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naraburns  nihil supernum  1yr ago (text post)   32865 thread views

Culture War Roundup for the week of October 10, 2022

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How bad can America’s health actually get? And what shall we do?

All kinds of ill health are steadily increasing, from age-adjusted obesity to autism and depression. Anxiety in young adults nearly doubled in the decade pre-pandemic. Type 1 and type 2 diabetes has risen dramatically. Deaths of despair have also risen. There seems to be no actionable plan, ready for implementation, to halt the rising tide of ill health. The numbers are steadily increasing adjusted for age, with some numbers rising faster in the young than in the old.

I find the willpower discussions to be missing the point. Unless there is a plan that we can implement in schools to significantly increase or teach willpower, then it hardly matters whether the will is relevant. The diseased from poor choices and the diseased from poor environment equally hurt the security of the nation, costing trillions from decreased productivity, decreased fertility, and healthcare expenditure. It is curious how much discourse in America is spent quibbling on issues that are so much less important than the health question. Health is something that directly impacts every aspect of the country, not the least of which is the plain happiness and fertility of citizens.

What I would like to see is a harm tax put in place that adds onto every unhealthy item the cost per item of its societal harm: the projected healthcare costs, the loss from intelligent citizens working for corporations that poison us, the projected loss of productivity. Now, this will always be an estimate, but so are many taxes. I think this would largely make sodas prohibitively expensive.

What I would like to see is a harm tax put in place that adds onto every unhealthy item the cost per item of its societal harm: the projected healthcare costs, the loss from intelligent citizens working for corporations that poison us, the projected loss of productivity.

This is regressive and will just make it so the lives of the poor are even worse. The amount of money some poor people spend on smoking and alcohol, most of it going to taxes, is likely enough to buy a house.

Further, most vices aren't increasing healthcare costs. Smoking doesn't. Most people will get cancer in their lifetime. Smokers will usually get it around the age of 65. In a few years they croak. We save on their future nursing home costs, their social security, etc. Similar with the obese. They are unlikely to make it much past 65. Old age is the most expensive period for healthcare.

Honestly, smoking should be encouraged, maybe even subsidized. It barely impacts productivity during one's work life, and it kills when people are more likely to retire and start hoovering up resources.

There seems to be no actionable plan, ready for implementation, to halt the rising tide of ill health. The numbers are steadily increasing adjusted for age, with some numbers rising faster in the young than in the old.

I'm cynical. I believe the plan is to get people so fucked that they need the government, and specifically a nanny-state, far-left, socialist government. It seems to me that activists push to make problems worse, so they can claim they are the solution. Find a thing you want to eliminate (single family homes, meat, cars), attribute everything bad in the world to it (climate change, cancer, inequality, racism, etc), and then work make those things worse (endless bureaucracy and permitting, dysfunctional layouts, taxes) so that eliminating it looks like a viable option. When it's gone, you apply all the bad things to a new target you want to eliminate.

Having a grand plan is antithetical to this.

single family homes, meat, cars

No-one wants to get rid of single-family homes. The goal is only to make it so that building other types of homes isn't restricted. If you want to buy a single-family home, no-one wants to stop you; the problem is when people start demanding everyone in their neighbourhood must not live any other way.

It's a similar story with cars. Drivers have been favoured for so long at the expense of transit, pedestrians and cyclists levelling the playing field a bit is now an unconscionable attack on cars. Again, if you want to drive a car that's fine but don't design cities such that the car is the only viable means of transportation.

Fair enough. But I want a single family home in a single family neighborhood. So I will advocate that my local government enforce strict rules to keep it that way. We should build more apartments and condos. Just not in my neighborhood, and enforced by law.

Just not in my neighborhood

Well, that's the problem, no-one wants new apartments in their single-family neighbourhood. If you live in a genuinely rural area, then that's more reasonable, but you can't expect to live within striking distance of a major city and demand that no new housing is built.

I believe the plan is to get people so fucked that they need the government, and specifically a nanny-state, far-left, socialist government.

It's funny because this is the exact opposite of a common left-wing theory here in Finland; that right-wing governments are consciously allowing the state-run health system to get underfunded and worse precisely so that it can be then be "rescued" by increasing the role of private, profit-oriented health care companies.

Both can be true. The malevolent actors in America need not be identical to the malevolent actors in Finland.

They're both right! The goal is to have the services run by some dystopian "private-public partnership" that can cut you off because of your tweets, or something.

Not everything is about culture wars. People can, in fact, has opinions on health policy without having some hidden agenda.

If the last decade or so has shown me anything, it's that it's an extremely small amount of people has any such opinions.

On top of that, even the ones that actually do have them, might not be able to resist the temptation of using the healthcare system to their political advantage.

If you adopt this kind of attitude, I don't know how you can do any sort of policymaking. At some level if you don't look at policies directly on the merits and start suspecting that everything is a secret plot by your culture war opponents, you would never be able to actually govern.

