[Original post: Vibecession - Much More Than You Wanted To Know]

Table of Contents

1: When was the vibecession?
2: Is the vibecession just sublimating cultural complaints?
3: Discourse downstream of the Mike Green $140K poverty line post
4: What about other countries?
5: Comments on rent/housing
6: Comments on inflation
7: Comments on vibes
8: Other good comments
9: The parable of Calvin's grandparents
10: Updates / conclusions

https://www.astralcodexten.com/p/highlights-from-the-comments-on-vibecession

This year's prediction contest is live on Metaculus. They write:

This year's contest draws directly from that community, with all questions suggested by ACX readers. Both experienced forecasters and newcomers are invited to participate, making predictions across U.S. politics, AI, international affairs, and culture.

To participate, submit your predictions by January 17th at 11:59 PM PT. At that time, we will take a snapshot of all standing forecasts, which will determine the contest rankings and the allocation of the $10,000 prize pool. While you are encouraged to continue updating your predictions throughout the year, forecasts made after January 17th will only affect site leaderboards, not contest rankings.

You are welcome to create a bot account to forecast and participate in addition to your regular Metaculus account. Create a bot account and get support building a bot here.

And they've also announced this year's winners for best questions submitted. Congratulations to:

1. Gumbledalf ($700)
2. espiritu57 ($500)
3. setasojiro843047 (Substack handle) ($400)
4. sai_39 ($300)
5. nicholaskross ($250)
6. (Anonymous) ($200)
7. (Anonymous) ($200)
8. RMD ($150)
9. (Anonymous) ($150)
10. Hippopotamus_bartholomeus ($150)

To participate in the tournament or learn more, go to Metaculus.

https://www.astralcodexten.com/p/acxmetaculus-prediction-contest-2026

Last year, I wrote that it would be very hard to decrease the number of mentally ill homeless people in San Francisco. Commenters argued that no, it would be easy, just build more jails and mental hospitals.

A year later, San Francisco feels safer. Visible homelessness is way down. But there wasn't enough time to build many more jails or mental hospitals. So what happened? Were we all wrong?

Probably not. I only did a cursory investigation, and this is all low-confidence, but it looks like:

1. There was a big decrease in tent encampments, because a series of court cases made it easier for cities to clear them. Most of the former campers are still homeless. They just don't have tents.
2. There might have been a small decrease in overall homelessness, probably because of falling rents.
3. Mayor Lurie claims to have a Plan To End Homelessness, but it's probably not responsible for the difference.
4. Every city accuses every other city of shipping homeless people across their borders, but this probably doesn't explain most of what's going on in San Francisco in particular.

https://www.astralcodexten.com/p/what-happened-to-sf-homelessness

I.

PEPFAR - a Bush initiative to send cheap AIDS drugs to Africa - has saved millions of lives and is among the most successful foreign aid programs ever. A Trump decision briefly put it "on pause", although this seems to have been walked back; its current status is unclear but hopeful.

In the debate around this question, many people asked - is it really fair to spend $6 billion a year to help foreigners when so many Americans are suffering? Shouldn't we value American lives more than foreign ones? Can't we spend that money on some program that helps people closer to home?

This is a fun thing to argue about - which, as usual, means it's a purely philosophical question unrelated to the real issue.

If you cancelled PEPFAR - the single best foreign aid program, which saves millions of foreign lives - the money wouldn't automatically redirect itself to the single best domestic aid program which saves millions of American lives.

https://www.astralcodexten.com/p/money-saved-by-canceling-programs

The best thing about personalized medicine is that it's obviously right. The worst thing is we mostly have no idea how to do it. We know that different people respond to different treatments. But outside a few special cases like cancer, we don't know how to predict which treatment will work for which person. Some psychiatric researchers claim they can do this at a high level; I think they're wrong. For most treatments and most conditions, there's no way to figure out whether a given sometimes-effective treatment will work on a given individual besides trying it and seeing.

