I don't want Biden to subsidize nuclear power by pouring money into it. I want him to remove the barriers which make the construction of new and novel nuclear power plants so ungodly expensive.
Build the damn Yuca mountain nuclear waste site. Give passively safe reactors fast tracked NRC approvals (it's incoherent to let existing designs continue to operate and go over inherently less dangerous new designs with a fine tooth comb). And, most importantly, limit the ability of opponents to use APA and EPA report and notice/comment requirements to hold up projects of all kinds (they aren't substantive requirements).
Besides, I want the nuclear people to get behind carbon taxes as their ticket to profits.
Anything the Deep State touches will be destroyed expensively. Case and point the California "Train to Nowhere project". Everyone who could stole the money and since everyone is guilty no repercussions for the billions wasted on nothing useful.
Did you know more people lost power in Texas and Louisiana in 2023 than during Winter Storm Uri?? Guess what caused the power outages?? Tree branches and trees falling on power lines. So tree branches turned a 1 GW nuclear power plant into a giant expensive paper weight! Bottom line—the grid is the weak link in the electricity system AND the grid is the most expensive aspect of the system!! Nuclear is a red herring unless you have ideas about how it reduces reliance on the grid. Btw, I have ideas about how to use nuclear to make the grid more robust.
To what extent do wealthy SF "progressives" believe their own rhetoric? I'm personally a great believer in Hanlon's razor, so I'm inclined to think this is caused by self-deception rather than craven self-interest. Humans in general are very good at convincing ourselves that what is good for us is good for everyone.
I'm honestly not sure there's a clear dichotomy between those two things. When something is in people's craven self-interest, they are quiet good at using self-deception to invent reasons to feel good about supporting that thing...
Some armchair psychology. If Peskin has firmly in his mind "this area isn't supposed to be developed" as a stand-alone idea that he relied on in his real-estate investments, he probably also developed the idea that "other people feel this area isn't supposed to be developed, and are relying on it". As a politician, he refuses to pull the rug on all these people.
The fact that these are all rich people doesn't enter it, because he doesn't think of himself as an out-of-touch rich person. Despite the housing crisis, he is not thinking about the much greater need in the all the people struggling to get housing, or if he is, he is not connecting their fate to the housing opportunity he is turning down.
This all started with "this area isn't supposed to be developed" which is a proposition never justified except by consensus of his personal bubble. Sometimes people insist on their thinking being more rigorous than that, but its hard because socially it feels like picking a fight over nothing, and intellectually it requires developing a conceptual framework for what zoning is even supposed to be (answer, it's not supposed to exist).
So he failed twice, first in gathering consensus with the wrong social circle and second not developing a principled basis for the important decisions of a lawmaker.
It matters a great deal whether he is misguided about the facts (in which case he is persuadable) or actually is clear-eyed about the reality and simply working towards the wrong moral end. For local YIMBYs, it would be the difference between putting their energies into lobbying Mr Peskin versus running him out of office.
To be fair, we’ve already been detecting cancers of questionable clinical significance for some time. This is a possibility any time you scan a healthy person (eg for a research study). Tumours picked up this way get called ‘incidentalomas’ and there are usually guidelines for how to deal with them, depending on where they’re found in the body
And I bet if all those who had just died were scanned they would find almost everybody had something lurking somewhere in their bodies. And without constant scanning we may never know how many of these things are there for a time, but the body actually clears them out.
I agree many will have cancer/tumours by end of life but think it’s more a case of something else killing you first rather than the body actively clearing out a cancer
No, the immune system clears out cancerous cells all the time. Tumors only form when the immune system can't detect or deal with certain cancerous cells. (That's why immunotherapy has been increasingly successful as a cancer treatment.)
The medical mafia's policies create cancers as a work product, that they get to treat expensively. Cancer is easily reversible. I am doing a podcast series on it.
RIP Daniel Kahneman, and thanks for the nice write-up Noah. I read Thinking Fast and Slow about ten years ago and it was an eye-opener. Understanding biases and the whole System-1/System-2 thing completely changed the way I approached my life. I think it should be required reading.
