How The Free Market Fails At Health Insurance

or, Why Universal Health Insurance Coverage Is Not (Necessarily) A Liberal Entitlement Program

____________________

THE INVISIBLE HAND of the free market works quite well for most traded goods and services. But health insurance is a unique situation, and there are unique reasons why the free market fails with it. These reasons have nothing to do with the way most people frame the issue, around rights and duties to our fellow humans and the morality of providing health services to those who would have trouble affording them.

Health care cannot be a right, as some say. I don’t think you can call anything a right that must be provided by one person for another, as health care is. Just because someone has studied and worked to become a doctor doesn’t give any other person a right to their services. That doctor is still a free individual. And while some would call it a moral failure when essential things like food or medical services are provided only to the rich and not to the poor, or when the rich get rich beyond all proportion, that’s not really a market failure in and of itself. The market is supposed to provide more to those who are able to produce more.

The way the free market fails in health insurance centers around a problem unique to it, the grouping problem. And though it is the central issue in the debate, it is little discussed. But it’s really not hard to understand.

The two main points of the grouping problem are 1) how any health insurance free market inevitably excludes some people arbitrarily and 2) why you cannot force health insurers to provide coverage for anyone who wants it without also forcing all individuals to buy health insurance (the so-called individual mandate). I’ll explain some other things as well, such as why the grouping problem is unique to health insurance in comparison to other types of insurance, and the difference between the price and the cost of health care, but these two are the essentials.

In the end, the answer of whether to adopt a health insurance free market or a universal health care scheme is not clear cut, as there are some serious downsides to universal health care that must be acknowledged. I discuss them in this post here.

But read the following first. It provides the foundational points for understanding health insurance.

_____________________

How The Free Market Fails At Health Insurance

TO GET STARTED, I’ll quote the writer from whom I first gained an understanding of this issue, economist Charles Wheelen, from his book Naked Economics:

Insurance is about getting the numbers right. Some individuals require virtually no health care. Others may have chronic diseases that require hundreds of thousands of dollars of treatment. The insurance company makes a profit by determining the average cost of treatment for all of its policyholders and then charging slightly more. When Aetna writes a group policy for twenty thousand fifty-year-old men, and the average cost of health care for a fifty-year-old man is $1250 a year, then presumably the company can set the annual premium at $1300 and make $50—on average—for each policy underwritten. Aetna will make money on some policies and lose money on others, but overall the company will come out ahead—if the numbers are right.

Let me first pause here for a moment and remind everyone that an insurance company like Aetna has to make a profit, and that their making a profit is in no way immoral. Insurance companies wouldn’t exist in the first place unless they provided a return on investment versus level of risk that was competitive, not just with other insurance companies, but with all other things in which to invest, including real estate, Google, and gold, because no one would put capital in the businesses if they weren’t. Aetna is a publicly traded company, meaning many individuals own shares in the company, including probably many retirement funds, including possibly you. You can’t judge an insurance company for “making profits off of sick people” unless you yourself never try to put your money into profitable investments, as that would just be telling other people what to do with their money while retaining the freedom to do as you will with your own. That is a deep hypocrisy.

Okay, so we have a $1300 policy Aetna is selling to fifty-year-old men, and with the average annual cost of health care for these men being $1250 (with some of these men using much less than $1250 worth of health care services each year, and some of them using much more), Aetna makes $50 a year on each policy. Everyone wins. But…

The $1,300 policy is a bad deal for the healthiest fifty-year-old men and a very good deal for the overweight smokers with a family history of heart disease. So, the healthiest men are more likely to opt out of the program; the sickest guys are more likely to opt in. As that happens, the population of men on which the original premium was based begins to change; on average, the remaining men are less healthy. The insurance company studies its new pool of middle-aged men and reckons that the annual premium must be raised to $1,800 in order to make a profit. Do you see where this is going? At the new price, more men—the most healthy of the unhealthy—decide that the policy is a bad deal, so they opt out. The sickest guys cling to their policies as tightly as their disease-addled bodies will allow. Once again the pool changes and now even $1,800 does not cover the cost of insuring the men who sign up for the program. In theory, this adverse selection could go on until the market for health insurance fails entirely.

That does not actually happen. Insurance companies usually insure large groups whose individuals are not allowed to select in or out. If Aetna writes policies for all General Motors employees, for example, then there will be no adverse selection. The policy comes with the job, and all workers, healthy and unhealthy, are covered. They have no choice. Aetna can calculate the average cost of care for this large pool of men and women and then charge a premium sufficient to make a profit.

