TOK Friends

As a result we end up with the most bizarre health-insurance system imaginable: One ever better designed to avoid sick people.

America’s giant health insurers are now busily consolidating into ever-larger behemoths.

In reality, they’re becoming huge to get more bargaining leverage over everyone they do business with — hospitals, doctors, employers, the government and consumers. That way they make even bigger profits.

researchers found, for example, that after Aetna merged with Prudential HealthCare in 1999, premiums rose 7 percent higher than had the merger not occurred.

The real choice in the future is either a hugely expensive for-profit oligopoly with the market power to charge high prices even to healthy people and stop insuring sick people.

Or else a government-run single payer system — such as is in place in almost every other advanced economy — dedicated to lower premiums and better care for everyone.

For instance, we might choose a different metaphor—like, say, the traffic system. Sounds ridiculous? No more so than the market metaphor. After all, we already talk about one important aspect of economic life in terms of traffic: online activity. We could describe it in market terms (the market demands Trump memes!), but we use a different metaphor, because it’s just intuitively more suitable. That last Trump meme is generating a lot of traffic. Redirect your attention as required.

We don’t know much about markets, because we don’t deal with them very often. But most of us know plenty about traffic systems: drivers will know the frustration of trying to turn left onto a major road, of ceaseless, pointless lane-switching on a stalled rush-hour freeway, but also the joys of clear highways.

We know the traffic system because, whether we like it or not, we are always involved in it, from birth

As of birth, Jean is in the economy—even if s/he rarely goes to a market. You can’t not be an economic actor; you can’t not be part of the transport system.

Consider also the composition of the traffic system and the economy. A market, whatever else it is, is always essentially the same thing: a place where people can come together to buy and sell things. We could set up a market right now, with a few fences and a sign announcing that people could buy and sell. We don’t even really need the fences. A traffic system, however, is far more complex. To begin with, the system includes publicly and privately run elements: most cars are privately owned, as are most airlines

If we don’t evaluate traffic systems based on their size, or their growth, how do we evaluate them? Mostly, by how well they help people get where they want to go. The market metaphor encourages us to think that all economic activity is motivated by the search for profit, and pursued in the same fashion everywhere. In a market, everyone’s desires are perfectly interchangeable. But, while everybody engages in the transport system, we have no difficulty remembering that we all want to go to different places, in different ways, at different times, at different speeds, for different reasons

Deciding how to improve the traffic system, how to expand people’s opportunities, is obviously a question of resource allocation and prioritization on a scale that private individuals—even traders—cannot influence on their own. That’s why government have not historically trusted the “magic of the markets” to produce better opportunities for transport. We intuitively understand that these decisions are made at the level of mass society and public policy. And, whether you like it or not, this is true for decisions about the economy as well.

Thinking of the economy in terms of the market—a featureless plane, with no entry or exit costs, little need for regulation, and equal opportunity for all—obscures this basic insight. And this underlying misconception creates a lot of problems: we’ve fetishized economic growth, we’ve come to distrust government regulation, and we imagine that the inequalities in our country, and our world, are natural or justified. If we imagine the economy otherwise—as a traffic system, for example—we see more clearly how the economy actually works.

We see that our economic life looks a lot less like going to “market” for fun and profit than it does sitting in traffic on our morning commute, hoping against hope that we’ll get where we want to go, and on time.

Rabies moves at a predictable rate, replicating every eight to 10 hours, moving rapidly through chains of neurons and revealing a network. The researchers could allow the virus to move up the nervous system and reach the brain but could sacrifice the monkey before it showed any symptoms of infection.

When the virus has had enough time to travel a predictable distance, the researchers anesthetize the animal, wash out its blood, perfuse the central nervous system with fixatives, and use antibodies to detect where the virus has spread. The kills were timed to various stages to create a map. By the time you’ve gone through several sets of synapses that mapping is an enormous task. There’s an exponential increase in the number of neurons.

the researchers were astounded at what they saw. The motor areas in the brain connect to the adrenal glands. In the primary motor cortex of the brain, there’s a map of the human body—areas that correspond to the face, arm, and leg area, as well as a region that controls the axial body muscles (known to many people now as “the core”).

