200th blog post!

Hi Ya'll:

This is my 200th blog post! Feel free to mark this momentous occasion by donating large sums of money using the Pay Pal button over in the right hand sidebar. (-;

A few reflections looking back over the 200 posts in the last two and a half years.

One of the things I want to do with this blog is to push the envelope in terms of how we understand progressivism. I was tired of kumbaya privileged white liberalism that categorically ruled out violence even as Martin and Malcolm and Bobby were killed by dog whistle death squads and corporations destroyed life as we know it on this earth. I want the writing on this blog NOT to be constrained by preconceived notions about what is proper or how we're supposed to talk about things. I want this blog to be an ideation factory -- capable of entertaining and developing a wide range of idea that will help reduce suffering and build the sort of world we all want to live in. And I have been motivated by the notion (popularized recently by Naomi Klein) that ideas have consequences and that one reason there is so much suffering in the world is because our minds are populated with such crappy ideas. I believe that if we can free our minds from the colonization imposed upon it by the dominate culture, parents, and ourselves, we can repopulate it with ideas that reduce suffering and lead to bliss. I really believe that. I just haven't experienced it much.

I'm writing a lot more on religion these days (I'm up to 17 posts on the topic). I'm really enjoying the religions posts a lot (even if they make my hands sweat as I worry that they will offend -- which I'm sure they often do). Even though I support the separation of church and state, I feel that so many of the mistakes we make in our theology later show up in our politics. So even though this blog is mostly focused on progressive politics, I feel that we have to get our theology sorted out in order to fix our politics. I think there is tremendous opportunity here -- in so many ways I feel that we are on the verge of the next great reformation -- but bigger even than the reformation. I think the Big 4 modern atheists (Harris, Dawkins, Dennett, and Hitchens) are doing some really important plowing -- destroying so many of the old structures that have caused so much harm in the world. But I don't think the modern atheists are gonna be the last word (or at least these 4 aren't gonna be the last word). I think that we'll develop a new way of talking about creation, better ways of relating to each other in community, and an evidence-based morality and politics dedicated not to ancient anthropomorphized gods, but rather dedicated to reducing suffering and increasing happiness. It'll have a lot of the elements of the new atheism -- while still leaving room for us to marvel at the joy of creation.

I think my posts on framing are probably the most helpful to other people (and not very controversial). I'm up to 9 posts on framing.

I think I rocked it with my 11 part series on coal back in 2008. But it's interesting to note that the evil coal lobbyists were writing to me every day to engage me in conversation -- and I didn't hear shit from the Sierra Club or NRDC or anyone else who I was actually fighting to support (Rainforest Action Network did send me a note on YouTube which was nice). In spite of all of our talk about progressives owning social media -- the bad guys still have WAY more resources for engagement.

When Yves Smith at Naked Capitalism links to me, my traffic goes through the roof! If she doesn't link to me, my traffic is just okay. If I cross post to Kos -- I get a nice bump. But nothing brings in the readers like a link from Naked Capitalism. Thanks Yves!!!

The blog gives me an excuse to read good stuff and then share my thoughts with others. I'm particularly pleased to discover The Wisdom of Crowds which totally blew my mind and led to 6 different posts exploring the implications and application of this idea.

I feel like I totally rocked it with some posts. I particularly love:

• Bleeding Heart Liberal: What does that even mean?

• Bowlingual: Translating Republican Code Words

• I and Thou
  

I probably missed it with other posts -- like my 2 on The Hills.

Interesting, my post The Palin Phenomenon: "Like Care Bears meets Jenna Jameson" is my all time most read post -- with something incredible like 1,500 hits in one day. In spite of the salacious title I do think there are some intriguing sociological observations in there.

But looking at my analytics -- it appears that my most beloved (and linked to) post is one I did back on Valentine's Day 2007 called 7,100 types of apples. There's just something simple and sweet about that post that seemed to resonate with folks more than anything else I've written. People also really seemed to like the otters (hat tip to Kos for originally posting the video).

