Astral Codex Ten Podcast

This is an entry to the Adversarial Collaboration Contest by Mark Davis and Mark Webb, who sent the following introduction along with their entry: Mark Davis is a naturopathic doctor. Naturopathic medicine is a century-old profession in the United States, but it's small, with fewer than 10,000 NDs licensed to practice naturopathic medicine in the US in 2018. The profession has been historically highly skeptical of vaccination in general, and the modern profession is contentiously split on the topic, with vocal advocates of CDC-scheduled routine childhood vaccination and vocal dissidents both offering continuing medical education for NDs. Mark Davis' main goal in this adversarial collaboration was to argue that there is enough reasonable doubt that routine childhood vaccines could contribute to hyper-inflammatory disease, and enough reduced harm from vaccine-preventable diseases from other medical and public health interventions (in countries with greater economic resources) that parents should be given wide latitude to make individual choices re: routine childhood vaccines despite the clear benefits to individual and public health from preventing those diseases. He became more convinced in his conversations with Mark Webb that widespread childhood vaccination is in the best interest of public health. Mark Webb is a clinical researcher – with a current focus in oncology. He completed a PhD in immunology, specifically focused on the mechanisms driving the development of asthma. Mark Webb's main goal in this collaboration was to argue that atopy and autoimmunity are likely not driven by vaccination, and that this idea is a distraction from finding the real causes of the increase in these diseases. Throughout the collaboration, he was reminded of the nature of safety surveillance with all drugs, and of the sensitive nature of vaccination as a medical intervention. He became persuaded that policy should not just reflect the best evidence currently available, but should also reflect a certain degree of humility that there will always be something we don't know.

[This is an entry to the Adversarial Collaboration Contest by John Buridan and Christian Flanery.] Matter: To what extent does liberalism and democracy obtain in Islamic countries. Whether Islam consistently poses political opposition to liberalism and democracy. Two simple narratives have split the western world's perspective on Islam. These two narratives do not exhaust the spectrum of opinion, but they do function well enough to establish the basic controversy around Islamic countries and Liberal Democracy. The first narrative opines that Islam is an ideology inimical to "western values," such as classical liberalism and liberal egalitarianism, and a rival to the Judeo-Christian social mores. It constitutes an ideological rival, inherently aggressive, both unable and unwilling to sustain non-partisan legal systems, democratic norms, fair treatment for opposition parties, protection of dissidents, or the basic rights and freedoms which Western European and Anglophone countries enjoy. And that Islam sustains this undesirable state of affairs. The second is that Islam is not qualitatively different from any other religion. Islam has contributed to civilization in a significant way, and ordinary Muslims share our own values of family, peace, and justice. In contrast to the first narrative which stresses Islam as an ideology, the second narrative emphasizes that Muslims are normal people.There is no problem with Islam eo ipso; the perceived "problems" of Islam are actually some combination of the fairly normal problems of traditional societies, poor socio-economic conditions, and legacy problems from colonialism. In order to avoid a point-scoring debate between these two narratives, our approach is to provide a descriptive examination of the performance of liberal democracy within Islamic environments. We take as granted for this paper that one cannot look at a religion on paper and predict what it will look like in a polity. Religious practice and theological doctrine inform every aspect of the pious person's outlook and life, but the way in which it informs that outlook is not deterministic and cannot be gleaned merely by looking at the source texts, nor by the impossible task of a quantitative comparison of which religion has produced more violence across regions and millenia. Although we believe original texts are not deterministic, that does not mean Islam is totally amorphous. Religious culture is a powerful force within society. It unifies people, allows them to feel part of something bigger and better, it provides solace in their troubles, and can mobilize political action. How that mobilization of power occurs remains largely up to the needs of the moment, but it's that mobilization of power which we are interested in.

[This is an entry to the Adversarial Collaboration Contest by TracingWoodgrains and Michael Pershan (a k-12 math teacher), on advanced students in the education system] "What do America's brightest students hear? Every year, across the nation, students who should be moved ahead at their natural pace of learning are told to stay put. Thousands of students are told to lower their expectations, and put their dreams on hold. Whatever they want to do, their teachers say, it can wait." – A Nation Deceived, p.3 "There is an apparent preference among donors for studying the needs and supporting the welfare of the weak, the vicious, and the incompetent, and a negative disregard of the highly intelligent, leaving them to "shift for themselves." Hollingworth, 1926 1. Eager to Learn and Underachieving Pretend you're a teacher. With 25 students, who gets your attention during class? There's the kid who ask for it, whose hand is constantly up. There's also the quiet kid in the corner who never says a word, but has been lost in math since October, who will fail if you don't do something. There's the student in the middle of the pack, flowing along. Finally, there's the kid who finishes everything quickly. She's looking around and wondering, what am I supposed to do now? In a survey of teachers from 2008, just 23% reported that advanced students were a top priority for them, while 63% reported giving struggling students in their classes the most attention. A 2005 study found the same trend in middle schools, where struggling students receive the bulk of instructional modification and special arrangements. This was true even while 73% agreed that advanced students were too often bored and under-challenged in school. While teachers, it seems, are sympathetic to the smart bored kid, that's just not a priority for them.

This week I'll be presenting entries from the adversarial collaboration contest. Remember, an adversarial collaboration is where two people with opposite views on a controversial issue work together to present a unified summary of the evidence and its implications. In theory it's a good way to make sure you hear the strongest arguments and counterarguments for both sides – like hearing a debate between experts, except all the debate and rhetoric and disagreement have already been done by the time you start reading, so you're just left with the end result. A few months ago, I asked readers to write adversarial collaborations and submit them to me. After the inevitable flakeouts and disappearances, I got four entries: 1. Does the current US education system adequately serve advanced students? (by Michael Pershan and TracingWoodgrains) 2. Is Islam compatible with liberal democracy? (by John Buridan and Christian Flanery) 3. Should childhood vaccination be mandatory? (by Mark Davis and Mark Webb) 4. Should children who identify as transgender start transitioning? (by a_reader and flame7926) I'm going to post one of these per day. Over the weekend, I'll post a link to a poll where readers can vote for their favorite. I'm also going to vote for my favorite, and my vote will be worth 5% of the total number of reader votes. Whoever gets the most votes wins. The prize is $1000; thanks to everyone who donates to the Patreon for making this possible. Please put any comments about the contest itself here, not on the individual entries.

Commenters on yesterday's post brought up an important point: sometimes bureaucracies aren't just inefficient information gathering and processing mechanisms. Sometimes they're the active ingredient in a plan. Imagine there's a new $10,000 medication. Insurance companies are legally required to give it to people who really need it and would die without it. But they don't want somebody who's only a little bit sick demanding it as a "lifestyle" drug. In principle doctors are supposed to help with this, but doctors have no incentive to ever say no to their patients. If the insurance just sends the doctor a form asking "does this patient really need this medication?", the doctor will always just check "yes" and send it back. Even if the form says in big red letters PLEASE ONLY SAY YES IF THERE IS AN IMPORTANT MEDICAL NEED, the doctor will still check "yes" more often than a rational central planner allocating scarce resources would like. And insurance companies are sometimes paranoid about refusing to do things doctors say are important, because sometimes the doctor was right and then they can get sued. But imagine it takes the doctor an hour of painful phone calls to even get the right person from the insurance company on the line. Now there's a cost involved. If your patient is going to die without the medication, you'll probably groan and start making the phone calls. But if your patient doesn't really need it, and you just wanted to approve it in order to be nice, now you might start having a heartfelt talk with your patient about the importance of trying less expensive medications before jumping right to the $10,000 one.

A surprisingly common part of my life: a patient asks me for a doctor's note for back pain or something. Usually it's a situation like their work chair hurts their back, and their work won't let them bring in their own chair unless they have a doctor's note saying they have back pain, and they have no doctor except me, and their insurance wants them to embark on a three month odyssey of phone calls and waiting lists for them to get one. In favor of writing the note: It would take me all of five seconds. I completely believe my patients when they say their insurance is demanding the three month odyssey. Or sometimes they don't have insurance and it would be a major financial burden for them to consult another doctor. Also, I've seen these other doctors and they have no objective test for back pain. 90% of the time they just have the patient stand in front of them, make whatever movement it is that hurts their back, ask the patient if it hurt their back, and when the patient says yes, the doctor says "That's back pain all right, take some aspirin or ibuprofen or whatever". Against writing the note: I am a psychiatrist. I usually treat patients via telemedicine, which means that in many cases I have literally never seen their back. All I remember about back pain from medical school is that some people call it "lumbago", a word that stuck in my head because it sounds like a cryptid or small African nation. I know even less about the ergonomics of chairs, or when people do vs. don't require better ones. Any note I write about back pain and chair recommendations is going to be a total sham, bordering on medical fraud. I could demand my patient take time off work to come in for an examination, sometimes from several hours away, just so I can do the thing where they bend their back in front of me and tell me it hurts. But that's kind of just passing the shamminess a little bit down the line in a way that seriously inconveniences them.

Say a prayer for John McCain Who passes from his earthly pain His eyes are shut upon his brow He warmongers to angels now Beyond the sky, where sorrows cease He rails against the Prince of Peace. The Holy Spirit, full of love McCain denounces as "a dove" All of the weak and the cowardly policies Heaven pursues that let sin subsist still Six thousand years of detente with the darkness In hippie cliches about "choice" and "free will" All the fifth-columnists, communists, peaceniks Since ur-commie Lucifer fell from the dawn John McCain pounds them, he trounces, denounces them Hounds them and counsels them: cease and begone All of the saints and the hosts of the angels Run to their weapons of lightning and flame Their swords made of sunbeams and sighs of the martyrs, Their gossamer banners of God's awesome Name, Their heavenly helmets and holy habergeons, Whose breastplates are bright with the light of the dawn; The Archangel Michael in malachite armor Blows blasts on his trumpet and beckons them on Reader, should your weather be Meteors falling lazily Or if your neighborhood should seem A John of Patmos fever dream Then say a prayer for John McCain Now passed beyond all earthly pain Not death, with all the peace it brings Could end his love of bombing things

[Content note: reading this post might cause feelings of suffocation or provoke panic attacks in susceptible individuals. Epistemic status is very speculative.] Last month I moved into a small cottage behind a big group house. The cottage is lovely. The big group house is also lovely, but the people in it started suffering mysterious minor ailments. Headaches, fatigue, poor sleep – all the things that will make your local family doctor say "Take two placebo and call me in the morning". Using my years of medical training and expertise, I was able to…remain completely unaware of the problem while my housemates solved it themselves. There's been a flare-up of research interest in indoor carbon dioxide levels, precipitated by a Berkeley study (paper, popular article) finding that increasing CO2 concentration from the level of a well-ventilated building to the level of a poorly-ventilated building had profound effects on cognitive ability, cutting various test scores by as much as 50%. This was so dramatic as to be implausible, but seems to match the result of previous Hungarian studies and a later Harvard study on the same subject. The Harvard team later replicated their result with real workers in real offices and found that, controlling for other factors, workers in the best-ventilated offices scoredabout 25% better on cognitive tests than in the worst-ventilated ones. NASA got really interested in this research because spaceships require a lot of intellectual work and don't have a lot of open windows. They're still running tests but they say that "preliminary results suggest differences" between better- and worse- ventilated environments. On the other hand, a 2017 study failed to find the effect, possibly because their cognitive tests were easier. And bloggers have pointed out that submarines have more CO2 than the worst terrestrial buildings, but don't have any problems overt enough for the Navy to notice or worry. So it's a crapshoot of contradictory results and considerations, just like everything else. Aware of this research, my housemates tested their air quality and got levels between 1000 and 3000 ppm, around the level of the worst high-CO2 conditions in the studies. They started leaving their windows open and buying industrial quantities of succulent plants, and the problems mostly disappeared. Since then they've spread the word to other people we know afflicted with mysterious fatigue, some of whom have also noticed positive results.

