Thoughts on the Future of Labor and Wages

One of the pivotal issues in the presidential election was the decay of the middle class.  Manufacturing jobs have fled to other countries and automation has taken its toll.  Significant numbers of desperate voters turned to Trump as a possible savior, believing that his promises to punish corporations who were shipping jobs overseas and negotiate new trade agreements with low-wage economies like China and Mexico would restore American economic prowess and herald a renaissance of middle class wages and jobs.

Much has been written about how complex trading relationships are and how an aggressive stance on trade may backfire.  At a minimum it seems likely that forcing a turnaround in our trade deficit would end up making products more expensive in the U.S.  The simple fact is that labor is cheaper in other nations and if products are made here then they will ultimately be more expensive. 

This in itself would not be a bad thing from my perspective, but more expensive products would probably reduce overall demand for products and the net effect might actually be worse than the status quo for the general population.

But I do not believe that the future holds any real hope for a return of manufacturing jobs.  The true culprit is not outsourcing but rather automation.  Outsourcing accelerated the disappearance of those jobs, but they are destined to decline because of relentless automation. A fix for trade deficits and outsourcing is a short-sighted band-aid for the larger problem.

When automation hit agriculture during the industrial revolution the impact was dramatic, but agricultural workers flocked to the cities and found manufacturing or service jobs to replace their work on the farms.  A long, painful process was necessary to find a new equilibrium (child labor laws, unions, safety regulations, etc.), and world revolution was narrowly avoided, but eventually a relatively happy state was achieved.

An optimist might say that the current evolution away from industrial jobs will also find a new, happy equilibrium.  But there are reasons to doubt that such a pain-free future will unfold.

Automation eliminates jobs. The only way to replace those jobs with similar manufacturing jobs is to create more products.  But at some point there is a saturation effect.  Human beings can only make use of so many products.  We are already seeing that most of the new jobs in our economy are ‘service’ jobs.  Service jobs are generally lower wage jobs than those in manufacturing.

There is a second factor at work here – the impact of women working.  Since the second world war, women have joined the workforce in ever greater numbers.  Indeed, having two wage earners in a household is seen as an unavoidable fact of life by most people.  The double income family has more earning power and provides a woman with the possibility of a fulfilling career.  But it also puts tremendous pressure on the family in terms of focus, free time and flexibility.  As I pointed out in a previous post, the double income family also plays a role in increasing the income disparity between the classes.

One possible solution to increasing automation and a dearth of higher wage jobs would be to decrease the number of days/hours that are worked by the average worker.  In essence this would be a form of job sharing and would increase the number of available jobs.  The work week decreased from six days to five in the early years of the twentieth century.  Is there any reason it can’t decrease further?

The argument against this change is that it would result in lower incomes for families and start a recessionary cycle of decreasing spending/demand and further loss of jobs.  However, in theory the cost of products should also decrease with increasing automation, as the labor required to manufacture and even to distribute products would be lower.

There is a type of optimism that argues that new forms of labor will replace the industrial labor in this coming post-industrial society.  We have already seen that the computer revolution has produced many new jobs in the so-called ‘knowledge’ industry.  It is tempting to imagine an endless array of ‘on-line’ jobs that will become available for displaced industrial workers.

However, there are obstacles to this type of job growth.  Knowledge jobs require much higher intellects and job skills than industrial jobs.  Furthermore, it seems unlikely that the number of knowledge jobs created could ever compensate for the jobs lost in manufacturing, textiles and other industries affected by automation.

That leaves service jobs as the only real alternative for job growth if we cannot accept job sharing or a shorter work week.  The move from industrial jobs to service jobs is a phenomenon that we have already begun to experience.  But service jobs generally have low salaries and the income disparity that results is very corrosive in a society.  Market forces have generally kept service job salaries very low, but that may have to change if we are to avoid all of the unpleasant and potentially dramatic ramifications of our increasingly class riven society.

I am not a pessimist at heart, but I do not see an easy solution to our current economic travails.  The revered ‘marketplace’ may eventually sort it out, but a little social engineering may be necessary to preclude a further deterioration of our civil harmony.

Empathy

One of the most important human attributes is empathy.  The dictionary definition is ‘the ability to understand and share the feelings of others’.  Empathy is the primary means for people to make progress in resolving their differences.  If you cannot understand what another person is feeling, then it is almost impossible to reach out to them in a way that will bridge the gap.  If you have no empathy, then your only means of interaction is to attempt to dominate or overwhelm your adversary and make them subject to your way of thinking.

Unfortunately, showing empathy is not an accepted attribute of leadership.  Empathy requires an admission of the ambiguity and nuance of human affairs.  Most people are not comfortable with ambiguity.  They crave certainty.  That is why demagogues are so successful.

One of the reasons I have found Obama such an incredibly appealing President and person is that he has a very strong inclination toward empathy.  He does not outright condemn other cultures or countries or even political views, and he tries to put other opinions into perspective and give them respect.  Many people see this as weakness.  They accuse him of going on apology tours and weakening the status of the U.S. in the world.

When people think of a strong leader, they equate strength with absolute conviction and dramatic declarations.  To be sure, when a country is facing a desperate situation and at the brink of destruction, strong leadership of this nature with no hint of doubt or hesitation is necessary.  The belief that any show of softness or empathy would demonstrate weakness and invite more aggression is reasonable and must be considered in such situations.

But leadership in this era of globalization and rapid change is no longer simply a matter of standing strong against an implacable foe. The world is integrated as never before and we can no longer afford to lead by posturing as the world’s only moral nation, as a people who are never wrong and have no weaknesses or failings.  We must acknowledge and comprehend the diversity in this world by empathizing with others, understanding their point of view, even when we do not necessarily agree with it.

We accept and celebrate empathy when it is in a religious leader like the Pope or the Dalai Lama.  But would it not be just as appropriate for a political leader who is engaging with other nations and peoples?  Isn’t it time for these leaders to project a moral and ethical message that is honest and thoughtful? 

Within our own land we see so many missed opportunities for empathy and it is at the core of our fractious political life.  Can I as a progressive not empathize with those who are frightened by the changing fabric of our society, who see their old world disappearing?  Is it so hard to empathize with the plight of those whose jobs have fled overseas and feel anger at the smug attitudes of the so-called liberal elite?  Conversely, can those on the right not empathize with African-Americans who are stymied by intractable poverty and hopelessness, and outraged by the parade of videos clearly showing tragic, unnecessary shootings of unarmed young men?  And can African-Americans not empathize with the incredibly challenging situations that police in urban settings face on a daily basis, whether black or white? 

