Quotulatiousness

June 2, 2019

QotD: Explaining modern female sexuality

Filed under: Health, Law, Quotations — Tags: , , , — Nicholas @ 01:00

I have a theory that for many women, sex, or rather agreeing to have sex is difficult, and especially so for the first time with a new partner. How else to explain the fact that so many women admitted that their first time with a new man was generally experienced in an alcoholic haze? (For those who haven’t been keeping up, the source data is here.) So if confronting herself about her “slutty” behavior (even if the sluttiness is only in her own mind), a woman would like to have an excuse like “Oh, but I was drunk…” and thus can excuse away or justify the indiscretion. Or else, as the original study showed, women can even explain away the drunkenness as just a regular part of the dating process, so therefore it’s okay.

I also believe that this is why so many women have rape fantasies, because “Oh, he forced me to do it…” is likewise an expression that denies the woman’s [shameful] complicity in the act. (Of course, now that it’s become okay to accuse a previous partner with actual rape as part of the excuse, the whole thing has become considerably more sinister, especially as such accusations can take place months or years afterwards and still be considered valid by law enforcement. But for the sake of argument, let’s treat this scenario as but a blip on societal consciousness which will disappear at some point when women regain their sanity. We can only hope.) Certainly, this explains female submissiveness (outside a natural submissive personality anyway), which can be regarded (by women) as a kind of watered-down rape fantasy.

The only time, I think, when self-delusion disappears is when a woman encounters a universal object of female desire, such as a hunky actor or popular musician. Even then, there is a “safety in numbers” excuse — “OMG everybody is crazy about him!” — which makes it okay, or at least, provides a figleaf of an excuse for irresponsibility and sexual licentiousness. You only need a sliver of an excuse, and it will be acceptable, in other words.

Kim du Toit, “Seeking Excuses”, Splendid Isolation, 2017-04-24.

May 31, 2019

QotD: How we gain weight

Filed under: Books, Food, Health, Quotations, Science — Tags: , , — Nicholas @ 01:00

I first learned about [Stephan] Guyenet’s work from his various debates with Gary Taubes and his supporters, where he usually represents the “establishment” side. He is very careful to emphasize that the establishment doesn’t look anything like Taubes’ caricature of it. The establishment doesn’t believe that obesity is just about weak-willed people voluntarily choosing to eat too much, or that obese people would get thin if they just tried diet and exercise, or that all calories are the same. He writes

    The [calories in, calories out or CICO] model is the idea that our body weight is determined by voluntary decisions about how much we eat and move, and in order to control our body weight, all we need is a little advice about how many calories to eat and burn, and a little willpower. The primary defining feature of this model is that it assumes that food intake and body fatness are not regulated. This model seems to exist mostly to make lean people feel smug, since it attributes their leanness entirely to wise voluntary decisions and a strong character. I think at this point, few people in the research world believe the CICO model.

    [Debate opponent Dr. David] Ludwig and I both agree that it provides a poor fit for the evidence. As an alternative, Ludwig proposes the insulin model, which states that the primary cause of obesity is excessive insulin action on fat cells, which in turn is caused principally by rapidly-digesting carbohydrate. According to this model, too much insulin reduces blood levels of glucose and fatty acids (the two primary circulating metabolic fuels), simultaneously leading to hunger, fatigue, and fat gain. Overeating is caused by a kind of “internal starvation”. There are other versions of the insulin model, but this is the one advocated by Ludwig (and Taubes), so it will be my focus.

    But there’s a third model, not mentioned by Ludwig or Taubes, which is the one that predominates in my field. It acknowledges the fact that body weight is regulated, but the regulation happens in the brain, in response to signals from the body that indicate its energy status. Chief among these signals is the hormone leptin, but many others play a role (insulin, ghrelin, glucagon, CCK, GLP-1, glucose, amino acids, etc.)

The Hungry Brain is part of Guyenet’s attempt to explain this third model, and it basically succeeds. But like many “third way” style proposals, it leaves a lot of ambiguity. With CICO, at least you know where you stand – confident that everything is based on willpower and that you can ignore biology completely. And again, with Taubes, you know where you stand – confident that willpower is useless and that low-carb diets will solve everything. The Hungry Brain is a little more complicated, a little harder to get a read on, and at times pretty wishy-washy.

But listening to people’s confidently-asserted simple and elegant ideas was how we got into this mess, so whatever, let’s keep reading.

