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PaperclipPerfector  5mo ago (text post)   29536 thread views

Culture War Roundup for the week of November 13, 2023

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I just heard what I think is a terrible atrocity (granted on the much milder-end of terrible atrocities) that no one seems to know or care about. Apparently Maryland requires that if you have been diagnosed with sleep apnea:

  1. you report it to the DMV
  2. you have to use a CPAP machine (edit: if that's your doctor's recommended treatment)
  3. your CPAP machine has to send data to the state showing that you're using it regularly for 70% of each night (edit: if CPAP is your doctor's recommended treatment)

Failure to do this will result in your driver's license being revoked.

This really makes my blood boil. I found out about this because my friend in Maryland is one such person affected by this, with her extremely mild case of sleep apnea (that probably 75% of Americans actually have). She didn't bother with or really need the CPAP, but now, the DMV found out, and is threatening to revoke her license, so she has no choice. Hell, I'm a person who's been diagnosed with very mild sleep apnea, but I chose to not use the CPAP machine, because I couldn't stand having an intrusive device strapped onto my face with tubes running on my bed, pushing air down my throat all night every night. Provided I didn't sleep on my back, I was completely fine, and I didn't need to use the device at all. Since then, I've lost weight, and I don't have sleep apnea anymore, or at least not as much, but I don't even know if they ever declare someone as "no longer having sleep apnea", or if I'd actually pass that threshold, or if the DMV would care. My only saving grace is that I don't live in Maryland, but man, this makes me so scared about what might come next, and how long I'll get to keep my driver's license for before this either comes to my state, or some other health-related driving restrictions start cropping up.

This seems like such rampant safetyism to me that it honestly makes me so angry, probably angrier than I should be. I guess this seems like such government overreach, much in the same way as covid restrictions. Except that these restrictions really could last forever, and expand to other states, and never go away, unlike the covid restrictions. Did Maryland honestly have rampant cases of drivers falling asleep because they were so tired from their sleep apnea that they needed to mandate an intrusive, ongoing, never-ending medical treatment to save people from crashing their cars? Does this help anyone at all, or were they just looking to do some security theater?

I really want to do something to fight this before it expands. Is this the sort of thing the ACLU would take up the fight for? Are there any organizations that would actually fund and spearhead a class action lawsuit for this sort of thing?

Crazy. Apparently your friend is not the first person, news story from February 2023: https://www.nbcwashington.com/investigations/little-known-maryland-law-requires-people-with-sleep-apnea-to-report-diagnosis-to-driving-authorities/3272929/

The I-Team reviewed driving laws from across the country and found several other states – such as Florida, New Jersey, Maine and Texas – also list sleep apnea as a condition that may be subject to medical review by state motor vehicle authorities.

Virginia law requires its Department of Motor Vehicles to ask drivers applying for or renewing a license if they have a medical condition that could prevent them from driving safely but doesn’t specify sleep apnea as among them.

This is probably because driving is treated as a "privilege" by the state.

This is probably because driving is treated as a "privilege" by the state.

Driving should be treated as a privilege. I'm more opposed to safetyism than the median person, but it still surprises me that we came up with a norm that operating one specific class of heavy machinery is basically a right that's hard to remove, even for individuals that are incompetent or repeatedly demonstrate that they will drive while inebriated. Tens of thousands of otherwise young, healthy people die in vehicular accidents annually and it remains an entirely niche issue to even think about traffic safety.

This doesn't get me to the point of favoring this particular sort of intrusion, but I generally think licensing is far too liberalized.

Your point of view makes sense, but it would make more sense to me if we haven't had 100 years of infrastructure that treats the operation of that heavy machinery as a given. It's really hard to live without driving a car in all but the most densely populated cities!

Your argument is just status quo bias. "auto licensing should be treated as a given because -> our infrastructure is designed around autos because -> we've always treated auto licensing as a given". If auto licensing were not treated as given, then we would be incentivized to adapt our infrastructure appropriately.

Not really. I just don't trust that threatening people with sleep apnea that they're going to take away their licenses would be enough to change that status quo. If someone were to actually make it as easy or easier for like 99.99% of people to live without a car, then I'm in favor of that status quo changing. Until then, I'm in favor of the status quo because it's a better system.

