Who cares if a "large segment of the financial community, including bankruptcy attorneys" will lose their jobs? First of all, there are too many attorneys anyway. Most colleges and universities offer law degrees because it is relatively easy and less costly to provide them. On the other hand, medical schools are very expensive to operate and maintain.
So, what is the solution? The American Medical Association needs to encourage more students to study medicine instead of law. There is a shortage of doctors because the AMA doesn't encourage or support the training of more doctors. Why should doctors become millionaires because of their profession?
If we have a universal healthcare system, the government can control medical costs. Our citizens would never have to worry about going bankrupt because of outrageous medical expenses.
I’ve admired and followed HEALTHCARE un-covered for over a year. Partly because I regard Wendell Potter as a mighty illuminator of a key challenge facing American society: healthcare. But also because I’m interested in the future evolutionary potential of complex societies. A framework I use tells me to take an interest in healthcare as one of a set of pivotal matters for social evolution’s next phase.
I welcome your advice for healthcare advocates to seek “foundational change” and play the “long game.” I quite agree, and here’s what I’m what I’m wondering: The ultimate answer to realizing foundational change in the healthcare sector may not lie within that sector, nor within the broader “medical-financial-industrial complex” (MFIC). The answer may depend on the eventual emergence of a new realm of society that health and other care-centered matters move into.
Our society, like all modern societies, is loosely organized in terms of three major realms of actors and activity: civil society, with its largely voluntary sectors; government, with its public sectors; and the market economy, with its private sectors. Healthcare does not fit neatly into any one of them; it gets bounced around. Some leaders claim it’s a public-sector responsibility; for others, it’s a private-sector matter; or it is keyed for mixed public-private cooperation. Plus, it’s a problem that civil-society actors have a role in addressing too. Healthcare is thus a vital matter without a true consistent home in the American system.
That has been the case for decades, even centuries. And by now, as a result of growing enormity and complexity, it seems evermore evident that healthcare cannot fit properly in our existing public and/or private sectors, and is too overwhelming to leave to civil-society. It’s a dilemma; and it’s likely to get worse.
Curiously, healthcare is not the only societal matter stuck in this kind of systemic doldrums. Education, welfare, and environmental matters are stuck there too — they are all stuck in it together. None is exactly a matter for civil society, or government, or the market economy to resolve. That lack of fit is now too big and burdensome to ignore; it's constraining America’s future evolvability
Here’s my point: While all four matters — health, education, welfare, and the environment — are viewed and treated separately by analysts, policymakers, and other actors, there’s a key commonality that’s being overlooked. All four are about maximizing care: people care, life care, planetary care; the care of body, mind, and soul, individually and collectively. Plus, each activity affects the others; their dynamics and vectors interact. Better health can lead to better education, and vice-vera, especially if welfare and environmental conditions are improved as well.
Furthermore, the set of policy principles and positions that may be raised for any one of the four is pretty much the same for all of them. For example, debates exist for all four as to whether it/they should be recognized as a constitutional right, whether to approach matters individually or collectively, how to protect against risks and vulnerabilities, etc.
What I deduce from this is that health, education, welfare, and the environment have so many affinities and are so intertwined as policy problems that it will make increasing sense for policymakers and other actors to view them as a bundled set — and eventually as bedrock components for constructing a new care-centric realm (sector) of society.
Today, even if that analysis may sound potentially sensible to some people, it will still seem like fanciful unwelcome academic speculation in many circles. As I’ve been told, government agencies and capitalist enterprises presently have “hammer-lock” grips on healthcare and education. There is no way they will let go in today’s political and economic environments, much less allow health, education, welfare, and environmental matters to be bundled.
But I see a path opening up in the years ahead.
