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Nov 4, 2022Edited
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Calion's avatar

In your edit on this topic: "Apparently more complicated, see comment thread here", the "here" link goes to a paper, not a comment thread.

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Calion's avatar

Another way to say that is "this measure discriminates against minorities by targeting something they particularly like."

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Nov 4, 2022
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Calion's avatar

They like them more than they like regular cigarettes, or they would buy regular cigarettes.

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Himaldr-3's avatar

Would these people like you to take away their preferred cigarettes, even so?

Not any smoker I've met. Not me when I smoked. It would just make me a little bit more unhappy. It isn't uncommon for smokers to scrounge butts from ashtrays in dire need; making menthols illegal isn't going to make them go "gee I guess I'll quit now."

Also, I object in principle to characterizing minorities as children who can't be trusted to run their own lives — "prey on minority communities" by letting adults make their own decisions?

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A. Klarke Heinecke's avatar

Good comment.

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A. Klarke Heinecke's avatar

I'm not sure one can speak about the experience of cigarette smoking if one is not or has never been a smoker. (But kudos for that.)

Smoking is EXTREMELY pleasurable. I only smoked briefly and less than a quarter pack a day, but I had had no idea beforehand of how pleasurable it really is, because the smoke from others used to repel me. Absolutely, the addiction is part of that pleasure. Nicotine feels good in my brain.

(Nicotine gum is not pleasurable. So it's not just the nicotine.)

And yes, I quit. For logical reasons. Not because I didn't *like* them.

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smilerz's avatar

Giving police yet another reason to hassle minority communities doesn't seem like a policy designed to make things better.

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Nov 4, 2022
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smilerz's avatar

And with every prohibition comes with a black market.

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Nov 4, 2022
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BRetty's avatar

Cigarattes are addictive, certainly -- my late mother being exhibit "A" -- but thinking that people don't enjoy them is absurd.

How many people made friends, got laid, maybe even met their future wife/husband through a smoking interaction/rituial? How many people reading this might not ever have been born without nicotine? (The same goes double dog for alcohol, of course.)

Dour sermonizing about all the "harm" and "lives lost" to these mild vices always seems to presume that the people, the smokers, were hapless victims of corporate propaganda. Especially, it assumes they never, ever, ENJOYED smoking.

Well, they did. Smoking is great. So what if you die at 60? Any remaining years would be sad and decaying anyway, who wants to live 90 years if you can't enjoy any of it?

Well, at least I know what my mother would have said to any child who tried to tell her she couldn't smoke. Probably would make Ben Kingsley blush.

https://www.youtube.com/watch?v=Nu_xTC5Gc2U

And as for telling her to wear a surgical mask in public, the withering stare that person would get, would have stopped the whole Covid panic right then and there.

Collegially,

BR :-)

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Jason Maguire's avatar

Remember, something having a negative effect on black people makes it much worse

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Cato Wayne's avatar

I knew this was coming. I’ve seen discussions where you’re racist if you support the ban and racist if you’re not.

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Calion's avatar

The racism singularity!

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sophiesmith's avatar

Who is this why is this on my feed

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Scott Alexander's avatar

This is a Substack. Presumably you subscribed to it at some point, or whoever manages your feed added it.

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sophiesmith's avatar

How do I remove it I’m only following one person on my feet that I want to hear from

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Scott Alexander's avatar

I think if you're using the Substack app, you can follow the instructions at https://support.substack.com/hc/en-us/articles/4474826883732-How-do-I-unsubscribe-from-a-publication-on-the-Substack-iOS-app- . If it's a different kind of feed, I'm not sure, sorry.

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Pope Spurdo's avatar

I'm really impressed with the customer service here.

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CleverBeast's avatar

Lmao at the incongruity of one of the largest writers on Substack politely helping someone deal with a basic technology issue.

Keep doing God’s work Scott, or whatever we Jews are supposed to say to get across the same meaning as that Christian aphorism.

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BigOinSeattle's avatar

Hey I got deleted for being a smart Alec! I was just joshing the guy.

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beleester's avatar

"You're a mensch" would work here.

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CleverBeast's avatar

Excellent suggestion

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BigOinSeattle's avatar

I know right? He could have said thanks.

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Doc Abramelin's avatar

This has got to be one of the best (joke) threads of the month, easily in contention for thread of the fall season; it's perfect, right on the borderline between slightly believable and super-clandestine troll humor.

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Calion's avatar

I have been wondering since this was the only comment whether it was real or a joke.

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jumpingjacksplash's avatar

I read it and thought it was meant along the lines of "Who are you and what have you done with Scott?"

But nope, guy's just not sure how this blog got on his feed.

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Calion's avatar

Umm…ignoring the text of the document in favor of the norms prevailing at the time is *not* originalism.

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Scott Alexander's avatar

Can you explain? I was thinking something along the lines of "the obvious intent of the writers and of the voters was to keep the 24 week ban, so judges will interpret the text in that context". How would you describe that, and how would you describe originalism?

By the way, trivial warning (1% of ban) for doing the thing where you accuse someone of being wrong but give no explanation.

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Calion's avatar

Ouch. Fair.

Originalism means we interpret the law according not to what was in the heads of the legislators (or what we want it to mean), but according to what the words of the law meant at the time. This amendment has a current plain-language meaning. That that's in contradiction to "you know what we mean" would mean nothing to an originalist. Wikipedia: 'Justice Oliver Wendell Holmes argued that interpreting what was meant by someone who wrote a law was not trying to "get into his mind" because the issue was "not what this man meant, but what those words would mean in the mouth of a normal speaker of English, using them in the circumstances in which they were used." This is the essential precept of modern originalism.' https://en.wikipedia.org/wiki/Originalism#Original_meaning

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Scott Alexander's avatar

It looks like that article describes two kinds of originalism - original meaning and original intent. Is the thing I'm describing original intent? If not, is there a name for it?

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Calion's avatar

Yes, I would call that original intent. It's dumb, for precisely this kind of reason, and not what pretty much anybody means by "originalism" nowadays.

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Scott Alexander's avatar

Is it dumb? It seems like all the law professors quoted expect people to use it to interpret this California law (and that they would be right to do so, if they don't want voters accidentally implementing a plan that none of them want).

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Calion's avatar

It is dumb because, for one thing, it makes it impossible for a regular citizen to know what the law means just by reading it. It makes the *text* of the law useless, and the presumed, inferred, and unformalized "intent" of the legislators (which how would you even know was uniform?) the *true* law. It's rule by "you know what we mean."

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Andrew Grossman's avatar

Justice Scalia's greatest achievement was sweeping away "original intent" originalism in favor of "original public meaning" originalism. That is by far the dominant approach today, to the point that original intent is largely regarded as just another form of purposivism.

Source: am originalist

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M M's avatar

https://scholarlycommons.law.northwestern.edu/cgi/viewcontent.cgi?article=1379&context=nulr

I thought that in addition to what else has been said, this study was somewhat of a killing blow to the validity of original-intent-style originalism, at least for interpreting the US constitution

The TL;DR is that the authors say "to tell whether original meaning or original intent is better originalism, let's look at what methods the people who originally wrote the constitution used" and they find that there was a consensus *against* using the intent of the writers of things at the time. Which renders original-intent-style originalism basically incoherent--their intent would not have been to have their intent interpreted.

But this could be reversed for things added later, I suppose. Perhaps, if something is added to a constitution with the intent of having its intent interpreted, we should interpret it. Or perhaps not, if we don't care about intent.

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Maximum Limelihood's avatar

Yes; however, textualism (here called original meaning) is the most popular form of originalism by far.

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Calion's avatar

Yeah, the meanings have shifted. First "originalism" meant "original intent" and what I describe was "textualism." Now what was called "textualism" is now called "originalism." Hard to blame anyone for being confused.

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Eric fletcher's avatar

Should we rely on the original intent or the original textual usage for the meaning of "originalism?"

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Richard Gadsden's avatar

I thought textualism was _current_ meaning?

That is: if the meaning of the words has changed then the constitution or law has substantively changed under current meaning, but has not under original meaning.

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Alex Woxbot's avatar

In the senses that we've been using them, Scalia et. al. would say both originalism and textualism have been abused, and advocates strictly following both: you must follow what's actually written (not what lawmakers said they intended), and you must use the original meaning of the words (not ways they've evolved over time).

You cannot use what lawmakers said, even at the time, because often different lawmakers will have different understandings of the same wording, and may agree only because the language is ambiguous. (To put it another way: If lawmakers had intended a specific meaning, they would have passed that as part of the law. That which is omitted from the law was likely done so for a reason.)

And hopefully the argument for not letting the meaning of the plain language of the words change is self-evident.

The authoritative text on this is Reading Law: The Interpretation of Legal Texts by Scalia and Garner.

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B Civil's avatar

> not what this man meant, but what those words would mean in the mouth of a normal speaker of English

You mean trying to get into someone else’s mind who’s saying the same thing?

That really streamlines the inquiry…

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Calion's avatar

Yes, it does. Because all you've got to do is stuff like look in contemporary dictionaries to see what the words meant at that time. You don't have to guess at what someone was thinking when he/they drafted/finalized/voted for (which one? All three)? the law in question. Especially since they may have been lying about their intent in order to get the wording they wanted passed, or different people may have had different motivations for voting for it.

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B Civil's avatar

So you are saying we can look up a word in a dictionary and preclude any dispute about it? I get the idea but not really sure it simplifies things much. It’s the old pound of flesh rabbit hole.

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Calion's avatar

Not all dispute, but you can certainly narrow it down.

All of adjudication involves interpretation and exercise of judgment. Originalism isn't some mechanistic method that is guaranteed to get the same answer from every jurist. But it grossly limits the scope of the debate. It says judges can't make up new meanings for old words in order to change the law to their liking, and they don't have to try to divine what the legislators *wanted* something to mean. Instead, they debate what the law actually meant in the language of the day. Moreover, it means that laws are meant to be able to be understood on their face, without having to consult a soothsayer to divine their *true* meaning.

I don't know what Shylock's case has to do with this. That wasn't an issue of interpretation of the law; he entered into an illegal contract.

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Kenny Easwaran's avatar

I guess the theory is that it’s easier to get into a generic someone’s mind than a specific someone’s.

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pxma's avatar

I admit to also being confused about the implications of Amendment 1, though it seems worth noting that the US Constitution has lots of absolutist statements ("Congress shall make no law...") but we still have defamation, false advertising, etc. as limits on free speech; likewise for the Second Amendment, but we still have gun restrictions like *trails off mumbling*.

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Calion's avatar

I believe the original intent was to have *Congress* make no law at all about such things, but to leave defamation, etc. to the States.

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pxma's avatar

The 1st Amendment (like most of the Bill of Rights) has been extended to apply to the states via the 14th Amendment's Due Process Clause.

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Calion's avatar

Right, but my point is that it was intended to be absolutist.

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Richard Gadsden's avatar

We have copyright as a limit on free speech; copyright is in the constitution, but was amended *by the first amendment*.

Defamation is in common law; Congress didn't make a defamation law, as there already was one. [Yeah, I don't like that argument either, but it's an argument that people have made]

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Kenny Easwaran's avatar

We certainly have restrictions on ownership of explosives, which are usually classed as arms when we say what arms dealers sell.

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Jacobethan's avatar

Originalism is a theory of constitutional interpretation -- it's about how to interpret old but still binding textual provisions, where the alternative theory is that those provisions should be interpreted in light of subsequent experience and legal development.

I don't know that it makes much sense to talk about "originalism" when we're talking about how a new provision should be interpreted by courts shortly after its enactment. That's really just a general question of textual construction: what are the background assumptions any reasonable legislator would have about the legal effect of this language?

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Calion's avatar

Well, that's just the question here: Which sort of originalism are we using? Scott's referring to original *intent,* not original *meaning.*

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Jacobethan's avatar

I think if you're talking about a court construing a recently enacted statute, it makes sense to juxtapose textualist vs. purposivist approaches to interpretation.

I don't know that it makes sense to call either of those two approaches "originalist," or to say that they represent two varieties of "originalism."

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Calion's avatar

Those two have, for better or worse, been folded into two types of originalism. https://en.wikipedia.org/wiki/Originalism

But first off, we're not talking about a statue, but a Constitutional provision. Secondly, should we interpret laws differently depending on how old they are?

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Richard Gadsden's avatar

>[S]hould we interpret laws differently depending on how old they are?

Yes, obviously. Older laws cannot account for unanticipated technological developments since they were passed and therefore there has to be an interpretive schema for how they apply. There is no such need for that schema for newer laws.

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Maximum Limelihood's avatar

The flavored tobacco ban is mostly a ban on vaping; the vast majority of vape products are flavored, while most cigarettes aren't.

I'm personally voting no because screw tobacco, I want people to vape instead.

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10240's avatar

It can also serve to attract current cigarette smokers if vapes are allowed to be flavored but cigarettes aren't.

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Himaldr-3's avatar

What? You can't see how making a product a more appealing alternative could incentivize a switch?

Flavored vape juice is what got me off tobacco and eventually off nicotine altogether. I object in the strongest possible terms to a) preventing adults from buying a product they want because "think of the children" *when it's already not sold to children* (†), and b) making illegal the only thing that ever worked for me and my friends to make the single biggest and best change in our lives.

(†)Edit: To be clear, I am aware that the argument is that kids will somehow get vapes anyway and be more incentivized to do so by the flavor, and somehow they will find a way that they couldn't find if there was no tantalizing flavor.

To my mind, this is a) misunderstanding teenagers (it's not the flavor, it's the rebellious cool adultness: no teenager thinks cigarettes or cheap liquor taste good), and b) sort of like saying "yes, we prevent kids from driving, but cool cars might make them want to drive anyway, so no adults can have a cool car.

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A. Klarke Heinecke's avatar

Thanks for making this very clear argument.

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Freestyle's avatar

Flavoring the vapes was the only thing that got me to quit smoking cigarettes. Flavorless vapes are not a better experience than cigarettes, and roughly equivalent to the gum, which never helped me quit. Flavored vapes are a lot more fun than cigarettes, and I quit smoking cigarettes when I bought my first disposable green-apple vape. To be honest I think the lack of public health messaging around how much safer and cheaper vapes are is astounding. If every cigarette smoker switched to vaping tomorrow it would be a massive improvement, and curtailing this switch in any way seems really destructive and small-minded to me.

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A. Klarke Heinecke's avatar

There has been something double-speakish going on with the government and cigarettes, way before vapes arrived. Perhaps they like cigarette taxes?

I tried a couple of cigarettes when suffocated by my artsy friends smoking, years ago. I am certain that if cigarettes were legally allowed to be sold singly as "loosies," far fewer people would ever have become addicted.

The minimum 20 pack seems perfectly calibrated to turn a curious smoker into an addict. Few people smoke a couple, then throw the pack away. No, they "clean their plates."

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BigOinSeattle's avatar

They do like the taxes and like the lottery they have the advantage of taxing only the willing. I am a binge smoker and I liked that in Mexico almost every corner store sold loosies. Because once I start I will smoke em till they’re done.

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A. Klarke Heinecke's avatar

Ah, I can answer that, as I have used vapes to help quit a quarter pack a day habit. Tobacco flavored vapes are vile and repellant. Not going to happen. Menthol vapes are acceptable. Mint vapes are best but apparently only criminals would propose such a thing. Hey, little girl, want some candy?

Like many commenters, I fail to see how it is anyone else's business which flavor vape I prefer. The classic "let's save the children!" argument has been discredited by the research I have seen. Young people smoke much less than previous generations. They vaped for a bit while it was trendy. Now even that is dropping in spite of the fact that they immediately found workarounds for the "making an example" of Juul.

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Maximum Limelihood's avatar

I don’t disagree in theory, but I’m skeptical that vaping fails the cost/benefit test. It *definitely* doesn’t while smoking’s still around, though.

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Calion's avatar

That sounds nice, but outlawing things doesn't deprive addicts of them; addicts find a way to feed their addictions. Instead, it turns addicts into criminals (or, at least, patrons of criminals), causes prices to skyrocket (leading addicts to become criminals to feed their habit), fills our courts and prisons with people who engaged in consensual behavior, and increases the power and reach of the police. Prohibition has not worked well in this county, or anywhere else I'm aware of.

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Himaldr-3's avatar

Stopping the vape industry from producing more does hurt existing addicts. They'll just switch to cigarettes, or drive long distances to get them, or get black-market products. That's exactly what I'd have done, certainly.

Also: nobody would pay such a high premium for a vape? My friend, exactly this happened in my state — and people died from improperly-made juice.

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Calion's avatar

And what about the murder rate? Even if we accept your numbers, is it desirable to exchange deaths from voluntary (and, at least in many cases, desired) behavior for deaths due to criminal activity?

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Himaldr-3's avatar

I dunno; I'm skeptical. It appears, on a cursory examination, that I cannot access more than the abstract there, but the graph of homicide rate decreasing for "selected cities" (and adjusted for some unclear measure of enforcement rather than the obvious markers of "Prohibition begins/ends"), seems — without being able to view the rationale — sort of like cherry-picking.

E.g., homicides as a whole rose during Prohibition, and fell after repeal; the effect is clearly visible, and significant. It was rising before Prohibition too, but a) less steeply and b) with fluctuation up and down — an effect not observed after Prohibition began; and it is possible, but quite a coincidence, that it would immediately fall after repeal if this was entirely due to some exogenous factor.

You can see some justification for looking at the effect in places wherein Prohibition was most strongly enforced; but we wouldn't expect effects on homicide rate to be entirely delimited thereby — e.g., consider displacement effects, smuggling and brewing routes and locations, organized crime moving more visible operations outside these cities and operating clandestinely inside them, etc., as well as mechanisms we aren't even thinking of. It seems at least arguable that the clearest view of effect on homicide would be presented by looking at the bigger picture.

Too, it's possible this paper is completely legit and unassailable, but I checked a few cities famous for Prohibition-era enforcement and results (Chicago, say), and *they* also don't show a decrease in homicide rate but the opposite.

As said, maybe this really does reverse if you have a reliable measure of enforcement, good arguments for why nothing outside these cities should be affected, and look at every city with strong enforcement all together; but... I'm skeptical.

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Paul T's avatar

Do you have a link to a write-up on this? I have never heard anyone argue that prohibition was net positive and I’m interested to learn more about this position.

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Paul T's avatar

Thanks! This seems to make two claims:

1. That prohibition decreased alcohol consumption. This seems obvious to me and I haven't encountered anyone arguing the opposite. Some benefits flow from this; for example a decrease in domestic violence (a bigger effect than I was previously aware of), and the obvious health benefits.

2. Prohibition decreased crime. The general argument I am familiar with against prohibition is that it caused a big increase in organized crime. The article argues that on net (including things like domestic abuse and other alcohol-related violence) crime actually decreased. This isn't really substantiated though. The study that is linked as supposedly supporting this actually says in its abstract "Alcohol prohibition decreased homicides for two years after enactment, but had no effect after two years." which sounds to me like it's compatible with "organized crime took a little while to ramp up, and then counteracted any benefits from prohibition". Still, based on my priors I'd have expected to see a more measurable negative effect here, so I think I need to update somewhat on this information.

Even if we do accept this result on its face (crime was shifted from domestic abuse and bar fights to organized crime, without changing the level), I think that still does not bode very well for Prohibition. You'd need to show a pretty big crime reduction to persuade me that this policy's benefits outweigh the costs of 1) harming users by putting them in jail or fining them, 2) reducing people's ability to enjoy their preferred activities (most alcohol users are not addicts/abusers), not to mention 3) creating the opportunity for selective enforcement of these laws by racist cops, thus harming marginalized communities.

If all you're getting net utility from is a health benefit, sure, that's a benefit in some sense, but you can't (or at least, I won't) mandate people be healthy at the expense of their liberty; the same logic would lead you to forcing overweight people onto daily treadmill sessions to get into shape, and I would be surprised if many people bite that bullet.

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BigOinSeattle's avatar

No it hasn’t. After WWII when they had tobacco rationing in Europe organized crime stepped in. People were literally killed over cigarettes.

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Maximum Limelihood's avatar

Prohibition might not be worth it in this particular case, but the argument that bans don’t work proves far too much; banning things usually makes people less likely to do them. Maybe the decrease isn’t worth it, but I find it extremely unlikely that out of the uncountably infinite number of reals, we just happened to land on exactly the number 0 for this effect size.

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B Civil's avatar

> banning things usually makes people less likely to do them.

I accept that it might weed out the fringe element but only by hugely increasing the cost of those who persist,

and introducing all the new costs of policing the ban. We need a study, but I’m leaning away from your proposal.

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Calion's avatar

Okay, let's narrow the claim: Bans don't work for *helping addicts.* The decrease in consumption is almost entirely in social or casual users. Addicts find a way to have their fix, and so bans simply make their lives worse.

Actually, no, I stand by my original claim: Prohibition doesn't work well. It benefits basically nobody except criminals and bureaucrats. The ones who stop consuming are those who were not being harmed by it, casual users who presumably saw some benefit in consuming it. Addicts, with few exceptions, do *not* stop consuming; instead they ruin their lives trying to find their next fix, engage in criminal activity to get what they need, switch to harder stuff since it's generally cheaper per unit of addiction-satisfaction, and risk being injured by impure product (sometimes produced by the government). Plus now "pushers" have the incentive to try to *create* addicts, as addicts are most of their business.

Add into this the additional societal knock-on detriments of massive increases in the police state, government intrusion into private affairs (awfully hard to uncover crimes nobody reports!), massive increases in crime, in government power, in government spending that has no effect, in caseloads in courts and in prison overcrowding…yes, I'm going to call prohibition a net negative, every time.

So no, the effect size isn't zero; it's *predictably negative,* if what you're measuring is social welfare.

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Elena Yudovina's avatar

Question: does prohibition work to reduce the number of new addicts? The mechanism I have in mind would be along the lines of "it's harder to get addicted to a substance when it's expensive and hard to get," but it's pure armchair speculation on my part.

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Calion's avatar

That's a good question. I can find no data on addiction rates; probably not surprising, given that it would be very hard to measure.

It's possible it would, for just the reasons you mention. Set against that is the possibility that dealers (and others, like pimps) now have incentive to create addiction in order to maintain or increase their market (given that, unlike in a legal environment, addicts are likely to be the majority of their business).

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BigOinSeattle's avatar

Well okay but I don’t feel comfortable dictating to adults what they can get addicted to. And really, nicotine isn’t any worse than coffee. Nicotine gum is sold OTC and doesn’t even require ID. It’s the particulates from the tobacco that kills people. Tobacco is really rough on the body so if people want to vape I say let them.

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A. Klarke Heinecke's avatar

As long as we ban coffee (addictive) while we are at it. Vapes do not appear to cause high levels of harm. It's not the addictive nicotine that is harmful, it is the products of cigarette combustion. Smoking coffee beans would probably be a bad idea, too.

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Himaldr-3's avatar

I had worse physical effects from quitting coffee than quitting nicotine. It was *easier*, but definitely more unpleasant.

Let's make it so adults can't decide to drink coffee! It's for their own good! Everyone is a mewling child now! :-)

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Aaron Traas's avatar

> Smoking coffee beans would probably be a bad idea, too.

Dammit -- now I want to try this! Why did you have to put this idea in my head?

(I'm only 2/3rd's joking. Maybe.)

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Himaldr-3's avatar

Vaping is fairly harmless; being addicted to nicotine when you're vaping isn't unpleasant at all, in my experience.

It also seems weird to me to say "people might make a decision that causes them to experience something sort of unpleasant for a little bit, so we need to make even those who would be completely fine unable to make this decision." Surely there is a better way.

(I also really, really don't want to set a precedent that the legal system should start making choices for adults. Slippery slope and all that.)

Also also, nicotine has a small but measurable positive effect on lots of stuff: it's the only nootropic that actually appears to increase intelligence (e.g., caffeine increases *alertness,* as does nicotine, but *only* nicotine increases # of problems solved correctly on Raven's); it is protective against certain forms of cognitive decline; it is a mild stimulant; etc.

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10240's avatar

Being addicted is unpleasant if the thing you're addicted to is harmful, and expensive if it's heavily taxed or is illegal (or naturally expensive to produce).

The non-paternalistic policy would be to neither ban tobacco or vape, nor tax them exceptionally. The ideal paternalistic policy (optimizing for people's average health, regardless of their own preferences) is probably to ban or heavily restrict smoked tobacco products, but allow vaping with low taxes. Any benefit from banning vaping in reducing the total number of nicotine users is probably more than erased if it results in some people continuing smoking who would otherwise switch to vaping.

Leaded gasoline is a wholly different matter than nicotine (except perhaps under fully paternalistic assumptions, where hurting one's own health is regarded as bad as hurting a non-consenting party's health) because leaded gasoline hurts everyone, while nicotine only hurts its users (and to a small extent other consenting parties).

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B Civil's avatar

> Being addicted is (I am told) a very unpleasant and expensive thing;

I think it gets worse on both counts when you throw in a black market and criminal sanctions.

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A. Klarke Heinecke's avatar

Agreed! One major reason I quit my mild smoking habit (still with difficulty) is that I just dislike being addicted to anything and craving it. Air and water I accept.

I think I tried smoking because I am very open to experience and curious. I respect that it takes strength to quit. It is great to quit!

Yet I so strongly agree that this decision is best when it comes from the individual, not imposed by government. I see the government's role as ensuring that accurate information is available to its citizens.

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B Civil's avatar

I am completely addicted to smoking. I feel like I was born with a Camel straight in my mouth. A victim of the James dean and Humphrey Bogart generation.

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Scott Alexander's avatar

Is this true? Google tells me 37% of cigarettes are menthol-flavored.

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Maximum Limelihood's avatar

You're right; "Hardly any" was an error and I'll edit the comment. The main thing is around 85% of vape products are flavored, so I suspect this would backfire by making vape products less appealing substitutes.

https://www.washingtonpost.com/health/2022/10/06/teen-vaping-cdc-fda-study/

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Maximum Limelihood's avatar

Apparently economists have done the experiments to verify this, and concluded that a ban on flavored tobacco would increase cigarette consumption.

https://pubmed.ncbi.nlm.nih.gov/29807947/

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Scott Alexander's avatar

Here's a probably terrible study saying the opposite - https://ldi.upenn.edu/our-work/research-updates/when-they-cant-buy-flavored-tobacco-kids-are-less-likely-to-smoke-or-vape/ - I've added a note of caution in the post and will try to have more of an opinion on this in time for the Open Thread.

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Maximum Limelihood's avatar

Having read through, it's got some big problems. The study there only compares tobacco sales in a single city (San Francisco) before and after a ban on menthol cigarettes. However, because there's no comparison to other cities, it's essentially worthless; tobacco sales throughout the US dropped at this time, and I don't know how this compares.

The study I referred to was pretty close to the gold standard--it's an experiment that surveys smokers' preferences, then models their choices with and without a flavor ban. The statistics are great, which is honestly shocking to me, since it's the first time I've said this about an experiment in... ever.

It's worth noting that the FDA is already planning to ban flavored cigarettes and cigars, so the law will probably only end up affecting vapes:

https://www.fda.gov/news-events/press-announcements/fda-proposes-rules-prohibiting-menthol-cigarettes-and-flavored-cigars-prevent-youth-initiation

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Kronopath's avatar

Scott, your "note of caution" doesn't link to this chat thread (as it said it should), it links to the pubmed study.

