4ideas

Liberals need a bank of new issues to focus our vision of the next 40 years.   The old ones are both a little out of date, and in some  measure accomplished.   Then there's the fact that all the hate speech from the right has taken its toll, poisoning so many of the old conversations.   We should take it as an opportunity.   The great forces of nature changing our world are a particularly fine source of issues of lasting relevance that the right seems unable to respond to, and need our leadership.   Another great source of new issues is the secrets of our adversaries, stealing their best plays for a different game plan.   I've tried to confront issues head-on and break new ground.   Take whatever fragments you find useful.

id@synapse9.com
PF Henshaw  NY NY

1 The Prix Fixé Health Plan 2 Mass Movements  3 Ending Terror  4 Energy Costs  
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1 The Prix Fixé Health Plan
(creatively redesigning market forces)

It used to be that good health was largely a matter of luck.   That was completely free and equitable.   Now good health is mostly a matter of cost,  going up from 5% to 17% of US Income in 50 years, and continuing to grow much faster than the economy.   What's happening is that science has been amazingly successful in inventing useful treatments and our insurance model spreads the cost for whatever healthcare we'd like to experiment with.    Sadly, of course, money can extend our lives and improve their quality, but the cost becomes prohibitive.   We can't actually afford immortality.  

The NY Times of 11/5/04 announced a great innovation by the director of Medicare,  choosing to pay for less tested new treatments, but only if the patient is enrolled in a study of its efficacy.    That's very creative.   That efficiently pushes better care.   We also need to cap the total expense somewhere.   Every added percent of our incomes taken by health care takes earnings and employment away from something else, dragging down the rest of the economy and creating dislocation.   

What we need and can have is a way to guarantee continually improving healthcare for a fixed price.   The key is carefully measuring how effective various treatments are, and use it as the market mechanism.    Basically you'd collect information telling you which treatments people getting them thought really did the job and were well worth the price.   Then an insurer could accurately pick the ones to fully support, or partly support, or not support at all.   A statistical model would show where to cut so that the program cost would be constant, and we'd get the care best rated by its recipients for a price we could afford.   You'd still get comprehensive insurance and steadily improving care, but it wouldn't cost ever more.   One HMO with an ambitious research office could do it on its own if it thought it's 'prix fixé' plan would sell.   Naturally the plan wouldn't be a true fix and would get a low rating unless there were a strict limit, say 10%, of its treatments requiring patients choosing them to pay an extra.  11/5/04, 3/05/05, 7/2/05, 10/16/05

2 Mass Movements
(mining the useful parts of other people's complaints)
 Mass movements are the pulse of history, and help us see the bigger picture.    Today there are the simultaneous great mass movements of the Muslim and Christian right wings have ascended to power, each living in whole different world of its own.   They're both very passionate, tend to be intolerant and contemptuous of others, and seem self-obsessed and unaware of the danger they put us all in.    Still, all complaints have some validity, and their complaints have gained them huge followings.  If we can sort out the pieces and find the valid basis of their complaints we can then creatively exploit the basis of their power.

Clinton used the right's welfare reform ideas, promoting self-reliance as a better personal choice than welfare, for example.  Another one is the idea of making government simpler and more effective, a great idea too.  The right wants to do that with radical surgical reductions.   Those of us who understand what government is actually for might be more likely to see how to do it successfully.   What about designing internal competition within bureaucracies using measures of how well they deliver services as the way of keeping score?   Then there's the right's interest in making money as a pleasure in itself.   If it centers on using money as a measure of giving creatively service to others, well why not welcome that too.  

It's tougher to turn around the complaints of the Muslim right.   It seems that Western societies fundamentally violate their moral values.  Their lack of social & religious freedom seems rather immoral to us too.   Maybe what's legitimate in their complaint is hidden.    Maybe the intensity of their moral objection to us comes from our own pretentious belief in our pure motives and evident dishonesty in many things.   It's asking a lot, but if we could discover the legitimacy of the Muslim right's complaints about us I think it would move politics by lightyears. 11/05/04, 3/6/05, 10/17/05
 


3 Ending Terror
 (reading the presence of natural systems complicating the task)
There is only one way to end terrorism, and that is to deny the terrorists new recruits.   We need to win over those in the pool of Muslim fundamentalists who might become terrorists but have not yet, deny the active terrorists their base.   That requires studying fundamentalist issues to find ones we can respond to.    Failing to do that is why we can't just 'hunt them down one at a time'.   Our attacks make them multiply, and leaving their base with no response but hatred. 11/08/04

When you attack something and that makes it stronger you're dealing with something bigger than you bargained for.   That's the evidence we see in Iraq and Palestine.   Our attacks against the radicals infuriate their larger community, drawing new recruits.   We need to oppose criminal behavior, of course, but in a way that does not attack the larger group, failing to make new enemies.   We need to study their deep issues and find some to support, co-opting them.   Co-option  is not always welcome at first, but it works in the end.   Could we tolerate a government in Iraq that was not modeled on American democracy?    Is there any other way we could make amends for being such a persistent unwelcome intruder in their house?   11/05/04

People on every side concerned with peace in the Middle East say the key is resolving the Palestinian and Israeli conflict.    Today nerves on both sides seem too frayed for cooperation, but each side can still act unilaterally in its own self-interest.   The Israeli pullout from Gaza is one step to follow with others, likely to reduce conflict.   The US, as Israel's good friend, should hold Israel to its highest standards, without relaxing security, and agree to the absolute standard of being a good neighbor.   The people of Palestine have suffered greatly.    Make peace with the people, and the leaders will follow. 11/05/04

4 Look before we leap
 (getting the science right)
With China and India rapidly taking up the slack in oil supplies, and global supply approaching its turning point toward terminal decline, the price will begin its long term rise relatively soon.     What's remarkable is that even 30 years after the first energy crisis the price of energy is nearly the same.    What we clearly need to be doing is using cheap energy to build a new world for living with expensive energy. The cost and time required is certainly large, but markets are clearly not going to charge the future price ahead of time and divert the windfall to our necessary rebuilding.   Only long range investment can do that, and we're not.   One thing we urgently need are national development standards for high amenity sustainable communities, pedestrian scale development, and the like.   Another thing we need is better predictions of the future.   As the economy gets bigger and continues growing faster we'll need to plan ever further ahead not to get into bad trouble.   Unfortunately among the worst lagging sciences are the sciences of natural change.  We need a huge new effort in environmental and economic modeling to improve our returns on long range investments.    The stakes are high.     11/05/04  7/2/05 10/17/05


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