Healthcare In America: How Do We Fix It?

[How to fix health care? When it comes to the current state of heath care services in the United States, there are no easy answers. However, most people I've spoken to — both within and without the industry — agree that the way we are providing health care services in America now just isn't working, and that something must be done. Both Democrat presidential candidates are touting a public/private system of universal health care; the Republican candidate favors tinkering with the current system. Other proposals include getting rid of all government involvement in the health care industry, full-on British/Canadian-style socialized medicine, and the unique quasi-public "social security" mode of healthcare provision as practiced in France. (Ref: Brookings report on the relative merits of the French and U.S. health care service models, and a Business Week article from last year on the French system.)

Which system is right for America? I don't know. It's a complex subject — and one we all need to understand better. Bearing this in mind, I have set out my understanding of how the health care industry in America works, and outlined the most commonly proposed methods of improving it. I urge you all to do your own research on this topic and draw your own conclusions. — BL]


Health care services are expensive. In every country, a static supply of providers has coupled with an exploding demand for services and the constant rise of new technologies available for diagnosis and treatment to drive the cost of health care services into the stratosphere.

Yet health care is different than other high-priced products. In a civilized nation, it is unwise to allow most of the population to go without health care services, lest civil unrest and/or plague result. A nation that allows the sick and injured to "die in a ditch" will not long survive — nor does it deserve to. Therefore, to stay on a "going concern" basis, each civilization must implement some way of forcing those with the means to pay for health care services to cover the costs of those without those means. Historically, this has been accomplished by three institutions: the Church, the State, and the Market.

In Judeo-Christian society, servitude is seen as a duty. In a country with a Judeo-Christian culture, it is unthinkable to allow human beings to suffer illness or injury without caring for them. In pre-modern times, the Church was seen as the guarantor of the human right to health care. To this end, the institution known as the hospital was created by the Church — a charitable organization operated by the Church which provided health care services to those too poor to afford them. This worked so long as the Church was a recognized Estate within the society at large — an Estate with its own lands and other sources of income — and as long as the limitations of pre-industrial food production (and other factors) kept populations small.

Over time, however, the number of poor and indigent patients began to exceed the number than the various religious charities could afford to care for. In modern times, the Church — now stripped of its status and incomes — has neither the resources nor the support to continue in this role. Our world is now secular; the Church has no fixed place among our society's institutions. The Revolution would never tolerate a Church rich and powerful enough to provide for the needs of today's poor.

As the Industrial Age dawned, the State and private industry therefore began to take on this responsibility — the State, with an interest in keeping the peace; private industry, with a eye toward making a profit. Proponents of State-provded "socialized" health care argue that the right to heath care is among the rights of any citizen in a modern society, and that the State should guarantee this right as it guarantees others. In countries with State-run health care systems, the usual form this took was the enactment of some sort of "national insurance" scheme, with the State collecting premiums in the form of taxes or other levies on employers and employees, and rationing health care services to citizens through State-funded (and often State-owned) hospitals and providers. Under national health insurance, the State is generally required by law to provide health care services to all, regardless of their current or potential health status. Sadly, the failure of socialism to guarantee citizens their rights in any form is a matter of historical fact.

The Church no longer has the power and income to provide for the health care of the indigent. State-run health care systems suffer from the same flaws which bedevil all enterprises of the State: mass inefficiencies, thick and cumbersome bureaucracies, impersonal service, and lack of personal vested interest by providers. On the face of things, then, it would seem that the free-market, private-insurance form of health care service is superior. Let us therefore examine how health care services are provided in a market economy.

In a liberal society, servitude is slavery — an intolerable affront to the rights of the atomistic Free Man. In our liberal society, where all forms of coercion are anathema, the free and unregulated exchange of goods and services by independent agents trading in an open market is seen as the only moral form of exchange. Proponents of free-market, cash-and-carry medical care argue that, left to itself, competition between providers in the market for health care services would in time provide everyone services that they could afford. It would therefore seem that the free market should be left to provide health care services the same way it provides soap and toothpaste: by unrestrained competition. Theoretically, medical care providers in a free-market system can compete for customer dollars on a fee-for-service basis until the cost of a given unit of health care service reaches its natural price.

