Star Ford

Essays on lots of things since 1989.

On weeds and keystones

Las Vegas is an optical illusion. At first it looks poor; the city eye is drawn to cracks in the pavement and boarded up businesses, and one expects to feel poverty. Once an ornate and grand city, larger than Albuquerque, the town now shows age and depleting resources with fewer people. But then nothing bears out the expected feeling, and over time the eye learns to see different things – the beauty that is still there.

From my one window I see weeds, graffiti, and a muddy puddle in an empty lot. And I also see hand-set bricks in arches with stone sills, keystones, quatrefoils, with elms and aspens. Out the other window there’s a quintessential abandoned factory with sawtooth shaped roof, a highway bridge, and a stone hotel with a belfry and artistic parapet. With so much variation there is choice – what do I choose to see?

It reminds me of Pisa, Italy. I still have a picture I took of a goat eating weeds in a neglected brick-strewn lot, next to a crumbling plaster wall, in bleating distance from the throngs of leaning-tower photographers.

On a dumpster diving errand today I found nothing, and everything was surprisingly clean. Investment in the big city is equated with wealth, safety and the standard of living. But in reality, the distribution of money does not entirely control the use of time. New cities in the west exist because of greed, not because of natural necessity in the way port cities exist. Subdividing land, the innumerable rules, and smooth new concrete all make someone rich and define the city. Homelessness is illegal, and those who can’t meet the wealth standard congregate only where enforcement of all the rules is lacking, where there is less safety. So the city is an engine of separating haves from have-nots to its very core. And it fogs ones brain with the urgency of the struggle to have.

Politics in the west is the art of profiting from subdivision and controlling public utilities. The desert is almost free, but the value of a residential zoned quarter-acre with water and electricity is enormous. We don’t all share in that value. The winners are the ones who approved the subdivision plat on their own land.

On my errand the thing I realized is that if I myself owned things like sidewalks and too many buildings, and didn’t have enough money to make it all nice, I’d choose to spend it the way Las Vegas does. It would not be a priority to fix all the pavement. We have choices about equity and we can choose between concrete and education.

The growing city as an engine of segregation and uniformity gives a person that city eye that believes it sees education when it sees nice concrete. Nice and safe and pretty and educated are supposed to go together, and dirty, crumbling, dangerous and desperate are supposed to go together. But those are false choices; if the money is tight, we can choose education over concrete without having to have both.

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On healthcare, disentangled

 

The current debate in Congress on healthcare is so hyperbolic and disingenuous that I felt it was time to actually pull out the threads and uncrumple the ball and lay it all out.

I will talk about the moral dimension, then the financial dimension, then the health dimension.

The moral dimension is simply this question: do we help each other through sickness and in health, or do we take the opposite extreme of every man for himself (women be damned)? Or do we take some middle road? Throughout most of my life, the moral choice made in the US was that middle and upper class people help each other out as a group, while we helped the working poor to a lower standard, and we essentially let the underclass die. Our sense of shame prodded us to ease the brutality of that death sentence somewhat by setting up a safety net. While that safety net was significant (medicaid, medicare, emergency services for the uninsured, for example), its moral foundation was that “we” treated “them” as inherently lower and less deserving. For generations health was never considered a right, and the debates focused on to what extent the recipients of “our” generosity were worth the expense.

The ACA fundamentally challenged that moral stance by declaring that we should take care of all of us to a more reasonable minimum standard, and it set in motion a trend towards more universal insurance coverage.

The current debate is completely hostile to that moral advance of the ACA, and I think racism and class superiority is a driving force. Some of the people who hate the ACA really want an underclass to exist, they enjoy winning, and nothing stimulates their competitive brain receptors like seeing the underclass waste away while they sip drinks by the poolside. They realize the ACA threatens to bring in more equality, so in retaliation, they ramp up their attack with an agitated fury and logical vacuum that can only be explained by the fear of the loss of their position in society. That is the moral failure in today’s debate, and it is driven by psychological forces that people experience when they lead narrow unexamined lives.

The financial dimension is a bit complex but important. Many people misinterpret the incentives of the four parties to each transaction, so I will lay them out:

  • Patients want to avoid doctors when we are well, but we also want the power to buy health-related services at only the level we need when we need it, no more and no less. It is important to see that there is not an infinite demand for services; thus patients are not the driving force behind cost escalation. But we want to be able to spend millions of dollars if needed, thus some kind of risk pooling is in our interest. It is not very relevant to us as patients whether costs are pooled by a public instrument or a private one. Like all consumer choices, we will minimize our personal costs and if insurance is not required or favorable, we will not buy it.
  • Providers (doctors, hospitals, etc) are private entities with the inventive to maximize income. Like anyone selling anything, they will do whatever it takes to make more sales – upselling, advertising, monopolistic practices, and lobbying. While the individuals involved in that system usually want to care for people at a personal level (they chose to go into that line of work), their corporate structures have the incentive to care less and charge more.

The first two of the three parties – buyers and sellers – operate just like with any other kind of financial transaction, but with healthcare, there are third and fourth parties.

  • Insurers and underwriters are private or governmental or non-profit organizations that provide the pooling of risk, taking a cut of the sales. Their incentive is to pay less out and charge more, but they operate in a market and under regulation, so they must stay within acceptable limits to stay in business. The important function of insurers is to determine what is an acceptable expense – more on that below. Many people on both sides incorrectly blame insurers for cost escalation and other problems, but insurers actually have the incentive to lower costs, so they are just a distraction from the central problems.
  • Courts are the final party involved in the money side of things, because ultimately they rule on insurance claims, if patients appeal, and thus courts ensure the insurers are following their own rules.