“Something about axial control has an impact on stress responses,” Strick reasons. “There’s all this evidence that core strengthening has an impact on stress. And when you see somebody that's depressed or stressed out, you notice changes in their posture. When you stand up straight, it has an effect on how you project yourself and how you feel.  Well, lo and behold, core muscles have an impact on stress. And I suspect that if you activate core muscles inappropriately with poor posture, that’s going to have an impact on stress.”

“These neural pathways might explain our intuitive sense for why there are many different strategies for coping with stress,” said Bruno. “I like the examples they give in the paper—that maybe this is why yoga and pilates are so successful. But there are lots of other things where people talk about mental imagery and all sorts of other ways that people deal with stress. I think having so many neural pathways having direct lines to the stress control system, that’s really interesting.”

Bruno specializes more in sensory neuroscience, so he read a more into the findings in the primary somatosensory cortex. Some of these tactile areas in the brain seem to be providing as much input to the adrenal medulla as the cortical areas. “To me that's really new and interesting,” said Bruno. “It might explain why certain sensations we find very relaxing or stressful.”

“It's not clear to me—from our work, and from their work—that what we call motor cortex is really motor cortex,” he said. “Maybe the primary sensory cortex is doing something more than we thought. When I see results like these, I go, hm, maybe these areas aren’t so simple.”

With this come implications for what’s currently known as “psychosomatic illness”—how the mind has an impact over organ functions. The name tends to have a bad connotation. The notion that this mind-body connection isn’t really real; that psychosomatic illnesses are “all in your head.” Elaborate connections like this would explain that, yes, it is all in your head. The fact that cortical areas in the brain that have multi-synaptic connections that control organ function could strip the negative connotations

As he put it, “How we move, think, and feel have an impact on the stress response through real neural connections.”

I want to advance a technology-driven hypothesis: This mix of youthful safety and adult immaturity may be a feature of life in a society increasingly shaped by the internet’s virtual realities.

It is easy to see how online culture would make adolescent life less dangerous. Pornography to take the edge off teenage sexual appetite. Video games instead of fisticuffs or contact sports as an outlet for hormonal aggression. (Once it was feared that porn and violent media would encourage real-world aggression; instead they seem to be replacing it.) Sexting and selfie-enabled masturbation as a safer alternative to hooking up. Online hangouts instead of keggers in the field. More texting and driving, but less driving — one of the most dangerous teen activities — overall.

The question is whether this substitution is habit-forming and soul-shaping, and whether it extends beyond dangerous teen behavior to include things essential to long-term human flourishing — marriage, work, family, all that old-fashioned “meatspace” stuff.

It wasn’t so long ago that people worried about a digital divide, in which online access would be a luxury good that left the bottom half behind. But if anything, the virtual world looks more like an opiate for the masses

trends in the marketplace — ever-more-customized pornography, virtual realities that feel more and more immersive, devices and apps customized for addictive behavior — seem likely to overwhelm most attempts to enjoy the virtual only within limits.

Patricia Snow (yes, even columnists have mothers), in an essay for First Things earlier this year, suggested that any effective resistance to virtual reality’s encroachments would need to be moral and religious, not just pragmatic and managerial

Reality-directed imagination, for its part, endeavours to re-create, in the intellectual realm, actions and events that have existed or have taken place, which we may have plenty or partial information about.

Reality-directed imagination is thus a means to retain a solid sense of reality rather than to submerge into the everlasting landscape of fantasy. We imagine what was and try to afford it life.  

Without reality-directed imagination, on the other hand, the study of history would be well-nigh impossible.

By resorting to reality-directed imagination we are able intellectually to disconnect ourselves from the present; to visualize, like a landscape gradually making its appearance as we move backwards in time, the setting in which an event occurred or the personal features of an individual we follow. We are able emotionally to connect ourselves to the prevailing conditions or to a person's thoughts.

