Thoughts on Public Health Care (II)

Last week I discussed my personal thoughts about the question of publicly providing for health care. That discourse examined three issues: (1) the parallel situation with public education in America, (2) the lack of choice available in all publicly provided systems, and (3) the unsuitability of insurance as a business model in an environment of rapidly improving medical knowledge and practice. Insurance is an inappropriate way to pay for routine health maintenance and a really bad way to take care inevitable processes, like dying.

4. Health Care Will Become More Effective—and More Complex

Of course, “inevitable” is just a state of mind. If you think medicine has advanced since the 19th century, you ain’t seen nothing yet!

The sequencing of the human genome in 2000 was originally intended to find “genes,” the A-C-G-T combinations that code for proteins, the building blocks of cells. This effort assumed that all three billion base-pairs in the genome were just the parts list. What we learned in the process was that protein-coding occupies only about 10% of the genome. The far larger and more complex story is that the other 90%—rather than being the leftover “junk” of evolution, as we first thought—is actually the internal mechanism for timing the expression of those proteins, controlling the differentiation of cells in the body, directing its development from a fertilized egg to an adult human being, and coordinating the daily operation and maintenance in all the different cell types. The larger part of the genome is an assembly and instruction manual riding along with the parts list.

Life scientists at universities all over the world are now working eagerly and productively on two fronts. First, they are linking proteins and their coding to various cellular functions and diseases. Second, they are figuring out the assembly manual so that we can understand how humans develop and grow. When we know the latter, we will be able to program the body’s repair kit—the various stem cells associated with each tissue type—to grow new tissues and replacement organs.¹ And then we will quickly advance from simply growing replacement parts, to fixing any genetic defects that may have damaged the original organ, to adding genetic enhancements so that the new organ functions better than before.²

People who worry about medical privacy and the possibility that insurance companies will deny a person coverage because of his or her inherent genetic propensities are simply not seeing the bigger picture. Genetic defects will be eradicated or compensated as a matter of routine practice, probably in the womb if not before conception. Accidents and diseases that now cause disfigurement and disability will no longer be life-changing events but mere temporary inconveniences. Aging will become optional, and its debilitating effects will be corrected as they occur. Medicine might not be able to repair a case of sudden accidental death—or not right away—or eliminate death’s ultimate arrival, but we’ll all go into old age as healthier, happier, and stronger individuals.

What do I mean by “all”? Surely, this new medicine will just be a perk for the super-rich, won’t it? In the meantime, the rest of us proles will struggle along with perfunctory care and shoddy medicine, won’t we?

Well, no. Once we have perfected the techniques for chemically manipulating stem cells and growing them on armatures that are mass-produced from proteins or other inert materials—and true, these techniques will first be tried out on the rich—the rest is just a matter of grunt work. Medical technicians will sample your tissues, isolate the stem cells, apply the appropriate reagents, take a prefabricated armature off the shelf, and put the whole works into an incubator. The most complex part of the medicine, requiring real hands-on expertise, judgment, and timing, will be the surgery that cuts out your old heart, kidney, spleen, or whatever and installs the new one. Getting a new heart will be about as complicated as getting a new titanium hip or knee replacement today.

In this environment, medicine becomes less expensive. It’s only “personalized” because it starts with a person’s own copy of the genome as coded in his or her stem cells. But as we know more about the body and its processes, about how each person’s genome guides his or her susceptibilities and propensities according to universally recognized patterns, medicine becomes less an art of diagnosis and discovery and more a science of observation and application.³ The mystery and the chance—and the heartbreak—go away, because we understand human bodies the way a mechanic these days understands your car. The processes become routine, simple, and inexpensive.⁴

What will we do with all these superannuated citizens? Since they’re stronger and healthier—we’ll put them to work. The problem in developed societies today is not over-population but under-reproduction. Smart, educated, busy people have less time for children and, with the Pill and other means of contraception, children become a decision for the future rather than an unexpected consequence of conjugal relations. In this environment, life becomes more precious, not less. We will cherish each new child and work to make its health and education complete. We will value the knowledge and experience of older people at the peak of their productivity and try to prolong their best years. Quality, not quantity, will become the human mantra.

In this environment, medical care advances far beyond being a response to an insurable catastrophe. Health maintenance, physical repair, and improvement of the body become a necessity of living, like education to improve and prepare the mind.

5. The Affordable Care Act Pushes Insurance Over the Cliff

If insurance is the wrong business model to pay for the new medicine, the Affordable Care Act is the perfect antidote. When it was first proposed, the insurance companies supported the legislation because it mandated that all citizens buy health insurance, whether they expected to need it or not. That way, healthy young people would pay premiums that covered the costs of caring for sick and old people. The insurance companies saw a bonanza of new premiums and came aboard.

But the act also does two things that insurance companies don’t like and wouldn’t support under the normal business model. The first poison pill is treatment of pre-existing conditions. Even if you’re sick or have a bad prognosis through a history of obesity, smoking, or lousy genetics, the insurance company has to take you on and then pay out for your treatments—which are now a matter of certainty rather than actuarial chance. The second pill is community rating. No matter how sick you become or how high the costs of your care, the insurance company can only charge you the same premium as everyone else. These are gifts to the patient at the expense of the insurance business model.

Add to these pills the fact that the legislation lets the government define the menu of benefits that an insurance policy must offer. As we’ve seen in implementation, these mandates now include routine maintenance practices like contraception and chemical abortion. Pretty soon, at the whim of government regulation, the business model becomes broken no matter how many healthy young people are paying premiums for catastrophic services they don’t expect to need for years.

No one can force the insurance companies to stay in business if they are losing money. So, for the uninsured, unemployed, or self-employed people whose insurance company happens to leave the industry, the legislation offers a state insurance pool, similar to Medicare and Medicaid, with funding shared between the federal government and the states. The bet, in the view of those who desire an end-result of single-payer medicine, is that insurance companies will eventually give up or go broke, and then the federal government and the states will have to step up and fund the entire system of providing medical care.⁵

It would probably not be legal, or even workable, for the government simply to close down the insurance companies one night and start funding health care through taxes the next morning. But the Patient Protection and Affordable Care Act sets up circumstances that accomplish this slowly, over time, with a maximum of apparent personal and corporate choice and a minimum of fuss. You’d call that pretty sneaky, if it wasn’t all out there in plain sight.

There are probably other potential systems for funding health care that would work better at a state, county, or community level—which is the way we handle education in this country. However, with the results of the national election, those won’t be proposed or tried now. And that probably makes no difference in the long run.

One way or another, health care as a societal obligation is no longer a matter of personal luck and a strong constitution. Advances in the life sciences are already taking medicine out of the realm of insurance and into the sphere of everyday expectations and necessities. Staying healthy and growing old while maintaining your strength and abilities will be like obtaining an education and ongoing training through state-funded schools, colleges, and training programs. Claiming the bonanza of scientifically boosted medicine will be like tapping into any of the other national infrastructures that are dominated by science and technology: the energy grid, transportation systems, food supply chains, the internet, and communications systems.

All of these complex networks are designed to provide good service and a rich lifestyle at low cost. They’re what’s keeping this continent-wide whirligig we call the United States functioning smoothly. Health care as a right of citizenship will be no different.

1. The concept of organ “transplants”—which involve taking a fully grown organ from one person and donating it to another, with the requirement of suppressing the recipient’s natural immune system so that he or she will not reject the foreign tissue—becomes a rapidly passing phase of our current medicine, rather like leech craft. Instead, it will become so much easier to grow a new organ from a person’s own cells, which already have all the right chemical signatures. These “implants” will become a huge part of medical practice. And the whole business of matching donors with recipients, fraught with issues of desperate need, fairness, and compensation, will wither away.

2. And I won’t even speculate on the issue of “designer” genes, so that new organs and tissues confer particular preferences beyond the normal human range—like the desirability of orange- or silver-colored eyes, or the ability to see in the dark by detecting ultraviolet or infrared radiation.

