Public Health is Harder than Long Division

James Scott’s book, Seeing Like a State (1998) came up in this fascinating discussion of public policy, health systems, government, expertise, and legitimate political authority. The following is from a review of Scott’s book in The New Republic, May 18, 1998 (“More is Less”, by Cass R. Sunstein). This is precisely what state governors and their advisors are doing during the COVID-19 pandemic:

German psychologist named Dietrich Dorner has done some fascinating experiments designed to see whether people can engage in successful social engineering. The experiments are run by a computer. Participants are asked to solve problems faced by the inhabitants of some region of the world: poverty, poor medical care, inadequate fertilization of crops, sick cattle, insufficient water, excessive hunting and fishing. Through the magic of the computer, many policy initiatives are available (improved care of cattle, childhood immunization, drilling more wells), and participants can choose among them. Once initiatives are chosen, the computer projects, over short periods of time and then over decades, what is likely to happen in the region.

In these experiments, success is entirely possible. Some initiatives will actually make for effective and enduring improvements. But most of the participants—even the most educated and the most professional ones—produce calamities. They do so because they do not see the complex, system-wide effects of particular interventions. Thus they may recognize the importance of increasing the number of cattle, but once they do that, they create a serious risk of overgrazing, and they fail to anticipate that problem. They may understand the value of drilling mote wells to provide water, but they do not foresee the energy effects and the environmental effects of the drilling, which endanger the food supply. It is the rare participant who can see a number of steps down the road, who can understand the multiple effects of one-shot interventions into the system.

These computer experiments have countless real-world analogues. As everyone now knows, an unanticipated problem with mandatory airbags is that they result in the deaths of some children who would otherwise live. Less familiarly, new antiterrorist measures in airports increase the cost of air travel, thus leading people to drive instead, and driving is more dangerous than traveling by air, so more stringent antiterrorist measures
may end up killing people. If government wants to make sure that nuclear power is entirely safe, it should impose tough controls on nuclear power, but those controls will increase the price of nuclear energy, which may well increase the use of fossil fuels, which may well create the more serious environmental problems. . . .

On Scott’s view, the failed plans and the thin simplifications ignore information that turns out to be crucial. To be sure, an all-seeing computer, capable of handling all relevant information and envisioning the diverse consequences of different courses of action, may facilitate tyranny. But it need not blunder. This is the real lesson of Dorner’s experiments, for which Scott has provided a wealth of real-world counterparts. And this is not
the end of the story. Dorner also demonstrated the possibility of successful planning by those who are attuned to long-range effects. Scott’s analysis would have been improved if he had compared success with failure, and given a clearer sense of the preconditions for success.

Still, Scott’s advice is far from useless. It can be applied to contexts far afield from those that concern him here. His case studies help explain, say, why national regulation tends to work better when it consists of altered incentives rather than flat commands. Some of the most successful initiatives in American regulatory law have consisted of efforts to increase the price of high-polluting activities; and some of the least successful have been rigid mandates that ignore the collateral effects of regulatory controls. Scott’s enthusiasm for metis also suggests that certain governmental institutions will do best if they act incrementally, creating large-scale change not at once, but in a series of lesser steps. We might think here not only of common law, but also of constitutional law. Many judicial problems derive from a belief that judges can intervene successfully in large-scale systems (consider the struggles with school desegregation in the 1960s and 1970s), and many judicial successes have come from proceeding incrementally (consider the far more incremental and cautious attack on sex discrimination in the same period).

And Scott also offers larger implications. A society that is legible to the state is susceptible to tyranny, if it lacks the means to resist that state; and an essential part of the task of a free social order is to ensure space for institutions of resistance. Moreover, a state that attempts to improve the human condition should engage not in plans but in experiments, secure in the knowledge that people will adapt to those experiments in unanticipated ways. Scott offers no plans or rules here, and a closer analysis of the circumstances that distinguish success from failure would have produced greater illumination. But he has written a remarkably interesting book on social engineering, and be cannot be much faulted for failing to offer a sure-fire plan for the well-motivated, metis-friendly social engineer.

