Oceans Yet to Burn

[Oceans Yet to Burn]

Anonymous asked:

Is cousin marriage for one generation bad beyond the genetic and possible tight family control aspect?

Well, see, here’s the thing.  White people (broadly) have been largely not-marrying-their-cousins for a while now, and they live in societies in which cousin marriage is fairly taboo.  So when white people marry their cousin, it typically is a one generation thing, preventing a whole bunch of snowballing consequences.

I’m sure it seems otherwise on this blog, but I actually don’t have a strong disgust reaction towards cousin marriage.  And if we continued to see rates around 1%, I wouldn’t really care.

But some populations have cousin-married at much higher rates, for much longer times.  So one generation of cousin marriage for them isn’t the same as one generation of cousin marriage for other people.

It isn’t “too late.”  Humans are resilient.  We just have to have them stop doing it now.

Since we don’t have the full lineages of everyone, and I don’t want to go by other categories, I’d rather just throw the (very tiny) baby out with the bathwater and ban it for everyone.

Also, a big chunk of the tight family control aspect is cultural transmission.  So now I’ll have to actually make that post about cultural transmission (generally) at some point, seeing as some things like FGM are cultural so cultural transmission isn’t all nice things like ethnic foods.

[Oceans Yet to Burn]

[feotakahari]

As long as I’m picking fights:

“Actually, attacking LGBTs is one of the single dumbest things SoCons have done, because LGBTs do not actually undermine the nation just by being LGBT. In fact, gay marriage is good because stable family units are good, and we can incentivize the creation of stable queer families with similar methods to straight families.

“(Polygamy, as practiced by people that aren’t autistic-spectrum rationalists, is still bad though.) …

“It isn’t enough that I not marry my cousins and engage in polygamy. For my home to not be terrible, I must stop others from doing so as well. And if they want to make a place where those are the norms, then let them, and not me, suffer the consequences of that. I don’t need dumb social policies banned everywhere, only in the places I live in/am responsible for.”

I can’t bring myself to care about “stable family units.” I just can’t. The only reason I give a crap one way or another about gay marriage is that I know some gay people who want to be married, and I like those gay people and want them to be happy.

I’m not sure if there’s meant to be a distinction between “polygamy” and polyamory in this post, but I know some polyamorous people. I like those people, and I want them to be happy, and that apparently means making polyamory into a thing that is considered acceptable.

Maybe “polygamists” as a class will make your home terrible. But I’ve never met “polygamists” as a class, just as I’ve never met “gay people” as a class. I’ve met individual people, and some of the individual people I have met don’t seem like they make society worse just by being present. Sure, I’ve also met polyamorous people who were assholes, but I think they’d be better covered by a rule against being assholes than a rule against being polyamorous.

To be clear, this is not to say that I don’t like you or don’t want you to be happy. I just feel like if you met some of the polyamorous people I’ve met, you’d have more in common with them than you seem to think.

[mitigatedchaos]

I can’t bring myself to care about “stable family units.” I just can’t. The only reason I give a crap one way or another about gay marriage is that I know some gay people who want to be married, and I like those gay people and want them to be happy.

Are we immortal yet?  No?  Then it matters.  A lot.  Because each generation needs to create and raise the next generation.

The last time I checked, broken families are not good for people, statistically.  

You can choose to be single or unattached until you die.  It just doesn’t work as a way to structure mortal human societies, unless you are willing to do things that are, hmn… drastic.

I’m not sure if there’s meant to be a distinction between “polygamy” and polyamory in this post, but I know some polyamorous people. I like those people, and I want them to be happy, and that apparently means making polyamory into a thing that is considered acceptable.

Polygamy is bad along multiple axes.  

Polyamory, it hasn’t been proven.  

Maybe “polygamists” as a class will make your home terrible. But I’ve never met “polygamists” as a class, just as I’ve never met “gay people” as a class. I’ve met individual people, and some of the individual people I have met don’t seem like they make society worse just by being present. Sure, I’ve also met polyamorous people who were assholes, but I think they’d be better covered by a rule against being assholes than a rule against being polyamorous.

1. Polygamy is, generally, really polygyny, and married polygyny is bad for women, it’s bad for children, and it’s bad for men.

2. No one actually has to be trying to be an asshole, so long as most people are straight and men marry multiple wives more than women marry multiple husbands.

