Recently, I’ve run across a number of articles, including some of the scholarly variety, which address the issue of “false news.” Several of them have made the points that so-called human “rationality” evolved to facilitate cooperation, not necessarily rational analyses of facts, and that the majority of human beings will accept “false news” that facilitates their inclusion in their belief group and reject verified facts that are in conflict with group beliefs.

If this is so, and from what I’ve observed, it seems to be for large groups of people, it gives rise to another question: How have human beings ever managed to evolve and develop a technological society?

The first response that came to my mind was: That’s why progress has been so slow and spotty, because you need consensus for a new way to become part of society.

One of the corollaries to this is that groups that more easily accept new and better changes will be able – still cooperatively – to outcompete groups or societies that don’t. And history tends to show that this is in fact true. When the Chinese culture essentially and gradually closed itself off to outside influences, symbolized by the government decree to destroy all ocean going ships in 1525 A.D., that marked the beginning of the long, slow, and inexorable decline of China, ending with the effective destruction of the “traditional” culture in the early twentieth century.

As I’ve noted in various previous blogs, a great number of more “modern” inventions, including the mechanical computer embodied in the antikithera mechanism, were actually developed and forgotten hundreds if not thousands of years before some society finally adopted them. Some were discarded because they were seen as uneconomic, others because people didn’t want to change existing ways of doing things, but what’s often overlooked is that economic factors aren’t entirely “rational,” but also part of a belief structure.

Some twenty-five years ago, my wife pointed out to an executive in the retail clothing world that there was a growing number of older women with money and taste who wanted professional and tasteful clothing not designed for twenty and thirty-year olds. The executive told her that there was no market for such clothing. I now know of several large retail firms making hundreds of millions, if not billions, from that market… but in the late 1980s and early 1990s, the group-belief in the clothing industry was that there was no market.

That’s where outsiders come in. They’re the people who are at least marginally part of society but who really aren’t part of a group, the ones who can set aside non-functional group “beliefs” and come up with changes.

Being an inside outsider can be dangerous, particularly in areas of belief. Many of the first theologians who started the movement that became the Reformation, like Jan Hus, ended up being executed. Although Alfred Wegener proposed the theory of continental drift in 1915, he was ignored and ridiculed for more than fifty years before conclusive evidence vindicated him.

But even inside outsiders can be trapped by believers, because, if they’re successful, they tend to attract a group of people who either share the same beliefs, or profess to share those beliefs, and, in time, that reduces the former outsider’s objectivity. Companies started by outsiders, such as Microsoft, Apple, or even Walmart, often have this problem after a while. One of Edison’s great advantages was that, for the most part, but not always, he relied on what he could prove or disprove, an attitude that often goes against group beliefs.

The problem, of course, is that for every outsider with a good idea, there are a dozen with bad ideas [which is often why they’re outsiders]. The fact that bad new ideas always outnumber good new ideas may also be why stable societies tend to be conservative. It’s also, I suspect, why when a society incorporates too much change too quickly the results are almost always disastrous, or close to it. Yet, without change, cultures stagnate and collapse… or are taken over or conquered by other cultures.

All of this is why I’m speculating, and it’s only a speculation, that societal/cultural success depends over the long run on the successful use and management of “outsiders” and their ideas.

There are so many different ways to categorize or analyze books that anything I write is likely to have been said or written many times before, but the other day something struck me, in an analytical sense, that I’ve known so intuitively that I never really ever verbalized it. It was simply that there are some books that one reads merely to get to the end in order to find out what happens, or who did what in what fashion, and there are others where each page is a delight, and one is disappointed when the book ends. The first kind of book is about “getting there,” and the second is more about “being there.”

Just as there are both kinds of books, and a great many that fall in the middle, readers also tend to fall along that spectrum as well.

Personally, I tend to like books that incorporate both aspects, and, obviously, I try my best to create both feelings, but my books, I suspect, tend to have a strong component of “being there,” and I’m reminded of that when I see reviews or comments by readers who complain about too little action or not enough battles or too many meal scenes.

But there’s more to “being there” than just language or description of mundane events. As a former Navy search and rescue pilot, I can’t help but recall the description of Naval Aviation that instructors brought up more than a few times – “ninety-nine percent routine boredom and one percent pure terror.” I also held a variety of fairly senior staff positions in national politics over nearly twenty years, from the Nixon Watergate years through Reagan years and some of the first Bush presidency. There were some tense moments there, about which the less said in this or any other public forum, the better, but the bottom line was the same. Pulse-pounding, heart-stopping action is rare and infrequent, as is political tension and true drama… and both are usually caused because someone’s screwed up the “being there” and routine parts of life [as we’re now seeing in the U.S. political arena at present].