I continue to be satisfied with Blogger as a platform although I'm getting envious of those who rave about Wordpress.

I'm gonna open my blog up for unregistered comments again. But we all know that if you have any balls you'll sign your name. However, if too many global cooling freaks come out of the woodwork again, you will be deleted (please take a moment to read my No Haters Policy in the right hand sidebar). Conservatives who are trying to destroy the world with their ignorance are still strongly encouraged to go elsewhere.

Good times.

The case for atheism, part 1

I hope this post blows your mind. It blew my mind when it came to me so I thought I'd share it with you:

The moral and ethical case for vegetarianism is not difficult to make. There are probably hundreds of different ways to make the case but let's examine one:

No animal wants to die. In particular, no animal wants to be killed by another animal. Turn on any nature show and see the gazelle running in terror to escape the cheetah and you'll know this is true. Even the lowly cockroach seems to follow our gaze and dash from the underside of our angry shoe. Now, different animals have different pain thresholds and different levels of intelligence but it is obvious to everyone but a psychopath that no animal wants to be killed by another. Can we all agree on that point?

So there is a strong moral and ethical case to be made for vegetarianism: it is obvious that the killing of any animal is cruel. We want to live in a humane world with less cruelty and violence. So we choose to eat only plants. It's a pretty strong case. And indeed if we all had to kill our food ourselves, many of us would likely become vegetarians pretty quickly. Nothing complicated about that argument, correct?

Okay but here's the thing. The earth is designed for animals to kill other animals. Cheetahs eventually do catch a gazelle or a zebra. The shark is never gonna become a vegetarian -- it has to eat other fish in order to survive. The history of this planet is filled with lots and lots of predators -- animals who kill other animals against their will.

So God if there is a God, designed a world filled with predators.

But as I just showed above, even the most basic understanding of morality shows that it is cruel to kill another animal.

So by even the most basic definitions of morality -- YOU (or at least people who can understand vegetarianism -- which is pretty much everyone) have a HIGHER system of morality than God does (if there is such a thing).

That's an idea that is incredibly painful to comprehend -- there may indeed be a God and that God might just be an asshole. Most ancient people could understand this concept -- indeed pantheistic religions -- with multiple gods often in conflict with each other, have the ability to account for whimsical deities whose ethics are worse than our own. But the moment people embrace monotheism -- we experience the theodicy problem -- why do bad things happen to good people (the good and the bad of creation are located in one creator causing cognitive dissonance for the rest of us). The All Loving Santa Claus God (TM) that is popular in America today seems to leave no room for the fact that the hand we were dealt by creation can be incredibly violent and cruel (and totally lovely other times, it's true).

The alternative of course is to say that we can't explain creation through appeals to anthropomorphized God(s).

I'm not saying I have an answer, only that whatever answer we come up with for how we got here and why we are here necessarily needs to also explain all the evil, violence, and cruelty that seems built into the natural world.

Update #1: Indeed, isn't that what the Genesis story attempts to explain? Faced with the possibility that God is just an asshole (how else to explain all the violence and cruelty around them) the ancients took one for the team and said, 'oh no no, God is really good and things were really peaceful here once -- but then WE messed up by eating an apple and now we're gonna be punished for eternity.' Ya gotta hand it to them for trying -- a lifetime of guilt being a more desirable emotion than existential dread I suppose. But as we unearth dinosaur bones with really really big teeth for eating other dinosaurs -- we see that there likely never was a peaceful time -- violence and cruelty were the plan BEFORE we ever showed up on the scene.