Scott Alexander, “Book Review: The Hungry Brain“, Slate Star Codex, 2017-04-27.

May 15, 2019

QotD: Women competing against other women

Filed under: Health, Quotations — Tags: , , — Nicholas @ 01:00

There are women out there who still see dressing to please a man as some sort of Stockholm syndrome thing — participating in your own (flouncy, spaghetti-strapped) subjugation. So, it’s possible that those advising you “Don’t change for a man!” are just trying to help you be a modern and empowered woman. Of course, one could argue that actually being a modern and empowered woman means you don’t have to dress like you’re hoping to get a call to clean out a sewer line.

Maybe those in your advice coven really do believe they’re acting in your best interest. Maybe. Social psychologists Roy Baumeister and Jean Twenge report that it’s widely believed that men drive the “cultural suppression of female sexuality” — which could include shaming women for how they dress. However, in reviewing the research, they make a persuasive case that it’s primarily women (often without awareness of their motives) who work to “stifle each other’s sexuality.”

This is right in keeping with research on female competition. While men fight openly — “Bring it! I will ruin you!” — women take a sneakier approach. As female competition researcher Tracy Vaillancourt explains it, women fight for their interests using “indirect aggression,” like gossip, mean looks, disparaging remarks, and other underhanded tactics to “reduce the mate value of a rival.” Underhanded tactics? You know — like suggesting you’re selling out womankind if you wear a skirt or winged eyeliner.

Amy Alkon, “Casual Coroner”, The Science Advice Goddess, 2016-09-20.

May 7, 2019

The Science of Ginger: Why and How it Burns and Its Impact on Cooking | Ginger | What’s Eating Dan?

Filed under: Food, Health, Science — Tags: , — Nicholas @ 02:00

America’s Test Kitchen
Premiered on 22 Mar 2019

Why does ginger burn? Why does ginger turn pink? How come ginger makes meat mushy? Dan answers these questions and more about one of the most interesting ingredients cooks have at their disposal in this episode of What’s Eating Dan?.

Click here to browse our ginger recipes: https://cooks.io/2FlixBy
Click here for our Ginger Snap recipe: https://cooks.io/2JuniOB
Click here for our Ginger-Scallion Everything Sauce recipe: https://cooks.io/2Yh01Tu
How to make Ginger-Milk Curd and the science behind it: https://blog.khymos.org/2014/02/24/gi…

ABOUT US: Located in Boston’s Seaport District in the historic Innovation and Design Building, America’s Test Kitchen features 15,000 square feet of kitchen space including multiple photography and video studios. It is the home of Cook’s Illustrated magazine and Cook’s Country magazine and is the workday destination for more than 60 test cooks, editors, and cookware specialists. Our mission is to test recipes over and over again until we understand how and why they work and until we arrive at the best version.

May 6, 2019

“Casual sex” isn’t actually all that casual to most women

Filed under: Health, Liberty, USA — Tags: , , , , — Nicholas @ 03:00

Suzanne Venker makes the case that the innate physiological and psychological differences between men and women accounting for most women’s much lower comfort level with “no-strings-attached” sexual encounters:

The differences between women and men are vast, and in no domain is this more true than sex. Our bodies alone prove this in spades! If one body carries life and the other doesn’t, this clearly makes the sexes unequal. Newsflash: The birth control pill doesn’t change a woman’s inherent nature — it merely gives the illusion she’s just like a man.

She’s not. A woman’s need to bond with a man, to feel safe and loved and committed to, is crucial for her to feel secure enough to let down her guard sexually. That’s why she feels uneasy about one-night stands. Her body won’t cooperate.

It’s also why men, not women, are the ones who gain the most from casual sex. (To be clear: I’m not arguing that it’s “OK” or even good for men to sleep around; I’m simply pointing out why, from a physical standpoint, they aren’t angst-ridden when they do.)

Women just aren’t designed for one-night stands. What do we think all those films and television programs are about where the man and the woman have sex and he doesn’t call her the next day, so she thinks he’s a jerk? If women were “just like men,” this would never be a theme in the first place.

When it comes to uncommitted sex, women are playing a game they can’t win. Feeling “used,” or like a “booty call,” is the most common experience of women who engage in casual sex, or “hookups,” whether they’re teenagers or grown women. That just isn’t the case for most men.

