Sunday, March 20, 2011

Ambient Awareness -- The New Social Capital

The readings for this post, combined with a trip back to my childhood home, gave the opportunity for considering this topic from several perspectives. Now I’ll warn you – and apologize – right up front. This is more of a personal story, not because my life is particularly interesting, but because it illustrates a broader continuum of the topic than is discussed in the readings.

We grew up in a tight-knit farming community where church was the center of the known world. If the church doors were open and the lights on, our family was there – all 11 of us! That was life in this farming community. From my recollection, we either visited another family or had another family over to our home for dinner (the noontime meal) every Sunday after church. Several times a year, all the churches in a larger area would get together for special events. We had our own self-contained cultural system. While many of us had some connections outside of this system, they were most likely relatives who lived in similar cultural constructs.

I was five years old when we got our first telephone, a party-line system that included seven other families – some of whom were not members of our church. For the first time, we could find out what was happening in the neighborhood – not just the church community – on a daily basis rather than relying on the weekly update at church.

We got our first television when I was in the sixth grade, and suddenly a window into a world beyond our agrarian culture was opened. It was very unsettling to the older generation, but a welcomed relief to the younger generation.

As awareness grew of issues outside of our immediate community, opinions that had never needed to find expression began to find voice. Conflicts and stresses grew where ideas had never been discussed before. Should we be patriotic and support the Vietnam War or honor our faith history of pacifism and resist? Should we build our own schools to protect the kids from the outside influences or accept change. What should the church’s position be on Rock and Roll, television shows, movies? The privacy of our culture had been compromised.

The traditional Sunday dinners became less frequent. I recall that because of the phone, there was less need to get together in person, so with the extra time, we began to become interested in new things, like NFL Sunday afternoon football.
As the party-line gave way to a private telephone lines with long distance capability, the social fabric became thinner, but more extensive. We could find out that Grandpa had broken a hip the day it happened rather than waiting two weeks for a letter to arrive.

As the ability to stay in touch became less of a barrier, the need for face to face interaction became less necessary. Now Sunday dinners tended to include family rather than cycling through the families who attended our church. Face time was reserved for the closest circle of friends.

Technology was changing the amount of time we had to invest in relationships in order to maintain them. If you were to go back and apply the Dunbar number, it wasn’t much different back then. We had very close ties with a small knot of people. Our social network included maybe 8 – 10 families, and the larger network could include 100 – 150 people. Even then, the shift was happening. We were replacing a face-to-face relationship with people with an ambient awareness of the people in the community. We still knew what was going on, we just collected the information in a different way.

Traveling back home last weekend made me aware that I still carry an ambient awareness of most of those people all these years later. I could still stop by for a visit or pick up the phone and call any one of them and carry on an enjoyable conversation. Yet, I choose to connect sporadically with many of them through Facebook or email – basically on a “need to know” basis.

Last summer, several individuals updated me on what was probably the largest auction of John Deere tractors in the world. My Uncle Louie’s estate was selling off hundreds of tractors from his collection. It was promoted nationally via a website set up for just that auction. People passed the word on Facebook and arranged meetings through email. It even hit Twitter among a few brave souls. The internet and social media were playing a significant role in the sale of assets of a man who had never touched the power button on a computer in his lifetime.

The threads of the local community were suddenly woven into the fabric of a much larger “community” of people interested in John Deere tractors. People who didn’t know each other or even know they had a common interest were getting together and creating a new collective commons around Uncle Louie’s tractor collection.

Even as the availability of new technologies seemed to diminish the value we placed on community, that value was being bolstered through new methodologies. The telephone made it less important to get together each week. The television provided information directly that previously came through a weekly newspaper or letter. The connections were still there, just being maintained in a different way.

Similarly, today’s cultures are not so much replacing or failing to establish relationships, but rather are relying on “commons” other than location to establish communities. People who have been or choose to be isolated in real life can seek relationship in virtual environments. Friends who can no longer walk next door for coffee can maintain the relationship despite job relocation or divorce. The transience of our people and fluid nature of our culture has found a new stickiness that is reshaping the concept of community. The physical community is no longer required as a basic building block in the structure of culture. Common interest has become the new thread through the fabric of our many cultures.