Writing policies for individuals, however, is a much scarier undertaking. Companies rightfully fear that the people who have the most demand for health coverage (or life insurance) are those who need it most. This will be true no matter how much an insurance company charges for its policies. At any given price—even $5,000 a month—the individuals who expect their medical costs to be higher than the cost of the policy will be the most likely to sign up. Of course, the insurance companies have some tricks of their own, such as refusing coverage to individuals who are sick or likely to become sick in the future. This is often viewed as some kind of cruel unfair practice perpetrated on the public by the insurance industry. On a superficial level, it does seem perverse that sick people have the most trouble getting health insurance. But imagine if insurance companies did not have that legal privilege. A (highly contrived) conversation with your doctor might go something like this:

DOCTOR: I’m afraid I have bad news. Four of your coronary arteries are fully or partially blocked. I would recommend open-heart surgery as soon as possible.
PATIENT: Is it likely to be successful?
DOCTOR: Yes, we have excellent outcomes.
PATIENT: Is the operation expensive?
DOCTOR: Of course it’s expensive. We’re talking about open-heart surgery.
PATIENT: Then I should probably buy some health insurance first.
DOCTOR: Yes, that would be a very good idea.

So we can see the start of the problem here. Insurance has to be given to groups, not to individuals, because the premiums from healthy people are needed to pay for the medical bills of sick people, and if it were only given to individuals then a disproportionate number of sick people would want to buy it and the system would break down. The American solution to this is generally to group people by their employer. This need to insure people in groups is not just an idiosyncrasy of the American system, but is absolutely essential to health insurance. There is no way to have private health insurance without grouping and more or less compulsory participation within that group. In that sense then, all health insurance schemes are based on people being forced to buy health insurance. The only difference is how you group the people.

Further, people who are insured have to be paying for their insurance in sickness and in health, from early in their lives. No one can be allowed the freedom to wait to buy insurance until they are sick. A system like that just wouldn’t work. As an investment of your own money, you wouldn’t agree to pay for someone’s cancer treatment in exchange for a premium of $500 a month, or even $1,000 a month, possibly not even for $10,000 a month. It is absurd to expect anyone else to do the same. However, you might agree to a contract to pay for someone’s cancer treatment if they get cancer and knowing they do not have cancer now for a modest premium.

So denying coverage for preexisting conditions to people trying to buy insurance on an individual market isn’t just something evil that insurance companies do to make a buck, nor is it just an idiosyncratic feature of the American system. It is an essential systematic feature of any health insurance free market. A health insurance free market could not operate without this feature. It is comparable to denying a homeowner’s insurance policy to someone whose house has already burned down.

(And anyone who tries to wait until they get sick before they buy health insurance is trying to cheat the system—whether that system is public or private—and any system that would allow that is bound to break down, and to reward people for cheating and punish people for playing by the rules.)

So this is the grouping problem. People have to be grouped in order for health insurance to work, and in any health insurance free market some people are going fall outside of any group. Therefore, a health insurance free market denies access to insurance to many people on a mere technicality, based not on whether they are employed or whether they can afford the premium, but on where they work (i.e., on whether or not they can be grouped). Many people who do not qualify for a group plan are just as much productive members of society as those who do. Their exclusion is arbitrary. This is why I would call a health insurance free market a failed market.

The question then is, should attempts be made to correct this failure? The above facts do not answer that question. You are free to decide the answer to that question. But my answer is yes, attempts should be made to correct this failure. I’ll explain below.

Consider how severe the consequences of being excluded from the health insurance market are for an individual. You could incur a crushing lifelong debt, that could prevent you from for example ever being able to own a home when under normal circumstances you would have, and severely curtail your ability to save and invest for your future. You could incur a lifelong disability that could be avoided, or lifelong pain that could be alleviated. Or, you could die.

These are very grave consequences indeed, especially if you are arbitrarily chosen to suffer them on the technicality of where you happen to work.

A logical solution to this then would be to shore up the gaps left in the individual market, and for a government to force insurance companies to treat the individual market the same way they treat a group policy, so that everyone has equal access to health insurance, and coverage is no longer denied for preexisting conditions. But as I said above, we can immediately see a problem with just this one baby step. It sounds very nice, triumph of the little guy over the big evil health insurance companies, leaving all the freedom of whether and when to buy health insurance in our hands. But with a system like this, we’d just be screwing the health insurance companies, and in the process screwing our own selves, as the health insurance companies would just pull out of the market altogether. I know if it was my capital I sure would. You are guaranteed to lose money if the rules of game are that you have to sell a health insurance policy to someone who has just found out they have cancer and is going to be embarking on some very costly treatments. I’d rather invest in Google.