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Scott Alexander's avatar

Thanks, fixed.

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BRetty's avatar

I just want to say this about menthol cigarettes: black people use the word "menthol" and "cigarette" interchangably, there is no distinction, all cigarettes are menthol flavored.

This observation comes from spending 9 months in a halfway house with 2 or three black roommates. I even asked G why they only smoked menthols and he didn't even understand the question.

Sometimes the map is also the territory.

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Jacob Steel's avatar

By "black people", do you mean "two or three black people"?

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BRetty's avatar

Closer to "every African American smoker I have met in the last ten years." When I ask, "So why do black folks all smoke menthols?", most just look either sheepish or puzzled, and say something like, "It's just a thing I guess."

For a while I was very curious about this and asked people like on subway platforms, "What's up with menthols?" So small sample but better that *some* behavioral studies.

For me the mystery is why it's ubiquitous yet nobody knows why or it never occurred to them.

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BigOinSeattle's avatar

Vaping is a lot less bad than cigarettes. Menthols are smoked mostly by blacks in my experience. In the Bay Area outside of Oakland their numbers aren’t great. To me it just seems like Karens running a nanny state.

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Himaldr-3's avatar

I vote NO as strongly as I've ever voted for anything, although I'm not in California so this does nothing.

Still, it boggles my mind that Scott — an individual I *previously* held in high esteem (kidding, kidding! about the "previously" part, I mean) — would even consider this. In what world is it a good idea to make a healthier product (one that personally probably saved my life) a worse alternative AND encourage the use of blanket bans from above to regulate the life choices of adults?!

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Calion's avatar

I don't think he grasped that this was about vaping. He only talks about cigarettes in the post. As the FDA has proposed banning menthol cigarettes, I assume that's what he thought was going on here.

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A. Klarke Heinecke's avatar

I admit that I was extremely surprised about Scott's choice, in this case especially, too. Overall, it did seem as though his immersion in Californian values is normalizing authoritarianism more than he realizes.

I lived in and loved California for most of my adult life. One does not realize how f'ed up that beautiful, productive state is, in many ways, until one leaves the groupthink.

I can walk to California from Oregon along the coast now, and find it incomprehensible that some of my friends live on the CA side of that border. The taxes. The stifling, micromanaging regulation. (The CA side features crime, meth and vagrancy, even in that remote and beautiful outpost.)

Prediction: Only in California will it even seem plausible that Newsom has a prayer as Presidential candidate.

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BRetty's avatar

I am pretty sure that the focus on flavored vaping products is just a flag of convenience for the real goal of using the FDA to outlaw existing companies' competitors.

I have done some work for a vaping company here in Los Angeles. My boss is personal friends with the owner(s) and we helped install the clean room for their packaging line.

Whatever you think of vaping, playing rope-a-dope with business owners whose whole investment can be wiped out by government caprice backed by lobbyists, is a really crappy thing. See also: california marijuana legalization.

People wonder why politics is so intense now: it's because so much is at stake, the govt now is the biggest player in almost every facet of society and the economy.

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EP's avatar

Thank you for pointing this out with a concise and clear explanation. Voters in California do not realize that the direct initiative process is gamed like this and believe that they are making actual policy choices about discrete things. It's a shame because California is such a heavyweight in the nation's marketplace that when they do something, it creates quite the downward pressure for other states to follow along.

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A. Klarke Heinecke's avatar

Yes. It was terrible how the government targeted Juul, made an example of them.

I would never have guessed in the late 20th century that the powerful lesson of authoritarian command economies would just swirl down the drain, forgotten.

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Ian's avatar

You wouldn’t have? Even with every university teaching that free markets bring pain and suffering to populations and at the very least we need mixed markets, but really command economies can work now and are great because algorithms and AI? Because they’ve been doing that worse and worse for over half a century and it’s clearly had an effect.

All of the people who know better are busy. All of the parasites spend all of their time spending our money and teaching their bullshit, while infesting every institution with a modicum of power (and now the multinationals). Say thanks to the bankers, who funded Marxists for race & gender agitation (to marginalize the Occupy stuff they were actually scared of).

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A. Klarke Heinecke's avatar

Well, yes, that is what has happened. I started worrying about it in the 21st century though there were hints with political correctness in the late 20th.

There are a lot of parasites. We have such a productive society that we have been able to carry them, but they may be getting strong enough to kill the host. I wish these folks would turn their fevered energies toward creative pursuits, though sometimes I do feel inundated with bad art.

It will be very interesting to see how the widely misunderstood and misrepresented Elon Musk does with Twitter.

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Ian's avatar

It’s nightmare Earth. I could go on and on. We’ll get a good shellacking from inflation (not even close to done), lose a lot of people to death and poverty, and possibly have to fight a world war, but it’ll (the country) probably truck on in some form.

I’m not sure I trust Elon yet. He feels like the the rest of the dialectic, but we’ll see.

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Nick's avatar

Yeah I vape and the ban is annoying as hell. It doesn't actually work at all, you just have to go to the head shop and talk to the guy for like 10 minutes until he pulls out the secret box under the counter where he has flavored vape juice. OH, and you can also still buy flavored nicotine free juice and unflavored nicotine solution and mix them, which is a pain in the ass. All in all, as always, prohibition is stupid and creates stupid work arounds which just make everything more annoying.

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Paul T's avatar

It's also a ban on menthol cigarettes, which disproportionately affects people of color. I'd also note that Eric Garner was stopped by the police for selling loose cigarettes, a trade which would increase if we introduced prohibition on menthol cigarettes.

This prohibition won't prevent people from getting access to flavored tobacco, but it will increase the amount of petty crime going on, and at the margin will provide new revenue streams to organized criminals smuggling flavored cigarettes.

I also think it's crazy that we're seriously proposing to increase prohibition of drugs (tobacco) in CA, while at the same time are working to roll back the war on drugs in other areas like weed. The cognitive dissonance here gives me a headache. This is an example of a common cognitive error I see in politics; Thing A is causally upstream of Thing B. Thing B is bad. Therefore we must ban Thing A. Not considering that there are plenty of consentual and legitimate use-cases for Thing A.

In this case, if you really care about advertising and selling tobacco products to children, then increase the penalties for doing so. Juul was recently nuked from orbit by the FDA for its advertising campaigns in schools and online targeting high-schoolers, but it's still doing business; perhaps we need more strict penalties and liabilities here. These guys were clearly targeting children, AND the product is clearly something that many adults want to purchase; maybe Juul should be fined into oblivion, but I don't think the product category should be.

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Sandy's avatar

I can't figure out how to vote on this. I want to vote no because I don't support prohibition. However, at least in this case, I have much stronger feelings opposed to California's proposition system. The legislature passed this law, and then the tobacco lobby spent a bunch of money to get it overturned by our awful, awful proposition system. I can't support that, but voting yes doesn't include any statement that I am only voting yes as a vote against the way California statewide propositions work.

Why am I not seeing anyone else attack this issue from that angle?

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Andrew Grossman's avatar

Per the WSJ (and L.A. Times), Prop. 29 is a labor union thing:

>The measure is backed by the Service Employees International Union-United Healthcare Workers West, which has tried unsuccessfully to unionize the industry. The same union pushed dialysis initiatives that failed in 2018 and 2020.

WSJ: https://www.wsj.com/articles/union-coercion-on-the-california-ballot-prop-29-dialysis-providers-seiu-uhw-big-labor-11665770524

LAT: https://www.latimes.com/california/story/2022-10-10/skelton-proposition-29-dialysis-california

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Scott Alexander's avatar

Huh! I saw that the union was the main group in support, but I was confused because I couldn't see how this would help union members. Apparently it doesn't and it's just intended to hurt clinics as punishment for not unionizing! Interesting!

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David Gretzschel's avatar

It is like the AGI punishing everyone who did not bring it into existence!

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Viliam's avatar

Making sure that general intelligences are brought into existence is the Proposition 1.

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Daniel B. Miller's avatar

Careful... YUD may be watching

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Deiseach's avatar

What do you think of the move to move dialysis out of the clinics and into the home?

https://www.fiercebiotech.com/medtech/davita-fresenius-team-up-to-bring-dialysis-care-out-their-clinics-and-into-home

"The two largest dialysis providers in the U.S. are teaming up to pursue a business proposition that might seem antithetical in nearly any other field or at any other time outside of a worldwide pandemic. They aim to help get patients out of their respective clinics and have them access treatment from inside their own homes.

DaVita Kidney Care will expand its use of home hemodialysis machines supplied by Fresenius Medical Care—including the smaller, portable and digitally connected devices Fresenius picked up in early 2019 through its long-awaited $1.9 billion acquisition deal for NxStage Medical.

DaVita maintains over 2,800 brick-and-mortar dialysis centers in the U.S., while Fresenius’ North America subsidiary owns more than 2,500 on the continent—together accounting for more than 80% of the entire U.S. market.

However, the spread of COVID-19 plus the advent of lockdowns and social-distancing measures have spurred high demand for home care. In 2020, Fresenius said it provided more than 14% of its dialysis treatments in the home setting, with home hemodialysis alone growing by 37%.

Meanwhile, recent changes to Medicare have also worked to accelerate the adoption of home-based therapies. The program expanded payments last November for new home dialysis equipment after finalizing a value-based payment model designed to incentivize at-home therapies over in-clinic treatments."

From a cynical viewpoint, this means they can cut down on brick-and-mortar clinics, bill Medicare for the rent of home machines individually, and put the onus on people and their families to take charge of their dialysis, and if you have any complications - well, I guess, just ring an ambulance?

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Melvin's avatar

On the other hand, from a non-cynical point of view, you can sit around in your own home instead of needing to go to some clinic for 12 hours a week, which sounds pretty good.

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Jeff K's avatar

It really depends on the patient and family, but home dialysis can be quite helpful in certain situations as it is certainly much more pleasant to be sitting at home on dialysis than stuck in a dialysis clinic with a bunch of other sick patients for twelve hours a week.

There are a couple of things which would disqualify patients from home dialysis. Probably the biggest issue is that it isn't really feasible for someone to operate a dialysis machine on their own because there is a large needle occupying one of your arms, so there needs to be a family member consistently available three days a week who is able to operate the machine. The other issue is that some patients suffer from low blood pressure while on the machine and probably need some sort of medical professional available. The good news is that it tends to be the same patients who have issues every time, so if someone has been on dialysis for a few months with no issues, you can be fairly confident it won't be a major issue.

I think the main reason that home dialysis has been so rarely done historically is that dialysis machines are extremely expensive, so they've historically been kept in a central location so you can have one machine for four patients or so (two patients on MWF, two on TuThSa). I guess recently the cost of trained medical staff and real estate must have risen to the point that it's cheaper to have one machine per patient if you can avoid the other costs.

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Notmy Realname's avatar

It's the same reason Pilot's unions want flight engineers and teacher's unions want more teachers; another mandatory person being present, even if they aren't in any way required and have no purpose, is still a potential union member. Union administration budgets come out of Union dues which come out of industry salaries, so anything that increases the total workforce is good for them.

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Daniel B. Miller's avatar

To quote Tony Soprano (approximately by memory): 3 no-work and 5 no-show

Also, satisfaction guaranteed or double your garbage back.

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Griff's avatar

My feeling is that it’s the unions job to be advocates for their membership, and expand that membership. The rest of us don’t have to go along, however. It’s like the construction unions blackmailing builders by filing fake environmental lawsuits against developments — that’s the unions job, to get more union jobs, but the government and courts and citizens don’t have to allow it.

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Deiseach's avatar

On the other hand, if I believe the Yes on 29 people, the push *against* it is down to big multistate chain companies that want to keep their cosy arrangement and not pay out for having qualified staff on site.

"How many dialysis clinics are there and who owns them?

There are more than 650 dialysis clinics in California. Two large corporations — DaVita and Fresenius — monopolize the dialysis market in the United States and in California as well, where they own 73% of the clinics.

Where are these clinics located?

Most of them are located in strip malls or other remote locations, often nowhere near a hospital.

So, they must be low-profit operations, right?

Actually, the clinics are making huge profits. The operating margin for the dialysis industry in California is more than ten times higher than the hospital industry in California. In 2021, DaVita and Fresenius, the two corporations that own 73% of dialysis clinics in California, made combined profits of $415 million from their clinics in the state.

Who actually takes care of patients during their treatment?

The primary patient care is performed by Patient Care Technicians (PCTs) who are generally paid little more than minimum wage. Clinics also have at least one Dialysis Nurse overseeing the care of the patients, but with no minimum staffing regulations for PCTs, the caregivers are often overwhelmed providing care for multiple patients at a time.

Can clinics afford to have a doctor, nurse practitioner, or physician assistant on site?

Two big dialysis corporations dominate the industry, and clinics have operating margins more than 10 times higher than hospitals in California. They could invest in better care and safety — like having a doctor, nurse practitioner, or physician assistant in the clinic whenever patients are being treated — and still make large profits.

Are clinics currently required to report infections or other problems with sanitation or hygiene to the state?

No, right now they don’t have to. Patients have reported seeing bloodstains, cockroaches, and other sanitation problems in their clinics. Problems with sanitation and hygiene could put patients at risk of infections.

Who’s supporting Prop 29?

In 2016 dialysis patients and clinic workers came together to try to make improvements to patient care and safety in dialysis clinics. They worked to increase staffing, ensure more recovery time for patients, and end profit-increasing schemes to move patients from public to private health insurance. The patients and clinic workers are supported by the 97,000 healthcare workers in SEIU – United Healthcare Workers West.

Who’s behind the “No on Prop 29” campaign?

The two corporations that dominate the industry — DaVita and Fresenius — have done everything possible to keep their huge profits flowing by stopping patients and workers from making improvements to dialysis care. In 2020 the “Big Dialysis” corporations spent over $100 million just to defeat Proposition 23, which like Prop 29 would have implemented better protections for dialysis patients in California. Those same corporations are fighting Prop 29 and have already put $36 million into defeating the initiative."

Who do I believe?

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Notmy Realname's avatar

There is no need for "trained staff on site". Dialysis is not surgery, it is a routine procedure that largely consists of just sitting there. They are located where people live, not in hospitals, because they are a regular everyday thing like a supermarket or barber shop. You imply it's somehow wrong that people shouldn't have to go all the way to a hospital multiple times a week in perpeuity; why would it be?

People already use California's clinics and are fine. This initiative tries to fix a nonexistent problem in order to create pointless union jobs.

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Carl Pham's avatar

In re location, for what it's worth the only DaVita clinic in my neighborhood is located (in a strip mall) about 500 yards from the nearest big hospital, although I live in a suburban area on the coast. But also, it would seem to me you *want* your dialysis clinics in strip malls and remote locations, because that's where your least ambulatory patients are located. If you live anywhere but in the dense urban and suburban parts of the state -- and a lot of people do, according to the USDA 34% of California's population is considered "rural" -- you might easily have to drive 30-45 min each way to get to a hospital, and that would be hard on people who need this 3x a week. (Especially once they are obliged to buy a $65,000 electric car after their $1,000 used Corolla breaks down for good.) So this statement already strikes me as disingenuous.

Also for what it's worth salary.com tells me the average salary in Calfornia for a Dialysis Patient Care Tech is $47,000. Minimum wage in California in 2020 is $13/hour, which for a 2000 hour work year works out to $26,000, so the average PCT salary is 35% higher than minimum wage. I guess that is "little more" than minimum wage, for certain definitions of "little," but again I'm not impressed with the honesty in this statement, although it's about average for ballot statements.

I think it's neither here nor there what the profit margins are in the business -- it would be beyond naive to think that 30 million voters can make good business decisions for an entire industry, compared to the people who actually work in that industry -- but it is strange that only two companies so dominate the business. *That* is concerning, as it means competition is severely constrained, and I would wonder if there's some way to improve that situation -- to make it possible for a new operator who thinks he can serve patients better for less money, e.g. *have* an NP on premises all the time, be sparkling clean, and still make a decent profit, to start up.

It's impossible to know if this is economically and practically possible from a ballot argument or website, you have to see it done or failed in the real world, or at least take a deep dive into what people have already done or tried. What is the problem here? Are the barriers to entry just too high, is the legislature in the pocket of the two big existing operators, are the capital costs outrageous, are the regulatory burdens so steep that only big companies with a platooon of specialized lawyers on staff can cope? I'd be in strong support of efforts to figure out what the barriers to entry are and how to lower them. Nobody's passionate about regulating via initiative California's (vast) boob-job or laser eye surgery clinic industry, presumably because low barriers to entry and fierce competition means patients feel they're getting their money's worth, and being unsanitary or unhealthy and causing your patients to end up with roaring infections results in sufficiently bad Yelp reviews that you go out of business.

In principle, this is exactly why we elect legislators, so they can detail a team of twelve $80k/year staffers to go and do a 6 month investigation and come back and propose legislation that would address any problems. But of course this is California, and legislating on nuts 'n' bolts quality of life issues for the peasantry is not what we elect our legislative knights errant to do -- they're there as anyone can tell you to pontificate on the deep philosophical, social justice, or x-risk issues of the day, or at the least as a springboard to national office. They don't have time to get into the muck on these difficult and plebeian issues.

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Deiseach's avatar

"but it is strange that only two companies so dominate the business. *That* is concerning, as it means competition is severely constrained"

That's part of my concerns here. If you're a patient on Medicare or otherwise don't have good enough insurance, then complaining about the infection you got or the dirty clinic won't do you any good, as your doctor is recommending you visit the clinic of Tweedle-dum or Tweedle-dee (where he has a financial interest, see the doctor in the article who was doing work for a clinic of both chains), the only clinic in your area is Tweedle-dee's clinic or Tweedle-dum's clinic, and dialysis is not like deciding to have laser surgery for your eyes or getting your boobs pumped up.

If the choice is "shitty quality of care" or "no care and I die", which are you going to pick?

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Carl Pham's avatar

I'm not generically opposed to "shitty quality of care" for the same reason I'm opposed to minimum wage laws: because low-cost low-quality care is sometimes all people can afford, and when you rule it out they are condemned to no care at all. That ends up being a case where the people who supported banning shitty care seem more concerned with their own sense of virtue than the actual outcomes for poor people -- sort of a gloss on the famous Anatole France quote. ("The law in its majestic equality, forbids rich and poor alike to sleep under bridges.")

My opinion on this was shifted by an argument some time ago on the troubled King-Drew Medical Center in South LA, which is notorious for two things: (1) a crappy standard of care relative to almost any other hospital in the LA area, and (2) serving a desperately poor and violent neighborhood with care that they would probably otherwise not get at all, or which would cost far more.

The argument pointed out that when you're really poor sometimes all you can afford is a crappy car, food that is a bit past its sell-by date, education by second-rate teachers, and medical care by the bottom graduates from second-tier medical schools, and nurses who were fired from better jobs because of addiction -- but this is all better than nothing at all, and if you lock off the second- or third-best quality options, what you really do is condemn people to no option at all (or quackery), which is not genuinely helpful. It's essentially the same as the argument against a minimum wage law, which is that the true minimum wage is $0, and that's what you get if you set the legal minimum wage above the economic value delivered by certain employees.

I have a mild personal experience in the area: once when I was pretty hard up I was compelled for complicated and irrelevant reasons to buy insurance against catastrophic medical care (a $250,000 ICU stay after a car accident say), the cost of which meant I had to forgo almost all ordinary cheap doctor office visits (like getting a check-up, or antibiotics for an infection). I resented the constraint on my choices, as I felt I'd rather take care of the ordinary stuff that affected my life in a more routine way and take my chances on the rare catastrophe.

One can of course argue, as the idealists do, that we should find a way to compel the wealthier to subsidize everything the poor need up to some level -- and the exact level is a matter of fierce moral and practical debate, which is just one of the reasons this problem has probably never been practically solved to anyone's satisfaction. It perhaps awaits the moment when all men's good be each man's rule, and universal peace et cetera. I'm just as eager for that day as anyone else, but I'm skeptical it can be done in the next few election cycles.

But at the very least, in the meantime, we can try to make sure that *if* it is economically plausible that a better quality per unit price can be achieved, the people who might think of ways to do it are not barred or discouraged from trying -- which circles back to the concern about too few operators in this space. That doesn't *sound* economically efficient, unless there are some Facebook-style network effect or electric utility economies of scale at work, which a priori makes little sense to me. Why *aren't* there competitors in the dialysis market, who offer different standards of care at varying prices, who say "don't go to the GM of dialysis (DaVita), come on over to the Tesla of dialysis (us) and get much better value for the price?"

I don't know the answer, but it seems like this is very worth knowing, and addressing it by legislation, if there is some reason rooted in law that causes this consolidation, would be a much wiser step to take than amateur voter micromanagement of how the existing dialysis operators choose to operate, something it seems much more likely to fall afoul of the Law Of Unintended Consequences.

By the way, that doesn't mean I thinks this proposition is wrong. For all I know, it coudl be bang on correct. The problem is more that I *don't* know, and I tend to think it's the kind of thing you couldn't know, unless you were in this business, had years of experience as patient or care staff. I can spend an hour or two researching it before the election, but the odds that I'll find out the truth are realistically very slight. Hence I'm inclined to vote it down on the grounds that this preserves the status quo, and if it is truly a dire situation encourages the proponents go to the Legislature, which has time and liberty and money *and* the ambit to look into it far more carefully than I can.

But I would also have no difficulty with someone who voted the other way because he or she was persuaded by experience that it was better than the status quo.

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eldomtom2's avatar

"I think it's neither here nor there what the profit margins are in the business"

I would have thought an obvious believer in the free market would want to ask "can the business afford this regulation".

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Griff's avatar

Why? If it’s a worthless regulation, why would you impose it?

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Carl Pham's avatar

I'm not sure what you mean by a "believer in the free market," so can't really say anything about that. And what I said is that the question "Can this business afford this regulation?" is not even in principle answerable by voting on the question.

People who have studied the cost of regulation intensely and honestly, because their livelihood depends on it, such as entrepreneurs deciding whether to go into a given business, have a very hard time answering that question in general. The idea that J. Random Voter can figure this issue out in the 20 minutes he might devote to the question before voting is laughable.

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Kayla's avatar

It's pretty funny that the union is calling their opponents Big Dialysis while the WSJ calls the union Big Labor. Big is bad!

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Griff's avatar

I can tell who you believe, but the rest of us do not.

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Wency's avatar

Just expressing some skepticism about that claim about DaVita having 10x the operating margins of hospitals:

HCA (largest public US hospital operator): 21.3% operating margin in 2021

DaVita (DVA): 16.0% operating margin in 2021

Now, maybe in CA the picture is much worse, but it doesn't sound like there is anything structurally making dialysis centers 10x as profitable as hospitals. Of course, most hospitals are non-profit, and I doubt that their operating income figure, if they even provide one to the public, offers a meaningful apples-to-apples comparison to a for-profit company.

Of course, when we talk about powerful healthcare corporations in the US, we're not normally talking about "Big Dialysis", we're normally talking about the "payers", i.e., managed care/health insurance companies. I think Kaiser (a non-profit) is pretty dominant in CA and reported $93bn in 2021 revenues. DVA reported $12bn. UNH is the biggest player nationwide and is roughly 3x the size of Kaiser.

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Griff's avatar

Good to see some facts, rather than ideologically-inspired rants. Thanks.

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BigOinSeattle's avatar

Pretty funny….oh lord I’m really not looking forward to this. I’m a Bay Area California voter and it’s depressing. Pelosi hasn’t had to campaign in years. And if the east coast has a black Whoopi Goldberg certainly we deserve a black Malia Cohen 😉

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jumpingjacksplash's avatar

Back in the day my parents knew an Irish (RC) Cohen, who couldn't get a job because all the gentiles thought he was Jewish and didn't interview him, and all the Jews invited him in and got a nasty shock in the interview.

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Peter S. Shenkin's avatar

I meant to write this earlier. H. L. Mencken says the following in "Thirty-Five Years of Newspaper Work", p. 168. He is covering the 1928 Republican Convention, in which Hoover was nominated. As I am sure you know, he was later elected. (Hoover, not Mencken!)

"One day we called on a curious character named Walter Cohen, who had been for many years the Republican boss of Louisiana. He was a man of color, but his authority over the white members of the Louisiana delegation was not diminished by the fact, and he delivered eleven of its twelve members to Hoover. Cohen turned out to be an amusing fellow, and was full of interesting tales of his political adventures. 'Imagine my situation,' he said, 'in the days when the Klan was running Louisiana! I was a Republican, I was colored, I was a Catholic — and my name was Cohen!' "

I always assumed that his ancestors had been slaves on a Jewish-owned plantation.

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Peter S. Shenkin's avatar

just decided to look him up. Walter L. Cohen High School in New Orleans was named after him and was set up as an all-black high school The schools alma mater appears on the web site of its alumni (https://www.wlcohenalumniassoc.org/), and makes interesting reading:

--

Alma Mater

By Elaine Davis-Hayes, Class of 1953

Cohen we hail thy name today!

In glory and praise and song.

We'll try to build thy fame, dear school,

As we go marching on and on.

​​

We love thy colors, yes we do,

Of Kelly Green and White.

With praise may they unfurl to thee,

To stand always for truth and right.

Cohen we hail thy name today!

In glory and praise and song.

We’ll love thy halls and walls, dear school,

Yes, whether near to us or far.

We’ll love the colors, yes we will,

They’re ever in our sight.

With praise they will unfurl for thee

And always stand for truth and right.

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Peter S. Shenkin's avatar

There's also an article about him in "Conservapedia' (a new one on me): https://www.conservapedia.com/Walter_L._Cohen. They state:

"Cohen's father, Bernard Cohen, was Jewish. His mother was the former Amelia Bingaman. Like his better-known compatriot Homer Adolph Plessy (1862-1925) of the Plessy v. Ferguson opinion of the United States Supreme Court, Cohen was a free black prior to passage of the Thirteenth Amendment to the United States Constitution. He was a Roman Catholic despite his Jewish heritage. He noted that he was part of 'the most-hated ethnic group and most-hated religious group by the resurgence of the Ku Klux Klan."

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descripter's avatar

If you had bothered to look at Bruce Dahle’s website, as I did for 2 minutes, you would see he prioritizes removing regulatory barriers to new housing. Those include the expensive solar panels mandated for every new home by Gov. Newsom.

I can’t recall why I signed up for this newsletter and hardly read it. But if this is an example of your thought process, it was clearly a mistake.

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Scott Alexander's avatar

Dahle is also good on housing, although I think the solar panel thing is a giant red herring only mentioned for anti-environmentalist cred. I think the most important thing is being willing to challenge/sue cities with local anti-housing policies, which Newsom has been great at and I don't really know how Dahle would do. As I mentioned, I am also partly voting as a referendum on the Democrat's performance, given the political realities.

Major warning (50% of a ban) for tone and insultingness.

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G. Retriever's avatar

Solar panels are not expensive. Solar panels are ludicrously cheap. Their main cost is permitting and installation labor, both of which are mooted if they're required as part of new construction. There is literally no downside to a policy like this unless you prefer to pay more for electricity and really like air pollution.

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Sarabaite's avatar

"There is no downside to this unless you really like air pollution" is a lousy argument and off putting to people who disagree with you.

