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Comment by logicalmonster | Hacker News Reader

Assuming this is a genuine effort and not some kind of corruption, this potentially sounds great.

But as far as bang for the healthcare buck goes, why not advocate a serious national physical fitness campaign? Many people have gained weight and lost their fitness during the last 2 years, and we're doubling down on doing counterproductive things in cities like introducing friction and barriers for people to get to the gym in the name of defending them from Covid which is completely backwards. Losing weight is probably the single best thing the nation could do for not only better Covid outcomes, but also improving a bunch of other health issues from diabetes to heart disease and possibly cancer as well, if I remember right.

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It’s a worthy goal but I doubt the government could move the needle with any amount of money, much less with just $1.8 billion.

Culture is incredibly difficult to intentionally shift. People actively resist when they feel they are being manipulated even if it is supposed to be for their own good.

Culture is easy to shift, Madison Avenue style ad companies specialize in it. The Frankfurt School is a positive theory that focuses on changing society. Modern nudge initiatives are continuations of this. I would say that the majority of modern culture was at some point the product of some campaign.

Why did the US gov lose the war on drugs? Did the this your brain on drugs commercial series use the wrong ad agency?

The US never intended to win the war on drugs.

More specifically the war on drugs was never about drugs. US is great at manufacturing proxy reasons for biased punitive punishment.

It was probably aliens.

It was Nixon undermining the civil rights and anti-war movements. The CIA probably did more than just turn a blind eye to the heroin importation from the Golden Triangle in Asia.

I heard Nixon was a Freemason.

No, they didn't.

Don't forget that in the US they named their anti-drugs policy in schools: DARE!! lol!

That's some twisted reverse psychology stuff..

The war on drugs was never about drugs per se, and winning was never the goal. It was always primarily a political tool to marginalize certain communities and minority groups.

Why did my 99% white, upper middle class school district have a DARE program? How did that serve to advance the cause of marginalizing minority groups?

Interesting logic; maybe they didn’t want to marginalize the non minorities....

Also, it makes sense to publicly do one thing and privately do another.

DARE campaign was Reagan era, when they were importing cocaine by the plane load.

How did that serve to advance the cause of marginalizing minority groups?

Don't bother pointing out facts or using logic. Any time someone mentions drugs on HN, the usual group of addicts-in-denial show up parroting the same tired and disproven talking points that High Times magazine has been flogging for the last 40 years.

Indoctrination.

Well, exactly. They tried to indoctrinate kids not to take drugs and it failed miserably. So the claim that it’s super easy for the government to shift culture seems wrong, no?

Rather than making a bigger picture point out of a single example, I'm thinking;

In the US, dependent on location, a person may be living under several different governments.

Governments recognize and/or create holidays, and holidays can go on to be cultural events.

Governments organize and finance festivals and events, which can and do become culture of a place or people.

They built statues, museums, parks, libraries, theatres, etc; all with several different levels and layers of culture.

You'd need to start defining parameters of what is a government, what is a culture shift, etc.

Okay. If the US government, in the form of the NIH, spent 1.8 billion dollars trying to get people to exercise more do you think we’d see substantially more exercise happening than we would have otherwise?

Personally, I would doubt "substantial" increases, but that would depend on how you'd want to define that and such.

That doesn't mean they can't, won't, and don't, shift cultures in many other ways.

The overall war on drugs waged by the government was about power and control, but that doesn't mean individual persons and communities couldn't decide for themselves what they were fighting for.

> Why did my 99% white, upper middle class school district have a DARE program? How did that serve to advance the cause of marginalizing minority groups

DARE is a program to increase public positive image of, deference to, and political support for the arbitrary action of police. (And t it's only demonstrated effect is on attitudes toward police; it doesn't have any effect on drug use.)

How that advances the cause of marginalizing minority groups is left as an exercise for the reader.

So the claim is it was deliberately ineffective at getting kids not to take drugs because …?

> So the claim is it was deliberately ineffective at getting kids not to take drugs because …?

