Fans of the TV serial House, will notice that every time Dr. House diagnoses a problem he scrawls on a white board. In scientific terms, he creates a decision table.
When approaching any decision, we try to estimate the chances of reaching certain intended outcomes. Then we weigh them against our abilities and the costs of achieving them. In parallel, we try to estimate the costs and risks of unintended consequences. Even a simple decision, with a few variables, can quickly become a complex problem. Just by putting possible options and potential outcomes in writing, and – practically – drafting a basic decision table, we make it easier to comprehend. Wikipedia says it best: “decision tables are a precise yet compact way to model complicated logic.”
Barely anyone questions the need for health care reform; however, reaching a consensus on how to do it seems unobtainable. The debate turned into name-calling and shoving one’s agenda, focusing not on merit but on the loudness of the crowds at town hall meetings. Obviously, it is impractical to draw decision tables when writing an essay, when commenting on the internet, or when sending an email. However, one might expect that each voice would bring some arguments for or against the proposed reform, hence addressing one or more aspects of the decision table that every one of us drafts in our imagination.
At least this is what I thought in my naiveté. In reality, very few incurable optimists like me do it. My email address is on the mass mailing list at Organizing for America; therefore, every few days I receive an email related to health care reform. Some are signed by President Obama, some by his staffers. None of these emails has ever addressed any merit of the proposed reform. They are full of lofty talk about historical mission, about mean opponents spreading lies, and about the need for action. None of these emails explains how the proposed reform would resolve any of our problems. They did not provide me with any information intended to fill up my decision table. Nothing in their emails even indicated that they ever made any decision table when drafting their health care reform proposal.
Most vocal opponents of the health care reform proposal are not any better. It is about name-calling, it is about “death panels”, and it is about socialism. Decision tables are nowhere to be seen. In the country proud to be founded on reason, the major debate of our times is guided by feelings and emotions. In a country claiming world’s leadership in science, the scientific approach is absent in the most important debate about our future.
Talking about health care almost with everybody I can, I encountered someone working at Rockwell Automation. They claim that their Arena simulation software could be used for simulations of possible scenarios of different variants of the health care reform, as it is already widely used by the health care industry. I do not feel competent to verify this claim, but even if it is untrue, I bet that there are experts and simulation software out there that could do it.
Computers have been in commercial use for over half of a century. Among other things, they can easily compute, much faster than we could, the possible consequences of our decisions. Let me ask everybody: why do we not have simulations of the different options of the health care reform run back and forth in the public view, so we all could better comprehend what we are getting into? Why were not simulations run before the current health reform proposal was presented for approval? Why did not the opponents of this reform run these simulations? Why did not they arrive with simulations of alternative health reform proposals? If, in my business, I was faced with a decision of putting $1.3 trillion of my money at stake, I would allocate some time and money to run simulations giving me some insight into the possible risks and benefits of different options. Oops, as a taxpayer, is it not my money? Is it not my country? Is it not my right to see the results of these simulations, before giving my OK to any health care proposal?
When I read speculation about how the Gang of Six might affect the fate of heath care reform, I had to pinch myself to verify the world I live in. It is a world where society makes pivotal political decisions based on arms wrenching in the narrow circle of powerful. It is a world where mobs are called to action and brought to the public square to shout whatever they were told to yell. It is a world where a decision table is an invention thousands of years away from being discovered. It is a world without universities. It is a world where most people cannot conduct even a basic logical deduction. It is a world where Microsoft and Google are galactic distances away. It is a world where fears, prejudices, and other emotions dominate over reason. This is a Stone Age society in action. In this way, Americans decide the future of the health care in this country.
A version of this text was published by Huffington Post