Filed under: Uncategorized
Hi,
I’m moving this blog to a new address, on True/Slant:
http://trueslant.com/matthewsteinglass
Some old content will, alas, disappear with the move. But I hope you all follow over there, and update your RSS readers. The content and topics will be the same, only much better.
Best,
Matt
Filed under: Oddities
Driving through southeastern Utah in June, 2000, somewhere between Arches National Park and Escalante National Reserve, Pauline and I stopped in a town that had the only food store with outdoor, apparently local fresh fruit we’d seen in, oh, probably 200 miles. The sun was blazing, the main road through town was empty, the plane trees were sighing; I believe a single tumbleweed blew through frame. Next to the crates of slightly dried-out peaches and funky, spotted tomatoes was a soda machine. The brand: Shasta. Shasta! Shasta?! (“We haven’t had that spirit here since 1969…”) The price of a can was 25 cents. Unbelievable. I hadn’t even heard the brand name “Shasta” in probably 20 years, and I suddenly felt again with a vivid pang of remembered thirst the moment when the price of a can of soda at the machine down at the Chevy Chase Community Center in Washington, DC went from 25 to 35 cents. I believe the year of that price shift was 1980. How could a can of soda anywhere in the US still cost 25 cents in 2000? It was the soda machine forgotten by time. We stood there looking at each other and laughing like we were in a horror-flick spoof. Come to think of it, we did that in several places on that trip. Utah and Arizona are weird.
The other day my wife came back from L’s Place, the local “supermarket” (in the US, we would call it a “convenience store”) up on Xuan Dieu St., and said she’d seen some cans of Shasta. I didn’t believe it, I thought she’d made a mistake. But this afternoon I went in and checked it out, and she was right. Shasta Strawberry Soda. (They always had kind of weird flavors.) So here’s my question: is Shasta just a fairly common California or West Coast down-market soda brand that’s always been quite common in its regional market, but that had a failed push to go national in the ’70s, so I think of it as a soda of my childhood? And now it gets imported to Vietnam at stores catering to foreigners because of the Vietnam-California ethnic link? Or what?
Anyway, here’s one of those amazing Shasta commercials from the ’70s:
Megan McArdle has written another post on obesity, responding among other things to some of the points raised by Ezra Klein and to those raised here. I’m going to just respond to her responses to the points I raised. To the question I asked earlier, “What exactly is the harm in trying to reduce obesity?”, Megan responds:
Of course, in their minds, none of this trying has costs, or at least, not any interesting ones. I mean, sure, maybe it’s a huge infringement of property rights, but those are sucky and archaic anyway, and no one cares about them except right wing nut jobs who don’t deserve to have anything they want. And okay, maybe people want to live in the suburbs despite ample warnings from the television that driving is making them fat, but they must not really understand this, and at any rate, once we’ve made them all skinny they’ll be so happy with their new flat-front capri pants that they won’t even notice they have a 45 minute train commute and have to go grocery shopping every day.
This is a big tangled ball of different threads, but I’ll try and untangle them. What is the “huge infringement of property rights” Megan refers to? Here are a few things I think of when I think about public policies in the “property” realm to create or encourage less obesogenic lifestyles: devoting more road space to more bike lanes and sidewalks, and less to cars. Changing zoning laws so that commercial businesses can be mixed in more easily with housing, thus allowing people in more neighborhoods to walk to the store. Spending more public money on rail and other public transit, and less on highways. Removing parking-space requirements for new housing. Building more and better parks and playgrounds. These are cases which involve property that is already public, or already existing government regulation of private property, or more government construction — which might involve higher taxes, and which conservatives might thus legitimately oppose, but that’s not the same as infringing on someone’s property rights. I cannot think of an obesity-reducing program that would involve a “huge infringement of property rights”.
What about the “people want to live in the suburbs” argument? Well, what about it? People have every right to live wherever they want, and no one is going to stop them. People also want to live in the city, and in walkable neighborhoods. That’s why housing in cities and walkable neighborhoods costs more than housing in non-walkable suburbs. But urban planners have to make urban plans. Since the 1940s, those planners have been zoning the US for a lot of non-walkable suburbs, in large measure because they were working under an obsolete and ideological utopian modernist paradigm of how people should live that never matched up to the way people actually do live, and that incidentally ignored the existence of traffic jams. Now, the new generation of urban planners has a different and much more complex and multifaceted paradigm that takes account of people’s preferences for walkability and of public health issues. The planners are making these plans, one way or another. The question is whether they should or should not take account of the issue of whether a given plan for a neighborhood is likely to make more of the people who live there fat.
