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Culture War Roundup for the week of August 25, 2025

It's worth noting that specific market segments in the U.S. can and do do things like this but while that stuff can be a large fraction of the profit it isn't a large percentage of the overall activity.

A large part of the problem is that insurance companies will deliberately provide poor service because their clients are usually unrelated institutions and not the individual patient or anyone on the healthcare side (remember we mostly get our insurance from our employer).

When they do fuckery like the examples I'll provide below nobody has any recourse unless they randomly manage to fuck up the CEO's healthcare or something.

Right now one of the world's most prestigious health systems (Johns Hopkins) is threatening to punt United from their health system. One of the two will blink but the service insurance provides to everybody is awful as hell.

A few classic examples: -My patient has been stable on an inhaler for 20 years. They get new insurance company which is one of the ones that has some kinda of complicated kickback program where they rotate the covered inhaler every year. My patient might die if they change inhalers and switch to one that doesn't work for them, so I can spend 5-10 hours on the phone fighting insurance or just cross my fingers and switch. FUCK THIS.

-Patient is sitting in the hospital and needs rehab placement after discharge. The insurance company refuses to approve rehab. The patient sits in the hospital getting hospital level care for an extra 3-5 days before going to rehab. The insurance company pays for that care. Why did they do this? WE DON'T KNOW.

-Psych patient in the ED, clearly needs involuntary care. Insurance refuses to approve, likely hoping that the patient calms down enough to be sent home with suboptimal care or the ED gets frustrated enough to roll the dice on sending the guy home and hope he doesnt kill anybody. THIS WORKS DAMNIT.

Also the "Hawaii" example: You provide a service, you are the only one on your island who does it. Insurance offers you a deal that's barely over cost for your services. You say no. The insurance company spends the next five years flying patients to one of the other islands for their care until you break or go out of business.

The more charitable explanation for what is going on is that when the private insurance is functionally the whole system (Medicare/Medicaid aside) it has to work for all parts of the system not just the ones where you can make things simple and offer a boutique product like your UK elective stuff.

Small-Scale Question Sunday for August 24, 2025

Not to mention a lot of apps suck on the phone when compared to their desktop or browser versions. Wunderground app for example. I like to click on local weather stations and view their temperature history and some other stats, the app doesn't let you do as much of this and not very easily.

Culture War Roundup for the week of August 25, 2025

Did you perhaps miss the disclaimer right at the start that none of those are my true feelings? My no-bullshit personal strategy is "lay low, turtle up, wait for Armageddon - most forms of which will mortally wound SJ due to urban/rural demographic divides - and then, with the room to breathe thus granted, dismantle SJ's levers of power (most notably, its ability to gatekeep careers via tertiary education and HR; Scott's solution here and Hanania's here are some of the more obvious), but leave the adherents alive and mostly unmolested". A Leninist purge to strip people of power, not a Stalinist one to strip them of life. In point of fact, I would expect a great deal of my advocacy in the aftermath to be expended on begging people not to enact another White Terror.

(To address the elephant in the room: I will grudgingly grant that KillAllMen is not something most SJers currently believe nor, for various reasons, something they're likely to be able to implement. I wasn't especially happy at the whole "it's just a joke, find me a single person who takes it seriously" thing, though; while this was slightly before SJ's heyday, I did have a single mother who told me the Y chromosome's a genetic defect and literally starved me as a teen after I started registering to her as a "man" rather than a "child".)

Culture War Roundup for the week of August 25, 2025

I take the opposite view that most disagreements are value disagreements that ultimately map to aesthetic disagreements about the nature of a good life.

What led you to think this? Can you take some central disagreements and drill them down to the object level?

Culture War Roundup for the week of August 25, 2025

Just no one has even tried to explain how exactly government buying up and owning private enterprise is a smart idea (something that we've been saying isn't good for decades) and why it's a solid goal towards improving the nation's economy and wealth.