In 1960 JFK Had to Explain Himself to Texas Baptists

In 2015 Hillary Clinton, a Methodist, needs to explain herself to Roman Catholics. And she does so by jumping on the Pope Francis bus (which is about to leave nation):

For the first time in history, we are within reach of eradicating hunger and extreme poverty. But climate change threatens that progress.

Thanks to President Obama’s leadership, the United States is rallying the world to act. Now Pope Francis is bringing his extraordinary moral leadership to the fight.

I’m grateful — as so many Americans are — for the pope’s teachings. And as president, I hope to follow his example. I will make combating climate change a top priority of my administration.

We’ve made progress in promoting clean energy. Now we must do more to help developing countries embrace lower-carbon fuel sources, and continue to pick up our pace at home.

We’ve made progress in managing our lands and waters. Now we must do more to protect our global forest, which is still being slashed and burned, and our global ocean, which is growing more acidic, threatening the lives and livelihoods of billions of people.

We’ve made progress in cleaning our air over the last 40 years. Now we must do more to protect our poorest and most vulnerable citizens — including the elderly, children and communities of color — from the worst health effects of climate change.

But in spite of the strongest possible scientific consensus about what climate change means for our environment, economy, health, and future, there are still some who deny the facts. They’re intent on obstructing progress.

We can’t let them win this fight. We have no choice. There is no Planet B.

We need to develop an ethic of stewardship, of responsibility and sustainability — in our businesses, in our governments, and as citizens of the earth. The scale of the challenge we face demands nothing less.

The great American conservationist John Muir wrote, “Everybody needs beauty as well as bread, places to play in and pray in, where nature may heal and give strength to body and soul.” Climate change threatens every place on our planet, from majestic landscapes to ordinary city streets. It threatens every facet of our economy—our agriculture, energy, transportation and tourism. And most importantly, it threatens the health, happiness, and future of every one of our children.

I want my granddaughter Charlotte to know that her grandmother did everything possible to protect and preserve God’s gift to us, this beautiful planet, our common home. That’s why I’m in this fight. And I want all children everywhere, in countries large and small, to know the same thing about their leaders.

This week, as Pope Francis visits the White House, Congress and the United Nations, I urge Americans of every faith and political persuasion to listen to what he has to say. Heed his message of God’s love for all creatures. Follow his urging to become good stewards of the earth. And do your part to fulfill our shared responsibility to our planet, our children, and our future.

Did Jesus really teach progress?

As he sat on the Mount of Olives, the disciples came to him privately, saying, “Tell us, when will these things be, and what will be the sign of your coming and of the end of the age?” And Jesus answered them, “See that no one leads you astray. For many will come in my name, saying, ‘I am the Christ,’ and they will lead many astray. And you will hear of wars and rumors of wars. See that you are not alarmed, for this must take place, but the end is not yet. For nation will rise against nation, and kingdom against kingdom, and there will be famines and earthquakes in various places. All these are but the beginning of the birth pains.

“Then they will deliver you up to tribulation and put you to death, and you will be hated by all nations for my name’s sake. And then many will fall away and betray one another and hate one another. And many false prophets will arise and lead many astray. And because lawlessness will be increased, the love of many will grow cold. But the one who endures to the end will be saved. And this gospel of the kingdom will be proclaimed throughout the whole world as a testimony to all nations, and then the end will come. (Matthew 24:3-14 ESV)

Biblical Pessimism

Today’s reading took me again to Roman Catholic and Kuyperian expressions of optimism. In the face of mounting evidence that our society is coarsening, Billy Boyce and Michael Sean Winters affirm hope. First, pastor Boyce (the Kuyperian):

