The Market-Based Healthcare Fallacy

One of the primary goals of the Republican effort to ‘repeal and replace’ Obamacare is to achieve so-called ‘market-based’ healthcare.  In the conservative world view, every complex social problem can be solved by the magic of the ‘free market’.

Of course everyone understands that government tends to be bureaucratic and inefficient and that market-based, competitive industries are preferable to monolithic, centrally-controlled bureaucracies.  But selling toothpaste and providing healthcare are two very different things, and there are certain things in a society where market forces are not as efficient nor as compelling.  For example, we do not generally outsource our military to the free market or our legislature (though perhaps that might be a good thing . . . ).

The free market and associated market forces work best on commodities, products or simple services in direct buy/sell relationships.  A consumer purchases a product or service based on a combination of quality and price, and the competition for the consumer’s dollars causes the supply chain – retailer, manufacturer, etc. – to become more efficient and the products and services of higher quality to earn the business.

But healthcare is not a simple buy/sell relationship.  Consumers do not directly buy healthcare services – they are too costly.  Instead, a consumer buys an insurance plan that pays for the services.  But how much healthcare service a consumer utilizes is a complex interplay between healthcare providers (doctors and hospitals), the patients (consumers) and the insurance companies.  Efficiency, quality and cost reduction are not simple concepts here.  Having a consumer visit doctors less frequently or having the doctors prescribe fewer tests or drugs might seem like good cost reductions and improvements in efficiency, but the result might be long terms problems and massive increases in the cost.  It is not likely that these very nuanced and long term aspects of the healthcare relationship will be comprehended and improved by a short-term, profit-oriented market approach.

When we talk about market-based healthcare, we are talking about competing healthcare insurance programs.  At first blush, this sounds like a good thing – as insurance companies compete for healthcare dollars they would in theory become more efficient and find cheaper ways to deliver healthcare for their customers. 

But the question is how would they reduce those costs and gain efficiencies?  The insurance companies have four primary cost factors – (1) their own administrative costs, (2) hospital costs, (3) physician costs and (4) the ‘use’ of the insurance by their customers – i.e. how sick they are and how much healthcare they utilize.

The easiest and most lucrative way for insurance companies to be more competitive and ‘efficient’ is for them to control the 4^th factor – how much their customers utilize – by enrolling a relatively healthy set of customers, excluding people with chronic healthcare problems and denying or restricting services.  This is what insurance companies have been doing for years. 

A relatively small amount of benefit can be obtained from controlling the first factor, administrative costs, though I imagine it is the one advantage that this structure has over a single payer system. 

The insurance companies can pay hospitals and doctors less and insist that they become more ‘efficient’, but that is a very indirect process and it is not at all clear that a multiplicity of insurance companies with varying schemes of healthcare policy can impact those areas as well as a single payer with a unified vision can.

Giving the insurance companies and consumers a ‘free market’ with few restrictions will work great for the healthy and those who work for generous employers who are willing to foot the bill for great healthcare benefits.  But as seen in the past, this system will be a nightmare for people with chronic issues or sudden catastrophic illnesses, or those who are under- or un-employed.

A fairly large percentage of U.S. citizens already receive healthcare from a single payer system – the U.S. military, government, Medicare and Medicaid – more than 30% of the population.  No one will claim that these systems are efficient, and their costs continue to grow dramatically.  But that is the challenge that all healthcare provisioning systems face in a time of increasing human longevity and medical complexity.

The biggest question that Americans need to answer about healthcare is whether our society is obligated to provide at least a minimum of healthcare to every member.  If the answer is yes, then a single payer system available to all, with a private insurance system in parallel would probably be the best way forward.  We need only to look at the EU healthcare systems for excellent examples.  These systems are far from perfect, but they are generally valued by their constituents as preferable to the U.S. system.

A market-based healthcare system would almost certainly not be the panacea that our conservative members of congress claim it will be.  This is one area where capitalism’s profit motive will create more problems than it will solve.  Medical costs will ultimately need to be reined in, but the free market is not the mechanism to accomplish this.  Medical providers and community health experts need to drive the future of healthcare, not accountants and MBAs!

The Culture War - Is there a Way to Move Forward?