Costs can only be kept “correct” (not artificially low or high) if there are market forces at play, and the root reason why health costs have gone up in the last decades is that the market forces are not strong enough. Markets must have buyer choice and seller choice to be true markets, but in the US consumers cannot effectively shop around for health-related prices, so there is too little choice. Insurers commonly make deals with providers that cap prices on each procedure (more proof that insurers are on our side), but they are not allowed to cap the number and kind of procedures done.

Countries with more efficient health delivery systems (that is, all other countries) achieve that because they do fewer procedures, do them more efficiently, do not spend as much on marketing, and do not pay the doctors and CEOs outlandish salaries. Their cost savings are not achieved by pooling (insuring) differently.

The ACA changed the way the parties collude to set costs in some important ways, but it did not change the basic set of incentives. The main changes were that insurers were required to spend 85% of revenues on health costs, and they no longer could deny coverage (thus their whole business model became simpler, and they downsized). So under ACA, insurers are a less important variable in the cost equation than before.

There is an important link between the moral and financial dimensions, which is the question: what do we do if someone is not insured and they get sick and need help? They were not paying their share into the risk pool to help others, so when they need help, do we help anyway? (The same question is asked in the Little Red Hen story.) Or do we let them get insurance when they need it? Ultraconservatives say no, if they failed to think ahead, we should let them die. They are right on purely economic grounds for the same reason that if you sustain a loss of property that was not insured, you are out of luck; no one will pay you back the value of your loss. But it is clearly barbarian for us to live like that. If we really pause to consider this, we can only come to the conclusion that if we do not want to be barbaric, we need to require people to be in the risk pool. That is, either we have a public pool that automatically covers everyone, or else we require them to be in a private insurance pool. It does not make moral sense to have the “choice” to be uninsured.

The ACA was a compromise plan that favored the private pools to appease conservatives, and one of its failures was that the penalty for not being in a pool was too small; thus its adoption rate has been gradual.

The second financial dimension concerns the role of health spending as a tool of wealth distribution and equality. (I was talking about spending on health itself above, and now switching to issues of taxes and credits.)

Pre-ACA, health spending wasn’t tied in any rational way to income equality, so those expenses, being relatively equal across economic tiers, was a “regressive” type of expense; that is, one whose percentagewise impact on the poor is greater than that on the rich.

One of the most important effects of the ACA was in how it changed the distribution of wealth generally. It shifted the tax burden and entitlements on a gigantic sector of the economy such that wealthier people were paying a much larger chunk of the cost of health services for all of us, and many more people were getting those services at little or no cost. If you’re into active public management of poverty (as I am), this form of progressive taxation was a good start. Two or three more programs of that magnitide (such as in housing, food, or transport) would have made the US more like the compassionate socialist European states.

The condensed version of the way ACA was affordable is that Medicaid was theoretically expanded to include more people, and additionally, if you graduated out of Medicaid (by earning too much to qualify), then you still would qualify for credits towards premiums. Thus there was little or no gap which had existed previously. (One of the persistent failures of US social programs is that they often have a cutoff, so people have an incentive to stay poor to remain eligible.) As income goes up between around 30 to around 90,000 per year, the credits phase out.

The current agenda is being set by the uberrich, who seem to always want more money, so the brunt of their health reform proposals are to reverse the ACA taxes and entitlements. They say the ACA is broken and use terms like “choice”, but all of that is lies and distractions, and their actual motive is that they do not want to pay the taxes, along with the racist/classist motives as noted above. They propose reducing Medicaid and eliminating income-based help on premiums. Not only is the entire dimension of the health system as a tool of equality being chopped, it is even proposed to be reversed by creating a credits that the wealthy qualify for.

The health dimension includes the questions of what gets done for patients, who decides what gets done, and whether it is effective. Amidst all the noise about choice and rising premiums, these questions are not making the news. The current debate is completely missing the much larger factors of what the money gets spent on. We should be debating the finer points of who gets to decide whether to do each procedure and how much they can charge for it. Or we should be implementing more market forces to keep those prices under control. One of the ways to shift incentives is to pay for outcomes rather than procedures, so insurers only pay after the patient is treated successfully, instead of paying simply because something was done to them.

One of the big principles missed by conservatives is that people will not make good decisions about insurance in an unregulated market. Generally speaking we will under-insure ourselves if given too much choice. We might choose a plan with a 1 M$ lifetime cap, because that seems like a lot, but then need 2 M$ to survive cancer, and having made that choice when we were not thinking we might get cancer, we end up dying because of it. Or we might choose a plan that does not cover some drug that we never heard of, and then end up needing that particular drug.

We also do not know what procedures we need if we do not happen to have medical training. But on the other hand we cannot let doctors decide everything, or they would simply order every known test for every patient and drive prices up forever.

So the question of what gets done ultimately has to be a community decision – made either publicly or by insurers backed by courts. It does not make sense to make those decisions as individuals or as providers. The conservative’s notion that “doctors and patients” will decide on everything on a case-by-case basis is naive and does not contain costs. The ACA took a rational approach to that question by making those choices nationally, and putting into law specifically what had to be covered for everyone.