Unfortunately, in the real world, there are costs associated with health care (physicians’ and nurses’ salaries, medical equipment, the costs of providing full-time care to invalid patients, and the ever-increasing price of medicines, et al) that are already at a natural price — a bottom, below which they cannot go. No amount of competition is going to reduce the costs of services, increasingly advanced technology, and new medicines. Due to these fixed costs, the price of medical care has been, is and will continue to be extremely high.

The institution of mutual insurance was extended to the heath care field by private industry as a means of spreading these high costs (and the associated risks) among as many people as possible. In a typical private insurance scheme, the insurer collects money in the form of premiums from subscribers; in return, it pays a certain portion of their health care costs (in the form of claims). Since those who pay premiums without filing claims pay for the care of those who file claims, the insurers must guarantee that those likely to file claims are kept out of the system. By restricting coverage to those groups least likely to file claims, private insurers guarantee that the amount of money gathered from premiums each year exceeds the amount paid out in claims plus operating expenses and taxes; this profit is reinvested, producing income for the owners of the company.

The problem with free-market, private insurance in countries with such a system is that not everyone can get insurance. In the United States, for example, most people are covered by group insurance purchased at bargain-basement group rates through their employer. However, those who are not employed (or who are self-employed) often cannot qualify for insurance coverage at any price — nor can they afford to pay the required premiums.

(Saving for medical care is futile; a person making $50K annually with a realistic savings rate of 20% can save at most $10K per year — the cost of a day or two in a hospital.)

Likewise, many persons who have serious chronic illnesses (e.g. cancer, kidney failure, HIV etc.) or are otherwise high risks (e.g. the aged) cannot get coverage at any price in a private-insurance regime due to the high costs of their care. In the U.S., some people in this situation are provided for by a piecemeal system of socialized medicine (Social Security, Medicare, Medicaid), but not everyone is covered by these programs, and those that are covered often experience lackadaisical care, impersonal treatment, and the other typical problems of socialized medicine when they present for treatment.

For the rest — those outside the world of employer-provided private health insurance and/or the Social Security system — the only health care system to which they have access is the emergency room at the local hospital — an institution spectacularly ill-suited to the task of providing basic health care services. Due to the flood of uninsured patients using the ER as their sole health care provider, the costs of providing emergency room care to the indigent and uninsured — which care is mandated by Federal law — are ballooning out of control, forcing hospitals around the nation into insolvency and closure.

And these problems exist in a society where most people have insurance. What can we expect in a world where most people are without it? As costs rise, the number of employers offering health insurance as a benefit to employees is certain to drop; employers will be faced with the choice of going out of business, eliminating jobs, or cutting insurance benefits. In a situation where most people are without health insurance (whether national or private) to help patients pay these costs, health care would become something like owning a share of a private jet is today — a luxury service available only to those with the means to pay for it. The resulting society would greatly resemble the nineteenth century; like something out of a Charles Dickens novel, top-quality private care would be available for middle-class Lady Estella Havisham, while spotty and inadequate charity care would be the lot of working-class Bob Cratchit and Tiny Tim. Oliver Twist would receive no care at all, and would be reduced to obtaining health care services from unlicensed practitioners, quacks, cuaranderas, and witch doctors. Those with communicable diseases would be imprisoned, quietly murdered, or left to spead their sicknesses among the public; those with chronic illnesses and serious injuries would be left to suffer and/or die in the gutter. A revolution would soon follow, after which Soviet-style State-provided “care” would be implemented by force.

To avoid this grim scenario, therefore, we as a society are going to have to figure out a way to make sure everyone has access to health care services. And, since the private insurance companies have proved themselves unable to do this, it is likely that (barring a revival of Christendom) we as a nation will have to ration health care through some form of private/public national health insurance program.

With this in mind, I think that the only prudent course of action a citizen can take is to make a thorough examination of the various national health insurance systems extant, and compare their various strengths and weaknesses. Only in this way will each of us be able to have an informed opinion on the subject when the time comes for the U.S. to consider such a system of its own.

