Quotulatiousness

March 21, 2018

Playing with Pleasure l HISTORY OF SEX TOYS

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

IT’S HISTORY
Published on 19 Sep 2015

Erotic sex toys like dildos are no modern day invention. Thousands of years ago, stone phalli already served their purposes contributing to lust and passion. Throughout history more inventions like the vibrator have been developed to improve catering to our desire. Although love toys have been around for more than 20.000 years, society and religions have been struggling with their acceptance. Almost as long as they have existed.

March 10, 2018

Carl Jung, “the Madame Blavatsky of psychotherapy”

Filed under: Books, Health, History — Tags: , , , , , — Nicholas @ 03:00

A few notes on Carl Jung, by Anthony Daniels (more often known by his pen name, Theodore Dalrymple), commenting on a biography from several years ago:

What exactly were [Jung’s] achievements? Oddly enough, although this biography is more than 800 pages long (649 of them are text, each of them so closely printed that they are the equivalent of two normal pages), by the time you finish it you will nevertheless be hard put to say. You will know a lot about the petty quarrels and squabbles in which Jung repeatedly engaged, and about the details of his domestic life, but relatively little about why any of these things matter in the first place. The author therefore assumes not only a familiarity with Jung’s ideas, and a sympathy towards them, but that the reader also assumes that Jung is worthy of such a lengthy biography. This is not an assumption I share, and though the book is written in serviceable prose, it contains not a single humorous remark. From very early on, therefore, I picked it up with some words that Macaulay wrote in a review of a two-volume biography of Lord Burleigh echoing through my mind like the insistent snatch of a tune (I quote from memory): Compared with the labour of reading these volumes, all other labour, the labour of thieves on the treadmill, the labour of children in the mines, the labour of slaves on the plantation, is but a pleasant recreation. That Miss Bair has been diligent is indisputably true; that her diligence has been wisely applied, unfortunately, is a more open question.

Some men are born charlatans, some achieve charlatanry, and some have charlatanry thrust upon them. Jung was decidedly not born a charlatan — or at least, he was not one throughout the whole of his career. True, he grew up in a family with a more than average number of table-rappers, which no doubt inclined him later to the study of the esoteric (for it certainly never occurred to him to wonder why the esoteric was, in fact, esoteric), and was subjected in his youth to that Teutonic windiness which comes so easily, though no means inevitably, to those who think and write in the German language. There is nothing quite like esoteric windiness for creating a penumbra of profundity, to which bored society ladies are drawn like flies to dung: and this no doubt explains how he became the Madame Blavatsky of psychotherapy. At the same time, however, he received a thorough grounding in classics as well as in science, spoke four languages fluently, could read Latin as if it were his native tongue, was not bad at Greek, and contributed several expressions to our daily discourse — complex, collective unconscious, archetypes, animus and anima, persona, introvert and extrovert — which by itself is far more than most of us will ever achieve. This is not the same as saying, however, that he contributed to human knowledge: for it is perfectly possible to give names to non-existent entities.

[…]

One of his patients, who has gone down in history as the solar-phallus man, thought (among many other strange things) that there was a phallus that emerged from the sun, and that by causing this solar appendage to move, he controlled the weather, particularly the wind. Jung subsequently discovered, in his reading about ancient myths, that there was a Persian Mithraic belief of exactly the same kind as his patient’s. Now his patient was not a well-educated or widely read man, so it seemed to Jung impossible that he had learnt of the Mithraic myth from external sources. He therefore concluded that the form of myths was almost — as we should now put it — hard-wired into the human psyche, and he called these forms archetypes. The collective unconscious was full of such archetypes.

Jung was a preternaturally unclear writer and thinker: he would never say anything clearly when obfuscation would do. Whether this was from lack of talent or an unconscious appreciation that clarity led to the possibility of contradiction and even refutation, no one can say, but the precise nature of archetypes, their ontological status as it were, has remained unclear ever since. At any rate, the solar-phallus man’s delusion, which he quoted for the rest of his long life, was the rock on which his theory was built: a somewhat inadequate basis for an entire, far-reaching theory about the mental life of all of humanity. But Jung’s theorizing was always like an inverted pyramid: a mountain of speculation resting on a pin-prick of fact.

