I am allegedly a human being, and as such I am susceptible to cognitive bias. One of my safeguards against gaining too much confidence in my own mental abilities involves periodically comparing my predictions to actual events.

I will pause here to say I assume that I forget the bad predictions and remember the winners. That's how bias works. That's also why I do this publicly, so you can keep me honest. I'll tell you when I get one right from time to time, and I expect you to remind me of the ones I got terribly wrong.

I've been predicting for some time that healthcare spending was going to drop dramatically in our lifetime. This was a prediction based on the Adams Rule of Slow-Moving Disasters. The rule observes that whenever society recognizes far in advance a coming disaster, the disaster never materializes. That's partly because humans rise to the challenge and partly because we are bad at predicting the future.

In October I predicted that Obamacare (which looked like a slow-moving disaster) would turn out okay. It's premature to claim my prediction was right, but it's moving in the right direction.

Here's my blog prediction and here's an article on the unexpected slowing of healthcare spending.

When doctor-assisted suicide becomes legal in most states, healthcare costs could plunge again because medical expenses are disproportionately allocated to the last months of life that most of us would gladly do without.

Today's prediction is that doctor-assisted suicide will become legal in most of the United States in the near future. The battles over legal weed and gay marriage have proven that the majority of citizens are increasingly biased toward personal freedom and that the majority wins in the long run. And in this blog I've shown that when you ask the question right, nearly everyone is in favor of leaving government out of end-of-life medical decisions for loved ones. Liberals and conservatives agree on the wisdom of keeping government out of this sort of decision. (Some safeguards would be welcome though.)

The alternative to doctor-assisted suicide is a slow-moving disaster in which all of society's resources are increasingly redirected toward keeping seniors alive. That future won't happen. We'll figure it out.


Scott Adams

Co-founder of CalendarTree.com

Author of this book



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Jul 17, 2014

You make an interesting point, but I'm still not convinced. Your argument boils down, essentially, to a person's love of (their own) money trumping their fear of death (in others). And there is certainly some truth to that.

It depends on how much "there, but for the Grace of God, go I" philosophy survives. It appears to be ebbing now, as the libertarian "selfishness" waxes. If it continues, then it will be the libertarianism that wants to cut off funding for other people's grandpas. If people see themselves in others, then they will be more inclined to help other people's grandpas, so as to help their own (even if such help is not needed).

So ultimately, Scott is right -- that libertarianism will bring about assisted suicide. It may be that this is why libertarianism is on the rise now: we are running out of resources (energy; minerals), and we intuitively know it, even if we aren't consciously acknowledging it (or even actively denying it). As social survival becomes threatened, we retreat into personal survival, so as to maintain the species even if its culture is doomed. That's something that it would take a Hari Seldon to answer.
Jul 17, 2014

[I think what @language trying to say is: A slow moving disaster to look at is the degradation of moral values, in that laws are needed where conventional wisdom and societal pressure were generally sufficient]

That doesn't qualify as a slow moving disaster that WE ALL see coming.
Jul 17, 2014
Many of the people signing up on the federal exchange are re-insured - meaning they previously had insurance and are changing companies. Obamacare is not reaching the masses that are uninsured. The reality is Obamacare is not health care reform, it's about health insurance reform. The people who sign up that previously didn't have health insurance are high risk. Insurance companies will be subsidized based on the risk of this group. Those subsidies will eventually go away and rates will go up. Whether the government subsidizes these people or rate go up, the result will be higher costs through taxes or others paying for the uninsured. Remember, the government doesn't have their own money, they have our money, so either way, we pay. The jury is still out on Obamacare, but it's proving it will be unsuccessful already. The government doesn't run efficient or effective business, and Obamacare will prove this again. The criteria stated to have lower costs will have no impact on the cost of health care. And most importantly, the cost of health care has no correlation to the outcomes of improved health. See the world wide studies on costs versus health.
Jul 17, 2014
Dang! Big red button on the right.
Jul 17, 2014
As a bleeding heart liberal, I've decided to go ahead and invite the hate: The down vote is the big red button on right. (Hmm...)

The Affordable Care Act was designed to help insure the uninsured and to lower the overall cost of healthcare, and it seems to be doing that.

Go figure.
Jul 17, 2014

I respectfully submit you look to the right as well, where traditional values are quietly but forcefully trampled underfoot even as they're used as political cudgels.