NOTE: If my analysis above is in error at any point, I'd appreciate someone pointing out the errors to me. Thanks.

In Memoriam

In Memoriam

Clyde J. McGee

September 19, 1930 (Beach, MS)— May 11, 2008 (Dallas, TX)

BMC, USN

Retired from the U.S. Navy after thirty years of service. Laid to rest on Wednesday, May 14, 2008 at 10:00 A.M. at Restland Memorial Park in Dallas.

My beloved uncle and inspiration.

Clyde McGee was a tall, lanky, hairy-armed Scot — a real man's man — but over the many years I knew him, he was always kindhearted, soft-spoken, and witty. His most memorable trait was his sense of humor. As kids, his sons and I spent hours listening to his hilariously ribald aphorisms, jokes, and sea stories, and his many unprintable-but-true tales of his adventures in both the brown- and blue-water Cold War Navy often left us with aching sides and eyes filled with tears of laughter. He was, as we say in Texas, a Hoot.

But my uncle was no mere storyteller. He was among the last examples of the Real Navy — a boatswain's mate, a master of decorative ropework, and a true marlinspike seaman. Our modern Navy is full of fine men and women, but the ascendence of shipboard automation has made many of the things my uncle did obsolete. They don't make sailors like Clyde J. McGee any more.

My uncle was a Mensch. He was a tough customer who knew how to suffer without whining about it. He grew up in the worst of circumstances — as part of a family of sharecroppers in a Depression-era Mississippi cotton patch — but did not allow his hard upbringing to turn him bitter. (He did hate cotton until his dying day.) Later in life, he lost a lung due to service-related injuries, but did not use that injury as an excuse for laziness; instead, he continued to work long hours as an armed security officer until his second retirement. My uncle was unfailingly kind and fair to everyone, but he did not like bullies, goldbrickers, or cheats. He expected everyone to pull his own weight, as he unfailingly did.

He was also not the biggest fan of certain famous civil rights leaders of the 1960s, although his distaste for them was on the grounds of their politics, not their race. He married a Japanese girl when it was not at all the thing to do, after all. Together with her, he raised three fine American sons — plus many of us nieces and nephews.

He was a loving man: he loved his God, his family, and the USS MIDWAY until the day he died. You can still see his fancy knotwork on display as you cross the quarterdeck of that famous ship in San Diego.

He inspired me to join the Navy, and to many other things as well. I owe him a great deal.

I'll always miss him. May his name never be forgotten.

***

In Memoriam

Franklin Patric Willeford

HN3 USN

NAVY CROSS

March 17, 1943 (Lawton OK) — December 14, 1968 (Quang Nam, Republic of Vietnam)

Vietnam Memorial

Panel 36W, Row 021

Citation

The President of the United States takes pride in presenting the Navy Cross (Posthumously) to Franklin Patric Willeford (3537852), Hospitalman, U.S. Navy, for extraordinary heroism on 14 December 1968 while serving as a Platoon Corpsman in Company C, First Battalion, Fifth Marines, FIRST Marine Division (Reinforced), Fleet Marine Force, in Quang Nam Province, Republic of Vietnam. As Hospitalman Willeford's platoon was participating in a company-sized sweep through an area, the lead element came under intensive automatic-weapons fire which wounded and trapped one Marine in very close proximity to one of the enemy bunkers. Seeing his comrade fall and subsequently receive another hit from a grenade, Hospitalman Willeford unhesitatingly left his position of relative security and moved forward to the side of the mortally-wounded Marine. Hidden from the enemy positions by the tall grass in the area, he found the Marine bleeding severely and in no condition to be moved. Hospitalman Willeford raised himself up and into the grazing zone of hostile fire in order to administer a heart massage and mouth- to-mouth resuscitation, continuing his desperate attempts to save the Marine until all hope of life had expired. Only then did he begin the slow return through the fire-swept zone to the trench line, bringing with him the body of his comrade. As his platoon again started through the area, the enemy opened up with intensive small-arms and automatic-weapons fire, wounding and trapping the three lead Marines. When two Marines started to move out of the trench line to retrieve the casualties, one was mortally wounded and the other critically wounded. Disregarding the intense danger, Hospitalman Willeford again moved forward to aid his fellowman. Finding the first Marine mortally wounded, and realizing the impossibility of trying to move him back to a secure area, Hospitalman Willeford stayed with the Marine, rendering what aid and comfort he could, until the Marine succumbed to his injuries. After he had informed the remainder of the platoon that the Marine had died, he proceeded deeper into the fire zone toward the second Marine, and drew fire from an enemy bunker a short distance from the wounded man. With full knowledge that the enemy was now concentrating their fire upon him, Hospitalman Willeford forged his way through the tall grass to the wounded Marines' side and began administering aid. While treating the fallen Marine, Hospitalman Willeford was also struck and mortally wounded. His courageous actions were an inspiration to all who observed him and were in keeping with the highest traditions of the United States Naval Service.