Per that evolutionary framework I mentioned earlier, societies have relied across the ages on four cardinal forms of organization: kinship-oriented tribes, hierarchical institutions, competitive markets, and collaborative networks. These forms have co-existed since people first began to assemble into societies — there was always someone doing some activity using one or more of those basic forms. But each has emerged and taken hold as a major form of organization, governance, and evolution in a different historical era. Tribes were first millennia ago (with civil society becoming its modern manifestation); institutions developed millennia later (e.g., states, armies); then centuries later came market systems for growing our economies — hence modern societies with their three major realms.
If that were the end of the story, our prospects for evolving still more complex societies would be nearing an evolutionary cul-de-sac (“the end of history”).
Notice, however, that the network form is only now coming into its own, starting a few decades ago. Network forms have been around, in use, for millennia. But they have lacked the right kind of information and communications technology to enable them to take hold and spread. Each preceding form emerged, in turn, because an enabling information technology revolution occurred at the time — i.e., speech and storytelling for tribes, writing and printing for institutions, telegraphy and telephony for markets. The ongoing digital information technology revolution is finally energizing the network form, enabling it to compete with the other forms and address problems they aren’t good at resolving.
As a result, information-age network forms of organization and related strategies, doctrines, and technologies (not to mention ideologies) are currently spreading far and wide. One way or another, they lie behind and help explain nearly all the turmoil disrupting our society and the world at large. Network factors and forces are modifying the natures of civil societies, governments, and markets everywhere, often via the creation of hybrids with the earlier forms — sometimes for the better, sometimes not. The growth of so-called health and hospital networks in the profiteering hands of venture capital firms and giant insurance corporations is a manifestation of this.
But it’s one thing to disrupt and modify what exists, quite another to transform and radically improve a system’s complexity. Still missing so far are clear signs that the rise of the network form will have the major evolutionary consequence that each earlier form has had: the generation of a distinct new realm/sector of society, through a long hard-fought process of structural-functional differentiation.
Maybe it’s too early for signs of that. Or maybe I don’t know how and where to look yet. Nonetheless, assuming my deductions are correct — i.e., that a fourth realm will emerge in the decades ahead, and its core purpose and function will be care-centric — then I’d say it’s advisable to start anticipating and planning for its emergence and construction.
Here are some signs I’ll be looking for, and questions to wonder about. I’ve derived them from wondering what makes the earlier three realms so distinctive.
• Have actors in the fields of health, education, welfare, and the environment started talking together, making common cause, finding mutual concepts, developing a language around care that spans all their fields — much as civil-society, government, and business actors have distinctively done for their own realms of activity?
• To the extent this next/new realm may be deemed a particular sector of society, what would be a good name to reflect its essence? My own sense is that it will (and should) be a “commons sector” per writings by Elinor Ostrom, as well as other pro-commons theorists. Or a “social sector” per an old proposal by Peter Drucker. Other theorists already have other intentions for those concepts, so my view is bound to be debatable.
• What specific types of network organization and governance are going to be needed? I’m doubt they exist yet. It’s encouraging to see experiments with DAOs (decentralized autonomous organizations) and DisCOs (distributed cooperative organizations) moving ahead, but so far mostly for small artisanal business ventures that are not care-centric. New kinds of internetted collectives and cooperatives may be what are needed. But my sense is that something unusually vast and dense, that spans and integrates all four care-centric fields, and that is transnational as well as national in scope is what will be needed. Such networks don’t exist yet, but I like to think of them as “equinets.”
• If the above is roughly correct, then lots of additional questions and issues will surely require attention, say about instituting new forms of property, finance, administration, and metrics specifically for this care-centric realm of actors and activities. The answers will surely be, and will have to be, different from what people have developed for the existing three realms and their various sectors.
I’ve raised these ideas and observations with a few evolutionary and complexity theorists in recent years. This is the first I’m trying to do likewise with sector experts. Any review comments? Advice? I shall hope so, for I mean to keep working on clarifying the underlying framework and its implications for future policy and strategy. Onward.
Universal, single payer healthcare will not improve health in our nation. The insurance equation has nothing to do with horrible outcomes, chronic conditions, obesity, Type 2 diabetes and rampant mental illness.