3. Consider that, today, prescribing a medication to treat a condition is a matter of the doctor’s experience and judgment—and luck. The active ingredient in any medicine is selected and developed according to a drug researcher’s particular theory of the disease. The medication is then tested in clinical trials against a limited number of people—usually about 3,000 at the third-stage trial. The medication remains under prescription, with strict requirements for reporting adverse effects, until about a million patients have used it. But not every medicine works for every patient. Genetic differences control how an individual responds to the disease, or to the medicine’s operative chemistry, or to its recommended dosing. In the future, we’ll know how those genetic differences interact with the disease process and the therapeutic process. Prescriptions will then be targeted not only to the disease but also to the patient’s genetic inheritance. The practice of medicine will become much more effective.

4. Of course, it will help if the patient is already mindful and careful about lifestyle and health. Yes, we’ll be able to replace lungs damaged by years of smoking, but complete replacement of smoke-damaged arteries will be a little trickier. And it’s easier to replace a liver if you don’t have to cut through cubic centimeters of belly fat to find it.

5. Under the Affordable Care Act, health insurance does remain the primary responsibility of employers. But the legislation offers them the alternative of paying a fine for every employee they fail to cover—usually at a much lower rate than the cost of insuring the employee in the first place. This fine becomes a tax to defray the expenses in the state insurance pools to which the newly uninsured citizens will have to apply.

Thoughts on Public Health Care (I)

My conservative friends are not going to like this posting. Come to think of it, neither will my progressive friends. But here are my thoughts, from what I conceive to be the political center, on the issue of public health care.

With the Supreme Court decision in June and results of the national election this month, the Patient Protection and Affordable Care Act of 2010 will stand as the law of the land. Whatever the details of this legislation, some of which are still being worked out, its import and I believe its intention are to move the country to a single-payer system of publicly provided medicine. (More next week on how a bill requiring universal insurance coverage achieves this.) This will align the United States with the health care systems used in most of the rest of the world—if those governments address the issue at all. But is this really such a huge departure for our country?

1. We Publicly Pay for Education

Health care and education are two of the personal-, family-, and society-level necessities that cannot be supplied on an ad hoc basis—not in the way that you can build houses one at a time, or provide dry clothes and hot meals adequately from any number of possible supply channels. Unless you’re a parent providing home schooling, or a tribe wandering in the wilderness and teaching its young to hunt and fish, you need a complex infrastructure to educate a generation of people: locally situated classrooms, a plethora of introductory books on different subjects, teachers trained to present those subjects, and a supporting network that extends beyond the purely local level to decide on and shape the curriculum, approve the books, train the teachers, and accredit the institutions.

From our earliest days, Americans have agreed that providing basic schooling is a community function, because raising a generation of literate adults with a common base of knowledge is essential to democratic government. Grammar schools and high schools have always been public. Yes, certain communities also host parochial schools and elite “preparatory” schools, which are privately funded, but these have functioned in addition to the local public school for families who felt the need of something different or better. And those families still pay the taxes that support the public school. Higher education—at the college level and above—started out as a collection of privately or religiously backed institutions. In the middle of the 19th century, however, states began funding land-grant colleges and “normal schools” (i.e., for educating teachers) as public institutions.¹ Today, public colleges and universities are a big part of the education mix.

Health care is not that different from education, in that it requires a complex infrastructure of hospitals, clinics, testing laboratories and services, primary care physicians, treatment specialists, researchers, medical technicians, nurses and orderlies, and administrators, as well as pharmaceuticals and medical supplies, and a supporting network of teaching hospitals, training programs, accreditation, and drug and equipment manufacturing. Even if personal health is not properly a community concern—as we agree that educating the young should be—providing for people’s various health requirements and caring for them when they are sick and injured is a hugely complex business. And we can all agree, I think, that any society functions better when people are healthy and strong.

At current reckoning, health care in the U.S. represents at least 14% of the national economy. That’s why many people hesitate to turn our patchwork of private providers (doctors’ practice groups, for-profit and religiously funded hospital organizations, insurance companies, and drug and equipment companies) and public providers (Medicare and Medicaid funding, community hospitals, county clinics, and various national institutes managing health issues) over to a single government system operated at the federal level. When all the eggs are in one basket—who’s watching that basket?

2. You Get What You Pay For

Right now, the average American experiences health care in a world of choice—well, some choice. Most people get health care through their employer, and most employers offer a variety of insurance plans with varying options about coverage, copays, premium costs, provider lists, and other pieces of the puzzle. If you don’t have coverage, then you take whatever you can get from an emergency room visit or the charity of a public hospital. No one, except the truly rich, gets everything he or she wants.

When you buy something for yourself, you get to make choices. You weigh what you’ll pay against what you ideally want, what you actually need, and what makes the most sense to you. When you get insurance through an employer, the company is paying part of the insurance premium, so the options are more limited. You can buy the gold-plated health plan with all the bells and whistles, but you’ll pay more out of your own pocket for it.

Advocates of a single-payer system—universal health care provided at government expense—tend to forget about the choice side of the equation. When a third party pays the piper, you dance to his tune. When you eat at public expense, you don’t get to choose between steak and chicken. Under a single-payer system, you may have a strong, bonded relationship with a certain doctor, but he or she might be assigned elsewhere. You may be in pain and need a new hip now, but resources are limited and so you might have to wait. You may be a vigorous, healthy 78-year-old with a lot still to contribute, but if you get cancer after the mandated cutoff age for aggressive treatment, then you will get only palliatives and hospice care.

If health care in America follows the British model, where private insurance and religious-based or for-profit medical providers are permitted to function, then you will be able to exercise choice by paying more outside the system—in the same way that parents can choose to put their children in a parochial or private school. If the system limits competition from private resources, as in the Canadian model, then you will accept the choices made for you by bureaucrats in the state capital or in Washington, DC.

3. Insurance Isn’t the Right Business Model

In the early days, certainly at the beginning of the 19th century, only two kinds of people went to doctors: the rich and royalty. With their theories about the four humors, bleeding, and black bile, the most that doctors were really good for was setting broken bones or stitching up wounds. For the rest of human ailments, their practice involved administering placebos, watching, and waiting. Oh, surgeons could cut out a large tumor or amputate a mangled limb in extremis. And hospitals were filthy places where you went to recuperate or die—and usually the latter.

Not until the melding of science and medicine—which began with the germ theory of disease in the late 19th century and progressed to antibiotics with the discovery of penicillin in 1929—did medicine gain a solid and respectable footing. But still, for most people, health was a matter of good luck and a strong constitution. Serious illness and injuries were considered natural catastrophes, and death usually followed quickly.

It made sense, in this medical environment, to insure yourself against the catastrophes. You took out hospital insurance, also called “major medical,” against surgery or an acute condition like cancer involving a long hospital stay. But for routine aches and pains, fevers, and the occasional broken bone, a family would pay out of pocket to visit their neighborhood doctor.²

In the 1930s, while building what became Hoover Dam, the Henry Kaiser organization set up the first comprehensive health care system—Kaiser Permanente—which tended to their workers’ complete medical needs through a network of dedicated facilities and physicians that was paid for through insurance-style premiums. Providing complete medical services through insurance at the workplace became an employment perk during World War II, because health insurance was not subject to federally imposed wage caps. Gradually, with the rise of Health Maintenance Organizations in the 1970s, the emphasis moved from catastrophic coverage to complete medical coverage. This was generally a good thing, because regular checkups and preventive care were now encouraged and paid for, but the transition had some bad consequences, too.

Insurance is a means of alleviating the potentially crippling costs of an unexpected catastrophe, such as your house burning down, crashing the car, or a family member becoming badly hurt and needing surgery and months of therapy. Insurance is not meant to pay for routine and expected expenses like replacing the roof, painting the porch, or changing the oil and tires. To be sure, medical checkups, routine diagnostics, booster shots, and birth control all have to do with a person’s health, but they are not unexpected expenses and therefore not properly paid for by insurance. If you insist on paying for these services through insurance premiums, then you are no longer making an actuarial bet—like betting that the house won’t burn or that you’ll stay healthy—but instead you are simply structuring your monthly expenses through an exotically complex and costly method of payment.

