Confronting Complexity

The book you are seeing on your screen may look like a normal book; it is not. It is a conversation in which you are a participant. The book does not offer pat answers to hard questions. In fact, it barely even gives definition to hard questions. Rather, this book presents that stage in which science is most challenging and, arguably, most interesting—the period of identifying just what the problems and issues are. That is why we solicit your help in writing this story—the story of extreme events in social systems.

The participants in this book-writing enterprise are independent thinkers who wish to understand the forces impinging on social systems and the systems’ often dramatic and extreme responses to those forces. Extreme events, the sudden and discontinuous response of social systems to these forces, are what we for shorthand term X-Events. X-events We imagine the reader to be a person who wants to intelligently manage his or her actions and behaviors in the midst of an X-event—in short, to manage an organization in chaos. And not only manage, but be a beneficiary of that event. Explicitly, we understand that there are no simple answers to social questions. But but there is at least a gestalt that can help an individual anticipate and manage X-events. The program outlined here is to build the gestalt by total immersion in the topic—by examining the issues from many perspectives.

Why Healthcare Cannot Be a Completely Free Market

The concept of supply and demand is the cornerstone of economic theory. For simple commodities, the theory predicts that the demand for a product decreases as the price of the product increases and consumers are unwilling to pay the higher price. The supply increases as the price increases and suppliers increase production to capture increased profits. The actual price of the product is a compromise between the desires of consumers and the acumen of suppliers.

Tutorial on the Regulation of the Pharmaceutical Industry

The pharmaceutical market place is not entirely a free market. The extreme demand for lifesaving products can make standard economic assumptions inoperable. Therefore, regulatory mechanisms have emerged to protect patients and to provide patients access to affordable medications. There are three aspects of pharmaceutical operations in the U.S. that are regulated by the government:

Two Visions for Healthcare

It is clear that the U.S. cannot continue its current course in which healthcare costs are more than 17% of GDP and outcomes are significantly behind the rest of the world. It is also clear that Americans are an optimistic people with a firm belief in the idea of progress, which manifests itself in technological and business innovation. The two visions for healthcare that were presented at the Forbes Healthcare Summit are almost caricatures, however. There is opportunity for creative individuals and institutions. Technology has not been applied evenly in healthcare. While the U.S. can be proud of its innovations in high-technology procedures, its adoption of information technology is not even at the level of the pizza industry. Both visions emerged as a result of economic incentives, one to increase revenue, as was the case in Texas, and one to reduce costs, as was the case in upstate New York. The question now is how do we shift the incentives to create the proper mix of outcomes, cost, and risk?

Landscape and Extreme Events

To understand extreme events (X-events) and how they occur, we first have to understand the way events, in general, take place. A good picture for this process is to imagine that you are walking in the mountains, where the landscape consists of hills, valleys, mountain peaks, plateaus, and flat, lowland terrain. At any moment, you occupy a position in this landscape. The event of immediate concern is where you will be at the next moment. Unless you happen to be standing on the edge of a cliff or on the top of a sharp mountain peak, your next step will not change your position much. But if you are near the edge of a cliff or on a mountain peak, even the smallest step in the wrong direction will change your life dramatically and very likely not for the better. In fact, such a small step for a man (or woman) may well be the last step. So there are two kinds of locations, or points, here in this mountainous terrain: an ordinary point, from which a small step doesn’t change your situation much at all, and a critical point, where even a minor step in the wrong direction can lead to a major discontinuity in your life.

US PRESIDENTIAL ELECTIONS AND SOCIAL MOOD

Conventional wisdom has it that political trends are a key determinant of the stock market’s gyrations. As an election approaches, commentators endlessly debate the effect the outcome of the election will have on stock prices. Investors weigh up which candidates will influence the market to move up or down. Statements like, “If Jones is elected, it will be good for the market, but Smith’s election will cause stocks to tank” are common.

Personal Resilience

The first item on the road to a measure of resilience is to remember that resilience is a context-dependent systemic property. It depends on the type of extreme event (X-event) you want to be resilient against. This point must be kept uppermost in mind, since it does no good to build resilience against a terrorist bombing when what happens is a hurricane or an Internet crash. So to set the stage for our Four As resilience measure, let’s assume we want to be resilient to an Inter- net failure. So that’s our target X-event. But even that’s not enough. We have to specify a few more details about the failure before we start measuring how well our protection is working. These details include whether it’s a purely in-house IT failure of a server or some other part of the local information-processing infrastructure or the failure goes outside your own organization. In the latter case, we then must ask if it’s local in the sense that the failure rests in your local ISP or if it’s global in the sense that the failure extends beyond simply your own provider. We can further subdivide the problem. But this is probably enough to get the general idea, which is that you have to have a very good idea of what you’re trying to be resilient against before you can even begin to put protection in place.

Planning for the Unimaginable

One of the threads running through this book is the notion that there can be no human progress without X-events. Of course, here we are speaking of the kind of “progress” that’s revolutionary in character, not evolutionary. This is progress in which visible, meaningful change happens rapidly enough that we can often see the change taking place before our very eyes. The argument we’ve given for the claim that X-events are a necessary condition for this type of progress is that revolutionary change requires that existing social, economic, and/or political structures that have outlived their usefulness be swept away. But if there is anything the power structures in modern society—mostly politicians, banks, and megacorporations— want, it is to maintain the status quo. So the only thing that can overcome that sort of power-induced stasis is an “act of god,” i.e., an X-event, some- thing that the existing power structure is powerless to prevent.

Let’s not focus on the elimination of risk

In his book The Edge of Disaster, security expert Stephen Flynn speaks of a panoply of threats to our safety and well-being: a breakdown in the power grid, stoppages in the global food supply chain, a chemical accident in a major urban area, damage to urban water supplies, and so forth. In Flynn’s world of terror, the most likely threat is a terrorist attack that pushes panicked legislators to overreact by doing something stupid, such as tearing up the Bill of Rights!

What is Resilience?

In the summer of 1973, one of us (JC) took a position as one of the first scientists at the International Institute for Applied Systems Analysis (IIASA), located at a former hunting palace of the Austrian Empress Maria Theresa, just a few miles south of Vienna in the village of Laxenburg, Austria. IIASA was a joint venture of the US National Academy of Sciences and the Soviet Academy of Sciences, with several junior partners, the countries of eastern and western Europe, along with Canada and Japan. The research structure of the Institute was set up along the lines you’d find in a university, except that the “depart- ments” had names like Energy, Urban Studies, Water Resources, Methodology, and so forth, reflecting the fact that IIASA was set up to study questions common to the industrialized countries of the world.

Over the Edge of the Technology Cliff

In the latter half of the twentieth century, two of the highest-flying tech firms were Wang Laboratories, manufacturer of word processors, and Research in Motion (RIM), a Canadian company that produced the famed Blackberry, which took the world of cell phones and electronic email by storm. It’s instructive to look at the timeline of these two companies, both in terms of technology and revenues, to see how things can go very badly very quickly for a company operating in a fast-changing environment.

Lessons From the Biggest Air Disaster

On March 27, 1977 the greatest airline disaster in history took place at Los Rodeos Airport on the island of Tenerife in the Canary Islands. Two 747 aircrafts, KLM Flight 4805 and Pan Am Flight 1736, collided in fog. The crash killed 583 people, with just 61 survivors. The accident has been analyzed in depth and the conclusion is that it was caused by a cascade of errors in both communication and human nature.