No, a government cannot make it illegal for insurance companies to deny coverage for preexisting conditions without also making it illegal for individuals to not have insurance. The two go hand in hand, and you cannot have the first without the second. You cannot force them to sell policies to anyone without forcing everyone to buy a policy, now, before they get sick. Otherwise people would wait to buy insurance until they needed it, and there would be no way for an insurance company to make a profit by charging any kind of premium people could pay, so no one would invest money in insurance companies and they would all go out of business.

And what we’ve arrived at then is universal coverage. We’re not trying to create a utopia here, not trying to implement a socialist paradise. Not talking about injustice and the poor, and what the government should or ought to do. No, we’ve arrived at a rational reason to want universal coverage by considering simple, basic, and systematic issues of selection biases, by considering the way decisions will be made by individuals and outcomes that will be achieved given certain sets of rules at the outset. We are merely trying eliminate arbitrary exclusion from the health insurance market, because exclusion is so costly.

So universal coverage is not merely another liberal entitlement program as so many of its detractors claim. It is an idea that aims to solve the grouping problem, a simple systemic breakdown in the free market for health insurance.

If you are against universal coverage, then you must find it acceptable for some sick people to not be able to get any insurance at all and therefore be subject to either unbearable debt, bankruptcy, or simply not getting the care they need and possibly dying, due merely to the arbitrary reason that they are unable to become part of a group plan in which their risks and costs are shared by a large number of other people. This outcome results not from any failings of character on their part, and not because they are unwilling to work for a living. It is merely the arbitrary outcome of where they work.

Now, the reality is that in America it doesn’t even work this basically on a libertarian principles. Actually, people without health insurance do often get treated anyway, and the costs get foisted on the public via their bills going unpaid or a program of emergency, government-funded after-diagnosis health insurance. What the individual mandate portion of universal coverage does is force people to participate–pay into–health insurance before they need it, because they or their loved ones will be begging for treatment when they do need it and we as a society don’t really have the stomach to not give it to them just because they either couldn’t get insurance or didn’t think they’d need it before they got sick or hurt. As is pointed out in this New Yorker article, the individual mandate was originally a conservative idea, to make sure everyone pays for what they get. As the conservative foundation that supported individual mandate legislation in 1989 said, “Many states now require…anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness.” Liability insurance is a requirement because the amount of damage a car can do in an accident can easily exceed the amount that an individual would be able to pay. The problems with catastrophic health incidents are very similar.

But I don’t claim to have proven that universal coverage is the only system a rational person would want to live under. There are great downsides to universal coverage. Logically, it probably will stifle innovation. It will probably lead to some rationing and waiting lists. It will probably encourage overuse. If the government were to actually run an insurance scheme, it would be susceptible to bureaucratic inefficiencies that a free market would likely correct with price competition. These are all very real concerns, not to be diminished, and possibly not able to ever be overcome completely. I discuss them in more detail in Part 3.

Ultimately, it is a matter of opinion, not logic, which sets of upsides and downsides you think is better, the ones for health insurance free markets or the ones for universal coverage. The important thing is that you know the full story when you make your decision.

_______________________

THAT IS THE foundational point. But there is another point I’d like to make in this first section. The issue of health insurance may be confused in the public debate because, on the surface, health insurance appears to be just like any other kind of insurance. Other kinds of insurance operate just fine on the free market, with no need for government involvement. So why does health insurance need to be treated as a special case?

How Health Insurance Is Different From Other Kinds Of Insurance

Let’s consider one criticism of universal coverage that I often encounter when I state this position, the idea of risk assessment. In selling insurance for anything, whether it’s car insurance or homeowners insurance or health insurance or insuring a concert pianist’s hands, an insurance company assesses the risk that the car will be in an accident, the house will burn down or be flooded, the person will get sick, or the concert pianist will break his or her hands, and on that basis decides whether or not to sell an insurance policy to the person, and if so, how much the premiums will be.

Note that, under a normal insurance market, an insurance company doesn’t have to provide insurance to someone. The insurance contract is entirely voluntary, and its acceptance is contingent on the insurance company being able to make a profit and the insured being willing and able to pay the premium. Either party is able to refuse the contract.

And for most types of insurance, this is a good thing. If someone wants to build a million dollar house right on the sandy part of the beach on the east coast of Florida, it is doubtful that any insurance company would insure them against hurricanes. (Although, insanely, the government probably will.) This therefore discourages people from building a house in such a ridiculous location, even if it is perfectly legal to do so and someone is willing to build it. The insurance company, because it is their money at stake, is doing all the hard work of research and risk assessment and is being the voice of reason. They are not telling you can’t have a home, they  are telling you that if you want insurance you need to build your house elsewhere. And if you are smart you will listen to them.