Effective altruism ("EA") is a movement dedicated to redirecting charity-related resources to the most important and successful charities. In practice this involves a lot of research into how important various problems are, and how well various charities work. Some of this research is done by well-funded official institutions. Other research, maybe exploring more unlikely scenarios or starting from weirder assumptions, is done as individual labors of love. These smaller-scale efforts might be self-funded, or supported by a few small donors. For example, Wild Animal Suffering Research, which investigates ways to improve the lives of animals in the wild, has yet to catch the attention of any hedge fund managers. Like everything else, effective altruism is centered around San Francisco. San Francisco is the most expensive city in the world, so this isn't very efficient; most of the relevant research can be done online from anywhere in the world. The official institutional charities eat the expense in exchange for the extra access to funders and other resources, but it's a problem for small independent organizations. There's been lots of research into possible solutions, but only if "let's see how many people we can cram into one house in Berkeley" counts as "research". Blackpool is a beach resort in northern England. "Beach resort in northern England" is exactly as fun as it sounds, so nobody goes there. Everything is really cheap, and you can buy a whole hotel for the cost of a parking spot in San Francisco. Enter Greg Colbourn, an effective altruist and successful cryptocurrency investor. He bought the 17-bedroom Hotel Athena and wants to offer free room and board to researchers working on effective altruist projects Colbourn writes:: Do you long to be free from material needs and be able to focus on the real work you want to do? I know I've certainly been in that situation a few times in the past, but instead have lost time doing unimportant and menial jobs in order to be able to get by financially. Talented effective altruists losing time like this is especially tragic given that a lot of cause areas are currently constrained by the amount of quality direct work being done in them. Buildings in the run-down seaside holiday resort of Blackpool (UK) are really cheap. I've bought a 17 bedroom hotel with dining room, lounge and bar for £130k. Assuming a 7% rental yield (which is reasonably high), this works out at about £45 per person per month rent. Factoring in bills, catering, and a modest stipend/entertainment budget, living costs could be as low as £5700/person/year (or lower for people sharing rooms, see budget). This is amazing value for hotel living with all basic services provided. The idea is to invite people to live there, with all their expenses covered by donors, for up to two years. Funding is already in place (via me) for the first year of operations. The project will be managed by someone who lives on site and deals with all the admin/finances, shopping/cooking/cleaning/laundry, socials/events and morale – they will also have free living expenses, and be paid a modest salary. Note that this should be considered as a potential high impact, high prestige supporting role, for those excited to be involved in such a capacity on an EA mission. Guests will be free from concerns of material survival, and be able to have prolonged and uninterrupted focus on whatever projects they are working on. Obviously these will be largely limited to purely desk-based, or remote work.

Because I hate you, I included this question on the SSC survey: It's a weird trick question, but I would say B is right. Imagine converting "(" to X and ")" to Y. Then the first answer is XYXY, and the second answer is YXXY. I suppose you could group the parentheses in pairs, in which case the answer would be "both", but in practice few people wanted to say that. Of the 6,000 answers I received, most were either A or B. And one factor had a dramatic effect: age. This is a big effect. People in their 20s were more than twice as likely to choose B as people their 60s. There's a slight improvement after 70, but I think that's just noise caused by a low sample size in that group. My first thought was that the younger population on this blog is disproportionately techies, and techies have to work with very finicky parentheses all day. There was indeed a slight tendency for techies to do better on this, but it was a very small part of the effect. Even controlling for that, or limiting the analysis to only non-techies, most of the effect remained.

Traffic to this blog is declining. I need to act decisively to draw people back. Write something so interesting it can't help but go viral. I'm going to write about…negative results from the perception questions on last year's survey. The last SSC survey had a lot of optical illusions and visual riddles. I had hoped to expand on some of the work in Why Are Transgender People Immune To Optical Illusions and Can We Link Perception And Cognition? This post is a very brief summary of results and, basically, an admission of failure. While I was able to replicate the same suggestive results as in the last survey, I was unable to expand on them, strengthen them, or really turn them into any kind of interesting framework. I was able to weakly replicate the headline result from Why Are Transgender People Immune To Optical Illusions: transgender status still correlated with all three mask illusions, and with the average of all three mask illusions, but very weakly: r = -0.04, p = 0.001. This was true even when I excluded everyone who took place in last year's survey, providing an independent confirmation of the result. But with correlations this low, it's hard to get too excited. I was also able to weakly replicate the headline result from Can We Link Perception And Cognition?. I haphazardly gave people a "weirdness score" based on them having more mental illnesses, more unusual political opinions, and more minority sexual/gender identities (without looking at their illusion results). People with higher weirdness scores consistently had more ambiguity-tolerant results on illusions, with correlations around r = 0.05 for most tests. They also had notably higher average Tolerance of Uncertainty Test scores. But none of these results were very striking and there was minimal individual structure in them. If I was going to take this further I would have come up with a more principled definition of weirdness, but at this point it doesn't seem worth it.

Introduction ADHD is typically considered a disorder of attention and focus. There are various other traits everyone knows are linked – officially, hyperactivity and "behavior problems"; unofficially, anger and thrill-seeking – but most people consider these to be some sort of effect of the general attention deficit. Dr. William Dodson pushes a different conception, where one of the key features of ADHD is "rejection-sensitive dysphoria", ie people with the condition are much less able to tolerate social rejection, and more likely to find it unbearable and organize their lives around avoiding it. He doesn't deny the attention and focus symptoms; he just thinks that rejection sensitivity needs to be considered a key part of the disorder. I say "Dr. William Dodson pushes", but this requires a little research before it becomes apparent. What a Google search shows is just a bunch of articles saying that rejection sensitivity is a key part of ADHD that gets ignored by non-expert psychiatrists and that it's important to educate patients about it and include it in any treatment plan. My conclusion is that all of these articles can be traced back to Dr. Dodson or people inspired by Dr. Dodson, of which there are many. The ADHD patient community has gotten really into this and pushed it in a lot of support groups and patient communities and so on, where it is repeated uncritically as "an important ADHD feature psychiatrists often forget about". But the genesis is just Dr. Dodson saying so, with limited formal evidence.

Thanks to everyone who offered to host a meetup. We're scheduled for meetups in 77 cities (and one ship!) in 23 countries, soundly beating last year's list. Full list of cities, times, and places is below. Most people who are on the fence have said they've enjoyed going. Most people who felt intimidated about going have said they've enjoyed going. Most people who felt they were too different from the median SSC reader to fit in have enjoyed going. Most people who worried they weren't smart enough to fit in have enjoyed going. Etc. Some tips from past experience with these meetups: 1. If you're the host, bring a sign that says "SSC MEETUP" and prop it up somewhere on a table 2. Bring blank labels and pens for nametags. 3. Pass around a paper where everyone gives their name and email address, so you can start a mailing list to make organizing future meetups easier 4. If it's the first meetup, people are probably just going to want to talk, and if you try to organize some kind of "fun" "event" it'll probably just be annoying. 5. Some things that have worked for later meetups include people giving short presentations on topics of interest to them, or discussion of some particular blog post 6. Nothing is going to get done unless there's a Schelling point for who has to do it, and right now that's the meetup organizer. 7. It's much easier to schedule a second meetup while you're having the first compared to trying to do it later on by email 8. Surprisingly many people will love you forever if you bring stim toys 9. In case people want to get to know each other better outside the meetup, you might want to mention reciprocity.io, the rationalist friend-finder/dating site. It runs off Facebook, so you have to Facebook friend the other person first. 10. If you have a vague location like "in the mall" or "at the North Park", nobody will ever find each other. Give a specific place (eg "at the North Park, by the big oak tree in the northwest corner") and be carrying a sign saying "SSC MEETUP". If you were too vague in your description, comment with a better one and I can edit it in. Remaining issues with the times and dates: – Brisbane's time was unclear; please confirm I got it right – Portland did not provide readable information (seriously, ROT12?!) and will have to be clearer and give a location – Copenhagen should finish their debate about whether to move the meetup somewhere else – Paris has a weird phone number with words in it. I don't know if this is a mistake or just how French phone numbers work

STUDY: Trigger Warnings Are Harmful To College Students says the Daily Wire, describing a study whose participants' average age was 37 and which did not measure harm. You can find the study involved here. A group of Harvard scientists asked 370 people on Mechanical Turk to read some disturbing passages – for example, a graphic murder scene from Crime and Punishment. Half the participants received the following trigger warning before the passage: TRIGGER WARNING: The passage you are about to read contains disturbing content and may trigger an anxiety response, especially in those who have a history of trauma Participants were asked to rate their anxiety before and after reading the passages. After they had finished, they were asked to fill out a bunch of questionnaires that measured their opinions about how trauma worked. The researchers found that people who received the trigger warning were 5% more likely to endorse the idea that they were vulnerable to trauma, and also 5% more likely to endorse the belief that people with trauma could suffer persistent negative effects from that trauma. There were some subgroup and moderation analyses which I ignore for the usual reasons. What might be some causes for concern with this study? First, Stuart Ritchie points out that the results are statistically weak. Most of the results have p-values around 0.05, and are not corrected for multiple testing. That means it hasn't been formally proven whether or not the results are random chance. I don't like haggling over whether something is just above or just below a significance threshold. But if you do like that kind of haggling, this study doesn't survive it very well.

Official statistics say we are winning the War on Cancer. Cancer incidence rates, mortality rates, and five-year-survival rates have generally been moving in the right direction over the past few decades. More skeptical people offer an alternate narrative. Cancer incidence and mortality rates are increasing for some cancers. They are decreasing for others, but the credit goes to social factors like smoking cessation and not to medical advances. Survival rates are increasing only because cancers are getting detected earlier. Suppose a certain cancer is untreatable and will kill you in ten years. If it's always discovered after seven years, five-year-survival-rate will be 0%. If it's always discovered after two years, five-year-survival-rate will be 100%. Better screening can shift the percent of cases discovered after seven years vs. two years, and so shift the five-year-survival rate, but the same number of people will be dying of cancer as ever. This post tries to figure out which narrative is more accurate. First, incidence of cancer: This chart doesn't look good (in both senses of a chart not looking good – seriously, put some pride into your work). Although there's a positive trend since 2001, it's overwhelmed by a general worsening since 1975. But this isn't the right way to look at things: average age has increased since 1975. Since older people are at higher risk of cancer, an older population will look like higher cancer rates. Also, something has to kill you, so if other issues like violent crime or heart disease get better, it will look like a higher cancer rate.

"Nobody makes an IRC channel for no reason. Who are we doing this versus?" — topic of #slatestarcodex I. Some old news I only just heard about: PETA is offering to pay the water bills for needy Detroit families if (and only if) those families agree to stop eating meat. (this story makes more sense if you know Detroit is in a crisis where the bankrupt city government is trying to increase revenues by cracking down on poor people who can't pay for the water they use.) Predictably, the move has caused a backlash. The International Business Times, in what I can only assume is an attempted pun, describes them as "drowning in backlash". Groundswell thinks it's a "big blunder". Daily Banter says it's "exactly why everyone hates PETA". Jezebel calls them "assholes", and we can all agree Jezebel knows a thing or two about assholery. Of course, this is par for the course for PETA, who have previously engaged in campaigns like throwing red paint on fashion models who wear fur, juxtaposing pictures of animals with Holocaust victims, juxtaposing pictures of animals with African-American slaves, and ads featuring naked people that cross the line into pornography. People call these things "blunders", but consider the alternative. Vegan Outreach is an extremely responsible charity doing excellent and unimpeachable work in the same area PETA is. Nobody has heard of them. Everybodyhas heard of PETA, precisely because of the interminable stupid debates about "did this publicity stunt cross the line?" While not everyone is a vegan, pretty much everybody who knows anything about factory farming is upset by it. There is pretty much zero room for PETA to convert people from pro-factory-farming to anti-factory-farming, because there aren't any radical grassroot pro-factory-farming activists to be found. Their problem isn't lack of agreement. It's lack of publicity. PETA creates publicity, but at a cost. Everybody's talking about PETA, which is sort of like everybody talking about ethical treatment of animals, which is sort of a victory. But most of the talk is "I hate them and they make me really angry." Some of the talk is even "I am going to eat a lot more animals just to make PETA mad."

