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Comment by Perseids | Hacker News Reader

And one other thing: Cheap, anonymous tests for everyone. It should be the norm that when you hook up with a new person / one night stand that you show them your recent negative test result. At least where I live (Germany) you can already get them sent to your home for 50€ (https://samhealth.de/) and you can get free tests at your local health office (Gesundheitsamt) if you are not too shy to argue a bit. AFAICT it should be a net positive for society to completely subsidize home tests for everyone, but that is probably an uphill battle against conservative prejudices even in Germany.

> A bit of diet, exercise, and an once of prevention is worth its weight in gold.

All those cases of just eating less sugar / exercising more / sitting less are unfortunately really hard for most individuals. We really should strive to create environments where doing the good thing is as easy as possible. Like offering free daily work breaks for sport or having healthy lunch meals for children in school.

View on HN

For the people living in London: https://www.shl.uk/. Home delivery and completely free.

> AFAICT it should be a net positive for society to completely subsidize home tests for everyone, but that is probably an uphill battle against conservative prejudices even in Germany.

Great, now we’re “prejudiced” for not wanting to subsidize other people’s risky sexual behavior.

Did it ever occur to you that if there is, as you suggest, a large health burden associated with casual sex culture (and, according to the article, drug use culture), that maybe the “conservatives” are correct to be “prejudiced” against it?

You can yell about it, concoct vindictive policies to punish people whose behavior you don't like, dress up these policies by describing them in purportedly scientific economic terms like "subsidizing," "externality," "free rider," etc., but ultimately, this is a futile position to take. People are going to do what they want.

If the effect of peoples' real aggregate behavior creates a negative effect that you might suffer from in the future, e.g. breeding antibiotic resistant bacteria, then the more effective position is to STFU with all of the moralizing and support policies that actually work, even if you have to pony up a bit to pay for them. It's cheaper for you in the long run -- you're not just paying to support risky behavior, you're paying so that behavior that is going to happen anyway doesn't put you at risk in the future.

Your options are to be angry today and sick or dead tomorrow, or to let it go, support effective policies today, and get a better shot at a successful tomorrow. Yelling at people doesn't work.

> STFU with all of the moralizing

Parent is responding to accusations of "conservative prejudice." That is its own moralizing.

You can make the pragmatic argument that it's pointless to try to control the risky behaviors of others, or to expect the people engaged in those risky behaviors to bear the cost of them. But it's pretty insulting to then disparage others as "prejudiced" for not liking this deal, while having no criticism of the behavior itself. "People are going to do what they want" -- well maybe some people want to be upset about subsidizing behavior they don't approve of.

This guy is reasonable. Kudos to making reasoned and nuanced observations regarding both sides of the argument.

Seems pretty obvious to me that conservatives would be as susceptible to prejudices as the rest of humanity. Stating that common prejudices amongst those who identify as conservative might negatively affect specific policies is not itself moralizing.

The snippet just before your quote was:

> then the more effective position is to

(emphasis added)

I agree with you that people have the right to be upset, to moralize, etc. My insinuation was that it isn't effective as public policy, which is the extra step that moralizing conservatives seem eager to take.

I'm fine if they want to sit in the corner and whine, but if they're going to use this whining to enact policies that don't work, and that haven't worked despite decades of trying, then I'm going to push back, and yes, I'm going to be a little insulting, especially seeing as they have no problem berating the people that they don't approve of.

People who insist on maintaining a delusion despite evidence that it doesn't work, and despite examples of other policies in other places that produce better results annoy me. Why should I have to pay for the externalities of their stupid opinions when I'm not the one the one having them? (See, it sounds just as ridiculous from the other side)

How much evidence is there that insulting others is an effective way to get them to change their opinions and support the policies you favor? If the basis of your annoyance is ineffectiveness, then I would expect you to feel a lot of annoyance at people who insult others and call them stupid as a strategy for changing their behavior.

Turning that question around: do you have any evidence that it's not effective? Do you have evidence of another argumentation style that's more effective?

I'm hard pressed to design a good, reproducible experiment on the question one way or the other.

I won't pretend to be familiar with the academic literature, but here is one paper I found: https://www.sciencedirect.com/science/article/abs/pii/002210...

