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In general, both the Republicans and Democrats are centrist parties. And more ideologically-driven members of both parties are, IMO, correct when they say that "RINOs" or "neoliberals" are weaksauce versions of their ideologies.

Trump talks a big game about deportation and immigration, but will accomplish very little. No mass deportations will occur during a Trump presidency any more than under a Harris presidency. Trump also talks about repatriating trade, but will only implement tarriffs that will increase prices without increasing US manufacturing. Republicans also talk a lot about how great of a pro-life success Dobbs was, but as far as I can tell, handing control over abortion policy back to the states has resulted in a more pro-choice regulatory landscape than under the status quo. And there's a lot of discussion of "law and order," but the streets are unsafe even in red states, and forget about riding public transit.

Likewise, Democrats talked a big game about defunding the police, and while there were definitely areas where budgets were slashed, no actual "defunding" or "abolishing" took place. They've also talked about healthcare reform for a long time, but since 2010 have accomplished approximately nothing. Redistribution of wealth in any appreciable sense has never happened, and entitlements continue to be soaked up by boomers with fat wallets while the poor and disabled are still means-tested to the bone. Significant movement on workers' protections hasn't happened; instead delusional baristas are setting up labor unions, because when I think of exploitation of labor, I think of not putting up rainbow flags. And not, you know, what's going on in Amazon warehouses.

But while the serious economic and philosophical problems of the US continue to fester, we keep getting distracted by irrelevant culture war issues like weird sex and gender identity things and whether or not Trump is literally Hitler. It's good to know we're focusing on the important things!

However, I am not a medical doctor, so what am I missing?

Coming in way too hot.

The VA has had hiring freezes for the last two years, to my understanding. So no traditional shortage there.

Hiring extra VA physicians does nothing for the general problems we have in any case (which isn't a traditional shortage).

Ymeskhout called it a crazy conspiracy theory to think progressive prosecutors were using procedural manipulation to favor BLM rioters.

DeBoer does this:

https://freddiedeboer.substack.com/p/clinton-and-obama-gave-us-trump

when the far-right party and the center-right party both move right, guess what direction the country goes in?

The Marxist left thinks of the left-right in economic terms and considers anyone not explicitly socialist/communist as being right wing, the reactionary right considers the divide mainly in cultural terms and thinks anyone not based is essentially left wing.

because neither of them can offer anything which actually helps people deal with the problems they're facing in their daily lives

I think I agree with you, but I'd like to hear you elaborate: if we could snap our fingers and generate political capital for things that would help pepole deal with the problems they're facing in their daily lives, what would those things be?

I would love to know why you don't think it wouldn't help with the shortage. I figure that, having a shortage of doctors willing to work in VA, combined with doctors from other countries who are willing to work at VA because it will gain them the higher US pay + a path to US citizenship, would indeed alleviate shortage of doctors at VA. However, I am not a medical doctor, so what am I missing?

I think this is an unfairly low effort dismissal. I don't like all the people above, but they are thoughtful and making more of an effort at fairness than you suggest. Read Ymeskhout's if you haven't and look at things like Trump's post about AI crowds that were included in it. I understand the traditional Motte argument that Trump lies like a used car salesman and Democrats lie like lawyers and there is certainly some truth to that. And I agree that at the moment Democrat lies are more dangerous precisely because they have a veneer of respectability and acceptability by institutions. However, I don't think that changes the fact that Republicans really have become the party of choice for conspiracy theorists that have very little grounding in reality. It is a very particular kind of mindset that is a not insignificant portion of the electorate and it has become increasingly partisan in recent years particularly since Trump and doubly so since COVID.

I live in downtown Chicago and this does not reflect my experience. It's less that you need to be in an excessively exclusive area, just avoid the very bad areas. People actively want to live in several of the downtown clusters, especially in their youth. We'll probably move out to the burbs when we have out kid of school age for the better schools, not because we fear the area.

Apologies for the delayed response - I don't post on the motte on weekends.

Out of curiosity, have you actually read any books about the history of Israel and the Israeli-Palestinian conflict? Do you think you could accurately summarize both the Israeli and the Palestinian positions in words that they themselves would agree with?