3. Not everyone is bisexual.

Alright?  So what are we supposed to do with all the “extra” men?

To be clear, this is not to say that I don’t like you or don’t want you to be happy. I just feel like if you met some of the polyamorous people I’ve met, you’d have more in common with them than you seem to think.

This isn’t about whether individual polyamorous people are mean.  It’s about the overall effect on society when polygamy is widely practiced, and “the overall effects on society when polygamy is widely practiced” are backwards anti-feminist-as-in-gender-equality societies when it’s a subset (even in developed countries), or the Middle East when it’s most of society.

When weird autistic (lovable!) internet nerds do it, it stays below the threshold necessary to fuck everything up, unless they’re foolish enough to start normalizing it and spreading it among normal people.

[Oceans Yet to Burn]

@thathopeyetlives

Also at some point around 2014 the old philosophical neoreactionaries had an internal dustup and either disappeared or unmasked themselves as horrible fascists.

Oh, is that what’s going on?  

People keeping asking if I’m someone else.  Maybe they think I’m some former True Neoreactionary that became disillusioned, deconverted, and sought out a new path from the shadows.

[Oceans Yet to Burn]

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[Oceans Yet to Burn]

[diarrheaworldstarhiphop]

DEMOCRATS ARE GETTING EMAILS TO VOTE ON THWIR NEW SLOGANS LMAO

[mitigatedchaos]

I’m so glad I don’t consider myself a Democratic partisan.

[Oceans Yet to Burn]

[anaisnein]

It’s not just this, it’s a fundamental inability to *identify* with other people and realize that *that could be me*.

Today I am 31 and healthy and always exercise regularly and eat well so why should I pay for other people’s expensive preexisting conditions and disabilities? Because obviously it’s not possible that when I’m 34 I might get diagnosed with an autoimmune disease or a chronic leukemia and need expensive meds forever. Or that when I’m 36 I might have a child with cerebral palsy who is able to live a full, rich, happy and ~productive~ life but will need expensive healthcare and ongoing assistance to do so. Or that when I’m 48 I might get hit by a car and be left unable to work full time, in need of assistance, etc, myself. Or that when I’m 53 I might get some random-bad-luck cancer (let’s make it easy: not even talk about how lung cancer does in fact happen to nonsmokers or how in any case it’s disgusting to call it “fair” when it happens to a smoker because that punishment doesn’t fit the crime you sadists; instead, let’s consider one of the myriad cancers that hits at genuine fucking random or by some familial genetic vulnerability the individual can’t affect) for which a curative treatment actually exists but it costs $260,000 and without it the prognosis is eighteen months.

Same applies to poverty. (And for some of the same reasons as already sketched, as well as economic cycles and industrial shifts and automation and so on.)

It’s this pervasive prosperity-gospel belief that bad things by definition only happen to the undeserving and trying to help people who experience misfortune is hubris and interfering with the will of the great gods Natural Selection and The Market and doomed to create more problems than it solves because fate favors the lucky because the lucky are deserving because Gnon because *blithering evil*.

[slartibartfastibast]

I don’t know how to explain thermodynamics and free lunch stuff to people who don’t already have some acquired grounding in physical reality. I also keep saying that caring about other people isn’t the problem (Richard Spencer would probably say he “cares about people”). It’s caring about systems, some of which take care of people (and in a catastrophic failure would become unable to take care of people at all) that’s the problem. If you’re too nihilistically individualized, you’ll apparenrly fail to notice how systems fit together (and don’t). Screaming about it doesn’t seem to help, because systems still fail even when you scream at them. I don’t have an easy answer, but if the most widespread centrist position means ignoring Rotherham-type stuff, then fuck that too.

[mitigatedchaos]

The economy is like the tyranny of a rocket equation.  You only have so much fuel, the gravity between the worlds is already there and you can’t change it.  

It is physically impossible to meet all the goals - there just aren’t enough resources (natural resources * capital * labor * technology) to accomplish them all.

American GDP-per-capita is above $50,000.  Foreign GDPs outside of a few hyper-efficient places like Hong Kong or Singapore are lower.

If one person takes $3,000,000 to keep alive, you have effectively consumed the complete economic output of one person’s whole entire life.

But it’s worse than that, because our worker had to pay for housing, for food, for transport, for education, and taxes to support all the secondary systems required, and also raise a child to perpetuate the system.  If all that’s leftover after all that is $10,000 per year, then any $3,000,000 case consumes the total lifetime surplus resources of five workers.