I am in favor of solar panels that don't enrich China and aren't made with coal and slave labor.

I am not in favor of adding to the cost and upkeep complexity of new houses.

I am very much in favor of trees in cities. I am also not in favor of increasing transaction costs for selling those ancient buildings built in, oh, 2010.

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G. Retriever's avatar

Then buy your panels from First Solar.

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Nolan Eoghan (not a robot)'s avatar

The coal argument is spurious. Everything has to be built with energy including existing renewable technologies.

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Sarabaite's avatar

If we can't produce solar electricity without using Chinese burnt coal, we shouldn't do it. It's not like there are zero other options.

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Nolan Eoghan (not a robot)'s avatar

Going to have to reiterate that we need to use fossil fuels to build solar and renewables. Rabbiting on about China doesn’t change that.

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Sarabaite's avatar

If you are going to ignore that China makes cheaper solar panels because they have less restrictive coal use regulation, and therefore the whole greenwashing solar thing is a sham, I can't help you, but I don't have to listen to your promotion of solar either.

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A. Klarke Heinecke's avatar

Do you have solar panels yourself? My friends in Malibu bought their house with panels and it has been a nightmare, regulatory and otherwise. I don't understand it all. Weird liens because somehow the utility owns the panels. Expensive repairs.

After seeing what they are going through, there is no way I would ever, ever get subsidized solar linked to the grid. Maybe my own off-the-grid system, but that is not subsidized enough to make it pay off in my lifetime.

I ran the numbers on the "free" solar installation the utility offered for my winter home in Arizona and the insurance costs alone, not to mention my responsibility for maintenance, made it a dealbreaker.

I'm a fan of nuclear.

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Jacob Steel's avatar

I think requiring all new homes to come with nuclear power plants would be problematic.

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A. Klarke Heinecke's avatar

Illogical non sequitur. Analogously, few homes come with individual coal or gas or hydroelectric or even wind power.

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Carl Pham's avatar

But it would make HOA meetings *so* much more interesting. So-and-so at 1666 Sbagliato Lane has been neglecting the leak to her backyard baby fission plant and now there is a wisp of steam rising from it, which is making everybody's Geiger counter stutter excitedly. I vote we fine her $100 and invite her to the next meeting...um...if there is one...

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Deiseach's avatar

"There is literally no downside to a policy like this unless you prefer to pay more for electricity and really like air pollution."

I work in a building that has solar panels as part of the construction. So far, the only contribution they have made is exploding(!) due to an unseasonably hot day and needing to be replaced (thankfully, our organisation is not responsible for this, it's the owners of the building).

They haven't done a thing for our power usage, whether that is because they don't work or were installed incorrectly or what have you. If we want hot water and heating for the rooms, we run the oil-fired boiler and/or the electric wall heating. Solar panels were all part of the green craze in the 90s but it takes a lot between "make it law for all new builds to have solar panels" and "do the damn things actually work".

Now, if someone could work out rain-powered electricity generation, we'd be in clover!

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Nolan Eoghan (not a robot)'s avatar

Hmm. Odd, but solar has come on massively since the 90s.

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Carl Pham's avatar

So have iPhones. Is the universal solution to communication needs an iPhone?

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Nolan Eoghan (not a robot)'s avatar

That makes no sense. Either factually or logically.

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Carl Pham's avatar

Well, I'll see if I can spell it out using smaller words. Your argument was that Deiseich's experience with solar must be completely beside the point, because solar has expanded significantly since the 90s. That is, you implied that her experience must be so unique and rare -- because the use of solar electric has exploded from < 1% in 2000 to an incredible 3% a mere 22 years later -- that it is no useful guide at all to the advisability of enforcing the universal use of rooftop solar electric by legal fiat.

I pointed out that usage of iPhones has similar grown enormously over the same period, but implied only a fool would suggest that everyone be required to buy an iPhone to meet his primary communication needs on account of people are different.

Thus hopefully pointing out to you that the mere growth in adoption of a modality from negligible to noticeable says approximately squat about the advisability of making it universal. And implying that perhaps real-life experience (such as Deiseach is relating) is not credibly gainsayed by observing that other people don't have the same problem.

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Tossrock's avatar

Don't you live in Ireland? I think that might be part of the problem. Not a country noted for its abundant sunshine.

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Melvin's avatar

The fact that something is a good idea means you should do it, not that you should make it compulsory. Brushing your teeth is a good idea, but we don't have laws forcing you to do it.

Having solar panels on new builds is probably a good idea in most circumstances at this particular point in history, but I trust people to make up their own minds about the circumstances when it isn't. Like when your whole house is permanently in the shadow of the apartment block which some YIYBY insisted in building next door. Or if you live in Eureka CA where it's sunny for, like, six days of the year.

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G. Retriever's avatar

Leaving things to people's personal choice is sometimes appropriate and sometimes leaves edge cases that make people uncomfortable. For example, it's hard to see any reason why abortion shouldn't be left to the best judgment of a woman and her doctor, and setting arbitrary time-based limits on when that decision should be made would appear silly. Yet some people are bothered by the idea that some woman, somewhere, might make a decision they disagree with, and so abortions past 24 weeks are banned. Think of the solar-panel mandate like the abortion restriction, but in reverse and with rooftops instead of uteruses (uterii?).

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Paul Brinkley's avatar

I don't think it's hard at all to see why someone would want to intercede between a woman and her doctor, if that someone believes (a) that a fetus is a person, and (b) killing that person is morally wrong. To that someone, failing to intercede would be like standing idly by while a woman hires someone in a labcoat to kill an obviously innocent person.

You might, like many, disagree with (a), and believe therefore that (b) is irrelevant. Or you might disagree with both, or some other variation on that someone's premises that changes the conclusion. But your comment here seems to imply that people who are pro-life believe strawmanny things that I know they don't.

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G. Retriever's avatar

So I take it you support solar mandates?

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Jacob Steel's avatar

Well, you win the

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Carl Pham's avatar

Sorry, but that's just wrong. I've had multiple quotes for solar on my house, and the cost is never less than about 6% of the cost to construct the house from scratch (according to my insurer). So at the very least you are adding 5-10% (depending on where you are) to the construction cost of a house. And then there's the capital cost to the utility industry to absorb a very large number of extra rooftop solar installations -- don't forget, the way almost all of these work is that the grid is the "battery" in the system, that redistributes excess power minute by minute. That requires expensive capacity as well as monitoring and control apparatus, if everybody is doing it, and particularly in rural locations. Those capital costs will be added to rates, making California electricity even more sky-high than it is (60% higher than the national average).

This is one of those Marie Antoinette ("The peasants have no bread? Why don't they eat cake?") mandates, which seem like a no-brainer if you earn excellent Bay Area wages, but which are unbearable if you're among the several tens of millions of Californians who don't. Stuff like this is why the rich-poor divide keeps growing in California, because the Legislature is too beholden to wealthy coastal voters who really have no freaking clue what it's like to be lower middle class out in the boonies.

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Daniel Filan's avatar

NB: Lance Ray Christensen is also opposed to the California Math Framework which would make California math education totally suck. See, for example, this post and links for why it sucks: https://scottaaronson.blog/?p=6146. One part of the Framework you might like is the assertion that people are better at math when neurons in different regions of the brain are more connected, so the math curriculum should draw connections to other subjects. Tony Thurmond does not seem troubled by any of this, and has been in charge while the Framework was being developed. So I consider this an additional reason to support Christensen.

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Andrew Lang's avatar

If you support Newsom because he's being YIMBY, I really think you should support Bonta because he is backing Newsom's YIMBYism forcefully. I highly, highly doubt you'll see that sort of cooperation from Hochman, and without it a lot of this falls apart.

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Martin Glusker's avatar

Yeah I was gonna say this. Bonta has been even better on housing than Newsom.

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Deiseach's avatar

Have any of these houses/this housing been built, though? X may be great on YIMBYism but if the districts aren't building the housing, what good does that really do?

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Martin Glusker's avatar

I guess you’re right, but putting in place regulations to force municipalities to build housing, enforcing the law, and building the housing takes time. Im pretty confident that the actions Bonta is taking to sue municipalities to get them to comply with their RHNA numbers will actually increase housing.

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Andrew Lang's avatar

There are requirements for municipalities to allow for X number of units to be zoned for in the new 10 year RHNA cycle that is rolling out right now. This used to be a joke that cities would ignore/lie about but now Newsom and Bonta are giving it teeth - including enforcing the "builder's remedy" (very lax zoning across a city) in areas that don't have approved housing plans. You're seeing more "builder remedy" housing developments being proposed every day because of this, in otherwise terribly NIMBY cities like Santa Monica, Beverly Hills, South Pasadena, Huntington Beach, etc - and even when cities get out of the "builder's remedy" window they will have to allow for more construction - it's the only way out. More info here: https://www.latimes.com/homeless-housing/story/2022-10-24/santa-monica-housing-apartment-boom

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Tunnelguy's avatar

I voted NO on 30 because I hate jamming multiple different things into the same Prop, and electric vehicles are a red herring in dealing with climate change. I had no idea it was sponsored by Lyft, that's really interesting haha.

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toolab's avatar

What is #30 doing that you consider too many different things compared to #27 (or, depending on your meaning of "jamming multiple things", the more egregious #26)? Both #30 and #27 lead to more tax income and promise to use some of it towards some cause. Maybe you mean multiple topics, taxing the rich + environmentalism.

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Tunnelguy's avatar

That's a good point, maybe it was hypocritical of me to vote Yes on #27 and No on #30. I guess the funding part of #27 doesn't seem very alarming to me - dedicating money to "homelessness" seems like a very broad concept, and something California is already doing, so it's not much of a policy shift. #27 reminds me of reading that some states set up lotteries and sold it to the public with "the extra tax money will go to our schools", but then later on they cut the other part of the school budget so that the schools get roughly the same funding. Kind of a shady move, but ultimately our legislatures will have authority to rebalance the budget as they like, so some money being directed towards homelessness really doesn't seem like a significant policy change. On the other hand, #30 funding tax breaks for electric vehicles seems like a very specific proposal, that we weren't doing before, that I really disagree with.

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Daniel Filan's avatar

Also FYI for the Controller section you're including an explanation of the Board of Equalization for some reason.

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Scott Alexander's avatar

Thanks. I originally had the Board in there, but I couldn't bring myself to do good research on every Board race, so I took it out, but it looks like I screwed up.

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Alex Power's avatar

The Controller is the fifth member of the Board of Equalization.

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John (jc) Comeau's avatar

I voted NO on all the propositions, even though I was sympathetic to #1 and am all for relaxing control on gambling. But my reading of #27 was that it, too, had a poison pill in it, as does #26, funding law enforcement crackdowns on non-sanctioned activities. I didn't vote for any candidates, left them all blank except wrote in Nobody where that was an option. And voted No on all judges.

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BigOinSeattle's avatar

I almost always vote NO on them all because I assume that they are written by dishonest tricksters to grab more money and power. Remember high speed rail? Yeah…ashamed to say that I voted for this, I think it was in the 90s!!

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Scott Alexander's avatar

Just remember they can trick you by making a "NO" vote do something and a "YES" vote prevent it from being done - on Prop 31, a "YES" vote respects the current law as per the Legislature, and a "NO" vote changes it.

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BigOinSeattle's avatar

Damn them! Now I have to read the bloody things

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EmilyPigeon's avatar

I don't know if it's true, I recall arguments that this happened back in 08 with Prop 8-- people thought voting "yes" meant "yes to same-sex marriage."

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Sarabaite's avatar

Pro same sex marriage people have argued this, yes. This opinion isn't supported by polling at the time.

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Melvin's avatar

Presumably these votes would be cancelled out by a roughly equal number who thought that voting "no" meant "no to same-sex marriage"?

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toolab's avatar

I would assume the same _rate_ of voters would misunderstand, in which case the plurality opinion would lose if the misunderstanding rate is >50%, which is a long shot, but it will still lose signaling points (lower percentage on poll for the popular cause).

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RZB's avatar

HSR is important and will contribute to CA future development. I am glad you voted for it.

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BigOinSeattle's avatar

Not as presently constituted and financed it isn’t . We were promised high speed rail from San Francisco to LA in 10 years. They’re way behind and way over budget

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Lambert's avatar

The French contractors got so fed up with Cali politics that they decided to pull out and work with a more functional government instead. In 2018, they completed the first ever HSR project in Africa, taking passengers between Tangier and Casablanca in under 3 hours.

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Richard Gadsden's avatar

Abandoning it will not result in a better-planned HSR being built. It will just result in what has been done being abandoned.

I don't know how to create competent management (well, I do: make Alon Levy the absolute dictator of all transit design and construction, but, well, that's not going to happen) but I do know that giving up doesn't help.

The question to the ordinary voter is not "is this good compared to what we were promised / what should have been possible", but "is this good at the price we will actually pay compared to nothing at the price of all the contract breach fees"

[But also: what are your elected officials going to do about actually fixing the shitty building, contracting, permitting system that is making it cost so much and take so long?]

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Melvin's avatar

It might not be abandoned. It might just get completed and there'll be a high speed train, once a day, forever, connecting Bakersfield to Fresno, carrying thirty passengers a day, and costing a billion a year to keep running.

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Calion's avatar

I'm not sure you grasp the extent of this boondoggle:

"there never has been, at any stage of this living monument to political unseriousness and hubris, even a "little chance" that the S.F.-L.A. line would zip passengers between the cities in just 160 minutes, let alone deliver on the whole ragbag of laugh-out-loud promises that the state and federal political establishment delivered with a straight face." https://reason.com/2022/10/13/we-told-you-why-and-how-californias-high-speed-rail-wouldnt-work-you-chose-not-to-listen/

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BigOinSeattle's avatar

That sounds an awful lot like the sunk cost fallacy. What are the officials going to do about it? Probably what they’ve done for the last 20 years: make noise about how great it’s going to be if they only had another billion dollars or so, then enrich their politically connected cronies.

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Jared's avatar

The high-speed rail bond was Proposition 1A in 2008.

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Nolan Eoghan (not a robot)'s avatar

“ This proposition would mandate the California legislature to devote $1 billion more to public schools, earmarked for arts and music, than it is doing already.”

With potential amendments like this why bother even having a legislature?

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Scott Alexander's avatar

I do think sometimes the voters should be able to go over the legislators' heads if they've been captured by special interests or gone mad with power or something, but this clearly isn't a shining advertisement for the process.

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Erica Rall's avatar

The way most other states with ballot initiative processes thread the needle is by making allowing the legislature to amend or repeal a ballot measure after some number of years have passed. The idea being that maybe the current legislature has gone mad with power or is paralyzed by institutional inertia or something voters need to overrule then, but if the legislature is still wrong-headed enough to repeal the initiative for bad reasons after a few more legislative elections, then that's kinda on the voters for persistently voting for bad legislators.

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RZB's avatar

I voted yes on Prop 28 . Proposition 28 “Provides Additional Funding for Arts And Music Education In Public Schools. Initiative Statute”

Arts education is woefully underfunded in California schools

I know the focus on STEM has drastically reduced Art and Music in K-12 compared with courses available when my kids were in elementary school.

Art and Music are particularly important in K-6. Kids with technical and math ability will shine in grade 7 and above no matter what is done in K-6.

Financing California’s Public Schools $125B

California has 1,021 School Districts with 10,558 and 5,892,240 students. or $21,214.34 per student

California has 115,000 prison inmates and a budget of $14.2 billion or $124,561.40 per inmate

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drosophilist's avatar

"Usually people who become a major party candidate for President have some positive quality that has helped them get that far. Donald Trump is a master showman and figured out how to tap a vein of populist anger no one else could."

Saying that the ability to tap into populist anger is a "positive quality" is, um... uh... well, it's certainly an opinion!

[Insert gif of Emperor Palpatine saying: "Good... Good! Use you aggressive feelings, boy! LET THE HATE FLOW THROUGH YOU!!!"]

Yes, I understand that you're using "positive quality" in an instrumental sense, like, "Utter ruthlessness is a positive quality when trying to become a mob boss," but it's still striking.

Other than that, thank you for an interesting writeup and for making me lol at your description of the Zombie Kidney Proposition.

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Scott Alexander's avatar

Commenter banned for this after receiving previous warnings.

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Scott Alexander's avatar

If you understand how I'm using it (and everyone else apparently understood since they aren't complaining), what's the problem?

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Erica Rall's avatar

It parses better if you read "positive" here as meaning "affirmative" rather than "good". I.e. that a "positive quality" in this sense indicates a thing the candidate has, as opposed to a "negative quality" which would indicate a thing that he lacks. For example, "has never said anything offensive, or indeed anything substantive whatsoever" would be a negative quality, while "is loudly and consistently in favor of banning birthday parties" would be a positive quality in this sense.

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dionysus's avatar

Why is tapping into populist anger not good? When the masses have been ignored and disdained for too long, having a candidate aligned with their values is a win for democracy.

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drosophilist's avatar

Tapping into populist anger could conceivably be good if you *sincerely intend* to do something to address the causes of that anger. E.g., "I am tapping into the people's anger about unaffordable healthcare in order to win, and if I win, I will do my darnedest to promote affordable healthcare."

That's not what Trump does. He's just riling up people in order to get/stay in power.

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David Hugh-Jones's avatar

Didn’t he reduce illegal immigration and change the default and discourse on trade? Those seem substantive.

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Stephen Saperstein Frug's avatar

Apparently Jewish pirates of the Caribbean were in fact a thing:

https://www.amazon.com/gp/product/B001FA0JNW/?tag=charity48-20

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jumpingjacksplash's avatar

I don't understand how this never became a Mel Brooks film.

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Pycea's avatar

I would guess that Newsom doesn't have a candidate statement because they're only allowed for people who accept campaign spending limits, see https://www.sos.ca.gov/elections/candidate-statements. Which means he's spending over $9.7 million on this election.

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Scott Alexander's avatar

Huh, interesting, thank you.

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Steven Buss's avatar

Yep, Pycea is correct. See https://www.sos.ca.gov/elections/candidate-statements for the rules, and https://elections.cdn.sos.ca.gov/statewide-elections/2022-general/statewide-501-report.pdf for which candidates did or did not accept the spending limits. Newsom did not accept the spending limits.

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Maximum Limelihood's avatar

Why is he spending any money on this at all? It's not a hard election for him.

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Rebecca's avatar

I want to say maybe voters are still ticked off about his behavior during Covid (I sure am), but given that he won the relevant recall that probably isn’t it so… I don’t know. I suppose losing his own state would thoroughly crush any ambitions for President but he’s running against a Republican in California, not a serious challenge from the left, so he’s not going to; as you say it’s not a hard election. So… good question. Any idea if this kind of spending is normal? I can’t remember whether he has previously had statements.

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Martin Blank's avatar

Well my guess is running national ads and the better his victory in CA the more compelling case he has.

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Erica Rall's avatar

It sounds like he's been spending money running ads in other states, presumably to reach Californian who are vacationing in those states and certainly not to raise his national profile in preparation for a run for President in 2024 or anything.

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Melvin's avatar

Well, it's not like it's his own money. Part of his job as a California Democrat is to collect money from people who need to show their loyalty and disburse it to people whose loyalty must be bought.

There's a money tap, and you can't go round shutting it off just because it's useless. That's not how politics works.

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Carl Pham's avatar

Also proving your ability to raise gargantuan sums of money is the kind of thing that makes you a very credible candidate in the eyes of the party, of potential future donors, high-level allies, et cetera.

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Nick's avatar

My understanding is that he's spent a lot of his personal campaign funds advocating for Prop 1. Not sure how that interfaces with the spending limit rule but that could be it

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Richard Gadsden's avatar

Because he's raised the money and there's all sorts of legal issues if he raises it and doesn't spend it.

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Axioms's avatar

Newsom probably really needs House dems to do good in CA to keep his positives up for a presidential run. "Gavin saved the House" is a good slogan.

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Deiseach's avatar

True, but given what we saw in the recall election, he may also presume he doesn't have to bother with this because he's a shoo-in, and the election is only a ceremonial ritual to affirm his power.

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Sniffnoy's avatar

Hm, Proposition 1 it seems to me goes much further than keeping abortion legal. Maybe you should vote YES on it to prevent California from, say, banning human genetic engineering. :)

(Granted, genetic engineering is something of a scary technology, but it seems likely to me that the helpful uses would take off before the harmful uses...)

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jumpingjacksplash's avatar

That was literally the first thing that occurred to me - I can't see how you can read prop 1 without it legalising at least embryo screening, including for aesthetics, personality, sex selection and atypically desired traits (eg. deafness). Frankly, abortion is probably a side consideration.

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Calion's avatar

Is that how we want our law—our *constitutions*—to work? "The law doesn't mean what it says; it means what we want it to!"

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Calion's avatar

People will think (or say they think) in any way that they perceive will benefit them. That doesn't mean we should legitimize it.

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Mio Tastas Viktorsson's avatar

I'm not sure this addresses the substantive gripe that we shouldn't make constitutional provisions for every law we support.

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Lost Future's avatar

I will use this opportunity to once again plug Garret Jones' book 10% Less Democracy, which persuasively argues that the US should have less random elected offices, and more appointed ones. Treasurer, Insurance Commissioner, Attorney General (!), Controller and Secretary of State should be boring appointed bureaucrats, and not elected offices. In general law enforcement/judicial functions should absolutely, positively not be incentivized to play to the public. Fun fact, for a long time the US was the only country in world history to ever elect judges (we have since been joined by Bolivia in 2011).

For one thing, these offices aren't really 'accountable' to the public because for the most part 98% of voters don't know the differences between the candidates. The whole theory of democracy breaks down when you offer voters 57 different options for different offices- you hit decision & information fatigue.

In some Southern states the coroners are popularly elected. I'd love to know what issues are discussed during the campaign!

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BigOinSeattle's avatar

I think most coroners jurisdictions now have medical examiners but your point is still valid. As 18 Tiny Deaths tells it very few jurisdictions had MEs well into the 20th century

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Deiseach's avatar

Possibly it arose out of the historical functions? Coroner was an office under English law, and the United States inherited English law even after the Revolution.

Coroners didn't start as medical examiners, that became part of the office/replacement for the office due to the duty to investigate deaths:

https://en.wikipedia.org/wiki/Coroner#Etymology_and_history

"The office of coroner was established by lex scripta in Richard I's England. In September 1194, it was decreed by Article 20 of the "Articles of Eyre" to establish the office of custos placitorum coronae (Latin for "keeper of the pleas of the Crown"), from which the word "coroner" is derived. This role provided a local county official whose primary duty was to protect the financial interest of the Crown in criminal proceedings. The office of coroner is, "in many instances, a necessary substitute: for if the sheriff is interested in a suit, or if he is of affinity with one of the parties to a suit, the coroner must execute and return the process of the courts of justice." This role was qualified in Chapter 24 of Magna Carta in 1215, which states: "No sheriff, constable, coroner or bailiff shall hold pleas of our Crown." "Keeping the pleas" was an administrative task, while "holding the pleas" was a judicial one that was not assigned to the locally resident coroner but left to judges who traveled around the country holding assize courts.

...The person who found a body from a death thought sudden or unnatural was required to raise the "hue and cry" and to notify the coroner.

...In the United Kingdom a coroner is an independent judicial office holder, appointed and paid for by the relevant local authority. The Ministry of Justice, which is headed by the Lord Chancellor and Secretary of State for Justice has the responsibility for the coronial law and policy only, and no operational responsibility.

...The coroner's court is a court of law, and accordingly, the coroner may summon witnesses. Those found to be lying are guilty of perjury.

Additional powers of the coroner may include the power of subpoena and attachment, the power of arrest, the power to administer oaths, and sequester juries of six during inquests."

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bulb5's avatar

Coroners in some states serve as a last-resort check on law enforcement - they are the only local official with the authority to arrest the county sheriff. The "watch the watchmen" function seems important, and worth being electorally accountable, but combining it with medical examiner duties is weird.

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Erica Rall's avatar

Another way in which they can serve as a check in law enforcement is that they oversee and direct the process by which deaths are officially classified as resulting from homicide, misadventure, or natural causes. If the cops are trying to conceal homicides for some reason, e.g. to make crime stats look better, to corruptly look the other way for certain mob hits, or to conceal deaths due to police brutality or police negligence, then the coroner is one of the major lines of defense against this.

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Calion's avatar

Does this book explain *why* we elect judges? It's never made any sense to me.

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AntimemeticsDivisionDirector's avatar

Partial agree. A friend of mine is now registrar of wills for his county because there were no other candidates and he wrote himself in, intending it as a joke.

Strong disagree with regards to law enforcement though. Electing sheriffs can be a major safeguard against state aggression.

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numanumapompilius's avatar

Personally, I look at our society and wonder how anyone could possibly think the problem is that unelected bureaucrats have too little say over our lives. Especially with the glaring example of how state and county public health agencies ran absolutely roughshod over individual rights over the past three years.

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Calion's avatar

Are elected bureaucrats measurably better? ("Bureaucrats" specifically not including executives or legislators.)

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numanumapompilius's avatar

Depends on your meaning of better. I'll stipulate that they are, on average, less technically competent at the nuts and bolts of their jobs. But their bias is legible and they can easily be thrown out in the next election. And ultimately I'd rather have officials who incompetently effect the electorate's will than officials who competently work to frustrate it while hiding behind a veneer of technocratic impartiality.

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Pope Spurdo's avatar

Was the time that you spent studying these issues and candidates in an effort to make the best utterly meaningless decision that has zero effect on anything well-spent?

I vote NO.

I also don't vote, for the same reason. Whether they realize it or not, most people vote because it's the liturgy of our civic religion. Already having a religion, I don't need Our Democracy. And while my prayers might not affect the material world one bit, neither does my vote.

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Scott Alexander's avatar

I partly believe / pretend to believe / choose to act as if I believe that me doing things like this increases the general quality of governance through spooky correlations, see https://forum.effectivealtruism.org/posts/ySRfNKPecrCsbd8oN/can-you-control-the-past

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David J Keown's avatar

If Pope Spurdo reads that link and still thinks voting is a waste of time, does it decrease the general quality of governance?

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Pope Spurdo's avatar

After reading the link, I now think Scott's act of voting is _worse_ than a waste of time, as non-causal control may result in more people voting, and I judge the sign of dQUALITYOFGOVERNANCE/dVOTERPARTICIATION to be negative at VOTERPARTICIPATION(2022).

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Calion's avatar

I mean, Scott has a large enough audience that it might make some difference…

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Bardo Bill's avatar

Hmm. Trying to imagine a society in which everyone was a "civic atheist"; coming up with some pretty dismal scenarios...

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jumpingjacksplash's avatar

It depends what you're in to I guess. If you started getting elections with 4% turnout, that would be a pretty strong signal to the army/communist party/fascist party/anarchists/incumbents that they could overthrow the government without much pushback.

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Pope Spurdo's avatar

I wouldn't say that rejecting voting in a republic built on the principles of Enlightenment Liberalism requires Civic Atheism, for the same reason that rejection of Hinduism does not require atheism. In my case, it merely requires the rejection of the philosophical project of Enlightenment Liberalism. I still want to have civic institutions; I just prefer to choose those institutions that weren't invented in the bathtub by wig-wearing French and English dudes in the 18th century.

