2007-11-29
Saving space
2007-11-26
Airlines and laissez-faire
The problem is that airlines depend on the government at various levels for many things. It simply isn't possible for laissez-faire to extend to things like air traffic control, noise abatement, safety and interoperability standards, security, and so on. This is why various other countries have opted for full or partial state-ownership of the national airline. I'm not advocating a federally-owned passenger airline, but it illustrates the point that the government is already, necessarily, involved in oversight and control of airlines.
Why doesn't some particular airline take the step of upgrading coach amenities unilaterally? The answer to this is clear: it would be economic suicide. The NY Times piece gives examples of this. Each time, the change reduced profits and was withdrawn. Clearly, under the present circumstances, the situation will only continue to worsen.
Therefore, the question for America as a society is whether we will continue accept the consequences of relinquishing oversight of passenger comfort. Only a centralized, government mandate can improve the situation. This would also be fair, since such a mandate would apply equally to all airlines, not giving a competitive advantage to any one.
Why don't we adopt standards for such things as:
- Spacing between seats (possibly as a function of the length of a flight).
- In-flight meal service.
- Maintenance of passenger comfort items such as seats, music systems, lights, video systems, and so on.
- Width of the seats.
What about cost? Well, yes, the cost will go up. However, airlines will still compete on cost in coach class. Since all of them would be subject to the same passenger comfort standards, this competition will reduce ticket prices without sacrificing passenger comfort. We will end up paying a little more, but, given a level playing field, not as much more as one might expect. Airplane travel could actually become pleasant, not something to be dreaded. The question is, will we continue only to look at the cost side of the cost-benefit equation, or will we accept that a greater benefit might be worth a greater cost?
2007-11-19
Ideological Terrorism As a Mental Health Issue
In the US and in many countries around the world, there are laws that allow people to be committed involuntarily as the result of mental illness. In the United States, there are many kinds of safeguards against false or unnecessary imprisonment, which can be summed up as the following basic principles:
- The person must be found to be mentally incapable by a psychiatrist or panel of psychiatrists.
- Because of their mental status, the person must be a danger to himself or herself, or to other people.
- The danger to self or others must be such that only institutionalization can prevent harm.
- While in the institution, the individual must receive treatment for their disorder.
- While in the institution, the individual's status must be reviewed frequently (e.g., every six months).
The question has often been asked, why so few Islamist terrorists? If the ideology intrinsically promotes violence, why is it that only a few individuals actually commit terrorist acts? I believe that this state of affairs is strong evidence for the terrorism-as-mental-illness hypothesis that I am promoting here. That is, as the ideology itself becomes prevalent throughout the community, ITD is triggered only in susceptible individuals, not universally.
If this hypothesis is accepted--and I'll return to an important reason why it will be difficult for this to happen--then it follows that ITD individuals are not responsible for their actions, any more than other mentally deranged individuals are for theirs. Therefore, the issues of guilt and punishment do not apply to them. Instead, the important question is whether those individuals present a danger to themselves or to others that cannot be controlled without institutionalization. If an individual presents with ITD, they are almost by definition a danger without institutionalization, and so in most cases, an ITD diagnosis would lead directly to long-term institutionalization, until periodic review indicates that the person no longer has ITD.
I believe that this approach is highly satisfactory compared to the military or criminal approaches that we now apply, for two reasons. I think that this approach will be more effective at preventing harm to the individual or to society, and I think that it offers the possibility of treatment and possibly a return to normal or near-normal life for the ITD individual, through out-patient monitoring or eventual remission and release.
Why isn't this approach already in place? In the face of the horrible acts perpetuated by ITD individuals, why hasn't the mental health community and the government responded in the manner outline above?