Plenty of people have explained it. The race for AI is seen as existential between the U.S. and China. If Intel is owned and operated by a Chinese CEO, that's a major security risk. Therefore Trump and his team took extreme measures to make sure Intel was loyal to the U.S.

I'm not saying it will work or won't have other knock-on effects, but that was the straightforward justification.

Culture War Roundup for the week of August 25, 2025

No, of course not, I was only speaking hypothetically.

Culture War Roundup for the week of August 25, 2025

I'll agree that effectiveness can be objectively measured. But "principles are for suckers" isn't a statement on effectiveness, it's a value judgement of what a person should do. Thus, it is not (and can't be) objective.

Culture War Roundup for the week of August 25, 2025

Pointed but fair, even the heated rhetoric at the end. I’ll clarify that blue/red tribalism changes the perception of the cooperative value lost in each defection, inflating the out-group’s tats and deflating the in-group’s tits.

If the average red-tribe American (citizens since their grandfathers’ time at least) have the perception that they’re being prevented as a class from getting jobs by blue-tribe HR choosing naturalized immigrants, H1B workers, or unnaturalized migrants, tit-for-tat looks like mass deportations. The blue-triber sees this as a massive escalation of defection against their in-group or favored far-group.

If the average red-triber sees their wages stagnant vs inflation since 2008, yet the lowest rung of blue-tribe government worker can buy a suburban house and pay “our” taxes for their kids’ soccer practice, tit-for-tat looks like mass firings of government regulators. The blue-triber sees this as a massive escalation of defection against the people keeping them safe from capitalist overreach.

And so on, and so on. Sure it’ll make the Whigs (the blue-tribe and grey-tribe Republicans who disproportionately make up the GOP’s donor class and elected representatives) take pause, but the red tribe can finally smile at the perception of having shaken off, or at least told off, their oppressors.

This is also what it looks like when the red tribe no longer sees the blue tribe as a far group but its outgroup.

Culture War Roundup for the week of August 25, 2025

I think we need to go back to basics

I'd really rather stay focused, because you made a very specific claim, and whether or not healthcare "functions as a market" is not even relevant to it. Literal socialized industries (including healthcare in other countries) are able to give you the price of a particular product / service, so even if American healthcare is somehow not a market, it still should be able to the patients information about the prices of it's services.

Culture War Roundup for the week of August 25, 2025

Pompey’s side defected 80 years earlier when they beat the Tribune of the Plebs to death with table legs, committing what was in the Roman worldview both treason and blasphemy. Then they spent most of the next century being shocked at the succession of demagogues who were suddenly willing to break all sorts of political norms, for some unknown reason.

Culture War Roundup for the week of August 25, 2025

Instrumentality is an objective metric.

What ought to be done is subjective. What can be done is objective.

My point, and Machiavelli's, is that a certain conduct is necessary to attain and retain power in the first place, independently of one's ultimate aims. Making it a necessary precondition to the enactment of any political program.

Whether one should engage in politics is a subjective question, but once one answers yes, the requirements placed on one are the same regardless of ideology. And they include the necessity to destroy one's enemies that they may not rally against one.

Culture War Roundup for the week of August 25, 2025

Principles are objectively for suckers.

This is by definition a subjective, not an objective, topic. There can't be an objective evaluation of what values one should hold.

Why does advice work so poorly?

Advice works poorly because of attitudes like those evinced in this article.

Or maybe we can just blame Martin Luther, if we don't want to pick on my friend @greyenlightenment. Possibly Bruce Lee.

People generally don't follow advice, even obviously good advice, because doing so would conflict with their ego. Taking advice, really taking it to heart and following it, requires a radical act of submission foreign to the modern mind. To truly accept advice, one must first place oneself below the advice giver.