I'm growing increasingly convinced that "policymaking" is a rather vapid exercise. Sure, over the years we identified some bad policies you should steer clear of, but you can't say much beyond that. It's pretty trivial to twist any policy into something worse than the problem it aimed to address, and that sort of stuff has been happening regularly for decades now (or possibly for all of human history).

Find a thing you want to eliminate (single family homes, meat, cars), attribute everything bad in the world to it (climate change, cancer, inequality, racism, etc), and then work make those things worse (endless bureaucracy and permitting, dysfunctional layouts, taxes) so that eliminating it looks like a viable option.

I find this kind of a bizarre position to hold, because several of the alleged (and, in my opinion, quite possibly real) downsides of all of the 3 things you mention are the exact thing you claim are trying to be achieved.

Car-dependent sprawl and single-family-only zoning means nobody walks or bikes, which causes obesity. It also makes children less independent and capable, both physically and emotionally/psychologically. If someone is trying to make you more dependent on the government and less capable of being independent, then getting you away from a sprawling suburb is mostly counterproductive. Meat is more debatable, but meat with a high fat content is probably not great for you and at the very least we could use fewer agricultural subsidies. Moreover, getting completely rid of cars and single family homes is a weakman of most urbanists; to the extent that anyone is trying to achieve that, they're about as close as conservatives are to taking over academia. Right now, the overwhelming majority of bureaucracy, permitting, and taxes is applied to everything except single family homes and car infrastructure.

Car-dependent sprawl and single-family-only zoning means nobody walks or bikes, which causes obesity.

I've found single-family zones to be much more active. It only seems like dense areas are more active because of the higher population. But people feel less and less safe in high density urban environments.

  • It also makes children less independent and capable, both physically and emotionally/psychologically.

I wouldn't ever consider someone who grew up in a city to be more independent or capable. My experience has been the opposite; people in cities are highly dependent on others, and far less capable. They have to rely on others, because they have less experience having to depend on themselves. They only feel independent because of systems that the government has built. I'm sure some people feel independent hopping on the subway to go get groceries. But those living with yards can be independent by growing their own food. Hell, I've noticed that most city folks don't seem to understand how to do this. Cities aren't even great places to grow gardens, since the fluoridated water absolutely ruins the yield. So you have to use a rainwater system, which needs a bit more space. Composting in dense cities? Nope. Can you keep a bunch of random crap to reuse at some point in your life? Doubt it. It all goes in the trash.

Dense cities suck. You're more dependent on the government. You only feel independent because you don't know your neighbours. And that's another major downside of cities. In a zombie apocalypse, I know my neighbour isn't going to rob me blind, they are going to help me build the barricades.

I've found single-family zones to be much more active.

I can't speak to your experience, but I think the available evidence says that people are generally more active in walkable places. e.g. https://cs.stanford.edu/people/jure/pubs/activity-inequality-nature17.pdf

See also this video more generally.

But people feel less and less safe in high density urban environments.

Being near other people makes things safer. Think about an empty parking lot compared to a town square full of people. Which is safer? Urban environments only feel unsafe to walk in when everyone except the poor and homeless are in cars.

I wouldn't ever consider someone who grew up in a city to be more independent or capable. My experience has been the opposite; people in cities are highly dependent on others, and far less capable. They have to rely on others, because they have less experience having to depend on themselves.

Again, I can't speak to your experience; perhaps we're using different definitions of "independent." In my experience, there are a lot of these people, who now live in the city as a young adult, but grew up in suburbs.

Being able to walk to school is one of the best things for children's independence and growth; see e.g. https://www.sciencedirect.com/science/article/abs/pii/S0272494402902434 or https://www.utoronto.ca/news/why-walking-school-better-driving-your-kids. And as one would expect, walking to school is correlated with living near school and low car traffic.

But those living with yards can be independent by growing their own food.

Ok, but what portion of them actually do this? It seems like you're using notions of independence that most people don't actually experience or engage in, regardless of whether they theoretically could or not. I grew up in the suburbs and I doubt anyone in my neighborhood could grow more food than a handful of tomato plants. Not one of them would survive a zombie apocalypse; to the extent they had extra space for storing things, it went to holding the kid's car, or a lawn mower, or useless old crap, not canned food and jugs of water (and I'm not sure anyone other than our family had ever even fired a gun).

The notion of independence I'm thinking of is making people capable of making their own decisions, evaluating and dealing with risks, handling disagreement, controlling their emotions, etc. But mostly in the context of every day life; I think a lack of independence in this sense is largely at the root of recent spikes in childhood depression and anxiety, in anti-free-speech behavior, in refusal to engage with the outgroup, etc. Being driven everywhere until you're 16 and not being allowed out on your own prevent children from developing these skills.