I'd prefer if driving with insurance was treated as a right. And that car insurance companies were allowed to price in all relevant information.

I get the dangers of vehicles, I avoid dangerous drive times, avoid highways if I can take slower roads, and generally follow all rules of the road. I've gone 15 years without a ticket for a driving infraction. And I've never been in an accident worse than a fender bender at the wheel.

The state can be a bit of a sledgehammer with things. Sleep apnea and bad sleep can increase your risk of causing an accident, but the state is applying a one size fits all solution: take away the license.

The price of admission to driving on shared roads should be to compensate others for the risk you pose. If the risk you pose becomes too large then it will be too expensive for you to drive.

I'd prefer if driving with insurance was treated as a right.

It is worth noting that only a small minority of rich, socially responsible Americans drive with adequate liability insurance for the traditional libertarian argument to apply. Most drivers have state-minimum liability coverage, which is something like 25/50 for bodily injury in most states. Even "full coverage" is only 100/300. $100k is not nearly enough to cover a wrongful death or a disabling accident, and probably not enough to cover a broken limb. So the only people who could plausibly claim that their driving safety was between them and their insurer would be the small number of people with 100/300 insurance and a multi-million personal umbrella on top of it. (The UK travel insurance industry treats £2 million umbrella liability coverage as the bare minimum for Brits planning to drive in America).

This raises the question of whether irresponsible Americans impose a larger burden on responsible Americans by commiting crimes or by un/underinsured driving. Looking at the cost-of-injuries tables on https://wisqars.cdc.gov/, the total "cost of injuries" (including medical bills, time off work, quality of life costs, and VSL for fatalities - this is an estimate of what a sane personal injury system would award in damages) is $440 billion for violent crime and $820 billion for car crashes. Given that just under half the car crash number is self-inflicted, and most of the cost is driven by accidents which comfortably exceed policy limits, the answer is that as regards injuries, the two problems are roughly the same size. (I don't know how you would compare the cost of property crime to the property damage caused by car crashes)

Given that such a system would require the state to maintain to the same extent as a strict licensing regime, surely all that is being preserved here is the illusion of liberty? If you have no issue with the state being able to demand you insure yourself before driving, drawing some line between there and the state being able to demand you demonstrate yourself a competent and trustworthy driver seems arbitrary and pointless.

The underclass already elects to just skip insurance, so I'm pretty skeptical of making much headway on this without dramatically changing enforcement mechanisms in a way that looks pretty similar to just taking away licenses from the incompetent. Years ago, I got T-boned by an uninsured motorist that ran a stop sign and they didn't even receive a ticket before driving away. Anarchotyranny gonna anarchotyranny when it comes to vehicular law enforcement.

The underclass already elects to just skip insurance

And frequently, licenses as well

Years ago I read a suggestion that you should be legally required to provide proof of insurance when buying petrol, and the petrol station should refuse your custom if you can't.

The proposal was made before smartphones, I can imagine all kinds of ways it could be implemented nowadays. Like you download an app from your insurance provider and the app displays a QR code which the petrol station scans, and if the scanning fails then the petrol nozzle locks.

To note, lots of people buy gasoline without using it to fuel cars on public roads- lawn mowers, off road vehicles, machinery, etc all run off of gas and the norm is to fuel them with ordinary gasoline even if you’re technically supposed to buy specially mixed gas.

I’ll make a bunch of money reselling petrol to the uninsured at mark-up.

How? Are you currently making a bunch if money selling contraband?

Will you fill up a bunch of 5 gallon cans and sell it out of your garage?

I own a gas station.

More comments

What are the rules around pricing car insurance? I can guess some things are disallowed (e.g. race), but if someone started an insurance company that had a model that took in educational attainment, job, health records, home ownership, social media use, real time driving information, etc to offer lower rates to people who are predictably less risky, would that be allowed?

I get a substantial discount for allowing my insurer to use real-time driving information and(through a back door- that’s what ‘bundling’ is) for being a homeowner.

Years ago insurance providers in Ireland were legally allowed to discriminate on the basis of sex (as women have fewer accidents than men) but not anymore.

Was it really fewer accidents or less severe accidents? From what I last read, women get in more minor fender benders but men dominate the car-totaling jaw-of-life-required accidents.

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