Most people fail when implementing advice because they fail to truly implement the advice. They give it a half-effort, they don't persevere long enough to see results, they don't really feel the advice. Because they don't really respect the advice giver. You have to start by submitting your own will and intellect to the superior, to the rabbi or the guru or the priest or the professor or the doctor. And that act of submission is radically antithetical to the modern mind. We want to pick and choose, Jeet-Kune-Do style, take the best of all aspects of all advice and combine them, rather than take the advice of our superiors. Every one of us is trying to run our own custom set-up of values and cherry-picked advice, our own unique choices. Not to pick on @Pitt19802 but this is emblematic, saying the adulthood is all about realizing:

no one is going to walk you through life. It's on you to pull out the bits of advice that resonate with you and decide to try those out, then decide which of those you want to keep trying, which of those you want to stop trying, and what you want to try out that no one advised you to do.

If you are always keeping a part of your mind detached, observing, assessing whether the advice is working or not, then you're never really following it. At the first sign of failure, you are ready to jump ship, you have the lifeboats already inflated, you're already writing your clever comment about how the unsinkable advice sank.

When you look at cults like People's Temple, Synanon, NXIVM, or Gwen Shamblin; ok yeah they end up drinking the kool aid or murdering journalists or stealing money or abusing kids. But first, they work as self-improvement. Every cult story is full of people who join the cult, submit their will to the leader, and they get off drugs, they work hard at cult activities, they become functional members of society, they lose weight. They did all these things easily, like it was nothing, no big deal. And the key element is the submission, the surrender of will to the leader. This is why any effective advice program, like Crossfit or TRP, starts getting accused of being a "cult." When we see progress coming from submission, we defensively call it a cult, rather than question our own determined independence. I'm guilty of this myself: I disdain basically all self-help books on the principle that the person writing it doesn't impress me enough, and I giggled at Evola eviscerating the existentialists as pasty philosophy-professors who lacked real world experience while citing Nietzsche of all people.

Let's talk about fitness examples, since those were used in OP, and are also my favorite.

In the OP:

Even the best advice will still be constrained by one’s innate limitations. In my post “Individual differences of metabolism are real and matter” I give a real-life example of someone who despite only eating 1,800-2,000 calories/day, which he carefully tracks, and doing cardio, is still overweight at over 200lbs at 5’10”.

Genetic limitations are real, genetic limitations are an infohazard that prevents you from making progress. Both these facts are true. Once you are aware of and accept the idea that your genetics might be special and unique and prevent you from progressing based on basic advice, particularly where information on "slow metabolisms" or "hardgainers" is presented without a percentage-rate of the population, everyone wants to jump ship on the simple-but-difficult advice in favor of anointing oneself a hardgainer or having an unspecified and undiagnosed thyroid or metabolic problem. Some people are harmed by trying to follow advice that won't work for them because of their genetics, vastly more are harmed by not following basic fitness advice because they've given up and decided they are a special snowflake who can't follow basic advice.

This is why there is so much fluff in so many popular fitness programs. The actual program could be communicated in a spreadsheet; why do the authors give us treatises on physiology that don't matter, or stories about the athletes or champions or movie stars or secret-commandos or Soviet scientists that built or followed the program. Sometimes you get a mad-libs pile on: JALEN HURTS followed a workout program developed by SPETZNAZ COMMANDOS using hitherto ignored SCIENTIFIC PRINCIPLES that were discovered by EASTERN BLOC COMMUNIST SCIENTISISTS. And you get 20 pages about Jalen Hurts performance in the NFL, how badass the spetznaz commandos are, the intense scientific research sponsored by the USSR to develop athletes, how revolutionary these scientific principles are...and two pages with the actual program you need to follow. All the fluff is designed to get you to buy in, to actually follow the Program as written, to swallow your ego and accept that the Program and its creators are better than you and you need to follow their advice.

It's easy to dismiss the fluff as unnecessary, just give me the program, but it is probably the most necessary thing. A theoretical program with zero fluff, just sets and reps with no testimonials and no confusing pseudo-bro-science arguments about why it is effective, is unlikely to be followed by many people, a program offered with no story will not persuade people to try it. The story is necessary to convince people to do the work. A perfect program with no story probably has no adherents, or if anyone tries it they quit lacking a reason to continue when they start to dislike it or it gets hard or something seems to go wrong. A workout program that is distinctly sub-optimal, but with a narrative attached that convinces everyone who reads it to commit to doing that sub-optimal program with 100% compliance and effort, would deliver huge results.