Or if someone develops a horrible driving record, getting numerous speeding tickets and in many accidents, their premiums will go up and it might even get to the point where no insurance company will insure them at any price and the person may therefore lose the right to drive legally, even before they lose their license. This is also a good thing, as it encourages people to drive safely and responsibly, and removes from the road people who cause most of the problems and dangers there.

But here we can see how a health insurance market is different from any other kind of insurance market. Many reasons a health insurance company would want to deny coverage cannot be simply discouraged. You cannot provide incentives for someone to not get cancer the same way you can provide incentives for them not to build expensive houses right next to the ocean, or to drive safely. You can encourage someone to build a house in a safer area, but you cannot encourage someone to get a less cancer-prone body, or to go get a body without cancer. Unlike houses or driving habits, everyone has a body they are stuck with no matter what incentives are given to them otherwise.

Hang on, not so easy you say. Health insurance is like car insurance. You can encourage someone to drive safer, and you can encourage someone to live healthier. Maybe people who eat horrible food and smoke endless packs of cigarettes deserve to have their health insurance premiums skyrocket or their health insurance cancelled. This is actually a cogent argument. I do believe that people who engage in behaviors that risk their own health should have to pay the costs of those risks themselves, rather than others paying them for them.

The problem with this comparison is twofold: the degree of cause and effect and the degree that someone’s risk profile will rise due to one infraction. Cause and effect is much easier to establish in drivers, where the number of accidents correlates pretty closely with someone’s safe driving habits. In fact, safe driving habits are more or less tacitly defined by their outcomes. If you get in accidents, you aren’t driving safely, and if you don’t, then you are. But behaviors that are judged to be risky to health, such as smoking or eating poorly, have a lower correlation to poor health outcomes, and therefore the insurance company cannot provide as strong of incentives for or against the behaviors. It is also difficult to monitor these behaviors.

(I’d also like to point out that, really, monetary incentives often pale in comparison to the incentive of just not being sick. No one in Britain is getting HIV just because it’s free.)

More importantly though is the degree of risk profile increase. People can get in a single car accident without it ruining their chances of getting car insurance forever. A single car accident, or even a few, raises a person’s risk profile anywhere from moderately to significantly, but they are usually still able to get car insurance, even though it may be very expensive. But a single case of cancer raises someone’s risk profile out of the individual insurance market altogether. And this is completely in spite of how risky their behaviors are. I’ll say it again: it would be like trying get to homeowners insurance after your house has already burned down.

And this goes back to the notion of being stuck in your own body. Anyone who buys a house takes care of all of the insurance issues before they even sign the deed to own the house. To own a house for even ten minutes without insurance would be folly. (And no bank that gave you a mortgage would let you anyway). The same is true of auto insurance, where it is illegal to drive for even ten minutes without liability insurance, and for good reason. But of course, you can’t get health insurance before you get your body. Under a free market for health insurance, there will always be moments when some people are uninsured, even completely upstanding and responsible people, and if they get in an accident or get a diagnosis for an illness during that time, they are screwed.

So those are some of the ways in which health insurance is different from other types of insurance.

______________________

ONE OTHER THING that needs to be covered as groundwork for understanding health care is that discussion of ‘price’ versus ‘cost’ I mentioned earlier. This is possibly the most frequent and pernicious error made in the public discussion of health insurance.

The Difference Between Price And Cost

Economist Thomas Sowell provided my first exposure to this idea, in an article in Capitalism Magazine (which can also be found in his excellent collection Ever Wonder Why? And Other Controversial Essays):

If you ask most people about the cost of medical care, they may tell you how much they have to pay per visit to their doctor’s office or the monthly bill for their prescription drugs. But these are not the costs of medical care. These are the prices paid.

The difference between prices and costs is not just a fine distinction made by economists. Prices are what pay for costs—and if they do not pay enough to cover the costs, then centuries of history in countries around the world show that the supply is going to decline in quantity or quality, or both. In the case of medical care, the supply is a matter of life and death.

The average medical student graduates with a debt of more than $100,000. The cost per doctor of running an office is more than $100 an hour. The average cost of developing a new pharmaceutical drug is $800 million. These are among the costs of medical care.

When politicians talk about “bringing down the cost of medical care,” they are not talking about reducing any of these costs by one cent. They are talking about forcing prices down through one scheme or another.

The cost of health care is how many resources are actually required to provide it, including drugs and implements, doctor’s fees and nurse’s salaries, administrative costs, the costs for the buildings, the costs for developing new drugs, implements and procedures, and the costs for malpractice suits and insurance. When the government promises to bring down the cost of health care for poorer people, they really mean they promise to bring down the price. And if the government mandates lower prices for some while the costs remain the same, then that means the price must be raised for others, i.e., the portion of the cost that those given the lower price don’t pay must be paid by someone else.