There were obvious problems with the theory of archetypes. The theory suggested itself to Jung because of the exact, or very close, correspondence between the madman’s delusion and the original Mithraic myth: but how close did correspondences have to be before they were manifestations of archetypes, which were more platonic forms than actual contents of the mind? Only an analyst can say, of course, and there is no public criterion other than the analyst’s authority.

March 9, 2018

Bad news about the Peltzman Effect and opiate use

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

Megan McArdle recounts the US federal government’s attempt to improve automobile safety in the 1960s and the surprisingly mixed results of those efforts on overall safety for drivers (better), pedestrians (worse) and the frequency of non-fatal accidents (higher). Those results were summarized by Sam Peltzman as indicating that most of us have an innate tendency to take more risks when we’re less likely to suffer the costs of those risks (hence, the “Peltzman Effect”). She then talks about a tragic new instance of this in the opiate crisis:

A chemical called naloxone acts as an “opioid antagonist” — which is to say, it reverses the drug’s effects on the body. It can thus save people who have overdosed.

As opioid usage has worsened in the United States, more and more jurisdictions have acted to increase access to naloxone. Not only first responders but also friends, family and even librarians have started to administer it. These state laws were passed at different times, giving researchers Jennifer Doleac and Anita Mukherjee a sort of a natural experiment: They could look at what happened to overdoses in areas that liberalized naloxone access and compare the trends there to places that hadn’t changed their laws.

Their results are grim, to say the least: “We find that broadening Naloxone access led to more opioid-related emergency room visits and more opioid-related theft, with no reduction in opioid-related mortality.”

You can never assume that the results of one study, however well done, are correct. But these results look pretty robust. If they hold up, they would mean that naloxone is not saving lives; all we’re doing is spending a lot of money on naloxone to generate some increase in crime.

It makes a certain amount of sense that the Peltzman Effect would show up particularly strongly in drug users; after all, drugs hijack the brain’s reward system, redirecting it toward drug-seeking even at high personal risk. Drug users, one would think, would be highly likely to recalibrate their risk-taking so that the risk of death remains constant, while the frequency and potency of drug use increases.

The coldly logical response to this would seem to be to discontinue naloxone use. But there’s something repulsive about that conclusion, and Doleac and Mukherjee can’t bring themselves to go there. “Our findings do not necessarily imply that we should stop making Naloxone available to individuals suffering from opioid addiction,” they write, “or those who are at risk of overdose. They do imply that the public health community should acknowledge and prepare for the behavioral effects we find here.”

February 28, 2018

Psychology’s replication failures – “many casualties of the replication crisis do indeed bear a strong resemblance to voodoo”

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

In Psychology Today, Lee Jussim says that once upon a time in the benighted, ignorant past, we generally believed in magic. In these more scientific, advanced, de-mystified days, we believe in psychology. He wonders if there’s actually much of a difference between the two:

Are some of the most famous effects in psychology – priming, stereotype threat, implicit bias – based on smoke and mirrors? Does the widespread credibility given such effects in the face of very weak evidence have a weird kinship with supernatural beliefs?

Many findings in psychology are celebrated in part because they were shocking and seemed almost magical. So magical that psychiatrist Scott Alexander argued that many casualties of the replication crisis do indeed bear a strong resemblance to voodoo — the main difference being an appeal to mysterious unobserved unconscious forces rather than mysterious unobserved supernatural ones.

Belief in the efficacy of voodoo itself can by psychologized: Curses work, some say, because believing you are hexed can kill you. There are similar mind-over-matter tales involving implausibly strong effects from placebos and self-affirmations. Priming studies claim that even thinking about the word “retirement” can transfer the weakness of old age into a young body, and make young people walk slower. The idea that people gravitate toward occupations that sound like their names bears a strange resemblance to sympathetic magic: If you name your daughter Suzie, she’s now more likely to wind up selling shells by the seashore, whereas your son Brandon will be a banker.