Cancer screening has had the problem of significance of "early" detection forever. This doesn't just apply to "incidentally" found tumors but to screening programs themselves. it is called overdiagnosis. Perhaps best known in prostate screening, it shows up essentially in all cancer screening programs including breast and lung. There was a famous study from South Korea looking at thyroid cancer screening in which the incidence went through the roof but the change in mortality was zero, since screening detected very low grade tumors that had no effect on mortality. (https://www.nejm.org/doi/full/10.1056/NEJMp1409841) There is no reason this doesn't apply to AI detected breast tumors as well. The usual solution is to do a randomized control study (which Noah loves for economics) to see if finding these small tumors changes outcomes. Outcomes is what you really care about, not finding tiny tumors.
I guess the other way to go would be to so screening even better: eg if the screening itself could distinguish between dangerous and non-dangerous tumors. Problem there is how to run the clinical trial since once you’ve detected any tumor it’s not ethical to tell people “we’re just gonna wait and see if it kills you to improve our dataset. “
In clinical practice, we do trials that do exactly that. It is not to improve the dataset, it is to decide what to do. There are lung cancers we just watch these days as a result of that kind of data.
I was talking to my dad (a retired pathologist) about this at the weekend and he did highlight the risks of overdiagnosis (and remember him telling me about the South Korea study previously). I think AI should in time improve both accuracy and speed of assessment. A point to note in relation to overdiagnosis is that a pathologist will only look at a tissue sample once some form of primary clinician has decided that something is worthy of taking a biopsy. Earlier picking up and possible overdiagnosis may have an impact in screening programs but for samples outside of this there is normally a reason for a biopsy (and normally more than simply an unexplained lump) if there is a either a lower error rate at this stage or malignent tumours are picked up at an earlier stage you would expect it to lead to better outcomes. Although properly run trials to assess this would be important. False positives are as important as false negatives in cancer screening as most people would not (and should not given side effects and other risks) go through surgery, chemotherapy or radiotherapy if its not needed.
From the Washington Post (also in Thinking Fast and Slow):
"During World War II, he was forced to wear a Star of David after Nazi German forces occupied the city in 1940. One night in 1941 or ’42, he later recalled, he stayed out past the German-imposed curfew for Jews while visiting a friend, and he turned his sweater inside out to hide the star while he walked a few blocks home. He then crossed paths with a soldier in the SS, who called him over, picked him up — and hugged him.
'I was terrified that he would notice the star inside my sweater,' Dr. Kahneman noted …... But the German pulled out his wallet, showed him a photo of a boy, gave him some money and sent him on his way. 'I went home more certain than ever that my mother was right: people were endlessly complicated and interesting.'”
Have "progressives" ever really favored the poor? as with everyone, they actually just work for their self-interest, and their big government policies eventually pave the way for more poverty, state violence and homelessness while the well-connected are more powerful than ever. I sure as hell wouldn't want to live in California
I think that’s what right wingers like to tell themselves so that they don’t have to feel guilty about being nakedly selfish.
I think there is a lot of idiocy on the far left - mostly because they cannot cope with trade offs - but most of them do care about poor people. It’s not a coincidence that they support universal health care for example.
Not to mention the whole idea that the road to hell is paved with good intentions...I think of communism and how the world really dodged bullet. If well-intentioned people had been allowed to enact their heartfelt policies to help the poor the entire world could be like Russian, China and North Korea.
Well-intentioned individuals can be among the most dangerous...I am sure there were any number of priests in the inquisition who strongly believed they were saving people's immortal souls...
What exactly is your claim here? That we should dismiss everyone who exhibits good intentions because they exhibit good intentions? You're conveniently ignoring the great deal of welcome change that came about because of well-intentioned people who fought for it against reactionaries like yourself playing Chicken Little about it.
The reason we don't have things like chattel slavery, child labor, and disease-ridden meat at the grocery store is due to people acting on good intentions. Wonder of wonders, sometimes they work out! But sure enough there were people right there to call it (falsely, as it turns out) the road to serfdom.
The privileged using fear-mongering to guard their privilege ... same as it ever was.
No…most people have good intentions..I am just arguing that only that we do not assume good intentions is all (or even much of what matters, be aware of the bootlegger and baptist dilemma and check outcomes. This is not an extreme view….most of the NMBY arguments are built on some combination of this.