The Tourist Board of Xanadu Did recently impose a fee On those who travel far from home To visit Kubla's pleasure dome Of $20, 9 – 3 So twice five miles of fertile ground With fence and wire are girdled round And signs proclaiming "ENTRY AT THE GATE" Where gather many a camera-bearing crowd And here are docents, who in solemn state Explain the Mongol histories aloud But oh! That deep romantic chasm protracting Into a hill, athwart a cedarn cover A savage region, visitors attracting By actresses, forever reenacting A woman wailing to her demon-lover And from this chasm, with ceaseless turmoil spilling Crowds of old men in fat thick pants are milling And there, a fountain momently is forced: Amid whose swift half-intermitted burst Groups of eight to ten people, screaming ever White-water-raft upon the sacred river

[Previously in sequence: Fundamental Value Differences Are Not That Fundamental, The Whole City Is Center. This post might not make a lot of sense if you haven't read those first.] I. Thanks to everyone who commented on last week's posts. Some of the best comments seemed to converge on an idea like this: Confusing in that people who rely on lower-level features are placed higher, but the other way would have been confusing too. We need to navigate complicated philosophical questions in order to decide how to act, what to do, what behaviors to incentivize, what behaviors to punish, what signals to send, and even how to have a society at all. Sometimes we can use theories from science and mathematics to explicitly model how a system works and what we want from it. But even the scholars who understand these insights rarely know exactly how to objectively apply them in the real world. Yet anyone who lives with others needs to be able to do these things; not just scholars but ordinary people, children, and even chimpanzees. So sometimes we use heuristics and approximations. Evolution has given us some of them as instincts. Children learn others as practically-innate hyperpriors before they're old enough to think about what they're doing. And cultural evolution creates others alongside the institutitions that encourage and enforce them. In the simplest case, we just feel some kind of emotional attraction or aversion to something. In other cases, the emotions are so compelling that we crystallize them into a sort of metaphysical essence that explains them. And in the most complicated cases, we endorse the values implied by those metaphysical essences above and beyond whatever values we were trying to model in the first place. Some examples: People and animals need a diet with the right number of calories, the right macronutrient ratios, and the right vitamins and minerals. A few nutritional scientists know enough to figure out what's going on explicitly. Everyone else has evolved instincts that guide them through this process. Hunger and satiety are such instincts; when they're working well, they make sure someone eats as much as they need and no more. So are occasional cravings for some food with exactly the right nutrient – most common in high-nutrient-use states like pregnancy. But along with these innate heuristics, we have culturally determined ones. Everyone has a vague sense that potato chips are "unhealthy" and spinach is "healthy", though most people can't explain why. Instead of asking ordinary people and children to calculate their macronutrient and micronutrient profile, we ask them to eat "healthy" foods and avoid "unhealthy" foods. There's something sort of metaphysical about this – as if "health" were a magic essence that adheres to apples. And in fact, sometimes this goes wrong and people will do things like blend a thousand apples into some hyper-pure apple-elixir to get extra health-essence – but overall it mostly works. EXPLICIT MODEL: Trying to count how many calories and milligrams of each nutrient you get EMOTIONAL EXPERIENCE: Feeling hungry or full REIFIED ESSENCE: Some foods are inherently healthy or unhealthy ENDORSED VALUE: Insisting on only eating organic foods even when those foods have no quantifiable benefit over nonorganic Every society has some kind of punishment for people who don't follow their norms, whether it's ostracism or community service or beheading. There's a good consequentialist grounding for why this is necessary, with some of the most academic work being done in the field of prisoners' dilemmas and tit-for-tat strategies. But again, we don't expect ordinary people, children, and chimpanzees to absorb this work. The solution is the (innate? culturally learned? some combination of both?) idea of punishment. Punishment relies on a weird metaphysical essence of moral desert; people who do bad things deserve to suffer. The balance of the Universe is somehow off when a crime goes unavenged. Take this too far and you get the Erinyes and the idea that justice is the most important thing. There are references from ancient China to Hamlet that if you have something important you need to avenge, you need to do that now or you're a bad person. None of this follows from the game theory, but it's a really good way to enforce the game-theoretically correct action. EXPLICIT MODEL: Trying to figure out how to best deter antisocial behavior and optimize society EMOTIONAL EXPERIENCE: Feeling angry when someone wrongs you REIFIED ESSENCE: Justice: the world is out of balance when crimes go unavenged ENDORSED VALUE: Wrongdoers must suffer whether or not that prevents future crimes

Related to yesterday's post on people being too quick to assume value differences: some of the simplest fake value differences are where people make a big deal about routing around a certain word. And some of the most complicated real value differences are where some people follow a strategy explicitly and other people follow heuristics that approximate that strategy. There's a popular mental health mantra that "there's no such thing as laziness" (here are ten different articles with approximately that title: 1, 2, 3, 4, 5, 6, 7, 8, 9, 10). They all make the same basically good point. We shame people who don't work very hard as "lazy", and think they should have lower status than the rest of us. But actually, these people don't just randomly choose not to work. Some of them have psychological issues, like anxiety and trauma that are constantly distracting them from their work, or a fear of success, or self-defeating beliefs about how nothing they do matters anyway. Others have biological issues – maybe hypothyroidism, or vitamin deficiencies, or ADHD, or other things we don't understand that lower their energy and motivation. Still others just don't want to do the specific thing we are asking them to do right now and can't force themselves to work uphill against that gradient. When we call people "lazy", we're ignorantly dismissing all these possibilities in favor of a moralistic judgment. A dialogue: Sophisticus: I don't believe in laziness. Simplicio: What about my cousin Larry? He keeps promising to do important errands for his friends and family, and then he never does them. Instead he just plays video games all the time. This has happened consistently over the past few years, every time he's promised to do something. One time my aunt asked him to go to the DMV to get some paperwork filled out, he promised he would do it, and then he kept putting it off for a month until it was past the deadline and she almost lost her car. He didn't forget about it or anything, he just couldn't bring himself to go out and do it. And he's been fired from his last three jobs for not showing up, and… Sophisticus: Yes, yes, I'm sure there are people like this. But he probably has some self-defeating beliefs, or vitamin deficiencies, or mental health issues. Simplicio: Okay. Well, my mother is going to be away for the next week, and she needs someone to dog-sit for her. Her dog is old and sick and requires a lot of care each day. She's terrified that if he doesn't get his food and medication and daily walk on time, something terrible will happen to him. She's willing to pay a lot of money. Do you think I should recommend she ask my cousin Larry? Sophisticus: No, of course not. Simplicio: Why not? Sophisticus: He probably won't do it. He'll just play video games instead. Simplicio: Why do you think so? Sophisticus: Because he has a long history of playing video games instead of doing important tasks. Simplicio: If only there were a word for the sort of person who does that! Sophisticus: Oh, I see. Now you're making fun of me. But I'm not saying everyone is equally reliable. I'm saying that instead of denouncing someone as "lazy", we should look for the cause and try to help them. Simplicio: Hey, we did try to help him. Larry's family has taken him to the doctor loads of times. They didn't anything on the lab tests, but the psychiatrist thought he might be ADHD and gave him some Adderall. I would say now he pulls through on like 20% of the things we ask him to do instead of zero percent. We also tried to get him to go to therapy, but the therapist deferred because ADHD has a very low therapy response rate. His parents tried to change the way they asked him to do things to make it easier for him, or to let him choose a different set of tasks that were more to his liking, but that only worked a little, if at all. Probably there's some cause we don't understand, but it's beyond the reach of medical science, incentive design, or the understanding that exists between loving family members to identify. Sophisticus: See! The Adderall helped! And letting him choose his own tasks helped a little too! Simplicio: I agree it helped a little. So should I recommend him to my mother as a dog-sitter? Sophisticus: No, of course not. Simplicio: Then I still don't see what the difference between us is. I agree it was worth having him go to the doctor and the therapist to rule out any obvious biological or psychological issues, and to test different ways of interacting with him in case our interaction style was making things worse. You agree that since this still hasn't made him reliably fulfill his responsibilities and we don't have any better ideas, he's a bad choice for a dog-sitter. Why can't I communicate the state of affairs we both agree on to my mother using the word "lazy"?

Ozy (and others) talk about fundamental value differences as a barrier to cooperation. On their model (as I understand it) there are at least two kinds of disagreement. In the first, people share values but disagree about facts. For example, you and I may both want to help the Third World. But you believe foreign aid helps the Third World, and I believe it props up corrupt governments and discourages economic self-sufficiency. We should remain allies while investigating the true effect of foreign aid, after which our disagreement will disappear. In the second, you and I have fundamentally different values. Perhaps you want to help the Third World, but I believe that a country should only look after its own citizens. In this case there's nothing to be done. You consider me a heartless monster who wants foreigners to starve, and I consider you a heartless monster who wants to steal from my neighbors to support random people halfway across the world. While we can agree not to have a civil war for pragmatic reasons, we shouldn't mince words and pretend not to be enemies. Ozy writes (liberally edited, read the original): From a conservative perspective, I am an incomprehensible moral mutant…however, from my perspective, conservatives are perfectly willing to sacrifice things that actually matter in the world– justice, equality, happiness, an end to suffering– in order to suck up to unjust authority or help the wealthy and undeserving or keep people from having sex lives they think are gross. There is, I feel, opportunity for compromise. An outright war would be unpleasant for everyone…And yet, fundamentally… it's not true that conservatives as a group are working for the same goals as I am but simply have different ideas of how to pursue it…my read of the psychological evidence is that, from my value system, about half the country is evil and it is in my self-interest to shame the expression of their values, indoctrinate their children, and work for a future where their values are no longer represented on this Earth. So it goes. And from the subreddit comment by GCUPokeItWithAStick: I do think that at a minimum, if you believe that one person's interests are intrinsically more important than another's (or as the more sophisticated versions play out, that ethics is agent-relative), then something has gone fundamentally wrong, and this, I think, is the core of the distinction between left and right. Being a rightist in this sense is totally indefensible, and a sign that yes, you should give up on attempting to ascertain any sort of moral truth, because you can't do it. I will give this position its due: I agree with the fact/value distinction. I agree it's conceptually very clear what we're doing when we try to convince someone with our same values of a factual truth, and confusing and maybe impossible to change someone's values.

Yesterday I wrote about melatonin, mentioning that most drugstore melatonin supplements were 10x or more the recommended dose. A commenter on Facebook pointed me to an interesting explanation of why. Dr. Richard Wurtman, an MIT scientist who helped discover melatonin's role in the body and pioneer its use as a sleep aid, writes: MIT was so excited about our research team's melatonin-sleep connection discovery that they decided to patent the use of reasonable doses of melatonin—up to 1 mg—for promoting sleep. But they made a big mistake. They assumed that the FDA would want to regulate the hormone and its use as a sleep therapy. They also thought the FDA wouldn't allow companies to sell melatonin in doses 3-times, 10-times, even 15-times more than what's necessary to promote sound sleep. Much to MIT's surprise, however, the FDA took a pass on melatonin. At that time, the FDA was focusing on other issues, like nicotine addiction, and they may have felt they had bigger fish to fry. Also, the FDA knew that the research on melatonin showed it to be non-toxic, even at extremely high doses, so they probably weren't too worried about how consumers might use it. In the end, and as a way of getting melatonin on to the market, the FDA chose to label it a dietary supplement, which does not require FDA regulation. Clearly, this was wrong because melatonin is a hormone, not a dietary supplement. Quickly, supplement manufacturers saw the huge potential in selling melatonin to promote good sleep. After all, millions of Americans struggled to get to sleep and stay asleep, and were desperate for safe alternatives to anti-anxiety medicines and sleeping pills that rarely worked well and came with plenty of side effects. Also, manufacturers must have realized that they could avoid paying royalties to MIT for melatonin doses over the 1 mg measure. So, they produced doses of 3 mg, 5 mg, 10 mg and more! Their thinking–like so much else in our American society–was likely, "bigger is better!" But, they couldn't be more wrong. So he's saying that…in order to get around a patent on using the correct dose of melatonin…supplement manufacturers…used the wrong dose of melatonin? I enjoy collecting stories of all the crazy perversities created by our current pharmaceutical system, but this one really takes the cake.

