September 2018 was quite the month—its political related events stimulated discussions and thoughts at a deeper than normal level. For one of my young mentees, the Kavanaugh Supreme Court nomination process brought out the good and bad side of many people, so we had discussions, many discussions. The Atlantic Magazine’s June 2018 cover story, “The 9.9 Percent Is the New American Aristocracy,” prompted a conversation with my niece. The article puts a different frame on class in America, why it exists and how real are its distinctions. I received and read The Atlantic’s October 2018 issue—yes, I continue to receive physical magazines—which provided a series of articles that debated the theme,”Is Democracy Dying.” Also, The Economist magazine published in its Sept 15 issue—the 175th anniversary edition—an essay on Liberalism with the subtitle, “Reinventing liberalism for the 21st century.” The reinventing notion caught my attention, especially within the context of this political season’s tactic to label Democrats as socialist. My efforts slowly and surely drew me to the whiteboard in my office, where I cobbled together my thoughts to the question, “What are my political principles?” Those white board thoughts and a some encouragement from a young mentee, another set of discussions, led to this blog post—a public display of my political principles. And, my principled based solutions to some of society’s challenges. Now, if there were only a political party aligned with my thoughts.
My political principles intersect my understanding of human behavior and my beliefs about what it means for humans to successfully operate in a group. Therefore, these principles used as a basis for political activities creates in my estimation a high probability of societal success.
1. Society is a place of conflict. It will always be so; it is neither a good nor a bad, it just is.
Societal conflict occurs when more than one citizen wants to lay claim on the same thing: an idea, an asset, a resource, or a commitment of another. Conflict reveals itself in many forms. Sometimes conflict shows itself as competition or fruitful argument but, in other times its disruption to status quo or disputes between citizens. At the core of behavior, conflict manifests itself as an assertion of a thought, principle or notion from one to another.
Society can benefit as conflict is interjected in, then resolved, through the give and take of human interactions. As person A asserts a thought it may create a new idea in person B’s mind. The back and forth can move a relationship toward progress—a societal benefit. A typical flaw in human thinking is to label a conflict as good or bad based on an evaluation of the outcome to one societal member. To label outcomes reflects a short sighted view that progress should be pain free or is only good when one receives benefits with little costs. Such a notion misses the cause and effect when one conveys a principled requirement in a negotiation as a method to unlock disagreement or stalemate. By asserting a requirement, the negotiation counter-party can now see, something to trade for or trade off, thus stalemates are broken and value can be created for both negotiation parties. There are many ways that conflict can be a productive step toward progress.
For a successful society the focus of its laws and norms should be on the citizens’ response to conflict, not on removing or discouraging conflict. As an example, consider a typical contract dispute. A focus only on what was in the contract without exception, a rule of law mentality, seeks to discourage conflict by fiat, simply everyone comply with prior agreements. Yet this focus ignores the discovery of potential gains from the new information that one party wants to insert into a contract negotiation—a want that if compensated for is a path to create more value for both parties. But to create or claim value by either party requires skill. Skills that citizens need to develop, practice, and improve upon. The conflict avoidance response—stick to contract, no changes, no compromise, your word should be your bond—preempts value creation.
Thus, a societal aim should be to develop citizens that can embrace change, innovate, or experience personal growth. A focus on removing conflict or avoiding negative outcomes encourages the status quo, low innovation, low levels of critical thinking, and mindsets that distrust differences espoused by others. Low progress.
2. Society is dynamic; it can get better or worse.
Societal change occurs. Despite the wants and preferences from some societal members for the status quo, change results from many causes, such as:
- Interaction with other societies on the planet,
- Mass change in the adopted behaviors or beliefs—trends,
- Uncertain events in life,
- Resolved conflicts, and
- New discoveries.
No society can control or predict with certainty when the causes occur nor the outcome of the underlying events. But each change can make a society change for the better or worse. Thus, a society’s goal should be to progress for the better. While the measurement of progress can vary considerably (for example, material possessions, adopted ethics, character, skills or capabilities of the citizens), a core requirement for progress is that the members of society have the opportunity to learn and grow from their experiences. Thus, the citizens must take risk.
The policy objective then is to develop broadly the member’s skills to take better risk, to learn from their experiences with uncertainty, and to appropriately share risk. The political conflict needed for progress results from monitoring the state of society, and putting in place the norms and rules that support the occurrence of progress. Thus, the great challenge to keep the focus on the process rather than the end result. Focus on the end result means a government that tells citizens, “just do what I tell you, we will achieve “X” and life will be good,” while a focus on the process continually promises and reinforces discovery by each individual, “take these steps to improve your lot in life, have pride in your actions, learn from your experiences, and live with the dignity from effort.”