There is an existing problem with the diagnosis of delusional disorders: many delusions are so widespread that they cannot be considered abnormal. I may offend many here, but the prime example of this is religious delusions. There are many psychiatric patients whose delusional systems involve religious aspects. Millions of "normal" people accept as true the reports that Jesus, Moses, Muhammed, or Joseph Smith conversed with God or with angels, and that God, angels, or other supernatural entities affect their daily life. Society can accept this kind of delusion as long as it is benign, that is, that it doesn't cause antisocial acts. This fact interferes with the diagnosis of some individuals, such as many schizophrenics, whose delusions tend to run along conventional religious tracks. For example, we accept that people somehow hear God telling them what to do, as long as their actions are not harmful to themselves or others, or are not outside the conventions of normal behavior.
This can also be true of non-religious ideologies. People can become "true believers" in such things as racial or national superiority, or that certain social systems are inherently bad or even evil, as long as they do not harm others or themselves, or become too eccentric in their personal behavior.
This makes the task of diagnosing standard disorders such as schizophrenia more difficult, not to mention a disorder like ITD where the defining symptom, outside an ideology that is shared by millions of "normal" individuals, is the commission, planning, or substantive support of acts of terror. Yet, there seems little doubt that in susceptible individuals, certain ideologies have been demonstrated to trigger antisocial acts, including terrorism.
I do not think that simply because ITD individuals may share the same ideology as people who do not commit antisocial or terrorist acts, that we should fail to recognize the fact of the disorder; that the disorder, with proper study, may have brain correlates and may eventually be treatable. If we are to combat terrorism, and if terrorism is the product of a mental disorder, as I believe the facts indicate, then the failure to involve the mental health community, and the system of laws, procedures, and safeguards that exist for them to use, is like fighting with one arm behind our back.
The US government has imprisoned hundreds of individuals, and our leadership has basically spun a web of legalalistic rationalizations to support their continued imprisonment, in ways that go against our legal tradition and our constitution. However, if ITD were recognized, along with peer-reviewed, tested standards of diagnosis and treatment, it is my contention that the individuals we have imprisoned could have been treated much more justly using the mechanisms of our mental health system mentioned above. Their rights would have been protected, but also their safety and the safety of society, in an open and compassionate way.
One final thought. What about people like Osama bin-Laden? He personally, as far as I know, has committed no terrorist act; certainly no act of suicidal terrorism. Where does he fit into this picture?
I think that bin-Laden is a sociopath. He understands very well the processes of ITD, and he works to trigger it in as many susceptible individuals as he can, and he assists them in manifesting their disorder by carrying out ideologically motivated terrorist acts. This kind of malevolent parasitism has been seen from time to time in the past, where a sociopath has manipulated mentally ill individuals to carry out acts of violence, but because of the very nature of ITD, it is possible for al-Qaeda to work on a much wider scale, and for a much more focused purpose, than in the historical examples of the deliberate manipulation of schizophrenics.
In summary, I suggest that there is a mental disorder that I have labeled Ideological Terrorism Disorder, ITD, that is at the root of the vast wave of terrorism we are currently witnessing; that ITD individuals should be handled via the mental health system rather than solely by the military and criminal justice systems; that this approach would be more effective in protecting society as well in protecting the ITD individuals themselves.
2007-11-17
On credibility
We also hear about the credibility of Congress. A lot of people voted for Democrats so they would end the war. However, the war is still going strong, facilitated by legislation passed by a Democratically led Congress.
What interests me, however, is that there are actually two different issues that tend to get lumped under the credibility rubric: truthfulness and delivery of what was promised.
Under the law, intentions are everything. If you promise something in good faith but cannot deliver because of circumstances that you cannot control and that you couldn't reasonably have been expected to know about, then you are considered blameless. A somewhat similar situation obtains in politics.
If a political leader promises something and doesn't fulfil the promise, there are a couple of possible consequences.
- Everyone knows that it was just campaign rhetoric ("no child left behind"), no one expected it to be fulfilled literally. In this case, no credibility is lost unless the politician's behavior goes flatly against the entire flow of the campaign. Even then this is a gray area, and it depends in large part on the economy.
- The individual leader makes a strong attempt to fulfill the promise, but is blocked by other politicians or other factors. This is more serious. No one doubts that the individual told the truth when he made the promise initially, but he still loses credibility in terms of effectiveness.