Yes, I have, and I've read a lot about the history of the region due to the prominence of the issue. As for accurately summarizing both positions... the Palestinian side would be easy but as for the Israeli side I honestly don't think so - there are real divisions in Israeli society on these topics, and coming up with an answer that could satisfy all of them is hard. There are hardline settlers who believe that all the land God gave them in their scriptures belongs to them with no negotiation, and there are Israelis who want a two or one-state solution to the Palestinian issue. At the same time I have actually discussed the issue with people who were born Israeli citizens and they've agreed with my understanding... but given that I met them at a protest against the genocide, I am not actually sure that they'd qualify for your purposes here. I could definitely come up with an accurate summary of the Israeli position that the current government would agree with, but I would prefer not to lie.

Who is them? The footballers in Amsterdam?

"Israeli partisans". The Amsterdam crew count, but they're a subset of the larger category.

It's undeniable that tens of thousands of Palestinians have been killed. There is no war, especially one happening in an urban environment, where lots of casualties weren't women and children. This doesn't make their war just, but it does make it unexceptional.

Disproportionate numbers of women and children are showing up in the casualty lists and this is being reported on by reputable media organisations - these figures are actually exceptional.

https://www.reuters.com/world/middle-east/nearly-70-gaza-war-dead-women-children-un-rights-office-says-2024-11-08/

The U.N. Human Rights Office said on Friday nearly 70% of the fatalities it has verified in the Gaza war were women and children, and condemned what it called a systematic violation of the fundamental principles of international humanitarian law.

The U.N. tally since the start of the war, in which Israel's military is fighting Hamas militants, includes only fatalities it has managed to verify with three sources, and counting continues.

The 8,119 victims verified is a much lower number than the toll of more than 43,000 provided by Palestinian health authorities for the 13-month-old war. But the U.N. breakdown of the victims' age and gender backs the Palestinian assertion that women and children represent a large portion of those killed in the war.

This finding indicates "a systematic violation of the fundamental principles of international humanitarian law, including distinction and proportionality", the U.N. rights office said in a statement accompanying the 32-page report.

Nor are the Israelis exceptional in having some drunken footballers chanting terrible things and soldiers in the field sometimes getting up to stupid and offensive grunt shit to amuse themselves.

I have never in my life heard a football chant that was as offensive and cruel as the ones from Maccabi Tel Aviv. Taking glee and exulting in the mass extermination of children is way beyond the bounds of football banter, at least in my experience. Do you have any examples of ones that were worse or even comparable? As for soldiers in the field, I'm going by reputable third-party numbers as linked above. There's a difference between soldiers in the field getting up to stupid and offensive grunt shit to amuse themselves and "systematic violation of the fundamental principles of international humanitarian law, including distinction and proportionality." Even if your argument holds, the idea that they're disproportionately murdering women and children to amuse themselves says worse things about the IDF than any of the claims I've made so far.

That would require you to describe them as they would describe themselves. Do you think they would describe themselves as "a blood-drenched, bronze-age state intent on ethnic purity and conquest via force of arms to reclaim the territory their god said was theirs"?

I have had conversations with hardline Israelis who would proudly adopt that label for themselves, but I understand those people are a minority in Israeli society. At the same time, I know several people who would object to entirely accurate and factual descriptions of themselves because they don't want to admit something that they actually did. If I murdered someone in cold blood and was convicted, you'd be entirely justified in calling me a murderer, even if I would disagree and describe myself as a patriot who did what I had to do to save my nation. The standard you're applying here prevents any kind of condemnation of the Nazis as well - they'd view themselves as brave heroes protecting their nation from evil parasites, so they'd disagree with any of the negative descriptions that they deserve to receive.

Again, you aren't using the word "evil" but you're clearly saying, in not so many words, that they're evil monsters and there is no other way to explain them.

I believe they're ethnonationalists who want to reclaim the territory that their god supposedly promised them in their religious scriptures. That's the explanation! It sounds unflattering to modern, non-Bronze age ears, but that's because the actions the Israelis have actually undertaken are unflattering. You don't get to run an apartheid state and then complain that people are saying you run an apartheid state because you'd call it something else that's not as bad for your reputation.

Also, Likud is one political party in Israel whose popularity waxes and wanes. They do not speak for the Israeli state and the entirety of the Israeli citizenry. This would be like taking some of the Republicans' most extreme statements and saying they speak for Americans. (Which of course is exactly what they and their enemies would both like to claim, but it doesn't make it true.) Much has been made of Netanyahu's "Amelek" comment. Netanyahu is a sort of Trump-like figure in Israel - he has a lot of supporters, especially after 10/7, but a substantial portion of the Israeli's population hates him. Think of all the outrageous things Trump has said, which a sizeable portion of the American population would not agree with, and then claiming that Trump was clearly speaking for the American people, and reflecting what Americans think. In an abstract sense, this may be true (they elected him, after all), but at the same time, you'd be completely wrong in claiming he's channelling the American psyche and voicing what the average American thinks about everything.

