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Birthrates only matter because of mass immigration. If you don't have mass immigration they're irrelevant, especially with the pace at which automation via LLM (including in the material world with PaLM-E and other multimodal models for robotics) is advancing.

It doesn't really matter if South Korea's population falls from 50m to 10m provided two things are true:

  • Firstly, that total productivity can be maintained (this seems likely with LLMs able to take over a large percentage of white collar labor over the next few years, and robotics + multimodal LLMs likely to take over a large percentage of blue collar labor over the next decade or two). In this case, no economic collapse is likely, and while fiscal policy might need to adjust to redistribute generated wealth, that's not an existential issue.

  • Secondly, that those very same advances mean that military preparedness isn't damaged by falling number of young men, which again, advances in drone warfare suggest is likely. Plus, North Korea's birthrate is also collapsing (see Kim's recent comments) and it has half SK's population, so any disadvantage is unlikely to be large.

The main reason to be worried about birthrates is demographic competition as in Lebanon, in Israel, in India and so on. If a minority group has much higher birthrates than the native population, the long-term balance of power in a nation is almost guaranteed to shift.

  • The war in Ukraine is strong evidence that manpower will continue to matter in war.

  • There is a longterm dysgenic effect with 2 kids per household, because the way human fertility is designed to work is that ~8 births occur and perhaps 1 or 2 of the healthiest go on to have 8-12 births themselves. A norm of 2 births is a norm of decreasing health over generations until the problems become apocalyptic.

  • In America, even without mass immigration, you have the high fertility of the ultra Orthodox Jews. So unless you want a future without music or art or equality or indigenous Europeans itโ€™s a good idea to incentivize births. Eg 200k in New York, doubling every 20 years means hundreds of millions within 200 years. And they already wield an absurd amount of political power in New York

The dysgenics is trivial to solve with embryo selection, which unlike AI-powered robots has the perk of existing and already being cheap enough to be accessible for middle class people if they so choose. Even in the current form it'd be trivial for western government to subsidize usage for poor people (though I think there is enough slack to make it much, much cheaper to begin with through scaling).

Agree on the Ukraine war & on the problem of extremely fertile ultra-conservative populations, though.

The dysgenics is trivial to solve with embryo selection

The obesity pandemic is also trivial to solve with people eating less. Mass migration would be easily solved if a wall would be build at the Mexican border.

Even if an easy solution is known, even if the solution is proven to work, it can be very very hard, often impossible, to implement it.

The Obesity epidemic is, in fact, easy to solve.

Start handing out Ozempic.

In the blink of an eye, the price dropped from ridiculous to well worth it, in India of all places. Fucking give the people killing themselves with food the pills to stop them wanting to.

Even if the price stays high, it doesn't have to get much cheaper for the cost-benefit to be grossly positive from the reduced healthcare costs for the fat and sick.

This is not impossible, or even very hard to implement. Negotiate costs. Make insurance cover it, if they don't make a rational decision to do so. Buy it from countries where it's cheaper.

Fucking give the people killing themselves with food the pills to stop them wanting to.

Not pills, it's an injection. You try finding different places on your stomach to stab yourself weekly ๐Ÿ˜

Plus, there are side-effects. Some people react so badly that they can't stay on the medications. If you're lucky, you'll just end up constipated because of the mechanism of action, which is to slow down the passage of food through the digestive system. If you're extra lucky, you get the "not wanting to eat so much" side-effect, but not everybody does get that.

Not pills, it's an injection. You try finding different places on your stomach to stab yourself weekly

No, it's not necessarily injections, you can quite literally get Semaglutide in oral form. I was looking up formulations for my mom yesterday.

Plus, there are side-effects. Some people react so badly that they can't stay on the medications. If you're lucky, you'll just end up constipated because of the mechanism of action, which is to slow down the passage of food through the digestive system. If you're extra lucky, you get the "not wanting to eat so much" side-effect, but not everybody does get that.

Sigh. Everything has side effects. For semaglutide, they're not particularly noteworthy, regardless of your personal bad luck with it.

I didn't know about the oral formulations, the only ones I've encountered for both Ozempic and Trulicity have been the injectables, (ouch ouch ouch), and even then supply was intermittent because demand outstripped it (particularly for those looking for quickie weight loss).

India makes half the pharmaceuticals you consume in the West, be they cheap or expensive. So it's not surprise I can get it for next to nothing, especially in bulk. So could anyone really, depending on their appetite for Chinese grey markets.

Oral formulations of semaglutide are less effective than a jab, but they're also cheaper, and you can just take more of them.

The long and short (and thin) of it is that it works for most people, and for those it didn't work on/couldn't tolerate it, there are both similar drugs that are likely better at the weight loss deal, and tens of billions of dollars being spent finding more.