Democratization of Choice? Can’t Think of a Catchy Title

– By Gitabushi

We are in a very weird time, politically speaking.

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Leftist Spokesmodel is Not Amused by my Unwillingness to Pay for her Birth Control

The Left is moving farther and farther Left. They seem to feel encouraged by their victories in matters like Same Sex Marriage, Govt-funded health care and successful use of the Overton Window to protect their preferred politicians.

At the same time, the Right has had a series of victories that, in the United States at least, leaves conservatives with control of the Supreme Court, the Presidency both halves of Congress, 33 Governorships, and a majority of the state legislatures.  I’ve seen it said that Democrats lost more than 1000 seats during Obama’s terms, if you include state positions.

From another perspective, however, Democrats have won more overall votes than Republicans in the US, it just hasn’t translated into victories because of the way their votes are concentrated in urban areas.

There have been conservative victories in individual gun rights, conservative victories in religious liberty; we’re making some progress in dismantling the Democrat money machine, appear to be ramping up to defund Planned Parenthood (striking a blow for human rights of the most vulnerable), and widespread vote fraud is finally getting attention. (There was no proof of vote fraud previously because Democrat officials had successfully prevented us from looking).

Simultaneously, there is a great realignment, as Democrats doubled down on identity politics, driving moderates into voting GOP, no matter how reluctantly.

The thing is, there’s something else at work here.

Information explosion.

Amazon could not have been successful 30 years ago.  It was impossible to gather the information and present it in a way that people could make informed choices.

Just as the internet and computing power have gathered information and enabled algorithms to help people make better choices in their purchases, these same elements will also enable individuals to make better choices in the government they want.

This, more than anything, will destroy all the Leftist politics that rise from Marxism.

Marxism and its descendants, like Communism, socialism, Progressivism, Feminism, etc., are all predicated on one-size-fits-all governing, with choices given to you by an all-powerful, all-knowing government.  But these isms always fail, too, because a central government can’t do as well as individuals making choices that work bets for them.

However, many aspects of life were easier to implement via government.  I’m sure there are many examples, but right now I’m thinking specifically of education.

With credentialing, standards, infrastructure, payroll, etc., it was just easier to let govt handle education, providing school systems that served local geographic areas.  Economy of scale made it work poorly, but still work.

Vouchers have the potential to cause an education revolution, however.

But linking education dollars to the student rather than to their local school, it opens up the possibility of all sorts of schools opening up in competition to the govt school. It was never cost effective to have more than one school in a small town of 2500 people with, say, 240 in the high school.

With vouchers, though, it becomes cost-effective to have 12 schools of 20 students each, all competing to be the best school so that parents will want their students to attend. Of course, it wouldn’t break down that way.  The most popular school would probably grow (why not capture more of the voucher money?), while less popular schools would probably specialize to try to retain what they could of the voucher income.  So maybe one 100-student school for average students, a military school for discipline problems, a 40-student college prep school offering only AP courses and requiring a test to get in, and two or three Vo-Tech schools focusing on different practical skills for those who least suited for college.

It would have been impossible to organize, staff, and fund this much diversity in a small town before, dealing with all the accreditation and public school dollars.  But the internet and computing power will allow us to Amazonize education, letting parents (or the students themselves) choose the best way to spend their education voucher dollars.

Sure, there will be mistakes, and failures, and bad choices.  Some kids will be worse off in this sort of system. But despite our best efforts and high ideals, students are already being failed and left behind by our current education system. Throwing more money at the current system hasn’t helped…it just sucks up money to no effect. The biggest advantage of the Voucher system will be the innate incentive for schools to fix problems and minimize damage to the students.

Vouchers provide economic incentive and economic freedom to experiment and innovate.

And this will happen in other areas, too. Expect the information revolution to come to Health Care soon. And energy consumption.  Why can’t we have a nationwide grid that allows me to buy energy from Wyoming if they can provide it to me cheaper?  Sure, the power plant in Wyoming can’t push the electrons that far, but energy is somewhat fungible….we should be able to make power companies source-agnostic, and buying electricity should eventually be as competitive as your cellphone service.

The Left is going to collapse. It’s going to be interesting to see what takes its place for the people that *want* to give up their liberty in exchange for security and/or preferential treatment.

My Political View Is Founded on Grasp of Human Nature

I recently got caught up in a huge conversation on Twitter, when a bunch of Progressives tried to shame someone I follow for asking for donations to attend school.

They insisted it was hypocrisy on her part to ask for help, since it betrayed conservative values.  My take was that the principle of Individual Freedom doesn’t preclude conservatives asking for help. She’s free to ask, others are free to help, or not. What would betray conservative values would be complaining about government assistance not being enough to let her be comfortable as she tries to go back to school.  Conservatives can, and do, reward people for trying to improve themselves and their family’s lives.