On the “train commute” question, I do not understand where Megan derives the assumption that devoting more public money to rail transit leads to longer commutes. In every place I’ve ever lived, the availability of robust public transit alongside private cars reduces congestion and leads to shorter commutes than would otherwise exist. People who live in Alexandria, VA and Westchester, NY are free to drive to their jobs if they prefer; when they take commuter rail, it’s generally because that is quicker (and less expensive than parking). For international comparisons, it is much easier to get around in Paris or Hong Kong than in Jakarta or Lagos; it used to be hard to get around in Beijing, but then, well, they built a bunch of new subway lines, and now it’s a lot easier.
The more-frequent-shopping question may have a real issue buried back there somewhere. The argument is presumably that local food stores are uncompetitive on price with big-box supermarkets, so they tend to disappear, and the only way to maintain the option for people to walk to the store would be regulatory intervention against big-box supermarkets. But I think one can find a happy medium where planning does enough not to discriminate against local stores, by permitting density etc., without eliminating the big-boxes. We already have a lot of small food stores that survive even though they charge much higher prices than big-box supermarkets. We call them “convenience stores”, and they’re not exactly unheard of, even in suburbs.
Megan then responds, I think, to my point that while I agree with her that obese people are unlikely to lose much weight themselves, it would be good to engage in public-health initiatives to keep overweight people from becoming obese, and especially to keep kids from getting fat in the first place.
I know, I know . . . it’s for the children! I am very fond of children. But I do not actually think that they are some sort of master race in whose name anything at all can be justified. And if I did, I’d be a lot more worried about, oh, abortion, than McDonalds ads.
I also do not think that children are a master race in whose name anything at all can be justified. The GM bailout, say, is hard to justify in the name of the children, per se. But preventing children from becoming obese is pretty easy to justify in the name of the children who are being prevented from becoming obese. Restoring PE in public schools is easy to justify in the name of the children in public schools. And so forth. More generally, anti-obesity interventions probably aren’t very effective for adults who are obese, but may be quite effective for children who aren’t obese yet. Eating and exercise are habits, and habits are formed more easily in childhood.
I don’t understand what this has to do with abortion.
The deeper point is that Megan’s argument is broadly that obesity is one’s own personal business and no one else has any business interfering in it. There is, however, a class of relationships in which everyone, even libertarians, understands that “it’s none of your business” does not apply, and that is the relationship of a society towards its children. This is true at the personal level — it is my business if the rest of society is doing things that will tend to make my children fat — and at the collective level — it is all of our business if we are doing things that make our children fat, because we are responsible for them.
On the kid issue, Megan then argues:
Kids exercise less not because crime is higher, or even because we’ve become more suburban, but because they’re no longer allowed to operate unsupervised until they’re quite old, and Mom and Dad both work. Schools don’t have P/E because they’re using the time to teach kids to read. Maybe those were bad tradeoffs. But they’re not irrational tradeoffs, and switching them back is not costless.
I think the fact that kids are not allowed to walk to school is a real example of counterproductive hysteria, and I oppose it. I’m sure such irrational fear of public spaces has indeed contributed a lot to rising obesity. There’s a bit of a shift in the opposite direction now, which is a hopeful sign.
Schools don’t have PE not because they’re teaching kids to read, but because they’re teaching kids to pass standardized tests. How to assess educational quality without driving schools to implement counterproductive changes like canceling PE for test prep is a real problem. But one thing this makes clear is that educational assessment reforms have to establish rules about what things schools are not allowed to do to improve their test scores, and eliminating PE is one of those things. Before the No Child Left Behind bill was implemented, if you had asked voters or even the bill’s authors “should we eliminate PE to raise reading test scores?”, I’m confident the answer would have been no, that’s a bad tradeoff.
Finally, Megan argues that we should care about the “costs” of trying to reduce obesity
because not least among those costs is the simple fact that the government cannot do everything well. Making all sorts of changes in the name of obesity means not making others that might be more important, because we have limited political and bureaucratic bandwith. Do you want obesity intervention, cap and trade, or health care reform? You may not be able to have any of them. But you probably can’t have all three. And if you did, you’d make it more likely that the government would screw all of them up.
