Choices Made

Look around at any of the systems that matter these days. Let’s take health care in the United States as an illustrative example.

Unless you’re the CEO of an insurance company (and maybe even if you are), the system we’ve got isn’t the one you’d design if you started from scratch, knowing what you know now.

So how did things get this way, and what does that say about us?

On the one hand, it’s true that our current trajectory was and is determined by past decisions. Once somebody hooked insurance to employment, it was going to really hard to undo. And, as everyone knows, decisions accrete over time (not always how we expect or desire).

On the other hand, people are still making path-determining, value-demonstrating decisions every day. And if we don’t like the path, or the priorities and metrics that are driving them, it’s not impossible to imagine that we could make different decisions.