[I am not a sleep specialist. Please consult with one before making any drastic changes or trying to treat anything serious.] Van Geiklswijk et al describe supplemental melatonin as "a chronobiotic drug with hypnotic properties". Using it as a pure hypnotic – a sleeping pill – is like using an AK-47 as a club to bash your enemies' heads in. It might work, but you're failing to appreciate the full power and subtlety available to you. Melatonin is a neurohormone produced by the pineal gland. In a normal circadian cycle, it's lowest (undetectable, less than 1 pg/ml of blood) around the time you wake up, and stays low throughout the day. Around fifteen hours after waking, your melatonin suddenly shoots up to 10 pg/ml – a process called "dim light melatonin onset". For the next few hours, melatonin continues to increase, maybe as high as 60 or 70 pg/ml, making you sleepier and sleepier, and presumably at some point you go to bed. Melatonin peaks around 3 AM, then declines until it's undetectably low again around early morning. Is this what makes you sleepy? Yes and no. Sleepiness is a combination of the circadian cycle and the so-called "Process S". This is an unnecessarily sinister-sounding name for the fact that the longer you've been awake, the sleepier you'll be. It seems to be partly regulated by a molecule called adenosine. While you're awake, the body produces adenosine, which makes you tired; as you sleep, the body clears adenosine away, making you feel well-rested again. In healthy people these processes work together. Circadian rhythm tells you to feel sleepy at night and awake during the day. Process S tells you to feel awake when you've just risen from sleep (naturally the morning), and tired when you haven't slept in a long time (naturally the night). Both processes agree that you should feel awake during the day and tired at night, so you do. When these processes disagree for some reason – night shifts, jet lag, drugs, genetics, playing Civilization until 5 AM – the system fails. One process tells you to go to sleep, the other to wake up. You're never quite awake enough to feel energized, or quite tired enough to get restful sleep. You find yourself lying in bed tossing and turning, or waking up while it's still dark and not being able to get back to sleep. Melatonin works on both systems. It has a weak "hypnotic" effect on Process S, making you immediately sleepier when you take it. It also has a stronger "chronobiotic" effect on the circadian rhythm, shifting what time of day your body considers sleep to be a good idea. Effective use of melatonin comes from understanding both these effects and using each where appropriate.

The rationalist community started with the idea of rationality as a martial art – a set of skills you could train in and get better at. Later the metaphor switched to a craft. Art or craft, parts of it did get developed: I remain very impressed with Eliezer's work on how to change your mind and everything presaging Tetlock on prediction. But there's a widespread feeling in the rationalist community these days that this is the area where we've made the least progress. AI alignment has grown into a developing scientific field. Effective altruism is big, professionalized, and cash-rich. It's just the art of rationality itself that remains (outside the usual cognitive scientists who have nothing to do with us and are working on a slightly different project) a couple of people writing blog posts. Part of this is that the low-hanging fruit has been picked. But I think another part was a shift in emphasis. Martial arts does involve theory – for example, beginning fencers have to learn the classical parries – but it's a little bit of theory and a lot of practice. Most of becoming a good fencer involves either practicing the same lunge a thousand times in ideal conditions until you could do it in your sleep, or fighting people on the strip. I've been thinking about what role this blog plays in the rationalist project. One possible answer is "none" – I'm not enough of a mathematician to talk much about the decision theory and machine learning work that's really important, and I rarely touch upon the nuts and bolts of the epistemic rationality craft. I freely admit that (like many people) I tend to get distracted by the latest Outrageous Controversy, and so spend way too much time discussing things like Piketty's theory of inequality which get more attention from the chattering classes but are maybe less important to the very-long-run future of the world.

I'm late to posting this, but it's important enough to be worth sharing anyway: Sandberg, Drexler, and Ord on Dissolving the Fermi Paradox. (You may recognize these names: Toby Ord founded the effective altruism movement; Eric Drexler kindled interest in nanotechnology; Anders Sandberg helped pioneer the academic study of x-risk, and wrote what might be my favorite Unsong fanfic) The Fermi Paradox asks: given the immense number of stars in our galaxy, for even a very tiny chance of aliens per star shouldn't there should be thousands of nearby alien civilizations? But any alien civilization that arose millions of years ago would have had ample time to colonize the galaxy or do something equally dramatic that would leave no doubt as to its existence. So where are they? This is sometimes formalized as the Drake Equation: think up all the parameters you would need for an alien civilization to contact us, multiply our best estimates for all of them together, and see how many alien civilizations we predict. So for example if we think there's a 10% chance of each star having planets, a 10% chance of each planet being habitable to life, and a 10% chance of a life-habitable planet spawning an alien civilization by now, one in a thousand stars should have civilization. The actual Drake Equation is much more complicated, but most people agree that our best-guess values for most parameters suggest a vanishingly small chance of the empty galaxy we observe. SDO's contribution is to point out this is the wrong way to think about it. Sniffnoy's comment on the subreddithelped me understand exactly what was going on, which I think is something like this:

Chris Stucchio recommended Matt Rognlie's criticisms of Piketty (paper, summary, Voxsplainer). Rognlie starts by saying that Piketty didn't correctly account for capital depreciation (ie capital losing value over time) in his calculations. This surprises me, because Piketty says he does in his book (p. 55) but apparently there are technical details I don't understand. When you do that, the share of capital decreases, and it becomes clear that 100% of recent capital-share growth comes from one source: housing. I can't find anyone arguing that Rognlie is wrong. I do see many people arguing about the implications, all the way from "this disproves Piketty" to "this is just saying the same thing Piketty was". I think it's saying the same thing Piketty was in that housing is a real thing, and if there's inequality in housing, then that's real inequality. And landlords are a classic example of the rentiers Piketty is warning against. But it's saying a different thing in that most homeowners use their homes by living in them, not by renting them out. That means they're not part of Piketty's rentier class, and so using the amount of capital to represent the power of rentiers is misleading. Rentiers are not clearly increasing and there is no clear upward trend in rentier-vs-laborer inequality. I think this does disprove Piketty's most shocking thesis. Rognlie also makes an argument for why increasing the amount of capital will decrease the returns on capital, leading to stable or decreasing income from capital. Piketty argues against this on page 277 of his book, but re-reading it Piketty's argument now looks kind of weak, especially with the evidence from housing affecting some of his key points. Grendel Khan highlights the role of housing with an interesting metaphor: Did someone say housing? As an illustration, the median homeowner in about half of the largest metros made more off the appreciation of their home than a full-time minimum-wage job. It's worst in California, of course; in San Jose, the median homeowner made just shy of $100 per working hour. See also Richard Florida's commentary. See also everything about how the housing crisis plays out in micro; it is precisely rentier capitalism. In the original post, I questioned Piketty's claim that rich people and very-well-endowed colleges got higher rates of return on their investment than ordinary people or less-well-endowed colleges. After all, why can't poorer people pool their money together, mutual-fund-style, to become an effective rich person who can get higher rate of return? Many people tried to answer this, not always successfully. brberg points out that Bill Gates – one example of a rich person who's gotten 10%+ returns per year – has a very specific advantage: Not sure about Harvard's endowment, but it's worth noting that the reason Gates, Bezos, Zuckerberg, and other self-made billionaires have seen their fortunes grow so quickly is that each of them has the vast majority of their wealth invested in a single high-growth company. This is an extremely high-risk investment strategy that has the potential to pay off fantastically well in a tiny percentage of cases, but it's not really dependent on the size of the starting stake. Anyone who invested in Microsoft's IPO would have seen the same rate of return as Gates. This is a good point, but most of Piketty's data focuses on college endowments. How do they do it? Briefling writes: I'm not sure you can take the wealth management thing at face value. The stock market since 1980 has 10% annualized returns. Instead of trying to replicate whatever Harvard and Yale are doing, why don't you just put your money in the stock market? Also a good point, but colleges seem to do this with less volatility than the stock market, which still requires some explanation.

[Original review is here. Don't worry, people who had interesting comments on the review – I'll try to get a comments highlights thread up eventually.] For Ricardo, who published his Principles of Political Economy and Taxation in 1817, the chief concern was the long-term evolution of land prices and land rents. Like Malthus, he had virtually no genuine statistics at his disposal. He nevertheless had intimate knowledge of the capitalism of his time. Born into a family of Jewish financiers with Portuguese roots, he also seems to have had fewer political prejudices than Malthus, Young, or Smith. He was influenced by the Malthusian model but pushed the argument farther. He was above all interested in the following logical paradox. Once both population and output begin to grow steadily, land tends to become increasingly scarce relative to other goods. The law of supply and demand then implies that the price of land will rise continuously, as will the rents paid to landlords. The landlords will therefore claim a growing share of national income, as the share available to the rest of the population decreases, thus upsetting the social equilibrium. For Ricardo, the only logically and politically acceptable answer was to impose a steadily increasing tax on land rents. This somber prediction proved wrong: land rents did remain high for an extended period, but in the end the value of farm land inexorably declined relative to other forms of wealth as the share of agriculture in national income decreased. Writing in the 1810s, Ricardo had no way of anticipating the importance of technological progress or industrial growth in the years ahead. Like Malthus and Young, he could not imagine that humankind would ever be totally freed from the alimentary imperative. One underappreciated feature of Piketty is his engaging presentation of economic history. A constant feature of the theorists he discusses is that they are all brilliant thinkers, they all follow the trends of their time to their obvious conclusions in ways deeper and more insightful than their contemporaries – and they all miss complicated paradigm shifts that make the trends obsolete and totally ruin their theories. Rationalists take note. Like Ricardo, Marx based his work on an analysis of the internal logical contradictions of the capitalist system. He therefore sought to distinguish himself from both bourgeois economists (who saw the market as a self-regulated system, that is, a system capable of achieving equilibrium on its own without major deviations, in accordance with Adam Smith's image of "the invisible hand" and Jean-Baptiste Say's "law" that production creates its own demand), and utopian socialists and Proudhonians, who in Marx's view were content to denounce the misery of the working class without proposing a truly scientific analysis of the economic processes responsible for it.7 In short, Marx took the Ricardian model of the price of capital and the principle of scarcity as the basis of a more thorough analysis of the dynamics of capitalism in a world where capital was primarily industrial (machinery, plants, etc.) rather than landed property, so that in principle there was no limit to the amount of capital that could be accumulated. In fact, his principal conclusion was what one might call the "principle of infinite accumulation," that is, the inexorable tendency for capital to accumulate and become concentrated in ever fewer hands, with no natural limit to the process. This is the basis of Marx's prediction of an apocalyptic end to capitalism: either the rate of return on capital would steadily diminish (thereby killing the engine of accumulation and leading to violent conflict among capitalists), or capital's share of national income would increase indefinitely (which sooner or later would unite the workers in revolt). In either case, no stable socioeconomic or political equilibrium was possible.

