Re: The difference between red and blue.

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Conservatives are so galled by the terrible decisions of brown people, that they have no compassion for the fact that the stakes are really, really high.


Posted by: potchkeh | Link to this comment | 07- 7-08 10:03 AM
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Yes, absolutely.

But you'd see this split operating in a small Nebraska town, where they debate what to do with the town alcoholic, where he and everyone are white as white bread.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:05 AM
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I think your post is going back and forth between types of bad decisions. Are you talking about criminal acts or just dumb decisions like poor money management? (Although eventually bad decisions plus no safety net leads to criminal acts- how long it takes is probably a function of how much money you have in the first place.)


Posted by: SP | Link to this comment | 07- 7-08 10:09 AM
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The leading bad decision that causes personal bankruptcy: getting sick.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:10 AM
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Seriously, the problem you are looking at is that dreadful fourth class of people who are foolish enough to get sick--really, really sick, like developing cancer--when they don't have a safety net. Republicans can't tolerate that kind of poor decision making, and democrats are so obsessed by the "ooh, cancer" part that they forget that bad decision making led us to this point.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:12 AM
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No, I'm trying to avoid "Republican" and "Democrat" and have a conversation with an arm-chair conservative who might be your uncle and is generally a reasonable person. So getting sick is not part of the conversation, even though it's a huge problem in reality.

Are you talking about criminal acts or just dumb decisions like poor money management?

Criminal acts and medical problems are not includable as categories without specifics about the personal decisions that are making the whole thing much, much worse.

An example would be the person who has mismanaged their disease because they don't take their medication, etc. (NOT because they can't afford it. That is sympathetic.)

I play soccer with a woman who has mismanaged her diabetes so disastrously since she was a teenager, that now she has seizures almost daily and can't live on her own. She had to move back in with her parents, and has some brain damage at this point. What if she had no resources?


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:19 AM
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I'm really trying to say, what do you do with the person who you have lost every shred of sympathy for? So it dodges the question to repackage them as sympathetic.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:21 AM
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Seriously, the problem you are looking at is that dreadful fourth class of people who are foolish enough to get sick--really, really sick, like developing cancer--when they don't have a safety net.

Seriously, Rob, this is condescending as hell.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:22 AM
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This is a bleeding heart vs. tough split that does sort of track liberal vs. conservative in some ways. It's helped create the background stereotypes of the two parties, for sure. The old social policy debate on the "worthy" vs. the "unworthy" poor that goes back to the early 19th century at least. One can question the sort of inherently patronizing aspect of wanting to help the "unworthy poor", as well as the ways poverty itself makes the sober bourgeois virtues very hard to attain, but I think there's something to it.

But in the 90s (and today) the Democratic party and liberalism as a political movement did quite a lot to distance itself from being just advocates for the "unworthy poor". Tough-on-crime, fiscally responsible, self-consciously aligned with middle class economic interests around health care and the like, a rhetorical shift to trying to speak for "working families", welfare reform that jettisoned AFDC (which pays you not to work) in favor of income supports for the working poor like the EITC and expanded Medicaid, etc. This did a lot to lay the groundwork for the Democrats as a new majority party.

Also, liberalism today is connected to a whole bunch of environmental and foreign policy issues that have little or nothing to do with the "bleeding heart" thing, although the Reps try to cast them that way. If anything, the Republicans can easily be cast as the profligate irresponsible ones who make bad choices.


Posted by: PGD | Link to this comment | 07- 7-08 10:23 AM
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I'm really trying to say, what do you do with the person who you have lost every shred of sympathy for?

If your blood flowed truly blue, you could not ask this. Few indeed are they for whom I can manage to lose every shred of sympathy.


Posted by: Di Kotimy | Link to this comment | 07- 7-08 10:24 AM
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About 300 nanometers, I'd have said.


Posted by: Populuxe | Link to this comment | 07- 7-08 10:25 AM
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FWIW, I actually have had long discussions with intelligent Republican economists who seriously argued that publically financed health care was bad because people should pay all the costs of their bad lifestyle decisions that led to health problems. I felt the vast philosophical gulf open between us.


Posted by: PGD | Link to this comment | 07- 7-08 10:26 AM
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Sorry heebie, that was uncalled for. I'm a little cranky right now.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:28 AM
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Sigh.

I dare you to define a 'bad' decision in such a way that everyone agrees with it. You will quickly run into the attribution error where my bad decisions were obviously either bad luck or normal human error but your bad mistakes indicate a character flaw.

So before you define your terms any discussion is fruitless. I suspect that defining your terms will be very difficult because of all the gray areas where a decision turns out bad because of a combination of ignorance, stupidity, where one came from, one's experiences, one's character, and bad luck.

For me personally I try to follow Jesus' advice that what I do for the least of us I do for him. I try to let God do the judging.

Yes, I am dodging the horribly complicated snarly mess you are trying to straighten out.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 10:31 AM
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Partly, what rob says, though there are whole other categories of bad decisions. Drug, gambling of various sorts, etc. It wasn't Mary McCarthy, but somebody said of Republicans that they simply have a profound misunderstanding of the meaning of achievement. But it isn't only Republicans, it is the rest of us too.

Hey the Xian metaphors just come to mind. "There but for the Grace of God go I" & "There is nothing good but comes from God" are profound serious moral ideas.

Your work, love, charity...nothing entitles you to anything you have or anything you are as a just desert. You are free to celebrate a world of injustice, which I think was the pre-Enlightenment position.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 10:32 AM
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10 is correct- the view of what's a bad decision vs. sympathetic is going to vary along with views of what to do for such people. You might see an obese person and think about how they can only afford unhealthy processed food because they're poor, while Uncle Republican will think about how that fat person needs to get off their ass and exercise more before we all end up paying for their trip to the ER for a heart attack.


Posted by: SP | Link to this comment | 07- 7-08 10:33 AM
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Pwned by Tripp & others I suppose, tho I tried to be more obnoxious about it.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 10:34 AM
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Personally, my decision to be born an upper middle class white American was the best I ever made. If you failed to make the same choice, that's your problem.


Posted by: SP | Link to this comment | 07- 7-08 10:35 AM
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Yes, I am dodging the horribly complicated snarly mess you are trying to straighten out.

I think you are doing the right thing, tripp. Framing the issue in terms of the worthy and unworthy poor is a horrible mistake. Any serious attempt to look at the complexities of someone's life will make it almost impossible to sort out blame.

And what good would it do if you did sort out the worthy from the unworthy poor? It would not help you reduce either category. The factors that lead to both bad decisions and the inability to deal with bad luck are the same: Inadequate access to health care (including drug rehab)and eduction, isolation of the very poor, lack of jobs, etc.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:36 AM
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Well, I'm glad you all see the world in such unambiguous beautiful clarity.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:37 AM
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Few indeed are they for whom I can manage to lose every shred of sympathy

I have to say I agree. Perhaps heebie overstated. The woman who's mismanaged her diabetes -- well, why? It's actually a complicated thing to do, and likely easy as hell to stray, repeatedly. So, sympathetic.

Ask the armchair conservative whether the people in question are outside his monkeysphere.


Posted by: parsimon | Link to this comment | 07- 7-08 10:37 AM
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You are going about this in the wrong way, rob. Conservatives think people should pay for their mistakes. Ergo, they create policies that punish people who make mistakes. These policies end up largely punishing people for mistakes such as "thinking that having children will make me more mature", or "thinking that the price of a college degree bears some relation to its quality or usefulness", or in your example, "failing to buy the kind of insurance that covers every unforeseen and random occurrence".

Then you conclude that conservatives hate "brown people" and people with no personal wealth. Maybe Tom DeLay does, but most people who will vote for McCain for domestic-policy reasons only know that they want to support a culture of personal responsibility, or an end to unfair handouts, or some such nonsense. You won't convince anyone by telling them that the destructive and evil results of their votes reveal that what they were actually intending to vote for is destruction and evil.


Posted by: Fatman | Link to this comment | 07- 7-08 10:37 AM
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Bob, I think I managed to be more obnoxious than you. I'm teaching health care distribution in my online class right now and it is pissing the hell out of me. I have a whole chorus of "I shouldn't have to pay the medical bills of lazy people." Yet, oddly, most of the people I teach would be bankrupted by a major illness.

That's the thing. Getting sick isn't an odd case that you can dismiss, compared to the legions of unworthy poor. The *majority* of cases of bankruptcy are caused by personal illness.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:40 AM
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Aside from all the anarcho-syndicalist stuff about redistributing wealth and forgiving criminals, the most forgotten part of Jesus's teachings might be the stuff about how we are all sinners, we all make mistakes, there but for the grace of God go I, et cetera. And I think these were things that most Christians believed in this country just a century ago. Oh well, they were more racist back then too.

This is a symptom of the peak of affluence we've been reaching recently, from which we are now going downhill. There are people now, more than the traditional tiny fraction of aristocrats, an actual voting bloc, for whom if they do stick to the straight and narrow, nothing particularly bad will ever go wrong with them, except deaths or medical emergencies, both of which are financially alleviated by health insurance. Therefore they think that this unprecedented state of comfort is something that people can achieve, rather than lucking into.


Posted by: Fatman | Link to this comment | 07- 7-08 10:43 AM
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Well, I'm glad you all see the world in such unambiguous beautiful clarity.

Well, compassion & empathy makes it all very complicated, of course.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 10:43 AM
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Framing the issue in terms of the worthy and unworthy poor is a horrible mistake.

Look, let's use the word "self-sabotaging" then.

The poor who make self-sabotaging decisions are why the two groups in charge of legislation keep talking at cross-purposes.

Everyone here is certain that this group does not exist. You may have utmost sympathy for the person who makes self-sabotaging decisions, but that doesn't make them an easy-to-deal with case.

Ask the armchair conservative whether the people in question are outside his monkeysphere.

He's probably got some people in his family that he would categorize in this way.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:45 AM
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Well, I'm glad you all see the world in such unambiguous beautiful clarity.

I actually though I was acknowledging complexity when I said that it was impossible to sort out the worthy from the unworthy poor in real cases.

I should step away from this thread.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:45 AM
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This post would be considerably better if the various instances of "terrible decisions" were replaced with "bad luck."


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 10:45 AM
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I'm lurking, and shouldn't be commenting, but heebie is perfectly right that this is a huge issue with political consequences, and people attempting to reject her premises are being silly. Of course there are people who are poor/injured/sick/in trouble of whatever sort because they made inexcusably stupid decisions. I'm related to people in this category. And 'you made your bed, so you lie in it' is an appealing response on some level to people in this sort of position; either out of a straightforward sense of justice, or a belief that making people suffer from bad decisions is practically sensible because it will 'incentivize' them to to make better decisions in future (or terrorize other people into not fucking up).

I'm a liberal, so I think that's a foolish response, both practically and as a matter of justice. But it's an issue that has to be addressed clearly, rather than by claiming that it's not reasonable to think of anyone's problems as meaningfully their own fault.


Posted by: LizardBreath | Link to this comment | 07- 7-08 10:45 AM
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Rich people make self-sabotaging decisions too! I'm not saying this is a feature of being poor! Just that the stakes are high.

Ugh, I feel like I'm defending conservatives, when from the get-go I said that my heart bleeds blue. Screw all this.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:47 AM
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The *majority* of cases of bankruptcy are caused by personal illness.

I don't buy this number, BTW. They only get to it by counting everyone reporting both a bankruptcy and unpaid medical bills as a bankruptcy "caused" by illness. Plus they count stuff like addiction or uncontrolled gambling as medical problems.

Here's the study for anyone who is interested.

http://content.healthaffairs.org/cgi/content/full/hlthaff.w5.63/DC1


Posted by: PGD | Link to this comment | 07- 7-08 10:47 AM
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Ugh, I feel like I'm defending conservatives, when from the get-go I said that my heart bleeds blue. Screw all this.

This is turning into a peek at the beginnings of Ogged. Soon Heebie will embrace this seeming concern troll position. Then she will eschew team sports in favor of obsessive focus on individual performance...


Posted by: Po-Mo Polymath | Link to this comment | 07- 7-08 10:49 AM
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30: Don't give up! I really can't comment all day any more, but I will be distraught if you let a valuable discussion drop because people are attacking your perfectly sensible premises.


Posted by: | Link to this comment | 07- 7-08 10:50 AM
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I am incredibly grateful for 29.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:50 AM
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bob,
tho I tried to be more obnoxious about it.

You must not have tried very hard. I've seen you be way more obnoxious than that.

heebie,

Well, I'm glad you all see the world in such unambiguous beautiful clarity.

Au contraire, mon frère. I see the moral world as a snarly mess full of shades of gray.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 10:51 AM
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33 was me again. I have a ridiculous belief that if I don't tell the checkbox to remember me, I'm not really commenting from work.


Posted by: LizardBreath | Link to this comment | 07- 7-08 10:51 AM
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"There but for the Grace of God go I"

Reminds me of one of the most striking examples I saw of the difference between my mom and dad. We were at Mass, and they had some speaker who had been a hard-on-his-luck Vietnam Vet (and, presumably, found Jesus). Anyway, my dad said "there but for the grace of god,"* while my mom was all, "that wouldn't have been you, because you wouldn't have made all those bad decisions."

My mom was, in many ways, the classic conservative who was very supportive and sympathetic on an individual basis, but really had no respect and not much pity for "bad decision-makers," especially in the abstract (although even with individuals, she wouldn't nec. ignore the "bad decision-making;" she'd be supportive while thinking, "you dummy.")

I wonder what the congruency is between that type of conservative and the "little England" kind of conservative - the ones who are conservative in a literal, almost quotidian sense. My mom was both, but (off the top of my head) I see no reason that they should overlap more often than not.

* He wasn't, and isn't, a believer in any meaningful sense


Posted by: JRoth | Link to this comment | 07- 7-08 10:53 AM
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This is a great post, heebie. Gonna have to percolate on it a bit.


Posted by: Becks | Link to this comment | 07- 7-08 10:53 AM
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30,

Rich people make self-sabotaging decisions too!

True, but usually they have, as you say, the safety net to recover from them.

It is like a baseball game where one team gets three outs and three strikes and the other team gets only one strike and one out an inning.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 10:54 AM
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I have cousins that probably fit somewhat into the fourth category. They aren't really poor and could probably use family as some safety net. They are currently doing OK, but they are living paycheck to paycheck as far as I can tell. The reason that I would put them in the fourth category is that they could easily be creating some kind of safety net for themselves, but they spend all their money on bigger trucks, boats and other toys. It wouldn't take much bad luck for them to be kind of screwed. It would probably be up to my aunt and uncle to bail them out. Which I have to admit would kind of irk me.


Posted by: CJB | Link to this comment | 07- 7-08 10:56 AM
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A little dose of Tom Nagel might be helpful here, too.

You aren't really that responsible for your character. If you have good impulse control, that's just a matter of luck too. Just a random coincidence of nature and nurture.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 10:56 AM
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But you'd see this split operating in a small Nebraska town, where they debate what to do with the town alcoholic, where he and everyone are white as white bread.

They actually had a benefit dinner for the town alcoholic here, to buy him a new liver or something. He has dozens of cousins around town. According to people who know him he's a mean drunk too, though a harmless one because of the wasting effects of a bad liver.

I think that some places are structured more than others around resentment and harsh judgments, with less of the "there but for the grace of God" spirit.

I talked to a Swede once 20-30 years agao, and he reported that alcoholics who didn't really work were their bugaboo. (And Finns, above all alcoholic Finns). People hated them, but they kept supporting them on general principles. A rather small influx of Kurds, Turks, etc. has weakened that consensus, though.


Posted by: John Emerson | Link to this comment | 07- 7-08 10:58 AM
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You aren't really that responsible for your character.

So the racist homophobe can't help it?


Posted by: heebie-geebie | Link to this comment | 07- 7-08 10:58 AM
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JRoth,

I see a similar split between people who are apprehensive, anxious, and risk-aversive and people who are adventurous and risk takers.

Being a risk taker is another luxury that the rich have because one mistake (or even a couple in a row) won't sink them. Few people see that though.

The rich have greater resources than the poor. This means they can do more risky things and they have more ability and flexibility to recover from a mistake.

Essentially the rich have much greater freedom, including the freedom from judgment.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 10:59 AM
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Back when I read Ezra Klein, one of the things he was good on was stressing the fact that most Americans seem to think they've earned what they have, when in fact everything we've got is a product of luck. Everything. I had the good luck of being born white and male and middle class; I've had bad luck in some other ways - notably healthwise - but I would've had a much, much harder time dealing with my health over the last several years if I were black, female and born poor. The main difference between liberals and conservatives isn't how they treat "bad decisions," but how they imagine the safety net should respond to those of us who've been screwed by circumstance. The conservative response is to write off luck entirely and see one's place in society as an almost Calvinist product of one's own hard work or lack thereof (or of one's "bad decisions"); the liberal response is to recognize that this isn't the case, and that those members of society who've been fucked by fortune need to be compensated by a generous safety net.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:01 AM
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Some of y'all are acting like heebie said everyone should pull himself up by his bootstraps and get on with it. Please let's no pretend that people say and do things that make them less sympathetic, on either an emotive or intellectual level.

I have a lot of family who feel very little sympathy for people who make consistently bad decisions. The most effective way to have a conversation about that response is not to explain ad nauseum how those bad decisions are effected by larger forces or cannot be construed as meaningful choices. This line of reasoning sounds mealy-mouthed and infantile at a certain point. Instead, we have to be able to discuss how a community as a whole benefits from people being supported through a paradigm that is something other than a meritocracy. Which is, as I understand it, what heebie is getting at.


Posted by: Sybil Vane | Link to this comment | 07- 7-08 11:01 AM
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The *majority* of cases of bankruptcy are caused by personal illness.

Whether it's literally true is irrelevant; it didn't use to be the case at all, but the breakdown that Heebie oultines has existed from time immemorial.

I think y'all are spending too much time worrying about defining h-g's terms. I don't think that you have to worry too much about the definition of "bad decision-maker" to understand the category.

I guess I'd compare it to the hedonic treadmill: just as some people with objectively shitty lives are happier than those with objectively good lives, some people squander whatever their opportunities are, while others make do or even transcend their opportunities. It's not that there's no circumstance, luck, or contingency; it's that they're not exclusively determinative.

Anyway, all you bleeding hearts explaining that no one could possibly deserve anything bad that happens to them kind of proves heebie's point, doesn't it? Do you think that the same discussion at a conservative board would lead in this direction? Fuck no. By the end, people would be arguing over whether or not Jesus got what he deserved.


Posted by: JRoth | Link to this comment | 07- 7-08 11:01 AM
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Two thoughts.

First, once upon a time, my daughter slapped her school nurse when the nurse was trying to give her medicine. The school suspended her. The Assistant Principal said that my daughter had to be punished because my daughter knew right from wrong because she acted ashamed after she had done it.

Fortunately, before I could get too upset the Head of Special Education said, with some force "She has no impulse-control!!! That is part of her condition!"

Second, everyone knows that any one person can lift themselves out of poverty, right? We have all seen examples of it personally and from a distance.

So, since one person can do it, everyone should be able to do it. Those who do not are just lazy and dont deserve our help.


Posted by: Will | Link to this comment | 07- 7-08 11:02 AM
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43:

So the racist homophobe can't help it?

Aww geez. Define "help it."

In my view we all are dealt a hand of cards and then we play those cards. Some people get a good starting hand, some don't. The rich start with a bigger pile of chips, but as they say in poker, all you need is a chip and a chair to play.

The odds may be for you, or against you, and the hands are definitely not the same for everyone.

Still, it is the only game in town. You can't change your starting hand and you can't change your starting chips. All you can do is change the way you play.

So to answer your question - Everyone can 'help it' but it is easier for some and harder for others.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 11:04 AM
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Or, somewhat like Dr. Vane said, maybe we should focus on reminding people that we need to create little consumers in order to grow the economy.


Posted by: Will | Link to this comment | 07- 7-08 11:04 AM
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Stras' 45 is more or less exactly what I was going to write next.

The liberal/generous/True Xian position is that we are in no position to judge who is deserving of mercy/help, and so we want a system that will be merciful/helpful to everyone.

The non-hateful conservative critique of that idea is that it creates moral hazard, but I tend to think that's a valuable counterbalance, but we should never make it a principle - always better to err on the side of generosity. Better to ensure that no one starves, or dies from inadequate health care, or must live on the streets, and risk that there might be some society-wide loss of productivity.


Posted by: JRoth | Link to this comment | 07- 7-08 11:06 AM
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Will,

So, since one person can do it, everyone should be able to do it.

Heh heh. Sure, sure. Since one person wins the Powerball then everyone *can.*

Heh heh. Such a powerful word 'can' is. It hides so much realism and complexity and it ignores so much.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 11:07 AM
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We already have treatment programs and halfway houses and social services. I know it's fashionable to dis American social services, and they're far from perfect, but I am frequently reminded and amazed by how good they are to people I know.

I'm thinking in particular of someone I know who has a lifelong history of making terrible -- like, catastrophic -- decisions. She dropped out of high school, started doing heroin, and dabbled in prostitution. Part of that was youth and stupidity, but she's a full-formed adult now, and her self-sabotage does not abate. I don't want to go into details, but at this point, she has pretty much alienated all of her close friends, can't hold a job, and lives with her mom in a one-bedroom apartment. She's on some sort of disability services or welfare of some sort. She's pretty close to alienating her mom and getting kicked out.

I feel truly, truly bad for her. Her current situation is pretty much all her own doing, but I can see that, in some sense, she couldn't help it. Mostly though, I am so very glad she lives on the other side of the country and is someone else's problem. I think it's great that we have social services that will keep her in food and medicine for now. I'm not sure what else that you could do for her that she wouldn't just piss away.


Posted by: jms | Link to this comment | 07- 7-08 11:07 AM
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Essentially the rich have much greater freedom, including the freedom from judgment.

As a Pirates fan, I understand this intuitively. If a Yankees prospect flops, they just buy someone else's success. If a Pirates prospect flops, we have to wait for the next one to come through our system.


Posted by: JRoth | Link to this comment | 07- 7-08 11:08 AM
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So the racist homophobe can't help it?