You're more dependent on the government

This is such a silly thing to say in the modern day - everyone is dependent on government. In fact, the very existence of single-family neighbourhoods is dependent on government regulation and the banning of other types of housing.

They have to rely on others

As if you don't. Who maintains the suburban roads without which you wouldn't be able to get anywhere?

But those living with yards can be independent by growing their own food.

Growing vegetables in your garden is a hobby. A very pleasant one to be sure, but not a means of subsistence.

Further, most vices aren't increasing healthcare costs. Smoking doesn't. Most people will get cancer in their lifetime. Smokers will usually get it around the age of 65. In a few years they croak. We save on their future nursing home costs, their social security, etc. Similar with the obese. They are unlikely to make it much past 65. Old age is the most expensive period for healthcare.

I dunno about that. Cancer treatment is insanely expensive, so is treating long-term health consequences of obesity or smoking. Some may drop dead at 60, but others get sick at 50 and then die at 70. Old age is not that expensive, its old people getting sick which is expensive.

But most old people are going to get sick. Most people who don't die young will get cancer. Most will die of cancer (or heart disease). So whether you get it at 50 or 70 or 90, it doesn't matter. The cost is the same. But if you get it around 65 and croak, then that's potentially a couple decades of social security saved. A decade of nursing homes expenses. A couple decades of medicare. And most of these people aren't contributing to society, they are just consuming.

It seems mostly tied to an old Dutch study. Many health services come to opposite conclusions using different methodologies. I think many of them don't even factor lifetime costs of care and simply report certain amount of costs associated with treating the health conditions of certain socially disapproved lifestyles.

How exactly do cars, single family homes, and meat (of all things) make people harder to control?

Also, are you saying single family homes and car culture are not a cause of poor urban planning, which makes housing inaccessible, worsens people's health (as they just drive a car everywhere instead of walking) and contributes to climate change (as people need to drive everywhere, hence using more fuel)?

There are greener options for vehicles these days. I don't think climate change is the existential risk that it's made out to be; I think it's made out to be an existential risk to further policy goals.

Poor urban planning really comes down to the government meddling and trying to create 'livable' neighbourhoods that fall apart. Housing is inaccessible because meddling bureaucracies have made it that way. If you can build what you want on your land, suddenly housing becomes really accessible and very affordable.

If you can build what you want on your land

And isn't that what the activists are asking for? Lifting restrictions on construction?

‘Houston’ is not what Yimbies have in mind.

And isn't that what the activists are asking for? Lifting restrictions on construction?

No, they just want to change the restrictions on construction.

OK then, "easing" or "partially lifting" the restrictions?

Or are they planning to implement some entirely new restrictions?

Summarizing that post: The cars, houses, and meat aren't what make people harder to control. They're the things that the activists want to control. The activists want other problems to be worse so they can use those problems as an excuse to control those things.

Single-family homes seems like a poor example compared to the other ones, since the main thrust of the pro-density activism is loosening control -- giving people more scope to do with their property what they wish

It gives people more scope to create externalities. The activists wish to control the people affected by the externalities, not the people who produce them.

since the main thrust of the pro-density activism is loosening control -- giving people more scope to do with their property what they wish

No, it isn't. It's marketed that way, but it really means "giving people more scope to do with their property as the activists wish". None of them is going to be OK with my building a 10-foot fence or a 6-car garage or just parking my cars on the lawn or building a building for a business or any of the various other things I'm not allowed to do. All they want to do is "allow" more dwelling units.

Maybe this applies to some people but not all of us. I consider myself a YIMBY and I support your right to do all of those on your own land. Principled libertarians are not a myth

And more flexible setbacks, and mixed-use, and less arduous parking minimums, etc etc. Even if you think the position is too minimal or cynical, the net result is certainly not an expansion of state power.

Setbacks are one of those weird things where they don't seem like they matter until they really really do. Like when putting up a barn on the border of your property in violation of local zoning washes out your neighbors drive way. (The #barnlaw saga has been a trip but @morlockp went private when he started running for state office.)

But are rigid setbacks (as the lawyers say) the least restrictive means of preventing your land from draining to somebody else's land? Instead, the code could say something like:

Your site plan should include a hydrologic study showing that your proposed building will not shed additional water onto any adjacent property. If your site plan does not include such a hydrologic study, then it must adhere to this table of default setbacks, which will produce a presumption (rebuttable by a hydrologic study) that your proposed building will not shed additional water onto any adjacent property.

More comments

I'm cynical. I believe the plan is to get people so fucked that they need the government, and specifically a nanny-state, far-left, socialist government.

BZZT! You have been fined one credit for a violation of the verbal morality statute.

I wonder how many downvotes are from people who don't know how to use the three seashells.

Avoid low-effort snark.

Sorry, the parent post just reminded me so much of Lenina Huxley's litany of things that are bad, and therefore banned.

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