RenOS
Real libertarians LIKE being outsourced
10mo ago
The dysgenics is trivial to solve with embryo selection, which unlike AI-powered robots has the perk of existing and already being cheap enough to be accessible for middle class people if they so choose. Even in the current form it'd be trivial for western government to subsidize usage for poor people (though I think there is enough slack to make it much, much cheaper to begin with through scaling).
Agree on the Ukraine war & on the problem of extremely fertile ultra-conservative populations, though.
The dysgenics is trivial to solve with embryo selection
IVF costs 10-30k per cycle, with a success rate of around 20-30%. There are around 3.5 million births per year in the US. Even discounting sequencing costs (you want whole genome? Just a SNP chip?), assuming I'm understanding you correctly, won't your program have a roughly hundred billion/year budget? Not to mention that many women don't want to do ivf.
I don't think it's necessary to use for every birth, just consistent usage for people who struggle with pregnancy in the first place & people with certain known problems (I'm deliberately vague here because I think there is a wide range of reasonable policies that should be subject to debate by both the public and experts to collectively find out what we find or find not adequate to select against) is likely to be sufficient to make effective dysgenics per generation almost zero or even turn it around. Many dysfunctions and abnormalities impact fertility, so even just better embryo selection for those that already use IVF is imo likely to impact dysgenics more than you'd naively expect. From the initial data I've seen, simple general-health PGS is likely to even substantially improve the chances for a successful pregnancy beyond what the existing standard tests do, so it's win-win for absolutely everyone.
My first rough idea is something like this:
Make sequencing (again, deliberately vague because while I think deep WGS should be the goal, WES, larger SNP arrays, etc. would be a big step up compared to current practice) for would-be (in the sense of planning, not already pregnant obviously) parents completely free. Even if we assume every second parent takes you up on this, and even assuming one of the most costly option, 100x WGS at ca. 1k (see Nebula for example), this is more in the ballpark of low single digit billions. Probably we will go for a cheaper option, and probably less parents will use it initially, so in practice I'd expect less than a billion.
Only if the parents fulfill the aforementioned "certain known problems" they will also have access to free IVF + embryo selection. Likewise, people that get regular IVF due to struggling to get pregnant also get free genetics-based embryo selection by default on top. Here there is a wide range of costs; I'd probably be initially in favor of a policy that subsidizes only the worst 1% or so. So this would again be in the low single digit billions or less than a billion depending on the take-up.
We can also save a lot by only subsidizing it for people who can't afford it otherwise, but I'm personally against such policies since they have bad incentives imo. But it's an option on the table that would slash the cost down substantially.
I think such a program would be very cost-effective initially as mainly people who already have family histories take it up + those struggling to get pregnant. Over time, success and normalisation would increase the take-up and hence costs, but - and here you can call me out I guess - I think the scaling will more than make up for it. Remember, dysgenics is a pretty slow long-term problem, it's fine if it takes some time, as long as we get the process started and don't just completely ignore it.
In my ideal future, it's completely normal and free for everyone to have access to their own genome through ultra-deep WGS, access to several different risk scores for various diseases, abnormalities and dysfunctions for themselves, there is simple, accessible software that can estimate the joint risk for the same things for the offspring of any two people, and there are clear, commonly agreed guidelines when embryo-selection is subsidized or free for you (ideally with a linear or a multi step function instead of a simple free vs full price).
All in addition to full-price IVF/embryo selection for those who don't agree with guidelines and want to select for the things they personally care about. And in think this ideal future is actually possible even just with the current technology level.
Thanks for the reply, and sorry for being slow to get back to you. I'm not trying to give you a hard time, just understand what you're really proposing.
For the record, I briefly looked into embryo screening when I was trying to have children but it seemed like we're not quite there yet. And IVF is such a pain in the ass that the only people who really go through with it really want a child.
I don't think it's necessary to use for every birth, just consistent usage for people who struggle with pregnancy in the first place & people with certain known problems (I'm deliberately vague here because I think there is a wide range of reasonable policies that should be subject to debate by both the public and experts to collectively find out what we find or find not adequate to select against) is likely to be sufficient to make effective dysgenics per generation almost zero or even turn it around.
