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Mar. 8th, 2013

lihan161051

This is why we can't have nice things ..

I've been thinking a lot over the past couple of days about social-normative enforcement, the kind that ranges from general hostility to outright verbal harassment and/or violence. And there are some thoughts in there that I think are worth sharing.

One fact of life that social-outliers like me grow up aware of, that isn't immediately obvious to people who tend to be closer to majority social norms, is that being a social outlier can sometimes be dangerous in unpredictable ways. There are people in this society who are driven by a certain kind of impulse to feel powerful over other people in ways that involve punishing them, and people who feel such impulses tend to justify them with pseudo-religious reasoning of various sorts to rationalize what they are at least dimly aware is not actually right, in general, but might be excused in specific cases.

And make no mistake about it, the impulse comes first, and the outlet is only a superficial perception that the abuse the impulse calls for is somehow socially sanctioned .. the bottom line is that if you are visibly and publicly not compliant with some aspect of Accepted Social Order, and you happen to come into contact with someone who sees that as an excuse to use you as an outlet for that kind of violent impulse, you're likely to become a victim of a hate crime, whether it's called that or not.

And this kind of thing happens in the shadows, in private, covertly, all the time. Feminist bloggers encounter this every day, in anonymous vitriolic sockpuppet comments from angry men that escalate exponentially with the success of their blogs. The news is full of stories of men who begin an evening with the desire to go out looking for men they think might be gay, because they're feeling the impulse to engage in violent behavior and looking for an excuse. I could go on.

But it seems to be very significant to me that these things happen in the dark, in the wee hours, up close and personal, and out of sight, most of the time. It seems to me to speak of a deep seated inner raging hate, simmering and biding its time until something comes along against which it can feel safe lashing out, but even then it hides to some degree, behind supposed anonymity or safety-in-numbers. To some extent, that's also due to the disconnect between the reality of the law and the standards of genuinely civil society and that perceived social sanction for "corrective" harassment, abuse, and violence, but to me, there's something about the nature of it that seems to be dark in and of itself, that seems to belong in those out-of-sight moments when deeper and baser emotions can come out to play more easily.

To me, that dark rage and the perception of that kind of twisted social sanction for using it to punish anyone who strays too far from (again, mostly arbitrary) Accepted Social Order is the heart of the cancer I see in this society, in the genes of the dysfunctionality inherent in it. And I don't see any way at present to get past its superficial rationalizations of pseudo-religious reasoning and deal with the darkness itself, and it's far too easy for people to give in to impulses and far too difficult for their victims to counter it when neither side has enough critical awareness to have any idea what's really going on under the surface.

I intend to write more on this, but it may be in book form ..
lihan161051

I'm back.

I've been online mostly through Facebook and Google+, and had some success and made some connections on both, but I'm not happy with either, because neither one is particularly geared to writers. So I'm re-emerging from my dormancy here and will be posting again from time to time. I might link some or all of my posts here to both FB and G+, but I'm going to be migrating my longer and more elaborate posts here because this site just works better for some of what I want to say..

Aug. 14th, 2012

lihan161051

Crossing a bridge .. maybe.

This article started out in a direction sort of like the one that triggered a near-catastrophic meltdown for me, a couple of days ago, but then went somewhere interesting. And I decided to open up a bit about why the one a couple days ago nearly caused me to cut almost all of my social connections with a certain community where it was circulating pretty widely with pretty enthusiastic applause -- and a lot of connections with other communities associated with it -- and why a few conversations with friends, and the more recent article, changed my mind on that and made me aware of a bridge I've burned down and rebuilt so many times in my life, but never crossed, that it was time to maybe make some steps in that direction.

To start with, as anyone who knows me is already well aware, I'm not the most socially conscious or socially skilled person around, not by a long shot. I can function socially in a variety of situations I've managed to adapt to consciously, but when I hit the limits of what I know how to handle, I tend to get cautious about approaching new territory, very cautious indeed. And I'm very neuro-atypical in some ways, ADHD for sure, and almost certainly some degree of high-functioning autistic and Asperger's in addition, and some of the ways I interact with people can seem very weird to people who aren't already used to them. I have a number of cognitive and functional hacks in place that allow me to emulate "normal" social behavior, even some aspects of extrovert behavior, in specific contexts and specific circumstances and specific environments, but those are conscious adaptations I've put in place to be able to function well enough in social environments to allow people to get to know me as I really am before they hit the "weird" nature and get scared off by it.

And I'm male. And this is a big deal in the context of this particular question, because the male and female experiences related to "creepy" sexually-predatory behavior, and the unintentionally "creepy" behaviors that fit the profile of that kind of behavior enough to make people uncomfortable, are fundamentally different, in ways that are very difficult to explain from either side. And there's been a lot of discussion of it in various aspects from the female experience, because, unfortunately, the female experience is very often that of being on the receiving end of a whole range of extremely unpleasant behavior from (usually male) perpetrators, with few if any warning signs other than vague profiling-type indicators that have a very high false-positive rate, and that experience is anywhere from extremely frustrating to existentially terrifying, and everyone reacts to experiences in that range in their own way. But there's been very little discussion of it from the male perspective, with the possible exception of social-in-group-entitled-extrovert male perspectives on how best to intimidate and shame and out and exclude types of men who may or may not be actual predators, but who are, shall we say, just a little bit less conventionally "hot younger male" type attractive and maybe possessed of less than astronomical self-confidence.