If people could start with empathy, acknowledging the fears, concerns and hopes of their adversaries, avoiding the simplistic labeling that constructs a deep chasm – racist, elitist, xenophobe, socialist, sexist, radical – and carefully analyze problems with data and an open mind, then perhaps we could get past the entrenched ideological stalemate that seems to have gripped our country.

Reflection on the Election

Like many of my friends, and indeed perhaps half of the nation, I was in shock and depression after the Trump victory.  I felt a bit of apprehension before it occurred, but I discounted the close polling as somehow reflective only of the normal liberal conservative divide, and believed that many of the conservatives would in the end find it impossible to vote for a man such as Donald Trump, even if they could not vote for Clinton.  I was wrong.

So what does it all mean and how will things go on from here?  Much has been written about how Trump managed to win over so many white voters.  Upon reflection it seems fairly simple to me.  One portion of the Trump supporters embraced him as an unapologetic voice against progressive values.  They want immigration trends reversed and illegal immigrants deported; they believe African-Americans must take responsibility for their own problems; they believe climate change is a left wing conspiracy; they think Obama has weakened the US in international affairs; they want to roll back entitlements; and they want to eliminate Obamacare.

These are the people that would have voted for any republican nominee, even an axe-murderer.  They would not be deterred by major character flaws in their candidate, no matter how egregious they might be.  Indeed, the flamboyant and bellicose character of Trump excited them and whipped them into a frenzy of giving the middle finger to the ‘system’ and voicing a newfound joy of political incorrectness!

The other large group of Trump supporters crossed over from the labor union side of the democratic party.  They were seduced by Trump’s claim to know how to ‘fix’ the economy.  Out of desperation, they were ready to be true believers.  And sadly, they too found the racist, xenophobic, and even the misogynistic rantings of Trump somewhat appealing.  They had previously embraced liberal leaders only because the democrats had established themselves as the friend of labor.  The sad state of the middle class in the current economy severed those bonds and left them adrift where they were easy prey for a demagogue.  Disruption is inevitable in times of transition.

The last group, smaller but decisive, was the independents who held their noses and voted for Trump because they had become convinced that Hillary Clinton was not to be trusted and they believed the false (in my opinion) equivalencies drawn between Trump and Clintons’ flaws, transgressions and character.  The Hillary hate campaign was incredibly effective in this regard.

Combine all of this with a heavy dose of apathy in the African American community – almost a sense of fatalism – and voila, Trump wins!

There are many potential ramifications of this result.  With a republican congress generally supporting him, Trump can impact a lot of things fairly quickly – immigration, energy and environmental policy, financial regulations and some foreign policy decisions (Iran, Syria, Cuba).  We can only hope that the damage is temporary and not cataclysmic.

But ironically, the most important issue for his supporters, and the one that really powered Trump into the White House – the economy – will likely be much more resistant to change.  Even if he is able to enact tariffs on certain trading partners – and this is not something that the congress will necessarily greet with enthusiasm, free trade being a long-held Republican ideal – their impact could very possibly be negative rather than positive, i.e. make consumer goods more expensive without bringing back jobs.

People are generally clueless about the economy.  It is simply too complex for the average citizen to understand in any deep way.  Even the most respected economists differ greatly on how to address macroeconomic issues.  A country is VERY different from a business.  The belief that Trump’s success as a businessman, which is certainly not a universally-accepted fact in itself, will translate into success for the national economy is simplistic almost to the point of self-delusion.  The last much-heralded titan of business who entered the White House was Herbert Hoover, and his commercial genius ushered in the Great Depression!

Trump’s best hope for economic success is probably deficit spending in the form of vastly overdue infrastructure improvements.  Obama has been trying to promote such improvements throughout his tenure as President with little success because of the gridlock in congress and the fear of the growing national debt.  But now that it is a conservative idea, it may get some traction . . . .

The sad truth is that middle class manufacturing jobs are unlikely ever to return in great numbers.  The automation and globalization genies are out of the bottle and no amount of demagoguery will put them back.  We face a brave new post-industrial world in the labor market, and we will probably have to go through a lot more pain before we evolve into a sensible new order that will not leave millions out in the cold.

So good luck Trump!  I really do wish you well.  Not because I have even the slightest admiration for you as a person.  I believe the way you ascended to the Presidency is the most pathetic spectacle I have witnessed in U.S. political life.  I wish you well because I want our nation to survive and, ultimately, to thrive.  It will most likely have to do that in spite of your leadership and policies rather than because of them.  But if it does I will be happy, even if it means that your petty but gargantuan ego can lay claim to having saved the republic.

Sexual Predation

It is ironic, although certainly not entirely unexpected, that the final nail in Donald Trump’s coffin will be driven in by a legion of women coming out with stories of groping, harassment and unwanted sexual advances by the Republican nominee for president.  Ironic, because the Republican Party considered itself well established as the party holding the moral high road after Bill Clinton’s sexual misconduct.  And not entirely unexpected, because any fool could have predicted from first glimpse of ‘the Donald’ that his past must be a veritable treasure trove of sexual improprieties.

This may go down as the year when society finally became fully aware of the extent of sexual predation in our social interactions.  From the Stanford swimmer who was caught attempting intercourse with an almost unconscious woman to the army of sports figures and celebrities who are implicated in rape and domestic violence, to Mr. Trump and his incredible hot mike recording with Billy Bush.  After this recording went viral, millions of women came forward with stories of their own encounters with sexual predators.

Sexual predation is clearly more about power and control than it is about sex.  Most men have strong sex drives.  But a normal, healthy sex drive is oriented around mutual attraction, affection and consent.  A healthy, well-adjusted man may desire an attractive woman he encounters, but he would never make an overt sexual gesture such as kissing, touching or even verbally suggesting sexual activity unless he received a clear signal that the woman is a willing participant. Indeed, the quickest way to turn off a normal man is to show indifference, contempt or resistance to his sexual interest.  This should douse the flames immediately.

Any sort of pleasure that a man feels in forcing a sexual encounter is out of the realm of normal sexual behavior.  It is the perverse pleasure of a bully or a psychopath.  It is the sad expression of some serious psychological flaw.

When a man forces a kiss or gropes a woman’s breast or vagina, or even propositions her, it is a pathetic attempt to overcome feelings of inadequacy or insecurity.  It is the expression of a frantic need to be powerful and in control.  It has little or nothing to do with sexuality in any healthy sense, but rather is exploiting a sexual urge to establish dominance.  It is conflating a healthy human desire with a sordid, perverse need to produce a toxic, anti-social action.

So called ‘locker room’ talk is something every man encounters.  Some participate and some do not.  It occurs most often in one’s youth, in gym class or on sports teams, hence the term locker room.  For the most part it consists of boys talking in sexist terms about girls’ looks and bodies, and speculation or even bragging (often on a fictional basis!) about sexual activity in raw language.