And even if you are perfectly healthy, eventually you will die. In the early days, this was a fairly uncomplicated process. Some part of the organism was damaged by disease or injury, began to break down, the patient failed to thrive, and—on a time scale dictated by the nature of the disease or damage—further living became impossible and you said good-bye. Now, through the miracles of modern medicine, we can hold off that final act for an unnaturally long time and can even keep a brain-dead shell breathing and pumping blood in perpetuity. If you had to pay for such “heroic measures” out of pocket, you would eventually call it quits and succumb to the inevitable. But so long as someone else is footing the bill out of premiums you’ve been paying all along—why spare the expense?

It’s commonly understood that about 50% of the medical costs a person consumes are incurred in the last six months of life. From a personal point of view, the natural feeling is “Why not stick it to the insurance company? We’ve been paying the bloodsuckers all these years!” But from a societal point of view, “Why spend these resources on the dying, who ultimately can’t be helped? There are more important medical needs to be served!”

Insurance is a bad business model for paying out monthly expenses. It’s a really lousy model for trying to delay or override the inevitable.

So that’s the background to my thoughts on public health care. Next week I’ll explore where I think medicine is going in the future and why a better system of paying for it will become inevitable.

1. I went to a former land-grant university, Penn State.

2. This was back in the days when a doctor, lawyer, or other trained professional expected to earn a solidly middle-class living. Doctors still made house calls and charged for their services according to the wealth of the community in which they lived. Training as a physician was not considered a sure route to a six-figure income, high society, and a vacation home in the Hamptons. Hospital stays cost a lot back then—more than a local hotel room, certainly—but they were not like moving into the Waldorf Astoria with concierge and room service.

Not With a Whimper

… But with a sprained ankle. That’s the way life ends—or at least how it starts the final and irrevocable slide.¹

As I grow older, the one thing I’ve learned that the young have still to discover is how adaptable and accommodating the human body, the human mind, and many other aspects of human life can be. If you maintain your body and brain, keeping both flexible and strong through daily exercise, challenging reading, animated conversation, complex music and puzzles, and occasional stress tests that require you to move outside your comfort zone both physically and mentally, then you can find health, a measure of happiness, and peace of mind. If you live within your means, save some money, buy insurance, and prepare for the unexpected, then your household can survive any number of economic shocks.

But that’s not actually my point in this posting. “Adaptable and accommodating” can also mean just the opposite: the body gradually shapes itself and its potential to whatever becomes your everyday way of life. I’ve been to that comfortable place, seen others go there before me—and now I’m trying to come back.

The young are, for the most part, gifted with healthy bodies, supercharged metabolisms, clarity of mind, and a future full of possibilities. Life is a golden promise. But what they don’t yet know is that life is also a succession of idle minutes, passing days, repetitive stresses and choices, accumulating habits, and suddenly passing years. The cigarettes, the drugs, rich foods, and other treats we once consumed only at parties and on special occasions eventually find their way into our fingers and our mouths every day. The book we put aside to watch a really stupid television show, because we were just too tired, becomes a dusty stack on the bedside table. The workout that we skipped on Monday is soon skipped on Tuesdays and Wednesdays, then for a week at a time, and eventually forgotten. The unpaid balance that we once tolerated on our credit cards “just for this month,” because payday fell a week after the “due by” date, slowly becomes the balance we carry from month to month and expect to pay off someday. Life has a way of catching up with us and becoming real, the norm, the expected.

And we adapt to and accommodate our changed reality. We carry the physical and mental debits because our resources are, of course, still boundless. We schedule our day around that little hangover which lingers in the morning. We carry the extra pounds because they really don’t slow us down that much.² We pay the finance charges on our cards from month to month because we’re making more money now and we need more things to match our lifestyle.

Life has a way of creeping up, however. Soon we’re taking a glass of wine or whisky at lunch to chase the hangover that will otherwise fog up the afternoon. We have trouble bending over to tie our shoes and instead buy a pair of loafers we can slip into standing up. We take the elevator, even if we’re only going up a floor or two, because the stairs would leave us out of breath. We’re paying finance charges on the credit cards that have gradually become a noticeable fraction of the monthly rent.

My point is that we adapt to these stresses, we become comfortable with them. They are part of the life we lead. And meanwhile, silently, invisibly, without even a whimper, the boundless resources we once enjoyed in youth—and thought we could rely on in a crisis—are eaten up with the need to support these daily deficits. We go from being able to climb the steps of a picturesque lighthouse or the medieval towers of Bologna,³ to being winded by the stairs in a friend’s home. We go from running marathons to being unable to walk five miles if the car breaks down. We can still carry the weight, the strain of drinking and smoking, the cost of the debts—but we have arrived on a knife edge.

And then the unexpected happens, the jolt that takes us out of our daily path: we sprain an ankle, get stranded with a broken fuel pump, lose the roof to a freak windstorm. And what would have been an inconvenience in our youth becomes a life-and-death situation. We can no longer move our bulk from the chair to the table to the bathroom, no longer walk to find a payphone, no longer absorb the added cost to keep our house.

It’s certainly not the case that shedding our vices, losing the weight, and paying off the cards guarantee we’ll live forever. Everybody dies of something. But you don’t have to die of something silly like turning your ankle or running out of gas.

What applies on a personal scale also applies on a national scale. Like a person who’s become careless about credit card debt, our country has relied on deficit spending because we’ve always been able to cover the finance charges. The current mountain of national debt—$16 trillion and counting—won’t sift down like snow and smother us softly, so that we go out with a whimper. Instead, we will face a crisis—one more war we cannot avoid, an earthquake that shatters the infrastructure of an entire region,⁴ or some other unexpected national crisis—and the debt will suddenly become unsustainable. Our resources will have been eaten out from the inside, and the collapse will be fast and unavoidable.

We don’t necessarily want to live forever. But we also don’t want to die of something stupid. That would just be embarrassing.

1. The reference, of course, is to T. S. Eliot’s poem The Hollow Men and its last line about the way the world ends: “Not with a bang but a whimper.”

2. If you think about it, an extra fifty pounds is like packing two suitcases and carrying them strapped around your middle and across your buttocks. Most of us resist the effort to carry those two suitcases for a mile through the airport, yet we carry that much weight around with us every day.

3. It’s 498 steps to the top of the Asinelli Tower. I could climb them twenty years ago. Oh, what a view!

4. As I’m writing this, the East Coast is still recovering from the super storm called “Sandy,” with billions of dollars in damage repairs ahead of us. I woke up wondering if this is the sprained ankle that our economy has been shuffling towards for a couple of years now.

Mass Effects and Magical Thinking

We live in an age of wonders. Humanity’s new way of thinking, based on observation, hypothesis, and testing—the scientific method—supplies us with new machines and tools to support our advanced and rapidly evolving lifestyle, things like electric motors, microprocessors, satellite communications, and sophisticated data mining. This way of thinking also enables us to understand the principles behind many natural processes which humans have observed, wondered about, and created religions to explain since the first primate became self-aware, things like storms, earthquakes, solar eclipses, and the nature of life itself.

Some of the tools and their underlying principles are easy to understand and observe, like the actions of spark plug, piston, connecting rod, and crankshaft that drive an internal combustion engine. Some are difficult to understand and almost impossible to observe, like the electrons chasing around circuits inside a microprocessor, or the complex statistical algorithms that let researchers sift huge amounts of data to answer specific questions. For processes and principles that a person can’t study on a human scale and trace out with a fingertip, one is usually forced to accept—on faith, as it were—the explanations of trusted experts and the empirical fact that, whatever’s going on, the machine or process does work and provides reliable, usable results. Even if you don’t understand transistors and binary logic, you can still use a cell phone or computer.

But some processes are so vast, played out on inhuman scales of distance and time, or involving so many interactions and moving parts—for which I’ll use the shorthand term “mass effects”—that most people have a hard time seeing the chains of cause and effect. And so they may tend to disbelieve that the process is actually working at all. Two examples come to mind. First, the process of evolution, which plays out in millions of individual organisms over thousands of generations. Second, the price-setting mechanism of a marketplace, which plays out in thousands or millions of individual buy-sell decisions over a like number of transactions.