But I'm not here to argue the superiority of monarchism or fascism to representative democracy. My top-level comment was that voting and figuring out how to vote is not an effective use of Scott's time. The same can be said for a lot of things -- watching NFL football, playing vidya -- but we all know that we're goofing off when we do that stuff. We don't pretend that we're doing something important or meaningful. Not so with voting, where we are active participants in a liturgy. (C.f. Scott's post about the civic religion of the SF Pride parade).

Note that it's only voting and deciding how to vote that I think are complete wastes of time. I don't think that discussing ideas is as meaningless as voting. And Scott's case, of course, he has an audience that's large enough to contain persuadable California voters, so he potentially could shape outcomes. His writing may be meaningful; his individual vote is meaningless.

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Bardo Bill's avatar

I guess I don't see liturgical practices (in this broad sense) as a waste of time. There's more to life than instrumental rationality. Or, if you prefer, a more enlightend understanding of instrumental rationality would say that performative expressions of the value of civic responsibility - a "signal" of its "virtue," if you will - will lead to a stronger civil society, which is good for me, a self-interested abstract subject or whatever.

I'm, uh, very glad you're not here to argue the superiority of monarchism or fascism. But then if you're just talking about "effective uses of one's time" then I don't think there's any reason to dismiss liturgical practices (again, just taking this to mean: public expression of the value of civic responsibility) as "ineffective." Such gestures are important in any society. (Though that's not to say that voting is the only such gesture...)

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Pope Spurdo's avatar

I agree that liturgical practices are not necessarily a waste of time. But we should be clear about what we're doing. There's social utility to getting together at the school/church and standing in the voting/communion line and receiving our "I Voted" sticker/Ash Wednesday ashes. But the idea that our votes themselves mean anything is false, and sometimes harmful. My sister-in-law had a strained relationship with her father for a while because he was voting for Trump and she relied on Obamacare for treatment of a serious autoimmune condition. The false belief that my father-in-law's vote mattered, that it actually did harm to my sister-in-law, that disrupted the harmony of the family. Many such cases!

The reason that I'm not advocating for monarchy or fascism here is that it's off-topic. (I would, in fact, prefer Franco's Spain to Newsom's California, and it's trivally true that some monarchies are superior to some democracies). I will say that - all else being equal - I prefer a form of government that doesn't cause rifts in families over meaningless votes.

I made my original comment in the context of Scott's interest in Effective Altruism. Let's say it took him an hour to study up on the issues and candidates and decide how to vote. That's an hour that he could have seen a patient or two, netted a hundred bucks, and fed an African family for a week. In terms of policy impact, his vote accomplishes far less, even if he votes the correct way.

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Morgan's avatar

I understand if you don't want to get into an off-topic discussion that will take over the thread.

But can you elaborate on your reasons for preferring Franco's Spain to contemporary California?

While I very much dislike Newsom's draconian Covid lockdowns, they really do seem to objectively pale in comparison to Franco's mass imprisonment of his accused political enemies in horrific conditions.

A *much* higher percentage of the Spanish population was imprisoned for political crimes under Franco in the '40s than in the Stalinist USSR at the postwar height of the Gulag system.

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Pope Spurdo's avatar

Sure!

Franco's enemies were Communists, and Communists deserve to be jailed.

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Matt H's avatar

What would you say is the best argument in favor of voting? Or, in which kinds of elections do you think your individual vote is MOST likely to have an effect on the outcome?

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Pope Spurdo's avatar

The answer to the second question is obvious, no? There needs to be a chance of influencing the outcome of the election significant enough to justify the cost of voting. At minimum, my vote must have a greater chance of changing the outcome than I have of dying in a car accident on the way to/from the polling place.

Let's put some numbers on it: probably about 13,000,000 people will vote in the upcoming California elections. Let's also assume (against evidence) that 95% of those voters are locked in equally for the R and D, so it comes down to 650,000 persuadables, who could go either way, i.e., their votes could be simulated with fair coin-flips. The probability that they'll split 325,000 to 325,000, leaving it up to me, is about 1 in 10,000. For the mayor's race in a town of 10,000, it's about 3.6%. In a community of 400, it's 18%. Now assign values to the utility of each outcome, figure out your opportunity cost of voting, and plug and chug.

But I have a more fundamental problem with voting: no one has given me a satisfactory explanation for what a vote _is_ in an ontological sense. The question resolves simply in the case of casting the deciding ballot: your vote gives you some measure of moral responsibility for everything the official does (or at least those things that his opponent would not have done). But what is a vote that makes no difference to the outcome? Joe Biden has been fond of noting that he received 87 million votes (or whatever the number is), implicitly arguing that he has broad support for his agenda. Would he moderate his policy goals at all if he had won by a narrower margin? We'll never know, so we'll never know whether a meaningless vote for Biden makes the voter morally responsible for Biden's decisions.

More broadly, voting asks too much of morons, and by "morons" I mean "everyone." We all have our areas of expertise, and I would defer to Scott on any questions about psychiatry. But he and I are both morons (I'm guessing) when it comes to trade policy with Cambodia. (I had to look up U.S.-Cambodia relations just now because I had no idea how well we get along). But I think that we own the moral responsibility for everything that our preferred candidate does. We don't get to decide that we only want moral responsibility for our favored issues; if Biden's trade policy causes poverty in Cambodia, his voters own that. Given the size of the government, it's literally impossible that the people we put into power aren't going to do immoral stuff.

We might get around this problem by adopting a value system that says that it's moral to put someone into power if on balance, based on the information you can reasonably be expected to obtain, he'll do more good than bad. For Catholics, it's not so simple: morality isn't a balance. We don't put good deeds on one side and hope they're heavier than our bad deeds. Any evil separates us from God. Any sin can keep us from Heaven, no matter how good the rest of our lives are. We can be sophisticated about it and consider material versus formal cooperation with evil, and we can try to decide how remote our material cooperation is. But that usually kind of a wank, because we generally figure out a way to call our actions and their bad consequences "remote."

All of this is to say that I see a lot of evil lurking in voting. I'm taking on moral responsibilities that I probably don't realize. I know, as a matter of virtual certainty, that any major-party president I vote for will do some evil that I can identify in advance. I don't want him to interpret my vote as support for his evil Cambodia trade policy... and he probably will. So by voting, I haven't changed the outcome of the election, but I might give the winner encouragement to do evil things. No thanks. I'll stick to voting, if at all, on extremely local issues with low risk of evil.

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boop's avatar

Aren't you sort of ignoring the whole... way in which a system is comprised of small parts? Take consciousness. A single neuron firing for years may be completely meaningless and even redundant, but if enough of them cease, you're gone. Would you tell that neuron to go ahead and stop, it's totally pointless after all? Even the incredibly overused metaphor with "the ocean is made of tiny drops" holds. Your vote might not mean anything in and of itself, but that's not the point - like marching in a protest or reviewing or rating a text or piece of media, it's the emergent general consensus that does anything at all.

Secondly, re: your "opportunity cost" argument, you've spent at least a few minutes reading this post, some comments, and responding. At this point, surely voting would have taken a similar amount of time. At the very least, I sincerely doubt voting would be a greater waste than anything else people waste time on. Perhaps it's an hour someone could have spent being productive, but it's also an hour someone could have spent vegetating in front of a screen or scrolling social media; why is the calculus based on the belief that time would have been spent better, not worse?

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Retsam's avatar

As a bit of a "civic atheist" myself, I'm not so sure. If only 4% voted, but they were the 4% that really understood the issues (maybe the sort who wrote entire blog-posts on the issues), is it really hard to imagine that that might lead to better outcomes than the "everyone votes, no matter how little informed they are"?

Obviously there's failure states here (particularly if you tried to enforce this - it would be hard to not make it a filter for a particular race/class/etc), but I'm also generally mystified by the extent towards which people actively push the opposite direction and tell everyone to vote, no matter what.

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Bardo Bill's avatar

I don't even know what it would mean to refer to the "4% that really understood the issues." Politics is mostly about values, not having some store of objective knowledge, whatever that would mean. And values will shape your understanding of the issues.

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Retsam's avatar

A ton of Scott's analysis here is not just "values". It's stuff like reading close enough to realize that "California Solutions To Homelessness And Mental Health Support Act" is mostly about legalized, taxable sports betting. Or that the "wildfire prevention" bill is mostly about Lyft wanting to save money on car purchases. Or the extended discussion in these comments about what a tax on flavored tobacco products really means.

A lot of these propositions seem to be banking on the fact that a lot of people are just going to have a very cursory understanding of them, and in fact are crafted to maximize that. It really seems like these are designed to appeal to someone who says "Oh, I like wildfire prevention, music, homelessness and mental health, LGTM" even if some of these bills will very likely have effects that go against the values of the person voting for them.

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Alistair Young's avatar

Well, in my fictive treatment of such, it mostly came out along the lines of "Imagine a senior civil servant sipping a glass of sherry. Forever."

(Minarchist technocracy via Sir Humphrey Appleby. Could do worse.)

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Greg Janza's avatar

Sadly, your voice becomes muted and meaningless by not voting.

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McClain's avatar

This is a fully general argument against emergent properties and socially-constructed anything. It proves too much. And suggests a certain poverty or miserliness of temperament

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Pope Spurdo's avatar

Okay, but I'm still not gonna vote.

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McClain's avatar

Ok, you do you then. Perhaps it's just as well. I'll be voting in NH. Cheers!

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aps's avatar

But in some way have to coordinate so enough of the population votes that democracy keeps working. This is a coordination mechanism, not a religion, though I suppose religions can be coordination mechanisms too.

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EmilyPigeon's avatar

"Meanwhile, Brian Dahle is a farmer and California state senator. He seems nice, he is moderate by Republican standards, and I enjoy the way he generates artwork from prompts"

Nah, I'm writing in a vote for GPT-3.

Also, does the kidney one account for good versus evil kidneys?

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Melvin's avatar

Mostly this just makes me glad I don't live in California. The idea of needing to navigate, at each election, a bunch of propositions which are all called "Proposition Support Fluffy Kittens" but which inevitably turn out to be an incomprehensible maze of legalese designed to benefit some bizarre confluence of shadowy special interests, seems awful. I think I'd just vote no to every proposition on principle.

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skybrian's avatar

On the other hand, figuring out what propositions mean is easier and more fun than figuring out which people I don't know are best qualified for a job I don't understand well. (Particularly for local offices, where there's little information online about them.)

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Melsya's avatar

This is my overwhelming feeling every time I vote. Weighing the reasonableness of actual, concrete laws is way less annoying than looking through a dozen campaign websites just in case there's someone who roughly agrees with me.

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Carl Pham's avatar

Why worry about it to that degree? This is like political feng shui, trying to make sure your County Recorder's ponytail is aligned along true magnetic north and the crease in your Senator's pants points in the direction of the winter solstice.

The political machine is far too inefficient and creaky to achieve anything like the ideals the candidates for office routinely bleat about. You can assume none of them will ever achieve 1/1000 of what they say are their ideals, even if they genuinely try.

So take the easy way. If you know something specifically evil about a person, vote against him. Same if you happen to know something specifically wonderful. Vote for or against based on political party, too, because party strength has a real and lasting impact, whether it's at the national or local level, and you probably know pretty well what each party stands for. Beyond that...there is usually some value in continuity, because people do get better at any job the longer they're in it, so I tend to support incumbents if no better reason interferes.

Since I have very low expectations of the quality of government I'll get, I'm not really ever very disappointed. I don't live in Soviet Russia, 16th century France, or modern China, so that makes me pretty happy. It's a long way from Paradise, but that's no surprise at all. Is it better than New Zealand or Norway? Eh. Maybe in some ways, probably not in others.

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David Hugh-Jones's avatar

A lot of people do just that. The default position on most propositions is No. I agree it seems like a dysfunctional system though.

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Carl Pham's avatar

That's pretty much what I do, although every now and then there's one that's worth supporting, like Prop 209. You can usually tell these by the fierce opposition they get from the political establishment.

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Kenny Easwaran's avatar

In Texas they aren’t that sophisticated. They just say “this ballot measure funds roads more” and people vote for it.

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Ivan Fyodorovich's avatar

"Somehow Chen has endorsements from the LA Times, the San Francisco Chronicle, and the San Jose Mercury. I don’t know if this many California papers have ever endorsed a Republican before."

Every cycle I've followed, they seem to find one non-Democrat to latch onto and endorse. In 2014 it was Republican Pete Peterson for Secretary of State. In 2018, it was independent (and ex- Republican) Steve Poizner. I'm curious if this is because they want to encourage non-one party rule, or just because their endorsements of other Democrats are more credible if they include one Republican in the mix.

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CleverBeast's avatar

Consider also option 3: that around once every cycle the Democrats nominate someone so comically inept, and the Republican nominee is so decent, that even liberals go red.

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Carl Pham's avatar

Well, it allows them to say "some of my best friends are Republicans!"

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Rebecca's avatar

Re: Secretary of State - do either of them discuss mail-in ballots? I have read enough historical accounts of machine politics and other shenanigans around voting to view our current system as dearly won and not to be sabotaged, and it’s very clear the new system has no safeguards at all against any of the standard methods of vote-buying or otherwise compelling specific voting patterns. I am very uncomfortable with the unwillingness of our current California political establishment to admit this might be a problem and would probably go single-issue over it for Secretary of State. Any sign the challenger thinks it’s an issue?

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bulb5's avatar

Are you saying you think vote-by-mail is more vulnerable to vote buying or intimidation? I agree that that's possible, but it seems to work fine in states like Oregon. You just have to do a better job enforcing laws against those things that I'm sure exist.

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Yug Gnirob's avatar

Buying is probably even, but potential intimidation will always be higher in an uncontrolled setting. In-person voting has a booth with a curtain that only one person can enter at a time; mail-in ballots have the potential of someone standing over your shoulder watching what you mark.

Same with Zoom calls. https://www.youtube.com/watch?v=xgz3Tx69zXk

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Calion's avatar

My God, that's horrifying.

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Colin C's avatar

I think buying is worse too - you're more likely to try to buy a vote when you can actually observe how they voted. Otherwise, someone could accept your money and not follow through, and you have to way to check. But that video is pretty crazy.

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AntimemeticsDivisionDirector's avatar

When I was first in college I voted via absentee ballot for a few years. I stopped doing that when one year I received two ballots for no apparent reason. It occurred to me that even in the absence of malice I was trusting quite a bit to the the competence of both the postal service and whatever peon at the county election office was responsible for recording things, and really I'd just rather put the thing in the machine myself. This was well before voting by mail was a matter of general public controversy.

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Kenny Easwaran's avatar

I do think it’s a potential problem for people in troubled family situations. I haven’t heard any evidence of anything outside the household.

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jumpingjacksplash's avatar

It's hard to imagine that harming Republicans in a general election. Battered spouses/kids getting their ballots filled in for them who are die-hard Republicans, but their Liberal dad is stopping them.

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Melvin's avatar

Are you basing that on anything other than stereotypes?

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Alex's avatar

Aren't stereotypes what you would ideally based a hypothetical generalization on?

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jumpingjacksplash's avatar

No.

For what it's worth, I'm not convinced that the Republicans could gain a non-trivial number of votes like this, and I'd wager based on stereotypes (psychology's own hard-wired empiricism) that the bulk of mail-vote fraud is people getting their ballot filled in with basically who they would have voted for anyway.

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Yug Gnirob's avatar

What would evidence even look like? What penalties are in place for intimidating a mail-in ballot that would convince people to make the accusation?

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Kenny Easwaran's avatar

It would look like people on a Tumblr form writing anguished posts saying "My abusive husband made me get out my ballot today and fill it in while he was watching and said he'd kick me again if I didn't vote for (insert politician)" or it would look like someone writing a letter to the editor in their local newspaper saying "at work today our boss told us that anyone who brings in their absentee ballot and shows it filled out with a vote for proposition Z gets a $100 bonus". Whether or not there is an actual legal remedy available, if it's going on in any significant numbers, you'd expect some fraction of people to complain about it publicly, even if anonymously. Evaluating how many of these complaints are real would of course be difficult. I do expect this must be a real thing to *some* degree, just as at least once in a while someone will go cast a ballot in someone else's name who they know is not voting. I even think this would be more common than that sort of fraud. But I haven't heard of any significant number of complaints (and I would expect that union activists and shelters for domestic abuse victims and various other centers like that would want to catalog at least some such complaints against some such individuals, if there are many).

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None of the Above's avatar

I think mail-in ballots have a lot of opportunity for soft forms of influence that aren't quite coercion--we all sit down and fill out our ballots, and nobody's going to fire or beat you up if you vote the wrong way, but people will notice and comment on it and maybe you find it easier to just go along with how everyone else is voting. I've always thought the domestic violence version of voter coercion was a bit silly, in the sense that it probably can't have any noticable impact on the election and also that people having their votes coerced this way would probably list "can't vote the way I want" as item #100 on their list of ways their life sucks.

Mail in ballots also make a lot easier to do vote buying, but in order to have a big impact on the election, you need to buy a *lot* of votes, which means a *lot* of people who can blab about it to journalists, the other party, the FBI, etc.

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Metacelsus's avatar

Is there anyone who does this for Massachusetts?

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Bullseye's avatar

Is the missing period at the end of the paragraph on Howell deliberate?

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Bullseye's avatar

The 1872 anti-gambling clause refers to "cards, dice, or any device"; how is a slot machine not a device?

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Dweomite's avatar

I would guess the reasoning is that slot machines are not a "banking or percentage game". (But I am only guessing.)

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Muskwalker's avatar

I think the segmentation of the clause would be "any banking or percentage game played with cards, dice, or any device", i.e. only the card/dice/device games falling under the categories of 'banking games' or 'percentage games' are affected here.

(And what games are those?) A page that came up in Google (https://www.egattorneys.com/illegal-gambling-penal-code-330) describes these categories:

"For purposes of the law:

- a "banking game" is any game where a bank or house collects from the losers and uses the money to pay the winners; and

- a "percentage" game is when the house takes a "rake" or percentage of the bets for profit."

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Procrustes' Tongue's avatar

Interesting, so is roulette only banned under this law because it is explicitly called out?

If so, I'm surprised no one has invented shmoulette, where you spin a 37-sided top with numbers and green or white colors on each side, and make bets about where it'll land. Trust me bro, it's definitely not gambling according to california law.

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Muskwalker's avatar

Wikipedia seems to suggest this has already happened:

"In 2004, California legalized a form of roulette known as California Roulette. By law, the game must use cards and not slots on the roulette wheel to pick the winning number."

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toolab's avatar

Interesting "sh-" prefix that I have never seen before reading OP. Is it something created in this post, specific to this community or something else? I assume it's for "sham" but I don't know.

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Misa Kai's avatar

It's not specific to any community. https://en.wikipedia.org/wiki/Shm-reduplication

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Bullseye's avatar

Why wouldn't slot machines be banking games under that definition?

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Muskwalker's avatar

It looks like the distinction is that it is not a mechanic of the game itself—unlike in some of the specifically named games like Faro.

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magic9mushroom's avatar

>He wants to “investigate” Fauci and the CDC

There's a case to do that re: gain of function (though that's more the NIH than CDC IIRC).

Whether that's what Meuser intends to investigate them for, I know not.

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Kenny Easwaran's avatar

Fauci is the head of NIAID, not NIH or CDC.

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magic9mushroom's avatar

I've heard his name come up in association with the illegal GoF funding, but I could be misinformed I guess.

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Kenny Easwaran's avatar

Yeah, I would not be surprised if there is some grant somewhere in NIAID that has been involved in something that is problematic (but unfortunately perfectly legal). However, because he's attracted a lot of attention, people who want to hijack the real cause of avoiding GoF research in order to satisfy their personal vendetta against Fauci, from his role as the public face of covid response, have then attached his name to all of it, or focused on the small amount connected to him and made it stand in for the more significant things done by others.

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magic9mushroom's avatar

Yeah, reading a rundown of the Boston "let's make a SARS-CoV-2 with Omicron's infectivity and the original's lethality", it was funded by NIH and NIAID.

I vaguely recall hearing that someone, maybe Fauci, was using a creatively-narrow interpretation of what is and isn't GoF in order to fund GoF without the legal issues of officially funding GoF; that is what I mean by "illegal GoF funding". Not super-clear on details, though.

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Sarabaite's avatar

I take a firm stance to not get involved in the democratically determined political choices of another population, at least as applicable to that population's domestic affairs, so I try not to care what shenanigans CA is pulling (except where they attempt to drive choices for the whole nation) in any particular year.

But this was both amusing and a useful reminder that Scott is still reflexively a Bay area liberal even when I would rather he was not.

I second the request for contributions from commentariat in other parts of the nation.

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Cato Wayne's avatar

The dude voted No on #1 (abortion) and taxing the rich. Huh??? Do you realize how nuts people have to be to run for R in CA? Half of these R think Trump might’ve won the election…

I live among “Bay Area liberals”, and Scott is reflexively not that. Unless you meant a well-educated classical liberal, which surely you did not.

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Sarabaite's avatar

I'd rather you didn't take it as an attack on Scott.

I am often surprised by just how liberal/progressive his politics are, as his thought process is generally rational and well thought out. It's a good reminder that a) not all rational people think alike and b) there are rational sorts on both sides of the aisle.

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Scott Alexander's avatar

This seems sufficiently contentless and detracting from the discussion that I'm going to ban this person, feel free to criticize this decision if you'd like.

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avalancheGenesis's avatar

It woulda been a fairer control group to actually fill out my ballot before reading this post - but at least from what I knew before reading (looks like not much info changed since the summer elections?), I'm over 90% confident that I'll end up bubbling almost all the same bubbles as Scott. Only disagree is on 27 - my version of "vote to indicate level of mandate for inevitable victory" also includes not endorsing misleadingly-named-and-advertised things. (The "Inflation Reduction" Act also pissed me off for same reason.) This doesn't extend so far that I'd actually vote against an on-the-merits good thing just for the bad messaging, if it looked like it might be competitive...but as you note, #CAVotingLol, so whatever.

On that note, genuinely conflicted regarding Governor. I voted for Dahle because "well obviously Newsom will win anyway, doesn't matter, useful to signal support for the rare shiny Sane Republican when opportunity presents". But now the dog's actually caught the car, and I'm like oh, huh. Odds for Newsom are still good anyway, but I genuinely don't care much for Governor Vacuous Greathair. On the other hand, housing is so critical that I'm pretty willing to overlook various deficiencies if it means encouraging a YIMBY champion. (I feel this same way about Senator Scott Wiener). I'd likely vote for Dahle again in the counterfactual where some other Democrat had somehow beat out Newsom.

>The sponsors of this proposition have vowed that Californians will never know peace until it passes: our choice is surrender, or binding our descendants to a war that will last through generations.

Hey, this worked pretty well for The Legend of Zelda franchise. I'd play TLoZ: The Kidney One.

Anyway, thanks for giving me the perfect excuse to get off my ass and go fill out that damn ballot right now instead of Real Soon Now.

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Level 50 Lapras's avatar

I actually did fill out my ballot beforehand, and I was surprised how many places I differed from Scott in, given that we have similar political sympathies.

Prop 1: YES

Prop 27: NO - Still can't believe Scott endorsed this. He must REALLY love prediction markets to ignore all the usual reasons to vote against these things.

Treasurer: I didn't bother researching anything and just voted R as a protest. In retrospect, I think I'd vote D or abstain.

Attorney General: D

Insurance Commissioner: D

Superintendent: I didn't bother researching the race and just abstained out of laziness.

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avalancheGenesis's avatar

1: Prefer to signal against costly symbolic signalling games. Especially annoyed since it's not that difficult to imagine having that vote dug up someday as part of a smear campaign..."X did(n't) vote for enshrining abortion in the California Constitution, heretic!" Hoping things don't get that crazy, but we'll see.

27: Yeah, I think Hanson Markets are interesting, but that seemed like a kinda specious reach rationalization.

Treasurer: wanted to keep my vote consistent from summer. Scandals suck, but if someone's unusually good at the job, they're unusually good at the job. Competence is rare and should be rewarded.

AG: I __really__ don't like Bonta's endless grandstanding and faffing about on social media. (Used to be subscribed to the AG newsletter, it was embarrassing.) Helping further weaponize the financial system against state-disfavoured groups also leaves me uncomfortable, after what happened in Canada earlier in the year. Also lots of tendentious rigamarole about greedflation, which, yeah, lol. The pro-YIMBY stuff is excellent...but ultimately it just didn't feel right being that single-issue for a guy whose other enforcement priorities I genuinely don't much care for.

IC: Voted against Lara in summer, voted against again. Not sure why more attention hasn't been paid to skeevy financial dealing with insurance companies, that seems pretty low-integrity and directly disqualifying for the job role?

Superintendent: Haven't been impressed with most of what Thurmond's done during his tenure. It wasn't, like, San Francisco School Board bad...but like Scott says, mostly just the same old usual throwing money at useless solutions. We can do better.

Also ended up voting not to ban flavoured vapes - years of subsequent research (like linked in the comments) seem to show it really doesn't meaningfully attract kid users, but does significantly help smokers reduce or quit. That's a clear utility tradeoff that I'm happy to bite the bullet on. Unclear if Scott ended up changing his vote or not, though, so perhaps it isn't a disagreement.

Otherwise I went straight Scott. I think most votes woulda eventually been the same after I got through researching...but I do appreciate avoiding a couple Rs that Scott notes have some reservations about the 2020 election. Not the sort of extra research I'd have bothered to do (yeah, lazy, but cmon, already spent like 8 hours on the damn ballot). Election shenanigans don't freak me out as much as most people, but if the candidate isn't that interesting anyway, then I see no compelling reason not to vote inevitable D. Low bars and all that...

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David Walker's avatar

Two points:

1) It's silly to address a subject which will interest only Californians. I'm in Australia. What's the point?

2) This was disarmingly funny and smart and high-quality humour, I chuckled a lot and would vote for it in an awards ballot. You should do it for the other 49 states and Puerto Rico too, as well as Australia's six states and two territories and its federal elections.

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Scott Alexander's avatar

ACX sponsors an Australian lobbying organization - I'm happy to take their suggestions. Right now most of what I know about Australian politics is not to mess with Big Emu.

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David Walker's avatar

Solid start.

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Mystik's avatar

I think that a lot of Americans, regardless of whether they're in California, are pretty aware of California politics. It's sort of the standard example for "a liberal state," so it comes up a lot what new policies they're doing/what their politicians are up to. So, it at least does make a bit of sense for a general american audience, though maybe not a global audience.

Also, there's a bit of voting theory going on here right? How do we weight scandals vs policies we like, do we vote for a position when the winner is obvious but we dislike both candidates? I think these questions, which are at some level being discussed, are pretty universal across democracies

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Jason's avatar

CA's dominance in the media as the example of "blue states" really skews perceptions.

CA is a special kind of western US crazy. There are lots of normal blue states, like NY, MA, IL....these states certainly have problems but they are quite different from CA.

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Paul Botts's avatar

California is also uniquely consequential in the prosaic ways, being by far the largest state population and by far the largest state economy. Google tells me that at the moment CA by economy would be the 5th or 6th largest nation in the world; 1 in 9 Americans live there. I'm not in California and have never lived there but it's the one state besides my own whose politics I follow slightly, just because of its significance nationally.

