Conversation Starter – Universal health care

It is health that is real wealth and not pieces of gold and silver. – Mahatma Gandhi

One of the things I find so frustrating about the problems that plague us is that we’re not having the adult conversations needed to solve them. I’m a firm believer that if people talk together and truly listen to one another, better solutions result. As Margaret Wheatley has said,

Nothing has given me more hope recently than to observe how simple conversations give birth to actions that can change lives and restore our faith in the future. There is no more powerful way to initiate significant social change than to start a conversation. When a group of people discover that they share a common concern, that’s when the process of change begins.

Over the next few months, I’m going to occasionally post what I’m calling “Conversation Starters.” The posts will be about important and contentious issues that impact all of us, our communities and our country. For each, I will try to lay out a non-ideological, non-partisan framework around the issue, trying not to inject my personal prejudices (remember the word “trying”). Even though we all know that I’m infallible (Right!), I do occasionally have weak moments. So, please, feel free to point out things I’ve missed. Or to involve me in your own conversations.

We need just such an adult conversation about health care. Many are calling for some form of “Universal health care” saying it’s a fundamental right. Others decry it as “socialized medicine.” Everyone recognizes that we in the US are paying far more than any other country for health care and not having better outcomes as measured by indicators such as life expectancy

or infant mortality.

And too often we ignore the fact that our health, our wellbeing, is far more dependent on our lifestyle choices and our environments than on our health care. To me, the conversation about universal health care encompasses four dimensions.

• Purpose. Generally speaking, few countries have a true health care system – one that comprehensively and relatively seamlessly maximizes well-being. We certainly don’t have that in the US; what we have are treatment systems with a few preventive overtones. We have separate systems for the aged and for long-term care, and for those with mental health issues. We also have what I’ll call for want of a better term a “wellness system” (e.g., gyms, walking paths, tennis and pickleball courts); its purpose is to keep us healthy.

Without a clearly defined purpose, I’m not sure we can arrive at an acceptable solution. So what do we want our universal health care system to be – a better version of what we have now (with “better” to be defined)? A more comprehensive systems that incorporates all aspects of health including wellness? Or something in between?

• Access. Finances ultimately limit access to our current systems in at least two different ways. From an individual’s perspective, my access depends on my ability to pay (and, often, who’s paying me and how). However, in much of rural America, finances limit access indirectly. If there are not enough patients (i.e., paying customers) to support hospitals, clinics or sometimes even a doctor in a given location, there is unlikely to be one.

We also should recognize that solutions that work in smaller countries may not work for a country of 340+ million people scattered across 3.5 M square miles. In addition, discretionary income limits access to the “wellness system” for those with limited incomes; you don’t see many of the poor at a gym. We also need to decide under what circumstances we’re willing to pay for the care of non-citizens.

• Payment. This is where so much of the attention has been focused. In the US, we have a complicated multi-dimensional tug of war among patients, care providers, insurers and governments (local, state and federal). We have Medicare for older and disabled Americans; TriCare for the military and the VA for veterans; Medicaid for the indigent; private health insurance; catastrophic insurance; long-term care (and a host of others I can’t remember!). Costs are exploding for each of these. Payments are going to doctors and other health professionals, hospitals, testing labs and equipment manufacturers, drug companies, pharmacies, pharmacy benefit managers, and insurance companies (whew!). We have federal regulations and programs, state regulations and programs (and sometimes city or county regulations and programs). Recent revelations have shown just how fraud-prone some of these are. Given the relatively poor lifestyles of so many, and the fraud surrounding the systems intended to pay for care, it’s really no surprise that our life expectancy per dollar spent on health care is so low compared to other countries. So here we need to ask, “Who pays? How? How do we limit the opportunities (some might even say built-in incentives) for fraud that we have in the current system?”

It’s important to point out that there are several models for paying for so-called Universal Health Care. For example, Norwegians pay high federal taxes for hospital and specialty care, while primary care is funded through local government taxes. The UK’s model is the most centralized – financed through income taxes. Canada’s system is the least centralized – each province levies taxes for its own single payer plan, which are augmented by federal funds. In the US, this would be the equivalent of having 50 different state plans, operating within federal guidelines. Several foreign countries have included a competitive aspect in their payment plans – citizens of Germany and Uruguay can choose between several different private insurers. No matter how health care is funded, there are usually co-pays or limited coverage for some aspects (e.g., vision or dental).

• Quality. Getting access to care says nothing about the quality of that care. “Quality” of care means getting the needed treatment in time for it to be effective. In almost all foreign countries the central government mandates a minimum level of care. In general, there are no mandates for timeliness so “quality” is not mandated. If we look at Canada or the UK, we see long wait times for some specialized treatments. In too many sad cases, patients have died before they could get the treatment they needed. We in the US have earlier access to emerging life-saving drugs and technologies than almost any other country.

In most other countries, health care is provided by the private sector – the government (or a fund operating under government auspices) pays private providers. Several countries have a competitive aspect to care – Uruguay and Germany, for example.

Our experience in trying to establish “Universal health care” in the US has been at the state level, aiming to set up a state single payer system. Vermont got close, but ultimately couldn’t make the finances work – large (unpalatable) tax increases would be needed. In Colorado, voters resoundingly defeated a proposal to establish a single-payer system. Massachusetts has also looked at a single-payer system several times, but again and again states encounter three problems:

  • Large tax increases are needed to keep programs solvent.
  • Changes in federal laws would be needed so that employer-sponsored health care plans could be folded into state plans.
  • State plans would also require federal funding (e.g., diversion of Medicare and Medicaid funds) to ensure program solvency.