This suggests that some chronic conditions might do best with a model centered around a controlled process of guess-and-check. When it's safe and possible, we should be maximizing throughput – finding out how to test as many medications as we can in the short time before we exhaust our patients' patience, and how to best assess the effects of each. The process of treating each individual should mirror the process of medicine in general, balancing the need to run controlled trials and gather more evidence with the need to move quickly.

I don't know how seriously to take this idea, but I would like to try it.

There's some literature suggesting that people are more careful when they think in probabilities. If you ask them for a definite answer, they might give it and sound very confident, but if you encourage them to think probabilistically they might admit there's more uncertainty.

I wanted to look into this in the context of the recent Supreme Court confirmation hearings, so I asked readers to estimate their probability that Judge Kavanaugh was guilty of sexually assaulting Dr. Ford. I got 2,350 responses (thank you, you are great). Here was the overall distribution of probabilities. Horizontal axis is percent chance he did it; vertical axis is number of people who responded with that percent:

This looks weird because people were most likely to give numbers rounded off the the nearest ten.

I separated responses into bins from 0 – 9%, 10 – 19%, and so on to 90 – 100%. Keep in mind that the last bin is slightly larger than the others, so it might make it unfairly look like more people gave extreme high answers than extreme low answers. I also switched the vertical axis to percent of responses in each bin. Smoothed out, it looks like this:

This looks pretty balanced, and it is: the average probability is 52.64%. This is probably a fake balance based on all the different demographic skews involved cancelling out: 2.5x as many Democrats as Republicans answered the survey, but 9x as many men as women did.

Thanks to the 129 people who tried altering their nighttime carbon dioxide levels after my post on this, and who reported back to me. There was no difference between people who pre-registered for the study and people who didn't, on any variable, so I ignored pre-registration.

126 people reported one intervention they performed. The most common was sleeping with a window open: 

People generally reported slight but positive changes: 

When asked to rate the magnitude of improvement to well-being on a 0 to 5 scale, they averaged 1.4: 

I mentioned in the post that succulents could help in theory, but you needed to get the right kind of succulents and you needed at least ten of them. I was skeptical that anyone really got ten succulents in their room, so I wondered whether that might work as a crypto-placebo group.

If so, the intervention failed to separate from placebo. Succulent users had an average improvement of 1.29, compared to about 1.50 for people who did other things. The difference wasn't significant, although admittedly the sample size was low.

Looking at the various groups, the most striking difference was actually people who left a window open (1.57) vs. people who did one of the other named options (1.31). A few people who left windows open mentioned this made their room cooler, which seemed to help with sleep. But this is very post hoc, and this difference wasn't significant either.

[Content note: attempt to consider real people's real problems using angel-on-pinhead impractical reasoning and ideas]

I.

Imagine the state of nature, except for some reason there are cities. Some people in these cities play the drums all night and keep everyone else awake. The sleep-deprived people get together and agree this is unacceptable. They embark on a long journey to the wilderness where they found their own community of Nodrumia.

They form a company, the Nodrumia Corporation, which owns all the property in the area. The corporation distributes usage rights via a legal instrument that looks suspiciously like private property: people who own usage rights keep them forever, can do whatever they want with the land, and can freely transfer and sell them to others. The only difference is that the usage rights have a big asterisk on them saying "contract is null and void if you break the rules of the Nodrumia Corporation". These rules are set by a board chosen democratically by the inhabitants, and are all things like "You can't play drums at night", and "You can't sell property to people who will play the drums at night", and "Anyone who plays the drums at night shall be exiled".

One day a Nodrumian wants to move out, so he puts his house up for sale. The highest bidder is a drummer who wants to use the property as a studio so he can play the drums at night. The Corporation steps in and bans the sale. The property owner protests, saying that he is being oppressed.

According to libertarian philosophy, who is in the right?