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Chris's avatar

Those two points are somewhat contradictory, at least insofar as you don't consider Scott's occasional posts pointless in which the humour is almost exclusively the point :)

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David Walker's avatar

You could be onto something ... ;-)

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Chris's avatar

Got it :)

Didn't quite cross the ACX-specific irony detection threshold

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David Walker's avatar

Yeah, my fault. I broke my own rule never to use this sort of deadpan humour in comment or social media threads. It just doesn't come across.

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Chris's avatar

I feel it's even worse on here, because there always seems to be at least one person saying smth that sounds like it should be a joke, but who is completely serious.

Hence the "ACX-specific threshold".

I had actually briefly considered that you were joking, but I think I was caught in a false "either the entire comment is a joke, or none of it is" dichotomy :D

And the second part seemed to be clearly genuine, so...

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Auros's avatar

Rob Bonta is the single most YIMBY person in the CA executive branch right now, for whatever that's worth to you. He set up the CA AG office's Housing Strike Force, and has used it to good effect.

https://www.sfchronicle.com/politics/joegarofoli/article/california-housing-rules-17188267.php

He also entertainingly smacked down Woodside when they tried to declare themselves a "mountain lion sanctuary". (To be fair, I think they would've lost that fight no matter what... But Bonta took them down _with style_.)

https://twitter.com/agrobbonta/status/1490401800905580549

https://www.latimes.com/california/story/2022-02-06/bonta-woodside-mountain-lions-housing

It's a damn shame that Malia Cohen ended up as the Dem on the ballot instead of Ron Galperin, the LA Controller, who was running on an "abundance liberalism" type platform. He's been harshly critical of how LA is wasting affordable housing funds, and his ideas of what they should be doing about it are good. (He just hasn't had cooperation from the Mayor's office or the city's legislative branch.) He'd be a solid future candidate for Gov.

https://www.nytimes.com/2022/10/23/opinion/los-angeles-homelessness-affordable-housing.html

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Auros's avatar

My feeling was that if Woodside really believes mountain lions are too important to allow construction of any _new_ homes in their city, they should take that logic seriously and start demolishing the existing homes.

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Clutzy's avatar

Big whiplash on that Newsome turn.

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David Hugh-Jones's avatar

Overall comment. The discussion here is very thoughtful and informed. But the Propositions and candidate platforms are not written as if the electorate were thoughtful and informed. If we assume the writers knew what they were about, then this enjoyable bit of democratic deliberation is not representative of how the whole system works. It’s fun for hobbyists, but it might distract or fool you into overestimating the quality of the democratic decision process.

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Andrew Edstrom's avatar

What about your local ballot? I’d be really interested to hear what you thought of all the candidates running for Oakland’s Mayor.

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Aaron's avatar

If you accept that housing is by far the most important issue in California - and it is - then you should vote to re-elect Rob Bonta.

Why? Every eight years California has a process where some incomprehensible formula assigns every city in the state a certain number of housing units, and then the cities have to create plans for how they’ll get that many units built. This process is called the Regional Housing Needs Assessment (RHNA).

However, historically cities would just bullshit their plans - claiming that ludicrous housing projects would come to fruition. For example, they might claim that a church is going to be demolished and replaced with 200 units of low income housing with 100% certainty, despite the fact that the church had no plans to actually do that. The state would simply rubber stamp all these plans.

But in the last couple years, new state laws have dramatically ramped up the RHNA requirements and the penalties for violating them. Planning for the next eight year cycle is concluding right now (different areas have deadlines which differ by a few months) and the state department responsible for reviewing these plans has done a 180 and is now reviewing them with a fine tooth comb, rejecting the vast majority of them.

The Attorney General is responsible for suing cities who refuse to cooperate - something Rob Bonta has done a number of times already while publicly signaling that these lawsuits will continue. If the AG didn’t want to support team YIMBY, he could let these cities off the hook and crush much of the progress we have made liberalizing housing development in this state.

So for that reason alone I am willing to look past everything else Bonta has done and, even though I usually vote Republican, cast my vote for him.

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Carl Pham's avatar

Well, if Newsom really wants to run in 2024, he's going to spend the next two years moving as far right as he can, so he has a prayer in any state other than California, New York, Massachusetts, and Illinois.

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Jason's avatar

As a life long east coaster I resent the inclusion of NY and MA in the same breath as CA.

Just because we both hated Trump doesn't mean we're that similar.

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Carl Pham's avatar

All four states will cast their electoral votes for the Democratic candidate even if the Democrats nominate a yellow dog or one of the undead. That's all I'm saying.

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Alex's avatar

fwiw if the Republicans would nominate someone vaguely credible (aka whose worldview is not built on conspiracy theories about antifa autocracy or whatever / who breaks with the Republican lineage a bit) I bet they would win in a landslide.

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Pope Spurdo's avatar

Slight disgreement: I don't think many swing voters in Ohio, Wisconsin, and North Carolina will be paying all that much attention to what Newsom _does_ as governmor of California. So I think he can govern as leftishly as he desires. His messaging (and I understand that he has been running television ads in Texas and Florida for some reason, but I haven't seen the ads) will have to portray him as a moderate, though.

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Carl Pham's avatar

Maybe. You can be 100% sure if he does anything spectacularly lefty that can be fashioned into a 30-second attack ad, his opponents will commission that ad. Remember how Romney was hammered on "Romneycare?" So it's a complex judgment call. He can do quotidian lefty stuff, he can do complex lefty stuff that can't easily be made into an attack ad, but he's got to be careful otherwise. Personally, I see him already positioning himself as a moderate when he can, for example throwing his support behind the Poseidon desalination plant. I don't think it's an accident.

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Scott Alexander's avatar

I understand your reasoning, but is there a history of governors running for president doing this?

Also, wouldn't he have to get through the Dem primaries first, where it would benefit him to have a pretty far left record?

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Pope Spurdo's avatar

Best recent example I can give you is the mirror image: Chris Christie, Republican governor of New Jersey starting in 2010, was talked up as a major 2016 contender. When Sandy hit the state two weeks before the 2012 election, Christie praised Obama's response. I don't know if doing so was a political calculation, but it was the kind of thing you'd do if you wanted to start building bipartisan cred a couple of years before you'd begin your run for the White House. It definitely was a shift for Christie, who got national attention for taking on, in a brusque Jersey style, teachers unions.

This turned out to be the beginning of the end of Christie's aspirations, though. It was perceived as helping Obama in the crucial final days of the 2012 campaign, not something that Republican primary voters could forgive. Perhaps if Sandy had occurred a year later, when bipartisanship would have looked less like betrayal, we'd be in the midst of the second term of the Christie administration. I don't know if anything could have defeated the Trump juggernaut in the primaries, but Christie somewhat neutralized two of Trump's advantages: the plain-talking New Yorker personality, and distance from the most unpopular legacies of the Bush administration: Iraq and the financial crisis.

https://time.com/4208219/chris-christie-barack-obama-hurricane-sandy-hug/

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Carl Pham's avatar

Maybe. There haven't been that many sitting governors who were angling for the Presidency while still in office, so this is the land of small numbers and exceptions. The two most obvious possibilities off the top of my head are Clinton and Ricky Ray Rector, or Clinton's evolution on the death penalty generally, plus his speech in 1988 on being a "New Democrat," and Bush's inclusion of the requirement for 2000 MW of "renewable" energy in the 1999 Texas law deregulating energy generation in that state, as well as his emphasis (particularly during the campaign) on educational reform.

We saw the reverse dynamic at work with Mitt Romney, against whom one of the most effective criticisms in the 2012 primaries was that he had signed the 2006 Massachusetts health care reform law a.k.a. Romneycare, and Romney's strenuous efforts to suggest that the difference between state and national level should be obvious to all.

I don't think a seriously left record going forward would help Newsom that much in the Democratic primaries. If he thinks he's got a good shot in 2024, it will be because what looks like it might be a Democratic wipeout next week means Biden and a Republican Congress have been at loggerheads for two years, and Biden is seen as ineffectual and/or fossilized by coming of age in the 1970s. It's a big deal for a party to dump a sitting President as its candidate, the last serious consideration I can think of being Carter in 1980, so to move in 2024 versus 2028 he'll need to be persuaded everyone is sick of Biden and gridlock, and will want to appear as the centrist, the mediator, the guy who can get stuff done even with a strong and hostile opposition.

Furthermore, the primaries he would need to win big to lock in support ($$$) are the early ones in Iowa, NH, and the Super Tuesday set in the South, all of which are in red-to-purple areas far from his home base, where electability would presumably be a high concern if Biden isn't running or looks too wounded to survive.

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Pope Spurdo's avatar

Scott's assumption that "a pretty far left record" will be helpful in the Democratic primary seems wrong. I don't think Biden, Rodham, Kerry, Gore, or Clinton can be characterized as "pretty far left" of their fields. I'll grant that in what was essentially a two-person race in 2008, Obama was to Rodham's left. I could argue that Obama's ascendancy was a black (heh) swan event to which the normal rules don't apply, but I don't need to. Even treating 2008 as a typical case, only 1 out of the last 6 Democratic nominees can be said to have come from the left part of the field.

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Carl Pham's avatar

Obama was a stealth candidate. He sounded amazingly moderate and big-tentish on the hustings, and it was only after he was elected that he was found to be a garden variety 1970s lefty, more or less a younger Joe Biden with black skin. (In his partial defense I think that's because he really didn't think he would actually win up until he did, and so didn't have an individual governing philosophy prepared, so he just took the old Mondale playbook off the shelf.)

But that's just a footnote, because on the main point I agree with you, I think an actual *far* left record would sink a candidate in the first two or three primaries like a stone. However, I also think Newsom has time to work on at least sounding a lot more moderate. I don't think it will do him any good in the end, mind you, because I think the Democratic Party remembers the last time they nominated a coast liberal (Dukakis) well enough to not go down that road any time soon. They know very well that California currently takes turns with New York as what 60% of the country sees as the epicenter of blue crazy, and there's just no way Newsom can escape that. If he were exactly the same person with exactly the same record, but hailed from Arkansas, Virginia, Pennsylvania, or Georgia, I think it's conceivable he would have a good shot. He seems to have a pretty good political "ear," in the sense that he can sense which way the wind is blowing and adapt smoothly. He's come quite far, especially given no obvious gifts of intellect or character, and being somewhat of an ideological cipher. I think he has real political talent.

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KrakenHead's avatar

I get posting an article to get people to vote since you have actual influence. Not sure why almost anyone actually votes, though. It’s as casually efficacious as pissing in the wind.

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KrakenHead's avatar

The autocracy thing doesn’t follow at all. I don’t vote but am pro democracy-ish systems because what’s rational at the individual level diverges from what’s best at the group level. (That’s just how collective action problems work.) That said, lots of people act irrationally (by voting) such that democracy turns out to be preferable to autocracy. That’s a perfectly coherent view.

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Jason's avatar

National politics is a distraction and local politics is true power & wealth. We just ignore it and let thieves run the show. Then we complain about it, convince the Feds to steal more of our money and shower the thieves running our local governments with it, who then steal it and spend millions building one story elevators in public facilities. We're so broken it's unbelievable we're still #1.

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Jason's avatar

National politics is a distraction and local politics is true power & wealth. We just ignore it and let thieves run the show. Then we complain about it, convince the Feds to steal more of our money and shower the thieves running our local governments with it, who then steal it and spend millions building one story elevators in public facilities. We're so broken it's unbelievable we're still #1.

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PotatoMonster's avatar

A subculture that says "voting is important" or maybe "it is morally right to vote" can have enormous impact on a democracy. And being part of such a subculture can signal that being part of such a subculture is important and that can make the subculture grow.

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KrakenHead's avatar

It doesn’t signal enough to make a real difference to anything. If it makes you feel good, that’s enough reason I suppose.

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Kenny Easwaran's avatar

I think it’s as causally efficacious as cleaning up a piece of litter that you find.

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Calion's avatar

Interesting comparison.

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Pope Spurdo's avatar

Cleaning up one piece of litter, which would not be cleaned up but for you, makes the world one unit less Littery.

Voting for Biden, who would win regardless of your vote, does not make the world one unit more Bideny.

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Calion's avatar

Are you sure? Remember the "mandate" thing Scott discussed?

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Pope Spurdo's avatar

No, I'm not sure, but the burden of proof runs the other way. I definitely know that my street looks slightly better after I picked the soda bottle out of the gutter. I have no idea if Biden would do a single thing differently if he got 81,283,502 votes instead of 81,283,501. I'm guessing not.

But 99,999,999 versus 100,000,000? Perhaps.

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Carl Pham's avatar

Good analogy, well put

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Carl Pham's avatar

George Bush won the 2000 Presidential election by 327 votes. You don't think 328 Democratic voters haven't been kicking themselves ever since?

You might consider voting to be like taking out fire insurance on your home. The chances are very low that you'll ever need it, but if you do, and you have punted because you mistook the quotidian for the eternal, you will learn an expensive lesson.

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Carl Pham's avatar

Pretty confident that had the margin been 1.2 million votes it would have never come to the Supreme Court.

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Carl Pham's avatar

Same thing as what? You figure there were an extra million ballots with hanging chads that were never counted?

Anyway, feel free to amend my comment to "327 +/- 5000." Doesn't really change the point. It's an incredibly tiny margin for an election in which >100 million votes were cast.

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McClain's avatar

I like that phrase: “mistaking the quotidian for the eternal” is a damn stupid thing to do, which people do all the time anyway. Well said!

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Christopher's avatar

I. Am. Dying. The Kidney One write up made me lol 5 times. It’s like that scene in Young Frankenstein where Kemp rallies the villagers.

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dorsophilia's avatar

In regards to prop 28 Scott Says:

"Its supporters say again and again that it will definitely not increase taxes, but provide no explanation for how this could be."

Isn't it that 1% minimum of revenue that schools receive music now go to music, dance, visual art drama etc? This seems like they would be shifting how money is used, rather than increasing overall funding for schools. I am missing something? Edit: After reading about California budgeting I figured out that prop 28 would indeed require more money to be spent on education. But the news sources often make it seem like the money would come from existing education funds. Shifty.

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David Gretzschel's avatar

re: prop 30

"Proposition 30: Tax The Rich To Fund Electric Cars And Wildfire Prevention

Taxpayers will pay an extra 1.75% on income above $2 million, and the money will go to electric car stuff and wildfire prevention."

Does anyone even make more than $2 million annualy in taxable income? Isn't that level of riches already all about stock appreciation or owning a company? Seems maybe symbolic.

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Kenny Easwaran's avatar

There are apparently a few hundred thousand of them. The university football coaches, a few star business professors, and probably some state finance managers are public employees over a million. The rich people that get stock options often get a few million dollars too.

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Erica Rall's avatar

Stock share and option grants are taxed as income at both the state and federal level when the grant vests. E.g. if your employer gives you 100 shares of stock worth $50/share, that counts as $5000 income on your tax returns. So an exec who gets $1MM cash salary and $5MM worth of stock will pay taxes on a $6MM income.

Also, California taxes investment income as ordinary income, so people who realize a whole bunch of capital gains in any given year will show up in statistics as if they're mega-rich and pay marginal rates intended for the mega-rich. Some of these people are indeed mega-rich selling some stock so they can buy stuff for themselves, but there's also going to be people who are just "successful mid-career professional who made good/lucky financial decisions" rich. For example, someone who joins a startup relatively early and holds onto their stock until the company gets bought out a decade later with their share worth $6MM will get taxed by California the same that year as the executive I used as an example in the first paragraph who's getting paid $6MM in cash and stock every year.

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Mike W's avatar

A business owner selling the business to retire can have that much taxable income in a single year.

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Jared's avatar

I strongly suspect it's mostly different people each year. Some people will have "bursty" income patterns, especially because long-term capital gains get special treatment in federal taxes, but are treated as ordinary income in California taxes. Federal tax rates are much higher than California tax rates, and California tax rates are much flatter than federal rates once you hit $100k, so there's no real incentive not to delay large capital gains, but that delay isn't forever, so people will periodically have years of high captial gains and over the whole state it tends to average out.

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Carl Pham's avatar

https://data.ftb.ca.gov/California-Personal-Income-Tax/PIT-Annual-Report-2020/s2q7-rtsh

In 2020 there were ~96,000 California tax returns showing an AGI over $1 million. Total AGI for this group was $318 billion (!) so the average AGI on a $1 million+ tax return was $3.3 million.

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Jerden's avatar

I always enjoy this, not for the specifics since it's irrelevant to me, but more for the insight it gives into your decision process.

I honestly wish more people, including me, put this much thought into our own ballots, we'd presumably be doing democracy better.

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Geoff Nathan's avatar

Random related thought from another state entirely. Michigan has a similar amendment on the ballot which enshrines the right to an abortion in the constitution. But Michigan also has a nineteen thirties law forbidding abortions that was put on hold while Roe was in effect. This amendment is an attempt to nullify that law. I'm voting 'yes', incidentally.

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Hilarius Bookbinder's avatar

Prop 30 is sort of funny to me: get more electric cars and cut back on wildfires. I say that because these are contradictory goals. I’m doing some consulting for a fire retardants organization, and the fire retardant guys are scared to death of electric cars. Apparently they are very flammable and nearly impossible to extinguish when they do catch on fire. Maybe prop 30 is there to help mitigate the risk from the cars.

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Carl Pham's avatar

They're not flammable per se, but if the battery pack catches on fire it is extremely difficult to extinguish, as are all metal fires. Lithium will easily burn in air, and remarkably enough combines with *both* O2 and N2.

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Scott Alexander's avatar

I've never heard of a major wildfire caused by an electric car - do you know of one? Should we discount the risk based on millions of electric car x years without this happening?

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Hilarius Bookbinder's avatar

No, I don’t know of a wildfire caused by an electric car. But search for “Paris electric bus fire” or “China electric bus fire” on YouTube to get a sense of what happens when one catches on fire. I don’t have a dog in this fight, but I can tell you the fire retardant pros wouldn’t put an electric car in their garage.

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Carl Pham's avatar

If you want to connect electric cars and wildfires, the more troubling connection is the fact that (1) the California electric grid would have to expand by ~50% with a lot more long-distance high-voltage transmission lines, particularly to rural locations (where you put the windmills and solar farms), if everyone is going to drive an electric car, and (2) electric transmission lines are already a major source of wildfires in California[1].

Now, of course, we can hope that a very rapidly expanding electrical grid in a state where people already hate that the price of electricity is so high and are severely impatient with increasing rates to cover big capital investments will nevertheless be built with much higher standards than has heretofore been the case, so that all these new power lines will *not* increase the risk of fire at all.

-----------------------

[1] https://www.businessinsider.com/pge-caused-california-wildfires-safety-measures-2019-10

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Richard Gadsden's avatar

Prop 29 appears to be funded by SEIU, ie the union for the people who do the dialysis without a nurse/doctor on site.

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Kalimac's avatar

Late abortion. Abortion rights advocates tell us over and over again that the casual elective late abortion that anti folks wave about as a boogeyman is not much of a thing. Late abortions occur for one of two reasons: 1) medical crises that arise late in pregnancy and threaten the woman's health (or that of the other twin in the womb), 2) women who wanted an abortion earlier but were impeded by anti-abortion laws.

I'm sorry to see Scott fall for the boogeyman. He also uses the term "partial-birth abortion" which is a catchphrase of the anti folks. It's not a term that makes much sense medically and is not used there. That the exact same medical procedure is used to remove dead miscarriages is what makes the term misleading.

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Pope Spurdo's avatar

If the boogeyman "is not much of a thing," then don't worry so much about not being able to have it. People getting very, very worked up about being told that they cannot have the thing that they insist is not much of a thing tells me that it is, in fact, much of a thing.

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Kalimac's avatar

Did you read my comment at all? It's the =casual elective= late abortion that isn't much of a thing. (I phrase it that way because I can't guarantee it's never happened. But basically it doesn't exist.)

The reason we don't want to prohibit late abortions is that the =medical crisis= late abortion =is= very much of a thing. And that has to be allowed to save the woman's life.

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Pope Spurdo's avatar

If the casual elective late abortion isn't much of a thing, then let me ban it. My ban will not touch medically necessary abortions. The great news for you is that because basically the thing I want to ban doesn't exist, the ban will have zero effect on anyone...

...and yet the ban on something that never, ever happens is fought tooth-and-nail. That's because, duh, it obviously happens, and "what about the medically necessary stuff" is an argument that exists only to obscure the non-medically-necessary abortions.

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Kalimac's avatar

No, first because the selective ban you suggest isn't on the table. The other reason is that you can't draw the line that way. Look at existing attempts to ban elective abortions while allowing medically necessary ones. Prosecutors don't automatically defer to medical judgments; the doctors (and the patients) have to work in a state of fear that some prosecutor will decide it isn't necessary after all and send them to prison. For instance, what does "to save the woman's life" mean? The doctor has to judge whether her life is in danger, and how much it's in danger. If there's a 50% chance she might die, is that too much? Does the doctor have to wait until she's actually dying to operate?

It's absurd and it sticks criminal prosecution in a place where it doesn't belong, the practice of medicine. And that's why the selective ban you suggest doesn't work.

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Pope Spurdo's avatar

How committed are you to the belief that criminal law has no place in medicine? For example, should prescribers have the unlimited right to prescribe any type or quantity of narcotics they wish, to anyone they wish, for any reason? Or is this an abortion-only exception?

The argument about the rarity or necessity of late-term abortion is an exercise in question-begging. The actual sticking point is that one side believes that a nine-month-old fetus has no moral rights, and therefore any risk, no matter how slight, of making the wrong decision about the necessity of late-term abortion must break in the mother's direction. If those folks did believe that a late-term fetus had moral rights, they would accept (as we do in other areas of criminal law, such as lethal self-defense) that tough and imperfect decisions must be made through criminal law.

No criminal law, no matter how narrowly tailored, will satisfy those folks. I would be comfortable with a law that said that if the board-certified abortionist was willing to swear under oath (subject to license revocation but no criminal sanction if committing perjury) that he believed that a late-term abortion was not elective, he could perform it. Would you accept such a restriction?

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Kalimac's avatar

Such a restriction as you suggest -might- work in an atmosphere of generosity and understanding. It can't possibly work in an atmosphere of hostility and suspicion. The very fact that you believe that medically necessary late abortions are some sort of phantom stalking horse for an epidemic of casual elective ones, an epidemic that exists only in your imagination, illustrates how toxic the environment is. The doctors will not be believed by those hostile to them. Election officials swear under oath that they are conducting elections honestly; they're not believed by those hostile to them. You can't carry out your honest work in either area if the threat of criminal sanctions is hanging over you: that is in fact the goal here, to prevent honest work from being carried out.

Even under narcotics, where the goal is, or ought to be, prosecuting criminal behavior being carried out under the disguise of medicine - and I agree that prosecuting that is a legitimate goal - there have been many cases of completely legitimate uses of the drugs that have been prosecuted because someone suspected they were criminal.

The reason any doubt about an abortion's necessity must break in the woman's direction (to call her a "mother" is to beg the question) is this. It's been said by those who oppose abortion that permitting it makes the fetus nothing more than the property of the woman. That argument can be made. But by the same token, prohibiting abortion makes the woman nothing more than the property of the fetus. Thus you get rhetoric about how the antis treat a woman as merely "a sentient uterus."

In my view, the rights of the fetus versus the rights of the woman who has to carry it is an insoluble dilemma. Therefore, society has no business passing draconian laws regarding it.

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BigOinSeattle's avatar

Has any doctor been prosecuted for a medically necessary abortion; say an ectopic pregnancy, which has a 0% chance of coming to term and a 100% chance of killing the mother?

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Kalimac's avatar

I'm not sure if an ectopic abortion actually has been prosecuted. But laws defining any fertilized egg as protected allow it to be. Fear of that is just as effective at creating a chilling environment. See https://tennesseelookout.com/2022/09/16/waiting-for-the-test-case-lawyers-say-prosecutions-inevitable-under-tennessee-abortion-ban/ and https://www.vox.com/science-and-health/23191865/abortion-ban-medical-emergency-ectopic-pregnancy and (this is a bill, but its medical nonsense illustrates the extremism at work here) https://www.theguardian.com/us-news/2019/nov/29/ohio-extreme-abortion-bill-reimplant-ectopic-pregnancy

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Viliam's avatar

> Has any doctor been prosecuted for [...] an ectopic pregnancy, which has a 0% chance of coming to term and a 100% chance of killing the mother?

I remember reading about such case; not in USA. (I don't remember the exact country and don't have a link now.) Technically, the doctor's crime was doing the abortion too soon -- the woman's life wasn't acutely threatened *yet*, and... you know, a miracle *could* have happened.

This is exactly the kind of legal uncertainty Kalimac talks about. Among a group of rational people who don't have an agenda, we might come to a reasonable conclusion. But when someone sues you, the prosecuting lawyer is not trying to be reasonable -- he is trying to get XP by getting you in prison, and will ask the most misleading questions. "Are you saying the mother could not have survived another *week* without your intervention? Then, why didn't you wait that extra week? Is that because you don't give a fuck about the law, or the sanctity of human life created by God? (Objection!) Yeah, I am sorry, your honor. Anyway, this doctor murdered a helpless baby, and only has a lame excuse."

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Carl Pham's avatar

Er...you don't think physicians aren't *always* making medical decisions with one eye out on the legal ramifications? I mean, *especially* when it comes to treating pregnant women? Let me introduce you to the cost of medical malpractice insurance:

https://www.ama-assn.org/sites/ama-assn.org/files/corp/media-browser/public/government/advocacy/policy-research-perspective-liability-insurance-premiums.pdf

"For example, in 2017, OB/GYNs faced premiums that ranged from a low of $49,804 in some areas of California to a high of $214,999 in Nassau and Suffolk counties in New York"

What do you think the legal risk is if it costs at least $50,000/year to insure you against it?

There is no area of medicine in which decisions are made entirely between physician and patients, and where the lawyer and the prosecutor aren't looking over the shoulder of the former. If you want such a halcyon world, probably the place to start is not with late-term abortion, since it is as you say a very rare circumstance.

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Kalimac's avatar

1) I think the malpractice insurance situation is terrible.

2) But at least it protects you from criminal prosecution.

3) Why add a further risk to an already risky situation?

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The Genealogian's avatar

Re Malia Cohen, I did a little digging. Her grandfather had the absolutely priceless name "Bishop Cohen" (https://casetext.com/case/cohen-v-cohen-in-re-estate-of-cohen). He was a longshoreman from Galveston. His own father was Frank Cohen, a farmer originally from Alabama. When he died in Galveston in 1939, his widow named his father as "Henry Cohen," but wasn't sure where he was born. We can find Henry in the 1880 Federal Census, a Coffeeville, Alabama laborer (probably in a sawmill).

Henry is listed as a "mulatto" born in Alabama in 1845, so it's at least possible his father was a white slaveholder. You can find an online family tree connecting Henry to the family of Solomon Cohen, a prominent Jewish South Carolingian, but based on five minutes of review and several years of experience, there are serious problems with this family tree. But--great family to do a Y-DNA test on! If you get a common Jewish haplogroup or even the "Cohen modal haplotype," you've got a compelling clue.

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Scott Alexander's avatar

Impressive! I'm guessing from your username that you do this kind of thing often - would you mind giving quick tips for the rest of us who might want to try something like this?