You can’t observe the process of evolution in any one individual or any one generation. Instead, you have to understand—or believe in—the cumulative power of thousands or millions of small changes to create a big effect over time. Similarly, you can’t observe the dynamics of a marketplace in any single interaction where A sells and B buys—which is the classic haggle of the bazaar. Instead, to understand a market, you have to multiply that interaction over hundreds or thousands of instances that establish a relationship among desire, availability, and price.

Curiously, if you divide the world into political parties—right and left, conservative and progressive—you find no appreciable difference in the power of these mass effects to confuse rational thinking. Each party has its adherents who face the challenge of understanding these far-flung and abstruse principles and then reject them as a kind of “magical thinking.” On the right, there is a tendency to doubt the power of evolution; on the left, a distrust of markets. These tendencies are not universal, of course. You can find traditionalists who are confirmed evolutionists (I’m one myself). And you can find progressives who are market-based economic theorists. But the tendency to doubt in either realm is well enough established to have become almost a trademark.

The traditionalist has a reason, of course, for dismissing evolution: it flies in the face of established teaching about the nature and intention of God. Evolution is messy. It has no foresight and cannot “intend” to produce any specific result. It builds on a series of tiny changes to simple structures that eventually, over time, creates more complex structures. And those tiny steps can as easily go backwards as forwards.¹ Darwin understood this process and theorized about random changes that could be inherited long before anyone had defined the DNA molecule or worked out complementary base pairs, triplet reading frames, amino acid coding, and the mutations that might change one base in that genetic code into another.

Evolution works because it applies a filter, a process of selection, to the random changes that mutation produces in our genes and so affects the structures they build. The filter, the selection, is fitness of purpose. It doesn’t matter what the purpose might be or how it’s achieved.² If the change abets the purpose, it creates advantage, and the next generation fares better. If the change defeats the purpose, it creates liability, and the next generation suffers. If the change is neither beneficial nor harmful, it might carry forward unnoticed for many generations—a genetic time bomb, as it were—until the environment and its demands change around the individual.

Religious believers hate this for a variety of reasons. Evolution makes no promises. It might have easily conferred the gift of awareness, thought, and personal purpose on sharks or dinosaurs or field mice as on a particular branch of the primates. What does that say about the God who made us in his own image? And evolution is cruel. It ignores the individual, his or her personal welfare, and any sense of destiny in this cascade of random improvements and disfigurements. A loving and benevolent God simply wouldn’t work that way.

The progressive has a reason, of course, for distrusting markets: they are inherently unfair to some portion of the people involved. Markets are based on discretionary transactions. A thousand or a million individual buyers look at the offering of a product at a certain price, weigh their need for the product, and decide, “Yes, I’ll pay that” or “No, too expensive.” A thousand or a million individual sellers look at the cost they’ve incurred to offer the product and the price they can get for it, based on the hunger in a buyer’s eyes, and decide, “Yes, now is the time to sell” or “No, I’ll wait for a better price.” For the average person of average means who can choose to buy or not, this might work equitably and fairly.

But the progressive sees and responds to the inherent disparities in the population. No matter what the market price may be, the rich man can always afford to buy—and take as much as he desires. No matter the market price, in times of scarcity it will usually rise out of reach of the very poorest. This disparity at the two extremes doesn’t matter much if the product in question is caviar or diamonds. But when the product is a necessity of life like food, housing, energy, or education, it becomes intolerable that the rich should gorge themselves while the poor go hungry. Market-based pricing makes no promises about what the “fair” price will be. And markets are cruel, because in times of scarcity some segment of the population will suffer. The market ignores individual wants and needs.

I find it curious that in these two areas, where mass effects play such a decided role, rational people deride belief in and reliance on these natural processes as some kind of “magical thinking.” Traditional believers deny that evolution can be the author of so much beauty and complexity to be seen all around us.³ Progressive economists deride the “dead hand” of the market as a means of distributing goods and services.⁴ In each case, the natural, human desire is for some kind of “intelligent design”—meaning an intelligence that an average human being can observe and accept. The religious believer wants a kind and loving God to design the living world along lines which he can understand and in which he can believe. The progressive theorist wants a kind and benevolent state to identify the population’s needs and fill them from available resources according to principles of fairness and equity of which he can approve.

Unfortunately, in each of these strivings for some human-quality intelligence to drive the natural system, the result does violence to the underlying principle.

A market can be made fair and benevolent for the disparately advantaged only by doing violence to the opposing party in the transaction. When products are naturally in short supply, holding prices artificially low for buyers robs the producers and distributors of their choice not to sell. When products are abundant, enacting price supports in favor of producers and distributors robs the consumers of their chance to stock up and save. When the benevolent state decides to take control of the entire economy and tries to direct production and sales according to “rational” principles, it always ignores niche markets, the needs and preferences of contrary-minded individuals, and the voluntary nature of an equitable exchange.

A planet’s flora and fauna that were created according to some “rational” or “intelligible” design would fix each creature in its niche within the environment. Even with godlike understanding and foreknowledge guiding the creation, the environment itself would have to remain fixed and unchanging forever: no climatic drift, no asteroid impacts, no solar life cycle, no perturbations among the stars. The slightest change, with its effects allowed to accumulate over millions of years, would oust each creature from its appointed place in the great scheme. Ultimately, life would die out entirely—a greater violence than the small daily and annual dyings out that set the stage for new life that is better adapted to current conditions.

What these systems of “mass effects” both address is the underlying dynamism in everyday affairs. In economics, that dynamism responds to the wide ranging differences in human needs, desires, ambitions, and preferences—the innate individualism of our species. In ecology, that dynamism responds to the unstable nature of reality—in which nothing is fixed, nothing permanent, nothing undying and unchanging.

People who live in modern apartment blocks tend to believe they inhabit a comprehensible, three-dimensional, clockwork, Euclidean-Newtonian world, because the walls, floors, and ceilings all come together in straight lines and neat corners, and the train schedules, banking hours, and television programming of their daily lives all run on the same time structure. They haven’t yet absorbed the underlying nature of reality, which is fluid, relativistic, stochastic, quantum-Einsteinian, and responds to statistical probability rather than to human constructs. In the same way, people who crave “rational” and “intelligent” solutions think they live in a static and unchanging world, where all humans want the same things, all fish swim in the sea, and horses run forever across fields of green grass under a warm and benevolent sun.

We live in an age of wonders. Not least of them is the amount of catching up required for human thought and emotion to match our accelerated scientific understanding.

1. The classic example of evolution is the bird’s wing, and you can duplicate the process in a metal shop—if you have enough time and patience, not to mention enough metal. Take a thousand or a million strips of sheet metal. Give each one a random whack with a hammer, then put it in a wind tunnel and see if the bent metal generates any kind of lift. If it does, set it aside; if not, discard it. For those pieces that generated some lift, give each one another random whack and test it. If it lifts, keep it; if not, discard. Repeat this process over and over, adding new pieces of metal as necessary. Eventually, over time, one piece will survive that has the perfect airfoil curve of a bird’s or an airplane’s wing. But a dozen times in the process, heartbreakingly, you will be one step away from the perfect wing and destroy it with the next random whack. Evolution cares more about results than progress and decrees that life is cheap.

2. A bunch of single-celled protozoans swim in a puddle. One undergoes a mutation that gives it the ability to manufacture a chemical sensitive to visible light. After that, and in every generation of single-cell division, the little animalcule makes that chemical without particular effect. Then, eventually, a second change lets the protozoan react to this newfound photosensitivity. If the creature also happens to acquire its daily energy through photosynthesis, suddenly it can move toward the light and thrive. Or, if the puddle happens to be gradually drying up—and drying faster in areas exposed to sunlight—the protozoan can move toward the shade and perhaps survive the drying out. Purpose and benefit are not directed. But still, in the land of the blind, the light-sensing protozoan is king. From that single chemical and the ability to sense it, to a full-grown eye—with an iris to regulate the amount of light that enters it, a lens to focus that light into an image, and a retina to retain and interpret the image—is just a matter of so many more baby steps.

