Cybernetics and domestic policy - social and health

A suggestion from Jon Li for a SubWG on Cybernetic Archives and Domestic Policy - Social and Health
 
 
Background From Jon Li:
Jon Li's work for this year is focused on creating an intellectual environment
to value social programming with a public utility lens rather than a
marketplace lens.  The Vermont League of Women Voters has an
"anti-privatization" resolution that we are bringing to the US LWV
Convention in Washington DC June 27-30 that I am calling it our
"Declaration of Interdepence".

I think we each have our complex model of how the world works.  If we
start too specific, it is too easy to get lost.  After International
Relations and domestic social polity, if some group wants to focus on
the economy, and some group wants to focus on nature, and some group
wants to focus on cultures, that would seem most useful.
 

My Values and where I am Coming From
I have been a systems scientist since I read Asimov's Intelligent Man's
Guide to Science in the 8th grade when it first came out (celebrating
the Geophysical Year 1957-8).  I am totally into seeing a system within
a dynamic environment.  1976, John Van Gigch told me to get Platform for
Change by Stafford Beer, and in 1994, the 2nd edition has my Reader's
Guide, but I continue to have an unresolved faith in the Viable System
Model.

Since 1979, I have attended and/or had a paper at 15 of the 45 meetings
of the Society for General Systems Research/International Society for
the Systems Sciences.

2019, Stella Lobo MD and I VSM mapped the entire Brazilian Health
system, to apply it to National Health Service England, California and
China.  My work this year is to explain that to the US League of Women
Voters so that they can implement the VSM health system in their state.
 

What to do with the Systems Archives?
Peter is my mentor, so he is familiar with me.  His father was a General
Practice Physician in London; Peter shared many times with his father on
his home visits - it shows by how he treats people and how he "runs"
meetings.

Some of the systems work is REVOLUTIONARY.  Stuff we should be making
sure every body in the world understands.
A lot of it is exploratory and only useful to a small group for a
limited time.
Almost all of it is difficult to fathom.
To me the question is not historic, it is the present-future: what is
useful for now and in the future?
I am reminded of Asimov's Foundation series which begins with creating
the Encyclopedia in Far Star.  Like the archives goes to where?
 

Systems Agreements
I believe we have 3 agreements and cannot go much beyond them:
1. The S-curve: dynamic status quo - progression - new status quo
(analogue as opposed to the anti-evolutionary machine digital model).
2. 1st Order Cybernetics: (1. above) see the system being studied as
dynamic rather than a single change step function locked into future
time
2nd Order Cybernetics: Include the Observer as part of the dynamic
process.
3. Ashby's Law of Requisite Variety: social-biological systems are more
complex than mechanical systems, so require real time re-assessment to
monitor and control.

I believe that 3rd Order Cybernetics is Politics: talking about changing
the structure so that different outcomes are default and options.
 

Where American Cybernetic Society is in the Community of Systems Science
Peter and others have spoken about ACS being more social and human than
the science-y ISSS, both tiny ego-trips in the Universe of systems
thinkers.  At the 2019 ISSS meeting at Corvallis, ACS had two
conversations, and I was part of the 2nd one.  The focus became the
fight between ISSS and ACS.  People said that when Len Troncale was the
Executive Vice President for Administration of ISSS, he demanded a more
scientific orientation, intentionally alienating the less academically
oriented.

Len Troncale continued to demand a science orientation.  At 2019 ISSS,
his presentation of his Taxonomy of Pathologies was so complicated that
it was hard to follow.  But he was so sure of himself that I said to
Peter that it is hard to appreciate Ode to Joy when then only instrument
is a bass drum.
 

September-October 2009 issue of Systems Research & Behavioral Science
published Len Troncale's "The Future of General Systems Research:
Obstacles, Potentials, Case Studies" (1984), as well as his 25-year
update.

But I question using academic research as the measure of analysis.    
Papers published seems to reflect only the first layer of impact in the
larger society, almost as though the real world does not exist.   When
SGSR changed its name to the International Society for the Systems
Sciences in 1988, the orientation was shifted from a focus on research
to an effort to impact on the larger society.

Troncale paints a bleak picture of the systems movement's impact.   His
analysis completely leaves out management science: applied systems
theory as a tool for dynamic management of organizations.  Beginning
with Peter Drucker's Management: Tasks, Responsibilities, Practices
(1973) and Katz and Kahn's Social Psychology of Organizations (1978),
there is a rich intellectual tradition within management education about
a systems approach to organizational diagnosis as well as prescription,
so much that systems thinking is now pervasive within the entire
education system as well as the private sector, the government and the
military.

One constellation of additions in management science that are missing in
Troncale's 2009 analysis that significantly affected my thinking ever
since I read them:
- Creative Problem Solving: Total Systems Intervention (1991) by Robert
Flood and Michael Jackson is a catalogue of systems management tools,
with description, analysis and pragmatic evaluation;
- Liberating Systems Theory(1990), by Robert Flood is a more far
reaching thoughtful exploration of the potential to create a systems
philosophy.

Troncale brings a fabulous biological academic perspective to the
systems literature discussion, and it is reflected in his scholarly
analysis. In addition (speaking from systems as a management paradigm
point of view) I found Flood's book particularly useful as a
mega-analysis of what he calls a general theory of systems, which
Troncale is seeking.  I believe Flood's book would significantly expand
Troncale's frame of reference in his 2009 analysis.

Metaphors?  Troncale places a lot of emphasis on isomorphism research,
identification, and quantification, as the chief emphasis of
interdisciplinary scientific work in the field of systems.  An
alternative strategy is for systems science to focus on the s-curve,
before take off, increase, and plateauing, and the reverse s-curve with
alternating stages of deterioration and stabilization.  Most dynamic
systems fluctuate between those conditions.

