This weekly roundup thread is intended for all culture war posts. 'Culture war' is vaguely defined, but it basically means controversial issues that fall along set tribal lines. Arguments over culture war issues generate a lot of heat and little light, and few deeply entrenched people ever change their minds. This thread is for voicing opinions and analyzing the state of the discussion while trying to optimize for light over heat.
Optimistically, we think that engaging with people you disagree with is worth your time, and so is being nice! Pessimistically, there are many dynamics that can lead discussions on Culture War topics to become unproductive. There's a human tendency to divide along tribal lines, praising your ingroup and vilifying your outgroup - and if you think you find it easy to criticize your ingroup, then it may be that your outgroup is not who you think it is. Extremists with opposing positions can feed off each other, highlighting each other's worst points to justify their own angry rhetoric, which becomes in turn a new example of bad behavior for the other side to highlight.
We would like to avoid these negative dynamics. Accordingly, we ask that you do not use this thread for waging the Culture War. Examples of waging the Culture War:
-
Shaming.
-
Attempting to 'build consensus' or enforce ideological conformity.
-
Making sweeping generalizations to vilify a group you dislike.
-
Recruiting for a cause.
-
Posting links that could be summarized as 'Boo outgroup!' Basically, if your content is 'Can you believe what Those People did this week?' then you should either refrain from posting, or do some very patient work to contextualize and/or steel-man the relevant viewpoint.
In general, you should argue to understand, not to win. This thread is not territory to be claimed by one group or another; indeed, the aim is to have many different viewpoints represented here. Thus, we also ask that you follow some guidelines:
-
Speak plainly. Avoid sarcasm and mockery. When disagreeing with someone, state your objections explicitly.
-
Be as precise and charitable as you can. Don't paraphrase unflatteringly.
-
Don't imply that someone said something they did not say, even if you think it follows from what they said.
-
Write like everyone is reading and you want them to be included in the discussion.
On an ad hoc basis, the mods will try to compile a list of the best posts/comments from the previous week, posted in Quality Contribution threads and archived at /r/TheThread. You may nominate a comment for this list by clicking on 'report' at the bottom of the post and typing 'Actually a quality contribution' as the report reason.
Jump in the discussion.
No email address required.
Notes -
In the wake of the House of Representatives passing a Continuing Resolution maintaining current funding levels a group of Republicans, led by Matt Gaetz (R-FL), have filed a motion to vacate against Kevin McCarthy (R-CA). This is a motion that, if passed, would remove McCarthy as Chair of the House of Representatives after only nine months on the job. The reporting I'm seeing on Twitter says Democrats are united in supporting the motion, which means only three Republicans would need to join Gaetz for the motion to pass. I believe this would also be the first time in US history the House will have removed a Speaker with a motion to vacate.
What happens after that is anyone's guess. In a literal sense we move back to where we were this January and do another election for Speaker. Presumably Democrats are going to nominate and vote for Hakeem Jeffries (D-NY) as they did then. It's not clear who on the Republican side would be a replacement for McCarthy. He still enjoys the support of a strong majority of Republicans, but the Republican majority is so small he needs basically everyone. His getting elected Speaker again would almost certainly need someone who voted to vacate to vote for him to Speaker. I'm skeptical there are promises McCarthy could make to the Republicans voting to oust him that could convince them to support him again. On the other hand I'm not aware of any consensus about who Republicans could be convinced to support except McCarthy. By far the funniest outcome, I think, would be the Republicans who voted to oust McCarthy abstaining in the Speaker vote, letting the Democrats elect Jeffries Speaker.
Vote on the motion is supposed to be held this morning though the House is currently debating other bills. You can watch the House Session on C-SPAN. Will update this post as the news develops.
ETA:
By a vote of 216-210-0 Kevin McCarthy becomes the first Speaker of the United States House of Representatives removed by a motion to vacate.
Vote breakdown by party (based on the vote on the motion to table, C-SPAN roll call doesn't break down by party):
As expected McCarthy retains the support of the vast majority of his own Conference. I think the rule is the House can't do business without a Speaker so I imagine we go directly into elections for Speaker of the House now. Given the multiple days it took to elect McCarthy before I am not confident about any particular path forward from here.
