“The press has been chewing lately on China’s ’soft power’ foreign policy. The term ’soft power’ was originally coined by Harvard’s Joseph Nye and refers to the “ability to shape the preferences of others . . . leading by example and attracting others to do what you want.” It has become a common reference in international relations especially when used in contrast to ‘hard power’ (military might).”
See my complete post over at the World Health Care Blog.
Everyone knows that life on a bike aint easy or particularly safe. Us bicyclists complain to whomever will listen about the sorry condition of our roads, the absence of bike lanes, and the lunacy of motorists, but the risks are definitely there. Yet, our persistence in remaining as brightly dressed targets for every sociopath with a driver’s license out there does offer some moral consolation. We are part of the vanguard solution to the urban and environmental woes we see everywhere around us. By making cities around the world more bicycle-friendly, we save lives, save energy, and save a few pounds.
But there is a dark side to all this. Salon blogger, Andrew Leonard, touched on it today. He wrote:
“Bikes are high-tech products manufactured according to the latest advances in metallurgical and plastics sciences in robot-run factories connected to globe-spanning supply chains and taking advantage of the differentials in labor costs between the developed and developing world.”
In other words, bikes (like health care) are a globalized commodity with all that that implies. Leonard opines that the financial connections between bike advocates and bike manufacturers are, well, extremely complicated. Yes–the bike industry is a multi-billion dollar business. And business is business whether it be about bikes, or anything else.
“I’m all for a more bike-friendly world,” says Leonard, “where every road has a bike lane (or at least a wide shoulder) and every city goes the extra mile to welcome bikers with open arms. But let’s not pretend that there’s something simple, or bucolic, about what we’re doing. It’s darn complicated and only getting more so.”
“Keeping the world at an arm’s length is no longer possible or desirable. Much like an “American” car or anything you can buy at Wal-Mart, health care is fast becoming the product of a complex world-wide process. While the health care services Americans receive may appear to be local, each drug, patient record, and operating room is the culmination of a complicated international exchange we need to better understand.”
See my complete post over at the World Health Care Blog.
Ok, I’m sorry. You and I know this is just an unvarnished and blatant attempt to promote this blog. But I’m going to point you to my top ten posts anyway just on the outside chance you may have missed one or two over the last several months. These posts are like children who grow up too fast and then leave home. Every now and then you want them to visit for awhile to see how they’re doing. So here goes.
I know we have a lot of themes running through this list so I hope there’s a little something for everyone. And I hope you keep an eye on this blog in your daily web travels. Aloha!
A conscientious reader of this blog from Boston Massachusetts has alerted me to another discussion of Black Swans (see my previous post) at a blog by the folks who brought you the book, Freakonomics. Steven D. Levitt and Steven J. Dubner have authored a rogue economic interpretation of everyday life that turns a lot of conventional thinking on its head. So when the two intellectual outliers rub shoulders, well it could be downright freaky. This might be an interesting exchange for those of sympathetic temperaments to follow.
Over the last week I’ve been following the trials and tribulations of Floyd Landis, the would-be Tour De France champion. His doping arbitration hearings began a week ago Tuesday in Malibu, California at Pepperdine University’s school of law. Since they started things have just gotten weirder, weirder and WEIRDER. You would think with so much on the line, with cycling and sports enthusiasts the world over watching, this kind of high school immaturity (threatening phone calls to a famous cyclist testifying against him, made by Floyd’s business manager no less) would be the last thing you would see.
I’m going to admit– probably to my detriment — that from the beginning of all of this mess, and even now I believe Floyd did not dope. But I will say that given his testimony today about how he handled this recent stupidity, I am struggling to keep the faith, because faith is mostly all we got left here. The science is incomprehensible, the politics petty and vicious, and the rules ambiguous.
Dear Floyd, we’ll stick with you until the end, but please, let it be quick and merciful.
“The Bill and Melinda Gates Foundation has landed in China with some heavy duty personnel, including Dr. Ray Yip a former Director of the China office of the U.S. Centers for Disease Control and Prevention. The Foundation is now working out terms of the partnership with the Chinese government.”
See my complete post over at the World Health Care Blog.