And I look at many of these cases and do think “fuck, that could be me” - which is part of why I suggested a wage subsidy program!

But a lot of Leftist or Liberal language wants to allow people to create unlimited burdens on society.  They want us to pay for treatment while not allowing us to prohibit people from doing things that would require more treatment, or creating people that require more treatment.

You can’t have both!  You can’t have both!

The fewer the number of people that require expensive treatment, the more resources you can spend on them.  The more that need expensive treatment, relative to the size of the productive economy, the less you can spend on each one, until it falls below the level required for them to survive.

If is vitally important that society become more efficient and more technologically advanced.  We must produce more, and more efficiently.

And we can’t just throw aside social technologies.  If broken homes fuck people up, statistically, and cause them not to do well in the labor force, then the cost of that comes out of liver transplants, not just ferraris.

[anaisnein]

@mitigatedchaos

“But thermodynamics!” isn’t even remotely convincing. In asserting that, you’re merely creating a word problem or thought experiment defined in your chosen terms for your chosen purposes. Deductive reasoning from first principles in the clean arena of the logical mind is seductive, but we aren’t actually dealing with a thought experiment set in deep space describable by a zero-sum cold equation™ that’s expressible using only two or three variables all of which, most terribly unfortunately, turn out in the real world to be empiric constants i.e. unchanging and unchangeable facts. In fact there are literally thousands of variables involved in varying degrees, and most certainly a meaningful proportion of those are going to be subject to varying degrees of adjustment, mitigation, recalibration, disruption, etc, etc. I have yet to see a compelling argument based on real numbers that a rich nation literally ~cannot afford~ to provide its citizens with healthcare because ~not enough money~. And quite frankly if I do see such an argument I am going to approach it with the prior that it’s highly suspect and extremely likely to be based on misrepresented and/or cherry-picked metrics and statistics. This is because I am able to observe many counterexamples in the actual empirically verifiable real world: Germany, for instance, provides and pays on a national basis for very good universal healthcare that includes excellent coverage in oncology and other expensive therapeutic areas.

Even just looking at your abstract-example numbers: if by “$3,000,000 cases” you mean cases that cost $3,000,000 in a single year, well, I don’t know the incidence of those but I’ll bet you $3 in cash that it’s far, far lower than than 1 case per 5 average productive workers. If you mean cases that cost $3,000,000 over the course of an entire normal lifespan following a catastrophic diagnosis in young or middle adulthood, or in infancy, then first of all I’d like incidence figures on those as well, but, unlike in the previous case I can intuitively accept that it’s at least a potentially meaningful question to be asking in this context, so let it slide, BUT if nothing else we need to amortize those people’s maintenance costs out on an annualized basis in the same way we do for per-worker economic output. I mean, if I compared my personal expenditures over a lifetime to my average annual income I’d be despondent, but I don’t, because it’s pointless. The only possible motivation I would have to do that is to depress myself profoundly enough to induce an extreme frugal mood, and I respect myself enough not to feel like I need to fool myself into frugality using dirty tricks. And if you’re just lumping these very different health cost scenarios together as “$3,000,000 cases” and comparing that to annualized per capita output, tbh it reads as a low and transparent ploy to rack up scare points. (NB: if by “$3,000,000 cases” you mean neither of these, nor an amalgamation of both, but something else, please advise. I’m reading and writing hastily today.)

Pursuant to both of the above points: healthcare pricing, specifically, in the U.S., specifically, is extremely distorted by employment-tied insurance and assorted other fuckeries. A nominal $3,000,000 price tag cannot be simplistically assumed to represent $3,000,000 in value. If an MRI costs the payor — not the patient; the payor — $8000 here and $800 in France due to a bunch of systemic blabla, and I am suggesting that we consider altering the U.S. way of doing things at the systemic level on the grounds that the system we have observably sucks dead donkey dick, then I am in no way obligated to accept the U.S. cost of the MRI as a fixed constant for purposes of discussing What We Can Afford. The same goes for lifesaving drugs priced at five and six figures per patient-year. 

(Yes, screwing too much with pricing will break R&D, and we need to look at other approaches as well and generally to prioritize coming up with and operationalizing ideas that can preserve and ideally increase the incentives for innovation and remove barriers thereto. That’s not an insurmountable difficulty. If we can change the system we have wrt delivery of care, we can also change it wrt advancing care.)

