Tag Archives: health care

Thoughts on Complicated Issues

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Dealing with complicated issues is a complicated issue. I find that it is impossible for a non-expert to rationally debate a complicated issue. Instead, it all comes down to belief.

Take global warming, for instance. There are people in the world who have spent their lives studying this: climatologists. As scientists (the real climatologists anyway) they posit a theory, test it against empirical evidence, publish the results, and let their peers (other real climatologists) analyze, critique, and collectively approve or reject it. The Wikipedia article references a separate page that cites hundreds of scientific organizations who collectively agree that the world is warming overall, the climatological system is changing, and that these changes are attributable to human activities. More conclusive, though, is that aside from four groups who stand by non-committal statements, "no scientific body of national or international standing has maintained a dissenting opinion" (the last was the American Association of Petroleum Geologists who updated their stance in 2007 with a non-committal statement.)

However, I am not a climatologist by any means. As such, I'm left to judge by belief alone: I believe that climatologists have studied this issue and agreed that humans are causing climate change, and that these climatologists do not have sufficient ulterior motives to lie. I don't think it's possible to predict exactly how these changes will manifest themselves, but as a believer that humans are well-suited to the current climatological situation, I can't see any change being likely to give advantage to us — almost all climatological changes will be unpleasant to our situation.

Some people choose instead to believe what they hear through the media, or from someone they respect (regardless of their true expertise as a climatologist), or from a celebrity or public figure, or from their personal experience, or from their non-climatological-expert analysis. Some believe much more strongly in the predictions than the assessment. But in all those differences, people are trying to debate with insufficient information. Belief is irrational and can't be debated: all that can be done is to explain one's rationale and listen to another's rationale and decide for yourself whether you want to change your mind.

Health care, on the other hand, has three sets of experts: one for the health facet, one for the money facet, and one for the moral facet: I have not encountered rigorous scientific analysis from any group, nor on the system as a whole. Doctors (while their medical practice is scientifically based) can only say that most people will live a comfortable life and may need temporary corrective care to maintain that, that any corrective effort is exponentially less severe the earlier it is started, and that a few people will require more constant care to permit a comfortable existence. Insurance companies and nations with nationalized health systems provide data indicating cost; as best I can tell, any system has approximately the same cost across its whole population. Finally, philosophers can provide the moral facet by asking, "is health valuable?" The answer transcends the other two groups as doctors' Hippocratic oath implicitly declares it so, and it is certainly a lucrative proposition as no parent would keep any wealth or a specific possession in preference to their child's life and health.

Without the benefit of a quality analysis, we are left to muddle through argument without full knowledge, again leaning on belief. Do we have more faith in government or corporations (as if they are different masters)? Should we help strangers? Will people we don't know exploit our generosity? Would we be willing to watch our own child die? Would we wish that on someone else?

My point of this exercise is to say that we all select where we get our knowledge and we use our beliefs to decide which knowledge informs our decisions. Implicit in that statement is my own belief that rational, reasoned discourse is the superior form of changing opinions.

The Next Revolution

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I think I'm starting to see the boundaries of the next social revolution. Let me lay out a little context of recent references that I believe are related.

First, I talked last year about the "monkeysphere" idea.  The basic idea is that our primate brains can only accept about 150 people who we consider part of our clan, tribe, or village, and beyond that, all the other people are equivalent to "things" in the world.

Next is related to things I've seen in discussions about Burning Man and the idea of "community".  To me, the notion of "community" is like a lot of words: they are there to provide a spectrum upon which to measure.  So when one says, "the community", that is a reference to a specific group of people with traits that tie them together.  The thing that is important is that being "in the community" means you have the traits of the community — it does not mean that you must adapt your behavior because of your physical location.  In other words, actions cause description; description does not cause action.

Related to that, I recently found a new term: POSIWID.  According to Wikipedia at least, Stafford Beer coined the term as an acronym for "[the] purpose of [a] system is what it does".  The underlying principle is that the intended function of a system is irrelevant: its purpose (or function) is solely defined by what it does.  If, for instance, you set out to create a community of people who share art and resources, you might end up with a big party in the desert: the purpose of that system is a big party in the desert, no matter what your intentions were.

I have observed (especially in the last 10 years) that people I encounter are much more polarized by political party or political views than ever before.  It is probably most attributable to whom I hang out with, but I also believe there is a trend.  What I mean, specifically, is that I was finding prejudice in myself concerning politics: that I would judge someone favorably or unfavorably solely based on their political party affiliation.  I thought this was interesting to observe, and generally not good.

I also see the strong opinions of people concerning socialized health care. Although there many facets to it, the one I find most interesting is the debate on whether an arbitrary stranger should be cared for.  I'm neglecting any specifics because you can create straw men to support either side (i.e. abusers of a taxpayer-funded system versus a hard worker who circumstantially loses access to care).  The question is: will you help someone you don't know anything about?

So finally, what's this next revolution?: it's how we treat strangers.

I see people lining up along a spectrum.  On one side are people who are only willing to help those people they know personally (i.e. who are within their "monkeysphere") at the expense of the well-being of people they don't.  On the other are people who willing to support everyone equally, even if that means they may not have resources to help people they know personally.

I think it is more noble to lean toward helping everyone, and a testament to the superiority of humankind.  However, I also know that such civility is frail: a small percentage of people working to their own advantage can poison the whole system.  All societies have blind-spots and points of leverage for the advantage-seeker, but civility is maintained by the unspoken agreement among people that they not take advantage at those points.  And in America, there are socially-acceptable points to find advantage: that permission is specifically what allows capitalism to work.

Anyway, I find myself playing both sides of the fence for the time-being.  I have a network of friends who I help freely (with my time, skills, money, and resources) and who will do likewise for me.  I also strive for a better solution that is more inclusive because I feel better when my behavior also helps other people.