site banner
PaperclipPerfector  1yr ago (text post)   31304 thread views

Culture War Roundup for the week of May 15, 2023

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.

9
Top Bottom Old Controversial Comments
Jump in the discussion.

No email address required.

And I don't have a problem with elective treatments being excluded from insurance. After all, I paid for my visit out of pocket. It's the emergencies and other life-threatening conditions that bankrupt people.

And I don't have a problem with elective treatments being excluded from insurance.

Electives are a very wide set of treatments, it doesn't mean plastic surgery. It is pretty much anything that you schedule in advance.

It's the emergencies and other life-threatening conditions that bankrupt people.

I thought about this for a minute, couldn't actually reason from first principles whether or not it should be true. For example, I'm not sure why the modal medical bankruptcy isn't more of the type, "I got cancer or whatever, so that blew my out-of-pocket max for a couple years. I'd have been okay financially even with just my out-of-pocket-max, but I also couldn't work anymore, so I lost my income. That's what really tipped me over into bankruptcy." One could plausibly categorize this in the "life-threatening" bucket (one could quibble by type of cancer, as some may be curable/treatable but still prevent you from working for a long time), but even then, it's not clear that the medical cost side is the long pole in the tent.

So then I went to see if I could find some data in the literature. Unfortunately, while I didn't spend hours and hours doing a complete literature survey, my sense is that this data is not readily available. Medical expenses/debt relating to bankruptcy became a political football, so there was a flurry of papers on the general topic. As expected, many of them feel like they're picking/choosing their metrics specifically to try to get a splashy number/talking point to support this political position or that political position. But even given those limitations, I got a little bit of a sense for what I think is available.

Turns out that even figuring out the connection between general "medical expenses/debt" and bankruptcy is difficult. Publicly-available bankruptcy documents don't come pre-packaged with a nice conclusion, "This bankruptcy was because of medical expenses." Even when you can tell from the bankruptcy filings that some of the debt was medical, it doesn't often contain information that allows a categorization of whether or not it's specifically emergency-related. Nor whether it's life-threatening. One example is that folks just try to put some measure on the amount of debt at bankruptcy (like, the medical debt needs to be some percentage of total debt and some percentage of income), which obviously has benefits/drawbacks as a measure. There are some more clever attempts. Consider one study, which

reported that the bankruptcy rate for drivers who were admitted to an emergency room after a crash (“EDA Admit”) was 45% higher than the rate among drivers who did not seek medical care (“Not EDA Admit”). Although this may show a correlation, the authors found that it did not establish causation because bankruptcy rates were “thirty to fifty percent” higher for EDA Admit drivers in every pre-crash year. Thus, the authors conclude that households whose financial characteristics make them more likely to file for bankruptcy are also more likely to have severe auto accidents, but that health shocks (as represented by auto accidents) are not a causal factor on bankruptcy filing rates.

This attempt is really nice and clever, because we can access pretty good data on auto accidents, knowing that they at least reflect a sudden, unexpected event, though some could quibble over whether all the folks who go to the ER after a wreck are actually in "emergency" condition or are just being cautious given the circumstances (I say this without judgment; this is a very unexpected event where caution may be appropriate; the circumstances are much more likely to rapidly develop into a true emergency situation, even if the instant symptoms are minor). It has some obvious drawbacks, too, as auto accidents aren't necessarily reflective of all types of medical emergencies, and they may correlate with other behavior more than other types of emergencies or life-threatening conditions.

In sum, I'm just not sure I have data that swings one way or the other on this question, and I'm sort of leaning toward the position that measurement issues push me toward, "We just aren't going to be able to conclude something here," at least until someone is able to be extraordinarily clever in overcoming the limitations in the data. I also think that "emergency" and "life-threatening" sometimes go together, but sometimes don't. Car crashes are unlikely to permit much shopping around for most people. Cancer does moreso.

Thank you for writing this. I really enjoyed the deep dive.

What is this place?

This website is a place for people who want to move past shady thinking and test their ideas in a court of people who don't all share the same biases. Our goal is to optimize for light, not heat; this is a group effort, and all commentators are asked to do their part.

The weekly Culture War threads host the most controversial topics and are the most visible aspect of The Motte. However, many other topics are appropriate here. We encourage people to post anything related to science, politics, or philosophy; if in doubt, post!

Check out The Vault for an archive of old quality posts. You are encouraged to crosspost these elsewhere.


Why are you called The Motte?

A motte is a stone keep on a raised earthwork common in early medieval fortifications. More pertinently, it's an element in a rhetorical move called a "Motte-and-Bailey", originally identified by philosopher Nicholas Shackel. It describes the tendency in discourse for people to move from a controversial but high value claim to a defensible but less exciting one upon any resistance to the former. He likens this to the medieval fortification, where a desirable land (the bailey) is abandoned when in danger for the more easily defended motte. In Shackel's words, "The Motte represents the defensible but undesired propositions to which one retreats when hard pressed."

On The Motte, always attempt to remain inside your defensible territory, even if you are not being pressed.


New post guidelines

If you're posting something that isn't related to the culture war, we encourage you to post a thread for it. A submission statement is highly appreciated, but isn't necessary for text posts or links to largely-text posts such as blogs or news articles; if we're unsure of the value of your post, we might remove it until you add a submission statement. A submission statement is required for non-text sources (videos, podcasts, images).

Culture war posts go in the culture war thread; all links must either include a submission statement or significant commentary. Bare links without those will be removed.

If in doubt, please post it!


Rules


Recommended Posts And Communities

Recommended Realtime Chats