The post originally scheduled for this time (“Put On Your Emotional Armor”) has been delayed so that engineering thinking can be applied to the current debate about health care reform.
Complex subjects such as health care can — and should — be reviewed and debated from various perspectives, including federalism, privacy, cost, freedom of choice, and others. But is there a way to avoid being overwhelmed by complexity? Oftentimes, yes. One of the most important tools of the engineer is called sensitivity analysis. This is simply a methodical way of separating the wheat from the chaff, or a way of detecting what is truly important and allowing trivial distractions to be dismissed.
For example, assume that you’re relaxing on a beach and are trying to optimize your comfort. You’ve picked a scenic spot with a breeze, you’ve adjusted the umbrella for just the right amount of shade while not spoiling the view, and you’ve brought along your favorite drink. As you take a sip, you gaze out idly at the blue-green sea, and —- no, it can’t be! Suddenly there is only one factor of importance affecting your comfort, and you make a frantic dash away from the shore to escape the inrushing monster tidal wave.
These dominant factors are the Big Gorilla variables. Compared to the Big Gorilla, all other factors are largely irrelevant, and one can simply focus on the Big Gorilla and see where it leads. From an engineering thinking perspective, the Big Gorilla variable in the health care debate is how well government performs as a system:
Assertion: The government is a better system for providing health care services to the public than the free market.
Assumption: “Government” is defined as a social system wherein power is centralized in the hands of a relatively small number of leaders who make decisions for the balance of the population. “Free Market” is defined as a social system wherein power is distributed broadly and evenly among the population.
- If a social system is effective at providing health care services then there will be a tendency for good outcomes, regardless of the talent of those who work within the system.
- If a social system is ineffective at providing health care services then there will be a tendency for poor outcomes, regardless of the talent of those who work within the system.
- The governmental system has the following attributes: (Note: these attributes will be explained in more depth in future posts.)
- Poor feedback (services provided are not significantly affected by whether or not the population wants or likes the services).
- Slow response time (it responds very sluggishly, which can trigger instabilities that can create the opposite of the desired result).
- Control is not distributed (its centralized organization makes it unreliable, inefficient, and prone to corruption).
- The free market system has attributes that are the opposite of the governmental system.
Conclusion: The assertion is false. Government provision of health care services will be ineffective and therefore highly unsatisfactory compared to the free-market alternative.
Corollary: Improvement in health care services will be more effectively achieved with the government strictly avoiding any attempt to control the health care industry, and instead by providing a judicial framework that supports free-market principles (e.g. prevention of monopolies, elimination of laws that favor one company over another, reduction of barriers to free trade between the states, and streamlining judicial review rather than relying on regulatory micromanagement).
An important aspect of analysis is that it often allows results to be generalized. The above analysis leads to the following important general conclusion:
The Government Should be Used
To The Minimum Extent Possible For Providing Services
The above may seem counterintuitive since, after all, what is government for, if not for providing services? Nonetheless, an objective systems analysis indicates that the governmental system is vastly inferior to the alternative of free-market capitalism. This is not an ideological conclusion, nor is it a criticism of government workers. It is simply a fact that, regardless of the talent, integrity, intentions, and compassion of those in government, they will always be hobbled by an inefficient system. Plus some of these good folks will, over time, tend to become corrupt.
Engineering thinking requires, wherever possible, that theory be compared to empirical data. A future post will present a Big Gorilla historical antecedent that supports the above conclusion.
We Return To Our Regular Scheduled Program: Put On Your Emotional Armor