An integral factor in the continuing saga of political turmoil in the USA is the culture war.  This conflict may be framed as follows: 

One side sees the USA in cultural and moral decline as characterized by the following:

•  changes in sexual morality, including sexual promiscuity, rampant pornography, and the liberalization of attitudes on homosexuality, gay marriage and gender transformations
• the weakening of the American work ethic and increase in entitlements
• the over-emphasis on perceived racism and its use as an excuse for criminality and the breakdown of the family in African-American society
• increased drug use and a decline in law and order and respect for the police
• the rejection of religion (specifically the Christian religion) and the weakening of its moral impact on our society
• the domination of a liberal elite with their liberal media ridiculing alternative viewpoints and promoting political correctness
• a foolish naivete that embraces too many immigrants and allows dangerous religious groups into our society without demanding conformity to our values
• a worldview and foreign policy that diminishes American exceptionalism and panders to a feckless UN and various bad actors in the international community

The other side sees the USA in the dangerous grip of a simplistic populism and ignorance that manifests itself in the following:

• ethnic and religious bigotry that is sadly reawakening and becoming culturally acceptable
• a hardhearted and misguided perception of the poor and disadvantaged as pariahs and parasites rather than victims
• misplaced and hypocritical religious zeal that is based on outdated moral codes rather than social justice
• a perverse obsession with guns that has derailed all reasonable discourse and study about sensible gun control and violence in our society
• a blind nationalism that ignores the intertwined fate of all nations and peoples
• an overly aggressive focus on law and order that has resulted in the USA having the largest % of its citizens in prison in the world
• an active rejection of peer-reviewed science and other forms of knowledge that makes the US population woefully ignorant and easily brainwashed
• a misinformed public that blames the poor, the immigrants and free trade for economic woes rather than demanding initiatives to decrease wage disparity

These viewpoints are dramatically different and seem irreconcilable.  It is hard to believe that people can view the same world and come to these radically different perspectives on what is happening.  Yet it is indeed the situation we are in.

The question is whether there is some mechanism to bridge the chasm in these worldviews and come to some sort of compromise and way to move forward.  As a person who tries to confront problems with a rational and logical approach, I believe that the only way to achieve progress is to present people with the data that are relevant to these topics and then have an in-depth public analysis of each area.

For example, the ‘black lives matter’ movement and its focus on racial profiling have generated a typical response from the left and the right, with the right dismissing the movement as another example of black people playing the race card and not being willing to confront the rampant criminality in their neighborhoods, and the left righteously proclaiming that the videos of police shootings are dramatic evidence of what black people have been saying for generations – that the police are routinely harassing and targeting them.

These are ‘polemical’ positions.  What needs to be done is a deliberate and comprehensive analysis of police shootings and confrontations across all races and ethnic groups as well as an in-depth look at violent crime. This data needs to be collected, evaluated by an impartial group and then presented to the public in an easily understood manner.  Statistics and data may not tell the full story, but they will certainly get us a lot closer to a better understanding of what is happening.  Anecdotal, isolated incidents give a strong impression, but they may or may not be indicative of the true situation.

While it is true that different people will view the same set of data and come to different conclusions - especially in non-scientific subjects such as human behavior and economics -  a detailed look at the numbers behind a problem will certainly bring people to a more nuanced view of the problem and hopefully defuse some of the incendiary rhetoric around the issue.  A departure from the shrill tone of today’s political discussion would be the first step in finding an acceptable common ground.

Sometimes

Sometimes when I see a headline of yet another senseless shooting;

sometimes when I hear a politician make outrageous remarks with the clear objective of getting headlines;

sometimes when I see incomprehensible numbers of refugees and migrants desperately seeking safety;

sometimes when I hear a CEO try to justify the fact that his salary is 350 times that of the average worker in his company;

sometimes when I hear someone claim that the science of climate change isn’t yet ‘settled’;

sometimes when I see another video of a policeman shooting an unarmed man;

sometimes when I hear of a random shooting of a policeman;

sometimes when I reflect on the hopeless nature of Mideast violence;

sometimes when the inevitability of human conflict seems overwhelming and the results seem to be growing ever more catastrophic . . .

I start to despair.

