Three Mass Movements, 60 years

Islamic Terrorists – death to America, fundamentalist Muslim, jihad, martyr, Sharia law, straight to heaven

60’s Radicals – peace, civil & women’s rights, soft tech, sex drugs rock & roll, communes, love & harmony

Neo-conservatives – anti communist, government & liberal, pro-military, family & life, anti-gay, born again

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These three great mass movements, as strangely different as they are, each multiplied from almost nothing to represent huge open communities of interest only because they struck some true chord in human experience. It’s an obvious fact. Actual fraud by an evil wizard wouldn’t have the success each of these have had, because huge cross sections of people are just not that stupid. What’s quite interesting, of course, is that the basic validity of each is extremely hard to see from each other’s point of view. Trying to force your mind to do it tends to leave you blank and angry.

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To me it’s apparent that each of these great mass movements represents a separate reality, not just a different style or group of opinions, but a profoundly self-validating world view that places the others outside its experience, alien and unwanted. Ask yourself, do they act like they’re off living in a bubble??? If the answer is yes, and you start with a list of others… well then it’s time to discuss what to do about it. Aliens are here and now, and all over history. For centuries we’ve mostly denigrated, repressed and murdered them, and that’s not good enough. A friend reminds me, look at the 600 year repression of the Irish, for just one of a million examples. We all deserve better.

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I’m not proposing a ‘freedom of reality’ any different from religious freedom, but mainly pointing out that there’s a need for improved strategies for dealing with it. Hate speech and its use for dehumanizing mind-control, by power hungry leaders, manipulating us with their war chants and fevers, are fairly easy to spot if you look for them. On the other side, since there’s something to be learned from other realities, we could try making a point of listening, perhaps most intently to their small voices.

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The main cause for this discussion now is what seems like a new openness, following the recent London bombings, to discussing what to do about Islamic terrorism. The problem seems to be with a fringe of a fringe, but when you look closer the roots are really with a very widespread community. There’s no doubt that effective police work, perhaps focusing on terrorist recruiters and schools, strong leadership from Muslim teachers world wide, better investigative reporting by the press, government security measures & constructive world engagement, bridge building people-to-people contact and church & community leadership, etc. will all have their good effect.

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The main thing though, as I see it, is asking, why do they say “death to America”. That this is a central structure of their distorted reality makes it a wide open invitation to interfere with their rigid iconic image of us by acting in a way that does not fit. All we’d need to do is come to understand some of our ‘great crimes’, deep insults to others that we’ll probably be very glad to get rid of, if only someone would kindly help us and point them out.

Health Care or Immortality?

It’s very telling that healthcare costs have been soaring at 3-4% above inflation since the 60’s, and no one seems to be talking about the underlying cause. Its share of GDP has grown from 5.1% in 1960 to 7.0% in 1970, 8.8% in 1980, 12.0% in 1990, 13.3% in 2000 and 15.3% in 2003. It has actually tripled, and is still heading higher (1). That’s perfectly unsustainable. All the restraints we’ve struggled to put in place have slowed it but failed to change it, and the impact on businesses large and small are visible everywhere. On the public side the Medicaid funding crisis is far larger and sooner than that of Social Security, and more and more individuals are losing their benefits. Major change is about to happen.

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Why we’re not talking about what’s doing it is the key. It isn’t because we don’t see the threat. It’s because we’ve run out of solutions that can be easily discussed in public. Most options seem to require a drastic change in our promises or values, so the politicians can’t talk about them. All would agree, doing nothing will only make matters much worse, but we’re still not doing anything.

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To open it up we need to talk about the real cause. The problem is that we’re inadvertently trying to buy immortality. It’s quite simple; we’ve made what used to be called a bargain with the devil. We’ve accepted the wonderful gifts of modern science and its ever more effective and expensive medical advances, and cling to an idealistic insurance model for sharing all natural risks. Good health used to be a matter of luck, and free. Now science has made it a matter of cost, multiplying exponentially the closer it gets us to achieving our impossible goal, to always be cured. It’s actually one of the strangely beautiful laws of nature, that perfection is unattainable because approaching it takes ever increasing effort to progress by ever smaller steps.

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One option is to conclude that medical insurance was just a bad financial idea from the start. It is indeed flawed. It’s like having unlimited demand (good health provided at a prix-fixe) chasing unlimited supply (an ever exploding menu of great treatments). The challenge is to design the market forces differently, so that the total price remains constant while the benefits of the service continually improve. To do that requires being able to measure and compare costs and benefits, and there is some good work under way in that area.

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Alternately, we could do simple rationing, cut out expensive care for hardship cases, expensive end-of-life care, expensive experimental and rehabilitation services, and various other things. Ultimately we could just stop insuring anyone who gets sick. These things might provide insurance more efficiently, with excellent average returns. The problem, of course, is that people are not numbers. Still, any effective system will have the effect of making us decline the most expensive care.