In the sense that most racist homophobes are overwhelmingly predetermined by a combination of genetics and environment to be racist homophobes, sure. This doesn't mean that you can't treat bigotry with opprobrium; in fact, the very reason we do so with bigots is because we're trying to influence their behavior and beliefs (by showing that ours is a society in which bigotry isn't tolerated).


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:08 AM
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So the racist homophobe can't help it?

The chief cause was probably her upbringing, which she has no control over. In any case, blaming and hating her won't help her change much, although I admit I do it a lot myself.

The language of praise and blame is really only of limited use. It is good for many individual situations, which is where it evolved. It is useless for public policy.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 11:09 AM
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I haven't been around much lately, but did the analogy ban retire along with Ogged? Or does Tripp have a special exemption?


Posted by: SP | Link to this comment | 07- 7-08 11:09 AM
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I just had an odd conversation at the park a couple of weeks ago.

I had gone up to shoot baskets around 8:00 in the evening, there was a guy sitting on the railing of the play area watching and, after I'd been shooting for about 20 minutes he called me over.

He said, "I just need to bullshit a little" and then told me that he was feeling conflicted an unhappy because he was, at that moment, relapsing. That he was an alcoholic, who was currently living at the Clean and Sober house as part of the conditions of his parole, had been living there for three months, and had just fallen off the wagon.

His plan was to keep drinking that night (because, once you've already messed up, why stop) and then head back the next day and deal with the consequences.

He said that he'd been homeless on and off for the last couple of years and that part of his problem, was that he didn't mind being homeless that much. In some ways he'd rather be sleeping under a bridge than dealing with the rules at the clean and sober house.

His comment, a couple of times, was "it's just hard to stay clean and sober."

He seemed like a nice enough guy. He seemed healthy, in good shape (he said he played tennis regularly, and hiked a lot), he looked younger than his age, and in many ways he clearly had an okay life, and made good decisions in some areas.

He also, as he said, had lost jobs because of drinking, had lost his drivers license, had gotten divorced, but still wasn't quite sure that not drinking would be better than drinking.

I felt deeply sympathetic, wished him the best, and had no idea what I could do or say that would make any difference. I just listened, wished him good luck, and watched him walk off.


Posted by: NickS | Link to this comment | 07- 7-08 11:09 AM
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You all are happy to dole out personal responsibility when it comes to the Republican's failure to view the world how we do. So that is the only arena where you believe in an age of accountability?


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:09 AM
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Her current situation is pretty much all her own doing, but I can see that, in some sense, she couldn't help it.

Low-grade mental illness is a bitch. Sometimes it is a lot easier when they drool and make crazy noises when they walk.


Posted by: Will | Link to this comment | 07- 7-08 11:10 AM
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Better to ensure that no one starves, or dies from inadequate health care, or must live on the streets, and risk that there might be some society-wide loss of productivity.

Right. Hell, for certain values of "productivity," I think the loss of productivity is pretty fucking awesome.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:10 AM
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59 was not a response to 56, btw. I hadn't seen 56 yet.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:11 AM
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Anyway, all you bleeding hearts explaining that no one could possibly deserve anything bad that happens to them kind of proves heebie's point, doesn't it?

I really don't like it when people intentionally twist my words.

In my novice understanding of Christianity the question is who *decides* who deserves it and who doesn't?

Sheesh. The gospels are full of examples of Christ proclaiming nearly the same thing.

Sheesh again.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 11:11 AM
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So that is the only arena where you believe in an age of accountability?

Personally, I do not often feel qualified to start dishing out heavy doses of accountability.


Posted by: Will | Link to this comment | 07- 7-08 11:12 AM
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In my novice understanding of Christianity the question is who *decides* who deserves it and who doesn't?

Why the hell would I be operating from a Christian framework?


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:13 AM
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Or does Tripp have a special exemption?

My understanding is one may argue by analogy if one includes the word "Crazed" in one's name.

But I may be wrong.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 11:13 AM
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The language of praise and blame is really only of limited use. It is good for many individual situations, which is where it evolved. It is useless for public policy.

I don't think this is responsive to Heebie's post. Whether or not praise and blame make for good public policy, you can't deny that they are a part of the current political discussions around public policy.


Posted by: mrh | Link to this comment | 07- 7-08 11:15 AM
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heebie,

Sheesh again. When you tell me (incorrectly) what I am saying I am free to explain the framework for my statements.

My sheesh was not at your ignorance. My sheesh was at your twisting of my words.

Besides, I think you are playing dumb because in this day and age in America "Christianity" (tm) is shoved down all our throats so it is very difficult to claim ignorance.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 11:18 AM
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Tripp, it's probably worth noting than in 63 you're actually quoting JRoth, not Heebie.


Posted by: mrh | Link to this comment | 07- 7-08 11:20 AM
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Ok, so here's one way to illustrate the problem that Heebie's talking about, but with a nod to what Rob's saying as well. I'm overweight and it's really my fault. I'm pretty self-indulgent with what I eat and drink and I don't push myself hard enough to get exercise. But I have a very secure job and decent enough health care. If next week I keel over from a heart attack, I suspect many of my friends and colleagues will say, "Silly man, I knew that was going to happen to him, why didn't he take better care of himself?" But it's not going to be an *angry* comment, I don't think, and people would (I hope) help me recuperate if I survived. I might get a certain amount of the generic smarmy hostility that it seems ok to direct at overweight people from the bottom-feeding levels of the blogosphere, I suppose, but I'm not going to be a "policy object" in that context.

Shift the same thing to a lower-income urban African-American man with no health care, and two very different narratives might emerge. The more stereotypically conservative argument would talk as Heebie says about "why should we pay for this guy". But the liberal narrative might say, "Look at what kind of food and health care is available to poor Americans...of course he's overweight and arteriosclerotic". This is absolutely true, and yet, it kind of writes any given particular individual out of the story. If I eat fatty food, drink wine and spend too much time on my ass reading blogs, writing stuff and playing videogames, there's a general comfort level with understanding those as my *choices*, as a product of my agency, and therefore in regarding me as personally responsible for the consequences. If I get phobic about seeing a doctor (I've been putting off an appointment to see a surgeon about a hernia), friends and acquaintances might say, "What is wrong with him?" If friends are sympathetic, it's with me as a person. This is just different emotionally and intellectually with sympathy for the structural social circumstances of whole groups of people.

====

Another way to complicate this: what about the choices of people with money or resources that are in some fashion underwritten by public policy? It's pretty hard to resist being personally vexed by those individuals as well as by the policy. Did anybody read the NY Times story on the $100 tank of gas? See the guy in the beginning who *last week* bought a gigantic ultra-SUV with TV sets in the leather seats but who is quoted as saying that he was surprised and discomforted by a $109.00 bill for filling up his car? If you had a saintly appreciation for the individual complexity of that person's world, you're a better man than I, Gunga Din, because I felt tremendous derision for him. Just like I do when I read about someone rebuilding a coastal luxury home in North Carolina after it's been destroyed once by a hurricane. But if I knew the SUV guy or the person building the home, I bet I'd be able to understand very sympathetically why they did it, and maybe I'd find that some of my assumptions about their "safety net", etc., were misplaced.


Posted by: Timothy Burke | Link to this comment | 07- 7-08 11:20 AM
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I'm a liberal, so I think that's a foolish response, both practically and as a matter of justice. But it's an issue that has to be addressed clearly, rather than by claiming that it's not reasonable to think of anyone's problems as meaningfully their own fault.

Of course, of course. I absolutely agree that this is a profound liberal problem. But I am not a liberal, and would not only give George Bush's ranch to the underserving poor, but bphd's new house, Lizardbreath's salary, Emerson's bicycle, and the t-shirt off my back. Until an equilibrium of subsistence and mutual support was reached. Or I would if the saintly communism wasn't merely some kind of pose.

The rest of you, as rational liberals, can hash out some reasonable middle ground based on arbitrary and self-serving distinctions while I sit under the tree and go aum.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 11:21 AM
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I suspect that most people believe in the importance of a temporary safety net.

I also think that most people are sympathetic to someone with one or two children.

Other ideas that have relative popularity:

Day care assistance
Subsidized housing
Emergency medical care
subsidized education


Posted by: Will | Link to this comment | 07- 7-08 11:21 AM
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68: I did not author the statement that you quoted in 63. And no, I am not operating from a Christian standpoint, while simultaneously not being ignorant of it either.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:21 AM
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29 couldn't be more right. This thread is baffling. I can't tell if most of you are joking just to get under heebie's skin, or if everyone is really this oblivious.


Posted by: Brock Landers | Link to this comment | 07- 7-08 11:21 AM
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The liberal/generous/True Xian position is that we are in no position to judge who is deserving of mercy/help, and so we want a system that will be merciful/helpful to everyone.

Uh huh. Great. You go ahead and give your money equally to little local organic farmers and to Kroeger then. Employees of both of those places need a job. And feel for the families of the dead soldiers and Jesse Helms and the Iraqi civilian equally, who are you to judge? And please don't ever feel a second of self-congratulation abotu any decent or moral decision you ever make, because it is purely luck that you are in a position to make that decisions. Nobody around here is ever making any judgments about anything, ever.

This is all well and good for conversations within an echo chamber. Heaven hopes we never need to talk with anyone else.


Posted by: Sybil Vane | Link to this comment | 07- 7-08 11:21 AM
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I can be more specific, actually. Blame and shaming helped advance the cause of civil rights when sometime in the 70s, it ceased to be publicly acceptable to voice openly racist attitudes. Mostly that shift occurred because of the segregationists really acted like buffoons, while people like Dr. King took the moral high ground.

I don't think there is much to be gained now, though, from making individual accusations of racism or trying to shame people into examining their souls for all their unconscious biases. I think we have largely reached the limits of the effectiveness of that tactic.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 11:22 AM
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"Everything we have is luck" is a vast exaggeration, though it always involves luck (e.g., not being born Palestinian or Bosnian). Successful people often, though not always do tend to be far too self-congratulatory, though. One of the evil things about the religious right, especially prosperity theology, is that they encourage this. "The Lord has blessed me".

I have known some minimum pairs of people who started from about the same place, where one took the self-sabotaging path and the other took the prudent path. And conservatives take these personalized contrasts as the whole story.

My sister's drug-alcohol rehab clients are mostly people without support networks, often people who didn't even have support (or were abused) as children. In many cases she sees people who wouldn't be in the legal / counseling web at all if they'd had a little support. Many of them also do make bad choices.

An aside: a lot of the social services require clients to jump through hoops. The agency doesn't actively seek people who need help; they sit and wait for people to fill proper applications. Getting help becomes another form of entrepreneurship, with the more competent needy beating out the less competent.

Just now my sister and I found out that an acquaintance of ours has qualified both for state and for federal disability. His disability looks to us mostly like a combination of bad attitude, being a fuckup, and reluctance to show up for work. But he worked in social services for 10-20 years and knows the ropes.


Posted by: John Emerson | Link to this comment | 07- 7-08 11:22 AM
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Heh heh. Sure, sure. Since one person wins the Powerball then everyone *can.*

Heh heh. Such a powerful word 'can' is. It hides so much realism and complexity and it ignores so much.

Exactly. But, we need to start from that proposition.


Posted by: Will | Link to this comment | 07- 7-08 11:22 AM
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I think that Heebie's original formulation was problematic. The difference between the way the unworthy rich and the unworthy poor are treated is what we should be talking about. Back in Portland I lived in a neighborhood (Pill Hill, if you know Portland) which was infested with downward mobile fuckups from rich families. They never have any consequences. I also have known problem-free individuals with no family support who were struggling to keep their heads above water.


Posted by: John Emerson | Link to this comment | 07- 7-08 11:27 AM
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But, to comment on the actual post:

I find the problem of people who consistently make terrible choices, with no safety net, horribly vexing.

I'm confused by this. Do you mean you find it vexing as a policy issue in its own right (and, if so, is the question whether we should help them at all, or just the wonkery of how exactly we can best do that?), or do you mean it is vexing only as a political question--i.e., how do we ovecome conservative opposition to those who are seemingly undeserving?


Posted by: Brock Landers | Link to this comment | 07- 7-08 11:27 AM
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"Everything we have is luck" is a vast exaggeration, though it always involves luck

I don't think it's an exaggeration at all. What did you start out with that didn't come down to genetics and environment, factors over which you had absolutely no control?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:27 AM
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Tripp @ 63: I wasn't talking about your comments much, if at all. We're on the same page in this discussion.

You so crazy!


Posted by: JRoth | Link to this comment | 07- 7-08 11:28 AM
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79: if I'm reading you correctly, you're talking about the difference between the way the unworthy rich and the worthy poor are treated. Which, I agree, is a good place to lay stress, politically.


Posted by: Brock Landers | Link to this comment | 07- 7-08 11:29 AM
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What did you start out with that didn't come down to genetics and environment, factors over which you had absolutely no control?

Well, THIS is certainly a tautology. When I was a baby, or even a ten-year-old, I didn't have that much aside from genetics and environment.

The question is not whether this applies to what you "start out with", but what you have when you're 50. The libertarian and the Republican believes that he deserves what he has at that point in life, much like the awful aphorism about having the face you deserve.


Posted by: Fatman | Link to this comment | 07- 7-08 11:30 AM
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last bit of 80 should have said "conservative opposition to helping those who..."


Posted by: Brock Landers | Link to this comment | 07- 7-08 11:30 AM
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The conservative response is to write off luck entirely and see one's place in society as an almost Calvinist product of one's own hard work or lack thereof

That is a very unfair characterization of Calvinism. They certainly don't "write off luck entirely" they consider unearned Grace central to their conception of the world.

There is an ancient conception of the world, well, Alexander didn't necessarily believe he "deserved" to rule the world, in our modern sense of meritocracy, but that he was destined or chosen to rule, as others were destined or fated to be slaves. He just went with the flow.

"All men are created equal" is an idea with cruel consequences.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 11:30 AM
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I want to see what Witt has to say here. She has hands on experience with this kind of case.

(Also, I'm upset to find myself on the opposite side of an argument from Lizard. That doesn't normally happen to me.)


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 11:31 AM
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I would give McManus's skunk-killing dogs to an unworthy Vietnamese dog butcher with a gambling addiction.


Posted by: John Emerson | Link to this comment | 07- 7-08 11:32 AM
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I don't think it's an exaggeration at all.

It's an exaggeration insofar as it fails to account for the fact that not all white males are equally successful. Not even all upper-middle-class white males.


Posted by: Josh | Link to this comment | 07- 7-08 11:34 AM
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That is a very unfair characterization of Calvinism. They certainly don't "write off luck entirely" they consider unearned Grace central to their conception of the world.

But the Calvinist conception of Grace is a lot weirder and more fucked-up than "unearned." Material success was a reflection of God's will, and God's will said something about the people God picked to succeed, and that "something" usually translated into various concepts of worthiness.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:34 AM
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Do you mean you find it vexing as a policy issue in its own right (and, if so, is the question whether we should help them at all, or just the wonkery of how exactly we can best do that?), or do you mean it is vexing only as a political question--i.e., how do we ovecome conservative opposition to those who are seemingly undeserving?

This is a good question, and helps me clarify what I'm trying to say.

I am interested in the wonkery of how to help self-sabotaging decision makers, and this includes how to interact with conservative opposition.

I was not questioning whether we should help them at all, although that is certainly how the post has been interpreted. I thought when I said that my heart bleeds blue, it would fend this sort of straw-anger off.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:35 AM
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This is like a parody. Is it really that hard to admit that there are some people who repeatedly make bad decisions, even though there is not a 1:1 correspondence between bad decisions and bad consequences. Go volunteer at the non-profit hospital or the homeless shelter. You'll find both types: totally sympathetic people who got really unlucky, and totally unsympathetic types who keep getting second chances and keep screwing them up.

I always make an effort to understand why people do what they do, even if it appears to be totally stupid or evil. But I am careful to separate understanding from forgiveness. You can understand what people do without automatically justifying it.


Posted by: F | Link to this comment | 07- 7-08 11:35 AM
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What did you start out with that didn't come down to genetics and environment, factors over which you had absolutely no control?

Everything I have does not come down to everything I started out with and certainly you know this is a point that will get you absolutely nowhere outside of this echo chamber. The lung cancer I may get because I can't put down the cigarettes may not have been determined in utero.


Posted by: Sybil Vane | Link to this comment | 07- 7-08 11:35 AM
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It's an exaggeration insofar as it fails to account for the fact that not all white males are equally successful. Not even all upper-middle-class white males.

Not all white males, or even upper-middle-class white males, are born with the same DNA and raised in the same family under the exact same circumstances.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:35 AM
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81: Emerson isn't completely wrong here. You can, for instance, improve your own impulse control. If someone does that, you can give them credit for their character.

The important thing for me is that shaming really doesn't help people improve their impulse control.

I'd really love it if people stopped making public policy decisions using bad analogies from their personal lives. "I know someone who sabotages herself, and I've totally given up on her. Therefore this should be government policy."


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 11:35 AM
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Bob, Calvinism transformed luck into the blessing of God. It's as if they made it holy. That's a little different than "writing it off", but it's certainly a violent reinterpretation and contrary to the way most people think of luck.

The Mongols were equally accepting of luck. Their argument was "If God's on your side, why are we able to kill you whenever we feel like it? seems like God's on our side, not yours."


Posted by: John Emerson | Link to this comment | 07- 7-08 11:36 AM
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And I'm baffled by Sybil's 75. What is the objection here? All I'm saying is that, rather than try to provide a safety net for people who make "good decisions" but get walloped by obvious bad luck (hit in the head by a meteorite), but no safety net for people who spend their meager paychecks on renting flatscreen TVs, we should provide a safety net that catches everyone - that's what a safety net does. I, personally, may make decisions that are laden with value judgments (say, giving $ to non-religious charities only), but that's not what I think our society should do.

This thread is making no sense at all.


Posted by: JRoth | Link to this comment | 07- 7-08 11:37 AM
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This thread is making no sense at all.

A-fucking-men.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:38 AM
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I'd really love it if people stopped making public policy decisions using bad analogies from their personal lives. "I know someone who sabotages herself, and I've totally given up on her. Therefore this should be government policy."

Again, how is this responsive to Heebie's post at all?


Posted by: mrh | Link to this comment | 07- 7-08 11:38 AM
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Materialistic determinism denying any kind of responsibility is an impossible can of worms. If someone says "I'm just the way I am, I con't do anything about it", it's pretty reasonable for everyone else to say "Me too -- you're on your own, buddy".


Posted by: John Emerson | Link to this comment | 07- 7-08 11:38 AM
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Not all white males, or even upper-middle-class white males, are born with the same DNA and raised in the same family under the exact same circumstances.

Of course not. But at some point the differences start to fade into meaninglessness, and yet you still have differential outcomes.


Posted by: Josh | Link to this comment | 07- 7-08 11:39 AM
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or do you mean it is vexing only as a political question--i.e., how do we ovecome conservative opposition to those who are seemingly undeserving?

I don't know precisely what Heebie meant, but this seems to be the case to me. It really comes down to the fundamental gap I've encountered between myself and my few principled conservative friends (and/or exes): while I feel that everyone deserves a certain level of creature comfort no matter what their decisions or circumstances, they honestly don't give a shit. When it comes right down to it, they'll support the few things that allow a ladder for the "good-decision-making, low-resources or poor luck" group to climb up (sometimes believing it should be offered through private charity instead of through the government for various annoying reasons), but they don't care if people who make "poor decisions" are dying in the streets or near to it.

I don't know that it's really a bridgable gap. You can make arguments involving society's discount rate versus the individual's, enhanced productivity versus being a pure drain on society, and a few others which encourage social welfare for the grey-area cases. But in the end, you still have that group (even if it's mostly hypothetical) who will just piss away anything given to them, will never be productive no matter what advantages they're given, and don't have a diagnosable medical problem. I feel that group should and can be taken care of still, while fundamental conservatives couldn't care less about that group's welfare.


Posted by: Po-Mo Polymath | Link to this comment | 07- 7-08 11:40 AM
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Is it really that hard to admit that there are some people who repeatedly make bad decisions, even though there is not a 1:1 correspondence between bad decisions and bad consequences. Go volunteer at the non-profit hospital or the homeless shelter. You'll find both types: totally sympathetic people who got really unlucky, and totally unsympathetic types who keep getting second chances and keep screwing them up.

Yeah, and I know this one homeless guy down the street who's always like "I just need fifty cents for the bus," and I'm like "here you go man, here's your fifty cents" and then he just stands there and asks the next guy for another fifty cents for another bus and I'm like what, is he taking two buses? and I hear he totally drives a BMW on the weekends 'cause he makes so much money on the street asking money for the bus, and that's why I'm opposed to health care reform.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:41 AM
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And whoever is arguing that everything is luck apparently doesn't believe in free will. Which, if true, is a very convenient place to end the argument.


Posted by: F | Link to this comment | 07- 7-08 11:41 AM
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If I really wanted to pour fuel on the fire, I would smirk and say that you all are illustrating "Liberals are so sympathetic to the disastrous consequences that they lose sight of the fact that terrible choices were made" this perfectly.

Since I'm about to leave, consider the flames fanned.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:42 AM
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The point I made in 9 perhaps doesn't bear repeating, but I'll do it anyway: the Democratic party is not any longer the bleeding-heart sympathy for the bad decisionmakers party. A lot of people did a lot of work to dig out of that hole. True that you'll find most of the bleeding hearts on the liberal side, but the liberal agenda is much broader and deeper than that and now much more identified with people who make decent decisions but still can't get ahead. I also think the notion that the Republicans stand for helping rich people who make bad decisions has gotten a lot more traction over the years.

I talked to a Swede once 20-30 years agao, and he reported that alcoholics who didn't really work were their bugaboo.

Alcoholism is a long-time Swedish problem. The advent of the socialist welfare state in Sweden had a lot to do with Christian temperance social reform movements -- encouraging temperance and other forms of self-improvement was one goal of building collectivist institutions for mutual support. This was part of the origin of the Swedish Social Democratic Party. Just another reminder that you do not have to accept the Republican framing of liberalism as enabling bad behavior.