Every American over the age of 40 knows this to be true, and adults in schools and at home are failing our youth by not passing this wisdom along — particularly when young people are bombarded with the lie that casual sex is empowering.

May 4, 2019

On the Ration | British Pathé

Filed under: Britain, Food, Health, History, WW2 — Tags: — Nicholas @ 02:00

British Pathé
Published on 13 Sep 2016

BON APPETIT – FOOD MONTH ON BRITISH PATHÉ (SEPTEMBER 2016): On the Ration.

A selection of films looking at food rationing during the Second World War.

(Film Ids: 1027.21, 1290.19, 1564.15, 1247.03)

Music:
The Show Must Be Go (incompetech.com)
Licensed under Creative Commons: By Attribution 3.0 License
http://creativecommons.org/licenses/b…

A NEW THEME EVERY MONTH!
Each month, a range of new uploads and playlists tell the story of a particular topic through archive footage. Let us know what themes you’d like to see by leaving us a comment or connecting with us on social media.

BRITISH PATHÉ’S STORY
Before television, people came to movie theatres to watch the news. British Pathé was at the forefront of cinematic journalism, blending information with entertainment to popular effect. Over the course of a century, it documented everything from major armed conflicts and seismic political crises to the curious hobbies and eccentric lives of ordinary people. If it happened, British Pathé filmed it.

Now considered to be the finest newsreel archive in the world, British Pathé is a treasure trove of 85,000 films unrivalled in their historical and cultural significance.

ALL RIGHTS RESERVED

A VIDEO FROM BRITISH PATHÉ. EXPLORE OUR ONLINE CHANNEL, BRITISH PATHÉ TV. IT’S FULL OF GREAT DOCUMENTARIES, FASCINATING INTERVIEWS, AND CLASSIC MOVIES. http://www.britishpathe.tv/

FOR LICENSING ENQUIRIES VISIT http://www.britishpathe.com/

British Pathé also represents the Reuters historical collection, which includes more than 120,000 items from the news agencies Gaumont Graphic (1910-1932), Empire News Bulletin (1926-1930), British Paramount (1931-1957), and Gaumont British (1934-1959), as well as Visnews content from 1957 to the end of 1979. All footage can be viewed on the British Pathé website.
https://www.britishpathe.com/

QotD: Calorie-dense modern snack food

Filed under: Food, Health, Quotations, Science — Tags: — Nicholas @ 01:00

So what does cause this fattening effect? I think the book’s answer is “no single factor, but that doesn’t matter, because capitalism is an optimization process that designs foods to be as rewarding as possible, so however many different factors there are, every single one of them will be present in your bag of Doritos”. But to be more scientific about it, the specific things involved are some combination of sweet/salty/umami tastes, certain ratios of fat and sugar, and reinforced preferences for certain flavors.

Modern food isn’t just unusually rewarding, it’s also unusually bad at making us full. The brain has some pretty sophisticated mechanisms to determine when we’ve eaten enough; these usually involve estimating food’s calorie load from its mass and fiber level. But modern food is calorically dense – it contains many more calories than predicted per unit mass – and fiber-poor. This fools the brain into thinking that we’re eating less than we really are, and shuts down the system that would normally make us feel full once we’ve had enough. Simultaneously, the extremely high level of food reward tricks the brain into thinking that this food is especially nutritionally valuable and that it should relax its normal constraints.

Adding to all of this is the so-called “buffet effect”, where people will eat more calories from a variety of foods presented together than they would from any single food alone. My mother likes to talk about her “extra dessert stomach”, ie the thing where you can gorge yourself on a burger and fries until you’re totally full and couldn’t eat another bite – but then mysteriously find room for an ice cream sundae afterwards. This is apparently a real thing that’s been confirmed in scientific experiments, and a major difference between us and our ancestors. The !Kung Bushmen, everyone’s go-to example of an all-natural hunter-gatherer tribe, apparently get 50% of their calories from a single food, the mongongo nut, and another 40% from meat. Meanwhile, we design our meals to include as many unlike foods as possible – for example, a burger with fries, soda, and a milkshake for dessert. This once again causes the brain to relax its usual strict constraints on appetite and let us eat more than we should.

The book sums all of these things up into the idea of “food reward” making some foods “hyperpalatable” and “seducing” the reward mechanism in order to produce a sort of “food addiction” that leads to “cravings”, the “obesity epidemic”, and a profusion of “scare quotes”.