[Epistemic status: I am not an economist. Many people who are economists have reviewed this book already. I review it only because if I had to slog through reading this thing I at least want to get a blog post out of it. If anything in my review contradicts that of real economists, trust them instead of me.] I. Thomas Piketty's Capital In The Twenty-First Century isn't just a book on inequality. It's a book about quantitative macroeconomic history. This is much more interesting than it sounds. Piketty spent decades combing through primary sources trying to get good statistics for what the economies of various Western countries have been doing over the past 250 years. Armed with these data, he tries to put together a theory of the very-long-term forces at work in economic change. His results touch on almost every big question in politics and economics, and are able to propose sweeping theories where other people resort to parochial speculation. While more knowledgeable people than I are probably already familiar with much of this, I used him as an Econ History 101 textbook and was not at all disappointed in the results. The most important thing I learned from Piketty is that since the Industrial Revolution, normal economic growth has always been (and maybe always will be) between 1% and 1.5% per year. This came as news to me, since I often hear about countries and eras with much higher growth rates. But Piketty says all such situations are abnormal in one of a few ways. First, they can have high population growth. Population growth will increase GDP, and it will look like a high economic growth rate. But it doesn't increase GDP per capita and it shouldn't be considered the same as normal economic growth, which is always between 1% and 1.5% per year. Second, they can have temporary bubbles. This definitely happens, but after the inevitable bust, the whole period will eventually average out to 1% to 1.5% per year. Third, they can have "catch-up growth". This is a broad category covering any period when a country that was previously underperforming its fundamentals gets a chance to catch up. This can happen after a long war in which a devastated country gets a chance to rebuild. Or it can happen after dropping communism or some other inefficient economic system, as the country transitions to a more practical form of production. Or it can happen when a Third World country globalizes and gets the benefits of First World technology and organization. But if a country is at peace and on the "technological frontier" (ie one of the highest-tech countries that has to invent its own advances and can't get them by osmosis from somewhere else), it will always have growth of 1% to 1.5% per year.

Sometimes I imagine quitting my job and declaring war on cost disease in medicine. I would set up a practice with a name like Cheap-O Psychiatry. The corny name would be important. It would be a statement of values. It would weed out the people who would say things like "How dare you try to put a dollar value on the health of a human being!" Those people are how we got into this mess, and they would be welcome to keep dealing with the unaffordable health system they helped create. Cheap-O Psychiatry would be for everyone else. Cheap-O Psychiatry wouldn't have an office, because offices cost money. You would Skype, from your house to mine. It wouldn't have a receptionist, because receptionists cost money. You would book a slot in my Google Calendar. It wouldn't have a billing department, because billing departments cost money. You would PayPal me the cost of the appointment afterwards – or, to be really #aesthetic, use cryptocurrency. The Cheap-O website would include a library of great resources on every subject. How To Eat Right. How To Get Good Sleep. How To Find A Good Therapist. The Cognitive Behavioral Therapy Workbook. The Meditation Relaxation Tape. But the flip side would be that Cheap-O appointments would be brutally efficient. If you had problems with sleep, I would evaluate you for any relevant diseases, give you any medications that might be indicated, then tell you to read the How To Get Good Sleep guide on the website. Boom, done. Small talk would be absolutely banned. How little could Cheap-O charge? Suppose I wanted to earn an average psychiatrist salary of about $200K – the whole point of cost disease is that we should be able to lower prices without anyone having to take a pay cut. And suppose I work a 40 hour week, 50 weeks a year, each appointment takes 15 minutes, and 75% of my workday is patient appointments. That's 6000 appointments per year. So to make my $200K I would need to charge about $35 per appointment. There would be a few added costs – malpractice insurance would probably run about $10K per year – but this is the best-case scenario.

Last year, Bryan Caplan wrote about what he called The Unbearable Arbitrariness Of Deploring: Let's start with the latest scandal. People all over the country – indeed, the world – have recently discovered that many celebrities are habitual sexual harassers. Each new expose leads to public outrage and professional ostracism. Why does this confuse me? Because many celebrities do many comparably bad things other than sexual harassment, and virtually no one cares. Suppose, for example, that a major celebrity is extremely emotionally abusive to all his subordinates. He screams at them all the time. He calls them the cruelest names he can devise. He habitually makes impossible demands. He threatens to fire them out of sheer sadistic pleasure. But the abuse is never sexual (or ethnic); the celebrity limits himself to attacking subordinates' intelligence, character, pride, and hope for the future. I daresay the average employee would far prefer to work for a boss who occasionally pressured them for a date. But if the tabloids ran a negative profile on the Asexual Boss from Hell, the public wouldn't get very mad and Hollywood almost certainly wouldn't ostracize the offender […] Or to take a far more gruesome case: When the Syrian government last used poison gas, killing roughly a hundred people, the U.S. angrily deployed retaliatory bombers, to bipartisan acclaim. But when the Syrian government murdered vastly more with conventional weapons, the U.S. government and its citizenry barely peeped. The unbearable arbitrariness of deploring! In the past, I've made similar observations about Jim Crow versus immigration laws, and My Lai versus Hiroshima. In each case, I can understand why people would have strong negative feelings about both evils. I can understand why people would have strong negative feelings about neither. I can understand why people would have strong negative feelings about the greater evil, but not the lesser evil. But I can't understand why people would have strong negative feelings about the lesser evil, but care little about the greater evil. Or why they would have strong negative feelings about one evil, but yawn in the face of a comparable evil. He concludes people are just biased by dramatic stories and like jumping on bandwagons. Everyone else is getting upset about the chemical weapon attack, and people are sheep, so they join in. I have a different theory: people get upset over the violation of already-settled bright-line norms, because this is the correct action if you want to use limited enforcement resources efficiently.

[Few people realize that the 1997 cult hit GATTACA was actually just the first film in a three-movie trilogy. The final two movies, directed by the legendary Moira LeQuivalence, were flops which only stayed in theaters a few weeks and have since become almost impossible to find. In the interest of making them available to the general public, I've written summaries of some key scenes below. Thanks to user Begferdeth from the subreddit for the idea.] GATTACA II: EPI-GATTACA "Congratulations, Vincent", said the supervisor, eyes never looking up from his clipboard. "You passed them all. The orbital mechanics test. The flight simulator. All the fitness tests. More than passed. Some of the highest scores we've ever seen, frankly. You're going to be an astronaut." Vincent's heart leapt in his chest. "Pending, of course, the results of the final test. But this will be easy. I'm sure a fine specimen like you will have no trouble." "The…the final test, sir?" "Well, you know how things are. We want to make sure we get only the healthiest, most on-point individuals for our program. We used to do genetic testing, make sure that people's DNA was pre-selected for success. But after the incident with the Gattaca Corporation and that movie they made about the whole thing, public opinion just wasn't on board, and Congress nixed the whole enterprise. Things were really touch-and-go for a while, but then we came up with a suitably non-invasive replacement. Epigenetics!" "Epi…genetics?" asked Vincent. He hoped he wasn't sounding too implausibly naive – he had, after all, just aced a whole battery of science tests. But surely there were some brilliant astronomers who didn't know anything about biology. He would pretend to be one of those. The supervisor raised an eyebrow, but he went on. "Yes, epigenetics. According to studies, stressful experiences – anything from starvation to social marginalization – change the methylation pattern of your genes. And not just your genes. Some people say that these methylation patterns can transfer to your children, and your children's children, and so on, setting them back in life before they're even born. Of course, it would be illegal for us to take a sample and check your methylation directly – but who needs that! In this day and age, everybody's left a trail online. We can just check your ancestors' life experiences directly, and come up with a projection of your methylation profile good enough to predict everything from whether you'll have a heart attack to whether you'll choke under pressure at a crucial moment. I'll just need to see your genealogy, so we can run it through this computer here…you did bring it like we asked you, right? Of course you did! A superior individual like you, probably no major family traumas going back five, six generations – I bet you've got it all ready for me."

I recently worked with a man who took LSD once in college and never stopped hallucinating. It's been ten years now and it's still going. We can control it with medication, but take the meds away and it starts right back up again. This is a real disease – hallucinogen persisting perception disorder. Most descriptions of the condition emphasize that it's just some the visual effects and doesn't involve distorted reality perception. I'm not sure I believe this – my patient has some weird thoughts sometimes, and 65% of HPPD patient have panic attacks related to their symptoms. Maybe if you can see the walls bubbling, you're going to be having a bad time whether you believe it's "really true" or not. Estimates of prevalence vary. It seems more common on LSD and synthetic cannabinoids, less common (maybe entirely absent) on psilocybin and peyote. Some people say about 1-4% of LSD users will get some form of this, which seems shockingly high to me – why don't we hear about this more often? If I were a drug warrior or DARE instructor, I would never shut up about this. But if most people just get some mild visual issues – by all accounts the most common form of the condition – maybe they never tell anybody. Maybe 1-4% of people who have tried LSD are walking around with slightly distorted perception all the time. There's a lot to say about this from an epidemiological or cultural perspective. But I want to talk about the pharmacology. How can this happen? Why should a drug with a half-life of a few hours have permanent effects on your psyche? It can't be that the LSD sticks around. That doesn't make metabolic sense. And a study discussed here using radio-labeled LSD definitively finds that although a few molecules might stay in the body up to a week or so, there's no reason to think the drug can last longer than this. I like this study, both for its elegant design and because it implies that somewhere someone got a consent form saying "we're going to give you radioactive LSD" and thought "sure, why not?" But then why does it have permanent effects? I know very few other situations where this happens, aside from obvious stuff like "it gives you a stroke and then you're permanently minus one lobe of your brain". The only other open-and-shut case 100% accepted by every textbook is a movement disorder called tardive dyskinesia. If you take too many antipsychotics for too long, you can get involuntary tremors and gyrations that never go away, even off the antipsychotic. Although traditionally associated with very-long-term antipsychotic use, in a few very rare cases you can get it from a single dose. On the other hand, most people can take antipsychotics for decades without developing any problems. Some other possibilities are controversial but plausible. The sexual side effects of SSRIs almost always stop within a few months of stopping the medication, but a few people have reported cases where they can last years or decades. Psychedelics may permanently increase openness and hypnotizability, though it's unclear if this is biochemical or just that drug trips are a life-changing experience – see my discussion here for more. Also, for every drug that has a mild week-long withdrawal syndrome in the average population, you can find a handful of people who claim to have had a five-year protracted nightmare of withdrawal symptoms that never go away. So, again, how does this happen? Every discussion of HPPD etiology I've seen is speculative and admits it doesn't know what it's talking about. Also, most of them are in gated papers I can't access. But a few papers seem to gesture at a theory where LSD kills an undetectably small number of very important neurons. Hermle et al talk about "the excitotoxic destruction of inhibitory interneurons that carry serotonergic and GABAergic receptors on their cell bodies and terminals, respectively". Martinotti seems to be drawing from the same inaccessible source in mentioning "an LSD-generated intense current that may determine the destruction or dysfunction of cortical serotonergic inhibitory interneurons with gamma-Aminobutyric acid (GABAergic) outputs, implicated in sensory filtering mechanisms of unnecessary stimuli". This would require some extra work to explain the coincidence of why the effects of HPPD are so similar to the effects of an LSD trip itself. In particular, if we're talking excitotoxicity, shouldn't the neurons be stimulated (ie more active) in the tripper, but dead (ie less active) in the HPPD patient? Maybe the tripper's neurons are just so overwhelmed that they temporarily stop working? Or maybe you could interpret the comments above to be about LSD exciting some base population of neurons, the relevant inhibitory neurons having to work impossibly hard to inhibit them, and then the inhibitory neurons die of exhaustion/excitotoxicity. Against cell death based explanations, some people seem to recover from HPPD after a while. But this could just be the same kind of brai