Authority: Navy Department Board of Decorations and Medals

My best friend's dad: a Christian, a pacifist, a combat medic, and a hero. He gave his life for the values he held dear. May his deeds of valor never be forgotten, and may Light eternal shine upon him.

A Letter To American "Conservatives"

[Note: The following rant is addressed to those Americans who consider themselves to be Conservatives. Of course, they are not; they believe that individual Liberty is the ultimate value, which makes them Liberals. (American "liberals" are likewise misnamed, and are actually socialists.) True Conservatives hold Duty to be the highest value, not Liberty. — BL]

My dear American conservatives:

You have cried out, and I have heard you. As the Obama juggernaut rolls on, and as the Republican Party flounders to field as a viable candidate a man who one advocated granting amnesty to foreign invaders of our country, cries of despair have begun to rise from your camps.

In reply, I say: save your whining for someone who cares.

"Oh, if Obama wins, the country will be controlled by the Democrats!" you cry. Well, so what? That's what the People want, right? Surely, all you believers in representative government would never want to deny the People their choice of the candidate that represents the things they believe in, would you?

THIS is why I'm a monarchist: because sometimes, the People are wrong.

Representative government is dangerous. It only works when the People are educated and intelligent enough to comprehend the issues, when they are sophisticated enough to see through the web of lies and propaganda spun by the political parties, and when they hold the values and mores of the Judeo-Christian worldview exclusively. None of this is true of the current United States population. Most people are damned fools who should no more be trusted with a vote than a chimp should be trusted with a machine gun. Most people are incapable of telling propagandistic shit from fact-supported Shinola. Most people, while nominally Christian, are actually pagan hedonists with no greater moral code than "if it feels good, and it doesn't hurt anybody in a way I can't rationalize, do it". And yet my little boy has to grow up in a country whose laws, military, and nuclear weapons are controlled by a gang of professional pirates chosen by whatever miniscule percentage of this slack-jawed populace remembers to show up on Election Day.

(Please note: I count myself among the slack-jawed populace. I am an unemployable, clinically-depressive Japanese cartoon voice actor, for Pete's sake.)

Yes, in our great country the People choose the political leadership, and the political leadership represents the people. But who represents the Nation — the culture, the values, the things that make a nation what it is? Under a monarchy, that is the role of the Crown. In a government "by the people", the answer is nobody.

So I will thank you all to please pardon me if I don't stand up and wave the flag this election year. All this (or any) election means to me is an opportunity for a new crew of rapists to show up and bend me and mine over the ol' prison bunk. No matter which dribbling assclown gets elected in November, abortion will remain legal, income will remain taxable, borders will remain porous, and the global Islamic jihad will be kept politely at arm's length instead of being smashed with a mailed fist, as it ought to be.

No matter who wins the election, America loses. But that's what we wanted: a free republic, where the government derives its just powers from the consent of the governed.

Too bad the governed are a bunch of morons.