And while I've been told by a number of friends that I'm attractive and intelligent and to a certain degree quite socially desirable, more so than I'd ever have expected to be even just a year or two ago, I'm the exact opposite of social-in-group-entitled, and apart from my conscious adaptations, I'm an extreme introvert, and I've had enough experiences during my lifetime of having intimidation and outing and shaming and any number of other exclusion tactics employed against me -- in some cases as a "suspected creeper", and in other cases as simply someone who dared to express interest in or attraction to someone the alpha males/females decided I wasn't entitled to associate with -- the "let's shut out all the creepy folk so all us cool kids can hang out together" approach is gibbering-fetal-position triggering for me, and in all honesty, this past few days, it almost did lead to me doing the disappearing-act thing again and never talking to anyone in the community again, possibly even cutting ties with a few very close friends, simply because I am the kind of person who very often gets caught up in the creeper-outing/shaming hysteria when this kind of thing gains momentum, just because of the kind of personality I have and the ways in which I normally interact with people, and it's happened to me before, and the consequences of still being around and having to be told to leave when that happens are catastrophic enough that I cannot risk letting this kind of thing go to that point without being long gone when certain substances hit the fan.

So that's why I almost burned a whole lot of bridges with a whole lot of people this week.

And the reason I didn't was because of one friend who went to great lengths to be constructive about what she recognized that I am not, and what other things she recognized that I very much am .. and because of another friend who was very up front that I wasn't the only one who was very concerned about the carelessness with which a lot of people were eager to burn witches and went so far as to make a public statement to that effect. And then I read the second article, and it gave me something of a new insight on the issue, one that's probably been out there for a good long while but I honestly just hadn't thought of it that way.

So, for the record, here's who I am and what my own perspective on this is.

I'm careful about boundaries and consent. Very careful. Extremely careful. Sometimes, i think, possibly pathologically careful. It has actually literally only been in the past few years, and mostly this past year, that I've figured out how to negotiate some of the things I want that go beyond the limits of basic social activity or friendship, or even ask about some of those things without panicking about the possible consequences of expressing interest. The latter is largely an artifact of some bad experiences I've had in the distant past where expressing attraction or interest was itself taken as a boundary violation -- which nowadays I chalk up to default-culture dysfunctionality -- and I'm getting more comfortable about asking for what I want and taking responsibility for my own agency in getting my own needs met, but it's been a long hard road, and I've erred on the side of caution for so much of my life that even now my default habit is to just assume the answer will be no and preemptively self-reject out of a (possibly misguided) sense of courtesy, which I'm still learning not to do, and that's probably going to take a very long time to get past just because it's set in so deeply in my usual behavior.

I've also gained familiarity with my own sexuality over a very recent period of time, basically over the last 8 years or so. Before that, I had only vague notions of what actually attracted me or what I actually wanted from sexual relationships, and when the reality of how that side of me works was revealed to me in the course of a brief experimentation with a friend that crossed a lot of boundaries I thought I had and needed that I turned out not to need at all, and were in fact getting in the way of what really worked for me, it came as a considerable surprise and it took me a while to put a sense of who I really was back together, but at the same time it was one of the most empowering and liberating experiences of my entire life, because it also taught me that desires are not wrong, no matter what they are (which was the hardest lesson there), and the only possible wrong is in acting on them in harmful ways .. and many desires can be met in ways that seem to be very wrong indeed (quite realistically, in fact) but which involve no actual danger to anyone. So some of my habits do still go back to those days of not being quite sure what I want, and being cautious about negotiating things that I'm still a little bit used to thinking of as off limits.

(And the thing about that caution that's sort of an underlying theme of my habits when I get out of the bounds of things I'm used to with people is that for people who don't have the experience of things I have, sometimes it reads to them like "suspected predator" profile behavior, and while that's a potentially legitimate misunderstanding, it's still a misunderstanding, and when people are in an outing/shaming mood, it can in fact be very dangerous to be a little too cautious and land in uncanny-valley territory.)

I'm very respectful of people for who they are, and when I'm interested in someone, I'm interested in the whole person, in very deep ways, and that interest may or may not include physical aspects -- it often does, because while I don't express it much, I am a very sexual person as well as a very affectionate person and, to the extent I believe is acceptable to whomever I happen to be with, and within my own comfort level, I might choose to express that in various ways. That's complicated, because while some people are very clear about verbalizing their boundaries and respond positively to being asked for permission, others view it very negatively -- I was once told that "if you have to ask permission, the answer's going to be no, so if you want to do something, just do it" -- and that's a serious problem for me, because as much of a hard limit as I have with boundaries and consent, I either need to ask in the moment or have the boundaries clearly negotiated before anything starts. But if I do something that goes beyond "average social behavior" with you, it's because I have reason to believe that consent has been negotiated, and I will not do it otherwise, so if consent has in fact not been established, it is absolutely OK to stop me and communicate that very clearly to me, and then we can talk it out or not depending on what exactly happened. I say that because mistakes and miscommunications happen, and as careful as I am, that kind of miscommunication is extremely unlikely, but if it should ever happen, that's why, and that's what I'm OK with being done about it.