In the study of history we make use of reality-directed imagination as we depict in our minds the characters of individuals or the nature of events. We even try to fill the gaps by resorting to our imagination ever vigilant not to lose sight of reality as it was. In other words, we attempt to imagine the unknown by resorting to the known.

Without imagination as a study-device, the learning of history becomes well-nigh impossible, for the information furnished to us is rendered unintelligible. We are unable to relate to it in any meaningful manner. We assess it in a mechanical way, devoid of image, sound and feel. Our attempt to understand it leads to a dead-end for we cannot leap forward from the stale fact before us and relate it to other facts beyond it.

Without imagination we cannot compare, distinguish and separate; we cannot know the difference between the particular and the general. In order to study history we need to avoid the mechanical, on the one hand, and the fantastic, on the other. In other words, we ought to eschew both lack of imagination and fantasy-directed imagination; the first does not allow us to proceed forward while the latter leads us to the realm of the unreal.

Having to take a test in swimwear seems not to distract most young men, but it does distract many young women, almost certainly due to the absurd beauty standards to which they are disproportionately subjected. In the words of the researchers, the swimsuit study effectively demonstrated “the psychological costs of raising girls in a culture that persistently objectifies the female body.”

Now, swimsuit season, especially for adolescent girls, no longer ends with summer because girls are using social media to share carefully crafted bikini shots all the time.

these are images with which girls become especially engaged. According to Dr. Walsh, “Girls are not comparing themselves to media ideals as much as one would expect, but they are making micro-comparisons to their peers. It’s not me versus Gisele Bündchen in a bikini, it’s me versus my good friend Amy in our bikinis.”

A new review of studies looking at the psychological effects of social media found that young people who spend a lot of time appraising their friends’ online photos ultimately feel worse about their own bodies.

Online imagery allows adolescents to observe one another in detail and gives unprecedented power to the age-old teenage preoccupation with appearance. We want to help our teenagers minimize the harm that can come from social media use, but the deluge of digital activity can make it hard to know where to start.

these ideas are not about looking within and finding oneself. They are about overcoming the self. They are, in a sense, anti-self-help.

Today, we are often told that our goal should be to look within and find ourselves, and, once we do, to strive to be sincere and authentic to that true self, always loving ourselves and embracing ourselves for who we are. All of this sounds great and is a key part of what we think of as a properly “modern” way to live.

But what if we’re, on the contrary, messy selves that tend to fall into ruts and patterns of behavior? If so, the last thing we would want to be doing is embracing ourselves for who we are — embracing, in other words, a set of patterns we’ve fallen into. The goal should rather be to break these patterns and ruts, to train ourselves to interact better with those around us.

Certainly some strains of Chinese political theory will take this vision of the self — that we tend to fall into patterns of behavior — to argue for a more paternalistic state that will, to use a more recent term, “nudge” us into better patterns.

many of the texts we discuss in the book go the other way, and argue that the goal should be to break us from being such passive creatures — calling on us to do things that break us out of these patterns and allow us to train ourselves to start altering our behavior for the better.

You argue that Chinese philosophy views rituals as tools that can liberate us from these ruts.

Rituals force us for a brief moment to become a different person and to interact with those around us in a different way. They work because they break us from the patterns that we fall into and that otherwise dominate our behavior.

In the early Han dynasty, for example, we have examples of rituals that called for role reversals. The father would be called upon to play the son, and the son would play the father. Each is forced to see the world from the other’s perspective, with the son learning what it’s like to be in a position of authority and the father remembering what it was like to be the more subservient one

We tend to think that we live in a globalized world, but in a lot of ways we really don’t. The truth is that for a long time only a very limited number of ideas have dominated the world, while ideas that arose elsewhere were seen as “traditional” and not worth learning from.

imagine future generations that grow up reading Du Fu along with Shakespeare, and Confucius along with Plato. Imagine that type of world, where great ideas — wherever they arose — are thought about and wrestled with.