Losing It For Lost In Space

I've been watching Lost In Space reruns over at hulu.com recently, and it's been quite an enjoyable time. In fact, in many ways I enjoy the show now more than I did as a child, which was a lot. A a child, I loved watching the original Star Trek, of course — and I still do — but I have to admit that in my early childhood I found a great deal of it to be baffling and or slightly scary. Lost In Space, however, was my favorite — the show I'd fight my little brother to see. It was never scary. It was exciting, yes, and suspenseful, but it far more suited the mental and emotional level of the slightly neurotic seven-year-old me than did the more cerebral Trek. I mean, what child of the moon landing era wouldn't love to watch a kid his own age having noisy, brightly-colored interplanetary adventures on distant worlds? What kid nurtured on Hogan's Heroes and Gomer Pyle USMC wouldn't cackle at the hilarious antics of a batty, pompous, and totally unpredictable fussbudget and his rapier-witted robot straight man?

The show itself is packed with entertainment. (For those unfamiliar with Lost In Space, the story centers on the family Robinson, a clan of astronauts who set out on a colonization mission to the star Alpha Centauri on October 16, 1997. Soon after their launch, however, their onboard robot "Robot B-9" is sabotaged by a stowaway saboteur, resulting in damage to the spacecraft, leaving the Robinson family hopelessly "lost in space".) In just one episode, the Space Family Robinson might find themselves facing the imminent destruction of their planet, while at the same time foiling the machinations of space croppers, bulb-headed aliens, and/or living statues, while at the same time dealing with the egotism-driven mishaps created by their hilariously prissy stowaway.

The actors in Lost In Space stand out as well. The series' headline star, the late Guy Williams ("Professor John Robinson"), was a fine actor, and his on-screen relationships with TV wife Dr. Maureen Robinson (June Lockhart, the mom from Lassie) and kids Judy (Marta Kristen), Penny (Angela Cartwright of The Sound Of Music fame) and Will Robinson (the ubiquitous Bill Mumy) were warm and believable. (Williams' son maintains a touching memorial to his father that is well worth a look.) Mark Goddard, as Major Don West (the Jupiter 2's pilot) is cocky and fun, especially when playing foil to the instantly memorable stowaway/saboteur Dr. Zachary Smith, portrayed with great brio by the show's regular "special guest star", the late Jonathan Harris. And of course everyone loves the warm-hearted, wry Robot (Bob May, voiced by Dick Tufield).

As production went on, the series' focus began to change from more-or-less serious sci-fi to a sort of space farce. During the first season, the episodes centered on the heroic and salf-sacrificing John Robinson character, but as the show went on it began to shift from straight-up action/adventure to a sort of Laurel-and-Hardy-In-Outer-Space comedy centered on the trio of Will, Dr. Smith, and the Robot. More than anything else, folks who remember the show recall with pleasure the many zinger-laden exchanges of repartée between the arch and self-aggrandizing Dr. Smith and the unflappable and dry-humored Robot. Even as Harris, Mumy, Tufield and May moved into the center spotlight, however, the rest of the cast continued to play the Robinsons and Major West absolutely straight, making the witty interplay between Will, Dr. Smith and the Robot all the funnier by contrast.

The special effects were truly special. Sure, the planetary surface sets and occasional monsters were cheap and unconvincing, and the "aliens" usually nothing more than character actors wearing whatever B-movie props the show's producer (the late Irwin Allen) found out on the Fox backlot, but when taken together, the show's visual effects were actually fairly sophisticated for a mid-'60s TV show.

And there was an upside to the cheesy effects. The series' low-budget SFX approach actually resulted in some of the most memorable sci-fi bad guys ever; at one point or another our heroes were variously menaced by space Vikings, space miners, and even "Chavo", the silver-skinned Space Mexican. (That episode must have been a hoot for series star Guy "John Robinson" Williams, who had famously played Zorro in a successful prior series.) The reliance on backlot props also facilitated some of the show's truly wacko episides, like the one where the Robot dons a crown and ermine robe from God-knows-which grade-Z Fox knights-in-armor epic and proceeds to rule over a race of tiny toy duplicates of himself. (He also recites the preamble to Lincoln's Gettysburg Address in that episode. Now that's value for one's entertainment dollar!)