And it is ultimately always individuals who pay. If the government pays that portion, then it is actually individual taxpayers who pay it. If the government mandates that insurance companies pay it, then it is actually other policyholders with that insurance company that pay it. The buck always stops at individual people; there is no way to foist the cost off on an organization or institution and avoid having individuals pay it.

This is important because right now the cost of health care is higher in the U.S. than anywhere else in the world (as far as I know). And Americans also pay the highest prices for visits to the doctor (as far as I know). Right now politicians are promising to reduce the price of health care for some people. But no matter whether they use the word ‘cost’ or ‘price’ or make a promise such as ‘affordable’ health care for all, they are mostly only addressing the the price issue, not the cost.

Nevertheless, they would surely like you to think they are addressing the cost issue as well. It is important that you see through this. Likely, they are also trying to implement measures to bring down the costs, but if we let them fool us into thinking that bringing down the price for some people is bringing down the cost, then we will give them credit for something they haven’t done and may end up ignoring important issues regarding why health care costs are disproportionately high in the United States compared to other countries (I cover one aspect of this in Part 3 section 3b). It’s important that you know what your elected leaders and representatives are and are not actually accomplishing, so that you can hold them accountable as you see fit, according to your values. It’s important to see that providing affordable health care for poorer people is mostly an entirely different issue than figuring out how to bring down the cost of health care.

It’s also interesting to note that you can be for either one without the other. You can be interested in bringing down the price of health care for poor people without having any interest in bringing down the cost. You can also be interested in bringing down costs without wanting to provide lower priced health care for the poor.

It’s not only important to understand the difference so as to keep our elected officials honest. Confusing the two issues can cause problems when comparing the American system to another system, as people often do in this debate. If someone goes to a doctor with a cold in Japan, where I live, and they are not part of the national health scheme here but instead choose to pay cash, they can see a doctor for about $30. To do the same without insurance in America might cost $100. Presumably these prices reflect the underlying cost of those doctor visits, and it is valid to compare the two situations. But if someone in America goes to the doctor with health insurance, they may pay a $20 co-pay, while their insurance pays the rest. But this doesn’t make it cheaper to go to the doctor in America than Japan. Similarly, if an American is griping about health care costs in America, it doesn’t make much sense for a British person to say that health care is free in the UK. They are each talking about completely separate things, but making the mistake of using the same word for it. It’s not free in the UK; they pay a premium through their taxes, and don’t pay any price for individual visits and procedures. But the costs are still there. They are less than the costs in the U.S., but they are still there.

___________________

Final Comments On The Basic Problems With Health Care In The Modern World

It seems to that the main problem with health care in the modern world is that many people are simply in denial as to how much the care we want really costs. No one wants to pay the prices to cover the real cost. Many conservatives want to keep the cost of insurance artificially low by retaining the right to deny medical services to a portion of the sick and injured population, those who find themselves not a member of an insurable group. Many liberals want something that is impossible: when you examine it closely, beyond the feel-good rhetoric, what they are asking for is that the government pay for health care so they the people don’t have to. This is utterly absurd. The money the government would use to pay for this health care is their money, the people’s money. Whether it goes through an insurance company, the government, or straight from their pocket to the doctor doesn’t change the face that it is their money. And people in countries that already have universal coverage simultaneously complain about the high premiums they must pay to the system and the poor quality of the service. There are of course many ways to increase the efficiency of any system and thereby cut costs, but at bottom, if we would just admit to ourselves that a lifetime of the modern medical care each of us desires, from cradle to grave, is necessarily going to be a large portion of our lifetime earnings (say, for the sake of argument, 30-50% of an average middle-class lifetime income), then much of our hand-wringing would go away. If everyone of similar income was paying a similar amount for it, and therefore had a similar amount of disposable income each month, all other things being equal, then few people would feel the pain of the cost.

Then again, there may be a permanent and intractable supply problem. Maybe there just aren’t enough people in the world who want to be doctors, or who have the native ability to be doctors, to meet our demand for medical care. Already most first world countries have to take doctors away from the third world to meet their needs, and the third world is left under-treated. We could raise what we pay doctors as an incentive, if we’re willing to admit to the actual cost of medical care and pay doctors what they are worth, but at some point increased pay is going to give us diminishing returns, both in the number of people we attract to the field and in the quality of the doctors we create. So possibly our reality check will be two-fold: admitting to the actual costs of the care we want, and to the limits on the care we can get.