Supernatural beliefs are a universal feature of human societies. For people in many tribal societies, magic is serious business — a matter of life and death. Sorcerers can make good money by selling their services, while those accused of sorcery might be killed. The same was true in medieval Europe, where many were executed for supposedly using evil magic against their neighbors.

Belief in magic has retreated in modern times. Science has rendered the world less mysterious, technology has given us more effective control over it, and bureaucratic rules make life more predictable. Magic retreated.

Or did it? Any belief as universal as magic may be marvelously adapted to well-worn ruts in the human brain and encouraged by common structures and rhythms of human interaction.

February 27, 2018

The notion of “uploading” your consciousness

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

Skeptic author Michael Shermer pours cold water on the dreams and hopes of Transhumanists, Cryonicists, Extropians, and Technological Singularity proponents everywhere:

It’s a myth that people live twice as long today as in centuries past. People lived into their 80s and 90s historically, just not very many of them. What modern science, technology, medicine, and public health have done is enable more of us to reach the upper ceiling of our maximum lifespan, but no one will live beyond ~120 years unless there are major breakthroughs.

We are nowhere near the genetic and cellular breakthroughs needed to break through the upper ceiling, although it is noteworthy that companies like Google’s Calico and individuals like Abrey deGrey are working on the problem of ageing, which they treat as an engineering problem. Good. But instead of aiming for 200, 500, or 1000 years, try to solve very specific problems like cancer, Alzheimer’s and other debilitating diseases.

Transhumanists, Cryonicists, Extropianists, and Singularity proponents are pro-science and technology and I support their efforts but extending life through technologies like mind-uploading not only cannot be accomplished anytime soon (centuries at the earliest), it can’t even do what it’s proponents claim: a copy of your connectome (the analogue to your genome that represents all of your memories) is just that—a copy. It is not you. This leads me to a discussion of…

The nature of the self or soul. The connectome (the scientific version of the soul) consists of all of your statically-stored memories. First, there is no fixed set of memories that represents “me” or the self, as those memories are always changing. If I were copied today, at age 63, my memories of when I was, say, 30, are not the same as they were when I was 50 or 40 or even 30 as those memories were fresh in my mind. And, you are not just your memories (your MEMself). You are also your point-of-view self (POVself), the you looking out through your eyes at the world. There is a continuity from one day to the next despite consciousness being interrupted by sleep (or general anaesthesia), but if we were to copy your connectome now through a sophisticated fMRI machine and upload it into a computer and turn it on, your POVself would not suddenly jump from your brain into the computer. It would just be a copy of you. Religions have the same problem. Your MEMself and POVself would still be dead and so a “soul” in heaven would only be a copy, not you.

Whether or not there is an afterlife, we live in this life. Therefore what we do here and now matters whether or not there is a hereafter. How can we live a meaningful and purposeful life? That’s my final chapter, ending with a perspective that our influence continues on indefinitely into the future no matter how long we live, and our species is immortal in the sense that our genes continue indefinitely into the future, making it all the more likely our species will not go extinct once we colonize the moon and Mars so that we become a multi-planetary species.

February 25, 2018

Masculinity and homicidal violence (aka “Not all men…”)

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

In Quillette, William Buckner looks at the violence inherent in the (biological) system. “Help, help, we’re being repressed!”

Understanding patterns of lethal violence among humans requires understanding some important sex differences between males and females. Globally, men are 95 percent of homicide offenders and 79 percent of victims. Sex differences in lethal violence tend to be remarkably consistent, on every continent, across every type of society, from hunter-gatherers to large-scale nation states. In their 2013 study on lethal violence among hunter-gatherers, Douglas Fry and Patrik Söderberg’s data showed that males committed about 96 percent of homicides and were victims 84 percent of the time. In her study on violence in non-state societies, criminologist Amy Nivette shows that, across a number of small-scale pastoralist and agriculturalist societies, males make up 91-98 percent of killers. To illustrate the consistency of this relationship even further: we see the same pattern among chimpanzees, where males make up 92 percent of killers and 73 percent of victims.