Our current health care system isn’t serving us very well – we’re paying more than any other country to get poorer outcomes than the rest of the developed world. Change is needed – we as a people should come together to devise the most effective [health? treatment? …?] system we can. Whatever system we devise will have trade-offs; that’s inevitable. But if people of goodwill reason together we’ll find our way to something better than what we have now. And that’s the purpose of this post: to provide a framework to start that conversation. So talk to your friends. Ask your representatives at all levels the tough questions. And push for something better than we have now. But it all starts with adult conversations…

Silence

“Silence like a cancer grows.” — Paul Simon

The motto of the Washington Post is “Democracy dies in Darkness.” Well, maybe. More importantly, though, the cause of Death is Silence. The Silence of actions not taken.

There are many kinds of Silence. There is the Silence of not wanting to get involved – not calling the police when a youth who organized a water balloon party is killed by a gang member. There is the Silence of “Not my Business” – passively allowing any injustice just because it isn’t happening to you – yet; watching “social justice warriors” threaten, harass and harm Jewish students simply because it’s happening to them and not you.

There is the Silence of Fear – ignoring fraud and corruption because you might be called a bigot or a racist. As Eli Steele has said: “Millions of whites were told that to defend themselves against the charge of racism was itself proof of racism. Many of them discovered that it was easier to go silent than to be brave, and so they surrendered their own voice rather than risk a word.”

There is the Silence of Acceptance – excusing a sociopath because, well, Trump. There is the Silence of Apathy – fewer than 5% of the voters in New York City effectively elected avowed anti-American communists and anti-semites to Congress. The silence of the rest of the voters – deafening. Perhaps most disgusting is the Silence of Opportunism – filming a child’s rape to get more clicks on social media.

As Simon’s simile says, Silence is a disease, a contagion that can consume our communities. Humans are social animals. If we are in a group of people remaining silent, we are likely to remain silent as well. And if we have remained silent once, we are likely to remain silent again.

Like cancer, there are no easy cures for Silence. How can the cowardly find courage? How can the uninvolved become involved? How can we help the apathetic to care?

In our large cities, there are few sounds of children playing in the streets. In some, the parks and even the sidewalks are littered with drug paraphernalia, human waste, and wasted humans. These cities are gripped by the cancer of Silence. Effective action is not taken because the powers-that-be are like patients in denial.

The cure starts with ourselves. When we see injustice, or fraud, or – worse – the flash of the killer’s knife, we must speak, we must condemn, we must turn the killer’s hand aside.

Last week, we celebrated our Fourth of July, while hosting one of the most exciting World Cups in memory. We Americans found ourselves flummoxed by the praise of our country by our foreign visitors. Those who visited our smaller cities and towns were in awe of our abundances – houses, restaurants, green spaces, friendly people, sense of place, and freedom. What they found was simply people who care about their communities, and are committed to them. In these communities, everyday people’s actions overwhelm the Silence, and put the cancer into remission. In our communities, as in our own lives, curing cancer starts with action.

Requiescat in pace – Lindsey Graham

As a South Carolinian, I voted for Graham many times. In SC, he was attacked as both too conservative and not conservative enough. To me, the quote that is the most revealing of who he was, came during confirmation hearings for one of Obama’s judicial picks: “Elections have consequences.” By this he meant that Obama [and later Trump] as the Chief Executive duly elected by the people, was due deference to his choices, barring any truly disqualifying factors [Consistent with the reasoning of a recent Supreme Court decision.]. 

Based on this, he worked tirelessly for his constituents. If he could be a friend to the President, he could do more for his state. If he could partner with like-minded senators of either party to do something he believed good for his state and the country, he did his best to avoid any partisan antipathy.

He was a man of some grace, willing to call out those bearing false witness. Most notably in the Kavanaugh confirmation farce. Though not the patrician that his predecessor was, his humor and humanity gave him a certain Southern charm that stood him well throughout his career.

We in SC are blessed with some outstanding possible successors (as well as the usual stinkers!). We can only hope that whoever his successor is has the same commitment to his constituents and devotion to his country as Senator Graham.

Happy Birthday, America

I say to you today, my friends, so even though we face the difficulties of today and tomorrow, I still have a dream. It is a dream deeply rooted in the American dream. I have a dream that one day this nation will rise up and live out the true meaning of its creed: “We hold these truths to be self-evident: that all men are created equal.” – Martin Luther King, Jr.

My grandfather came to the US in 1905, from Croatia. He had $19 in his pocket when he landed at Ellis Island. My grandmother came over three years later. Through hard work (and probably a good bit of pigheadedness!), he founded a furniture store and became one of the most respected leaders in his steel town.

When my Dad was about 8, another kid poured gasoline on him and lit it. Despite terrible burns, he participated in sports and became the first in the family to graduate from college. He eventually became the CFO of a major airline.

After I graduated from college, and started graduate school (1968), I got drafted into the Army to go to Viet Nam. This was at a time when many of my peers were heading to Canada. Whenever I was questioned why I chose to serve, my answer was simply — how could I not. My country had allowed my family to accomplish so much, had done so much for me, that not to heed its call was unthinkable.