Scott Alexander, “Book Review: The Hungry Brain”, Slate Star Codex, 2017-04-27.

May 2, 2019

“Wuv, twue wuv”

Filed under: Health, Science — Tags: , , — Nicholas @ 03:00

Debra Soh talks about the neurobiology of “wuv”:

We all remember the first time we fell in love. No matter how strong or independent or free you thought you were, all at once, you became powerless in the face of feelings that, to others, seemed obsessive and irrational.

When you’re in that state, everything reminds you of the one you love. They become the center of your world. Friends say your face lights up when you talk about them. You can’t sleep, you can’t eat. The thought of being without them feels like losing a part of yourself.

There are biological reasons that explain why the experience of being in love feels so overwhelming. These emotions serve an evolutionary purpose. Specifically, they allow two people to bond in a way that increases the likelihood they’ll procreate and maintain an environment in which the resulting offspring survive.

Neurobiologists know that love usually occurs in three phases: lust, attraction and attachment. In the first phase, lust, sex hormones create physiological arousal; in the second phase, attraction, dopamine creates intense feelings associated with the object of one’s desire (often tipping into something that resembles real addiction); and in the third phase, attachment, occurring in established couples, oxytocin and vasopressin (the “cuddle hormones”) facilitate the long-term bonding required to raise children over a time span of years or decades.

Romantic love is an intangible state of mind. But we are coming to understand it more clearly through techniques such as functional magnetic resonance imaging. FMRI, as it’s known, measures brain activity by examining changes in blood flow and oxygenation. These studies typically have involved researchers showing study participants pictures of their lovers, and then contrasting the observed brain activity with the activity observed when the study subjects are shown pictures of friends of the same sex and a similar age.

One of the first fMRI studies in the field found a distinct network of brain regions associated with being, as described by the researchers, “truly, deeply, and madly in love.” These regions included the insula and anterior cingulate cortex, which are associated, respectively, with feelings of desire and happiness. Other regions included those linked to sexual arousal, such as the hypothalamus and amygdala.

April 30, 2019

You Will Never Do Anything Remarkable

Filed under: Health, History, Humour, Space — Tags: , , , , — Nicholas @ 06:00

exurb1a
Published on 28 Apr 2019

Illegitimi non carborundum, yo.

So.
The original line was, “If they give you ruled paper, write the other way.” As far as I can tell it’s Juan Ramón Jiménez’s.

I am also now painfully aware I’ve written a half as ‘2/1’. Sorry maths.

Please note that this wasn’t intended to be a diatribe against critics or experts. They obviously play an important role. It was more directed at the recreational cynicism one comes across in daily life from time to time, generally pointed at young artists. I have had the privilege to meet plenty of people 1000x more talented than me, who are simultaneously doubting their abilities because of some stupid comment made by an unpleasant teacher or jaded family member.

If you are that artist, I really just wanted to say: You’re in good company; the Greats doubted themselves too. Don’t let the bastards get you down and I hope you make all manner of interesting and fantastic things.

The music is the 3rd movement of Big Baus Brahms’ Violin Concerto in D Major: https://youtu.be/Ev45Knhdlp8

I like that piece lots. I hope you do too.

Again, all the very best of luck in your projects.

April 28, 2019

QotD: Innovations in taxation

Filed under: Europe, France, Health, History, Quotations — Tags: , — Nicholas @ 01:00

The door-and-window tax established in France [in the 18th century] is a striking case in point. Its originator must have reasoned that the number of windows and doors in a dwelling was proportional to the dwelling’s size. Thus a tax assessor need not enter the house or measure it, but merely count the doors and windows.

As a simple, workable formula, it was a brilliant stroke, but it was not without consequences. Peasant dwellings were subsequently designed or renovated with the formula in mind so as to have as few openings as possible. While the fiscal losses could be recouped by raising the tax per opening, the long-term effects on the health of the population lasted for more than a century.

James C. Scott, Seeing Like A State: How Certain Schemes to Improve the Human Condition Have Failed, 1998.

April 27, 2019

Dating is dead

Filed under: Health, Randomness — Tags: , , , , — Nicholas @ 03:00

Suzanne Venker discusses the state of dating among the love-lorn Millennials and new-to-relationships members of Generation Z:

Remember when it [dating] was viewed as a step toward a committed relationship or even marriage?

Tell that to anyone under 40, and they’ll look at you like you have three heads.

