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.

Some Modest Proposals

I am a social-media whore. I am awake after midnight fascinated by what people might say next. Now that Mr. Trump won the Presidential election, the future no longer seems to be constrained by civilized precedent. Any proposal is now taken to be credible; even the dismantling of the extremely popular Medicare is on the table.

Crisis of the Middle Class

One of the most talked-about films of 2014 was Richard Linklater’s epic Boyhood, which gives a blow-by-blow account of the maturing of a young man in twenty-first-century America. While the film covers over 4,000 days of the growing-up of the film’s star, Mason Evans, Jr., the actual filming took just 39 days of shooting. Linklater describes his film as an “epic of the intimate,” which is very descriptive as we see the hero deal with various life trials that a young man confronts in early twenty-first-century America.

US Healthcare as a Complex System

Healthcare in the U.S. is complicated. There are dozens of components: hospitals, hospices, assisted living facilities, nursing homes, home care, pharmacies, pharmaceutical companies, the Food and Drug Administration, the Patent Office, specialized physicians, general physicians, physicians assistants, nurses, medical device manufacturers, Medicare, Medicaid, private insurers, self insurers, employers, self-employed, wellness centers, chronic conditions, acute conditions, end-of-life conditions, rare diseases, personalized medicine, cosmetic surgery, concierge medicine, and many more. The complication is impossible for any single person to penetrate or understand.