Today, our country is even more beleaguered than it was then. Our service is required now more than it has been in decades. I’m too old a dog to serve in the military, but I – and all of us – must speak out and stand up for the values that make America exceptional.

For America truly is exceptional – it’s the only country that has a dream. An aspirational dream that ennobles all of us as we aim for a better Future for ourselves and our families. As we enjoy our country’s birthday, let us hold the Dream sacred, and stand up for our country and what it stands for.

Memorial Day, 2026

Four score and seven years ago our fathers brought forth on this continent, a new nation, conceived in Liberty, and dedicated to the proposition that all men are created equal.

Now we are engaged in a great civil war, testing whether that nation, or any nation so conceived and so dedicated, can long endure. We are met on a great battle-field of that war. We have come to dedicate a portion of that field, as a final resting place for those who here gave their lives that that nation might live. It is altogether fitting and proper that we should do this.

But, in a larger sense, we can not dedicate – we can not consecrate – we can not hallow – this ground. The brave men, living and dead, who struggled here, have consecrated it, far above our poor power to add or detract. The world will little note, nor long remember what we say here, but it can never forget what they did here. It is for us the living, rather, to be dedicated here to the unfinished work which they who fought here have thus far so nobly advanced. It is rather for us to be here dedicated to the great task remaining before us – that from these honored dead we take increased devotion to that cause for which they gave the last full measure of devotion – that we here highly resolve that these dead shall not have died in vain – that this nation, under God, shall have a new birth of freedom – and that government of the people, by the people, for the people, shall not perish from the earth.” Abraham Lincoln’s Gettysburg Address

Yesterday was the day set aside to honor those who died in service to our country. This follows a long tradition reaching back to the ancient Greeks and beyond. These formal occasions have inspired some of the greatest encomiums to those who died while doing their Duty, with Honor, for their Country.

Pericles’ tribute to Athens’ dead has come down to us as perhaps the greatest of these. It was the custom in ancient Athens to hold services for those who had died in war. The city-state would choose a famous citizen to deliver a eulogy. In the first year of the Peloponnesian War, Pericles was chosen to deliver the oration.

As was customary, he began by praising Athenians who had died in battle. He then broke with tradition by praising the Athenian democracy, rather than reciting Athens’ historical military victories. In their democracy, the citizens of Athens enjoyed equal justice under the laws, and even the humblest participated in the Assemblies that decided on the laws and public policies. Pericles then cited the city’s freedom and greatness as the legacy of the honored dead. He challenged the citizens to be worthy of this legacy, and to valiantly continue the war against the Spartans.

Lincoln’s address covers the same ground, but with less than a tenth of the words. The Address was delivered in November, 1863, at the dedication of a cemetery for those who died in probably the greatest battle ever fought on this continent. It is somewhat ironic that Lincoln even spoke: the featured speaker was Edward Everett, considered by many the foremost orator of the day. After two hours of Everett’s oration, Lincoln spoke for only about two minutes.

This melancholy man reminds us that Past, Present and Future are intertwined. We, living in the Present, enjoy the fruits of the American government the Founding Fathers created. We, living in the Present, have a duty to honor those now Past. And we must defend and preserve the best of the Present – our Republic – to pass on to Future generations.

After giving the Address, Everett graciously acknowledged Lincoln’s words: “I should be glad, if I could flatter myself that I came as near to the central idea of the occasion, in two hours, as you did in two minutes.” Many of the newspapers of the day were not so gracious. But after Lincoln’s assassination in 1865, the Address began to be recognized as one of the greatest works of American letters.

I hope all enjoyed the Holiday! I hope you also remembered those who served, who gave the last full measure of devotion. For those who have children, please have them read Lincoln’s words. Lincoln himself had rued the loss of intimate understanding of our Revolution as those who had fought it died. Today’s youth display a more extreme lack of understanding of our history, especially the meaning and the impacts on us today of the Revolution and the Civil War. Doing this both honors the Past and can give us hope for a better Future.

A fatal flaw

“That is the key to history. Terrific energy is expended – civilizations are built up – excellent institutions devised; but each time something goes wrong. Some fatal flaw always brings the selfish and cruel people to the top, and then it all slides back into misery and ruin. ~ C. S. Lewis

I have occasionally used this figure in talks. It is intended to illustrate the nested nature of social systems. Families as parts of neighborhoods; neighborhoods as parts of communities; communities as parts of states or regions. But as I was walking this morning, I realized that the figure could be interpreted as saying that a community “inherits” – can make use – all of the resources or assets in the community. This led to a sort of revelation (you’d be surprised by what passes for a revelation at 6 AM!): not only is this wrong, but it actually is at the heart of the controversies swirling around the mayors of Seattle and New York.

At first blush, one might think that a community as a nested system – made up of many other systems – would “inherit” the resources of all of its community systems. If it did, then the community could use all of these resources whenever it wanted them. We, as individuals, could only use what the community allowed us to.

But we know that’s not what happens in the real world. A community’s leaders can only use the resources they directly control. They cannot use my money or my time or anything else that’s mine except through coercion (taxes and other legal takings) or persuasion.

In New York State, we have seen Governor Hochul trying to persuade businesses which have left to come back to fund the state’s social programs – with no success. In New York, Seattle and several other cities across the country, we have seen the socialist mayors using coercion – taxes on the “rich” (now spilling over to the middle class in NYC); taxes on the unrealized gain in value of investments; in CA and elsewhere, proposals for taxes on those leaving the state (Sadly, they haven’t figured out a way to tax fraud!).