That’s another reason why I write the way I do, because I like showing just how that can happen, and how disaster so often comes as a result of carelessness, thoughtlessness, lack of understanding, or incompetence in dealing with the routine. Seeing the protagonist fix the disaster, of course, is what most readers enjoy, but I’ve found in many novels that there’s little detail or creation involved in what causes the disaster, and that often there is problem after problem that, when considered for more than a moment, come off as improbable.

That’s why it helps to have at least at bit of “being there” because it makes the “getting there” more enjoyable and a deeper read… at least in my view.

Right now, the House Republicans are fighting to get enough votes to pass their bill to repeal and replace the Affordable Care Act, aka “Obamacare.” The Democrats are staunchly opposed. Both sides are arguing over the affordability of healthcare and access to healthcare insurance.

As far as I can see, they’re both circling around wrong tree, chasing each other’s tails. Insurance is only a symptom of the greater problem, and trying to deal with symptoms is not only expensive, but will also postpone dealing with the real problem, which continues to worsen. That problem? Healthcare costs. People need insurance because healthcare costs in the U.S. are effectively the highest in the world, and the vast majority of Americans don’t get as good healthcare as nations spending far less on healthcare.

In 2015, U.S. health care costs were $3.2 trillion, making healthcare one of the largest U.S. industries, nearly eighteen percent of Gross Domestic Product, but fifty-five years ago, healthcare only comprised five percent of GDP.

Part of the reason for the cost increase is emergency room treatment, the most expensive single aspect of current healthcare, making up one-third of all health care costs in America. And a significant proportion of emergency room care occurs because people can’t get or afford other treatment for various reasons.

Another component of rising costs is the continuing increase in the costs of drugs and medical devices. According to Forbes, the healthcare technology industry was the most profitable U.S. industry sector of all in 2015, notching an average profit margin of 21%, with the most profitable company of all being Gilead Sciences with a 53% profit margin. And no wonder, given that the list price for the top-20-selling drugs in the U.S. averages more than twice as much as those drugs as in the E.U. or Canada.

While the pharmaceutical industry pleads high research and development costs, a GlobalData study showed that the ten largest pharmaceutical companies in the world in 2013 spent a total of $86.9 billion on sales and marketing, as opposed to $35.5 billion on research and development, almost two and a half times as much on marketing as R&D. Those ten companies had an average profit margin of 19.4%, ranging individually from 10% to 43%, with half making 20% or more. And since Medicare is prohibited by law from negotiating drug prices for its 55 million beneficiaries, the program must pay whatever price drug makers set.

The U.S. medical technology market exceeds $150 billion a year in sales, and in 2015 the gross profit margin for the medical equipment and supplies industry averaged 12.1%, according to data from CSImarket.com.

Studies of doctors’ compensation show that over the past twenty years, that, in general, physician compensation has increased far less than all other components of healthcare. In fact, annual earnings actually declined for the typical physician between 2000 and 2010. Annual earnings for physician assistants and pharmacists have increased at a greater rate. More to the point, as a percentage of total national healthcare costs, U.S. physician wages are small – approximately 9% – a number among the lowest in the developed world.

Hospitals’ costs have increased significantly, but not because they’re making money. A Health Affairs study analyzed hospital income and costs of more than 3,000 hospitals nation-wide and found that fifty-five percent of hospitals lost money on each patient they served in 2013. This does raise the question of whether non-profit hospitals are paying more and more, possibly too much, for high-priced administrators apparently required by the bureaucratic and legal maze generated by the interweaving of private and public medical systems, government regulations, and insurance company requirements. Studies indicate that administrative costs make up twenty to thirty percent of the United States health care bill, far higher than in any other country. American insurers, meanwhile, spent $606 per person on administrative costs, more than twice as much as in any other developed country and more than three times as much as many, according to a study by the Commonwealth Fund.

Then add to that the skyrocketing costs of malpractice insurance and often excessive court judgments in medical tort claims cases.While the amount is subject to dispute, it’s not inconsiderable and also adds to costs.

Unfortunately, neither the Affordable Care Act nor any proposed Republican replacement will do anything to deal with what I’ve mentioned, and what I’ve mentioned are only the most obvious causes of ever-increasing health care costs.