3. But stop and think. Were not our eyes evolved to see and cherish, to take comfort in and seek pleasure from, the world in which we find ourselves?

4. Even though that “dead hand” merely represents the sum of individual choices freely made. What could be more fair and democratic than that?

American Culture, American Character

Culture is the stories we tell for and about ourselves. Those stories in the past have taken the form of novels, magazine articles, song lyrics, movies, jokes, and shared anecdotes. Today we must include Twitter feeds, Facebook posts, blogs, and—to use the new word—“memes.” Behind those stories and memes, shaping and driving them, is a commonly held set of values, expectations, and dreams. And if you can understand what a person or a people holds dear, expects to happen, and dreams about, then you have solid clues to that person’s—or the people’s—character, to what they will choose to do and how they will react to both stresses and to opportunities.

Call the next 2,500 words my love letter to the American culture and character. That’s a big subject for a small space, so expect some prodigious thumbnailing.

First, our culture—or rather, the “popular culture,” expressed in the most obtrusive song lyrics, action movies, and bestselling novels—is going through some kind of disruptive transition right now. Raunchy song lyrics, blatantly pornographic imagery, violent explosions, adolescent defiance, and brutal disdain for the old societal values are all underlying currents. It seems that the perceived relevance of a novel or movie plot today is directly proportional to how close the world comes to blowing up and how that situation frees the main characters to be violently destructive, abandoned, and vicious. The dominant image: the bulbous red lips with tongue sticking out, à la the Rolling Stones. The dominant challenge and response: “What are you rebelling against?” and “Whaddaya got?” à la Marlon Brando in The Wild One.

This disdainful hedonism has been sixty years—two, maybe three generations—in the making, if we take the year of the Brando movie, 1953, as some kind of starting point. That’s almost my entire lifespan. I think the roots of this wildness can be traced to the sudden release of pressure, like popping a champagne cork, when the weight and strain of the Great Depression and World War II were lifted from the American psyche. We suddenly found ourselves on top of the world with our new industrial power providing plenty all around and no one left to beat except the Soviets and Red Chinese—and they were a grim, gray, robot- and antlike people safely half a world away. The fizz of this sudden release might have died out in a single generation if two scientific developments hadn’t intruded. One was the prospect of global nuclear war, with the promise that tomorrow might never come.¹ The other was the invention and marketing of the Pill, with the promise that uninhibited sex need have no real consequences. Both developments rocked the psychic and cultural landscape.

But in the longer term—the sweep of history, if you will—the culture of youthful rebellion and apocalyptic abandon are still an aberration, a diversion, a departure from our true natures. If we count from the Plymouth and Jamestown colonies in the early 1600s up to the end of World War II and its aftermath in the 1940s, this nation had three and a half centuries to form a distinct culture. And that culture wasn’t based on “It feels good, and the world’s ending anyway, so let’s do it!”

North America under colonization by the English, Dutch, and French was a vast, empty, rich, and violent landscape.² The colonization effort created stories, dreams, and aspects of character that had never before existed in the world. The promise of endless land and opportunity experienced during that colonization—and the state that developed after those early colonies broke away from the mother country—shaped the nature of the people who settled here.

1. We All Came from Someplace Else

Every human on this continent—even the “native” Americans—either in person or at some point in his or her ancestry, arrived in North America from someplace else. Some came as seekers, strivers, and dreamers. Some came to escape persecution or personal defeat. Some came following a game trail across the Bering land bridge. And some came in chains as slaves.

But whatever our motivations, none of us found exactly what we were expecting. Except for the very few who stepped ashore carrying a royal charter and a bag of gold, everyone who came here had to struggle and adapt, had to learn to survive, had to make his or her way in a strange land that was never quite as advertised. We are all either the immediate products of that struggle, or we carry the genes of people who struggled and survived.³

Americans carry a selection advantage. We are not among the frogs who will wait quietly in the pot for the water to boil. We have a shorter than average fuse and a built-in tendency to say, “This sucks! I’m outta here!” We carry—if not in actual memory, then as part of our cultural heritage—the idea that things can get better, and that it’s worth the risk to move on and find that better time and place somewhere else. We do not worship tradition. We do not submit gracefully. We are hopeful. We are strong. We are not afraid. And we’re pretty much free of envy and jealousy.

With this heritage, we have a penchant for, and a fascination with, the resilient character, the cat who lands on his feet, the taker of chances, the jack of all trades, the artful confidence trickster, the Huckleberry Finn, Jay Gatsby, Al Capone, and yes, even Bernie Madoff. We don’t necessarily want to be them, much less become their prey, but we understand and tolerate them. We recognize their nature, at least a bit of it, in ourselves.

2. We Have No Natural Peasant Class, No Aristocracy

In most of the rest of the world—in Europe and Asia and, yes, even in South America—the culture sustains unconscious awareness of a large, background population of people who do not count, whose days are presumed to pass in torpid normalcy, whose dreams and aspirations can be dismissed, because their lives will never change. These are the peasants, the rural dullards, the stay-at-homes from which society raises its army of taxpayers and cannon fodder.

The existence of a natural peasant class also implies the existence of a naturally superior aristocracy, the better families and hereditary landowners, the people with an inborn nobility and unearned gifts, from which society develops its statesmen, churchmen, scholars, cavalrymen, and officer corps.

America never had this duality.⁴ In the extreme East you might hear some reference to “Boston Brahmins” and the “Old Knickerbockers.” Elsewhere you hear derisive comments about “Mr. and Mrs. Gotrocks”—who are usually the nouveau riche and not an established, hereditary class. They return the compliment by talking about “the great unwashed”—but with the uneasy feeling that they themselves are only about three wrong moves away from the trailer park and vocational education.

Everywhere, in every city and town and countryside, America does have its rich and poor. But the lines are fluid, and no one naturally “belongs” to either class. For every wealthy family whose sons now go to Harvard and whose grandfathers made money in furs or oil or newspapers, you can count half a dozen more whose grandfathers were small farmers or shopkeepers and whose sons just made a killing with a new app in Silicon Valley or with a new way of leveraging finance on Wall Street. And for every family clinging to a bit of hard-scrabble land up in the hills or a patch worked out on the plains, you can find a dozen more opening car dealerships and managing restaurants. Our mantra is “You can’t keep a good man down.” We value enterprise, spirit, opportunity, and initiative.

America has no disposable people who can be dismissed as naturally less worthy, less sensitive, with less future potential than anyone else. And we have no naturally valuable people who can boast presumed gifts of talent, knowledge, and gentility. Everyone is exactly what he or she can make out of life, given the opportunities at hand and his or her own imagination and dreams. And so as a culture we value providing readily available tools and remedies: free public school education and usually affordable higher education; easy access to capital through credit, loans, and mortgages; recovery from personal disaster through health and property insurance and bankruptcy protections; freedom to travel, to think and speak, and to try something different. It’s not a coincidence that Americans write, publish, buy, read, and follow the world’s share of self-help books and guides.

3. We Come from Small Towns

In the rest of the world, the life of the country is played out in the capital. Englishmen go to London to make their name and fortune, as the French go to Paris, the Russians to Moscow, and the Chinese to Beijing or Shanghai or Hong Kong. The provinces are known as a backwater if not a place of exile.

In America, at least until the latter part of the 20th century, people lived in small towns. And since World War II, with the rise of the automobile, even people who work in the cities have chosen to move out to the surrounding suburbs. Yes, aspiring writers and actors and hopeful lawyers and bankers have all followed their dreams to the cultural and financial capitals of New York and, lately, Los Angles. But our nation’s political capital, Washington, DC, has never been an object of pilgrimage—at least until the late 20th century, when the national government, its bureaucracy, and its influence started to balloon.

Small-town life is different from city life. For one thing you know your neighbors and feel connected to them. You volunteer to help them raise a barn or serve at a pancake breakfast. You join the business and charitable clubs, the fellowships, the church choir, and the volunteer fire department. If you feel isolated and alienated in the big city, the problem is likely your surroundings. If you feel disconnected in a small town, the problem is probably your personality.