But then I find these prophetic words: 

“We cannot understand the moral Universe. The arc is a long one, and our eyes reach but a little way; we cannot calculate the curve and complete the figure by the experience of sight; but we can divine it by conscience, and we surely know that it bends toward justice. Justice will not fail, though wickedness appears strong, and has on its side the armies and thrones of power, the riches and the glory of the world, and though poor men crouch down in despair. Justice will not fail and perish out from the world of men, nor will what is really wrong and contrary to God’s real law of justice continually endure.” – Theodore Parker, Unitarian Minister, Abolitionist, Transcendentalist 1810-1860.

And I am somewhat comforted.

Indeed, for all of its evils and failings, the world is becoming more moral, more tolerant, more equitable.  There are many challenges, and the practicalities of creating less war and more social justice are daunting, but the recognition of what is right and good is widespread, and we need only find the courage and energy to put conviction into action.

Indeed, the fact that civilization has triumphed in no small measure over chaos, war, selfishness, vengeance, envy, demagoguery and greed is a miracle of the first order.  When one observes the rage that appears daily with such minute cause on our roadways, one can only marvel at the fact that we have a society that functions as well as it does.

Think of the ways that our morality and social conscience have been transformed!  We no longer view war and conquest as something to celebrate.  We are repulsed by the idea of slavery.  An ever-increasing part of the world respects women and provides them opportunities to live any type of life they choose.  We are becoming more accepting of religious and cultural diversity (the recent populist and anti-immigrant fever notwithstanding).  We seek to comfort and aid the disabled, mentally ill and sick rather than cast them out coldly into the dark.

Sadly, though, the change does not come fast enough.  What can an individual do to hasten its progress?  We are confronted daily through all manner of media with all of the remaining evil and misery in this world and it is intolerably discomforting to be aware of it and do little or nothing about it.  This is the anguish of the modern age.

The only recourse for most of us is to lead our lives in good faith, resisting the impulses that we know will contribute to injustice or hostility, and play whatever small role we may be offered in helping our fellow human beings along the way.

Healthcare Challenges

Last week’s attempt to repeal Obamacare and replace it with what by pretty much all accounts was a rather pathetic package of half-measures, brings the challenges of healthcare back into clear focus.  Unfortunately, the solutions to these challenges are not nearly as clear as the challenges themselves.

Healthcare is a multi-layered problem, which makes it particularly resistant to easy fixes.  Cost and efficacy are interwoven in a complex web.  There are numerous basic contradictions or paradoxes at the heart of the issue.  Here are some of them:

Should healthcare be considered a right for every citizen, regardless of income level or status?  I find it difficult to understand how one can argue against this proposition in a modern, developed nation.  One can debate how much healthcare is guaranteed, but basic healthcare should be provided for everyone.  Someday soon we will be shocked that we once allowed people to go bankrupt with healthcare expenses or denied life-saving measures to people who could not afford them, just as we are now amazed that we once condoned slavery.

Should everyone in society participate in healthcare insurance?  This also seems irrefutably logical to me.  If we are willing to require participation in a social security system and medicare system for later years, then it only makes sense to extend this to the entire lifetime of healthcare provision.  How else can we conceivably fund the care of the sick if we do not have full participation?  This is simply an extension of the basic concept of shared risk and communal responsibility.

Do patients have certain obligations as recipients of societal healthcare?  Of course they do!  They should use this scarce and finite resource wisely, being careful not to waste it on frivolous practices.  They should attempt to lead healthy lives so as to minimize their own necessary usage of healthcare.  They should diligently follow the instructions of their healthcare providers. 

Is there any way to motivate or even force people to act responsibly in this regard?  That is a more difficult question.  There must be certain safeguards put in place to monitor and control usage.  Co-pays, deductibles and various other financial mechanisms should be carefully crafted to ensure that healthcare usage is not frivolously engaged, but also is available and encouraged when truly needed.  Moreover, there should be a strong public service ‘indoctrination’ for every citizen about how to lead healthy lives and how to use healthcare services effectively and economically.

There is a fine line between encouraging citizens to use healthcare services energetically to minimize disease and using it too much as a self-indulgence. 