And the crossing-the-bridge part is right here: There's a lot I want to do, and there's a lot I normally keep my mouth shut about because I'm never sure when it's OK to talk about it. If you're reading this (and are female, sorry guys!) and have ever entertained any notion of doing anything outside of ordinary boundaries with me and wondered if I'd have been interested, the answer is very likely yes. I'm saying that here because it's safer to say that to a collective audience that's not any one person in particular, so no one feels singled out or put in an awkward position. Chances are also very good that if you make advances to me, I'll be interested, and if I'm not for whatever reason, I'll be totally respectful and constructive about setting those limits -- believe me, I've been the guy with the non-mutual unrequited desires enough times that I know what that experience is like -- and it won't mean losing a friend, if we're friends, strictly no harm/no foul. (And that's crossing a bridge because it's very likely you didn't know that, or at least weren't sure, because under most circumstances in direct interaction with people, I keep my mouth shut about it unless the situation seems far more than normally safe and I already have reason to trust everyone involved.)

So that's who I really am. I'm not a predator, I'm not a creep, I'm not a stalker, I'm not any of those things. I know that guys who are any or all of those things also make exactly those claims and it's often hard to tell that, so if you need proof but can't tell which is which, I can't help you there. But I am not any of those things, and I will no longer be afraid of being mistaken for any of them. If you choose to be in my life, I will welcome you, and if you choose not to be, I will wish you well. That's all anyone can do.

Jul. 25th, 2012

lihan161051

Wow.



I don't know that much about Boston and have never been there personally (despite having both church and friend connections there), but this made my day. :)

Jul. 15th, 2012

lihan161051

An interesting conversation from work ..

I have a neighbor at work who's been doing an unusually good job of challenging my brain lately, and one of the subjects we keep coming back to is the economics of why the US economy fundamentally isn't working, and why the "economic stimulus" measures that were supposed to fix that don't seem to have done much other than make the bankers richer.

And what the discussion boiled down to was the basic fact that the economy is the middle class -- the whole middle class, as the entire middle three quintiles of the population -- and the problem with it is that while the middle class is working, after a fashion, the quality of that income is far poorer than it was a few decades ago, and the security of that income is questionable at best. The economy is that middle section of the population who are the customers that make it profitable for businesses to create jobs.

We are the job creators. The money we spend on goods and services is what makes creating jobs possible -- it's literally the heart and soul of the entire economy.

And the trouble with that, in turn, is that the way things stand now, we don't make anything in this country. Increasingly, we don't even design much in this country, with a few rare exceptions, companies that have managed to keep a core of knowledge and expertise in a few niche markets and succeeded in keeping it from being exported. The rest has been shipped overseas to places that aren't interested in implementing our relatively progressive labor laws where people will tolerate far worse working environments and far less pay.

And to a large extent, we, collectively at least, let that happen. A number of automotive, consumer goods, appliance, and other major manufacturing firms learned too late that outsourcing the raw labor aspects of their operations put those operations into the hands of people well equipped to analyze what that raw labor was doing, learned how the design process worked, and bootstrapped their own industries into higher and higher levels of proficiency until they were manufacturing the products from beginning to end and only the most superficial cosmetic aspects of those products were being designed here. Even the ones who managed to avoid exporting their entire intellectual capital to the outsource firms wage a constant fight against many of their suppliers and those vendors' competitors, who will happily counterfeit not just the products but many aspects of the entire marketing apparatus of the parent companies, and the sophistication of the competition steadily improves. And we let it happen because many of those manufacturers couldn't see past the next quarter's bottom line and the reduced cost of labor that quarter and maybe the one after that, when they were dealing with vendors who were thinking in much longer-term strategies.

This is a pattern of systematic neglect of the fundamentals that make a society work, that has progressively broken down over a generation or more. Part of that is a stagnation of our education process, aided and abetted by our almost universal cultural value of anti-intellectualism to the extent of genuine prideful ignorance -- encouraged in turn by a religious extremist faction that is simultaneously trying to wreck the public school system and subvert the remaining functional parts of it into mere tools of mass indoctrination to turn out whole generations of loyal followers, to be certain, but the cold fact of the matter is that such an absurdly, catastrophically irresponsible program of sabotage would not gain traction in a society that did not to a certain extent welcome the saboteurs into the machinery with open arms. The extremist campaign against public schools, public libraries, and taxpayer funded education in general should by all rights have been stillborn at its very inception, shouldn't have been allowed anywhere near our schools, but because this culture has its perverse fixation on the supposed virtues of a life lived unsullied by dangerous knowledge, the extremist con artists who know just which buttons to push are practically welcomed in to set up shop tearing the system down. We let this happen. It couldn't have happened here if on some level this society hadn't wanted it.

And the generation of kids fed on the useless drivel we let pass for primary education went on to high school where they slept through government class and skipped algebra class and goofed off in chemistry class and spent most of English class plotting how best to humiliate the few outliers who were, God forbid, actually interested in learning something into what they consider a proper sense of deference to the minimally-achieving "cool" kids who put their value in clothes and cars and dating. We let that image be sold to them on TV and in movies until it was practically a sacrament -- and even today the nerd/cool kid dichotomy permeates so many aspects of our society we practically breathe it.

And that generation of kids went to college where they were only minimally prepared for serious study, on student loans they were certain they'd pay off when they got the 6-7 figure job on graduation, and struggled through basic undergraduate math and science and business administration, and some of them did make it into the upper echelons of corporate management, but more by chicanery and knowing people who knew people than by any real merit, and got by doing just enough to look like they were doing something worthwhile, and wound up in the corner offices making the strategic decisions, and somewhere along the line someone decided that the factory full of union workers making their products cost too much and they should ship the operation overseas to 140-hour-week $2-a-day laborers and save a buck or two, and soon they found themselves dealing with vendors taking over more and more of the higher level operations, and even then didn't see the trap coming until the day the overseas vendors were driving them out of business.