Megan is mixing up two things here. The first is the question of what government can do. The second is the question of how easy it is to pass legislation. Government can, in fact, do an unbelievable number of things reasonably well all at once. The US government defends the country against foreign invasion, checks everyone’s automobile for harmful emissions, teaches millions of kids trigonometry, builds highways and water hookups to new suburbs, reviews grant applications for research on molecules that might treat rare cancers, and so on through a million iterations. Everyone would be worse off if the US government didn’t do these things, and you can’t realistically have a government in a modern developed country that doesn’t. But the US Congress has an increasingly hard time passing legislation on a lot of different things all at once. The question of whether a government can do effective obesity intervention, cap and trade, and universal health insurance coverage all at once can be answered in one word: France. Even the question of whether we can get bills on all these things passed is a bit of a red herring — Megan raised the whole obesity issue because she believes it is inevitably folded into universal health insurance legislation, so we’re really only talking about two issues, health care and climate change. Admittedly, it is looking pretty hard to get legislation passed on those two issues. But that is an argument about what strategy liberals ought to be adopting to get their most important goals accomplished, given the dysfunctionality of Congress. It’s not a rights-based argument about whether or not government should try to help people avoid obesity.
Filed under: Health
I wrote this post on the health insurance/fire department analogy on Democracy in America, and in comments, someone who calls himself Navarchos wrote what may be the most pithy and concise explanation I’ve ever seen of why a free market in private health insurance doesn’t work. I can’t link directly to his comment, but it’s at 17:39 on August 3. An excerpt:
No sane insurer will sell a policy to a sick person, just as no life insurer will sell a policy to someone who’s already falling off a bridge. Forcing insurers to cover everyone with preexisting conditions without enacting myriad other reforms creates perverse incentives to reduce coverage and raise rates across the board (to avoid looking attractive to unattractive subscribers).
Finally, since a health insurance policy can be called upon by choice, rather than catastrophe, moral hazard is rampant. To limit this, where life and auto insurance have simple deductibles and limitations, health insurance has ridiculously complex deductibles and limitations as well as co-insurance and co-payment structures that are more or less incomprehensible to individual subscribers. This prevents any meaningful measure of informed choice by subscribers, particularly as it’s impossible to gauge how cynically litigious an insurer will prove to be until after you’re sick. The asymmetry always favors the insurer, since the insurer can cancel a policy if the subscriber withholds information, whereas a subscriber just gets to die while his claim is held up in arbitration if the insurer reneges on its obligation. Oh, and most people don’t buy their health insurance; they get what their employers are pleased to give them in lieu of wages.
In short, y’all should quit pretending there’s a free market in health insurance, or that it’s possible to have one without deleterious effects on public health.
Read his whole comment. It’s great. Oh, and read my blog post while you’re at it.
The headline’s a cheat: I don’t know. But I had a very weird conversation recently with someone very in-the-know who first said, on the one hand, that Vietnam’s senior leadership is desperately looking for new energy sources, is horrified by the environmental consequences of Chinese coal, and is thus very likely to turn to renewables, such as wind, which has huge potential off Vietnam’s long coastline. And then, about half an hour later, started saying that because of the shortsightedness and corruption of the middle level of management in Vietnam’s government, that efforts to move towards renewables would probably lead nowhere, and the country would end up throwing away its potential.
In sum, I came away feeling I knew more than I did before, but haven’t actually advanced any further towards a yes-or-no answer to the question.
Filed under: Health
Here, I pioneer a new blog style: the epistolary. Basically I posted this as a comment on Megan McArdle’s blog and can’t be bothered to translate it into third-person. This blog is all about laziness! Enjoy.
——-
Megan, I’m going to egotistically assume I am the one other blogger you expect to accuse you of blindly endorsing nay-saying, and say: you’re blindly endorsing nay-saying. I am dull and predictable, and no one should read my blog. But more importantly, this whole subject initially came up because you were saying that increased government intervention in the health insurance market would lead to government increasingly telling us what to eat, and, as with the chocolate eclair example, that this was a problem because it entailed a curtailment of freedom.
But now you’re saying that the whole of the problem is that there’s nothing we can do about what people choose to eat. I still feel that you’ve got a really serious logical problem here that you’re just not addressing. If attempts to limit obesity prevalence don’t work, why will increased government responsibility for health care spending raise pressure on the government to waste money on them? If rising obesity doesn’t really entail very much higher rates of morbidity or higher health spending, then why will the government feel pressure to attack obesity to lower morbidity or heath spending? You may be saying that the government will do these things because it’s irrational, but in that case, what does this problem have to do with universal health insurance? The government does all sorts of irrational things, and its irrational campaigns against drugs and sex have proceeded quite aggressively without universal health insurance.
And, finally, if it’s just impossible to control what people eat, then how can there even be any curtailment of freedom here? If government interventions will be limited to TV ad campaigns that don’t work, am I really supposed to treat that as a serious harm worth worrying about? The amount of money is trivial; for citizens, it’s at most an inconvenience, or perhaps a wasteful subsidy of late-night TV comedy material. Weigh this against the cost of even 100,000 people in the US who actually need insurance being unable to obtain it. Which is more important?