Everyone who follows media in the entire world likely knows that President Trump sends messages via Twitter. What’s been almost lost in the Twitter-storm, and the swirling claims and counter-claims about Russian influence in one form or another, is another, and far more ominous message.

In the United States, indeed anywhere, one form of “reality” is not what necessarily is, but what people believe is so. If people believe that foreign aid comprises twenty percent of federal spending or that public television and radio constitute five percent of the budget, then for them, that is reality, regardless of the facts. Unfortunately for actual reality, a majority of Trump supporters hold such beliefs, despite hard dollar figures to the contrary. So when Trump’s proposed budget proposes massive cuts to federal programs such as those whose total budgets in reality only comprise than five percent of federal spending, Trump’s followers truly believe that he is trying to make a significant cut in federal spending, while the observations by those who understand the numbers and the federal budget that such cuts cripple worthwhile programs while not really addressing the actual debt and deficit are largely ignored or minimized as just being politics as usual.

The problem is that Trump has no interest in confronting reality. His interest is, as is the interest of all promoters and snake-oil salesmen, to sell people on his version of reality, or to affirm their illusory version of reality to increase his own power and image. He also understands, as apparently the mainstream media doesn’t, that repetition turns anything into popular “truth.”

This is something that the mainstream media still doesn’t seem able or willing to confront. It’s one thing to argue about what national spending priorities should be. It’s another to put forth a spending plan designed solely to appease and appeal to one’s supporters, as Trump has, while totally ignoring fiscal reality. Unfortunately, even a sizable fraction of the GOP members of Congress seems unwilling to come to grips with this, and that’s understandable because Trump will turn on “defectors” and because a majority of Republicans also want to believe in Trump’s version of reality.

The media should be pointing out, daily, and loudly, that the numbers don’t add up. Have you seen a headline claiming “Trump Budget Based on Lies”? Or: “EPA Head, Oil Industry Cause 5,000 Earthquakes.” Or: “Trump Buys Off McConnell.” All of those are legitimate headlines, but you haven’t seen them, and you likely won’t, because if they show up, Trump will accuse them of being crooked liars, or the equivalent.

There seems to be a media assumption that people will see the truth on their own. Really? In a nation that requires remote controls for their televisions, ten second sound-bites, and news by Twitter, maximum 128 characters? Add to that the fact that most media publishes Trump’s proposals without strong critical analyses and worries more about his criticism than letting the public know what is occurring.

Establishing “truth” by repetition is currently winning… and all of us are losing.

There are people who accomplish good or great things, and there are those who take credit for those accomplishments. As most intelligent individuals know, often the person who gets credit isn’t the one who actually did the work. Also, sometimes more than a few individuals take credit for something that was never accomplished or completed.

Over the course of my life I’ve certainly seen a lot of such instances. One of the best things – or the worse – about being a writer is that when a book is published you get the credit – or criticism. In my case, either, depending upon your point of view, is warranted, because I personally write every word that’s published, except for the few words corrected by my editor. I have been known to borrow/steal ideas from my wife, but the words are my own.

Not all books, however, are necessarily written by name on the spine of the book. While the original “Ellery Queen” mysteries were written by Frederic Dannay and Manfred Bennington Lee, more than twenty of the later Ellery Queen novels were ghost-written by others, including SF author Jack Vance.

Likewise, particularly in politics and often in business and academia, credit or blame is often taken by or placed on the wrong people. President Herbert Hoover didn’t cause the Great Depression, nor did Franklin Roosevelt end it [although he did make great efforts and did his best to mitigate its effects until the economic recovery caused by WWII kicked in]. Bill Clinton got credit for the economic recovery actually primed by the first President Bush.

Then there are the people who labor long and hard and slowly build something from virtually nothing, such as Fred Adams, who created the now well-known Utah Shakespeare Festival [which was good enough to win a Tony several years ago as the best regional theatre in the U.S.]. His wife Barbara did half the work, but only those who knew Fred and Barbara know that because Fred was not only a great builder, but a great showman. There’s also a well-known fantasy author whose wife contributed to every book, but whose name only appeared on the last few.

In more than a few cases, those who build an organization, a cause, a business just aren’t self-promoters, and often, because of that, others take credit… or the individual never gets credit.

More often than not, why someone gets credit, deserved or undeserved, is because they’re a good self-promoter, and there’s nothing wrong with that in itself – unless the self-promoter steals the credit from someone else. What is equally wrong is when the rest of us let the self-promoters who are stealing credit from those who deserve it reward the deceptive self-promoter.