This is a story of decades of systematic neglect of the things that make society function, driven by a combination of good-enough-to-get-by educational values and an absurdly myopic focus on short-term strategies of corner-cutting and cost-shaving that have, bit by bit, given away the principal of our savings, intellectually and financially both, in a mad chase after a few extra percentage points of interest.

And this will take a long time to fix.

We have to start by dispensing with that suicidal fascination we have with the supposed nobility of ignorance and the mythical dangers of somehow corrupting one's morals by being "too smart". That needs to go. Now. We simply cannot afford to go on congratulating ourselves for having escaped contaminating our hearts and souls with knowledge .. it's cost us far too much for far too long. We need to elevate curiosity, and creativity, and the pursuit of knowledge for its own sake, into our new ideals. We need to stir an insatiable hunger for new understanding in our kids and get them excited about every opportunity to learn.

Because the only way we win this game, in the long run, is to become the society that does what no one else can, and do that by becoming the society that has the vision no one else has. And we do that by rebooting our whole cultural knowledge-framework with regard to how we educate ourselves and our kids.

And we don't do it by emulating China, or India, or even Japan. We won't win anything by trying to out-discipline and out-regiment our kids and whip them into obedient little productive interchangeable parts. That approach created the forces that learned how to do all the tedious parts of making our stuff to the point of burying us in what we thought we wanted.

We do it by going the direction no one has gone before, by starting with the very next generation of kids and nurturing their curiosity and their innate desire to learn everything they can get their hands on. Kids are born with that, it's part of who we are, it's how our brains wire themselves up for language and cognition, but it doesn't stop there unless we kill it .. and we need to stop killing it with our socially-destructive memes about what makes a "cool kid" and keep nurturing it, and never stop. Imagine a whole generation of kids who have only known the fascinating, thrilling quest for understanding of everything around them, a whole generation of autodidacts with an insatiable drive to innovate and improve the world. Imagine that generation growing up and turning the whole society into the one that mines industrial raw materials from asteroids and colonizes the moon and Mars and does all the other things no one else even thought of doing.

Yes, it's subversive. We've been out-ordinaried, out-mediocred, and out-competed, and our only way forward now is to break the molds and reframe the whole economy game into something only we know how to do. Sputnik is beeping in our sky, and this is the wake-up call, and this time, we don't just run to catch up to the ones who reverse-engineered our former success, we jump in a completely new direction because that's what our new ideal and our new cultural value is, and our vision can't help but be subversive. We do nothing less than jumpstart the new paradigm, trigger the phase change, and embrace what we feared for so long.

That's the only way forward that I see. And that, folks, is what creates the future economy.
lihan161051

This book is free

.. both as in beer and as in speech:

From Dictatorship to Democracy

It is, in fact, the very definition of free in both senses, because the entire work was published virally, initially in the pro-democracy movement in Myanmar, and is now completely in the public domain.

I was not aware this book existed until about a month ago when CNN posted this article about Gene Sharp, the author, and the story of his conception of the book in the context of his discussions with friends and colleagues in Myanmar, and his development of a work that was necessarily rather abstract and general, due to his unfamiliarity the specifics of the protests in Myanmar, but which nevertheless ended up shaping and in many ways transforming the movement, largely due to its uncensored and viral publication.

But it didn't stop there. It had propagated to a number of other countries before Sharp heard from the people who were reading it, and around the time it was beginning to surface thousands of miles away from where it was first released, it had, among other things, provided the blueprint for non-violent anti-government protests in Serbia that brought down the government of Slobodan Milošević.

It's a free download, and officially in the public domain, and anyone anywhere with access to the Internet (or who has friends with Internet connections and printers) can read it.

Almost every non-violent protest I've seen since the mid to late 1990's has borne this book's DNA, from the Arab Spring to the anti-government protests in Iran to the Occupy movement to the anti-PRI protests currently happening in Mexico. Every one of those protests will make perfect sense if you've read it.

The basic idea is pure genius in its simplicity. Governments derive their just powers from the consent of the governed, and the only way dictatorships maintain power is by maintaining the illusion of the consent of the people. They do this in various ways, by isolating (and Sharp uses the ingenious word "atomizing") individual relationships with the state, and by making the idea of public dissent so frightening that no one dares speak out enough to break the illusion. Perform simple acts of defiance, just visible enough to communicate non-consent, and that small act in and of itself is both empowering and transforming for both the people feeling the heady rush of taking those brave steps out of their silence and for the people watching and realizing they are not alone. The defiance need not be directed at anything or demand anything -- the mere fact of its existence under the nose of the dictatorship galvanizes the people who immediately realize that the disaffection they thought only they felt is actually far more universal.

And some of those acts of defiance are subtle and ingenious, and freeing the defiance from the need to be violent puts it squarely in the realm of art with a purpose. Do something distinctive (I keep wishing someone would set some good Spanish words to Sibelius' Finlandia Hymn, and teach that song to everyone in Mexico who wants to learn it -- imagine hearing that song, everywhere in Mexico!) and simultaneously peaceful, yet defiant, and you not only show everyone who sees/hears what you do that defiance itself is possible, but if the dictatorship tries to silence you with violence, it only weakens its own power. Because this approach (as Sharp makes clear) fights a dictatorship not where it is strongest, but where it is weakest -- the more it abuses its people to hold onto its power, the more it demonstrates that it is exactly what the opposition has accused it of being.

