It’s always bugged me, at least as long as i can remember. People demand that someone should be there for them. Now, I am all for a caring society where we do our best for each other. We have built and maintain a social society that has done an amazing job of raising the standard of living. But, you can only go so far with the resources that we have to hand.
I live in the UK so if you are reading this elsewhere some of the details might not be too familiar but the principles are, I believe, universal.
There are some people that understand the principles of scarce resources but many do not, or don’t want to think about it. And of those that do understand, most don’t follow through to the logical conclusions or dare not talk about them.
I suspect that for most people I am going to end up being controversial at some point or other, please don’t be offended, I believe that if we truly took hold of these issues then we could have a far better society.
So, what is the real issue here? Let’s take a couple of specific examples and then come back to the underlying principles to tie it back together again. Please bear in mind that for the two examples I am not judging either way, i don’t have enough information to do that, but merely using them as an example to illustrate a point.
Example One: The Health Service
I recently heard on the news about a gentleman that died of cancer. Relatives of the man were upset that he had not been allowed to have a relatively new, and rather expensive, drug that would probably have extended his life by several months – but not cured him. I would argue most strongly that we should be making decisions to withhold drugs like this on both a national level because some drugs are just too expensive to use widely and also on an individual level because the cost benefit to society is too low.
Whoah ! I just measured several months of someone’s life against a cost to provide drugs. I know many people will be horrified by that and in one sense I would agree – life cannot be measured. However, the simple truth is that there are lots of expensive drugs and treatments out there that would benefit many people, extending their lives, improving the quality of their lives etc. If we were to apply a rule stating that anyone who would benefit from a treatment should get it then the NHS (National Health Service) would be bust very quickly or, if government increased their budget to match, the whole country would be.
In practise, our health professionals make decisions like this all of the time. But, we, as a society, don’t like to talk about it too much. The reason we don’t like to talk about it is because of the underlying resource scarcity and the fact that some people will not get treatments that would benefit them and ultimately, there is nothing we can do about it. Even worse, if we do raise it we find that the public has many different views ranging from we have a right to whatever we need, through a variety of views, based on values, on what is important right through to, what I believe is that the health service does an incredible job of managing resources and expectations most of the time. (Not that it couldn’t be improved of course, but I don’t have time for that here).
Occasionally these health service issues make the news as did the story I heard on the radio. We hear debates on talk shows. We obviously don’t have it all worked out because if we did we would not need to talk, and argue, about it every once in a while.
Example Two: Afghanistan
Recently there has been quite a lot of discussion here in the UK about our role in Afghanistan. More UK soldiers have been killed in Afghanistan recently and it is beginning to raise more questions. Most specifically though has been the question of resources. There has been quite a high level argument over whether the UK troops have enough helicopters. The argument was that without enough helicopters the troops are having to travel by road much more where they are a lot more susceptible to roadside bombs.
In the last few days I also saw a report on TV that when UK troops are hit by explosive devices while travelling they sustain higher casualties than US troops because they are not so well armoured.
Both of these issues come down to resources and, ultimately, cost.
I am not going to pretend to know enough about the particular issues here to know whether we should be sending the additional money for extra helicopters in particular and I don’t want to get into that here. I am simply pointing out that we again have a need and a resource / cost constraint. Decisions have to be made based on a cost benefit basis. And again, like in the health service, the cost/benefit involves people’s lives and the issues are complex.
The Big Picture
Resource at the National Level becomes a balancing act between the interests of lots of different needs. The health service and our role in Afghanistan are just two, albeit high profile, examples. It can’t be easy to perform this balancing act of allocating resources amongst all of the competing resources.
Essentially, most people don’t see this big picture and just want to fight their own corner which leads to well, metaphorically of course, one big fight.
But, there are a lot of people out there who actually have to manage public budgets and to make the required decisions as to who gets what budget – even if it does affect peoples lives and sometimes come down to life and death.
Personally I think it would help a lot if more people said that they appreciate the work that these decision makers have to put in. Even better if they could be supported in some of the more difficult decisions and not criticised so much. Maybe one day they will even be able to talk more openly about the hard decisions that have to be made regularly and even daily in some circumstance. And then we will be able to make decisions that produce the best overall for everyone rather than having so many special interests pulling budgets in directions that really are not the best.
But first, we need to do a lot more work with the values of our cultures to open up the dialog and ensure we meet the basic needs of everyone for which I would turn to Spiral Dynamics – a socio psychological model that enables actions that support the multivaried needs of a society.
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