To be sure, there is some cross-cultural variation. While I can find no well-studied population where women are known to commit more lethal violence than men, there are some societies where women make up an equal number, or even the majority, of homicide victims. These societies generally seem to have low rates of homicide overall, as the United Nations Office on Drugs and Crime mentions in their 2013 study on global homicide:

    Available data suggest that in countries with very low (and decreasing) homicide rates (less than 1 per 100,000 population), female victims constitute an increasing share of total victims and, in some of those countries, the share of male and female victims appears to be reaching parity.

Hong Kong, with a low homicide rate overall, has a comparatively smaller sex difference in homicide offending, and women make up a majority of homicide victims at 52 percent. Yet even in Hong Kong, males commit 78 percent of reported homicides. The world over, the majority of homicide offenders and victims tend to be reproductive-age males, between their late teens and early 40s.

To understand why this pattern is so consistent across a wide variety of culturally and geographically diverse societies, we need to start by looking at sex differences in reproductive biology.

[…]

Predictably, among humans, males engage in more direct, violent competition for mates than females do, and females provide more caregiving than males do. However, humans are unique in that some male participation in caregiving is ubiquitous across cultures. Human infants are particularly helpless during early development, requiring extensive provisioning and caregiving. Human males face the same tradeoff between securing mating opportunities and providing parental care that males of other species face, and the extent to which males utilize either of these strategies can vary significantly due to social and ecological factors.

Noting these sex differences in reproductive biology and parental investment is important because they help explain why males tend to engage in more violence than females. Aggressively engaging in violent conflict is more likely to reduce a female’s fitness, as it may bring unnecessary danger to her offspring, or cause an injury that may prevent her from reproducing in the future. For a male, however, violent conflict can potentially increase his reproductive success through increases in status, or by aggressively monopolizing access to key resources. Among the Yanomami of the Amazon, and the Nyangatom of East Africa, for example, males who participate in more violence and warfare have increased reproductive success. Even in the contemporary United States, there is evidence that more violent males have more sexual partners.

February 24, 2018

QotD: The use of the [awkward silence] in conversation

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

And then there’s [awkward silence]. I learned this one from the psychoanalysts. Nobody likes an awkward silence. If a patient tells you something, and you are awkwardly silent, then the patient will rush to fill the awkward silence with whatever they can think of, which will probably be whatever they were holding back the first time they started talking. You won’t believe how well this one works until you try it. Just stay silent long enough, and the other person will tell you everything. It’s better than waterboarding.

The only problem is when two psychiatrists meet. One of my attendings tried to [awkward silence] me at the same time I was trying to [awkward silence] him, and we ended up just staring at each other for five minutes until finally I broke down laughing.

“I see you find something funny,” he said. “Tell me more.”

Scott Alexander, “3/4”, Slate Star Codex, 2016-07-12.

February 22, 2018

Dieting and mental health

Filed under: Food, Health — Tags: , — Nicholas @ 05:00

Kaitlin Ugolik discusses her own recent experience of trying a new diet:

We don’t often discuss the mental impact of restrictive diets like Whole30 (no “inflammatory” foods), keto (low carb, high fat) or paleo (foods supposedly eaten during the Paleolithic era). People like to tout the weight loss and mood-boosting effects of these diets, but experts say they can push some of us toward disordered eating.

I tried Whole30 this January, and at first I kind of enjoyed it. I tend to get overwhelmed by options and confused about what’s the latest “right” thing to eat for breakfast, so it was nice to have guidelines. It gave me an excuse to make smoothies and try some new dinner recipes, too.

A few days in, though, I started noticing some disconcerting thoughts. I was reading the labels on everything and starting to think of anything that had any kind of processed sugar — cane sugar, brown rice syrup, anything — as “bad.” I also noticed that some of Whole 30’s carceral language was starting to stick in my head. Foods are labeled as “compliant” or “non-compliant,” for example. Knowing several people who have struggled with eating disorders, I wondered if diets like this, that say you can’t even eat beans or quinoa, might be a gateway to disordered eating for some people. The consensus among the experts I spoke to is that they are.