And this book cannot easily be censored, and it's a simple enough read that it can easily be remembered even if it can't be kept around. The idea cannot be stopped except with measures so brutal that they would themselves alienate even the most devoted followers .. it will get through, one way or another.

This, folks, is what genius looks like. My wildest dreams of memetic warfare against any kind of tyrant fall far short of what this book has already done, and will do in the future. It may not by itself trigger the oncoming paradigm shift .. but it will make it very difficult to stop it (or even dodge it) once it starts ..

Jul. 9th, 2012

lihan161051

Why free-market health care doesn't work ..

With the ink on recent SCOTUS decision on the individual-mandate provision of the Affordable Care Act still not quite dry, it's worth discussing some of the benefits and shortcomings of that measure as well as why it is a good thing for now, but is not a good thing in the long term.

One of the most fundamental aspects of economics is the law of supply and demand, in which supply and demand balance each other to drive pricing of a marketable commodity. For typical commodities, the demand for a product is driven by desirability, the supply is constrained by production capacity, and a consumer of the commodity (for appropriate definitions of "consumer" with regard to the commodity) can choose whether to buy or not buy at any given pricing, and thus incrementally influence the seller's pricing. For most commodities, whether they're tangible products, stock in publicly traded corporations, gold or silver, or what have you, that model tends to produce an equilibrium price for a given set of supply and demand considerations, and that price may fluctuate above and below that equilibrium, but by and large, the opposing pressures of demand driving pricing up and supply driving it down will balance out at some sort of equilibrium somewhere.

This is the fundamental way in which health care does not fit the classic supply/demand model. Health care consumers are not consumers by choice -- the circumstances that create their demand for health care services are dictated by forces mostly beyond their own control, preventive care notwithstanding -- and thus demand is not subject to decision making on the consumer's part, it either exists or does not depending on the consumer's state of health at the moment. It's probabilistic in that the circumstances under which any given individual might need to be a health care consumer are relatively unlikely at any randomly chosen moment, but for those who are in that overall-unlikely situation, the need for medical treatment is not optional. (Granted, this is an extremely simplistic modelling of what is in fact a nearly infinitely complex medical discussion, but for economic purposes, it covers enough of the nature of a health care consumer to suffice for this discussion.)

The fact that being a consumer of health care is not optional changes the entire equation, because it makes the demand side of the supply/demand balance effectively infinite -- there is no price point or scarcity of supply that makes the "oh well, I won't buy that today" decision appropriate, since it means either continued or worsening illness or even death. Thus the only equilibrium in that equation is the point at which consumers literally cannot afford the services at all, because that is the only point at which demand can begin to drop and stop driving the pricing up.

So health care is essentially a captive market -- its consumers have no choice but to seek services if they can afford them -- and this alone completely skews the supply/demand balance.

The other important condition of the supply/demand law is that it depends on a direct coupling of pricing to consumer ability to pay -- the drop in demand as the price rises above a consumer's desire, in the case of ordinary commodities, or ability, in the case of health care, to pay for those services is the pressure that limits pricing. Once pricing increases beyond a certain point, no one can pay for the services and it is no longer profitable to provide them, as they've been priced out of the market.

The widespread availability of health insurance was the last ingredient of the perfect storm.

For a bit of background on how insurance works, let's take an extremely simplistic example: A group of 100 people decide to protect themselves from a relatively rare -- 1 in 100 -- but expensive -- $10,000 cost -- event by each contributing the total cost of the event multiplied by the probability it will happen to them -- $10 in this case -- to a risk pool. If the 1-in-100 event happens to anyone in the pool, they then can use the entire $10,000 pool to pay for the cost of the event and not have to pay out of pocket. The pool as a whole might join up with other pools to protect themselves against the unlikely but expensive possibility of two or more people incurring the $10,000 cost at a given time -- this is called "reinsurance" -- but the overall effect is that under certain defined circumstances any one of the people in the pool could conceivably draw on it to pay a much larger cost than they could out of pocket.

What this does to supply and demand pricing, especially in the extremely asymmetrical case of health care with its anomalous demand side, is vastly increase the ability of any individual consumer to pay for certain costs .. completely decoupling the pricing from the individual's own ability to pay out of pocket, which in the short term makes the costs far more affordable by spreading them out across a large pool of individuals each of whom is relatively unlikely to need services, but can then pay for them when needed, but in the long term, allows providers to charge far more for those services, eventually reaching the point where even with the risk pool, the services cost more than the pool can cover.

At this point, the pool needs to either increase income by having each person contribute more, or reduce costs by reducing its liability for indemnity, in other words, what it's required to pay out for, so some instances of the large cost might be refused coverage (either completely or in part), or the pool may start being selective about who it allows in, since some people may have a higher probability of encountering the cost than others. (And all of these things have happened -- increasing premiums, increasingly restricted treatment coverage, and refusal to cover people with pre-existing conditions who bring more cost into the risk pool than they offset with premiums.)

The compromise in the ACA -- the mandate to obtain health care coverage -- was a necessary offset to the increased cost exposure of requiring coverage with pre-existing conditions, because it offset the costs in a third way, by expanding the pool to include a large number of people with a low probability of needing to use the coverage. This was also the main point of attack for opponents, who knew full well that eliminating the mandate would have made the remainder of the plan so costly to insurance providers that the entire plan would have collapsed and returned us to the same crisis we just escaped.