But there is a way forward. Kuyper’s emphasis on the antithesis keeps us humble, recognizing that there will always be spiritual warfare in this age against the powers of darkness. Simultaneously, Kuyper’s emphasis on common grace allows us to participate in the public sphere with hopefulness that, by our faithfully sowing seeds of righteousness, we can reap a harvest of flourishing for the common good. To quote Dr. Vincent Bacote, “Ultimately this is a vision of a society where change occurs because Christians participate in the realm of common grace, and, as a result, the world gets better.”[3]

There may never be a Golden Age (I’m an amillennialist, after all), but this does not mean that we cannot look for cultural renewal in this life. Because we acknowledge the presence of sin, we can view our past with honesty, as a mixed bag of good and bad. But because we know God is at work, we can hope for more. Our hymnal teaches us that “not with swords’ loud clashing, nor roll of stirring drums, but with deeds of love and mercy, the Heavenly Kingdom comes.” These deeds of love and mercy are powerful, and they include all sorts of cultural participation, even politics. Ours is a long march forward; our enlistment in the Church Militant is for the entirety of this age.

If not a Golden Age, at least point to an instance of cultural renewal. If we can spot that, then we might identify the ingredients that make for such positivity. Without the specifics — 1550 Geneva? 1630 Boston? 1900 Amsterdam? — we have only haze.

Michael Sean Winters (Roman Catholic) also keeps hope alive:

These prophets of doom may or may not be culturally attuned, but they misunderstand who is in charge. Maybe it is just that I have been reading Kuyper, but it seems to me that a truly holy preacher of the Gospel does not invite his listeners to despair, but to hope, hope not in their own efforts, but in God’s promises. Love and labor, then, not breast-beating and complaints about slippery slopes. Besides, sometimes we humans even slip up the hill.

So what does the Bible say about what Christians should expect from their futures on planet earth?

Anyone remember the curse?

To the woman he said,

“I will surely multiply your pain in childbearing;
in pain you shall bring forth children.
Your desire shall be for your husband,
and he shall rule over you.”

And to Adam he said,

“Because you have listened to the voice of your wife
and have eaten of the tree
of which I commanded you,
‘You shall not eat of it,’
cursed is the ground because of you;
in pain you shall eat of it all the days of your life;
thorns and thistles it shall bring forth for you;
and you shall eat the plants of the field.
By the sweat of your face
you shall eat bread,
till you return to the ground,
for out of it you were taken;
for you are dust,
and to dust you shall return.” (Genesis 3:16-19 ESV)

Unless I’m mistaken, the curse is still in effect. Mothers chime in if you want to correct that impression.

Remember Paul’s counsel to Timothy:

For the time is coming when people will not endure sound teaching, but having itching ears they will accumulate for themselves teachers to suit their own passions, and will turn away from listening to the truth and wander off into myths. As for you, always be sober-minded, endure suffering, do the work of an evangelist, fulfill your ministry. (2 Timothy 4:3-5 ESV)

Not much forward rhetoric there.

How about Peter’s closing words?

This is now the second letter that I am writing to you, beloved. In both of them I am stirring up your sincere mind by way of reminder, that you should remember the predictions of the holy prophets and the commandment of the Lord and Savior through your apostles, knowing this first of all, that scoffers will come in the last days with scoffing, following their own sinful desires. They will say, “Where is the promise of his coming? For ever since the fathers fell asleep, all things are continuing as they were from the beginning of creation.” For they deliberately overlook this fact, that the heavens existed long ago, and the earth was formed out of water and through water by the word of God, and that by means of these the world that then existed was deluged with water and perished. But by the same word the heavens and earth that now exist are stored up for fire, being kept until the day of judgment and destruction of the ungodly.

But do not overlook this one fact, beloved, that with the Lord one day is as a thousand years, and a thousand years as one day. The Lord is not slow to fulfill his promise as some count slowness, but is patient toward you, not wishing that any should perish, but that all should reach repentance. But the day of the Lord will come like a thief, and then the heavens will pass away with a roar, and the heavenly bodies will be burned up and dissolved, and the earth and the works that are done on it will be exposed.