What do we do next? There are a lot of ways to rationally pay for healthcare costs. Here is the super-consolidated list of points that would need to be decided:

  • Who sets prices – There has to be a market force limiting the ability of providers to set runaway prices. (This point is rarely mentioned in debates, but assumed to be the role of insurers.)
  • Who decides what procedure is done – There has to be a market force limiting the ability of providers to do unnecessary procedures. (This point is rarely mentioned in debates, but should be central.)
  • What choice of doctors will you have – If insurers are allowed to control prices, they have to limit choice of providers as a way to do it. If you want to be able to go to any doctor and they can charge whatever they want, then there is no way to control runaway prices. (Republicans pretend to favor choice but have no plan that makes sense; Democrats pretend to favor choice but actually favor insurer price controls.)
  • Self-pay versus risk pooling – Only the 1%s could afford to pay full medical costs without pooling their risk, so all the rest of us need to pool risk. However, some chunk of the middle/upper income people could pay for a fairly large portion of typical medical costs if they accumulated money in health savings accounts (HSA), thus partially being their own insurer. (Everyone is assuming the combination of insurance and HSAs as far as I can tell, but Republicans want to expand the use of HSAs.)
  • Who gets included – Let’s assume that our goal is to care for everyone equally, and leave no one out. So the baseline assumption is that everyone is in a cost sharing pool of some kind. (Democrats generally favor this; Republicans generally opposed.)
  • Mandated coverage – This is really another word for who gets included; it may sound draconian to say “mandated” but it is how every other country does it. (Democrats generally favor; Republicans generally opposed but without any rational alternative.)
  • Penalty for not being covered – Pre-ACA, the penalty for not being covered was that once you developed a condition, you could not get covered for it at all, or only after a long wait. Thus in some cases the penalty was your life. Starting with the ACA, the penalty shifted to a simper tax payment. Another alternative is paying higher premiums after a coverage lapse. Another alternative is to automatically include everyone, avoiding the question of enforcing a penalty. If there is a choice in coverage, there logically has to be a penalty for opting out; otherwise the insurance market would collapse. A lot of people do not get this, but it is the main thing we need to get if we insist on using the insurance model for health costs. (Democrats generally favor the tax penalty or universal automatic coverage; Republicans favor a penalty through higher premiums.)
  • Change in coverage – Risk pools inherently require people to pay into them as a group when they are not sick, and by the same token, you would need to pay for the level of insurance that you might eventually need, before you need it. The strategy of buying minimal insurance while healthy and then switching to better insurance when you get sick undermines the whole concept of risk pooling. The ACA dealt with this problem by limiting the period of enrollment in a plan to the calendar year, which was not sufficient, since it would be economically favorable to wait out the year and then switch, for those who develop a chronic, expensive condition. Other solutions are automatic universal coverage, higher premiums (as above), and longer enrollment periods such as 3-5 years. (Democrats favor the ineffective one-year period and do not seem to have a solution; Republicans favor higher premiums.)
  • How the risk pools are grouped – There has to be a way to decide who is in a pool together, if there are going to be multiple separate pools. One way is to have the whole country in one pool. Another way is by employer. Another way is by insurer. Pre-ACA, continuously insured people were in pools by employer or by insurer if covered individually, while those who could not get insurance in the market either were in the medicaid pool or public high-risk pools. With the ACA, this mostly did not change but the ACA “exchange” established separate pools with a more transparent market. (Democrats favor a universal pool or the ACA compromise; Republicans appear to favor the tiered pre-ACA pool system.)
  • Who underwrites the shared risk pools – This is the question of insurance backing, and currently includes government, quasi-government public insurance companies, non profit and for-profit backers. (Everyone appears to be sidestepping this and is OK with the current slate of complex options.)
  • Who pays premiums – This is the question of whether consumers pay directly, through an employer, or via taxes. Pre-ACA, taxes paid for most of medicaid, most people with private insurance paid through an employer, and some paid directly. ACA did not overhaul that system, but it added a major tax credit component, such that insurers could collect part of the premiums monthly from the government and part from the consumers. (Democrats favor the current complex system or universal “single payer” via taxes; Republicans appear to favor the pre-ACA system.)
  • How is poverty handled – This is the question of how and if the health system trends towards more or less income equality. As I said above, the ACA had a system of credits and overall expansion of low-income support. (Democrats favor the current ACA system; Republicans favor a regressive taxation/credit system instead which makes it impossible to fully include the poor in the whole healthcare system, leading to countless deaths.)

 

Given the huge range of ways to do things, here is what I would do. My first choice would be single payer via taxes, automatic universal inclusion, and essentially removing the insurance component. The market forces would be created by publicly setting rates for outcomes, allowing providers to compete by minimizing the procedures necessary to achieve the outcomes.

Given that my first choice is a political non-starter, my second choice would be to keep ACA with these few changes: (1) improve the ability of insurers to negotiate prices and procedures, (2) shift to fees based on outcomes, (3) increase tax penalty for non-coverage, (4) lengthen the enrollment period to 2 years, and (4) phase out employer-sponsored plans.

Conclusion: There are complex choices to make, there is no one obvious best answer, and Republicans (mostly) are clouding the issues through a steady stream of lies to the point where meaningful real debate is possible.