The essential disconnect in that discussion is the Left thinks the Right is against anyone helping anyone, whereas the Right is actually against the notion of the federal government helping anyone, largely because government “help”  encourages dependence, which doesn’t actually help people at all.

But that’s not the point I’m trying to make.

I also don’t like the term “conservative” because most of the societal conservatives were trying to conserve are well and truly dead.  “The Right” doesn’t work all that well, either, because the Left’s Overton Window incorrectly puts Fascism on the Right, and doesn’t recognize that Alt-Right is a Leftist ideology.  This, of course, is based on the idea that the most consistent way to understand the Left and the Right spectra is the Left’s “group/collective rights” versus the Right’s “individual rights.” What I think the Right wants most is to restore our society to the understanding of limited government and expansive individual rights as described by the United States’ Founders and as enshrined in the Constitution as written. Should we call ourselves Restoratives?

But that’s not the point I’m trying to make either.

The conversation proceeded from the discussion of whether accepting help is acceptable for conservatives to other topics, and the most recent and longest-running discussion has been Vouchers and School Choice.

The Progressives are against those, and insist the problem with education in the US is we don’t shovel enough money into the bonfire.

They cite “many studies” that show that Charter Schools don’t work, harp on the failed Charters Schools, and corruption.

I don’t deny those things happen. It seems to me, however, they are throwing the baby out with the bathwater.  Sticking with the current system certainly doesn’t ensure every child is well-educated, or that schools don’t fail, or even avoid fraud, waste, and abuse.

No system is perfect. No solution is perfect. The Left uses those imperfections to fight against the Right’s policy, but then uses an entirely different standard of “if it helps just one person” to support the policy they prefer.

If no system is perfect, then how do we decide what solutions to try?

Here, then, is the foundation of my ideology:

Most human attributes distribute along a bell curve.  Height, intelligence, talent, longevity, of course…but the attributes salient to my view are: laziness/industry. Some people work for their ideals, regardless of compensation, but most people work just hard enough to have the quality of life that makes them comfortable.

Discomfort is the source of all change and growth.  People will avoid what makes them uncomfortable, and will choose options that make them more comfortable.

Demand for money and material goods is literally unlimited.  Willingness to work for them is always limited, but distributed along the bell curve, so as population increases, so will income & wealth disparity. But that’s okay, because people have different motivations and different levels of comfort.

Natural consequences from decisions are the best way to teach people to make good decisions. It means people will suffer from bad decisions, which the Left uses to argue the Right is cold-blooded. What they fail to recognize is that shielding people from the natural consequences of their decisions actually creates and extends misery, because it obstructs people from gaining maturity and learning to make better decisions.

Everyone wants to improve their life a little bit. They want to do better and have more money this year than last year, and they want to feel like they can do better this month than last month.  Failing that, they want to hold on to what they currently have.  This is how a temporary government benefit becomes an entrenched, permanent interest.

Competition is always good.  Competition is an incentive for innovation: finding ways to do the same thing faster and/or cheaper, or finding ways to increase the quality while retaining current costs.  Without competition, there is no incentive to cut waste, because everyone wants to retain at least what they already have, right?

Wealth cannot be distributed. Wealth can only be created and destroyed.  This is because wealth is partly an attitude (your minimum requirements for life are less than what you have), and partly a sense of satisfaction from being rewarded adequately for creating value.

Money can be redistributed.  This is how wealth is destroyed.  Receiving money you didn’t earn destroys wealth because you have done nothing to deserve it.  Receiving money you didn’t earn engenders defensiveness, ingratitude, and entitlement.  Receiving money you didn’t earn  reduces the incentive to create value in the world, and is thus corrosive to human spirit.

Moreover, government assistance is set by government policy.  At best, it keeps up with inflation.  It is not designed to let you be better off than previously.  As such, people who depend on govt assistance must turn to other means to improve their life, and too often these other means are fraud or criminal behavior.  Thus, receiving government assistance is an inevitable moral hazard in and of itself, due to human nature.

Government regulation can be (and sometimes clearly is) necessary to ensure competition is fair.  This is because information is not always freely available, and those providing goods and services often have the power to control or manipulate information for their own advantage.  Look no further than the “many studies” that show charter schools don’t work.  Those studies are mostly done by those who have a vested financial and socio-political power interest in keeping the public education system exactly as it is.  The thing is, with the internet and processing power, information is becoming more and more accessible.  For example, many brick-and-mortar store retailers are in financial difficulty because so much is available online.  People were hesitant to purchase highly personal items, like clothing, without trying them first, but information availability has found ways to make this easier to accept, and people are embracing it.  How this works in education is that it should be easier for parents to locate successful charter schools that fit the needs of their family, if more of them exist.  What was once an impossibly-complex problem is now as easy to resolve as Amazon making used books available.