[…]

According to … the Wall Street Journal, Generation Z, most of whom are currently college-age, is “uniquely bad at dating.” The men and women of this generation are less independent, less resilient and more sheltered than previous generations, it says — and these factors make this generation “romantically challenged.”

That may very well be true, but it’s hardly the end of the conversation.

There are numerous factors at play that explain why men and women under 40 can’t sustain love, or why they can’t manage to get married and build a life together. In my next few posts, I will outline those reasons and offer solutions for how parents and educators can help young people correct what I personally consider to be the most pressing issue of our time.

The first and most obvious is that Generation Z, as well as the Millennials who preceded them, have been given zero guidance and encouragement when it comes to building a relationship with the opposite sex. Women in particular have been explicitly and repeatedly told to do just the opposite: postpone marriage as long as possible, while enjoying the supposed benefits of commitment-free sex, and make a career the center of their lives.

Given this cultural script, why wouldn’t we expect dating to die and relationships to fail? We specifically moved women away from this goal. It’s not their fault — it’s the fault of the adults who failed them.

If a woman’s professional life is considered the #1 most important thing, there’s no reason to date in the traditional sense of the word. The purpose of dating is to determine whether or not the other person is a match, potentially for life. Why go through all the rigamarole if marriage isn’t on your radar? Might as well hookup until you’re ready to settle down.

April 18, 2019

QotD: Roadblocks to deregulating the US healthcare market

Filed under: Bureaucracy, Government, Health, Quotations, USA — Tags: , , , — Nicholas @ 01:00

One problem America has is simply that our government administration isn’t very good. That’s not true across the board — our government statistics are, IMHO, the finest in the world. But there’s stuff that other countries can do that we can’t, either because our government is more decentralized, or because our civil service just isn’t as prestigious (and therefore as full of competent, motivated people) as those in other countries. And our regulatory approach — rules rather than principles based, and highly adversarial — is also suboptimal, and hard to change.

Given how much the government now interferes in health care, that’s a big problem. Given our lack of administrative competency, our first step should be pulling back where we can — trying to push more ordinary expenses onto consumers, for example, who can manage those the same way they manage their aspirin and antacid purchases now. And eliminating the tax deduction for employer sponsored health care would be major. But I fear, politically impossible.

Megan McArdle, “Ask Me Anything”, Reddit, 2017-04-10.

April 17, 2019

QotD: “[E]valuating food by its calorie count is like evaluating literature by the number of pages in a book”

Filed under: Food, Health, Quotations, Science — Tags: , , — Nicholas @ 01:00

… calorie-counting is an ineffective approach to eating. Calories are a crude metric that takes into account nothing about the properties of foods other than the total energy they contain. The value of activities can’t be reduced to a number, and nor can foods. Still calories are listed everywhere, enumerated in enormous fonts on food packaging and across menus and ads for packaged products with nothing to recommend them but a lack of calories.

A calorie is the amount of energy required to raise the temperature of a gram of water by one degree Celsius. The “calories” we talk about in food are the amount of energy released when that food is burned. Of course the first law of thermodynamics applies to humans, so if you take in less energy than you use, it’s impossible to store that energy (as body fat). But the factors that go into energy balance are many. The body burns and stores energy from different foods in different forms at different times in different people in different ways.

That crudity leads to mistakes, like the idea that 200 calories of Skittles are in any way equivalent to 200 calories of salad. In that way, calories have been weaponized by marketers to claim their ingestible products are innocuous. As Coca-Cola has advertised, for one, drinking soda is fine as long as you exercise enough to burn off those calories. That’s reasonable if it weren’t also true that constant exposure to high-sugar foods changes the way our bodies store energy. It’s like saying it’s fine to insult someone as long as you follow it with a compliment.

Worse still are the loudly advertised “100-calorie” packs of sugar-based edible products. They cause insulin levels to surge, affecting nutrient absorption and subsequent hunger in ways fundamentally different from eating 100 calories of almonds or spinach. That’s so much spinach. It would fill your stomach and please the microbes of your bowel.

James Hamblin, “It’s True, Hot Baths Burn Calories: Why calorie counting is almost useless and often misleading”, The Atlantic, 2017-04-13.