Posted by: PGD | Link to this comment | 07- 7-08 11:42 AM
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It seems like some folks in this thread (RH-C? Stras?) are saying that if we admit that some people make bad decisions, then we necessarily must decide to fuck them, as a matter of public policy. But can't we admit that some people make bad decisions, and still want to help them, as a matter of public policy?


Posted by: mrh | Link to this comment | 07- 7-08 11:43 AM
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So the racist homophobe can't help it?

On my better days, which are very few, no he can't.
This is what I meant about compassion and empathy.

To drop three names:We have Rorty's contingency and pragmatism, in which basic priors are simply not argued, and policy is empirically determined, without abstractions or justifications. Simply assert what you want or think is right (health care, end of war) and work toward achieving it. Don't justify unless for tactical reasons. (I am probably butchering Rorty.)

Now I am reading Spinoza the committed determinist. I like him.

Annd IIRC, Kant said you must assume free will in yourself, but lack evidence to assign it to others. All you zombies, you.

(PS:This is an excellent post, and I suppose the question could be about how do we sell our various preferences of general compassion, in the form of how do we justify to others. Drop another name:Rawls did some work on this, I think)


Posted by: bob mcmanus | Link to this comment | 07- 7-08 11:43 AM
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99: I don't think heebie was saying anything like this. The conservative she wishes to talk to reasons like that. Heebie wanted to talk to the conservative using his own framework, which allows for this kind of argument. I think we should ditch the whole way of framing the issue.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 11:44 AM
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What I am saying is that the "who are we to judge" angle is not useful when trying to persuade a person who has a different value system, particularly when that value system transparently values what are recognized, in the mainstream, as good decisions vs bad decisions. In part because you don't actually believe that society should act as though it is in no position to judge whether people have a moral accountability to good decisions: you believe we should penalize irresponsible decisions when irresponsible is understood as harmful to other people. "They" believe we should penalize, or at least help less, peple who make irresponsible decisions with irresponsible understood as harmful to one's self. The who are we to judge anlge is, I think, not so credible in this conversation. That is my objection.


Posted by: Sybil Vane | Link to this comment | 07- 7-08 11:44 AM
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I am interested in the wonkery of how to help self-sabotaging decision makers, and this includes how to interact with conservative opposition.

Eventually, if you're really serious, you're going to have to start restricting the domain over which those people make decisions. But that's a really creepy idea.

Maybe the best we can hope for is compromising on those programs in support of bad decision makers than wind up decreasing the budgetary costs of their actions. So preventative healthcare is cheaper than emergency rooms, sometimes just giving homeless hard cases a place to live is cheaper than devoting resources to managing them, etc.


Posted by: | Link to this comment | 07- 7-08 11:45 AM
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After re-reading the post, it looks like my 102 is just a restatement of it. So my question is, what's heebie's question? We really just seem to have tried to hash out the fundamental difference between welfare liberals and welfare conservatives. And if that's the case, why act surprised as in 105 that nearly everyone here comes firmly down on the welfare liberals side?


Posted by: Po-Mo Polymath | Link to this comment | 07- 7-08 11:45 AM
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One of the constant disagreements between liberals and conservatives is personalization (conservative) vs. depersonalization (liberal). Both sides can go wrong. These are tricky questions.

The extreme forms of liberal social engineering and welfarism are pretty much oblivious to individual choices. They try to manage people the way you'd manage a watershed or a warehouse.

On the other hand, conservatives often stop thinking when they can find a villain. Populist gut thinkers work this way, and this is where conservative populism comes from.

A somewhat off topic case in point is controversies about salmon fisheries. Fishermen are gut thinkers to the max, and they blamed Japanese, native Americans, and sea lions for shortages in that order. They were much less interested in habitat preservation, and were unwilling to ask whether there were just too many fishermen and not enough fish.


Posted by: John Emerson | Link to this comment | 07- 7-08 11:46 AM
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You can, for instance, improve your own impulse control.

Some people can.

Can you tell the difference between those who can and those who cannot?

There is a fundamental difference between people who think that virtually everyone can improve their impulse control or their bad decision making and those people who understand that it isnt such a clear cut decision.

LB alluded to this idea when she said that some people are fine with allowing the bad consequences to be suffered as a disincentive.

This falls close to "it is better for the mentally ill to suffer so that the lazy people dont get any help."


Posted by: Will | Link to this comment | 07- 7-08 11:47 AM
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103

That's an intelligent and concise restatement of my argument. Thank you, I'll use that next time. And when you're done being an asshole, maybe we can talk.


Posted by: F | Link to this comment | 07- 7-08 11:48 AM
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It seems like some folks in this thread (RH-C? Stras?) are saying that if we admit that some people make bad decisions, then we necessarily must decide to fuck them, as a matter of public policy. But can't we admit that some people make bad decisions, and still want to help them, as a matter of public policy?

This articulates the point of the post perfectly.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 11:48 AM
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111 was me.


Posted by: Trevor | Link to this comment | 07- 7-08 11:48 AM
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100: Give me a break. Everyone's circumstances are different: some people are born into well-off families, some people are born dirt-poor, some people are born with chronic health conditions, some people just have the bad luck of being born stupid - which also isn't anything you have control over - and some people, for whatever reason, are just fuckups. And you know what? The government should be there, as a policy, for all of these people if they need it. I don't care if they're fuckups or drug addicts or alcoholics or whatever, a civilized society doesn't let people go without housing or medicine or starve or freeze in the street when it's got literally hundreds of billions of dollars lying around. It's fucking barbaric.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:49 AM
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BTW, thanks for the post, Heebie. It's the most thoughtful and interesting I've seen on the site in a little while.


Posted by: F | Link to this comment | 07- 7-08 11:50 AM
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Part of the question is who gets to judge? In 19th century Ireland, the Anglo-Irish landlords decided their tenants were shiftless and lazy. The doctrine of personal responsibility/fear of moral hazard enabled them to continue to export massive amounts of food while evicting tenants who failed to pay rent because they were busy starving.

Failure of sympathy doesn't really tell you much about the worthiness of the bad decision-maker, because sympathy depends on your ability to identify with that person.

I've heard people say they didn't want to see over-mortgaged homeowners bailed out, because why should they get to live in their giant houses etc., etc. Then you ask, do they really want to see their sister and brother-in-law or whoever they're thinking of out in the street having lost everything, and they say no. But they don't sympathize with anyone outside the tribe.


Posted by: mcmc | Link to this comment | 07- 7-08 11:51 AM
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are saying that if we admit that some people make bad decisions, then we necessarily must decide to fuck them, as a matter of public policy

I can see how you think I'm saying this, but I'm not.

There are plenty of situations where it makes sense to acknowledge that an individual has made catastrophically bad decisions. Social workers need to say this to people all the time.

But figuring out how much poverty, say, is caused by bad decision making isn't worthwhile. The things that we can do at the public policy level to affect poverty won't be changed by this fact. No matter what, the solution will involve things like improving access to health care, schools, child care, public transportation, etc.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 11:51 AM
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I am interested in the wonkery of how to help self-sabotaging decision makers, and this includes how to interact with conservative opposition.

I guess it's perfectly fair to say you're interested in the whole bag of worms, but to me it seems helpful to keep these mentally separated (though they do of course intersect).

One difficult question is the degree to which we should be willing to throw the people in category four under the bus in order to help those in category three. I'm inclined to answer "not very much at all", but pragmatically I'm not sure that's always best. On the other hand, this seems to have been the motivating compromise behind some of policies of the 90s that I'm not especially happy about.


Posted by: Brock Landers | Link to this comment | 07- 7-08 11:51 AM
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Is anyone in this thread advocating letting people starve on the street? I must be reading too quickly, because I totally missed that. For the record, I'm totally against letting people starve on the street. That would be bad.


Posted by: jms | Link to this comment | 07- 7-08 11:51 AM
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Heebie, this is a truly excellent post. Thank you.

I think I draw the distinction a little differently. I have a bone-deep conviction about what kind of floor we should put under all members of society -- there should be a level, we should say that "No one is allowed to sink below this level," and we should move heaven and earth to ensure that no one does. So by those lights I should be a liberal.

At the same time, I have had long and intimate knowledge of people that make self-sabotaging bad decisions, consistently and boy are they monumentally, exhaustingly hell to be around. You don't even need to go to the depths described by jms to understand how frustrating it is to keep bailing out someone who seems never to learn from their mistakes, the more so when it means their kids are going to suffer if you don't. I am sufficiently intolerant that by those lights I should be a conservative.

At this point in my life I'm agnostic about whether it's a "can't" or a "won't." And I don't really care, because my reaction (and policy preference) is going to be the same either way. A tough-love kick in the pants plus encouragement to get them to do as much as they can themselves, and a nonjudgmental minimum amount of assistance that I will advocate for no matter what.

I've seen enough mental illness to know how much I don't know, but I've also seen enough playacting and victimhood to know that sometimes people, given a sharp shove, will surprise you (and themselves) with how much they are able to do for themselves.

I guess what I'm rambling around with is: There is a piece of the Divine in everyone, and we should remember that, but recognizing the Divine doesn't mean turning yourself into a doormat.

(This is not to touch on the extreme judgmentalism and active unhelpfulness of the social safety net, of which I have a generally dim opinion. Guaranteed minimum income for everyone!)


Posted by: Witt | Link to this comment | 07- 7-08 11:51 AM
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If I really wanted to pour fuel on the fire, I would smirk and say that you all are illustrating "Liberals are so sympathetic to the disastrous consequences that they lose sight of the fact that terrible choices were made" this perfectly.

What would you have said to the guy in 58? On most days, I would be interested in the wonky side of the question, but having just had that encounter I'm stuck at the level of not knowing how to respond on a personal level.

I suppose that part of what's nice about the policy level is that it takes personal sympathy out of the equation. But I take part of the point of the post to be that personal sympathy always plays a roll in how the political debates play out.


Posted by: NickS | Link to this comment | 07- 7-08 11:51 AM
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Materialistic determinism denying any kind of responsibility is an impossible can of worms. If someone says "I'm just the way I am, I con't do anything about it", it's pretty reasonable for everyone else to say "Me too -- you're on your own, buddy".

It is also, I believe, just as reasonable to turn the other cheek, forgive those who offend against you, or give your shirt to the rich Pharisee. I kinda hate using this Xian stuff, I need some Buddhist or Hindu metaphors.

In any case, I don't think any of this shit is particularly rational or reasonable. "Ethics is impossible" said Steve Martin.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 11:52 AM
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And whoever is arguing that everything is luck apparently doesn't believe in free will.

What, you mean you do believe in free will? How's that work, exactly?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 11:52 AM
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123 to 118


Posted by: jms | Link to this comment | 07- 7-08 11:52 AM
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103 is exactly what we have to deal with.

That is the kind of crap that drives a huge number of people.

Urban myth. Just like the McDonald's coffee lady.

So, are we trying to convince the rational or the irrational conservative?


Posted by: Will | Link to this comment | 07- 7-08 11:52 AM
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you still have that group (even if it's mostly hypothetical) who will just piss away anything given to them

I don't think they're mostly hypothetical.


Posted by: Brock Landers | Link to this comment | 07- 7-08 11:53 AM
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Well, after the close call of 45/51, I'm happy to be disagreeing with stras again. I don't believe that we are all wind-up automata, bouncing from circumstance to circumstance in a manner that could, with a sufficiently subtle model, be predicted at the moment of fertilization.

Anyway, on closer reading of 75 and subsequent, I think I get that Sybil's complaint is that my position (on the post, not free will) falls apart when it comes into contact with skeptics. I suppose so, but that doesn't mean that it's wrong. It's an argument that is unpopular in this time and place, but not always and everywhere (see John's town drunk).

If I had to make my argument to a skeptic, I would lean heavily on "there but for the grace of God," and on pointing out that, even if we wished to do so, it's too hard to weed out the undeserving poor. If the goal is "safety net for the deserving* but unlucky only," then every undeserving person who gets help represents a failure. Once you're helping some of those (while excluding some of the deserving in your efforts to be selective), you may as well help everyone.

IOW, there are 3 safety nets: A. One with holes that allow only the undeserving to fall through; B. One with holes that allow some deserving to fall through while catching some undeserving; and C. One without holes. A is plainly impossible; B is immoral, except perhaps in a place with resource constraints. That leaves you with C.

* Buying into this terminology because it's widely accepted, and I agree that, outside the echo chamber, there's no value in claiming that all people who need help are merely unlucky; it's not how most people think


Posted by: JRoth | Link to this comment | 07- 7-08 11:53 AM
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a civilized society doesn't let people go without housing or medicine or starve or freeze in the street when it's got literally hundreds of billions of dollars lying around. It's fucking barbaric.
Actually, this may point the way to a shared premise with conservatives. Couch results for the least well off (or worst decision makers) not as concern for the welfare of those people, but as a reflection of our strength and prosperity.


Posted by: Trevor | Link to this comment | 07- 7-08 11:55 AM
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Witt's comment sounds great. But, I suspect that her floor is about 5 floors above most people, except those on Unfogged.


Posted by: Will | Link to this comment | 07- 7-08 11:55 AM
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116: And But can't we admit that some people make bad decisions, and still want to help them, as a matter of public policy? really captures for me the core difference between welfare liberals and welfare conservatives. Liberals will say "yes", conservatives will say "no". It's a fundamental difference in viewpoint that leads to substantially different policy endpoints, even with the same empirical knowledge and similar reasoning styles.

I got closely and infuriatingly familiar with this during a multi-month relationship with a very intelligent and well-read principled conservative. We argued a lot about policy, and I kept trying to dig down to the root of our disagreements, since we seemed to know much of the same facts and had similarly logic-driven reasoning methods. Ultimately, each time, what it came down to was that I tended to see everyone's lives as pretty much equal regardless of nationality or circumstances, while she was willing to write various groups off entirely.


Posted by: Po-Mo Polymath | Link to this comment | 07- 7-08 11:56 AM
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I'm having trouble understanding where this is coming from. The premise, if I'm understanding it, is that the central difference between liberals and conservatives is (in a nutshell) the public policy question of how well to treat junkies? I mean, I'm sure that there are policies that I would support that a conservative would not, but that has to be about one millionth on my list of reasons why I'm a liberal.


Posted by: Walt Someguy | Link to this comment | 07- 7-08 11:56 AM
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I tried to anticipate Witt's point in 72 by addressing some components of that floor.


Posted by: Will | Link to this comment | 07- 7-08 11:57 AM
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I basically think that Heebie gives too much credit to the conservatives, though. Conservatives tend to take the worst (real) horror stories (welfare fraud) and take them as typical.

I'm not sure this argument is winnable at all in the US, though. Wedges like race, gender (sexuality) and religion split America into mutually hostile fractions. We're not really all in this together -- some Americans are real Americans and some aren't. Many self-satisfied, judgmental conservatives even have a convenient "white trash" category -- white people who are just as bad as dark people. They prove that they're not racists this way.

The argument about "enabling" is legit, though. We should try to minimize the degree to which safety net incentives make self-destructive behavior more likely.


Posted by: John Emerson | Link to this comment | 07- 7-08 11:57 AM
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Rob, I think your 121 is eminently sensible. I just think you're misreading Heebie if you think you're arguing with her.


Posted by: mrh | Link to this comment | 07- 7-08 12:01 PM
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The broader point I was trying to get at in both 9 and 106 is that there is a real and long tradition of both liberalism and socialism being seen as a way to assist bad decision-makers through communal support, as opposed to enabling them. If you think about how you'd try to help an irresponsible person in your family, real assistance would include a lot more than just punishment or cutting them loose to suffer the "consequences of their action". It would involve real mutual support, helping them become more responsible for themselves.

America is almost maniacally individualist. In part thanks to Republican propaganda we have difficulty seeing the connection between personal responsibility and communal support. This obviously shows up politically, but also culturally -- for example, the emphasis on "tough love" in popular psychology. Stuff like "co-dependency" and "enabling" are part of this too.

We should try to minimize the degree to which safety net incentives make self-destructive behavior more likely.

Agreed. This can be done somewhat by making safety net participation dependent on work.


Posted by: PGD | Link to this comment | 07- 7-08 12:02 PM
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Can you tell the difference between those who can and those who cannot?

Bingo. Do some people suffer simply because they're fuck-ups? Of course. Can you formulate public policy that excludes pure fuck-uppery? No, you can't. So you err on the side of mercy, generosity, compassion (which are commonly associated with the Sermon on the Mount, but I've heard that people of other religions, and even atheists, understand them as well). A more compassionate society would be a more just society, and I'd be willing to bet that fewer people would be fuck-ups in a more just society, if I didn't regard gambling as a moral weakness.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 12:02 PM
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I very much appreciate Witt's 124.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 12:04 PM
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Heebie wanted to talk to the conservative using his own framework, which allows for this kind of argument.

Or, you might say, she raises the question of how to defuse this kind of argument, because you aren't going to have a lot of luck eradicating it altogether.


Posted by: redfoxtailshrub | Link to this comment | 07- 7-08 12:05 PM
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I don't believe that we are all wind-up automata, bouncing from circumstance to circumstance in a manner that could, with a sufficiently subtle model, be predicted at the moment of fertilization.

I'm not sure why people are so reluctant to accept some version of this. We live in a deterministic universe with deterministic laws, and we accept that these laws apply to everything from planets to weather patterns to atoms. Why wouldn't they apply to humans? I'm also not sure why this would somehow turn us into "wind-up automata," as if a deterministic model of human behavior reduces all of human experience to that of an assembly line robot. It reminds me of the creationists who seem to think that the absence of God from a model of the universe instantly transforms nature into a collection of pointless overgrowth and humanity into a mess of gibbering apes.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:05 PM
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I basically think that Heebie gives too much credit to the conservatives, though. Conservatives tend to take the worst (real) horror stories (welfare fraud) and take them as typical.

True. This framework is only worthwhile for some platonic ideal of Conservative, if that doesn't stretch credulity too far.


Posted by: heebie-geebie | Link to this comment | 07- 7-08 12:06 PM
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143

We do not live in a deterministic universe, as discovered by Heisenberg et al nearly 100 years ago. But I suspect that this falls under the "luck" category for you instead.


Posted by: F | Link to this comment | 07- 7-08 12:09 PM
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free will can't be explained, and neither can unfree will. Both sides can demand that the other to knock the chip off their shoulder, and neither side will be able to do that. Buddha and Kant both declared that this is a useless controversy, and it is.

Maybe the other guy isn't really responsible for his condition, but then, neither am I, and I'm not responsible for my response to his condition either. If I say "Let him die" you have no argument with me. I was just born that way too.

Anyone who's been in these systems knows people who game them. Basically the incentive structure they see makes it more attractive for them to rip off the state than it is to earn a living or do anything useful. Some attention to minimizing that is necessary.

My fuckup friend / acquaintance scamming disability is not the poorest of the poor. He's a successful working class guy who didn't want to keep working. He knows the social services ropes. His financial problems are mostly due to compulsive gambling and fairly heavy drinking -- plus unfortunate relationships.

My sister is very pissed off with the guy, because she has genuinely miserable clients who really need the $12,000 or so he's scamming disability for.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:09 PM
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Can you formulate public policy that excludes pure fuck-uppery?

More to the point, why would you want to? What do you gain by letting some people starve to death, or die of some treatable disease, or of exposure or whatever, or turn to crime in desperation? The moral satisfaction of wagging society's mighty finger at the unworthies?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:09 PM
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she raises the question of how to defuse this kind of argument, because you aren't going to have a lot of luck eradicating it altogether

And I really don't think there is. There are ways of reducing the argument, through some incentives-gaming (see welfare reform, EITC, the controls on unemployment benefits used in Scandanavia, etc.), so that it covers a smaller group of people. But ultimately, you have to argue that there are some unhelpable people who either should or should not be paid for. And no system exists that will avoid paying for those people while covering the ones who just hit a rough patch but otherwise possess "solid working-class values" as they're so often called.

Thankfully, I think that the ability to just write off the existence of some people is very rare. Witt's view in 124 is almost certainly held by the vast majority, just with differing values for that "floor" below which no one should drop.


Posted by: Po-Mo Polymath | Link to this comment | 07- 7-08 12:12 PM
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139: Why "almost"?

Minnesota and Wisconsin are politically atypical in the US because Catholic and Lutheran religions are communitarian and anti-individualist. people are socially quite conservative but have much less of the "let them starve" attitude.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:13 PM
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And I really don't think there is.

...any way of eradicating it? I concur.


Posted by: redfoxtailshrub | Link to this comment | 07- 7-08 12:14 PM
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Maybe the other guy isn't really responsible for his condition, but then, neither am I, and I'm not responsible for my response to his condition either. If I say "Let him die" you have no argument with me. I was just born that way too.

John, see my 55. The bigot may have been determined to be a bigot by genetics and environment, but that doesn't mean I can't express my opprobrium for his bigotry in an attempt to exert an influence on that bigotry. Likewise, even though your lack of empathy may be determined by genetics and environment, that doesn't mean I can't express my opprobrium for your lack of empathy in an attempt to exert an influence on that lack of empathy. Our influences - deterministic though they may be - don't end at birth. We continue to influence each other.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:19 PM
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We live in a deterministic universe with deterministic laws, and we accept that these laws apply to everything from planets to weather patterns to atoms. Why wouldn't they apply to humans?

I suppose there are dozens of people here better-qualified than I to respond to this, but a combination of genetics and environment leads me to reply anyway:

Actually, we live in a universe where Newtonian determinism has been superseded by Heisenbergian uncertainty*. An electron's location isn't known, it's a probability. My decision about how to write this comment is a probability narrowed by all of the factors you cite, but ultimately is only a probability - I can post this, or toss it, and it's stupid to say that that decision was made in my mother's womb.

So my point is that I'm not clinging like a creationist to a just-so fairytale that denies the relationship between humans and the rest of the world. Rather, I don't see the predetermined universe you apparently see, and so I don't see human lives as predetermined either.

* Improved on preview by F's 145 - thanks


Posted by: JRoth | Link to this comment | 07- 7-08 12:19 PM
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152

Yes. For an intriguing take on how quantum mechanics is directly responsible for free will and why this means we will never have strong AI, see "The Emperor's New Mind" by Roger Penrose. I think he's wrong, but it's a fascinating theory.