What kind of responsibilities do healthcare providers have?  They must have both ethical and economic incentives to provide the best possible healthcare with as much frugality as possible.  These are often contradictory goals and fine tuning them will be a constant and intricate process.  ‘Playing it safe’ for a healthcare provider will often mean ordering excessive tests.  But with the threat of malpractice lawsuits ever-present, it is difficult to curb this tendency.  Malpractice reform seems to be necessary if we are to control the arms race of lawyers and doctors/hospitals.  Doctors must have the freedom to manage their patients and their practices, but they must also be held to reasonable standards of both patient care and healthcare expense.

End of life expense control must become a priority, or we will be spending a large percentage of our medical dollars on a period of life that quite candidly provides very little return on investment.  The predisposition of elderly people to over-utilize medical services is well known, whether out of boredom, loneliness or understandable frustration with a rapidly deteriorating body.  Hard decisions have to be met regarding how much healthcare can be provided for an ever-increasing number of senior citizens.

The concept of free market components of healthcare has been trumpeted as the way to control costs, avoid bureaucracy and increase efficiency.  In general, competition does indeed create more efficient delivery of goods and services.  However, here again there are paradoxical elements that make a free market approach somewhat problematic.

Insurance companies will naturally attempt to increase profits by limiting what procedures or care they pay for and limiting their clientele to the healthy rather than the sick.  If we are to create free market conditions, then the rules must be constructed such that any profits are derived from efficiencies in healthcare delivery and management, not from limiting care or rejecting people with less fortunate health profiles.  This, of course, is not easily tracked or accomplished.  There are certain aspects of society that do not easily lend themselves to free market implementations.  For example, we would never allow our military defense to become a free market commodity.  We have seen that private prisons are also not necessarily a panacea. The question is whether healthcare falls into this category as well.  The fact that we spend more dollars per person in the U.S. for healthcare than other developed nations with single payer systems certainly begs this question.

If our leaders would evaluate the healthcare challenge as a policy issue and avoid the polemics and demagoguery, then it might be possible to craft a plan that can meet the needs of society without the expense spiraling out of control.  There are numerous reasonably successful models in Europe and Canada to analyze.  The U.S. may be different than those nations, but it can certainly learn from them if we can for once humbly acknowledge that we are not always the most perfect nation on earth!

On Wisdom

Over the years, if one is honest with oneself, the fallacy in the old adage that we acquire wisdom with age becomes shockingly clear.  This realization is just one of a myriad of disappointments that cause one to careen through mid-life from crisis to crisis, but it has some profound implications and merits a closer look.

What is wisdom?  The dictionary definition is: ‘the quality of having experience, knowledge, and good judgment’.  Does one become wise over one’s lifetime?  Everyone has ‘experience’, and most people acquire more ‘knowledge’ as they go through life.  But does that make them wise?  How can we define ‘good judgment’? 

I will make the case that wisdom is a somewhat over-simplified concept and that what we generally call wisdom has a very narrow scope in our own lives and almost no application to others.

The question is whether we truly become wiser as we collect life experiences, or whether we simply become more ‘experienced’ or ‘knowledgeable’.  Our experiences shape us in some respects, but any lessons learned may only be applicable to the specific circumstances of our own lives (which will probably not repeat themselves) and not really general wisdom that would be of benefit to anyone else.  It is tempting to believe that we are wiser, but if we had the opportunity to repeat our lives I wonder whether we would prove any more adept at navigating life’s challenges than we were the first time through.

Of course we become more capable in certain aspects of our lives as we grow older – our business or professional skills may improve somewhat (which may, sadly, be an anachronism if the frenzied pace of technological change continues to increase); we may become more adept at certain hobbies; our physical capabilities and skills will peak at some point and then begin to wane.

But if one considers wisdom to be a deeper understanding of life and the choices that define our lives, then I am not at all convinced that older is wiser.

It is often said that people don’t really ever change.  That may be an exaggeration, but it seems to have a large kernel of truth.  I look at myself and those I know fairly well, and I see the same basic character traits – the charms, the foibles, the strength of character, the neuroses, the idiosyncrasies, the ethics, etc – that we have carried since early adulthood, and often from early childhood.

These character traits are a critical component of the template of our lives, and they are unique to each of us.  Add to that the unique circumstantial factors that impact every life experience and decision and you have a very specific set of conditions that each person confronts in his or her life.