We’re humans. We solve hard problems. It’s our best thing. If all you have for me is really “that’s just not possible! because, thermodynamics!”, quite honestly that seems to me to be defeatist bullshit unworthy of a transhumanist.

Postscript: the hint-dropping in this thread regarding immigration is not lost on me; I’m ignoring that angle for the time being because my time and my mental and emotional bandwidth are limited, not because I don’t have responses.

[mitigatedchaos]

A rich nation can provide some level of healthcare to all its citizens, under certain conditions.  

One of those conditions is that the people implementing it are not incompetent.  Another is that there is a cap to healthcare expenditure.

Pursuant to both of the above points: healthcare pricing, specifically, in the U.S., specifically, is extremely distorted by employment-tied insurance and assorted other fuckeries. A nominal $3,000,000 price tag cannot be simplistically assumed to represent $3,000,000 in value. If an MRI costs the payor — not the patient; the payor — $8000 here and $800 in France due to a bunch of systemic blabla, and I am suggesting that we consider altering the U.S. way of doing things at the systemic level on the grounds that the system we have observably sucks dead donkey dick, then I am in no way obligated to accept the U.S. cost of the MRI as a fixed constant for purposes of discussing What We Can Afford. The same goes for lifesaving drugs priced at five and six figures per patient-year.

My great worry here is that the people looking to implement such a system will, instead of doing it in a way that lowers these costs, do it in a way that retains these costs and fucks us all over in paying for them.  

The reason I suggested the approach that I did in What GOP Must Do To Avoid An American NHS is that I think it’s actually the safe medium-term approach (except for the amount, which may need to be higher).  Then, once that is in play to help start decoupling Americans from employer insurance and take some of the pressure off of American families, we can do the harder and more intricate work of untangling, trimming, replacing, and sometimes adding to the various regulations and conditions responsible for healthcare costs.

There was also an analysis, and I really wish I could find it (why isn’t it in my bookmarks? ugh), showing that American healthcare costs are actually more in line with its number of different populations, level of development (being somewhere in-between, in some cases, first world and third), and so on.

(Edit: I spent some time looking for this last night and could not find it, but I know I didn’t hallucinate it.  It’s out there, on some contrarian blog, somewhere.)

[mitigatedchaos]

The linked thing seems like an interesting if inadequate-on-its-own idea, and I don’t disagree at a v broad level with your desire to approach this pragmatically (bc apparently I need to say that or it’s assumed by some subset of readers that I speak as an emotion-driven innumerate hippie). Your earlier point re increasing efficiency and productivity is good. It’s an instance of my broader point: this shit is complex and – for that very reason – fixable/addressable.

I’m about to leave for a business trip and can’t tackle this in any more depth right now but wanted to acknowledge this and point to common ground, which seems not all that extensive but at least adequate for discussion

I should probably tag things like “this is mostly in response to how normal members of the Democratic Party and their political operatives behave (including ones making otherwise this same argument), and not Rationalists”, plaintext in the post, tbh.

Also, your baseline level of trust in the Democratic Party not to completely fuck it up is probably way higher than mine. “Let’s eliminate lifetime payout caps for health insurance” is one of those things, for instance, that they would do (as they apparently did under Obamacare), which is likely to result in lots of money trying to save someone who is too expensive to justify saving at current technology and development levels.

[Oceans Yet to Burn]

Anonymous asked:

What seriously separates cosmopoli from ethnonational states? And what seriously makes them worse? Their lifetimes seem comparable to me, especially given that most countries didn't experience a national awakening until kings started consolidating feudal conglomerations towards the dawn of capitalism.

mitigatedchaos answered:

You don’t need a pure ethnonational country, though that can cut down on certain bullshit like what’s happening between the Buddhists and the Muslims in Myanmar.  (Hint: It isn’t solely a story of purely poor, innocent Muslims, but one of those cases of cyclical retaliatory ethnic violence.)

The chief question is, are you willing to do what it takes to make that cosmopolitan polity not descend into retaliatory ethnic violence, potential ethnic predation, and ethnicity-aligned political parties?

Like, if you’re not willing to do that, then what you get is ethnic violence.