Likud is currently in power and Benjamin Netanyahu is the longest serving PM the country has had. Unless you want to make the claim that Israel isn't a democracy and their elected leaders do not represent the will of the people, Likud and Netanyahu do speak for the Israeli state. You make the point about extreme republicans, but Zero HP Lovecraft isn't the POTUS right now - and when Trump takes office again, I have no problem saying that he speaks for Americans. Do I think that all Israelis act like this? Absolutely not, I've even mentioned the Israelis I marched and protested alongside. But when I look at the polls, a lot of those more noxious beliefs have incredibly broad support amongst Israeli citizens.

https://truthout.org/articles/polls-show-broad-support-in-israel-for-gazas-destruction-and-starvation/ (yes, the source for this is anti-zionist - I don't believe that means they are just publishing fiction.)

Polls seem to offer confirmation of this statement. A 2013 survey showed that over half of Israeli Jews believe “very strongly” that Jews are the chosen people and that nearly two-thirds believe this statement either “very strongly” or “quite strongly.”

In a January 2023 poll, 93 percent of Israeli Jews said that all of the land between the Mediterranean Sea and the Jordan River belongs to them. The justification for this belief is not discussed in the poll

93 percent of Israeli jews support the claim that their god promised them all the territory between the river and the sea. If you put the claim that the Jews are god's chosen people and that he has given them all that territory (including Palestine) to the Israeli people on a referendum, polling data suggests that's what they'd vote for! I don't think you can really say that these ideas don't represent the will of the people when a majority of them say they do when asked.

Netanyahu, and other militant Likud officials, are pretty open about despising Palestinians, and there's a sizeable portion of Israel that would just like the Palestinians to go away (who can blame them, after all this time?).

Me! I can blame them! Not once have I ever in my life said that I would like another ethnicity to just 'go away' because I don't like the political consequences of their continued existence. If you want to defend that impulse, go ahead - but you're forever giving up the ability to criticize antisemites, racists and white nationalists. After all, they would just like the jews to go away - who can blame them, after all this time?

But most Israelis do not want to exterminate Palestinians because God said to, and you know this and you know it's not an accurate characterization, you're just using that description because it makes Israel sound really super-evil.

I said it because the polling data supports it. That's what it means when over half the population says that they are god's chosen people, and 93% of them of them believe that the territory promised to them in their scriptures belongs to them.

We have a number of white ethnonationalists here, and while sometimes they will admit that they would be okay with a violent solution to create the ethnostate they want, none of them would accept as uncharitable a description of their motives as the one you are claiming is the Israeli one.

I'm not just aware, I've spoken to and argued with them. And you're totally right - very few of them would accept as uncharitable a description of their motives. But at the same time, I'm willing to bet if you assembled all the white nationalists here on the motte and asked them if they were willing to go to the lengths Israel has gone to in order to rid their country of jews and non-whites, many of them would actually say that they would prefer less overtly violent and bloodthirsty methods. I have no problems criticising white nationalists and other ethnic supremacists who would support the disproportionate murder of women and children in support of their ethnostate, and when I see white nationalist troops blowing up hospitals I'll be protesting against them too.

No, you are assuredly and absolutely not. Again, can I ask what books you have read?

Most of them I read over fifteen years ago and can't recall, but the most recent one was Righteous Victims.

Ya have a bunch of setups like this on aquilo, and now maybe starting to do them on gleba

I mean it's like comparing ships from the age of sail to modern battleships. Do they both suck and are too expensive? Quite possibly.

Are they totally different things? Also true.

The population is completely different in terms of age and health. What we can do for patients is also totally different - more patients are on more medications that are more effective.

If a given type of health plan increases the chance that patients actually take their diabetes medication that alone will have a radical impact on outcomes.

Those things didn't exist 40 years ago. Nor did the diabetes rates...

Apple to oranges, maybe the conclusion is the same, but still apples to oranges.

Do you have a more recent study to cite because every factor that's changed since that one was published would have made the problem worse. Fewer doctors per capita, more regs, Obamacare, and an older, sicker population.

