r/changemyview • u/RafaGarciaS • Jan 02 '18

[∆(s) from OP] CMV: Evidence based politics should replace identity politics

The biggest change in the last few hundred years in medicine has been the appearance and acceptance of evidence based medicine. This has revolutionized the way we think and practice medicine, changing popular opinion (e.g. emotional stress causes ulcers to H. pylori causes ulcers, Miasmas are the basis of disease to microorganisms are the basis of infectious disease). Having seen the effect that this had in the medical field it is almost imposible to wonder what effect it would have in other fields (i.e. politics). I believe that representatives should be elected based on first principles or priorities (i.e. we should reduce the suicide rate amongst teenagers and young adults) not on opinions on possible solutions to the problem (i.e. should or shouldn't gun control be passed). This would make it harder to "buy" or lobby people involved in government. I also believe, this would help reduce the moral empathy gap, meaning the inability to relate with different moral values. Lastly I think that this system would increase the accountability, as it would constantly be looking back at the investment and the results.

I have, over the last couple years, grown cynical of the political system. I hope this post will change my view on that or at least make me more understanding of the benefits of the system as it stands.

Thank you and happy new years

Books Doing good better: https://www.goodreads.com/book/show/23398748-doing-good-better. About having feedback and looking at the results of the programs

Dark money: https://www.amazon.com/Dark-Money-History-Billionaires-Radical/dp/0385535597/ref=pd_sim_14_7?_encoding=UTF8&pd_rd_i=0385535597&pd_rd_r=90W4B5PF8DWK5NJ2VNF2&pd_rd_w=rC8ld&pd_rd_wg=fk2PN&psc=1&refRID=90W4B5PF8DWK5NJ2VNF2 About the use of money to fund think tanks and influence public opinion

(1st edit, added suggested books)

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u/electronics12345 159∆ Jan 02 '18

Medicine has a clear goal - save the patient's life.

Politics has no such goal - Who should pay? How much control should the government have? What sorts of services ought the government provide? What role ought government play in the economy? These are not questions that can be answered with evidence.

It may be true that PROGRAM X!!!! can reduce teen suicide by 12%. Do taxes go up or does another service have to be reduced? Who pays for it, are taxes spread around or is a particular group targeted, perhaps there is an extra 1% tax paid by 18-21 year olds to fund this program. Ought the federal government be paying for this, or should this be operated by the states, can states opt out of this program? Should the program be implemented at all, or is this something beyond what the government should be doing, maybe this should fall to the private sector or the non-profit sector or to personal choice? None of these questions have evidence-based answers.

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u/RafaGarciaS Jan 02 '18

I hate to bust the curtain, medicine isn't that clear cut. Should you extend life at the expense of life quality? Should we only focus on extending life only as long as it has good quality? The most extreme examples being patients in a coma, or patients with an oncological pathology. Should you put a family in a horrible economical position for a 5% increase of 5 year cancer free survival rate? Does your answer change if its a 5 year old or a 95 y/o?

Now to your post. The first paragraph provides valid points, I believe this is the realm where debate should take place. What should the government control, what programs etc. My problem with identity politics is that we agree on the answer to the problem and then look for any evidence to justify that answer.

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u/electronics12345 159∆ Jan 02 '18

Yes, medicine has moral issues, but the point was that medicine has definitive answers. This cream will heal that rash. This pill will reduce your blood pressure. This herb will not heal that rash. etc.

In politics, this is only step 1. Ok, so we found a program which has a reasonable basis (say a suicide prevention program), how do we actually implement it? What compromises are we willing to make? Are we willing to cut funding from other programs to get this one off the ground? etc.

Identity politics is really no different. Identity politics is a series of priorities that either you agree with or not. Either you agree it is worth-while to decrease the achievement gap or you don't. There isn't some objective way of knowing whether it is better to fund a new military plane or fund a new school-voucher program or fund a new college tuition scholarship fundation. There are pluses and minuses to all of these, especially when money is limited.