It takes the disguise of "responsibility to the shareholders" or hides behind "the invisible hand of the market." It rejects and mocks personal responsibility by deferring to the imaginary will of a corporation.

In its most offensive form, it clumsily quotes Ayn Rand and frankly preaches that self-interest trumps every value that places humanity above animals and machines. Randians whine about the commercial failure of the "Atlas Shrugged" movies. They actually feel wronged because their presumed inferiors don't embrace propaganda that tells them they're excrement. And in the next breath they're ranting about liberal elitists and demanding the love of those same masses.

In recent years the modern right has been falling all over itself trying to have it both ways: the Ten Commandments on the courthouse steps, yet legal protection to those who lie, covet or kill on a profitable scale. Creationism in the classroom, but no concession to the teachings of Christ in the boardroom. Trying to defend these hypocrisies has reduced many of their spokesmen to nonsensical arguments supported only by anger and outright falsehoods.

It's not aging hippies who are messing up the next generation. It's a society where the rich and powerful can publicly and proudly violate every value they want the rest of us to follow. And they want to be loved and respected for kicking their fellow citizens in the teeth. Yes, there's an example for youth.
+1 Rank Up Rank Down
Jul 16, 2014
I dispute your initial allegation and all of the other points that follow it.
Jul 16, 2014
Wow, c-i-r-c-u-*-s-t-a-n-c-e-s is a rude word? That's ... interesting.
Jul 16, 2014
Well, since you asked, let me remind you of this one:


(Granted, !$%*!$%*!$%*! have changed in a number of ways since then.)
Jul 16, 2014

I think you and Scott are both overlooking something in regards to assisted suicide. I agree with him that it will become legal and acceptable, but not necessarily because people are changing to become more libertarian.

Rather, as government takes control of more and more of the health care sector, costs will be increasingly socialized. As costs are socialized, decisions are no longer personal. All of a sudden, your neighbor who is keeping his 102 year old grandfather on expensive dialysis and radiation treatments isn't a noble and responsible grandkid sacrificing for the sake of family. No, YOUR money is on the line now. Elderly folks who continue to receive expensive treatments will be treated as welfare queens. The average citizen will embrace assisted suicide not for moral reasons, but because it will be saving "their" money.
Jul 16, 2014
People are currently afraid of death, and so won't permit suicide, however logical. Similarly, people were once were afraid of homosexuals, and so were against gay marriage (and gay anything else). As people got to know more gays, personally and/or publicly, their fears ebbed and their acceptance grew.

So in order for people to accept suicide, they need to not fear death; not fear the unknown. Right. Good luck with that.

That "we'll figure something out" is still pretty likely, so from that perspective, "Adams Rule of Slow-Moving Disasters" will probably still hold and you'll take partial credit for being right. But it may come more simply in the form of letting the marketplace decide, and accepting (while simultaneously ignoring) the fact that people without means will die faster/sooner/more needlessly than those with the means.

I don't recall being told (by anyone with the authority to make it happen) that Life is Fair.
Jul 16, 2014
@whitllnew I think what @language trying to say is: A slow moving disaster to look at is the degradation of moral values, in that laws are needed where conventional wisdom and societal pressure were generally sufficient. *End attempted translation* that's my best guess.
+13 Rank Up Rank Down
Jul 16, 2014
From my point of view, health care costs seem to be getting crazier. Just spent $275 (actually, complained and got it down to $180) for a < 15 minute office visit to hear the doc say "Yep, nothing we can do about that." Next up: Calling to complain about a 30 minute $400 office visit where the doctor...referred the case to another doctor.
Jul 16, 2014


Seriously, I couldn't follow what you just typed. Every so often it looked like maybe there was a point in there, but then I read on and got lost.
Jul 16, 2014
This IS a slow moving disaster.

The generational chart of baby boomers is a python that ate a crocodile. Tech advances have created expensive but useful life-extending treatments. Our economy is going south and we are in massive debt.