Since all these things are thus to be dissolved, what sort of people ought you to be in lives of holiness and godliness, waiting for and hastening the coming of the day of God, because of which the heavens will be set on fire and dissolved, and the heavenly bodies will melt as they burn! But according to his promise we are waiting for new heavens and a new earth in which righteousness dwells. (2 Peter 3:1-13 ESV)

Is waiting for the world to get torched much of a plan for cultural renewal?

But let’s not leave out Jesus’ pessimism:

“So when you see the abomination of desolation spoken of by the prophet Daniel, standing in the holy place (let the reader understand), then let those who are in Judea flee to the mountains. Let the one who is on the housetop not go down to take what is in his house, and let the one who is in the field not turn back to take his cloak. And alas for women who are pregnant and for those who are nursing infants in those days! Pray that your flight may not be in winter or on a Sabbath. For then there will be great tribulation, such as has not been from the beginning of the world until now, no, and never will be. And if those days had not been cut short, no human being would be saved. But for the sake of the elect those days will be cut short. Then if anyone says to you, ‘Look, here is the Christ!’ or ‘There he is!’ do not believe it. For false christs and false prophets will arise and perform great signs and wonders, so as to lead astray, if possible, even the elect. See, I have told you beforehand. So, if they say to you, ‘Look, he is in the wilderness,’ do not go out. If they say, ‘Look, he is in the inner rooms,’ do not believe it. For as the lightning comes from the east and shines as far as the west, so will be the coming of the Son of Man. Wherever the corpse is, there the vultures will gather.

“Immediately after the tribulation of those days the sun will be darkened, and the moon will not give its light, and the stars will fall from heaven, and the powers of the heavens will be shaken. Then will appear in heaven the sign of the Son of Man, and then all the tribes of the earth will mourn, and they will see the Son of Man coming on the clouds of heaven with power and great glory. And he will send out his angels with a loud trumpet call, and they will gather his elect from the four winds, from one end of heaven to the other. (Matthew 24:15-31 ESV)

Perhaps hoping for a restoration of cultural standards in the United States comes up a tad short of the kind of cataclysm that seems to await sinners in the hands of a righteous God.

Of course, some might want to point to any number of Old Testament prophecies as the basis for hope (even while avoiding signing up for Jack Van Impe‘s newsletter):

The wolf shall dwell with the lamb,
and the leopard shall lie down with the young goat,
and the calf and the lion and the fattened calf together;
and a little child shall lead them.
The cow and the bear shall graze;
their young shall lie down together;
and the lion shall eat straw like the ox.
The nursing child shall play over the hole of the cobra,
and the weaned child shall put his hand on the adder’s den.
They shall not hurt or destroy
in all my holy mountain;
for the earth shall be full of the knowledge of the LORD
as the waters cover the sea.

In that day the root of Jesse, who shall stand as a signal for the peoples—of him shall the nations inquire, and his resting place shall be glorious.

In that day the Lord will extend his hand yet a second time to recover the remnant that remains of his people, from Assyria, from Egypt, from Pathros, from Cush, from Elam, from Shinar, from Hamath, and from the coastlands of the sea.

He will raise a signal for the nations
and will assemble the banished of Israel,
and gather the dispersed of Judah
from the four corners of the earth.
The jealousy of Ephraim shall depart,
and those who harass Judah shall be cut off;
Ephraim shall not be jealous of Judah,
and Judah shall not harass Ephraim.
But they shall swoop down on the shoulder of the Philistines in the west,
and together they shall plunder the people of the east.
They shall put out their hand against Edom and Moab,
and the Ammonites shall obey them.
And the LORD will utterly destroy
the tongue of the Sea of Egypt,
and will wave his hand over the River
with his scorching breath,
and strike it into seven channels,
and he will lead people across in sandals.
And there will be a highway from Assyria
for the remnant that remains of his people,
as there was for Israel
when they came up from the land of Egypt. (Isaiah 11:6-16 ESV)

But if that is what the hopefuls are optimistic about, then they may want to stay away from the U.S. State Department’s diplomatic team in the Middle East.

