My Vote for Health Care Dictator: David Goldhill

Best article I've read on diagnosing the problem with health care and insurance.

His insight: until we make the individual patient the consumer as opposed to the insurance company standing in for the consumer, no meaningful progress will be made on reducing the cost of healthcare in the US.

The solution: make individuals responsible for their own tax-free health care accounts where they educate themselves and prudently shop for value when selecting doctors, hospitals and procedures. Relegate health insurance to catastrophic problems, not body maintenance. Make the costs of everything transparent, in just the same way as shopping for a hotel room or buying a computer

It's only by putting the consumer in control that we can hope to eliminate the vortices of self-interest that make up the current system.

I believe the Obama administration will fail to make a meaningful change in our healthcare program. For all the brains in this administration, there is no thought leadership on how to change the system, only a wish list of end goals, such as "reduce long term health care costs..."

Hopefully in the next ten years we'll get a chief executive that exploits the power of the office (in the same way that G. W. Bush did for his Iraq project), to base reform on a fundamental hypothesis on what is wrong, like the ones Goldhill articulates. Until then I'm tuning out this thread, as I believe most Americans will lose interest, because the Obama administration is not using a powerful lever to move this obstacle.

Fight Club #5: Is Life too Short for Physics?

Reading Gleick's Genius: the Life and Science of Richard Feynman was particularly successful for FC because it produced some of the best fights so far. The arguments weren't about politics, or economic theories, but instead got to the heart of why we do Fight Club to begin with.

At the center of the controversy is the fact that most readers found the physics in the book to be impossible to follow, and they faulted the author for either 1) including so much physics to begin with, or 2) not making it more understandable to the lay person. In other words, folks found the "Science of RF" to be confusing and frustrating.

On the other hand the book had plenty of rich narratives about the "Life of RF." His first marriage showed him as the romantic ideal worthy of Chretien de Troyes. His first wife is already wasting away to TB at the time he marries her, and he never leaves her side. Later he completely transforms into roue, fooling around with his grad students wives. In short, everyone found the "Life of RF" an engaging story of a complex man.

So was it worth having to slog through the physics? Could that have been edited out? Do we really want to read books for Fight Club that are so difficult? What kind of books do we want to for Fight Club anyway? Why are we here to begin with?

In defense of the book: the reader is made to feel the sense of fumbling around in the dark that the scientist feels when confronting the mysteries and puzzles of nature. Moreover, the curiosity and desire to learn and independently solve the puzzles were clear and aspiration themes of Feynman's life to the end. Our arguments about the book quickly became self-reflective.

Over dinner, to a man, most expressed the feeling that now was a time in their lives where they felt the greatest desire to learn. Remarkable mostly because around the table sits a group a particularly successful men, already midway through life.

For me, Dick Feynman has a permanent room in my head; I want to be like Feynman.

Godel says Relax

About the first time I learned about computability and Godel's Incompleteness Theorem, I had been playing around with forms of the Liar's Paradox. Specifically I used to make an argument for spiritual faith by appealing to the idea that there are some things that are true but not provable.

The argument would go something like this: "You say you are a non-believer, or that you cannot understand how an intellectual could have a spiritual life. But not only are there things that the most hardcore atheist must take on faith every day, but it is provable that there is are some things that are true but not provable, no matter how hard you try. So you might as well relax your objective of pure reason behind all your beliefs."

And then I would bring up the Incompleteness Theorem. But if you weren't a well-read philosopher, mathematician, or computer scientist, you probably wouldn't get it. So I tried finding a short form. I would use: "This sentence is true but not provable."

The form of the conversational proof was to assume the opposite is true, and find the contradiction. There is a question of whether this is a proof or merely a paradox, and the whole question probably would fall under the kind of word problem that justifiably bugged Wittgenstein, but it does give a sense of the Incompleteness Theorem without going into the diagonalization proof.

The real question is is there anything interesting that is true but not provable? That's a lot harder to show. Nevertheless, there was a time where I used Godel to give some pedigree to my principled, anti-intellectual position, or in other words, the smart Viennese guy says it's ok to believe. I have outgrown this argument; it wasn't convincing, but it was fun enough.

Fight Club #4: Is Zen Buddhism Moral?

This session we discussed "The Snow Leopard" by Peter Mathiassen. The original inspiration for this choice came from Fr Bob, who has known Peter since the 70's when they were associated with the same Roshi in New York.

The book was published in 1978, and won a National Book Award. While it got mixed reviews from the group, it didn't fail to stimulate three or four meaningful discussions. this had more to do with the group than the book.

I'm glad we did this book in particular because it finally got us onto Fr Bob's turf. He's a Jesuit, he's multi-lingual, he's an author, he's a professor of Theology and Japanese language, he's a Zen meditation Roshi, and he pronounces 'euphoria' as a Greek word (you-four-EE-ah), and takes it ever so mildly when the rest of us ignoramuses correct his pronunciation (no Bob, it's you-FOUR-ee-ah), though we haven't taken a single course of Greek.