> The field situation consisted of a park-bench discussion of a topical social issue, arranged by a public-opinion interviewer. Prepared experimental variations were introduced by one of the discussion partners, a confederate of the interviewer. In the critical variation, the confederate insulted the subject during discussion. In other variations, he tried to persuade but did not insult, or else simply gave certain arguments without intent to persuade. Attitude-change results supported the hypothesis of negative change in the insult condition.

Eleanor Gordon-Smith spent two years interviewing people who changed their minds, and suggests this:

> The strategy is this: Ask where people’s beliefs come from as well as what they actually believe.

https://www.marketwatch.com/story/this-is-the-difficult-secr...

Nifty that somebody at least tried!

The paper has been cited only about 40 times in the half-century since it was written, but I found one recent interesting citation:

https://www.researchgate.net/publication/327127198_The_Monta...

    Uncivil remarks uniquely diminished the speaker’s reputation, and had little impact on the reputation of the targets of the attack, the perceived winner of the verbal exchange, the reputation of the speaker’s party, or the sense that the country is moving in the right direction. Incivility made the speaker seem less warm and did less to affect perceptions of dominance or honesty. This warmth deficit explained the reputational costs of incivility.

That's from 2018 and specifically takes recent American politics into account.

I'm skeptical of the study for a variety of reasons, mostly coming down to the issue of what people tell researchers vs what they actually do. But it's good to know that somebody is at least trying.

You raise a good point... essentially the same point I made earlier -- insulting people is as bad a strategy for changing behavior as yelling at them.

If I were trying to get moralizing conservatives to agree with me, then not insulting them would indeed be the first part of an effective strategy. However, I'm not trying to change minds, because that is also fruitless.

For the same reason that trying to convince ordinary people that their promiscuous lifestyles are bad won't actually change their behavior, trying to convince moralizing conservatives that their entire worldview is wrong isn't going to change their perspective.

This kind of person is not trying to achieve an effective outcome through policy, they're trying to use policy as a weapon against people they don't like. Debating the effectiveness of various policy options won't move that particular needle, so why bother?

> I'm fine if they want to sit in the corner and whine, but if they're going to use this whining to enact policies that don't work despite decades of trying, then I'm going to push back, and yes, I'm going to be a little insulting

This is a little problematic for me. You are basically saying people have a right to whine, but not a right to try to remedy the situation causing their whining.

Say you live in a fictional country X. Country X has a problem called "Raw Water Fever" where people get these massive chronic migraines because they take untreated stream water and squirt it up their butts with a baster (this is called "basting" - and gives a nice euphoric effect due to some yet-undetermined combination of native bacteria in the water reacting with gut bacteria). Previous efforts to get people in country X to use treated water fail because they complain the treated water doesn't produce any euphoria. The country also tried outright banning basting, and that was also ineffective.

So, the government decides that the right solution to this problem is to reach into your wallet to subsidize free per-use testing kits for the whole country. These testing kits would be able to tell you whether the water you are about to squirt up your butt has the Raw Water Fever bacteria present.

If you protest, the government says that while are allowed to whine about them reaching into your wallet, that's about all you are allowed to do because they already attempted previously to ban basting and it was ineffective.

Are you cool with this, or would it leave a bad taste in your mouth? Now, say that basting is not country X's only source of problems, it has lots of other problems stemming from behaviors you don't partake in. The government wants to reach into your wallet for each of those problems too. How are you feeling at this point? Are you glad to give up your hard earned money to help citizens of country X continue their favorite behaviors safely? Or does it leave a bad taste in your mouth and make you want to move to a different country where the citizens' behaviors align more with your own?

Sex is something hardwired into people. Basting in this example? Not so much.

Like just replace the word basting with the word sex in your example.

"The government tried outright banning sex"--sounds pretty ludicrous! Has any government even tried such a thing in all of history?

Personally, I welcome the prospect of my tax dollars being used to help people rather than kill and maim them. The amount each individual has to contribute for such a thing is likely incredibly low as well.

Well, I was sort of thinking of drugs when I made the analogy, but the government policy response is similar (i.e. the government wants to reach into my wallet to subsidize free syringes, drug purity tests, etc.)