Understanding evolution: Stephen Jay Gould vs. Ken Wilber

I believe Ken Wilber's Sex, Ecology, Spirituality: The Spirit of Evolution is perhaps the best spiritual treatise ever written. Ever. In human history. Better than the Bible, better than the Torah, better than the Koran, better than the Bagvagita (as frequent readers of this blog will know, I find those other sacred texts rather woeful so perhaps that's not the best comparison). Published in 1995 -- Sex, Ecology, Spirituality (SES) benefits from the wisdom inherent in modernity but I believe it is also better than any of the modern spiritual treatises (Tolle, Chopra, Chodron) that have been put out over the last few decades as well.

SES represents one of the most ambitious intellectual undertakings ever attempted. Wilber's approach goes something like this: he argues that within any academic discipline (chemistry, sociology, psychology, economics, etc.) there are a generally agreed upon set of facts -- and there topics on the edges of the discipline that are still subject to dispute and disagreement. In Sex, Ecology Spirituality, Wilber attempts to take the generally agreed upon facts -- from EVERY discipline -- and map what we know to be true -- from the Big Bang, until today. As I understand it (and this may just be my read, not Wilber's intention) the unspoken hope in creating this map is either to reveal God (if we plot enough data points does it show us the outline of God perhaps -- like a sort of constellation of stars?) or point to God (the universe seems to be going in THIS direction so that must point to the omega point of human existence).

Wilber's map, also know as the 4 Quadrants, looks like this:


It won't make sense until you read the book. Regardless of where you come out in terms of his conclusions, I think you'll find that the 4 quadrant map is extremely cool.

But (you knew there was a But coming right?) there's something very strange that happens when you talk to people who are into Wilber's "integral theory":

• If you talk with a psychologist who is into integral theory, he/she will often say, 'I really like SES and integral theory, but he doesn't really get the psychology part right -- but I really like the rest of it.'

• If you talk with a sociologist, you'll often hear, 'I really like the map, I think SES is genius, but he doesn't really understand the sociology that he writes about.'

• As someone who studies politics, I find Wilber's writings on politics to be dangerously naive -- the sort of thing someone would write who has never tried to move a piece of legislation or made a call or knocked on a door in a campaign.

• I imagine a similar sort of thing happens in other disciplines as well.

Now some of this may just be professional jealousy. Wilber put this brilliant tome out into the marketplace of ideas and it's natural that some folks would try to knock it a bit -- in the hope that some of his greatness might rub off on them through association. I'm sure some of that is going on -- but I don't think that's the whole story. I really think SES is a case where the WHOLE is greater than the sum of the parts. Wilber constructs this elaborate house made up of plywood understandings of the various parts that make up the whole. And that's probably fine -- the house is beautiful -- and it's the most beautiful house on the block. The world needs generalists and the world needs specialists -- and they are two different kinds of people.

Recently, I started reading Stephan Jay Gould, because I felt like I wanted to better understand evolution, evolutionary biology, and evolutionary psychology. And in a few short sentences, Gould undercuts not only Wilber's understanding of evolution but the ENTIRE THESIS of Sex, Ecology, and Spirituality. Gould is not writing in reply to Wilber -- he's just writing about the evolution of life on earth, but he comes to every different conclusions than Wilber. I want to chew on a few quotes and then talk about what all of this might mean [you can read Gould's whole piece here]:

One might grant that complexification for life as a whole represents a pseudo-trend based on constraint at the left wall but still hold that evolution within particular groups differentially favors complexity when the founding lineage begins far enough from the left wall to permit movement in both directions. Empirical tests of this interesting hypothesis are just beginning (as concern for the subject mounts among paleontologists), and we do not yet have enough cases to advance a generality. But the first two studies - by Daniel W. McShea of the University of Michigan on mammalian vertebrae and by George F. Boyajian of the University of Pennsylvania on ammonite suture lines - show no evolutionary tendencies to favor increased complexity.

