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The Only Way to Fix Healthcare Insurance in the U.S.

Our system of government has been amazingly robust for hundreds of years, but it fails when you have these two conditions:

1. An issue is too complicated for the public to understand.

2. Big companies are willing to distort the system for profits.

That situation describes the healthcare debate going on in the United States right now. Our undersized brains can’t grasp all the nuances and implications of any particular healthcare plan. And when our brains are confused, we default to our biases (usually party loyalty) or to whatever metric is simple enough to understand. With healthcare, the one metric that matters is how many people will be covered compared to Obamacare. If the Republican plan covers more people, it will pass. If not, it will fail. 

Sure, Republicans will argue that the CBO projections are inaccurate. They will argue that comparing a mandatory plan with an optional one is comparing apples to oranges. They will be right about all of that, but it is irrelevant to the outcome. People will look at the number of people covered and stop there. So any Republican bill that covers fewer people than Obamacare is dead on arrival. That’s where we are now. And we don’t have a system of government that can fix this situation. 

But what we do have is an active citizenry and social media. That’s a better system for designing a healthcare system. I’ll describe one way to go about it.

Some of you are aware of Github, a company that lets software developers contribute bits of code that are made available to all other Github users. Github is a big deal, and software developers almost can’t live without it. Perhaps it is time to build a similar system for fixing health insurance in the U.S.

Imagine a website where any interested party can contribute suggestions for improving any individual element of healthcare in the United States, with a focus on lowering costs while improving outcomes. Perhaps you have an idea about lowering drug prices, and I have an idea about online doctors. We submit our ideas, and the Github-for-healthcare users gets to improve on them or ignore them. The system would allow users to rank the ideas. In time, citizens could develop multiple ideas for every element of healthcare. Citizen volunteers could eventually create up to three plans and present them to Congress for a vote.

I’ll get the ball rolling here by framing the problem as an innovation challenge, not a cost issue.

I think Congress can pass a bill that overspends in the short run so long as it comes with a plan (or path) to greater coverage than Obamacare. In my picture above, you see the growing gap between future health care costs and tax revenue. That growing gap can only be closed by some combination of innovation, cutting regulations, improving competition, and improving prevention. Let’s call that a “moon shot” challenge. We don’t know how to get there right now, but Americans are good at figuring out this sort of thing.

My suggestion for getting a healthcare bill passed is for Republicans to create a credible story for how they will cover more people than Obamacare, at a reasonable cost. And the best way to make that case is with visual persuasion, starting with this sort of simple graph and extending to images of startups that promise to lower medical costs.

At the moment, Paul Ryan and the Republicans are trying to sell their plan with facts, concepts, details, and logical arguments. That won’t work. You need an aspirational story about how to get to better coverage than Obamacare via American ingenuity. Everything else is just noise.

I don’t mind letting Congress take its best shot at improving healthcare. But realistically, they can’t. They are not the right form of government for this sort of complexity. 

Perhaps citizens can do what congress could not.

You might enjoy reading my book because it will make you healthier. (True story, according to my readers.)

I’m also on…

Twitter (includes Periscope): @scottadamssays​

YouTube: At this link.

Instagram: ScottAdams925

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Why the New Healthcare Bill Will Be a Loser

People accuse me of imagining that everything President Trump does is brilliant (persuasion-wise) no matter what he does. But I expect the next version of the Republican healthcare bill to be a complete failure. That’s because Republicans seem deeply committed to a losing path, thanks to what might be called the Contrast Problem. 

Contrast is the driving principle behind all decisions. You have to know how your options differ, and by how much, or else you have no basis for a decision. President Obama solved for the contrast problem by designing Obamacare to cover more people than before. The rest of the details – especially the costs – were hard to predict, so our brains flushed that noise and focused on the greater number of people covered. 

Everyone knew Obamacare would need future tuning to get it right. That gave us mental permission to focus on the good parts we understood – the greater coverage – and hope the other details would get worked out later. President Obama nailed the Contrast Problem like the Master Persuader he is.

That was then.

Now, President Trump and the Republicans have the “going second” problem. The public will compare their proposed bill with Obamacare and conclude that the one metric they understand – the number of people covered – does not compare favorably with Obamacare. The contrast is fatal.

