Health Care Debate

At the time I'm writing this the nation is hotly debating President Obama's health care reform ideas. One of the most contentious ideas is whether or not we should have a public option (government-provided health care).

I think we should give serious consideration to this idea--but not yet. Yes, the need is absolutely dire, but we'd be getting the cart before the horse in a dangerous way.

If we started providing complete or partial health coverage under the current U.S. health system the government would quickly bankrupt itself. Before we discuss a public option we need to completely address the cost structure of health care, which means driving costs out of care at all levels and capping the profit motive of private insurers (similar to utility company regulations). If ever all of these costs are brought under some sense of rational control, then let's discuss forms of government-provided coverage.

I'm not advocating socialism. Health (especially health insurance) is not a free-market business. The laws of supply and demand are very skewed here. How much will you pay to save your life? All you have, of course. So the built-in incentive to insurance companies is to charge as much as they can and provide as little as they can. Good business if we're talking about radios, cars, or cups of coffee because the market will counter the raw profit motive and create a price point. As prices rise, at some price a normal person will decide not to buy the fancy coffee. When enough people agree at that price, a price point is created and the seller will not be able to charge more without losing business. Not so in medicine. I propose that what appears to be a market price point in health insurance is in fact a wealth indication of people who can afford the insurance directly or happen to work at a decent-sized company that offers benefits. In that equation people will pay all they can until they can pay no more--there is no elastic point where an average person opts not to pay more for insurance. As prices rise they will pay more until they simply can't, then fall out of the system. The large insurance companies are playing a very twisted games of macro economics with no balancing power resting on the consumer side of the table to make a true market price. To put it more crisply, they are setting a wealth-indexed price point, not a market driven price point.

Where do these wealth-indexed profits go today? To the shareholders and executives of the insurance companies. More specifically they leave the health care system and provide no benefit to the insured or the medical community.

I believe there is some analogy to the electricity industry, e.g. how much would you pay for power? Maybe not everything you have, but certainly as much as you could. So to keep electricity from becoming a wealth-indexed commodity and see entire poorer regions of cities go dark governments set the price point (or they used to prior to deregulation). Why can't we do this for health insurance? It should be regulated to be a barely-profitable venture--just enough so some will want to be in the business. As a nice side effect this should also create a very stable investment vehicle for the risk-adverse.

Get all that put together--then let's talk about the government's involvement in health provisioning.

Looking for God

I've been reading a lot of online posts contributed by atheists on sites like reddit.com and others. So many seem to be better described as anti-theists (hate God, or the idea of God) vs. a-theists (don't care if God is there or not). There was one post by someone who very clearly seemed to have been bitterly disappointed that God did not respond to a major need in his or her life and therefore concluded God's non-existence. I wondered if that was a common experience of other atheists.

This is a common problem for believers, isn't it? Hasn't everyone been disappointed in God's non-appearance at some critical juncture of their life? I thought about this a bit and concluded that there should be a way to try to see God's existence by inference.

We can devise an exercise where the participant records prayer requests of various kinds: large, small, specific, more general. Then record any important events impacting the outcome of the request. The criteria is key here: Success is not indicated simply by things working out according to the prayer request coming to pass as asked. If we suppose there is a God eternally greater than us then we must concede that His plans will many times far exceed our ability to understand. However this is not a cop-out. We should be able to differentiate a natural-order outcome of events from outcomes that appear to be directed--whether or not in the direction of the request.

For example, we accept the world is set in motion and laws of cause and effect apply. If you wonder whether you should join a mission trip to Mexico and you are able to buy a plane ticket--is that God's will? Not an indicating event either way. Companies sell tickets and people buy them. No divinity required. If, when you go to buy the ticket you discover you hit on a 1-day super-saver sale, or conversely the last possible seat just sold out yesterday, these would seem to be stronger indications of divine interaction with events in your life.