I'm seeing only around 2% of people use IVF; why would you think they're the main potential drivers of (hypothetical) dysgenics? Most people around here seem to have 'welfare queens' in mind when discussing dysgenics. Note also that prenatal screening can have a pretty drastic effect, although I suppose many of the disorders you catch would be individuals who wouldn't go on to reproduce regardless so you may discount them.
From the initial data I've seen, simple general-health PGS is likely to even substantially improve the chances for a successful pregnancy beyond what the existing standard tests do, so it's win-win for absolutely everyone.
I can believe it.
Make sequencing (again, deliberately vague because while I think deep WGS should be the goal, WES, larger SNP arrays, etc. would be a big step up compared to current practice)
I've mostly focused on Mendelian disorders, but would you still be able to generate a PGS with whole exome? Or are you just looking for Mendelian diseases? Most of the well-validated genes are already tested for, whereas the disorders with a couple dozen known patients are more likely to just return VUS (variants of unknown significance) which aren't really actionable.
Over time, success and normalisation would increase the take-up and hence costs, but - and here you can call me out I guess - I think the scaling will more than make up for it.
I'm sure scale-up will factor in somehow, I just have no idea what order of magnitude to expect. The sequencing costs would probably scale. Analyzing the data and other bullshit probably wouldn't, unless we can get AI integrated into the healthcare system in some form or another. Hiring thousands of bioinformaticians, clinicians, nurses, lab techs, etc. would be a nightmare.
I'm not against what you're saying in broad strokes; I think something like this is coming sooner or later. I think it'll look a bit different than you outline, but maybe that's just splitting hairs. We'll almost certainly have the technology in place long before the public is anywhere close to accepting genetically engineered babies. It doesn't help that the godmother of CRISPR is profoundly decelerationist.
No problem, as you see I can be even slower, especially over the weekend when I'm barely touching my computer.
For the record, I briefly looked into embryo screening when I was trying to have children but it seemed like we're not quite there yet. And IVF is such a pain in the ass that the only people who really go through with it really want a child.
On my side, I also looked into embryo screening for our first child, and I briefly worked for an embryo screening company in the past. Similar to my proposal, I'd advise people to get themselves sequenced if they can afford it, and that they only should do embryo screening if there are specific reasons, such as that they already do IVF anyway or that they have higher risks for a serious disease based on their preliminary screening, score low on a general health PGS, etc. Btw, I'm also not opposed to germ cell selection since this came up somewhere else, but I'm not aware of this being an actual possibility at the moment.
I'm seeing only around 2% of people use IVF; why would you think they're the main potential drivers of (hypothetical) dysgenics? Most people around here seem to have 'welfare queens' in mind when discussing dysgenics. Note also that prenatal screening can have a pretty drastic effect, although I suppose many of the disorders you catch would be individuals who wouldn't go on to reproduce regardless so you may discount them.
As I wrote, I'd also advice people with a bad general health PGS/high risk for specific diseases etc. to get embryo screening, on a similar magnitude to the number of people who get IVF. So I don't think the IVF population is THE only main driver. But I do think the IVF population is very disproportionally an issue because they consistently have a much higher risks for almost every genetic/biological abnormality and this is often the reason for the pregnancy to fail in the first place. Sometimes because the parents are already unknowing carriers of something, sometimes the parents are even noticeably disabled themselves, and sometimes because the mother simply waited far too long (40+ the disability risk for children goes through the roof that mostly are down to genetics).
On the other point, despite the cliche that someone like me who believes in HBD and advocates embryo screening necessarily thinks that everything is genetics, I'd actually still attribute ~50% of most things to environmental effects. "Welfare queens", by the usual definition, are actually capable of work, they merely refuse to. And they very disproportionally are part of a culture that tolerates or even encourages this behaviour. I consider dysgenics, which actually makes you less capable of working, a related but not entirely identical issue.
I've mostly focused on Mendelian disorders, but would you still be able to generate a PGS with whole exome? Or are you just looking for Mendelian diseases? Most of the well-validated genes are already tested for, whereas the disorders with a couple dozen known patients are more likely to just return VUS (variants of unknown significance) which aren't really actionable.