Except even those people taking the shortcut frame their ideas as being well-intentioned. Even Hitler felt the need to justify himself…as did Mao and Stalin. Trickle down economics etc.
No one comes right out and says they have bad intentions…all the more reason to be suspicious
Truisms break down too easily. I won' be convinced that trying to do the right thing is the actually a bad thing let alone that an absence of good intentions will be better. Sure, look for the hidden self interested motivation, the loopholes, the politically expedient compromises but our greatest problems don't go away by avoiding facing up to them - or ignoring the ethical, moral, legal reasons they should be addressed.
I am absolutely positively an outlier here and I don't want to be part of a Kahneman error. But I'm alive only because of an almost random PSA test for prostate cancer. I don't really understand why you're only supposed to take the test if you're old. It seems to me that as you approach the end of your natural life prostate cancer becomes less and less likely to be the cause of your death. So why implant fear of something that almost certainly won't happen. But mine was caught at 50 when there's usually still a lot of life left in you. So if you have cancer with several decades to go you might want to nip it in the bud. I started out in the wait and see camp but it escalated remarkably quickly and if I had waited just a few months it would have been all over for me. But again that's extremely rare so don't pull a kahneman based on my experience.
I was a graduate student in Math Education at Stanford for five years shortly before Dr. Boaler arrived. The professors I knew (though I loved them dearly) consistently opposed anything that smacked of “tracking” or elitism, beginning algebra in middle school being one instance. Yet, the majority of them sent their own children to exclusive private schools. Most of the exceptions went to top-tier public schools in the wealthy areas in which they lived.
It also occurred to me that, considering Stanford’s very low acceptance rate, students there are already tracked.
> One interesting idea is to just come up with a different name for the lowest-risk, slowest-growing forms of prostate cancer, in order to stop people from freaking out about having “cancer”.
We already kinda have that concept, with "pre-cancerous" cells. I was born with a birthmark, a couple inches across, of a type that's known to sometimes turn into a melanoma. When I was in my teens, I was referred by a GP to a dermatologist, who looked at it, and decided that it was technically "pre-cancerous" but it looked like a high risk for turning into an actual cancer. (Something about the edges not being a nice smooth line, looking kind of like a moth-eaten edge on a piece of fabric. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738388/ ) Because it was right there on the surface, it would be pretty easy and cheap to remove it. So I got that done. (Simple procedure under local anaesthesia, in and out. The guy doing the surgery, when he was cauterizing the blood vessels from the removal site, quipped, "If you smell something burning, don't worry, it's just you.")
It doesn't seem like a stretch to start describing small clumps of cells that pose a _risk_ of turning into something life-threatening, but where the risks of doing surgery or chemo or radiotherapy outweight that risk, as "pre-cancerous".
Female baby boomer here: I struggled with math in school always-learned to hate it. In college, changed my major from art to biology and had to complete the math sequence or else no degree-so now, algebra, geometry, trig and calculus. Figure it out or else. The terrible math experience from middle/high school haunted me, but I learned how to learn it in college. Had to repeat Calculus, but got through the sequence, got the degree. My point is, that to eliminate early educational struggles because the students don't like it, don't see the point, everybody is frustrated, cheats the young person by allowing a future door to be closed before he/she is capable of understanding that there is something worth having behind that door. Ditto Latin classes which turned out to be a super helpful bit of programming in my head. It's a failure of the imagination to assume that because students don't need a skill now, they won't need it in the future or that in not having that tool, opportunity will be denied. That's the opposite of equity.
Fascinating about cancer detection. Right now, many of the tools we have are controversial, because there are so many false positives. It's an exciting time to be alive.
Would love to see a post on rapidly falling battery prices, and what it takes to get to the place where battery+solar can really scale to get rid of all the remaining coal and then gas.
I don't want Biden to subsidize nuclear power by pouring money into it. I want him to remove the barriers which make the construction of new and novel nuclear power plants so ungodly expensive.
Build the damn Yuca mountain nuclear waste site. Give passively safe reactors fast tracked NRC approvals (it's incoherent to let existing designs continue to operate and go over inherently less dangerous new designs with a fine tooth comb). And, most importantly, limit the ability of opponents to use APA and EPA report and notice/comment requirements to hold up projects of all kinds (they aren't substantive requirements).