 

(edited 3/11 to add more on medicaid and poverty)

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“Leveling up” as a societal design pattern

Americans are not used to living in a well-ordered nation. Stemming from the federal system, the history of the wild west, and the longstanding tension between individual and community needs, we tend to complicate things and then believe that they must be complicated. In France by contrast the country is divided into 18 regions, which are neatly subdivided into departments, which are further subdivided into communes. Each level delegates down to the next, and there’s not a lot of overlap in powers or in geography. For example you wouldn’t find a department that spans multiple regions, and all the schools and other organizational systems are more aligned with the departments and communes. But in the US it is typical to have overlapping jurisdictions, such as a school district or a water authority spanning parts of multiple municipalities. The districting of congress, the state legislature, the post office, schools, churches, and businesses rarely fall on the same lines.

The situation results in a feeling of being unitless, by which I mean not having a known basic unit of organization. If we want to solve a neighborhood problem, who are “we”? – what are the boundaries that define the people who can solve the problem, and what authority do we have to solve it? There’s often no clear answer because of widespread unitlessness.

I’ve argued before for jurisdictional alignment (19 years ago!) so in this paper I’ll take up the related but more elusive concept of “leveling up.” Leveling up is defining the relationship between a function of society at one level and its subordinate level, particularly defining the escalation of problem resolution upwards and delegation of authority downwards.

Here are 6 areas of organization with a discussion of leveling up for each one.

1. Justice vs legislation

Under democratic rule of law, an established pattern is that legislation deals in universals and justice deals in individuals. The leveling-up concept related to this is that individual cases need to be judged by a larger body (at a higher level) than that which made the law in question. For example if a town council decides to let students out of school for a religious holiday, but a particular family who doesn’t observe the holiday contests the decision, the trial should be held at the county or state level, not by peers at the same level as the town council. This is because human nature prevents us from being impartial regarding decisions about people immediately around us.

Laws made at extremely small local levels tend to be prejudicial concerning individual people even if names are omitted. For example “the village will permit tractors to use route 509” might really mean that Sam Jones can drive their particular tractor; alternately a law banning tractors might really be a way for people to get back at the nasty things Sam has done. A local judgment of whether the law is just turns into a contest of who is on Sam’s side; this is a basic failure of rule of law when done all at the same level. But a judgment at the state level would look at tractors in general, not just at Sam. Likewise, cities and states are more likely to enact racist laws even if they omit names of groups as a way to divert attention from the racist aspect. It’s more difficult to do that nationally. Human nature allows us to be impartial with strangers. The larger the unit is, the more people rulings apply to, and the more impartial the rulings tend to be.

2. Wild and human habitat

North America has a range of human density running from extremely sparse such as remote Alaska where people are incidental to the natural habitat, all the way up to big cities where nature is incidental to, and more completely under the control of people. In the latter extreme, land is first completely denuded of nearly all life, then a nature-substitute is designed and installed by professionals. There’s a continuous range of expression of that relationship between the extremes, including towns, suburbs, and vast areas of “managed” land, in which there’s a balance, and often a gradual increase in human control over time.

I’m not arguing against the extremes; despite being a nature lover, I concede that in big cities it can make sense to install a nature look-alike atop and between the areas of pavement.

In my mind the problems are more with the middle range. The first problem is the presumption that all land by default is “ours” with the exception of defined regions of “protected” land. So in the American mental model of land, there are dots (foreground) of “nature” on a background of human-managed land. In some cases the dots are connected by wildlife corridors, but many are not. We need to reverse that concept so that the “dots” are human settlements on a background of all other habitat. This is not by itself an argument for less overall developed land, but rather for a pattern of organization that condenses our development into the “dots” and leaves the rest of it in an interconnected continuous mesh of habitat for all other species.

The diagram below shows an abstract representation of green dots on a developed background (left) versus development dots on a green background (right).

naturedots1

The second problem with the middle density range is how much of it there is. Some people say the suburbs are the best of both worlds – country and city – but in other ways they are the worst of both: they lack the efficiency we get from the compactness of cities and also lack any true escape into nature. By sharpening the edges of the dots and making them more compact, then it’s possible to get the best of both worlds and use less land for human settlements overall. Furthermore if the edges of the settlements are highly reticulated, not simple squares or circles, then a great majority of people can be close to real nature, not stuck in vast suburbs.

Agriculture as the largest land use would do the same thing, only the dots are bigger. Fences would have to be discrete shapes enclosing pasture or human activity, not connected continuously to other fences as is the pattern now. Fences could no longer be used to “fence out”; they would only “fence in”.

(Of course I get this is just an ideal of the distant future, but it’s worth thinking about.)

There’s a couple ways this “dots on background” idea is a kind of leveling-up proposal. First, it sets the earth as the higher authority and puts all of our levels below that. Second, it creates place (dispels unitlessness) and consequently creates natural jurisdictions, which then lend themselves to orderly subdivision.

3. Transportation land

The land devoted to transportation is vast – more than half of all urban land. That includes roads, airports, parking, and rail-yards. The roads we use are classified by level – a state road, a county road, and so on, although often it doesn’t matter or it is not always apparent why the classification is made. There’s a lot of complexity and absurdity in the system. For example a road with lots of houses and businesses on it could be a state route and be slow and mainly serve local residents, while some other municipal road might be faster and mostly serve long distance travel; the jurisdictions that make decisions might not represent the main users. Roads can be reclassified, and organization can be rigidly imposed over a history that doesn’t fit.