“All weight-loss diets work against learning to eat ‘normally’ according to appetite cues, which is also called intuitive eating,” said Karen Koenig, a Florida-based social worker who counsels people with eating disorders. “The more we restrict eating—by food type, weighing food, or by counting calories or fat grams—the more we ignore and override our body’s signals for hunger, satisfaction and fullness.”

While some people do benefit from restrictive diets because of their choice-limiting nature, like I did at the beginning, many have a hard time not taking it to the extreme. Most people are taking part in these diets as part of some kind of goal, whether it’s to lose weight, clear up their skin, or just feel better. If (and more likely when) it doesn’t work, it’s normal for anyone to get frustrated. But for people who are already prone to anxiety and obsessive thinking (*raises hand*) or those who have “addictive personalities,” a detox or diet can actually lead to something much more dangerous.

February 18, 2018

The legal loophole that allows profiteering scumbags like Martin Shkreli to gouge the public

Filed under: Bureaucracy, Business, Government, Health, USA — Tags: , , — Nicholas @ 03:00

The US pharmaceutical market is a long way from a freely competitive environment, largely due to the amount of regulatory oversight required by lawmakers and enforced by the Food and Drug Administration (FDA). Among all the regulatory checks and balances, there’s one weird trick that allows predatory companies to reap excess profits legally — the “restricted distribution” loophole:

For immunocompromised adult patients who have the toxoplasmosis parasite, the FDA recommends taking 50 to 75 milligrams of Daraprim a day for up to three weeks, followed by half that dosage for an additional four to five weeks. So at the high end, an adult course of Daraprim therapy for a U.S. patient used to cost around $1,350 total.

While that might not seem cheap, it was a drop in the bucket compared to the cost after Turing Pharmaceuticals, Shkreli’s company, bought the rights to Daraprim and jacked the price up to $750 per pill in 2015. That move increased the cost of one course of treatment to around $75,000.

At that point you might have expected another company to jump in and start offering a generic version of the drug. But Shkreli used a regulatory loophole to keep that from happening.

You see, when a generic manufacturer wants to create a cheap version of a branded drug, it has to buy thousands of doses from the manufacturer in order to run comparison tests. Generic manufacturers use the results of these tests to prove to the FDA that their version is identical to the branded drug that the agency has already approved.

More often than not, the company that holds the marketing and distribution rights to a branded drug will sell those comparison doses to the generic manufacturer without being obstructionist, because that’s the trade-off for receiving a 20-year monopoly by way of a drug patent: The branded manufacturer gets to charge whatever they want for years and years without facing competition, and in exchange for that government-backed monopoly, it’s supposed to sell equivalency samples to generic companies.

But what if the company is run by an unscrupulous asshole like Martin Shkreli? Then it might opt to put the drug into what’s called “restricted distribution,” which means no distributor anywhere can sell comparison samples to a generic manufacturer.

The FDA originally created the concept of restricted distribution to limit the availability of drugs that might be dangerous. Methadone, for instance, was first approved in the 1940s as a painkiller. In the 1970s, the FDA restricted its availability because regulators didn’t want the opioid used for anything other than the treatment of opioid dependence. Even today, methadone can be dispensed only in highly regulated settings and only for one approved reason.

In 2007, Congress empowered the FDA to create an entire system of safety controls beyond restricted distribution, and the agency now requires the manufacturers of certain substances to develop Risk Evaluation and Mitigation Strategies (REMS) to prevent misuse and abuse of potentially problematic compounds.

The list of approved drugs that the FDA says must have an REMS is here. Daraprim is not on that list. You can’t get high off it. It’s not habit forming. Yes, the FDA label says it can be carcinogenic after long periods of use, and that it might cause birth defects if used in high doses by pregnant women. These potential effects are serious, but there is no post-market data suggesting that Daraprim is causing more harm than benefit in the intended patient population. Shkreli’s company put Daraprim into restricted distribution to boost their profits, not protect patients.