What's the current status of the situation, according to your research?

Huh, interesting - definitely missed how much things have changed on this front, thank you for the update.

I don't support catastrophic plans anyway so it makes sense, yeah some of it is the healthy need to subsidize the sick, but also people struggle to understand if they are healthy or sick, and how quickly that can change and so on.

The young always think they are invincible and then you get diabetes and sit on it unmanaged for a decade and end up with a heart attack and bilateral knee amputations or no kidneys.

Preventative care saves people and money in the long run and is cheap as hell but people will refuse.

Vance is a writer who later became a politician. Hillbilly Elegy is what made him famous and jump started a potential political career. It’s not a political memoir written for a sitting politician like Dreams From My Father

This may be nonresponsive and a tangent to your guys' dialogue, which was fun to read, but thought I would add it since I looked some of this stuff up.

Catastrophic plans are available on the marketplace

Interesting! I was sure this had been banned and it looks like it pretty much was banned. You have to qualify for an exemption to even be eligible (<30 or poor enough to likely qualify for near total subsidy of another plan anyway) and also still covers the minimum requirements under the ACA like some preventative care and pregnancy.

This is a far cry from what "catastrophic" plans were not even 10 years ago. I got a grandfathered catastrophic plan from my health insurer when I graduated school. My max out-of-pocket was $5,000 and I paid $67 a mo and that included a sort of pre-purchase plan for eye and dental for another $20 or so. That plan kept getting enforcement waivers under Obamacare until it was finally banned as a parting gift of the Obama administration to the next one.

My "catastrophic plan" was better than a current bronze plan except the bronze plan covers a bunch of things I'll never need, and the current "catastrophic plan" now also costs over 6X+ ($420 was the quote I just got using the same age I was in the catastrophic plan) what my grandfathered, ACA noncompliant catastrophic plan, and the max out-of-pocket is now >30% higher than the inflation adjusted max-out-of-pocket. The current bronze plan quote is almost 10X what I paid for a catastrophic plan, the deductible is ~30% cheaper than the inflation adjusted max-out-pocket, and the out-of-pocket max is also >30% higher.

Wow! Hard to think this was in the medical wild west of yesteryear, 2016.

I live in NYC, and I've never heard of anyone living like that.

You're about 30 years too late for NYC. There still are cities like that, though.

It depends whether you're modelling the increased demand for doctors as coming from pure population growth, in which case the point by @Quantumfreakonomics stands, or having greater demand for doctoring from the same total population in area, in which case your point stands and there's a natural cap

I live in NYC, and I've never heard of anyone living like that. I've lived here for about 8 years, and I know of exactly 1 instance of somebody I personally know being affected by street crime, and that was just a phone snatching. Maybe some women carry pepper spray, but I've never noticed it. IMO, carrying pepper spray indicates that things are pretty safe because it's not very effective against much. I do know lots of people, men and women, young and old, who have no concerns at all about walking around alone late at night, even drunk. I've never heard of anybody telling people everything they're doing in case "something happens".

I'm not really sure if car break-ins are much of a problem honestly, mostly because very few people have them, and if they do, they mostly park them in expensive private parking garages. It does seem a little surprising I guess, but I would think I would have heard of it happening at least some if it was actually common.

It is fairly common for people who want to have kids to move out, but that's more because it's quite expensive to get a large enough space, not because of concerns about crime. There definitely are a lot of kids of all ages around, including in strollers and being walked around. Enough that it's reasonably common to be mildly annoyed by someone wheeling a baby stroller around in a place that seems kind of inappropriate, like inside a crowded store.

Here's the initiation ceremony for Saiva Tantrikas, for example.

Interesting, thanks! By the way, if you want a modern take on possession, read "Impro: Improvisation and the Theatre". It has a section on masks and letting yourself getting possessed by characters. Psychologically, they probably have a lot in common. There's also some research on how virtual avatars and characters, and even ones social rules, affect ones identity and behaviour. As for the ceremony, is the bell and incense used? For that would affect the senses. The whole divinity/godly aspects are almost required in order for one to take something seriously. Things have the weight we give them, so we use rituals in order to legitimize them. Praying, for instance, is likely a form of visualization, but we envoke the idea of god because we cannot believe in our own power. Tarot cards and Rorschach tests help you read yourself without filter, but in order to believe in the power of their subconsciousness, people need to believe that a diety is present (The oracle). People can barely meet a wise character in a dream without thinking that some external being helped them. It seems like we need to believe in something higher than ourselves, or even in something higher within ourselves (being made in the image of god, the transcendental function, being connected to a higher power, etc). Not that we should take all the credit for ourselves, making ourselves out to be gods (at least not the ego or the self we identify with). Nietzsche kind of tried with the ubermensch thing, he regards the human body as divine because all of this is hidden within it.

