It hasn’t been easy for your Curmudgeon, being virtually the only Republican on the sane side of the evolution-creationism debate. Not only are many popular bloggers clustered way over at the left end of the spectrum, but so are many of our readers. Adding to our difficulties is the fact that almost everyone in the latest crop of GOP presidential candidates is so crazy that we’re seriously thinking of changing our registration to “Independent” when the current wave of primaries ends — if the GOP candidate is a creationist.
Anyway, from time to time we’ve posted about analogies that can be made between an unguided evolutionary process for the biosphere and the free enterprise system. For some of our previous efforts along those lines, starting with the most recent, see Creationism, Politics, and Everything, and then The Curmudgeon’s Theory of Everything, in which we link to a few of our earlier posts on the subject (including this fine oldie-goldie: Evolution, Intelligent Design, and Barack Obama) and where we also said this:
[T]he person who finds creationism appealing — that is, one who is obsessed with the idea that some intelligent agency planned and caused our existence — is the same kind of person who is attracted to the idea of governmental controls over the population. Such controls may be imposed over private relationships, economic activities, education, religion, or whatever. For some it’s all of the above.
The common thread that unites the statist tyrant and the theocratic creationist is that they’re both authoritarians. Such people are the opposite of those who advocate reasoned liberty and all the other benefits derived from the principles of the Enlightenment — including limited government, free enterprise, and freedom of scientific inquiry.
What causes us to mention free enterprise again, knowing that it distresses so many of you? It’s because we found an excuse for doing so during one of our routine news sweeps. We present to you, dear reader, some excerpts from NHS reform is nothing new, but it’s about time leadership delivered, which appears at a British website called Health Service Journal (HSJ). The site describes itself as “the UK’s leading health service management and policy title.”
We know what you’re thinking: Have you lost your mind, Curmudgeon? Of all the dreary subjects in the world, why are you writing about the British health care system?
Relax, we’re not really doing that. This post is about evolution, and you’ll see that if you stay with us. Besides, British articles are fun. There’s not only the delightfully exotic spelling we always encounter there, we can look at the HSJ’s personnel page and learn that their editor’s first name is Alastair. That’s how we know that we’re not in Kansas, Toto. Not only that, the author of the essay about which we’re writing is Nigel Edwards.
So it is with a cheery wave to Nigel and Alastair — and all our readers in the UK, be they named Cedric, Cyril, Nevile, or Sherlock — that we turn to see what our cousins have written. Here are some excerpts, with bold font added by us:
When I was asked by HSJ to reflect on what I have learnt about in my 12 years at the NHS Confederation, I thought I would specifically reflect on the constant process of reform including at least two which were billed as a once in a generation chance to change the NHS.
Has Nigel learned anything in 12 years of bureaucratic activity? Let’s read on:
First, the policy making process is messy and this is true across time and different countries. While many of those involved are very talented and committed there are some persistent and repeating problems.
Nigel has encountered “persistent and repeating problems”? We’re shocked — shocked! Well, not really. Okay, dear reader, now we’re going to jump around to give you the flavor (or flavour) of what Nigel says, skipping over the boring parts that are specific to health care:
[F]ar too much weight has been put on the ability of the centre to design incentives and policies that will elicit a precise response. The potential for adverse unintended consequences and the fact that policy may work differently in different areas are still too often ignored.
We have seen many cases where policy makers try to solve the problems created by the previous reform that were hobbled by poor design, inaccurate diagnosis or evidence-lite policy ideas. … Unfortunately the words experiment and variation are rather unpopular with policy makers.
Almost every change mechanism available to policy makers in the UK has been used in the last 20 years … . This leaves a worrying impression of explanations being made up in a hurry after the event.
Here comes the good stuff. We’ll use some color (or colour) for emphasis:
A key lesson is having some clear principles for reform, supporting evidence, a strong narrative about why it is needed and how it will work and that allowing evolution and experiment generally works better than ‘intelligent design’ and the one-off creation of policy.
Aha! Eureka! By Jove, he’s got it!
That’s where Nigel should have stopped his article, because the solution to the UK’s health service problem is rather obvious (at least it is to us). Unfortunately we’re only about halfway through the article. From this point on, Nigel wanders way too much through the bureaucratic tangle in which he’s spent the past twelve years — as if he might find something of merit that might be salvaged. At the end he seems depressed, and he says:
Perhaps we can weather the storm, maybe the pressure for change on our current business models will take more time to be felt, but we need all the time we can get – and it’s probably later than we think.
That’s where we’re going to leave it. In the land of Darwin, the government is playing intelligent designer. They know it’s not working very well, but they can’t understand why.
Hey Nigel: Read your own paragraph again — the one we liked. Then think a wee bit more. You’re a bright fellow. Maybe you’ll figure it out. We’ll even give you a hint — What would Darwin do? Don’t see it yet? Okay, here’s one more hint: Privatize.
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