The most comprehensive currently available risk scores I'm aware of, such as genomic prediction's embryo health score or the UKBB PGS release, are just based on genotyped SNPs or WES at best. WGS (ideally including SVs) would be optimal of course, but isn't really sufficiently available. You don't need to only look at monogenic/mendelian disorders. It works fine in practice for most reasonably common polygenic attributes/diseases, because even if you have an attribute that is associated with, say, 10.000 variants, then not a single of those needs to be significant for the score as a whole to be significant. But it's true that very rare diseases are still a problem. But also by definition they're not actually the most pressing issue, so it's fine if we can't act on them for the time being.
Most people around here seem to have 'welfare queens' in mind when discussing dysgenics.
And that’s interesting because as far as I can tell, the high TFR for very low incomes is driven by illegals picking fruit and Hasidic Jews not wanting day jobs, Shaniqua in the ghetto having 5 children was a 90’s stereotype and not one with a huge amount of basis in present-day fertility rates.
Instead the bigger driver of dysgenics looks to be the divergence between the TFR’s of college and high school educated women(I think the above replacement TFR for women with less than a high school diploma is mostly confounders and that it’s a small enough population for that to be the case).
The dysgenics is trivial to solve with embryo selection
The obesity pandemic is also trivial to solve with people eating less. Mass migration would be easily solved if a wall would be build at the Mexican border.
Even if an easy solution is known, even if the solution is proven to work, it can be very very hard, often impossible, to implement it.
In the blink of an eye, the price dropped from ridiculous to well worth it, in India of all places. Fucking give the people killing themselves with food the pills to stop them wanting to.
Even if the price stays high, it doesn't have to get much cheaper for the cost-benefit to be grossly positive from the reduced healthcare costs for the fat and sick.
This is not impossible, or even very hard to implement. Negotiate costs. Make insurance cover it, if they don't make a rational decision to do so. Buy it from countries where it's cheaper.
Fucking give the people killing themselves with food the pills to stop them wanting to.
Not pills, it's an injection. You try finding different places on your stomach to stab yourself weekly 😁
Plus, there are side-effects. Some people react so badly that they can't stay on the medications. If you're lucky, you'll just end up constipated because of the mechanism of action, which is to slow down the passage of food through the digestive system. If you're extra lucky, you get the "not wanting to eat so much" side-effect, but not everybody does get that.
Not pills, it's an injection. You try finding different places on your stomach to stab yourself weekly
No, it's not necessarily injections, you can quite literally get Semaglutide in oral form. I was looking up formulations for my mom yesterday.
Plus, there are side-effects. Some people react so badly that they can't stay on the medications. If you're lucky, you'll just end up constipated because of the mechanism of action, which is to slow down the passage of food through the digestive system. If you're extra lucky, you get the "not wanting to eat so much" side-effect, but not everybody does get that.
Sigh. Everything has side effects. For semaglutide, they're not particularly noteworthy, regardless of your personal bad luck with it.
I didn't know about the oral formulations, the only ones I've encountered for both Ozempic and Trulicity have been the injectables, (ouch ouch ouch), and even then supply was intermittent because demand outstripped it (particularly for those looking for quickie weight loss).
India makes half the pharmaceuticals you consume in the West, be they cheap or expensive. So it's not surprise I can get it for next to nothing, especially in bulk. So could anyone really, depending on their appetite for Chinese grey markets.
Oral formulations of semaglutide are less effective than a jab, but they're also cheaper, and you can just take more of them.
The long and short (and thin) of it is that it works for most people, and for those it didn't work on/couldn't tolerate it, there are both similar drugs that are likely better at the weight loss deal, and tens of billions of dollars being spent finding more.
Mass migration wouldn’t be solved with a wall because a large number of illegal immigrants (obviously more if the illegal land crossing route was closed) come legally and then overstay tourist or student or other visas. And, of course, a wall wouldn’t affect legal immigration.
The obesity pandemic is being solved as we speak with the new generation of appetite suppressant drugs. It will take time, but ultimately the market is generating the solution.
As soon as embryo selection for positive traits is possible, everyone except some religious extremists and the dirt poor (who should and in many nations will get it for free) will do it because parents have a biological drive to advantage their children in any way they can.
As soon as embryo selection for positive traits is possible, everyone except some religious extremists and the dirt poor (who should and in many nations will get it for free) will do it because parents have a biological drive to advantage their children in any way they can.