As Winston Churchill pointed out, socialist governments are incompatible with freedom: they require some form of police state. But that is precisely the dilemma that confronts these Karl Marx wannabes. In America, ours is a free society. We expect our communities to provide the quality of life we want – a quality education for our kids, clean and walkable streets, free speech, ability to attend worship services without fear. And if the quality of life in my community doesn’t approach that, I can and will leave. Thus, so many have left these promised utopias, and continue to do so.

The fatal flaw in the figure – and in the socialists’ view of the community – is that my community can only use the resources they bully or beg from me. And if they bully too much and provide too little of what I want, I will leave. As long as we have a free society, this will be true. But we must remember “A free society, if you can keep it (My apologies to Ben Franklin!).” These mayors will not stop trying to remake our cities so that our only rights are those they grant us; we must continually battle for our freedoms.

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Postscript: I find it profoundly ironic that the mayors whose ideology ultimately relies on coercion have been among the most adamant about defunding the police.

Poised on the edge of the AI Knife

Successful people recognize crisis as a time for change. ~ Edwin Louis Cole

…And so do successful communities.

Many of our communities are already in crisis. In our larger cities, too many men have given up, spending their days in drugs and isolation. There are too few opportunities for them – even for college graduates – to begin or to restart their careers. Many cities are being hollowed out by companies and residents fleeing grime, crime and poor governance. Falling birth rates (“Peak population”) and corporate flight have left behind empty homes, schools and commercial buildings.

For some cities, this flight has become a vicious cycle. People leave because of a declining quality of life – increased crime, deteriorating schools, limited opportunities. The local government’s tax base shrinks; business revenue becomes spotty and some businesses leave or go under. This causes more people to leave; and the cycle continues until there’s no one left who can leave.

In my last post, I looked at the potential impacts of AI on individuals. In this post, I look at the potential threats to communities inherent in AI. I’ll also suggest steps a community can take to prepare for AI’s impacts.

Impacts

Communities with large job losses due to AI will see losses in all of their community capital portfolios. These will be similar to those already being experienced in our larger cities. Local government will see immediate loss of income and sales tax revenue. Since many of the displaced workers are high earners, the tax revenue lost will be greater than the fraction of jobs lost. Businesses – especially small businesses like restaurants and shops – will struggle. Eventually property taxes will also fall, leading to less funding for schools and ultimately a poorer quality education.

The diminished need for commercial real estate may lead to a deteriorating downtown. Most seriously, the community’s social fabric will begin to unravel. More anti-social behavior and crime; more drugs; fewer volunteers for those things that enrich and enhance a community’s character. And on top of it all, an increased demand for those services that make up a community’s safety net, especially mental health services.

One other somewhat more speculative impact: AI may accelerate the drop in birth rate. It appears likely that more men will lose their jobs than women. Women – especially college graduates – are already having problems finding suitable partners; it is a recognized cause of the falling birth rate. This potentially could be the most severe impact of the AI revolution on our communities and society.

But let me quickly add that some communities will be relatively unaffected, or at least will not feel much pain for years, if at all. Communities whose economy is concentrated on “high-touch” jobs are unlikely to see much impact. Communities whose economy is reasonably diversified may be “safer” as well – there will likely be some jobs available in non-AI impacted industries to buffer some of the AI job displacement.

Communities whose businesses tend NOT to be early adopters of new technologies may also fare better. As with any new technology, AI’s first impact is to destroy old jobs. However, history suggests that eventually new jobs are created. Organizations which wait to adopt new technologies can then move their most valuable assets – their employees – from the old no-longer-needed jobs to the new ones. Those communities that will fare best are those that prepare. If well-prepared, they may even prosper.

Diffusion of AI

The job losses at software firms and others immersed in the “digital economy” have been well-publicized. Communities with clusters of these firms are already feeling AI’s impacts. However, according to the National Bureau of Economic Research, overall AI is primarily being used as a tool to support normal business processes, i.e., a productivity enhancer.

Despite strong substitution at the task level, overall employment effects are modest, as reduced demand in exposed occupations is offset by productivity-driven increases in labor demand at AI-adopting firms.

Thus, most communities have not yet had to face AI’s impacts, but just how much time do they have to prepare? Answering that is a little complicated – there are a few factors to consider.

  • Knowledge. As I noted in my last post, massive amounts of data are often needed for to develop an AI “bot” to replace a human. As I know from my own experience, the necessary data are often stored in various forms and various places, not least of which is in workers’ minds. And sometimes the data is contradictory. Extracting, rationalizing and codifying all of this can be a daunting, time-consuming – and expensive! – task.

  • Implementation and other costs. Often lost in the hype, there are real costs associated with using AI to replace humans. The most obvious is the cost of developing the AI “bot.” It has been relatively easy to develop AI to replace programmers and some others in the digital world: the AI developers have had access to virtually all of the data they needed and know the business. Development of algorithms is simple when you’re expert in the domain.

    But when you don’t know the business, it becomes much more costly and difficult to implement an AI solution. There is a translation step, converting domain-specific knowledge and jargon to something the AI developer can use. And the AI bot will also have to be able to translate its knowledge back into domain-specific jargon to be useful to humans. This requires at least some human involvement, and specialized expertise probably not available in most organizations.