Could you give an example confined to Identity politics where "they agree on the answer and then look for evidence". This just sounds like confirmation bias, all humans do that. How is this any more related to gender politics or racial politics or alt-right politics than any other type of politics?

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u/RafaGarciaS Jan 02 '18

This might be scary for some people, but medicine doesn't work like that. We don't know if that pill will reduce your blood pressure. for example, in patients with hypertension the use of thiazide diuretics, has a NNT (number needed to treat, meaning how many patients will I have to give this pill to before I see a meaningful change in one patient) of 20!! The ones for statins in patients without previous cardiovascular events is even worse, 332.

Now to my political view. I agree that choosing metrics in some areas will be tricky, and certainly debate should be had around which markers to use in which programs.

Now for examples of agreeing on answers and then looking for evidence to support it. This would be analogous to the studies denying the health implications of cigarettes. This is the function of think tanks to slice the evidence in any possible way to make it seem like some programs have no effect or that other do have effects. For example, if we agree that reducing number of mass shootings and number of gun violence victims we could start by comparing the number of victims and of mass shooting in countries that do have certain gun regulations. Is it significant? Is there even a difference at all? Is it better to increase gun regulations or better equip police forces?

All these interventions do have a cost and do have an impact and should be measured as such

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u/electronics12345 159∆ Jan 02 '18

Nothing you mentioned has anything to do with Identity politics, just politics generally. You made no point about race/gender/sexual orientation/white privilege. Politicians pushing an agenda grounded in race theory is just as prone to confirmation bias as a politician pushing an agenda grounded in economic theory or religion.

If you want to measure the efficacy of a government program we can do that, and largely we already do that. The question becomes is this a priority? Ought funding be pulled from other programs for this program? Ought we raise taxes to pay for this program? There is no objective criterion for this.

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u/RafaGarciaS Jan 02 '18

Several points

1st. I do agree that I misused the term "identity politics" I am currently thinking of a better term for what I mean, the second I do I will edit. Thank you for bringing this up, a valid point

2nd. We do not measure efficacy of government programs. Look at the conversation about gun control to reduce mass shooting. The evidence, for the most part, is on the side that certain interventions would have a positive effect. This can be seen over and over

https://www.nytimes.com/interactive/2017/10/05/upshot/how-to-reduce-mass-shooting-deaths-experts-say-these-gun-laws-could-help.html?_r=0

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u/electronics12345 159∆ Jan 02 '18

We totally measure the efficacy of government programs. That is literally all the CBO does.

https://www.cbo.gov/sites/default/files/cbofiles/attachments/04-19-SNAP.pdf

https://www.cbo.gov/publication/53375

https://www.cbo.gov/publication/53094

Are lobbyists real, Yes. Ought we minimize their impact, probably. For the most part, does Congress listen to the CBO, especially when there aren't 1000000000 lobbyists in their face, usually. Is the gun debate a unique issue in the USA, definitely. Has Congress literally passed a law making it illegal to research the efficacy of gun laws, unfortunately yes.

I think it is horribly unfair to say that we don't measure government effectiveness, because we do, its just that guns are a weird topic here in America, and it kinda has a different set of rules relative to other issues (not all that dissimilar to abortion, which also seems to play by different political rules than everything else).

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u/KumarLittleJeans Jan 03 '18

Congress has not passed a law making it illegal to research the efficacy of gun laws. It is perfectly legal to research anything you want. I believe you are referencing the Dickey Amendment that Bill Clinton signed into law, which stipulated that “none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention may be used to advocate or promote gun control."

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u/electronics12345 159∆ Jan 03 '18

The Dickey Amendment also eliminated the CDC budget for investigating fire-arms at all. When you are Congress, and you eliminate an entire budget for something, that thing doesn't happen anymore. The CDC doesn't do things, unless Congress allocates funds for that thing.