Besides, I want the nuclear people to get behind carbon taxes as their ticket to profits.
Anything the Deep State touches will be destroyed expensively. Case and point the California "Train to Nowhere project". Everyone who could stole the money and since everyone is guilty no repercussions for the billions wasted on nothing useful.
Did you know more people lost power in Texas and Louisiana in 2023 than during Winter Storm Uri?? Guess what caused the power outages?? Tree branches and trees falling on power lines. So tree branches turned a 1 GW nuclear power plant into a giant expensive paper weight! Bottom line—the grid is the weak link in the electricity system AND the grid is the most expensive aspect of the system!! Nuclear is a red herring unless you have ideas about how it reduces reliance on the grid. Btw, I have ideas about how to use nuclear to make the grid more robust.
Who is Uri?
The February 2021 storm that hit Texas!?! Probably the craziest weather event I’ve ever experienced.
To what extent do wealthy SF "progressives" believe their own rhetoric? I'm personally a great believer in Hanlon's razor, so I'm inclined to think this is caused by self-deception rather than craven self-interest. Humans in general are very good at convincing ourselves that what is good for us is good for everyone.
I'm honestly not sure there's a clear dichotomy between those two things. When something is in people's craven self-interest, they are quiet good at using self-deception to invent reasons to feel good about supporting that thing...
So where one stands depends on where one sits, huh? 😏
Some armchair psychology. If Peskin has firmly in his mind "this area isn't supposed to be developed" as a stand-alone idea that he relied on in his real-estate investments, he probably also developed the idea that "other people feel this area isn't supposed to be developed, and are relying on it". As a politician, he refuses to pull the rug on all these people.
The fact that these are all rich people doesn't enter it, because he doesn't think of himself as an out-of-touch rich person. Despite the housing crisis, he is not thinking about the much greater need in the all the people struggling to get housing, or if he is, he is not connecting their fate to the housing opportunity he is turning down.
This all started with "this area isn't supposed to be developed" which is a proposition never justified except by consensus of his personal bubble. Sometimes people insist on their thinking being more rigorous than that, but its hard because socially it feels like picking a fight over nothing, and intellectually it requires developing a conceptual framework for what zoning is even supposed to be (answer, it's not supposed to exist).
So he failed twice, first in gathering consensus with the wrong social circle and second not developing a principled basis for the important decisions of a lawmaker.
Your insight about the personal bubble is particularly salient here (and in homage to Daniel Kahneman (maybe a selection bias).
who cares? He's a scumbag either way
It matters a great deal whether he is misguided about the facts (in which case he is persuadable) or actually is clear-eyed about the reality and simply working towards the wrong moral end. For local YIMBYs, it would be the difference between putting their energies into lobbying Mr Peskin versus running him out of office.
fair enough, but I think in the specific case of Peskin it's been clear enough that he is not indeed a good faith operator.
To be fair, we’ve already been detecting cancers of questionable clinical significance for some time. This is a possibility any time you scan a healthy person (eg for a research study). Tumours picked up this way get called ‘incidentalomas’ and there are usually guidelines for how to deal with them, depending on where they’re found in the body
And I bet if all those who had just died were scanned they would find almost everybody had something lurking somewhere in their bodies. And without constant scanning we may never know how many of these things are there for a time, but the body actually clears them out.
I agree many will have cancer/tumours by end of life but think it’s more a case of something else killing you first rather than the body actively clearing out a cancer
No, the immune system clears out cancerous cells all the time. Tumors only form when the immune system can't detect or deal with certain cancerous cells. (That's why immunotherapy has been increasingly successful as a cancer treatment.)
The medical mafia's policies create cancers as a work product, that they get to treat expensively. Cancer is easily reversible. I am doing a podcast series on it.
RIP Daniel Kahneman, and thanks for the nice write-up Noah. I read Thinking Fast and Slow about ten years ago and it was an eye-opener. Understanding biases and the whole System-1/System-2 thing completely changed the way I approached my life. I think it should be required reading.
Truer words.
This post certainly lives up to your title "five interesting things."