Designer babies seem like they’ll suppress the birthrate further among the sorts who do it for the same reason ultraselective preschools and the like to, leading to a natural selection effect towards tabooing it.
This is not true in practise. Parents who go for antenatal screens don't abort on a whim because the kid isn't just right, even in IVF, those who want kids almost always accept the first viable pregnancy with no obvious abnormalities.
They don't get into a tizzy about finding the absolute best, just the best of what's at hand.
In practice, the "my child must be perfect" mentality seems to lead to people hating the idea of parenting and not wanting to have kids- that's the reason for east Asia's anomalously low birthrates. It's hyper-k selection and human beings really hate hyper-k selection. Embryo selection feeds into that mentality for obvious reasons and I find it dimly hilarious that the modern west is selecting for religious fundamentalism so strongly. In 2260 or whenever star trek was supposed to be set the stereotype of whites will be dogmatic, socially conservative, and highly natal.
That isn't what would suppress the birthrate, but rather changing the burden of action from having to end a pregnancy, toward having to take (non-fun, non-instinctual) action to begin a pregnancy.
Likewise, I would expect implants to suppress the birth rate vs oral contraception, because the implant has to be intentionally removed by a doctor, while the pill might just run out or be forgotten (or "forgotten" with some subconscious drive toward having children).
See, I think it's all moot because human labor will shortly cease to matter. But ignoring that:
The people who are opting for pregnancy in a considered manner, especially those who want to go through IVF and potentially embryo selection, want a baby more than is the norm, or they wouldn't bother. People who adopt instead of accepting being childless probably want kids more than average after all.
Likewise, I would expect implants to suppress the birth rate vs oral contraception, because the implant has to be intentionally removed by a doctor, while the pill might just run out or be forgotten (or "forgotten" with some subconscious drive toward having children).
My exam in about a dozen hours leaves me well prepared to field that point. You know why implants are offered in the first place? It's precisely because they reduce unwanted births.
Some poor 18 year old girl is scared of being knocked up? We give her an IUD. A 26 yo woman, we ask her if is planning a family. No? Or a 36 yo who says she's got 3 kids and not one more? Then an IUD, or perhaps an implant, which can be trivially removed for any reason, let alone if they desire kids.
Leaving aside total birth rates, where I expect changes to be minor, this is also helping mitigate dysgenics. A lower class girl with low time preferences has far lower odds of being knocked up again by her deadbeat boyfriend, and then has every opportunity to remove it when she legitimately feels ready.
See, I think it's all moot because human labor will shortly cease to matter.
Labor isn't the only reason it can be good to have children and grandchildren. Maybe they'll be good, interesting people. Human labor would also cease to matter if there were no humans, but most people don't want that.
The people who are opting for pregnancy in a considered manner, especially those who want to go through IVF and potentially embryo selection, want a baby more than is the norm, or they wouldn't bother.
Yes, and that's fine, if someone is already doing IVF, then embryo selection makes sense. I was pushing back about the claim above that "everyone except some religious extremists and the dirt poor (who should and in many nations will get it for free) will do it," which sounds awfully extreme, and I would certainly not want that to become a base level expectation at anywhere near our current level of technology.
I wasn't necessarily saying that IUDs and implants are bad, just that any impediment that requires expert removal will likely reduce births.
Anecdote: despite being 32 and married when I had my first child, I would probably not have had children if I had to intentionally make plans about it ahead of time, vs putting off turning in the renewal paperwork for the oral contraception. We got stable jobs and house because we had a child, not the other way around. Otherwise, we would probably still be wandering around erratically employed and houseless.
This is the kind of marginal situation pro-natalists seem most interested in pushing on. People who are basically pro-social, educated, able to form a stable relationship, mid twenties or older, but aren't in any hurry to settle down and have kids, because that would be a hard change. Short time preference selects for irresponsibly having sex without forethought or precautions. Long time preference selects for planning for and then having the number of kids the person actually wants. But there are a lot of people in the middle who don't necessarily want to raise a baby in the medium term, because babies are hard, but kind of know it would be better to form a family than not.