____________________

Parts 2 and 3 are both offered for anyone who wants to engage in the issues further and likes the way I’ve dealt with it so far, but the most basic and essential information has already been provided here in this first part. Parts 2 and 3 can be read in any order.

Health Insurance Part 2: Other Reasons To Favor Universal Coverage (Applications Of The Logic Supplied In Part 1)

Health Insurance Part 3: How Universal Coverage Fails, And Possible Ways To Mitigate The Failure.

I don’t know if quoting such long portions from Wheelan and Sowell is  copyrightorilly acceptable, but perhaps I can offset that by recommending the works from which I quoted as being of the same excellence throughout as the portions I quoted here. Wheelan’s Naked Economics is chock full of surprising and fascinating economics lessons on par with the one quoted here (just get a load of his analysis of the airline industry), all of which even the most casual reader can understand. A lot of what Sowell writes is also great, but while Wheelan is a centrist, Sowell is an arch conservative, and I have more complicated feelings about him. You can read more about those in my post What Every Liberal Should Know: Thomas Sowell’s Basic Economics.

Advertisements

Escape (The Piña Colada Song)

Rupert Holmes is really a terrible songwriter. Most of his songs sound like the guys from Ishtar wrote them. Check out “Nearsighted” from the same album as this song for a great example. His career up to that point is as good evidence as any that the late-70’s Los Angeles music industry was an affirmative action program for white men. But he got extremely lucky once and wrote and recorded a great song. Well, I think it’s great.

First stroke of luck: toward the end of recording sessions for the album this was on, he needed another track to fill up the space, but his drummer-for-hire that day had recently passed out drunk. So he looped some random noodling the guy had played earlier and put some basic percussive piano chords over it, which resulted in a rhythm far more interesting and dynamic than they ever would have come up with if they had thought about it.

Second stroke of luck: he hit on a story that was perfect to tell in three verses with a kicker at the end, and a chorus that would move the story along and carry a slightly altered meaning after each verse. The story is sweetly romantic but edgy in the manner of a conservative stand-up comic, and throws in jabs at everyone who’d been stepping out of line lately, from flaky new age spiritualists to the bizarre and creepy world of classified ad dating, which was guaranteed to resonate with anyone who starts to let the culture pass them by as they age and who feels both insecure and defensive about it. This is always a profitable demographic.

Third stroke of luck: he accidentally managed to avoid any laughably lumbering metaphors (such as the one he used in “Nearsighted”, which is also couched in a typically forced Rupert Holmesian melody).

Fourth stroke of luck: At the last minute, he changed “Humphrey Bogart”, which does not scan well, with “Piña Coladas”, which most definitely does, even though he’d never had one before at that point in time and as it turns out he doesn’t really like them. Considering his awkward choices of words in other songs (some might call them endearing), it is a miracle that he found an internal editor to kick in this time.

I love this song. I could listen to it every day for a year and not get tired of it. I’ll dance to it too, without much prodding.

Kate Bush’s “Babooshka” is also great, and the two contrasted are a fine study in middlebrow vs. highbrow, literature vs. stories. But they both capture important truths of the people for and about whom they were written. And they are each worthy of both close consideration and mindless enjoyment.

My Darling Is A Stereotype

(From March, 2011)

I watched My Darling Is A Foreigner the other day. It’s a 2010 Japanese film (ダーリンは外国人, da-rin wa gaikokujin) loosely based on a manga of the same name, about a young Japanese woman, Saori, dating and falling in love with an enigmatic and exceedingly gentle American guy, Tony. The movie itself is pretty good if formulaic, but I was most eager to see how my own culture, Western gaijin in Japan, would be represented by the outsiders, the Japanese studio and filmmakers that made the film.

The lead gaijin Tony is wholly admirable, though he is little more than a collection of quirks and mannerisms without much inner life of his own, as though he were designed in a romantic comedy laboratory for the sole purpose of being alternately endearing and endearingly exasperating to the heroine. But I can’t fault a film too much for objectifying men; Sex And The City wrung many entertaining moments out of this device, and it only seems fair play considering that the media objectification goes the other way in the vast majority of cases. At any rate, Tony’s line “To me, she’s not Japanese, she’s Saori” should probably be an oath extracted at the border from all aspiring charisma men along with fingerprints.

The representation of the gaijin community in general, on the other hand, is either comical or laughable, depending on your perspective. The very first scene has Saori showing up with Tony to a party at an unreasonably large and modernistic apartment in Tokyo, and, lo, turns out she is the only Japanese present. She slinks mousily to the corner while a few young-professional—looking beautiful people mutter snidely under sideways glances. One fellow with hipster hair swaggers over to speak with her (in English), and immediately starts an argument about her profession, manga illustration. Since Saori speaks no English, a young woman of slightly broader good will translates his astute observations: Japan is an immature country because adults read comics. Also, they are all pornographic and therefore bad for children. As she gets increasingly incensed, he haughtily tells her, in Japanese finally, that she should learn to speak English, then storms away.