But in my experience it does not include talk of sexual predation.  I cannot recall boys or men bragging about how they could force themselves on women or do things without their consent.  Even in my time in the Navy on a submarine where sexual banter was endemic, I rarely heard men describe forcing themselves on women.  And when they did, their comments were greeted with an awkward silence.  The majority of men know the boundaries.

This is not to say that men in general are not guilty of rampant objectification of women and misogynistic comments about them.  But there is a difference between predatory speech and typical male buffoonery.

Some will say that women invite sexual advances by dressing provocatively or emphasizing their breasts or other anatomical features.  It is certainly true that men find sexy outfits titillating.  But to imply that unsolicited sexual overtures are justified by any type of appearance is totally absurd.

Have men so little self-control or discipline that they cannot contain themselves in the presence of an attractive or even provocatively-dressed woman?  This seems to be the conclusion that society long held and that certain cultures still hold today regarding female attire and this is why historically women all over the world have been forced to wrap themselves from head to toe outside of the home.

Blame will also be placed at the foot of our more permissive, sexually liberated society.  This is surely specious reasoning, as predatory sexual behavior has been around for all of human history, and may even have been worse before women gained some level of liberation and power.  Sex is no longer a taboo topic, hidden behind closed doors fueling massive neuroses throughout society.  Its liberation may cause some degree of discomfort and has certainly challenged our way of dealing with it, but there is nothing in the new openness of sexuality that justifies sexual misconduct.

It is now time for men to draw clear lines around acceptable sexual behavior, and more importantly, to communicate to other men that they will no longer laugh at predatory language or jokes, or shrug off the claims or bragging of the predators themselves.  Silence is equivalent to approval.  Sexuality is a beautiful and exciting part of life, but like many beautiful things, it must be protected from toxic and malevolent forces.

Climate Change and the Election

If there is a single issue that a rational person could choose to make a decision on voting for Hillary Clinton instead of Donald Trump I would argue that it is climate change.  Trump has labeled theories of climate change as ‘bullshit’ and ‘a hoax’.  He has vowed to cancel the Paris Climate Agreement, to rescind the Climate Action Plan, to save the coal industry and to eviscerate the EPA.

Climate is a complex phenomenon.  A complete understanding of its trends and future will elude us for the foreseeable future.  But are we really willing to take the chance that climate change is not real?  Every major scientific organization in the U.S. has endorsed the theory of climate change and the influence of human factors on it.  Here are just a few of them:

• ·         National Academy of Sciences - "The scientific understanding of climate change is now sufficiently clear to justify taking steps to reduce the amount of greenhouse gases in the atmosphere.”
• ·         American Association for the Advancement of Science - "The scientific evidence is clear: global climate change caused by human activities is occurring now, and it is a growing threat to society."
• ·         American Chemical Society - "Comprehensive scientific assessments of our current and potential future climates clearly indicate that climate change is real, largely attributable to emissions from human activities, and potentially a very serious problem."
• ·         American Geophysical Union - "Human‐induced climate change requires urgent action. Humanity is the major influence on the global climate change observed over the past 50 years. Rapid societal responses can significantly lessen negative outcomes."
• ·         American Medical Association - "Our AMA ... supports the findings of the Intergovernmental Panel on Climate Change’s fourth assessment report and concurs with the scientific consensus that the Earth is undergoing adverse global climate change and that anthropogenic contributions are significant." 
• ·         American Meteorological Society - "It is clear from extensive scientific evidence that the dominant cause of the rapid change in climate of the past half century is human-induced increases in the amount of atmospheric greenhouse gases, including carbon dioxide (CO2), chlorofluorocarbons, methane, and nitrous oxide."

Climate science skeptics will argue that satellite data does not support the warming trend that earth scientists record very clearly (Ted Cruz has promoted this specific critique).  Never mind the fact that there is ample evidence that satellite data is seriously flawed. They will also say that climate change is not ‘settled science’.  In this modern age of social media where every opinion and every set of ‘facts’ is propagated endlessly the ‘truth’ can be hard to discern.   However, it takes a very stubborn skepticism to argue against ALL of the major scientific communities.

And even if one is skeptical, can it possibly be a prudent position to completely reject the risk of climate change and its possible consequences?  Only a fool would be adamantly opposed to careful consideration of this issue – to roll the dice and simply hope that climate change isn’t true or that its impact won’t be catastrophic.

It is somewhat understandable that conservatives fear the potential economic impacts of large scale emission control programs.  No one wants our fragile world economy to be unnecessarily hampered by new regulations or imposed restrictions on energy and commerce.  But what about the economic impact of climate change itself?  If recent events are any indication of what we are in store for in the future, then the costs of wildfires, droughts, floods, storms, famine and a myriad of other potential consequences of climate change – not to mention the political fallout of refugees and global conflict -  will make the control of emissions look like the best economic bargain in history.

Delaying a serious and considered handling of the climate change issue for 4 or 8 more years is perhaps the single biggest blunder our nation could make.  The U.S. needs to demonstrate global leadership on this issue and is perhaps the only nation qualified to do so.  It is clear that this will not happen with Trump.  This is reason enough to completely reject his candidacy.

The Insidious Nature of Boredom

The sentence ‘I am bored’ is probably one of the most frequently used sentences in the English language.  Children learn it early in life and recite it endlessly during long summer vacations or family car rides or moments of exasperation with various tasks or chores.

In its youthful form, boredom is generally a temporary state, brought on by either the lack of obvious play scenarios or by forced participation in an activity that holds no interest.  A child may be bored one second and merrily engaged the next in some new activity.  The mercurial nature of the child generally vanquishes boredom pretty easily.  Childlike curiosity and energy win the day, because there is almost always something new to discover.  But from adolescence on, boredom can be a more complex phenomenon that can easily skirt the edges of lassitude and ultimately plunge one into the abyss of depression.

Of course adult boredom can be as banal as childlike boredom – the boredom of a long meeting, the boredom of a vapid conversation, the boredom of a book that has lost its appeal or a formulaic movie.

But in many cases, to be bored as an adult is no longer the state of having nothing to do or perceiving a single, specific activity as boring, but rather finding no compelling reason to do anything! This sinister species of boredom – a writer’s block of the soul - seems almost nonsensical at first glance.  Why would human beings be so easily bored in a world that has endless possibilities of activity, both intellectual and physical?  A boredom of this nature would seem almost to indicate a very flawed character, a dearth of imagination or curiosity.  Yet, it is endemic in modern civilization and affects legions of otherwise industrious and energetic souls who find themselves inexplicably stricken by a melancholy boredom from time to time.

Why does the infection of a bored lethargy lurk so close to the human psyche, and how does one find an antidote?  Why do some people seem endlessly energetic and buoyant while others grapple constantly with a debilitating ennui?