Saturday, March 5, 2011

Healthcare Reform: Control and the Insurance Industry

[This is a post in reponse to a discussion thread about healthcare reform.]

There are a couple of very interesting threads going here. I'll try to steer a course through the "control" statement so you can see where I'm coming from.]

One individual said, ". . . the true crux of the conversation . . . can be reduced further to a single word: CONTROL" Now, I sense the implication was that control, the kind that tells me what I can and cannot do, is a bad thing. If I've misread that, I do apologize.

While I don't know if the statement was intended to ferret out who is "with us" and who is "against us," you have to acknowledge that without an abundance of control, there is chaos. The FAA "controls" airspace. That's a good thing. The USDA "controls" much of the practice of raising commodity crops. Many farmers chafe at that, but it does bring stability to the commodity pricing structure and worldwide demand situation. Despite lots of laws, lack of adequate oversight (or control) seems to have played a role in the banking collapse in September of 2008. Why do we pay so much of the national defense? Control! Yet there is very little control over what I say in public or over how many guns I own. There is a place for control and a place for it to be set aside. Balance is the tricky part.

To those who say we need to get the government out of everything, let me invite you to move to the Republic of Somalia where there is, effectively, no government. But apparently that isn't paradise either, because we have so many Somali immigrants here that I have to translate patient education materials into Somali to help advance their level of health literacy.

Government and business have very different roles in our society. If you need to establish ownership of your home and request a title search, you go to a business, a title or abstract company, to do research using documentation gathered and preserved by governmental entities. If you need a permit to build a house, the builder doesn't keep data on the land, soil samples, flood planes, ownership, easements, etc. You go to your local government to get the information. And those pesky inspectors that try to prevent you from building a structure that is unsafe -- oh, that's the ultimate in control. Until, that is, the place collapses and insurance doesn't want to settle the claim. Then they take it to the court system -- another governmental intrusion -- that has to sort out legalities and determine what's fair. If the person on the other side of the courtroom attacks you, the police step in to re-establish -- you got it -- control.

I guess at this point, I'd assert that there are many things that government does that are necessary and that are done quite well.

There is a valid point of view that says everyone should participate in a healthcare payment system so that the liabilities and benefits are available to the greatest number of people. (Have you ever tried not paying the Defense Department portion of your Income Tax?)

To denigrate the capabilities of the federal government because they can't meet someone's expectations for the cost of Medicare and Medicaid begs the question: Why is it that the elderly, the disabled and the veterans -- the most expensive groups to care for -- get their care from the federal government. If the free-market capitalistic system is so efficient and admirable, why are the most costly groups dumped on the government. I'd say it's because no one can turn a profit on those groups, and thus, will not accept the responsibility. (Using "pre-existing" conditions was another way of excluding those that didn't fit into a profit model.)

Government, in addition to many other things, does what would otherwise not get done. When's the last time Exxon-Mobile built, staffed and funded a facility for veterans? Or an insurance corporation, for that matter, provide coupons for free meals to the homeless or families needing food? If not for government, what kind of education would be available in rural Wyoming? How much of the technology we take for granted had the basic research funded by government grants? Why does the CDC worry about getting the flu vaccine "recipe" correct when it is the insurance companies and healthcare organizations that will be spared enormous costs?

Repeatedly, it is the government that has taken up the humanitarian torch for our society.

Why don't we have orphanages filled with disabled kids like some of the eastern bloc countries? Government intervention, regulation and direct care.

Now, tying the issue of control to the issue of healthcare reform, I agree that much of the fight is about control. But I see it as the insurance industry fighting to maintain control of the enormous amounts of money they absorb to support the industry that is providing little if anything to advance the health of the people. Other than providing a lot of jobs, I have a hard time making a case for the existence of a for-profit insurance industry.