Granted, I’ve heard that ignorant manga argument before. But when was the last time you went to a thirty-person party at which no Japanese were present or welcome? Never in my ten years. When was the last time you heard a group of attractive and successful gaijin making fun of a shy young Japanese woman? The poor, beleaguered salaryman breaking his back and selling his soul for god and country, sure, but definitely not this pixie.

But it’s fascinating that the filmmakers would portray us like that. Think of the millions of Japanese watching this who have never actually been to a gaijin party. Is this really the picture of us their fevered imaginations concoct, gathering in secret cliques on the weekends to disparage our hosts and congratulate ourselves for being Westerners? Wait, crap. Touché, Japanese filmmakers. Touché.

But I quite like My Darling Is A Foreigner. There is much to be learned from seeing someone else’s grotesque stereotype of you, whether it is affectionate, as in this film, or menacing. Reminds me of another movie about gaijin in Japan…

I know a lot of foreigners who were rather offended by Sofia Coppola’s Lost In Translation. The Japanese in that film were painted with broad and ridiculous strokes, generally being mere comic foils to the main characters, and the backdrop to their melancholy. Here a pronunciation-mangling prostitute, there an affable old man unaware he is being made fun of by one of the greatest and most misanthropic comic actors of our time. But I loved that film, because it is absolutely true to the perspective of many a wide-eyed and lost gaijin in their first few days in Japan. This place and these people really do feel that weird and alien to some Westerners (well, me and Sofia can at least speak for Americans) who come here for the first time. I could fill a book with the wildly inaccurate assumptions I made about this country on the basis of my initial brain-addled observations and sheltered Midwestern upbringing. And I think that’s a valid perspective from which to create a work of art. If you want to see accurate depictions of Japanese people, watch a Japanese movie.

But I do understand the criticism, and Lost In Translation is probably more deserving of it than My Darling Is A Foreigner, because Translation doesn’t have a Tony and doesn’t in the end have a rapprochement between the two cultures. Anyway, we should remember the way privilege works, and whose perspective we’re getting; Darling isn’t so much a caricature of who we are as foreigners, but of how Japanese people might feel around us. They are making fun of themselves too, which Translation doesn’t do so much. I reckon though that select scenes of the two films together form an acid test of your character. If you (as a gaijin) like Translation and hate Darling—for political reasons (or the lack thereof), not aesthetic—you are really kind of an ass. If you like Darling and hate Translation, you might be trying too hard. The most consistent philosophy is to join their fates in one mélange of absurdist stereotypy and privileged perspective, a grand and entertaining comment on our pan-human struggle to become the perfect metaphysical consciousnesses we aspire to be, rather than the contingently evolved animals that we actually are. And then choose a side: love them both or hate them both.

Me, I’ll go with whoever lets me laugh the loudest at inept prostitutes and invading ingrate gaijin hordes. My heart always opens wide to the world after a good laugh.

______________________________

(This was originally published in Metropolis in a slightly edited form.)

The Straight White Male & RPGs: An Expansion Including Candy Land

John Scalzi’s post Straight White Male: The Lowest Difficulty Setting There Is, in which he compares life to a role playing game is a nearly perfect metaphor:

In the role playing game known as The Real World, “Straight White Male” is the lowest difficulty setting there is.

This means that the default behaviors for almost all the non-player characters in the game are easier on you than they would be otherwise. The default barriers for completions of quests are lower. Your leveling-up thresholds come more quickly. You automatically gain entry to some parts of the map that others have to work for. The game is easier to play, automatically, and when you need help, by default it’s easier to get.

He goes on to talk about the number of points you are given at the start, and how the way you apportion them will affect your results. Nearly perfect metaphor. It will stick with me for a long time, and I haven’t played an RPG since about 1991.

And I’ve thought of a way to extend that metaphor to even more usefulness. Today I was listening to episode 4 of Slate’s negotiation academy podcast, and they were talking to Dr. Richard Haass, a guy who had been involved in some of the biggest and most important negotiations of modern times, such as those between Northern Ireland and the Republic of Ireland. As he was discussing negotiations he brokered between Arabs and Israelis, I realized that he went into it having completely lost his qualitative sense of who these two groups of people were.