Posted by: F | Link to this comment | 07- 7-08 12:21 PM
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||

My apologies to Heebie, but seeing as this is pretty much the political thread right now:

Obama's planning on eschewing the normal acceptance speech to the delegates and instead hosting a ginormous open-air speech outside the convention hall in front of 75,000+ people. The campaign's positioning this as another example of listening to his supporters and raising the grassroots above the party apparatus. Interesting, and I wonder if it will catch on.

|>


Posted by: Po-Mo Polymath | Link to this comment | 07- 7-08 12:21 PM
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Materialist determinism is no longer predictive, even in physics. As far as I understand there's no net advantage in thinking purely deterministically about behavior.

Even in a deterministic framework, incentives have to be considered. You don't want to incentivize fucked-upedness by making it easier.

You don't want to throw the baby out with the bath water, either, which is what conservatives do. There's not going to be a perfect system.

A lot of the hoops and restrictions put on benefits to reduce fraud actually help the scam artists gaming the systems, because they figure out how to play them. It's the actually troubled clients who are hurt worst.

The mentally ill and retarded routinely make bad choices. Lumping them in with sane, normally bright fuckeps isn't right. The borderline is not clear, but it's real.

I'm not willing to accept congenital fuckedupness as an extenuating circumstance, any more than congenital murderousness, congenital thievishness, or congenital rapishness. My problem with determinism, in one of its forms, is that it makes it seem that you should.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:22 PM
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I take it neither JRoth nor F are physicists.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:22 PM
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147: I should add that I'm in agreement with stras here, and I think that a) pure fuck-uppery without some elements of bad luck, desperation, alcoholism, mental illness, abuse &c is rare, and b) it shouldn't in any case be a justification for letting people suffer the worst consequences.

This is not to touch on the extreme judgmentalism and active unhelpfulness of the social safety net, of which I have a generally dim opinion

I would add to this that the social safety net is much more fragile than it seems, because even where there are programs, there is often no guarantee that they'll be there the next budget cycle. It's hard to plan long-term approaches when funding is short-term.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 12:24 PM
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OK, even though I previewed my 152, I still am not satisfied with the repeated use of "predetermined:" I realize that stras isn't being Calvinist, and that he's including ongoing environment as part of our makeup. I'm trying to use "predetermined" in the sense of "could be foreseen," because I'm not making any free-will decisions.


Posted by: JRoth | Link to this comment | 07- 7-08 12:24 PM
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I'm not willing to accept congenital fuckedupness as an extenuating circumstance, any more than congenital murderousness, congenital thievishness, or congenital rapishness.

In what sense is "being a fuck-up" as bad as killing someone, stealing things, or raping someone?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:24 PM
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151: I was just pointing out that that argument is a wash. It won't convince anyone non-stupid who disagrees. It pretty much erases all moral obligation of any kind. It gives you no way of convincing someone who disagrees.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:24 PM
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I should, I would. Add, that is.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 12:25 PM
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Scientist of another flavor actually. Would you like to object to my characterization of quantum mechanics, or just engage in ad hominem by implication?


Posted by: F | Link to this comment | 07- 7-08 12:26 PM
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I take it that Stras isn't a physicist, and doesn't read much pop physics either.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:27 PM
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how to help self-sabotaging decision makers,

A practical way to improve the safety net without raising taxes: changing zoning laws to allow single-room occupancy hotels, or supervised trailer parks. Tell conservatives that the apparently hopeless will spew germs if they die underfoot, and that SROs are cheaper than jail or emergency rooms.

Some people really do give up alcohol or drugs if they survive the worst self-abuse. There was a New Yorker article, I think by Gladwell, a while back, about the wisdom of focusing social services on the worst cases, who consume ER and prison resources if left to exercise free will. It's politically unpopular but seems cost effective.

In an attempt to change the subject from personally familiar examples: Isn't Iran among the places where heavy heroin use is most popular? Are there any first-person accounts of recovery from there? What happened to the young untrained pseudo-kamikazes after the war with Iraq and all those poppies back home? There's a lot of href="http://artofwar.ru/e/english/"> samizdat memoir from Russian Afghan and Chechen veterans, which often touches on addiction after coming back.


Posted by: lw | Link to this comment | 07- 7-08 12:27 PM
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I take it neither JRoth nor F are physicists.

Unless you are, stras, this is an instant Top Ten contender for the (very, very long) list of most dickish things you've said here.


Posted by: JRoth | Link to this comment | 07- 7-08 12:27 PM
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Stras, your comment about living in a deterministic universe is hurting me physically. You do know about quantum mechanics, right? Of course you do, so I'm confused at what you are saying.


Posted by: Walt Someguy | Link to this comment | 07- 7-08 12:27 PM
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Would you like to object to my characterization of quantum mechanics, or just engage in ad hominem by implication?

I know at least two physicists who would, actually.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:30 PM
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159: What you say is stupid. If you missed my point, ask me to explain it better.

Pure fuck-uppery without some elements of bad luck, desperation, alcoholism, mental illness, abuse &c is rare.

What a happy life you've had, Jesus.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:31 PM
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Well, let's hear it then. Because I'm getting tired of the implication.


Posted by: F | Link to this comment | 07- 7-08 12:32 PM
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A recent, I think, poem by Thomas Disch, which may be vaguely tangential to the topic. Or something. I gots me some grievings to do

Taking Action in the Current Crisis

They wouldn't be so eager
to clamber into our lifeboat
if they had anything more seaworthy
than that old piano they've turned into
a raft. That's just a metaphor, of course.
But suppose it weren't: imagine
an ocean teeming with drowning
Mexicans, and it's up to you,
in your drenched evening clothes, to choose
which of them to save and which to sacrifice
to the gods of necessity, your own mother
among them, hidden within the piano.
Millions of them! The thing to do,
our committee believes, is to organize
a charity for those of their children
who are blind. Help them learn to read
Braille. Some may die, but we'll be relatively
dry inside the lifeboat until help arrives.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 12:33 PM
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Besides quantum mechanics, so-called "chaos" (whatever you want to call it) makes predictive determinism impossible.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:33 PM
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168: John, I'm kind of confused as to 1. what your conception of "fuck-up" is and 2. what exactly you hope to gain, from a public policy standpoint, by punishing fuck-ups.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:33 PM
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Holy shit, is there a term of logic for stras' argumento ad "I know this dude who says?"


Posted by: JRoth | Link to this comment | 07- 7-08 12:34 PM
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I know at least two physicists who would, actually.

Seriously, stras, why are you here? It obviously isn't to have a good-faith argument, and your insults don't even have the saving grace of being witty or amusing.


Posted by: Josh | Link to this comment | 07- 7-08 12:34 PM
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171: What does predicting stuff have to do with anything?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:35 PM
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174: Neither do yours, but I'm polite enough to ignore them.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:36 PM
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"Alcoholism" is an aspect of fuckeduppedness -- drinking too mcuh is a thing that fuckedup people do. It's a sort of feedback loop. As an alcoholic, I'm hostile to the idea that alcoholism mitigates misbehavior in some way. Fucked up people who drink too much do fucked up things.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:36 PM
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176 is about what I should have expected, I guess.

Wait... you're not really Terry Austin, are you?


Posted by: Josh | Link to this comment | 07- 7-08 12:38 PM
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178

Pee-wee Herman is more accurate.


Posted by: F | Link to this comment | 07- 7-08 12:40 PM
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If this is about politics instead of policy, the way to sell a safety net to conservatives is to convince them that they may someday need it. Liberal conservative mugged arrested yada yada. Money for welfare queens is bad, money for hard working blue collar employees who's been outsourced is good. Set up your safety net to help everyone but make it address the concerns of conservatives as well (eg medicare).


Posted by: SP | Link to this comment | 07- 7-08 12:41 PM
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Changing the incentives, Stras.

"Fucked up" is not a technical term, Stras. Most people understand it. I'm trying to avoid that outcome in which anyone whatsoever who misbehaves in any way whatsoever can say "I was just born that way, it's al Inevitable Forces and not my fault."

We're getting to the point when I inexplicably lose my temper with you again because of that mysterious personal grudge, but I'll refrain today, and encourage others to do so in my stead.


Posted by: John Emerson | Link to this comment | 07- 7-08 12:42 PM
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I don't think it's the mysterious personal grudge that would cause the lost temper. I would say that something must have happened to cause stras to discontinue his previously mentioned efforts to behave like a normal human being, but now that there's no free will, the concept of "effort" is meaningless.


Posted by: water moccasin | Link to this comment | 07- 7-08 12:45 PM
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I asked whether F and JRoth were physicists because 1. it wasn't my impression we had any physicists who were regular commenters, 2. theoretical physics is, I'd guess, pretty complicated for laymen to try to understand and because 3. I used to assume that quantum mechanics was indeterministic before a very old friend, who recently completed his doctorate in physics, insisted to me that it was, in fact, deterministic. I can't remember his explanation for it because it sounded like complete gibberish to me and because I can't understand anything about physics. But if someone out there does know something about physics, and feels differently, go right ahead. I feel kind of bad having sent the thread so far afield when the original point I was trying to make in 45 really had nothing whatever to do with this.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:45 PM
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To get back to the topic: lw's suggestion in 164 is a really good one. To provide a social support group to those who seem to be especially prone to making bad decisions can be really helpful. It will still fail in a substantial proportion of cases, but it will succeed for some where prison and street life have failed.


Posted by: F | Link to this comment | 07- 7-08 12:46 PM
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stras,

That's a start. Several people here, at least one of whom must have had some experience with physics, have been telling you you were wrong. And you not only disagreed, you disparaged them all based on something you barely remember one of your friends telling you that you didn't understand? Is this an accurate representation of what just happened? This is why it's so frustrating to argue with you, even though you often have interesting things to contribute.


Posted by: F | Link to this comment | 07- 7-08 12:49 PM
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These are very basic questions about the justification for a liberal welfare state, are they not? Which is one reason the post is both puzzling and unclear.

There's no doubt that many have personal acquaintance with seeming self-saboteurs; as Rob and some others have suggested, while we may form value judgments on an individual level, we must not do so on a political level. This is fundamental to liberal policy.

If Heebie and others are asking how to speak to conservatives about this, that's the answer: the liberal need not be a "bleeding heart", needn't be blind to the fact that some people have made their own beds, but society as a whole has a responsibility to attend to its own overall health, including the well-being of its fuckups.

I find it almost impossible to say anything about this without digging into liberal theory, and we don't want that, because it's a raging, ongoing debate; and I assume that's not what heebie is after in the first place.

The conservative listens to arguments from self-interest. The crime rate will go up! Prisons are awfully expensive! You don't want all these crazy homeless people on the streets, do you? So we need prevention!


Posted by: parsimon | Link to this comment | 07- 7-08 12:49 PM
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What a happy life you've had, Jesus.

I'm filled with compassion, John. Seriously, I've known plenty of fuck-ups whose bad circumstances owe primarily to their bad decisions (and then to further bad decisions as they try to weasel their way around the consequences), but most have some kind of substance abuse and/or mental illness problems.

On preview, I'd say that alcoholism is borderline. It helps create a feedback loop, sure, and not all alcoholics fuck up, but to the extent that it's a disorder with a physical component, I wouldn't say there's no mitigating factor. Depends.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 12:50 PM
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"Fucked up" is not a technical term, Stras.

Going to be pretty hard to legislate against it, then.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:50 PM
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Going to be pretty hard to legislate against it, then.

Bill Clinton and the congresses of his time did a pretty good job of it, wouldn't you say?


Posted by: water moccasin | Link to this comment | 07- 7-08 12:54 PM
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I used to assume that quantum mechanics was indeterministic before a very old friend, who recently completed his doctorate in physics, insisted to me that it was, in fact, deterministic. I can't remember his explanation for it because it sounded like complete gibberish to me and because I can't understand anything about physics. But if someone out there does know something about physics, and feels differently, go right ahead.

So skimming through Wikipedia, I figured out what your friend was talking about. Basically, quantum mechanics is deterministic if you can plug all the right values into Schroedinger's Equation... but we have no way to know what the right values are. So, in practicality, it's non-deterministic.


Posted by: Josh | Link to this comment | 07- 7-08 12:56 PM
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What about the fuck-ups who are iconoclasts/visionaries? Risk is part of the process of moving forward, outside of the norm. For positive growth, a community needs to find a way to support experimentation, which is by nature risky. The original philosphy behind bankruptcy was to provide a safety net for entrepeneurs, so that we would all benefit. Henry Ford and Mark Twain went bankrupt. Countless artists died penniless, e.g., Poe, Van Gogh.


Posted by: Party of One | Link to this comment | 07- 7-08 12:57 PM
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but society as a whole has a responsibility to attend to its own overall health, including the well-being of its fuckups.

This is a position (and I agree) but I don't think it's a way to get anyone who disagrees with this idea from the start to agree with it.


Posted by: redfoxtailshrub | Link to this comment | 07- 7-08 12:58 PM
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Stras, your friend is wrong, or probably had some idiosyncratic meaning of "deterministic". The laws of physics are, as far as we can tell, at the lowest level random. I suppose your friend could be a partisan of something Bohmian mechanics, which has a non-random interpretation of quantum mechanics, but it's not a widespread view in physics.

I am not a physicist (my background is in math), but I know quantum mechanics pretty well. Why? Because my will to procrastinate from getting any real work done is that great.


Posted by: Walt Someguy | Link to this comment | 07- 7-08 12:58 PM
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186: I'm still not sure what the nature of this theoretical conversation is we're having. Are we having an earnest, good faith conversation with a true conservative, and attempting to convert them to believing in them awesomeness of the welfare state? Are we debating with the conservative for the affections of some imagined moderate audience? Because if it's the first, we're never going to win that argument anyway, and if it's the second, we've more or less already won - moderates already like Social Security, Medicare, Head Start, UHS, etc. Liberals need to actually grow a spine and speak out for what they believe in, assuming they still believe in anything at this point.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:58 PM
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189: "Poor" isn't the same as "fucked-up," WM.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 12:59 PM
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The conservative listens to arguments from self-interest. The crime rate will go up! Prisons are awfully expensive! You don't want all these crazy homeless people on the streets, do you? So we need prevention!

Ding ding ding! Winner!

This is also a good check on our (noble, laudable) instincts. People keep asking upthread why in the world shouldn't we help the screw ups, except to feel good about passing judgment on their failure. But in the real world helping them is expensive! Resources are finite, and ones spent on a project for the screw ups can't be used somewhere else. This is doubly true for political capital, for the reasons HG is worried about in the original post. And the worst cases tend to consume a disproportionate share of resources, so your welfare ROI isn't very good there.


Posted by: Trevor | Link to this comment | 07- 7-08 1:00 PM
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On preview, I'd say that alcoholism is borderline.

"Borderline" is a specific technical term for people who aren't strictly mentally ill but are the most annoying motherfuckers you've ever run into in your entire life. My sister begs to counsel psychopaths, murderers, and felons instead of borderlines. I am not exaggerating in the slightest.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:01 PM
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Is this discussion perhaps simply to abstract for some commenters here? Let's take a few examples.

(1) An aunt and uncle (in law) lived comfortably-enough on their modest incomes for the first two decades of their marriage. A few years ago, they went on their first real vacation since their honeymoon, a nice trip to Aruba. A bit of a splurg (for which they took on a small debt), but everyone was happy for them. They enjoyed themselves so much ("look what we've been missing!") they've been going back several times a year ever since, amassing very considerable debt in the process. They're now approaching retirement and are about to lose their house.

(2) Another relative (likely mental illness, but not of any variety that would garner sympathy, which is the only possible relevance of mental illness to this post) lives alone in retirement in very deep poverty, caused almost entirely by her giving away a great deal of her money (including a quite sizeable inheritance) to a televangelist. (We're talking about over $400,000 given away.) She continues to give away every spare penny she can (convinced that God will repay her 100 fold), but has no savings, and cannot afford medication to treat her quite severe health issues.

(3) A guy I was friends with in high school has trouble making ends meet because he owes child support to the seven different women with whom he's had nine children, all in the last five years.

And these are all separate from the garden-variety cases, like the the high health care costs incurred by long-term smokers, or the severely overweight, or alcoholics. Here many individual cases may be quite sympathetic, but as a class they are more apt to be given the "you made your bed, now lie in it" treatment.


Posted by: Brock Landers | Link to this comment | 07- 7-08 1:03 PM
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Determinism without predictivity is not what we think of as determinism. A system may be completely determined by causes, but random in a complicated way so that we don't know what will happen, even approximately.

In any case, even if behavior is deterministic and even if it were predictable, we'd still want to minimize incentives enabling fuckeduppedness.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:03 PM
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People keep asking upthread why in the world shouldn't we help the screw ups, except to feel good about passing judgment on their failure. But in the real world helping them is expensive! Resources are finite, and ones spent on a project for the screw ups can't be used somewhere else.

Right. Why should the government waste billions of dollars feeding people when it has the much more urgent task of blowing up foreigners half a world away?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:04 PM
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151

"John, see my 55. The bigot may have been determined to be a bigot by genetics and environment, but that doesn't mean I can't express my opprobrium for his bigotry in an attempt to exert an influence on that bigotry. Likewise, even though your lack of empathy may be determined by genetics and environment, that doesn't mean I can't express my opprobrium for your lack of empathy in an attempt to exert an influence on that lack of empathy. Our influences - deterministic though they may be - don't end at birth. We continue to influence each other."

And similarly conservatives express opprobrium for drug addicts in order to discourage drug addiction. The difference being liberals think bigotry is worse than drug addiction while conservatives think drug addiction is worse than bigotry.


Posted by: James B. Shearer | Link to this comment | 07- 7-08 1:05 PM
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I am completely supportive of visionary fuckups such as myself, but social policy deals with the standard average fuckup.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:05 PM
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we'd still want to minimize incentives enabling fuckeduppedness

There's worse things in the world than having a bunch of screwups lounging around slacking off. For example, having a bunch of hungry, angry screwups robbing people for money.

(See what I just did? I used the "lower crime" thing on a conservative!)


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:07 PM
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Go away, James.


Posted by: ben w-lfs-n | Link to this comment | 07- 7-08 1:07 PM
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192: This is a position (and I agree) but I don't think it's a way to get anyone who disagrees with this idea from the start to agree with it.

Right, which is why one has to argue from self-interest. Show people statitistics on the success of social programs, of educational funding, and so on. The claim isn't just, or necessarily, that these things help the disadvantaged, but that they make us a better society as a whole: a nice place to live in. It sucks, but there it is: arguing from compassion is a non-starter.

I don't know what to do with the conservative who's essentially a hardcore libertarian, feeling that we're all thrown to the lions, sink or swim, and so on.


Posted by: parsimon | Link to this comment | 07- 7-08 1:08 PM
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quantum mechanics is deterministic if you can plug all the right values into Schroedinger's Equation...

This is not true. QM reduces to classical mechanics for large objects at temperatures above say 10 degrees Kelvin. The determinism of an observable event does not follow from solving Schroedinger's equation.

The Feynman lectures are a good place to start further reading. Feynman's little book for laymen, QED, may be easier reading.

I wasn't advocating for the approach Gladwell (I think he was the author) mentioned-- personally I think such a tack would only work on a rich California beach. I have no idea how to create a workable safety net without creating a welfare state that productive citizens will flee. Small steps for improvement besides zoning laws would in my mind include more contacts between rich + poor in the US.


Posted by: lw | Link to this comment | 07- 7-08 1:09 PM
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Right. Why should the government waste billions of dollars feeding people when it has the much more urgent task of blowing up foreigners half a world away?

I can't see any reason other than pure nihilism to think "We waste money on a stupid war" implies "We should not care if our welfare spending is efficient."


Posted by: Trevor | Link to this comment | 07- 7-08 1:09 PM
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And similarly conservatives express opprobrium for drug addicts in order to discourage drug addiction.

And we both agree to not send bigots or drug addicts to jail. See? It works!


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:09 PM
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198: People tend to be somewhat indulgent of middle-class fuckups.

One factor in contemporary politics (emphasized by Ruis Teixeira of the DLC / New Republic) is that the truly poor are only about 20% of the population and are mostly minorities, scattered rural whites, and people with behavioral problems. Most of these groups are less likely to vote, and they're scattered and disunified. As a result, the political power of those issues is not great.

Teixeira's conclusion is that Democrats should forget those guys, and while I disagree, I agree that he's put his finger on a real problem.

There are ways of making it seem that families making $30,000 -- $60,000 a year are in some way poor, but they aren't really. And yes, I've been there.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:13 PM
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the seven different women with whom he's had nine children, all in the last five years.

Woo! Chest-bump!

Hmm. That may not be the correct response.


Posted by: JRoth | Link to this comment | 07- 7-08 1:13 PM
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206

Here's an example that seems to be working pretty well:


Posted by: F | Link to this comment | 07- 7-08 1:15 PM
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I am ashamed to say that I shared JRoth's response in 210, and in atonement I offer my shame for all to witness.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 1:16 PM
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The whole argument is about whether the welfare state reduces crime. Conservatives doubt that it does. "Re-invent government" neo-liberals propose tweaking the welfare state to make sure that it doesn't incentivize fuckeduppedness. I'm still an old liberal / Social Democrat / Democratic Socialist, but I agree that we should be concerned about incentives.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:16 PM
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I can't see any reason other than pure nihilism to think "We waste money on a stupid war" implies "We should not care if our welfare spending is efficient."

We don't just waste money on a stupid war. We waste money on many stupid wars, and on preparation for future stupid wars, and on a massive self-perpetuating industry that ensures an endless succession of stupid wars. It doesn't take nihilism to think that in the context of "efficient government spending," "war" might need trimming before we get to "money for poor people."


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:17 PM
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And this is even more ambitious, although in this case, I'm not convinced it's working as well.


Posted by: F | Link to this comment | 07- 7-08 1:17 PM
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Somewhat related, McCain is going to balance the budget by the end of his first term. Part of the money is going to come from the savings we will have when we win in Iraq and Afghanistan.


Posted by: Will | Link to this comment | 07- 7-08 1:18 PM
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197:I have been diagnosed as borderline by two different shrinks. I am actually quite proud of it. It is a personality disorder if not an official mental illness. Another called me paraschiz. Fuck her.