There’s a very strong debate going on in China about values — a sense that everything has become about wealth and power, and a questioning about whether this should be rethought. And among the ideas that are being brought into the debate are these earlier notions about the self and about how one can lead a good life. So, while the government is appropriating some of these ideas in particular ways, the broader public is debating them, and certainly with very different interpretations.

The study analyzed friendship ties among 84 subjects (ages 23 to 38) in a business management class by asking them to rank one another on a five-point continuum of closeness from “I don’t know this person” to “One of my best friends.” The feelings were mutual 53 percent of the time while the expectation of reciprocity was pegged at 94 percent. This is consistent with data from several other friendship studies conducted over the past decade, encompassing more than 92,000 subjects, in which the reciprocity rates ranged from 34 percent to 53 percent.

“Friendship is difficult to describe,” said Alexander Nehamas, a professor of philosophy at Princeton, who in his latest book, “On Friendship,” spends almost 300 pages trying to do just that. “It’s easier to say what friendship is not and, foremost, it is not instrumental.”

It is not a means to obtain higher status, wangle an invitation to someone’s vacation home or simply escape your own boredom. Rather, Mr. Nehamas said, friendship is more like beauty or art, which kindles something deep within us and is “appreciated for its own sake.

“Treating friends like investments or commodities is anathema to the whole idea of friendship,” said Ronald Sharp, a professor of English at Vassar College, who teaches a course on the literature of friendship. “It’s not about what someone can do for you, it’s who and what the two of you become in each other’s presence.”

Some blame human beings’ basic optimism, if not egocentrism, for the disconnect between perceived and actual friendships. Others point to a misunderstanding of the very notion of friendship in an age when “friend” is used as a verb, and social inclusion and exclusion are as easy as a swipe or a tap on a smartphone screen.

By his definition, friends are people you take the time to understand and allow to understand you.

Because time is limited, so, too, is the number of friends you can have, according to the work of the British evolutionary psychologist Robin I.M. Dunbar. He describes layers of friendship, where the topmost layer consists of only one or two people, say a spouse and best friend with whom you are most intimate and interact daily. The next layer can accommodate at most four people for whom you have great affinity, affection and concern and who require weekly attention to maintain. Out from there, the tiers contain more casual friends with whom you invest less time and tend to have a less profound and more tenuous connection. Without consistent contact, they easily fall into the realm of acquaintance. You may be friendly with them but they aren’t friends.

“There is a limited amount of time and emotional capital we can distribute, so we only have five slots for the most intense type of relationship,” Mr. Dunbar said. “People may say they have more than five but you can be pretty sure they are not high-quality friendships.

Such boasting implies they have soul mates to spare in a culture where we are taught that leaning on someone is a sign of weakness and power is not letting others affect you. But friendship requires the vulnerability of caring as well as revealing things about yourself that don’t match the polished image in your Facebook profile or Instagram feed, said Mr. Nehamas at Princeton. Trusting that your bond will continue, and might even be strengthened, despite your shortcomings and inevitable misfortunes, he said, is a risk many aren’t willing to take.

According to medical experts, playing it safe by engaging in shallow, unfulfilling or nonreciprocal relationships has physical repercussions. Not only do the resulting feelings of loneliness and isolation increase the risk of death as much as smoking, alcoholism and obesity; you may also lose tone, or function, in the so-called smart vagus nerve, which brain researchers think allows us to be in intimate, supportive and reciprocal relationships in the first place.

In the presence of a true friend, Dr. Banks said, the smart or modulating aspect of the vagus nerve is what makes us feel at ease rather than on guard as when we are with a stranger or someone judgmental. It’s what enables us to feel O.K. about exposing the soft underbelly of our psyche and helps us stay engaged and present in times of conflict. Lacking authentic friendships, the smart vagus nerve is not exercised. It loses tone and one’s anxiety remains high, making abiding, deep connections difficult.