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Few of us think we abuse the system when we get imaging studies for an odd swelling behind a knee, for example (it might be a blood clot, say). What we usually fail to do is consider with the doctor whether the measurable risks and benefits justify the expense compared to simpler treatments. That’s a complicated question, but we need to learn how to ask and answer it.

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Using that kind of reasoning we might begin a general system redesign by deciding that everyone has to assume the risk and responsibility for their own health care decisions. We don’t want HMO lawyers or the government making the decisions for us. We might also choose to keep the ‘all risks’ type of coverage we have. Where the pinch would come is in providing insurance payment only for new services with lower costs for the benefit than the old ones, with patients assuming the marginal cost of choosing treatments that are less efficient. For the same measurable benefit, if the new treatment costs less you get it, if it costs more, you don’t. Just accepting that ideal would be a start. With good design, benefits would then keep getting better and costs would remain the same. We’d need to measure the costs & benefits and provide consumers with the information. These are significant hurdles that would take time, effort and money to develop. Perhaps there’s no other way to get the information needed to make good decisions.

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You could call it the “Complicated Sensible Plan”. One thing is for sure, strong medicine is needed.

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(1)health care cost stats http://www.kff.org/insurance/7031/print-sec1.cfm

Real Complication

One of the strange long held ideas of the conservatives is that if you take money away from the federal government it will help restore old ways and simpler times. The supposed connection is that “tax tax spend spend liberals” were inventing needless government activity to meddle with business and private lives. The solution? Give away the money and budget pressure will force reducing the needless expenditure. Giving away money is always popular anyway.

I’m an architect and loose money every day providing mandated services I can’t sell, so you’d think I’d be jumping up and down in support. What I think kills the design business these days is redesign. The requirements are so complex that the solutions are less and less flexible and small changes force rethinking complex issues. We can’t sell that. Government has something to do with that in terms of new reg’s, but if you ask where modern complication comes from it’s pretty quickly apparent that it’s not from government really, but simply from economic growth. The complications of growth are not caused by the change in GNP, but by multiplying 1) the number and kinds of parts of our world, 2) the intricacy of their connections and 3) the power of their influence on each other. It’s called productivity.

Increasing productivity also gives us 4) increasing expectations, 5) increasing overlap between our (personal, business & interest group) spheres of influence, 6) confrontation with natural limits and unexpected environmental impacts, 7) information explosion and generational separation, 8) increasing opportunities for both new services and abuses, …etc. It’s a lot to contend with! Growth is revolutionary, continually accelerating reorganization of everything we know, a change of the earth and the meaning and structure of everything in our lives. It’s not just an increase in cash flow.

Adapting to it is a huge challenge, and a lot of that falls on government. If government could complain about the complication of modern life for itself I think it would be the biggest complainer. The real complication is that growth can only make things better (i.e. worse), and reining it in will require, as Einstein said, a whole new way of thinking. Arguably the conservatives offer a 'whole new way ot thinking'. They favor market forces over direct regulation, for example, and I think that's part of the answer. It doesn't work if the problem keeps exploding, or if you don't have a way to inform the markets that doesn't overwhelm them too. ...yep, you guessed it, another complication.

Myth v. Myth

Two years ago President Bush said “Bring them on”, but we still haven’t asked where the terrorists are coming from. That’s a real insult to the 1500 American dead and many more Iraqis who have been sacrificed to the cause since then. President Bush’s heroic myth of Iraqi liberation ignores the question, speaking as if the terrorists are just some band of criminals and losers. Our great free press mentions almost nothing about it except maybe that some of them are Suni and some come from abroad. The terrorists themselves don’t say, perhaps just too enraged to speak. Even the New Yorker Magazine, usually so reliable in detailing the hidden places in the world where everything comes from has completely missed the chance to just go and find out.

Where do they come from then? It’s kind of general, but the available evidence is that they’re from a fairly open multi-national community of people willing to sacrifice their sons to the cause of protesting the US. They apparently live by a distorted common myth about the world themselves, an open interest group to be found spread, apparently, throughout all Muslim society. I base this on the clear facts that 1) they come from Muslim communities all over 2) they’re clearly in touch 3) the more we kill them the more there are and 4) terrorism is an extremist form of protest, not a play for power.

If this is the case the only way to win the war on terror militarily is by silencing its source community, genocide. Some people might hate enough to do that, but there are also obvious drawbacks given how its community is intermingled in open societies around the world. To kill it we have to kill nearly everyone. Wouldn’t it be better to find out how to address its community myth and relieve their animosity towards us, so they stop sending their sons to kill and be killed in protest?

Relieving other people’s fears about you means dealing with people who hold you in contempt. It is tough unpleasant business requiring great creativity and emotional support. It seems we have a choice between that or endless killing.