Over the course of this upcoming presidential election, and for reasons I’ll get to later, the stridency factor in the debate over health care reform is bound to go up a notch or two. The candidates are putting health care front and center as a major issue, some a bit more thoughtful than others. And I suspect that health care stylists everywhere will be provoked into imposing their views or our ear-space whether we choose to listen or not.
But for the moment, I don’t want to get into the specifics of contending views here, as much as I want to talk to how we go about our thinking in health care. One interesting way to see the current debate is through a notion now making the literary and intellectual rounds — the Black Swan. At the risk of being faddish, I think it’s worth exploring for a minute.
A Black Swan is a rare event we never see coming, has extreme impact, and after it occurs, we rationalize that it was ever so predictable. Nassim Nicholas Taleb, author of popular book in question, argues that history and societies do not proceed along some linear line, but “go from fracture to fracture, with a few vibrations in between.” It is the singular, the unseen, the accidental and the unpredicted — and our “chronic underestimation” of these possibilities — that account for the FUTURE straying from any course we initially envisioned.
“We overestimate what we know and underestimate uncertainty,” according to Taleb. We overvalue facts, entertain illusions of understanding, and suffer from “retrospective distortion” when considering the lessons of history. We compress our knowledge and understanding of the world through our propensity for stories, and constantly mistake the map of the world for the world itself. We pay scant attention to the “silent evidence” or “silent consequences” of what we propose, and we know what is wrong with a lot more confidence than we know what is right. And when the gap between what we know and what we think you know becomes “dangerously wide”, it is here where Black Swans are produced.
Health care, and especially the financing of health care, is a human endeavor that produces more negative Black Swans (they hit hard and hurt) than positive ones. Without the money in the right places at the right times, many bad things, both predictable and unpredictable, happen in health care as a result.
If we take Taleb seriously for the moment, one should expect a lot more humility in the talk we hear about how to change the health care system. But, being overwhelmed by the complexity and chaos of health care, and by the devastating consequences of what is wrong, we fall back on our need to simplify. In doing so, we underestimate the contribution that subtle changes make to the creation of major catastrophes.
Taleb’s answer to how to avoid being immobilized by a full appreciation of what he is saying, is to be an empirical skeptic and always keep an open mind. It is all we humans can do. It’s not easy, however.
Let’s take for example the upcoming release of Michael Moore’s new movie on health care, SiCKO. This week the movie will debut at the Cannes Film Festival and be in theaters starting June 29th. The orchestrated buzz (subscription required) on the movie is building, and according to the producer, Harvey Weinstein, the new release will “ignite the country once and for all to deal with health care.”
I suspect the movie could do just that. It will not be humble. The movie could put all that is wrong in health care into a compelling narrative that may capture the national imagination. If it is like his other movies, it will take no prisoners. Names will be taken and there will be enemies identified. It will be a good story. People will find satisfaction in the “message”.Those who try to nickel and dime the movie with criticism of this or that point will probably be confronted with the mass certainty of the movie’s POV.
Yet, how all that certainty translates into what is right for the future of health care will remain to seen. For Taleb, that means going beyond the story, beyond the simplicity of the tabloid mentality, beyond the arrogance propping up what we do know, to a better appreciation of what we do not know. Let’s not let that gap between what we think we know, and what we actually do know get too wide. Otherwise, the surprises in store may be far from what we have been led to expect.
“The 60th World Health Assembly of the WHO continues to meet in Geneva, Switzerland. In 2005, the World Health Assembly adopted the revised International Health Regulations (IHR). The IHR, goes into effect this June and, according to Director-General, Dr. Margaret Chan, are a”pro-active” risk management strategy aimed to stop an international health event at its source, before it has a chance to become an international threat.”
See my complete post over at the World Health Care Blog.
“The World Health Assembly, the decision-making body of the World Health Organization, is holding its 60th annual meeting (May 14th-23rd) in Geneva, Switzerland. The Assembly, attended by delegations from the 193 Member States, will be discussing draft resolutions dealing with avian and pandemic influenza, smallpox eradication, noncommunicable diseases, better medicines for children and progress in the rational use of medicines.”
See my complete post over at the World Health Care Blog.
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