If you look over at what’s happening in the British cities, with the child sex trafficking, and grooming, and so on, and not only are you not willing to slam down the iron hand of the state to stop it dead in its tracks, but you won’t even stop them from marrying their cousins at rates way above what is normal or even healthy, then you don’t really have what it takes to make a cosmopolitan polity work.

And if you don’t have what it takes to make a cosmopolitan polity work, then an ethnic polity is a safer choice.  

This is somewhat disguised by the fact that not all cultures are equally destabilizing.  You can pretend, for a while, if the underlying conditions are right, and succeed by accident.

Additionally, cosmopolitan vs ethnonationalism is a continuum, not a binary.  Well actually it’s a multidimensional space, not a continuum.  But you get the idea.

[mitigatedchaos]

Anything that promotes cultural unity over cultural diversity, even shared experiences, heads in the direction of ethnonationalism, even if it may be far from reaching it.  Having one shared language, or having a required period of civil or military service, head in that direction.  Even soft unifying forces such as television can count, without any force of arms in backing.

Cultures have more than one layer.  American food court multiculturalism, in which deep differences are stripped away while surface differences, like cooking, remain, moves positively along the axis of ethnonationalism, even though many people will object that “American” is not ethnicity.

A theoretical total cosmopolity, in its maximal diversity, has one language for each inhabitant.  A theoretical total ethnopolity borders on hivemind.

[Oceans Yet to Burn]

Anonymous asked:

What seriously separates cosmopoli from ethnonational states? And what seriously makes them worse? Their lifetimes seem comparable to me, especially given that most countries didn't experience a national awakening until kings started consolidating feudal conglomerations towards the dawn of capitalism.

You don’t need a pure ethnonational country, though that can cut down on certain bullshit like what’s happening between the Buddhists and the Muslims in Myanmar.  (Hint: It isn’t solely a story of purely poor, innocent Muslims, but one of those cases of cyclical retaliatory ethnic violence.)

The chief question is, are you willing to do what it takes to make that cosmopolitan polity not descend into retaliatory ethnic violence, potential ethnic predation, and ethnicity-aligned political parties?

Like, if you’re not willing to do that, then what you get is ethnic violence.

If you look over at what’s happening in the British cities, with the child sex trafficking, and grooming, and so on, and not only are you not willing to slam down the iron hand of the state to stop it dead in its tracks, but you won’t even stop them from marrying their cousins at rates way above what is normal or even healthy (Wikipedia, wrt ethnic rates of cousin marriage and assoc. issues in UK, etc), then you don’t really have what it takes to make a cosmopolitan polity work.

And if you don’t have what it takes to make a cosmopolitan polity work, then an ethnic polity is a safer choice.  

This is somewhat disguised by the fact that not all cultures are equally destabilizing.  You can pretend, for a while, if the underlying conditions are right, and succeed by accident.

Additionally, cosmopolitan vs ethnonationalism is a continuum, not a binary.  Well actually it’s a multidimensional space, not a continuum.  But you get the idea.

[Oceans Yet to Burn]

[anaisnein]

It’s not just this, it’s a fundamental inability to *identify* with other people and realize that *that could be me*.

Today I am 31 and healthy and always exercise regularly and eat well so why should I pay for other people’s expensive preexisting conditions and disabilities? Because obviously it’s not possible that when I’m 34 I might get diagnosed with an autoimmune disease or a chronic leukemia and need expensive meds forever. Or that when I’m 36 I might have a child with cerebral palsy who is able to live a full, rich, happy and ~productive~ life but will need expensive healthcare and ongoing assistance to do so. Or that when I’m 48 I might get hit by a car and be left unable to work full time, in need of assistance, etc, myself. Or that when I’m 53 I might get some random-bad-luck cancer (let’s make it easy: not even talk about how lung cancer does in fact happen to nonsmokers or how in any case it’s disgusting to call it “fair” when it happens to a smoker because that punishment doesn’t fit the crime you sadists; instead, let’s consider one of the myriad cancers that hits at genuine fucking random or by some familial genetic vulnerability the individual can’t affect) for which a curative treatment actually exists but it costs $260,000 and without it the prognosis is eighteen months.

Same applies to poverty. (And for some of the same reasons as already sketched, as well as economic cycles and industrial shifts and automation and so on.)

It’s this pervasive prosperity-gospel belief that bad things by definition only happen to the undeserving and trying to help people who experience misfortune is hubris and interfering with the will of the great gods Natural Selection and The Market and doomed to create more problems than it solves because fate favors the lucky because the lucky are deserving because Gnon because *blithering evil*.