    There must also be extensive testing to ensure that AI is not “faking it to make it.” For example, a recent news report spotlighted a legal case in which a lawyer had submitted an AI-prepared legal brief which had references to non-existent precedents. Anthropic is being honest when it says “Claude is AI and can make mistakes. Please double-check responses.”

    Another important cost is the loss of capital when turning people out the door. Last year, American companies spent over $100 billion on new employee training, about $1000 per new employee. We are seeing AI reduce hiring of new employees, but more experienced employees are being retained. These people have not only been trained to do a job, but also to do it in a way that “fits” the rest of the company. Procedural knowledge can be gained to develop a bot to do a job (at a cost!) but cultural “knowledge” is much more difficult to capture.
  • Return on investment. In the short term, the benefit of AI is a reduction in cost. Salaries and benefits are always an organization’s major cost; reducing them helps an employer’s bottom line. But that return may be fools’ gold if AI cannot do everything the human could.

    In the longer term, AI may begin to pay larger dividends in terms of developing more effective corporate strategies. However, this requires that an organization’s AI becomes more attuned to its corporate structure and culture. We still don’t know how rapidly this can happen.

Suggestions for communities

Vulnerability. The most important first step for a community is to develop an understanding of possible impacts. Tufts University working with Digital Planet have developed a useful resource for this (https://digitalplanet.tufts.edu/ai-and-the-emerging-geography-of-american-job-risk-page/). They have determined vulnerability to AI by job, by industry and geographic region. The report itself has several interesting graphs and tables, and links to an interactive map. However, communities should concentrate on the Excel data sheet (e.g., there are some transition errors between the spreadsheet and the map).

But don’t use the report blindly. The spreadsheet has three different projections based on how rapidly AI is penetrating a community’s economy. If the community is already feeling the “AI Monster’s” bite, it would be wise to use the Median or Fastest Time data. Communities should also temper its projections based on local knowledge. For example, my community is becoming a center for cyber security study and practice. The Excel sheet predicts a 5% loss of jobs due to AI (Median time progression) but doesn’t consider the jobs that are coming in. Thus, my best guess is that AI will have relatively little negative impact on my community’s workforce in the next five years and may boost productivity.

Response and recovery planning. If the community believes it’s highly vulnerable, it should treat this as a Wild Thing – an extreme event similar to a natural disaster, or a pandemic, or a Recession. That should prompt emergency planning for response and recovery.

For extremely vulnerable communities AI’s bite can become an existential problem. A Whole-of-Community problem requires the entire community to solve it. The first step in planning should be to get all of the stakeholders working together. These may include:

  • The business community. Some businesses need to be involved because they are laying off people; some because layoffs will impact their business; and some because they may be able to hire those laid off. The latter are especially important: the specific qualifications they’re looking for should be articulated.
  • Educators. One of the most important unknowns right now is how to retrain and re-employ those laid off. This is a very different mission from traditional education of the masses (This is summarized nicely in https://dcjournal.com/to-prepare-for-a-future-with-ai-we-must-educate-differently/). Institutions of higher education that are in close contact with local industry are probably best equipped to build bridges between workforce reskilling and the needs of local businesses who may be able to hire those displaced by AI.

    Educators can also act as a source of information about best practices. Many of them are tuned into professional networks and have personal contacts spread across the country. They can provide innovative ideas that the community can include in plans.
  • Local government. As noted above, local government has a great deal to lose to the AI Monster’s bite. It should act as a convenor of meetings and facilitator of plan development.
  • Workforce representatives.
  • NGOs. Those laid off will eventually have to rely on the community’s safety net. NGOs are a large part of that in every community. However, many communities have NGOs that can play a part in reskilling or that can help the displaced to find new jobs.

Strengthen the safety net. Early on, vulnerable communities must determine what “safety net” services are going to going to see increased demand from displaced workers. Once known these communities need to determine what they can provide. And if they find insufficient capacity to meet demand, they should prepare for the consequences.

Education becomes an important of this safety net. This requires rethinking our approach to education; moving from a “once-and-done” model to life-long learning. I’ve written a lot about education over the years: it is essential that we prepare our kids to be able to learn and to want to learn even after they finish their formal schooling. Even before the advent of AI we were told that new workers were going to switch jobs several times over their working life, putting a premium on old dogs’ ability to learn new tricks. AI’s coming provides a crisis that spotlights the need for this change to happen.

I don’t know enough to go beyond this … and I’m afraid no one else does either. But what I believe is that every community can and must determine its own vulnerability and then develop its own plan. What we’ve seen from the federal government and some state governments is erection of barriers – a lot like old King Canute ordering the tide not to come in. And about as successful. But I also believe that a community that works together can weather the storm of layoffs and eventually reap the benefits of the new jobs AI will create. Successful communities will recognize the need for change and adapt to what’s coming. Some others will muddle through. And – I hope only a few – some communities will not recognize the approaching monster until they are devoured.

The AI monster will get you if you don’t watch out

All we need to do is make sure that we’re in a position to benefit from uncertainty and volatility instead of being harmed by it. ~ Nassim Taleb

If you’re confused about the impacts of AI, you’re not the only one. Some predict that AI will destroy civilization as we know it; some predict that AI will revolutionize our lives. Some say that our jobs will be gone; others that we’ll be able to do those jobs better, and there will be lots of new jobs we haven’t even conceived of yet. The one thing each of these seems to have in common is the impact that AI is currently having on the speaker, i.e., the impacts are seen only through the eyes of the beholder. Certainly the impacts of AI are both highly uncertain and highly personal.