Posted by: bob mcmanus | Link to this comment | 07- 7-08 1:19 PM
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216: I understand that the rainbow portal to Leprechaunland hidden in Achmadinejad's backyard is rich with elven gold.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:20 PM
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nice trip to Aruba ... debt ... house loss

I have a friend whose family is like this. I grilled at their house this weekend. I'd like to say something to the quiet younger sister who has a chance of escaping, but I don't know her that well, and telling her pointedly that she has parasitic family members who will destroy her unless she deserts them would probably be alarming enough that she wouldn't especially listen. She probably has the knowledge already but lacks will to cut off her family.


Posted by: lw | Link to this comment | 07- 7-08 1:20 PM
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I stopped reading the thread at about comment 80 because I have to get back to work, but in case you are all still worrying about heebie's original formulation about people who make bad decisions, I am here to tell you to get off your moral high horse. Of course "who are we to judge" applies for classes of individuals, like "people with heart disease" or "poor people" or "AIDS patients" but it is just absurd to claim that there aren't specific examples of people whose problems are the result of, at least in large part, bad decisions they've made.

I work with these kinds of people every fucking day, and it is maddening. People who are dying from liver disease from Hep C because they used dirty needles in feeding their heroin addiction. Like, two years ago. People who keep having alcohol-induced seizures. People who don't get disability because their medical records are incomplete--they don't show up for doctor's appointments. People who fail to bother to contact a lawyer, even though they have a perfectly good defense, until it's way way too late and end up evicted and losing their Section 8 housing.

You know, an important part of having compassion for people whose lives seem irretrievably fucked up is acknowledging them as volitional human beings who made some choices every now and then.

I'm sympathetic to these people, because I'm a sympathetic sort of person, but if you say that no one's plight calls for "GODDAMNIT WHY CAN'T YOU STOP FUCKING YOURSELF OVER, DUMBASS?" then you really just haven't dealt with many of these people.


Posted by: m. leblanc | Link to this comment | 07- 7-08 1:21 PM
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Show people statitistics on the success of social programs, of educational funding, and so on. The claim isn't just, or necessarily, that these things help the disadvantaged, but that they make us a better society as a whole: a nice place to live in. It sucks, but there it is: arguing from compassion is a non-starter.

I'm pretty sure that a major problem liberals have is that "showing people statistics" is no more effective, electorally, than "arguing from compassion." While Mr. Pencilneck is setting up his piechart, Mr. Rugged Individualist is spinning tales of welfare depravity.

I don't have a solution to this problem, but I have a goo example of a statistical argument that should work (but generally doesn't): I used to work with a program that worked with 3rd-5th graders from 5 different inner city schools. The age group was so young in order to preempt a lot of the bad cycles that begin in middle school, as well as to get kids from the 5 parts of this neighborhood to feel united before any sense of "turf" developed. The total annual budget for this program was almost exactly the same as the cost of one year's incarceration (for an adult). IOW, if each year, one kid out of ~55 was affected in a way that reduced his/her future incarceration by a single year (and, both statistically and IRL, at least some of these kids were headed for jailtime), the program had paid for itself. The fact that the program surely improved the lives and future prospects of these kids in a positive way was just gravy, financially.

But of course conservatives don't really care to help programs like this - far easier to use midnight basketball and the like as touchstones of liberal muddleheadedness in order to accrue power.


Posted by: JRoth | Link to this comment | 07- 7-08 1:25 PM
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You seem to be taking efficiency as some kind of code word for spending less money. That is not the case.

Recall that this is (was?) a thread about what kinds of rhetorical appeals one can make to conservatives to improve outcomes for the worst decision makers. I think that by pitching "efficient" programs, particularly ones that actually cost the government less money than the status quo, one an actually improve outcomes, even in the current political climate.


Posted by: Trevor | Link to this comment | 07- 7-08 1:26 PM
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GODDAMNIT WHY CAN'T YOU STOP FUCKING YOURSELF OVER, DUMBASS?

New hovertext?


Posted by: JRoth | Link to this comment | 07- 7-08 1:28 PM
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222 to 214


Posted by: Trevor | Link to this comment | 07- 7-08 1:29 PM
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Not really off topic: This chart (via Kevin Drum) shows how social issues dominate economic issues as far as party identification goes. All of the socially conservative states are Republican or swing, regardless of economic conservativism or liberalism; and all the socially liberal states are Democratic or swing, regardless of economic liberalism or conservativism.

The kind of thing we're talking about here converts the economic liberal/conservative argument into a version of the social conservative/liberal argument. PA, VA, WI, CO, and IA are in the middle on social conservativism, and all over the map on economic conservativism.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:31 PM
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225: P.S. There are methodological concerns about that graph, but it's something worth thinking about.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:32 PM
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You seem to be taking efficiency as some kind of code word for spending less money.

That's because it usually is.

Recall that this is (was?) a thread about what kinds of rhetorical appeals one can make to conservatives to improve outcomes for the worst decision makers.

I suggest to you that when talking to actual conservatives, there's nothing you can say that will convince them to save a particular program, because the goal of the modern conservative movement is, and always has been, to concentrate wealth among the richest people in the country, at the expense of the poor. And this is primarily done by tax cuts and cuts to social programs.

I think that by pitching "efficient" programs, particularly ones that actually cost the government less money than the status quo

Didn't you just say this wasn't about spending less money?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:32 PM
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The article from 211 is exactly what Gladwell wrote about. It would be great if a little of this (give visible public nuisance drunks a clean place to squat and either sober up or eventually die) was viable everywhere, but I don't really see it working well in LA, Morgantown, or Laredo.


Posted by: lw | Link to this comment | 07- 7-08 1:34 PM
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220: Part of what Leblanc talks about is the result of the fact that government help is effectively something that people have to be competent enough to get and use. In other words, it's just part of the mix of ways that enterprising people can better themselves. That kind of help doesn't get to people whose problem is that they're not able to take care of themselves and don't have anyone to take care of them. The individualism / anti-paternalism of our society means that incompetent people are SOL.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:35 PM
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I question the public policy relevance of "goddammit why can't you stop fucking yourself over dumbass."


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:37 PM
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I work with these kinds of people every fucking day, and it is maddening. People who are dying from liver disease from Hep C because they used dirty needles in feeding their heroin addiction. Like, two years ago. People who keep having alcohol-induced seizures. People who don't get disability because their medical records are incomplete--they don't show up for doctor's appointments. People who fail to bother to contact a lawyer, even though they have a perfectly good defense, until it's way way too late and end up evicted and losing their Section 8 housing.

You know, an important part of having compassion for people whose lives seem irretrievably fucked up is acknowledging them as volitional human beings who made some choices every now and then.

I'm sympathetic to these people, because I'm a sympathetic sort of person, but if you say that no one's plight calls for "GODDAMNIT WHY CAN'T YOU STOP FUCKING YOURSELF OVER, DUMBASS?" then you really just haven't dealt with many of these people.

I can appreciate this concept, having dealt with many such people. I have screamed. I have yelled. I have been royally pissed off by such people.

(Also add into the mix the people who lie to their lawyer and totally screw up their case.)

Why do these people act the way that they do? Is it a desire for self-destruction? An inability to understand cause and effect? Mental illness?

eh, I dont have any other answers.


Posted by: Will | Link to this comment | 07- 7-08 1:37 PM
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227

This is pretty defeatist and also kind of unfair. When you characterize the conservative movement this way, you accurately characterize it's leadership and the small proportion (~10%) of really politically involved people out there. The remaining 90% of people who vote conservative are open to having their minds changed by reasonable appeals because they are generally reasonable people, though we would consider them to be politically ignorant. And if you shave off some of these people, so that they no longer vote conservative, you reduce the power of the conservative leadership you so accurately vilify.


Posted by: F | Link to this comment | 07- 7-08 1:38 PM
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231: Neither do I, but I suspect once the neuroscientists get their act together, there will be some clear-cut answers.


Posted by: Klug | Link to this comment | 07- 7-08 1:38 PM
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Actually, taking into account the Crazification Factor, my percentages are a bit off (maybe it's more like 50-50 amongst those who vote conservative), but the point still stands.


Posted by: F | Link to this comment | 07- 7-08 1:41 PM
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I suggest to you that when talking to actual conservatives, there's nothing you can say that will convince them to save a particular program, because the goal of the modern conservative movement is, and always has been, to concentrate wealth among the richest people in the country, at the expense of the poor. And this is primarily done by tax cuts and cuts to social programs.

Oh, shut the hell up. The majority of actual conservatives are opposed to the economic goals of the Republican party because said economic goals fuck over almost everyone. They vote for the Republican party because they care about other things more.

Unless by "actual conservatives" you mean "political operatives". It's somewhat confusing because I don't know if we're treating "conservatives" and "Republicans" as synonymous.


Posted by: Fatman | Link to this comment | 07- 7-08 1:41 PM
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233 wins!

Let's blame them!

Cant you people figure out the brain already?!?!??!


Posted by: Will | Link to this comment | 07- 7-08 1:41 PM
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I suggest to you that when talking to actual conservatives, there's nothing you can say that will convince them to save a particular program, because the goal of the modern conservative movement is, and always has been, to concentrate wealth among the richest people in the country, at the expense of the poor. And this is primarily done by tax cuts and cuts to social programs.

Stipulating that this is true of the modern conservative movement, that certainly doesn't imply that it's true of every conservative you may meet.

On preview, pwned by 232, but since I went to all the trouble of copying and pasting, I may as well post it, right?


Posted by: mrh | Link to this comment | 07- 7-08 1:41 PM
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I suspect once the neuroscientists get their act together, there will be some clear-cut answers.

You just wait until the neuroscientists get their act together, young man! Then we'll get some clear-cut answers around here.


Posted by: JRoth | Link to this comment | 07- 7-08 1:42 PM
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And 235, mrh! Don't forget 235!


Posted by: Brock Landers | Link to this comment | 07- 7-08 1:42 PM
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This is pretty defeatist and also kind of unfair stras


Posted by: lw | Link to this comment | 07- 7-08 1:43 PM
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Without further specification, "conservative" and "liberal" should be understood in terms of American battle lines, and not historically in terms of deep thinking and age-old traditions.

A high proportion of American conservative politicos are non-ideological scam operatives, for example.


Posted by: John Emerson | Link to this comment | 07- 7-08 1:44 PM
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Pwned by F and the Fatman!


Posted by: mrh | Link to this comment | 07- 7-08 1:45 PM
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The goal is not to decrease spending on social programs. The goal is to increase spending on social programs. Actually, the goal is to improve outcomes, but we want to increase spending on social programs to accomplish that.

Now, in order to increase spending on social programs, you need to need the support, or at the very least to blunt the opposition, of some conservatives. One way you do that is by finding programs that, while representing an increase in direct social spending, decrease spending overall. It's true that doctrinaire conservatives aren't going to like this. But political parties are coalitions and the world is not neatly divided into Liberals and Conservatives with nothing in between. The right policies and the right framing can make a lot of difference at the margin.

Now if you want to be a troll about this you can point out that OMG SPENDING HAS GONE DOWN and then you can throw in a bunch of unrelated stuff about war sepnding, but the idea is that:

current programs + new programs = better outcomes + less cost


Posted by: Trevor | Link to this comment | 07- 7-08 1:45 PM
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Sounds like noir film.


Posted by: F | Link to this comment | 07- 7-08 1:45 PM
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244->242 and with the a inserted in the appropriate spot.


Posted by: F | Link to this comment | 07- 7-08 1:46 PM
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This is not true. QM reduces to classical mechanics for large objects at temperatures above say 10 degrees Kelvin. The determinism of an observable event does not follow from solving Schroedinger's equation.

Wait... you mean Wikipedia lied to me?


Posted by: Josh | Link to this comment | 07- 7-08 1:46 PM
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Augh! Triple-pwned!


Posted by: Trevor | Link to this comment | 07- 7-08 1:48 PM
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232 et al, see 194. If this imagined argument is happening between non-professional conservatives or moderate "winnables," then the kind of rhetorical concessions you're talking about aren't needed - the majority of the country already supports the liberal welfare state. This isn't the height of the Reagan revolution anymore; we aren't even in the middle of the Clintonian "end of the era of big government." You're making concessions that don't need to be made in order to defend something that's already pretty well-defended.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:48 PM
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243:

Hey, I've got it!!

Abortions cause a decrease in crime!


Posted by: Will | Link to this comment | 07- 7-08 1:49 PM
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THOSE DUMBASS NEUROSCIENTISTS REALLY NEED TO QUIT FUCKING THEMSELVES OVER, GODDAMMIT.


Posted by: IRATE PHENOMENOLOGIST | Link to this comment | 07- 7-08 1:49 PM
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Yeah, in effect, Schrodinger's equation spits out probabilities, not outcomes.

I'm surprised that Wikipedia would get something that basic wrong. IME, I've found the science pages to be pretty good.


Posted by: F | Link to this comment | 07- 7-08 1:50 PM
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SE gives you the time evolution of the wavefunction, not of its eigenstates. The Feynman books are good.


Posted by: lw | Link to this comment | 07- 7-08 1:51 PM
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248,

Screw defending. I want to go on offense.

And even if we hold social spending constant, using it more efficiently means we get more results for the same amount of money. Which is, you know, the whole idea.


Posted by: Trevor | Link to this comment | 07- 7-08 1:51 PM
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the majority of the country already supports the liberal welfare state -- when asked about it in certain ways.

And polling shows that the majority of the country is also badly uninformed or misinformed about the programs that make up the liberal welfare state. Surely you're not suggesting that welfare-state-loving liberals don't have any political work to do?

I think the legislative history of the past 20 years -- as you've argued in this very comment section -- shows that these programs haven't been very well-defended at all.


Posted by: mrh | Link to this comment | 07- 7-08 1:51 PM
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248

I've found numerous conservative friends who don't believe in social programs to be open to cost-benefit analysis arguments, especially when they would have rejected moral arguments (like "it's the right thing to do") out of hand.


Posted by: F | Link to this comment | 07- 7-08 1:52 PM
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249: lol. That one I don't have any hope for. We can't even get "contraception education will decrease the number of abortions"

One hopes that argument about poverty are more amenable to data-driven persuasion than ones about sexuality


Posted by: Trevor | Link to this comment | 07- 7-08 1:54 PM
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Surely you're not suggesting that welfare-state-loving liberals don't have any political work to do?

They've got a lot less work on it to do than they've got on foreign policy. There's a reason why Democrats are overwhelmingly trusted on economics, and have been for years, while they've only recently been more trusted on foreign policy.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:55 PM
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227: I suggest to you that when talking to actual conservatives, there's nothing you can say that will convince them to save a particular program, because the goal of the modern conservative movement is, and always has been, to concentrate wealth among the richest people in the country, at the expense of the poor.

Cut it out, stras. (smileyface, dumbass)

It should be noted, maybe, that a lot of this sort of debate is occasioned by the feeling that we're living in a time of finite resources. Not enough to go around, so some things, or some people, must be cut out. And actually, it seems we feel that resources are finite in general now; like forever. We didn't always think so, and this changes the nature of political discourse in a substantive way.

Is that right? In times of (felt) prosperity, are we (the US) more likely to embrace social programs? PGD? I'm unclear about any general picture to frame about this.


Posted by: parsimon | Link to this comment | 07- 7-08 1:56 PM
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Other areas liberals need to work on: the instinct to self-sabotage, the constant sense of panic, the urge to go start any fight by fleeing in terror and yelling "not in the face."


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 1:57 PM
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Conservatives are being badly misrepresented as monolithic and hegemonic in this thread. There is a real lack of imagination here about the variety of ways real people might operate.


Posted by: Sybil Vane | Link to this comment | 07- 7-08 1:57 PM
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Really, look at the link I posted. Republicans have won by making social conservativismdominant, and to do that they had to convince people that welfare-state issues are social.

"Do you want your tax dollars to go to a gay drug addict abortionist with 8 illegitimate children?"

And behind that is race: "Do you want your tax dollars to go to a gay black drug addict abortionist with 8 illegitimate children?"


Posted by: John Emerson | Link to this comment | 07- 7-08 1:59 PM
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In times of (felt) prosperity, are we (the US) more likely to embrace social programs?

Yes. We also like minorities more.


Posted by: Trevor | Link to this comment | 07- 7-08 2:00 PM
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190 gets it more-or-less right. Quantum mechanics is deterministic but decoherence makes that utterly useless in practice, so we might as well say that quantum mechanics is probabilistic. It seems pretty likely, from a physical point of view, that free will is an illusion, but it sure is a convenient illusion and I wouldn't really know what to do without it....


Posted by: essear | Link to this comment | 07- 7-08 2:02 PM
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In times of (felt) prosperity, are we (the US) more likely to embrace social programs?

Yes. We also like minorities more.

You know, I'm making a lot less this year than last, and I can tell you that my neighbors have been getting a lot lazier lately.


Posted by: JRoth | Link to this comment | 07- 7-08 2:04 PM
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260: Sybil, individual conservatives are diverse, but the Republican "majority of the majority" is genuinely hegemonic and monolithic. They represent about 22% of the country (~70% of the Republicans, when ~52% of the voters vote Republican and ~60% of adults vote), but they have used the system beautifully.

The real Republican issues are tax reduction and war. Social conservativism is lip service, but the Republicans are diligent about the lip service. Little-government and fiscal-conservative Republicans are the biggest suckers in the universe.


Posted by: John Emerson | Link to this comment | 07- 7-08 2:04 PM
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Heebie, check your email.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 2:05 PM
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Further to 263: even if you think that QM is fundamentally not deterministic -- which is a misunderstanding of QM -- you're still not going to get "free will" out of it, because quantum coherence doesn't really exist in the brain. Roger Penrose is a total crackpot on this issue.


Posted by: essear | Link to this comment | 07- 7-08 2:05 PM
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261 is right. Liberals aren't going to pick up support from the other end of the spectrum; they're going to pick it up from the middle, which largely believes in liberal social programs and policies (which is why John McCain is going out of his way to feign interest in global warming, health care, the economy, etc.)

258 has it right in that people are becoming more and more aware that our resources are finite, but I don't think this is going to scare them away from social programs. Think of how this scarcity manifests to most people: in greater economic hardship, in lack of security in our jobs and in our health care. Those are areas that, once again, Americans have traditionally looked to liberals for answers for.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 2:05 PM
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God, my grammar is for shit today. w-lfs-n is spinning in his grave.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 2:06 PM
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Heebie, you may have won $1,000,000.00. Some restrictions apply.


Posted by: John Emerson | Link to this comment | 07- 7-08 2:06 PM
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God, my grammar is for shit today. w-lfs-n is spinning in his grave.

w-lfs-n has been busy perfecting the sazerac. he only feels like he's spinning in his grave...


Posted by: Di Kotimy | Link to this comment | 07- 7-08 2:07 PM
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Putting one foot down on the ground helps.


Posted by: lw | Link to this comment | 07- 7-08 2:08 PM
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In times of (felt) prosperity, are we (the US) more likely to embrace social programs?

The Great Depression was a time of felt prosperity?


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 2:09 PM
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the legislative history of the past 20 years -- as you've argued in this very comment section -- shows that these programs haven't been very well-defended at all.

I would I guess agree with Stras that *universalist* safety net entitlements have always been very popular and reasonably well-defended. AFDC was a big problem because it was perceived as letting stigmatized populations live on the public dole without having to work. AFDC took shape in the 1910s-30s based on the assumption that single women with children should not have to work. This assumption was profoundly culturally outdated by the 1990s. I think the Democrats were right to jettison it. Doing so was a big element in repositioning the party as favoring "working families" instead of the non-working poor, which the club Republicans beat them with for a while.

There are ways of making it seem that families making $30,000 -- $60,000 a year are in some way poor, but they aren't really. And yes, I've been there.

Right (although $30K is effectively poor in some coastal areas). But these households are still being ripped off by the rich. One thing about the Democrats is that electorally they have to position themselves as the party defending the middle class making say $30-$100,000. By American standards this group is getting ripped off -- we could have a better middle class quality of life in this country than we do. But by global standards the group is still rather wealthy. This is relevant when it comes to trade policy, immigration policy, and also environmental policy, all of which have potential tradeoffs between the well-being of the global poor and the American middle class. (In some cases cheap-labor related ones that also help the American rich).

In times of (felt) prosperity, are we (the US) more likely to embrace social programs? PGD?

I dunno. There must be a literature on this somewhere. The usual connection people make is between war and more support for social programs. Shared sacrifice, etc. Not sure I buy it.


Posted by: PGD | Link to this comment | 07- 7-08 2:09 PM
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The Great Depression was a time of felt prosperity?

Thinking it over, casual observation would say there's a connection between the need to address social conflict and expanded social programs. Works for Bismark, late 60s, Depression. But doesn't work for 1890-1920 (labor conflict leads to crackdown -- although you do get workers comp), nor for Medicare in 1964.


Posted by: PGD | Link to this comment | 07- 7-08 2:11 PM
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I don't think that the link is very direct, and it may not be historically measurable. But when mass armies aren't needed, it's more plausible to ask "Do we really need those people for anything?" Economic worth becomes the only human worth.


Posted by: John Emerson | Link to this comment | 07- 7-08 2:12 PM
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260: Conservatives are being badly misrepresented as monolithic and hegemonic in this thread. There is a real lack of imagination here about the variety of ways real people might operate.

So explain.


Posted by: parsimon | Link to this comment | 07- 7-08 2:15 PM
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Economic worth becomes the only human worth.

John, I don't think I can quite stand to be this cynical, but it's tempting.

This goes toward the question in the post, to the extent that I understand it: can one possibly speak directly to the hypothetical conservative whose stance on public policy matters (I take it) is problematic in terms of his or her conception of human worth? I doubt it. Too abstract, if nothing else.


Posted by: parsimon | Link to this comment | 07- 7-08 2:33 PM
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277: Well, just going at the monolithic part... I consider myself pretty firmly liberal. The guy I have been kinda sorta seeing describes himself as libertarian (I know, I know... ), and yet he is decidedly more pro-gun control and I am decidedly more 2nd Amendment. My aunt is a life-long democrat. Her stepson is a Republican lobbyist. She is homophobic and he is supportive of gay marriage. I have a hardcore, religious right best friend (down to heavy emphasis on the submissive wife thing at her wedding) who is probably the second most committed environmentalist of all my friends.