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The Genealogian's avatar

Of course! Really depends what you're looking to do, but I'm going to assume you mean "quickly sketch a rough genealogy for public figures." If instead you mean do your own genealogy, feel free to email me (thegenealogian at gmail dot com) and I'm more than happy to steer you in the right direction.

The first step is usually the hardest part. If they're not American, good luck. But if they are American, you need to figure out their parents' names using public records or old newspaper articles. In California this is fairly easy. There's a public birth index (available on Ancestry.com among other places) that gives a birth date and mother's maiden name. From there you, can search the similarly public California marriage index to find a Cohen marrying that maiden name. Then Google the father's name to confirm you've found the right family. The father was born before 1950, so you can use the now-public 1950 US Federal Census to find him. If you don't want to pay, you just need to get back ten years extra to search FamilySearch.org's 1940 Census index.

Those are the easy cases. You can also use Newspapers.com or other local paper archives to find marriage announcements, birth announcements, and obituaries. If you need to get back to grandparents, this is your best bet to do that as well. It all used to be a lot harder before newspapers.com centralized so many local papers.

Once you have the name of a deceased relative (or really anyone born early enough), take advantage of the Mormons' head start and head over to familysearch.org. Search for the deceased relative, assuming they were born before 1940. If they were in the US, you'll be able to track them back ten years at a time using the federal census. For American families, I always start there. Then once you've sketched in an outline of the family tree with estimated birth dates, places, occupations etc., you can start searching the other record collections. This works pretty well for families outside the US as well (the FamilySearch collection is from all over the world and growing), but you may need to start farther back depending on local privacy laws in the country you're researching.

I always do my own research. Over the past decade, "genealogy" (or at least tracing your family tree) has become VERY easy to do VERY badly. Unless you're the only child of an only child of an only child, a few of your aunts, uncles, or 3rd cousins have already traced parts of your family tree and posted them on Ancestry.com. And maybe Uncle Ralph did a good job! But probably he did not. The internet is now so awash in bad dates, bad connections, and pure nonsense that there's basically no way to casually do good work. Spend 10 minutes on Ancestry.com and you'll have a 1000 person tree reaching back 600 years. But as a representation of the real world it's basically useless [Bracketing for now whether even good genealogy is "useless."] To do good work, you need to reinvent the wheel or be experienced enough to recognize a well-crafted wheel.

Anyway, I'll write at length about that someday. Short answer is: email me for more targeted advice (sources, pitfalls, etc.).

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Mike W's avatar

An example of "The Myth of the Rational Voter."

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Bardo Bill's avatar

"The argument in favor is that in a world where you can already buy stocks and crypto, I’m not sure sports gambling makes things any worse."

I have a real feeling of dread about how legalized gambling is suddenly ubiquitous (thanks, Supreme Court!). It's such a destructive and addictive activity with no redeeming social utility I can imagine. (At least alcohol and drugs are fun; gambling is almost as bad of facebook in terms of the dismal empty quality of the emotional experience it offers.) Like, one participates in gambling *precisely* to the extent that one's rational self-interest is circumvented; or, in Aristotelian terms, it's the antithesis of eudaimonia.

Or as a wise man once said, in an essay called "Meditations on Moloch":

"So we have all this amazing technological and cognitive energy, the brilliance of the human species, wasted on reciting the lines written by poorly evolved cellular receptors and blind economics, like gods being ordered around by a moron.

Some people have mystical experiences and see God. There in Las Vegas, I saw Moloch. "

All this to say, I'm not sure "people are gonna gamble so we might as well allow it in any form or venue whatsoever" is all that persuasive. Making things easier to do tends to encourage people to do them. For better or worse - and I mostly think it's fine - it seems that weed legalization has led to more weed consumption. With gambling I think that's not so fine.

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Pope Spurdo's avatar

Do you think that all prediction markets have no redeeming social utility, or only those associated with sportsball?

I would certainly say that a prediction market that created actionable information about, say, the risk of a forest fire or pandemic has more social value than one about whether the Astros or Phillies will win the World Series. Just curious if you think the social value of the latter is zero.

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Bardo Bill's avatar

I honestly don't know if prediction markets have or could have real social utility, but I'll grant that it's possible. But it was sports gambling that was in question here and it was gambling *as an industry* that I had in mind. I doubt the kind of prediction markets you're talking about will ever be more than a niche enterprise.

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Pope Spurdo's avatar

Sports gambling is a prediction market on the outcome of sports. Predicting the outcome of those games probably might not have enough social value to justify its legality, but I think its value is slightly greater than zero.

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Carl Pham's avatar

You sure? Gambling addiction is a real thing. People have gambled away the mortgage or health insurance premium money. I mean, gambling wasn't heavily regulated and restricted in all the states because a coalition of uptight bluenoses thought it was a slothful pastime compared to running triathlons or a carpentry hobby.

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Pope Spurdo's avatar

I'm sure that what you wrote is consistent with my assessment that prediction markets for sports outcomes have some value, but perhaps not enough to justify their legality.

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Carl Pham's avatar

I definitely agree it has some net value. I was wondering if you were confident the sign was positive. A lot of people think it's negative.

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Don P.'s avatar

I am speaking here as a person who enjoys minor sports betting, and I can see absolutely zero social value to knowing the general public's opinion on how many points the Celtics are likely to beat their opponent by, in a game to be played in six hours.

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Pope Spurdo's avatar

The only possible utility I can think of is this:

I'm emotionally invested in the outcome of one football game a week, but that's dependent on how closely I follow or watch it. If I don't watch a game and my team loses, I'm sightly bummer. If I watch and they lose, I'm bummed for the rest of the day. And this is largely independent of my expectation, i.e., when they lose I'm equally bummed if I expected them to lose or win.

So whether I decide to watch a game is influenced by whether I expect them to win. Knowing the point spread or odds helps me avoid getting bummed.

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Migratory's avatar

I agree that from a utilitarian point of view, gambling has immense negative utility. The industry produces very little of value (who can call slot machines fun?) and mostly has the effect of removing money from less-rational people and giving it to established casinos. Considering that non-rational people tend to be poor and thus most impacted by the loss of money, and the fact that casino owners are basically just collecting rents, it's not useful economic activity at all. And as you said, we have direct evidence in the form of cannabis and current casinos that legalization leads to an increase in activity. Given that, I also don't see any way that the tax revenue can be used to cover for the direct harms from gambling.

I see Scott's argument that this might lead to prediction markets being legalized, and I do think prediction markets are a productive use of the betting instinct. But I don't believe that this prop will actually lead to prediction market legalization, and I don't believe that incremental change is at play when it comes to California props. So I voted against this expansion of gambling.

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Carl Pham's avatar

Prediction markets so far have struck me as just track betting for the intellectual.

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None of the Above's avatar

They're a somewhat useful source of information (to the extent they work), and they offer a way to impose a tax on your own bullshit by making yourself decide if you're really convinced enough of some claim to bet your own money on it.

Personally, the last time I was sure enough of a questionable political claim to be willing to bet, it was my absolute certainty that Trump could never win a presidential election. So in that case, at least, my not having an easy way to bet on the outcome was a benefit--I'd have lost a bunch of money betting based on my actual beliefs there.

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Carl Pham's avatar

Sure, if you could compel[1] a wide representative swathe of American voters to bet on the election, I bet it would be a much more accurate poll than anything a polling firm produces. But that's kind of a big "if", and to be frank my read of the people who get enthused about prediction markets is that being able to do more accurate polls of social beliefs for the benefit of punditry is not their mainspring. It looks more like they are tickled at the possibility of *being right* when a whole lot of other people are wrong. But that is, of course, the core thrill of betting on horseraces, too. Ha ha none of you morons realized that Bay Theorem has been burning up the practice track and Dee Ontology pulled up lame last week -- the pot is mine!

-----------

[1] Because if it's all volunteers you are ipso facto only sampling the enthusiastic, the "base" if you will.

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None of the Above's avatar

"(who can call slot machines fun?) "

I guess I'd start with all those people who seem to flock to place that allow them to play slot machines. Perhaps this reflects them being dumb or wrong somehow, but it's hard to deny that they *exist*.

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FeaturelessPoint's avatar

I think this could easily be one of those cases where "enjoyable" and "reinforcing" activities differ.

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tempo's avatar

yes! voting as a protest! probably how Brexit passed.

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Axioms's avatar

My moderate Republican gentile neighbors gave their son the first name Cohen. My area is incredibly Jewish, used to have a derogatory name rhyming with the actual abbreviated name in reference to that, and this has been moderately controversial among the neighborhood gossips.

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Deiseach's avatar

"Cohan" is also an Irish surname. It's possible some African-American Cohens/Cohans could have picked up the name that way:

https://en.wikipedia.org/wiki/Cohan

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Deiseach's avatar

I'm going to stay away from the abortion one because that is a deceased equine. What interests me is the dialysis clinic one, since my late father was on dialysis for the last decade of his life.

What horrible tangle of red-tape bureaucratic over-regulation do the promoters of The Kidney One want, I wondered?

"SUMMARY Put on the Ballot by Petition Signatures

Requires physician, nurse practitioner, or physician assistant on site during treatment. Requires clinics to: disclose physicians’ ownership interests; report infection data. Fiscal Impact: Increased state and local government costs likely in the tens of millions of dollars annually."

That's it? "Hey, if you're running a dialysis clinic, at least have a qualified nurse on the premises"?

That seems both anodyne and obvious. Am I to take it from this that there are clinics in California that don't have one of "a physician, nurse practitioner, or physician assistant" on site during treatment?

Surely there must be more to this sinister proposition, else why vote "no" on it? The Kidney People even have a website touting their terrible opinion:

https://www.yeson29.com/

Quoting piecemeal from their dreadful plan to over-regulate the perfectly safe dialysis clinics of California:

"(2) In California, nearly 80,000 people undergo dialysis treatment.

(3) Just two multinational, for-profit corporations operate or manage nearly threequarters of dialysis clinics in California and treat more than 75 percent of dialysis patients in the state. These two multinational corporations annually earn billions of dollars from their dialysis operations, including close to $450 million a year in California alone.

(4) Studies have found that compared to patients at non-profit dialysis clinics, patients at for-profit clinics are less likely to get kidney transplants, more likely to be hospitalized, and more likely to die.

(5) Many dialysis clinics are operated as joint ventures between for-profit corporations and physicians. A physician who owns a stake in a dialysis clinic may also be serving as the kidney patient's primary doctor, creating a potential conflict of interest. More transparency is necessary for researchers to study the impact of physician ownership on patient care and whether these ownership interests influence decisions regarding dialysis care approaches, patients' choice of clinics, and when to start or discontinue dialysis.

(7) The dialysis procedure and side effects from the treatments present several dangers to patients, and many dialysis clinics in California have been cited for failure to maintain proper standards of care. Failure to maintain proper standards can lead to patient harm, hospitalizations, and even death.

(8) Dialysis clinics are currently not required to maintain a doctor or other advanced practitioner on site to oversee quality, ensure the patient plan of care is appropriately followed, and monitor safety protocols. Patients should have access to a physician or advanced practitioner on site whenever dialysis treatment is being provided.

(9) Dialysis treatments involve direct access to the bloodstream, which puts patients at heightened risk of getting dangerous infections. Proper reporting and transparency of infection rates encourages clinics to improve quality and helps patients make the best choice for their care.

(11) Dialysis corporations have lobbied against efforts to enact protections for kidney dialysis patients in California, spending over $100 million in 2020 to influence California voters."

I can speak to the risk of infection, my father got several infections in the catheter, which is a known risk:

"Prolonged catheter access can lead to multiple complications, the most common of which is infection. Even with excellent placement technique, bacteria can enter the bloodstream directly through the catheter during dialysis. Bacteria from the skin can also move down the catheter and enter the bloodstream. With catheter infection people develop high fevers and chills and need prompt treatment. Generally physicians must remove the catheter so the body can fight the infection."

He also had problems with blood clots. So it was a good thing the dialysis clinic was in our local regional hospital.

Okay, so I need to go back and look at the Proposition 29 Official Voter Information Guide:

"WHAT YOUR VOTE MEANS

YES A YES vote on this measure means: Chronic dialysis clinics would be required to have a physician, nurse practitioner, or physician assistant on-site during all patient treatment hours.

NO A NO vote on this measure means: Chronic dialysis clinics would not be required to have a physician, nurse practitioner, or physician assistant on-site during all patient treatment hours.

ARGUMENTS

PRO Dialysis patients deserve protection under the law. Prop. 29 will help ensure they receive safe treatment in dialysis clinics under the care of a doctor or another highly trained clinician in case of emergencies, without risk of infection, and without discrimination.

CON Join dialysis patients, American Nurses Association\California, California Medical Association and patient advocates: NO on 29—another dangerous dialysis proposition! Prop. 29 would shut down dialysis clinics and threaten the lives of 80,000 California patients who need dialysis to survive. California voters have overwhelmingly rejected similar dialysis propositions twice. Stop yet another dangerous dialysis proposition."

What I take away from this is NoProp29 is saying "lots of patients are getting dialysis in clinics that don't have medical personnel on hand for any complications, but if we close them down, there's nothing to replace them. Half a loaf is better than no bread - better a dodgy clinic than no clinic".

That, to me, is not a ringing endorsement of the safety of dialysis clinics in California. In fact, I am going to be an extra bitch here and say it sounds like "If poor people need dialysis, these clinics do the job. But don't worry, if you have good enough medical insurance and/or are rich, you will be treated in a hospital so you won't be exposed to the same level of risk. Vote 'no' and your nephrologist consultant can continue to give you private care of high quality while he makes money off the chain-store clinics".

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Melvin's avatar

> That seems both anodyne and obvious. Am I to take it from this that there are clinics in California that don't have one of "a physician, nurse practitioner, or physician assistant" on site during treatment?

As I understand it they have a Registered Nurse on site, not to be confused with a Nurse Practitioner which is a rare grade of super-nurse. (There's half a million Registered Nurses in California, 115,000 doctors, and only 22,000 Nurse Practitioners).

Based on what I know about dialysis, it seems in line with other nurse-supervised procedures. Insert needles and monitor the patient for complications -- this is exactly the kind of procedure that nurses are for.

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Deiseach's avatar

I looked up some job vacancies for the two companies mentioned, and in some of the reviews it was that there's one nurse (at least) who is supervising the clinic, but it's the dialysis techs who really run it.

https://www.indeed.com/companies/compare/DaVita-vs-Fresenius-Medical-Care-b12f795bad2a7c68-db9a1a39ddc6b7e3

And for the dialysis tech job description, they take you on so long as you have a high school diploma/GED, no medical qualifications needed! They train you to run the machine and do basic hygiene, and that's it. They're not nurses, and they're paid accordingly.

https://www.indeed.com/cmp/Fresenius-Medical-Care/jobs?jk=edbc00e592306d23&q=Patient%20Care%20Technician&l=&start=0

https://www.indeed.com/cmp/DaVita/salaries

https://www.indeed.com/cmp/Fresenius-Medical-Care/salaries

I don't know which side to believe, or whether both of them are right on one thing and wrong on another. The anti-side says everything is fine, this is just a union trying to muscle in. The pro-side says it's patient representative organisation and the union is backing them.

Anyone have any idea what the state of dialysis clinics in California is really like?

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Carl Pham's avatar

Might need some vocabulary definitions: a nurse *practitioner* is a very different thing than an RN. It's an advanced degree, with prescribing powers, sort of 3/4 of the way to a GP. The average salary for an NP in California is $150k/year. They are often used as the sole practitioner in a free-standing clinic or urgent care. Same for a "physician's assistant" or PA, which is not at all someone who takes notes for a doctor, but again someone 3/4 of the way to GP, who can prescribe and treat many things on his or her own. Also a very expensive person.

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Axioms's avatar

I'm actually pretty upset by the Newsome situation. Gavin is going hard on all the good leftwing positions and I am not a Gavin fan. But no one else is doing housing reform and insulin and various other things that he is doing. Do I have to vote for him in the 2024 primary now? Rough days for leftists.

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Scott Alexander's avatar

I figure when 2024 comes around we will know who our other options are and it will probably feel much more obvious.

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bill's avatar

"Lanhee Chen has a PhD and JD from Harvard and does public policy at the Hoover Foundation at Stanford. He was apparently Mitt Romney’s economic policy advisor and served on some board of important experts that decided things about Social Security. He is against Trump and apparently wrote in Mitt Romney’s name on his 2016 ballot, which, mood."

Scott is pro-Mitt? I'm thinking BASED!

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Leo Abstract's avatar

Serious remark, no more a 'bait' question than anything else posted on the internet, but I remain perplexed by the apparent tension between fears of "republican vote-rigging" and disdain for people who "challenged the 2020 election".

People cheat when they can, this isn't controversial. The only way to avoid this conclusion is to presume that our team is significantly less 'evil' or 'unethical' than the other team. But if the stakes are high to the point of existential, why should good or ethics even enter into it? If some folks who mistook Trump for Orange Hitler threw away some ballots in 2020, good for them! If some folks who mistook Hillary Clinton for a murderer and child-trafficker threw away some ballots in 2016, good for them!

People who still have bumper stickers on their cars that say "Bush stole the election and no, I'm not over it." are to be commended for their consistency. People who fly flags below Old Glory on the poles in their front yards that say "Trump Won!" are to be commended likewise.

I really don't get this one.

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PthaMac's avatar

Because eroding faith in democracy can _itself_ be the existential threat. If both sides refuse to accept the legitimacy of the other side when they win, then co-existence will ultimately be impossible.

It's one thing for everyday citizens to make these assertions. Half the time they don't really believe them and instead just adopt them as tribal signaling. Randos believe weird stuff all the time - we've lived with it before.

It's another thing when politicians turn that into rallying cries and stoke the lies, though. If you run on a platform of "they cheated and if you elect me I'll make sure we win," - and then the other side comes out ahead in votes - you're going to have a hard time accepting that. The concern isn't the dude waving the "Trump Won" flag - it's the state election official who is saying that.

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Leo Abstract's avatar

I suppose if we're starting with faith in democracy as an assumption that would make sense. But precisely what I'm saying is that it requires targeted amnesia to think that. Even if we completely ignore the widespread, top-to-bottom assumptions on the left that Russia somehow hacked the elections for Trump, Hillary Clinton was talking just this week about how the Republicans are planning to steal the election.

We only see it and condemn it when it's "not my team" doing it -- and I don't claim to be special or a genius here, I just don't feel identified with either the mainstream left or right in this country. If I did I'm sure I'd think one or the other side was not doing this.

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PthaMac's avatar

There is a giant difference between making vague allegations, and using the threat of violence to try to overturn elections. Hillary's offhand comments do not compare to the Jan 6th riot. They're on the same spectrum, but very opposite ends of it.

Are the Democrats pure on this topic? Of course not! And yes, Abrams has crossed the line, and anyone who wishes to be consistent should condemn her on this. But it's just not going on to the same extent on both sides.

For example, I can name specific fears of how Republicans might overturn future elections. State commissioners might refuse to validate election results on groundless fraud charges, causing a delay in sending Electors that could take away votes from the Democrats. State legislatures could retroactively change their election rules to allow things like this, and the Supreme Court will allow it under the Independent State Legislature doctrine. Congress could refuse to certify electors.

And why do I think these are reasonable fears? Because GOP officials are promising to do them. Or they tried to do them last time, failed, and have made public their plans to do them again.

These are specific measurable things that the GOP is planning. This is far beyond anything we have seen in the recent past.

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Deiseach's avatar

"For example, I can name specific fears of how Republicans might overturn future elections. State commissioners might refuse to validate election results on groundless fraud charges, causing a delay in sending Electors that could take away votes from the Democrats. State legislatures could retroactively change their election rules to allow things like this, and the Supreme Court will allow it under the Independent State Legislature doctrine. Congress could refuse to certify electors."

And do none of these things apply to Democrats? Are there no Democratic Party State commissioners that might refuse to validate a DeSantis victory? (I'm using DeSantis as a place holder name for a possible Republican candidate).

After all, we've had six years of constant drumming on how MAGA is the worst thing ever threat to democracy will destroy the nation. If a principled Resistance guy is in a position to put a halt, however brief, to the bad guys back into power, why would he not do it?

And if you say "Well because Democrats are all pure saints and Republicans are all pure devils", there's our problem right there about partisanship.

"These are specific measurable things that the GOP is planning. This is far beyond anything we have seen in the recent past."

If you Google "GOP hack voting machines", you will see a lot of 2022 stories about this kind of alarmism:

https://www.washingtonpost.com/politics/2022/08/16/gop-operatives-troubling-trend-copying-election-systems/

https://www.politico.com/news/2022/10/14/wireless-modems-could-endanger-midterms-00061769

https://apnews.com/article/2022-midterm-elections-technology-lawsuits-donald-trump-voting-6a1324cc6cf45c95ca086a5c81617b15

And a whole slew of others, too tedious to link them all here.

If you set the dates for 2012-2016 for the same search term, you'll get similar stories:

(At least Politico is consistent in running voting hack scare stories from 2016 to now)

https://www.politico.com/magazine/story/2016/08/2016-elections-russia-hack-how-to-hack-an-election-in-seven-minutes-214144/

"The revelation this month that a cyberattack on the DNC is the handiwork of Russian state security personnel has set off alarm bells across the country: Some officials have suggested that 2016 could see more serious efforts to interfere directly with the American election. The DNC hack, in a way, has compelled the public to ask the precise question the Princeton group hoped they’d have asked earlier, back when they were turning voting machines into arcade games: If motivated programmers could pull a stunt like this, couldn't they tinker with the results in November through the machines we use to vote?"

CNN did a timeline of "Russians hacked the election":

https://edition.cnn.com/2016/12/26/us/2016-presidential-campaign-hacking-fast-facts/index.html

In 2012 there were scares about hacking voting machines (not for any one particular side):

https://www.csmonitor.com/USA/Elections/2012/1026/Could-e-voting-machines-in-Election-2012-be-hacked-Yes

And in 2012, Harper's Magazine were laying it out how the introduction of electronic voting machines (after the whole hanging chad fuss) was actually a secret plan by the Republicans to "paint the country red":

https://harpers.org/archive/2012/11/how-to-rig-an-election/

So please don't tell me "this is far beyond anything we have seen in the past the GOP are out there blatantly stating they are going to do this".

The Republicans are talking about election fraud and the Democrats are talking about voter suppression. Same old, same old.

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PthaMac's avatar

Yes, this is a Republican thing. Here is a specific story from Michigan involving state officials trying to uncertify a Democratic victory, despite the fact that there was zero evidence of any sort of fraud:

https://www.bridgemi.com/michigan-government/monica-palmer-michigan-canvassers-got-election-posts-after-little-vetting

Here is a similar story from Wisconsin, about an official who certified Biden's win and was pressured to resign:

https://www.washingtonpost.com/politics/2022/05/27/trumps-gop-election-purge-marches-despite-setbacks-georgia/

If you can show me where Democrats have done something similar, I will happily adjust my narrative. But again: this about what people in power are doing. That is the difference here. Not just vague scare stories. Not just unfounded conspiracy theories. Those are a problem for both sides, I heartily agree.

But one party has made it much more of a mission to take control of election apparatuses, especially in swing states, and has openly talked of trying to change what it sees as an illegitimate result despite zero evidence to that effect.

Are Democrats angels? No. Is there an alternate world where a demogogue might have done the same thing from the left after a contentious loss, and organized a national movement along the same lines? Yes. But that's not the actual world we're in.

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PthaMac's avatar

Your answer deserves a deeper response in one regard, too ... maybe this will clarify where I'm coming from.

Not only do I not think the Democrats are angels, I think you can point to ways in which they have tried to game the system in ways that undermine norms. Their approach to social media, for example, and how every viral story that looks bad can be painted as 'misinformation'. Or their approach to media in general, really, though I think this can be overstated.

So they absolutely play games, too. But on this particular game (i.e. elections and the recognition of results) there is a clear unilateral escalation from state officials on one side.

For example, you correctly call out how Democrats were paranoid over some voting machines. But what was the result of that? It was not Democrats saying "we need Democratic Secretaries of State to overturn suspicious results." Instead, what you saw in many places (red and blue states) was a rejection of voting machines that left no paper trail that could be independently verified.

That's an example of the kind of constructive response that I'd rather see. If one side has trouble accepting the system due to some kind of weakness, then improve the system. I think mail-in voting is generally very secure, but I accept that if you're scared of "mules" that you would want to sharply limit it, as Republicans have done. If it helps them believe in the results, I think it will be a win as a whole.

But that's not the pattern we're seeing, especially at the state level.

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Leo Abstract's avatar

I absolutely sympathize with how all of what you typed looks from your perspective. Absolutely all of it is correct. But have you wondered what it looks like from the other side? It looks far worse than one or two examples of people in power. Every large city (which of course is deep blue) has elections that have been run for generations by democrats. A few guys who doubtless think of themselves as plucky resistance fighters standing against a sea of corruption trying to undo the results of an election that they appear to be morally certain was stolen doesn't frighten or offend me. "Ah," you say wisely, "But they are wrong in their perceptions!" Well of course they are! They're the OTHER TEAM. Obviously only OUR team is plucky and fighting against insuperable odds. More seriously, though, consider the following:

We have an election system that is opaque and cannot be audited, which means that any accusations from either side about actual cheating (rather than gerrymandering [R] or changing the rules for mail-in ballots [D]) forever must remain 'unfounded' and 'conspiracy theories'. This opaque system, of course, is kept in place with full bipartisan support when viewed from a national level. Why? Quite possibly because the places under (R) control are run by politicians who know they got there by cheating and aren't interested in changing it. Guess what we can say about the places under (D) control?

Is the election secure? Would be nice. Shame there's absolutely no way to check in any of the 50 states. Would be nice to think that the stories of people throwing away mail-in ballots or going around in church buses with lists of names to use at various polling places (since it's forbidden to check ID) are unfounded urban legends, and would be nice to think the same about the stories of people turning away folks at the polls for being the wrong color (and therefore likely to vote the wrong way) or threatening to call ICE on the families of people seen voting, etc. Do please go ahead and believe that if you have the optimism for it. As for me, when our election systems are even in the same league as those in Israel, I'll see if I can scrape up some faith.

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Hilarius Bookbinder's avatar

Both-sides-ism was a tenable, if tedious, position to hold until January 6, 2021.

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Leo Abstract's avatar

Thanks, both of you, for reminding me of the answer to my original question, which is that high intelligence and commitment to rationality do not inoculate against even the most transparent and laughable hoaxes for those in too thick a bubble.

Yes, a mostly-unarmed crowd taking stupid selfies in an empty room in a building is a dangerous, coordinated coup or insurrection, and is proof-positive that their side opposes democracy and the constitution.

Carry on.

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Pope Spurdo's avatar

There's a lot of talk about January 6th. There's very little talk about February 6th.

Assuming that it wasn't just Boomers and LARPers taking selfies, and that the rioters were as violent and insurrectiony as claimed by the most devoted Democratic partisans, what would the federal government look like a month later? If the QAnon Shaman held a vote on the House floor to certify the election for Trump, do these people think that a month later they'd be sitting around saying "Oh man it sucks that Trump is still the president, but what are you gonna do? The insurrectionists took a vote and we have to respect it."?