We know Paul Ryan will do his wonkish best to tell us about all the amazing advantages of this new bill. And we know the public won’t understand any of it. But they sure will know it doesn’t cover as many people. Done. Bury it.

During the campaign, candidate Trump made some references to taking care of everyone. It sounded like universal coverage, but no one thought he meant it. 

He did mean it. 

He meant it because he understands the contrast problem.  Any Obamacare replacement needs to cover more people than Obamacare, or else it is dead on arrival. Any skilled persuader would see that. 

Paul Ryan doesn’t see the Contrast Problem as important, evidently. 

I think most trained persuaders would agree that the one-and-only path to a successful replacement of Obamacare should include AT A MINIMUM a plan to reach greater coverage. And the only way to get there is by goosing innovation in the healthcare field. We can’t tax our way to full healthcare coverage. We need to lower the costs. And President Trump also needs to solve the Contrast Problem.

To that end, I suggest creating a special low-cost (or free) plan for low income people who are willing to accept a bit more risk. If the plan is robust enough, it could provide a path to greater patient coverage compared to Obamacare and solve the contrast problem. As a mental exercise only, the plan might have the following elements:

1. Online doctors for 90% of routine cases.

2. Require big pharma to provide free meds for people in this plan as a condition of selling in the United States. The low-income people covered would be the ones who would not otherwise buy these drugs, so the companies would only lose the cost of the materials themselves, which is trivial.

3. Recruit and approve special doctors for this plan who are by law exempt from any malpractice suits so long as they provide reasons for their decisions. This would allow them to avoid some red tape and also use new and inexpensive medical technology before full FDA approval – but only for the new stuff that common sense tells the doctors would not be especially dangerous. I’m not talking about pills and internal medicine. I’m talking about medical devices, mostly. It would be up to the doctor to decide when it was safe to risk using the new methods.

4. Patients agree to wear health monitors – the newest prototypes – and to share their medical information (anonymously) for the greater benefit of society. This would allow early detection and treatment. Perhaps the low-cost insurance could be free to those who walk 10,000 steps a day, or something of that nature.

5. Shine a government light on any medical technology or systems improvements that would lower cost, to guarantee that the good ones are known to doctors and investors. (Then stay out of the way.)

This is just a starter concept for what a special low-cost plan (with slightly higher risks) might look like. The main point is that you could cobble together a low-cost plan if you had some government muscle behind it to clear out the useless regulations and to focus energy in the right places.

If President Trump presents us with a healthcare plan that doesn’t cover as many people as Obamacare, but will cover more people eventually, that’s a winning contrast.

Otherwise, the bill will die on the Contrast hill. And that’s the direction we’re heading.

As I’ve said before, America can’t make a strong claim to greatness if we can’t do healthcare right. So let’s do it right. Or at least have a plan to get there.

You might enjoy reading my book because it will keep you healthy. 

I’m also on…

Twitter (includes Periscope): @scottadamssays​

YouTube: At this link.

Instagram: ScottAdams925

Facebook Official Page:

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The real purpose behind the Russian/Trump connection propaganda

Not long ago, I talked about the concept of “4th Generation Warfare” and how it is used by establishment elitists to defeat popular resistance to their agenda of centralization and globalization. 4th Gen tactics are confusing to many because most people think in terms of single movements and direct correlations; they think that a punch thrown is a punch intended to strike, rather than a feint or misdirection.

The post The real purpose behind the Russian/Trump connection propaganda appeared first on Personal Liberty®.

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Russia Hacked our Election! (So what?)

I see a consensus forming that Russia attempted to influence our election with fake news and other social media shenanigans. 

But why?

If you start with the assumption that Russia is an enemy of the United States, you probably assume they do bad things to us simply to weaken our power and effectiveness. For example, this article hypothesizes that Russia’s intention was to breed distrust between whoever became president and our intelligence services. I guess that hypothesis sort-of-almost makes sense. But I wouldn’t say it passes my personal sniff test.

Then there’s the more popular theory that the Russians were colluding with the Trump campaign because Putin thought he could somehow control President Trump via blackmail, or business ties, or something else we’re imagining. I guess that could be true. Sort of. But that doesn’t pass my sniff test either.