One of the knottiest problems that ensues with all this is when an individual resident, say a family with children, seeks protection from their previously peaceful road becoming a dangerously fast highway with noisy trucks. It’s impossible to serve both needs well – the legitimate needs of residents, and the legitimate needs for travel in the broader region. It might be counterproductive to everyone to balance the needs through compromise. For example, trucks limited to 40 mph instead of 60 doesn’t really address the family’s concerns, and it slows travel for everyone.

Leveling up to the rescue! We define a continent-wide lattice of superhighway corridors, airports, train lines, etc, and move that land ownership and all its decision-making to the national level. This is a tiny fraction of all land, but it is nationally significant. This land is built above or below the ground level where it crosses between human settlements, so that the background of natural habitat is not dissected. Then, we can decide as a country how to manage that land and its systems to work across the country, without primary regard to local needs. (There’s plenty of other land for local needs.) I get how this is expensive and certain people lose out, and that we have to seize property to make this happen, but ultimately I think it makes more sense because the level of government that is designated to solve a problem has the authority and resources to solve it.

The same concept applies then to the remaining state land: states make a more fine grained lattice of state owned corridors and leave the reminder to the lower levels.

Funding does not need to be collected at higher levels and re-granted to lower levels; each level can manage its own fees and taxation itself by whatever method makes sense to that jurisdiction.

4. Transportation systems

Following from the leveling of transportation land and funding, we can then imagine how transport systems can evolve more rationally without jurisdictional gridlock.

Here’s a technology picture that makes more sense than what we are doing now:

  • At the national level we acquire very straight corridors, and create supersonic evacuated-tube transport to supplement highway and air travel and freight. The federal level rids itself of regionally significant infrastructure, focusing only on long-distance travel. The cost savings and added focus allows us to shift towards renewable-powered high efficiency tube transport and away from the more dangerous and polluting modes. Because of the high speed, all of the systems are isolated from people – none of them would permit bicycles or pedestrian crossings.
  • States acquire a lattice of corridors of statewide significance, including much of the crumbling infrastructure that is deemed not nationally significant. States seize and release land over time as needed to create straighter routes between major population centers, and as with the national system, they focus on regional-speed travel such as maglev and other automated networks to supplement highways. Over time travel shifts greatly towards the safer, efficient modes.
  • Major cities do the same thing at a city scale. For example they acquire and release land such that the city owns a grid of arterials over time, so it can plan and execute efficient city wide travel on bus and surface transit, automated networks, and suitably restricted roads. (By restricted I mean they wouldn’t allow arbitrary number of left turns or connections with local roads, and may not permit pedestrians, or would have signalized pedestrian crossings.)
  • Neighborhoods, towns and boroughs then control the remainder or the developed land, and can focus on slow transport that serves all destinations. This is a very different problem than transport at the higher levels, and deserves creative solutions that fit just that level. For example, the entire local circulation system could consist of 5-foot wide one-way paths limited to 20 mph, so that neighborhood vehicles, electric taxis, bikes and pedestrians can safely share the surface.

The proposal is to think and design for distinct levels rather than a mix or balance; we don’t invest in widening a certain local road just because more people are using it for commuting; instead we route traffic through the corridors that have been designed for regional travel.

There have been many concepts for cities of the future, that generally depict the ground level to be greened up and free of congestion, pollution, utility poles and so on. The main problem with them is that we have already invested trillions in infrastructure, and many of those concepts rely on rebuilding everything from scratch. In reality, creating safe and sustainable transport systems is more urgent than the 100-year lifetime of buildings, so we need approaches that gradually improve what we have towards those greened-up visions. The leveling-up concept provides that mechanism: neighborhoods won’t have to consider speed and distance in their decisions, and the higher levels won’t have to consider access and pedestrians in their decisions. Eliminating the impossible task of balancing unbalancable needs opens up creativity to solve those levels separately and better.

There is also the market aspect to thinking about these transport systems. If the jurisdiction owning the corridors can set up a market for private providers to compete in the traditionally-public modes, then we can take advantage of innovation in those modes like we’ve been able to do with cars. For example, a neighborhood electric robo-taxi can consist of a fleet from multiple competing providers.

5. Utilities and infrastructure

Physical distribution of pipes and wires to millions of endpoints and the connecting grid is a system that parallels the transport network, and would also benefit from some leveling-up concepts.

The reason we have the utility model for some businesses (which is a regulated public-private hybrid business type) is because of the root problem that market competition cannot be effective when it comes to endpoint-oriented infrastructure. It is not reasonable for a variety of gas companies to run a separate network of pipes to every house in order to have consumer choice. Without consumer choice there can be no market, hence the problem.

Leveling-up solves the market problem like this: there are large scale providers of gas, electricity, and data, providing distribution from the global level down to a neighborhood interface. The neighborhood interface is where the private and public sides of the system connect. Neighborhoods provide local connectivity from each endpoint to the interface. While there is just one public network inside the neighborhood, there are one or more privately controlled grids at the higher levels.

This model preserves both market advantage and democratic control in two ways:

  • The regional and national utilities compete for consumer business, and they can reach all consumers without having to build duplicate endpoint networks.
  • Builders of local networks compete for the business of setting up and managing the local networks. Because there are thousands or millions of neighborhoods, they form a consumer pool which allows for market competition.