ThisIsSin
The boob tube emits harmful XXX-rays
Gaashk 10mo ago·Edited 10mo ago
People who are basically pro-social, educated, able to form a stable relationship, mid twenties or older, but aren't in any hurry to settle down and have kids, because that would be a hard change.
Which is why family formation happens far more often when socioeconomic conditions are "pro-social, educated enough, able to form a stable relationship, mid-teens or older". Robbing the young of their youth- or in this case taxing it into the fucking ground with the excuse of [insert your favorite here]- has significant and very real costs on time frames long enough that they become very easy to impose, yet very difficult to rectify, through democratic means (especially because the education-managerial complex has become a welfare system so large that any attempt to reduce it would tear any democratic government apart, and that's before considering that destroying this system of welfare would overwhelmingly affect women).
As such, the youth are getting the message "you'll never be considered a[n adult] human being[, the definition of which implies you're] able to start a family until you're well past your reproductive years" loud and clear, and they settle on playing video games until they die. This state of affairs is then subsidized by exactly the wrong people: that being "middle-class families who had children 30 years ago", and they aren't exactly energized to change things since they tend to be the kind of people who believe that nothing is wrong with this system in the first place specifically because they were the last generation to escape its consequences as children and the first generation of adults to benefit from the welfare.
Every additional thing we feel like we need to do before feeling ready for children is a roadblock to having children at all. So fertility goes down when women are expected to go to college and get a decent job before having children. And again if they're doing self actualization stuff, traveling, training for marathons, doing advocacy, or whatever else and getting social approval for it. And again if they need an unusually excellent partner, a house with a yard, to pay for private school. It would almost certainly go down again if they needed to go to a clinic multiple times to also choose the most excellent possible combination of their genetic potential.
DuplexFields
Ask me how the FairTax proposal works. All four Political Compass quadrants should love it.
2rafa 10mo ago
Why not germ cell selection for positive traits? I’m one of those “religious extremists” who believes creating new people just to throw most of them in the trash is evil incarnate made more evil by its banality, and I’d have no problem picking the right sperm and egg to combine and grow.
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Notes -
The dysgenics is trivial to solve with embryo selection, which unlike AI-powered robots has the perk of existing and already being cheap enough to be accessible for middle class people if they so choose. Even in the current form it'd be trivial for western government to subsidize usage for poor people (though I think there is enough slack to make it much, much cheaper to begin with through scaling).
Agree on the Ukraine war & on the problem of extremely fertile ultra-conservative populations, though.
IVF costs 10-30k per cycle, with a success rate of around 20-30%. There are around 3.5 million births per year in the US. Even discounting sequencing costs (you want whole genome? Just a SNP chip?), assuming I'm understanding you correctly, won't your program have a roughly hundred billion/year budget? Not to mention that many women don't want to do ivf.
I don't think it's necessary to use for every birth, just consistent usage for people who struggle with pregnancy in the first place & people with certain known problems (I'm deliberately vague here because I think there is a wide range of reasonable policies that should be subject to debate by both the public and experts to collectively find out what we find or find not adequate to select against) is likely to be sufficient to make effective dysgenics per generation almost zero or even turn it around. Many dysfunctions and abnormalities impact fertility, so even just better embryo selection for those that already use IVF is imo likely to impact dysgenics more than you'd naively expect. From the initial data I've seen, simple general-health PGS is likely to even substantially improve the chances for a successful pregnancy beyond what the existing standard tests do, so it's win-win for absolutely everyone.
My first rough idea is something like this:
I think such a program would be very cost-effective initially as mainly people who already have family histories take it up + those struggling to get pregnant. Over time, success and normalisation would increase the take-up and hence costs, but - and here you can call me out I guess - I think the scaling will more than make up for it. Remember, dysgenics is a pretty slow long-term problem, it's fine if it takes some time, as long as we get the process started and don't just completely ignore it.
In my ideal future, it's completely normal and free for everyone to have access to their own genome through ultra-deep WGS, access to several different risk scores for various diseases, abnormalities and dysfunctions for themselves, there is simple, accessible software that can estimate the joint risk for the same things for the offspring of any two people, and there are clear, commonly agreed guidelines when embryo-selection is subsidized or free for you (ideally with a linear or a multi step function instead of a simple free vs full price). All in addition to full-price IVF/embryo selection for those who don't agree with guidelines and want to select for the things they personally care about. And in think this ideal future is actually possible even just with the current technology level.