> Sex is something hardwired into people

This is an appeal to nature. We naturally want to do it, therefore we shouldn't try to resist it? There are many counter examples: violence, incest, tribalism, and other undesirable evolutionary behaviors are hardwired into people (and animals) too, yet our efforts to reduce/temper their influence and emergence can be quite effective (though not 100% effective). Why is sex any different? I think we could temper sexual activity with the right messaging (and more importantly, leading by example) to youth.

Something like "sex is something that should be reserved for a committed relationship, not a recreational activity you should do casually - the latter leads to a lot of problems in society. Nevertheless, the choice is up to you and here are the risks and things you need to know either way..." Obviously "accidents" would still happen, but the idea would be to address the root cause of sex-related issues in society instead of throwing your hands into the air and deciding to just treat the symptoms.

You could say it's special pleading on my part, but for the continuation of homo sapiens, sex is required (at least for now).

> violence, incest, tribalism, and other undesirable evolutionary behaviors

None of the explicitly mentioned things in this list are similarly essential to the continuation of humans and human civilization. Like violence may in reality be unavoidable, but that doesn't mean it's strictly necessary.

But I do agree that appeal to nature alone isn't very strong. Like to me, I guess it's moreso what seems like extreme impracticality in trying to control people's sexuality to a finer degree than is already in place.

> I guess it's moreso what seems like extreme impracticality in trying to control people's sexuality to a finer degree than is already in place.

I agree trying to "control" people's sexuality is extremely impractical. That's why I think it needs to be more a cultural value that we collectively decide is worth teaching to kids (and leading by example), not something the government forces on us. I think that would work because it worked for me and my extended family as far as I can tell (with a few exceptions).

Isn't this still a form of control? Like the idea here is to psychologically manipulate people to have different values? What happens when some people don't respond to this proposed conditioning?

I would like to believe I have somewhat of a unique perspective on this. I was raised with the exact cultural values you talk about, and I ultimately chose to reject them (at least partially).

However, I do want to acknowledge what seems like a destabilizing, negative effect "hookup culture" or the like has had on society. Dating apps are part of this whole issue as well.

My own position is that I want to be in a committed relationship but never married. So I guess you could peg me as a serial monogamist.

How exactly do you expect to impose this value on everyone else who doesn’t share it with you?

I don't want to impose the value on people that don't share it with me. I want to convince people to share the value with me first and rely on network effects to convince others to share the value until those that don't share it are in a minority.

Yes but how? Is it really realistic to expect the people in this story are going to be talked into monogamy?

The people specifically in the story? Probably not. Americans in general over a period of time? Maybe. I could see a "religious renaissance" happening at some point where religion goes on the rise again if/when people become disillusioned with secularism/nihilism/etc, a side effect of which would be people being "talked into monogamy"

The actual trend with religion is precisely the opposite.

I — and I’d guess most Americans — got such messaging in health class. Can’t say it had much influence on my actual behavior.

School has limited influence on kids when compared to parents. If your parents don't see casual sex as a big deal, neither will you. If your mom got pregnant at 14, well, I guess it's not a big deal if you get pregnant at 14 either.

I grew up in a fairly wealthy little town where pretty much nobody was the child of a teen parent. It’s awfully facile, and to my own experience, to pretend the children of such parents are the only people having sex in high school.

I live in a part of Maryland with high teen pregnancy rates. Unsurprisingly, the pregnant teens are often the children of single moms who were also pregnant teens. Is this a coincidence? Even ignoring truancy problem, somehow I don't believe sending all these kids to wealthy gold-plated schools to get a "proper" sexual health education will fix the issue because my argument is that the messaging they receive at home through their parent(s) is 10x stronger and more influential than the school's messaging.

I would guess failure to use effective birth control methods could be correlated pretty well with income but I’d be pretty surprised to see any evidence that sexual activity was much lower in the tony towns. I’m also going to refer back to my memories of being a teenager to say that I often didn’t really put much stock in my parents’ values or wisdom, and hardly think I was alone in this.

Anecdotal evidence

Do you think I’m wrong to say that sex education courses, regardless of whether they’re abstinence-only or more modern, typically already include admonitions against promiscuous sex?