Economies dominated by hedge financing—that is, those with strong cashflows and low debt levels—are the most stable. When speculative and, especially, Ponzi financing come to the fore, financial systems are more vulnerable. If asset values start to fall, either because of monetary tightening or some external shock, the most overstretched firms will be forced to sell their positions. This further undermines asset values, causing pain for even more firms. They could avoid this trouble by restricting themselves to hedge financing. But over time, particularly when the economy is in fine fettle, the temptation to take on debt is irresistible. When growth looks assured, why not borrow more? Banks add to the dynamic, lowering their credit standards the longer booms last. If defaults are minimal, why not lend more? Minsky’s conclusion was unsettling. Economic stability breeds instability. Periods of prosperity give way to financial fragility.

Minsky’s insight might sound obvious. Of course, debt and finance matter. But for decades the study of economics paid little heed to the former and relegated the latter to a sub-discipline, not an essential element in broader theories.

Minsky was a maverick. He challenged both the Keynesian backbone of macroeconomics and a prevailing belief in efficient markets.

t Messrs Hicks and Hansen largely left the financial sector out of the picture, even though Keynes was keenly aware of the importance of markets. To Minsky, this was an “unfair and naive representation of Keynes’s subtle and sophisticated views”. Minsky’s financial-instability hypothesis helped fill in the holes.

His challenge to the prophets of efficient markets was even more acute. Eugene Fama and Robert Lucas, among others, persuaded most of academia and policymaking circles that markets tended towards equilibrium as people digested all available information. The structure of the financial system was treated as almost irrelevant

In recent years, behavioural economists have attacked one plank of efficient-market theory: people, far from being rational actors who maximise their gains, are often clueless about what they want and make the wrong decisions.

But years earlier Minsky had attacked another: deep-seated forces in financial systems propel them towards trouble, he argued, with stability only ever a fleeting illusion.

Investors were faster than professors to latch onto his views. More than anyone else it was Paul McCulley of PIMCO, a fund-management group, who popularised his ideas. He coined the term “Minsky moment” to describe a situation when debt levels reach breaking-point and asset prices across the board start plunging. Mr McCulley initially used the term in explaining the Russian financial crisis of 1998. Since the global turmoil of 2008, it has become ubiquitous. For investment analysts and fund managers, a “Minsky moment” is now virtually synonymous with a financial crisis.

it would be a stretch to expect the financial-instability hypothesis to become a new foundation for economic theory. Minsky’s legacy has more to do with focusing on the right things than correctly structuring quantifiable models. It is enough to observe that debt and financial instability, his main preoccupations, have become some of the principal topics of inquiry for economists today

As Mr Krugman has quipped: “We are all Minskyites now.”

Trying to correct misperceptions can actually reinforce them, according to a 2006 paper by Brendan Nyhan and Jason Reifler, also cited by Graves. They documented what they called a “backfire effect” by showing the persistence of the belief that Iraq had weapons of mass destruction in 2005

“The results show that direct factual contradictions can actually strengthen ideologically grounded factual belief,” they wrote.

people remember the assertion and forget whether it’s a lie. The authors wrote: “The more often older adults were told that a given claim was false, the more likely they were to accept it as true after several days have passed.”

When critics challenge false assertions — say, Trump’s claim that thousands of Muslims cheered in New Jersey when the twin towers fell on Sept. 11, 2001 — their refutations can threaten people, rather than convince them. Graves noted that if people feel attacked, they resist the facts all the more

The study showed two interesting things: People are more likely to accept information if it’s presented unemotionally, in graphs;

and they’re even more accepting if the factual presentation is accompanied by “affirmation” that asks respondents to recall an experience that made them feel good about themselves.

Bottom line: Vilifying Trump voters — or, alternatively, parents who don’t want to have their children vaccinated — won’t convince them they’re wrong. Probably it will have the opposite effect.

The final point that emerged from Graves’s survey is that people will resist abandoning a false belief unless they have a compelling alternative explanation. That point was made in an article called “The Debunking Handbook,” by Australian researchers John Cook and Stephan Lewandowsky. They wrote: “Unless great care is taken, any effort to debunk misinformation can inadvertently reinforce the very myths one seeks to correct.”