I hope to see a world where even a town of a few thousand has multiple charter schools…instead of one high school of 250 kids, a Voucher system could make it possible to have 5 schools of 50 children each, or even 12 schools of 21 students each, with enrollment at each ebbing and rising according to performance and needs of the parents…maybe some schools doing all their classwork in 2 12-hour day weekends, and others holding classes in the evening instead of the day.  Choice is always a good thing.

We should return to following the founding documents, the Declaration of Independence and the US Constitution, as written; significant changes to how we do things (like abortion rights, social security, etc.) should only be enacted through Amendments to the US Constitution.  Yes, that makes it much more difficult to make changes than just getting a handful of judges to make a ruling, but that is actually a good thing.  The difference between the Wisdom of Crowds and the Screwups of a Committee are the amount of deliberation and length of processes ideas must survive to become law.

To sum up:

  • Incentives influence behavior
  • Discomfort is a motivator for change and improvement, comfort reinforces staying the same
  • Competition makes everything better
  • People making individual choices will always be better than a central govt picking winners and losers
  • Information proliferation makes it more and more possible to personalize all sorts of services. Schools of one school and one teacher could be cost-effective in a Voucher system
  • Everyone has the right to experience the natural consequences of their behavior. This is the best way to have a mature, independent citizenry
  • Wealth is enjoying at least slightly more comfort than you require, earned by your own efforts.  As such, wealth cannot be distributed
  • Government assistance is inherently morally hazardous
  • The nation needs more Tough Love treatment of citizens from government at all levels, even if that seems cold-blooded. Church and other non-govt organizations are the best way to care for those who fail to make good choices, as the help is not permanent, nor entitled
  • These points are all perfectly in accord with the nation’s Founders, and this is shown by the wording of the Declaration of Independence and the US Constitution.

CAN READ SFF: The High Crusade, by Poul Anderson

  • by Gitabushi

I picked this book up from the library at the same time I picked up “The Coming of Conan the Cimmerian.

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Conan has been okay (that’s a post for another time), but at one point I just didn’t want to start the next story, so I started reading this book.

It instantly drew me in.  It wasn’t a “can’t set it down” book, but I actively wanted to finish it, actively wanted to know what was going to happen, and actively cared about the characters.  That hasn’t been the case very much, lately.

Let me pause a moment to say that I think the book is adequately reviewed both by PC Bushi on this site, and by Jo Walton. I have zero disagreements with anything either of them said.

That said, this still isn’t a must-read book. It is entertaining, and made some interesting points, but it was merely solid, not amazing.

What I liked about the book:

— I think the framing device was perfect. I remembered the opening, and kept it in mind as I read the story, wondering exactly how it was going to end up with the individual reading the book that told the story I was reading.  The revelation of how the individual was reading the book was satisfying as well, although not clever or unexpected.

— I liked how the medieval characters considered themselves the height of civilization and sophistication, and how that played against the trope of superstitious and backward Christians from the Middle Ages.  This, too, was done effectively.  It is interesting, however, to contrast with Robert A. Heinlein’s J. Darlington Smith, a man from earlier times revived from a stasis field in his book “Beyond This Horizon.”

Smith was intelligent, but unable to catch up with modern education because he was simply too far behind. This is plausible, since we learn best as children, and because we learn the state of the art math, science, culture, etc., as a sort of integral mass.  Even a genius from the past would have a difficult time catching up with modern technology because he would have to learn the basis to the basis to the basis to the basis to the basis for many of the things we take for granted.  Not to mention having his head crammed full of knowledge and information about technology and societal norms that would no longer be operative and would have to be unlearned or forgotten.

In the High Crusade, however, it is lampshaded by positing a technology so mature that knowledge is less important than merely memorizing which button to press and which dial to turn, and how far.  In fact, this lampshade works pretty well.

Edited to add:

However, I would have liked to see more of the younger adventurers catch on to the alien technology more quickly, and especially see the children grasp it intuitively, but it doesn’t hurt the story that Poul doesn’t make the choice to include this.

— I liked the characters.

— I liked the writing in general.  It was almost comforting to encounter a true writing master again, for the first time in a while.  Every character was described in just enough detail to meet the needs of the story. Technological issues were handwaved just enough to meet the needs of the story without seeming like too much of a dodge. The story progressed well, with excellent pacing. Dialogue was all believable, and perfectly done despite having to represent archaic thought processes and communication. The action was detailed when it needed to be, summarized when appropriate. In short, this book has no flaws I can think of.

— I liked the fact that I didn’t have to wade through the latest diversity fashion archetypes. It was nice to not have some politically-correct notion shoved in my face over and over.  That’s not always the case even in other professional fiction (I’m looking at you, later Cherryh and McMasters-Bujold works), so it was nice.

However, if you have a problem with Christianity, Faith, or traditional roles for men and women, this book is going to trigger you over, and over, and over, and over.  Which is why you should read it, probably: face your fears.