3. Society should distrust power; it corrupts individuals and groups.
Power is that ability to get others to do as you wish. To establish a productive society, we grant certain roles power in one or more aspects of life—boss of a department, property owner, police or military officer, president, governor and many more. With good results those in power help individuals organize for the collective good and achieve desired benefits. But, downsides occur within those with the power to get things done, downsides also known as over confidence, arrogance, greed, extreme wealth and more.
The human brain develops norms, habits, cause and effect notions, and other beliefs that allow us to operate in an uncertain world. When we are granted power over periods of time, the brain adjusts (corrupts) our norms, habits, notions and beliefs in ways that harm the individual in relation to other society members. The brain’s adjustments disrupt the cause and effect truths behind human behavior. History records some of the forms of power corruption as the behavior displayed by monopoly companies, government dictators, or absolute rulers.
Societies that protect themselves from the ills of power corruption place sets of checks and balances on those they grant or allow to accrue power. For example, we term limit some politicians, we break up companies that become a monopoly, we divide government roles to legislate, execute, and adjudicate, and we provide leaders for military and police forces with election rather than self nomination. Those in power always resist the checks, as inefficient, or claim exception to the need for checks, I am good. Society’s crucial problem is that in exerting resistance, those not yet corrupted behave the same as those already corrupted. Thus, society can either follow a strategy to spend time distinguishing the clean from the foul and removing power accordingly, or to spend time limiting and balancing power so the most corrupted can never perform their irreparable damage. I suggest the checks and balances approach. The powerful who are corrupted are limited in the damage they can cause. The powerful who are fresh and clean, have to share their power across a broader spectrum of society, which for me is a small cost for society to incur.
The political elite in any society are an example of the challenge to place checks and balances in the society. The political elite have become proficient, or expert, at running government institutions that are the very ones needed to put checks and balances in place. As the corruption takes hold, we see behaviors designed to protect or project the political party over the society as a whole. The political elite forms resentment against the opposition (a check on their power). While the proper check and balance on the political elite deserves debate, we are faced with a natural conflict of interest as we have the political elite lead the discussion. It’s a difficult societal challenge.
4. Society should provide equal civic respect for the individual.
A society cannot exist without infringing on the rights of an individual to some degree, however it should be the goal to infringe as little as feasible. For a functioning society, minimizing individual infringement, and equally distributing infringement among the various subgroups within the whole of society are ambitions of constant pursuit and rare achievement. To live this principle a society must recognize at least three types of individual rights: personal, political, and property.
- Personal rights include the ability to do what you want to do as you live your life. Among the rights I include here are to determine ones own outcomes, pursue happiness as one defines it, receive protection from outside societies that seek harm and associate inside the society as one sees fit.
- Political rights are those necessary to interact within the greater society and with its government as needed. Among the rights included here are to speak free from government restraint speech, to practice the religion of your choice, to request action of the government and to organize with others to achieve a goal.
- Property rights include the ability to stake a claim on a thing, and to use that claim in ways you envision to provide goods and services for yourself or to others. If society needs to take your property for the greater good, just compensation should follow.
To provide equal civic respect for the individual, a society should find a balance to two points of view. One, is to provide enough respect to allow someone to learn and grow at their pace, that is to come to their own conclusions about something that someone else already knows—a mentoring mindset. The other point of view, is to respect someone enough to not care for them as if they are mentally incapable to make a decision, as if a child. A respectful society avoids providing answers with no explanations. This latter notion is often everything wrong with the corrupted political elites—they cannot help themselves but to put policy in place without explaining it. We hear their inefficiency argument quite often, “who has the time to explain how to get to the result that I already know is right for everyone.”
5. Influences impact the behavior of individuals.
Society should support and encourage those influences linked to individual effort, value creation for society, productive citizenry and appropriate risk taking. All others should be discouraged—a tall order, because influence is the aim of all those who seek personal gain at the expense of other societal members. No matter whether the motivation is greed or power, the primary aim of those seeking to gain at other’s expense is to engender trust, by the use of an influence technique, under false pretense.
As the human brain develops our norms, habits, cause and effect notions and beliefs, it does so under the heavy influence of our life experiences, which is inclusive of our interactions with other societal members. Every life experience is an influence on our being. Unfortunately, some influences on us are a negative for our existence as a part of society. Thus, society should encourage those influences that support positive benefits for society. I call out these benefits as crucial for a society:
- individual responsibility for actions – A resulting state derived from the provision of equal civic respect. One set of influences results in progress, new learning and value creation for the greater society. Another set results in regress, learning opportunity, and value destruction for the greater society.