So to track your prayer request outcomes you need to examine the circumstances carefully. Don't read anything into natural order outcomes--things that would happen anyway to anyone in the same circumstances. Likewise don't dismiss as coincidental events that intervene into the natural order to shape the outcome. Treat the whole experience lightly and look at the broad outcome in panorama, not looking for flaming lightning bolts from heaven in single experiences. Did the broad outcome seem to be directed (in your "favor" or not) or did it seem to be only the result of natural order? My guess if I were to conduct this experiment is that you would see a mix of results.

What would this suggest? Well, for one it should encourage faith of God's existence if you believe any of the outcomes were divinely guided in any way (even against what you prayed). It would also suggest that not every little thing we do is part of some cosmic master plan. It just may be that eternity (and your life) will proceed just fine whether you decide to attend university A or university B--your choice, says God.

Bottom line is that there is still faith involved. Some people will choose to see events as purely natural order, which includes improbable, unforeseen intervening events, and not see a place for God in that world view. Others may see a God working in their life, perhaps frustratingly not in the ways we want or expect.

Why Machiavelli Bothers Us

My company is sending me to some executive management training this year, a program that includes several seminars throughout the year and a collection of about 30 books to read. So the other day a big box arrived at my house with all these books in it. Amongst all the how-to-be-a-great-leader style books, one stood out: The Prince by Machiavelli.

I've always been intrigued by Machiavelli, knowing the reputation his name carries as a colloquialism for getting things done in somewhat unscrupulous ways. I'm nearly done with the book now and have started to contemplate why this man's ideas have been so controversial and haunt our sense of ethical behavior even today.

The book talks a great deal about how princes (a.k.a. leaders) and their people, and other princes interrelate, but within the pages are two questions for which Machiavelli is most famous:

1. As a leader is it better to be loved or feared?
2. Does the end justify the means? (i.e. If the result of an action is generally good, does it matter if some not-so-good actions were required to achieve this result?)

These questions still pop up today--and they bother us, as would other elements of Machiavelli's advice to leaders in his book if people were to read all of it. By the way, Machiavelli's answers are as disturbing as the questions: it's better to be feared than loved, and yes the end justifies the means. We instinctively don't like these answers but yet as a culture we cannot dismiss the man or his questions. Why? What holds us so captive? It was these questions, rather than Machiavelli's, that drew my curiosity.

It is my belief that Machiavelli's ideas crash head-long into some key ideas of the Enlightenment, upon which much of our culture is based. This collision creates the distaste we have for his questions and especially his answers. Yet we don't simply dismiss Machiavelli because there is also something that rings true in his question that resonates in our souls. Let's unpack this ethical struggle a bit and the issues will become quite clear.

The Enlightenment was about the ascendancy of human reason as the authoritative basis of truth. If we could reason through a problem it's inherent truth could be discovered. This thinking continues to pervade today. For example most Western diplomats would likely ascribe to the view that if two countries explained their interests reasonably enough they may not come to agreement, but they would come to understand each other and have principled negotiations.

Sounds lovely, but there's a problem with this view. Enlightenment assumes the world is populated with rational people, or at least people who value reason. I don't know Machiavelli's religious piety but he certainly had a Biblical view of mankind: we're a fallen race and whenever possible will act according to our own selfish desires. Enlightenment assumes the best in others and Machiavelli assumes the worst. Perhaps this is the nexus of our struggle with him. We very much want to believe the Enlightenment world view but a casual survey of the real world would suggest Machiavelli's assumption was correct. So we can't dismiss Machiavelli's questions, but we don't like them either.

But what about Machiavelli's answers? Enlightenment thinking presumes that you, personally, are basically a good, if not perfect, person. Machiavelli again makes no such assumption, and his prescriptions are uncomfortably amoral in nature--ethically flexible, if you prefer. His arguments promote this flexibility as a necessary asset to properly govern and lead people. This certainly flies in the face of the ideal of a democracy based on Enlightenment principles. Once again as consumers of ideas we are torn between what we want to believe about ourselves and what we observe to be apparent truth.