It’s only in the 20th century, starting with the Great Depression—or perhaps a bit earlier, with the temperance advocates for Prohibition and the reform-minded journalists, called “muckrakers,” who worked for social justice—that Americans have looked to Washington to solve their problems on a national level. For three centuries before that, the Federal government was far away and usually not very effective at solving local problems. Americans looked to their neighbors for safety and a helping hand.

4. We Respect a Person’s Privacy

While everyone knows what’s going on in a small town, Americans tend to draw a curtain over matters that are considered private. These include—or used to—a person’s religion, politics, financial situation, historical antecedents, and hereditary background. The spirit that a person can move on to a new place and make something new and different of himself depends on this sense of delicacy.

We wrote into our founding documents that a person can believe and worship as he chooses, say what he thinks, publish what he believes without retribution, and act in the expectation that before he can be punished, the case against him has to be proven, in public, with a jury of his peers. These are not dusty sentiments written on parchment two hundred years ago and largely forgotten today. They are values that we are still actively debating, testing in the courts, and redefining in new ways as the world changes around us. Also, they are not mystical, hieratic concepts that we common folk leave for our judicial betters to decide: everyone has an opinion, a point of view, and a personal sensitivity about where the needle should lie along the spectrum between casual tolerance and social control.

In this atmosphere, the first question an American asks about a man or woman is rarely “What religion does he follow?” “What party does he belong to?” “How much money does he have?” “Where do his people come from?” or “What race does he belong to?”⁵ With our rough-and-ready frontier heritage, we tend to ask instead whether he’s reliable in a crisis, able to pay his way, hold his liquor, provide a steady hand with the horses, and willing to coach Little League. We ask if she’s a gossip or a minx, raises responsible children, and whether she can stitch up a wound and supply a cake for the bake sale.⁶

The American character—and the cultural stories we once told about ourselves and should be telling again—is practical and pragmatic, impatient with formalism, ambitious for success and advancement, independent, tilted toward fairness, respectful of education and demonstrated worth, willing to trust proven competence, small-D democratic, and grounded in common sense. We value what works, because we’ve had to depend on it. We’re willing to try something new, because you never know until you try.

We’re not the best people in the world, but we’re pretty damn good. We still think there’s a future worth working toward and a world of opportunity waiting for us just over the horizon. We might entertain ourselves on Saturday night with movies about churlish adolescents lusting after supermodels and blowing up the world, but such stuff barely touches our minds and hearts. Come Monday morning, we roll up our sleeves and get back to work.

1. See Never the Devil You Know from October 14, 2012, for thoughts on nuclear war and other apocalyptic thinking.

2. As to being “empty,” well yes, perhaps 7 to 10 million native Americans were already living in this vast open space. But for the European settlers, they were a grim, gray, Stone Age people out beyond the edge of the woods—an impediment rather than actual, rightful landowners. The American colonization, at least from the European viewpoint, was not at all like the Vandals and Goths coming into the settled areas of the Roman Empire, or the Mongol hordes invading the plains and developed civilizations of India, the Middle East, and Eastern Europe.
       As to being “violent,” the forests of North America were a wild and stony wood, as yet untouched by ax or plow. The Europeans, who had long ago harvested their native forests for timber and fuel and now lived among trees that were carefully nurtured in “plantations,” had never seen anything like the dense forests of the eastern part of the North American continent. And when they got to the Great Plains—with their sudden tornados, torrential floods from thaws and storms far beyond the horizon, and herds of millions of stampeding bison—they marveled at the raw, untamed power of the land.

3. See We Get the Smart Ones from November 28, 2010.

4. Well, yes, in the Old South the black African slave was dismissed as a person of no account with no future by the slave owner, who thought of himself as a naturally superior being. But that was not a common view throughout the country. In fact, enough of the population abhorred the notion that we fought a war over it which killed 600,000 Americans.

5. Or not, thank God, so much anymore. In the past, skin color and physiological features have meant more, especially when dealing with those we considered “the Other.” Today, we—or at least, the best among us—tend to listen for tone of voice, reliable values, sensible advice, breadth of spirit, and level of education more than we look for gene pool and country of origin.

6. Yes, I know, these are rather sexist examples—and throughout this essay I’ve been writing “he” when I should have been using “he or she,” or liberally substituting “she” for the third person pronoun. But I’m reflecting three centuries of attitudes here, and it’s just recently that men and women have started to shrug off their past sexual stereotypes. Only when we can casually ask if a mother will coach Little League and a father provide a cake for the bake sale will we be totally free of gender roles.

In the Palm of Your Hand

Back when I was at the university, in the late ’60s, if you had told me that one day my telephone would also be a camera, a record player, a television set, a compass, a bookshelf, a newspaper, a reference library, a stock ticker, a weather report, something called a “video recorder,” something else called a “global positioning system” that could find my exact spot on a local map and guide me to all sorts of nearby stores and services, and, oh yes, also a “picturephone” like the one that was demonstrated at the New York World’s Fair in 1964 and played cameo role in 2001: A Space Odyssey … I’d have said you were crazy.¹

I wouldn’t have said this because I was a bumpkin with no imagination. I had been reading science fiction since grade school (the glory years of Asimov, Bradbury, and Heinlein), watched every sci-fi oriented television show (Captain Video, The Twilight Zone, The Outer Limits and later Star Trek), and listened to radio plays (X Minus One). While still in high school I wrote a full-length science fiction novel (not a very good one—I was a late bloomer). And as an undergraduate I took a three-credit course on the future (including various methods of prediction through analysis of historical, economic, and cultural trends). So I lived through my school years with one foot in the future, but I never saw the smartphone coming.²

It’s not hard to see why. At the time, all of these tools and services required vastly different technologies. The telephone ran on wires through a dedicated switching system. Cameras used film impregnated with light-sensitive dyes to produce flat images. Records created sounds by running a needle along wavering grooves impressed into vinyl disks. Television came through the air with pictures broken up into scan lines beamed across a phosphorescent screen. Compasses were metal needles mounted on pins. Books, newspapers, and libraries were heavy wads of paper. The stock ticker was essentially a telegraph, and weather had to be drawn out on large maps. Video recording was done in a studio with a camera the size of an ice chest and a tape machine as big as a desk. And locating places on the Earth by triangulating signals from satellites was, at best, a gleam in some defense analyst’s eye.³

If you had asked an engineer of the time to pack all these devices into one machine and then to make it portable, the result would have been a rig something like a one-man band’s. These self-styled musicians usually have a drum hanging off their shoulders, cymbals between their knees, harmonica on a bracket at mouth level, and washboard, guitar, and accordion slung across their chests, all held together with cinch straps and a belt. In the engineer’s vision of a 1960’s “smartphone,” you would wear a helmet with earphones and a microphone plus a pair of rabbit ears for TV reception, a chest pack porting various lenses for the cameras and spools or cassettes for film, a shelf at the back with a platter and tone arm for playing records, a cathode-ray tube bracketed at eye level for television, and a shelf with reading table across the stomach for those books and newspapers. It would trail long connecting wires that you could plug in for telephone service. Oh, and it would run on really big batteries or need to plug in somewhere else for power.

All of these devices and services—except for books and newspapers, and the film camera—had only one thing in common: electricity. But conceptually their use of that energy was still diverse: low-voltage diaphragms and carbon granules to run the telephone; electric motor and vacuum tubes to run the record player and its amplifier; high-voltage cathode-ray tube for the television; and so on. These were “electronics” in the primitive sense of analog signal propagation and simple amplifying circuits. And for the camera and the books, nothing.

The 1960s was still an analog world. Voices, sounds, and pictures were all captured in real time, stored physically, and recalled and played out as wavelengths. The rising and falling pitch of a human voice or the musical notes from an instrument were presented in infinitely variable gradations from loud to soft and from high to low. And these were captured as deeper and faster—or shallower and slower—zigs and zags in the endless spiral cut into a vinyl disk, or as stronger and more rapid—or weaker and more widely spaced—magnetic pulses in the iron oxide coating on a piece of tape. The light and dark areas that make up a picture were captured as more or fewer grains of dye held in an emulsion on film and turned sideways—or not—when struck by photons from the visible spectrum. The light and dark of a television image depended on the strength of a electron beam that scanned across a glass screen coated with phosphorescent dyes.