In my life I seem to vacillate between extremes.  In one moment I am ecstatically imbued with almost superhuman energy and passion, engaged in multiple activities and joyfully contemplating each new endeavor.  Each activity seems to hold endless fascination for me and I almost vibrate with a mad desire to experience everything and master as much as humanly possible.  I am bewitched by the endless possibilities of engagement and reluctant to leave my tasks even to eat or sleep.

But those same passions can be cast aside in paralyzing indifference when I find myself in the clutches of a bored state of mind. The powerful elixir of playing guitar or writing songs that provides me such exquisite pleasure on one evening can seem dull and meaningless to me the next.  I can catalog through the bountiful list of hobbies and interests that are normally a bottomless treasure trove and find not a single item that beckons to me.  It all seems so purposeless.

Sometimes in this state of listlessness I can trick myself out of the ensuing despondency by starting an activity with little or no hope for pleasure.  If I am fortunate, I find myself slowly drawn into its inveterate magic.  Often this will break the spell of boredom and return me to my happy, energized self.

But other times the spell is not to be broken, and I lurch from activity to activity with heavy heart and find nothing to awaken the child within.  In these moments I begin to despair that I have lost the thread of jubilant exertion.  Perhaps I am peering into the chasm of depression.

When I was in college I took a class on the writings of Jean Paul Sartre.  His book, La Nausee, made a strong impression on me.  The protagonist, if he can be regarded as such, is overwhelmed by a ‘nausea’, an awareness of the absurdity and meaninglessness of existence – a glimpse into ‘nothingness’.  But somehow he is able to comprehend and accept pure existence and find the courage to overcome his nausea and live ‘authentically’.  It was somewhat unclear to me whether living ‘authentically’ is supposed to give our lives meaning in spite of the absurdity of existence.

When I am experiencing a time of ‘boredom’, I think about existentialism because the strongest quality of my boredom is a sense of futility, of meaninglessness.  I perceive every possible activity as repetitious and pointless.  As a person who has not embraced atheism but remains rather ever-optimistic that there is indeed a higher order or divine state of being, I want to reject and overcome this flirtation with nihilism.  But my best efforts to do so are not always immediately successful.  Fortunately, the passage of time eventually clears the miasma of my ennui and I can once again throw myself into an activity, albeit without ever solving the puzzle of why such attacks occur.

Here’s hoping that my more ebullient nature and native curiosity are able to continue to triumph over the insidious threat of boredom.  I will certainly do everything I can to ensure that they do!

E=MC² and Other Spiritual Matters

Energy is matter times a constant!  That was a revelation from the great Albert Einstein, the culmination of a century of incredible progress in scientific knowledge that set the Newtonian world on its head and ushered in a new age of uncertainty in science where there had previously been unbridled confidence.  For even as this discovery and others that created the fields of quantum mechanics, particle physics and relativity allowed us to harness the energy of the atom and create nuclear weapons and power, we also found ourselves opening new doors faster than we could understand the rooms we were entering.

Now the once unchallenged belief that science would ultimately clearly define everything in our universe and provide clear guidance for our lives and experiences has been more or less abandoned, and scientists have declared themselves satisfied to explore the mystery and the beauty of the universe without a clear path to total comprehension!  (This is of course my interpretation and may not represent the views of actual scientists J)

But what indeed are matter and energy?  As our concepts of matter have evolved we have found ourselves chasing an ever more elusive final tally of matter’s constituent parts – compounds, molecules, ions, atoms, protons, electrons, neutrons, fermions, bosons, leptons, quarks, neutrinos and so on. 

And even as the names of these particles have become familiar to us, their nature has been stubbornly resistant to any “sensible” description.  Are these pieces of matter ‘particles’ or ‘waves’?  They are both!  Do electrons really orbit around nuclei like small solar systems?  No, they appear to be a probability cloud of charge and energy!  They are everywhere and nowhere, phantoms that can only really be conceptualized through quantum physics equations and mathematics.

Energy is even less comprehensible than matter, if indeed we can even regard energy as a different phenomenon.  We have deluded ourselves about energy for a couple hundred years, pretending to understand electricity and magnetism, different types of heat transfer, kinetic and potential energy, and even nuclear energy.  We have become comfortable with its use and speak glibly of its properties, but energy remains just as mysterious and unseen to us in the 21^st century as it did to the ancients.

In the end, the conceptual models we were comfortable with had to be abandoned and new ones attempted that are much more abstract and difficult to grasp.  But the models are not the essence of what we are experiencing.  The ‘essence’ is the way that these physical phenomena impact our lives – their enduring truths!

Perhaps the abstract natures of matter and energy, and their complex but intimate relationship, have something to teach us about flesh and spirit.  Just as our material selves have been exposed as something quite different from what we historically conceived, so perhaps are our spiritual selves in need of a ‘quantum’ leap in understanding.  Our concepts of spirituality and its relationship to the material world have not evolved significantly over the past two millennia.

Of course many will argue that our understanding of the spiritual world has indeed evolved – that a great number of people have totally rejected religion and any idea of a divine or spiritual realm.  This is certainly true, and a great many of those that reject these ideas are scientists.  The ancient models of religion that incorporate a distinct and separate God on high with a heaven and hell seem nonsensical at a time when we have extensive scientific knowledge that appears to refute many of the underpinnings of this type of theology.  Our literal interpretations of scripture have painted us into a corner, but we are reluctant to abandon the models we have relied on for centuries for fear of finding ourselves with an amorphous spirituality that has no real doctrine or ritual.

But an amorphous, untethered spirituality would be loosely analogous to the mysterious nature of the physical world that we explore through science.  A world where certain truths shine through the haze, but where our imaginations struggle to grasp or categorize the phenomena in any comfortable way.

In the end, spirituality and theology are tasked with identifying basic truths about our existence - its meaning and purpose.  Does it really matter what types of models and frameworks we use to discern these truths?  Is God a human-like deity or rather some form of energy?  Is heaven a place of eternal bliss or rather a probability cloud of energy and charge that our own inscrutable ‘matter’ inhabits for eternity in various forms? 

These are fascinating questions and worthy of deep contemplation by those whose passion lies in this domain, but it is more crucial that we confront the spiritual truths that every human attempt at spiritual identification seems to impart – that compassion and love are paramount and profoundly motivating despite the human inclinations toward greed, power, lust and violence; that humility and generosity are more deeply satisfying than selfishness and vanity; that our needs for community and social interaction and harmony trump the disparate forces that alienate and estrange us.