In the end, I can’t put this as a Must Read because I don’t think I’ll ever want to read it again, and I don’t feel the need to add it to my collection.  You should read it, but your life and grasp of Speculative Fiction will be fine even if you don’t.51ylLMuLTCL._SX326_BO1,204,203,200_

MUST READ SFF: The Cool War

  • by Gitabushi

Well, this post is by Gitabushi.  Not “The Cool War.”  That was by Frederick Pohl.

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Anyway, this book sticks in my memory as one of the most memorable and singular books I’ve ever read.  I recommend everyone read it, not just SFF fans.

It is Near Future science fiction. I don’t recall any technology in it that might not already exist; very little, if any, didn’t already exist at the time of publishing.  It doesn’t require any alternate Earth aspects.  It is mostly just a glimpse at a coherent reason behind the chaos we see in the news every day.

The reason it left such a deep impression on me, perhaps, is I read it when I was about 14 or 15. At that age, I really believed that books held actual answers to life, that authors were published because they were deemed to have some sort of accurate insight.

I still am not sure why I thought that.

Maybe it was because I was raised to believe the Bible has Answers (and it does, even for those who don’t have Christian faith, but that’s another topic), so it was a short step to think other books had answers?  Or maybe I didn’t think there was any Divine imprimatur in books, but simply that we were taught from books in school, and a PhD is the study of ideas in books, and when people have good ideas they write them down in books, and the books with ideas that prove to be correct are the ones that survive?

I don’t know.  All I know is for a few years, I looked for the meaning of life, love, and general existence in books.

And that’s when I encountered “The Cool War.”

All that is maybe too big of a setup.  I didn’t learn anything from this book that changed my life.

But it did give me a view of how the world itself works that persists to this day, more than 30 years after I first read it.

I’ve since come to understand Frederik Pohl writes from a Conspiracy Theory viewpoint. I’ve also come to understand that the Unitarian-Universalist faith is both real and accurately described in the book, instead of it being a snarky prediction on the future of the watering-down of Christian faith I assumed it was at the time.

Still, it is an entertaining, engaging, well-written story that may provide you with hours of philosophical fodder to digest.

Happy Reading!

Socialism Vs Capitalism

  • by Gitabushi

I saw this picture a few days ago:

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I think this lays out the salient issue. The Right can insist Socialism always ends badly, the Left can counter that whatever has failed isn’t *true* Socialism, but the picture nails it perfectly: Socialism hasn’t even come close to replicating the wealth and choice that Capitalism has in a Free Market.

One possible argument is that Capitalism/Free Market results in inequality.  It does.  But this kind of inequality:

capitalism-vs-socialism-fairness

In a Capitalist/Free Market, you always have the option of working harder to achieve the quality of life you want. I’ve recently become fond of pointing out that discomfort is the agent of change; no one improves if they are comfortable where they are.  In a Capitalist/Free Market system like the US has, if you aren’t working to improve yourself, you are getting some sort of payoff to keep you where you are.  For some people, yes, that is an emotional payoff of being able to complain that the system is keeping you down.  In a Capitalist/Free Market system like the US has, with some exceptions (because the US isn’t a perfect Capitalist Free Market…there are some Socialized aspects, and varying levels of regulation), you have pretty much exactly the life you are willing to work for.

And that, then, is the difference between Socialism and Capitalism.  If True Socialism has never been tried, well, neither has a True Free Market. Yet the UnAuthentic, Impure versions still inevitably have this disparity:

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I will give the Socialists one point, though: True Socialism has never been tried. Where they get it wrong, however, is True Socialism can never be enacted.  This is simply because human nature is incompatible with Socialism.  The basis of socialism is the classic “From each according to his ability, to each according to his need”.   However, as highlighted by the arguments over socialized medicine in the US (and I truly do not understand why so many people who don’t live in the US are so emotionally invested in our health care system), people inevitably overestimate their own contribution, and underestimate the true cost of what they want.  Socialism is always nothing more than an experiment in how quickly people realize they are in a Prisoner’s Dilemma, and how long it takes before everyone is doing as little as possible and taking as much as they can.

The urge to Socialism is, then, is based on a jealous moralism, like this picture argues:

Socialism-v-Capitalism

Another argument I’ve seen recently is that the Deaths Due To Capitalism are greater than the Deaths Due to Socialism.

I think an appropriate counter argument is that the people who died under Capitalism would surely have died under Socialism, as well, but without the offsetting lives that were saved and improved by Capitalism.  If/when people die under Capitalism, it is because of individual choices.  Sometimes these choices are unfortunate and unfair, like a West Virginian choosing to work in a coal mine to feed his family, then dying of black lung.  I don’t celebrate that choice. However, it is Capitalism that has incentives to work out better ways to extract and employ energy, so that the miner’s children don’t have to die of blacklung; moreover, it is Capitalism that has the wealth to compensate the workers’ untimely deaths, and the shame to do so. In Socialism, in contrast, the miners are assigned the work by the State, there is no incentive to develop a better system, and the dead are buried where they fall with the family charged for the cost of the shovel.