This is all an act of self-criticism, Pride is a flaw in myself that I am struggling with in my efforts to improve in life and to find my way back to religion.

Learning jiu-jitsu has required me to radically submit, at age 33, to people I would normally avoid going to for advice on other topics. The head coach/owner at our gym is a Puerto Rican guy with barely a high school education*; though at least he has the job title "BJJ coach," most of the other upper belt teachers are blue collar by day, factory workers or in construction or government social work. They're not, broadly speaking, people I would normally seek out as my intellectual superiors. But in the gym, they know vastly more than me, and trying to exercise my own intellect, to pick and choose what I think will work, is a road to nowhere. Luckily, the demonstration of superiority is frequent, rapid, certain, violent, and kinetic. And at that point, if I can soothe my ego past excuses like "bjj is stupid and gay anyway" or "I'm [genetically weak/too old/unique and the advice won't work for me;" then I can make progress if I accept that the guys who beat me up probably have something to teach me, even if I'd smoke them on the LSAT. And without that respect, I probably won't learn anything. But even within the gym, we see the same narrativizing, the same devising of stories and lineages to techniques, used by the professors to hammer home that this move works. It was a favorite of Marcelo, or Renzo, or Gordon Ryan. It's the oldest trick in the book, or it's the brand new meta-game solution that's taking the competitive scene by storm. Because they need to convince the students to study the move diligently, and apply it with confidence, or it won't work, and will be discarded as useless advice.

Because as the Buddha tells us there are:

“Three kinds of wisdom: wisdom from hearing (suta-mayā paññā), wisdom from thinking (cintā-mayā paññā), and wisdom from development (bhāvanā-mayā paññā).”

And while I might have wisdom from hearing, or even wisdom from thinking, until I reach their level I will lack their wisdom from development, the true understanding that makes the advice part of my being.

*Though, realistically his education level does not reflect his genetics. He has two sons, one just became an anesthesiologist, the other is teenage but seems very bright, gets good grades, and is a nationally competitive BJJ phenom. Evidence that ethnic minorities are still working their way through the Great Sort?

Culture War Roundup for the week of August 25, 2025

Of course. And the iterated prisoner's dilemma is a limited model anyways.

But do you really doubt the existence of prior defection in American politics at this point?

Culture War Roundup for the week of August 25, 2025

I am more optimistic, their currently tested designs are innately better than Falcon 9

Citation needed? I would say "currently in testing", but "tested" suggests they've made it to orbit, and AFAIK there are no non-expendable Chinese designs that have reached orbit so far. And even if you consider hop tests and engine tests to be "tested", everything seriously in the works there is basically working off the Falcon 9 playbook.

"Gravity-2 aims to operate at a similar price per kilogram as the SpaceX Falcon 9", which is about what you'd expect from a lineup that looks like someone was frantically cribbing from SpaceX. (which is mostly the right thing for them to do, to be clear; it beats the hell out of Europe's response to SpaceX)

The Hyperbola-3 hasn't had any prices announced yet but it also looks more like "cribbing from Falcon" than "innately better", except for the choice of a methalox rather than kerolox engine.

Deep Blue Aerospace is at the advanced cribbing stage, surpassing its competitors' infographics of not-Falcon-9 and not-Falcon-Heavy rockets by putting a not-Starship rocket at the end.

Pallas-1 gets us back to not-Falcon-9 and not-Falcon-Heavy territory.