No, you are not wrong to say that... but that’s not what your parent comment was saying. Your comment was saying that messaging did not have much influence on your behavior later in life. I’m saying that just because it didn’t have much influence on your behavior does not mean it hasn’t had much influence on the behavior of others

Well, if it’s widespread, and yet people are not behaving as we would wish, I would conclude it’s not very effective at influencing their behavior.

You do not know that the problem wouldn’t be worse without widespread messaging.

That's impossible to prove or disprove. Fortunately we don't have to because it's been well demonstrated that it's not sufficient.

Certainly some governments have attempted to criminalize extramarital sex. However 1) limited efficacy 2) creates an extremely regressive society I think few Americans would welcome

I reject the thinking that "people are going to do what they want" and we are helpless to influence their behavior so we should just accept whatever they are doing no questions asked and work around it with public policy if it causes a problem. The reason I reject it is because I would argue "what people want to do" does not spontaneously arise in their minds, but rather is influenced by popular culture, marketing, and more.

Take alcohol for example. You might say "you can't prevent people from drinking, look at Prohibition, it was a complete failure, don't even try", and in a certain sense you are right. You can't prevent all people from drinking.

However, you can prevent many people from drinking (or at least, reduce the total amount of drinking to more moderate levels) by:

- Not glorifying alcohol via pop culture and movies (especially American binge drinking at age 21)

- Restrict/regulate alcohol advertisements and marketing to reduce the influence of "drinking = happiness" messaging

- etc.

Or, stated in other terms, you can exacerbate your country's alcohol-related issues by glorifying alcohol and enshrining it in popular culture.

In the same vein, maybe we wouldn't have as big of a problem if we didn't glorify casual sex encounters so much in our media. If popular media/culture instead glorified things like self-restraint, commitment, etc, I'm sure some % of people would be influenced.

> I reject the thinking that "people are going to do what they want" and we are helpless to influence their behavior so we should just accept whatever they are doing no questions asked and work around it with public policy if it causes a problem. The reason I reject it is because I would argue what people want to do does not spontaneously arise in their minds, but rather is influenced by popular culture, marketing, and more.

Hmm, let's see how well that worked with sexually active teenagers in the bible belt, shall we?

https://www.healthline.com/health-news/abstinence-programs-i...

https://www.npr.org/sections/health-shots/2017/08/23/5452891...

https://www.publichealth.columbia.edu/public-health-now/news...

That just proves that Sunday school can’t do much in the face of a culture that overwhelmingly normalizes casual sex in TV, movies, music, etc. That doesn’t mean that societies committed to the opposite don’t exist. And many do—such as much of Asia. We can argue about the merits of say Bangladeshi society (where I’m from) but we have almost completely escaped the global AIDs epidemic.

Bangladeshi society focused more on education and healthcare initiatives, not propaganda -- at least according to wiki

If one of the attempts did not work, it doesn't mean that none of them will.

Excellent point! Seems like some are more interested in pushing their own beliefs and morality on others rather than examining the evidence of what makes effective (or ineffective) public policy.

Gay man here, on prep in a long term open relationship.

To date I have yet to come across anything in mainstream media that comes close to 'glorifying' the type of relationship I have with my partner, or non-monogamy in general. Can you give any examples of this?

I'd also argue I'm in a committed relationship, but I'm not going argue semantics.

Yeah, I would argue "long term relationship" is a sign of commitment.

I'm more talking about shows and movies that make it seem like non-committal hookups and switching sexual partners rapidly for any reason is cool and totally normal:

- How I Met Your Mother (Barney)

- The Office (everyone has slept with everyone by the end)

- Game of Thrones

You could argue the "good" characters like Tyrion typically showed more commitment in their sexual activities than "bad" characters like Theon who just knocked up random women for fun. But even then you have instances where the "heroes" like Arya have one night stands with no consequences (because HBO wanted to be edgy).

- Friends

I'll be honest I've not seen the first two series so I'll avoid speculating. I'm sure you are absolutely right.

In the case of Game of Thrones, a lot of the more 'liberal' sexual encounters were really put in for shock value or an excuse for nudity, for example Oberyn's orgy scenes. I never really got the feeling it was trying to normalise these things, but that was just my interpretation.

Similarly for Friends my interpretation was characters like Joey were to be the punchline of a joke, not to say his behaviour was normal. It felt more to laugh AT him, not to normalise it.