Our pursuit of spirituality in the form of world religions has long been a self-contradictory force in the world, providing solace to many, inspiring incredible acts of love and compassion, but also inspiring hideous forms of prejudice, self-righteousness, exclusion and even violence.  If we could take joy and comfort in the spiritual models that are our cultural heritage yet not regard them as absolute and rigidly literal perhaps we could come closer to living out their spiritual truths.  Like the modern physicist, let us embrace mystery and revel in its beauty and complexity, trusting that the beautiful universe that we inhabit will not let us down.

The Mystery of the Trump Candidacy

The candidacy of Donald Trump continues to mystify me, because I cannot comprehend how such a distasteful person can be so enthusiastically embraced by so many Americans.  In attempting to understand this rather disturbing phenomenon, I have come up with the following ideas or observations:

1.      America’s fascination with celebrity and wealth – A significant part of our population is obsessed with the lives of the rich and famous; possessed by an almost religious awe of these TV and cinema figures that causes them to ascribe special powers and insight to them.  Trump supporters are somehow willing to overlook hideous character flaws in the hope that his business and Reality TV success can translate to similar marvels for the nation.

2.      A population of desperate economic left-behinds – The US economy is in a post-industrial transition.  Globalization and immigration have conspired to create a deep fear of economic doom in many quarters.  The three major complaints are that (a) jobs have fled overseas or been outsourced, that (b) unfair trade practices have eliminated jobs, and (c) that illegal immigrants have taken many of the remaining jobs at the lower end of the economic spectrum.  Add to this the elimination of many jobs due to automation and you have a perfect storm of economic despair for some part of the population.  Poor job prospects can understandably lead to desperate acts, and those affected will grab onto anything that promises relief, even if there is not a shred of evidence that the proposed solution is realistic, or, as in the case of Trump, the only ‘proposal’ is to ‘make better deals’ and ‘win’.  Economics is a complex topic and people do not generally have the patience or the intellect to see past the demagoguery and simplistic declarations.  The truth is that there is no simple quick fix to our economic challenges and the only sensible course is to pursue carefully planned and researched bi-partisan policies that will hopefully create new jobs without jeopardizing the fragile recovery from the near economic disaster of 2008.  But people don’t want to hear that.

3.      Fear of the ‘New America’ or Decline of the ‘Real America’ – Change is always unsettling.  For some part of America the many changes in our society have sparked a frantic sense of isolation and alienation.  This is not a new phenomenon – every wave of immigration and flurry of social change has produced a similar reaction.  However absurd it may seem, Trump seems to represent a return to a more comfortable and familiar world.  What are the changes that people seek to turn back?  Ethnic and religious diversity is probably the most prominent, especially as it also incorporates the economic fear of immigrants taking away jobs, and the security fear of fifth column terrorism.  The increasing indifference to religion and the growth of agnosticism and atheism – a general sense that we are ‘turning away from God’ and no longer the Christian nation that the founders built – is another big one.  Then there is the continuing liberalization of views on sexual orientation and sexual activity, which is seen as a corollary to the rejection of Christian faith and morality.  Add to that the racial tension that appears to have heightened in recent years due to the public focus on police shootings and treatment of black men, and the fear that crime and drug addiction are on the rise and that our society is at risk for some sort of orgy of violence and decay.  These changes are real, but they have been amplified through the right wing blogosphere and media to create a sense of impending doom and disintegration of the America that we knew and loved!  Trump has harnessed this unease and ‘dared’ to speak out in incredibly racist and xenophobic ways that are interpreted as courageous because they flout the conventions of political correctness.  I would argue that reality TV and social media have de-sensitized us to this type of incendiary speech.  Thoughtful, respectful dialog is no longer valued by the general public because it has no drama and will not attract views, shares and ‘likes’.  Political correctness may indeed have been pushed too far, but the race-baiting and xenophobia of Donald Trump will only exacerbate the situation, not improve it.

4.      The Scary World Disorientation – The rise of ISIS, replacing Al Qaeda and Osama bin Laden as the new American nightmare, has people understandably on edge.  We are also seeing the resurgence of Russia and the growing challenge of a more aggressive China.  Tough, xenophobic talk and promises of dramatic action are always the easiest way to comfort and reassure a nervous public, even if they would obviously play into the hands of our adversaries.  Trump has mastered the art of the demagogue and armchair warrior.  Careful diplomacy and long-term military strategy are clearly the required attributes of the next US president, but a significant number of people will be dazzled and bewitched by saber-rattling and chest-beating.  Some people long for the good old cold war days when we stood on the brink of total annihilation of the human race but didn’t have to fear a bomb or some nut with an AK-47 at our local shopping center.  We all would love a quick fix to the terrorism problem, but beware of anyone who promises one!  As we have seen in the past, today’s quick fix is tomorrow’s unintended consequence that turns out to be worse than the original problem.

These are a few of the conditions that appear to buttress the Trump candidacy.  In previous blog entries I have expressed my fear that Trump is a megalomaniac not so dissimilar to the likes of Mussolini (whose bluster and facial expressions he seems almost to mimic) and Hitler.  With our long history of democratic rule and the relative stability of our nation it is unlikely that a Trump presidency could devolve into a tyrannical state.  However, one cannot dismiss the dangers associated with a personality like Trump - a man who:

1    1.   Engages in the lowest forms of insult and slander of his opponents to gain favor with an audience.
2.      Tells lie after lie and refuses to acknowledge or correct them.
3.      Is extremely thin-skinned, has absolutely no self-humor and is hyper-sensitive about any criticism.
4.      Brags about himself and his accomplishments with not the slightest hint of humility.
5.      Never backs down from a quarrel, but rather doubles down and escalates in all cases.
6.      Rarely takes the advice of others and relies almost solely on instinct and reaction.
7.      Preens and gloats and struts with a smugness that masks a deep insecurity and a fearsome ego.
8.      Makes no apparent effort to master the details of any issue or topic or to acknowledge the complexity of problems he says he will ‘fix’
9.      Promotes the most absurd conspiracy theories such as the Obama birther theory, the rigged election theory, the theory that somehow Obama and the democrats are in league with terrorists or ‘Muslims’, the Obama as a secret Muslim theory, the Obama inciting race riots theory, etc.
10.  Ridicules or insults women, other religions, handicapped people, Hispanic people and anyone who disagrees with him.

These are the character traits of a dictator, a demagogue and a megalomaniac.  Putting a man like this at the helm of the most powerful nation on earth because he makes good theater might be the worst mistake that we could ever make.

The Curious Hagiography of Muhammed Ali

I will confess that I have always been a bit perplexed by the seemingly universal adulation of Muhammed Ali.  His death has prompted so many tributes that I am almost reluctant to express any reservations whatsoever about his place on the pantheon of heroes, but I will forge ahead anyway.

I can understand why Ali is a fascinating figure.  Certainly as an athlete he appears to have been uniquely gifted and convincingly successful (a career professional record of 56 wins and 5 losses).  What is even more remarkable is that he was able to achieve this record despite being suspended from boxing for three years during what could have been the most productive years of his career.