Signal strength—and the various ways to capture it, record it, and play it back—ruled the day. And what makes the smartphone and its many functions now possible is, of course, digital technology. Or rather, all of the various digital technologies that have come together in the years since the 1960s.

Sounds, for example—whether telephone voice transmission, music, or anything a microphone can pick up—instead of being captured as an amplitude-dependent analog signal, are now chopped into digital values representing pitch of voice and speed of delivery. Those binary values⁴ can be transmitted through a variety of signal formats (wire, microwave, radio), or stored electronically in a memory chip or on a magnetic disk, or manipulated through mathematical algorithms to compress the speed of transmission, filter out background noise, or even completely alter the signal content. Images—whether photographs, maps, or video frames—instead of being captured as pulses representing analog signal strength in each of three primary colors (the red, green, and blue of emitted photons) are now interpreted as an array of picture elements coded for hue and brightness, with more codes for coordinating the line scans and refresh rates in video. Simple book text is stored and sent as binary codes, with more codes for coordinating typeface, treatments, layouts, placement of illustrations, display of footnotes, and the reader’s current position in the text stream.

Computers existed in the 1960s, of course. And large amounts of data—mostly words and numbers—were already being interpreted, stored, and manipulated digitally. But the computers themselves were still huge installations, with core memories the size of walk-in closets and storage on banks of spinning tape drives or magnetic disks the size of washing machines. The cost and complexity of these assets restricted their use to large institutions, with access closely controlled and limited to highly trained operators.⁵ These users typed information on keyboards, which usually transcribed lines of data or code onto Hollerith or “punch” cards, which reading machines would then feed in stacks into the computer’s memory. Users received their output on reams of fanfold paper. Graphical user interfaces, with a high-resolution screen to display data and a mouse to select among it, were only just being invented. Even the science fiction of the time envisioned computers as massive, requiring dedicated rooms full of machinery. Robert Heinlein’s The Moon is a Harsh Mistress is a classic example.

It wasn’t until the next decade that microprocessors—“computers on a chip”—brought computing power down to something you could pack into a suitcase (the Osborne 1) or a typewriter frame (the Apple II). The designers of these original computing chips were not aiming at general-purpose, portable, personal computers but rather controllers for automated machinery. The computer that controls the fuel injection in a modern car or the clock functions of an automatic coffee maker⁶ is a microprocessor.

From the 1970s onward, we’ve seen digital technology advance and converge with the expanding capacity of computer chips, until today you can hold in your palm a telephone that’s also a camera, a television set, a record player, and so on. It all seems natural and logical in hindsight. But from the perspective of the 1960s, this combination of handheld devices was unimaginable. Even to contemplate it bordered on magical thinking—or madness.

The point of this meditation is simple. What other advances similar to the digitization of analog signals are out there, perhaps already on our intellectual horizon, that will make the world of 2050 unimaginable or magical to the average person of today? Up until this summer, I would have placed large bets on biological advances through manipulation of individual genomes and cellular functions. But with the announced discovery of the Higgs boson in July, I think we may also see a comparable leap in physics and possible applications through the manipulation of gravity, space, and time.

As I’ve noted before, scientific exploration and understanding have put humankind on an express escalator to a future we can’t even imagine. Fasten your seatbelts, it’s going to be a wonderful ride!

1. And if you had told me that one day I would like peanut butter on my grilled chicken and enjoy raw fish wrapped in cold rice and seaweed, I’d also have said you were crazy. But then, I was a suburban lad brought up on the East Coast, and the specialties of Thai and Japanese cuisine were still unknown to me.

2. Still, I and everyone else who read the Sunday supplements knew that by 1990 our cars would fly like George Jetson’s. We all seriously misunderstood the amount of energy and the sophistication of control required for that little trick.

3. The first global positioning satellite, Navstar 1, wouldn’t be launched until 1978.

4. Quick overview of the technology: All a computer knows and can handle is a two-value system—a switch at a certain location is either “on” (for “1”) or it’s off (for “0”). By selecting either 1 or 0 in each placeholder, and recognizing an orderly progression of placeholders, you can count up to any number, in the same way that you can select from among the ten symbols of Arabic numerals for 0 to 9 in one place, move a place to the left and count 10 to 99, move a place further and count 100 to 999, and so on.
       Binary counting, in base two, originally used eight placeholders (that is, eight binary digits—or “bits”—which can be either “1” or “0”) to count up to 256. A group of eight bits is generally recognized as a “byte.” By assigning each of those 256 possible values as code for an upper or lower case letter, Arabic numeral, punctuation mark, or other commonly agreed-upon representation, you can you can turn a string of eight binary digits into a letter, number, or symbol.
       You can then make groups of those bytes into words, sentences, and paragraphs. Or, with a different interpretation of the 1’s and 0’s, those bytes can become the pitch and delivery timing for a sound fragment in a conversation or piece of music; or the color and intensity for a picture element (or “pixel”) in a photograph or drawing; or a location reference on a map; or anything else that you and a community of programmers can agree upon. The programmers can then write software that manipulates those values mathematically in any way that human beings can imagine and absorb.
       Side note: When I was growing up, a long-distance telephone call was very expensive. This was because telephones using analog signals required human operators or mechanical switches to align various lengths of wire between one place and another into a single circuit—a connected span of wire—all the way from the telephone of the person making the call to the phone of the person receiving it, and then hold that circuit open while the two people talked back and forth. It took a lot of effort to arrange a call and dedicated a lot of expensive wire to carrying that single conversation back and forth.
       These days, using digital technology, a computer in the telephone itself (or alternatively in the local switching office) chops the conversation into convenient digital packets, attaches an identifying address to each packet, and sends it out across the system, which is a vast web of circuits, some carried by wire, some by microwave, and some by radio. Automatic switches along the route pass the addressed packets to the receiving office or phone, where they are reassembled into human speech or whatever else went into the handset microphone. Those digitized packets are chopped, sent, and reassembled by computers operating so fast that the process is virtually undetectable to the humans participating in the conversation.
       Those packets can also be shunted and stored on a memory chip (“voice mail”) or sampled and stored by government agencies (“wire tap”) just as easily as they can be reinterpreted through a loudspeaker for the human ear. Digital technology opens vast possibilities for the use and abuse of human speech or any other signal.

5. My alma mater, Penn State, ran most of the university’s accounting and academic recordkeeping with an IBM System/360, located in the heavily air-conditioned basement of the Computer Center. System capacity at the time was laughable by today’s standards: core memory in the thousands of bytes and tape or disk storage in terms of millions of bytes per mount. But then, my entire personal file and transcript—name, gender, home address, campus address, telephone numbers, courses taken, grades received, and payment history—would probably fit into the space of 2,000 bytes. So storing and retrieving the files on 26,000 active students was entirely feasible, although high-resolution photographs were not included.

6. Another question that someone from the 1960s would ask in wonder: “Why does my coffee pot need a clock?”

Never the Devil You Know

We live in the age of The Scream. Edvard Munch’s iconic melting person, paralyzed and destroyed by a nameless terror—that’s us, folks. This psychological condition, which seems to pervade the subconscious of all of western civilization, is more than simple alienation, malaise, or a free-floating anxiety brought on by the increasing complexity of technology and stresses of modern life. It’s the innate sense that the sky will soon rip open and the fire rain down upon us.

I’ve lived with this sense my entire life. I was born in the lull between the fission bomb based on uranium and the much more powerful fusion bomb based on hydrogen. My birth year coincides with the death of Gandhi and the birth of the State of Israel—both momentous psychological events. In the first grade, at six years of age, we practiced “duck and cover” as a defense against a nuclear explosion. We knew people who dug fall-out shelters in the backyard—not bomb shelters, because no one was expected to survive the initial blast, but places where you could live for two weeks or so while the radioactive dust blew over.¹ But, of course, Nevil Shute’s novel On the Beach, and the Gregory Peck movie made from it, proved that no one could survive the cloud of radiation that would ultimately sweep across the planet.