My experiences of mainstream media seems to largely focus on the young bachelor(ette) who has casual sex as a 'phase', or the monogamous faithful couple who've grown up and matured. Despite this narrative, I really don't believe monogamy works for a fair percentage of the population. This leads to either two states:-

1. They never form close romantic relationships, leading to more casual sex and probably larger risk of spreading STDs.

2. They do engage in a monogamous relationship, only for it to turn sour because of the tensions it causes. In some cases this leads to a party cheating on the other. These people almost never go to STI clinics to get tested for fear it will ruin their relationships.

How about instead the mainstream media embraced the idea of wanting to have multiple sexual partners is fine regardless of your stage of your life or your relationship status? That way, we can have make sure that everyone is informed of the risks and getting the medical treatment they need to keep themselves and others safe (particularly regular testing). As soon as you start demonising it and saying you shouldn't feel that way, people will do it anyway and just hide it instead.

Have you considered the possibility that this might have more to do with the fact that serial monogamy is already widespread (and has been since before it was commonly depicted on television) and the shows have a relatively limited cast of characters?

Even if not, are we asking the government to step in and ban Friends? Because if not, I don’t see how this observation gives us anything approaching a solution.

Continuing to raise awareness of the consequences of assuming risky behavior is a reasonable action that could be taken. With widespread messaging, the burdens of the consequences of risky behavior greater fall solely onto those who engage in the behavior, rather than being distributed evenly across society

“Raising awareness” sounds pretty much useless.

No evidence provided.

Of course it is useful - if you don’t know of a thing, you don’t know the consequences of engaging in that thing. It’s as axiomatic as the trite and age old saying “knowledge is power”. Your comment is completely disingenuous.

I don’t think the problem here is people aren’t aware that venereal disease is a possible result of unprotected sex. You have provided just as little evidence for your assertion to the contrary.

My hunch is that people are probably generally unaware of the recent rise in syphilis cases, would do well to be more informed, and with proliferation of the message some general adjustment of behavior in society is to be expected

My hunch is that that isn’t true because people on the story are shrugging off multiple infections.

Again anecdotal evidence. Just because some people shrug off multiple infections does not mean awareness has no influence.

And your "hunches" are rigorous? If you are going to demand rigor of your interlocutors I would say you have an obligation to demonstrate it yourself.

> Even if not, are we asking the government to step in and ban Friends? Because if not, I don’t see how this observation gives us anything approaching a solution.

Absolutely not. Government should not have to solve every problem in society. The solution is for us (consumers) to not watch shows that promote values we don't agree with. And if you do agree with them... you reap what you sow.

So in other words you don’t have any solution.

I have a solution, just not a solution the government can implement.

Attempt to derail parent argument by citing inadequacy of reflection of anecdote in a general survey of literature/media

Pretty much every sitcom today glorifies casual sex and avoidance of committed relationships. “How I Met Your Mother” for example.

So what do you actually want to do? Create a board of censors? Bring back the Hayes Code?

>However, you can prevent many people from drinking (or at least, reduce the total amount of drinking to more moderate levels) by:

actually doing something effective like taxing the purchase of alcohol to such a level that people don't do as much of it unless they are alcoholics.

So all we have to do is tax when people purchase their genitalia for the weekend.

> People are going to do what they want

Sure, but that doesn’t stop us from trying to influence people in other areas, so why should it stop us here. By this argument we should abolish all laws because what’s the point of telling someone “don’t murder” when “people are going to do what they want”?

Your post makes it sound like you are also against taxing cigarettes or taxing cars with big engines or banning guns since we should not (or it would be pointless) to influence behavior in such ways.

> People are going to do what they want.

That’s obviously not true. Asian countries for example have far lower rates of drug use, sex outside of marriage, etc. than western countries. For example Bangladesh, the country where I’m from, has virtually no prevalence of HIV. (And it actually has quite a good system of health reporting so it’s not just failure to collect data.) Societies can in fact shame and coerce people into avoiding harmful behaviors.

This is always the hard part with public health policy, you can barely make any demands before people say screw this and ignore you, as we've learned from asking people to wear masks :/

>STFU with all of the moralizing

Why subsidize an activity that puts health at risk? Sure, people will do what they want, but this just incentivizes people to put themselves at risk and makes everyone else pay for it.