Into this mix of my curiousity I stir my own Christian world view and see error in both of the others. The Enlightenment assumes man's reason is authoritative truth, but the problem is that Machiavelli was right. We are not creatures of reason but creatures of selfish pride. Machiavelli's questions were spot-on. However a Christian would take issue with his answers. Machiavelli believed that to be loved without fear and to be ethically pure were both weaknesses. Perhaps they are, but a Christian's life is underwritten by a living God active through his or her life. The individual Christian is still a selfish and prideful person, but they commit in faith to the irrational idea that to be weak in ourselves is to be strong in Christ. This means that a Christian believes that God will work through people or circumstance such that projecting their own strength is unnecessary and would even be a weaker position. (Do you think Jesus would find anything new in all the "servant leadership" buzz making the rounds in corporate circles lately?)

Non-Christians in the western world are left with a dilemma. They can forfeit ambition to put their full faith in an Enlightenment ideal that has serious observable cracks in its execution, or they must to some degree become amoral to achieve great ambitions, thus having to admit to themselves that they are indeed a sinful, prideful person, and live with that knowledge. What a heavy burden. This is why we don't like Machiavelli--and why we can't stop reading his book.

In Defense of WalMart

There's a lot of bad feelings out there towards America's largest retailer. People argue it kills the "mom and pop" businesses and contributes to suburban sprawl. I'm not so convinced--in fact I think there's a lot of good WalMart does that goes under appreciated.

First let me say I don't work for WalMart and have no relationship with them at all, except I buy stuff there. I don't think they're perfect and I'm sure if we dig we won't have to go far to find genuine controversy, as with any big organization. But I do think people slam WalMart unfairly.

One of the most common complaints people seem to have with WalMart is that it pressures the locally-owned small retailers out of business. This is bad, the thinking goes, because it takes away good jobs and replaces them with "McJobs" at WalMart.

This line of thinking has a big problem, namely that mom 'n pop main street stores were in decline long before WalMart showed up. And while most WalMart jobs are certainly unglamorous low-level jobs there is a management track. If you worked at a mom 'n pop store and weren't a relative of the owner then good luck moving up the ranks at all.

The truth is that the only businesses WalMart forces under are weak ones that can't adapt. Too harsh? I've noticed that WalMarts have a "reef effect". Around them spring up strip malls full of little locally-owned stores and restaurants. Of course if you want to live you had better be smart enough to stay out of WalMart's way!

In my neighborhood WalMart opened a superstore (groceries). Immediately the incumbent stores, Albertsons, Tom Thumb, and Kroger started to compete. Albertsons tried to stick to basic groceries and compete on price. They didn't last long--store closed. Kroger thrives by moving its product coverage outside of WalMart's, which carries lots of basics but few extended product lines. Tom Thumb does well by moving upmarket and focusing on service. You can indeed compete, or at least coexist, with WalMart if you're smart.

Another example: my local Ace Hardware store. Its located less than a mile from WalMart and Home Depot yet it does good business. Why? Service for one. I don't have look over acres of store for help. It also works because I can run in and out faster than a big-box. I would argue that both retail models have their advantages and efficiencies in the community and needn't be mutually exclusive.

I also don't agree that big-box retail contributes to sprawl. These big box stores like WalMart are full of products, like the old general stores. So if they didn't exist this product would be distributed over a wider area in smaller shops. Centralizing everything in a contained retail area may highlight the large big-box stores and make them an easy target for simplistic scorn but to my eye its more efficient than scattering the same product volume all over town. Logically that's why the model is successful. Carry the argument further to say these big box retail areas provide a nexus around which apartments and housing are grouped. If the WalMarts were gone then what would group suburban development at all? You really would have some big sprawl issues then.

Then there's health care. WalMart has done a lot to drive down the cost of generic drugs and expand their use. The company is now preparing a pilot program to put clinics in some stores. I see this as the future of basic health care. The government seems useless to address our problems so it will take a WalMart to make any meaningful change. If people who currently have no health insurance can someday go to their WalMart clinic and see a doctor for $30 or $40 then isn't that much better than where where we are now?