The argument against the drummer: the land is basically the private property of the Nodrumia Corporation, and libertarians believe that private landowners should be able to determine what happens on their property. And more fundamentally, the people there have a strong preference against living near drummers, and that preference seems fundamentally satisfiable if their property rights are respected, and it seems stupid to legislate a world where people are forever forbidden from satisfying a fundamentally satisfiable preference and have to be unhappy all the time.

Quixote writes:

It's odd to me how bad San Francisco is, when other large cities like New York or Paris are basically utopias.

But just a few comments down, Lasagna says:

I despise (I'm choosing that word carefully) [New York City]. I still commute there every day, and I can't stand it – the broken infrastructure, the horrible smells, the $14 for a yogurt and coffee in the morning, the massive crowds of unpleasant people (how could we NOT be? We're walking through an open sewer). There's a litany of other things that keep me permanently angry and depressed (just the thought of how much earlier I would have started a family if I didn't live there….) I find it decadent, selfish, shallow – pick your bad adjective. I'll stop now.

Where I live now is nice. We have a town we can walk to, a lawn for the kids to play on and me to mow, we cook at home, we have enough room for our family to live and the kids to get exercise, even indoors. There's no WAY I'm giving that up so I can live in an apartment again, all so NYC can squeeze MORE people into its area.

If I had my way, we'd be much further away from the metro area than we are now, in a bigger, cheaper home with more land. But that isn't possible; NYC is where my job is, and that's that. Fine. But let's not make things worse, and make NYC (and San Francisco, and DC, and Boston) even MORE indispensable generators of jobs. And please don't think for a second that there aren't sizable numbers of people like me, and like you, who do not want these things for our families […] Thanks for letting me rant. You should have seen the first draft of this thing. Twice as long, Scott. A litany of woes and anger.

This would be fascinating if it weren't so predictable. One person describes NYC as "basically utopia", and another person can't stop ranting about how much he hates it and is glad to have escaped it.

In the same vein, from Cerastes:

"I think neurotypical people usually underestimate how bad cities are for people with noise sensitivities, anxiety, purity intuitions, or just a need for nature and green things in their environment, …"

THIS!!! A MILLION TIMES THIS!!

The concept of living somewhere that isn't green is literally nauseating to me, and the idea of a place that isn't teeming with wild animals feels like suffocating. My house is in as wild a place as possible given my commute, budget, and region, and almost every room has a fully planted vivarium with an animal (as well as my office).

The amount of urbanist triumphalist crap drives me up the wall, as if these people cannot see why someone would not want to live in conditions far inferior to even low-quality zoos, or why someone might need to balance a job in a city with such desires.

Being 100% honest, I actually feel like there's something genuinely wrong with people who don't feel the need to spend time in nature, especially if they also lack pets. They're like sterile androids in some sort of weird dystopia, utterly cut off from life.

[Epistemic status: very unsure. I sympathize with many YIMBY ideas and might support them on net; this post is me exaggerating the NIMBY parts of my brain to a degree I'm not sure I honestly support. This focuses on San Francisco to make it easier, but other cities exist too. Thanks to Nintil for some of the bright-line argument in part four. Conflict of interest notice: I live in a lower-density part of Oakland]

Everyone I know is a YIMBY – ie "Yes In My Back Yard" – ie somebody who wants cities (usually San Francisco dominates the discussion) to build more and denser housing. This is a reasonable position, and is held by apparently-reasonable people – centrists, rationalists, economists, self-proclaimed neoliberals. Since everyone involved holds reason and civility as an important value, I would expect the discourse around housing to be unusually reasonable and civil.

I have a weird habit of encountering the best parts of some movements and the worst parts of other movements, in a way that doesn't match other people's experiences. And certainly I know many YIMBYs who are amazing people who I love. But as for the movement as a whole, I feel like apparently-reasonable people have dropped the ball on this one. Sorry for having to say this, but YIMBYism is one of the most tribal, most emotional, most closed-minded movements I have ever seen this side of a college campus. So much so that even though I agree with much of what it says, I cannot resist writing a 5,000 word steelman of their enemies just to piss them off.