Who cares if a "large segment of the financial community, including bankruptcy attorneys" will lose their jobs? First of all, there are too many attorneys anyway. Most colleges and universities offer law degrees because it is relatively easy and less costly to provide them. On the other hand, medical schools are very expensive to operate and maintain.
So, what is the solution? The American Medical Association needs to encourage more students to study medicine instead of law. There is a shortage of doctors because the AMA doesn't encourage or support the training of more doctors. Why should doctors become millionaires because of their profession?
If we have a universal healthcare system, the government can control medical costs. Our citizens would never have to worry about going bankrupt because of outrageous medical expenses.
Go Bernie!
I’ve admired and followed HEALTHCARE un-covered for over a year. Partly because I regard Wendell Potter as a mighty illuminator of a key challenge facing American society: healthcare. But also because I’m interested in the future evolutionary potential of complex societies. A framework I use tells me to take an interest in healthcare as one of a set of pivotal matters for social evolution’s next phase.
I welcome your advice for healthcare advocates to seek “foundational change” and play the “long game.” I quite agree, and here’s what I’m what I’m wondering: The ultimate answer to realizing foundational change in the healthcare sector may not lie within that sector, nor within the broader “medical-financial-industrial complex” (MFIC). The answer may depend on the eventual emergence of a new realm of society that health and other care-centered matters move into.
Our society, like all modern societies, is loosely organized in terms of three major realms of actors and activity: civil society, with its largely voluntary sectors; government, with its public sectors; and the market economy, with its private sectors. Healthcare does not fit neatly into any one of them; it gets bounced around. Some leaders claim it’s a public-sector responsibility; for others, it’s a private-sector matter; or it is keyed for mixed public-private cooperation. Plus, it’s a problem that civil-society actors have a role in addressing too. Healthcare is thus a vital matter without a true consistent home in the American system.
That has been the case for decades, even centuries. And by now, as a result of growing enormity and complexity, it seems evermore evident that healthcare cannot fit properly in our existing public and/or private sectors, and is too overwhelming to leave to civil-society. It’s a dilemma; and it’s likely to get worse.
Curiously, healthcare is not the only societal matter stuck in this kind of systemic doldrums. Education, welfare, and environmental matters are stuck there too — they are all stuck in it together. None is exactly a matter for civil society, or government, or the market economy to resolve. That lack of fit is now too big and burdensome to ignore; it's constraining America’s future evolvability
Here’s my point: While all four matters — health, education, welfare, and the environment — are viewed and treated separately by analysts, policymakers, and other actors, there’s a key commonality that’s being overlooked. All four are about maximizing care: people care, life care, planetary care; the care of body, mind, and soul, individually and collectively. Plus, each activity affects the others; their dynamics and vectors interact. Better health can lead to better education, and vice-vera, especially if welfare and environmental conditions are improved as well.
Furthermore, the set of policy principles and positions that may be raised for any one of the four is pretty much the same for all of them. For example, debates exist for all four as to whether it/they should be recognized as a constitutional right, whether to approach matters individually or collectively, how to protect against risks and vulnerabilities, etc.
What I deduce from this is that health, education, welfare, and the environment have so many affinities and are so intertwined as policy problems that it will make increasing sense for policymakers and other actors to view them as a bundled set — and eventually as bedrock components for constructing a new care-centric realm (sector) of society.
Today, even if that analysis may sound potentially sensible to some people, it will still seem like fanciful unwelcome academic speculation in many circles. As I’ve been told, government agencies and capitalist enterprises presently have “hammer-lock” grips on healthcare and education. There is no way they will let go in today’s political and economic environments, much less allow health, education, welfare, and environmental matters to be bundled.
But I see a path opening up in the years ahead.