But the ACA was not a long-term fix, it merely delayed the inevitable and shifted the equilibrium cost point still higher, because costs, as yet, are still following the free-market model, which with captive demand, will only drive pricing higher until it strains even a pool containing every single citizen in the country. The flaw in free-market health care is still the captive demand side of the equation, which only drives pricing up and has no countering force to drive pricing down except the limit of consumers, in this case now insurance and reinsurance risk pools rather than individuals, and already astronomical costs will increase still further until they reach the limit of what that market will bear.

So why are we not looking at the supply side of that equation yet? Why are we not regulating costs at all? "Because it's SOCIALISM!!1!1!" is one answer -- not a particularly helpful one in that tone, but an answer nonetheless. In essence, the free-market model is what got us into this mess, and while it's making a handful of healthcare and medical technology CEO's and upper level management rich beyond the dreams of avarice, and making them very disinterested in changing the game and killing their golden goose, the fact is that as long as the supply side of the system is unregulated and there are no controls on end-delivery-to-patient costs, we're simply going to be going through this cycle of straining increasingly widely distributed resources to their limits until payers start refusing coverage again.

So how do you control costs? By getting out of the free-market mentality, because these services are not really free-market services -- they're captive-market services and need to be treated accordingly. Every single cost point of the chain needs to be analyzed to determine whether it's excessive or whether it covers upstream costs, starting far enough upstream that all of the price-gouging (and I'm certain there is price-gouging) is squeezed out, going back to raw materials suppliers for pharmaceutical companies and medical technology providers, and working forward through the chain to point of delivery to the patient. And a lot of the "fat" in a lot of the pricing throughout the chain is liability insurance -- because malpractice insurance is an ever-present threat at almost every point in the chain that has deep pockets -- so some offset to that may need to include addressing the liability in other ways that don't pass costs through to the patient. Like it or not, that will probably include some form or other of subsidies at various points in the system.

And I'm sorry, but the payer side of the system cannot continue to be for-profit. The runaway price escalation we've seen over the past few decades has been partly due to insurers and providers both taking profit margins off the top of virtually every transaction in the system. For-profit corporations are required to turn profits, every quarter, or face civil liability to their stockholders -- they are not in the charity business. They have to make money everywhere they can find a profit center, and the proliferation and expanding exploitation of profit centers inflates both sides of the equation. Remember, individual consumers are not a part of this pricing game at all anymore -- the costs are far more than the wealthiest of the wealthiest of us could possibly pay out of pocket -- and it's strictly a game between for-profit payers and for-profit providers controlling the price equilibrium. The only way for-profit payers can continue to be part of this system is if the entire structure of transactions between payers and providers is so structured and so regulated that their choice in the pricing equation is minimized or even eliminated.

And it has to be on both sides. Control only the costs, and unregulated payers might inflate their margins and still deny care. Control only the payers, and providers will simply find the point at which the market bleeds and prices will settle there. Create any solution that regulates one but not the other, and the more regulated one will revolt and lobby (most likely successfully) to get the regulation removed and you're back at square one. It has to be a balanced solution that takes the captive-market nature of health care into account, or it won't work long-term at all.

So, ultimately, the long-term workable solution is either to nationalize both sides of the system, to put governments on various levels in both the payer and provider roles, or so thoroughly regulate both sides as to create more or less the same system out of the private payers and providers by strict regulation of both sides. Simply expanding the pool of consumers to offset the cost of including the higher-cost one is nowhere near enough .. it gives us a break for now, but doesn't address the free-market thinking behind it ..

Jun. 29th, 2012

lihan161051

And a tangent ..

One aspect of mass-media communication that bears further discussion is the one-to-many (or in some cases, few-to-many) aspect of mass media, and the illusion of perception that it creates, and the illusion of legitimacy that it lends to what it presents to us on the screen.

Everything you see on TV, hear on the radio, read in a magazine, or receive any other way from commercial mass media is carefully filtered. You've been conditioned to perceive what you receive in all those ways as part of your extended reality, your view over the horizon, so to speak, in certain contexts, and that "events really happening a long distance away" perception is triggered by certain visual and/or aural cues that signal "news".

There's a trust built into that perception that leaves us extremely vulnerable to manipulation. Consider for a moment that you perceive a large part of the world through mass media communication channels that are run by corporate owners who are not impartial, and the bulk of the ownership is concentrated in a very small number of companies with their own agendas .. and you still perceive what they report as actually happening, somewhere in the world far outside your direct experience. You also tend to perceive things not reported through these channels as not really happening. Mass media, corporate-owned media, shape your perception of the world in ways that convince you they're reality or, by their absence, remove themselves from your perception completely. It's a subtle trick, and there are countless ways to exploit it. And it's been exploited, in a number of those ways.

How much of that shaping process is deliberate and by design? Probably very difficult to tell for sure, but given the concentrated ownership of most news outlets, and the agendas most if not all of them are pressured to follow, it's almost a certainty that it's being exploited in at least some ways. And it's a shaping process you're exposed to on a nearly constant basis, if you watch TV or listen to the radio at all during the day, or read magazines on a regular basis. It's a wicked bargain -- you gain the sense of being an informed citizen who's knowledgeable about current events, but your perception of those events is inevitably skewed and slanted in the direction the people who bring it to you want it to be, and you accept information as factual that is often incomplete if not outright misleading.