ETA2:
Am hearing online that the Speaker pro tempore (selected by McCarthy when he became Speaker) may be able to function as Speaker indefinitely. They may not have to have an election for Speaker on any particular time table.
I’ve been relatively happy with McCarthy. But I support Ukraine funding.
We do need to cut federal spending. The current levels are harming the economy. If we cut federal spending it would cause demand to fall. But that fall is easy for the fed to compensate for by cutting rates. We could go back to the 2010’s economy of big but workable deficits and low rates. Bidenomics has been a disaster.
Also I wish they were doing a better job impeach Biden. (Let’s not relitigate that but personally I believe it’s correct and just).
What should we cut? If you don’t want to cut Ukraine spending I presume it isn’t defense. Social security is reckoned separately from the rest of the budget. Everything else is a rounding error.
Defense is less than 20% of the budget if you lump in veterans benefits. If you take out social security you still have 60% left to play with.
https://fiscaldata.treasury.gov/americas-finance-guide/federal-spending/
Personally I would slash Medicare and Medicaid to start, it's just subsidizing a good that has a restricted supply because of over regulation. It's a political non starter though as are pretty much all spending cuts.
One of the reasons supply is restricted within medical care is because MMS helps fund residency slots and have historically capped their funding at '96 levels, keeping supply of doctors lower than it could be. Only in 2022 have we started to fix this and raise the residency slot funding. Cutting MMS funding would be moving backwards on doctor supply.
Most of the rest of the supply restrictions are state level like Con and COPA laws. Cutting MMS funding won't do anything to fix those problems.
What does the government spend funding residency slots though? Medicare has a budget of $800 billion for example and google tells me that $16 billion of it goes to funding residencies, so 2% of their budget. You could make massive cuts to medicare without touching that. A lot of programs are like that where they use the miniscule fraction that's actually useful to justify the fact that the rest of it is bloat.
My point that it's an oversimplication to describe federal spending as "just subsidizing a good that has a restricted supply because of over regulation." Just as easily a lack of funding can be the root cause of a dearth of supply.
Administrative excess should be culled everywhere, but I'm unconvinced that "the rest of [the budget] is bloat". From this graph on their budget it looks like a reasonable 5-10% is administration while the overwhelming majority is compensation for services, 50% for hospital care, 25% for physician services, and the remainder broken between prescription drugs, and smaller categories like equipment and nursing homes.
I'm unconvinced the future is bleak either. The largest growing category in spending has been prescription drugs and the IRA should arrest that trend substantially. You've likely also read the recent headlines that our projections have wildly overestimated growth in Medicare spending, which has leveled off significantly per beneficiary for the past decade.
Administrative waste is bad but isn't the core problem here. The problem is that the government restricts the supply of people allowed to practice medicine through regulations and then provides subsidies to purchase healthcare so that people buy more of it than they otherwise would. New players are legally barred from entering the market to raise the supply so the subsidies go straight into the pockets of the providers. It's like when the government provides section 8 housing vouchers but at the same time makes it illegal to build new housing via zoning restrictions or environmental regulations. You can't subsidize your way out of a cartel.
And the fact is that we're just not getting a good return on investment. We spend more on healthcare than anywhere else in the world but life expectancy is declining. Paying a trillion dollars a year so people with alzheimer's can linger in the nursing home for another year is just a bad way to spend money.
This is like saying the government restricts the supply of tanks or something. There's no regulation artificially restraining something that would be in more abundance on the free market, the subsidy just isn't big enough. There is no law restricting resident doctors, which hospitals can have as many of as they want, there just isn't extra public funding to have more of them, so hospitals make up funding shortfalls out of pocket, from state governments, or philanthropy. Cutting government would ofc result in less residency slots, not more.
There are lots of regulations that genuinely do restrict the supply of medicine via laws that shield hospitals from anti-trust and prevent new competitors from emerging. But these are mostly on the state level. Even the lengths of residencies themselves are usually required by state-level licensing rules. If there's anything federal scale that's as significant as CON/COPA laws, I'm more than interested to hear about it though, that's why I asked.
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link
More options
Context Copy link