Making Straight the Way of the Green

Lots of excitement in certain quarters of the Roman Catholic Church about Pope Francis’ forthcoming encyclical about the environment, but Protestants wonder where the energy was when Protestants beat the papacy to the punch.

First, what’s coming:

Vatican officials announced Tuesday that Pope Francis’ much-anticipated encyclical letter on the environment is now finalized and is being translated into various languages, with an expected release date sometime in June.

The announcement came during a Rome summit on climate change co-sponsored by the Vatican and the United Nations, headlined by UN Secretary-General Ban Ki-moon and Cardinal Peter Turkson of Ghana, president of the Pontifical Council for Justice and Peace.

An encyclical letter is considered the most important, and most developed, form of papal teaching. This will be the first-ever encyclical entirely devoted to environmental themes.

Next, the excitement:

Ron Pagnucco of the College of St. Benedict and St. John’s University “would like to see Francis continue to use the concept of ‘solidarity’ in the encyclical, discussing what global solidarity means in regards to the environment.”

“Just as Catholic social doctrine teaches that no person exists without society,” said Vince Miller of the University of Dayton, “we need to also learn that our species does not exist without the rest of creation.”

“How climate change and related environmental issues connect with other important concerns, including war and peace, economics, and health care,” needs to be articulated in the encyclical, according to Tobias Winright of St. Louis University.

“It is very important to discuss the environment, conflict and peace,” Pagnucco agreed, since environmental degradation is a “threat multiplier.”

The relationship between the environment and the economy is especially important.

“Environmentalists are looking to the pope for continued linkages to poverty and impact of degradation on the poor,” said Catholic Climate Covenant’s Ellis. Jesuit Fr. James Keenan of Boston College would also “like to see the sustainability issues related to climate change woven into issues related to economic inequality.”

Environmental problems are also connected to racism, said Alex Mikulich of Loyola University New Orleans. And “it would be important to consider the connection between the desire to dominate the earth/cosmos and domination of women,” according to M. Shawn Copeland of Boston College.

One of the reasons environmentalists are embracing religion is because it is one of the few things that can motivate people to sacrifice their own self-interest for the sake of others.

David Cloutier of Mount St. Mary’s University calls for a “forthright confrontation with so-called lifestyle choices.”

“It’s all the choices we make that cause the per capita carbon footprint of the average American to be roughly twice that of most European countries, and that cause the insanity of California lawns and water-thirsty agriculture,” he said. “I’m all for better laws and structures, but until we stop expecting strawberries in February, spacious living quarters, and large SUVs, I’m not sure how those structures change.”

Likewise, Scheid said he hopes for “a critique of consumerism and a ‘scrap culture’ or ‘throwaway culture’ that uses and then discards as trash people, especially the poor, created goods, and the Earth as a whole. I hope he ties the preferential option for the poor and solidarity with ecological concerns.”

Grazer said he hopes the pope “will call upon the larger and more wealthy nations to lead and make the ‘sacrifices’ needed to make urgent progress regarding climate change, and in particular, helping the most vulnerable people and nations mitigate and adapt to climate change.” The pope “needs to call for much greater leadership on the part of wealthier nations and also for sufficient changes in personal and corporate life style, moving away from consumerism,” he said.

But Miller of Dayton University stressed that structural change, not just individual choices, is essential. “Our moral and Christian obligation is not simply to change our consumption as individuals, but to collectively build a culture/society/civilization that is sustainable,” he said.

It requires “a broadening of moral responsibility to care for creation from individual choice to the larger, structural, policy responses that are required to address the environmental crises we face,” he said. “Yes, greed is a problem, but environmental despoliation is cooked into the system we have built.”

Peppard agreed that “market processes are not morally trustworthy guides to long-term flourishing of the physical bases on which all life depends” because the markets are oriented “towards short-term profit and economic growth without a recognition of natural capital as a substrate of those developments.”