- productive citizenry – A desired state that accounts for societal roles that support progress, which include those that spread norms which encourage the growth and development of other members, and provide services and goods to others, while engendering their trust.
- cooperation and civil treatment of others – A desired state that reflects society’s ability to exist with individuals with many differences and yet resolve conflicts amongst its members.
- appropriate risk taking – a crucial element to progress is society members that operate well in the face of uncertainty. However, a society’s success is not driven by taking every presented risk, but by an ability to judge the difference between those we should take and those we should avoid.
Human influences are more complex than pursing money (our exchange medium between citizens). Money as a motivation has many negative and positive influences on society, yet the political objective to provide influences must account for our medium of exchange—to separate the good pursuits of money from the bad. Good pursuits includes those where money is exchanged to convey the claimed portion of value that was created. For example, you create a company that improves other’s lives and therefore, earn a fair profit. Bad pursuits include money received through false claims, representations or reneging on promised services—some of the better known terms in the US society are false advertising, fraudulent representations, broken contracts, con jobs, and conflicts of interest. While the simple examples provide good illustration, the societal challenge is a difficult one to provide influences that benefit society. Constant monitoring is required, setting norms or precedent for behaviors among members is needed, as is the ability to make adjustments and reverse norms and precedent once we realize society has moved in a negative direction. The political challenge is immense, needed, and requires resolution of conflict, not squashing conflict, to succeed.
Societal Challenges – USA Perspective
Concentrations of Wealth and Power
It might strike many acquaintances as odd that I see concentration of wealth as a societal challenge. After all, I worked closely with the Mars family—consistently featured on global list of the wealthiest families and ranked as high as number three while I tracked such things—for four or five years and my complete employment is a direct contributor to my personal wealth acquisition. When my father passed away, the most memorable note of condolences was provided to me from Jacqueline Mars, who had recently lost her farther. However, my principle does not imply power corrupts only bad people, no, the concentration of wealth into the hands of few societal members is bad for the greater society. The concentration of wealth is a factual result, which indicates a lack of checks and balances in society on those that create value and thus exert power and influence within the society.
In today’s societies the concentrations, and lack of checks and balances manifest themselves in a number of ways including:
- the lack of governance for multinational corporations,
- the concentrated collection of behavioral data in the digital world,
- the corruption and bribery that exist by government leaders and the resultant lack of trust in governments to lead a society. Brazil, a favorite country of mine, provides many examples
- the political elites that retain power and drive elections results with an any means necessary to implement an agenda devoid of rigor and debate. These people live by “do what I say” and over use social proof as a way to cement power, and
- the income inequality measures, which provide evidence of a growing gap in the distribution of wealth around the world.
All these examples signify the lack of check and balance on the capture of value creation and accumulation of wealth. The examples also signify a lessened amount of dignity to accrue to the average person as they self determine their lot in life.
My principled solutions are many, because of the complexities of the global government influences (for example, tax policy, international trade, and economic aid payments) to the concentrations, however, my solutions do center on putting in place, and restoring in many cases, the checks and balances on power accumulation in all its forms. For example, the antitrust framework used in many places of the world is outdated and in the case of our digital livelihood is non existent. Our tax systems provide incentives for wealth accumulation, even by less than beneficial means for the society. Additionally, the tax systems provide incentives for economic free riders through the many forms of “safety net.” Safety net, a polite term for sure, but really is a pure transfer of money from one citizen to another and in today’s forms, absent the dignity of self-determination for the recipients. One standard of evaluation for government policy and regulation has to be, are profits from economic activity distributed in a manner to influence dignity across the citizenry without concentrated profits into the hands of a few. A evolving standard, and with learning opportunities from the applications across time.
Free Market vs Government
As a society seeks progress, its government and economic policy experts will certainly debate the role of the free market versus the government to provide solutions for society’s challenges. Such debate is a crucial illustration of conflict that spurs progress for society. Never in my business school studies or business interactions have I met anyone who proposes a socialist or communist type state as a solution for the United States of America, however there have been plenty of arguments of where to draw the line for government versus free market solutions.
A large portion of the line drawing contention seems to center around estimates and forecast of how well a profit motive spread across multiple economic participants provides broad social good for the greater society. A second portion of argument debates whether the free market or government delivery of service is superior to the other, because implicitly they violate the principles, to treat individuals with civic respect, by their notion of one way is right and all others are wrong. A better frame of argument would focus on incremental improvement and experiments for the society.