And that's one of many ways in which we're programmed to believe what we're supposed to, and accept a view of reality that's favorable to certain powerful interests in this society that have a vested interest in our beliefs about them -- and about ourselves -- not undergoing significant changes from the status quo. And those beliefs serve the people controlling our perceptions, not us, because their interests are entirely motivated by profit, and reinforcing devaluing perceptions of ourselves is a profitable angle to their business.

One reason there's any awareness of this process at all is the channel by which you're reading this: the Internet. For the first time in history, we have genuine many-to-many communication -- we can talk back to the TV, in a sense, and be heard. This one medium is a complete game-changer in this equation, and its true significance and the extent to which it will ultimately change our perception of the world and our interactions with others is still largely unknown. It's potentially as fundamental an innovation as the invention of printing itself, and has the potential to make one-to-many mass communication completely obsolete.

And challenge or even completely defeat the process by which we've been trained over the past decades to think the way we're supposed to.

And the major corporate media players have come late to the game, and for once, the democratic nature of many-to-many communication slipped in under their radar, and gave us a huge head start. We have the potential, still, to leverage that advantage into a true fair marketplace of ideas that allows us to gain a truer understanding of our world and of ourselves. The corporate players have definitely joined the game and begun putting strategies in place to monopolize our perception through this channel, as well, and have engaged in a number of legislative lobbying efforts to dilute the influence of many-to-many communication if not outright make it impossible, but in this instance, it's not at all clear whether or not they even can succeed. That question is one we have the power to answer, ourselves, by either asserting our ownership of the channel -- which we still have, for now -- or allowing them to take it over and turn it into just another kind of TV that tells us what we're supposed to think.

So, if it comes down to it, are you willing to fight for an unfiltered reality and the right to your own autonomy in it, or are you comfortable going back to being told what to think and how to perceive the world? It's up to you .. if you're reading this, you have the power to get involved, and there's a window of opportunity that may soon close ..
lihan161051

The dysfunctional society

I had a conversation the other day about relationships and other sorts of human interactions that put some things into perspective for me.

We are a social species. Our experience of our lives is shaped in large part by our connections and interactions with others, and almost every part of that experience exists in a social context. It's part of our perception to such an extent, both consciously and unconsciously, that our understanding of the universe we live in is inevitably shaped by our communications with others.

And that communication must be balanced and fair for that experience to be a healthy one. We have to have a sense of agency in those communications -- some aspect of them must represent our identities, desires, needs, some aspect of them must actualize our selves in some external way -- and we have to feel that the meaning we are communicating to others is respected at least in the most basic sense as fellow human beings, for those communications to feel nurturing and healthy.

Many aspects of our interaction with others outside of our immediate person-to-person connections (and in some cases, within that sphere as well) completely ignore this, and this starts in the schools when we are children, when we're taught to value obedience, and deference to authority, and acquiescence to challenges -- all the behaviors that condition us to be compliant employees and consumers, and condition us to be other-centered in our reasoning -- but not taught to value our own identities and our own selves in ways that strengthen our sense of agency. And it continues through our adult lives with a constant bombardment of advertising messages that train us to want what corporations and political candidates want to sell us in an almost infinite number of overt and covert ways. We're subjected to pressure to normalize our behavior every day, largely in the examples we're presented in mass media programming but often in the more immediate sense by partisan bullies who criticize us for deviating from their own concepts of conventional behavior.

I believe that the majority of this is evolved, emergent social behavior that probably served us well as hunter-gatherers when divergent behavior had serious consequences for the survival of the tribe as a whole, and normative influences of various kinds ensured social cohesion in the face of a number of existential threats. The only fault in these mechanisms is the progressively accelerating rate at which our circumstances change, and will continue to change; the coerced normalization that used to ensure the social cohesion of small tribes at the mercy of an often dangerous environment, and in fact a generalized notion of the tribe itself, have been carried over largely intact into a modern world where they have mostly lost relevance and become liabilities, but are nonetheless still part of our collective psychology, and the behaviors they still tend to drive in us are largely just part of how we're wired and part of how we function in terms of interacting with each other.

But there are a number of elements in our society that have learned to exploit that wiring in a variety of ways. Some of them are organized, some are individuals, some are loosely organized groups who simply exchange information on what gets them what they want and what doesn't, but all of them in one way or another make some sort of use of our tendency to comply with normative pressures from others, whether through direct person-to-person interactions or through an increasingly broad range of mass-communication surrogates, and all of them in some way benefit from exploiting that tendency. Some are cynical and sophisticated, such as the complex and nearly ubiquitous campaigns of collective social programming run by major corporations that not only condition us to want to buy their products, but now more often than not condition us to vote in favor of comfortable legal environments for them and thus make them even wealthier. Some are very simple and individual indeed, such as bullying others for simple ego gratification, or the slightly more complex strategies of social and sexual predation that use coerced compliance for psychological advantage. And last but not least, there are religious extremist organizations that leverage both the tendency to bow to normative social pressure and the common (and somewhat inaccurate) perception of the norms being enforced as being of some cultural value in and of themselves simply due to tradition.

So on the one hand, we find it difficult to accept non-tribal social functioning even when its value to us as a species has been clearly demonstrated, and on top of that, appeals to that sort of non-tribal social functioning immediately attract active opposition from actors of various sorts who have a stake in maintaining the vulnerabilities that are part of their daily business of exploiting us.