Anyway, that was a bit of a tangent. I will try various breathing techniques, but only when I feel certain that I won't be giving myself brain-damage (I'm a bit high in neuroticism).

metaphysical truths on the one hand, and perceptive shifts on the other

We experience life through ourselves, so truths about ourselves are truths about the world as we experience it, or truths about our relation to the world (not the agent nor the environment, but the agent-environment interaction). But the truth simply is, right? Figuring our a profound truth feels good, and results in viewing the world differently, but it doesn't change anything. By the way, I do believe that these ancient sages did figure out important things. The hermetic principles and modern physics have a lot in common. Can you understand the world just by thinking? Probably to an extent, Einstein seemed to manage this, and Tesla also ran physics experiments in his working memory (which was huge, likely due to anesthesia with his visual field or spatial intuition).

The fact it wasn't supposed to be this way!

This is a huge factor in what's called enlightenment. But isn't this just a function of the ego? It thinks it can control reality by rejecting parts of it. It even thinks that having negative thoughts against something helps protect against it or weaken it. That worrying about a family member helps in keeping them safe. But you can "let go" of all of this tension and just let things happen, and everything will continue as it did before, because you never controlled anything. The river flows all the same, and all your resistance amounted to was exhausting yourself. The truth is always bearable for you're already enduring it. What's false can ever harm you, as it cannot exist. It's realizations like this which helps people relax and approach the mindset of a sage. The brain wants to be correct, and to have what it already believes confirmed. It's like your memories and beliefs themselves are afraid of death, or like the brain sees the loss of a belief as the loss of a part of yourself, and reacts as if somebody tried to cut off your hand when somebody attacks a belief or a value you have.

And to generalize these contradictions: All splitting, multiple personality disorders, internal conflicts, etc. are caused by internal contradictions. Nietzsche wrote a lot about this, especially about how willpower affects our ability to control these fragments rather than getting swept away from them. But he also spoke of the positives of contradictions: "Because we forget that valuation is always from a perspective, a single individual contains within him a vast confusion of contradictory valuations and consequently of contradictory drives. This is the expression of the diseased condition in man, in contrast to the animals in which all existing instincts answer to quite definite tasks. This contradictory creature has in his nature, however, a great method of acquiring knowledge: he feels many pros and cons, he raises himself to justice-to comprehension beyond esteeming things good and evil. The wisest man would be the one richest in contradictions, who has, as it were, antennae for all types of men - as well as his great moments of grand harmony - a rare accident even in us!" By the way, if you try to solve all contradictions by taking the intersection of all beliefs and knowledge, you will likely end up with the empty set. Like I said in another comment, there's no one true worldview, you simply need to choose one.

I also want to point out that contrast between two things are required in order to feel much of anything. To feel your strength at the gym, you need to lift a weight which makes you use this power. To feel heroic, you need to feel like you're facing a great difficulty. Even the flow state requires a task with sufficient stimulation and resistance. Some people feel a lot of hate, but they don't want to point it at other people, so they ultimately point it at themselves. If they could just point this at a safe target, like "Poverty", then they could allow themselves to feel this emotion and even use it towards a constructive goal. In other words, be careful of removing any Yins as the Yangs will disappear as well. As I got less lonely, I found myself caring about other people less. As I got more confident, I started valuing compliments less. My Youtube feed is recommending a video called "How to never feel shy again", but it's considered bad to be "shameless" for a reason. Shyness is cute, I don't want to destroy it. I agree with everything you wrote here, though!

where your thoughts connect and everything naturally clicks into place

Haha, I might try this!

I mentioned Krishnamurti downthread

Looked him up now. His "insanity", so to speak, of letting go of memories is actually just letting go of the map and living in the territory, no? To live in pure experience, rather than living in cognitive models of the world. I found a quote saying "To live in the eternal present there must be death to the past, to memory. In this death there is timeless renewal". Earlier I wrote that the ego just wants its memories validated, and like you said, for its models to be correct, and to feel bad when there's a conflict between reality and ones model of it (the experience of cognitive dissonance). I too wish to experience life like I experienced as a child, and if possible, experience things as if experiencing them for the first time - but this means to erase ones memory, at least in a sense. I don't think this is "insanity". Do you know how some people lose faith in love because they deconstruct it to being mere chemicals? That is to overwrite life and experience by creating lifeless mental models and making them out to be actual reality. What sages tells us to do is merely the opposite of that. To deem reality and experience as real, and mental models as false, rather than doing the opposite and becoming excessively objective and robotic.