There were other attractions. The Space Family Robinson lived in a split-level flying saucer (the Jupiter 2), drove a cool, jeep-like vehicle (the Space Chariot), and actually did stuff, like escaping exploding planets and whatnot, instead of talking the viewer to death. They also loved one another and stayed together no matter what, which at the time seemed more fantastic to me than the split-level flying saucer. All this, combined with fast-paced direction, lots of things blowing up, and "eerie" outer-space SFX (usually created by flashing lights of one sort or another) make for a solid hour of TV fun.

(As an aside, I must admit that as I grew older Lost In Space took on an added dimension of enjoyment for me, in the form of a monstrous crush on Angela Cartwright. Through my now-middle-aged eyes she appears in the show as a talented and cute child actress, but in 1973, the seven-year-old me regarded her as a mysterious and disturbingly attractive older woman.)

Lost In Space was, at its heart, a silly kids' show — a futuristic fairy tale designed to appeal to the romanticism and love of adventure that we kids of the Space Age grew up with. And there's nothing wrong with that. Sure, we all love Star Trek and so forth, but in this world of serious TV science fiction (e.g. Battlestar Galactica) it's fun to occasionally step away from the realistic dialog and densely-plotted storylines and enjoy an hour of good dumb fun.

As I watch Lost In Space today, the word that comes most readily to my mind is "charm". The show was charming — the bright colors, the earnest young actors, the goofy plots, and all. It was pure family entertainment in the best sense: traditional without being hackneyed, warm without being overly corny, thrilling without being frightening, and imaginative without being self-consciously weird (as so many shows of the late '60s were.) Sure, as science fiction it was a joke — I mean, come on, a vegetable rebellion? — but Irwin Allen thankfully saw no need to try and capture the high-brow skiffy audience with the show; he just wanted to entertain kids and make a buck doing it.

Mission accomplished, Mr. Allen.

Are You Ready For The Sex Bots?

"Once they invent the Sexaroid, that's it for marriage" — Cliff Spears

Whither the Droid? The personal servant/buddy/crapworker robot was a staple of the Wonderful World Of Tomorrow that we kids of the '60s were sold back in the olden days. That world turned out to be a BIG FAT LIE — and no part of it more so than the foretold robot pal. I can live withot my rocket belt and flying car, but, dammit, why didn't I get the robo-butler I was promised?

It's not due to any lack of effort on the part of industry. The factories are full of fine, upstanding robots that pay their taxes and love their families. The military has lots of cool robots, too, some of which can kill terrorists in exciting ways. And of course there are the uninspiring-but-functional robot probes that NASA sends into space instead of using a MAN to do a MAN'S JOB — but I digress. Anyway, companies have been trying to market personal robots to middle-class consumers for years, but so far all have failed to catch on. It seems that no one wants to pay thousands of dollars for an instantly-obsolescent, mechanico-electronic serf when a real serf can be had much more cheaply from Mexico or one of those rinky-dink Central American countries. Neither is technology the show-stopper. While it's true that the technology of home robotics has not advanced at the pace once expected, the low operating cost and easy disposability of tiny Mayan maids have been the real roadblocks that have kept R2-D2 from becoming a reality in the US.

Will we ever have buddy robots of the kind seen in sci-fi? My guess is "no" — because there is no market for a robot of that sort. I predict that when better droids are built, we'll skip the clunky, metal-and-plastic Star Wars model and go straight to building Chobits — sexy girl robots that combine the functions of girlfriend and all-in-one digital device. Let's face it — no one wants another G.D. computer around the house; the damned things make life miserable enough as it is. Only winsome, obedient androids with which the Average Joe/Jane can have sex will bring in the big bucks. The first company to combine the functions of a PDA / palmtop / phone with the charm (and body) of a soft, sweet-natured, long-haired girl (and the functionality of a Hibernate/Mute button!) will have created the ultimate "killer app" — and one that will destroy the twin institutions of marriage and prostitution forever. Move aside, June Cleaver! Begone, Pretty Woman! Lo, the Sexaroid approacheth!