As both Niels Bohr and Yogi Berra have said (in almost identical words!), prediction is difficult, especially about the future. So I won’t try to predict AI’s ultimate impacts. Undoubtedly they will be profound, and compounded of good and bad. But I will provide some facts to help think about AI’s impacts, and how to adapt to them. For one thing is certain: the more adaptable we are, the better our chances of avoiding being devoured by the AI Monster.

Impacts on individuals

As a few of you know, I was involved in some of the early attempts to deploy AI in the real world, in the 1980s. At that time, the practical emphasis was on development of “expert systems.” These required gathering the knowledge and experience of experts in a given field, and converting it to a set of rules along the lines of “If some condition, then do this.” And the results were sometimes impressive. For example, a psychological diagnostic system was developed that was as good at dealing with psychological trauma as human therapists.

A lot of the current effort in AI is still this: replacing the “man-in-the-loop” for foreseen situations with a set of rules. The major difference is that our increased computing power and the advent of Big Data are allowing developers to vastly increase the scope of what is “foreseen” and our ability to act swiftly. As a result, we have self-driving cars with accident rates below those of human drivers. We have “apps” that write computer code more rapidly than human programmers, and (if not now, eventually) with fewer errors. AI has growing capability to diagnose diseases, to dig through case law to find relevant precedents, even to point to promising areas for research.

This is due to the evolution of AI from task-based – if-then rules based on a defined body of knowledge trained to act; to generative – systems able to change themselves in response to new knowledge. This is often called “machine learning.” App-adaptation might be a more apt term.

This makes it seem like the doom-and-gloomers are right. The AI Monster will devour us all. Well, not quite; it’s complicated. And if you’re going to escape from the AI Monster [maybe] lurking in your closet, you need to look at your situation through several different lenses.

Current employment. The most quoted unemployment rate in the US is currently at 4.3%. Personally, I find labor force participation more meaningful; for 25-54 year-olds it’s about 84% (pretty high). Conversely, it is in the 60% range for those 16-24. This implies that level of experience is important. If young people aren’t being hired to do a job, or, worse, those with experience are being laid off, that’s a sign that the job is in jeopardy.

The job itself. It’s almost become a truism that AI won’t displace those in the “high touch” professions (e.g., family services, sales) for a very long time. But even there, many of the more routine tasks in health care (e.g., reading x-rays, billing) are being taken over by AI. On the other hand, many knowledge workers are at extreme risk. It seems like every week thousands are being laid off by one of the Big Tech companies. Whatever the field, jobs requiring flexibility, especially those developing policy or strategy, are likely safe for a very long-time.

Cost-benefit. Generative AI systems are expensive to develop. They require massive amounts of domain-specific data, tremendous computing power, and extensive testing. And lots of electricity and air conditioning as well! The greater the complexity of a given job, the less attractive it becomes for AI – the costs may outweigh the value of displacement.

I asked both Claude and ChatGPT (two of the leading AI apps) “What will be the impact of generative AI on future jobs in the US?” Both gave lengthy responses. Claude’s was better written, and I found more generally useful:

The pattern with previous automation was that it tended to displace routine physical work — assembly lines, data entry, basic bookkeeping. Generative AI breaks from that pattern in an important way: it’s targeting cognitive and creative work first. Paralegals, junior analysts, radiologists reading scans, software developers doing boilerplate code, copywriters, customer service agents, financial advisors doing routine portfolio management — these are all in the crosshairs in the near term.

Jobs with the highest short-term resilience tend to share one or more of these traits: they require physical presence and dexterity in unpredictable environments (plumbers, electricians, nurses doing hands-on care), they depend on genuine human relationship and trust (therapists, certain kinds of sales, clergy), or they require highly contextual judgment in novel situations (senior executives, certain researchers, emergency responders). …

The most likely scenario is not a clean “AI takes jobs, new jobs appear, equilibrium restores” story. What’s more probable is a bifurcation: a class of highly-educated, adaptable workers who use AI to become extraordinarily productive and well-compensated, and a much larger group of workers displaced faster than they can retrain, in a demographic environment that offers fewer natural correctives than past transitions. The demographic plateau softens the raw unemployment numbers, but doesn’t address the human cost to specific workers and communities.

ChatGPT, on the other hand, gave a similar answer with two interesting twists. First it provided more detailed impacts for important sectors (e.g., tech and IT, government, education, manufacturing). ChatGPT also looked at the impacts of AI over time. In the short-term, it predicted job losses, some increases in joblessness and reduced hiring of new college graduates. In the medium-term (3-10 years), ChatGPT saw restructuring of existing jobs (skill in using AI becoming embedded in many jobs) and the rise of new categories of jobs (e.g., “prompt engineering,” data governance, AI trainers and testers). In the long-term (10+ years) ChatGPT weaseled out of prediction and instead fuzzily pointed toward a bifurcated future.

From all of this, let me offer the following guidance to all of you worried about becoming a victim of the AI Monster.

