[We interrupt the previously scheduled rant for another rant.]
At some point, if you are so lucky, you will be old. You may already be old. Somebody you love may already be old. Old people, being people, require medical care, and are often treated – because this is basically what primary care in our society consists of – with medications.
Thing is, old bodies handle medicine differently than young ones.
( Take the liver... [3,340 Words] )
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There seem to be three different groups:
1) Republican Senators who can see that Obamacare is actually about as right-wing a way to have universal healthcare as you can get**, and don't actually want to get rid of it.
2) Republican Senators who may or may not be in favour of Obamacare, but can see that their constituents are now attached to their healthcare, will be furious if they lose it, and only have a slim majority which they are terrified of losing at the next election.
3) Republican Senators who really are against Obamacare.
The problem here is that all three groups need to pretend that they're in category (3), because they've spent the last decade telling their supporters how terrible Obamacare is, to the point where there are voters who support all of the individual parts of the bill, and even the "Affordable Care Act" but will be will be against Obamacare.
And the longer the ACA exists, and the more that voters understand about it (as is happening the more Republicans talk about it) the more popular it gets. To the point where a majority of the public are now in favour of it***. But the Republican Party now has a central point of belief that "Obamacare is bad".
Which means that in order to be against it, but not actually remove it, we're left with a few Republican Senators taking it in turns to vote against repeal, on various largely spurious grounds. Being very careful to say "Oh no, I hate Obamacare as much as the next person. But I can't vote to repeal it this time, because of a minor provision. Maybe next time." - and then the next time a _different_ Republican Senator can do exactly the same thing.
None of which means that Obamacare is safe. It's balanced on a bunch of senators believing that if they repeal it they'll lose their jobs. So every time a repeal bill is put forward they have to be persuaded _again_ that the public still cares. And I am very grateful for my US friends who are involved in getting people to phone their representatives every time it comes up.
But I am moderately hopeful that we'll make it through to the mid-terms without it being repealed. Because I don't think that a majority of the senate actually wants it to be.****
*There were over 50 of these between 2011 and 2014, goodness knows how many we're up to now
**Not surprising, as it's very similar to RomneyCare.
***But only 17% of registered Republicans. It's the swing voters who have moved.
****But don't trust me. This is just my impression from what I've read from, frankly, a long way away.
In general, neither organizations nor individual people do the thing that their supposed role says they should do. Rather they tend to do the things that align with their incentives (which may sometimes be economic, but even more often they are social and psychological). If you want to really change things, you have to change people’s incentives.
But I feel like I’ve had to gradually piece this together from a variety of places, over a long time; I’ve never read anything that would have laid down the whole picture. I remember that Freakonomics had a few chapters about how incentives cause unexpected behavior, but that was mostly about economic incentives, which are just a small part of the whole picture. And it didn’t really focus on the “nothing in the world works the way you’d naively expect” thing; as I recall, it was presented more as a curiosity.
On the other hand, Robin Hanson has had a lot of stuff about “X is not about Y“, but that has mostly been framed in terms of prestige and signaling, which is the kind of stuff that’s certainly an important part of the whole picture (the psychological kind of incentives), but again just a part of the picture. (However, his upcoming book goes into a lot more detail on why and how the publicly-stated motives for human or organizational behavior aren’t actually the true motives.)
And then in social/evolutionary/moral psychology there’s a bunch of stuff about social-psychological incentives, of how we’re motivated to denounce outgroups and form bonds with our ingroups; and how it can be socially costly to have accurate beliefs about outgroups and defend them to your ingroup, whereas it would be much more rewarding to just spread inaccuracies or outright lies about how terrible the outgroups are, and thus increase your own social standing. And how even well-meaning ideologies will by default get hijacked by these kinds of dynamics and become something quite different from what they claimed to be.
But again, that’s just one piece of the whole story. And you can find more isolated pieces of the whole story scattered around in a variety of articles and books, also stuff like the iron law of oligarchy, rational irrationality, public choice theory, etc etc. But no grand synthesis.
There’s also a relevant strand of this in the psychology of motivation/procrastination/habit-formation, on why people keep putting off various things that they claim they want to do, but then don’t. And how small things can reshape people’s behavior, like if somebody ends up as a much more healthy eater just because they don’t happen to have a fast food restaurant conveniently near their route home from work. Which isn’t necessarily so much about incentives themselves, but an important building block in understanding why our behavior tends to be so strongly shaped by things that are entirely separate from consciously-set goals.
Additionally, the things that do drive human behavior are often things like maintaining a self-concept, seeking feelings of connection, autonomy and competence, maintaining status, enforcing various moral intuitions, etc., things that only loosely align one’s behavior with one’s stated goals. Often people may not even realize what exactly it is that they are trying to achieve with their behavior.
“Experiental pica” is a misdirected craving for something that doesn’t actually fulfill the need behind the craving. The term originally comes from a condition where people with a mineral deficiency start eating things like ice, which don’t actually help with the deficiency. Recently I’ve been shifting towards the perspective that, to a first approximation, roughly everything that people do is pica for some deeper desire, with that deeper desire being something like social connection, feeling safe and accepted, or having a feeling of autonomy or competence. That is, most of the things that people will give as reasons for why they are doing something will actually miss the mark, and also that many people are engaging in things that are actually relatively inefficient ways of achieving their true desires, such as pursuing career success when the real goal is social connection. (This doesn’t mean that the underlying desire would never be fulfilled, just that it gets fulfilled less often than it would if people were aware of their true desires.)
Going to Target yesterday was about all I could manage, decided to have conveyor belt sushi for dinner, and then got the trash together once I got home.
Its nice outside today, not sure what I want to do yet.
Its also officially Autumn...
( Loads of photos and four videos )
Finally figured out where I bought the socks I gave to my Godson, his wife wants her own pair, or he needs his own pair cuz she took his.
Got a couple more things out of the Van, and read some more.
Yay, the cover for The Murderbot Diaries III: Rogue Protocol is on Tor.com:
The cover reveal for Murderbot Diaries II, Artificial Condition was here on The Verge:
Art by Jaime Jones
"That is not okay! You can’t do science with two people at once!"
"I mean, you can’t do science with two different people and not tell them about each other!"
(which of course won't make much sense unless you've read the 86 chapters before that part.)
And then I reflected that I could relate a lot more to that statement taken literally, than to that for which it might be interpreted as a metaphor.