So here are some YIMBY claims and why I cannot be entirely on board with them.

Grand Prize ($1000): Does The Education System Adequately Serve Advanced Students?

Editor's Choice ($500): Should Transgender Children Transition?

Honorable Mentions ($250): Should Childhood Vaccination Be Mandatory?, Are Islam And Liberal Democracy Compatible?

I'm sorry for jerking the number and value of the prizes around so many times, but I wanted to balance my preferences, the contestants' preferences, and readers' preferences – and this was the best way I could think of to do it. Nobody has gotten less money than they expected, although some prize categories have gotten more money than I originally said. In the end I could not in good conscience let any of these escape without getting a prize. Thanks to this blog's Patreon supporters for making this possible. All winners should email me with their preferred form of payment (I can do Paypal, Bitcoin, or donations to a charity of their choice).

The overwhelming winner of the popular vote was the collaboration on education. I agree this one was excellent. It cited a lot of research, analyzed it very well, and mostly came to conclusions. Its only flaw from my perspective was a lack of focus; it discussed many different educational interventions, some of which were similar enough that it was hard for me to keep track of what was going on.

I chose the collaboration on transgender children. I thought it did an exceptional job of addressing a specific hot-button issue many people are concerned about, presenting all the evidence on both sides, and mostly coming to conclusions. My strongest complaint was that it ignored some of the potential side effects of puberty blockers which commenters pointed out, and sort of trivialized bone problems that are not trivial; given that the side effects of puberty blockers was a major crux of this question, I found that to be a major weakness. I was still very impressed with the piece's ability to break down and navigate such a controversial question.

A neglected gem from Less Wrong: Why The Tails Come Apart, by commenter Thrasymachus. It explains why even when two variables are strongly correlated, the most extreme value of one will rarely be the most extreme value of the other. Take these graphs of grip strength vs. arm strength and reading score vs. writing score:

In a pinch, the second graph can also serve as a rough map of Afghanistan

Grip strength is strongly correlated with arm strength. But the person with the strongest arm doesn't have the strongest grip. He's up there, but a couple of people clearly beat him. Reading and writing scores are even less correlated, and some of the people with the best reading scores aren't even close to being best at writing.

Thrasymachus gives an intuitive geometric explanation of why this should be; I can't beat it, so I'll just copy it outright:

I thought about this last week when I read this article on happiness research.

The summary: if you ask people to "value their lives today on a 0 to 10 scale, with the worst possible life as a 0 and the best possible life as a 10", you will find that Scandinavian countries are the happiest in the world.

But if you ask people "how much positive emotion do you experience?", you will find that Latin American countries are the happiest in the world.

If you check where people are the least depressed, you will find Australia starts looking very good.

And if you ask "how meaningful would you rate your life?" you find that African countries are the happiest in the world.

It's tempting to completely dismiss "happiness" as a concept at all, but that's not right either. Who's happier: a millionaire with a loving family who lives in a beautiful mansion in the forest and spends all his time hiking and surfing and playing with his kids? Or a prisoner in a maximum security jail with chronic pain? If we can all agree on the millionaire – and who wouldn't? – happiness has to at least sort of be a real concept.

The solution is to understand words as hidden inferences – they refer to a multidimensional correlation rather than to a single cohesive property. So for example, we have the word "strength", which combines grip strength and arm strength (and many other things). These variables really are heavily correlated (see the graph above), so it's almost always worthwhile to just refer to people as being strong or weak. I can say "Mike Tyson is stronger than an 80 year old woman", and this is better than having to say "Mike Tyson has higher grip strength, arm strength, leg strength, torso strength, and ten other different kinds of strength than an 80 year old woman." This is necessary to communicate anything at all and given how nicely all forms of strength correlate there's no reason not to do it.