Ask anyone of my generation how the world was supposed to end, and the immediate answer would be “Nuclear fire!” We all knew the U.S. and the U.S.S.R. were just sparring in Europe and were itching to obliterate the world many times over. We all went on some kind of twenty-four-hour warning over the Cuban Missile Crisis in 1962—after hearing Kennedy’s nationwide address on October 22, I remember at age fourteen thinking that this was it, we were all going to die before morning—and only narrowly drew back from the brink. The danger of nuclear holocaust remained right through the fall of the Berlin Wall in 1989.²

But even before the collapse of global Communism, a new end-of-world scenario had raised its head. Through my work at a public utility, I attended Energy Daily’s conference on national energy issues in 1987 and heard one of the early presentations by James Hansen of the NASA Goddard Institute for Space Studies on global warming. The amount of carbon dioxide being pumped into the atmosphere by the human energy infrastructure was going to tip the planet into a runaway greenhouse effect with catastrophic results. By the middle of the next decade, Hansen said—meaning the mid-1990s—the change in climate would be obvious to the man in the street. He also said that the immediate effect might not be rising temperatures all over but falling temperatures in some places, as the Earth’s climate went through an initial period of disruption.³

But even before the catastrophe of global warming played out in the 21st century, we had the impending doom of Y2K. Because the creators of the COBOL business language allowed only two digits for recording the year in all transaction dates (after all, it was going to be 1900 forever, wasn’t it?), all sorts of financial and commercial software installations, and the businesses that depended on them, were going to collapse at the stroke of midnight in the year 2000. Computers would be unable to distinguish between new transactions and those booked a century earlier. Calculations of interest earned and owed, rents due, and future deliveries to be met would go haywire. Civilization would fall.⁴

A couple of years later we had a spate of movies, some appearing back to back, about a comet hitting the Earth and wiping out humanity just as the Chicxulub asteroid took out the dinosaurs. In both movies, we benefitted fictionally from having a fully developed space presence and the ability to go and deal with the comet—something we don’t, in reality, happen to possess. Still, our ability to averting catastrophe before the closing credits was a near thing.⁵

Today we have the prospect of financial collapse, “the fiscal cliff.” And, as if the implosion of the Housing Bubble in 2007 and the five years of Recession-That-Might-Be-Depression since then were not bad enough, we are generally offered a future in which the democracies of western civilization, chronically unable to live within their means, haplessly tax and borrow and spend themselves into bankruptcy, penury, and dissolution. No one knows exactly what the doom will be. It’s not as easy to predict the effects of a financial collapse as it is to imagine nuclear fire and rising sea levels. But it will be grim: 1932 squared, selling apples and picking rags, perhaps aggravated by a hyperinflation like the Weimar Republic’s. Money will at once deflate, or perhaps it will inflate. Banks will fail, or maybe they’ll end up owning everything.

The apocalypse foretold in movies, novels, and comic books—er, graphic novels—has been part of the culture for so long that a writer today barely needs to provide any backstory at all. What do you care? Things went haywire. Money was no longer any good. Electricity—even if you could get it—became all hand cranks and windmills. Everybody broke out the guns and went tribal. But the upside is that nobody has to pay a mortgage or show up at the office on Monday—and you get to kill anyone who looks at you cross-eyed. You might miss the clean food, digital movies, and hot showers we enjoy today, but you’ll absolutely love the manly thrill of freedom and adventure.

Yeah, the world is going to end and it will be terrible—except for the bits that will be exciting and wonderful.

It’s said that western civilization went through something like this before. As the year 1000 AD approached, people anticipated the Second Coming of Christ, Judgment Day, the rise of the Antichrist, and the collapse of public order with riot and fire. Whether or not the rioting and the penitence actually occurred—because the first written accounts of this millennial fever didn’t actually surface until about 1500 AD⁶—the notion of millennial panic is one of our civilization’s memes. And in truth, going back beyond Christianity and its dating system, the pattern of human history has been that civilizations really do fall. Various empires—Sumerians, Akkadians, Babylonians, Persians—chased each other up and down the Fertile Crescent. Egypt’s dynasties collapsed several times—as did China’s. Rome grew, flowered, dominated the known world, and collapsed. Why shouldn’t the collective democracies and commercial superpowers of Europe and the New World follow Rome down the rat hole of history?

Like stories of a worldwide flood—found in almost all cultures and obviously representing some kind of species memory of rising sea levels after the last Ice Age about 10,000 years ago—so the human consciousness expects that, whenever things get too good for too long, a collapse is not far away. The 19th century began with the wars of Napoleon but quickly became, for the western world, a time of peace, prosperity, and technological advancement. That glide path toward a better future was interrupted in the early 20th century by two world wars with a global depression in between them, but the inexorable rise of technology and improvement in living standards proceeded without missing a beat. Now, like people who’ve been partying for twenty hours straight and have yet to see the lights go dim and the booze run out, we’re wondering what comes next.

Nuclear fire, global warming, financial collapse … each bogeyman rises up, waves its all-too-real arms in our face, and then subsides. I’ve seen that pattern repeated often enough in my own life that I just don’t believe it anymore. The world might end one day. It will surely end in about five billion years when the sun proceeds along its inevitable Hertzsprung-Russell life cycle and balloons into a red giant, and humans will go with it unless we find a way to get ourselves off this rock. Until then, I’m betting that the premature end of the world and life as we know it won’t be from any pattern we can predict and subsequently spend dozens of years and millions or billions of dollars agonizing about.

It’s never the devil you know who shakes your hand. Perhaps the world will end in a burst of gamma rays from a supernova exploding too close nearby. Perhaps we’ll freeze in another Ice Age brought about by another fading of the sunspot cycles.⁷ In any case, and until then, the best course both for individuals and for society as a whole is to pay our mortgages, show up at the office, and live each day with patience and fortitude.

1. I remember seeing shelter designs that had no elaborate seals to keep out the dust but did have a short cinder block entrance tunnel that made a single right-angle turn—presumably so the radiation, which followed straight lines, could not penetrate the living quarters. Pure magical thinking.

2. The psychological pressure remained, despite the fact that no one had ever exploded two nuclear bombs simultaneously, let alone hundreds of them over one hemisphere. The theory of fratricide—that either the electromagnetic pulse of one bomb would destroy the firing circuits of any others above its horizon, or that the initial wave of radiation would change the fissionable characteristics of the nuclear material in their triggers—suggested that a full-scale nuclear war was physically impossible. As a theory, it was never tested. But the risk was averted by changes in geopolitics and socioeconomics, rather than strategic considerations. While isolated nuclear exchanges from one country to another might still take place, a rain of fire across all the world remains only a distant possibility.

3. And yes, we’ve had some hot summers as well as some cold snaps. The Arctic sea ice is melting, while the Antarctic land-based glaciers appear to be growing. (I’m reminded that we’ve only been watching the world’s weather—and the icepack in particular—in real time with geosynchronous and polar-orbiting satellites for about forty years. Hardly time to establish long-term trends.) It’s a wonderful prediction that is to be proven by winds that blow both hot and cold.

4. And yes, a lot of programmers and accountants worked long into the night in the two or three years before 2000 to apply patches and workarounds. Did spending all that time and money save the world? We’ll never know.

5. I contributed my own bit to this futuristic folklore with my first novel, The Doomsday Effect, first published in 1986.

6. For a general overview of the controversy, see this article from the New England Skeptical Society about the more recent source, and debunking, of millennial panic.

7. Solar Cycle 24—which began in 2008, after a prolonged sunspot minimum, and will peak in 2013—is expected to be one of the weakest cycles in a hundred years. Since the sun’s energy output is greater during periods of high sunspot activity, this doesn’t bode well for a warm climate. It was the utter lack of sunspots during the Maunder Minimum between 1650 and 1725 that brought on the Little Ice Age in Europe and the freezing of the Thames. One might propose that the increasing temperatures since then were—at least in part—a product of the renewed and increasing solar activity that coincided with the Industrial Revolution.