Cancer screening has had the problem of significance of "early" detection forever. This doesn't just apply to "incidentally" found tumors but to screening programs themselves. it is called overdiagnosis. Perhaps best known in prostate screening, it shows up essentially in all cancer screening programs including breast and lung. There was a famous study from South Korea looking at thyroid cancer screening in which the incidence went through the roof but the change in mortality was zero, since screening detected very low grade tumors that had no effect on mortality. (https://www.nejm.org/doi/full/10.1056/NEJMp1409841) There is no reason this doesn't apply to AI detected breast tumors as well. The usual solution is to do a randomized control study (which Noah loves for economics) to see if finding these small tumors changes outcomes. Outcomes is what you really care about, not finding tiny tumors.
I guess the other way to go would be to so screening even better: eg if the screening itself could distinguish between dangerous and non-dangerous tumors. Problem there is how to run the clinical trial since once you’ve detected any tumor it’s not ethical to tell people “we’re just gonna wait and see if it kills you to improve our dataset. “
In clinical practice, we do trials that do exactly that. It is not to improve the dataset, it is to decide what to do. There are lung cancers we just watch these days as a result of that kind of data.
Misdiagnosing cancer is very profitable. They will still charge you for the service even if nothing is there and claim it was a success. Like magic.
I was talking to my dad (a retired pathologist) about this at the weekend and he did highlight the risks of overdiagnosis (and remember him telling me about the South Korea study previously). I think AI should in time improve both accuracy and speed of assessment. A point to note in relation to overdiagnosis is that a pathologist will only look at a tissue sample once some form of primary clinician has decided that something is worthy of taking a biopsy. Earlier picking up and possible overdiagnosis may have an impact in screening programs but for samples outside of this there is normally a reason for a biopsy (and normally more than simply an unexplained lump) if there is a either a lower error rate at this stage or malignent tumours are picked up at an earlier stage you would expect it to lead to better outcomes. Although properly run trials to assess this would be important. False positives are as important as false negatives in cancer screening as most people would not (and should not given side effects and other risks) go through surgery, chemotherapy or radiotherapy if its not needed.
From the Washington Post (also in Thinking Fast and Slow):
"During World War II, he was forced to wear a Star of David after Nazi German forces occupied the city in 1940. One night in 1941 or ’42, he later recalled, he stayed out past the German-imposed curfew for Jews while visiting a friend, and he turned his sweater inside out to hide the star while he walked a few blocks home. He then crossed paths with a soldier in the SS, who called him over, picked him up — and hugged him.
'I was terrified that he would notice the star inside my sweater,' Dr. Kahneman noted …... But the German pulled out his wallet, showed him a photo of a boy, gave him some money and sent him on his way. 'I went home more certain than ever that my mother was right: people were endlessly complicated and interesting.'”
You say "Meanwhile, on the left, Palestine protests were never that common and have become even rarer." Do you have any numbers on this?
Have "progressives" ever really favored the poor? as with everyone, they actually just work for their self-interest, and their big government policies eventually pave the way for more poverty, state violence and homelessness while the well-connected are more powerful than ever. I sure as hell wouldn't want to live in California
I think that’s what right wingers like to tell themselves so that they don’t have to feel guilty about being nakedly selfish.
I think there is a lot of idiocy on the far left - mostly because they cannot cope with trade offs - but most of them do care about poor people. It’s not a coincidence that they support universal health care for example.
This is true, but I suppose it does make it easy for bad actors to infiltrate these spaces and push forward their own malign agendas.
Not to mention the whole idea that the road to hell is paved with good intentions...I think of communism and how the world really dodged bullet. If well-intentioned people had been allowed to enact their heartfelt policies to help the poor the entire world could be like Russian, China and North Korea.
Well-intentioned individuals can be among the most dangerous...I am sure there were any number of priests in the inquisition who strongly believed they were saving people's immortal souls...
What exactly is your claim here? That we should dismiss everyone who exhibits good intentions because they exhibit good intentions? You're conveniently ignoring the great deal of welcome change that came about because of well-intentioned people who fought for it against reactionaries like yourself playing Chicken Little about it.
The reason we don't have things like chattel slavery, child labor, and disease-ridden meat at the grocery store is due to people acting on good intentions. Wonder of wonders, sometimes they work out! But sure enough there were people right there to call it (falsely, as it turns out) the road to serfdom.