Thanks for the reply, and sorry for being slow to get back to you. I'm not trying to give you a hard time, just understand what you're really proposing.
For the record, I briefly looked into embryo screening when I was trying to have children but it seemed like we're not quite there yet. And IVF is such a pain in the ass that the only people who really go through with it really want a child.
I'm seeing only around 2% of people use IVF; why would you think they're the main potential drivers of (hypothetical) dysgenics? Most people around here seem to have 'welfare queens' in mind when discussing dysgenics. Note also that prenatal screening can have a pretty drastic effect, although I suppose many of the disorders you catch would be individuals who wouldn't go on to reproduce regardless so you may discount them.
I can believe it.
I've mostly focused on Mendelian disorders, but would you still be able to generate a PGS with whole exome? Or are you just looking for Mendelian diseases? Most of the well-validated genes are already tested for, whereas the disorders with a couple dozen known patients are more likely to just return VUS (variants of unknown significance) which aren't really actionable.
I'm sure scale-up will factor in somehow, I just have no idea what order of magnitude to expect. The sequencing costs would probably scale. Analyzing the data and other bullshit probably wouldn't, unless we can get AI integrated into the healthcare system in some form or another. Hiring thousands of bioinformaticians, clinicians, nurses, lab techs, etc. would be a nightmare.
I'm not against what you're saying in broad strokes; I think something like this is coming sooner or later. I think it'll look a bit different than you outline, but maybe that's just splitting hairs. We'll almost certainly have the technology in place long before the public is anywhere close to accepting genetically engineered babies. It doesn't help that the godmother of CRISPR is profoundly decelerationist.
No problem, as you see I can be even slower, especially over the weekend when I'm barely touching my computer.
On my side, I also looked into embryo screening for our first child, and I briefly worked for an embryo screening company in the past. Similar to my proposal, I'd advise people to get themselves sequenced if they can afford it, and that they only should do embryo screening if there are specific reasons, such as that they already do IVF anyway or that they have higher risks for a serious disease based on their preliminary screening, score low on a general health PGS, etc. Btw, I'm also not opposed to germ cell selection since this came up somewhere else, but I'm not aware of this being an actual possibility at the moment.
As I wrote, I'd also advice people with a bad general health PGS/high risk for specific diseases etc. to get embryo screening, on a similar magnitude to the number of people who get IVF. So I don't think the IVF population is THE only main driver. But I do think the IVF population is very disproportionally an issue because they consistently have a much higher risks for almost every genetic/biological abnormality and this is often the reason for the pregnancy to fail in the first place. Sometimes because the parents are already unknowing carriers of something, sometimes the parents are even noticeably disabled themselves, and sometimes because the mother simply waited far too long (40+ the disability risk for children goes through the roof that mostly are down to genetics). On the other point, despite the cliche that someone like me who believes in HBD and advocates embryo screening necessarily thinks that everything is genetics, I'd actually still attribute ~50% of most things to environmental effects. "Welfare queens", by the usual definition, are actually capable of work, they merely refuse to. And they very disproportionally are part of a culture that tolerates or even encourages this behaviour. I consider dysgenics, which actually makes you less capable of working, a related but not entirely identical issue.
The most comprehensive currently available risk scores I'm aware of, such as genomic prediction's embryo health score or the UKBB PGS release, are just based on genotyped SNPs or WES at best. WGS (ideally including SVs) would be optimal of course, but isn't really sufficiently available. You don't need to only look at monogenic/mendelian disorders. It works fine in practice for most reasonably common polygenic attributes/diseases, because even if you have an attribute that is associated with, say, 10.000 variants, then not a single of those needs to be significant for the score as a whole to be significant. But it's true that very rare diseases are still a problem. But also by definition they're not actually the most pressing issue, so it's fine if we can't act on them for the time being.
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And that’s interesting because as far as I can tell, the high TFR for very low incomes is driven by illegals picking fruit and Hasidic Jews not wanting day jobs, Shaniqua in the ghetto having 5 children was a 90’s stereotype and not one with a huge amount of basis in present-day fertility rates.