This radically simple system also applies to shipping: different long distance carriers don’t need to drive separate trucks into each neighborhood; packages transfer at the neighborhood interface, and the neighborhood manages the local distribution. Trash collection is a parallel problem that can be handled the same way as shipping.

6. Everything else

I have a tendency to want to engineer everything according to my extremely egalitarian views, but at the same time I find most renderings of future green cities to be eerie, and have an overly sterile regularity. Here’s an example rendering of a city concept that may have lots of great points, but it doesn’t feel like real people could live there.

greencity

I think some people approach the problem of improving human settlements with an assumption that it will be centrally planned like Soviet apartment towers, and that is what gives it the eerily unreal flavor. I’m more interested in freedom, diversity, and small democratic units, which would yield a future that can’t be rendered in a picture like this because the places would be all different from each other.

Everything else besides the way we use and connect space is important too – that is, policing, education, health, taxation, and so on. But if feels like if the physical organization and transportation aspects were first, other forms of organization could follow more easily. All those things could be run on the level at which they make the most sense – so things like education would not need to be absurdly centralized. Those things would become easier to improve because the units would be clearer and the power to accomplish things would rest cleanly within the unit.

As a final topic, why should we care about any of this when there may be more pressing concerns? I feel like it is important to care about all of these:

  • The concrete topics on a progressive agenda like deforestation, climate change, poverty, crime, and equality (to name a few), and..
  • ..The power structures and power holders that block or promote those agenda topics, and..
  • ..The principles of organization that give rise to the power structures.

Leveling up is one of the principles that, if in practice, would power different power structures than we have today. The structures we have today partly block the human-centered political agenda in America, which is why we have so much worse performance than other countries in things like literacy, health, crime and energy use, despite being wealthy and partially democratic. I don’t think the bad performance is because we’re different than other people culturally; it’s because we organize in a way that twists democracy, and the fragmented federal system of overlapping jurisdictions gets leveraged by minority power holders to overpower majority values.

So that’s why we need to care about it.

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Legal arguments on birth

When does life begin? At conception, or nine weeks thereafter? When the baby is born? Or maybe after it gets its first master’s degree? Or never? Personally I think it’s never. Life reorganizes; it does not begin.

I saw a nun praying outside Planned Parenthood the other day. My urge was to pray with her, not against her. Instead of wondering what her thoughts were, or what she was for or against, I felt the power of her upholding that life which does not begin. It felt like there were not two opposing sides at that moment; her energy felt unifying.

1. Abortion

I grew up with the semantically twisted stance that killing babies before birth was not really “killing”. But when my heart softened about “abortion” (a sanitized word), I admitted it was killing, and I couldn’t be “pro-death”. Instead I wanted to uphold mother and child, to protect and strengthen all of us. When we sit to feel and consider abortion in the abstract, we need to honor the strengths and mourn the losses of the mothers. We should not be stuffing down the feelings of loss simply because we hold a political view of choice. Politics has a way of making abstract ethics central and extreme, and suppressing mercy for each individual circumstance. We should use the word “killing” because that is honest, but using that word doesn’t make it a blanket wrong. Read the rest of this entry »

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Advertising as way to fuel inefficiency

Humans are omnivores mainly by culture, not in the same innate way that other species are omnivores or carnivores. If you consider the innate desires of puppies and other meat eaters, you see that they get excited about eating their prey, they pounce on it, and tear it apart and eat it raw. Humans don’t have the hunting skills or desire to do any of that. The only way most of us can eat animals is by having them killed by someone else, cut up, and cooked so that the disgust that we would otherwise feel at seeing dead carcasses is as far removed from the dinner table as possible. If we were innate animal eaters, we would not feel disgust – we would feel happy and excited about tearing into living creatures. Yet a lot of people really want to believe that we’re innately omnivores. I believed it for a long time, until I learned otherwise.

The fact that I had always accepted that we were innate omnivores only proves I’m human, the only creature that can be so deluded about what we are by manufacturing beliefs and replicating them on a massive scale. When I think for myself, I find it is more gratifying than just adopting the beliefs transmitted by culture. There is a certain grace in the cessation of stupidity that I occasionally experience: things become so simple; I see them as they are without the imposed lens of culture. But I feel very silly for allowing myself to be deluded by the culture around me for so long on the question of eating animals. What kept me in the dark?

Generally speaking people replicate the beliefs of the people around them, except maybe the autistic, who, to various degrees, do not. I’ve experienced both extremes: thinking like everyone else, and being unable to think like anyone else. Another example is using toothpaste, which I’ve heard is unnecessary, but it never really seemed important enough to find out or even form an opinion one way or the other, so I just found it easier to go along with the toothpaste-using culture that I’m in. So I’ve gone through many tubes of toothpaste and eaten lots of animals because … most people do. On other other hand I’ve reinvented things, and it wasn’t because I was too obstinate to do it the normal way. It was because I couldn’t detect the normal way, or the normal way had so much apparent inconsistency or waste that it didn’t feel adoptable to me. I suppose people who acculturate even less than I do would copy fewer beliefs, and they would end up reinventing more things independently, or just failing to do a bunch of normal things.