Where people can make no headway on incremental improvements or small experiments in the name of progress, there is usually a motive to gain power or profits. Thus, the debates about one or the other are more often clues to where we need a check and balance to excessive power or profit seeking activities, rather than the illustrations of foresight, and forecast of brilliant solutions to the problems that they purport to be. When we compare societies around the world, we can often see success and failure (if we are able to look without using our confirmation biases to select data that supports or preconceived notions) for either model, which suggest our emphasis should be how to improve our future not which model is superior.
As a society progresses, either government or free market solutions can be improved upon through the assertions made in policy solutions that experiment with new knowledge or remove conflicts of interest from participants; A focus on future possibilities for improvement. Progress should be able to start with the status quo and move toward a incremental improvements. So a solution such as the recent call for Medicare for all, a move away from insurance companies and individuals as purchasers of many medical services to a system of single payer government would be a conflict with my principles of society as dynamic and a place of conflict. As much as the repeal and replace healthcare notion of early 2016 would violate the same principles, I would rather support politicians who focused on incremental improvements that address the imbalances in power between the manufacturers of medical equipment, providers of medical services , insurance companies, the citizens under the duress of medical need, and the lawyers who today try to alter the power positions through lawsuits. It’s the evolution of society I want to focus on, not wholesale change nor revert to the past for success.
How a society chooses to relate with another society, Foreign Affairs, is a great challenge for any society. The difficult question seems to be, “How does a society treat those societies that openly distrust their principles?” The answer depends on many factors including the relative military or economic might of the two societies, historical flows of people between the two societies, existence and nature of multinational organizations that wish to exist in both societies, and, of course, the similarity in predominate religious practices. In terms of trade in goods or services, does the society sanction, open markets, or adjust limits as a form of reward or punishment? In terms of military support, does the society open a base, form an alliance or treaty, or is the society a country for hire? When the other society treats its citizens poorly, does the society cut off formal government relations, sanction to punish, or dangle positive agreements for future compliance? What if a sanction is placed and still the other society flouts our objective, what is done next? Should the society behave in a paternalistic manner and spread its values to the less fortunate societies through influence and awarding economic support, or install a new governing regime and give direct economic support? These challenges and many more face the arena of foreign affairs. From my perspective, there are four core responses to any foreign affairs situation:
- Seek to change the other society, by force
- Seek to change the other society, by influence
- Adapt to the other society’s behavior, lower one’s resolve and tolerate the other society’s actions
- Isolate and ignore the other society, as if they don’t exist
From the perspective of the United States of America, the same four core responses apply if subject matter is our trade with China, which provides cheap labor to the world, the instability of the middle east, which provides fuel supplies to the world, or our evolving level of similarity with Western Europe, which extend our military might and supports peace on the plane, we are challenged to evaluate the level of alignment on our principles. Some societies align better than others, I agree, but none are perfect, thus to manage foreign affairs one should give up the ideal of perfect match and evolve to a model where we seek to get what we want by giving up something less costly to our society. Yes, foreign affairs is a negotiation.
My principles call for a society that respects the individual, recognizes that power corrupts, and uses more good and less bad influences. I see the United State’s foreign affairs as overly reliant on military might and economic sanctions, both of which are used as forms of force the behavior we want. No doubt, a paternalistic position fueled by memories that we won World War II. The United State’s challenge then becomes to learn how to exert influence and receive things of value back in a negotiation other than the promise of compliance. The rise of multinational corporations have insured that the USA’s economic might, as a country, is an irrelevant concept as the multinational corporations make their investment decisions to drive profits and power. The the societies are tools the multinational uses against each other to manage the level of profits. Additionally, the United State’s military-superiority mindset is too close to that of a bully. Other countries see it, and as with most bullies, we will see our overconfidence far too late in a battle we are in process of losing; a fate I would rather not live through.
So, what should change if politicians applied my principles to the United State’s foreign affairs? One example would be an end to the calls for regime overthrow. Live examples could be just about any speech John Bolton made in the last 20+ years. Another example, would be ending the implicit role as the world’s judge of right and wrong. A good example is the media framing and reporting on the disappearance and death of Washington Post reporter Jamal Khashoggi. The event occurred in Turkey to a non US citizen. Sad event, for sure. But, the general call to hold other government leaders accountable by our government are implicitly rationalized by beliefs that the USA’s values are superior and other countries should follow our values; it is a delusional position. Some will surely ask, then how are governments such as Saudi Arabia held accountable under my principles. The answer is two fold, a) by their own citizens which have granted them power, b) by what we extract in negotiation from their provision of a point of leverage, and c) by an act of war when they behave in a manner that justifies our congress to declare we fight. Neither of these principles involve our executive branch issuing sanctions and using other forms of force without the permission of the people’s representative. Today’s norms are an abuse of power. The United States Constitution should be updated to make all forms of “force” by the executive branch require congressional approval—it would be a reasonable check on the power to direct the military.