What I mean is this. When you think about Israelis, or about a specific Israeli, or about Arabs or a specific Arab, you most likely get a feeling in your gut about that person based on everything you know of their culture, food, religion, clothing, history, everything. That feeling could be positive or negative, and your reaction to that feeling could be positive or negative as well. For example, if your gut is giving you bad thoughts about an Arab, you still might have the presence of mind to override that gut feeling. And further, the way you act on that may be to overcompensate, or compensate perfectly, or do nothing.

That’s qualitative. You see an Arab or hear the word “Arab”, and you have a feeling about him or her. What Dr. Haass did in the negotiation situation was to attempt to have no qualitative response at all. Instead, he just saw the Arabs and Israelis as having particular competing interests, particular histories, particular economic situations, etc. These factors may all sound qualitative, but the video game analogy helps provide a mental crutch for removing the qualitative aspect, for suppressing your gut reaction to the word “Arab” or “Israeli”. It allows you to see (or at least attempt to see) another person not as Arab or Israeli, or black or white, but as a human blank slate to which has been added quantifiable characteristics.

To be sure, I’m not advocating that this is the way everyone should regard each other, all the time. Engaging our intuition and qualitative feelings is an important part of human interactions, and an essential part of the kinds of relationships most of us want, friendships and loves. What I’m saying is, the quantitative approach can be a useful tool, both for use in specific cases and interactions, and in thought experiments aiming to change your general paradigm.

For me personally, mention “Arab” or “Israeli”, and I immediately am awash in feelings and judgments. And closer to home, as much as I want to be neutral and want to fight for social justice, I know that when I see a black person I get certain qualitative feelings welling up inside me, based on direct friendships I’ve had with black Americans, based on my lifetime of experiences with the African-American culture through person-to-person contact and the media, based on all the thinking and philosophizing I’ve read and done, based on conflicts I’ve been in, and likely based on other factors I haven’t thought about. Some of the associations are positive, some of them are negative. And what I choose to do with these associations is constantly evolving, and again is sometimes positive (which I of course strive for) and sometimes negative (which I of course strive to weed out).

What the video game analogy does is allow us to put all of those qualitative things aside, and instead give everyone the same blank human-shaped slate, and then characterize that slate with numbers. Or, more accurately, with “numbers”, since you won’t actually be assigning specific numbers to any specific characteristics. You will just be thinking in terms of reducing all characteristics to those that could be assigned numbers. So for example, in this model, there are no numbers for “black” or “white”, because those are qualitative. But there might be a number for degree of marginalization of a person’s culture, and another number for degree to which the person can be recognized as coming from that culture. Or maybe you can reduce these characteristics to things even more fundamental than those. I won’t even begin to try to provide a list of characteristics that could be reduced in this way.

In the game Candy Land, there are six colors and six kinds of tasty treats that stand in for numbers of spaces moved. This analogy might not work as well if you never loved Candy Land as a kid, but when I was five I very specifically remember getting caught up in the game. The colors and especially the treats all fired my imagination, even though they were all just stand-ins for simple numerical values, spaces on the board that were closer or further away from the goal. I love numbers and analytics and can be quite competitive, and part of my excitement in the game was indeed in getting the largest numerical jump forward possible, but if the cards had just shown numbers they never would have gotten me into the game the way the colors and treats did. The fact that the candy cane and the gum drop were the least desirable of the candy spaces and the fantasmagoric neopolitan ice cream sandwich was one of the best meant so much more to me than if they had merely been given, say, letter designations (e.g., “move to space D”). This quantitative and qualitative coupling has served me into adult life, where Monopoly and Risk are two of my favorite board games.

So you can see how you can apply this to people. That person across from you is not black or white, is not an ice cream sandwich or a gum drop. They are a person with certain underlying analytical characteristics that represent their experiences, desires, blind spots, struggles, joys, angers, confusions, etc. What’s more, you yourself are too.

As a concrete example of the benefits of this technique, try this thought experiment: what if we did this exercise and discovered that the numerical profile of Irish and Northern Irish exactly matched that of the respective numerical profiles of Arabs and Israelis? (Clearly not so, but just by way of example.) This is similar to the techniques I imagine Dr. Haass uses. As a good negotiation facilitator, he would have to drop his cultural associations and open himself to understanding the ways in which, say, Northern Irish and Israelis might be the same. Or Northern Irish and Arabs. Or any such combination. But mention any of these four groups to me and I am immediately flooded with emotional associations about them, and they are all very different. But by imagining applying the quantitative approach, I suddenly see them very differently, almost as an alien would. All of my qualitative feelings about their cultures and stereotypical behaviors get washed away, and I’m left with only the image of blank slate human being filled with characteristics.

And then I can see myself in the same way. I’m not that special. Just a container of characteristics.