February 11, 2018

Bay area food entrepreneurs shut down by local health authorities

Filed under: Business, Food, Government, Health, Technology, USA — Tags: , , — Nicholas @ 03:00

In Reason, Baylen Linnekin recounts the rise and fall of Josephine, an online operation intended to connect home cooks with willing buyers:

A dozen or so years ago, as my friend Dave was planning a move from Washington, D.C., to Philadelphia, he used the need to clean out his fridge before the move as an excuse to offer a half-empty jar of homemade kimchi for sale on Craigslist. While I don’t think the kimchi sold, Dave’s effort opened my eyes to the seemingly limitless possibilities of homemade online food sales.

The truth is that while those possibilities are limited theoretically only by imagination, they very often bump up in the real world against — to paraphrase Waylon Jennings — the limits of what the law will allow.

That truth was evident last week, when Bay Area food startup Josephine announced it will close its doors in March.

As I described in a Sacramento Bee op-ed in support of Josephine last year, the company launched nearly four years ago with a mission to provide cooks who are typically underrepresented in restaurant leadership — including women and immigrants — with a platform by which to sell home-cooked meals with their neighbors.

It’s a cool idea. And it worked quite well for a time. That is, as I noted, until local health officials “sent cease-and-desist letters to several Josephine cooks.”

Josephine responded by trying to work with lawmakers and regulators, pushing a bill in the state legislature that would provide some legal avenue for its cooks. Despite the fact that the bill is now moving through the California legislature, the company decided its passage would be too late for Josephine and its funders.

Josephine didn’t have to die. The regulations that have made it impossible for the company to operate should have died instead. But its fate mimics that of other similar home-food startups. A similar New York-based startup, Umi Kitchen, flamed out last year after just four months of operations. I wrote an appreciation of Forage Underground Market, the inventive San Francisco food swap that was shuttered by California state and local health authorities, way back in 2012. And I predicted at the time the food underground movement was just beginning to blossom.

February 7, 2018

Better Safe than Sorry! l THE HISTORY OF CONTRACEPTION

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

IT’S HISTORY
Published on 26 Sep 2015

The development of contraceptives has come a long way. It all started with questionable ointments and rituals to avoid pregnancy. The effectiveness of new inventions have since improved greatly. Especially the invention of rubber and latex for condoms or contraceptive ideas like the diaphragm or the pill. Learn about the development of contraceptives and their societal standing this episode on IT’S HISTORY.

February 3, 2018

Arizona’s legally protected blow-drying cartel

Filed under: Business, Government, Health, USA — Tags: , , , — Nicholas @ 05:00

Eric Boehm reports on the fantastic lengths protected businesses will go to to protect themselves from “unlicensed” competitors, even in such areas as hair drying:

Brandy Wells never anticipated the amount of vitriolic abuse she would receive over — of all things — her public support of a proposal to let people blow-dry hair without a state-issued license.

“I’ve been called a cunt, a bitch, an ass, trashy, a puppet, a pawn, repugnant,” Wells says. “And my favorite: ‘your logic on deregulation of cosmetology is much like your hair, dull and flat.'”

Wells says she’s received several attacks from cosmetologists on social media accusing her of being “uneducated” or “clueless” about cosmetology because she doesn’t work in the industry. It’s true that Wells isn’t a licensed cosmetologist (though she does, in fact, know how to use a blow-dryer, she confirmed to Reason), but that’s actually the precise reason why she’s speaking up.

Wells serves as the lone “public member” of the Arizona State Board of Cosmetology. That means she is the only member of the seven-person board who does not work in some capacity as a cosmetologist or with a connection to a cosmetology school. Last month, she voiced her support for House Bill 2011, which would removing blow-drying from the state’s cosmetology licensing requirements. Under current law, using a blow-dryer on someone else’s hair, for money, requires more than 1,000 hours of training and an expensive state-issued license. Blow-drying hair without a license could — incredibly — land you in jail for up to six months.