We must progress more to adapt our resolve and lower our contempt for other nations. Our executive branch should be there to mentor, guide and influence other leaders and power structures as a way to conduct our foreign affairs. Two governments arranging trade rules at the request of a group of multinationals seeking profit, should end as a way to check the power that accrues to those seeking profit in multiple places. However, the government must maintain its military might as protection from outside societies that are corrupted by power, err in overconfidence, or seek revenge for any past actions. Without military might, a society awaits attack. But, playing world cop or peace keeper through use of our military power, as a way of conflict reduction, should not be our role. To do so, implies the world should be without conflict and that is false true. Would their be more war and death under my principles, in the short-term, yes. However, a dynamic society requires conflict to grow and develop. The death and war result from those who in the short term to fail to negotiate progress out of conflict, not from the existence of conflict itself.
My immigration perspectives have certainly been shaped by my life experiences. To think otherwise would be silly. However, understanding the experiences may help position future questions or challenges to my thoughts, therefore a bit of sharing is in order. I often describe to my mentees my most difficult management conversation; the day I had to inform an associate that our company would no longer allow me to, nor would it itself, participate in her immigration case. The implication was clear you have to leave the country to keep your job with company, or lose job and stay in the US illegally. The conversation broke my heart. But, it was one of many conversations that resulted from my management roles which, included the direct management or hire of six individuals from the countries of Romania, Hungary, Japan, France, Argentina and Mexico. Additionally I’ve gained international experience because of the jobs I have held. Aspects of international trade were shaped by my experiences purchasing raw materials for Mars Incorporated. I had direct purchasing responsibility for a global supply chain, and served on a strategy team to influence demand and supply perceptions and ultimately prices in various countries to our corporate benefit. Aspects of lobbying and government relations with multinational corporations were shaped by my experiences as External Affairs director for Mars. I had responsibility for crisis management, public affairs, and public relations for all countries in North and South America, and coordination responsibility with two others for global activities in these areas. One memorable activity in this role was the morning I viewed the testimony on an activist in the US Senate make the statement that the chocolate industry benefited from the use of slavery and the only responsible action for congress was the end of all chocolate imports into the USA. Resolving the global issue–the same lobbying point was made to the European Union–with my international team was quite the learning experience. Combine vacation and work experiences, Beverly and I traveled to more than 35 countries. And in many countries, we have maintained relationships with individuals we grew to trust and know—a wonderful benefit of the internet.
Immigration captures the idea that people move from one country to another for reasons other than temporary purposes such as to relax on vacation, to attend to a business objective, to acquire knowledge through an education endeavor or participate in a conference, or to observe a sporting event, wedding or any other ceremony. When a boarder is crossed for long-term purposes, several elements of life inevitably need to be addressed such as housing, employment, or interactions with the local legal, medical, or social services systems. Why do people move for long-term purposes? Certainly, political events such as war would drive people to move. Or, on a local level, violence that the government cannot control would motivate some to leave a country. Homes and businesses that are destroyed in natural events such as hurricanes or earthquakes; creates a motivation for some, sure. For me there are lots of reasons why someone might want to move across a border, but the better question is, why should they be accepted into the new country?
Across the world we have seen countries accept immigrants for many reasons. Some reasons involve economics; the country needs labor. Other reasons have included guilt from past actions such as slavery or exerting colony leadership over a group of people. Some times the acceptance of immigrants is a act of kindness or quite simply a lack of border control—people came, settled in, and stayed. Europe has conducted a grand experiment with its notion of free movement of people, goods and services during the last 20 years. I’ve never thought it wise to treat people like goods and services; it gives a choice to people to move but requires an exchange for goods and services. People should not have a choice. My personal desire is that they put energy and effort into fixing their home country, or securing the resources and alliances from wealthy nations to fix their home country. People decline where they are born. Unheard of. Illogical. Thus, people should not choose which society to join, there should be some type of exchange. The society receiving people has to have some say, about who is invited in. I have a nice home, no one has the right to move in because they like the amenities. I can invite someone to live there, but not the other way around.
Thus, a government employing my political principles would operate with strong boarders, on land, sea and airports, to facilitate their knowledge about who is in and out of the country and for what purpose. The government would use immigration as a tool to provide progress to the society, such as to balance low birth rates, address an age distribution gap, to add undeveloped skill sets in the society, or to exemplify the society’s character. However, the tools and techniques used by the government to manage a flow of people results from the evaluation of how many immigrants are needed versus how many want to show up. At times of excess people for a smaller number of entry slots, the government needs tools to prioritize, rank, and limit quantity. At times of less people for a larger number of entry slots, the tools and techniques focus on incentives, recruitment and encouragement. There are legitimate discussions a government needs to have in order to manage immigration well. My questions that a leader would address in any state of the union message:
- Given the state of our society, its age distribution, and its skills surplus and deficiencies what are our immigration targets for the next five to ten years?
