Paternalism is Everywhere!

I’m reading “Why Grow Up” by Susan Neiman.  The main theme is that our path from infant to adult is actively hindered by those put in a position of responsibility for our welfare.  This includes parents, teachers, and all forms of government. These authorities are motivated by either the lust for power, a need to maintain a veil of relevancy, or just the efficiency in discharging their responsibilities by maintaining a state of compliant dependency in all under their dominion. Their means is to establish a steady stream of  amusements and/or necessary provisions, etc that their charges demand from them and thus divert their attention from the task of becoming self sufficient, one of the requirements of being an adult.

Thus, the title “Why Grow Up” is actually a rhetorical question implying that we needn’t bother if all of what we think we want is channeled to us by someone else. Caveat, I am only a third of the way thru the book so far and presumably it goes on to describe in detail what we would be missing or the risks of allowing ourselves to be dependent.

The author describes this situation both as an individual and as a society and provides analysis originating from several 18th century philosophers.  These authorities (note the recursive nature here) were trying to rationalize the both child rearing and the social orders imposed by governments and religious hierarchies. In many ways they were ahead of their time and were disregarded or worse.

I see several parallels in today’s technology-driven lifestyles, our diet, and in healthcare provision.  I am guilty myself of establishing a service of convenient technical support that insures my continued employment and regular adulation for managing complexity in other peoples lives.

To a certain extent, its a food chain as I am equally dependent on (and thus limited by) the many levels of abstraction between the engineers at Intel, Apple, Microsoft, etc and my own feeble analytical powers.  These include technical forums, Help text, product manuals and FAQ pages, and sometimes even resorting to direct contact at the alter of personal unworthiness, the “Customer Support” phone line.

Somewhere along the line, as the goal of perfection became distilled down to “good enough”, we put away our tools, both intellectual and manual, and accepted the solutions that were offered to us by our perceived benefactors.  As noted above, these solutions are often really just abstractions of complexity we don’t want to deal with. This is necessary because we are overwhelmed with the volume of ideas and relationships that we are exposed to through many different media all day long. To become competent in just one, we need to sacrifice expertise in many.  Thus, we look for and willfully submit to the generic solutions that give us satisfaction.  Often, maybe usually, these are the product of a benevolent provider such as myself.  Sometimes they are Trojan horses, making us more dependent in broader ways than we initially intended or even at risk of significant loss or harm. Thus, we trade capacities for one complexity for the capacity of risk analysis and remediation.    (How much time and effort have you spent installing, maintaining antivirus software and still removing malware from a computer?)

In the healthcare field, I see an increasing use of the paternalistic business model where as an individual requests a specific service from a specialist, say a dentist or a doctor, and instead gets channeled into a long term relationship with the clinic or office. This relationship is arbitrated between the healthcare provider and the insurance provider.  Suddenly, instead of getting a filling or a checkup you are on a maintenance plan with a regimen of extra preventative services, tests, cleanings, etc.

In lieu of basic education on self provided care, you are expected to commit time and co-pay or “uncovered” dollars to just stay healthy.  This issue is the battle ground where the war for the individual is being fought on many fronts ranging from self-help websites to medical journals and healthcare policy briefs.  There is no end in sight.

Our diet is a much simpler case, at least on the surface.  We either prepare our food ourselves or we buy it preserved in our grocery stores or prepared on sight at restaurants, cafes, food trucks, etc.  The spectrum from surf/turf to mouth is pretty explicit and we can make our choices without too much guidance. Or so it seems from a distance. The battle of what goes into our food at the genome level and the question of what is the right kinds of food seems to be fought by marketing and the healthcare industrial complex at every point of intersection.

It has even infiltrated the dining service industry.  Somewhere there is a tutorial on proper wait person protocol that instructs service providers that the way to maximize tips is to develop a state of dependency on them. They insert themselves as a mediator between your meal and the kitchen.  This is implied not so subtly with the phrase “Hi, my name is <insert nom de guerre here>.  I will be your server today. (my emphasis).  Note the lack of options on your part.  And the term “server” implies provide a service for a fee aka tip.

Some restaurants conveniently provide a terminal in which to swipe your credit card which already calculates a suggested tip, relieving you of the heavy math not to mention the moral quandry of having to decide how much your servers assistance was worth to you.

As you can tell, I have a personal grudge here so I’ll let it go…for now.

In summary, the book “Why Grow Up” exposes our willingness to be “managed” by others. Any self respecting adult will repel the insipid attempts to infantilize us and strike out for the richer and more mature life of independence from this paternalism.