The privileged using fear-mongering to guard their privilege ... same as it ever was.
No…most people have good intentions..I am just arguing that only that we do not assume good intentions is all (or even much of what matters, be aware of the bootlegger and baptist dilemma and check outcomes. This is not an extreme view….most of the NMBY arguments are built on some combination of this.
The road to hell may (allegedly) be paved with good intentions but the shortcut has none.
Except even those people taking the shortcut frame their ideas as being well-intentioned. Even Hitler felt the need to justify himself…as did Mao and Stalin. Trickle down economics etc.
No one comes right out and says they have bad intentions…all the more reason to be suspicious
Truisms break down too easily. I won' be convinced that trying to do the right thing is the actually a bad thing let alone that an absence of good intentions will be better. Sure, look for the hidden self interested motivation, the loopholes, the politically expedient compromises but our greatest problems don't go away by avoiding facing up to them - or ignoring the ethical, moral, legal reasons they should be addressed.
I am absolutely positively an outlier here and I don't want to be part of a Kahneman error. But I'm alive only because of an almost random PSA test for prostate cancer. I don't really understand why you're only supposed to take the test if you're old. It seems to me that as you approach the end of your natural life prostate cancer becomes less and less likely to be the cause of your death. So why implant fear of something that almost certainly won't happen. But mine was caught at 50 when there's usually still a lot of life left in you. So if you have cancer with several decades to go you might want to nip it in the bud. I started out in the wait and see camp but it escalated remarkably quickly and if I had waited just a few months it would have been all over for me. But again that's extremely rare so don't pull a kahneman based on my experience.
I was a graduate student in Math Education at Stanford for five years shortly before Dr. Boaler arrived. The professors I knew (though I loved them dearly) consistently opposed anything that smacked of “tracking” or elitism, beginning algebra in middle school being one instance. Yet, the majority of them sent their own children to exclusive private schools. Most of the exceptions went to top-tier public schools in the wealthy areas in which they lived.
It also occurred to me that, considering Stanford’s very low acceptance rate, students there are already tracked.
> One interesting idea is to just come up with a different name for the lowest-risk, slowest-growing forms of prostate cancer, in order to stop people from freaking out about having “cancer”.
We already kinda have that concept, with "pre-cancerous" cells. I was born with a birthmark, a couple inches across, of a type that's known to sometimes turn into a melanoma. When I was in my teens, I was referred by a GP to a dermatologist, who looked at it, and decided that it was technically "pre-cancerous" but it looked like a high risk for turning into an actual cancer. (Something about the edges not being a nice smooth line, looking kind of like a moth-eaten edge on a piece of fabric. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6738388/ ) Because it was right there on the surface, it would be pretty easy and cheap to remove it. So I got that done. (Simple procedure under local anaesthesia, in and out. The guy doing the surgery, when he was cauterizing the blood vessels from the removal site, quipped, "If you smell something burning, don't worry, it's just you.")
It doesn't seem like a stretch to start describing small clumps of cells that pose a _risk_ of turning into something life-threatening, but where the risks of doing surgery or chemo or radiotherapy outweight that risk, as "pre-cancerous".
Female baby boomer here: I struggled with math in school always-learned to hate it. In college, changed my major from art to biology and had to complete the math sequence or else no degree-so now, algebra, geometry, trig and calculus. Figure it out or else. The terrible math experience from middle/high school haunted me, but I learned how to learn it in college. Had to repeat Calculus, but got through the sequence, got the degree. My point is, that to eliminate early educational struggles because the students don't like it, don't see the point, everybody is frustrated, cheats the young person by allowing a future door to be closed before he/she is capable of understanding that there is something worth having behind that door. Ditto Latin classes which turned out to be a super helpful bit of programming in my head. It's a failure of the imagination to assume that because students don't need a skill now, they won't need it in the future or that in not having that tool, opportunity will be denied. That's the opposite of equity.
Fascinating about cancer detection. Right now, many of the tools we have are controversial, because there are so many false positives. It's an exciting time to be alive.
You might want to look into using what3words when guiding people to your hanami party.
Would love to see a post on rapidly falling battery prices, and what it takes to get to the place where battery+solar can really scale to get rid of all the remaining coal and then gas.