In response, Wells says, members of the cosmetology profession have sent messages to her employer, the Arizona Chamber of Commerce, suggesting that she should be fired — fired because she thinks people can safely blow-dry hair without 1,000 hours of training!

The cosmetology board is “a group of special interest bullies,” said Arizona Gov. Doug Ducey, a Republican, in his recent State of the State address. The board, Ducey said, “is going after people who simply want to make a living blow-drying hair. No scissors involved.”

This week, the fight over the so-called “blow-dry bill” spilled into the state legislature. The state House Military, Veterans, and Regulatory Affairs Committee held its first hearing on the bill, and licensed cosmetologists packed the room to speak one-by-one about the potential dangers of letting unlicensed professionals blow-dry hair

The logical endpoint of socialized medicine

Filed under: Britain, Government, Health — Tags: , — Nicholas @ 03:00

In the Guardian, Nick Cohen explains what Brits will need to do to maintain the National Health Service as their key defining national institution:

If you imagine a healthy future for Britain, or any other country that has put the hunger of millennia behind it, you see a kind of dictatorship. Not a tyranny, but a society that ruthlessly restricts free choice. It is a future that views the mass of people as base creatures jerked around by desires they cannot control. Expert authority must engineer their lives from above for their own good and the common good.

The one who pays the piper calls the tune, and when it’s the government paying the need to keep healthcare costs down will first encourage and later mandate more and more restrictions on the freedoms of the people. Oddly, although he starts out strongly, the rest of the piece falls short of the more stringent restrictions that logic would dictate, concentrating on the relative trivia of expanding pedestrian and bicycle access to downtown areas and corresponding restrictions to private vehicles, plus moving fast food outlets further away from schools.

I can feel the force of the objections. When we imagine a healthier future we are also imagining a more authoritarian state. Individual choice will be constrained and wisdom of the crowd rejected. Women will wonder who will chop the vegetables and cook the dinners when ultra-processed food is taxed to the point of extinction.

Beyond gender lies an undoubted class element in public health campaigns. Sugar and fat addiction, like all addictions, provide a temporary respite for the poor, the depressed and the disappointed. Perhaps we should offer them better lives rather than snatch away the few comforts they enjoy. This sounds a stirring counter-argument. But as any reader who has been an addict will know, addiction prevents you finding a better life. For when you suffer the multiple morbidities of diabetes, arthritis, cancer and strokes, your sicknesses are your life. You do not have the freedom to choose to change it.

God knows, there are good reasons to mistrust experts re-engineering societies from above. But as with tobacco, freedom of choice in the food and car markets has left us with no choice but to trust them.

To safeguard the NHS from bankruptcy, the government will end up looking at quite draconian efforts to reduce or eliminate risks to public health (generously interpreted). First the minor nudges, like raising the prices of alcoholic beverages and tobacco products to discourage smoking and drinking, then perhaps the same for whatever foods are currently considered to be Public Enemy Number One (last year it was fat, this year it’s sugar, next year it might be carbohydrates in general). Then, when the nudges haven’t achieved their intended ends, harsher measures are called for and will need to be implemented over a wider range of products, services and activities, as human beings have an amazing capability to sidestep or avoid what their betters want for them. Exercise will be first encouraged, then demanded, and finally required. Dangerous activities will first be discouraged, then penalized, then finally outlawed.

We’ve already seen the beginnings of the move from mere nudges to more open control, as smokers and the obese are starting to face restrictions on their access to the NHS until they show more than a token obedience to medical authority. Your doctor will slowly morph from mere caregiver to guardian to overseer. All in the name of public health, of course.

H/T to Natalie Solent for the original link.