With the amount of thinking you do during the state

Interesting idea. I don't think it's false, but we have two models of thinking, system 1 and 2, in other words, conscious and unconscious processing. Ever felt down and then suddenly felt better with no explanation? I think that's what happens when subconscious processing resolves a conflict. So "thinking" is still taking place doing this, unless even the subconsciousness is calmed.

Tantra and Tibetan practices are the most confusing side of Buddhism

I found a book on libgen called "Mahamudra and Related Instructions: Core Teachings of the Kagyu Schools". Page 31 starts out by mentioning impermanence, but we already know that "Change is the only constant" and why getting stuck in the past is not a good idea. The book recomments letting go of this life (as it's not permanent anyway). By the way, this is probably for the same reason that one can't think clearly on topics that they're biased about. In order to see things as they are, you must not have beliefs about how they ought to be (resulting in that cognitive dissonance) so it makes sense that understanding these teachings is helped by being alright with any conclusion and implication, even when they suggest something that most people feel threatened by. Then it mentions the "ultimate bodhicitta" which is basically just letting your mind do its thing, letting things be like they are, and accepting what comes, as it's all there is. In the words of Werner Erhard: "Take what you get, for its all you get".

What's new to me is how Buddhism practices good and morality, rather than just complete indifference. This seems a little inconsistent of them, but I suppose they just assume that morality and altruism the true default which is corrupted by the ego and the brains self-survival medhanisms. There's 780 more pages than this, but I believe that I already got the general point of Buddhism, and I've come to like Samsara, and since I've learned to enjoy life despite my suffering, escaping Samsara would be a loss for me. If you can modify your perception as much as the Buddhists recommend, then you can certainly learn how to enjoy imperfection, in which case there's no need to escape anything. This worldview would probably offend a lot of gurus though.. If they're still capable of being offended, I'm not sure. And there may be more interesting ideas covering psychology that I don't yet know, I'm just very unconscientious/lazy. And sorry about my arrogance, I hope the information makes up for it.

I would say right now that there is in fact broad variation in competence in the medical profession. You can see from the average medical licensing exam scores of different specialties that the best MDs tend to go into opthalmology, dermatology, and neurosurgery, whereas the worst ones go into family medicine and psychiatry.

About a year ago I had a rather severe case of mononucleosis, and was sick for about a month. I went to my primary care provider after having a 102F fever for about five days straight, but all the tests they ordered were negative, including the test for Epstein-Barr (though that particular test has like a 30% false negative rate), and they weren't able to give me a diagnosis. After the fever dragged on for ten days I went to the ER, where the resident suspected a cyst in my liver due to elevated enzymes and ordered a CT, along with a huge number of other tests. The next day I was seen by an infectious disease specialist, who suspected mono. Eventually a more accurate blood test confirmed the diagnosis. My health insurance covered everything, but in total my ER visit and 1 night stay in the hospital cost the insurance company about $18,000. There was no intervention except to rest, so I chose to go home. The fever went away like two days later.

Hilariously, my friend who's an anesthesiologist and medical school professor gave me the correct diagnosis before I went to the hospital. He advised me to go to the ER just to be safe but suspected mono, despite the initial negative test result. We've collaborated on research and I know him to be exceedingly competent, but this episode just reinforces in my mind that there are significant differences in the competence of physicians.

There definitely need to be more residency openings to keep up with demand, but part of that problem is that Americans are just so unhealthy compared to other developed countries. Japan has an older population, about 3/4 as many doctors per capita, yet they seem to be doing somewhat better.

What's the best body temperature?

Bryan Johnson, anti-aging zealot, recently raised eyebrows on X when he claimed to have a body temperature of just 93.4 °F (34.1 °C). He claimed that this was evidence of superior health. To me, his claim seems immediately suspicious and more likely to be a faulty measurement. Others pointed out that it would be very difficult for his body to fight infection at such low temperatures.

Nevertheless, body temperatures do vary between people and, interesting, over time.