I don’t care whether True Socialism has ever been tried, or ever can be tried. Show me one Socialist city that has the wealth and choice of the grocery store in a small rural Montana town.  A Capitalist/Free Market system is the only system that elevates people, gives them choices, and treats them as assets waiting to unleashed. Socialism grinds people down, gives them ultimatums, and treats them as liabilities that must be managed until eliminated.

I know which I choose.

Hard SF v Soft SF

  • by Gitabushi

So apparently there exists some heartburn within Speculative Fiction circles about Hard SF versus Soft SF.

Perhaps Hard SF writers and fans are a little too smug about the scientific aspect of their designated works.

Perhaps Soft SF writers and fans are a little sensitive about having to live with the connotation of being “soft”.

Some, like the esteemed PCBushi (The Couch: “…esteemed by who?” Me: “Whom.” The Couch: “Fine.  …esteemed by whom?”  Me: “Dunno, but there’s gotta be someone who esteems him. It just stands to reason.” The Couch: [shrug] “It’s your fantasy conversation sequence. Also, you probably owe Jonah Goldberg royalties.”) say that labels are unimportant, and only confuse the issue.  He has somewhat of a point, in that there is no reason to entrench ourselves into hostile, opposing camps. We all love Speculative Fiction, and the categories shouldn’t be limits.

For instance, I really enjoy Larry Niven and Jerry Pournelle, who are some of the best Hard SF writers in the business.  But my favorite author is CJ Cherryh, who writes Soft SF.

Still, I think the category is helpful.

Let’s say you want to watch a Rom-Com on Netflix.  I’d say you need to review the life choices that brought you to that point, but wouldn’t you want movies grouped into some sort of category to help you find what you want?

But, you say (and,  yes, please say this out loud.  Google is listening through your mic, and it will eventually get back to me), why would it matter? Is anyone ever really in the mood for Hard SF rather than Soft SF, or vice versa?

Okay, that’s a good argument, too.  Yes, I’m padding the length of this blogpost.

So let’s look at a deeper argument.

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This is a picture of a robot, so that: 1) PCBushi won’t bitch at me about my lack of pictures, and 2) so I can use the robots category tag

We have grown accustomed to certain aspects of Western Fiction (Aside: if you think these things are universal, try reading Asian fiction).  One aspect is that the story should signal what type of story it is from the beginning, by setting up the problem.

In a character story, the story begins when it becomes obvious the main character needs to make a change, and ends when that change finally occurs.  In a milieu story, it begins when the main character is transported to the new world. A milieu story can end in different ways (by fully exploring the world, by the character returning to the “normal” world, by covering the issues the author wanted to cover in their compare/contrast effort), but if the character never goes anywhere, never explores the new world, and works on changing their character, you’d feel disappointed.  An Event story begins by establishing the normal life of characters, then introducing the Event, then showing the impact of the Event on everyone’s life (like a Stephen King novel or Niven/Pournell’s “Lucifer’s Hammer”). An Idea story starts when the idea is introduced, and then ends when the idea is fully explored.

You can tell what kind of story you are reading from the first few pages.  If you can’t, you probably won’t keep reading.  And if the book doesn’t fulfill the expectations you have when reading, you’ll be dissatisfied with the book and either stop reading, or never recommend it and perhaps never purchase the author’s book again.

For all that I don’t really like ERB, I admit he has top-notch milieu skills. The story of a Princess of Mars certainly brings John Carter through a wide span of territory, encountering different societies and people.

And this is the reason I find Jack Vance disappointing.  In Cugil’s Saga, he clearly intends to write a milieu story, but I can’t see why he chose what he did.  It doesn’t seem to have much application to our human, earthly lives, and it almost seems like the only point is to show off Vance’s imagination.

But I digress. Again.

Larry Niven likes milieu stories.  He’s pretty good at them.  He doesn’t do much character development, really.  He also combines Milieu stories with Idea stories.  One of his most common Ideas is that when given an opportunity, sub-groups of people will seize the opportunity to make themselves Elite and exploit their monopoly over a scarce vital resource to enforce their status.  And a Milieu story is a great way to explore the entire society of all the various ways an Elite Caste can come about and maintain itself.