You have it completely backwards. This policy isn't subsidizing risky sex. It's the opposite--subsidizing STD testing to make casual sex less risky.

Btw. I have a friend who likes fast reckless driving. Now we could yell about it or just except that some people like to drive with no regards to theirs and others safety and not punish them for it and maybe even pay fines for them?

>STFU with all of the moralizing and support policies that actually work, even if you have to pony up a bit to pay for them. It's cheaper for you in the long run

>Your options are to be angry today and sick or dead tomorrow, or to let it go, support effective policies today,

You're asking for one portion of the populous to take on the burden cause by lack of restraint by another. There is legitimate reason for "moralizing" here. This is the point where what "two people do in the privacy of their bedroom" spills over into affecting everyone else.

It's ironic that "yelling at people doesn't work" yet we see just as much yelling and moralizing by the people who want the freedom to do whatever they want even when their actions DO negatively affect others.

You are suggesting something like how mafia works. STFU and pay for your protection or else.

I didn't know asking people to fund public health programs through tax was equivalent to the mafia?

The person I was replying to, wasn't asking.

Do you think people are having unprotected sex to punish you?

No. Did you read the post I was replying to?

I did. But unless you think the act is vindictive and specifically intended to punish, the analogy to a protection racket doesn’t make a lot of sense.

The person I was replying to implied that if we don't do things the way he thinks it should be done, we might end sick or dead. And to say STFU and except my wisdom as pure gold is also ill mannered and unkind.

Lots of things are ill mannered or unkind yet have little in common with a protection racket. His point is that people are going to engage in risky behavior regardless and we have the choice to attempt to mitigate the consequences or just stick our hands in the sand.

That is a false choice. Prevention is better than cure. Supporting safe sex or sex in steady relationships seems to work much better so far than his ideas that nothing can be done we should all just chip in.

Moral argument: functioning society's don't expect their member to act perfectly and always make the right choices. Would you expect a hospital not to treat you because you got injured while committing risky behavior (e.g. extreme sports, trying strange foods, or arguably driving a car)? Treatments like this support "repeat offenders" and the poor bastards who make a wrong choice once alike.

Pragmatic argument: It's better economically and for productivity for people to not have HIV, Syphilis, etc. It's far easier to provide treatment and testing then to tell people to stop having sex.

I think it's actually fine to charge higher premiums to people who take significantly greater risks than the average person. we already do this with car insurance for people who drive certain models, have been in at-fault collisions, have traffic infractions on record, etc. no one "needs" to go skiing or drive a fast car, but a.) we should let them and b.) they ought to pay a bit more into the pool.

I can see the argument for that, however from my reading OP was arguing that people who take greater risks shouldn't get treatment at all or be "subsidized" by people who don't. You seem to be arguing (and correct me if I'm wrong) that people making riskier choices pay more for themselves to make up for that.

I don't really understand the distinction you're trying to draw between "make those who choose to live risky lives pay more" vs. "people who take risks shouldn't be subsidized by people who don't".

Aren't those the same thing?

yes, that is exactly what I'm arguing. if everyone pays into a pool without any risk adjustment, that is effectively a subsidy to the risk-takers. I think that is a more fair way to understand rayiner's objection to "subsidies". I don't think he is seriously arguing that risk-takers should be denied care/testing/whatever altogether.

of course this is all hypothetical with the current state of US healthcare. step one has to be a reasonable cost baseline for people who don't elect a bunch of extra risk.

How is this different from healthcare as it is set out now or in the past? (Pre existing condition? Too bad. Too expensive to keep you around. Pay out of pocket.)

Hypothetically, you don’t need healthcare if you live/lived a near fundamentally perfect lifestyle. Accidents happen but then maybe don’t use knives or ever leave your home too.

Be a bubble boy.

you are strawmanning me a bit.

> people who don't elect a bunch of extra risk

I'm not talking about preexisting conditions. I'm talking about conscious choices people make that increase their risk level. I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.

> I'm not telling you how to live your life, but if our care is funded from the same pool and you live a riskier life by choice, I don't think it's unfair for me to ask that you pay proportionally more.