- What improvements to our current boarder security scheme, would help us have a more accurate accounting of the people who move in and out of our country?
- What’s the best estimate of the number of people who wish to come to our country and what are the implications for the tools and techniques we have in place to invite others in, given our immigration targets?
The political climate of the United States combined with the piecemeal immigration laws on our books is an ineffective mess. Political objectives confuse and blur legitimate calls for improvement, or calls to help others driven by kindness. As a result, there are several political arguments floated around by the media and political parties that are simply ridiculous. One is “we are a country of immigrants, everyone who wants to be here and contribute is welcome.” First, we are not a country of immigrants, we are a country of opportunist who believe in property rights. We took what was unprotected and then protected what we occupied. Second, there is no truth to the notion that everyone is welcome that wants to arrive. The economic ups and downs of the USA create better and worse moments for new arrivals. Granting a choice to those who want to seek a personal gain is an unwise principle. We control our borders, we decide who to invite in. Another argument is that “immigrants take from citizens and provide nothing of value.” The argument makes an incomplete comparison and frames the discussion as a zero sum game. The reality is more complex. First, immigrants can help the society in many ways given the economic roles that they play. For example, our agricultural production needs low cost labor. We will not let agricultural land owners use slaves as a method to obtain low cost. Since, we struggle to encourage citizens to move from cities to rural areas, we need immigrants to provide the work. Our government does a poor job of identifying our needs, don’t blame immigrants for that. Second, there is a large role for the government to allocate the benefits from immigrants—which largely accrue to business owners who employ immigrants—and the cost of immigrants, which may fall to society in the form of social services provided to the immigrants. The tool should be the tax system (in the broad sense income taxes, fees for services, and different qualifications for services based on immigration and citizenship status). The solutions will require debate, transparency, change and progress in the society and it is the responsibility of government—no perfect split exists. The last argument I want to discuss is “we are better off without immigrants, we are self-sufficient.” First, no country on this planet is self-sufficient. Only politicians seeking personal gain from overconfidence and inflated egos allow people to believe this falsehood. Second, politicians have a role to explain the trade-offs needed to address the immigration needs of the country and how we choose to meet them. Thus, as a society, our education of the citizens should give a fair account of:
- our lack of self sufficiency,
- what as citizens we can do that can help meet our society’s future needs, and
- the gaps that exist between our societal demand needs and the citizenry supply available to work with.
There are other arguments, but I hope I have illustrated my key points. The role of a society’s government is to layout a plan for progress. If the plan includes a shortage of population or skills, make immigration happen. And, if it includes an excess of population, make migration out happen or birth rates drop (see for example, China’s one child policy that began about 1980). And, by extension of a belief in property rights, the government should know at all times who is in and out of the country and individuals outside a society cannot invite themselves into the society—just cannot happen.
The origins of the United States’ welfare state began with attempts to support citizens during the economic downturn of the nineteen thirty’s—the great depression. But, over time the programs morphed from a) temporary programs provided to assist the public’s transition through difficult economic times into pure wealth transfer programs from a tax payer to another citizen and b) government demand generation for service providers who earn profit from citizens that receive “free” benefits. The models moved from support to an influence mechanisms for the government to produce desired behavior. Almost nothing about today’s programs of unemployment insurance, Medicaid, Medicare, social security, food stamps or the other programs fit my principle of treat individuals with equal civic respect. Given the government’s dual role of demand generation for service providers and orchestrator of citizen behavior (e.g. qualify for free stuff by doing …), today’s programs are closer to “do what I say and I’ll take better care of you than you can for your self.” For recipients, personal dignity has been stripped out of the support system and replaced with get what you are due from your government. For providers of goods and services, taxes become pooled marketing expenditures, which leads to fraud from the greedy and complaints from others who debate if they got their fair share.
While there are many examples to illustrate intended and unintended consequences, our social security system is a perfect illustration of the government’s morphed purpose. The program started as a vehicle to teach savings and promised to return savings plus investment earnings from the US Government. As now executed it is simply a transfer from one generation to another, as politicians stop investing on behalf of the citizens they collected money from and spent the investments on other purposes. As private citizens they would have been jailed for theft. As such, there is no benefit to greater society as an older family receives funds provided by a younger family taxed on their earnings.
By applying my principles, each welfare state program would be challenged to make sure the intended and unintended consequences provide a net benefit to society. Questions such as:
- What behaviors is the program influencing? Are the behaviors desired?
