Dike or No Dike?
Why dikes are not politicized in the Netherlands and public health shouldn’t be politicized anywhere.
Written with Miroslaw Manicki.
In all governments, there is some kind of continuity as leadership changes. To the extent that the needs of the citizens are being made and the future is adequately dealt with, the more continuity the better.
It is insufficient to consider the needs of the citizens on average. Every effort must be exerted to meet the individualized needs of each of them. Every person represents a universe of questions, conditions, strengths, weaknesses, risks, and opportunities. The collective message of the boy with his finger in the dike, saving everyone, resonates with an ever-present commitment to identify and fulfill on those individualized needs and wants.
The two kinds of questions
There are two fundamental kinds of questions —those of nature and those of society. They are both complex. They both are made up of complex relationships. This is to say that they are constantly changing, but according to defined and largely understood patterns — referred in the aggregate as processes.
Those patterns present themselves in whispers. The relationships can be understood using symbols that transcend spoken and written languages. Mathematics and derivations of numeric study can serve to connect these and support layers of conditions. These can then be linked together in tree-based structures to define and protect contexts so that clarity and rationality reigns. Societal questions and preferences are built on top of these. Successful cultures have brought these in harmony in some kinds of systematic ways.
The four fundamental needs
Nature does not care about society regardless of whether society cares about nature. Nature will do what nature does — as it is uncontrollably powerful and expansive. Although nature does not depend on the human race, humans clearly depend on nature. It has been thought that there are three irreplaceable needs by humans as provided by nature: Food, shelter, and protective clothing. Social questions are built on top of these. Throughout all time, cosmic energy — principally from the Sun in our case — determines the limits. The question isn’t one of being able to afford something. It is whether our natural endowment can be made available and under what terms in the aggregate this can be done.
What has been learned in recent studies is that a fourth need surfaced when people made the choice to live in cities, sedentary, and in close quarters. Scientists have learned that when that shift occurred, the stature of the people decreased substantially —by about a foot — and infectious diseases began to present themselves. With people on the move, pathogens — bacterium, virus, or other microorganism that can cause disease — had little opportunity to grow. This change was supercharged by the close proximity found among people in the cities. The same is true of domesticated animals and animals constrained to close quarters. The patterns of infection of the current pandemic reinforce our understanding of this.
Messing with the hole in the dike
Commerce is a wonderful thing. It is commerce that serves as a means of distributing goods and services and giving those who provide them rewards according to their skills and commitments.
Commerce is lousy at health, however. It works on the periphery, but it is fundamentally problematic when it comes to both public and personal health decisions. This can be seen in the fundamental questions associated with the coronavirus pandemic. Even a most optimistic and sunny views of its history reveal a shady past. There is both circumstantial and direct evidence of malfeasance. It seems that if there was a plan, it had some kind of commerce as its object — likely an attempt to set up coercive requirements for commercial transactions. To the degree that the effort depends on band-aids — like vaccines and expensive therapeutic drugs — rather than on public and personal health efforts to eliminate comorbidities and enhance function and performance, the effort is an illegitimate one equivalent to Dutch politicians fiddling with the hole and the dike.
Where coercion is evident, commerce isn’t really the question — as the open markets that represent commercial dynamics cannot thus occur. There can be no invisible hand to pull price and cost to optimal levels. These are subject to dictates of providers who can name their price. Medical people think they are in business, but they cannot be. They must be public servants who make their decisions based on the most realistic view of the science in question, which they cannot be in a position to determine, as if will affect their monetary rewards — an intractable temptation.
The system we need
There is no reason public servants cannot prosper. That doesn’t mean that they should be able to stack the deck in their favor, nor that they should be able to evaluate themselves and otherwise skew the science and the practice. There should be a constant, reliable flow of process information to adjudicate both kinds of questions — what is to be done and who should do it. This needs to be enlivened and energized by constant flows of data representing all aspects of nature and society that can be brought to bear on the health and well-being of the people. We have the technology. It is simply being wasted on the most trivial of things. As to tests, the infrastructure should be in place to regularly carry out hundreds of tests for each person if indicated by the network of expert-designed processes. Any additional tests should be brought on based on minimal costs and Fair, Reasonable, and Non-Descriminatory (FRAND) principles. This is a public health issue, not a doorway to individual wealth by setting up coercive purchase structures and exorbitant prices.
It is clear that there is something wrong with testing. There is a disconnect between the science and the practice. There are huge commercial abnormalities. This is an area that demands governmental attention, with the possibility of penalties and punishments where knowing marginalization of testing products and protocols has taken place.
No one is capable of resolving such problems alone. An infrastructure is needed where legitimate parties can contribute to the whole. This should be ubiquitous and capable of taking advantage of economies of scale and automation. The system should be linked to the networks of scientists and professionals who know best what to do. They should be able to design processes for this system based on a clear, straightforward, and rational continuation of their work — peer review and collaboration taken into account. Their symbols should be incorporated, their mathematical formulas, and the logical maps of processes and iterations should be unfettered by people outside of the fields in question. Knowledge should shine for, so that advances anywhere can be immediately incorporated into the system everywhere.
This being said, every culture, every country will have its own priorities and its own constraints as to monetary, human, and other resources. If there is such a system as described, it would help them to leverage these. It may result that such a system would be a greater contribution by the richer countries to the poorer ones.