[Content warning: suicide. Thanks to someone on Twitter I forget for alerting me to this question] Among US states, there's a clear relationship between gun ownership rates and suicide rates, but not between gun ownership rates and homicide rates: You might conclude guns increase suicides but not homicides. Then you might predict that the gun-loving US would be an international outlier in suicides but not homicides. In fact, it's the opposite: Why should this be? We've already discussed why US homicide rates are so high. But why isn't the suicide rate elevated? One possibility: suicide methods are fungible. If guns are easily available, you might use a gun; if not, you might overdose, hang yourself, or junp off a bridge. So getting rid of one suicide method or another doesn't do much. This sounds plausible, but it's the opposite of scientific consensus on the subject. See for example Controlling Access To Suicide Means, which says that "restrictions of access to common means of suicide has lead to lower overall suicide rates, particularly regarding suicide by firearms in USA, detoxification of domestic and motor vehicle gas in England and other countries, toxic pesticides in rural areas, barriers at jumping sites and hanging…" This is particularly brought up in the context of US gun control – see eg Suicide, Guns, and Public Policy, which describes "strong empirical evidence that restriction of access to firearms reduces suicides". The state-level data from above support this view – taking guns away from a state does decrease its suicide rate. And then there's this graph, from Armed With Reason: …which shows that adding more guns to a state does not decrease its nonfirearm suicide rate. But if suicide methods aren't fungible, then why doesn't the US have higher suicide rates? Here's another way of asking this question: The US has fewer nongun suicides than anywhere else. The seemingly obvious explanation is that guns are so common that everyone who wants to commit suicide is using guns, decreasing the non-gun rate. But that contradicts all the nonfungibility evidence above. So the other possibility is that the US ought to have an very low suicide rate, and it's just all our guns that are bringing us back up to average. Of all US states, Massachusetts, New Jersey, and Hawaii have the fewest guns. Unsurprisingly, suicides in these states are less likely than average to be committed with firearms. In MA, the rate is 22%; in NJ 24%; in HI, 20%. Their suicide rates are 8.8, 7.2, and 12.1, respectively. Hawaii has an unusual ethnic composition – 40% Asian and 20% Native Hawaiian, both groups with high suicide rates (see eg the suicide rate for Japan above). So it might be worth taking Massachusetts and New Jersey as examples to look at in more detail. Either state, if it were independent, would be among the lowest-suicide-rate developed nations. And both still have more guns than our comparison countries. If we did a really simple linear extrapolation from New Jersey-level gun control to imagine a state where firearms were as restricted as in Britain, we would expect it to have a suicide rate of around 5 or 6 – which is around the current level of non-gun US suicides. This is much lower than any of the large comparison countries in the graph above, but there are two developed countries currently around this level – Italy and Israel. I think it makes sense to suppose that the US might have a low Italy/Israel-style base rate of suicides. For one thing, it's unusually religious for a developed country. Religion is one of the strongest protective factorsagainst suicide. This also seems like a good explanation for Italy and Israel. For another, it's culturally similar to Britain, which also has a low suicide rate somewhere in the 7s. Other British colonies don't seem to have kept this effect – Australia and Canada are both higher – but maybe the US did. And for another, it's unusually ethnically diverse. Blacks and Hispanics have only about half the suicide rate of whites; which means you would expect the US to be less suicidal than Europe. I previously believed this was because whites had more guns, but this doesn't seem to be true: Riddell et al find that whites have higher non-firearm suicide rates too. So this could be an additional factor driving US rates down.

These are some of the best comments from Basic Income, Not Basic Jobs: Against Hijacking Utopia. I'm sorry I still haven't gotten a chance to read everything that people have written about it (in particular I need to look more into Scott Sumner's take). Sorry to anyone with good comments I left out. Aevylmar corrects my claim that Milton Friedman supported a basic income: Technically speaking, what Milton Friedman advocated was a negative income tax, which (he thought, and I think) would be much more efficient than basic income – I don't remember if these are his arguments, but the arguments I know for it are that the IRS can administer it with the resources it has without you needing a new bureaucracy, it doesn't have the same distortionary effects that lump sum payment + percentage tax does, and it's probably easier to pass through congress, since it looks as though it costs less and doesn't have the words 'increasing taxes' in it. And Virbie further explains the differences between UBI and negative income tax: The main difference is that discussing it in terms of NIT neatly skips over a lot of the objections that people raise to flat UBIs that are abstractly and mathematically (but not logistically or politically) trivial. Many of these focus on how to get to the new policy position from where we are now. For example, people ask both about how a flat UBI would be funded and why rich people should receive a UBI. Given that the tax load to fund a basic income plan would likely fall on the upper percentiles or deciles, a flat UBI + an increase in marginal tax rates works out to a lump sum tax cut for high-earners and a marginal tax increase. Adding negative tax brackets at the bottom of the existing system and modifying top marginal rates is a simpler way to handle this and extends gracefully from the current system instead of having to work awkwardly alongside it. In the example above, the NIT approach has the logistical advantage of the bureaucracy and systems we already have handling it more easily. And the political advantage of the net cost of the basic income guarantee looking far smaller than for flat UBI, since we're not including the lump sum payments to upper-income people (that are more than offset by their marginal tax increases). There's some further debate on the (mostly trivial) advantages of NIT or UBI over the other in the rest of the thread. Tentor describes Germany's experience with a basic-jobs-like program: We had/have a similar thing to basic jobs in Germany and it worked about as well as you would expect. Companies could hire workers for 1€/hour and the state would pay social security on top of that. The idea was that long-term unemployed people would find their way back to employment this way, but companies just replaced them with new 1€-workers when their contract was over and reduced fully-paid employment because duh! Plus people on social security can be forced to take jobs or education. As a result a lot of our homeless are depressed people who stopped responding to social security demands because that's what caused their depression. (Links are to German Wikipedia, maybe Google translate helps) Another German reader adds: I agree that it doesn't work as expected in Germany, but I think it it important to point out that not everyone is allowed is to hire workers for 1€. The work has to be neutral to the competition and in the public interest. So people are hired at a lot of public institutions (e.g. schools, universities, cleaning up the city). Additionally these jobs improved the unemployment statistics at a low cost for the government, as people who are working in these jobs count as employed although most of these jobs are only part time jobs.

Dr. Matthew Dumont treated a 44 year old woman with depression, body dysmorphia, and psychosis. She failed to respond to most of the ordinary treatments, failed to respond to electroconvulsive therapy, and seemed generally untreatable until she mentioned offhandedly that she spent evenings cleaning up after her husband's half-baked attempts to scrape lead paint off the walls. Blood tests revealed elevated lead levels, the doctor convinced her to be more careful about lead exposure, and even though that didn't make the depression any better, at least it was a moral victory. The story continues: Dr. Dumont investigated lead more generally, found that a lot of his most severely affected patients had high lead levels, discovered that his town had a giant, poorly-maintained lead bridge that was making everyone sick, and – well, the rest stops being story about psychiatry and turns into a (barely believable, outrageous) story about politics. Read the whole thing on Siderea's blog. Siderea continues by asking: why don't psychiatrists regularly test for lead? Now, in my case, I'm a talk therapist, and worrying about patients maybe being poisoned is not even supposed to be on my radar. I'm supposed to trust the MDs to handle it. Dumont, however, is just such an MD. And that this was a clinical possibility was almost entirely ignored by his training. Dumont's point here is that while "medical science" knows about the psychiatric effects of lead poisoning and carbon disulfide poisoning and other poisons that have psychiatric effects – as evidenced by his quoting from the scientific literature – psychiatry as practiced in the hospitals and clinics behaves as if it knows no such thing. Dumont is arguing that, in fact, he knew no such thing, because his professional training as a psychiatrist did not include it as a fact, or even as a possibility of a fact. Dumont's point is that psychiatry, as a practical, clinical branch of medicine, has acted, collectively, as if poisoning is just not a medical problem that comes up in psychiatry. Psychiatry generally did not consider poisoning, whether by lead or any other noxious substance, as a clinical explanation for psychiatric conditions. By which I mean, that when a patient presented with the sorts of symptoms he described, the question was simply never asked, is the patient being poisoned? Dumont wants you to be shocked and horrified by what was done to those people, yes. He also wants you to be shocked and horrified by this: psychiatry as a profession – in the 1970s, when (I believe) the incidents he relates where happening, in the 1990s, when he wrote it in his book, or in 2000 when a journal on public health decided to publish it – psychiatry as a profession did not ask the question is the patient being poisoned? And it didn't ask the question, because clinical psychiatry had other explanations it liked better, to which it had a priori philosophical commitments. And that, when you think through what it means for psychiatry, is absolutely chilling. And:

The New York Times recently reported on various anti-PC thinkers as "the intellectual dark web", sparking various annoying discussion. The first talking point – that the term is silly – is surely true. So is the second point – that it awkwardly combines careful and important thinkers like Eric Weinstein with awful demagogues like Ben Shapiro. So is the third – that people have been complaining about political correctness for decades, so anything that portrays this as a sudden revolt is ahistorical. There are probably more good points buried within the chaff. But I want to focus on one of the main arguments that's been emphasized in pretty much every article: can a movement really claim it's being silenced if it's actually pretty popular? "Silenced" is the term a lot of these articles use, and it's a good one. "Censored" awkwardly suggests government involvement, which nobody is claiming. "Silenced" just suggests that there's a lot of social pressure on its members to shut up. But shutting up is of course is the exact opposite of what the people involved are doing – as the Timespoints out, several IDW members have audiences in the millions, monthly Patreon revenue in the five to six figures, and (with a big enough security detail) regular college speaking engagements. So, from New Statesman, If The "Intellectual Dark Web" Are Being Silenced, Why Do We Need To Keep Hearing About Them?: The main problem with the whole profile is that it struggles because of a fundamental inherent contradiction in its premise, which is that this group of renegades has been shunned but are also incredibly popular. Either they are persecuted victims standing outside of society or they are not. Joe Rogan "hosts one of the most popular podcasts in the country", Ben Shapiro's podcast "gets 15 million downloads a month". Sam Harris "estimates that his Waking Up podcast gets one million listeners an episode". Dave Rubin's YouTube show has "more than 700,000 subscribers", Jordan Peterson's latest book is a bestseller on Amazon […] On that basis alone, should this piece have been written at all? The marketplace of ideas that these folk are always banging on about is working. They have found their audience, and are not only popular but raking it in via Patreon accounts and book deals and tours to sold-out venues. Why are they not content with that? They are not content with that because they want everybody to listen, and they do not want to be challenged. In the absence of that, they have made currency of the claim of being silenced, which is why we are in this ludicrous position where several people with columns in mainstream newspapers and publishing deals are going around with a loudhailer, bawling that we are not listening to them. Reason's article is better and makes a lot of good points, but it still emphasizes this same question, particularly in their subtitle: "The leading figures of the 'Intellectual Dark Web' are incredibly popular. So why do they still feel so aggrieved?". From the piece: They can be found gracing high-profile cable-news shows, magazine opinion pages, and college speaking tours. They've racked up hundreds of thousands of followers. And yet the ragtag band of academics, journalists, and political pundits that make up the "Intellectual Dark Web" (IDW)—think of it as an Island of Misfit Ideologues—declare themselves, Trump-like, to be underdogs and outsiders. […] [I'm not convinced] they're actually so taboo these days. As Weiss points out, this is a crowd that has built followings on new-media platforms like YouTube and Twitter rather than relying solely on legacy media, academic publishing, and other traditional routes to getting opinions heard. (There isn't much that's new about this except the media involved. Conservatives have long been building large audiences using outside-the-elite-media platforms such as talk radio, speaking tours, and blogs.) In doing so, they've amassed tens and sometimes hundreds of thousands of followers. What they are saying might not be embraced, or even endured, by legacy media institutions or certain social media precincts, but it's certainly not out of tune with or heretical to many Americans. The bottom line is there's no denying most of these people are very popular. Yet one of the few unifying threads among them is a feeling or posture of being marginalized, too taboo for liberal millennial snowflakes and the folks who cater to them. The basic argument – that you can't be both silenced and popular at the same time – sounds plausible. But I want to make a couple points that examine it in more detail.