The obsession with Falcon Heavy clones is IMHO a bad sign for some of these companies. Even SpaceX admits that Falcon Heavy wasn't worth the trouble in hindsight, and there was a point where if they hadn't already accepted Air Force contracts for it (or if Gwynne Shotwell hadn't talked Musk into staying on the feds' good side) they'd have probably canceled it entirely. The original rationale behind it was that they didn't think Falcon 9 would be nearly as powerful as it was, but after some engine improvements and tank stretching and propellant subcooling the F9 got pushed into the FH weight class, and FH got pushed out into a weight class where (with its small fairing) it will never have enough payloads to pay back the investment.

I don't know much about Tianlong-3. I'd give the company points for being the first Chinese startup to put a liquid-fueled rocket in orbit, but then take away a quarter of those points for being the first to launch a rocket stage unintentionally, to fly for miles out of control before impact, when a test fire stand broke.

Maybe LandSpace is the best bet here? 4 successful Zhuque-2 launches with 2 failures, VTVL and relight tests with Zhuque-3, using methalox now and working on full-flow methalox upgrades. There's no hint of Starship-scale plans in their future, but they're at least setting up to have Starship-quality institutional experience.

But I think what's impressive about the Chinese effort isn't any single rocket design, it's the sheer volume of these efforts. All but one of those companies has already reached orbit, albeit with smaller and less-ambitious designs than what they're working on now. Two of them have reached orbit with liquid-fueled stages. Even if most of them fail or come up with something mediocre, they're actually trying and achieving impressive things quicky. In the US, after SpaceX, our best efforts are probably Blue Origin (made it to orbit after only 25 years!), RocketLab (the Electron would have been impressive if they'd got reusability working, and I'm hopeful for Neutron), Stoke (still just doing hop tests, but actually trying out a potentially better-than-Falcon-9 idea), and maybe Firefly (with no impressive launch vehicle plans, but they made orbit).

and may allow rapid scaling beyond Starships, though this might take 5+ years

Even in the "I made a PowerPoint!" dreams of (the 4th redesign of) the Long March 9, a rocket scaling to Starship is supposed to be not flying before the 2040s.

Culture War Roundup for the week of August 25, 2025

I'm not going to litigate which of Pompey and Caesar defected first

Because you bloody well know that there are many points in the First Triumvirate where he could have crushed Caesar who had demonstrated his danger to him but let his friendship and honor get in the way. A courtesy that Caesar did not pay him later, except perhaps posthumously.

Saint Thomas More was playing a different game

To be sure, but once again it is politics we are talking about, not Godliness. His martyrdom did not change England's course.

Culture War Roundup for the week of August 25, 2025

counterproductive and harmful policy to the US makes sense as a form of vengeance

That probably has something to do with the fact that, while you have provided examples that you call "principled", you've largely handwaved the "revenge" assertions you've made.

Perhaps provide some more concrete examples in an edit to OP?

Culture War Roundup for the week of August 25, 2025

Just no one has even tried to explain how exactly government buying up and owning private enterprise is a smart idea (something that we've been saying isn't good for decades) and why it's a solid goal towards improving the nation's economy and wealth.

Is your modeling of Trump so poor that you attribute it to deliberately wanting to wreck the US economy, during his own term, because fuck the Democrats?

He's just not very committed to specific ideology, he mostly plays things by ear and gut feeling and he has a good feeling about this one. Sometimes his gut feelings are right and sometimes they're wrong. His feeling about sending those B2s to Iran seems to have been pretty much just upside so far. The dust hasn't settled on the tarrifs but at least it didn't lead to the immediate collapse that his detractors were claiming were coming. Governing outside of ideology is what his voters wanted, "Making America Great Again" is spectacularly vague and non-committal as to the method of achieving it after all, and for what it's worth I don't think it's a particularly bad way of going about it in reality. Pure ideology will get you all fruits of that ideology, the good ones but also the rotten ones. A wise king who can pick and choose which fruits to pluck is the best political system, and with the short supply of wise kings nowadays, a businessman with good instincts is not the worst stand-in. Of course, opinions can vary as to whether Trump has good instincts.