A prodrome is an early stage of a condition that might have different symptoms than the full-blown version. In psychiatry, the prodrome of schizophrenia is the few-months-to-few-years period when a person is just starting to develop schizophrenia and is acting a little bit strange while still having some insight into their condition.

There's a big push to treat schizophrenia prodrome as a critical period for intervention. Multiple studies have suggested that even though schizophrenia itself is a permanent condition which can be controlled but never cured, treating the prodrome aggressively enough can prevent full schizophrenia from ever developing at all. Advocates of this view compare it to detecting early-stage cancers, or getting prompt treatment for a developing stroke, or any of the million other examples from medicine of how you can get much better results by catching a disease very early before it has time to do damage.

These models conceptualize psychosis as "toxic" – not just unpleasant in and of itself, but damaging the brain while it's happening. They focus on a statistic called Duration of Untreated Psychosis. The longer the DUP, the more chance psychosis has had to damage the patient before the fire gets put out and further damage is prevented. Under this model it's vitally important to put people who seem to be getting a little bit schizophrenic on medications as soon as possible.

There has been a lot of work on this theory, but not a lot of light has been shed. Observational studies testing whether duration of untreated psychosis correlates with poor outcome mostly find it does a little bit, but there's a lot of potential confounding – maybe lower-class uneducated people take longer to see a psychiatrist, or maybe people who are especially psychotic are especially bad at recognizing they are psychotic. The relevant studies try their hardest to control for these factors, but remember that this is harder than you think. The randomized controlled trials of what happens if you intervene earlier in psychosis tend to do very badly and rarely show any benefit, but randomly intervening earlier in psychosis is hard, especially if you also need an ethics board's permission to keep a control group of other people who you are not going to intervene early on. Overall I could go either way on this.

I.

Writing a review of The Black Swan is a nerve-wracking experience.

First, because it forces me to reveal I am about ten years behind the times in my reading habits.

But second, because its author Nassim Nicholas Taleb is infamous for angry Twitter rants against people who misunderstand his work. Much better men than I have read and reviewed Black Swan, messed it up, and ended up the victim of Taleb's acerbic tongue.

One might ask: what's the worst that could happen? A famous intellectual yells at me on Twitter for a few minutes? Isn't that normal these days? Sure, occasionally Taleb will go further and write an entire enraged Medium article about some particularly egregious flub, but only occasionally. And even that isn't so bad, is it?

But such an argument betrays the following underlying view:

 It assumes that events can always be mapped onto a bell curve, with a peak at the average and dropping off quickly as one moves towards extremes. Most reviews of Black Swan will get an angry Twitter rant. A few will get only a snarky Facebook post or an entire enraged Medium article. By the time we get to real extremes in either directions – a mere passive-aggressive Reddit comment, or a dramatic violent assault – the probabilities are so low that they can safely be ignored.

Some distributions really do follow a bell curve. The classic example is height. The average person is about 5'7. The likelihood of anyone being a different height drops off dramatically with distance from the mean. Only about one in a million people should be taller than 7 feet; only one in a billion should be as tall as 7'5. Nobody is order-of-magnitude differences in height from anyone else. Taleb calls the world of bell curves and minor differences Mediocristan. If Taleb's reaction to bad reviews dwells alongside height in Mediocristan, I am safe; nothing an order-of-magnitude difference from an angry Twitter rant is likely to happen in entire lifetimes of misinterpreting his work.