Charging people more for coverage is telling them how to live their life. And where is the line drawn? "Oh, you like to go 10mph over the limit? Higher medical coverage fees, sir. You're likely to get hurt. Oh, sir, you live in a rough neighborhood? Very likely to get shot sir, you should definitely have higher premiums, yes."

You may as well ask people to not have health insurance and just pay out of pocket for everything.

Btw - do you really think if you do this that costs will go down for you in this hypothetical system? They won't. Premiums will go up for everyone and the people who will profit are executive leadership.

Very well and succinctly put

Moral argument: functioning societies don't move the burden of the consequences of known risky behavior from those doing such behavior to those who are not. In fact, that's a recepie for a civilizational death spiral.

I think I'd need to see a better argument that we're moving the burden of consequences. Riding a bike with no helmet is known risky behavior; if they get hit by a car or fall or their bike and have to go to the hospital, would you say that's shifting the burden of consequence? People with Syphilis who get tested and help for it still pay their taxes, which helped fund their treatment. They still have consequences such as having to see a doctor, take medicine which may be unpleasant (ever have GI side-effects from an anti-biotic?), and of course they experience the side-effects of, you know, having Syphilis. The government isn't taking $20 out of your wallet to bribe the bacteria to not infect someone.

By this standard we’re arguably at greater risk of civilizational death spiral, e.g., helping homeowners to rebuild in natural disaster-prone areas than trying to treat venereal disease.

strange: drunk driving continues to cause grave personal, public health and economic harm to non-participants and has for, what, well over 50 years? yet the US seems to be largely "functioning".

If we're just handing out everything for free then I'd argue it's also better economically for people (and particularly kids) to have free eye care, free dental care, and a million other things I'd rather see subsidized over free Syphilis tests.

I 100% agree with you and I'm sorry this is not the case in the country you live in. I keep forgetting how bad the health care system is in some parts of the rich and developed world. I agree with my sibling comments that fortunately you can have all of those for free, for affordable prices for society, if the right policies are implemented.

Economically, I absolutely agree and fortunately we have the power to do both. Plus Syphilis testing is very cheap, relative to most testing (about $20-$50 for early infections) and testing costs are only going down. Rapid testing is even cheaper, down to something like $5 per test.

Why does it have to be either/or?

It's better economically and for productivity for people to not have HIV, Syphilis, etc.

Stop this. It isn't an economics issue. This is a moral issue. Your tract of reasoning is precisely why the world is growing so untenable for the human element. There needn't exist laws or programs or any other edifice by which regulation is effected. People need to be made to realize that they're being wholly indiscretionate and their disposition to do so comes at a cost, and it should be personal to make the point manifest.

With all due respect, the first half of comment is literally prefaced with "the moral argument". Personally I believe that argument should be enough, but you gotta play to the audience.

I always love reading your comments...

You know, it's interesting that we highlight the health burden of other activities like smoking and some governments want to go as far as banning salt and sugary soda for the same reasons.

But on this one topic we treat people like they're monsters for suggesting we should be choosier about our sexual encounters. Not just that sexual freedom is prioritized in our society, but _exercising_ that freedom is treated like a virtue. Despite all of the obvious costs and despite the fact that most people end up being less active than we'd expect and on the other side of that spectrum a lot of people come to regret their choices.

You yourself are making the distinction between the casual sex culture and STD testing. Diseases have a way of spreading and not testing for STD is a piss-poor way to change hookup culture for the better.

The question is whether you want to deal with the STD health problem or not. Moralising doesn't get you anywhere.

People are engaged in this behaviour either way, it doesn't require subsidy.

What you do by enabling everyone to self-monitor is solve the collective harm of harmful viruses spreading.

So do you want to preserve your moral sensibility, or do you want to stop the spread of viruses?

I think it is perfectly reasonable to say, of people who choose the former, that they aren't very praiseworthy people.

> Moralising doesn't get you anywhere.

Society is terrible at this, though. Issues like this tend to become proxy wars for other things.

I mean, look how mask wearing has become moralized. It should never have become a silly political fight, it should've been people helping people get masks and avoid disease. Instead, we have all sorts of nonsense like idiots burning masks or arresting someone alone on a deserted beach for not having a mask.

You're advocating taking money from those who don't participate in these health-risking activities to subsidize those who do, and you're chastising the parent post for moralizing? How absurd.

