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I have been blessed to have read such great authors as Yevgeny Zamyatin, Alexander Solzhenitsyn, Victor Klemperer and many others in the safe light of American freedom, where knocks at the door can be ignored.  The price of learning terrible things like this brings the obligation to see and root out poison when it comes; propaganda. Other notable writers in this area are Ayn Rand, Umberto Eco, George Orwell and Aldous Huxley, very bright lights themselves, not quite the magnitude of the first three. From the early 1700’s, it was heard that “eternal vigilance is the price we pay for liberty,” and we must watch for it in every corner.
We have fallen into the habit of continuing a certain style of approach to management championed by both Vladimir Lenin and Henry Ford – how can you go wrong with those two? – and lampooned by Huxley. It is too much to denounce Taylorism here – look at Whiting Williams‘ denunciation of Taylorism in the Harvard Business Review around 1922.
Eco’s list on proto-Fascism from 1999 gives a good guideline to unlock some of the dangerous nonsense masquerading as “innovation in the healthcare industry.”
Much of America used to be free of this sort of nonsense, and people would at least demonstrate pangs of guilt when parroting it. But now we have belly-flopped into Max Weber’s Iron Cage of Bureaucracy, and that is the thing one must pry the “cold dead hands” off of. It is fundamentally oppositional to American values; nevertheless, we have allowed it to creep into our systems over a few decades.
The concept of “tools conditioning the workers” is, I believe, a genuine re-invention; no thoroughly horrible ideas are ever bad enough to die off without being eternally retried. If Trotsky were alive, he would make a bang-up leader for DHHS, Medicare, etc. And we will not round out of “useful idiots” and quislings that Trotsky worked so well with.
One of the sorrows of the Peasants’ and Workers’ Paradise was that human beings just wouldn’t change, darn it, even that they really OUGHT TO. They kept their stubborn humanity and human nature, irrespective of the New Future. They will do so under the Big Data revolution. Humans are what they are.
One of the greatest problems is that human illness is not a very insurable thing – it is a ubiquitous occurrence that must be accounted for, not something for Lloyds. It is cost of doing business, living.
Even more so, the ability to provide health and treat illness is a metric for human civilization, as one of the essentials for living, like food, air and water. The penalty to civilizations that violate the laws for the essentials of living is not fines or penalties – it is extinction, as Angkor Wat and the many other ruins where millennia of human enterprise has gone bust.
We don’t “have” to get it, any more than the Wooly Mammoth “should have” understood evolution. Extinction is a natural event of species and civilizations; preventing it is a novel idea. And with healthcare, we are not showing off our best abilities, I fear.
The Titanic was truly great, massive, a brilliant example of the human mind put to steel. Unfortunately, the iceberg was bigger.

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