
Sun 2024-12-15 4:25PM Pittsburgh Steelers @ Philadelphia Eagles
Sun 2024-12-15 4:25PM Tampa Bay Buccaneers @ Los Angeles Chargers
Sun 2024-12-15 8:20PM Green Bay Packers @ Seattle Seahawks
Mon 2024-12-16 8:00PM Chicago Bears @ Minnesota Vikings
Mon 2024-12-16 8:30PM Atlanta Falcons @ Las Vegas Raiders
This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?
This is your opportunity to ask questions. No question too simple or too silly.
Culture war topics are accepted, and proposals for a better intro post are appreciated.
Be advised: this thread is not for serious in-depth discussion of weighty topics (we have a link for that), this thread is not for anything Culture War related. This thread is for Fun. You got jokes? Share 'em. You got silly questions? Ask 'em.
Transnational Thursday is a thread for people to discuss international news, foreign policy or international relations history. Feel free as well to drop in with coverage of countries you’re interested in, talk about ongoing dynamics like the wars in Israel or Ukraine, or even just whatever you’re reading.