Will we ever see the dawn of the age of the Sex Bot? No one knows, but it is certain that, should that day ever come, confessionals from coast to coast will be sporting long lines of sheepish penitents. Until then, however, we are left with the cold comfort of Japanese big-breast videos on YouTube and the gallery of failed robotmakers past at megadroid.com.

Are you ready for the sex bots? Ready or not, here they come! As Criswell once said: "God help us... in the future".

Loving The Dictators

In a recent article ["The dictators are back ... and we don’t care", The Times (London), April 27, 2008] Robert Kagan bemoans the rise of authoritarian governments in Russia and China, among other venues. His reaction is natural — and typical of the post-Soviet generation. With the victory of the Western Allies over the USSR's Communist empire in World War III (aka the "cold war"), liberal democracy über alles was the watchword of the day. Papa Francis Fukuyama told us that we were at the "end of history", didn't he? Surely, the evil idea of authoritarian rule went down the tubes along with the USSR, right?

Wrong. Around the world, so-called "soft" dictatorships such as Putin's Russia (and auto-bureaucracies such as Singapore) seem to be perfectly acceptable to those living under them. It appears that despite the hand-wringing of some in our own media/government elite, authoritarianism is back. How can this be? Can't the Masses in these countries see the obvious benefits of liberal democracy, of voting, laws, and representative government?

In a word, no. To many people around the world, democracy does not bring to mind Pericles of Athens in a fresh, slave-laundered tunic, lecturing the people on the beauty of freedom; instead, it brings to mind guns in the streets, riots, and general social chaos. Democracy is not a one-size-fits all form of social order, after all, and representative government is neither suitable for nor adaptable to every culture. Believe it or not, many (most?) people in the world are profoundly distrustful of nose-counting as a means of government, and I'd like to propose a reason why.

From what I've seen in my travels and read in my studies, the truth is that people don't want to participate in an equal sharing of political power. I think most people want the social order to be ruled by a single, non-participatory authority. I submit that this esire for top-down order is a natural part of human psychology, and is one reason why representative governments always fail over the long term.

I know the dogma these days is that people everywhere instinctively crave democracy (or a republican form of government, at the very least). The historical truth, however, is that most people don't really care what form of government is in place at the national level as long as they are free to trade, worship, and live their everyday lives as they please. Singapore, for example, manages to function quite nicely under an authoritarian government today, as did Franco's Spain and Salazar's Portugal. Even the French, those lovers of liberté, prefer to live under a central government that would be considered intolerably invasive here in the States. (For example: in France, the government gets to decide if the name you've picked for your newborn baby is acceptable or not. Imagine the State of Arkansas or Alaska having the power to block you from naming your kid Canyon or Ta'niqua!) And it's not just the furriners who prefer to let the Big Boys run the playground; our current abysmally low rates of voter participation in the United States are proof that most people in America couldn't care less about participating in government as long as the streets are reasonably safe, gas and beer are reasonably cheap, the Big Game starts on time, and taxes are reasonably low.

Democracy is the system in which the masses (the demos) rule. As practiced by the Athenian city-state in ancient Greece, democracy was never intended as a means of organizing any polity bigger than a city-state, and did not allow all citizens a say in government. The system established in 510 BC under Cleisthenes allowed all male citizens their say before the general Assembly, but carefully limited the power of the hoi polloi to make laws and shape policy (this was the function of the Boule, a body of representatives elected from the heads of the local political and tribal groups.) The system began to crack almost immediately, as the leaders of the various demes (sub-groups) of Athenian society began jockeying among themselves for political advantage.