His athletic endeavors were accompanied by a penchant for publicity.  His professions of invincibility (“I am the greatest”) and his trash talking were as much a part of his persona as his success in the ring.  From the little bit of research I can do on the topic, Ali is credited with legitimizing trash talk and bringing it to an art form.  He even is credited with a full length record album consisting solely of trash talk that apparently sold quite well.

I have written previously about my opinion of trash talk and the decline of sportsmanship, so it should come as no surprise that this aspect of Ali’s fame leaves me rather cold.  But the story does not end there, and it is what Ali did after he achieved fame in the ring that secured his place in history.

Cassius Clay began his association with the Nation of Islam around 1961 and came under the influence of Malcolm X in 1962.  By the time he fought Sonny Liston in 1964, he was a Black Muslim.  He soon changed his name officially to Muhammed Ali, which was a pretty dramatic move in the mid-60s.  The new Muhammed Ali began speaking out very energetically on civil rights and black empowerment, taking a much more aggressive stance than the dominant civil rights leaders such as Martin Luther King, Jr.  He famously stated: "I am America. I am the part you won't recognize. But get used to me. Black, confident, cocky; my name, not yours; my religion, not yours; my goals, my own; get used to me."

Even his trash talking reflected his growing focus on black liberation.  He frequently referred to his opponents as Uncle Toms and ridiculed them for being part of the white establishment.  He referred to his birth name, Cassius Clay, as his slave name.

To African Americans who had grown up under almost apartheid conditions and, though grateful for the MLK inspired non-violence movement, thirsting for more triumphant and provocative claims of liberation and pride, Muhammed Ali was a potent symbol.  He was a fist in the face of the white plantation owner, a no excuses, stand-your-ground example of black manhood.

In this way, Muhammed Ali was transformed from a braggart to a prophet.  He was not afraid to provoke the white establishment, indeed he relished the opportunity.  And he went one step further: He refused to be inducted into the U.S. military on the basis of his unwillingness to fight for a country that was oppressing his race.  He said "Why should they ask me to put on a uniform and go ten thousand miles from home and drop bombs and bullets on brown people in Vietnam while so-called Negro people in Louisville are treated like dogs and denied simple human rights?"

His refusal to be drafted was not a simple publicity stunt.  It cost him about three years of his prime fighting period.  One has to respect the courage it took for him to stand by his principles and give up the lost income and opportunities.

This act of defiance, occurring at a time when even white young Americans were beginning to question the Vietnam War, created an impression of Ali that transcended his comic boasting and arrogance.  As one of the most famous athletes in the world during that period of time, his racial radicalism and anti-war stance took on a profound significance that propelled him to a place of status based on courage and independence rather than athleticism and self-confidence.

To better understand why Ali is so cherished, read Kareem Abdul Jabbar’s reminiscences: "I remember the teachers at my high school didn't like Ali because he was so anti-establishment and he kind of thumbed his nose at authority and got away with it. The fact that he was proud to be a black man and that he had so much talent ... made some people think that he was dangerous. But for those very reasons I enjoyed him."

The impact of Muhammed Ali and his place in history are unquestionable.  He is a symbol that encompasses much more than athletic prowess.  And he appears to have had a charm that few could resist.  There are few major public figures that have anything but high praise for Ali.  And all this from a man whose IQ was below the threshold that the Army would accept for recruitment until it reduced the threshold in 1966.  So add to his accomplishments the dispelling of the belief that IQ does anything but quantify a narrow range of potential.

I started out to write this essay with a view that Ali’s fame and exalted status were somewhat mystifying, but as I finish up now, having explored the topic and read quite a bit about the man, I am much more sympathetic to the prevailing interpretation of his contributions.  Rest in peace, Muhammed Ali!

The Future of Work

The ever-widening income gap, the loss of middle class jobs, the increasing automation of factories, services and agriculture all conspire to paint a fairly bleak picture of the future of work.  On the one hand, automation has long been anticipated as a solution to the de-humanizing aspects of industrialized work – the tedious assembly line job, the numbing repetitive work that so many laborers perform.  However, the prospect of no work at all for significant groups in society makes one rather nostalgic for the good old days of relatively low-tech factories, banks with human tellers, and other real people jobs.

Automation was supposed to free mankind from the drudgery of certain types of work and allow us to direct our energies toward more productive, creative and self-fulfilling endeavors.  But if that was the dream, the reality is rather disappointing, at least at this stage in the process.  Of course, the U.S. accelerated the transition by moving many of its middle class, industrial jobs to lower wage economies in a spasm of off-shoring and outsourcing that had nothing to do with automation.  This tsunami of job losses was probably much faster and more disruptive than a steady evolution of automation would have been.  But now, even with significant increases in manufacturing output in recent years, the number of manufacturing jobs is still a shadow of its former self, due in great part to gains in productivity and automation.  Factories that once hosted thousands of workers are now typically running with hundreds, and even the hundreds may soon be unnecessary.  The genie is out of the bottle.

The effect of automation is not limited to the manufacturing sector.  Many types of service jobs are also on the chopping block and easily replaced by robots and other high tech gadgetry.  Once the self-driving and navigating vehicle and associated robot are available (and that day is not far off), then many of the remaining service sector jobs will be readily accomplished by inexpensive, reliable and low maintenance (compared to messy human beings!) automatons.  We have already experienced a similar transition in the incredibly frustrating world of automated telephone support systems that take us on a Kafkaesque journey in every attempt to interact with a company or medical provider.

Were it not for protectionist efforts in many countries, farming would already be automated and collectivized to a very high degree.  Autonomous tractors, combine, spreaders and sprayers are already roaming across fields like some sort of dystopian nightmare, and agribusiness long ago accomplished the almost complete extinction of the family farmer in the U.S.

Automation in healthcare, legal work, accounting, construction and a host of other industries is certain to come before too long.

In theory, automation should ultimately reduce the number of hours of work that are required of every human being - a supposed blessing and desirable outcome!  But of course that is not how it is playing out.  Work is not reduced but rather jobs are eliminated.  The lucky, skilled and connected maintain their jobs and increase their income, and the unfortunate and unskilled find themselves in unemployment lines and rallies for Donald Trump.

It seems clear that some serious analysis and planning is needed to avoid a cataclysmic breakdown of our economic and social systems.  It is highly doubtful that the free market will resolve this fast-moving rupture in our economic fabric before major social unrest occurs.  A Darwinian approach is unlikely to produce a very satisfactory outcome.  

The last major technology shift, the industrial revolution, brought us perilously close to a world revolution.  The millions of lives lost in the Soviet Union, communist China and a host of other revolutionary attempts to counter the calloused indifference of free-market capitalists should serve as a warning.  If we do not act to make this next transition less traumatic then there will surely be hell to pay.