WalMart isn't perfect. I have issues with how their purchasing power carries capitalism to an extreme by supporting Chinese manufacturing and the many anti-competitive aspects that entails. There are many reports of employment issues in the media. I do think however that they deserve credit for the good they do that often goes unnoticed by those so quick with their words to tear them down.

No Nukes--What?

Believe me, as I sit here typing I never thought I'd be proposing the idea that the U.S. should abolish its entire nuclear weapons stockpile! I mean c'mon...that's some kind of hippie concept from the 60's, right?

Well actually no, in 2007 its different. Nuclear arms served a valuable purpose in history during the bi-polar Cold War. They sustained a balance of powers and ironically proved the uselessness of these weapons. After both sides acquired enough capacity to obliterate human existence their use as a viable, usable weapon became ridiculous.

History has moved on. The world is now multi-polar with the U.S. still a dominant force but a power in a lake of other smaller powers. In a global context we need to recognize modern, high-yield nuclear arms for what they are: civilization killers. Under what circumstances would a justified, moral response to an attack be the obliteration of our enemy's civilization? Perish the thought, but even if one of our cities were taken, would an eye-for-an-eye response be appropriate or barbaric? I think technology answers this question by providing rational (and stronger) options no military force has had before.

Leveling a city with a nuke is the bluntest of blunt instruments. It is ultimately ineffective as an offensive capability. Whoever had friends or family in the doomed city will be out for your blood--it will never stop (especially in sand-covered parts of the world where memories of past offenses seem to carry on indefinitely). Far more effective is the ability to make precision strikes against military, civilian, or human targets of our choosing. We now have awesome capabilities for lightning-fast, precision attack. We can touch almost any target we choose with ever-increasing focus and accuracy. Like the great WWII battleships, nuclear arms have been made obsolete by these modern weapons.

The new message is indeed powerful: if you misbehave we don't need to destroy your cities...we can hit just you! For all but the largest opponents (who we never want to tangle with anyway) we can instigate action up to and including change of government in response to an attack on U.S. soil, without ever having to consider a nuclear option.

With these capabilities the U.S. has conventional assets that can mete out mind-numbing retribution if need be with a focus that leaves no doubt who or what the target is. Isn't this infinitely more effective as a military tactic and as a policy message than leaving a big hole where a population center once stood?

On the political front the U.S. is currently in a hypocritical position. On the one hand we pressure smaller countries to disarm their nukes or not pursue them in the first place, while hoarding stockpiles of these weapons. What's the message? "We're in the club, and you can't be!" Of course this incites these countries to want nukes all the more--to be in the club!

If we were to abolish our stockpiles and renounce nukes as a useful weapon how much stronger would our leadership be? We would have an immense moral imperative to provoke other nations to likewise abandon this path.

The hopeful message is that whether others follow our lead to abandon nukes or not isn't the issue. Since we have better, more effective alternatives then we are not in any way diminished by not having them, regardless of what others have. We can be fully prepared to respond appropriately should someone else decide to use one of these doomsday devices.

I hope the U.S. takes this opportunity to reclaim our global leadership by moving to abolish our own nukes, while continuing to aggressively pursue modern, focused military capabilities. The danger if we don't is that countries far less stable than ours (or the old Soviet Union for that matter), some of whom already have nukes, will be in a position of thinking they are useful and valuable--and perhaps even usable. Lets get rid of these things before they get rid of us!

Can't We All Just Be Forgiven?

I had the opportunity to discuss my faith with a co-worker the other day in an exchange of ideas and beliefs. I wasn't selling my faith but simply talking about different beliefs. My co-worker voiced an opinion that I hear a lot in one of two flavors:

1) There is an ultimate truth but there are many paths/religions/beliefs to get you there.
2) If Jesus died for the sins of mankind, then why aren't we all just forgiven?

If you squint a bit these are really the same idea I label universal forgiveness. Why can't God just forgive us all? I thought about this a good while and am convinced there is a principled reason why this can't work.