Some Democrats angling for the 2020 presidential nomination have a big idea: a basic jobs guarantee, where the government promises a job to anybody who wants one. Cory Booker, Kirsten Gillibrand, Elizabeth Warren, and Bernie Sanders are all said to be considering the plan. I've pushed for a basic income guarantee before, and basic job guarantees sure sound similar. Some thinkers have even compared the two plans, pointing out various advantages of basic jobs: it feels "fairer" to make people work for their money, maybe there's a psychological boost from being productive, you can use the labor to do useful projects. Simon Sarris has a long and excellent article on "why basic jobs might fare better than UBI [universal basic income]", saying that: UBI's blanket-of-money approach optimizes for a certain kind of poverty, but it may create more in the long run. Basic Jobs introduce work and opportunity for communities, which may be a better welfare optimization strategy, and we could do it while keeping a targeted approach to aiding the poorest. I am totally against this. Maybe basic jobs are better than nothing, but I have an absolute 100% revulsion at the idea of implementing basic jobs as an alternative to basic income. Before getting into the revulsion itself, I want to bring up some more practical objections: 1. Basic jobs don't help the disabled Only about 15% of the jobless are your traditional unemployed people looking for a new job. 60% are disabled. Disability has doubled over the past twenty years and continues to increase. Experts disagree on how much of the rise in disability reflects deteriorating national health vs. people finding a way to opt out of an increasingly dysfunctional labor market, but everyone expects the the trend to continue. Any program aimed at the non-working poor which focuses on the traditionally unemployed but ignores the disabled is only dealing with the tip of the iceberg.

In 2008, Paul Graham wrote How To Disagree Better, ranking arguments on a scale from name-calling to explicitly refuting the other person's central point. And that's why, ever since 2008, Internet arguments have generally been civil and productive. Graham's hierarchy is useful for its intended purpose, but it isn't really a hierarchy of disagreements. It's a hierarchy of types of response, within a disagreement. Sometimes things are refutations of other people's points, but the points should never have been made at all, and refuting them doesn't help. Sometimes it's unclear how the argument even connects to the sorts of things that in principle could be proven or refuted. If we were to classify disagreements themselves – talk about what people are doing when they're even having an argument – I think it would look something like this: Most people are either meta-debating – debating whether some parties in the debate are violating norms – or they're just shaming, trying to push one side of the debate outside the bounds of respectability. If you can get past that level, you end up discussing facts (blue column on the left) and/or philosophizing about how the argument has to fit together before one side is "right" or "wrong" (red column on the right). Either of these can be anywhere from throwing out a one-line claim and adding "Checkmate, atheists" at the end of it, to cooperating with the other person to try to figure out exactly what considerations are relevant and which sources best resolve them.

I. A spectre is haunting Europe. Several spectres, actually. One of them is the spectre of communism. The others are literal ghosts. They live in abandoned mansions. Sometimes they wail eerily or make floorboards creak. If you arrange things just right, you might be able to capture them on film. Or at least this must have been the position of the founders of the Fabian Society, Britain's most influential socialist organization. In 1883, ghost hunters Frank Podmore and Edward Pease spent the night at the same West London haunted house, looking for signs of the paranormal. As the night dragged on without any otherworldly visitations, they passed the time in conversation and realized they shared an interest in communist thought. The two agreed to meet up again later, and from these humble beginnings came one of the most important private societies in the history of the world. Before the Fabians, communism was a pastime of wild-eyed labor activists promising bloody revolution. The Society helped introduce the idea of incremental democratic socialism – not just in the sense of Bernie Sanders, but in the sense of the entire modern welfare state. In the process, they pretty much invented the demographic of champagne-sipping socialist intellectuals. Famous Society members included George Bernard Shaw, Muhammed Ali Jinnah, Jawaharlal Nehru, and Tony Blair; Fabian ideas were imported wholesale into the economic policies guiding newly-independent India, Nigeria, Egypt, Syria, among others. I became interested in the Fabians after reading Kerry Vaughn's excellent essay on the early neoliberal movement. I'm tempted to say "on the early neoliberal conspiracy", choosing that not because any of what they did was secret – it wasn't – but because it seems like the only term that describes their efficiency. A small group of people who wanted to change the world founded an organization, garnered influence in a bunch of little ways, thought strategically and acted with discipline. And after decades of work they got into positions of power and successfully changed the world, shifting the economic consensus from state socialism to free(er) markets. And the Fabians seem like the same story, told in reverse. A small group of idealists, thinking strategically and acting with discipline, moved democratic socialism from the lunatic fringe to the halls of intellectual power. If aspiring generals study Alexander the Great and Napoleon, surely aspiring intellectual movements should study the neoliberals and the Fabians. Kerry's essay on neoliberalism was great, but I really wanted to know how the Fabians progressed from failed ghost hunters to puppetmasters controlling half of the twentieth century.

Thanks to everyone who expressed interest in the adversarial collaborations contest. There was a lot of good discussion in the last thread, with lots of people offering projects, but I'm not sure if people actually got in contact with each other and finalized their agreements. So, if you proposed a collaboration in the last thread, please go back, take a look, and see if someone you might want to work with responded to your proposal. I'm going to post two comments in the comment section of this post. One is a coordination comment. If you're looking to find someone who you agreed to do a collaboration with in the last thread, so you can exchange emails with them, please post as a subcomment there. For example "I offered to do a collaboration on gun control, I see Bob839 agreed to partner with me, my email is [email protected], please get in touch with me." The second is a contest registration comment, so I know how many teams there are. If you and a partner have gotten in touch with one another and chosen a topic (you can always change it later), please post a subcomment there so I know that you're officially in. If for some reason you're not comfortable posting there, you can also email me at scott[at]shireroth[dot]org. Please mention your name, your partner's name, your topic, and (if you're comfortable giving it), your email.

An adversarial collaboration is an effort by two people with opposing opinions on a topic to collaborate on a summary of the evidence. Just as we hope that a trial with both prosecutor and defense will give the jury a balanced view of the evidence for and against a suspect, so we hope an adversarial collaboration will give readers a balanced view of evidence for and against some thesis. It's typically done for scientific papers, but I'm excited about the possibility of people applying the concept to to less formal writeups as well. For example, a pro-gun activist might collaborate with an anti-gun activist to write a joint article on the evidence for whether gun control saves lives. We trust each person to make sure the best evidence for their respective side is included. We also trust that they'll fact-check each other and make sure there aren't any errors or falsehoods in the final document. There might be a lot of debating, but it will happen on high-bandwidth informal channels behind the scenes and nobody will feel like they have tailor their debating to sounding good for an audience. I don't know to what degree true adversarial collaborations are really possible. It might be that people who disagree on high-level issues might not be able to cooperate on a survey of the field at all. But I'd like to find out. So I'm offering a prize, plus a chance to get the results published on SSC, to any teams (probably of two people each) who want to do adversarial collaborations. If you want to participate, comment on this post with what subject you'd like to work on and what your opinion is on the subject. Or look through existing comments, find someone who has the opposite opinion to you on a subject you care about, and reply to them saying you want to be their foil. After that you can exchange emails and start working.

Everyone knows medical care in the US is expensive even with insurance and prohibitively expensive without it. I have a lot of patients who are uninsured, or who bounce on and off insurance, or who have trouble affording their co-pays. This is a collection of tricks I've learned (mostly from them) to help deal with these situations. They are US-based and may not apply to other countries. Within the US, they are a combination of legal and probably-legal; I've tried to mark which is which but I am not a lawyer and can't make promises. None of this is medical advice; use at your own risk. This is intended for people who already know they do not qualify for government assistance. If you're not sure, check HealthCare.gov and look into the particular patchwork of assistance programs in your state and county. I. Prescription Medication This section is about ways to get prescription medication for cheaper. If even after all this your prescription medication is too expensive, please talk to your doctor about whether it can be replaced with a less expensive medication. Often doctors don't think about this and will be happy to work with you if they know you need it. They may also have other ways to help you save money, like giving you the free sample boxes they get from drug reps. 1. Sites like GoodRx.com. This is first because it's probably the most important thing most people can do to save money on health care. For example, one month of Abilify 5 mg usually costs $930 at Safeway, but only $30 with a GoodRx coupon. There is no catch. Insurances and pharmacies play a weird game where insurances say they'll only pay one-tenth the sticker price for drugs, and pharmacies respond by dectupling the price of everything. If you have insurance, it all (mostly) cancels out in the end; if you don't, you end up paying inflated prices with no relation to reality. GoodRx negotiates discounts so that individual consumers can get drugs for the same discounted price as insurances (or better); they also list the prices at each pharmacy so you know where to shop. This is not only important in and of itself, but its price comparison feature is also important to figure out how best to apply the other features in this category. Even if you have insurance, GoodRx prices are sometimes lower than your copay. 2. Get and split bigger pills. Remember how a month of Abilify 5 mg cost $30 with the coupon? Well, a month of Abilify 30 mg also costs $30. Cut each 30 mg pill into sixths, and now you have six months' worth of Abilify 5 mg, for a total cost of $5 per month. You'll need a cooperative doctor willing to prescribe you the higher dose. Note that some pills cannot be divided in this way – cutting XR pills screws up the extended release mechanism. Others like seizure medication are a bad idea to split in case you end up taking slightly different doses each time. Ask your doctor whether this is safe for whatever medication you use. Do not ask the pharma companies or trust their literature – they will always say it's unsafe, for self-interested reasons. Contrary to some doctors' concerns, this is not insurance fraud if you're not buying it with insurance, and AFAIK there's no such thing as defrauding a pharmacy.

That story about the blockchain-based dating site gets better: its designer is an enlightened being. I got this from Vinay Gupta's wiki, which describes some of his thoughts and experiences. Since reading Mastering The Core Teachings Of The Buddha, I've been looking at a bunch of this stuff, and it's interesting how it does (or doesn't) converge. For example, from the MCTB review: If you really, really examine your phenomenological experience, you realize all sorts of surprising things…one early insight is a perception of your mental awareness of a phenomenon as separate from your perception of that phenomenon. And from Gupta: The real process of meditation is paying real close attention to what is happening around you without passing it to the mind immediately for analysis…the mind becomes perceived to be another sense. You see, you listen, you hear, you smell, you think. Once you are aware that you are not your mind and your mind is basically a sense organ, it's a thing that brings information to you, you enter the real work of enlightenment, which is: what is this me that the mind is bringing information to? And that's the big one. That question is at the heart of everybody's enlightenment process. From the MCTB review: The main point of [mindfulness] meditation is to improve your concentration ability so you can direct it to ordinary experience. Become so good at concentrating that you can attain various jhanas – but then, instead of focusing on infinite bliss or whatever other cool things you can do with your new talent, look at a wall or listen to the breeze or just try to understand the experience of existing in time. From Gupta: Building the instrumentation to keep your consciousness stable enough to put the attention on the thing, is about three or four years work. It's like grinding a mirror if you're going to make an astronomical telescope. It takes years to grind a perfectly smooth reflector. Then you silver coat it. Then you point it at the sky and now you can see the moons of Jupiter. It takes you years to design the microscope, you look into the water, now you can see the microbes and you just discovered germ theory. Building the instrumentation takes time. Years and years and years because you need long periods – 35, 40 seconds minimally – when there are no thoughts in the mind to be able to begin to turn the awareness onto itself. So lengthening the gap between thoughts means lowering the mental background noise.