  1. No matter your profession or vulnerability, become familiar with AI tools. AI is here to stay. And it’s getting better at doing routine and non-routine tasks. If you can use it, it will increase your value to your employer/customers/clients. More importantly, using AI tools can actually increase your job satisfaction.
  2. Work to redefine your current job to require more non-routine problem-solving. This will help you to further develop AI-complementary skills: learning, planning, creativity and decision-making.
  3. Continually increase your knowledge about how your job/profession plugs into everything around you. Most importantly, focus on your own personal value proposition. But be brutally honest with yourself: if you’re mired in the routine, your value-added may not be high, i.e., you may be vulnerable.
  4. Increase your value. Certainly, taking on more responsibility is one obvious way. Perhaps more importantly, increase the complexity of what you do, especially if your work is largely repetitive or routine. If you can’t, best brush up your resume, and your skill set (see #1). If you can, find a way to apply your skills in a “high touch” environment.
  5. An important way to do both #2 and #3 is to expand your own personal network. Try to determine how people with your skills are used elsewhere. Perhaps more importantly, become a linchpin: a conduit for useful information. Involvement in professional societies can help you do this.
  6. Develop a “Plan B” for yourself. Identify where your current skill set might be of use. Continue to expand your skill set (again, see #1).

Impacts on communities

Claude’s response quoted above points out that AI will impact both individuals and communities. In my next post, I’ll explore potential impacts, and suggest things communities can do to better buffer themselves against potential harm.

Narratives

Narratives … help us to make sense of the world and understand our place in it. — Simon Webb

Each of us has our own story. It is our perception of our own histories stitched onto an underlying fabric that extends beyond our experience. This fabric is Narrative. It is a compounding of history and myth; memorializing our cultural history.

In pre-literate times, each tribe had its own Narrative. These tribal Narratives preserved (and often embellished!) the exploits of the tribe’s heroes and served as a sort of cultural infrastructure. The tribal Narrative channeled action into certain areas while often constraining or even preventing action in others. Unfortunately, in America we have begun separating into two tribes, each with their own Narrative.

The more traditional American Narrative is aspirational. In its purest form, it teaches us that, with hard work, we can rise above any adversity – poverty, racism, ignorance – to make a better life for ourselves and our families. In that sense, it embodies a philosophy of Hope, and emphasizes the ability of the individual to “make a difference.”

And it has its own Heroes – Andrew Carnegie, a poor shoeshine boy who became a titan of industry; Frederick Douglas, overcoming slavery and illiteracy to become one of the most influential figures of the last half of the nineteenth century; Chris Gardner, growing up poor in an abusive home – functionally illiterate – becoming a multi-millionaire stock broker (and the inspiration for The Pursuit of Happyness).

The other Narrative, born in academia, seems founded on a philosophy of Despair. No one can rise above adversity on their own; only groups (sub-tribes) can. It stresses the “warmth of the Collective,” and despises the individualism inherent in the traditional Narrative. According to this Narrative, nothing that came before is good or worthy of emulation. America is inherently —ist: racist, fascist, capitalist, misogynist…

There are no Heroes – or if there are, they are remembered for their acts of destruction (e.g., Luigi Mangione, for murdering an insurance executive). Action based on individual merit – how can that be when the individual is unimportant? The only action worthy of the name is destruction of the current evil – America – and opposition to everything it stands for. Not least of which is the traditional Narrative.

Intolerance is inherent in this Narrative. Rooted in righteousness, the Narrative cannot be questioned. Action taken in accord with this Narrative is self-evidently correct – any failures are anything less than success is due to the perversity of individuals (like the homeless in New York who froze to death due to the Mayor’s “compassionate” new policy).

As the Singaporean scholar and politician, Eugene Tan, has pointed out, successful community action is tied to its Narrative. The community’s Narrative tells the community what it can do and what it can’t. If the purpose of a community is to provide an acceptable quality of life to its members, then which Narrative is most likely to be successful?

Numbers don’t lie. How many have come to America to achieve the American Dream – to improve the lives of themselves and their families. How many have left those communities whose policies are rooted in the second Narrative? Ultimately, Nihilism can’t win. We can only hope that this seond Narrative – rooted in Despair – will eventually return to the dustbin of history.

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I’ve been a rather poor correspondent so far this year. My book writing and travel and now surgery on my knee have been obstacles. I am working on two new posts: one on AI the future of work, the other on a community’s adaptive capacity.

Thanksgiving

Duty, Honor, Country — motto of the US Military Academy

Those of you who have had to listen to my [often] interminable war stories know that I was an – indifferent – soldier. In spite of that, I have always had the utmost respect for those who have made the military their career. That is especially true for those who accept and try to live up to Duty, Honor, Country.

Duty bespeaks their commitment to service, and their acceptance of the responsibility for that service. Honor means that they carry out their duty to their Country with integrity and faithfulness. It also signifies that they have a code of living, a set of standards that that they try to live up to. Simply put, they try to do the right thing even when no one is looking.

Sadly, it often seems that Honor is no longer valued in our world. Many who try to live up to a set of standards see those standards – indeed, any and all standards – demeaned as old-fashioned and of no use in the modern world. The honorable are seen – even derided – as anachronisms; curiosities from a bygone age.

And yet, at this time of year we see the volunteers loading boxes with toys for children who otherwise wouldn’t have any. We see ordinary people serving meals to those without family in soup kitchens and church basements across the country. We see the Salvation Army’s bell ringers collecting money for the Army’s shelters and other services.