Its obvious that baby boomers are going to get screwed over.

the problem with the theory of preventing slow moving disasters is that power is not wielded by the reasonable, rather the vicious. reason does not rule the troglodyte voters mind. without a culture that actively promotes such values (puritanical zealotry), you end up with unwashed masses who are more interested in kim kardashian's as s than congress censuring obama over an illegal war in libya.

once you jump the shark and quit culturally promoting trad values, you have to start making all kinds of idiotic laws to protect voters from themselves. banning trans fat and large soda. your choices are voluntary virtuous culture (no laws against immorality, only social mores), or compulsory secular (no social mores, only laws bossing you around).

challenging notions of morality is healthy. abandoning morality is not. the left (mainstream pc culture/hollywood) has dismantled the very idea of pursuing good, as an irrevocable and self-evidently valid life purpose. that kind of populace that has been brainwashed by this dogma NEEDS to be told to not stab themself in the eye with a knife, and not as a public service announcement, they need to be told by a law that threatens them with a tangible punishment.

they will conform to social mores on stupid garbage like recycling, AGW, hating the rich, accepting alternative lifestyles but any time a social mores takes a traditional value position, its 'controlling', 'narrowminded', 'restricting', 'stifling'. no, the statist laws that amoral culture necessitate are stifling. mores are socially enforced voluntary recommendations. law will throw your as s in jail.
Jul 16, 2014
I think you should keep Wally alive, despite the character's best efforts ...
+10 Rank Up Rank Down
Jul 16, 2014
I think you're being bamboozled, Scott. Couple of thoughts to consider...

Your article specifically mentions FEDERAL estimated spending as percent of GDP going down. Not the overall cost of health care.

Something to consider from a 2009 article:
When the bills force somebody to pay $10,000 to the government, the Congressional Budget Office treats that as a tax. When the government then hands that $10,000 to private insurers, the CBO counts that as government spending. But when the bills achieve the exact same outcome by forcing somebody to pay $10,000 directly to a private insurance company, it appears nowhere in the official CBO cost estimates — neither as federal revenues nor federal spending. And it hides maybe 60 percent of the legislation’s total costs.

And a headline you may have missed:
"Obamacare Increased 2014 Individual-Market Premiums By Average Of 49%"

And another quote from USA Today in April 2014:
"Health care spending rose at the fastest pace in 10 years last quarter, a development that could foreshadow higher costs for consumers this year."
http://www.usatoday.com/story/money/business/2014/03/30/health-care-spending/7007987/?utm_campaign=KHN: First Edition&utm_source=hs_email&utm_medium=email&utm_content=12358435&_hsenc=p2ANqtz--GGyUQfk6iUTIB9-LKxQMFuaZp-Ypxiz_jZOhuKpcHbdsirWpqx9c4LDICQulYB
Jul 16, 2014
Yeah, "health care spending" as a solitary data point is nearly useless. Generally, we would expect more spending to correlate with better health outcomes (I know, I know, there are a million reasons this doesn't always happen exactly, Canada spends less and has higher life expectancy, I get it, I'm speaking generally from an economic perspective).

When it comes to voluntary choices, the amount spent is irrelevant. If people spend more on health care, it's because they value health care more than they value other things. If the government takes over health care and makes these decisions for us, then things get tricky. You no longer get to choose. The amount spent on your health care has already been decided by some bureaucratic agency. You may want to spend more or you may want to spend less, but it's not up to you anymore.

The government can easily reduce the total amount spent on health care - by rationing. This is essentially *exactly* what many critics of Obamacare predict will happen. It is a complete impossibility that somehow you can institute a system that lowers prices while having no effect on the quantity or quality of goods available. For spending to go down, quality or consumption must also go down.
Jul 16, 2014
For you to make the statement that Obamacare looks like it's going to turn out okay only reveals to us what kind of news sources you are informed by. (And me making that comment reveals what kind of news sources I am informed by.)

As for the slowing of health care spending, that's pretty much because Obamacare has upended the system and right now a lot of people that need health care have trouble getting it. More people dying sooner would certainly count as less health care spending, I suppose.
+19 Rank Up Rank Down
Jul 16, 2014
[...in this blog I've shown that when you ask the question right, nearly everyone is in favor of leaving government out of end-of-life medical decisions for loved ones....]

You're right. You are biased. I agree with you on the right to die, but my own impression of the blogpost in question is you insisted the other side come here and argue with you on your own terms, in effect ceding you your point before the argument could start, and then declared yourself the winner when no one took you up on it. That's not how it works. When you try to persuade other people on an issue you have to do better than that when it comes to how they view that issue.
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