- Are the programs encouraging citizen responsibility for actions and the risk they take? Are citizens better prepare to face the uncertainties of tomorrow, to take more appropriate risk in their lives?
- Are the citizens and companies who capture value from the program’s generated demand, under the proper checks and balances?
- In completing the program are citizens fulfilling productive roles for society? Does the program encourage cooperation with others and provide for civil treatment to other society members?
As the government addressed these questions, in a transparent manner, they would deal with conflicts and lead to progress for society through the answers that encourage modification and improvement. Instead what we get in today’s society is politicians avoid all questions in the name of a promise, if you vote for me, I will support you getting your benefits when your turn comes. Sad state of affairs.
Fixing the welfare state is a gargantuan task, and will only be accomplished by developing a transition plan to move people from today’s mindset of getting what is due me to a new future state mindset to get what I earn and to improve with each opportunity provided. Such a transition plan would acknowledge the different generational impacts, and focuses on the underlying principles that define the desired future state and how each citizen can contribute. Hard work for today’s conflicted politicians.
In 2018 many politicians have made efforts to make promises about healthcare, but none, in my opinion, have offered a real solution. One group promises vote for me to get the healthcare you are due as a right. Another group promises you’ll get the best healthcare you can buy and you’ll buy more as you stop paying for freeloaders. In reality, healthcare provision for a society falls into two areas:
- making sure the skills needed to provide health care are supplied in appropriate amounts, and
- deciding the model, or models, of how to exchange healthcare services across the population.
Any government that addresses these two areas has numerous models to review, which have been tried around the world, single payer, income only distribution, government supplier of medical services, and others. Therefore, no model we have heard discussed is an original unique idea to be applied to the citizens, there is opportunity to learn from others. But, how do we decide which elements to learn about?
Two notions stand out as I start to apply my principles to healthcare. One, treat individuals with equal levels of civic respect and two, power should be distrusted. The provision of medical services in the U.S. is run through insurance companies. As a consequence, individuals are unfamiliar with risky decision-making, accountability for decisions, or trading off price for services. Additionally, today’s insurance system lessens the responsibility for care of extended family or loved ones. The notions of insurance and risk sharing are all misappropriated. Today people who buy insurance do not share risk, they are pay into a system with the aim of getting out as much as possible when their time of need arrives. To provide effective care to citizens, the government must consider how to check the profit incentive of medical service providers, especially in a model where profit drives the supply of services, against the desire to receive services so that their profit is constrained on mechanisms like excessive testing, over prescribing drugs, or conducting unnecessary “preventive measures.” Providing checks and balances for this knowledge gap is crucial to proper medical service application, especially in areas with low education or income while encouraging citizens to make decisions in an uncertain world and hold themselves accountable for their choices.
Additionally two situations deserve special mention for the USA system, the link of medical insurance to employment and the provision of medical services at the end of life. There is no special reason for employment and payment for medical services to exist, yet it does. Under today’s system, Medicare in particular, the role of family and government become intertwined as individuals have to make life or death decisions and pay their service providers. Neither situation produces productive health care decisions, but because of the resistance to change, each system is an accepted norm for many citizens in the population, which makes a great challenge for political leaders.
The USA government, and most medical associations approach medical services with an objective to reduce the occurrence of death from the measured and tracked reasons; a ridiculous standard because death continues and we simply spend resources to alter the cause of death. In my opinion, the government should be concerned with the spread of infectious diseases because they spread through the population with no level of control by individuals. Other elements of medical services, accidents, end of life, or non-infectious conditions that impact economic productivity are not the business of government—these are the responsibility of individuals and their decisions of how to address risk. Government actions to try and reduce risk for individuals, creates a nanny state and violates the principle of treating people as individuals.
So how would a government operating under my principles treat healthcare provision? The first thing is to create a model for healthcare that respects individual choice and appropriate risk taking, while protecting the greater society against individual choice in the arena of infectious diseases. Frame medical services differently and then align the notions of individual choice and appropriate risk sharing to the service types.
Parts of medical services
- Infectious Diseases – these diseases spread among the population through normal human contact, thus government mandates of behavior for treatment and preventive measures are reasonable as a form of appropriate risk sharing models. Examples include flu, AIDS, or measles.
- Non-Infectious Diseases, Conditions or Disorders – these diseases or conditions occur as result of our life choices and or our DNA, thus the government should support risk sharing models (among people with similar life choices and or DNA). There is no doubt however the risk share is delivered, continuous monitoring and improvement should be expected. Examples include cancer, or birth conditions, mental illness, obesity.