Instead the bigger driver of dysgenics looks to be the divergence between the TFR’s of college and high school educated women(I think the above replacement TFR for women with less than a high school diploma is mostly confounders and that it’s a small enough population for that to be the case).
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The government spends $120bn a year on food stamps, which is much less net positive than this program.
I also wouldn't describe that program as 'trivial.'
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The obesity pandemic is also trivial to solve with people eating less. Mass migration would be easily solved if a wall would be build at the Mexican border.
Even if an easy solution is known, even if the solution is proven to work, it can be very very hard, often impossible, to implement it.
The Obesity epidemic is, in fact, easy to solve.
Start handing out Ozempic.
In the blink of an eye, the price dropped from ridiculous to well worth it, in India of all places. Fucking give the people killing themselves with food the pills to stop them wanting to.
Even if the price stays high, it doesn't have to get much cheaper for the cost-benefit to be grossly positive from the reduced healthcare costs for the fat and sick.
This is not impossible, or even very hard to implement. Negotiate costs. Make insurance cover it, if they don't make a rational decision to do so. Buy it from countries where it's cheaper.
Not pills, it's an injection. You try finding different places on your stomach to stab yourself weekly 😁
Plus, there are side-effects. Some people react so badly that they can't stay on the medications. If you're lucky, you'll just end up constipated because of the mechanism of action, which is to slow down the passage of food through the digestive system. If you're extra lucky, you get the "not wanting to eat so much" side-effect, but not everybody does get that.
No, it's not necessarily injections, you can quite literally get Semaglutide in oral form. I was looking up formulations for my mom yesterday.
Sigh. Everything has side effects. For semaglutide, they're not particularly noteworthy, regardless of your personal bad luck with it.
I didn't know about the oral formulations, the only ones I've encountered for both Ozempic and Trulicity have been the injectables, (ouch ouch ouch), and even then supply was intermittent because demand outstripped it (particularly for those looking for quickie weight loss).
India makes half the pharmaceuticals you consume in the West, be they cheap or expensive. So it's not surprise I can get it for next to nothing, especially in bulk. So could anyone really, depending on their appetite for Chinese grey markets.
Oral formulations of semaglutide are less effective than a jab, but they're also cheaper, and you can just take more of them.
The long and short (and thin) of it is that it works for most people, and for those it didn't work on/couldn't tolerate it, there are both similar drugs that are likely better at the weight loss deal, and tens of billions of dollars being spent finding more.
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Mass migration wouldn’t be solved with a wall because a large number of illegal immigrants (obviously more if the illegal land crossing route was closed) come legally and then overstay tourist or student or other visas. And, of course, a wall wouldn’t affect legal immigration.
The obesity pandemic is being solved as we speak with the new generation of appetite suppressant drugs. It will take time, but ultimately the market is generating the solution.
As soon as embryo selection for positive traits is possible, everyone except some religious extremists and the dirt poor (who should and in many nations will get it for free) will do it because parents have a biological drive to advantage their children in any way they can.
Designer babies seem like they’ll suppress the birthrate further among the sorts who do it for the same reason ultraselective preschools and the like to, leading to a natural selection effect towards tabooing it.
This is not true in practise. Parents who go for antenatal screens don't abort on a whim because the kid isn't just right, even in IVF, those who want kids almost always accept the first viable pregnancy with no obvious abnormalities.
They don't get into a tizzy about finding the absolute best, just the best of what's at hand.
In practice, the "my child must be perfect" mentality seems to lead to people hating the idea of parenting and not wanting to have kids- that's the reason for east Asia's anomalously low birthrates. It's hyper-k selection and human beings really hate hyper-k selection. Embryo selection feeds into that mentality for obvious reasons and I find it dimly hilarious that the modern west is selecting for religious fundamentalism so strongly. In 2260 or whenever star trek was supposed to be set the stereotype of whites will be dogmatic, socially conservative, and highly natal.
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That isn't what would suppress the birthrate, but rather changing the burden of action from having to end a pregnancy, toward having to take (non-fun, non-instinctual) action to begin a pregnancy.
Likewise, I would expect implants to suppress the birth rate vs oral contraception, because the implant has to be intentionally removed by a doctor, while the pill might just run out or be forgotten (or "forgotten" with some subconscious drive toward having children).