Then there’s the hypothesis that Russia was messing with our democratic system to weaken the country by sowing distrust about the election process, or possibly by electing a president they believed would be less effective. But I have a hard time believing the Russians thought Trump would be ineffective. Maybe they just thought he would be divisive, and perhaps they thought that’s good for Russia in some way.

I suppose any one of the versions of reality I described could be true. But my brain has to work hard to make sense of any of those explanations. The pieces fit, but only when I hammer them. That raises a red flag for confirmation bias. 

Just for fun, let’s compare the standard explanations for Russia’s alleged influence on the election with two other hypotheses.

Hackers and Misdirection

As Putin accurately pointed out in a recent interview, hackers can make their attacks seem to come from other sources, including Russia. I assume there are hundreds, if not thousands, of Trump-supporting Americans with the skills to hack poorly-secured servers. Even if you assume Putin wanted to hack American servers, he would have needed to get in line to do it. Given all the American hackers who opposed Hillary Clinton, there is perhaps a one-in-a-hundred chance Putin’s hackers (if they exist) got to the DNC and Clinton’s servers before the hordes of non-Russian hackers did it. So even if Putin tried, the odds are low that his team got to the good stuff first. 

But that’s just the hacking allegation. The “influence” goes further than that, including fake news and other social media shenanigans.

Fake News and Social Media Shenanigans

Let’s say Russia did attempt to influence American voters to support Trump. The first question I have to ask is this: Aren’t all the big countries trying to influence elections in all the other countries, all the time? If Russia did try to influence an American election, wouldn’t that be business as usual? Do we imagine the United States is NOT trying to influence foreign elections through our own fake news and social media manipulations? I always assumed we do that sort of thing. I base that assumption on the following observation about human beings:

If the payoff for bad behavior is high, and the odds of getting caught and punished are low, bad behavior happens every time.

That describes the situation with influencing foreign elections. The payoff is high (potentially) and one assumes the major intelligence agencies know how to avoid getting fingered. Whenever you have this sort of situation, you always have mischief. 

But let’s get back to Russia’s presumed payoff for somehow destabilizing the United States. I think we need to check that assumption because Putin seems like a smart guy. It’s hard for me to believe he thinks he would come out ahead by destabilizing the world’s most important military and economic power. And that is doubly true when you are teaming with that country to fight ISIS, put a cap on North Korea, and keep the economy chugging along. It’s hard for me to imagine a scenario in 2017 in which Russia gains by poking America with a sharp stick. The probable outcome seems more bad than good. Who wants a pissed-off nuclear superpower looking in your direction? It doesn’t pass the sniff test. If Putin were an idiot, I could see him wanting to cause this sort of trouble just because he was dumb.

Putin isn’t dumb.

Global Democracy Hypothesis

I’d like to introduce a new hypothesis to explain why Russia might have wanted to influence American elections: They believed a Hillary Clinton presidency would be a disaster to the world, including Russia.

We’ve been brainwashed by the media and our own government to believe Russia always acts against our interests. I think it would be more accurate to assume Russia always acts in its own best interest, and that can sometimes be in conflict with our interests.

But not always. 

There is no rule that says Russia’s best interests have to diverge from America’s. For example, both countries want to defeat ISIS. Both countries prefer a non-nuclear North Korea. Both countries prefer robust trade. And so on.

As a thought experiment, imagine the United States watching some other country’s election process while believing one of the main candidates would be a disaster for the world, including the United States. Would our intelligence services try to influence that election, even if it was a NATO country?

Of course they would. At least I hope so. 

But something much larger than government-on-government influence is happening, and I’d like to call that out in this post. We keep talking about physical border security, but what about influence security? Any country with widespread Internet access is susceptible to the same kind of fake news and other social media influence that we suspect Russia of doing. And every citizen can play this game. For example, if I were highly motivated to influence an election in Great Britain, I’m sure I could move a few thousand votes in any direction I chose. Could it be said in that case that America is trying to manipulate a foreign election? Yes, unambiguously so. And I believe it is totally legal, even if I use fake news as my persuasion.

