The Health of Truth

By Mike Koetting      June 14, 2017

Earlier this month in various cities around the country, there were protests against Trump under the banner of March for Truth. That got me thinking about some observations I wanted to make about the role of “truth” in a democracy, a role currently under obvious fire.


A recent Time Magazine cover starkly asked “Is Truth Dead?” paralleling their “Is God Dead?” cover from 50 years ago. That story, however, focused only on Donald Trump’s troubled relationship with truth. Fair enough. It’s a big problem. But, it seems to me, the problem of the impending death of truth in our democracy goes much deeper than whether or not (really, the extent to which) Donald Trump is a liar.  Problems with truth seem to extend to almost all of our political discourse.

It isn’t easy; truth can be messy

We should start off with the concession that when it comes to political and policy actions and interpretations, “the truth” is rarely as clear cut as we like to believe. To the extent things are amenable to being analyzed with scientific methods, something called “truth” is more likely to be reliable than something without that backing. But sometimes “the truth” is equivocal, as when there is an element of truth in the contrary of a generally true statement. Sometimes “the truth” is really a probability statement based on data available. And often “the truth” is really contingent on a bunch of interdependencies where changes elsewhere change many other things.

None of the above should be taken as an argument that all theories are equal. They are not. The above should perhaps engender some humility and tolerance as we strive for evidence-based policies. But we can remain confident that over the long run, we will be better off as a society if we follow generally accepted facts.  Especially if we are willing to subject those “facts” to constant reanalysis in the face of changing circumstances and new evidence. Facts Great Again

 The Reality Is Far from There

In today’s world, there is a disturbing tendency to treat facts cavalierly. The messiness of political and policy truths, rather than inspiring humility and common truth seeking, has become an excuse for attacking any notion of truth promulgated by someone whose motives we suspect. Uncertainties become cracks by which all statements can be discarded and others, some times with only the barest shred of evidence or plausibility, can be offered as alternatives. This is often attributed to the rise of a fragmented communication system whereby individuals can find “facts” to suit any position.  No doubt the anarchy of our media reinforces the trend. But I think these are more symptoms than causes.

They are symptoms of the fact we don’t trust each other any more because there is no sense of common interest. The world has been reduced to a zero-sum game. All statements are considered more as allegations and largely disposable if they don’t suit one’s interests.

We can see this all as cynical or malicious discarding of inconvenient facts—and sometimes it is no more than that–but the reality is often more complicated. Consider if you were a coal-miner and saw your livelihood slipping away and your community falling apart.  And you note that the loudest voices for restrictions on coal mining are from people whose economic situation is not only better than yours, but still continuing to improve while yours is deteriorating. And, while attacking your livelihood, they aren’t offering much in the way of real help. Seems to me, at that point an alternative hypothesis on the causes and consequences of global warming and might sound more plausible.

Disregarding facts is a very bad thing for a democracy that wants to make choices built on rational discussions, It cannot be redressed by any amount of facts if people are determined not to listen to one another. In order for democratic discourse to take place, there must be a certain amount of “suspension of disbelief” so that different ideas can jostle with one another and a new consensus emerge.  This happens only when people have enough shared sense of common interest to trust each other.  (By the way, this sometimes seems just as problematic when Democrats are presented with “Republican facts”.  Facts are not partisan in their various inconveniences.)

In a recent New Yorker article, the reporter was surprised at the answer General James Mattis gave to the question as to what worried him most about being secretary of defense: “The lack of political unity in America. The lack of a fundamental friendliness. It seems like an awful lot of people in America and around the world feel spiritually and personally alienated….If you lose any sense of being part of something bigger, then why should you care about your fellow man?” Or, I might add, even believe your fellow man?

This isn’t going to be solved by simply wishing for a way to create a sense of shared interest. Or just using the words. Creating a sense of common interest will require specific and explicit tactics that can readily be ascertained as working toward that goal. They have to conspicuously call attention to how they are designed to unite interests rather than divide them.

In a different world, some of this would happen at organically at the local level as people came together to work on common cause initiatives. And even in the current world, some of this can and should happen. But it is not a sufficient strategy for where we are. Our communication systems have become fragmented and the vast bulk of the population lives in our bubbles, segregated by race, class, neighborhood and belief systems. We need something with broader scope and more leverage.

I have two, possibly quixotic, thoughts about how to get there. The central idea in both is transparency about trade-offs.

First, I was taken with the carbon tax Initiative in Washington last year. The idea was to tax carbon emissions as an environmental amelioration, and use the bulk of the proceeds to rebate people who were overtly disadvantaged by the tax.  Apparently, some of the specifics were not quite right and the messaging was clearly not good. (And the initiative lost.) Nevertheless, the idea of a very transparent approach to undertaking one necessary step while taking obvious care to reduce collateral harm seems like a potentially useful framework for proposals that could move us forward while still strengthening the idea of a shared common interest. If, of course, they can generate enough enthusiasm to get enacted. But there are proposals out there that seem to enjoy sufficient general levels of support that they could be turned into law if swing voters weren’t suspicious that the proposals would be enacted at their expense.

A broader approach might be for a political party to outline a core set of principles—say, 6 to 10—to which it would hold itself. It could then develop a more or less explicit framework for evaluating how specific proposals impacted on each of the principles. Generally speaking, this would still have the problems of all campaign platforms, and the principles would have to be flexible enough to not result in self-checkmates, but it might be enough to create sufficient transparency as to give comfort that one’s high priority principles were not being carelessly traded off for someone else’s principles.

But in the end, without some collective interest that is widely accepted, it will remain difficult to have rational discussions because there will be insufficient trust to recognize the truth in other people’s proposals.  If this happens, the country will continue down a path toward becoming ungovernable.  I also don’t believe that starting from reality, we can get to a notion of common interest without considerable, explicit effort. Maybe other proposals would be more effective. All ideas should be welcome at this point. But it needs to be a priority. And that is the truth—I think.


Author: mkbhhw

Mike Koetting’s career has been in health care policy and administration. But it has always been on the fringes of politics. His first job out of graduate school was conducting an evaluation of the Illinois Medicaid program for the Illinois Legislative Budget Office. In the following 40 years, he has been a health care provider, a researcher, a teacher, a regulator, a consultant and a payor. The biggest part of his career was 24 years as Vice President of Planning for the University of Chicago Medical Center. He retired from there in 2008, but in 2010 was asked to implement the ACA Medicaid expansion in Illinois, which kept him busy for another 5 years.

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