In Larry Niven’s “Destiny’s Road,” he posits a partially terraformed world that restricts mobility due to geography and native flora/fauna threats.  Add to that a dearth of natural appearance of a vital nutrient, without which you are permanently brain damaged.  The Elite manage to control the harvesting and dissemination of that nutrient.  The Hero goes on an unintended journey, and, well, I don’t want to ruin the story with spoilers.  The point is, there are scientific elements behind many of the world’s aspects.  The plot is driven by the scarcity of the nutrient and the main character’s dilemma, as well as the Elite control of technology spread.  A writer could have written the same story as a Soft SF novel, but it wouldn’t have been the same…and quite probably wouldn’t be anywhere near as good.  Niven makes a scientific assumption, and then *rigorously* applies it. That means that certain choices are closed, but other choices are open.  It helps the reader suspend disbelief…this is a story that *could* happen, based on our current understanding of science.

Or perhaps a better example is the Ringworld Series.  He posited an artificial world, made by technology much greater than we have, but still feasible, that actually uses planetary material volumes more efficiently, giving the inhabitants the right amount of heat, day/night cycles, but nearly endless room to expand.  It was written during the era of real fear of overcrowding and insufficient resources on the earth, before we proved that human ingenuity provides enough resources that we can pack several billion more people on the planet. It was also in response to a scientist’s theoretical exploration of constructing more efficient land space, called a Dyson Sphere.

But I digress. Again.

The point is that Niven thought of every possible thing he could, and then wrote the novel, and many aspects of the novel were dictated by the science and math behind his imagined world.  Then readers wrote in with complaints, questions, and scientific holes.

Niven’s response?

He wrote another book answering some of the objections and challenges.  This spurred more challenges, complaints (and some readers suggestions on how to resolve issues).  Result: another novel.

All Hard SF.

What about Soft SF?

Two of my favorite series are CJ Cherryh’s Merchanter Alliance books and Lois McMasters-Bujold Miles Vorkosigan books.

There is little verifiable science behind either of their series.

However, once they posit things (like Cherryh’s method FTL travel, or Bujold’s high-tech handweapons), they rigorously apply the rules to add to the drama.  I can’t consider them Hard SF, but once they built their world, they applied the rules of Hard SF to add verisimilitude.  Their books would certainly be the poorer for having an “anything goes” attitude.

Since the focus of Cherryh’s and Bujold’s books isn’t the exploration of technology, the resolution to the problems usually don’t involve their non-scientific technology.  The tech can provide limits and add tension (as in Cherryh’s FTL travel depends on destructible ship attributes, and imposes costs), but they are never the crux the way they are in a Hard SF story.

Or another comparison:

Terminator is Hard SF. With the exception of Time Travel, everything described is within the realm of plausible future technology.  The focus is on how the technology itself is advanced enough that it is a threat to the protagonist and, eventually, the entire human race. And in the end, the Terminator is defeated by current technology. Compare that with Predator, which is Soft SF.  No attempt is ever made to explain the technology we see. No attempt is made to fill any plot holes possibly created by the technology we see.  The focus isn’t on the technology at all, it is on the struggle between two beings.  Aliens is also Soft SF, because while there is high technology present, it is all incidental. The focus is on the interaction between the people, and the impact of alien rapaciousness.

I think most would agree that the stories use the Hardness and Softness of their science fiction effectively and appropriately, and the stories are better because of it.

I think we need both kinds of stories.  I think Hard SF already borrows from Soft SF in that sometimes the Hard SF writer fudges over scientific details.  I’ve seen some compelling explanations that a lack of the rare nutrient wouldn’t impact humans the way Niven described in “Destiny’s Road.”  And that’s okay.  And I already showed how two writers borrow from Hard SF’s discipline after they created their Soft SF Universes.

So all this is to say that I don’t think there should be this opposition between Hard SF and Soft SF camps.  I’d like to write Hard SF, because I like the way they come up with fascinating worlds, more compelling in their application of science than something just made up from imagination. But I don’t have the education to do it.  So I will write Soft SF, but I wont’ feel inferior for that.  It just means I’ll develop my stories more like Cherryh and Bujold than Niven.

I still think we need the separation and designation of sub-genres, however. Just as I think there is a need for the separation of Science Fiction from Fantasy.  One is not better than the other.  A few more of my favorite writers are Steven Brust, Emma Bull, and Fred Saberhagen, who are all known mainly for their Fantasy stories.  Brust included some science fiction explanatory hand-waves  in the backstory of his world (the races are all genetic experiments by a race of super-high-tech aliens), but I think that may be more just playing with the trope of “any sufficiently advanced technology is indistinguishable from magic”, because there are too many non-scientific aspects of Brust in the form of Gods, souls, reincarnation, etc.  Cherryh and Bujold have also written some excellent Fantasy.

Still, Fantasy is developed differently than Science Fiction.  It has different tropes, and different payoffs.

We need the designation of genres and sub-genres to help us, both as writers and readers.

We should stop fighting and learn to appreciate the differences.