John may well have it right that the real conservative hegemony is that narrow minority who are focused only on tax reduction and on war (as a convenient vehicle to their own prosperity), but they've been successful largely by successfully playing the more stereotypical social conservative cards -- and could very well be undone as more and more social conservative types start recognizing that they've been played. hasn't there already been talk here about the religious right growing increasingly dissatisfied?


Posted by: Di Kotimy | Link to this comment | 07- 7-08 2:33 PM
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Thanks for this post Heebie - I thought you were pretty clear about your point despite the fact that a bunch of people needed a few rounds of explanation to get it. To me it comes down to the realization that if Dubya had been suddenly transferred into the body of a poor person at pretty much any point in his life so far he'd have ended up in a spiral of self destruction leading to skid row and ending in a pauper's grave. Lucky for him he was able to externalize his destructiveness and has lead a very nice life indeed. I do not feel a lick of sympathy for hypothetical homeless Dubya, but I still support programs to mitigate the suffering of such people. For one thing, they tend to hurt a lot of people on their way down, and the people they hurt are often those least able to absorb the damage - better to socialize that damage even at the cost of more total dollars spend, since it otherwise comes directly out of opportunities for the 'deserving' poor.

Unfortunately I came to this thread late (job, dontchaknow), so I missed out on the quantum silliness. I'm a physicist by profession, so I feel I ought to say something on the subject but really - quantum mechanics is a stupid fucking digression if you're talking social policy. Every discussion of personal responsibility ends up with a mention of QM, but that's just because people are silly.


Posted by: togolosh | Link to this comment | 07- 7-08 2:45 PM
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John,

To me the Republican party appeals to selfishness, judgementalism, and fear. The Democratic party appeals to generosity, empathy, and sympathy.

Looked at another way, the Republicans are old testament and the Democrats are new testament.

When we know more about the brain we'll know more about why that is.

In the meantime there is a constant tension between these competing values.

Since the poor will always be with us then what should our society do with them? Human history suggest we exploit them. In other words, what is the point of having power if we don't use it?

Personally I think some things are a matter of principle and not subject to debate. Some things should be done because they are the right thing to do and do not need any more reason than that.

I acknowledge that this will hold no sway over some others. Some people crave judgment and lack the ability or time to do a good job of it. They crave a simple easy answer, and hopefully one that lets them punish someone else. To them self-righteous wrath is da bomb.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 2:45 PM
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I wish you guys weren't having this interesting discussion when I'm at work. Also, I'm losing my voice. In July. What's up with that? /whine off

AFDC took shape in the 1910s-30s based on the assumption that single women with children should not have to work

It was first sold as "mother's pensions," as beautifully documented by Linda Gordon in Pitied but Not Entitled.

Regarding getting social programs funded, I'm wondering how much of it is evoking a "There but for the grace of God" in a majority of the electorate, and how much encouraging people to look through a pragmatic lens rather than emotional one. E.g., I think state-sponsored lotteries are a shame upon humankind, but I am pragmatically convinced that state-regulated gambling is preferable to unregulated. *

*Yes, big gulf between state-sponsored and state-regulated, not addressing that right now.


Posted by: Witt | Link to this comment | 07- 7-08 2:59 PM
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they tend to hurt a lot of people on their way down

This is a really, really key point.

I am kind of worn out in arguing with people on these issues, mostly as a result of dealing with self-proclaimed liberals in the philanthropic world who are more interested in punishments and restrictions than effectiveness. But to the extent that I'm ever in true dialogue with people who don't believe that everyone deserves a floor, it's useful to be able to point out that ignoring the screw-ups does tend to have repercussions for people unfortunate enough to be dependent on them.

This does lead us to the absolutely bizarre universe of child-only food stamp cases, in which the adult's food stamp benefit has been "sanctioned" (cut) due to noncompliance with program regulations, but the child's is protected. Talk about your delusional notions of family grocery shopping.


Posted by: Witt | Link to this comment | 07- 7-08 3:05 PM
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The Republicans are old testament and the Democrats are new testament.

T.T. Crazed, you might have taken Heebie's earlier hint, but let me point out that she's an Old Testament gal. That's not a fruitful line of argument.


Posted by: John Emerson | Link to this comment | 07- 7-08 3:06 PM
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Speaking of gambling, I predict that in the US we re-criminalize gambling some time around 2045.

That pendulum seems to swing back and forth every 75 years.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 3:07 PM
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McCain loves craps. Obama loves poker.

That is what I learned today.


Posted by: Will | Link to this comment | 07- 7-08 3:14 PM
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Actually, to edit myself, more interested in punishments and restrictions should be more interested in avoiding being snookered or not seeming "savvy" in front of their professional peers.


Posted by: Witt | Link to this comment | 07- 7-08 3:19 PM
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284: John,

If you are saying heebie is Jewish I should point out that I don't really consider most modern Jews to be very old-testament. From what little I know the modern Jewish religion seems to have considered a large variety of interpersonal and societal situations and has written a large amount of guidelines on what to do with them, most of which I find very sensible. I think I would be very happy to take advice from a Rabbi.

To me it is ironic that many so-called "Christians" seem to neglect what Christ actually taught and many non-Christians actually seem to follow many of Christ's teachings.


Posted by: Tripp the Crazed | Link to this comment | 07- 7-08 3:20 PM
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279.1: The post was clear in wanting to differentiate between the Democrat/Republican distinction in favor of a liberal/conservative one. Some said a clarification of terms was needed; others later said this was quibbling.

As it panned out, we took the post to be about stances on government funded social, or socioeconomic, programs for the down and out. I imagine that positions on this can span the spectrum; "conservative" is used as code, then, but as an identifiable code.


Posted by: parsimon | Link to this comment | 07- 7-08 3:22 PM
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To me it is ironic that many so-called "Christians" seem to neglect what Christ actually taught and many non-Christians actually seem to follow many of Christ's teachings.

There's a parable on this, IIRC. Something with the moral being that the true believer is the one that follows the teachings, not the one professing it loudly. That would be more convincing if I remembered more than a vague impression....


Posted by: Di Kotimy | Link to this comment | 07- 7-08 3:25 PM
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Is 290 a gag?

The Good Samaritan, but also stated in explicit terms by J.C.


Posted by: JRoth | Link to this comment | 07- 7-08 3:37 PM
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Matthew 7:21-23? Not exactly a parable, but that may be what you're remembering. Of course, that's also at least an implicit message in probably half or more of the parables, so there's a lot of passages you could be thinking of.


Posted by: Brock Landers | Link to this comment | 07- 7-08 3:42 PM
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Hi, I'm back and I'd like to start over. Ignore what I, said before, I started off with the wrong tone, and didn't have the sense to walk away from the internet when I was crabby.

I find the problem of people who consistently make terrible choices, with no safety net, horribly vexing.

This is an excellent topic heebie. I've had some bad personal experiences where I've tried to help individuals who are bad decision makers, and realized quickly that I was going to be sucked into a vortex of despair.

My first year of graduate school, I lived in a tiny studio apartment down the hall from a belligerent alcoholic named Paul. He would have been homeless, but the veterans administration checks paid his rent. At the first of the month he'd get his check, and he'd convert it into four money orders, which he would then distribute among his friends, in a kind of alcoholic's Odysseus contract, with instructions not to return the money order to him until a certain date. He was a mean drunk who would stand in the hall and yell "MY NAME IS PAUL. I FUCK LIKE DOG. I FUCK LIKE PIG" when he was loaded. He talked about guns a lot. I don't think he had one, but I was never sure about his friends.

Paul was also the only person I've ever seen panhandle *inside* an apartment building. He would stop me in the hall and ask for money. Being a (love me love me live me I'm a) Liberal, I would tell him that I would give him food, but not money. He would then come into my one room apartment and watch me make pasta for him, asking me all the time for money. At one point, he just up and said, "look, I don't even like your food. I'm just here because I know that if i ask you for money long enough, you will give it to me.

Sometimes it was hard to get him to leave my apartment.

One morning at about 9AM, he entrusted me with the money order from his veterans check. He was back at my door at 10AM drunk to hell and asking for his money back. I wound up giving his money to his friend Jermaine, who said he would handle it. I didn't really trust Jermaine, but felt relieved to be rid of the money order.

Another day, when I was playing John Coltrane on the stereo, he knocked on the door of my apt. When I opened the door, he was air-saxing manically.

When he was finally evicted, I thought about complaining to the landlord, but didn't.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 3:43 PM
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To finish my story. In the end, the only way to deal with persistent bad decision makers on a personal or a social level is *harm reduction*. Personally, this will often mean walking the fuck away. On the social level, though, this can mean all sorts of policies that conservatives hate. Free needles. Focus on drug rehab rather than punishment.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 3:46 PM
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On the social level, though, this can mean all sorts of policies that conservatives hate

Wasn't this the point of the post?


Posted by: Brock Landers | Link to this comment | 07- 7-08 3:48 PM
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It's a testament to rob's mellowness that I'm not sure what he said earlier in the thread to make himself feel so bad.


Posted by: strasmangelo jones | Link to this comment | 07- 7-08 3:53 PM
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293: I almost always kick down to panhandlers, but knowing this is only to salve my own conscience. (Because I also know this is what I'm doing, I almost never try the "I'll only give you food" thing; no point, and I know if I were the panner it would really piss me off.) Of course, the fact that some of the people who need social safety nets are self-destructive or mentally ill is all the more reason why structured social programs specifically built to correct for these things are the way to go, and why relying on a diffuse network of personal and private charity is ineffective.


Posted by: DS | Link to this comment | 07- 7-08 3:53 PM
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295: I'm all about agreeing with heebie now.


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 3:58 PM
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I'm all about agreeing with heebie now.

Say it, rob. C'mon, say it.

"Heebie is r____."


Posted by: JRoth | Link to this comment | 07- 7-08 4:02 PM
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-eally nice?


Posted by: rob helpy-chalk | Link to this comment | 07- 7-08 4:04 PM
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harm reduction

policies that conservatives hate

That's the kernel of it, right there. Conservatives (IME) hate harm reduction.


Posted by: Witt | Link to this comment | 07- 7-08 4:07 PM
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When did Unfogged start remembering the italics tags after line breaks?


Posted by: Witt | Link to this comment | 07- 7-08 4:08 PM
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-ouge.


Posted by: DS | Link to this comment | 07- 7-08 4:10 PM
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On the social level, though, this can mean all sorts of policies that conservatives hate.

The point of the above-referenced Gladwell article, however, is that it also means policies that liberals hesitate to endorse, such as denying people some liberty.


Posted by: Wrongshore | Link to this comment | 07- 7-08 4:11 PM
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We have seen more than once that the public welfare may call upon the best citizens for their lives. It would be strange if it could not call upon those who already sap the strength of the State for these lesser sacrifices, often not felt to be such by those concerned, in order to prevent our being swamped with incompetence. It is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. 274 U.S. 200 (1927).

I just wish one party or the other would come out in favor of sterilization. Then people could REALLY pick sides and get upset. I think it's odd, or at least interesting, that the abortion debate's been hashed out in such a way that both parties are equally (un)likely to support such an approach.


Posted by: ed bowlinger | Link to this comment | 07- 7-08 4:34 PM
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Denying liberty to self-destructive people is the least of the problem. The tactic Gladwell describes, linked in 211, means devoting scarce resources (a building, educated social workers) that could go to deserving single-parent families to people who are so self destructive that they become public nuisances.

Since public nuisances are expensive to clean up humanely, less subsidized housing and social worker time to explain FAFSA to single parents. This is the concrete dilemma. "Care for them all" is not a productive response.


Posted by: lw | Link to this comment | 07- 7-08 4:40 PM
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306: Or you could... spend less money on hyper-advanced weapons...

...

Nahhh.


Posted by: DS | Link to this comment | 07- 7-08 4:43 PM
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Inability to reproduce is a byproduct of single-sex incarceration with long sentences.

Personally, I'd love to see a smaller defense budget, but not 0. But, given a social services budget of X, it looks like crowded cities do well, at least in some sense, to concentrate that budget on the most intractable citizens. Unfair but apparently practical. An experiment happening now. Not actually sure that Gladwell was the author.

-easonable.
-esponsible.
-ing-tailed.


Posted by: lw | Link to this comment | 07- 7-08 4:51 PM
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given a social services budget of we should stop spending so %^!&$()^!! much on punitive programs that create new offenders and/or cost us $30K/year to house nonviolent ones.

Seriously, have you guys even been inside a residental behavioral health facility for teens? They're awful places, the staff is paid miserably, nobody gets better in them, and a lot of people get abused -- and they cost a lot to run.

My favorite picture of all time (that I didn't take): city-owned vehicle emblazoned with slogan "Our Children Are Our Future" and then below it "Juvenile Justice."


Posted by: Witt | Link to this comment | 07- 7-08 4:56 PM
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even s/b ever


Posted by: Witt | Link to this comment | 07- 7-08 4:58 PM
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To me it is ironic that many so-called "Christians" seem to neglect what Christ actually taught and many non-Christians actually seem to follow many of Christ's teachings.

Ironically, Christ didn't think this was very ironic at all.


Posted by: Populuxe | Link to this comment | 07- 7-08 5:00 PM
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Personally, I'd love to see a smaller defense budget, but not 0.

Maybe shoot for "only four times the size of the next largest defense budget." That could provide some wriggle room.

-econdite.


Posted by: DS | Link to this comment | 07- 7-08 5:05 PM
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Or maybe even "only as big as the next five defense budgets put together, instead of the next ten."


Posted by: John Emerson | Link to this comment | 07- 7-08 5:19 PM
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I should point out that I don't really consider most modern Jews to be very old-testament


Posted by: mrh | Link to this comment | 07- 7-08 5:20 PM
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Huh. Let's try that again:

I should point out that I don't really consider most modern Jews to be very old-testament

O RLY?


Posted by: mrh | Link to this comment | 07- 7-08 5:20 PM
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294 is basically right.

There are lots of 'mixed' positions one can take here. One can be emotionally pretty unsympathetic to the worst cases, intellectually committed to some robust notion of personal responsibility and yet still be entirely in favour of 'liberal' policy prescriptions purely on pragmatic harm reduction grounds. One can think that certain types of offenders are clearly utter bastards, responsible for their own wrong-doing and yet still believe that custodial sentences are counter-productive and relatively generous social provision the way to go in terms of least bad outcomes.

One can think* that very little is exculpatory at the level of individual moral responsibility [sort of a bastard existentialist take on things, say] but still believe that strong social safety nets that catch the 'undeserving' as well as the deserving are the best answer out there.

* I sort of do and don't really think this and it's heavily context dependent. But in darker moments it certainly has its emotional appeal ...


Posted by: nattarGcM ttaM | Link to this comment | 07- 7-08 5:22 PM
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And the answer "We need to fund education better!", while it is a practical solution for reducing the size of the fourth group, does not actually address the existing members of the fourth group.

I'm not actually sure this is truly a good solution as a practical matter. There are plenty of people with very expensive (i.e well funded) educations who make consistently terrible choices. Whether or not "good judgment" can be developed educationally, it's really not what our current system addresses...


Posted by: Di Kotimy | Link to this comment | 07- 7-08 5:33 PM
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Stras: But the Calvinist conception of Grace is a lot weirder and more fucked-up than "unearned." Material success was a reflection of God's will, and God's will said something about the people God picked to succeed, and that "something" usually translated into various concepts of worthiness.

Please, that's not Calvinism, that's a caricature of vulgar Calvinism.

Calvin would have denigrated that belief as presumption.

It's quite funny the ridiculous amount of bigotry against Calvinism amongst liberals in America, when very similar remarks about Catholicism or generic Anglicanism would be laughed out of court.


Posted by: Keir | Link to this comment | 07- 7-08 5:35 PM
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Once I've succeeding in having Karl Rove impaled and fed to my hogs, I plan to go down the list. At a certain point I'll run out of Republican crime lords and will have to feed my hogs something else. At that point I might want to toss them an occasional habitual fuckup as part of my Very Tough Love program.


Posted by: John Emerson | Link to this comment | 07- 7-08 5:35 PM
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Vulgar Calvinism is one of the kinds we're most familiar with in these parts. "The visible signs of invisible grace".


Posted by: John Emerson | Link to this comment | 07- 7-08 5:37 PM
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re: 318

It's also ironic given the relatively liberal social policy choices made by the countries that actually have religions that derive from Calvin.



Posted by: nattarGcM ttaM | Link to this comment | 07- 7-08 5:41 PM
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At that point I might want to toss them an occasional habitual fuckup as part of my Very Tough Love program.

Just so long as you started with the blueblooded habitual fuckups first.


Posted by: DS | Link to this comment | 07- 7-08 5:42 PM
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321: Other than the US and probably South Africa.


Posted by: John Emerson | Link to this comment | 07- 7-08 5:43 PM
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322: There's not going to be any black Canadian exemption, if that's what you're angling for. That's not where I'd start, of course, but don't get complacent.

And don't go all "racist hegemonist" on me. I'm objective and neutral, like all Americans.


Posted by: John Emerson | Link to this comment | 07- 7-08 5:45 PM
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Vulgar Calvinism is one of the kinds we're most familiar with in these parts. "The visible signs of invisible grace".

But, I submit, that's not true of all times and places? Or, at least, there's different forms of vulgar Calvinism at different parts. Hogg's Gil-Martin's views are rather contradictory with your form of vulgar Calvinism.


Posted by: Keir | Link to this comment | 07- 7-08 5:45 PM
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323: How Calvinist-influenced is the Dutch Reform Church? (It occurs to me that I have no idea.) Other than that it's African Independent, Roman Catholic, Methodist, Anglican, Presbyterian & c.


Posted by: DS | Link to this comment | 07- 7-08 5:47 PM
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Yeah, it's historically specific to the U.S., especially the South but also parts of the Midwest, with surviving pockets in New England. And I don't know if Baptists count as Calvinist, though I think they do. (Anabaptists are unrelated, though theologically similar on a few points.)


Posted by: John Emerson | Link to this comment | 07- 7-08 5:48 PM
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There's not going to be any black Canadian exemption, if that's what you're angling for.

Wouldn't dream of it. But with the black Canadians, start with the Yardies, plsthx.


Posted by: DS | Link to this comment | 07- 7-08 5:48 PM
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AFAIK most of the American non-Southern Calvinist churches have become very mild liberal churches: Presbyterian, Methodist, and the United Church of Christ (most of the Reformed, now including Dutch I think).

There's also a fundamentalist Church of Christ so don't go by names.


Posted by: John Emerson | Link to this comment | 07- 7-08 5:52 PM
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i divide people to mean and not mean, irregardless of their finances or security, then it's easy whom to empathise
Very Tough Love program
calvinism
i think western societies are pretty good with doing charities, compassionate b/c of their main christian morality maybe
our people are not that generous, generally tough imo b/c believe in karma
so it's believed that if one is miserable or happy, it must be his/her deeds in this or previous life and one gets what one deserves etc
though good is not necessarily things material
moreover if one's helping the 'miserables' it's of course good karmically, but otoh it's like bringing bad luck to self as if bad karma is contagious
i wonder whether it's a pretty common belief in buddhist or other societies, i suspect for example hinduism with their casts system


Posted by: read | Link to this comment | 07- 7-08 5:53 PM
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Oh, I guess the Dutch Reformed Church of South Africa is really quite Calvinist. There you go, then.


Posted by: DS | Link to this comment | 07- 7-08 5:54 PM
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326: Very, from memory.

Note, by the way, that one of the Free Presbyterian Church was one of the first religious denominations to oppose apartheid in Britain, at least according to Ken MacLeod.


Posted by: Keir | Link to this comment | 07- 7-08 5:55 PM
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328: I feel that DS is presuming on our imaginary friendship. Were I the type to lose my temper, I'd send him to my imaginary hogs forthwith. But I am completely under control, and scrupulously fair.


Posted by: John Emerson | Link to this comment | 07- 7-08 5:55 PM
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That's right. I'm that rare beast, a procedural serial killer.


Posted by: John Emerson | Link to this comment | 07- 7-08 5:57 PM
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326, 327 --

Baptists are not really Calvinist; if anything, they (like many US chrisitians) are more Arminian than anything else, although Arminianism is most closely associated with the Methodists. The Dutch Reformed Church is emphatically Calvinist and not Arminian, and has been so since the Synod of Dordt.

Wiki has a decent description of Arminianism here:

http://en.wikipedia.org/wiki/Arminian


Posted by: Robert Halford | Link to this comment | 07- 7-08 5:59 PM
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333: I feel that DS is presuming on our imaginary friendship.

You wrong me, sir. I'm merely suggesting genuinely worthy candidates for the hogs. Any ethnic clustering in the data is the merest, as Ben would say, coïncidence.

(Okay, okay. Don't feed the Yardies to the hogs, that's disagreeable. Let's start with former Color Me Badd fans instead.)


Posted by: DS | Link to this comment | 07- 7-08 5:59 PM
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OT bleg: does anyone remember a survey that came out this decade that stated that Americans would rather be at work than at home? It got a lot of play for a few years. Upshot was that a lot of people went to work and stayed late because they liked it better than being at home.


Posted by: Wrongshore | Link to this comment | 07- 7-08 5:59 PM
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Hm, where does Peter Tosh fit into this?


Posted by: John Emerson | Link to this comment | 07- 7-08 6:03 PM
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338: He never staked out a position on Color Me Badd, so I think he's okay.


Posted by: DS | Link to this comment | 07- 7-08 6:04 PM
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Somehow I feel that the purity of my hog farm concept has been corrupted by these negotiations.


Posted by: John Emerson | Link to this comment | 07- 7-08 6:06 PM
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The nearest thing in nature to a negotiation involving a man is a negotiation involving a pig.


Posted by: DS | Link to this comment | 07- 7-08 6:07 PM
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re: 332

The Church of Scotland had a fairly long history of doing so. Not just the Free Church. It's also historically adopted a fairly strong stance pro-asylum seekers and refugees.

That said, the Church isn't that liberal on other issues. There aren't any openly gay Ministers, for example, as far as I am aware.