Then, you say that it will simply be impossible to achieve any of the more serious measures that advocates argue might lead to reducing obesity, like cutting corn syrup subsidies or building a less car-oriented society. Again, if these measures will not pass, where is the threat to freedom? If they do pass, and work, isn’t that good? What is the harm you’re claiming? You may be saying that people should just not use their votes to get government to intentionally intervene in shaping policy or the built environment towards any particular lifestyle preferences, that this is in itself a curtailment of freedom. But then in the next breath you say that the reason we have a car-based society is because people voted for the governments that built it. And I really get the sense that you think this was okay. Well, people are voting now for governments that want to do something about reducing childhood obesity. Explain to me again what’s wrong with that.
Filed under: Uncategorized
I was the Mystery Blogger, for 42 minutes. Damn crowdsourcing.
Filed under: Health
For what it’s worth, I agree with Megan McArdle that the people who are currently obese in the US will probably stay that way, and that while efforts to help them lose weight if they so desire are a moral good, they shouldn’t be a major, expensive, or coercive component of public health policy. I think we’re largely stuck with the waistlines we have, give or take a bit of improvement, and that this generation of Americans probably has a rendezvous with diabetes.
What I am concerned with is reshaping incentives in America so that this generation doesn’t get any fatter, and the next generation never gets this fat. Because the next generation of Americans includes these two guys.

Sasha on zip line

Sol on rope bridge
Okay, Andrew Sullivan has now called Megan’s post a “must-read“, and I’ve heard from another source that the conservative-libertarian crowed really seems to like it. I have to reiterate: this is ridiculous.
What is the catastrophic outcome Megan is afraid of? It is this: that the government will start trying harder to help fat people lose weight. Seriously. This is the dystopian example that she provides of how increased government involvement in the health market will “curtail future freedoms”.
She provides two examples of the kinds of programs she’s talking about. One is a hypothetical government behavior change communication program for overweight people, which she argues will not work. Again: why is she afraid that the government, when it comes under pressure to save money on health care, will thus be driven to spend money on a program that does not work? The other program would be hypothetical government coercion not to eat fattening food. Again: every single advanced country in the world except for the US has government-supported universal coverage. There is not a single case of a government that forcibly restricts the food consumed by citizens. This is ludicrous, on a Jim DeMint level.
The other harm Megan claims from universal health insurance is that it will destroy innovation in the health care sector. How? Well, “in the absence of a robust private US market” — what? Hold it right there. Who proposed getting rid of private health insurance in the US? Exactly no one. Certainly not the health care reform bills currently in Congress. And if they did, there would still be the private health insurance market in France, the private health insurance market in the Netherlands, the private health insurance market in Germany, and so on, to pick up the slack. In each of those three countries, private health insurance covers almost the exact same percentage of total health spending outlays as in the US! Most countries in the world that have universal health coverage have robust private insurance markets. What health care universe does Megan inhabit?
Even if the above mistakes weren’t enough, there is simply no evidence that innovation in effective health care is mainly driven by the private US market. And when Megan says there’s a crisis in pharmaceuticals innovation going on these days, she’s right. The crisis is this: private pharmaceuticals companies aren’t producing, or even working on, a significant number of new drugs for major health problems. No new lines of antibiotics to fight antibiotic-resistant strains of TB and other bacteria. No new anti-malaria drugs. And so on. The pharmaceuticals companies claim it’s because patent terms are too short. Whatever. If the private US insurance market is supposed to be driving innovation in pharmaceuticals, then the private US insurance market is failing.
Look, Megan’s post doesn’t make any sense. That conservatives of a free-market bent read through it and think that it does shows that they have been conditioned by 30 years of Friedmanite language to react positively to a particular ideological style of rhetoric and set of catchphrases even when those catchphrases have been assembled to form a proposition that is incoherent.
Here’s my post for DiA on the possible radicalization of the new generation of moderate liberals of the Ezra Klein style:
THERE was a pretty illuminating exchange yesterday between Matt Taibbi and Ezra Klein, two pithy guys whose hair is currently on fire. Mr Taibbi was born with his hair that way; Mr Klein’s hair is usually neatly combed, but has finally ignited in despair at the spectacle of inadequate health-care legislation emerging, or not, from the 111th Congress. “This whole business, it was a litmus test for whether or not we even have a functioning government,” Mr Taibbi wrote…