Culture War Roundup for the week of August 25, 2025

I have used private healthcare in the UK, both as a cash-paying patient and as an insured patient. The following are basic expectations that the system does, in fact, deliver on.

  1. For simple out-patient procedures like scans, the price-list is available on the provider's website. As a cash-paying patient, you will pay the price on the website. As an insured patient treated in-network, your insurer will pay the price on the website less a small negotiated discount (and your deductible/co-insurance if applicable).
  2. The price for elective surgery (including urgent elective surgery like cancer treatment) will be reasonably predictable. You will receive a written estimate before admission if you want one. If nothing untoward happens, the bill will be within 10% of the estimate.
  3. If you are cash-paying, you can get a "fixed-price" quote for standard procedures. Even if something untoward does happen, your hospital bill will match the quote plus the possible upcharges that were clearly explained on the quote letter. The standard case is that you pay the basic room rate (but nothing else) for an extended hospital stay, and the surgeon's and anaesthetist's bills (but no hospital charges) for any unplanned follow-up surgery.
  4. The up-to-date, accurate list of in-network providers is available on your insurance company's website. Any doctor's secretary knows which insurance companies they are in-network for. Any private hospital or clinic receptionist knows which insurance companies their employer is in-network for.
  5. Pre-authorisations are turned around quickly if the doctor co-operates. 48 hours for simple stuff, a week for complex surgery. The pre-authorisation letter states clearly and in language comprehensible to the average adult what your deductible/co-pay/whatever will be, and the rules are simple enough that this explanation is at most one paragraph.
  6. Pre-authorisations are honoured. You end up paying the deductible/co-pay/whatever that was explained on the pre-authorisation letter, and no more.

The private system in the UK doesn't really touch actual emergencies (there are a few private A&E departments, but they are effectively providing an overpriced out-of-hours GP service), and I understand why they are difficult. But I don't see why the insurance-based system in the US can't deliver the same level of service in non-emergency cases as the insurance-based private system in the UK, particularly given how much more money the US system has to play around with.

Culture War Roundup for the week of August 25, 2025

Well, they can't, can they?

Culture War Roundup for the week of August 25, 2025

I don't want revenge.

In fact I fully understand that it actively degrades the commons and that forgiveness is a higher principle.

I just want you to understand that it is required by "good and effective politics". Without that understanding it's impossible to entertain what forms of reconciliation are even possible.

Culture War Roundup for the week of August 25, 2025

I'm old enough to remember when the boot was on the other foot and the Red Tribe held enough institutional power that the Dixie Chicks could face lost earnings owing to their criticisms of George Bush.

Ever notice that this is the only example the left ever brings up that's newer than McCarthy?

And it's still nonsense. The Dixie Chicks were "cancelled" for actions done as professionals in the job for which they were "cancelled". There wasn't social media back then, but the equivalent to cancellation would be if they were overheard by a reporter making some anti-American comment while eating lunch, and this got reported worldwide, and they lost their job for it. Or if someone dug out some ten year quote they made in their school newspaper which could be vaguely interpreted as not liking America and they were fired for that.

The reason people got upset about the Dixie Chicks being "cancelled" is that they made their anti-Bush comments to a different audience, and they didn't expect their normal audience to find out about it. This often worked back then, but when it didn't, tough luck--they weren't actually speaking privately just because they wanted it concealed from the wrong audience.

Culture War Roundup for the week of August 25, 2025

The implication of this is that the entire rest of the internet exists as a left-wing dominated space.

And no one ever tries this precious stuff there.

Culture War Roundup for the week of August 25, 2025

“When they go low we go high” was the motto for quite a while

It was a nice thing Michelle Obama said, not something that any Democrat that mattered actually did.

Culture War Roundup for the week of August 25, 2025

Given the structure of this deal (same money, equity instead of specific obligations), I suspect "making sure the Trump administration gets the credit" is the main thing here. And that's not revenge or retaliation, it's politics-as-usual.

(I don't think there actually will be any credit to hand out, though certainly Trump will claim it anyway)