It's not a subsidy. It's the cost of avoiding public health crises.

Treating STIs is more expensive than testing, and also paid for through statutory insurance.

Do you drive a car? Do you eat red meat? Do you burn fossil fuels or rely on any kind of electricity? Well done. We are all subsidizing your risky lifestyle.

When you are willing to retire to a plot of land and live entirely upon it, including starving each winter, then you may throw stones at "subsidizing" other people's risky behavior. Until then, you don't get to pick and choose which behavior we subsidize and which we do not.

Alternatively, we can pass a law that says citizens can choose which kinds of risky behavior they are willing so subsidize with their taxes.

"prejudices" was a bad wording. I'm sorry to have ignited that much emotional heat which deters from good discussion culture. My usage of "prejudice" was the best kind of correct: technically correct. I was thinking about how nearly everyone that I had a personal discussion with lost their view point about how subsidizing STI tests was a bad idea after I told them about personal experiences of some acquaintances of mine. So those people were (technically) prejudiced, as a close inspection of such cases changed their judgement.

Nonetheless, the word itself has strong connotations and it's mostly neither nice nor effective to tell someone to their face that they are prejudiced. And I can't assume it to be the case about a potential reader of my post.

Regarding whether it is good policy, even with a conservative value system, my sibling comments have already presented most of the points I would make.

This is a really gracious comment, thanks for being so understanding.

The people disproportionately getting STDs have short time horizons. Regardless of the incentives in place, they're going to be having risky sex. It's less costly for society to pay for widespread testing and the occasional treatment than it is to pay for widespread treatment and no testing.

A prejudice is just a pre-conceived notion about something. So yes, if you have decided that casual sex is bad, you are prejudiced against it. Don't be so upset, it's not a problem.

There's a huge cost associated with child-rearing as well but that's just part of human civilization, as is lots of sex and, while we're at it, drug use.

There are many countries where sex outside of marriage and drug use occur at very low rates. As a result they have escaped the attendant social problems, such as single parent households, the AIDS epidemic, etc.

Other people's risky sexual behaviour can harm you even if you (normally) don't engage in it yourself; it's not like skiing where people can break only their own necks. You can do two things to minimize the harm:

(a) try to reduce the number of people who engage in risky sex—through changing people's views, different upbringing and whatnot;

(b) try to mitigate the consequences of their behaviour—by subsidizing testing for infections and treatment.

Note that there's no dichotomy here.

I don't know if there's a good, reliable way to do (a); also, some people can be against it for ideological reasons. But (b) in the meantime is straightforward to implement and is known to be efficient. Why not implement (b) and make it work it while we are arguing about (a)?

> maybe the “conservatives” are correct to be “prejudiced” against it?

Conservatives should not be stigmatized for supporting (a), this is not prejudice, they can have the view they have on sex. But I don't see a single reason, except prejudice, that can make you go against (b), which is simply practical.

>> that maybe the “conservatives” are correct to be “prejudiced” against it?

Because the most vocal "conservatives" are often the ones that, in private, are the most casual about sex. Not a day goes by without a news story about a conservative politician caught in some sexual scandal/coverup/fiasco. It is to the point that if I see any powerful man advocating abstinence I just assume he has a couple girlfriends stashed somewhere. Thou doth protest too much.

The "conservatives" seem to be prejudiced against casual sex behaviors for the wrong reasons: religious dogma, moral panic, personal bias etc...

The dollar cost of casual sex culture is not a reason I have heard cited as an argument against casual sex in pop conservatism. If you want to get into what costs society a greater amount, gay men getting syphilis is going to be way farther down the list than people having large numbers of children. We heavily subsidize that form of sexual activity.

> It should be the norm that when you hook up with a new person / one night stand that you show them your recent negative test result.

While I agree, €50 for an ONS is not exactly cheap.

One would think an order of magnitude of the bar tab is not too much to ask.

In the US we are deterred from getting STD testing because the cost will be variable and sometimes very high, depending on what insurance you happen to have (or not) at the time.

From a libertarianish perspective, the best way is not a subsidy, but letting the price of the test drop into readily affordable levels.

This also helps less developed and rich nations than Germany. A USD 10 comprehensive test for basic STDs would be a huge game changer in Africa.

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