 

My Proposed Health Care System Amelioration Plan

  • By Gitabushi

I can’t tell you how many times people walk up to me and ask me, “Gitabushi, what you you do to improve the mess that is our nation’s health care system?” but it is at least seven or eight times a day.  That’s why I carry a taser with me at all times.

But sometimes someone asks me that question online, and if I can’t find their physical address to tase them, even after a few days of intense googling, then I have no choice but to answer the question.

So here goes.

Change Attitudes

To begin with, the first thing that needs to be changed is the general understanding of health care.

Everyone wants to get more care than they pay for.  Everyone.  I’ve seen strong conservatives go extremely Socialist when it comes to health care.  The Rich can be taxed for health care costs, it seems.

Maybe that’s unfair. Maybe the Conservatives that like health insurance, and like the US Govt underwriting their health insurance in some manner, are really just attracted to the idea of risk pools with people that are relatively healthy, so that they get roughly what they pay for, with the security of a really big medical bill being spread out across all the people in the pool, and that happening rarely enough that they can still get roughly the amount of care they pay for.

The problem with this attitude is, the math simply doesn’t work.

First, the US is excellent at trauma and life preservation, but not so good at actually treating illnesses. So for any given life-threatening situation, there are probably dozens of things that can be tried; most of them are expensive, and depending on the seriousness of the threat to your life, there may be little chance of success. Is it worth it? If it is your life, or the life of your loved one at stake, then of course the answer is “yes”. But if you are in charge of the money behind those choices, sometimes it isn’t.

Look, I get it: it is horrible to have some bean counter decide your life (or your Grandma’s) life isn’t worth a series of risky life-preserving attempts, and writes that life off to ensure the company doesn’t go bankrupt.  That’s bad.  But it is far, far, far, worse to have a bureaucrat make the decision based on whether you are still a source of tax revenue or whether you vote the way the bureaucrat wants.  And that is what Single Payer brings about.

There are more than 300 million people in the US. 90% of us will see a life-threatening situation at least once in our life, where our life could be preserved for years more if money were no object. Multiple times, if you include situations where a life could be extended for a few extra months, or days.

There is simply no way to pay for all that without someone else making choices for you and/or your loved one based on cost. And it will seem heartless to you.

So the first change that needs to be made is:

“If your life isn’t worth your own money, why is it worth mine?”

I think one serendipitous benefit of this is it would be harder for people to just be assholes to everyone. You’d have to work to maintain relationships with family, to extend your circle of friends, etc., so that if you get extremely sick and can’t pay for it, there are more people willing and able to help out and pool resources to save your life.  But that might be a stretch.

Moreover, we need to get the Health Insurance Companies out of the business.  As has been pointed out several times, what would your car insurance bill look like if you had gas fill-up insurance, oil change insurance, and air freshener insurance?

Routine and predictable care should not be paid for by insurance. I don’t know why anyone wants to, even.  If it costs  you $100 to see a doctor, you can bet you are getting billed at least $130.  Because your visit has to be logged, approved, tracked, etc., and that takes manpower, and manpower costs money, and the company has to make a profit on top of that.  Heck, the visit to the doctor only costs $100 because they have to pay the people to make sure the insurance is billed correctly.  So get insurance companies out of routine visits, and the price probably drops from $130 to $75.

So the second attitude change needs to be:

“Pay for more care out of pocket, particularly routine and predictable care”

Another problem was alluded to above. The US is great at trauma, not so good at cures.  In many cases, the medicine and treatment is mostly designed to keep the symptoms from killing you until your body recovers on its own.

A study of Medicare in Oregon showed that having Medicare didn’t improve health outcomes at all. So that’s a hella amount of tax dollars spent to merely improve people’s sense of security.

People need to understand that choices have consequences.  Poor health is the result of poor choices. If you want better health, you don’t need cheaper health care,  you need to make better choices.

Once, I was walking with a girl and she started to go through a crosswalk, but a car was coming. I held her back, and she was indignant. She said, “If that car hits me, my Daddy will take care of the driver!”  My response was, “Even if your Daddy kills him, that doesn’t change the fact you got hit by a car!”  There are some things that can’t be fixed by cheap health care.

So the third attitude change needs to be:

“Health Care Reform can never be a panacea. Live better, or accept poor health outcomes. Don’t expect taxpayers to bail out your poor choices. That’s where your family/friend relationships come in.”

Okay, Gitabushi, this article  is getting really long, and you are still talking about attitude adjustment.

Yeah, well, I’m writing this piece, and you’re not.  But I needed to explain those necessary attitude to shifts to make the rest make sense.  Well, more sense, anyway.

Concrete Reform Proposals

Retail clinics: Most people don’t really need to see a doctor. They certainly don’t need to see an ER doctor, most of the time. People go see a doctor because they don’t have the ability to know whether an injury, illness, or condition is serious or minor. So they see a doctor.