February 1, 2018

Penn and Teller on Vaccinations

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

UltraMiraculous
Published on 20 Aug 2010

January 13, 2018

The common factor of the Net Neutrality fight and the EpiPen price gouging scandal

Filed under: Bureaucracy, Economics, Government, Health, Technology, USA — Tags: , , , , — Nicholas @ 05:00

Lili Carneglia explains what these two examples of “capitalist excess” are actually the result of regulatory failures:

Without net neutrality, regulations that prevent internet service providers (ISPs) from charging more for priority speeds and higher bandwidth-use sites would disappear. Most Americans are pretty confused by the revised rules but highly skeptical that this action could have any benefits. Many people, especially those living in the rural south where choices are limited, feel like these companies have been taking advantage of their customers for years, and loosening regulatory constraints on these companies seems like a terrible idea.

Net neutrality was a regulatory policy set under the Obama administration in 2015 that mandated ISPs to treat the internet like other utilities, such as highways and railroads, under laws established before most people had TVs. Under these rules, companies must act as neutral gateways to the internet without controlling the content or the speed of the content that passes through that gateway. Supporters of the rule argue that these regulations ensure the free flow of information, while those against the policy see net neutrality as a misapplication that stifles an industry that is more dynamic than other public utilities.

[…]

Yes, a handful of industry giants can and have abused their market power. Most consumers have limited ISPs to choose from in a given area, and options are more limited outside of big cities, where “three-quarters of American homes have no competitive choice for the essential infrastructure for 21st-century economics and democracy,” according to the former FCC chairman Tom Wheeler. It is important to consider how these circumstances came about before deciding that federal regulation might help consumers.

Governments, by and large, prefer to have fewer players in a given market as it makes that market easier to regulate, and the easiest market to regulate is a monopoly. When cable networks were beginning to spread across North America, many local governments were persuaded that a single cable provider would be the best option for their jurisdiction and the broadband internet market that came later was heavily shaped by the already carved-up markets for cable TV. For many, there were no competitive options because the local government had precluded the chance of competition for their already entrenched cable monopoly (or, in a few cases, tight oligopoly).

Competition is the best answer to monopolistic abuse of customers … if you get shitty service from the Blue Cable Company, you’ll be more likely to switch to the Red Cable Company. If you only have Red and Blue to choose from, your leverage is small, but if you have a full rainbow of competing options, Red and Blue are forced to make their services at least comparable to what Orange and Pink and Magenta are offering, or they lose too many customers. If there’s no threat of a competitor scooping up unhappy customers, there’s no incentive for the existing company to do more than the absolute minimum to keep customer complaints down to a dull roar. The customer’s only recourse — other than giving up the service or moving to a different jurisdiction — is to complain to the regulator.

The base problem with Mylan’s EpiPen price gouging is the same: an effective monopoly supported by the government:

The arguments against net neutrality repeals center around fears about what producers will do without regulation since they have significant market power and the ability to raise prices to levels that would not be sustainable under more competitive conditions. The concern about increased internet prices is similar to what happened in 2016 when a pharmaceutical company with market power, Mylan, increased the price of life-saving EpiPens by about 400 percent.

The “greedy” pharmaceutical companies were hung out to dry as Congress berated Mylan representatives in hearing after hearing. There were similar cries of outrage and demands that the federal government do something to prevent such selfish price-gouging, similar to what many consumers fear ISPs will do absent regulations.

Even (supposed) free-market advocates started supporting further regulation during the EpiPen debate. Most notably, then fiscal hawk representative and now Trump budget director Mick Mulvaney, defended further market intervention on the condition that, “If you want to come to the state capitols and lobby us to make us buy your stuff, this is what you get. You get a level of scrutiny and a level of treatment that would ordinarily curl my hair.”

However, in all of those hearings, almost no one bothered to unearth the problem that Mulvaney hinted at: Why was Mylan able to increase that price in the first place? Government intervention. Burdensome FDA regulations and other laws pressuring public schools to buy the drug essentially granted Mylan a monopoly. It was as misguided then as it is now to think that these same institutions can be trusted to clean up the mess they created.

Mylan had no effective competition, so there was nothing to stop the price gouging until it got so bad that even the regulator had to pay attention. If there were other pharmaceutical companies allowed to compete, do you think Mylan would have risked jacking up the price only to watch their competitors gaining market share?

Scott Alexander explained the Mylan monopoly quite expansively in 2016.

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