Moreover, when we consider that for each mode of life involving greater complexity, there probably exists an equally advantageous style based on greater simplicity of form (as often found in parasites, for example), then preferential evolution toward complexity seems unlikely a priori. Our impression that life evolves toward greater complexity is probably only a bias inspired by parochial focus on ourselves, and consequent overattention to complexifying creatures, while we ignore just as many lineages adapting equally well by becoming simpler in form. The morphologically degenerate parasite, safe within its host, has just as much prospect for evolutionary success as its gorgeously elaborate relative coping with the slings and arrows of outrageous fortune in a tough external world....

Then this:

Although interesting and portentous events have occurred since, from the flowering of dinosaurs to the origin of human consciousness, we do not exaggerate greatly in stating that the subsequent history of animal life amounts to little more than variations on anatomical themes established during the Cambrian explosion within five million years. Three billion years of unicellularity, followed by five million years of intense creativity and then capped by more than 500 million years of variation on set anatomical themes can scarcely be read as a predictable, inexorable or continuous trend toward progress or increasing complexity.

And then my favorite quote:

Sigmund Freud often remarked that great revolutions in the history of science have but one common, and ironic, feature: they knock human arrogance off one pedestal after another of our previous conviction about our own self-importance. In Freud's three examples, Copernicus moved our home from center to periphery, Darwin then relegated us to "descent from an animal world"; and, finally (in one of the least modest statements of intellectual history), Freud himself discovered the unconscious and exploded the myth of a fully rational mind. In this wise and crucial sense, the Darwinian revolution remains woefully incomplete because, even though thinking humanity accepts the fact of evolution, most of us are still unwilling to abandon the comforting view that evolution means (or at least embodies a central principle of) progress defined to render the appearance of something like human consciousness either virtually inevitable or at least predictable. The pedestal is not smashed until we abandon progress or complexification as a central principle and come to entertain the strong possibility that H. sapiens is but a tiny, late-arising twig on life's enormously arborescent bush - a small bud that would almost surely not appear a second time if we could replant the bush from seed and let it grow again. [Full article by Stephen Jay Gould here.]

Wilber's entire thesis rests on complexification -- on the idea that the increasing complexity we see in evolution points us towards God. And here Stephen Jay Gould, one of the world's leading experts on evolution, in just a few short sentences says, 'nope, evolution likes simplicity just as much as complexity.'

Look, I don't know who's right, Gould or Wilber (and I imagine some integral theorist out there has found a way to harmonize the two) -- but it is alarming to say the least to see Gould, one of the world's experts on evolution look at the same data -- and come away with the opposite conclusion (from Wilber).

I just want to make two notes about this:

1. This simple exercise points to the dangers of being seduced by a theory. Oftentimes we look at a theory on paper -- and it just feels right and so we become passionate about it. But are we qualified to evaluate the merits of the theory? Do we have data to back up the theory? And are we equipped to evaluate the merits of that data? In the modern world, we are all completely in over our heads -- we rely on tools and technology that we don't understand. And by necessity we take most things on faith -- even the most rational scientifically minded of us -- because we can't all be specialists at everything.

2. What I LIKE about Gould's point above is the way that it destroys ego. That's one of the biggest problems of integral theory -- it is so goddamn egocentric. Integral theory seems to wish for a world where the wise meditative theocrats rule over the ignorant tribalists. [We've seen what that world looks like actually -- it's Tibet prior to the Chinese invasion -- it's a feudal world with stone age technology where a handful of theocrats rule over the desperate and permanently impoverished population.] It is no surprise then that problems of ego cripple the integral movement every time it seems on the verge of a major breakthrough in popular consciousness.

So again, I don't know who's right or wrong on this issue of the evolutionary merits of complexity vs. simplicity -- but I think there's great food for thought in the dissonance between these two writers. I think it also suggests that the next great spiritual work won't be the product of any one person. Increasingly, even the world's smartest person is no match for Google and the modern world's capacity for parallel processing. What would SES look like as a collaborative project with each of its pieces written by the experts in each particular field? Would the thesis still hold or would we end up with a very different map of the universe? [Said slightly differently would it be possible to MAP all of the knowledge on Wikipedia -- and if so, what would it tell us?]