The dream of a less tedious work-life through automation is fast transforming into a nightmare of inequality and disorientation.  In the end, neither border walls nor artful trade negotiations and tariffs will do anything but provide short-lived band-aids for this societal hemorrhage.  The world is changing rapidly and our ability to adapt is dependent on bold new ideas for sharing work and creating new types of enterprise.

Of course if automation only serves to free us up for longer spells of watching TV and engaging in various forms of mind-numbing social media and virtual reality, then perhaps the real solution would be to fully embrace neo-ludditism and take hammer and chisel to the devices that have insidiously transformed us from master to slave.  Humans of the world unite, you have nothing to lose but your cyber chains!

Vanity, Envy and Competition Part 5

This is the final segment in my essay on Vanity, Competition and Envy.  Previously we have explored the tight relationship between our cultivated need for praise, our fragile egos, the endless oscillation between insecurity and vanity, and the envy that results or feeds this dynamic.

In this segment we will look at competition.  Praise, vanity, envy, insecurity – they all have at their core either an explicit or implicit comparison between ourselves and other human beings.  And that comparison is nurtured or confirmed through competition.

Of course there are times when we are praised for having done well in comparison to our own capabilities or previous accomplishments, but I would argue that these are the exception rather than the norm.  Almost every aspect of our culture and society is based on competition and there appears to be a basic assumption that the competitive spirit or drive is a fundamental and even desirable element of human nature.  Moreover, competition is seen in a generally positive light as the primary motivation for personal achievement, character development and the general progress of civilization.

But is this really true?  Is competition a positive force in our world?  Is it a necessary one?  When I think of competition I remember a Peanuts cartoon I saw long ago.  Linus is telling Charlie Brown about a football game he just saw on TV.  He describes in vivid detail over several panels how his team snatched victory from the jaws of defeat in the final seconds of the game.  He can scarcely contain his joy.  On the last panel, Charlie Brown, looking pensive as always, responds ‘How did the other team feel?’

The fact is that competition creates winners and losers.  In many cases, the winning and losing have only psychological impact, though clearly this impact should not be trivialized.  But in other cases, losing has more dramatic consequences – the failure of a business, the loss of prestige or reputation or self-confidence. 

There are numerous platitudes about the benefits of failure and losing.  Our culture accepts as orthodoxy that the struggle of life requires competition and that it is important to experience both winning and losing to develop character and resilience.  Indeed, there are many contemptuous references these days to a perceived tendency to make everyone a ‘winner’ – trophies or participation medals for every child in a sport and grade inflation at schools come to mind.

Losing and failure are declared to be prerequisites for later business success by every entrepreneur and executive on the motivational speaking circuit.  The idea that people learn from mistakes does indeed seem to be a truism.  But is a competitive environment required to create the conditions for the crucible of success and failure?  Could cooperation be just as effective for development of character and capability, but far less damaging than competition?

Much of my life has been characterized by competition – in school, in sports and in business.  The moments of winning, of being acclaimed as ‘better’ than my competitors, were stimulating, but they were also unsettling, creating a separation between me and my competitors that was at turns awkward and alienating.

A competitive instinct is viewed as a favorable character trait, as in ‘that person is a real competitor’, or ‘he/she has a real competitive drive’!  But how is this competitive spirit different from a basic energetic trait?  What we are really saying about a person is that they will work hard, overcome obstacles and endure heartache, pain and fatigue (and even failures or setbacks) to succeed.  Does that character trait have to be defined in terms of beating someone else at something or proving someone is better than someone else?  Aren't the characteristics commonly associated with a ‘competitor’ – work ethic, resilience, energy, passion – valuable and commendable qualities in any endeavor, and particularly well suited for working cooperatively?

Would focusing human energy more on cooperation rather than competition be a laudable goal of 21^st century society?  Can human passion be developed to as high a level when there is a common goal rather a prize that can only be defined or won by beating or diminishing another? 

Cooperation would not imply an easy path with no frustration or disappointments.  All human activity is subject to the vicissitudes of success and failure, of agony and ecstasy.  The difference is where the motivation lies – in achievement for the sake of a group and one’s own self-fulfillment rather than proving oneself better than others.

Competition was a necessary by-product of our quest for survival and progress in the first fifty thousand years of our evolution.  But perhaps cooperation is the key to the human race surviving the next few millennia!

21st Century Fascism

Donald Trump continues to defy all expectations.  His surprising popularity has been analyzed every possible way, and it seems to rise in almost inverse proportion to the condemnation he receives from every quarter.

The question for me is whether Trump is truly the neo-fascist that he appears to be, or whether he is masquerading as one in a cynical but clever ploy to gain the nomination.  He has been compared with Il Duce (Benito Mussolini of the ‘glory’ days of the short-lived Italian empire in the 1930s) because of his huge ego and his smug proclamations.  Indeed, the continuous smirk on his face and his puffed-up demeanor are amazingly similar to those of Il Duce.

Calling Trump a fascist is not really an exaggeration.  Fascism has the following characteristics:  a fanatical demagogue as a leader; a maniacal embrace of nationalism; a set of enemies that are blamed for the current perceived downfall of the state (e.g. immigrants, Muslims, blacks, media, political correctness, liberals, tax laws); a belief that a strong leader can ‘solve’ economic problems through central control; a belief that a nation can recover its past glories by adopting an aggressive, unyielding position on global affairs; a strategy of economic growth by large infrastructure projects and military build-up.

It is difficult to discern what Trump’s platform and plans are, but his appeal to ‘angry’ Americans seems to parallel the classic fascist pattern.  The big difference between Trump’s rise and those of Hitler and Mussolini is that the economic conditions are far less dismal today than the late 1920’s.

The ‘anger’ that is accepted as a given in today’s political environment is somewhat of a strange phenomenon.  Clearly our political process is frustratingly dysfunctional.  However, the country is not in any great economic or social distress when compared to the rest of the world.  So why the almost palpable anger?

For the average white American, there are certainly unsettling trends – the increasing diversity of our society, the changing sexual and gender mores, the decrease in traditional religious affiliation, the erosion of American influence in world affairs. 

But these trends and circumstances do not really impact people in a very direct way.  The everyday of our lives is no worse for these changes.  Our economy, though not robust, is still functioning fairly well and indeed performs better than that of almost any other nation on earth.  We still have all of the freedoms, opportunities and pleasures that make the U.S. an incredible place for most of its citizens.  Very few of the people who are so angry are in any type of distress, other than psychic.

I believe the anger is a manufactured entity, a Frankenstein created by right-wing media, bloggers and politicians that is now out of control and about to destroy its master, the Republican Party. Let’s hope and pray it doesn’t also destroy the whole country.