But the single weakest point in all of this is that omission in our social conditioning that I mentioned above: self-value, self-actualization, and agency. It's not always a simple omission -- part of what many of us were taught as children was the profoundly stigmatized concept of selfishness, and its latter-day cousin, entitlement. Granted, there are selfish and entitled people, and they can be unpleasant and tedious to interact with, especially when one stands in between them and what they want, and entitlement at its worst can include aspects of bullying or even predation. But when we fear being selfish or showing entitled behavior, we risk throwing out something very important along with those -- we run the very real risk of defeating our own sense of self-value and agency along with those undesirable behaviors.

Agency is central to our self-actualization, and in many ways, it actually defines it. Almost every single positive interaction we have with other humans begins with ourselves -- you cannot respect others until you respect yourself, and you cannot love others or indeed have much hope of receiving love from others until you love yourself -- and agency is literally our ability to represent those basic needs and values. It is important to respect others and maintain a balance between that and our agency, but it's also important not to neglect our own agency and our own self-value.

And we don't teach that enough to our children, either in school or in many cases at home to our own kids. To some extent it's a convenience thing -- even the best behaved children can be trying, and it's always tempting to emphasize obedience and other-centeredness in what we teach to children simply to get them to settle down and exercise some self-control -- but to some extent, for some parents and teachers alike at least, it's more of an emphasis on control and obtaining obedience at all costs, which either accidentally or in some cases crushes the entire life out of their sense of self-value and trains them not only not to seek a sense of agency in their own lives, but to actively resist it on an often-unconscious basis .. and there are few things more solidly guaranteed to produce a hostile, malicious person who only relates to the world in ways that involve breaking or destroying every part that comes within reach than to plant a suggestion that seeking one's sense of agency is forbidden somehow. There is no deeper resentment than that, and no surprise -- it's a direct attack on one's own identity.

I think the single best thing we could do for this society is to ensure that every child grows up with a balanced sense of agency and respect for fellow human beings and has it well established throughout childhood and into early adulthood. Where that takes them from there should take care of itself. I think the entire dialogue on what constitutes traditionally undesirable behaviors such as selfishness, entitlement, bullying, and so on should be defined in that framework, and kids in school who show signs of being other-centered to their own detriment should be treated with the same level of concern as the ones who show signs of being self-centered to the detriment of others. Fix that one thing, and many other things fall into place .. maybe not all of them, but a lot of them, to be sure.

Jun. 24th, 2012

lihan161051

On agency, consent, respect, and identity ..

I've talked a lot about consent in the context of how one responds to, or reacts to, the actions and expressed intents and desires of others, and about choosing which of those expressed intents and desires one is and is not willing to participate in. Mostly in the context of sexuality, sex-related communication, and promoting sex-positive culture, but these concerns abstract much farther than that relatively limited area .. in fact, in an ideal world, they would reflect back into those things rather than be confined entirely to that territory.

I've also talked a lot about the principle that everything positive and empowering about the human experience begins with oneself -- that one must respect oneself in order to be able to respect others, honor oneself to be able to honor others, and love and care for oneself in order to be able to love and care for others, and so on -- and touched on the ways in which one's own treatment of oneself is mirrored in one's treatment of others and their behavior in return. And I've touched on the need to know oneself and be honest with oneself about one's own needs and desires, and express them without fear or shame.

The latter argument is about agency, which Wikipedia defines as "one's independent capability or ability to act on one's will." Consent is a passive thing -- it comes down to choosing what one accepts or refuses from the external social influences one can exert control over, either directly or indirectly -- but it's about choosing from what's on the menu, so to speak. Agency is a more active process of choosing which menu to order from, or if need be, going off the menu and creating choices on one's own, asserting one's own identity and autonomy.

There's a balance, I think, and a very important one, to be struck between agency and respect of others' boundaries. We are social creatures and our lives are largely defined by the points where our lives intersect with those of others, but agency is crucial to using our fair share of the space we live in, both literally and figuratively, because without agency, we concede too much of ourselves to others and allow them to set their boundaries so close in to us that we have no room left to live in. It's certainly important not to do the reverse, to steamroller over other people's boundaries and force them into such a crisis, but it's equally important to assert our own and strike a fair balance.

This is kind of a new concept in western society at least, mainly because the majority religious traditions in this society have a history of downplaying individual agency as a concept and demonizing it as rebellious selfishness in all but the most limited cases. That's an inevitable consequence of living under religions that have been all about social control since the 4th century if not earlier, and one religion in particular that has the unique distinction of having conducted one of the most complete programs of cultural genocide in the history of our species, and one from whose shadow we are only now beginning to emerge. Agency is still a suspect idea, in many ways, because the vast majority of people in this society were taught as children that being too assertive about one's own desires, especially if one should have the temerity to desire things that differ slightly from what the collective considers "normal", is at least suspect if not an open invitation to corrective action either from the church or from other authorities, or even from extralegal social normative enforcers like the bullying institution still tacitly tolerated in many school systems. So there are a lot of forces working against this idea as a general concept, on outdated but still very much enforced moral principles.

But my vision of the society of the future, the one that has outgrown motivating people by fear and shame and has embraced positive and empowering human interactions, definitely includes agency as a core value, as much as it does a basic mutual respect for the people one interacts with, all in balance, but in a fair balance, one in which our respect for others flows from our respect for ourselves, and one in which none of us fears the judgments of others simply for speaking our minds and our hearts. Both of those, agency and respect, are core responsibilities, to ourselves and to those around us, and I believe that to be true about everything we do as a species. We're not there yet, but I believe we can get there if we try. And I for one plan to lead the charge.

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