The claim is keeping kids off drugs was probably never the real goal, and even if it was the program continued to expand to new places and be funded in existing places long after it was proven ineffective as anything but pro-police propaganda, which wasn't an accident by decision-makers.

Which reveals that even if keeping kids off drugs was once part of the motivation, it wasn't what sustained the program.

Some parts of culture are easier to create than others.

But losing weight? Endless amounts of effort is already spent towards this goal, it is deeply embedded in our culture(for ex. Fat shaming).

I don't some large ad campaign would change that much.

I think there is a rather powerful fat acceptance movement paid for by food lobbyists. Being fat is only socially unacceptable among my upper class friends, I think the middle class has leaned into it.

I think being able to have healthcare discriminate based on smoking has been hugely impactful in cutting US smoking rates, I think the same should be done for being overweight.

They've flipped "fat shaming" into "fat pride", which is the latest territory of "wokeness"

> I think there is a rather powerful fat acceptance movement paid for by food lobbyists.

Fat anxiety is driven by food industry propagandists (more marketers than lobbyists.) Most weight-loss companies are basically high-priced subscription food services with add-on food marketing and a hook that gets people to pay for that as a service. While they've become a big enough business too often be standalone, it's not telling that Weight Watches spent a couple decades as a subsidiary of HJ Heinz.

> I think being able to have healthcare discriminate based on smoking has been hugely impactful in cutting US smoking rates

Health insurance was never prevented from discriminating on that basis, even while smoking rates went through the roof. There's plenty of policies for which there is evidence of utility in cutting smoking rates, health insurance price discrimination isn't one of them.

That’s a fair point, they can already discriminate. I think the insurance plans being tied to jobs led to non-smoking workplaces, and a non smoking workforce, so I think it put employment options for smokers at risk. I think the stats may have been tied to if employers could discriminate based on weight. I forgot the name of the study but I was compelled by the evidence when I saw it. It did speak to my biases so I’ve left the door open to being wrong.

> But losing weight? Endless amounts of effort is already spent towards this goal

The government can educate on and encourage healthy eating and fitness. The goal is not weight loss. Weight loss is just a side effect.

The ad was written in my early childhood. "Can you pinch an inch ?", was the tag-line in a Kellogg's commercial decades ago.

In part thanks to that advert, my entire life whenever I can pinch an inch I simply stop drinking my calories. Admittedly it is harder to eat healthy when you are time constrained and poor. But could there be anything faster and cheaper than pouring a glass of filtered tap water ? Can we advise that first before developing more PSAs about nutrition, exercise routines, etc.

I sedulously disagree.

https://www.globalissues.org/article/532/media-manipulation

https://spinwatch.org/

(note: this is not an endorsement of these sites, but took me 30 seconds to locate online, and verify at least glancingly.)

Same question (hopefully not the same answer): https://news.ycombinator.com/item?id=30238626

Getting people to hate other people, that's easy, the us vs them is baked into human psychology.

Getting people to eat less, not so much.

People wanting to feel good, be more sexually appealing, sleep better, and so on? The desire to achieve higher fitness is pretty ubiquitous, but that is always up against how hard it is to achieve. There are certainly things an org like NIH could do to make it much easier. Better tools, better information, deep subsidization of healthy alternatives all come to mind.

The idea that we cannot make substantial improvements to people’s decision-making context and instead should spend all this money trying to hack the genome is obviously ridiculous.

Are you honestly believing that fat people don’t enjoy life and food, have bad sex, and and stay awake at night worrying about it? I think you will find instead that overweight people are of typical happiness. I think someone has mislead you with false advertising, and done a better job at sharing information than the NIH could ever hope to manage.

What a remarkable straw man argument you’ve defeated! My actual claim is that all other things held equal, people in general prefer to have higher fitness levels over lower fitness levels.

I think you underestimate my laziness. All else being equal, I would likely binge watch TaskMaster.

> The idea that we cannot make substantial improvements to people’s decision-making context and instead should spend all this money trying to hack the genome is obviously ridiculous.

Except piles of cash per year ARE spend trying to change people's habits for the healthier, and it's obviously falling in the US.