Update #1: I see that that others have plowed this path before I had (which of course, I should have figured out BEFORE I start writing this post). But if you google: Stephen Jay Gould and Ken Wilber, you'll find lots of interesting further reading.

Update #2: I actually find Stephen Jay Gould's writings on "non-overlapping magisteria" to be unhelpful. So I think Wilber is right to whack him on that.

It's a tough call

Evidence FOR the existence of God:

creation
puppies
dolphins
frogs
children
laughter
flowers
pie
water
sex
love
friendship


Evidence AGAINST the existence of God:

childhood leukemia
1 billion extinct species
violence
genocide
rape
war
religion
loneliness
Nazis
disease
death
dinosaurs
meat
the end of creation
The Boston Celtics

I don't know, it's a tough call.

They asked the Buddha, what is the meaning of all this, and he holds up a lotus flower and people are all like, yep, that's it!

Then you ask Richard Dawkins, what is the meaning of all of this, and he can point to the second list and say, 'really, your all loving all powerful god is into all of this?' And that's pretty convincing too.

And they're both right and yet it doesn't necessarily tell us anything about what's behind the curtain or whether there is anything behind the curtain at all.

Punking the population mafia-style

Digby asks a great question today -- when folks steal elections, why do they make it so obvious? Why not cover their tracks a little better? I'll turn it over to her for the play by play (the intro and conclusion are Digby, the long quote in the middle is from Kevin Drum at Mother Jones):

I was going to talk a bit about why this vote rigging was so obvious and then I came across this post by Kevin:

I was at a book party for Bob Wright's The Evolution of God last night, and even then it was obvious that the Interior Ministry was probably rigging the vote. One of the topics of conversation was: when autocracies decide to do something like this, why do they do it so clumsily? Why not give Ahmadinejad 52.7% of the vote, which would be at least within the realm of reason? Or force a runoff and let Ahmadinejad win a week from now? Why perpetrate such an obvious fraud?

Hard to say. Maybe it's just too hard to orchestrate something more believable. Maybe, against all evidence, they believe that smashing victories are always more convincing than close ones. Maybe it's just rank panic and stupidity. It's a mystery — and a counterproductive one, too: there isn't a person on the planet who thinks that Ahmadinejad could have won two-thirds of the vote with a turnout of 85%, and the possibility of inciting an internal revolt is a lot higher with a barefaced fraud like this than it would be with something a little more subtle.

On the other hand, maybe we're looking at this through the wrong lens. Obviously something about Mousavi started to badly spook the powers-that-be during the past week, and maybe they decided something needed to be done about it. Maybe they wanted to provoke a round of violence from Mousavi's supporters as an excuse to lead a crackdown on dissidents. And what better way to do that than to make the election rigging so obvious even a child could see it?

I think it's clearly the latter. Authoritarians need to demonstrate their power and one of the ways they do it by making openly ridiculous claims and daring anyone to prove otherwise. If dissidents try, they will be put down hard. This is how they make the population feel impotent and powerless: "Yeah, I stole the election, what are you going to do about it?"

If they can get the media to tell the citizens to "get over it" they will complete the process.

Yep, that's it exactly.

Iran election results haiku

I kinda feel dumb,
watching the riots in Iran,
that we didn't burn the mutherfucka down,
when they stole the (2000) election here.

But that's the thing right?
No one was gonna lay their life down
for a guy who picks
Joe Lieberman for VP.

3 major prefab housing developers bite the dust

Christopher Hawthorne, architecture critic for the LA Times, is out with a fascinating article today on how several big players in the prefab housing industry have closed in recent months. From the article:

It's always a little risky to see in one headline about the architecture business, or in the fate of a single firm, a parable for the profession as a whole. But news that the prefab specialist Michelle Kaufmann has suddenly closed her Oakland office and laid off all 17 of her employees does seem to have Larger Symbolism written all over it.

Kaufmann's is hardly the only prefab firm to face trouble in recent months. Empyrean International, the company that built houses for Dwell magazine's prefab arm, abruptly shut down last fall. Marmol Radziner, the Los Angeles firm known for smartly designed Neomodern houses, has mothballed its prefab factory in Vernon in what it says is a temporary move. [Full article here.]

Hawthorne puts his fingers on the disconnect in the recent years between prefab's promise and reality:

How to make the leap to high-volume business remains prefab's central dilemma. You don't become the prefab version of a big residential developer by building houses one at a time on steep city lots and in vacation spots, as many high-design prefab firms have done. You reach that point by colonizing big swaths of flat land and building 1,500 identical houses at the same time.

As a longtime subscriber to Dwell, I drooled over their modern designs and the promise of cool architecture at an affordable price. But then when I actually looked at the prices of these houses -- they weren't all that affordable. Too often they were second house play things for those with disposable income rather than design for the masses (which may be one reason why Dwell editor Allison Arieff left the magazine citing, "a "fundamental change in the magazine's mission and philosophy").

That's the paradox that prefab still has not been able to overcome -- affordable architecture for the masses necessarily relies on mass production -- and yet few people want to live in a neighborhood of 1500 identical houses. We want the promise of prefab's lower costs and environmental sensibility, without prefab's downside of forcing us to live in identical little boxes.

The fashion industry faces the same problem -- people want low cost but they also want their clothing choices to be distinct and an individual reflection of their personality. The fashion industry's solution was to outsource production to Asia where child labor, police states, and crushing poverty keep wages down -- while producers make small batches of lots of different designs which creates the appearance of individuality. But of course that's no solution at all.

In many respects -- the economic downturn should create the climate in which to PROVE the genius of prefab modern housing -- mass production and low cost should be more desirable than ever. And yet, that home run prefab design, development, or company has yet to emerge.

Perfect analysis of the California budget disaster

The Root is out with an analysis of the California budget catastrophe and it is spot on. Hat tip to Digby for highlighting the article -- and trimming it in helpful ways. The money graphs:

In 1978, California's voters approved Proposition 13, which changed the state constitution to require a two-thirds majority vote of the state legislature to raise taxes. Meanwhile, the state's progressive constitution allows voters to impose spending requirements on the legislature, borrow money or amend the constitution by a simple majority vote.

Voters everywhere want low taxes and generous government benefits. In most government systems, they elect legislators who try to balance these imperatives. But only in California can voters both give themselves tax cuts and require the state legislature to spend more money on their chosen programs. Well-meaning initiatives have taken large chunks of the budget out of the legislature's control and have saddled the state with heavy interest payments on endless bonds used to pay for infrastructure such as new schools and earthquake retrofitting for public buildings. These sound nice when described in one sentence on a ballot, but funding them through debt is unnecessarily expensive and limits the legislature's options, short-changing less sexy programs such as services for the poor. [Full article here.]

Yep, that is it exactly. Through 3 decades of hodgepodge state ballot initiatives Californians have made it almost impossible to increase revenue -- but it remains fairly easy to increase spending and debt obligation. No wonder the system is ALWAYS in crisis.

Things that seem normal that aren't

[editor's note: I've been meaning to do this post for a while. I imagine it's the sort of post I could keep adding to for years and years.]

It seems to me that there are lots of things that SEEM normal in society that, when you actually stop to think about them, are actually very very strange. Here are a few:

1. Holy Communion (aka The Eucharist). The Roman Catholic Church teaches that through the process of transubstantiation the wafer and wine are LITERALLY turned into the body and blood of Jesus -- and then EATEN by the members of the congregation. That's not a typo or a misuse of the word "literally." Catholics believe that the wafer and wine are literally the body and blood of Jesus. So that means that 1.1 billion people on the planet practice cannibalism on Sundays to honor their creator. That's some crazy shit. And Protestant communion really isn't that much better is it? "Take and eat, this is my body broken for you." Really? Did I ask you to do that? I'm supposed to eat a representation of your body to honor a decision you made without consulting the rest of us? Really? What if I would have actually preferred for you to build an army, overthrow the government, and then pass universal health care instead?