Trump’s campaign pushes buttons that social scientists understand. When the GOP nominee paints a dark picture of a violent, frightening America, he triggers the “fight or flight” response that’s hardwired in our brains. For the body politic, it can produce a kind of panic attack.

A woman named Diana, who wore star-and-flower earrings, said that before she tidied, her life was out of control. Her job had been recently eliminated when she found the book. “It’s a powerful message for women that you should be surrounded by things that make you happy,”

“I found the opposite of happiness is not sadness,” Diana told us. “It’s chaos.”

Another woman said she KonMaried a bad boyfriend. Having tidied everything in her home and finding she still distinctly lacked happiness, she held her boyfriend in her hands, realized he no longer sparked joy and got rid of him.

She realized that the work she was doing as a tidying consultant was far more psychological than it was practical. Tidying wasn’t just a function of your physical space; it was a function of your soul.

. She wants you to override the instinct to keep a certain thing because an HGTV show or a home-design magazine or a Pinterest page said it would brighten up your room or make your life better. She wants you to possess your possessions on your own terms, not theirs

she would say to him what she said to me, that yes, America is a little different from Japan, but ultimately it’s all the same. We’re all the same in that we’re enticed into the false illusion of happiness through material purchase.

She leaves room for something that people don’t often give her credit for: that the KonMari method might not be your speed. “I think it’s good to have different types of organizing methods,” she continued, “because my method might not spark joy with some people, but his method might.

Conference was different from the KonMari events that I attended. Whereas Kondo does not believe that you need to buy anything in order to organize and that storage systems provide only the illusion of tidiness, the women of Conference traded recon on timesaving apps, label makers, the best kind of Sharpie, the best tool they own (“supersticky notes,” “drawer dividers”)

They don’t like that you have to get rid of all of your papers, which is actually a misnomer: Kondo just says you should limit them because they’re incapable of sparking joy, and you should confine them to three folders: needs immediate attention, must be kept for now, must be kept forever.

each organizer I spoke with said that she had the same fundamental plan that Kondo did, that the client should purge (they cry “purge” for what Kondo gently calls “discarding”) what is no longer needed or wanted; somehow the extra step of thanking the object or folding it a little differently enrages them. This rage hides behind the notion that things are different here in America, that our lives are more complicated and our stuff is more burdensome and our decisions are harder to make.

Ultimately, the women of NAPO said that Kondo’s methods were too draconian and that the clients they knew couldn’t live in Kondo’s world. They had jobs and children, and they needed baby steps and hand-holding and maintenance plans. They needed someone to do for them what they couldn’t naturally do for themselves.

the most potent difference between Kondo and the NAPO women is that the NAPO women seek to make a client’s life good by organizing their stuff; Kondo, on the other hand, leads with her spiritual mission, to change their lives through magic.

She went to work in finance, but she found the work empty and meaningless. She would come home and find herself overwhelmed by her stuff. So she began searching for “minimalism” on the internet almost constantly, happening on Pinterest pages of beautiful, empty bathrooms and kitchens, and she began to imagine that it was her stuff that was weighing her down. She read philosophy blogs about materialism and the accumulation of objects. “They just all talked about feeling lighter,”

“I never knew how to get here from there,” she said. Ning looked around her apartment, which is spare. She loves it here now, but that seemed impossible just a couple of years ago.

She found Kondo’s book, and she felt better immediately, just having read it. She began tidying, and immediately she lost three pounds. She had been trying to lose weight forever, and then suddenly, without effort, three pounds, just gone.

when it comes to stuff, we are all the same. Once we’ve divided all the drawers and eliminated that which does not bring us joy and categorized ourselves within an inch of our lives, we’ll find that the person lying beneath all the stuff was still just plain old us. We are all a mess, even when we’re done tidying.

question formulation exercises can be used as a substitute for conventional brainstorming sessions. The idea is to put a problem or challenge in front of a group of people and instead of asking for ideas, instruct participants to generate as many relevant questions as they can. Kristi Schaffner, an executive at Microsoft, regularly conducts such exercises there and says they sharpen analytical skills.