Wednesday, February 8, 2017

What Would An Alternative Do About Healthcare?

I thought that Bernie Sanders and Ted Cruz doing a debate on the Affordable Care Act was as reasonable of an incentive as any to talk about how my alternative to Capitalism might handle this sort of thing.

It is especially important here because it speaks to one aspect of the alternative that is important to make clear on.

I am, essentially, trying to move from a specialist based economy to one that is, well, something less than that.

I am circumspect in that statement for a reason. And to explain that I need to start from this supposition: My intent here is not to do away with specialization. Such a thing would not only be very impractical, it would tend to go against something intrinsic in, at least, a good portion of us; that tendency, or desire, to focus on being really good at something in particular; something that resonates with a special passion.

My intent, rather, is to suggest that we can, in fact, de emphasize it to a very significant extent; which is all we really need do. That being said, however, begs the exposure of the other side of this de emphasized coin, and that is that the rest of us are going to have to be much more generally capable than we currently are, at least population percentage wise. Which means a good number of us will need help in the beginning, and continuing onward, in establishing the alternative.

So. We have two aspects here that need greater clarification:
1. What do the existing experts do in this alternative?
2. How do the rest of us do good enough in whatever situation until greater expertise can be utilized if needed?

Starting with the first one let me again make it clear at the get go that each City State (with my usual rejoinder that "City State" is simply an easy catch all for communities of whatever size participants deem appropriate) will be able to set the specifics of the deals they make for specialists, but I would like to think that they would all revolve around various combinations of resource bonuses (applied to their share of community output), and limits on the total numbers of other task requirements (the community would identify all tasks required to keep it going, group them by type, and then allow each citizen to choose a certain number from each) an expert would have to beyond their expertise..

That last point, certainly, deserves a bit more clarification, at least as to why I prefaced part of the paragraph above with "I would like to think." The bottom line here is that this is meant to be Republic, or a Federation, with a lot of freedom of action for each City Sate. I made that choice because I think it's perfectly clear now that "one size does not fit all." As well to say that we are now figuratively, and literally, "The Relative States of America." This means an overall constitution that keeps a good portion of what it now has, but not necessarily everything; unless, of course, clarifications can be made.

In any case, though, with that flexibility you will inevitably get City States that will simply let experts continue to function has they have, at least in terms of the task groups that everyone else will have to chose from. And if a community wants to do that fine. If it works for them it works for them. I indicated hope here because that's what I'm talking about in getting us all to work together more, across the board, towards what makes our communities go. If nothing else, you would think, sticking with health care, that all doctors, or nurses, or health techs of whatever variety, would want to go out and teach, or evangelize on lifestyle practices that promote good health, in addition to their regular duties. All of which would, it seems to me, to be a very big win win for all concerned. But that's just me.

On number two above we need to consider several, broad stroke, ideas that would be a good starting point. Needless to say, a great deal more thought, and yes, expertise, needs to begin looking into this in a deeper fashion, but we have to start somewhere. And this is where the tech we already have, albeit with knowledge base extensions still required, could help tremendously. Especially if we could make transitioning from one system to another as practically rational as possible. No simple thing either, but the assumption here is that we convince, by greater majority of the electorate, the existing government to work the transition just as if it were a mobilization for a world war (which is pretty close to what we actually did during WW 2, what with the price controls, rationing, production mandates and conscription).

What I am ultimately talking about here is AI assistance that can lead generally capable people through the intricacies of pretty much any kind of task that experts had to be doing before. Assistance that would combine context sensing in detail, with step by step specifics to deal with 85 to 95 percent of the contingencies of most situations. In other words sort of like having robots involved, only they don't do everything. An important point, in my view as we never want to become too separated from all of the things that sustain us. You combine this with both beforehand training on pump, motor, electronic, civil engineering, etc. basics, as well as working with folks who do have the experience, you start to give yourself a fair chance of success. Not for everything mind you, but for a good portion of it.

However you put it, however, there is absolutely no getting round the point that this will be anything but difficult. Things will go very slowly. There will be some very rough spots to get through and it won't happen unless everyone is willing to commit to patience and a lot of sacrifice. And even if we do achieve this it is not going to give us some bright, shiny utopia to finally live in. It will give us a great deal more control over our lives. It will give us actual direct vote Democracy. It will give us a situation where City State's rights actually mean something, even as it works to foster incentives for cooperation; cooperation between folks who don't like each other very much now, and probably still won't when things settle in. And at the end of the day, it will be better for us; for our prosperity long term. For our physical and mental health, and for the health of the planet.

And, if you take the time to get into the arguments presented by Mr. Sanders and Mr. Cruz, just remember this: So much of why healthcare is a bitch to manage in anyway even resembling rationality, these days, is that pretty much everything involved in it is a commodity to one degree or another. And in that we have the "name of the game is net gain" situation in spades. Which means that the output, though some what related to competition, is seldom to do with good outcomes, over all, as much as it is profit for the one whose capital is at risk. Even Insurance, which is supposed to be there to help us pay for it, isn't really there for that at all, but rather as a means to raise enough capital that investment returns can show a profit, putting the incentive to actually pay for any health item right where you would expect it to be.

Change is coming. Of this we can all be certain. Whether the planet forces it on us, or our own insanity forces it on us, or the insane contradictions of Capitalism itself. Change is coming because what we've been doing just won't be able to hold it all together for very much longer. I mean seriously. Where do you think a good portion of all this apocalyptic fever dreaming stems from in the first place? Either we start acting now, because universe knows the lead times on this are really going to be a bitch, so that some reason can be applied to the change effort, or we just wait till circumstances takes all options for rational thought, much less action, out of our hands for a long time to come.

As always, the video here is another take on the alternative: