patrick.net

In his 2019 book Code Blue: Inside America’s Medical Industrial Complex, Dr. Mike Magee, an MD and former physician-spokesman for Pfizer, memorably described the corruption of the U.S. healthcare system.

Cozy relationships and generous gratuities have demonstrated a remarkable ability to corrupt even those we would instinctively put on the side of the angels, including members of the biomedical research community, deans of medical schools, directors of continuing medical education programs, officers at the NIH and FDA, and even seemingly altruistic patient advocacy organizations like the American Cancer Society.

A theologian looking at all this might conclude that American health care has lost its soul. A behavioral economist would point us toward studies showing that the exercise of moral judgment in a business context draws on a completely different cognitive framework from the one we use in making such decisions in our personal lives.[i]

Dr. Magee is one of many observers who has perceived that the American healthcare industry—in its close relationship with U.S. government agencies and funding—closely resembles what President Eisenhower called the “military-industrial complex.” In his 1961 Farewell Address, he warned:

We must guard against the acquisition of unwarranted influence, whether sought or unsought, by the military-industrial complex. The potential for the disastrous rise of misplaced power exists and will persist. We must never let the weight of this combination endanger our liberties or democratic processes.

Eisenhower’s warning wasn’t new. Presidents Washington and Madison also warned about the danger that could arise if the new American Republic allowed the establishment of an organized interest in waging war. Because entanglements and conflicts with foreign powers would necessarily result in massive government spending on the army and navy, this would likely result in organized military interests seeking such entanglements and conflicts, even if they in no way benefitted the American citizenry.[ii]

The inner workings of such complexes, in which participants are motivated by financial rewards, raise a question that goes to the heart of the human condition. Under certain circumstances, can normal and decent people lose their moral judgement to the point of “losing their souls”? As Dr. Magee pointed out, studies have shown that people working together in a profitable enterprise tend to be less constrained by ethical considerations than they are in their dealings with family and friends. Their highly focused, goal orientation is perhaps reminiscent of Paleolithic hunters in single-minded pursuit of valuable prey. It seems that when we are engrossed in this mental state, we tend not to think about the negative consequences of our behavior for others outside of the enterprise.

People may be slow to recognize that their organization or community has been corrupted if they benefit from it. As Upton Sinclair famously put it, “It is difficult to get a man to understand something when his salary depends upon his not understanding it.” Herein lies the power of patronage. If your patron—i.e., the wealthy man or company that pays your salary and benefits—starts behaving dishonestly, you will probably be reluctant to see and oppose it. This isn’t a matter of willful denial. Because your status, sense of purpose, and remuneration are provided by your patron, you may never even think about questioning his conduct.

Amplifying this is what cognitive psychologists call “normalcy bias.” When immoral conduct seeps into an organization and goes unopposed for a long time, it may become endemic and therefore seem normal. Americans witnessed this in the corporate scandals of the 2000s, starting with Enron in 2001. This period of financial malfeasance culminated in the great Financial Crisis of 2008, largely caused by the massive sale of fraudulently valued mortgage-backed securities. After the crisis erupted, many wondered why regulatory agencies hadn’t seen it coming and stopped it. At root of the problem was “regulatory capture”—that is, incentives for the people who worked for agencies, and especially bond rating agencies, to turn a blind eye to the corruption they were supposed to be preventing.

A singularly terrifying corruption of a society occurred in Germany during the 1933-45 period, when the country—previously the most advanced and cultured in the world—lapsed shockingly far from civilized norms. Likewise, many intellectuals who prided themselves on their moral and intellectual discernment failed to recognize the criminal nature of the Soviet Union and its allied regimes in Central and Eastern Europe.

Reflecting on this disturbing reality, the Swiss playwright, Max Frisch wrote a black comedy titled Biedermann and the Arsonists, published in 1953. The play’s protagonist, a businessman named Gottlieb Biedermann, reads in the paper that arsonists are afoot in his town. Their modus operandi is to introduce themselves as door-to-door salesmen in need of overnight accommodations, and to talk the house owners into allowing them to stay in the attic, where they then set fire to the house. Mr. Biedermann marvels that anyone could be so gullible, and he is confident that he would never be taken in by such an obvious trick.

The arsonists then arrive at his house, and through a combination of apparent normalcy and charm, they persuade Mr. and Mrs. Biedermann to allow them to stay in their attic. In a key scene, one of the arsonists proclaims, “The best disguise, even better than humor and sentimentality, is the truth, because no one believes it.” The naive couple can’t see what is about to happen to them precisely because it is so out in the open. They mistakenly assume that such perfidy would be cleverly concealed and not hiding in plain sight. The arsonists then set the house on fire, which spreads to the neighboring houses and burns down the entire town. In the final scene Mr. and Mrs. Biedermann are transported to the gates of hell, where they encounter the arsonists, who introduce themselves as the Devil and his companion Beelzebub.

Mr. and Mrs. Biedermann’s trip to the gates of hell is suggestive of observations made by the Swiss psychiatrist Carl Jung, who believed that all human beings have a dark side that renders them capable of committing or participating in grossly immoral and even criminal acts. Those who fail to recognize the “Shadow,” as he called the dark side of human nature, often fail to recognize that they are participating in a corrupt enterprise. Preferring not to see evil makes them susceptible to it. As Jung put it:

The shadow is a moral problem that challenges the whole ego-personality, for no one can become conscious of the shadow without considerable moral effort. To become conscious of it involves recognizing the dark aspects of the personality as present and real. This act is the essential condition for any kind of self-knowledge.[iii]

A dramatic twist of people failing to see what’s right in front of them was presented with delightful effectiveness in the 1995 film, The Usual Suspects. In this iteration, people don’t recognize the arch villain because, though he is constantly in their midst, he seems harmlessly inept. He emphasizes his method, and the reality of humanity’s fatal delusion, with the famous line, “The greatest trick the Devil ever pulled was convincing the world he didn't exist.”

Within the context of current affairs, a similar aphorism may be said of powerful interest groups—namely, “The greatest trick that powerful interest groups ever pulled was convincing the world that everyone who detects and reports their activities is a conspiracy theorist.” Only the naivest consumer of mainstream news reporting would fail to recognize that powerful interest groups in the military, financial, and bio-pharmaceutical industries work in concert to further their interests. Their activities cross the line into conspiracy when they commit fraud or other crimes to advance their interests.

"Dr. William Shatner introduces the Aries variant and pushes the vax."

Governor DeSantis held a blockbuster press conference yesterday titled “Mandate Freedom,” in which he coined what may be my favorite new expression. He was talking about the possibility of new federal mask mandates, and said:

“We see all this stuff, and we see they are not following the science. They are trying to follow a narrative. They are trying to follow an agenda. Here in Florida, we did not — and we will not — allow the dystopian visions of paranoid, hypochondriacs control our health policies, let alone our state.”

https://twitter.com/DeSantisWarRoom/status/1699784459103711376

Haha! “Dystopian visions of paranoid hypochondriacs!” That’s money! I can’t wait to use that terrific line someplace.

Optimizing outcomes by thinking the best of people...

The first trap I managed to escape was trying to convince ‘narrativers’ of anything other than the narrative. Stepping away from those pointless ‘arguments’ saved me a lot of heart ache and time. My energies went to analyzing data.

The second trap I managed to escape was falling for the lures of trolls with regard to wasting my time responding to their hit pieces. ...

The third trap I am still learning how to side-step is the one that is really hard to see. I am not even sure how to define it, but I do know how to define the outcome: division. If I do fall into one of these traps, I usually end up with misgivings against someone that perhaps I have never even met. That kind of thing. It reminds me of when I found myself yelling at my screen when I still had facebook back in 2020. I had to stop myself one morning and simply ask the rational question: Why am I wasting all this energy, and ramping up my blood pressure over something I can’t even verify? Is this the purpose of these ‘messages’?

Ultimately with people, my strategy is basically to think the best until I have proof that they are crapola. And by crapola, I mean someone who really is consistently intent on hurting others. I think these people are few and far between, in reality, and that most people want to do good and perhaps even think that they are doing good even if they aren’t. ...

Thinking the best of someone creates and maintains an environment of possibility - a best potential whereby that someone has a chance to live up to this best potential. Thinking badly about someone does the opposite, and creates and maintains an environment of doubt, deprivation and non-productiveness. The former is productive and allows for the possibility of best outcome. The latter is non-productive and encourages worst outcomes and actually, potentially prevents any good from manifesting. ...

Try something new. Optimize our outcome. Even if some people are doing ‘questionable things’ ask yourself: have you walked a mile in their shoes? Will you? Are they really evil, or are they just ego (driven)? To be egotistical is not the same thing as being evil and let’s face it, none of us have any idea what we’re doing so isn’t it best to try to drop ego stuff and help each other along the way. This is hard one for us humans.

Optimizing outcomes by thinking the best of people...