The Bush administration had developed a reputation in left-wing circles as dishonest, and as a result had little credibility. However, for the population at large, it wasn't until Hurricane Katrina, when the administration was exposed as grossly ineffective, that the most serious credibility problems began.
It is also true that there is a kind of osmosis here. If you doubt someone's effectiveness, then it becomes easier to doubt their honesty, and vice-versa. Furthermore, when some people with a given label lose credibility, for either reason or both, then it becomes easier to see other people with the same label as having low credible. This can result in a downward credibility spiral such as we have seen with the Bush administration and Republicans, within the US, and Americans in general, outside the US.
In the domain of politics, it is extremely difficult -- usually impossible -- to rebuild lost credibility. This means that the response we have seen by the Bush administration of ignoring the credibility issue may actually be rational. That is, the credibility game is irreparably lost, so the only thing that matters is (1) helping their contributers, and (2) trying to clean up the future historical record by both actions and secrecy.
In first few years of the Bush administration -- George Lakoff has pointed this out also -- Bush's credibility was actually protected by this "good ol' boy" pseudo redneck shuffle. That is, if Bush didn't carry through on a promise or made some other error, it was put down to ineffectiveness rather than dishonesty. Even in leftwing circles, where his honesty had been questioned for some time, there was debate about whether such and such a piece of wrongdoing was the result of dishonesty or of foolishness. This is in large part why it took Katrina to make most people realize not only that the administration was ineffective, but, by osmosis, that it was also dishonest. In a way, it was only after Katrina that many people finally understood that the Bush administration never had any significant supporting evidence for the contention that Saddam Hussein either had weapons of mass destruction, or that he had any desire or intention of using whatever weapons he did have against the United States.
Well, it's definitely been a strange almost-seven years since the 2000 elections, and the issue of credibility has been a large part of the strangeess.
2007-11-15
Abolish Veterans Affairs Healthcare?
Up until now, I have been against this because it seemed unfair to the population at large that they could not share the benefits given to prisoners and military veterans. But today, I read about the study by CBS investigators concerning the suicide rate among veterans, especially young veterans of the "War on Terror". It seems that the rate is about four times higher for those individuals than it is for their age-mates in the general population, as many as 120 suicides per week among those veterans. This is obviously a failure of the VA healthcare system, yet, it is difficult to criticize them unduly. The VA must provide healthcare to veterans both during peacetime and during and after combat episodes. This means that there will be long periods of relatively low and stable utilization punctuated by surges of high utilization. Its is very difficult for the VA to respond adequately during these surge periods because their resources tend to be optimized to the long periods of inter-war stability.
But what if there was no separate VA healthcare system? What if all Americans could receive the healthcare they needed from government-operated facilities? Over time, the resources of the system would become optimized to cover the needs of all Americans, a much larger and more widely distributed group. This would benefit all Americans in obvious ways: no one would be without healthcare; costs would go down; there would be an increased focus on preventative care and so overall health would improve. The undoubted benefit to the general population of socialized medicine is something I've believed in for a long time. It clearly would also benefit veterans, because one of the complaints that veterans tend to have about the VA is that for many of them, it's a long trek to the regional VAMC where they can be treated. Under universal socialized medicine, there would be few if any VA-specific medical facilities, and veterans would largely be treated closer to where they lived, which would benefit them greatly. However, the CBS study suggests another benefit to veterans that would follow the abandonment of VA healthcare in favor of universal socialized medicine: it would help mitigate the wartime surges of healthcare demand -- for the kind of mental health treatment that could reduce the suicide rate among veterans, but also for other kinds of healthcare. All those veterans who must wait a year or more for treatment by the VA would be much more likely to get prompt attention if they could go to any facility in the nation.
So, rather than blame the VA for the suicide epidemic among young veterans, to me they are just another casualty of the greed-based American healthcare system in general. Maybe someday we will be able to move past our individualistic cowboy mentality and understand that there are certain things that simply work better when we operate collectively as a nation "united".