The rest of us are business guys, and he's not. So when we inevitably get to talking about buying and selling things and economics, he's not in his comfort zone. This Fight Club, however, we were able to stay away from business more, and we kept to the deeper side of the pool.

Was Mathiassen acting morally when he went on this trip?

After getting through the gripes about the long nature descriptions, the overly-detailed accounts of cultural details that seem to contrast sharply with the ideals of Zen outlook, we came to the discussion of was it right for Mathiassen to go on this nature trip, right after his wife had died, leaving behind his young son for three months (and breaking his promise to get back for Thanksgiving).

Izzy and Ted were moved by the journey, and felt it was justified. Ted might have gotten the most out of the book, because it was able to take the reader on an arduous trip to a remote world. It was a different world then, the Seventies, it was the me-generation and maybe kids back then didn't have the same expectations about parents being present.

Michaal and I thought Mathiassen's trip was self-indulgent, and while the author did experience occasional insights, he didn't seem significantly changed by the trip.

Bob shared an insight that folks that tend to be monastics many times grew up with distant, or absent mothers.

Is Zen Buddhism at odds with personal responsibility?

This discussion followed on the heels of the last, and was particularly meaningful to me. Since high school, I have been drawn to Zen Buddhism, particularly reading Thomas Merton. Zen offered a way to gain perspective in the middle of the rat race. It also had a esoteric quality that was alluring ("if you have to ask, you're not enlightened"). But how to reconcile this with my Catholic upbringing? I remember my friend John Frazee and I at Chaminade H.S. carrying Lao Tzu around, and Brother Gillen wagging his finger at us passing through the hall, pointing to the book, warning "there's no God in there." Man, we were rebels! (Well, well-groomed rebels with short hair, jacket and tie, religiously observant and obedient rebels...)

Bottom line is that while the detachment of one's identity from desire is a very useful way to keep perspective and maybe even avoid sorrow (which is the big idea with Zen Buddhism), the ideal of detachment is self-centered, despite the Zen ideal of self-annihilation. The priority of "love thy neighbor" doesn't figure in to the radical Zen ideal (though plenty of Zen Buddhists exemplify that principle).

In the end, Fr Bob's concept of Christianity, spiked with Zen, seems like the right answer to me.

The discussions are so lively, that it's easy to forget about the wonderful dinner and environment Michael A sets up for us.

Fight Club #3 (GM Breakup)

While the topic of this month's Fight Club was "Alchemy of Air" by Thomas Hager, one of the interesting economic questions that came up was whether the restructuring of General Motors was correct. Specifically, was it fair and correct in the long-term for the bondholders to take a back-seat to the unions in the restructuring?

Traditional business response: "No, it wasn't right because the bondholders had a legal contract that by definition put it in a superior position in a bankruptcy. To allow the rewriting of the law would be setting a dangerous precedent that would undermine the trust in the US rule of law for businesses. Bondholders rely on this rule of law in order to have the confidence to loan, and if that confidence is shaken, loans won't be made."

Traditional liberal response: "Yes, it was right because employees are stakeholders too, just like bondholders and management, and if they aren't taken care of in this bankruptcy, then they are going to go on welfare and get Federal assistance anyway. So let's take care of them now."

Almost everyone at Fight Club gave a variation of the traditional business response. But because it was Fight Club, and not Yes Club, I disagreed. I thought it was acceptable for the Government to give the unions preferential treatment in this particular case. But my reason for saying this is NOT what you might expect. My belief is the Smarter business response.

Enlightened business response: "Yes, it was acceptable for the Government to advance the union over bondholders, because the bondholders, when they loaned the money, did not assign enough risk to GM's viability precisely because it has a really big union workforce. If they did assign the correct risk of lending to a too-big-to-fail company with a strong union, then GM might never have been able to raise the capital over the years, and would have had to break itself up into smaller companies to survive. Hopefully with this Government action, bondholders will learn an important lesson, and will avoid lending to unionized, too-big-to-fail companies.

Imagine a world where GM was forced to raise money at much higher interest rates. They might have failed earlier than 2009, instead of being artificially sustained by capital markets for more than a decade. It would have been better all the stakeholders if they were unable to raise the capital at reasonable rates sometime in the last dozen years, and instead of taking the capital in to sustain their too-large size, they would have downsized earlier, and possibly broken up into more competitive sub-companies.

I believe this Government action, while somewhat undermining the rule-of-law, ultimately will produce a positive result because it will signal to capital markets not to lend to really large companies that have really strong unions. Either these companies need to shake off the union power, or they need to break apart into smaller, more nimble companies. I'd rather see the free-market forces break apart a struggling behemoth like GM earlier, than a Government orchestrated breakup later.