From 2017 onward, the democratic process in any country is open to “voting” by the entire world. The foreign “votes” will come in the form of social media influence on the local voters. There is no practical way to stop any of that from happening. And that means political power will migrate from the traditional triumvirate of politicians, rich people, and the media, to individual persuaders who are good at it. In 2017 and beyond, the best persuaders in the world will be influencing democratic elections in every country. And those persuaders will be from anywhere on the globe. Borders can’t stop persuasion.

While you were watching the news coverage about physical borders between countries, and physical immigration, the democratic process in each country became global. We can (and do) influence politics across borders now, bigly. And fake news is part of the soup, unfortunately.

Did Putin or other Russian nationals try to influence American elections? I assume so. I also assume America has done the same – in terms of influence on their local politics – to Russia, and to every one of our allies. 

And if we aren’t doing that sort of thing, why the hell not? Voting is open across borders now. We would be wise to vote in those other countries. That’s what Russia did. Allegedly.

You might enjoy reading my book because Russia. (See video review here)

I’m also on…

Twitter (includes Periscope): @scottadamssays​

YouTube: At this link.

Instagram: ScottAdams925

Facebook Official Page:

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The gamer president

Full disclosure: I set out this week to write a column about how President Donald Trump’s team needs to change the password on his Twitter account, confiscate his mobile devices, and throw them in the Potomac. The President, I reasoned, should be above social media sniping. Besides, he’s kinda busy.

The post The gamer president appeared first on Personal Liberty®.

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The Comey Fog

Ex-FBI Director Comey released a statement ahead of his appearance before Congress, and it has heads spinning. I’ll tell you how things look through what I call the Persuasion Filter.

There are several related stories swirling around the news that involve Russia, Trump, Trump’s campaign staff, and Comey. All together, the stories are beyond the capacity of the human brain to hold the details and keep them from automatically conflating in our minds and becoming more soup than individual ingredients. When you have this level of complexity, humans reflexively default to using bias over reason. Our capacity for reason isn’t up to the job in this case because all the Russia-Comey-Trump stuff has started to run together in our minds. We would happily use our limited powers of reason in this situation if we could, but the complexity of it all makes that a dream beyond our grasp.

Could a trained lawyer sort out this complexity and at least tell you whether or not a law has been broken? Apparently not. Otherwise the lawyers on both sides would agree. They don’t.

So what we are seeing is a super-clean example of what I call two movies on one screen. The anti-Trump media and citizens are peering into the Comey fog and seeing some serious Trump-related wrongdoing that is impeachable at the very least, and treasonous at worst. Meanwhile, Trump supporters are looking at the SAME FACTS and seeing nothing illegal except for some leaking by anti-Trumpers.

Now add to the Comey fog the recent news of how President Trump worded his conversations. The nation will be word-thinking like crazy today, trying to figure out whether “honest” and “hope” mean something. That’s just enough ambiguity to create confirmation bias in literally every observer. (Including me, of course.) We’re all seeing what we want to see at this point.

I’m not a lawyer, and I’m as biased as the rest of you on this topic. But for what it’s worth, I’ll tell you what I’m seeing through my filter.

“Honest Loyalty”

Comey reports that Trump asked him during a private meeting for “loyalty.” Comey promised “honesty” instead. When Trump pressed the point a second time, Comey said he would give “honest loyalty.” Trump agreed that “honest loyalty” is what he wanted. The way you interpret this conversation depends on whether you think Trump or his associates are guilty of anything. If you think Trump is guilty of a crime, the conversation sounds like a Mafia-style threat. But if you believe Trump and his associates are innocent of any crimes, you probably see honesty and loyalty as the same thing in this situation. Innocent people want law enforcement to be honest. For the FBI to act otherwise would be disloyal to both the Constitution and any citizens involved in the investigation. In the context of an investigation of an innocent citizen, honesty and loyalty from law enforcement are the same thing.

“Hope you can let it go”

Regarding the FBI investigation of Flynn, if you think there was wrongdoing by Flynn, Trump’s expression of hope that the FBI can “let it go” sounds like a gangster sending a threat. But if you believe Flynn was innocent of everything but lying to Pence (for which he was fired) then you see it as entirely reasonable that Flynn’s friend (Trump) would “hope” Comey could “let it go.” The alternative would be hoping that Flynn was harmed for no reason, and the government continued to be distracted over nonsense. Does anyone hope for that outcome?