We see these ordinary people, and we recognize that they, too, are abiding by a code. They, too, are serving, with fidelity. And if they, too, had a motto, it might be:

Duty, Honor, Community

Yin and Yang

The essence of Yin and Yang centers on the tension between two halves of a whole that are both divided and connected. – Angellia Moore

A few thoughts on “opposites” …

• This Chinese ideogram represents crisis. It is often misrepresented as a compound of “danger” and “opportunity,” but, in fact, that is the nature of a crisis. Crises are tipping points – the danger is that we fall into the muck. But they also provide us with an opportunity to become stronger.

We have seen examples of this in communities. Charleston and the SC Low Country was devastated by Hurricane Hugo. But out of Hugo’s damage rose a revitalized downtown with new amenities – the Aquarium, parks – and a new spirit.

• Scott Manning – one of the sharpest people I’ve ever encountered – recently reposted a note about the limitations of most studies of disasters. The note pointed out that too often they focus on the successes and failures of standalone events. His point is that we need a more integrative approach.

And he’s right. But I would also go a step further. Currently, we treat community development and community resilience (writ large) as two separate entities. Yet both are focused on strengthening the community. Both require investment and community attention. If successful, both increase a community’s adaptive capacity. But in practice, they seem to be at odds. To me, the synthesis of these not only makes sense but ultimately is essential if our communities are to Win Tomorrow.

• Charlie Kirk’s murder has brought out the best and the worst from both Left and Right. Kirk was a smiling Socrates, puncturing ideology-inflated beliefs. He was sometimes smug, sometimes condescending (and often annoying!) but – I believe – sincere in his beliefs, especially his faith.

On the Left, Bernie Sanders made an excellent video deploring political violence. But the celebrations of Kirk’s killing in the social media feeds from so many on the Left were disgusting. Similarly, the calls by some on the Right to doxx some of the worst offenders on the Left were equally disgusting. We can’t fix intolerance with more intolerance.

• One essential difference between “liberalism” as she is today and “conservatism” is their differing views of mankind. Most liberals (at least the ones I know!) have this view of mankind as a sort of tabula rasa, waiting only to be filled with good and right opinions leading to good and right actions. “Good and right” is determined by reason, and there is this optimistic belief of a sort of spiralling up as we gain more knowledge, ever redefining “good and right.” This leads to naive constructions such as native Americans as Noble Savages, and “mostly peaceful demonstrations,” and our rights are given to us by the law.

Conservatism, however, views humans as inherently flawed. We humans seldom behave rationally (although we rationalize a lot!). Though each of us may rue the fact, emotion and our subjective values drive most of our actions. I think there is also an echo of “history rhyming” that runs through conservative thought – that we can use our history as a guide for future action. I believe it is in this way we should understand the wisdom of Edmund Burke: society as “a partnership not only between those who are living, but between those who are living, those who are dead, and those who are to be born.”

• A personal problem. I am as close to a First Amendment absolutist as you’re likely to find. Although I’m not religious (I don’t believe in Church-ianity) I respect those who are. That means that I’m against any repression or persecution of those of faith. Catholic organizations should not be forced to pay for abortions or birth control, IMO. Sincere evangelicals should not be forced to support gay marriage, IMO. Sincere people of faith should not be forced to do anything that violates their faith – full stop.

But here’s my dilemma. If we can “make no law prohibiting the free exercise” of religion, how can we stop the barbarism of genital mutilation by Muslims? How do we stop the abomination of Sharia Law being imposed in any community where Muslims are a majority?

Of course, our Founding Fathers never conceived of an America that was anything but Christian. The virtues inculcated by their Protestant forebears were embedded in the social contract that is our Constitution (Of course, many of those virtues are now under attack under the anathema of “White Privilege”). But Muslims come from very different cultures. While Christian faith communities are no longer trying to eradicate each other (at least in the West), Shia and Sunni are still at war with each other in many places, as well as killing Christians.

The only way I can resolve my dilemma is through visualizing a Yin and Yang. Yin is moral law, establishing what we must be and do as a good person, i.e., inner-directed. Yang is Man’s law regulating our dealings with each other – protecting the weak, establishing equality under the law, i.e., outer-directed. As Moore’s quote indicates, there is a natural tension at the boundary between Yin and Yang. It’s where my dilemma resides.

More importantly, however, the whole – Yin and Yang together – is greater than either by itself. Their tension forges a society of good people doing the right things by each other. Without Yang, we get the barbarism I abhor. Without the Yin, we get ever-changing laws without a firm basis, reflecting the whims of whoever is law-giver that day.

This is a little philosophical for a Friday afternoon, but I’m afraid it is an uncomfortable reflection of what we are becoming in the Western world. Our moral compass is becoming more and more demagnetized – many of us are having trouble finding the “True North” to guide our conduct. Without that compass, then our rights will be guaranteed to us only by the Law (h/t to Senator Kaine), changing whenever the law changes.

We see this already in the British laws censoring free speech, and allowing Muslim “grooming gangs” to harass (and much worse) young British women. We see a manifestation of this in the US, where a judge gives an attempted-assassin a slap on the wrist because he/she is gender-confused.

Without the union of Yin and Yang, there can be no real basis for a community. Instead, you have groups of individuals with no purpose greater than competing for power. What one builds, the other tears down. As difficult as it is, we must restore the creative tension of Yin and Yang to save our communities.