How people and governments respond to the encyclical will be critical. “The theology of the encyclical is important,” said Marian Diaz of Loyola University Chicago, “but the implementation or the lack thereof matters more.”

But Protestants have been there and done that. First came the National Council of Churches in 200friggin’6, almost a decade ago:

BE IT THEREFORE RESOLVED THAT THE NATIONAL COUNCIL OF CHURCHES IN CHRIST:

Expresses its deep concern for the pending environmental, economic, and social tragedies threatened by global warming to creation, human communities, and traditional sacred spaces.

Urges the Federal Government to respond to global warming with greater urgency and leadership and gives support for mandatory measures that reduce the absolute amount of greenhouse gas emissions, and in particular emissions of carbon dioxide, to levels recommended by nationally and internationally recognized and respected scientific bodies.

Urges the Federal, State and Local Governments to support and invest in energy conservation and efficiency, sustainable and renewable, and affordable and sustainable transportation.

Calls for business and industry to respond to global warming with increased investment in conservation and more efficient and sustainable energy technologies that are accessible, sustainable, and democratic.

Stands firmly with all of God’s children by urging that adaptive measures and financial support be forthcoming from government and industry to aid those directly impacted by global warming and in particular those least able to relocate, reconstruct, or cope with the current and pending impacts of climate change.

Calls on all Christians, people of faith and people of good will the world over to lead by example and seek active means whereby they may, individually and in community, quickly reduce their emissions of green house gas emissions and speak out for engagement by their elected officials on matters of global warming.

In the same year, evangelicals added their moral heft:

The basic task for all of the world’s inhabitants is to find ways now to begin to reduce the carbon dioxide emissions from the burning of fossil fuels that are the primary cause of human-induced climate change.

There are several reasons for urgency. First, deadly impacts are being experienced now. Second, the oceans only warm slowly, creating a lag in experiencing the consequences. Much of the climate change to which we are already committed will not be realized for several decades. The consequences of the pollution we create now will be visited upon our children and grandchildren. Third, as individuals and as a society we are making long-term decisions today that will determine how much carbon dioxide we will emit in the future, such as whether to purchase energy efficient vehicles and appliances that will last for 10-20 years, or whether to build more coal-burning power plants that last for 50 years rather than investing more in energy efficiency and renewable energy.

In the United States, the most important immediate step that can be taken at the federal level is to pass and implement national legislation requiring sufficient economy-wide reductions in carbon dioxide emissions through cost-effective, market-based mechanisms such as a cap-and-trade program. On June 22, 2005 the Senate passed the Domenici-Bingaman resolution affirming this approach, and a number of major energy companies now acknowledge that this method is best both for the environment and for business.

We commend the Senators who have taken this stand and encourage them to fulfill their pledge. We also applaud the steps taken by such companies as BP, Shell, General Electric, Cinergy, Duke Energy, and DuPont, all of which have moved ahead of the pace of government action through innovative measures implemented within their companies in the U.S. and around the world. In so doing they have offered timely leadership.

Numerous positive actions to prevent and mitigate climate change are being implemented across our society by state and local governments, churches, smaller businesses, and individuals. These commendable efforts focus on such matters as energy efficiency, the use of renewable energy, low CO2 emitting technologies, and the purchase of hybrid vehicles. These efforts can easily be shown to save money, save energy, reduce global warming pollution as well as air pollution that harm human health, and eventually pay for themselves. There is much more to be done, but these pioneers are already helping to show the way forward.

Finally, while we must reduce our global warming pollution to help mitigate the impacts of climate change, as a society and as individuals we must also help the poor adapt to the significant harm that global warming will cause.

Conclusion
We the undersigned pledge to act on the basis of the claims made in this document. We will not only teach the truths communicated here but also seek ways to implement the actions that follow from them. In the name of Jesus Christ our Lord, we urge all who read this declaration to join us in this effort.

I understand that critics often blame Protestantism for encouraging modernity and lacking a sense of tradition, and once again Protestants seem to be out in front of Rome. But does 9 years count for establishing one’s traditionalist bona fides?