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Thursday, March 25, 2010

My Thoughts On Government (and Health Care)

Let me just begin by stating that the next few paragraphs are going to be scary...for both of us. The only reassurance I can offer is that, if you read through to the end, I promise we can remain friends.

I am not a card-carrying member of any political party. Nor are my politics of the militant fringe variety. In fact, ideologies make me queasy. I have lived long enough, traveled broadly enough, & read widely enough to know that there's no such thing as an iron-clad ideological system that allows for every contingency. (Thank you, Kurt Godel!) After all, even the 10 Commandments need interpretation. In fact, whenever someone starts spouting an ideology near me, I am reminded of an epigrammatical little poem from The Jesus Incident by Frank Herbert & Bill Ransom: "Dig your stubborn heels/Firm into dirt./And where is the dirt going?"

Before the zealously faithful of all stripes among you get vertigo from the previous paragraph, let me also assure you that I am neither a nihilist nor a complete relativist. I do believe in ground rules. No man is an island, and we really do have to work together to get anything worthwhile done. So here, in no particular order, are some of my personal social priorities: Public safety is important, as is free speech. Individual rights are paramount, and a basic education is a necessity. Capitalism is a better economic system than its alternatives, but it must be regulated to prevent predatory monopolies & to ensure fairness of opportunity.

I also know that every power gets abused, often for the worst of reasons. This goes for governments, corporations, churches, and book clubs. No matter what group of people you're talking about, what passes for power within that group will get misused, sooner or later. But gathering into groups is essential. As I said before, we need each other. And rules are the foundation of any group -- rules that are widely-known and consistently applied.

I could go on. But I won't. My own preconceptions really aren't the point.

What has spurred the disclosures above is the level of public vitriol I've been hearing over the subject of health care and the legislation that has just passed the House of Representatives on a party-line vote. If I hear another slippery-slope prognostication about the consequences of this legislation, my eyes may roll all the way out of my head. Let me just add this little note to the din on either side of the public debate: I am confident this legislation will neither destroy this country nor save it, but I do feel that the problem it addresses (the state of our national health-care system) is in dire need of some kind of solution.

When confronting national issues, I prefer government solutions that are concrete, practical, and evidence-based, but I also recognize that governance is as much art as science -- and that mistakes are the necessary cost of any eventual success, however provisional. Again, there is no perfect system for navigating through these dilemmas. The best we can hope for is a kind of self-correcting competence in our governments. After all, the strongest law, beside those of physics, is the law of unintended consequences. (See both Freakonomics and Superfreakonomics for ample evidence of the pervasive power of the law of unintended consequences.)

And here's where my own viewpoint gets too weird for most people: I recognize that I am probably wrong. But most of us are. Our preconceptions, even the relatively anodyne personal ones I listed above, inevitably hamstring us at some point. For instance, on abortion, does my belief in the rights of individual self-determination & expression posit primary importance on the mother or the fetus? In other words, when having to choose between the welfare of the fetus and the welfare of the mother, who comes first? My own answer to this question changes almost every time I think about it.

On the subject of health care, comparisons to other countries indicate that our nation's health-care system needs to change. We spend too much on ineffective care that is unfairly distributed. The evidence for the truth of this is strong, as is the evidence that countries can effectively construct fair & effective health-care systems without stifling medical innovation or draining their national coffers. (See T.R. Reid's The Healing of America for a convincing first-person exploration of this comparison between the U.S. and the rest of the world.)

My own doubts about the health-care legislation recently signed by the President (doubts buoyed by my not having read its two-thousand-plus pages & by my belief in the strength of the law of unintended consequences) are outweighed by the evidence that something needs to be done about the health-care system in this country.

In the end, whenever I am confronted by a complex issue that excites competing interests into active conflict, I tend to split the difference. I recognize the importance of ideologies in forming a framework for group success, but I also see how such ideologies can blind their adherents and hinder concrete progress, however incremental. In terms of governance, the middle ground is usually the most fertile. But it is also the most-contested.

An old boss of mine, whenever a staff meeting debate had reached an impasse, used to shout, "Do something! Even if it's wrong!" And, one way or another, the issue of the debate would get solved, and we would move on. Politicians are in a similar position, having to weigh the competing interests on all sides of a given issue, including their own. However, unlike a poll quoted on the most recent Freakonomics podcast, I do not hold politicians in less esteem than accused murderers. While I concede that there are many anecdotal accounts of loathsome behavior among politicians, I honestly don't think that, as a group, they are any more corrupted or corruptible than the rest of us. I have seen low-level supervisors get just as drunk with power as long-serving, cronyist Congresspeople.

