Saturday, January 23, 2010

York was lovely; now onto the controversy.

First of all, York was quite nice. I did take a few pictures (mostly of buildings), and as soon as I can run them through iPhoto, I'll post them up here. But, I have something more personal that I feel like I need to discuss. No, I'm not pregnant. Though, that would be AWESOME. Imagine tiny Stephens running around. Plus all the press coverage.

Since I've started the blog I've, naturally, moderated some content. Some to protect what little dignity remains (though clearly, that has been shredded by pictures on Facebook). And some because, well, I knew it would piss people off. But, I've decided that I need to discuss this topic because it's important to me, and because it is part of my experience here (I know, I know, get on with it). The wall is coming down--I'm posting about politics. Specifically generational politics and the politics of anger. For those of you not interested, close your browser now. For others, read on. But, know that I write this with the greatest trepidation, and for those of you whom I offend, I apologize. There, apologia done.

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I've loved the game of politics from an early age, as my parents will surely inform you. Growing up, around the dinner table we had lively debates on all manner of things, from abortion rights to international policy. This parlayed into one-half of my undergraduate degree in the form of a BA in Political Science (the other half was History). With regards to political philosophy, it's a mix between a libertarian ideal, conservative pragmatism, and a liberal view of personal rights.

I have watched the health care debate from both sides of the Atlantic now, and frankly, it's frustrating. Much of what I see are reductionist politics playing into American anger over the state of the economy. We are so stuck in a state of paralysis by the current debate that we fail to be able to step back and understand the complexity real issues at hand. Healthcare is a series of interlocking components that feed into one another. The fact that there are so many uninsured continues to drive up the cost of healthcare daily. Issues like mental illness (e.g. depression) which plague more than a quarter of the population and often play into a feedback loop of physical illness (e.g. obesity) are rarely treated properly due to stigmas and chronic underfunding of treatment, further driving up costs. The system is so overly fragmented between the insurance company paying the hospital, the doctor, and the pharmacist, that rarely does anyone know the true price of any component much less the proper billing code. We have failed ourselves by refusing to take responsibility of the actions that we can control. How many people could significantly reduce their health problems if they were to lose weight and stop eating unhealthy food (again, demonstrating the complexities of poor agricultural priorities)? How much asthma could we prevent in young children if we were to fix emissions standards and reduce air particulates? A free market system ultimately fails in healthcare because it's nearly impossible to put a price on health since it is an immensely personal issue that is extraordinarily difficult to remove from emotion. Just try it. Ask 10 people how much they think a life is worth. And tell them they can't say "priceless." Yes, a market economy should theoretically work this all out, but the problem is the price you might put on your neighbor's health is likely very different than that of your child's. Does it make sense to spend thousands of dollars per-year to extend the life of a 75-year-old man for just one more year? Economics would say no. But, ask me how much I would have been willing to pay to extend the life of my grandparents and the number is incalculable.

It is due to this inherent complexity that I support universal, single-payer healthcare--with a caveat. I truly believe that universal healthcare will help remove complexity in the system on a basic, interface level. But the caveat is this: the universal system should not be an all-you-can eat plan. In my mind, it should provide a base level of care that would be necessary to maintain adequate health for a normal person. But, it should allow for supplementary care above-and-beyond what the base plan offers. Everyone should have access to truly affordable healthcare. No patient should have to die because they couldn't afford basic medical attention and generic drugs. But, patients should also be allowed to purchase supplemental policies that cover chiropractic work, plastic surgery, and gastric lap-band procedures.

Looking at the current social programs in place, this is surprisingly the model that we often use. Social security provides a base level of income for many workers, but should you want to supplement that income, you can invest in an IRA or a 401(k). (Clearly there are issues with the benefit structure due to miscalculated life-expectancies, but let us assume that the fundamental model works). The same actually goes for another little social program: Medicare. You are provided a base level of Medicare for a relatively low fee; however, should you wish to purchase Medigap insurance or additional prescription drug coverage, you are afforded the opportunity to do so. And you know what? Medicare has been successful by many accounts in holding down costs (and by some marks has less waste than traditional insurance providers). Do I think this will solve every problem? Far from it. But, it's a start.

I honestly don't find this potential system that radical, given our current policies, but I can guarantee you that if it were proposed, people would throw a fit about the expansion of government and more government waste. It's not infrequent that I am asked about my positions on healthcare and/or the U.S. government generally. I think in many ways, people can't understand a system in which you wouldn't provide basic care for all citizens. Honestly, I can't either. It's difficult to explain the divide in U.S. politics between liberals and conservatives because I don't necessarily think there always is one. I truly believe the difference is between those who are willing to accept that many of the problems we face are immensely complex and exist at the intersection of emotion, economics, and personal history, and those who would rather reduce problems to slogans and newspeak because they would rather not have to think about it.