Posted by: nattarGcM ttaM | Link to this comment | 07- 7-08 6:10 PM
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The pig and the long pig are mythically one.


Posted by: John Emerson | Link to this comment | 07- 7-08 6:58 PM
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And not just mythically.


Posted by: DS | Link to this comment | 07- 7-08 7:49 PM
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Mmmmmmmm.

Note however that I have never proposed eating Republicans. I have proposed eating porcine Republicanivores. Not cannibalism.

And in the extreme hypothetical case, porcine Canadianovores blind to color.


Posted by: John Emerson | Link to this comment | 07- 7-08 8:01 PM
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345.2: There are troubling signs here of Emerson falling into the habitual Democratic cringe on cannibalism. This bears watching.


Posted by: DS | Link to this comment | 07- 7-08 8:18 PM
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"Bears". Ha.

Canadians and their kinky animal obsessions!


Posted by: John Emerson | Link to this comment | 07- 7-08 8:33 PM
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Color Me Badd

passe


Posted by: lw | Link to this comment | 07- 7-08 8:36 PM
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Back in Taiwan in 1983-4 I occasionally listened to the Taiwanese Wolfman Jack. I couldn't understand a word and I'm pretty sure it was all Hokkien rather than Mandarin. He had a great act.


Posted by: John Emerson | Link to this comment | 07- 7-08 8:40 PM
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I found this story to be funny.


Posted by: feldspar | Link to this comment | 07- 7-08 8:45 PM
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Maybe Taiwan has changed? I don't think this is what Li Po hoped for.


Posted by: lw | Link to this comment | 07- 7-08 8:46 PM
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Canadians and their kinky animal obsessions!

Please don't hold it against us, John, that "we drink more often, but we live longer and have fewer diseases."


Posted by: Mary Catherine | Link to this comment | 07- 7-08 8:48 PM
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Hey, run out and look at the moon. Really.


Posted by: Nápi | Link to this comment | 07- 7-08 8:53 PM
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Not more often than me. Cheers.


Posted by: John Emerson | Link to this comment | 07- 7-08 8:53 PM
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353
so, what's wrong with the moon?


Posted by: read | Link to this comment | 07- 7-08 9:15 PM
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Did you look at it? An orange crescent. Here in DC, anyway. It may have already set for you . . .


Posted by: Nápi | Link to this comment | 07- 7-08 9:20 PM
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It is not orange in Los Angeles.


Posted by: Wrongshore | Link to this comment | 07- 7-08 9:24 PM
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too late to go out and can't see it from my window
but your description is very that, vivid, so i imagined it
good night, all


Posted by: read | Link to this comment | 07- 7-08 9:24 PM
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Not orange here yet, but maybe soon; we've been getting smoke from the CA fires. I'll be sure to keep everyone posted.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 9:24 PM
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It is not orange in DC from the CA fires.


Posted by: Wrongshore | Link to this comment | 07- 7-08 9:27 PM
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I've only skimmed the first 100 comments, but here's my take on the post (and initial discussion).

My example for the "bad decision maker," even though that's not my own preferred language, would be the abusive/addicted/fucked-up parent. Now, I believe, truly, that all parents do the best they can--but I also know that for a lot of people, the "best they can" is fucking horrifying, because what they're capable of, caring-for-someone-else-wise, is nothing at all; they're not even capable of caring for themselves, so they use kids as an outlet for their own self-loathing, blah blah however you want to psychologize it.

So you have people who genuinely are crappy abusive parents. What do you do about it? Do you provide "safety nets" to help them get marginally better--even if they actively resist and refuse that help? Do you sever custody, knowing that doing so is actually really traumatic for a kid even *if* their parents are abusive? Do you invest a lot of money and resources into making sure that a kid has ongoing contact of one sort or another with a terrible parent? That last is my preferred solution, but it really would be extremely expensive if you did it properly: tracking down the parent, good solid foster care including training and support for the foster parents, ongoing medical and psychiatric treatment, educational support, social services for kids with problems of their own, and what about college expenses and so forth? I don't think there's any kind of will to actually do any of that, and even if there were you'd run into all sorts of questions about do kids in that situation deserve a working class type of upbringing? A middle class type of upbringing? An upper middle class type of upbringing? Etc.

I think that the problem hinges in part on recognizing that even people who are undeserving aren't free-floating isolated individuals, and that their fuckups cause problems for the people connected to them (and even total strangers). I also think that at some point you have to talk about minimizing the damage, and that the way to cross that line between the "everyone has bad luck" and the "some people make shitty decisions" camps is to focus on *that*, on acknowledging that yes, some people are going to drink themselves to death or refuse to comply with necessary treatment. And that whether or not they're "responsible" for those actions, that minimizing the damage they have on the people around them means providing them with *some* basic things--a place to sleep that's safe enough that most of them will go there, some kind of health care, free needles, whatever. Because even if they don't deserve those things, the consequences of not supplying them are worse for everyone else.


Posted by: bitchphd | Link to this comment | 07- 7-08 9:29 PM
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360: You seem pretty certain about that. Can you be sure?


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 9:30 PM
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B, that's an elegant demonstration of why families are a good place to start thinking about society (pace Thatcher, for whom they were a good place to stop.)


Posted by: Wrongshore | Link to this comment | 07- 7-08 9:35 PM
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Also, it's been orange since the 4th here in Ventura.


Posted by: bitchphd | Link to this comment | 07- 7-08 10:00 PM
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Why thank you, Wrongshore. I am nothing if not elegant.


Posted by: bitchphd | Link to this comment | 07- 7-08 10:02 PM
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The joke's on Wrongshore. The moon in DC and the moon on the West Coast? It's the same fucking moon.


Posted by: Jesus McQueen | Link to this comment | 07- 7-08 10:03 PM
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Yeah! Frege proved that!


Posted by: John Emerson | Link to this comment | 07- 7-08 10:04 PM
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In Frege's time, sure. Do you know how many more moons we've gotten since then? Hell, even Emerson's little boro has an orbiting asteroid.


Posted by: Wrongshore | Link to this comment | 07- 7-08 10:09 PM
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Any plan that starts with the assumption that you're going to make fuckups stop being fuckups will fail. Nudging fuckups toward fucking up less can work to a degree, but generally only when the random walk of their consciousness settles on enlightened self-interest for a moment or two. So you deal, which at the policy level means harm reduction, which we all agree on in general if not in all cases. To the extent that incentives matter even to the fucked up (limited but not non-existent), rewards make a hell of a lot more sense than punishments, so of course public policy in the Untied States of America is all about the punishments. Blech.


Posted by: Not Prince Hamlet | Link to this comment | 07- 7-08 10:15 PM
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I think that the problem hinges in part on recognizing that even people who are undeserving aren't free-floating isolated individuals

I agree with this, B, and with basically everything you've said in 361. And yet, I still think it's a mistake to buy into the language of deserving and undeserving, as a matter of politics, or maybe of policy (which I think Parsimon was getting at way upthread).

Yes, some people are going to be fuckups, and some people are going to make bad decisions, or whatever. But what's vexing about "terrible choices, with no safety net," as Heebie put it, is not so much the "terrible choices" as the "no safety net." There should be a floor, as Witt says, below which nobody can fall, no matter what "choices" they make (and not to deny free will or anything, but "choice" is, I believe, a highly dubious concept, and I'm sorry American feminism ever hitched its wagon to this libertarian star, I very much doubt it has helped American women overall in the achievement of equality).

It should have to do with citizenship, or membership in a community or a commons, I believe. There should be a level, below which you cannot fall, no matter how personally crazy fucked-up you might be, just because you belong to a broader entity, the standards of which insist upon a minimum for all members, no matter their individual shortcomings. It shouldn't be about "deserving" or "not deserving," in other words, it should be about what's due just by virtue of being a member (of the community, polity, or whatever).

And it's not about, as lw would have it, "care for them all." That's putting it the wrong way altogether, in its explicit opposition between "them" and "us." That "them" is a grave error of the first order, it really is about our own care of "us."

Also, I'm glad Witt mentioned Linda Gordon. Her work on the history of women and welfare is really great stuff.


Posted by: Mary Catherine | Link to this comment | 07- 7-08 10:17 PM
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147: Why would you want a public policy that excludes fuckups? Not for the moral satisfaction of wagging your finger, no, but because of a very real and very human feeling that it fucking sucks to be taken advantage of. I really believe that that's what's behind the basic conservative instinct--"no one's going to put one over on *me*".

A more defensible reason is that it is another sad fact of human nature that some people who fuck up will do so as long as there is *any* kind of enabling safety net, and that not only are they harming others, they are harming themselves. So one potential problem of a good welfare state with a genuine refusal to let people fall below a certain level is that there will doubtless be people who, as long as they have a place to lay their head, will continue their self-destruction but who, when they "hit bottom," will pull themselves together.

Minor, non-life-threatening type example: my mother is a version of one of those people, and I just thank fucking god that her own personal sense of "bottom" isn't high enough that I can (barely) stand to let her hit it without stepping in. And yes, she is mentally ill. And no, she will not get treatment, even when I have found therapists for her and offered to take her to see them. She somehow manages to pull herself together enough to find a job whenever she finally runs out of credit--and she's better off for it, because working gets her out of the house and around other people. But she won't work unless she really is at the end of her financial rope, which means she's very socially isolated.

I mean, fine for her; she's not literally killing herself, she's just enabling her craziness. But would she be better off if she could count on state assistance letting her live alone? Or is she better off being "allowed" to get to the point where she has to get her ass out of the house sometimes?


Posted by: bitchphd | Link to this comment | 07- 7-08 10:31 PM
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370: There should be a floor, as Witt says, below which nobody can fall

I read that, and I wondered if it's actually possible to have such a thing--and what do you do if people will insist on falling below that floor? You can't force people to go to the doctor; you can't force them to register for welfare.

I actualy agree with you, MC. But I think that the language of "deserving" and "undeserving" isn't something we can not buy into, because too many people (and I personally suspect that a lot, if not most, conservatives are in this camp) have personal experience of dealing with fuckups and it's their own psychological response to that--including their insistence that they will not make excuses for themselves like the manipulative fuckups they know have done--that makes that whole question of "desert" so important.

It *is* important, to people who deal with fuckups, to be able to draw a line between what the fuckup *deserves* and what the person in question can say no to. I know my mom is mentally ill, and deserves not to be as fucked up as she is, and that it's not her fault, etc. I also know that her craziness and refusal/inability to manage it is not my fault, and not my responsibility. On a personal level, it's really important to be able to draw that line. I don't think it's fair to draw the same line--"not my problem!"--in policy terms, but I think that that feeling both drives policy and needs to be acknowledged as legitimate.


Posted by: bitchphd | Link to this comment | 07- 7-08 10:37 PM
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Um, in 371 I should have said her own personal sense of where the bottom is *is* high enough that I don't have to intervene.

Shutting up now.


Posted by: bitchphd | Link to this comment | 07- 7-08 10:40 PM
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You can't force people to go to the doctor; you can't force them to register for welfare.

You actually can. Furthermore, you can put people on welfare without registering them.

As I said above, American individualism makes the welfare system too much just another place for people to go to get what they want, instead of being a place that takes care of people who aren't able to take care of themselves. Ambition, competition and striving are American life, and an ambitious, competent welfare recipient or crazy person will do well for themselves, whereas the loser welfare recipients and crazy people are just fucked.


Posted by: John Emerson | Link to this comment | 07- 7-08 10:48 PM
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Life With Fuckups is also a hell of a lot easier for those of us who are rich enough in social capital, financial resources, and plain old coping skills to be able to hang in. But most fuckups don't have people like that to look to for help, and many people who have fuckups looking to them for help are in situations where giving the help may well be a fuckup for the giver.


Posted by: Not Prince Hamlet | Link to this comment | 07- 7-08 10:50 PM
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Linda Gordon. Her work on the history of women and welfare is really great stuff

Even Lynne Cheney likes some of her work.


Posted by: eb | Link to this comment | 07- 7-08 10:50 PM
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374: "without their having to resister themselves".


Posted by: John Emerson | Link to this comment | 07- 7-08 10:54 PM
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374: Yes, I suppose you can, actually. You can even have home health care people come in to make sure they take their damn medication and shit. But now you're talking again about a very expensive social safety net that basically assigns someone to hold the hands of the very worst cases. Which sounds good in theory, but in practice?

I do agree with you about the problem with the American system being that people have to seek help, rather than having it come to them.

375: I gotta admit, I could probably afford to help my mother more than I do. But I don't. I actually avoid her as much as possible.


Posted by: bitchphd | Link to this comment | 07- 7-08 10:55 PM
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378.3: I have a b-i-l like that. More important, said b-i-l has six kids we could do more for. But there are limits.


Posted by: Not Prince Hamlet | Link to this comment | 07- 7-08 10:57 PM
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You can't force people to go to the doctor; you can't force them to register for welfare.

True enough, you can't force people to go to the doctor, and nor should you. But here's the weirdness of America to me: there's such a huge gap between forcing people to go to the doctor, and making it prohibitively expensive, if not all but impossible, to go to the doctor. And yet somehow setting things up so that it's more difficult to go the doctor is defined as freedom or something, and then fuckup outliers who wouldn't go the doctor unless absolutely forced to do so are cited as a reason for the restrictions/prohibitions, and it just don't make much sense to me.

Set universal access to the doctor as the standard, and then let the few outliers fall below that goal and don't worry about it. But don't let the fuckups be the reason to deny access to everybody else! See, that's what the GOP wants you to do: we can't make it easier to go the doctor because some people wouldn't go, or something. Don't play that game, is what I'm saying. At least give people access in the first place, and then let the chips fall where they may.


Posted by: Mary Catherine | Link to this comment | 07- 7-08 10:57 PM
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Amen, B.

371.1 and .2 are exactly right, and ignoring them is what gets liberals into trouble the most. There are defensible reasons to want to limit the social safety net and tarring all conservatives with the evil brush ignores these reasons and alienates potential allies. Just because the conservative leaders are evil fucks doesn't mean that ordinary conservative voters are.


Posted by: F | Link to this comment | 07- 7-08 10:58 PM
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378.3

Sometimes you gotta say enough is enough. An ex of mine had this kind of relationship with her crazy mother. Just dealing with her took a significant toll on her own sanity and well-being, but cutting her off outright was not something she was willing to do. So she had to find the compromise level of dealing.


Posted by: F | Link to this comment | 07- 7-08 11:02 PM
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Look, everyone has a crazy mother or brother or first cousin once removed. The craziness of one's own relations is not a firm and unerring guide to matters of broader social policy.


Posted by: Mary Catherine | Link to this comment | 07- 7-08 11:06 PM
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not about, as lw would have it, "care for them all."

That's not my opinion. I don't know what's best for people who consistently act to hurt themselves. Just remarking about the experiment to focus extra resources on the most messed-up people, that this implies less for the marginal cases. I meant that wishing for more welfare capacity isn't a useful way of assessing what works.

I don't think extra care for the worst cases is viable, I'd expect failure in poor places where there's not enough to go around, it might work in Seattle. Loss of a sense of community probably is what makes this so hard to solve, but people basically flee from tight-knit communities where they exist now.

One way to make medical care more widely available cheaply would be to allow nurse-practitioners to do basic prescribing and diagnosing in neighborhood clinics, rather than requiring MDs.


Posted by: lw | Link to this comment | 07- 7-08 11:07 PM
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383

The contrast between what we do personally and what we do as a society has already been noted several times. It is still illustrative to consider what we do individually as a guide to what we might do societally.


Posted by: F | Link to this comment | 07- 7-08 11:09 PM
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And the lack of access to universal health care is truly shameful.

Of course, to fix that particular problem we in the US will also have to make some difficult decisions about what will be covered, but one step at a time, I guess.


Posted by: F | Link to this comment | 07- 7-08 11:11 PM
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The craziness of one's own relations is not a firm and unerring guide to matters of broader social policy.

Of course not, and I don't think anyone here is saying it is. But it's a little glib to say that everyone has a crazy uncle, isn't it? For a lot of people, dealing first hand with serious hard cases does shape how they *view* these policy questions. I think that sweeping that fact away is fair enough--god knows I do it all the time myself. But I think it's at the center of the question Heebie posed, and that it's a legitimate problem to chew on.


Posted by: bitchphd | Link to this comment | 07- 7-08 11:16 PM
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Wow, how did this get back on topic? Way back in 131, jroth said:

IOW, there are 3 safety nets: A. One with holes that allow only the undeserving to fall through; B. One with holes that allow some deserving to fall through while catching some undeserving; and C. One without holes. A is plainly impossible; B is immoral, except perhaps in a place with resource constraints. That leaves you with C.

If you want to talk to a conservative of any stripe you have to realize that C is untenable from the conservative perspective. Resources are constrained (by economics, by a desire for a small government and a balanced budget, and so on), and as you move down the continuum from B to C the individual safety net for any given mistake maker gets exponentially more expensive. What's the cost-benefit analysis for that? Talk about morals and ethics all you want, but since almost anybody can name a particular bad decision maker in their lives that helping won't actually help (be it a friend, relative, or just the crazy guy on the street by the office every day) you're never going to convince a conservative of the financial worth of providing a limitless safety net to everyone. They can point to at least one counterexample, if not many.

There's a particular aggressive panhandler who comes to mind for me in these discussions. Instead of shoes, on his feet he wore newspaper bags or the plastic bags from loaves of bread. He was filthy, and he wore layers of tattered clothes that made it hard to figure out exactly what all he had on. And when I worked downtown he stood, every day, in any weather, on the corner of 15th and G Sts, shouting unintelligibly, and alternately flailing his arms and beating himself. I never actually saw him hit anybody but I did see him swing at passers by. What help could be provided to him, with what chance of him receiving it well, and with what minor chance of success? How can you help the less obviously crazy ones who still choose the street instead of the shelter?

If you can come up with some way to give dignity to the relentlessly downtrodden that doesn't approach infinite responsibility (and one that the aggressive -- or aggressively crazy -- panhandlers would accept) then you might convince a conservative that the cost of a universal safety net is worth bearing. Certainly non-emergency access to basic health care is something that could probably be agreed upon (since non-emergency health care is also cheaper than the ER), but there are all sorts of other economic factors that come into play when you start dealing with doctors, hospitals, health insurance malpractice insurance, etc. Who foots the bill for malpractice insurance when a doctor treats somebody who can't pay anyway?


Posted by: fedward | Link to this comment | 07- 7-08 11:19 PM
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Resources are constrained (by economics, by a desire for a small government and a balanced budget

Meh, this isn't true. There's more than enough money in the U.S. budget to have a huge safety net; it's just that it gets spent on other things. That's a question of priorities, not a question of finite resources.


Posted by: bitchphd | Link to this comment | 07- 7-08 11:32 PM
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387 gets it exactly right. Knowing how hard it can be to help someone close to you, with all sorts of advantages that most people don't have, tells you something about how much harder problems are when you have to deal with them wholesale, with social service agencies as your tools. Establishing floors is good, and supporting people even though they make bad decisions is good, but delivering services effectively to fuckups is a genuinely hard problem even before you start talking about political and resource constraints.


Posted by: Not Prince Hamlet | Link to this comment | 07- 7-08 11:34 PM
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Who foots the bill for malpractice insurance when a doctor treats somebody who can't pay anyway?

Look, the NHS is 60 years old this week.

There's sixty years of experience there (and in the rest of the developed world, basically). Lots of these things are solved problems. I strongly suspect there's an elegant solution to this problem -- replace malpractice, etc, insurance with a generic accident insurance body, and treat malpractice as a purely disciplinary problem? But there must be knowledge about how to do this extant in those nations that provide health care free at the point of need.

Also: legislating based on the crazy guy on the street is an extreme example of self-selecting samples. There's not many edge cases, so it isn't always smart to make them your main interest.


Posted by: Keir | Link to this comment | 07- 8-08 12:06 AM
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The crazy guy on the street is the counterexample against a universal safety net, as without any additional knowledge he is as close to 100% unsympathetic as they come (well, the particular one I mentioned above is, anyway). It's not so much that I'm saying you have to solve universal care for that guy particularly, as that if you wish to have a constructive discussion with a conservative you have to be prepared to acknowledge that even universal care would have its limits. You will, in fact, do better if the conservative knows up front that you understand this.

This assumes, of course, that you've found a conservative who's willing to talk to you at all. And if you do, you'd best not bring up the National Health, as he'll probably have a bunch of examples of particular failures there to throw back at you. Here in the US the conservative would rather fix the system he has than replace it with something that from a distance appears much worse ("Universal? Try universally terrible!").


Posted by: fedward | Link to this comment | 07- 8-08 12:27 AM
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Here in the US the conservative would rather fix the system he has than replace it with something that from a distance appears much worse

The thing is, by almost any measure, it isn't worse. The NHS isn't perfect, and there are, arguably, other EU systems that work better, although they tend to actually -- surprise surprise! -- be more expensive, but on most measures it's better than the US system.*

It's significantly cheaper, per capita and in terms of % of GDP and life expectancy figures and most (but not all) other measurable health outcomes are generally the same or better.

One of the things proponents of universal health care are going to have to do is correct that misapprehension.

* which is why whenever discussions of universal health care come up proponents of the US system always revert to some kind of fucked-up 'free rider' argument in which -- allegedly -- the quality of care given by universal health care systems is only possible because of the research carried out by private industry funded by the US insurance industry. We've kicked this particular argument around quite a bit on unfogged before.


Posted by: nattarGcM ttaM | Link to this comment | 07- 8-08 12:59 AM
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Here in the US the conservative would rather fix the system he has than replace it with something that from a distance appears much worse ("Universal? Try universally terrible!").

Yes, I know that the American conservative can be out of touch with reality and insular.

I strongly suspecting humouring them in that won't long term work. I think that if you are talking with someone who doesn't realise that the NHS is at least as good as the American system, you should focus on that empirical fact before going to abstract theories.