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Leo Abstract's avatar

Let's not stoop to mockery -- hoaxes happen to everyone not merely on both "sides" but everywhere else too.

Whether it's the right believing things like Pizzagate or QAnon, the left believing that Trump called neo-nazis "fine people" or told them to drink bleach, it's all over the place.

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Carl Pham's avatar

Trying to cheat, or at least act in the gray area between outright ballot box stuffing and Marquess of Queensberry rules, is a long American tradition. So is contesting elections after the fact, in the media or in the courtroom. There does not breathe a committed Democrat who think Al Gore was wrong to contest the Election of 2000.

I think this one is used because many people on all sides really hated the 2020 election. Even people who pulled the lever for Trump were often not doing it happily, but only because electing Joe Biden -- perennial Presidential candidate always heretofore dismissed as unserious -- seemed worse. Likewise I think plenty of people voted for Biden reluctantly, and only because they thought the Trump circus had just gone too damn far, and even an ill-tempered senile fool was better than having a squalid TV reality show in the White House for another 4 years.

So plenty of people, on all sides, just wanted the damn wretched thing over, at the time, and since. So when you point out that Trump and his allies are *still* yammering about it, it makes a negative impression on anyone who isn't part of their hard core base. "This again! I just want to forget that damn election, why do these assholes keep reminding me?" I think this is why it's used.

It can certainly backfire, of course, and I think maybe it has in fact reached its sell-by date. At this point the people who keep reminding us of the Election That Should Be Forgot are mostly Democrats, and I think it is now doing them harm (evidence of which could be Kari Lake's increasing success). That could all change if Trump throws his hat in the ring for 2024, in which case we're going to see plenty of people, both left and right, who remember that they would rather he just went away.

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Deiseach's avatar

As I've discussed with Gunflint, there's a tension between "Of course the last election that voted Our Guy in was totally legit and there was no way anything could have been fiddled, even under the exceptional circumstances, because That Doesn't Happen Here" and "I am very worried that this time there will be fiddling to get Their Guy voted in".

If it can happen, then it's reasonable to wonder about the previous election since there was a lot of rushing through vote-by-mail in order to permit the election, and some of the decisions don't seem the most stringent (if the vote turns up without a postmark, or three days after the close of voting, sure, count it anyway).

If it can't happen because the last election was The Most Secure Ever, why are you worried this time round vote fiddling will happen? The people doing the counting, etc. are in the main the same people as last time round.

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FeaturelessPoint's avatar

Again, people are not super worried about Republican interference with elections this time because of vague allegations of "vote fiddling" but rather because of highly verifiable stories of Republican officials in the last major election trying procedural tricks like refusal to certify in order to ignore/overturn election results that they didn't like.

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Carl Pham's avatar

Magdalene, I am a peasant when it comes to elections, not a sophisticate. I view all politicans by default as narcissistic and incompetent, until proven otherwise. I assume they will *all* lie, cheat, and steal to acquire even the smallest scraps of power, and devil take the hindmost. I think the little old ladies who oversee elections hereabouts are as honest as the day is long, but they do make mistakes, and impatient voters in a hurry do, too, and there is noise on the phone line and hanging chads, and people tick the wrong box anyway all the time.

So I believe in a vote count that is correct to the last digit as much as I believe one of those "debt clocks" or "population clocks" that purports to show the national debt to the exact dollar at this moment, or the population of the Earth right this moment to the exact person -- i.e. not in the slightest. I mentally add error bars of anywhere from 1-10% on any election result, depending on the jurisdiction and importance.

But! I also think that it doesn't really matter. Let us take Bush v. Gore in 2000. According to Wikipedia Bush got 50,456,002 votes, and Gore 50,999,897 -- and by gum not a single vote more or less in each case, a proposition of precision I find laughable.

But if 50.5 million people think Bush would be the better President and 51.0 million think Gore would, then I would say the only really reliable conclusion you can draw is that The People can't make up their silly mind. Both candidates are manifestly equally desirable, or equally undesirable, to the electorate. Choosing either one will please about as many people as it disappoints. Vox populi has thrown up its hands and resoundingly said "dunno!"

In which case -- who cares what the acutal choice is[1]? You might as well flip a coin, that would be just as representative of The People's will as the vote was. If the actual choice is made by whomever's lawyers are more silver-tongued, or whoever can put together a small conspiracy of minor elected officials faster -- well, maybe we should give that person the edge on the grounds of ruthless efficiency anyway.

But either way it strikes me as not a thing to get truly worked up about. Democracy is a terribly crude instrument. It routinely tramples on the rights of the minority, it routinely gets stuff wrong in a big way, since it venerates the judgment of the average man over anything better informed. But we put up with its inefficiencies for the comfort of knowing that it short-circuits tyranny. And that's about all I expect it to do. I just want a system where if 80% of my fellow voters agree with me that President Doofus has got to go, then he'll go. I just want it to protect me from outrageous abuse of power, from being East Germany under the Soviet boot, and I don't need a margin of error (including from cheating) that is 0.1% or better to get that.

--------------------

[1] I mean to the concerns about the viability of the Republic. Obviously it will matter a lot to each individual candidate's partisans.

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Scott Alexander's avatar

I think it's possible this is true in genuinely existential situations - ie one-shot prisoner's dilemmas - but false short of that (if it's a multi-shot prisoner's dilemma, it's perfectly possible to develop cooperation norms and in fact this has happened in most cases throughout history). See eg https://slatestarcodex.com/2014/02/23/in-favor-of-niceness-community-and-civilization/ .

I think people on both sides try to claim every single election is existential to drum up panic and get voters to vote for them (and possibly cheaters to cheat for them?) but this is basically never true (evidence: one side has lost every election, yet we still exist) and it's almost never worth sacrificing the potentially-permanent norm for the one-off chance of a temporary victory this time around.

See also https://www.lesswrong.com/posts/K2c3dkKErsqFd28Dh/prices-or-bindings - I think Eliezer has said at some point "you can only sell your principles once, after that you don't have any". This is not the point I want to sell my principles at (and it's possible we shouldn't sell them at all even in a one-shot - see https://www.lesswrong.com/posts/HFyWNBnDNEDsDNLrZ/the-true-prisoner-s-dilemma

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Leo Abstract's avatar

I agree, and certainly wouldn't think any of these elections are a big deal. I just earnestly commend people who act with courage in response to having been bamboozled into thinking so. I would also hope they develop better cognitive hygiene between now and the next election cycle, but the likelihood of that is low.

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None of the Above's avatar

I think part of this is pure conflict theory types who are happy to simultaneously accuse anyone who disputes their sides' electoral victories of undermining democracy while also doing their best to undermine the legitimacy of the other side's electoral victories.

There are people with sincere beliefs that the 2020 election was cooked, or that Georgia's voting laws are the New Jim Crow. But there are also a lot of people who are informed enough to know that both of these claims are bullshit, but who find it in their personal or partisan interest to make make those claims as loudly as possible.

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Leo Abstract's avatar

Quite possibly, yes. I realize as I type out responses in this thread that while perhaps I sound cynical ('the system is corrupt', 'both sides probably cheat') also I naively insist on the fundamental goodwill of the misled, the biased, and the deluded. It's hanlon's razor, and I submit that it is good practice to apply it doggedly and without reservation.

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A1987dM's avatar

How comes the "or any device" in the 1872 constitution doesn't apply to slot machines?

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Jonathan Ray's avatar

All of my professional gambler friends are extremely extremely anti prop 26 because it gives the indian casinos a monopoly on sportsbetting and creates a lawfare mechanism for people to harass the Indian casinos' main competitors (California cardrooms, which are not operated by Indians). It's a very blatant attempt by a special interest group to use government power to crush their competition. Perhaps there should be some kind of meta-constitution that prohibits this sort of racket.

The professional gamblers are split on prop 27, but I'm against it. On the one hand it finally legalizes online sports betting, which is something we have wanted for a very long time. On the other hand, it does it on shitty terms that will create a high regulatory barrier to entry, empowering a small group of large corporations at the expense of their competitors and the public. It also has this terrible clause to go after individual people who bet at offshore/unlicensed sportsbooks:

"Provides New Ways to Reduce Illegal Online Sports Betting. Proposition 27 creates new ways to reduce illegal online sports betting. When people place online sports bets with any unlicensed entity, the proposition requires those people pay the state a penalty. This penalty equals 15 percent of the amount that they bet. The proposition also allows for a $1,000 penalty for each day this money is not paid. These payments would go into the COSBTF. Additionally, the state’s new regulatory unit could take certain enforcement actions. These actions can include requiring unlicensed entities provide the names of people placing bets with them and blocking online access to these entities."

This could theoretically be used to go after anyone who bets on blockchain-based or offshore prediction markets. 15% of every bet is extremely steep and would make it impossible to turn a profit. The 1000/day penalty could bankrupt people who weren't expecting it. It censors the internet and tries to impose US rules on foreign companies that aren't even supposed to be under US jurisdiction.

In practice they'll probably be unable to enforce it. There are a lot of states where online gambling is illegal in theory, but I know lots of people who do it anyway and no one who has ever been penalized in any way. (except back in 2011 when some offshore bookmakers had their assets siezed by the US, but after that all the offshore bookmakers that accept US customers were careful to keep their funds where the US can't touch them) If California demands a list of customers from some offshore sportsbook now, it'd be like King Arthur demanding the grail from the insulting French castle guy in Monty Python. And that's the way it should be, because the US doesn't have the right to dictate what foreign companies do, or prevent wagers across borders between consenting adults.

IMO we should just drop the pretense of being able to stop people from betting at offshore sportsbooks, because we can't, if they can figure out how to use crypto to get around the financial censorship. Just legalize it all and federally repeal UIGEA.

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Deiseach's avatar

"And the argument against on the ballot is by the Black Chamber of Commerce, saying that these card clubs are a useful source of revenue for poor minority communities."

I'm not sure this is the best reason to put forward; after all, knocking over liquor stores or dealing drugs is also a useful source of revenue for poor minority communities. "Sure it's illegal but it makes money for some of our people" isn't a great look.

I have no opinion one way or the other on the rest of it, save that it's strange that on-course betting at horse races is not already legal (over here, we are constantly bombarded with ads on my local radio station about 'have a great night out for Christmas/Easter/your birthday/the works do at the greyhound races!') and if people want to throw their money away, why not on online betting as much as anywhere else?

Not my local greyhound track but hey, if you want a fun time, go to the dogs!

https://www.grireland.ie/go-greyhound-racing/our-stadiums/shelbourne-park-greyhound-stadium/plan-your-night/dublin-nights-out

"All of our restaurant packages in Shelbourne Park include:

Your Admission and Race Programme, worth €10 alone

Reserved seats in our glass-fronted Restaurant

Bar & Tote Betting service direct to your table"

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Jonathan Ray's avatar

If there was a good case against allowing gambling in general, California could shut down the Indian casinos also instead of only shutting down their competitors.

But I think gambling should remain legal for basically the same reasons that alcohol, tobacco, soda, ice cream, pornography, etc are legal. Although if someone wants to found a community where all of the above are banned I won't try to stop them (call that meta-libertarianism?)

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FeaturelessPoint's avatar

I think the best case for shutting down gambling specifically is that unlike other addictive things the high in gambling is substantially less than linear in the money you are betting (and thus how much you spend) at any given level of tolerance x wealth, so it has a greater ability to ruin people when they would still otherwise be functional addicts.

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Carl Pham's avatar

California almost certainly lacks legal authority to shut down Indian casinos:

https://en.wikipedia.org/wiki/California_v._Cabazon_Band_of_Mission_Indians

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Jonathan Ray's avatar

"

The State of California contended that the Bands’ high-stakes bingo and poker games violated state law and requested that the Court recognize its statute governing the operation of bingo games. Riverside County additionally sought legal recognition of its ordinances regulating bingo play and prohibiting the operation of poker and other card games. California argued that under Public Law 280 (1953) Congress had granted six states – Alaska, California, Minnesota, Nebraska, Oregon, and Wisconsin – criminal jurisdiction over Native American tribal lands within the state's borders.[3] If California's regulatory laws prohibited gambling on a criminal basis, then it is likely Public Law 280 would have given the State of California the authority to enforce them on tribal lands. However, as the Cabazon Band argued, California's laws on gambling were civil regulatory laws, and therefore the tribal lands would not in fact fall under the lawful jurisdiction of the state.[4]

The Supreme Court held, as the Cabazon band argued, that because California state law did not prohibit gambling as a criminal act – and in fact encouraged it via the state lottery – they must be deemed regulatory in nature. As such, the authority to regulate gaming activities on tribal lands was found to fall outside those powers granted by the Public Law 280.

Cabazon had lasting implications regarding the sovereignty of Native American tribes in the United States. The ruling established a broader definition of tribal sovereignty and set the precedent that if the few states that with some lawful jurisdiction over tribal lands could not impose state regulations on reservation gaming, then no state could have such a right. Indian gaming could thus only be called into question in states where gambling was deemed criminal by state law."

The Indians just have immunity to California's civil regulations of gambling, but not california's criminal law. California could make it a criminal offense to have slot machines, for example. They shouldn't, but they can.

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Carl Pham's avatar

Uh...thanks for copying in all those paragraphs, saves a click there I guess.

Yes, California could make all gambling criminal, but then of course they couldn't run a lottery. Cabazon was an "all or nothing" decision, it said you can make *all* gambling criminal, and that would stop the Indians, but you can't use your regulatory powers to say gambling is OK in some places or situations but not others -- and have this affect the Indians.

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Ian's avatar

Drug distribution and card clubs are all consensual affairs. If it makes them some money, great. Kind of bizarre to lump armed robbery in with those, but then that’s what happens when people take laws seriously. They forget most of them are stupid and shouldn’t be followed as a matter of principle.

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Amy G's avatar

I do not like your choices and your reasoning is in most cases anything but rational. Done with this.

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Calion's avatar

What would count as more rational?

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Jared's avatar

Rob Bonta's pro-housing actions are more than enough reason to vote for him IMHO.

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Plumber's avatar

Frankly this seems as good a voter’s guide as any and I’ll probably use it, with one exception: the pro prop 27 side has annoyed me with an unrelenting avalanche of advertising that I’m voting against it to send a signal that being that annoying is counter productive.

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Logan G.'s avatar

"a friend convinced me that most of California’s problems are downstream of high land prices"

Consider this the lazy attempt to shoehorn Georgist advocacy into a post that has very little to do with it on the face. There must always be at least one.

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Andrew Holliday's avatar

"...I enjoy the way he [Brian Dahle] generates artwork from prompts."

This took me a minute to get, but then I laughed out loud. Well done.

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pozorvlak's avatar

I'm surprised you didn't comment on the gematrial implications of a contest between candidates called Cohn and Cohen.

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Paul T's avatar

On Prop 1 - TLDR: as a supporter of abortion rights, this replaces CA's good existing abortion law with a morally repugnant one.

I think the logic of Roe was awful even if the implementation results were in practice positive, and I despair at the movement to re-implement the "privacy-based" right to abortion. I don't want to open the can of worms about whether we should have kept Roe or not. But since it's gone now, we can and should do better. In California, (not an expert but AFAICT) we already have broadly sensible laws regulating access to abortion; it's allowed unconditionally until fetal viability (~23 weeks), and conditional on medical necessity after that (citation: https://www.shouselaw.com/ca/defense/laws/abortion-laws/).

This is how abortion laws should be written! You might disagree with the specific timings, but I think we must pick some medical/physical/developmental criteria. I find idea repugnant that the law should enshrine a mother's right to privacy as the only determinant, rather than recognizing that at some point the unborn child has rights. An elective "abortion" at 30 weeks should not be allowed, nobody thinks it should be allowed, and nobody wants to allow it. It would be a terrible thing to do. So it should be (and under CA law currently is) illegal. Under the logic of Roe, we have nothing to say forbidding this, except "in practice nobody would do that" -- which is just apalling, and conservatives rightly castigate liberals for this position. It's a ludicrously weak position from which to try to argue for abortion rights, and there's no reason to maintain it.

Resolving this issue requires us to make a decision around when we actually allow abortions, which is fraught, technical, and difficult. But it's the morally right thing to do. And indeed, it's what California law already does. In general we should say "abortions are allowed until the Xth week, unless there is some medical justification, in which case X+Yth week". This is what pretty much every other developed country does, for different values of X and Y.

I take this position nationally, too; I strongly oppose writing Roe into federal law. I think the right solution is to recognize that states disagree strongly on exactly how this should be regulated, but there actually is quite broad agreement even among conservatives that first-trimester abortions should be allowed and third-trimester should not. The disagreement within the non-fundamentalist 90% of the population is about where in the late-first-to-second trimester the restrictions should be. Re-implementing Roe is not politically feasible, but you could perhaps put something broad into place federally, like "Abortions must be legal until N weeks" where N is the lowest value you can get agreement on, perhaps as low as 6-12, and states are free to make this higher, and "elective abortions are not legal after M weeks" with some high value that everybody agrees on like 24 (or whatever is negotiated), with states free to pick some stricter value that is greater than N. Given that the vast majority of abortions are first-trimester, I'm more interested in securing broad protection for womens' right to access the abortions they actually need and use, than protecting some abstract (and actually morally repugnant, if taken to its logical conclusion) concept of privacy or forcing an aggressive relatively-late term abortion limit onto conservative states. So, basically a hybrid states-rights-on-the-details with federal guardrails approach.

I understand why politically most Democrats want to pretend that the logic of Roe was great, since to do otherwise is to admit that one was intellectually contorting to preserve a flawed but pragmatic solution, but now that it's gone, we should let it die. We would do more benefit to the national cause by promoting and strengthening CA's existing sensible and morally defensible legal framework for abortion, rather than replacing it with Roe's flawed logic.

[Citation on public opinions on abortion timings: https://www.vox.com/policy-and-politics/23167397/abortion-public-opinion-polls-americans]

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Deiseach's avatar

"An elective "abortion" at 30 weeks should not be allowed, nobody thinks it should be allowed, and nobody wants to allow it."

https://theconversation.com/less-than-1-of-abortions-take-place-in-the-third-trimester-heres-why-people-get-them-182580

"One woman I interviewed, for example, explained that she needed an abortion following a diagnosis at 29 weeks of pregnancy that her fetus’s brain was not developing. Because a great deal of fetal brain development happens after the 24th week of pregnancy, there was no way to diagnose this problem earlier."

There's not much difference between 29 weeks and 30 weeks, and we can argue over whether this counts as an "elective" abortion or a "fatal foetal abnormality" abortion, but it's risky to say "nobody never" because there will always be some exception.

This clinic conducts abortions after 26 weeks - do they do it up to 30 weeks? I don't know, they're so discreet it's hard to find out what limits, if any, they act under:

https://dupontclinic.com/services/abortion-after-26-weeks/

"If you are 26 weeks or later into your pregnancy, we can still see you, regardless of your medical history, background, or fetal indications. We do not require any particular “reason” to be seen here – if you would like to terminate your pregnancy, we support you in that decision."

Oh hang on, they have a FAQs page!

https://dupontclinic.com/frequently-asked-questions/

"Is abortion legal in DC?

Abortion is legal in all trimesters in Washington, D.C.

For more information on whether abortion is legal in your home state, visit this site which is updated regularly: https://reproductiverights.org/maps/abortion-laws-by-state/

Do you require a waiting period or other state mandated requirements?

Washington, DC does not have waiting period laws, gestational age restriction, or requirements to see or hear ultrasounds.

How far into my pregnancy will you see me?

We provide care for patients through 31 weeks and 6 days of pregnancy. However, we have limited appointment availability so we encourage all prospective patients to call as soon as possible to ensure we have an appointment for you before the price increases or we aren’t able to provide care for you"

And from their menu:

"OUR SERVICES

FIRST TRIMESTER IN-CLINIC ABORTION

ABORTION FROM 15-26 WEEKS

ABORTION FROM 26-31 WEEKS 6 DAYS"

But don't worry, an abortion at 31 weeks and 6 days is *not* a "late-term abortion" because that is just a made-up term by those nasty conservatives:

https://www.kff.org/womens-health-policy/fact-sheet/abortions-later-in-pregnancy/

"“Late term” abortion typically refers to abortions obtained at or after 21 weeks, however it is not an accepted medical term, nor is there a consensus around to which gestational ages it refers. Members of the medical community have criticized the term “late-term” abortion, as it implies abortions are taking place after a pregnancy has reached “term” (37 weeks) or “late term” (>41 weeks) which is false. In fact, the American College of Obstetricians and Gynecologists (ACOG) has written that “late-term abortion” has no medical meaning and should not be used in clinical or legal settings"

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Paul T's avatar

Fair enough; shame on me for saying "never", the claim that can always be disproved. Thanks for providing concrete examples; I think these help frame the conversation.

I suspect but am not certain that the first example you from the article you shared is in the "medical exemption" category; it sounds like the sort of case where carrying the fetus to term would have been dangerous to the mother. And I think that would fall under the exemption afforded under existing CA law. (But please correct me if I'm wrong here.) Anyway, I think a reasonable law will make exemptions for specific medical conditions that make the abortion not strictly "elective".

The second category of example of "abortion past 26 weeks because I couldn't afford/access abortion earlier" I would support outlawing, and I think the vast majority of Americans would agree with this (the Vox data doesn't clearly prove this but does suggest it), as would the legal frameworks of most developed countries in the world. Inasmuch as this is a problem I'd strongly advocate for expanding access to abortion (including funding) for those that want it so that there is no excuse to be in this position, rather than solving this problem by allowing elective abortions after 26 weeks. However the numbers you shared do suggest that it's very rare; 1% of abortions were at >= 21 weeks, so it must be a tiny fraction after CA's 24 weeks, and a tinier fraction once you exclude medical justifications.

As a moral justification for forbidding elective abortions past some date like 24 or 26 (or whatever people agree on) weeks: one doesn't get an exemption to kill one's newborn because one couldn't access an elective abortion in time, and I think the same sort of argument applies to elective abortions at some point (though I think the "badness" of the action increases the more developed the fetus is, it's not a binary transition from "acceptable" to "murder" at some arbitrary threshold). If this is something that would be allowed by the constitutional amendment in CA then this gives an even stronger reason to oppose Prop 1.

On the general discussion of what would float federally, for the window of 26-31 weeks you found advertised in DC that site says that it doesn't require a medical/health consideration for the mother:

> We do not require any particular “reason” to be seen here – if you would like to terminate your pregnancy, we support you in that decision.

Like most people, I don't support allowing elective abortions that late. Though I think this may be a bit of a red herring, as they seem very rare. I would want to see a breakdown of reasons why abortions are taking place this late; I suspect most of them would qualify for medical exemptions if that was the framework under which they were being evaluated, and so a restriction on elective abortions likely wouldn't affect many people.

On the discussion of "late-term" as objectionable terminology... ugh. I think this is perhaps part of why the debate on abortion is so fraught; we should probably start talking specifically and precisely about weeks, because when you do that, most people give much more measured/nuanced responses to questions. (But also, lots of people don't know exactly what is happening at what milestone! It's quite a complex and marvelous process!)

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Alex's avatar

fyi: plenty of people (such as myself) think elective abortions should be allowed at any time. Also, plenty of left-aligned people (such as myself) think that Roe was a shitty way to guarantee a right and was only ever a stopgap. (Ideally eventually the churches are kicked out of politics and everyone can do what they want with their own bodies.)

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Paul T's avatar

> plenty of people (such as myself) think elective abortions should be allowed at any time.

So you think it’s ok to have an elective abortion at 40 weeks, one day before the due date? Just want to make sure we are being clear here.

Regarding “plenty of people” think this, you need to provide some evidence to back this up. The Vox data I linked showed 19% supporting abortions at 24 weeks for any reason, and given that AFAIK no jurisdiction in the developed world allows it, I strongly doubt many of those 19% support 40-week elective abortions.

> was only ever a stopgap

I agree that it should have been considered no more than a stopgap. But I think in fact Dems thought they had won the war a generation ago, and did not have a plan/intention to spend the political capital to replace Roe with something else.

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Brian's avatar

"The Kidney One" literally made me LOL.

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Mio Tastas Viktorsson's avatar

> "Thurmond is the incumbent and touts his record of getting money to put lots of computers in California schools, despite research showing this is useless. "

As an elected municipal representative in a small European country where municipalities set school budgets, this interests me. I couldn't find any previous writing on this on a quick googling, and education research is a very messy jungle to sift through. Does anyone have any reading to recommend on this?

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Carl Pham's avatar

Two of the most notorious failures:

https://www.govtech.com/education/what-went-wrong-with-la-unifieds-ipad-program.html

https://www.philanthropydaily.com/the-spectacular-failure-of-one-laptop-per-child/

Certainly people can and have rationalized away both failures as failures of execution, basically saying adding computers to the classroom *all by itself* is in no sense any kind of magic elixir that automatically boosts outcomes, in the absence of training, judicious use, good software, a good pedagogical plan, et cetera. But there are other people who point out if you have all the latter things -- basically, a high-performing academic environment all around -- then why do you even need to add computers? High-performing academic environments produced highly educated students 50 and 100 years ago, without any computers.

As a parent I'm a little agnostic on the point. All my kids went to pretty well-off schools, but because of the years when they went, only the youngest had routine access to computers. Did they get a better education? Meh. Not really. I don't see a huge difference now -- because the quality of the education had far more to do with the quality of the teachers and curriculum. It was somewhat more convenient to have stuff on a Chromebook or laptop instead of on paper, because stuff didn't get lost as easily. But on the other hand, there were software and access problems you don't have with a paper, pencil, and textbook. The available software was, and still is, largely mediocre, with a few bright spots here and there (I mean genuinely good and useful educational software, scarce as hen's teeth). There's a lot of useful videos out there, but you can use those with only the teacher having a computer.

I'm inclined to think at the K-12 level, the utility is not yet proven. At the higher-education level, I think it's a much easier call: there's so much more you can do with a computer that I think it is very plausible that it measureably improves a college education (although I got a very good college education at a time when nobody had computers on his or her desk, not even instructors).

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Mio Tastas Viktorsson's avatar

Thanks for the articles, they were interesting reads. They certainly reinforce my presupposition that even if widespread computers in school do have net benefits after all (and they may not), they're unlikely to measure in opportunity costs against teachers, training, facilities and more traditional school supplies ("what is needed is clean water and real schools”). Digitalised schools certainly seem more prone to cost-disease in a general sense, especially with shitty blanket purchase agreements and technologically illiterate public procurement officers.

What I'm still curious about though is that first part, which I think is what the research Scott references too might answer: on a pedagogical level, do access to computers for students help more than they sabotage? My own experience here lines up roughly, but not perfectly, to your inclination here:

Young as I am in a progressive country, in senior high (equivalent) I had personal access to a school lap top at all times. On one hand, it was indispensable for the kind of text production and independent research you were expected to do at that level. On the other hand, it certainly completely ruined my attention in class having the lap top in front of me. I have no doubt that had catastrophic effects on my overall performance, and played no small part in my dropping various natural science subjects.

The same kind of pattern holds at university: a lot of independent work centered around the laptop, but I paid attention to lectures better in halls without space for the laptop, had more lively participation in group seminars where they were forbidden and found studying more interesting when it relied on real books more than PDFs. (This assessment isn't entirely fair; those modules were political science and law, while the more digitalised courses included economics and statistics. I don't think that explains away it all though, because I do like those latter subjects.)

