I’m a bit concerned this may turn into more of a time-suck than I thought it would be. But I’m game to give it a month or two. Who knows. Maybe it will be wildly popular.
An uncommonly honest front-page editorial in The New York Times: There’s no way to provide affordable healthcare during an obesity epidemic.
But ... the remedy to the epidemic involves massive government intrusion into the private realm in a way that will infuriate everyone.
On the other hand ... what private realm? (See below.) Does anyone truly think that still exists?
And they’re right. Anyone proposing to expand public financing for health care needs to answer this question: why exactly do Americans spend so much more on health care than peer countries? Is it because of the healthcare system, or is it because they're more sick, more often? It’s both. Clearly, American food accounts for a great deal of the surplus morbidity and mortality—and thus a great deal of the cost.
It’s both insane that insulin costs so much more in the US than in peer countries and insane that so many more people need it. Health care costs in the US won’t norm down to those of peer countries unless both problems are solved. Which isn’t easy.
An interlocutor replied:
“Our food is completely packed full of steroids, hormones, and other toxic ingredients thanks to our vastly unregulated agribusiness sector, which average Americans buying groceries and eating in restaurants have no control over.”
“Let’s not forget the elephant in the room,” I replied. “We eat too much.”
“No argument from me on that,” he said. “But the argument that we don't deserve Medicare for All until we all commit to eating rabbit food is still victim-blaming at its core, and I ain't here for it.”
I was puzzled. “Well, you’re here for something,” I said. “It must have been for that argument precisely. Otherwise—given that 330 million Twitter users are having at least a billion conversations today—why on earth would you choose this thread?”
“Here for it,” he explained, pointing me to the Urban Dictionary.
That trending list on the Urban Dictionary is fascinating. Zootube? Pink Yeti? Humans are such an inventive species, aren't they?
Of course Silicon Valley is building a Chinese-style social credit system, and there’s not a thing we can do about it; it’s inherent to the technology. We probably don’t want to do anything about it; we’ll probably like what they build.
Do you think Amazon’s not figuring out how to make a killing in health insurance? They’d be fools not to do it. Bundle up all the people under thirty-five who buy yoga mats and kettlebells, the people who order clothes in sizes that suggest they’re not overweight, the people who don’t do a lot of driving, and the ones who never even look at the hang-gliding gear. Voilà: Low-risk, low-cost premiums. Everyone else? Enjoy your high-priced insurance.
“So,” replied another person on Twitter, “my strategy of posting nothing but pictures of young athletes that look vaguely like me, captioned ‘just finished another triathlon! only 6 more states to go!,’ ‘new PR in the 13.1 miler!," and ‘love me some egg white omelets!’ might pay off?”
Only, I explained, if you’re actually buying the triathlon gear, and if the data from your watch indicates that you actually ran it. I mean, that is the kind of data we now emit all day long. Only other humans are fooled. Amazon is not.
They know who’s posting those photos and then ordering, “The Ten Secret Supplements for Opioid Detox.” They know who hasn’t left her apartment for six weeks, seems to sleep fourteen hours a day, and never buys soap or shampoo.
They know more than enough to make the most detailed and accurate actuarial forecasts that any insurer has ever been able to make, by far. Between their data, Facebook’s, and other trackers, they can probably estimate the probability of your illness and death with such precision that if you’re genuinely unlikely to get sick or die this year, they can pool you with millions just like you and get you fully covered for pennies.
And if the risk’s a little higher, based on your unwillingness to lose a few pounds (which they know because of the size of your clothes) or your risk of suicide (which they know because of the kind of books you read and the number of hours you spend here), you go in the medium-risk pool.
And you bet you will not know why your premiums are higher than your friend’s, even though he’s the same age and frankly, you’d have said you were the healthier one (especially since you plan to quit shooting smack once those supplements arrive).
The way they calculate the premium will be as secret as the recipe for Coca-Cola. And it will really work well, as everything Big Tech does. It will cover most of the healthy population. What remains are the people they won’t insure. They will need Medicare. And we’ll have a much better chance of being able to afford it.
Privacy is gone forever—I see no way it isn’t—so we’d best just make our peace with it.
This piece by Edward Lucas is excellent. “History casts pall over eastern Europe — and us,” says the headline. “The 1939 Hitler-Stalin pact deserves condemnation. But we forget Britain’s role in this tragedy.”
It is not just “we in Britain” who forget history, though. The way and the degree to which it's forgotten does vary from culture to culture, from what I've seen, but it is often forgotten, often faster than one would think possible.
And I’m not sure if that’s a curse or a blessing. Probably both. It limits our ability to learn from it—and perhaps condemns us to repeat it, though that’s a cliche, not an argument—but how could societies function if memories of the past didn’t fade—and fade quite quickly?
If everyone gave appropriate time and thought to the Anglo-German Naval Agreement of 1935, who would now have the confidence to make any foreign policy decision?
And is it a coincidence that often the countries and cultures where the popular sense of history is more fully developed—where, as far as everyone is concerned, 1389 is a vivid, recent memory—aren’t as healthy and flourishing as one might hope?
This too, by David Rieff, about the cult of memory, is also an excellent piece.
It seems all of you are facing professional decline much faster than you think. But there’s one exception, and only one, and it just happens to be ... historians. That’s a relief. It means I need not find a deeper, spiritual meaning in life, like the rest of you. I can keep fueling it on naked ambition.
Off to the archives!
And that’s it.