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Scott-featured global health philanthropist and activist John Green made a video about TB treatment and USAID. tl;dw, TB is the brick-shithouse of bacteria, so treatment takes 4-6 months, but the good news is that people mostly aren't contagious during treatment. Stopping treatment increases the risk of treatment-resistance, including the spread of newly-treatment-resistant strains, so interruptions in the supply chain are a major global health problem. Yes, it's bad that global health was overly reliant on the USA, but it requires government-level funding and logistics. (Unsaid, his family pledged $1m/year 2024-2027 for a USAID TB program in the Philippines, in addition to $6.5m for Partners in Health, so he's literally put his money where his mouth is.) His contacts in confirm that drug supplies are being interrupted.
Even if one wants to cut USAID, a stop-work order, rather than a phase-out, was likely a net-negative by most measures of utility.
Seventy years pro-life activists have called their opponents baby-killers and it did not swerve their opposition's resolve by one inch.
Conservatives, particularly MAGA conservatives, must harden their hearts as such. In the coming months and years, there will be no end to the wailing. They will beg you in the name that all that is decent and humane to give them the one exception and save many lives. The rationalist crowd will come to you with spreadsheets and lives per dollar and give logical arguments to save lives. You will be constantly bombarded with propaganda designed to psyop you to support the return of the old status quo.
Put on your biggest smile and say no. That's your cross to bear. Resist the temptation to give in, and to be seen as 'one of the good ones'. Mercy and compassion are the luxuries of the victor, and you have not won yet. This is but the first of many battles in a long war. If your opponents say that your proposals will cost millions of lives, say to them: "Billions." And do what you intended to do, and do it so throughly and completely that it does not have to be done again. Embrace the virtue of Lycurgus and destroy what you must to save what you can.
I see this somewhat regularly and I really dislike this style of comment, written like a Roman general giving a speech to the senate.
On a surface level, get a grip! You aren’t fighting a war. Most anybody here engages with politics to is to squabble on the internet and maybe vote.
On a deeper level, I think it really reflects a polarized view. The battle-lines are drawn, and you’re rallying for a cause. But in reality these issues are often not as polarized in the public as you might think. There is room between ‘change nothing’ and ‘blow it all up’.
You flatter me. I have a sophist's love of rhetoric: but if politics is serious - if it is about human life - then it should be taken seriously. I find it less moral to equivocate, to pretend that there is a difference between 'save some lives' and 'save all'. Removing the room for argument is the only way to reduce the size of government otherwise you are merely a ratchet on Leviathan's appetite.
‘Removing the room for argument’
That’s already been done. I don’t know all the details, but Trump seems to have direct authority over USAID. In theory, he/DOGE could take even a cursory look at what programs they fund and make some decisions from a rational basis. But it doesn’t seem like they have a real methodology, it’s just ‘XYZ is corrupted by the woke left, burn it all down’.
I’m fine with making things more efficient, when it comes to aid programs, grants, and regulations, I want people to be arguing over the merits. What I don’t want is for it to be all-or-nothing situation. It doesn’t have to be that way, it would be better if it wasn’t, and I simply don’t agree with your framing.
The other side of that is that leaving room for arguments just leads to the deed never actually getting done.
Imagine a situation where a patient is morbidly obese. He weighs 500 lbs. if he doesn’t lose weight, he dies. Do you start by “negotiating” about how many cheat days he gets? How many sugary drinks he’s allowed to have? How many times he gets to eat dessert? Or do you hand him a strict diet plan that tells him that if he wants to see 2035, he needs to drink only water, not eat more than 2200 calories a day, and he can’t go over. When you start from the position that the cure is negotiable, you end up coming up with excuses to continue the behaviors or in this case the spending habits because if there are loopholes, then you’ll tend to find ways to squeeze more and more programs into the loopholes and not end up doing any actual cutting. If things that are national defense are okay, everything becomes national defense. Just like if you start allowing people to declare cheat days, every day will eventually meet the criteria for a cheat day.
This is why metaphors are overrated outside of poetry. They tend to obscure at least as much as they illustrate. If you want to stick with the fat guy metaphor, DOGE's "economy" drive is hectoring the patient for eating a salad for lunch while ignoring that he eats two pounds of bacon for breakfast and a box of Krispy Kreme donuts for dinner. You would discuss dieting plans where you step down food consumption and coming up with a plan the patient could actually follow and doesn't harm them. You wouldn't just say "you're going on a starvation diet now, figure it out."
But in actual fact the USG is not a fat guy. Spending is not food. It's not going to drop dead of a heart attack if it has irresponsible fiscal policy. The worst case scenarios involve a lot of economic turmoil, but the US isn't going to collapse because social security becomes insolvent.
Moreover, the US has a lot of tools with which to solve its fiscal problems, but no one wants to use them. Conservative elites are primarily focused on cutting taxes for conservative elites and weakening consumer/labor protections; electoral success dictates protecting transfers to elderly and rural voters. So the obvious solution of trimming entitlements and raising taxes is a nonstarter and instead we get a pantomime of cost savings* as a cover for re-legalizing banking scams.
*high confidence prediction: these will not result in meaningful government savings over the long run and will incur higher social costs
*intermediate confidence: they will actually increase government costs over the long run as even more Federal staff are replaced with more expensive, less efficient contractors
The worst case scenarios involve a lot of economic turmoil, in a social context where the taboo on political violence has been trampled to nonexistence. Many millions of people are openly cheering for political assassins at this present moment. Many millions more have already demonstrated their willingness to shred the basic constitutional, legal and social protections of those fellow Americans they consider their outgroup, without apparent limit.
If you think "a lot of economic turmoil" is survivable under these conditions, it seems to me that you are stretching optimism beyond the bounds of credibility.
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