The highly inefficient system of converting solar energy to nutrition circuitously via other animals is just one of many industries that thrives on waste and socially constructed needs. A lot of the media, pharmaceuticals, makeup, sports, cars, and sugar are in that same category. These are products that people have no true need for, and therefore do not even want innately. People want these things based on convention, but not innately. We have to learn to want them. Because of our inherited culture, we spend a great deal of our lives in highly wasteful pursuits that don’t actually make us happy or fulfill any true need.

Something has to work to keep us in the dark, and keep the waste going. If there was no force sustaining the waste, it would dwindle over time and we would adopt more efficient ways to meet our needs. We would harness the sun to heat buildings rather than drilling for oil and all the complications that go with that. I mean we would do this out of sheer laziness, not for any ethical reason. If the reason for doing the complicated and inefficient thing were to go away, that habit would extinguish. This is similar to a fundamental point in genetics: If the advantage of a trait goes away, then the trait will gradually extinguish. Nothing sticks around indefinitely for no reason.

My proposition then is that all these inefficiencies are sustained in large part through money and advertising, which are the socially constructed means to keep power imbalanced, and falsehoods alive, respectively.

I’ve wondered a lot about advertising because it doesn’t seem to work on me, and so I’m surprised that it works at all. But when I found out about autism, it started to make sense, because non-autistic people believe things simply because they are repeated so many times. And to some degree I do to (like the idea of being omnivorous) but noticeably less.

Advertising pairs something that people innately want with something that costs money, creating an association. For example, it pairs a field of wildflowers on a spring day (an innate attraction) with an oil company. Or, it pairs sex with a car. The main things appearing in ads are either (1) something you already want, or (2) something they want you to want.

Ads also exist for things that people truly need, like food, shelter, and exercise – and are just claiming that one supplier is better than another. To some extent advertising is just part of the information exchange needed in a market system. But consider a tomato. The tomato gets a starring role in so many food ads, yet it is hardly ever the product being advertised. That’s because it is something we already innately want – so there is no need to push it. Instead it is used as the innate need that pairs with the hamburger or other food being advertised. You see the tomato (an innate attraction) and a hamburger (a culturally constructed, highly inefficient means to meet your needs), and the brain makes an association between them, so with enough repetition, you want the hamburger. When you were very little, you probably didn’t like hamburgers – little kids are often not attracted to meat. If you like them now, it is because your tastes were molded by cultural learning, and importantly, the tomato continues to play a lead role in reinforcing that association. Without a force sustaining the cultural, non-innate, and inefficient habits, they might gradually extinguish.

Here are the top advertisers in the US, starting with the highest spender: Procter & Gamble, General Motors, AT&T, Verizon, Johnson & Johnson, Time Warner, Toyota, General Electric, Ford, and Pepsico. Procter and Gamble makes a lot of things, like toothpaste, makeup, razors, detergent, and diapers. The other companies sell cars, communications, pharmaceuticals, media, appliances, and sugar. Other top ad categories are for meat/diary, cleaning products, and alcohol and other drugs. In general the things that are advertised the most are actually needed the least.

I wonder what would happen if those vast concentrations of power could somehow be evaporated. The forces maintaining cultural beliefs in the necessity of all these products would be weakened, and the desire might gradually extinguish. Is it possible that by simply not telling everyone day in and day out to consume sugar, that our taste for it would gradually be forgotten? Would movies fail to entertain us if we weren’t told over and over to watch them?

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­Cost of disability

­This essay discusses the way we pay for autism, from a marxist perspective. It goes into economic reasons that certain people are disabled from participation in the economy, some models of redistribution of money, the kinds of incentives that affect behavior in each of those models, the complexities of insurance as a redistribution model, and what to do about it. I’m starting with economics background to frame disability. Even though it is probably too long and thick, I hope you will read it and discover a completely different take on costs of disability than the conventional wisdom.

1. Efficiency and exclusion from the workforce

The very rich and very poor live off the work of others, as do the old and young, all those whose work is undoing the work of others, and all those who are disabled in the quest for employment. Various wealth redistribution systems exist to maintain the imbalances, and those systems constitute the livelihood of the majority; actual economic productivity is relatively uncommon. For every one person doing economically productive work like growing food, installing windows, or teaching children, there are several operating within the economy, but just doing paperwork or fighting over money and attention, the result of which meets no actual human needs. The more efficiently industrial production is accomplished, the more inefficiency we create on purpose to soak up the excess time. So far, we are seeing advanced capitalism playing out as Marx predicted.

There was a time when we could not afford to exclude people from the workforce: people who were too weak to plow fields were still needed for other things, and generally speaking, if you could not do one thing, you could probably do something else. There was no retirement and no adolescence. With gains in efficiency, however, we can now afford to be idle; or looked at another way, we can now afford to exclude the old and young from the workforce. As efficiency marches on, we are not using the gains to better meet the needs of everyone; in fact we just become more competitive and we concentrate the wealth more, creating a large chronic underclass with no means to provide for their own needs.

Advanced capitalism therefore has two opposing effects: increasing efficiency, which tends to exclude an ever greater portion of people from the workforce; and increasing inefficiency which tends to concentrate wealth. Both opposites operate together. For example, in the food production chain, the actual farming, transport and delivery of food becomes more labor efficient over time, and the resulting wealth is distributed in the sense that the people doing that work are all getting paid and the consumer is getting a necessary product for less money over time. But there is also a growing workforce in the areas of food patents, genetic engineering, marketing and legal sectors, who are all working exclusively for the owners of the food production chain in order to increase the owner’s advantage and increase their assets, and has no benefit to others.