See, I think it's all moot because human labor will shortly cease to matter. But ignoring that:
The people who are opting for pregnancy in a considered manner, especially those who want to go through IVF and potentially embryo selection, want a baby more than is the norm, or they wouldn't bother. People who adopt instead of accepting being childless probably want kids more than average after all.
My exam in about a dozen hours leaves me well prepared to field that point. You know why implants are offered in the first place? It's precisely because they reduce unwanted births.
Some poor 18 year old girl is scared of being knocked up? We give her an IUD. A 26 yo woman, we ask her if is planning a family. No? Or a 36 yo who says she's got 3 kids and not one more? Then an IUD, or perhaps an implant, which can be trivially removed for any reason, let alone if they desire kids.
Leaving aside total birth rates, where I expect changes to be minor, this is also helping mitigate dysgenics. A lower class girl with low time preferences has far lower odds of being knocked up again by her deadbeat boyfriend, and then has every opportunity to remove it when she legitimately feels ready.
Labor isn't the only reason it can be good to have children and grandchildren. Maybe they'll be good, interesting people. Human labor would also cease to matter if there were no humans, but most people don't want that.
Yes, and that's fine, if someone is already doing IVF, then embryo selection makes sense. I was pushing back about the claim above that "everyone except some religious extremists and the dirt poor (who should and in many nations will get it for free) will do it," which sounds awfully extreme, and I would certainly not want that to become a base level expectation at anywhere near our current level of technology.
I wasn't necessarily saying that IUDs and implants are bad, just that any impediment that requires expert removal will likely reduce births.
Anecdote: despite being 32 and married when I had my first child, I would probably not have had children if I had to intentionally make plans about it ahead of time, vs putting off turning in the renewal paperwork for the oral contraception. We got stable jobs and house because we had a child, not the other way around. Otherwise, we would probably still be wandering around erratically employed and houseless.
This is the kind of marginal situation pro-natalists seem most interested in pushing on. People who are basically pro-social, educated, able to form a stable relationship, mid twenties or older, but aren't in any hurry to settle down and have kids, because that would be a hard change. Short time preference selects for irresponsibly having sex without forethought or precautions. Long time preference selects for planning for and then having the number of kids the person actually wants. But there are a lot of people in the middle who don't necessarily want to raise a baby in the medium term, because babies are hard, but kind of know it would be better to form a family than not.
Which is why family formation happens far more often when socioeconomic conditions are "pro-social, educated enough, able to form a stable relationship, mid-teens or older". Robbing the young of their youth- or in this case taxing it into the fucking ground with the excuse of [insert your favorite here]- has significant and very real costs on time frames long enough that they become very easy to impose, yet very difficult to rectify, through democratic means (especially because the education-managerial complex has become a welfare system so large that any attempt to reduce it would tear any democratic government apart, and that's before considering that destroying this system of welfare would overwhelmingly affect women).
As such, the youth are getting the message "you'll never be considered a[n adult] human being[, the definition of which implies you're] able to start a family until you're well past your reproductive years" loud and clear, and they settle on playing video games until they die. This state of affairs is then subsidized by exactly the wrong people: that being "middle-class families who had children 30 years ago", and they aren't exactly energized to change things since they tend to be the kind of people who believe that nothing is wrong with this system in the first place specifically because they were the last generation to escape its consequences as children and the first generation of adults to benefit from the welfare.
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That would be my expectation as well.
Every additional thing we feel like we need to do before feeling ready for children is a roadblock to having children at all. So fertility goes down when women are expected to go to college and get a decent job before having children. And again if they're doing self actualization stuff, traveling, training for marathons, doing advocacy, or whatever else and getting social approval for it. And again if they need an unusually excellent partner, a house with a yard, to pay for private school. It would almost certainly go down again if they needed to go to a clinic multiple times to also choose the most excellent possible combination of their genetic potential.
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Why not germ cell selection for positive traits? I’m one of those “religious extremists” who believes creating new people just to throw most of them in the trash is evil incarnate made more evil by its banality, and I’d have no problem picking the right sperm and egg to combine and grow.
Sure, I should probably have said ‘designer babies’ or whatever to include that whole category of possibilities.
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