Per that evolutionary framework I mentioned earlier, societies have relied across the ages on four cardinal forms of organization: kinship-oriented tribes, hierarchical institutions, competitive markets, and collaborative networks. These forms have co-existed since people first began to assemble into societies — there was always someone doing some activity using one or more of those basic forms. But each has emerged and taken hold as a major form of organization, governance, and evolution in a different historical era. Tribes were first millennia ago (with civil society becoming its modern manifestation); institutions developed millennia later (e.g., states, armies); then centuries later came market systems for growing our economies — hence modern societies with their three major realms.
If that were the end of the story, our prospects for evolving still more complex societies would be nearing an evolutionary cul-de-sac (“the end of history”).
Notice, however, that the network form is only now coming into its own, starting a few decades ago. Network forms have been around, in use, for millennia. But they have lacked the right kind of information and communications technology to enable them to take hold and spread. Each preceding form emerged, in turn, because an enabling information technology revolution occurred at the time — i.e., speech and storytelling for tribes, writing and printing for institutions, telegraphy and telephony for markets. The ongoing digital information technology revolution is finally energizing the network form, enabling it to compete with the other forms and address problems they aren’t good at resolving.
As a result, information-age network forms of organization and related strategies, doctrines, and technologies (not to mention ideologies) are currently spreading far and wide. One way or another, they lie behind and help explain nearly all the turmoil disrupting our society and the world at large. Network factors and forces are modifying the natures of civil societies, governments, and markets everywhere, often via the creation of hybrids with the earlier forms — sometimes for the better, sometimes not. The growth of so-called health and hospital networks in the profiteering hands of venture capital firms and giant insurance corporations is a manifestation of this.
But it’s one thing to disrupt and modify what exists, quite another to transform and radically improve a system’s complexity. Still missing so far are clear signs that the rise of the network form will have the major evolutionary consequence that each earlier form has had: the generation of a distinct new realm/sector of society, through a long hard-fought process of structural-functional differentiation.
Maybe it’s too early for signs of that. Or maybe I don’t know how and where to look yet. Nonetheless, assuming my deductions are correct — i.e., that a fourth realm will emerge in the decades ahead, and its core purpose and function will be care-centric — then I’d say it’s advisable to start anticipating and planning for its emergence and construction.
Here are some signs I’ll be looking for, and questions to wonder about. I’ve derived them from wondering what makes the earlier three realms so distinctive.
• Have actors in the fields of health, education, welfare, and the environment started talking together, making common cause, finding mutual concepts, developing a language around care that spans all their fields — much as civil-society, government, and business actors have distinctively done for their own realms of activity?
• To the extent this next/new realm may be deemed a particular sector of society, what would be a good name to reflect its essence? My own sense is that it will (and should) be a “commons sector” per writings by Elinor Ostrom, as well as other pro-commons theorists. Or a “social sector” per an old proposal by Peter Drucker. Other theorists already have other intentions for those concepts, so my view is bound to be debatable.
• What specific types of network organization and governance are going to be needed? I’m doubt they exist yet. It’s encouraging to see experiments with DAOs (decentralized autonomous organizations) and DisCOs (distributed cooperative organizations) moving ahead, but so far mostly for small artisanal business ventures that are not care-centric. New kinds of internetted collectives and cooperatives may be what are needed. But my sense is that something unusually vast and dense, that spans and integrates all four care-centric fields, and that is transnational as well as national in scope is what will be needed. Such networks don’t exist yet, but I like to think of them as “equinets.”
• If the above is roughly correct, then lots of additional questions and issues will surely require attention, say about instituting new forms of property, finance, administration, and metrics specifically for this care-centric realm of actors and activities. The answers will surely be, and will have to be, different from what people have developed for the existing three realms and their various sectors.
I’ve raised these ideas and observations with a few evolutionary and complexity theorists in recent years. This is the first I’m trying to do likewise with sector experts. Any review comments? Advice? I shall hope so, for I mean to keep working on clarifying the underlying framework and its implications for future policy and strategy. Onward.
Universal, single payer healthcare will not improve health in our nation. The insurance equation has nothing to do with horrible outcomes, chronic conditions, obesity, Type 2 diabetes and rampant mental illness.