Which brings us to another point: democracies are brittle and prone to sudden collapse. Even the "ideal democracy" of Athens was hardly robust; 170 years after its establishment, the Athenian democracy had coalesced into an autocratic quasi-empire run by small, special-interest groups. It was then conquered, first by the autocratic Spartans, then by Alexander the Great, whose Macedonian empire ruled the Athenians for two centuries. Finally came the Roman Republic (not a democracy — they had elected dictators) which lasted five centuries off-and-on but which reverted to autocratic rule with the (elective) dictatorship-for-life of Julius Caesar in 44 BC. Thereafter, Athens was under the Roman imperium in one form or another until AD 1806. Thus we see that even in its most pure form democracy has a lousy track record versus autocratic rule. Like communism, representative government looks great on paper but just doesn't work well in Real Life.

Keep in mind we're tallking about big government here. At the city and county level, people do prefer to have a say in government, but only to the extent that their government influences their everyday lives. Otherwise, they are content to raise their families, run their businesses, and earn their wages — and leave the big decisions to the local aristocracy.

Yes, I said "aristocracy". Every city in America has one: a cohort of four or five families who control (overtly or covertly) the local business, civic and governmental institutions. In every community, a sort of cream (or scum, if one prefers) of leaders naturally rises to the top of the general churn of citizens. It seems that some people are simply born with a talent for governing and administrating, and this talent tends to run in families. (In our city, for example, the V_________ family has been involved in running the show in one form or another for sixty-plus years, and most people are fine with that, because they do a fairly good job of it.) People born with this ability tend to rise to the levels of power of whatever community they inhabit, and tend to do what's best for the community out of a sense of noblesse oblige. Such families represent a natural aristocracy, and without them, most communities would be chaotic.

And they are. The city of Dallas is a perfect example of what can happen when The People are allowed to take the reins of power. Over the first 120 years or so of its existence, the city was dominated by an unelected Power Elite of wealthy merchants, landowners, and industrial leaders, and things ran fairly smoothly under their crass, pitiless but generally benevolent domination. During this time, the city had an elected government, of course — a government composed of various candidates carefully groomed by the power group to fill these positions, but an elected government, nonetheless. This shadow government was not perfect, nor was it always run for the benefit of all, but under its offhanded tyranny the city thrived and grew, and most of its citizens prospered.

But beginning in the 1960s this tidy system began to be undermined. Due to legal pressures and societal changes, a genuine democracy began to rise in Dallas, and the aging (and now mostly suburban) members of the Power Elite decided to quietly and gradually surrender their control of the city rather than risk plunging Dallas into the kind of chaos that had gripped places such as LA, Detroit, and Chicago. (This is why there were never any real race riots or integration-related violence in Dallas: the Powers That Be simply decreed that Dallas would integrate, democratize, and desegregate, and it was so.) By surrendering their power gradually, the Power Elite facilitated the keeping of the peace, ensuring that Dallas remained an attractive haven for business.

Unfortunately, by surrendering their power, the monopolar rule of the “old money” tribe was slowly replaced by a multipolar battle for power between the city's various ethnic tribes, each of which of course had its own clique of the natural leaders, each of which had its own aims and interests. The city of Dallas today is "governed" by an exquisitely democratic, representational, and sensitive elected government — and is, of course, a big frigging mess, with a declining tax base, a rising crime rate, and a sputtering economy. The exurbs, which are now run by the sons and daughters of Dallas former Power Elite, are where the peace, quiet, and economic action is.

Democracy does not scale well. The lesson here is that representative government, where it works at all, works only at the scale of a city-state like Athens, and even then only when it is dominated by a natural aristocracy. A state or nation run by democratic principles will sooner or later devolve into chaos, as self-interested groups of all types battle each other for control. One need only look at Dallas — or the former Yugoslavia — for proof of that thesis.

So let the dictators come. We don't have to love them, of course — but we can live alongside them, so long as they respect the basic human dignity of their thralls (e.g. no genocides, mind control, or organ harvesting), and otherwise do not threaten their neighbors or the peace of the world. The United States and her allies can coexist in peace with any number of benevolent authoritarian nation-states. We might not want to live in an authoritarian state ourselves, but to people in other countries a dictatorship or autocracy could very well be an alternative preferable to chaos. As a representative republic that grows ever less representative and republican by the day, we can tolerate the dictatorships of the world as merely the latest examples of what might be called the default mode of human government.