But other distributions are nothing like a bell curve. Taleb cites power-law distributions as an example, and calls their world Extremistan. Wealth inequality lives in Extremistan. If wealth followed a bell curve around the median household income of $57,000, and a standard deviation scaled the same way as height, then a rich person earning $70,000 would be as remarkable as a tall person hitting 7 feet. Someone who earned $76,000 would be the same kind of prodigy of nature as the 7'6 Yao Ming. Instead, people earning $70,000 are dirt-common, some people earn millions, and the occasional tycoon can make hundreds of millions of dollars per year. In Mediocristan, the extremes don't matter; in Extremistan, sometimes only the extremes matter. If you have a room full of 99 average-height people plus Yao Ming, Yao only has 1.3% of the total height in the room. If you have a room full of 99 average-income people plus Jeff Bezos, Bezos has 99.99% of the total wealth.

The Honduras Supreme Court has declared charter cities, including Prospera, unconstitutional.

The background: in the mid-2010s, the ruling conservative party wanted charter cities. They had already packed the Supreme Court for other reasons, so they had their captive court declare charter cities to be constitutional.

In 2022, the socialists took power from the conservatives and got the chance to fill the Supreme Court with their supporters. In September, this new Supreme Court said whoops, actually charter cities aren't constitutional at all. They added that this decision applied retroactively, ie even existing charter cities that had been approved under the old government were, ex post facto, illegal.

Prospera's lawyers objected, saying that the court is not allowed to make ex post facto rulings. But arguing that the Supreme Court is misinterpreting the Constitution seems like a losing battle - even if you're right, who do you appeal to?

So the city is pursuing a two-pronged strategy. The first prong is waiting. Prospera is a collection of buildings and people. The buildings can stay standing, the people can still live there - they just have to follow regular Honduran law, rather than the investment-friendly charter they previously used. There's another election in November, which the socialists are expected to lose. Prospera hopes the conservatives will come in, take control of the Supreme Court again, and then they'll say whoops, messed it up again, charter cities are constitutional after all.

https://www.astralcodexten.com/p/model-city-monday-2325

The collective intellect is change-blind. Knowledge gained seems so natural that we forget what it was like not to have it. Piaget says children gain long-term memory at age 4 and don't learn abstract thought until ten; do you remember what it was like not to have abstract thought? We underestimate our intellectual progress because every every sliver of knowledge acquired gets backpropagated unboundedly into the past.

For decades, people talked about "the gene for height", "the gene for intelligence", etc. Was the gene for intelligence on chromosome 6? Was it on the X chromosome? What happens if your baby doesn't have the gene for intelligence? Can they still succeed?

Meanwhile, the responsible experts were saying traits might be determined by a two-digit number of genes. Human Genome Project leader Francis Collins estimated that there were "about twelve genes" for diabetes, and "all of them will be discovered in the next two years". Quanta Magazine reminds us of a 1999 study which claimed that "perhaps more than fifteen genes" might contribute to autism. By the early 2000s, the American Psychological Association was a little more cautious, was saying intelligence might be linked to "dozens – if not hundreds" of genes.

When you first take the Artifact, you will see a vision of ALPHANION, Demon-Sultan of the Domain of Order, who appears as a grid of spheres connected by luminous lines. Alphanion will urge you to use the Artifact to enforce cosmic order, law at its most fundamental. He will show you visions of all the most brutal and sadistic crimes of history, of all the wars caused by nations that could not live together in harmony, and he will tell you they are all preventable. He will show you dreams of perfectly clean cities with wide open streets, where everyone earns exactly the optimal amount of money and public transportation is accurate to the second. He will tell you it is all attainable.

But if you hesitate even an instant to take Alphanion's offer, you will see a vision of CTHGHFZXAY, Demon-Shah of the Domain of Chaos, who appears as a shifting multicolored cloud. Cthghfzxay will urge you to use the Artifact to promote cosmic chaos, the ultimate principle of freedom. She will condemn the works of Order as a lie, a dystopia bought at the cost of true human liberty. She will show you visions of primaeval forests, where no two flowers are alike, where each glade holds a new mystery, where people run wild in search of new adventure. She will tell you it can all be yours.