[Content warning: harassment. This discusses the comments to SSC Survey Results: Sexual Harassment Levels By Field] brmic writes: Thank you for posting this and the data file. FWIW, I tried to reproduce the results and couldn't reproduce the correlations between female victimization, male victimization and male perpetration. fem vic vs. male vic is 0.65, same as yours. fem vic vs. male perp is 0.01 for me, and male vic vs. male perp is 0.21 for me. Everything else more or less checks out. As a reviewer, I'd say the combination score is not convincing, especially since it ignores all considerations of different male to female ratios in the various industries. Also, if you have two measures with r = 0.8, Fig 6 is not a good idea IMHO. It's probably just noise. (Also, it should be a dotplot centered around 1, because the relevant info is distance from 1:1 ratio.) Instead, I'd focus on the correlation between female victimization at work and female victimization outside work of 0.65 (for me) and the same for males at 0.59, which also leads to the conclusion that there's a strong 'people in fields' effect, without having to go through the combination score. If you're so inclined, you might then do the at-work by outside-work ratios and end up a kind of cross-validation set, where you can see whether the bad fields for women are bad for men as well. Of course, once you then consider sex ratios per field. it's story time all over again. Still, e.g. men report similar levels of out of work victimization in computers (20%) and Health Care (24%), but at work victimization of 4% and 12% respectively, which strongly suggests that Health Care is worse. Their code is available here. Thanks for doing the work to try to replicate my results. I've removed the non-confirmed correlations from my post until I can figure out what's going on with them. I agree that Figure 6 was barely worth it, which is why I tried to make Figure 4 (the unadjusted version) the center of my thesis. Chris quotes a TIME article that argues that predominantly-male communities generally have lower harassment rates than predominantly-female communities:

[content note: sexual harassment] I. Recent discussion of sexual harassment at work has focused on a few high-profile industries. But there has been relatively little credible research as to how rates really differ by occupation type. There are many surveys of harassment rates in specific industries, but they can't be credibly compared with one another. The percent of people who report sexual harassment varies wildly from survey to survey – thus studies finding that anywhere from 12 percent to 48 percent to 60 percent to 85 percent of women have been harassed at work. If a survey shows that 60% of female nurses get sexually harassed at work, does that mean nurses are victimized particularly often (because more than 12%) or are unusually safe (because less than 85%)? It doesn't matter, because another study says only 19% of nurses get harassed. Why do all these numbers differ so dramatically? The most important issue seems to be how you ask the question. "Have you ever been harassed?" gets numbers more like 12%; giving a long list of specific behaviors and asking "Have you ever experienced any of these?" gets numbers closer to 85%, depending on what the behaviors are. Surveys also differ on whether they ask all employees or just women, whether they include a time frame (eg "…in the past two years"), whether they specify that it had to be at work vs. work-related events, and whether they include witnessing someone else's harassment. Taking these surveys entirely seriously would lead to the conclusion that Uber has the lowest sexual harassment rate of any company or industry in the world; I choose not to take them seriously. This means we need investigations that use the same methodology across multiple fields. Whenever the media talks about this – see eg the Washington Post's The Industries With The Worst Sexual Harassment Problem – they're working off of the Equal Employment Opportunity Commission's records. But these are totally unsuitable for the task – they just report raw number of claims per industry. The industries that rank lowest in EEOC's data tend to be small industries with very few women – for example, taken seriously the WaPo's graph shows that mining has the least problem with sexual harassment of any industry in the world. Is this thanks to their uniquely progressive culture – or because there are practically no female miners? I'm going to say the second one. The takeaway that most real researchers take from the EEOC claims is that the lowest-paying and most mundane occupations – retail, restaurant work, hotel work, etc – have much higher sexual harassment rates than the prestigious occupations people generally talk about. Eyeballing the data, this looks basically true. But trying to get anything more fine-grained than that out of EEOC is basically hopeless. I only know of two surveys that have even attempted to compare different fields in a principled way, and neither really inspires confidence.

Medicine loves guidelines. But everywhere else, guidelines are still underappreciated. Consider a recommendation, like "Try Lexapro!" Even if Lexapro is a good medication, it might not be a good medication for your situation. And even if it's a good medication for your situation, it might fail for unpredictable reasons involving genetics and individual variability. So medicine uses guidelines – algorithms that eventually result in a recommendation. A typical guideline for treating depression might look like this (this is a very over-simplified version for an example only, NOT MEDICAL ADVICE): 1. Ask the patient if they have symptoms of bipolar disorder. If so, ignore everything else on here and move to the bipolar guideline. 2. If the depression seems more anxious, try Lexapro. Or if the depression seems more anergic, try Wellbutrin. 3. Wait one month. If it works perfectly, declare victory. If it works a little but not enough, increase the dose. If it doesn't work at all, stop it and move on to the next step. 4. Try Zoloft, Remeron, or Effexor. Repeat Step 3. 5. Cycle through steps 3 and 4 until you either find something that works, or you and your patient agree that you don't have enough time and patience to continue cycling through this tier of options and you want to try another tier with more risks in exchange for more potential benefits. 6. If the depression seems more melancholic, try Anafranil. Or if the depression seems more atypical, try Nardil. Or if your patient is on an earlier-tier medication that almost but not quite works, try augmenting with Abilify. Repeat Step 3. 7. Try electroconvulsive therapy. The end result might be the recommendation "try Lexapro!", but you know where to go if that doesn't work. A psychiatrist armed with this guideline can do much better work than one who just happens to know that Lexapro is the best antidepressant, even if Lexapro really is the best antidepressant. Whenever I'm hopelessly confused about what to do with a difficult patient, I find it really reassuring that I can go back to a guideline like this, put together by top psychiatrists working off the best evidence available. This makes it even more infuriating that there's nothing like this for other areas I care about.

Bizzolt writes: DC Public Schools HS teacher here (although I'm not returning next year, as is the case with many of my colleagues). As noted, one of the biggest factors in the graduation rates is the unexcused absences–if you look at the results of our external audit and investigation here, you see that for many schools, a significant number of our seniors "Passed Despite Excessive Absences in Regular Instruction Courses Required for Graduation"–over 40% of 2017 graduates at my high school, for example. So the attendance policy is being strictly enforced now, and you can see how from that alone, a ~30% drop in expected graduates is possible. Some more details about strictly enforcing the attendance policy though: 1: DCPS has what's called the '80 20′ rule: A student that is absent for at least 20% of their classes is considered absent for the whole day. 2: Most schools have 5 periods, so an absence in one class would be considered an absence for the whole day. 3: If you have 10 or more unexcused absences in a class, you automatically get an F for the term. 4: If you are over 15 minutes late for a class, that is considered an unexcused absence. 5: A majority of these absences are in first period. 6: A majority of students in my school and many others live in single parent households. 7: These students are typically responsible for making sure their younger siblings get to school, if they have any. 8: Elementary and middle schools in my neighborhood start at the exact same time as high school. 9: Their doors do not open until 5 to 10 minutes before the starting bell, presumably for safety reasons. 10: Refer to point 4. There's many other problems at DCPS to be sure, but this set of circumstances alone is causing the largest increase in failing grades and graduation ineligibility at my high school, and basically every other 90+% black school in the district. You could see how this accounts for quite a bit of the difference between white and black graduation rates as well. There's a reason why across the board, DCPS schools were not strictly enforcing this policy in previous years. It looks like most other school districts don't have this policy; it seems plausible that this is the main difference between DC and other poor school districts that nevertheless manage to pass most of their kids. Userfriendlyyy also focuses on the absences: Looks to me like the policy they changed was losing credit for bad attendance. This might be from a few things. Kids might need to help out with the family finances. The only part of the job market that is doing well right now is low end unskilled workers who are willing to get paid crap (no matter how much the financial press wants to pretend otherwise, I listened to an hour of local NPR and the Topic was 'call in and tell us how the booming job market is helping you out', 20 callers not one had anything good to say and my state has one of the lowest unemployment rates in the country). If you know you don't have the grades for a scholarship, your family is broke and since we have effectively made going to college impossible for anyone but the offspring of the oligarchy, and you can find a minimum wage job easily; what exactly is the utility of that little piece of paper compared to the ability to put food on the table tonight?

[Some changes to the conclusions in this post; see edit at the end and entry 21 on Mistakes page] US News: DC Schools Brace For Catastrophic Drop In Graduation Rates. "Catastrophic" isn't hyperbole; the numbers are expected to drop from 73% (close to the national average of 83%) all the way down to 42%. There's no debate about why this is happening – it's because the previous graduation rate was basically fraudulent, inflated by pressure to show that recent "reforms" were working. Last year there was a big investigation, all the investigators agreed it was fraudulent, DC agreed to do a little less fraud this year, and this is the result. It's pretty damning, given how everybody was praising the reforms and holding them up as a national model and saying this proved that Tough But Fair Education Policy could make a difference: As far as scandals in the education policy world go, D.C. schools so profoundly miscalculating graduation rates at a time when the high-profile school district had been so self-laudatory about its achievements may be difficult to top […] Indeed, when Michelle Rhee took the reins of the flailing school system a decade ago, it galvanized the education reform movement, which had just begun blossoming around the country, and ushered in a host of controversial changes that included the shuttering of multiple schools, firing of hundreds of teachers and the institution of new teacher evaluation and compensation models. The changes not only dramatically altered the local political landscape in Washington but also shined a national spotlight on D.C. schools that prompted other urban school districts and education policy researchers to consider the nation's capital a bellwether for the entire education reform movement. Well, darn.

[I am not a neuroscientist and apologize in advance for any errors in this article.] Hey, let's review the literature on adult neurogenesis! This'll be really fun, promise. Gage's Neurogenesis In The Adult Brain, published in the Journal Of Neuroscience and cited 834 times, begins: A milestone is marked in our understanding of the brain with the recent acceptance, contrary to early dogma, that the adult nervous system can generate new neurons. One could wonder how this dogma originally came about, particularly because all organisms have some cells that continue to divide, adding to the size of the organism and repairing damage. All mammals have replicating cells in many organs and in some cases, notably the blood, skin, and gut, stem cells have been shown to exist throughout life, contributing to rapid cell replacement. Furthermore, insects, fish, and amphibia can replicate neural cells throughout life. An exception to this rule of self-repair and continued growth was thought to be the mammalian brain and spinal cord. In fact, because we knew that microglia, astrocytes, and oligodendrocytes all normally divide in the adult and respond to injury by dividing, it was only neurons that were considered to be refractory to replication. Now we know that this long accepted limitation is not completely true

From sclmlw: While I don't agree with lots of Jordan Peterson, I think Scott fundamentally missed the boat in some of his criticisms because he systematically views things from a different perspective than Peterson, which was missed. From what I can tell, Peterson is intensely interested in the idea, "Everyone has the capacity to become a Nazi war criminal. What causes that phenomenon?" His answer, and the central driving idea of his philosophy, seems to be, "Anarchy/chaos is worse for society/humanity than horrific, unimaginable cruelty. So evolution pushed society to develop in a way that will always choose cruelty over chaos. Thus, if you were in Stalin's Russia, you'd run the gulags to stave off anarchy, and you'd kill hundreds of people if you had to. You may hate it, but it was required for humanity to soldier on, so it's what evolutionary forces produced." Peterson cares because he wants to understand how to steer societies away from the gulags and the killing fields.

Recently on Marginal Revolution: Are the Amish unhappy? The average levels of life satisfaction [among the Amish] was 4.4; just above the neutral point…the Amish fall lower than members of many other groups. In a study of more than 13 thousand college students from 31 nations, for example, only students from Kenya (whose average life satisfaction was 4.0) scored lower than the Amish (Diener & Diener, 1995). Sounds like Amish people are quite unhappy. This came as a surprise to me, since I'd heard from Jonah Lehrer and Business Insider that the average Amish person is as happy as the average non-Amish billionaire, proving once and for all that community and old-fashioned values are more important than money: As an illustration of the striking disconnect between money and happiness, the average life satisfaction of Forbes magazine's 400 richest Americans was 5.8 on a 7-point scale. Yet the average life satisfaction of the Pennsylvania Amish is also 5.8, despite the fact that their average annual salary is several billion dollars lower.