The issues of reductionist politics occur on all facets of every issue. Democrats are just as guilty as Republicans in this. People would rather not think about the complexities because in doing so, they have to give recognition to the "other side." It's easier to get angry at your enemy than to understand where they're coming from. We have gotten into a mode that says that because 1/100th of the counterargument is false, suddenly the entire position is false. That's like saying because you get one foul in basketball, you lose the game. These issues are fluid networks of problems and solutions that flex and sway in the winds of academic and social debate. We have entered into a phase wherein we are unwilling to educate ourselves through experts and would rather be told a 30-second sound clip by a blow-dried desk jockey. This is inane. There are multiple angles to be told. I recognize that my position on healthcare has a counterargument. And I am willing to have that debate. But not with someone who is only willing to call me a socialist and reduce my position to a word they saw on a poster.

But I do have hope. I look at the current generations in power and it seems that much of their socio-poltical beliefs are rooted in a distrust of authority and a post-modernist mindset. Boomers and Gen-X were the first generations to feel the effects of divorce on a personal level, through themselves and their parents, respectively. Social institutions that had once been the norm slowly broke apart. Naturally, this engendered a mistrust of authority figures. After all, how could you believe anyone when your spouse, to whom you had promised a life of love, decided that they didn't feel the same. How can you trust an authority figure after you see part of your world destroyed in a parent's divorce. This is not to condemn divorce, as I think people often grow apart. But the difference is that we have social mechanisms through television and mores that help people deal with divorce now. It is no less shocking, but it is now a common experience, which reduces its impact to the collective psyche of the nation. Both generations saw immense socio-political change as presidents (Nixon and Clinton) were publicly discredited. How easy is it to trust authorities, experts, and anyone when the status-quo is evaporating on the front pages?

Similarly, the Boomers grew up at a time when post-modernism was coming into our national consciousness. No longer was there an ultimate purity of truth to be attained, to put it simply, if your worldview was your reality, why would you need to consider others opinions? It was this shift towards post-modernism that served to reinforce this distrust of authority. I think Americans were profoundly affected by these social shifts, in far larger ways than we realize. Much of the anger we are experiencing now is misdirected. I don't really believe that people are upset at Obama. Or the health reform bill. Or taxes. I think what people are upset with is the fact that we're in situations that are complex and difficult and are going to be extremely difficult to solve and work through. And that brings up issues of insecurity and uncertainly, causing people to lash out with anger.

So the hope part. It really does exist. I think it comes through Gen-Y and Gen-Z, but through new concepts of society and interconnectedness. As trite as it may sound, growing up in a fully globalized economy with the internet available at a moment's notice has prepared these generations to accept and appreciate complex issues more than other generations. They grew up with a basic understanding that the products came from all around the world, seeing and interacting with networks on a daily basis, from satellite feeds on CNN to Wikipedia entries on Miley Cyrus. When issues of distrust of reigning authority still persist, the solution is not necessarily to get angry and hurl pathetic barbs, but instead to band together to work around the problem. These generations embrace complexity, as long as it is wrapped in a simple, easy-to-use interface. Witness the technologies created or modified by the current generations. Peer-to-peer file sharing (e.g. Napster or Bittorrent) is perhaps the epitome of network visualization, intended as a workaround to poor distribution models and over-priced content, but achieved through a simple click and download interface. The creation of social networking sites with clean and simple designs (e.g. Facebook, Twitter) as a counter to the disconnectedness of a modern lifestyle. Home-brewed apps that enhance the functionality of existing systems (e.g. the iPhone). Yes, Gen-Y and Gen-Z may demand more on-time access and total connectivity, but the ways in which they create solutions to roadbloacks is a new paradigm that serves to enhance society. The good news is that more and more, the Boomers and Gen-X are utilising this paradigm--albeit in more traditional ways--as a way to work through problems.

The current generation of politics, exemplified by the healthcare debate, is simply a symptom of larger problems in society. But by embracing complexity, and using it as a medium through which we can understand problems and develop new solutions, we have the potential to actually improve our global society. The trick is this complexity must be wrapped in a cloak of simplicity. A paradox, to be sure, but consider the fact that most people don't know and don't care how the internet works, they only care that it works when they open up their simple browser. Universal, single payer healthcare will not remove the complex financial and emotional decisions and networks that underpin a hospital, or the doctor-patient relationship, what it will do is simplify the interface so that people can focus on the things that can benefit their health, rather than worrying about the complexities of getting a bill paid. And the more complexity we remove, the more we can focus on the networks that matter--our personal relationships.

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