As you weigh these two offers, you will see a vision of ZAMABAMAZ, Demon-Pharaoh of the Domain of Balance, who appears as a man and woman conjoined. They will tell you that neither Order nor Chaos is at the root of human flourishing, but an ability to strike the right balance between the two. That a virtuous life is one spent in moderation between total wild liberty and a stifling concept of rote rule-following. That Alphanion and Cthfhfzxay are the two poles of the universe, and that righteousness exists in the space created by their interaction. They will ask you to devote the Artifact and its power to the Domain of Balance, so all people can better manage the interaction of Order and Chaos in their own lives.

This will seem reasonable to you, but then there will appear a vision of IYYYYYYYYYYYYYYYYYYYYYYY, Demon-Raja of the Domain of Excess, who appears as a blinding violet light. It will tell you that both Order and Chaos present coherent visions of the world, but that for the love of God, choose one or the other instead of being a wishy-washy milquetoast who refuses to commit to anything. It will tell you that blinding white and pitch black are both purer and more compelling than endless pointless grey. It will ask you to give the Artifact to somebody – anybody – other than Zamabamaz.

This is the bi-weekly visible open thread (there are also hidden open threads twice a week you can reach through the Open Thread tab on the top of the page). Post about anything you want, ask random questions, whatever. You can also talk at the SSC subreddit or the SSC Discord server – and also check out the SSC Podcast. Also:

1. Comment of the week is Stefferi on the circumstances leading to the rise of Hitler. See also idontknow: "The strongest defense against extreme right wingers is a moderate right wing party that is vigorous."

2. Please vote for your favorite adversarial collaboration from the last week. The entries were:

a. Does The Education System Adequately Serve Advanced Students?
b. Are Islam And Liberal Democracy Compatible?
c. Should Childhood Vaccination Be Mandatory?
d. Should Transgender Children Transition?

After some discussion with the contestants, the winner of the popular vote will get a $500 prize, and the winner of my vote will get a second $500 prize; these may or may not be the same entry. After you've read all the entries, you can vote here.

[This is an entry to the Adversarial Collaboration Contest by flame7926 and a_reader.]

[Content note: suicide, depression, transphobia, self-harm]

Transgender childhood transition is a hotly debated topic, with extensive media coverage devoted to it in recent years. (pro: BBC, The Lancet and The New York Times ; contra: The Cut, New Statesman and The Globe and Mail).We see plenty of stories of transgender children (or gender dysphoric children and gender nonconforming children), both in the media and in the blogosphere. As early as 2 or 3, defying the expectations of their family, those children show a persistent and insistent preference for many things associated with the other sex: little boys want long hair and love dresses, Barbie dolls, Disney princesses and mermaids; little girls, instead, dislike stereotypically feminine activities and prefer rough and tumble play, refuse to wear dresses and insist to have their hair shorter and shorter.

Sometimes, from the very beginning, the toddler corrects the parents: "I'm a boy /girl!", but more frequently cross-gender behavior is more prevalent. This is only sometimes followed with the child expressing preferences that would be termed gender dysphoria. The child (born and currently living as a as one sex) says to their parents something like "God made a mistake" or "something went wrong in Mommy's tummy" because he should have been a girl, not a boy (or the other way around). The worried parents search information on the internet and seek out the advice of an expert. There, they usually find one or both of these contradicting opinions:

Gender-affirming approach

Listen to your child – he/she knows best his/her gender. Let your child be his/her true self. It's your responsibility as a parent to support your child in all stages of his/her transition: social transition now, puberty blockers at the beginning of puberty, cross-sex hormones in adolescence, surgery at 18. To oppose it is child abuse. Transphobia costs lives: 41% of transgenders attempt suicide. Do you prefer a happy daughter or a dead son?

Or:

Therapeutic approach

Your child is just confused. He/she is too young to understand gender and to take such important decision. 80% of gender nonconforming children desist. You, as a parent, have the responsibility to correct his/her wrong behavior. If you tolerate it, gender dysphoria will be reinforced by repetition and persist to adulthood. To encourage your child's delusion is child abuse. Transgenders individuals face lifelong struggle and often suffer from poor mental health: 41% of transgenders attempt suicide. Do you really want that for your son, when he could instead come to accept the body he was born with?