2. Cheer leaders. At major sporting events, heck even at high school and junior high sporting events (and pee wee football games!) we take the prettiest girls from the surround area, dress them in the skimpiest outfits imaginable, and have them act as public emotional fluffers for the boys/men playing in the sporting event and the partisans who watch them. That's some crazy shit. And culture is powerful enough that many girls/women actually seek to perform these roles -- the task is seen as desirable and status producing. When I see college sports, with male "yell leaders" hoisting young women up for display or throwing them in the air, I feel like it is some weird Druidic taunting of the opponent -- like 'look at how hot our women are -- you can't have them because our warrior men (athletes) are so fierce.' But really, it seems that cheer leaders are the prize that the two teams are competing for -- because everyone knows that women prefer the alpha males. Cheerleaders are like the brief case full of cash that gets put on the table in the final round of the World Series of Poker -- letting everyone know what they are really playing for. And that is really really weird when you think about it.

3. Horror movies. In our country and indeed around the world, people pay money for entertainment which consists of moving images of young women (some young men, but mostly young women) being tortured and killed in the most gruesome ways imaginable. It is considered normal to consume this entertainment with friends or even a "cool" date. And often, these brutal sadistic images are considered funny. Again, that's some really weird shit when you think about it.

That's what I got for now. I'm sure other examples will come to me. If you have any examples of "thing that seem normal that aren't" I'd welcome them in the comments.

Providing Health Care is Like Building a House

Atul Gawande, has an article titled "The Cost Conundrum: What a Texas Town Can Teach Us About Health Care" in the June 1, 2009 edition of The New Yorker. The article is a must read for anyone hoping to understand the importance and complexities of health care reform in the United States. Gawande, author of Better: A Surgeon's Note on Performance, is increasingly becoming the Malcolm Gladwell of health care writing. Like every New Yorker article, it's really damn long, but if you only read 2 paragraphs, read these:

Providing health care is like building a house. The task requires experts, expensive equipment and materials, and a huge amount of coordination. Imagine that, instead of paying a contractor to pull a team together and keep them on track, you paid an electrician for every outlet he recommends, a plumber for every faucet, and a carpenter for every cabinet. Would you be surprised if you got a house with a thousand outlets, faucets, and cabinets, at three times the cost you expected, and the whole thing fell apart a couple of years later? Getting the country’s best electrician on the job (he trained at Harvard, somebody tells you) isn’t going to solve this problem. Nor will changing the person who writes him the check.

This last point is vital. Activists and policymakers spend an inordinate amount of time arguing about whether the solution to high medical costs is to have government or private insurance companies write the checks. Here’s how this whole debate goes. Advocates of a public option say government financing would save the most money by having leaner administrative costs and forcing doctors and hospitals to take lower payments than they get from private insurance. Opponents say doctors would skimp, quit, or game the system, and make us wait in line for our care; they maintain that private insurers are better at policing doctors. No, the skeptics say: all insurance companies do is reject applicants who need health care and stall on paying their bills. Then we have the economists who say that the people who should pay the doctors are the ones who use them. Have consumers pay with their own dollars, make sure that they have some “skin in the game,” and then they’ll get the care they deserve. These arguments miss the main issue. When it comes to making care better and cheaper, changing who pays the doctor will make no more difference than changing who pays the electrician. The lesson of the high-quality, low-cost communities is that someone has to be accountable for the totality of care. Otherwise, you get a system that has no brakes. You get McAllen.

[Full article available here.]