Sunday, October 18, 2015

The CURIOS CASE of UNCERTAINTY


There is an inimical power distribution curve that covers a lot of area and devours all thought’s food. It is the charade of certainty. The power exudes directly from the certainty of the word “certainty.” Projecting something with the net of realism and a confined future within certain artificial bounds is tantamount to being a prophet. And there are a lot of prophets to behold. In fact prophesizing has now reached epic proportions in the 21st Century.


Let us look at some of them with a critical eye.

 1. Life Expectancy: In the United States, an adult male expects a life expectancy of 80 years. Barring all the other natural shocks that the flesh is heir to, that might not be too certain. Things happen. There is no certainty here, except that projected and demanded by the experts and lawyers. “ He should have lived…”

      2. Regulations are for the Public Good:  Nancy Thorner wrote about the Dodd-Frank Bill; “Its purpose was to create a sound Economic Foundation to grow jobs, protect consumers, rein in Wall Street and big bonuses, end bailouts, and "too big to fail," as well as prevent another financial crisis.” Paul Atkins stated, “…the 2,319 page bill is basically rubbish. Dodd-Frank created thirteen new offices and agencies, the government only got rid of one agency.” And according to Oversight and Investigation Subcommittee Committee Chairman Rep. McHenry, "Rather than institute market discipline and a clear rules-based regime, four years later Dodd-Frank's failed policies have only worsened the risks within the financial system and recklessly handed financial regulators a blank check for taxpayer-funded bailouts." 

    
      3. Quantitative Easing will prevent a financial Crisis: Thus far the wealth of the nation has increased with fiat money and aggregated in the 1% population. The median income and wealth effect has diminished steadily since 2009. The United States Debt has ballooned to almost $19 Trillion (around 108% of GDP) and counting. Someone will have to pay in some form or another. Food hyper- inflation that matters to an average individual is eating away at his or her meager earnings while adding energy and electronics into the calculations makes the inflation picture appear tame for the time being to the politicians and the economists. All good for the forecasting experts. Hey if you cannot afford food, you can always take a selfie. “We have continued economic recovery…”

      4. ACA is a boon for Healthcare in the United States: 9 million souls are covered by the ACA while 33 million still have no insurance, this from five-thirty eight. Meanwhile those that had personal or private coverage have had to relinquish their insurance and are forced into a substandard coverage with high deductibles and higher co-Pays. Insurance denials are rampant and “Less is More” is the mantra of the experts. The tail has wagged the dog into a state of panic. The experts keep drumming the virtues of a failed system while the ordinary citizens walk around dazed and confused. The countercoup injury to reason appears devastating at present. “The Affordable Care Act!”
       
      5. ACA affords Quality Medical Care: Physicians are burdened by the morass of paperwork where they spend more time trying the “Meaningful Use” of a computerized binary logic of medicine in an uncertain human pathology, while the patient gets less and less time of meaningful encounters. How does one measure “Quality” is the question asked often. The answer still evades even the most sophisticates. Using metrics of cost and time and resource usage is one way this is being calculated currently. “Call it the stupidity of the American voter or whatever…”

      6. Patients are getting quality Care: Patients who are newly forced into the Medicaid system are unable to find doctors who participate in the overly regulated Medicaid environment and thus are left seeking help many miles away from home, leading to delay and detrimental care. If that is quality, there is a bridge in Brooklyn ready for sale. “If you like your doctor, you can keep your doctor…”

      7.  Electronic Medical Records: A physician’s time is spent trying to get reimbursed for rendered care so as to continue feeding the managerial beast of burdensome regulations within their private and hospital practice. The demands by the regulatory body for compliance and the need for the hospitals to make a profit to pay for the 3000+% increased managerial staff pits the doctor against the patient in providing the best care. All that time spent in clerical computerized tasks is, time away from the patient; time is wasted in the bureaucratic jungle. "Initially you drop about 30 percent [of productivity following an EHR implementation], sometimes more.” John Rodgers MD.


8. A Purell in every corner to arrest spread of germs: When did washing hands become a rarity in everyday life before eating? The simplest and best form of defense against acquiring infections from others is still Agnes Simmelwies’ well documented and proven “Washing hands to prevent transmission of infections,”  in “Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers” (“The Etiology, the Concept, and the Prophylaxis of Childbed Fever”) Purell unlike hand-washing might have unintended consequences; might help mutate the exposed bacteria at a faster rate to gain access to the human body. The dream for another antibiotic is kept alive. Just a thought, take it for what it’s worth. Purell in every Walmart and Grocery store.

9. Vaccination will lead to eradication of viruses: Although vaccination is an important landmark in population health against disease, it crackles the imagination that a virus will acquiesce and lay down its arms for survival against this sea of defense. Viruses mutate and they will, to find a foothold again. Eradication is impossibility, because paramount in the viral code is its own survival. Polio virus keeps making a comeback as does the tuberculosis bacterium, the devastating mycobacterium. The human immunity learns to live over time with microbial adversaries. The elusive dream of certainty remains elusive. "There is no cure for polio, it can only be prevented." - World Health Organization. Unfortunately pockets of Poliomyelitis still exist but with a more virulent mutated form of the virus. (here)

10. The Food Pyramid:  That pyramid was responsible for the current obesity rate in the world to a large extent! It was a well-meaning platform by some health experts. What it touted was the fairly excessive use of carbohydrates. The hunter gatherer had not so easily transitioned from the meats to the carbs so quickly and storage of excess not-utilized carbs turned into fats for later use. The human girth exploded as a consequence. Since there was little chance of a famine given the burgeoning racks of food varieties in the supermarket, more and more fat storage occurred that is now threatening chronic illnesses, heart disease and cancer in 36% of the population? The Big Gulp addiction continues. Again an ill-advised certainty gathered on the shoulders of giants in the academia has now become the bane of existence. And a new industry is born; wearables! The uncertainty of human certainty creates a new uncertainty!

11. Volkswagen: The bosses were almost certain that the cool software that fooled the emission standards software was undetectable, were proven wrong once again. Back to the Enron days a similar set of rules were used and we know what happened there. The confirmation bias exists only in the mind and uncertainty has a habit of redressing it. "I personally am deeply sorry that we have broken the trust of our customers and the public,"- Martin Winterkorn, Volkswagen's CEO."

We live in a world defined by the Fallacy of Anecdotal Evidence used as a surrogate for certainty. An anecdote is cited and the drumbeat follows. The poor are richer by world standards in the United States but they are told they are poorer. Healthcare in the United States has spawned the most innovation and continues to do so yet we are told that we have the worst care in the developed world by using some arbitrary metrics that satisfy the academia and the politicians for their personal fortunes. Even Heisenberg's Uncertainty Principle about Nature's fuzziness seems to have escaped the minds of the elite to their own peril.

There appears only one certainty in this world today and that is the certainty of invoking fear. The media is complicit. The politicians love it. The experts spawn it and the populace drinks their Kool-Aid. Disaster looms at the sound of daylight. Fear rides at the tick of the second and citizen helplessness is the all-encompassing fait accompli. Entitlements abound, hope is touted, change is demanded and through all this the human dignity suffers a little with each passing moment. The only certainty in life is death. Life is a terminal disease.

Maybe we might consider that certainty in an uncertain world is the utopian creed. Chaos is the norm, admit it! Certainty is a human mind construct to feed it’s sense of security. After all it is in the uncertainty that innovation is made and progress stimulated. In certainty, life becomes a mournful indignity, a known, known; an exposed drudgery.

“We sail within a vast sphere, ever drifting in uncertainty, driven from end to end.” – Blaise Pascal

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