I don't mean to offend. It's probably going to happen anyway.

Tuesday, January 17, 2012

How Convenient

The modern world is full of little conveniences. Remarkable enough that cell phones are capable of putting me in real time conversation with people essentially anywhere in the world, they can at this point find you a restaurant, give you directions to it, give rough calorie counts of the meal, and calculate the tip at the end. This blog can be read by people anywhere in the world for the cost of an internet connection. If I want to read up on a controversial piece of legislation, it's the matter of a few keystrokes, instead of going to a library or government office, if indeed they would ever have had the information. I turn a handle and an apparently unlimited supply of water is there, complete with a range of temperatures. Emergency medical care is three numbers away.

Technology and human ingenuity have conspired to remove a great many minor irritations previously inherent in the human condition. Health, comfort, and wealth are by no means guaranteed, but they are significantly easier to attain and maintain than probably at any other time in history.

I wouldn't have it any other way. Existence is so thoroughly improved with these things that to wish them away is folly. Assuming that these conveniences come without cost however is probably the more egregious folly. The downside to convenience is complacency. The two are all but inextricably linked. Water loses its importance with ease of acquisition. Agriculture never comes into being in places like Tahiti where food is so readily available.

There's a socio-historical theory serving to explain the differences in rates of growth and progress across different geographical regions. In essence, the difference depends on how difficult it is to live in a region as a bell curve. On one end, there is Tahiti, where the motivation towards progress is stifled by no particular driving conflict or force. Food, shelter and water are everywhere, neatly covering Maslow's base. On the other end, there are arctic cultures where there is plenty of motivation for improvement, but the daily trials of existence are so grueling as to leave no energy for anything other than survival.

Somewhere in the middle ground of hardship then is a relatively narrow band that lends itself to very rapid progress. The classic western example of this is England driving the industrial revolution. Over the course of a few hundred years, England went from an isolated island where little grew and life was nasty, brutish and short to an empire that spanned half the globe. The balance between motivation and excess energy was exactly right for progress. Rome, China, Macedonia and the Mongols all came to the height of their power under similar circumstance.

Of note is the past tense of the Roman, Chinese, Macedonian, Mongolian and English empires.

The problem faced by a culture that has reached its pinnacle is that there's nowhere left to go. The efforts of the forefathers provide wealth and ease of life enough to lead to the complacency of Tahiti. The problem lies in the fact that although life in these places may simulate the life of absolute leisure, they aren't inherently easy. Maintenance of the position gained takes constant work, work that progressive generations are less and less willing to do. Complacency leads to slipping standards and efforts, and the inevitable decline of empire.

To return to the modern context, let's take a look at two systems that have become highly convenient. Modern healthcare from the average patient perspective is very convenient. An employer deducts a certain sum from the paycheck* to cover insurance.** Upon a visit, they perhaps pay some small co-pay, get the care they need or desire, and leave. The doctor's office bills the insurance company, and the patient need not think of it any more.

While this may seem like a perfect sort of situation, it is largely responsible for the modern state of the United States healthcare system. Insurance companies looking to make a profit do not pay the bill in full, medicare being perhaps the single worst offender. The companies have no accountability to the doctors, and are able to pass the savings on to the policy holders as reduced premiums. These provider losses are then necessarily passed on to patients as increased costs, resulting in patients who blame the doctors for the costs.

Imagine instead if the doctor billed the patient directly, who then in turn could bill the insurance company. There need not and should not be any relationship between provider and insurance. Adding in the patient as a middle man means that all the relationships are in their proper form. The patient has the relationships with provider and payer, and correspondingly should be the means by which payment is allocated. This way, accountability flows naturally, and theoretically, everyone is paid as they should be.

This system however is inconvenient. It adds a step, and people are naturally averse to inconvenience. It would likely cause quite a number of headaches as people struggled with corporate insurance and doctors both, trying to get the money to flow as it would. The net result however is a number of unhappy people making changes to the system, for the best.

Similarly, take public education. For a parent, it is perfectly simple. Live in a town, pay your taxes, and the child is educated. However, one doesn't need to look long at modern educational standards to see how good that education is. Once again we have a problem of accountability. Most parents have little choice in which school their children attend, as it is tied to location. My parents chose to center their choice of town around the education available. To many though, that is not an option due to employment, finances, or other concerns.

Add to the inherent problems of the system indifferent parents. School is one half of a proper elementary educational experience. Parental involvement is critical, helping kids to understand homework and concepts. As a parent, one has significantly more ability to deal one on one with the child, address issues, and provide personalized assistance. This, however, is inconvenient.

School voucher systems make great strides in correcting systemic problems, prompting competition between the schools and introducing a layer of accountability. This however, like engaging with children's education personally, is inconvenient. It means researching schools, altering plans to accomodate less local schools, and generally taking a more active role. In most areas that have switched to a voucher system, the quality of the education has gone up, at the expense of convenience.

Similar things can be said for all sorts of circumstances. Taxation is done primarily by withholding, and while the april 15th deadline leads to much hair-rending, it's still easier than signing over a block check for thousands of dollars. People never see the money, and so it doesn't hurt that it's gone. Going to legal battle for gun rights is just about as inconvenient as a process gets. Going through alternative patdowns at airports is inconvenient, uncomfortable and embarrassing. In short, the decline of our country and individual civil liberties is the path of least resistance. Complacency leads only one place.

It's by definition difficult. I have a hard time keeping up with it. At the airport returning to Dallas yesterday, I ended up in the line for the backscatter without realizing it. Once I realized, I was next in line, and it seemed likely to be far too problematic and inconvenient to make the exhibition, especially as I was in a hurry, and get flustered in crowds. Within minutes of going through though, I knew I needed to write this, as much as a reminder to myself as anything else.

Freedom isn't free. Neither is the convenience with which we live our lives. I for one am disinclined to allow the US to fade from greatness any more than it already has done. Waiting for someone else to pay the piper and save the country isn't a solution.



*The fact that people don't recognize that this is happening is another issue
**The fact that routine care being covered by 'insurance' is absolutely nonsensical is likewise another issue.

1 comment:

  1. Well spoken. Assuming your parents are still alive, they must be nearly unbearably proud of you. That is as well thought and well rendered an opinion as I have seen in many moons.

    The inevitable decline of empire unfortunately comes at a price. Most never recover enough to pay that price. See e.g. Argentina, England, Spain, the Mongol hordes, Rome, even the USSR. I fear we too shall fall into the dustbin of history.

    Led by the One, The Obama, the light of Hope and Change.

    Pardon me while I go vomit.

    ReplyDelete

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