Do life experiences make us wiser?  Who in good faith truly believes that their life experiences justify them preaching to others about how to conduct their lives?  Isn’t each life so unique that it can only be planned and critiqued by its owner?  And isn’t it highly presumptuous to believe that our own life’s joys and sorrows offer any sort of blueprint for someone else?

Of course there are extremes where good counsel is appropriate.  The recovered alcoholic or drug addict certainly has some good advice for those unfortunates who are heading down a similar path. 

But there are other types of so-called sage advice that require a second look.  Advising against rash life decisions such as getting married young or resigning from jobs to travel may sound like wisdom, but who can say for sure that these decisions are unwise?  Of course the probability of an early marriage succeeding or a travel hiatus from a career leading to future success may be low, but there are factors to consider that only that person can know.

Parents may earnestly advise their children on a number of topics as they grow into adulthood, but most children blithely ignore this free wisdom.  As the old Cat Stevens song Father and Son goes: ‘if they were right, I’d agree, but it’s them they know not me’.

Who in good faith can tell the aspiring actor not to leave that small town and journey to Hollywood, or the musician with dreams of rock and roll fame not to leave school and hit the road?  You can tell them the odds aren’t good, but they probably know that already and there may be enough fulfillment in the journey even if wild success is not the outcome.

There are self-help books by the thousands that peddle well-worn platitudes for achieving success or happiness served up as new and innovative concepts.  If nothing else, the never-ending supply and demand for these tropes serve as strong evidence that wisdom is neither easily acquired nor easily dispensed.

Perhaps one of the beauties of life is its enigmatic nature.  There is no manual for living, no secret formula for success, fulfillment or happiness.  One man’s wisdom may be another’s folly.  We outsource our life decisions at our own risk.  Live life with courage and energy, and wisdom be damned!

Optimism

Trump’s victory in November shocked me and put me in a rather discouraged state of mind.  I worried that this was the beginning of a downward spiral of demagoguery and the decay of American values, ideals and civility.

But in recent days I have seen a rising tide of resistance and resolution that gives me hope for the future.  Trump’s victory, his incredibly childish antics and his mean-spirited directives have awakened a broad movement of outrage and activism.

The political pendulum swings to and fro.  That is the nature of American politics and it is generally a satisfactory if not inspirational phenomenon, sacrificing speed to avoid radical, potentially de-stabilizing changes.  The American experiment has never been a revolution, but rather a continual tinkering with the detailed machinery of governance and public policy, full of compromises and experimental half measures.  The general trend has been toward a more equitable, enlightened and appealing life for all Americans, though certainly there has always been much to improve.

The U.S. citizenship is split almost 50/50 on many of the large policy issues of the day.  This has almost always been true and it must reflect some basic crossroad of human development when one’s sentiments begin to veer in one direction or another and soon the other path is in the murky distance and hardly recognizable.

When the people are at loggerheads on basic issues, it is difficult to gain consensus and it may be impossible to push forward.  This stalemate is frustrating, but perhaps it is better than moving aggressively on new policies and potentially alienating large groups to a point of no return.

Trump and the Republicans have no mandate from the American people.  The fact that the Senate is slightly Republican is a strange artifact of the red state/blue state distribution.  Most of our least populous states are conservative.  They still have two senators.  Even the distribution of representatives has some very peculiar demographic attributes that make it more likely that conservatives can win.  The true picture of how the American people are divided is best portrayed by the popular vote, which despite Trump’s petty claims, show a fairly substantial majority of Americans are opposed to either him, his platform, or both.

It appears that Trump will be at least partially frustrated in his efforts to act upon his campaign promises.  This is only fair, because most of those promises are anathema to a majority of Americans.  His refugee directives, which make no sense whatsoever and are an affront to basic American values, should never be allowed to stand.  Hopefully the judiciary will stand firm and the congress will oppose any new legislative efforts to circumvent the courts.

The efforts to roll back financial and environmental regulations will probably have some success, because these are also Republican hot buttons.  But there will be strong resistance, especially on the environmental front.  Americans are finally waking up to the reality of global climate change, and there is the beginning of an internal Republican challenge to the ‘drill, baby, drill’ mantra.

Health care changes will also be hard fought.  The Republicans have been successful at making the abstract generality of ‘Obamacare’ a bogeyman, but once the details have to be hammered out they will find that sleight of hand will no longer suffice.  In the end, I will not be surprised to see congress only tinker slightly with Obamacare, change the name, confuse the hell out of everyone and declare victory.