Sure, an elected government will attract the kind of people who are attracted to power, just as the medical profession will attract people who are attracted to medicine. But we need politicians as much as we need doctors. Who else are we going to elect? And, honestly, most of them are competent most of the time. It's true: they sit in endless meetings and engage in endless rounds of discussion & negotiation that result in imperfect results. That's politics, folks. That's how the process works. The best way to innoculate the political process from corruption is to pay attention & participate as much as you can.

Have you ever sat through a government meeting? In my experience, both in attending local government meetings and in watching lots of C-Span, expressed ideologies tend to get in the way. These meetings, from the local school board to the U.S. Senate, are about concrete pieces of legislation & regulation, and negotiations about these pieces can be mind-numbingly detailed. And, yes, ideologies are inescapable, but their articulation, usually in the form of demonizing the opposing side, just gums up the works. The sausage-making process of governance is ugly & tedious enough. Histrionics just slow things down. There's just no need to yell "Baby Killer!" across the House floor.

Most of the people I know who have strong opinions about political issues would not have the patience or skill to represent a constituency, even if it was one that fully-agreed with them ideologically. The tedium of actual governance would make them run, screaming, from the chamber. A paraphrase of Vonnegut comes to mind: "Everybody wants to build, but nobody wants to do maintenance."

It is in the nature of representative government that most issues will get decided in ways that any particular individual won't agree with. There are too many of us, and we are too different from each other to ever expect any single issue to be resolved to the one-hundred-percent satisfaction of any single person. (This is called "diversity" and it's a good, if inconvenient, aspect of our civilization.) Compromise is essential, and, I think, a good check against extremism of all stripes. The fact that everybody hates the new health-care legislation, to my mind, speaks to its strengths. I prefer a kind of managerial, consensus-building competence in my politicians over adherence to any party line, which is why I'm a registered "Independent."

Personally, I am what John Keats coined as "negatively-capable," meaning that I don't have to resolve my doubts before getting to work. I can use doubt itself as a useful tool for finding workable truths. And I prefer politicians who act likewise. Such politicians, however, would probably sound too wishy-washy in today's polarized political climate to ever get elected.

The reason I find this blog entry so scary is that I know & love people who occupy every strata of the political spectrum. From religious conservatives to liberal secularists, I'm related to them all. And I fear that articulating my own position, even as tenuously as I have, will alienate them. But I also believe in free speech, and I know that the surest way to protect a right is to exercise it.

I certainly hope that, having read this far, you can understand my position on the issue of health care. I'm in the middle, and, whatever political party or ideology you belong to, I hope we can still be friends.

3 comments:

  1. Everyone hates it so it's probably okay? That's all you've got?

    For all you know, in some respect in which you'd think it should adhere more to a leftist line it veers toward a slightly more conservative approach and vice versa. You're presuming it's striking a reasonable middle ground but it could be adopting the wrong ideological elements in precisely the wrong area and be worse than any supposed middle ground.

    Your logic is very disappointing.

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  2. Ugh. Didn't finish writing.

    The simple fact is that whether the bill had given one side 90% of what it wanted or that same side 10% of what it wanted, both sides would have yelled in approximately the same way. To judge the quality of what is produced by a largely arbitrary perception of the complaints of both "sides" is silly.

    It reminds me of seeing an umpire who had made several terrible calls in a playoff game and who rationalized his work as being okay by saying that both sides had complained about it.

    It may all be moot anyway as lawsuits have been filed. The parties who've done so have noted that there would effectively be no 9th amendment, 10th amendment or commerce clause in the Constitution if you can be told that you *have* to buy service or product X.

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  3. Your first point is well-taken, as I've downloaded the legislation and am going through it, albeit slowly.

    Your second point, about the presumed unconstitutionality of the legislation, is weaker. While there are lawsuits moving forward, legal consensus is that most of those lawsuits have little to no merit and will fail.

    Find me a peer-reviewed legal opinion that says otherwise, and I'll take that argument seriously.

    BTW, my basic point was NOT that "if everyone hates it, it's ok" but that ANY legislation regarding such a complex issue would necessarily include compromises and half-measures. Any other view is reductionist and unrealistic.

    Anyone with any experience in management and/or governance knows the importance of compromise efforts and incremental success when tackling large, complex issues.

    Ideologies, from the left or the right, generally get in the way of such compromises and often prevent people from doing real good. THIS was my real point.

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