[slartibartfastibast]

I don’t know how to explain thermodynamics and free lunch stuff to people who don’t already have some acquired grounding in physical reality. I also keep saying that caring about other people isn’t the problem (Richard Spencer would probably say he “cares about people”). It’s caring about systems, some of which take care of people (and in a catastrophic failure would become unable to take care of people at all) that’s the problem. If you’re too nihilistically individualized, you’ll apparenrly fail to notice how systems fit together (and don’t). Screaming about it doesn’t seem to help, because systems still fail even when you scream at them. I don’t have an easy answer, but if the most widespread centrist position means ignoring Rotherham-type stuff, then fuck that too.

[mitigatedchaos]

The economy is like the tyranny of a rocket equation.  You only have so much fuel, the gravity between the worlds is already there and you can’t change it.  

It is physically impossible to meet all the goals - there just aren’t enough resources (natural resources * capital * labor * technology) to accomplish them all.

American GDP-per-capita is above $50,000.  Foreign GDPs outside of a few hyper-efficient places like Hong Kong or Singapore are lower.

If one person takes $3,000,000 to keep alive, you have effectively consumed the complete economic output of one person’s whole entire life.

But it’s worse than that, because our worker had to pay for housing, for food, for transport, for education, and taxes to support all the secondary systems required, and also raise a child to perpetuate the system.  If all that’s leftover after all that is $10,000 per year, then any $3,000,000 case consumes the total lifetime surplus resources of five workers.

And I look at many of these cases and do think “fuck, that could be me” - which is part of why I suggested a wage subsidy program!

But a lot of Leftist or Liberal language wants to allow people to create unlimited burdens on society.  They want us to pay for treatment while not allowing us to prohibit people from doing things that would require more treatment, or creating people that require more treatment.

You can’t have both!  You can’t have both!

The fewer the number of people that require expensive treatment, the more resources you can spend on them.  The more that need expensive treatment, relative to the size of the productive economy, the less you can spend on each one, until it falls below the level required for them to survive.

If is vitally important that society become more efficient and more technologically advanced.  We must produce more, and more efficiently.

And we can’t just throw aside social technologies.  If broken homes fuck people up, statistically, and cause them not to do well in the labor force, then the cost of that comes out of liver transplants, not just ferraris.

[anaisnein]

@mitigatedchaos

“But thermodynamics!” isn’t even remotely convincing. In asserting that, you’re merely creating a word problem or thought experiment defined in your chosen terms for your chosen purposes. Deductive reasoning from first principles in the clean arena of the logical mind is seductive, but we aren’t actually dealing with a thought experiment set in deep space describable by a zero-sum cold equation™ that’s expressible using only two or three variables all of which, most terribly unfortunately, turn out in the real world to be empiric constants i.e. unchanging and unchangeable facts. In fact there are literally thousands of variables involved in varying degrees, and most certainly a meaningful proportion of those are going to be subject to varying degrees of adjustment, mitigation, recalibration, disruption, etc, etc. I have yet to see a compelling argument based on real numbers that a rich nation literally ~cannot afford~ to provide its citizens with healthcare because ~not enough money~. And quite frankly if I do see such an argument I am going to approach it with the prior that it’s highly suspect and extremely likely to be based on misrepresented and/or cherry-picked metrics and statistics. This is because I am able to observe many counterexamples in the actual empirically verifiable real world: Germany, for instance, provides and pays on a national basis for very good universal healthcare that includes excellent coverage in oncology and other expensive therapeutic areas.

Even just looking at your abstract-example numbers: if by “$3,000,000 cases” you mean cases that cost $3,000,000 in a single year, well, I don’t know the incidence of those but I’ll bet you $3 in cash that it’s far, far lower than than 1 case per 5 average productive workers. If you mean cases that cost $3,000,000 over the course of an entire normal lifespan following a catastrophic diagnosis in young or middle adulthood, or in infancy, then first of all I’d like incidence figures on those as well, but, unlike in the previous case I can intuitively accept that it’s at least a potentially meaningful question to be asking in this context, so let it slide, BUT if nothing else we need to amortize those people’s maintenance costs out on an annualized basis in the same way we do for per-worker economic output. I mean, if I compared my personal expenditures over a lifetime to my average annual income I’d be despondent, but I don’t, because it’s pointless. The only possible motivation I would have to do that is to depress myself profoundly enough to induce an extreme frugal mood, and I respect myself enough not to feel like I need to fool myself into frugality using dirty tricks. And if you’re just lumping these very different health cost scenarios together as “$3,000,000 cases” and comparing that to annualized per capita output, tbh it reads as a low and transparent ploy to rack up scare points. (NB: if by “$3,000,000 cases” you mean neither of these, nor an amalgamation of both, but something else, please advise. I’m reading and writing hastily today.)