You're idea of, "Don't throw a pile cash at medical research, that's stupid! No, spend it on advertising, but healthy stuff!" seems like the obviously ridiculous idea.

Where did I advocate for advertising or PR campaigns?

There is very little funding of behavioral science research compared to pharmacological.

I disagree. The government could easily move the needle if it had the guts to implement nationwide financial changes that would actually make a difference on food contents - tax sugary foods & drinks, implement a sugar daily % value, end corn and dairy subsidies, etc.

I remember when Bloomberg put in some sugary food taxes in NYC. Do you know if there’s any data on whether those policies worked?

I remember it being unpopular, but haven't seen results on the NYC one specifically. Wikipedia has a roundup of results on a few similar implementations, though, and they seem to somewhat work: https://en.wikipedia.org/wiki/Sugary_drink_tax#Consumption

> Culture is incredibly difficult to intentionally shift.

Look how much culture has changed in the last few years, in a direction that closely matches the intentions of some powerful people.

Look at changes around public health, smoking for example.

> People actively resist when they feel they are being manipulated

The only way to change things is to manipulate people?

> It’s a worthy goal but I doubt the government could move the needle with any amount of money

If you are talking about promoting exercise, here I agree: More money isn't always needed.

What about smoking and alcohol consumption, both linked to increased rates of cancer.l, as well. This is just anecdotal but alcohol seems like such an American culture and the prices are incredibly cheap as compared to Canada. I remember buying a 26oz vodka for $7.50 in Hawaii a state where they had to fly that vodka in. Vodka here in Canada would cost me about 3 times the price. Same with cigarettes they are about 2 times the cost here in Canada. People here of course still smoke and drink but I know many have quite due to price. It seems if the government really wanted to reduce cancer it would target some of the other risk factors like smoking and drinking as well.

The benefits of exercise are already well known, by pretty much everybody.

The power of government PSA campaigns is also well known. On average, they enrich advertising agencies and produce no change in the public's behaviour.

> The power of government PSA campaigns is also well known. On average, they enrich advertising agencies and produce no change in the public's behaviour.

It's not well known at all to me. What is the basis of that?

This isn't really a problem that the federal government can solve. The President’s Council on Sports, Fitness & Nutrition has existed for decades but was never very effective. We could make some minor improvements around the edges by giving income tax credits for things like sports equipment, participation fees, diet counseling, etc.

Most of the really pointless and counterproductive Covid restrictions were implemented at the state and local levels where the NIH has no real authority.

> The President’s Council on Sports, Fitness & Nutrition has existed for decades but was never very effective.

It didn't fix everything, but what were its aims and what were the outcomes?

> a serious national physical fitness campaign

ParticipACTION!

Unfortunately, although it gets high marks for awareness, trust, and organizational capacity, it doesn’t seem to have been very effective: Canadian kids are at the bottom of the rankings for fitness and activities.

What makes you think that money spent on changing peoples behavior, will actually change their behavior? What statistics do we have that would make this a "better bang for healthcare buck?"

What do you think the most important meal of the day is?

There is a lot of research on those questions. The people doing it aren't taking shots in the dark.

Do you really think that the US obesity epidemic could ended simply but public outreach campaigns? If so, I have 4 bridges to sell you.

Now, if you would be advocating banning advertisements for fast food, candy and other junk , you might be on to something.

Not the NIH, but this was actually a thing for several decades up until Trump:

https://en.wikipedia.org/wiki/The_President%27s_Challenge

It does not seem to have been effective.

> Assuming this is a genuine effort and not some kind of corruption, this potentially sounds great.

It’s a genuine effort to put something positive on the table for the administration as the mid-term elections ramp up. Biden, like his predecessor, is historically unpopular. The administration is desperate to do anything to maintain control of the house and senate.

This “plan” is a retread of Biden’s 2012 scheme that went nowhere.

As for corruption, probably just run-of-the-mill NIH feudalism. Even Joe Biden isn’t so brazenly corrupt that he’d directly pay his bag men while he’s the sitting President.

It’s good to see cancer get more money & attention, regardless of the motive.

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