- Non-Disease Injury – these conditions are often short term, but can be longer-term. Characteristically they result from an act of another. The injuries require medical services to induce recovery, thus a model focused on pay by the party responsible for the injury is required. There are no risk to share in these models because the cause of injury cannot be categorized and predicted. It may be appropriate to encourage savings for uncertainty or subscription models where you pay over time for access to services, but savings for uncertainty or subscriptions are not risk sharing among the population. Examples would include injury through sport, work, accidents while living life, or slip and fall situations.
- Elective Procedures – these conditions or services result from a choice we make as individuals about how to live our lives. Thus, a pay on your own mode of services is appropriate. The government could support savings plans and subscription models where payments are spread out before and or after a decision is made, but there should be no transfer of cost sharing with non deciding individuals.
Future of medical service provision
The government would set up markets where individuals can contract with medical service providers (or their designated group representative assuming the checks and balances on power in the relationship are in place) based on the economic model’s inherent risk to society—share risk, save or subscribe, constrained choice for the benefit of society existence.
Today’s idea of pricing treatments after a person has conditions is unfair and gives too much negotiation advantage to the service providers. There should be no connection between employment and medical services provision in the future as, the society would benefit from the individual decisions and learning from experiences, which the society should encourage. The poorest in the society would get the medical services they can afford, and providers would adjust services accordingly as groups would form to thrive in a high volume low profit margin environment. For example, there is no reason that society should do away with midwives to deliver babies. Forcing doctors and hospitals for all births is excessive and wasteful. If you want the additional services, pay for it, but a business model that thrived on serving the local neighborhood was abolished to steer demand to the few and powerful. Under my vision, most end of life services (Non-Infectious Diseases and Non-Disease Injury) would be allocated by the income of the recipient and their families.
The one role government should adopt , insure availability of service providers across the society—where the citizens live. The government must create and then maintain the institutions that provide knowledge transfer in the medical services areas. And, the government should provide incentives that support people learning the knowledge and providing the care to the citizens in appropriate numbers. These might involve tax incentives, payments for education, contracts or other means needed to insure that the health care services of the citizens are met.
So what about today changes? A lot.
The tax policy related to payment of insurance premiums, business get 100% deductions, but individuals do not, remove the incentive that is advantageous to business. Government mandates on insurance policies, end them. Citizens need to be educated to make risk decisions, not coerced into compliance with zero comprehension of why an action is mandated. Government providing insurance/pooling of citizens in the poor category (Medicaid) or old age (Medicare), both need a transition plan to end the policies that rob people of dignity and create rationalized entitlement mindsets (i.e. get what you are due from the system). The transition plan needs time to allow the market to set up reasonable models of transactions and for families to adjust their perceptions of normal while they accept their responsibility.
Writing this blog post was a challenging exercise, far from perfect, but worthwhile to help me clear my thinking. From this point I’ll continue to grow and develop my point of view by constantly asking, “Are my principles still correct? What if they are wrong?” And, of course, I’ll keep talking to others, listening and considering their point of view. It’s my source of learning.
No single political party is fully aligned, and it is unlikely to ever be a simple choice choose the political party that closely aligns and stop thinking. So, I’ll continue to write or communicate with my elected leaders and share my point of view. Not to threaten or punish for non-compliance, no, but to share and create an opportunity for others to have an idea or to recognize something worth negotiating in a trade-off. But, those politicians who refuse to reveal their principles, or avoid critical thought about principles, do not deserve support. They are followers of someone else and represent the interest of their leader not the interest or beliefs of their constituents.
As I have presented my challenges and solutions, I made a conscious effort to avoid the mental frame that I have the “one solution” that everyone else should listen to. The challenges I’ve discussed are difficult problem to resolve. Since, I believe strongly in the benefits of collective effort, to have proposed “one solution” would have been inappropriate. As is often said in my workplace, more minds involved are better than one.
Hopefully, my writing leads you to understand some of the inputs, needed to solve the challenges. But, the challenge’s resolution should come from a diverse set of decision makers who listen well.
As the readers, I have a few suggestions for your consideration:
- Develop your set of principles, make them clear in your head. To communicate or keep to yourself is a different decisions, but I encourage all to stand for something.
- Guard yourself against influence attempts that play on fear and uncertainty. The state of political communication, at this time, encourages individuals to follow a leader to safety, to avoid critical thought for one’s self. The political communication today seeks a vote with the cheapest currency possible, “fear others, I am with you.” Our society, and each of us as individuals can grow and develop, we can improve.
- Identify appropriate and inappropriate risk, this is wise. With risk categorized, seek improvement in your decision making ability when you face uncertainty—your life outcomes will improve.