We all "know" that the normal temperature is 98.6° F (37 °C). As it turns out, this was true once, but no longer. Body temperatures have been consistently falling. Today, the average temperature is closer to 97.9. My temperature is typically around 97.

Why is this happening? No one knows. Of course, many people blame measurement error. Other theories are that 1) people today have lower infection load 2) people today have lower metabolisms. #2 does seem likely. When we look at historical records, we often see even relatively sedentary men ate 3000, 5000, or even more kCals per day. Now, many men (myself included) will maintain their weight at 2000–2500 kCals, even with exercise.

The good news? There does seem to be some indication that lower temperatures correlate with longer life spans (in mice, of course). This is likely to be similar to caloric restriction where it might help humans, although not nearly as much as mice.

But what if I don't want to live forever, I just want to look good naked and have tons of energy? It turns out that there are people who take the opposite approach as Bryan Johnson and say that we need to increase our body temperature. For one, it will help prevent illness. But it will also increase one's metabolism, giving a person boundless energy, and allowing him to eat like a hummingbird while looking lean and ripped. Here's a guy who invented a diet where you can eat unlimited sugar before 3pm. There was another guy on Twitter who posted about his sugar maxxing diet and bragged about his body temp of 99.5. He looked pretty ripped. (Curse you, Twitter search).

These high-temperature guys all seem to follow an obscure Oregon dietician named Ray Peat who doesn't have a Wikipedia article, and is indeed only mentioned in Wikipedia on the article for Bronze Age Pervert. From the best I can tell, Ray Peat ate something like 3500 calories a day, half coming from simple sugars. He died in 2022 at age 86.

So, what's your body temp? What should it be?

All three of these articles about "cranks" on the right parse as: People who disagree with right-wingers think right-wingers are wrong. I am not a crank -- I'm right about everything!

These same Republicans voted for Merrick Garland, who proceeded to try to throw Trump in jail. They have completely different standards from what constitutes "unfit" from the mainstream Republican voter. It's a two-party system, you vote for your guy and against the other. Talking about vetting candidates for being "fundamentally unfit" is missing the point: that's why Republicans continue to lose! Trump wins specifically because he's not the party of Murkowski, McConnell, Collins, et al. Republicans would have lost without Trump, and instead of going along with what Trump wants to do, they sabotage his cabinet. That's "defecting".

Literally any combination of picks could be rationalised in this way.

Describing cabinet appointments as managing factions is basically a truism. Calling cabinet appointments fundamentally random, as OP did, is an anti-explanation.

Her only political experience is as a backbencher and later twitter poster

Tulsi served in Hawaii and was the heir to a minor Hawaiian political throne. She served in the military and was at one point No. 2 at the DNC. She's not some grizzled veteran, but come on: She has more experience in politics than Obama or Trump did when they assumed office.

I’m not sure I’m following you here. I’m not talking about someone who doesn’t get into med school. I’m talking about a typical medical office visit in a family practice where the doctor doing much more than backstopping the NP or PA is in fact a waste of time simply because you don’t need 8 years of college and a couple years of residency to read blood pressure, heart rate, or oxygen levels. You don’t need that level of education for minor issues. I had a spider bite and needed to get an antibiotic for it. Nothing about that visit required a full fledged doctor to personally see me or prescribe antibiotics (other than liability issues and legal stuff) for a fairly minor complaint.

As such, I don’t see why it’s a problem that someone who didn’t go to medical school goes into software. It’s not going to make much of a difference in terms of the kind of care that I’m talking about. Probably 90% of medical care is pretty routine.

We have left-wing musings that the failure to reach low-propensity voters comes from a “lack” of a left-wing media ecosystem, which makes me scratch my head somewhat, given the disproportionate skew of media to the left. There doesn’t appear to be any introspection or soul-searching here. The issue might not be a lack of left-wing media, but a lack of trust in that media; becoming more online creates a healthy level of skepticism about what we consume, especially as AI becomes more prevalent.

People who seriously identify as left-wing would often dispute this. Many on the left see the Democrats as a right-wing party, and the mainstream media as centrist, liberal, centre-right, or something else other than left. There is a sense among dedicated left-wing partisans that they are a tiny minority.

Like most of the narratives that people tell themselves about their own political tribes, this is probably false or at least illusionary, but the point is that when people complain about the absence of a left-wing media ecosystem, those probably are not people who regard most of the media as currently on the left.