I won’t defend what President Trump said or did on this issue. Clearly it was problematic because we’re discussing it instead of something more useful. But I don’t see a broken law.

Persuading Comey

Was President Trump trying to persuade Comey in any of their private conversations? Of course he was. In a political context, all conversations are about persuasion. Comey was trying to persuade Trump that Comey was a competent and capable player with no bias. Trump was expressing his preferences from a power position, which is persuasive by its nature. 

Persuasion isn’t inherently good or bad. Persuasion is a tool. It’s goodness or badness depends on the context of its use. If you believe Trump knows he and his associates were innocent of any wrongdoing, and you observe that the investigations are making the government less effective, it feels entirely legitimate for the President to persuade in a direction that is a benefit for all citizens. No one wants to waste time, money, or energy on a useless investigation. But if you think there is some wrongdoing yet uncovered, presidential persuasion would be wildly inappropriate in this case, even if technically legal.

I haven’t seen evidence of any crimes on the Trump side, so my filter sees a president trying to remove some obstacles that are not serving him or the American public. That kind of persuasion doesn’t feel wrong to me. 

If new information emerges, I’m happy to update my opinion.

You might enjoy reading my book because I it is chock-full of honest loyalty. 

I’m also on…

Twitter (includes Periscope): @scottadamssays​

YouTube: At this link.

Instagram: ScottAdams925

Facebook Official Page:

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An Example of Cognitive Dissonance

What the heck is “climate denial”? Is that even a thing?

I mentioned on Periscope the other day that I created a Sunday comic as a cognitive dissonance trap. I wanted to see if I could make an argument about the reliability of ECONOMIC models and dupe irrational people into labelling me a climate denier. 

As you can see below, the experiment worked as planned. Notice the excerpt below leaves out the part of the comic that mentions ECONOMIC models.

I know many of you don’t believe I planned this as a cognitive dissonance trap. But I did. If I do something like this again, I’ll call it out for you in advance so you can follow the experiment.

My hypothesis (to myself) was that i could make a public argument about the reliability of ECONOMIC models, and partisans on the climate debate would not be able to see the word ECONOMIC on the page. Literally.

If you see the word ECONOMIC in the comic (twice), you probably can’t find anything objectionable about the point of it. Both sides of the debate would agree that you need an economic model to make a decision. And both sides would agree that no such credible model exists. 

Science tries to tell you what is true, as best it can. Economics tells you how one true thing COMPARES to another true thing on cost. Those are very different models. For example, science might tell you the sea level will rise by three inches. But you need an economic model to decide whether spending money to address that problem is better than spending money to fix other problems. If you leave out the other options for spending your limited money, you have done no decision-making analysis whatsoever.

No scientist would disagree with what I just said. Likewise, no scientist who sees the word “ECONOMIC” in my comic would find anything with which to disagree. The only way you can disagree with the comic is to (literally) hallucinate that it says something other than what it says. And that’s what happened. As I predicted.

The trigger for cognitive dissonance is this:

1. Climate scientists are 100% sure they are right.

2. My comic explains that no credible decision-making models (economic models) exist. 

3. Climate scientists reading my comic realize they haven’t done the work necessary to make their case to the public because science is only the first step. Economics is the tool you need for policy-setting and decision-making. And the economics of climate change – which would necessarily compare all spending options for our limited money – haven’t been modeled in any credible way. 

4. Given this set-up, a climate scientist would either need to admit that his or her career-defining opinions about climate policy are incomplete (at best), or the scientist must spontaneously generate an illusion that masks the words ECONOMIC in my comic. In other words, climate alarmists experiencing a state of cognitive dissonance can read that comic ten times and not remember seeing the word ECONOMIC when done. I mean that literally. The word ECONOMIC will be mentally invisible to anyone in this cognitive dissonance trap.

Try showing this comic to a climate alarmist friend and see how well the trap works. Look for your friend to fight like a wounded weasel to avoid talking about ECONOMIC models. And watch how quickly you get labelled a “climate denier.”

As if that is even a thing.


You might enjoy reading my book because science.

I’m also on…

Twitter (includes Periscope): @scottadamssays​

YouTube: At this link.

Instagram: ScottAdams925

Facebook Official Page:

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