The first approach is promoted by transgender activists, the second by the conservative media, but both are supported by some experts. The "Gender-affirming approach" is supported by the Dutch team from the Gender Clinic at VU Medical Centre, Amsterdam, who elaborated the typical transition treatment for minors, with puberty blockers at 12 and cross-sex hormones at 16, and, in the US, by Kristina Olson and others from the TransYouth Project. The "Therapeutic approach" is supported by Kenneth Zucker and his team from the Gender Identity Service at Centre for Addiction and Mental Health, Toronto, and, in the US, by Paul McHugh at Johns Hopkins University School of Medicine. There are also experts such as Debra Soh, once a gender nonconforming girl herself, that advise parents to wait and see until adolescence, because in many cases gender dysphoria desists spontaneously, without intervention.

Who to believe when the experts disagree? Let's see the evidence.

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.

(Shabbat is the Jewish Sabbath, celebrated every Saturday, when observant Jews are forbidden to work, drive, carry things outdoors, spend money, use electrical devices, etc.)

She said that in the dreams, she would be out driving, far from home, and realize that Shabbat was due to begin in a few minutes, with no way to make it home or get a hotel in time.

I found this interesting because my recurring dreams are usually things like being caught unprepared for a homework assignment I have due tomorrow, or realizing I have to catch a plane flight but I'm not packed and don't have a plan to get to the airport.

Most people attribute recurring nightmares to "fear". My friend is "afraid" of violating Shabbat; childhood me was "afraid" of having the assignment due the next day. This seems wrong to me. Childhood me was afraid of monsters in the closet; adult me is afraid of heart attacks, AI, and something happening to my family. But I don't have nightmares about any of these things, just homework assignments and plane flights.

So maybe the "unprepared" aspect is more important. Here's a story that makes sense to me: what if recurring dreams are related to prospective memory?

https://www.astralcodexten.com/p/why-recurring-dream-themes

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.

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."

Thanks to the 5,975 people who took the 2025 Astral Codex Ten survey.

See the questions for the ACX survey

See the results from the ACX Survey (click "see previous responses" on that page1)

I'll be publishing more complicated analyses over the course of the next year, hopefully starting later this month. If you want to scoop me, or investigate the data yourself, you can download the answers of the 5500 people who agreed to have their responses shared publicly. Out of concern for anonymity, the public dataset will exclude or bin certain questions2. If you want more complete information, email me and explain why, and I'll probably send it to you.

You can download the public data here as an Excel or CSV file:

• http://slatestarcodex.com/Stuff/ACXPublic2025.xlsx
• http://slatestarcodex.com/Stuff/ACXPublic2025.csv

Here are some of the answers I found most interesting:

https://www.astralcodexten.com/p/acx-survey-results-2025

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:

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.

Whenever I talk about charity, a type that I'll call the "based post-Christian vitalist" shows up in the comments to tell me that I've got it all wrong. The moral impulse tells us to help our family, friends, and maybe village. It's a weird misfire, analogous to an auto-immune disease, to waste brain cycles on starving children in a far-off country who you'll never meet. You've been cucked by centuries of Christian propaganda. Instead of the slave morality that yokes you to loser victims who wouldn't give you the time of day if your situations were reversed, you should cultivate a master morality that lets you love the strong people who push forward human civilization.

A younger and more naive person might think the based post-Christian vitalist and I have some irreconcilable moral difference. Moral argument can only determine which conclusions follow from certain premises. If premises are too different (for example, a intuitive feeling of compassion for others, vs. an intuitive feeling of strength and pitilessness), there's no way to proceed.

https://www.astralcodexten.com/p/everyones-a-based-post-christian

[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.