It is on foreign policy that Trump is most dangerous and unpredictable.  Here, we can only hope that his early missteps and embarrassments will serve to create a braking action on his tweets, hapless phone calls and pronouncements.  His advisors may be a motley crew of billionaires and Alt-right zealots, but hopefully there will be enough common sense on hand to avoid catastrophic errors.  The U.S. will cease to be a leader in the world for these four years and transition to the role of a bully, but perhaps the damage will be only temporary.  It may actually be healthy for other nations such as Germany, the UK, France and Japan to become more influential and active as leaders in the world.

On the economic front, Trump’s chest-beating and saber-rattling over trade policies and outsourcing will probably have minimal impact.  The economy will evolve, as it almost always does, somewhat independently of the policies that are targeted, with great fanfare, to impact it. 

It seems to me that there is an unavoidable fact that automation is steadily reducing the number of available middle class jobs, and that there is probably no way to compensate by creating ‘new’ industries or jobs.  This is a characteristic of the way that the global economy is evolving and the genie has long since been out of the bottle.  The problem is massive and it will become ever more massive.  Demagoguery, bullying and threats will not solve it.  We can either study it and try to socially engineer changes to lessen or thwart its impact, or we can allow it to create chaos and catapult us into a morass of unstable political and social turmoil. 

I believe Donald Trump has had his moment of glory. It is going to be a long, painful four years, and Trump will tweet himself into ever more pathetic absurdities as he confronts his impotence.  As for his rabid supporters, they will grind their teeth in fury at the resistance that thwarts his every move, but eventually they will grow weary of the Donald’s ineptitude and realize his supposed business acumen either never existed or is totally unsuited for running a country.  They will no longer believe his preposterous claims of being the one and only possible savior.  They will no longer thrill to the inarticulate ravings of political incorrectness that they once somehow found courageous, and they will realize, though probably never admit, that he is just a desperately insecure man who has managed to bully and connive his way to a fortune and hoodwink a lot of people in the process.

Religion From the 'Other Side'

When I try to rationalize the theology and dogma of the many religions that human beings have concocted throughout history I find it useful to attempt to view them from God’s perspective – from the ‘other side’.  This may sound presumptuous and perhaps even blasphemous, but we humans have an intellect and reasoning power, so it would be surprising for God to fault us for employing that intellect in such an exercise. (The fact that Adam and Eve were supposedly banished from Eden for pushing the envelope in the knowledge department might make one think otherwise, but I am going on the assumption that this metaphorical version of the creation is not an indication that God does not want us to use our given intellect!)

Conceptualizing God is a fool’s errand of course.  Historically mankind has envisioned deities in anthropomorphic fashion – Gods with human form and human foibles.  Now that we have some idea of how vast and unfathomable the universe is, our past fantasies seem somewhat foolish.  If God created man in his own image, as the bible surmises, then is God just a super-sized human being with super powers?  Even with a healthy dose of ‘blind faith’, that concept seems rather absurd and unlikely.

If there is indeed a God or some form of divinity, and I, for one, am hopeful that there is for a variety of reasons, then I imagine that God would be more amorphous and less tangibly physical than we envision.  But the form of God isn’t really that germane to our discussion, so its mystery can safely be left unraveled.

So God, in whatever form, creates the universe, in whatever manner – big bang, evolution, and any other mechanisms that may be useful.  A first question might be why he even wants to create the universe.  For sake of later questions and argument, let us just say that it is God’s nature to create.

The next big question is: What is God’s purpose in specifically creating human beings? Are human beings truly unique in our possession of a self-conscious state?  Is God uniquely interested in our activity as opposed to the rest of his creation, simply because we are self-conscious and have free will?  These are already tough questions, but in order to move forward with this analysis, let’s assume that God does regard us as special creatures.  What does he want from us?

Is our chief end, as the Judeo-Christian faith speculates, ‘to glorify God and to enjoy him forever’?  Did God create man for his glory?  Is our sole purpose to ‘worship and love God with all of our heart, soul, strength and mind’? 