Instead, we need to have a triage system where people see nurses, who send most people home with pain reliever or something. When there is something complicated, they are sent directly to the Physician’s Assistant.  Minor treatments can be prescribed at this stage. If it is more serious, they go to see a Doctor.  And if it is really bad, they then are sent to a  specialist.

With proper manning and proper triage training, someone with actual trauma could receive life-saving treatment quicker than waiting in line at the ER. The precious (and expensive!) time of the doctors and specialists would be reserved for people who actually need it.

The US govt can and should set up incentives to encourage the development of retail clinics.  Tax breaks to corporations are great for that.

Let the Rich be Guinea Pigs: The Rich already are guinea pigs.  Like your surgery-corrected vision?  Thank a rich person. Like that miracle cure that is now cheap enough for you to pay for?  Thank a rich person who paid for it when it was still experimental.

The rich have plenty of money.  Let them pay for experimental treatments that are very expensive.  Once we figure out what works, economies of scale make it affordable for the rest of us.

Again, the US govt can establish some incentives to encourage this.  Perhaps tax breaks on inheritance if you die in an experimental trial?

Other Experiments: Likewise, there are many drugs and procedures that might be lifesavers, but can’t get enough trial subjects to determine their safety. At least part of this is due to FDA rules that prevent exploitation. It is insanely easy to set up incentives to encourage people to participate: just look at how many parents are subjecting their kids to experimental gender reassignment procedures, just so they can get some minor improvement in social status! But along with incentives, we probably need to look again at some of the rules surrounding volunteering to be in a medical trial.  At the very least, people with terminal illnesses should be given incentives to participate…by being terminal, and the treatments they undergo to deal with being terminal, the results of experiments won’t be fully applicable to the wider population, but we’ll still get valuable information.

Price Transparency:

Doctors and hospitals should provide a clear, itemized price for every service and treatment, before you are given that service or treatment.  The biggest problem with pricing right now is that it is a list price, not an actual price…insurance companies use the power of groups to negotiate a lower price, cash payments can get a lower price, and the hospitals/doctors need to cover the free care they gave at the ER (required by law).  So the list price is a fiction for everyone except the responsible individual who wants to pay for care himself, and you get charged $17 dollars for a glass of juice (whether you drink it or not) and $27 per OTC analgesic.  And since that price is fiction, how can you comparison shop?  And if you can’t comparison shop, where is the pressure to control costs and find innovations that deliver better service at lower cost?

Where, indeed.

Stop Giving Incentives to Illegal Aliens:

I don’t think the law that requires hospitals to give care to anyone/everyone at need is a bad law. It prevents someone from bleeding out while hospitals are doing a credit check or trying to figure out if you have insurance.  However, like all systems, this one has been exploited nearly to death.

There is nothing we can really do about indigents using Emergency Rooms.  They have no money to go after.

But illegal immigrants use Emergency Rooms because, being illegal, they are more difficult to hold responsible for payment.

We don’t need to change the compassion law about treating people without demanding up-front payment. However, we need to provide incentives for going after non-payers. If you want life-saving treatment and can’t pay for it immediately, then you will owe.  Yes, it sucks to have spend the next 50 years paying back debt on life-saving treatment, but at least you are alive to make those payments. And then you have stronger incentive to figure out a way to get rich to pay it back earlier, don’t you?  And if you don’t want to be in debt for 50 years for something that isn’t life-saving, don’t go to the ER for minor colds.  It all goes back to one of the first attitude changes: if your health isn’t worth *your* money, why is it worth *mine*?

I’m open to arguments the “Illegal Aliens in the ER” costs aren’t really that high.  Even so, that’s a non-zero cost that drives up expenses for the rest of us.   Medical care rules represent a subsidy that benefits illegal alien employers by shifting costs to the rest of us. There are multiple reasons to end incentives for illegal aliens.  When multiple issues align to the same solution, it is more likely to be a correct policy.

Tort/Malpractice Reform:

We need to do a better job of figuring out what is actual failure to be responsible in treatment decisions/actions, and what is an honest mistake.  Bad things happen. Drugs have side effects that aren’t fully clear in drug trials.   People who undergo treatment sometimes die or have less-than-perfect outcomes, and sometimes that is due to circumstances not related to the treatment.  Maybe this should also be under the “attitude change” section, but the point is: just because something bad happens doesn’t mean someone with money is at fault.

Juries are too easily moved by descriptions of misery and suffering, to the point they assign awards because they want to help the plaintiff, rather than their condition actually being the fault of the doctor or company.  All the massive awards increase the costs of medical treatment to everyone else.

Okay, there are other things I’ve thought of before, but this is getting long enough. If we enact even some of these changes, health care will have outcomes more in line with costs, and people will be able to make better decisions about their health and health care that will avoid costs being a disproportionately large expense in life.

If I think of anything else, I’ll add it in the comments.