April 10, 2019

Theodore Dalrymple on obesity

Filed under: Food, Health — Tags: , , , — Nicholas @ 03:00

His latest in the New English Review:

It hardly requires me to point out that obesity has become a greater threat to the health of the human population in most parts of the world than famine. There was a wonderful cartoon recently in the British magazine, The Oldie, which captured this perfectly. A mother is taking a plate of food away from her child, who is protesting. “Think of the obese millions!” she says to him. When I was young, of course, we were told to finish what was on our plate and to think of the starving millions. Being a precocious little brat, I used to ask how eating what I did not want would help them. Let us just say that the reply was seldom well-reasoned, either in form or content.

It has now become an almost unassailable orthodoxy, at least in medical journals, that obesity is an illness in and of itself: that is to say, it does not merely have medical consequences, but — even without those consequences — is a disease. To be fat is, ipso facto, to be ill, in the same sense as to have Parkinson’s disease is to be ill.

Nor, according to the modern orthodoxy, is obesity to be considered the natural consequence of bad or foolish individual choices, a lack of self-control. That would be to blame the victim. The fat person is in effect the vector of forces that play upon him or her, without any contribution on his or her part.

This is an idea of long gestation. Reading an old text on obesity, published in 1975, and edited by one of my medical mentors, I came across the following quote from a paper written in 1962:

    I wish to propose that obesity is an inherited disorder and due to a genetically determined defect in an enzyme: in other words that people who are fat are born fat, and nothing much can be done about it.

This is like saying that addicted people are born to be addicted, and until doctors discover a technical means of stopping their addiction, they might as well make no efforts on their own behalf. No doubt the people who adhere to this view – that obesity and addiction are illnesses simpliciter – think they are being generous but in fact they are forging psychological manacles. No doubt the fat woman in the bakery was at some level trying to prove to herself that obesity was a fatality and not under any possible individual control.

But is the theory in accord with the scene I have described above? In fact, the scene might lead us to a more nuanced or less categorical view of the problem of obesity (and, by extension, of other social problems) than we might at first adopt.

April 8, 2019

QotD: Why does US healthcare cost so much?

Filed under: Bureaucracy, Business, Economics, Health, Quotations, USA — Tags: , , — Nicholas @ 01:00

This is a hotly debated question in health care policy. Here’s my rough stab at it: the 1970s inflation interacted particularly badly with two pre-existing policy choices: the tax deduction for employer-sponsored health insurance, and Medicare.

Start with employer-sponsored health insurance, which is, as everyone knows, tax advantaged relative to salary, because your employer can deduct it as an expense, but you don’t have to show it as income on your taxes.

This was an incredibly dumb decision, but in the defense of the folks who made it in the 1940s, at the time, health insurance wasn’t very expensive, because the health care system couldn’t do all that much (and the female labor that ran hospitals was cheap due to discrimination, or in the case of nuns, basically free).

Come the 1970s, inflation started causing a problem called “bracket creep”. Back then tax brackets weren’t indexed for inflation, so as inflation went up, folks got pushed into higher and higher tax brackets, even though the buying power of their salary had stayed the same, or [had] gone down. This was great for the government (and is a big reason our deficits were not disastrous in the 1970s), but it was terrible for people, and led to the tax revolts that helped put Reagan in office.

But I digress. The point is that bracket creep made non-taxed benefits much more attractive relative to salary, so insurance started getting more generous. That process has continued for decades. Insurance used to be “major medical” that covered big ticket items like hospital stays. Now we expect it to cover the cost of going to the doctor for the sniffles. Well, if you insulate people from those costs, they will incur more of them.

Effectively, this raises demand for health care services. But the US system, decentralized and litigation-happy, is very bad at controlling the supply side. End result: high costs.

The other thing that happened is Medicare. The original legislation called for reimbursing services at “reasonable and customary rates”. This was a gold mine for doctors and hospitals. In New York, for example, doctors used to be forced to do charity care as the price of their admitting privileges at prestigious city hospitals. Once Medicare came into the picture, there was no need for that! Or to economize on beds; you could always find someone to fill them. Eventually, Medicare tried to crack down (http://reason.com/archives/2011/12/13/medicare-whac-a-mole), but by then, it was damned hard to cut physician and hospital incomes, in part because they had made decisions based on their — like building new hospitals with all private rooms — that couldn’t be undone. Our cost base is permanently higher, and politically, we have shown no will to slash provider incomes. So even though our growth rate is about average for the OECD, we’re growing from a much higher level.

Megan McArdle, “Ask Me Anything”, Reddit, 2017-04-10.

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