What does all that really mean?  It seems to ascribe a very human narcissism and vanity to God.  Does a God that can create a universe really need a fan club?  Does God need glory from his creation?  Whom is he trying to impress?  Is there a competition with other universes and Gods?  These questions may sound flippant but I believe they are worth asking.

I interpret all this worshiping and glorifying purely in the context of God wanting humans to bend their hearts and behavior toward Godly things.  God doesn’t need worship or glory in the sense that is normally associated with those words. 

Now if one understands this idea of a relationship between God and humans to be one of mutual love, and that by ‘worshiping’ and loving God, as well as loving other human beings we are reflecting the love that God represents and instantiates in the universe, then that would be much more plausible and palatable.  It seems like the kind of thing God might want.

It is reasonable to believe that if there is a God and he created the universe, then he must have created the universe and human beings for some higher reason than to simply have a functioning machine that would run in a predictable manner like a huge train set in his basement.  If so, then he would be curious and perhaps even passionate about creating beings that have free will and the capacity for both creation and destruction, good and evil, love and hate, compassion and cruelty.  This is the line of reasoning that people use when trying to explain why there is evil and calamity in the world if God is a loving God.

Perhaps God is interested in simply seeing how humans progress with their free will and intellect.  But apart from the pure curiosity of seeing how his creation evolves and how these beings with free will act, what would he expect from this creation and how would he interact with it?  If God is love, and love is the goal and motive force in his creation, then perhaps God would seed the whole enterprise with some mechanism for inspiring this love and animating it in the non-deterministic elements of the creation – the human creatures.

And out of this love would come a sense of morality and an inclination toward ethical behavior that would somehow be innate or at least periodically suggested through some link to the divine – a soul or a spirit perhaps.  And maybe God would be intrigued, even passionately determined, to have the creatures hearken to this call of love and ethical behavior.  Wouldn’t it be logical that God would want his creatures to evolve toward a more loving and compassionate state? 

But what seems highly improbable is that God would be insistent on humans having a specific set of abstract beliefs about the nature of God or the universe, or that he is terribly interested in whether his creation formally acknowledges his existence, given his penchant for avoiding direct contact or communication with his creation! 

Is it really likely that God cares whether we believe in the inerrancy of various forms of scripture?  Can we really believe that God will test us on our knowledge of the trinity?  Is it rational to think that ‘accepting or following Jesus’ (whatever that might mean in practical terms . . . ) is a litmus test that determines whether we go off to eternal damnation or bliss?  Is God likely to care whether we embrace love and compassion via Jesus, Isaiah, Mohammed, Buddha, or through a friend or teacher or self-study?

We trivialize God and strain credulity when we claim that he cares about things like whether we:

• ·         eat pork or shellfish
• ·         believe that Mary was a virgin
• ·         believe that Jesus performed miracles
• ·         believe that Mohammed was God’s last and greatest prophet
• ·         believe there is one ‘chosen people’
• ·         believe that there was actually a flood and Noah’s ark housed representatives of every species on earth
• ·         swear
• ·         doubt God’s existence (as Bertrand Russell famously said: Not enough evidence, God, not enough evidence)
• ·         wear a burka, hajib, yarmulke, veil or any other garment
• ·         keep a certain day holy
• ·         pray in schools
• ·         Or a thousand other laws, customs, dogma and idiosyncrasies that religions have decreed as necessary for membership that do not move us any closer to a spirit of love and compassion

Wouldn’t it be reasonable to believe that the only things God truly cares about are things that mold and refine our hearts and actions to be in tune with the morality that every religion as well as secular movements have slowly embraced over thousands of years?

Religious metaphors and traditions, and the cultural heritage associated with them can be wonderfully enriching aspects of our lives and communities, and to the extent that they bind us together in communal life and nurture our interest and search for God’s message of love and compassion they can be very positive forces.  But they are not the essence of our quest to seek God and they should certainly not encumber us in our search or prevent us from reaching out to one another in a spirit of common humanity.

The ‘arc of history is long but it bends toward justice’.  This must be the arc that God wants to see, because justice implies love and it implies compassion.  And all of the human baggage that gets in the way – the divisive religious squabbling and exclusivism, the arrogant, self-righteous insistence on having the ‘one true’ understanding of God – must be jettisoned along the way if this arc is ever to complete its travel.