Adolescence and retirement were invented concepts at one time, which served the progress of capitalism by ejecting people who were no longer needed for industrial and agricultural production, and at the same time, creating a dependent class with a redistribution system around them. We now have vast budgets for schooling and social security, and whole sectors of the economy dedicated to wealth redistributing and otherwise providing for the young and old, who either may not work or cannot compete against a narrowing class of employable people. I’m not making the case that the old way is better than the new way, or vice versa, but just that a class of people have become recipients who were once contributors.

This historical pattern has not stopped with age-exclusion; capitalism demands that we continually invent new categories of exclusion, expand the pool of people who are non-productive beneficiaries, and build a distribution system for these new categories. I’m looking at disability in this context: a class of non-worker with a distribution system surrounding it to allocate money to that class. Disability is a lot of things, but this essay is only about disability in that particular economic sense.

2. Why am I writing this?­

As an autistic person, I’m focusing mainly on the redistribution system we are building today to support the neurologically disabled – including autism, so-called attention deficits and other conditions of the mind that affect interpersonal relations. This dependent class is currently undergoing rapid expansion. This affects me greatly where I am in the economy. In the 20 years I’ve been in the workforce, a lot changed. I was not considered autistic before, under the older definition of autism. Earlier in my career my particular style of social communication was a disability, but not so major, in the sense that people would willingly pay me to do things in the information technology sphere. However, over the course of two decades, autism has expanded to engulf me: the definition changed to include people like me, and at the same time, I’ve been less able to compete in the market. As I write, I’m moving into more dependence on government programs for the disabled. It is important to see this not as any change in my objective value or ability to contribute, since I have actually become more skilled over time. It is rather a change in the economy: a new criterion is being used to filter out people from productive roles. Terms like “autism” probably stay roughly synchronized over time with the set of people who have fallen out of economic favor.

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A parable explaining how to think about budget shortfalls

 

This is the video version of a parable I wrote back in 2009.

 

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Retreat center in the Sangre de Cristos

We bought some land on the East side of the Sangre de Cristo mountains, near Angel Fire. Here’s what it looks like in October:

Quick specs on the land: 100 acres, 9,200 feet above sea level, 13-18 inches of rain

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A parable explaining how to think about budget shortfalls

Some years ago a group of pioneers arrived from various directions, and decided to settle some miles North of here. By chance, the group had a great variety of gifts. Some were teachers, some were builders, some farmers, and some healers. Consequently the children could all read, ate well, and slept in warm beds with beautiful woven blankets. The elders said, when the village was new, they must attend to the most important things first – having food and shelter enough for the winter. Being so industrious, they soon accomplished the basic needs of life, and turned to higher forms of employment such as tending to rows of flowers along the public promenade, and building a theater. For these pursuits, each family contributed according to a wonderful formula devised by the village economist. And as it happens in other villages, their society became gradually more complex and specialized, and most people turned to the more advanced trades such as acting, finance, and law. Late in his life, after working for years in his home, the village economist completed a study of the conditions of the time, emerged, walked into the common house, and heaved onto the great table two great volumes of his work. These were the two remaining options, he said. At that time neither the public officers nor their staff took notice, as they were in full time meetings concerning the village budget. It had been determined that there was a growing backlog of needs, and not nearly enough revenue to cover those needs. At each meeting, the villagers thought of more needs that they wished to have provided, and these were added to a great list. When it was finally decided to consult the economist’s work, he had already died, and his chart of annual economic indicators along with the rest of his life’s work was no longer legible because it had been buried in snow that came in through a hole in the rotting roof of the common house. All that was known about the two remaining options was that one option was to reduce public services, which was impossible because so many people were not working and depended on them. The other option was for each working family to contribute more, and that was also impossible because they were already working long hours at cross purposes, and didn’t have enough extra to give. With no other options, the villagers sat on old crates and watched each other die one by one, either by starvation or disease, while their houses rotted and the fields went to weeds. There was nothing else they could do: the economy had ruined their good fortune.

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Village Economics: A theory of economics for a high quality of life in a village

The discipline of economics seems to muddle everything. Specifically, measurements and indicators are seen as ultimate goals. Money, the principal economic tool, takes on independent value within the discipline and therefore in policy. Money-focused policymakers then neglect the quality of life, which is the whole point of economics in my view. Since policies target the indicators of quality of life directly, such as interest rates or GNP1 (rather than targeting the quality of life, which indirectly results in an affect on the monetary indicators), they reduce the accuracy of the indicators and therefore reduce the overall ability to manage the economy.

The situation is analogous to focusing on the tools of publishing (media) to the total neglect of what the tools are in service of: literature. While the study of media is interesting and important, it is ultimately only a container for literature (in the general sense). If, for example, the sales of a book are an indicator of the quality of the literature in the book, and the cost of book production drops, and consequently the sales increase, the quality of the literature cannot be presumed to have increased. Similarly, money itself may be fascinating, but it is only a tool to facilitate labor exchange. And labor is the primary variable in the quality of life.

In this article I am discussing village economics. I am using the word “village” for any manageable population. It is very important for me to think of economics in terms of a village, because I can visualize the quality of life in a village. My mind can encompass the entire economic activity of a village, but I can’t grasp at once the whole economy of an industrial country. Read the rest of this entry »

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