On the face of it it's entirely possible God himself might find the idea of universal forgiveness as attractive as anyone else. Why not? It's pretty loving, isn't it? The problem is that each of us has committed grievous offences against God and someone has to pay for it. If God simply wiped the slate arbitrarilly clean or didn't worry too much how we reached "enlightenment" (i.e. reached out to Him) then all His God-ness disappears. It'd be like a country with laws but nobody ever enforced them. It wouldn't be long before everyone totally ignored the laws, right?

So how can God fully satisfy the law while extending full loving pardon to us? The idea of sending Jesus, God himself, to die and pay for our sins and have such a simple act of decision to receive eternal life and forgiveness, is in fact the easiest, most inclusive thing God could have done without compromising who He is.

The great thing about understanding this principle is that it doesn't require blind faith, but a rational faith in God's way of salvation.

Wanted: Simple and Genuine

Last week I quietly slipped over the keynote threshold marking 40 years of life. I find there are lots of interesting things going through my mind, searching for new meaning, etc. Among the tangled threads of thought and emotion is a pretty big desire for a back-to-basics approach to living that permeates a lot of areas of my existence.

Take software architecture for example. For years I worked to grow my technical skills and amass expertise in several complex framework systems. I can now integrate these frameworks like smashing planets together. Great fun...and totally useless. After more than 10 years of reaching ever higher technically I've now come to the thoughtful conclusion that 80% of it is unnecessary. What benefit is there in having an application that "only has 10 lines of code" if you also have to master a complex framework with hundreds of lines of configuration? No thanks. A simple approach that I can hand to someone else and they immediately understand how it works--that's a good system.

I've also developed an itch for a classic car. A BMW 2002 tii to be specific. I like my newer cars but they lack soul. Its like they are all extruded from some tube of plastic somewhere and the whole system would come to a halt if one of the electronic bits conked out. The 2002 is a machine through and through. The only thing remotely electronic is the radio. Yep--roll-up windows, no electronics in the engine, and manually adjusted seats. Chrome bumpers! Everything clearly bolts together unlike new cars that try to hide every connector furthering the illusion that somehow these new cars simply sprang into being from a single lump of plastic and alloy. Not the 2002--someone had to build it bolt by bolt. I can't explain why, but that speaks to me.

Here's a guy who restored an old 2002 over a period of years. Gorgeous work, but why would someone go to all that trouble? I think I understand. Its a quest to have something genuine. There aren't that many genuine things in the world but when you find one they ring true. Think of a Harley Davidson, Airstream trailer, or an iPod for that matter. Genuine things aren't pretending or striving to be something else--they are what they are. They are things that will stand the test of time and be just as cool 25 years from now as they are today. I think the fact that it took this guy several years, and probably a good chunk of cash, only added to the value of the exercise. He was reclaiming something.

As I turn 40 I'm looking to recapture the simple--the genuine. My hope is that these things become an externalization of an inward quest to become more simple and genuine myself.

Leadership Lost

Count me as one of those who had high hopes for President Bush. Before sharing my disappointment with Mr. Bush I'll offer that I do hold in spite people with an "I told you so" attitude. There was much to hope for when Bush took office and I have found that people with loud voices and wagging fingers are oft long on complaining and remarkably silent when asked for constructive ideas.

That said, I am bitterly disappointed with a great number of decisions the Bush administration have made. I can't imagine how the Iraq war could have been handled any worse. It was based on flimsy, and a likely dishonest representation of the facts as justification. Let me say that I agree with the idea to topple Saddam, violently if need be, but strongly disagree with misleading the American people into supporting the war. Colin Powell exemplified my approach, which exhausted diplomacy--however ridiculous it seemed. The diplomacy was never for Saddam's benefit but for the world. We should have been clear and focused with the American public and the world that this was a mission to topple Saddam. Period. It would have been far wiser to seek a coalition, not so much for the invasion, but for the stabilizing U.N. force to sweep in afterwards.

Once inside Iraq we didn't move nearly fast enough to reestablish basic services to win the hearts and minds. We didn't create clear "sweep zones" where we effectively turned over the more stable areas to the new provisional Iraqi government. And of course we made the fatal mistake of dismissing the Iraqi army rather than repatriating it under a new Iraqi command.

Now we are faced with what I can only imagine is an inevitable civil war brought on by the long-suffering struggle between Suni and Shiite Muslims. Moving quickly and decisively would have done much to dispel the tensions that pulled people back into their old habits.

On the diplomatic front Bush failed to capitalize on the liberation of the Shiite population from Saddam's persecution. Handled better this could have gone far to renew ties with Iran, especially now that their leader has revealed himself as insecure and dangerously uninformed in the ways of the West. I wonder how much of the diatribes we're now hearing from this country today could have been avoided by making international "hay" from the Shiite liberation and to show the world the America is not at war with Islam. In this we have also failed miserably.

The capstone of this grief are the horrific events at Abu Grehb prison and more recent reports of what (as of this writing) appear to have been a massacre of innocent Iraqi civilians by U.S. troops. Our proud men and women in uniform have the best discipline and training of any force in the world. American soldiers simply don't just snap! I can only surmise that leadership and morale must be on razor's edge for events like this to occur.

What President Bush has been missing all along is honesty, planning, and savvy. The American people to this day are rarely told the accurate and complete story of life on the ground in Iraq. Instead we hear about virtually meaningless structural "victories" of governmental organization. This information means about as much to me as it does to the average Iraqi citizen. Planning was and is very poor. As for savvy--if there was any question in the minds of your average poor Muslim man on the street anywhere in the world as to American intentions--we have outright handed them the ideological stick with which they will try to beat us. This alone is a setback in American policy interests that will take many years to eradicate.

I am grieved to think that Iraq may be a "Vietnam", but for different--sadder reasons. This was not a military standoff. Iraq is a failure of leadership, focus, and follow-through. It tells the world that after a truly jaw-dropping display of force projection that Americans will fail to follow through and devolve into confusion. After years spent telling the world we have a grand plan for the welfare of all mindkind a display like this would leave anyone asking "OK--So where's the plan?" The tragedy is that we really do have a good plan for how a free people can live. The bungling in Iraq will close the ears of many of the people who would benefit most from the message.

Like every American, and perhaps much of the world, I want the U.S.A. to be a good guy with a shiny silver star. It will take a long time and a lot of bridge-building to recoup that image.

Crushing the Competition in the Automotive Industry

Any current headline will tell you that the auto industry is doubled over and writhing around on the floor grimmacing in pain. Without a clear differentiator the major auto companies whack each other over the head competing with ever-larger rebates.

One area of innovation no one has been brave enough to tackle is the sales and delivery pipeline. What is the one thing universally hated and reviled above nearly all other earthly creations? The car salesman! I suppose there are many reasons to hate car salesmen but one sticks out in my mind: these guys train and drill relentlessly, like Navy SEALs, to perfect techniques to manipulate and coerce a hapless customer into a purchase decision that may not be in their best interest. Since the average consumer is so ill-equipped for this kind of hard-nosed "negotiation", and the bargaining table so stacked in the dealer's favor, most people come away feeling taken advantage of--and they're probably correct!

What real value does the car salesman offer? For the short term blip of a sale today people often wind up in "upside-down" car loans that hurt their ability to buy a new car later. They don't benefit the car maker. The salesman-based business model is tired and its time to get rid of it. Disintermediation is the new world order! Kill the middlemen!

Now consider what would happen if a brave car manufacturer got rid of the whole dealer/salesperson model and went with a straight store model. Go to the mall and see and test-drive sample models but order and buy either online or at a kiosk in the store. Salaried staff that don't work on commission can help facilitate these functions. The service departments can either be owned by the car maker or licensed out to certified franchise operators.

Whouldn't that be a radical change? Saturn almost got to that point, but not quite. Even so, for a time the Saturn dealer experience was very highly rated by consumers.

Let's see who'll be first to be brave enough to tamper with the sacred cow of the car salesman business model!