Given these experiences, it seems to me that in young years where you don't (shouldn't?) have as much independent study + text production the computers are all drawbacks, and in higher education you very much need the computer but should be restrictive with its use. In the years in the middle there, I guess years 10-12, I'm not really sure how to strike the balance.

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Carl Pham's avatar

I would agree with that generally. As an instructor I did not allow the use of laptops in the classroom, because they are far too distracting. I also think they are very constraining: you are looking at the world through a visually crowded 14" window, as if you were peering into a room in which a circus was going on through a tiny basement window. The human eye-brain combination is not used to taking in information through only such a narrow window and narrow modality -- it's used to looking around 360 degrees, scanning, watching slight changes here and there, taking in slight sounds and smells and variations in light and shadow -- how the instructor shifts his weight, the rise and fall of his tone, the posture of your fellow students, the expressions on their faces, even your own hand as it writes notes. All this pours information into the brain, and we use it in ways that are difficult to fathom, although there are hints.

We certainly know taking into account the instructor's emotional state gives you valuable information about the categorization and iimportance of what he's saying. Taking into account the emotional state of the students around you helps orient you to your own learning -- am I the only one confused here? Is this surprising to everyone else, or not? -- and taking notice of your own physical actions helps build a more complex and lasting memory of being in the class. You may remember some little tidbit in a more complex and durable way if it includes the little doodle you made on the page while trying to figure out the meaning of a new terms, as well as a whispered puzzled remark by your neighbor student you overheard. Being in a social situation also prevents your attention from wandering, and causes a heightened sense of self-evaluation -- am I doing what is expected of me here? I'm expected to learn, is that what's happening? It builds richer and more complex memories of all that happens, including discovery and information flow.

Human memory is exceedingly complex, and we know it uses a forest of cues, both conscious and unconscious, to form and place information in context. We also know humans have learned well for millenia in social settings, by having another human in front of them talking, demonstrating, moving, and with other humans around them. It's a proven model, and I imagine one reason learning by reading from books didn't immediately supplant person-to-person instruction as soon as the printing press was invented. One is hesitant to substantially change it without good reason.

Which is not to say the computer isn't an exceedingly valuable tool for learning, it absolutely is. But it has its place and should stay there. It's not a general amanuensis, it's a tool well adapted to certain quite specific uses.

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Viliam's avatar

Unless you have a very specific purpose for the computer in mind, it will almost certainly serve as a distraction. Kids will mostly use it for something highly addictive, like social networks or games.

On the other hand, I can imagine computers with a web browser that only allows you to access Wikipedia, Khan Academy, and Duolingo; that could be quite useful. Not during the classroom, but in the afternoon. Computers could also be useful for spaced repetition. Etc.

You should have a computer during computer science, duh. But even there, you should spend some time sitting away from the computer, discussing and making notes, and only then go to the computer and do stuff.

In other words, the right question is not "computer, yes or no" but rather "what specifically are you going to do with it". (If you do not have a specific purpose in mind, the answer is no.)

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Scott Alexander's avatar

I owe you a better answer but this is something I remember reading from I think Freddie de Boer. Some Googling turns up hhttps://www.bbc.com/news/business-34174796 and https://www.nytimes.com/2011/09/04/technology/technology-in-schools-faces-questions-on-value.html , but I can't find the exact Freddie post I'm thinking of - maybe he'll show up here and remember.

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Mio Tastas Viktorsson's avatar

Haven't been able to access the NYT article, but that BBC one seem convincing, so I'll look through that OECD report when I get the chance. I'll check out de Boer's stuff too.

The part where occasional computer use improves results, but constant use makes them worse is interesting. That seems to suggest it's wise to make sure there's a well-equipped and accessible "computer room" and computer access at libraries, but not to invest in one-to-one iPads for every student. That obviously removes some benefits of "ownership" of a computer, but I'm not sure how much difference that makes for the very locked-down devices usually supplied anyway.

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Tom Stevenson's avatar

As an Englishman, this was eye-opening simply because you vote for so many different positions on one ballot. Obviously the USA is a federation which the UK isn't, but you still vote for so many different positions. It's refreshing in a way. We get to vote for our MP, local councillors and police commissioners (though I don't know how much influence or authority they have). Enjoyed this for the reasoning behind your votes and for an insight into democracy in America. Thanks!

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Tom Stevenson's avatar

Ah ok, fascinating how democracy works in America and how varied it is. We don't have much variance here in the UK, even with parliaments for Wales and Scotland, it's mostly the same wherever you are.

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Deiseach's avatar

Okay! So I did some Googling about what the state of dialysis clinics in California is (are they good, as Scott's sources claim, or are they bad, as the Prop 29 crowd claim?) and couldn't find much.

There was a 2017 segment by John Oliver (which immediately puts me off, as I think Oliver is as funny as a toothache) which didn't rate them much:

https://www.seiu-uhw.org/press/hbo-exposes-problems-plaguing-dialysis-industry-as-ca-bill-seeks-to-improve-patient-care/

"During the 24-minute clip, which has been viewed more than 900,000 times on YouTube, host Oliver highlighted the dialysis industry’s practice of boosting profits through alleged schemes that resulted in million-dollar legal settlements for fraudulently billing for drugs and failing to disclose risks of medication. It also mentioned federal regulations that allow for woefully low staffing levels at dialysis clinics, and included excerpts from a dialysis company video in which the CEO compares his management of dialysis clinics to that of Taco Bell restaurants."

Yeah but that's John Oliver, a dumb wokie comedian who's the cut-price Jon Stewart. Anything better out there?

An article about the inspection backlog (clinics may only be inspected once every six years or so) from 2010 so perhaps things have improved in the meantime:

https://www.propublica.org/article/led-by-california-inspection-backlogs-weaken-dialysis-oversight

The clinic in this article is or was owned by one of the two big chains, DaVita.

Looks like a separate bill about dialysis clinics is being backed by someone mentioned in one of the races above, the (allegedly) scandal-ridden Lara:

https://www.mercurynews.com/2017/03/28/dialysis-centers-california-bill-proposes-to-improve-staffing-inspections/

"But Senate Bill 349, carried by Sen. Ricardo Lara, D-Bell Gardens, is being fiercely opposed by a coalition of doctors, patients, rural clinics and dialysis centers.

Opponents of the measure argue that federal data shows that California’s dialysis clinics are currently ranked among the highest in the nation for quality of care and clinical outcomes."

Scandal-ridden senator versus nephrology consultant in that article, but then again the doctor also works for two clinics, one owned by each big chain, so conflict of interest there.

There's the union, of course, from 2019 but there's that problem of bias again:

https://www.seiu-uhw.org/press/dialysis-industry-breaks-national-record-by-spending-110-million-to-oppose-california-ballot-initiative-protect-profits/

"The dialysis industry officially broke a national record by spending more than $110 million to oppose California’s Prop. 8, an initiative on last November’s ballot that would have improved patient care in the state’s dialysis clinics, according to a Jan. 31 report filed with the California Secretary of State’s office that is a final accounting of how much the industry spent.

...Dialysis workers and patients have reported seeing mice, cockroaches, bloodstains and broken equipment in dialysis clinics in California. In fact, the California Department of Public Health documented more than 1,400 deficiencies during inspections at dialysis clinics in fiscal year 2016-2017, and more than 4,400 dialysis patients in California died from infections in the last five years, according to the Centers for Medicare and Medicaid Services."

Well, if nothing else, looks like there is indeed money in running private dialysis clinics. Anybody both sides can agree is some kind of almost-neutral on this?

There's a glowing recommendation from some bunch called DialysisIsLifeSupport, who turn out to be the people Scott mentions plus a whole bunch of others:

https://dialysislifesupport.com/about/

https://dialysislifesupport.com/ab-290/#coalition

Their Facebook page says "Paid for by Patients and Caregivers to Protect Dialysis Patients

Sponsored by the California Dialysis Council" and their press release for 2021 describes them as "A coalition representing dialysis patients, doctors and dialysis providers"

So I'm very confused. Is this just a "union shakedown" as the press release claims, or why is it that a request to have "requiring clinics to have at least one physician, nurse practitioner, or physician assistant - with at least six months of experience with end-stage renal disease care - onsite during patient treatments" would mean the clinics would all have to close down?

Is it really to do with the requirement to "requiring clinics to provide patients with a list of physicians with an ownership interest of 5% or more in the clinic; requiring clinics to provide the CDPH with a list of persons with ownership interest of 5% or more in the clinic" because the doctors don't want their revenue streams made public, or is it the union trying to muscle in and make it unprofitable to run a private dialysis clinic because of their unreasonable demands about wages and conditions?

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Erica Rall's avatar

>So I'm very confused. Is this just a "union shakedown" as the press release claims, or why is it that a request to have "requiring clinics to have at least one physician, nurse practitioner, or physician assistant - with at least six months of experience with end-stage renal disease care - onsite during patient treatments" would mean the clinics would all have to close down?

Because there's a pretty big shortage of doctors and "mid-level practitioners" both nationwide in general and in California in particular, and requiring specific experience with end-stage renal disease narrows the candidate pool considerably. There are about 650 dialysis clinics in California that would be affected by the proposition, and there are only about 8500 active nephrologists in the entire country, so hiring one per clinic would require hiring almost 8% of the total national workforce of kidney specialists. Or about 75% of California's kidney specialists, assuming the number of nephrologists in CA is proportional to CA's share of the US population.

But one nephrologist per clinic is a very conservative estimate: it assumes the clinic would have to close if its nephrologist got sick or went on vacation, and dialysis clinics seem to have insane hours for a single person to cover even by doctor standards, ranging from 12 hours per day six days a week to close to 24/7. More likely, each clinic would need 2-4 nephrologists on staff, meaning they'd need to hire something like 200% of California's total supply of kidney specialists, or about 20% of the entire country's kidney specialists.

This would also be an insane waste of a kidney specialist's time: the main thing a doctor or mid-level practitioner would do in general would be to diagnose kidney problems, prescribe a course of treatment, and periodically check in with the patient and order some lab work to assess how well the treatment is working. The actual dialysis is a routine procedure that involves placing two IV lines (usually connect them to permanently implanted IV ports for dialysis patients) and letting the machine run for the prescribe length of time, with is well within the capabilities of a medical assistant operating under the supervision of a registered nurse (*). Having a doctor, NP, or PA on site would add almost no value, since the odds of needing a doctor to do something that can't be done by a medical assistant or registered nurse are very small, and if something does happen that needs a doctor's attention, it's almost certainly going to be either "call your nephrologist's office at your earliest convenience" or at worst "let's get you to the nearest hospital", not "we desperately need a kidney specialist right this instant, an internalist or an emergency medicine specialist won't do, and we have no need for hospital facilities".

(*) Despite similar names, there are huge differences between medical assistants and physicians assistants, and between registered nurses and nurse practitioners: the latter of each pair is a "mid-level practitioner", who does the same kinds of thing as a doctor (typically about 80-90% of things a doctor does can be done by an NP or a PA) with about 3/4 of the training. Whereas a medical assistant is a technician who's qualified to perform routine medical procedures under the supervision of a doctor or nurse (the person who takes your temperature and blood pressure at the doctor's office is usually a medical assistant), and a registered nurse is a more advanced professional who also primarily handles routine procedures, but who is qualified to do more complex stuff than an MA, to operate independently without on-site supervision, and should be able to be relied upon to recognize situations that need a doctor's attention.

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Deiseach's avatar

Thank you, this is the first useful and informative reply I've received on this.

So the doctors/vote no side have a point, as this requirement is unfeasible due to the severe shortage of medical staff. It also lines up with what I was reading in comments about "rate the clinics for work" about how the nurses were scarce and over-worked, with the dialysis techs being the ones running the clinic.

The union/vote yes side also have a point, because of the scarcity of medical staff. Most of the patients are probably fine to come in, have the dialysis done, and go home - but if there is any kind of problem, then the clinics will be sending those patients off to hospitals.

Yes, it's going to eat into revenue. No, there aren't enough staff to be hired. So it's not quite as simple as "voracious union wants to punish plucky healthcare facilities" or "profiteering chains don't care about quality of service, just the bottom line".

If the staff aren't there to be hired, then voting "no" makes sense. Thanks, Eric!

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Erica Rall's avatar

My pleasure!

This looks like a classic "baptists and bootleggers" political economy situation to me. There seem to be some patient protection groups associated with the "yes" campaign, even if most of the money is coming from SEIU, and you presented a reasonable prima facie case for there being legitimate problems with at least some of the clinic.

I've got a couple reasons for seeing SEIU as the "bootleggers" here (i.e. cynically self-interested players, as opposed to altruistic moralists). One is that a bunch of medical industry unions and professional organizations seem to be actively campaigning against the proposition, whereas I'd expect them to support a well-tailored safety and best practices regulation, and they seem more central to the interests in well-run clinics than SEIU.

The other is that there's an existing (pre-Dobbs, at least) trend in US politics where anti-abortion politicians push regulations for abortion clinics that sound like reasonable safety rules to a casual observer, but which are actually tailored to be unreasonably burdensome. Both the overall pattern here and the specifics of the rules (for abortion clinics, one of the big ones was requiring each clinic have a doctor present who had admitting privileges at the nearest hospital, which is apparently much hard to get and maintain than it sounds like it should be) sound very similar here.

If this were primarily about safety and quality of care, I'd expect the rules to be about stuff like staffing ratios (i.e. requiring more medical assistants and registered nurses relative to the number of patients) and state inspections to ensure that the equipment is well maintained and proper safety and sanitation practices are being followed.

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Deiseach's avatar

Yes, I did see the resemblance with the abortion clinics.

On the other hand, the Kermit Gosnell case, which was an abomination, had some of the same "looking the other way" around shitty care, for the same argument: "he's serving low-income communities, if we close him down, where will they go?"

Gosnell had the habit of dumping the women (and girls) who didn't come out well of his abortion clinic on the steps of local hospitals, hence part of the insistence on having admitting privileges for a hospital if there are complications. But this is a different discussion.

I am going to presume that the union is aware that if they drive the clinics to shut down, then they have no workers and hence nobody to unionise. So I'm not entirely sure what is going on here, unless there is some kind of shakedown as to "pay us danegeld and we stop pushing this proposition every year". There is also, on the other side, financial considerations for doctors who work for these clinics or have part-ownership of same, so it's not a clear case of "money on one side, principle on the other".

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Ryan McCormick, M.D.'s avatar

Hi I’m just exploring tonight and found your substack, thanks for this rundown of California! Local politics are fascinating, especially from a distance here on the east coast. I’m intrigued by Newsom as a presidential candidate - but I have a hard time conceptualizing what he “is.” Interesting that you too seem to find him kind of charismatic but mercurial?

Here in PA we have a battleground between Fetterman and Oz for Senate, as everyone who follows politics (and cares about preserving democracy) knows. I tried to post some words of reassurance as a real physician (unlike what Oz has become) that despite Fettermans verbal challenges, he is still up to the task:

https://mccormickmd.substack.com/p/fetterman-vs-oz-senate-debate

For governor we have a more traditional Republican who participated in the insurrection, denies the legitimacy of our election process, wants rape victims to give birth, and dresses up like a confederate soldier at parties… you know, the usual. Nightmare.

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Erica Rall's avatar

Newsom made a name for himself in California largely through showboating in favor of progressive positions social issues. His actual positions were mainly mainstream liberal, but his rhetorical style was very partisan-red-meat, and he'd occasionally engage in unlawful publicity stunts, most notably the time that as Mayor of San Francisco he order the recorders office to issue marriage licenses to same-sex couples despite a state law explicitly forbidding this (that law was overturned by the courts several years later, but was considered valid and binding at the time). This action was mainly a symbolic stand: California courts promptly issued an injunction overruling Newsom, and not long after ordered the licenses that had been granted to be voided. The court decision voiding the licenses didn't reach the question of whether or not the law was constitutional, so the action didn't even serve as a test case challenging the law.

Since public opinion in the state (and state and federal court precedent) has since come around to support Newsom's positions if not necessarily his tactics, and since Newsom's fiscal policy positions are relatively centrist by California Democrat standards, he's in recent years been able to partially reinvent his image so as to be seen as a responsible moderate, but not so moderate that he isn't willing to take strong stands against right-wing extremists. The "responsible" part of his image took a bit of a beating during the height of the covid lockdowns, as he got some pretty bad press for personally violating the strict rules he'd imposed at the state level or advocated for at city/country levels. But most of that seems to have blown over except among people who already hated him anyway.

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Ryan McCormick, M.D.'s avatar

Excellent primer thank you so much. I feel like this gives me a good handle on him! Seems like some positioning for future goals

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Daniel B. Miller's avatar

I heard or read somewhere that the "Kidney-1" is about some union trying to unionize dialysis techs, and their tactic is to keep forcing the employers to spend money to fight this stupid referendum every cycle until they are completely worn down and just cry uncle about some card-check thing or whatever to make it easier to unionize.

Source: my imperfect memory

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Daniel B. Miller's avatar

not hard to find this analysis: https://www.kqed.org/news/11929612/prop-29-pits-dialysis-companies-against-labor-union-for-third-time-leaving-patients-stuck-in-limbo-again

One detail I forgot: if the prop passes it means dialysis clinics need an on-staff "clinician", but apparently even the union knows this is ridiculous, but it would be so expensive the clinics have to fight or give up. Apparently the union has signaled that if they get their way they will drop the fight to have clinicians on site.

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Deiseach's avatar

Is it the case that the owners of the clinics are not allowing unions in their businesses? Everyone has the right to join a union, so while this union might be strong-arming its way in, if the other side is "join a union and lose your job" that's not right either.

But I don't know about what policies they have in place, so I can only think of hypothetical cases.

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Schmendrick's avatar

One sneaky thing you might not have taken into consideration - "human trafficking" can also include those who bring undocumented migrants/illegal immigrants into the country, so Hochman's stance is essentially an attack on undocumented migration.

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Russ Abbott's avatar

The only direct experience I've had with either Meuser (R) or Padilla (D) is that I once heard Padilla interviewed on the radio. He struck me as blandly fatuous to the point that I couldn't stand listening to him. I certainly don't want to vote for a Republican for Senator, but neither do I want a Senator who doesn't seem capable of thinking.

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Max Ghenis's avatar

I'd also add that Prop 30 would reduce General Fund revenues as rich people reduce their income, move out of state, and decline to move in to California. By my estimates using elasticities from the literature, it would cost at least $1 billion per year, mostly via migration. That means ~20-30% of the tax is effectively a diversion of funds from programs like healthcare and education to cars. https://vote.maxghenis.com/2022/11/california.html#tax-analysis

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robryk's avatar

How do propositions that increase taxes work? IIUC it's not the Constitution of California that specifies tax rates, so what precisely gets added to the constitution? "Taxes shall be no lower than <the increase>"? "Taxes shall be no lower than they were in 2022 increased by <the increase>"? Something else? If this simply introduces a new tax of that magnitude, how is legislature prevented from decreasing the "normal" income tax to compensate (unless they intend to spend less than <the increase> on electric car subsidies and air pollution prevention, they can then also play the money shell game to make this totally toothless)? Am I missing something obvious?

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Chris's avatar

Yes, you seem to be missing something obvious:

California ballot propositions don't have to be changes to their constitution. Whenever Scott doesn't explicitly write that they are, they presumably aren't. I'm not gonna check the post again, but I think only the abortion one was a proposed constitutional change.

The "allow a little bit of gambling" one only mentions the constitution because Scott assumes the proposition is the way it is _because_ allowing other forms of gambling would not be allowed without a constitutional change.

Although that quoted paragraph from the constitution sort of demonstrates "Californians will put any crazy bullshit that doesn't belong in a constitution into their constitution", eg specifying individual games covered by a gambling ban by name, and specifying the range of the fine and prison term for a violation.

100$ to 1000$ in 1872 dollars must be a pretty hefty chunk of cash.

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robryk's avatar

Is there something that prevents the legislature from immediately passing a law that essentially repeals the proposition? The way e.g. Swiss referenda (or rather, referenda about positive propositions) prevent that from happening is that they are always constitutional amendments, so the legislature cannot abolish/amend the result with a referendum.

> Californians will put any crazy bullshit that doesn't belong in a constitution into their constitution

Swiss federal constitution limits the quantity of holiday homes in any "county" as a fraction of total quantity of residential buildings, so it's not only California that does similarly weird things :)

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Chris's avatar

To me, that's quite a bit below "specifying individual games and absolute dollar amounts for fines" in terms of appropriateness for a constitution, bc at least a specified fraction will have basically the same effect even if circumstances and total number of homes change. But yes, that's definitely also kinda weird for a constitution.

Is it the result of a referendum as well?

Because if all propositions introduced via rederendum are necessarily constitutional amendments, that definitely would explain a certain amount of weirdness.

As for the Californian legislature repealing laws voted on in ballot propositions, I don't know - you might need to ask someone who's actually from California or lives there (I'm from Germany, liebe Grüße!), or just check yourself.

I just answered with the "obvious bit" that covered most of your questions, because it seemed like you assumed they were all propositions for constitutional changes. Which makes sense if Switzerland is your reference point (and bc Scott started with constitutional stuff, so that assumption would be reinforced at first).

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Michael Watts's avatar

> Since roulette existed in 1872 but slot machines didn’t, the Constitution banned roulette but not slot machines, and that rule has continued to the present day. Now if slot-machine-filled casinos want to also have roulette, they need a Constitutional amendment.

Something's off here. The problem I see is that, although slot machines didn't exist in 1872, they are clearly covered by the text of the law anyway: they are percentage games "played with [...] any device".

At least, that is the inevitable implication of the definition of "percentage games" given here: https://www.egattorneys.com/illegal-gambling-penal-code-330

> A percentage game is described as a game of chance where the house collects money calculated as a portion of the bets made.

Slot machines are literally defined in terms of the percentage (note!) of bets they return to the gambler. The remainder is, obviously, kept by the house. How would we avoid considering slot machines to be percentage games?

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Ian's avatar

“This is the third time a labor union, Service Employees International Union-United Healthcare Workers West, has put a kidney dialysis measure on the ballot. As CalMatters notes, "The union says it wants to reform the booming industry and increase transparency, while dialysis companies that spent millions to defeat the two prior measures say it’s a union ploy to pressure clinics and organize dialysis workers."

SEIU has long sought to unionize dialysis workers, an effort that the companies that run the clinics have quashed again and again. Dialysis companies say the ballot measures are an effort to pressure them to come to the negotiating table in order to avoid costly ballot measure campaigns.” - Robert Garrova for LAist.com

“They don’t have to invest any of their money to support it, but the other side has to spend tens of millions because it would be a disaster if it were to pass.” - John Logan, director of labor employment studies at SFSU

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David Friedman's avatar

I get a lot of electoral spam, print and email. There were two candidates, both local, who I voted for because of it. In each case, what persuaded me was a message attacking them.

One mayoral candidate reported that her opponent, in his previous private business, had dealt with the NRA, thus proving that he was soft on gun control. I don't approve of that sort of guilt by association, and if he is soft on gun control that's a reason to vote for him.

The other was a candidate for some school position, possibly school board. The body he was on had a resolution saying they were against hate, entirely irrelevant to the job they were doing. He voted against the resolution, which they claimed showed he was in favor of hate. I'm not in favor of hate but I am against organizations wasting their time with irrelevant feel good statements, so I voted for him.

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Dirichlet-to-Neumann's avatar

I coming late just to say that despite all the problems with democracy in the USA, it's still amazing that you are asked to vote on so many different things.

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icodestuff's avatar

Probably too late to influence anyone’s decision, but…

Before reading my voter guide my priors were that I should vote YES on 27. The summary and arguments did little to dissuade me from that. And then I read the text, and it changed my view completely.

I can’t remember a ballot proposition that created a bureaucracy that seemed so ripe for corruption. The regulatory and enforcement committee is structured for super easy capture; 8 of 17 seats are allocated to company reps and reps of the tribes they have contracts with. Another 2 or 3 (apologies for the imprecision, it’s been a few weeks) are reps of non-gaming tribes who get a cut of the take. There’s also no conflict of interest protections. Committee members are not restricted from participating in sports betting, and there are no recusal requirements. It would be completely legal, AFAICT, for one of the companies to extend lines of credit or guve committee members “promotional credit” to buy votes.

The geolocation enforcement seems entirely punitive. No sports betting on Indian lands seems entirely designed to hurt gaming tribes who don’t want to contract with one of the big companies. Worse, the penalties for using unlicensed sports betting companies fall entirely on the consumer. There is no penalty for offering unlicensed sports betting, only using it. The details of the enforcement seem more draconian to me than on 26. I find it hard to believe that this could provide a legal basis for prediction markets, but I’d like to be wrong about that. Scott if you have more details on your thinking there, would love to hear them.

There’s also some factual claims on both sides that are false (or at least very, very unlikely). The con side says that age verification is not required. In fact, “commercially reasonable” age verification measures are required. Which is a bit weaselly, but this is CA. No doubt the courts will interpret something above “tell us your age and please don’t lie” as commercially reasonable. On the pro side, they claim this will increase tax revenues along with the very expensive license fee, but the license fee is creditable against those taxes. So only in cases where sports betting profits (less federal taxes and “promotional credits”) $200 million a year (just from CA) in the first five years does the state even get the entire license fee each year, let alone any additional taxes.

It’s an extremely one-sided proposition. I’m voting against it.

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Amanda's avatar

I am happy to use abortion as a litmus test for "generally respects human rights". If a candidate would force women to carry a fetus for 9 months against their will, I don't trust them to make other decisions that benefit all of their constituents.

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Cakoluchiam's avatar

The Prop 27 summary says it taxes 10% of revenues but all the pennies-on-the-dollar arguments refer to it as 10% of profits. I'm not a business economist, but I'm pretty sure those are different numbers, and 10% of revenues is a lot more than pennies on the dollar when it comes to profits. Can anyone with a better read of the law (I think the relevant section is 19775) and maybe more background in business/taxes tell me what the tax would *actually* amount to in practical terms?

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icodestuff's avatar

It's revenues, minus payouts, minus free bets, minus federal excise taxes, minus promotional credits, minus (in aggregate) license fees. So there are some business deductions that are not claimable (eg payroll), but it's very close to profits. The state would get a cut of the rake, not its own rake.

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Eric Rogstad's avatar

> Until now, Proposition 22 (make it hard for Uber and Lyft to do gig employment) ...

Isn't this backwards? Uber and Lyft *supported* Prop 22, which gave them an exemption to Assembly Bill 5, which had required them to classify drivers as employees.

https://en.wikipedia.org/wiki/2020_California_Proposition_22

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TenaciousK's avatar

Please. It's nicotine+ beta carbolines (reversible MAO inhibitors) that is so horribly addictive, not so much nicotine alone. Vaping is an effective cessation strategy in large part because it allows for withdrawal from the two substances in tandem to occur in separate steps. The propaganda associated with all of this is horrid.

I smoked for 25 years and was an early-adopter of e-cigarettes. I don't know that I ever would have quit otherwise (many attempts). I quit e-cigarettes nearly ten years ago, but I've given myself permission to use the gum or lozenges if I ever feel like I need them.

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