Posted by: Keir | Link to this comment | 07- 8-08 1:06 AM
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As a matter of practical finances, partial coverage can often be more expensive than full coverage. It's been a while since I last researched it and I don't have the data at hand, but some years back I looked up the costs of the typical SSI application, keeping in mind the actual typical pattern of denial followed by 2-3 appeals required to establish that the original facts were in order. It was a lot. Something like ten years of coverage. And of course in the years the appeals take, additional costs get incurred that could have been avoided. It would be cheaper to say "Yeah, if you're not covered by other stuff, here you go." And it would also greatly reduce the power of an intrusive, abusive bureaucracy - the folks involved in handling applications are (in my experience) much nastier on average than anyone clients are likely to deal with later.

And it's like that with a lot of things, starting with health care. On occasions when I'm dealing with someone skeptical about supporting the unworthy needy, I tend to emphasize the double-barreled advantages of reduced cost and reduction of bureaucratic intrusion into personal affairs.

But basically I believe that everyone, even the ugly, stupid, and foolish, deserve life, the basics of well-being, and dignity, even though it is awfully damned hard to want to deal with some of them. One of the functions of the state, after all, is to see that hard things get done anyway.


Posted by: Bruce Baugh | Link to this comment | 07- 8-08 4:08 AM
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I agree with Keir about the importance of establishing that the civilized alternatives to American practice do work, starting with health care. The level of lies about such things is really, really high.


Posted by: Bruce Baugh | Link to this comment | 07- 8-08 4:09 AM
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I often think that the crappy Irish healthcare system would at least be better than the current US one, and easier to get to from what you have now than the better European models. There is a bare-bones public system, GP care free only to the poor and over 70s, hospital care free for all but with waiting lists for all kinds of non-emergency stuff (including serious things like bypasses etc). Meanwhile there is a parallel private system for those with insurance who can get treated without waiting lists. There are private hospitals but also private bed allocations in public hospitals. Insurance is a lot cheaper than the US, too, and because of community pricing etc. it's the same for everybody. It's highly unfair and in need of reform but at least nobody goes bankrupt. The people who are badly served by it would be worse off in the U.S. system.


Posted by: emir | Link to this comment | 07- 8-08 5:19 AM
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Coming in late as usual.

To the post: I think "decision" does way too much work here. If we sort out people with substance abuse issues, gambling addicts and people with untreated clinical depression, the number of "bad decision makers" in our society looks vanishingly small to me. Sure, everybody knows a couple, and anyone who knows a social worker or therapist has probably heard stories about the most egregious cases. But I'll go against any conservative or schmibertarian with those few tens of thousands of chronic fuck-ups, versus the many tens of millions of people who do basically whatever they're able to do and still get mistreated by the current system.

The other thing, vis-a-vis partially nationalized healthcare vs. mostly privatized healthcare in the US, is that we already let the government pay for healthcare for a huge number of people. There's everyone on Medicare and Medicaid, everyone in the military, all the federal, state and municipal employees, public school and university workers, and the relatively few people who qualify for state-funded health insurance due to low incomes. Additionally, there's all the union employees from the big AFL-CIO unions who were basically bought off by the government acting in concert with big industry in the middle of the last century, plus pensioners of those unions, pretty much everyone in the defense industry, and a whole bunch of other people who owe their jobs and by extension their healthcare to direct government funding of their respective industries. And almost all of the dependents of the classes mentioned above. I'm guessing that the government already pays for the largest plurality of health insurance in this country, but unfortunately way too much of the money makes its way into the balance sheets of private insurance companies.

Oh well. Preaching to the choir/echo chamber again I guess.


Posted by: minneapolitan | Link to this comment | 07- 8-08 5:24 AM
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398: I have read that per-capita government healthcare spending in the US is as high as as high as it is in some European companies with "socialized medicine". That is, we spend as much government money -- but without covering everyone, while spending much more per capita on those we do cover. (No source, scuttlebutt).

One theory I've seen seriously offered is that that the US is the workhorse of the world medical biz, and that our overpayments finance research which the whole world benefits from.


Posted by: John Emerson | Link to this comment | 07- 8-08 7:51 AM
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399: Here.

WHO figures on per cap government healthcare spending. The US government spends more than the UK, Canada and Germany, all nations with universal healthcare.


Posted by: ajay | Link to this comment | 07- 8-08 8:07 AM
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One theory I've seen seriously offered is that that the US is the workhorse of the world medical biz, and that our overpayments finance research which the whole world benefits from.

I mentioned that above. It always seems like desperate special pleading to me. See 'bastardized free-rider argument' above. I've never seen much in the way of convincing argument for it beyond 'well, companies must profit to innovate, and we're the ones they are profiting from most'.


Posted by: nattarGcM ttaM | Link to this comment | 07- 8-08 8:10 AM
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Apparently just under half the 50 biggest pharma companies are American. So yes, the US probably is "the workhorse of the world medical biz". But it's a rubbish argument. Glaxo and Hoffman La Roche are hurting because their head offices are in countries with universal health care?


Posted by: OneFatEnglishman | Link to this comment | 07- 8-08 8:25 AM
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If we sort out people with substance abuse issues, gambling addicts and people with untreated clinical depression, the number of "bad decision makers" in our society looks vanishingly small to me.....I'll go against any conservative or schmibertarian with those few tens of thousands of chronic fuck-ups,

I have a different view. I think most of us are to some degree or other fuck-ups. At least measured against our true potential. Being a bit of a fuck-up is part of human life. Stigmatizing fuck-ups is a tool to get the rest of us to flog ourselves to death in the service of an impossible vision of "excellence". Of course, maybe I'm just saying that because I am a bit of a fuck-up.

Also, I don't think that substance abuse, "untreated depression", or other personality disorders are a separable issue from being a fuck-up. They're just one way in which the deeper fuck-up issue expresses itself. But that's another argument.


Posted by: PGD | Link to this comment | 07- 8-08 9:24 AM
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Glaxo and Hoffman La Roche
and AstraZeneca generally market new compounds first in the US, then try to get them included under European single-payer plans.

Aside from social questions, there is a real question about how to provide new medical treatments whose efficacy is known with certainty quickly and cheaply. China and India will soon be producing new treatments quickly and cheaply but without certainty. For a new compound, phase III clinical trials cost over $500M.


Posted by: lw | Link to this comment | 07- 8-08 9:43 AM
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The argument is that the pharma companies, whoever owns them, milk the American market and use the money to finance research that the free-riding socialists benefit from. It's not a nationalist argument at all, but a globalist argument. The loser is the American electorate.


Posted by: John Emerson | Link to this comment | 07- 8-08 9:52 AM
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There are also say that the rigorous American drug-testing requirements have been gamed by the big companies to their advantage. Small companies can't afford to test so the big companies buy them up. Furthermore, drugs and treatments which are not patentable (discovered long ago, with the medical uses discovered only recently) are not tested.

I'm just reporting that argument, not affirming it as true. I haven't spent a lot of time on this stuff.


Posted by: John Emerson | Link to this comment | 07- 8-08 9:56 AM
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I think that the "enabling" argument is legit, but the "free-rider" argument less so. I don't consider them to be arguments against socialized medicine, welfare, or social spending, but reasons for trying to optimize the way things are done.

I'm also pro-union and was a union member for most of 27 years, but there's a problem with unions protecting their worst members. I was convinced of this by three or four union stewards I knew personally, who got really tired of advocating for bad-attitude workers who hated their job, their co-workers, the company, and the union itself, and seemed to have dedicated their lives to taking revenge on all humanity. Seriously. A niche had been created for self-centered monkey-wrenchers and grievance collecters who cared about no one but themselves.

And no, these aren't most of the grievances these guys did. But a high enough proportion that they found it dispiriting.


Posted by: John Emerson | Link to this comment | 07- 8-08 10:04 AM
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401, 402, 404, 405: Re: Pharma companies and profits in America...

There is actually some decent evidence that the higher profits from the American market drive greater innovation. About a year ago, I believe, a working paper was published that looked at R&D spending, patents, and new product launches for major pharma companies as a function of their percentage of revenues in the US versus Europe and the rest of world. A higher proportion of revenues derived from the US did have a statistically significant effect on the research spending and output of companies. I'd have to pull the research again to try and find out what the supposed effects would have been of the US moving to European levels of spending, but they were also significant in size (it wasn't just one fewer major drug release a year or something).

lw's point in 404 is also key. Phase III trials are expensive. Really fucking expensive. There's some hope that costs can be trimmed as genomes get cheaper to sequence, so we can identify more genetic markers that affect the drug's actions and thus reduce the size of the studies to only the effectively treated groups, but that's a questionable avenue for cost savings.

Really, cutting pharma costs is a tough question. I don't think I've heard any really great ideas (though reimportation or a pricing pact does appeal to me, since it would force pharma companies to extract higher prices from Europe in order to squeeze profits out of the US).


Posted by: Po-Mo Polymath | Link to this comment | 07- 8-08 10:08 AM
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re: 405

Yeah, and I've never seen that argument as anything other than specious bullshit. OK, there's possibly some truth in some of the premises but ...

Violating the defunct analogy ban, I'm sure that Ferrari make much of their money from billionaires but I don't see why someone designing a public transport infrastructure ought to care about the needs of billionaires.

Thinking about health-care in terms of the funding of cutting edge pharmaceutical research* is just dumb.

For a new compound, phase III clinical trials cost over $500M.

Really? Always? I worked for a pharmaceutical company for a while [just a short term thing] and the money involved in the project I was associated with was NOTHING like that. Not even remotely in the same order of magnitude.

The specifics were slightly different, the compound they were working on was derived from a botanical compound but no clinical trials had been done and they were planning to run phase II and III trials. I know for a fact that their budget wasn't remotely in that area.

* I'd also pretty vigorously dispute the idea that the research wouldn't get carried out if the US had a more cost-effective health-care system.


Posted by: nattarGcM ttaM | Link to this comment | 07- 8-08 10:14 AM
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403 is exactly right.


Posted by: Di Kotimy | Link to this comment | 07- 8-08 10:17 AM
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I think we should get rid of generics, so pharma companies could charge monopoly prices for all drugs in perpetuity. This would incentivize even more innovation!

Seriously, higher profits always create an incentive for making more of the product in question. The U.S. system is still dumb because A) profits in the U.S. market do not generate the right set of innovation incentives...hello baldness cures!, and B) putting the profit generation in the user price effectively taxes sick people. Create a system of innovation prizes and be done with it. Organize global contributions if possible. We can spend our time negotiating for those contributions instead of endlessly nagging other countries to respect our impossibly tangled IP laws.


Posted by: PGD | Link to this comment | 07- 8-08 10:17 AM
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337

"OT bleg: does anyone remember a survey that came out this decade that stated that Americans would rather be at work than at home? It got a lot of play for a few years. Upshot was that a lot of people went to work and stayed late because they liked it better than being at home."

I remember this also. I found a NYT article which seems related.


Posted by: James B. Shearer | Link to this comment | 07- 8-08 10:18 AM
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Necessary to include the costs of tests that fail in the accounting. Most compounds tested fail phase III.

Personalized medicine will hugely expand the pharmacopeia, but not make it cheaper. A compound that now heals 95% of indicated individuals and kills 2% will be marketable, but both the classifying test and the compound itself restricted to the relevant subpopulation will have to go through phase III unless FDA rewrites rules. New medicines will consequently not come from the US or Europe by and large, I think. Pharmaceuticals will be more improvisational and scary.

Jurgen Drews' In Quest of Tomorrow's Medicines was interesting reading.


Posted by: lw | Link to this comment | 07- 8-08 10:24 AM
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407

"And no, these aren't most of the grievances these guys did. But a high enough proportion that they found it dispiriting."

Were they consistently winning unjustified grievances?


Posted by: James B. Shearer | Link to this comment | 07- 8-08 10:28 AM
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re: 413

I know for a fact this company's total operating budget was well under that reported cost for Phase III trials, and they had several compounds on the go. They ended up getting bought up by someone else, I think. So perhaps that was always their intention.


Posted by: nattarGcM ttaM | Link to this comment | 07- 8-08 10:31 AM
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411: Not to mention that the drugs with some of the best health-outcome value-added end up the cheapest due to their broad user base, leaving amazing high-technology but kinda useless small-bore cancer treatments at phenomenally high costs. Oncologists have a rule-of-thumb that they accept treatment costs of $300,000 per additional year of life, allowing such stupid-ass costs as $60,000 for a lung-cancer drug that adds 2.5 months to the life of a patient for diagnoses where they only bother to check survival times in months, since 5-year survivor rates are negligable. Somehow, managed care companies and medicare are alright with this.

Cosmetic medicine is its own thing, and I'm mostly fine with it since it tends to funded out of the patient's pocket. Plus, I'm kinda starting to thin out up there, so super baldness cures would be sweet, thank you very much.

Here's the summary of the research paper that I mentioned in 408 about the probable effects of cutting US pharma costs. It also gives some of the basic stats on how much the clinical trials cost, how many compounds actually make it to the approval stage, and what sort of returns can be expected. I'm sure there are a couple other papers which addressed some of the other issues I mentioned, but I can't remember them well enough to find them quickly.


Posted by: Po-Mo Polymath | Link to this comment | 07- 8-08 10:34 AM
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415: Chances are, they were going to put their compounds through phase I and possibly phase II clinical trials on their own dime, then partner up with a big pharma company for the super-expensive phase III clinicals. That's the typical progression for smaller, research-focused pharma firms. If nothing else, they need the big guys to actually generate sales, since a decent-sized pharma salesforce is phenomenally expensive (the salesforce and its relationships with specialty physicians and hospitals is almost certainly the single most valuable asset of a major medical device or pharma firm, more so than even their basic research department, and possibly only rivalled by their regulatory and clinical research department).

Also, in Europe, the regulatory environment may be less expensive to navigate. I'm not positive on pharma, since it's not my area of expertise, but I know for sure that medical device approval is a much easier and cheaper process in Europe than in the US.


Posted by: Po-Mo Polymath | Link to this comment | 07- 8-08 10:41 AM
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There must be out there somewhere a box score on drug-development successes over the last few decades, keyed to improvements in longevity or quality of life.

An MD I knew slightly was involved in a nationwide program to improve trauma care, from the moment when the rescuers reach the scene all the way through. IIRC their new protocol was very successful where used and if used nationwide would save a considerable number of lives as well as preventing a lot of pemanent damage.

Also IIRC, none of it was sexy new science. It was just a matter of testing various protocols for effectiveness, routinizing the best ones, retraining the emergency responders, and so on. It was science in the John Dewey sense, the application of intelligence to a specific problem, rather than science in the Platonist sense, learning the Truths about uUltimate reality.


Posted by: John Emerson | Link to this comment | 07- 8-08 10:47 AM
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The salesforce and its relationships with specialty physicians and hospitals is almost certainly the single most valuable asset of a major medical device or pharma firm.

This suggests to me that a lot of the new drugs are not terribly wonderful. It would seem that a genuinely revolutionary drug would sell itself.

I have seen pharm sales reps and it isn't a pretty picture. Actually, often it is -- a lot of them seem to be perky young things. They bribe MDs up the limit of what they can get away with, and the pharm companies have their fingers in the medical journals too. Where there's a lot of money, there's conflict of interest, and scientists are not at all immune to temptation.


Posted by: John Emerson | Link to this comment | 07- 8-08 10:53 AM
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"Why do these people act the way that they do? Is it a desire for self-destruction? An inability to understand cause and effect? Mental illness?

eh, I dont have any other answers."

Once you eliminate the clearly mentally ill, I think these people make bad decisions for the same reasons most of us occasionally make bad decisions. I don't think these reasons are particularly mysterious.

Some "bad" decisions are really just selfish or anti-social decisions or based on "bad" values.

Other bad decisions are the result of giving excessive weight to short term as opposed to long term effects. Or based on wishful thinking. Or the result of bad habits. Or made while impaired.


Posted by: James B. Shearer | Link to this comment | 07- 8-08 10:57 AM
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re: 417

Actually, they were going to skip Phase I [that was where my job came in, precise details under NDA but basically we were working on persuading the MCA to allow skipping of phase I] and then Phase II and III would be run in partnership with a university and an NHS hospital. I don't think they were set up to do the final marketing stuff, so after Phase III the plan was probably to license [or for the company to get bought out].

I don't know if they ever got to Phase II or III on the project I worked on, but know they had other compounds in Phase II when I worked there.

The company's unique selling point wasn't really their compounds but some innovations they'd made in bio-assaying methods that meant they could do better quality [and cheaper] repeatable trials on biologically derived products.


Posted by: nattarGcM ttaM | Link to this comment | 07- 8-08 11:20 AM
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Also IIRC, none of it was sexy new science. It was just a matter of testing various protocols for effectiveness, routinizing the best ones, retraining the emergency responders, and so on.

John, you should really read "Better" by Atul Gawande. It's all about these kinds of advances and their role in medicine. Really a well written and fascinating book, by a genuinely good and gifted person.


Posted by: PGD | Link to this comment | 07- 8-08 11:22 AM
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388: Resources are constrained (by economics, by a desire for a small government and a balanced budget, and so on),

Resources are mostly "constrained" by circular arguments about why resources shouldn't be allocated to social safety nets, issuing from a parallel universe in which such safety nets simply cannot be made to work and it's instead preferable to cut taxes for billionaires "limit the size of government."

Also, the crazy guy on the street with boxes on his feet? He's not an argument against universal care; he's an argument for it. The whole point of universal care is not abandoning people with illnesses -- including mental illnesses -- to their own devices.


Posted by: DS | Link to this comment | 07- 8-08 11:51 AM
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allowing such stupid-ass costs as $60,000 for a lung-cancer drug that adds 2.5 months to the life of a patient for diagnoses where they only bother to check survival times in months, since 5-year survivor rates are negligable

This deserves a thread of its own. I thought one of the usual suspects would have posted something on the NYT Avastin article on Sunday, but I haven't seen it. Apparently Ezra is occupied with healthcare issues closer to home.

My take is that it's a lot harder than "this is stupid." That may still be where you end up after you think it through, but a straight dollars spent per months of life calculation misses some important intangibles, particularly the value of improved quality of life in the last months for both patients and their families and the emotional significance of doing something to fight the cancer rather than just giving up and dying. Lines do need to be drawn, but in the insanity of the American healthcare system, they'll get drawn in silly places as often as not, and patients and families will spend even more of the time that they should be spending with each other on fighting insurers for coverage.


Posted by: Not Prince Hamlet | Link to this comment | 07- 8-08 1:14 PM
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something on the NYT Avastin article on Sunday

Heh, yeah, that was the main drug I was thinking about, in particular for its lung-cancer usage. That article just got passed around our team as a source for a discussion later this week, and I'm getting through it at the moment.

Regarding John's 418 and 419, it's really sad how much low-hanging fruit there is in medicine in terms of easy improvements to patient outcomes. Internet-based medical records shared by all practitioners would be a huge leap forward (they're currently only used by large practices who invest in the necessary IT). Evidence-based medicine in general is tragically underapplied, and many best practices are slow to be adapted due to most doctors being fairly conservative and not paying enough attention to the newest research. This is why the salesforce is so necessary even for an amazing new device or drug, just to overcome the natural inertia of most doctors and administrators. Since there's no money to be made in proselytizing for cheap, evidence-backed best-treatment-practices, they don't get a giant salesforce pushing for their adaptation.


Posted by: Po-Mo Polymath | Link to this comment | 07- 8-08 1:35 PM
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Since there's no money to be made in proselytizing for cheap, evidence-backed best-treatment-practices, they don't get a giant salesforce pushing for their adaptation.

Not just the money, but also physicians' conviction that they're all special snowflakes with unique insights into how best to treat their patients. Which is further complicated by the fact that some of them are probably right (at least for certain values of "right").


Posted by: Not Prince Hamlet | Link to this comment | 07- 8-08 1:42 PM
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I'm a real physicist! Quantum mechanics is the bread and butter of my experiments. And I'll tell you this:

A quantum system, in jargon, is described by unitary evolution of vectors in a Hilbert space. Less jargony: this evolution, unobserved, is deterministic, although the mindbending part is that superpositions of basis vectors ('spin up' + 'spin down', or, 'meow' + 'choke', if you will.) are allowed. By deterministic, I mean, the same initial condition of the evolution will yield the same final condition.

If one makes a *measurement* on the system, one projects onto one of the basis vectors with various probabilities. This, obviously, is not deterministic.

One can imagine a system which is sloshing *deterministically* between a superposition state (up + down), a 'basis' state (up), a different superposition state (up - down), and another basis state (down). Depending on when you measure things, you'll always get the same result, or you'll always get a probabilistic result. But the evolution of the wavefunction itself remains deterministic.

In the case of electrons going through slits, we would say that, until observed, the electron is *deterministically* proceeding through both slits simultaneously, and deterministically following many paths. But when observed, probability takes over, and your clicker says "one path."

So, at heart, I would say that quantum mechanics is indeed deterministic, in a very particular sense, but in the sense of the Laplacian dream of deterministic universal evolution, I'd have to say the probabilistic nature of of the (Copenhagen) measurement and observation process is a pretty big coffin nail.

I also think Penrose is wrong, and quantum uncertainty is not responsible for consciousness. But he is a very, very smart man.


Posted by: Counterfly | Link to this comment | 07- 8-08 3:06 PM
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Counterfly is lying. There's no such thing as a "Hilbert space". Hilbert was the town drunk, the exact kind of fuck-up that we know better than to help. Also, electrons avoid slits, because they make them look fat.


Posted by: Walt Someguy | Link to this comment | 07- 8-08 4:12 PM
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I haven't read the whole thread, but I want to offer heebie some positive reinforcement for a political post in the best tradition of ogged: provocative, familiar-yet-original, liberal in its sympathies, but free of cant, appropriately apologetic for acknowledging merit in the conservative point of view.


Posted by: Knecht Ruprecht | Link to this comment | 07- 9-08 7:29 PM
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I haven't read the whole thread, but I want to offer heebie some positive reinforcement for a political post in the best tradition of ogged: provocative, familiar-yet-original, liberal in its sympathies, but free of cant, appropriately apologetic for acknowledging merit in the conservative point of view.

It's spelled "Kant".l


Posted by: Brock Landers | Link to this comment | 07- 9-08 7:31 PM
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427: Penrose is an idiot, or disingenuous. I don't care how smart he is; The Empreror's New Mind is anti-scientific claptrap.


Posted by: Sifu Tweety | Link to this comment | 07- 9-08 7:37 PM
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