What Medicare services should be cut?

The New York Times' Room for Debate gives some suggestions.

Why do politicians lie so much?

Robin Hanson blames the voters.

Does wearing pink for Breast Cancer Awareness Month do any good?

Robin Hanson says:

In case you haven’t noticed, there’s lots of pink on display this month, especially in things that aren’t usually pink. The pink reflects a campaign to “raise awareness about breast cancer”, and I’ve been pondering what about it bugs me the most. . . .

I think I’m . . . bothered by the campaign being less about doing something and more about “awareness”, which translates mostly into social pressure to get other folks to show pink, buying pink products, wearing pink clothes, etc. Much of the money donated goes not to tests or research but to paying celebrities to make more publicity.

Now this social pressure couldn’t really work if it weren’t pretty widely known that showing pink is associated with the breast cancer, which seems at odds with the claim that there is a lack of awareness of breast cancer. Even more at odds is the fact that pink campaigns rarely offer concrete arguments that theirs is an especially worthy cause; it is just assumed that listeners pretty much agree. Really, what fraction of folks don’t know breasts can get cancer, tests might detect it, and academics research it? . . .

[A]nti-breast-cancer is framed as being pro-women. Thus one can insinuate that folks who resist social pressures to support the campaign are anti-women. Since folks fear seeming anti-women much more than seeming anti-health, a breast-cancer campaign can tap into far more social pressure than can an exercise or sleep campaign.

Think pink gets much of its energy by offering a way for folks to be indirectly political; one can seem pro-women, and insinuate that others are anti-women, while only ever explicitly talking about health and medicine. AIDS awareness gets a similar political punch; one can talk only health, yet insinuate that others are anti-gay. Much of medicine is not about health, but about showing that you care, in this case caring about the right political groups.

One good argument for breast cancer awareness would be that breast cancer used to be stigmatized. I'd agree that erasing this stigma is important. But have we not reached the point where the stigma has been successfully erased?

A commenter on Hanson's post notes the irony that the more beneficial an awareness campaign would be, the less likely it is to happen:

There are diseases that are not well known where wider knowledge could significantly improve the lives of those who suffer from it (such as Coeliac). However, because most people are ignorant of them and thus would require a larger time commitment in explaining them, they have little signaling value.

Another commenter says pink culture is actively harmful:

Someone who had breast cancer told me she hates it because it served as a ubiquitous reminder of her illness. Even after she was better, everything from tyres to water bottles made it impossible for her to move on. This seems like a significant cost to sufferers.

This is similar to the critique given by Barbara Ehrenreich, who devotes the whole first chapter of her book Bright-Sided to analyzing pink culture. She argues:

[T]here is a problem when positive thinking "fails" and the cancer spreads or eludes treatment. Then the patient can only blame herself: she is not being positive enough; possibly it was her negative attitude that brought on the disease in the first place. At this point, the exhortation to think positively is "an additional burden to an already devastated patient," as oncology nurse Cynthia Rittenberg has written. (42)

Ehrenreich gives her first-hand experience:

I, at least, was saved from this additional burden by my persistent anger—which would have been even stronger if I had suspected, as I do now, that my cancer was iatrogenic, that is, caused by the medical profession . . . .

Breast cancer, I can now report, did not make me prettier or stronger, more feminine or more spiritual. (43-44)

What I'd like to know is why certain kinds of cancer seem to be privileged over others. How do the people with less glorified kinds of cancer feel? Maybe they'll turn down a hospital blanket, saying, "'No, not for me . . . . That's for the other people.'"

Can you improve your blog comments by using esoteric terminology?

Robin Hanson, the blogger of Overcoming Bias, strongly endorses this idea by Eli Dourado about how to keep a high level of quality in your blog's comments section:

On small blogs, people typically comment when they have something to contribute or ask that is relevant to the post. These are frequently of high quality. … On more popular blogs, this positive commenting dynamic is confounded by the presence of eyeballs. Every post is read by many thousands of people. For the self-involved who could never attract such a large audience on their own, this is an irresistible forum for expounding pet hypotheses, axe-grinding, and generally shouting at or expressing meaningless agreement with the celebrity post-authors.

The first step, therefore, to higher quality comments is “be more niche.” Discourage your marginal readers with technical language, obscure references, and lengthy posts. Your marginal readers are not of high value anyway, and driving them away is an excellent way to improve the average comment of your inframarginal readers.

(I'm going to refer to these as Hanson's views, since I have the impression that Hanson is at least as enthusiastic about them as Dourado is. Overcoming Bias is the more popular of the two blogs, so the point is more relevant to Hanson -- and, indeed, he does seem to put this advice into practice.)

People are rarely as explicitly elitist as Hanson is here, though his reasoning is often used -- at least in other contexts.

I empathize with him in wanting to keep out certain commenters from your blog. (As you know if you've ever posted a comment here and read my notice, I've occasionally had to ban commenters.) But it's an open question how to identify which commenters should be excluded. The most obvious way is to judge the comments as they come in and delete them if they're not the kind of contribution you want. This is more aggressive but also more fine-tuned than what Hanson is describing. His approach is passive-aggressive, but that's not the main problem with it.

The problem is that he presupposes that the people whose comments he and his readers would benefit from reading are those who either already have a certain high-level education (which is strongly correlated with socioeconomic status) or have taken the time to absorb his blog's idiolect. Of course, I just used an esoteric term of art -- it's hard to avoid. But we should reach for these terms only when they allow us to express our thoughts more clearly, not as invisible barriers to keep out a poorly defined group of people we imagine are beneath us.

We're all hypocrites.

"Homo hypocritus" is a model of human behavior proposed by Robin Hanson (on his blog, Overcoming Bias, which often has thought-provoking observations about the quirks of human thought and behavior).

As Hanson puts it, a "large fraction of modern behavior is explained by our evolved capacities and tendencies to pretend to do X while really doing Y."

He gives this example: "Forager norms cut overt Y of dominance, bragging, sub-coalitions." This would explain why political candidates habitually declare, "This is not about me!" By definition, a political campaign is about the candidate, and they surely know this. But they also know that admitting this would be against their interests.

Hypocrisy is so fundamental to human nature that I would suggest it's not very productive to try to seek out, expose, and shame those who are guilty of it. The taboo against hypocrisy leads people to come up with convoluted and unconvincing rationales for why, for instance, there's no inconsistency in being a vegetarian without being a vegan. The more useful approach would be to admit that there is an inconsistency but explain why it's preferable to other ways of eating/living that are also inconsistent. I imagine that a lot of benefits would result if it were more socially acceptable to admit that we're all hypocrites.

UPDATE: This post was "featured" on Brazen Careerist. In the comments section over there, Jamie Nacht Farell makes an ironic confession:

[H]ypocrisy is probably the one constant in my personality as I've changed through the years.