Sportsmanship

The recent Super Bowl was yet another reminder of the decline of sportsmanship in the sports world.  I rarely watch football, but when I do I am disheartened by the endless, mean-spirited displays of poor sportsmanship that occur after almost every tackle, reception, interception, sack or touchdown. Taunting, mocking, grandstanding and rubbing your opponents nose in his or her defeat are standard behavior in most sporting events these days. The gracious victor, the humble sportsman is almost extinct.  Instead, most contests are spectacles of trash-talking and in-your-face confrontations, expressions of the worst in human nature.  How has it come to this?

I suppose it all ties back to money and the business of entertainment.  Television has always reached out to the lowest common denominator, and once it was discovered that people who sit mindlessly watching hours of sports on TV enjoy seeing crass behavior there was no holding it back.

It may be entertaining for fans to see someone perform a dance in the end zone after scoring a touchdown for their team.  But I would argue that it is appealing to our baser instincts.  We know that the opposition is already disappointed.  Why do we want to make them feel worse?  Our own joy and satisfaction are already assured.  Do we really need to revel sadistically in the face of the opposing team and fans?

Worse still is the fact that this type of behavior has become expected entertainment for viewers.  Trash talking and victory dances have become a type of art form that is encouraged by fans and the media.  Of course the only ones delighting in each instance are the fans of the mockers and the grandstanders.  The opposing teams fans are grinding their teeth in bitter frustration and perhaps even fury.

One may argue that this form of entertainment is harmless, just boys (or girls) being boys and having a little fun.  But I don’t view it as harmless.  It sets an example for everyone in terms of acceptable behavior.  It erodes the general civility of our society and of sports in particular.  It has all of the classic characteristics of a cheap thrill – momentarily titillating, but insidiously damaging in the long run.

The other justification that might be raised for this type of behavior is that it is a clever strategy to throw one’s opponent off his or her game - to deal a psychological blow – and therefore an acceptable tactic.  But I find this specious reasoning.  Following this line of argument could make any ploy acceptable, including purposely injuring an opponent, which, sadly, in many sports is also increasingly utilized to win at all costs.

With so much money at stake in professional and college athletics, it is not surprising that such despicable behavior has become the norm.  But this behavior trickles down to impact every sports contest, and we are the poorer for its dissemination.

Healthcare Woes

The U.S. spends more per capita on healthcare than any other developed nation in the world, yet our people are less healthy on average than most of those nations (data from OECD, the World Health Organization and the World Bank).  Here is one view of the spending data:

The U.S. in healthcare, as in so many things, is somewhat of an enigma.  At the top level, our healthcare must surely be more sophisticated than any other in the world.  Our medical research is more extensive and more richly funded than any other nation’s, as shown by the following chart:

Biomedical research and development expenditures classified by country in 2012 in billions of U.S. dollars:[2]
Country	Total	Public	Industry
United States	119.3	48.9	70.4
Canada	5.3	3.3	2.0
Europe	81.8	28.1	53.6
Asia-Oceania	62.0	19.3	42.7
Total	268.4

Our medical technology, surgical procedures and disease treatment are probably the best in the world, though that is my own wildly subjective assessment.  (I couldn’t find any convincing data – too broad a topic)

But our population is not as healthy as that of many other nations and does not score as well when health indicators are evaluated (see World Health Organization data, not included here). How can that be?

Before we look at the reasons for our low scores on health, let’s look at why our healthcare is so expensive.  I can think of several reasons:

1. The fear of lawsuits and litigation causes doctors to order more tests and undertake more procedures.
2. Our doctors and health executives are compensated significantly higher than those of other developed nations.
3. Our complex insurance structure adds significantly to the costs.
4. Our market-driven healthcare promotes newer and more expensive drugs and procedures.
5. We have more advanced (and thus expensive) treatments, technology and capabilities for the most serious diseases, injuries, etc.

I can’t measure the relative impact of these factors, and I have not done a rigorous search for data, but I believe this is a reasonable set of factors that would be hard to dispute.

Please note that only one of these factors actually contributes to better health outcomes (number 5).  This would explain why our very costly healthcare does not produce the best health in the world.

As to why we have lower scores in health indicators, one merely has to invoke the usual contradictions in U.S. society – the widening income gap, the number of uninsured people, poor access to healthcare in impoverished areas, our large prison population, our drug problems, our problems with obesity and our focus on treatment of disease rather than wellness and disease prevention.

As in most things, the U.S. is both a place of wonder and a place of stubborn disappointment.  The freedom that many of us have in managing our healthcare, and the incredible array of options for treatment are probably unique in the world.  But a sizable part of our population has the type of access to healthcare that one would find in a much poorer, under-developed nation.

So what is the future for U.S. healthcare?  I am certain that one day in the not-too-distant future we will shake our heads at the thought that we did not provide basic healthcare for all of our citizens or make it possible to obtain insurance if they had a pre-existing disease or condition.

But the future of healthcare is daunting.  The combination of several factors will require us to make difficult decisions:

1. People are living longer and the care needed to maintain quality of life and life itself is growing ever more capable and expensive.
2. As medical technology, drugs and treatment become more sophisticated and capable (which of course leads to number 1!), the costs and effort required increase.
3. If healthcare is provided at ‘no cost’ to everyone and access is easy and pervasive, then there may be an ever-increasing demand that overwhelms the system.

These factors may cause healthcare costs and effort to skyrocket.  There are already predictions of people born today living to 150.  If one assumes that the healthcare costs during this lifespan will increase at least linearly, and possibly exponentially over the last 50-80 years, then the healthcare system will certainly be unable to sustain itself.  We will become a world that focuses most of its energy and resources on maintaining life, rather than enhancing or enriching it.

There are also the questions of how to curb the appetite or need for healthcare.  Even with a focus on wellness and preventive medicine, human beings will ignore good advice and engage in risky behaviors that jeopardize and even ruin their health.  Should the obese have an added health tax?  Should the elderly be discouraged from endless rounds of physical therapy and other quality of life treatments by some sort of surcharge?  Should a smoker or drug-user be denied care or forced to pay extra to receive it?  Should sexually transmitted diseases be taxed to encourage less promiscuous behavior?  These may seem like draconian or big brother tactics, but a desperate need to rein in costs may eventually trump the hesitancy to apply such limits.

We are facing a brave new world of longevity/life expectancy, medical breakthroughs and treatments, and social awareness.  These will create a perfect storm of expense challenges and ethical dilemmas.  If our civilization manages to emerge from the political and socioeconomic crises and the menace of global warming relatively unscathed, then global health will be the final hurdle on the path toward a world that is more equitable, peaceful and enjoyable for all its denizens.