Pursuant to both of the above points: healthcare pricing, specifically, in the U.S., specifically, is extremely distorted by employment-tied insurance and assorted other fuckeries. A nominal $3,000,000 price tag cannot be simplistically assumed to represent $3,000,000 in value. If an MRI costs the payor — not the patient; the payor — $8000 here and $800 in France due to a bunch of systemic blabla, and I am suggesting that we consider altering the U.S. way of doing things at the systemic level on the grounds that the system we have observably sucks dead donkey dick, then I am in no way obligated to accept the U.S. cost of the MRI as a fixed constant for purposes of discussing What We Can Afford. The same goes for lifesaving drugs priced at five and six figures per patient-year. 

(Yes, screwing too much with pricing will break R&D, and we need to look at other approaches as well and generally to prioritize coming up with and operationalizing ideas that can preserve and ideally increase the incentives for innovation and remove barriers thereto. That’s not an insurmountable difficulty. If we can change the system we have wrt delivery of care, we can also change it wrt advancing care.)

We’re humans. We solve hard problems. It’s our best thing. If all you have for me is really “that’s just not possible! because, thermodynamics!”, quite honestly that seems to me to be defeatist bullshit unworthy of a transhumanist.

Postscript: the hint-dropping in this thread regarding immigration is not lost on me; I’m ignoring that angle for the time being because my time and my mental and emotional bandwidth are limited, not because I don’t have responses.

[mitigatedchaos]

A rich nation can provide some level of healthcare to all its citizens, under certain conditions.  

One of those conditions is that the people implementing it are not incompetent.  Another is that there is a cap to healthcare expenditure.

Pursuant to both of the above points: healthcare pricing, specifically, in the U.S., specifically, is extremely distorted by employment-tied insurance and assorted other fuckeries. A nominal $3,000,000 price tag cannot be simplistically assumed to represent $3,000,000 in value. If an MRI costs the payor — not the patient; the payor — $8000 here and $800 in France due to a bunch of systemic blabla, and I am suggesting that we consider altering the U.S. way of doing things at the systemic level on the grounds that the system we have observably sucks dead donkey dick, then I am in no way obligated to accept the U.S. cost of the MRI as a fixed constant for purposes of discussing What We Can Afford. The same goes for lifesaving drugs priced at five and six figures per patient-year.

My great worry here is that the people looking to implement such a system will, instead of doing it in a way that lowers these costs, do it in a way that retains these costs and fucks us all over in paying for them.  

The reason I suggested the approach that I did in What GOP Must Do To Avoid An American NHS is that I think it’s actually the safe medium-term approach (except for the amount, which may need to be higher).  Then, once that is in play to help start decoupling Americans from employer insurance and take some of the pressure off of American families, we can do the harder and more intricate work of untangling, trimming, replacing, and sometimes adding to the various regulations and conditions responsible for healthcare costs.

There was also an analysis, and I really wish I could find it (why isn’t it in my bookmarks? ugh), showing that American healthcare costs are actually more in line with its number of different populations, level of development (being somewhere in-between, in some cases, first world and third), and so on.

(Edit: I spent some time looking for this last night and could not find it, but I know I didn’t hallucinate it.  It’s out there, on some contrarian blog, somewhere.)

[Oceans Yet to Burn]

[cptsdcarlosdevil]

I am ANNOYED by people who are like “yay moderation boo extremism ~radical centrism~”

the centrist American position is that powerful people can commit crimes against humanity without ever facing trial, while poor people go to prison for being drug addicts

I hold extremist opinions like “the rule of law is a good idea” and “unchecked executive power is bad” and “people should respect the constitution” and “STOP COMMITTING WAR CRIMES”

[mitigatedchaos]

I don’t think that kind of Centrism counts as Radical™.

My Centrism, on the other hand…