Our Kingdom of Lies

kingdom of liesHeres an interesting but not surprising article in NYT today on healthcare pricing.

“There’s very little transparency out there about what doctors and hospitals are charging for services,” Mr. Zirkelbach said. “Much of the public policy focus has been on health insurance premiums and has largely ignored what hospitals and doctors are charging.”

A lie is not the opposite of the truth, there being no clear standard for truth. To lie is simply to report information that is intended to deceive.

In the health care business everyone knows that prices do not reflect actual costs. They are merely a starting point for negotiations with high-stakes players like insurance companies, governments and large groups who pool their costs. Pity the individual not included among such bloc negotiators, who must pay directly and through ever-increasing levies based upon deceptive pricing.

What’s interesting about this is that our entire socio-economic system is based on lying, not just health care.

Consider the Mafioso accountant who keeps two sets of books. One set of books is a pack of lies and the other the “true” accounting. But since the “true” accounting relies on numbers produced by others who also keep two sets of books, the hidden set of books is just another pack of lies as well.

Since everyone involved in transactions seeks to gain an edge over others the information we report to one another is always skewed in deceptive ways. Since EVERYONE is playing the same game, the net effect is that NOBODY KNOWS. Nobody can possibly know what it really costs to achieve any desired end and we are hopelessly lost and off to the Milky Way.

Deming’s idea about win-win–everybody wins–is the only way to exit the kingdom of lies. Once we adopt a moral stance that our interests are always mutual in a very PRACTICAL sense, then we strive to share information in a manner that is, to the best of our ability, mutually advantageous. In other words, we seek to construct and participate in a shared information space rather than in multiple individuated universes.

About marc

Instructional Design Consultant
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