Alternative hypothesis:
Troncale is looking at too narrow a database.  Robert McNamara
discovered PPBS (Program Planning Budget Systems) in the socio-technical
management thinking at Ford Motor Company, and then introduced it into
the Department of Defense.  Jimmy Carter was elected President of the
United States as a systems scientist.

Al Gore is the most prominent systems scientist active in the media
today, closely followed by the Intergovernmental Panel on Climate
Change.  Within that context, in reviewing the Madison ISSS conference
in 2008, between the climate scientist, the limnologist, David
Waltner-Toews the ecological veterinarian poet, and the health care
systems analyst from the Center for Disease Control, there are the
beginnings of the kaleidoscope of just how pervasive a systems approach
has entered the lexicon of public policy at every level.  The term
ecology has become captured to force the thinker to use a systems
approach.  In housing, transportation, health care, even economics and
the military, it is virtually impossible to avoid using a systems
approach.

There is little room in Troncale's database/analysis for evaluating the
relative impact of a paper printed in an obscure journal that maybe a
dozen people will read compared to a mass media movie in the popular
culture; how do we measure the transformational impact of an Academy
Award or a Nobel prize?

This is my version of the evolution of social thought, using Systems as
an example:

Theory of History of a Good Idea
Almost impossible to articulate (Systems: Von Bertalanffy's, Wiener's)
Crazy
Fringe
Radical (Systems: environmentalism: Rachel Carson's Silent Spring, Paul
Ehrlich's Population Bomb)
New Idea is glamorized by the media (Systems: 1970 Report of the Club of
Rome)
Serious enough threat to be attacked by the establishment (Systems:
1970s)
Liberal, too good to be true
Moderate (where I believe Systems is now)
The Establishment (universal use of the Viable System Model?)
Conservative, the boring status quo
The enemy that the next stage must challenge to defeat
Only History
 
 

How to analyze a system
Complexity can be made tractable by reducing it to an interaction
between empirical levels of observation.  Notice that this type of
analysis is a very different solution from reducing a multileveled
system to a small set of variables, over which tight control is
exercised.  The goal is not to eliminate multiple levels, but rather to
identify their boundaries and infer causal relations between them.  
Addressing complexity one level at a time breaks the phenomenon into
components that are still manageable in terms of memory and information
processing.  After that analysis, one has a grasp of the levels
individually, and can begin to piece them back together into a whole.  
We should emphasize that putting them back together is not a matter of
simple summation, because different levels involve differently scaled
subsystems.
     By being aware of the scale of one's investigation, the student of a
complex system can shave off a level from the entirety of a phenomenon.  
Once each level has been analyzed, then the set of levels may be pieced
back together according to their scale and observational criteria.  The
resulting hierarchy will be a coherent set of explanations that answer a
particular question.  The levels above give meaning, while the levels
below explain by giving the origins of behavior.  [Hierarchy Theory: A
Vision, Vocabulary and Epistemology, Valerie Ahl and Tim Allen, 1996:
This is how the Viable System Model by Stafford Beer works.]

Jon Li
Davis CA LWV Health Care Committee
Witness, Manatee FL LWV
US LWV Health Care Interest Group  Newsletter Committee
Institute for Public Science & Art
Transforming US Care Organizer
 


 
 
-------- Original Message --------
Subject: draft: sub-working group on domestic policy (social and health)
Date: 2024-02-09 11:50
From: jonli@dcn.org
To: Peter D Tuddenham
 
Jon Li is the author of the Reader's Guide in the 2nd edition of 
Platform for Change by Stafford Beer (1975, 1994)
 
For me, the purpose of archives is to utilize the work of the past to 
access ways to see into the future.
 
TIMING OF MEETING
I propose that the group on domestic policy (social and health) convene 
at 5 pm ET US first and third Fridays monthly through May
 
THEORY
In discussion, Peter Tuddenham defined our boundary as the word 
"cybernetics" which I believe is a cult word without common agreement 
about the definition; the advantage is it creates a population that has 
self-selected to celebrate the word cybernetics with their own 
definition.
 
I prefer the larger sub-population of the word "systems" which has a 
more generic common amorphous definition that most people would 
understand to mean the same thing.
 
Theory of History of a Good Idea
Almost impossible to articulate (Systems: Von Bertalanffy's, Wiener's)
Crazy
Fringe
Radical (Systems: environmentalism: Rachel Carson's Silent Spring, Paul 
Ehrlich's Population Bomb)
New Idea is glamorized by the media (Systems: 1970 Report of the Club of 
Rome)
Serious enough threat to be attacked by the establishment (Systems: 
1970s)
Liberal, too good to be true
Moderate (where I believe Systems is now)
The Establishment (universal use of the Viable System Model?)
Conservative, the boring status quo
The enemy that the next stage must challenge to defeat
Only History
 
Letting the cat out of the bag:
I believe that systems science is about consciousness, about 
transcending the dominant male paradigm of linear oral argument with 
experience; instead of using analog to attempt to describe how the 
components of nature fit together mechanically see the natural world for 
what it is.  Teaching men how much better women think.
 
My work is helping women organize transforming the US health and social 
care delivery system.
This involves socio-technical analysis at every functional level: 
biological, organizational, financial, information science, 
psychology/sociology/economics/political science/technology, ecology, 
epidemiology; it converges the meaning of life, the role of the family, 
personal recovery and health maintenance, and how the world has dealt 
with the pandemic and its economic and social consequences.  What we 
have learned from the pandemic is that the modern hospital and medicine 
are ill equipped to address the problems of a growing aging population 
which requires palliative care: the current system is exploding and 
dying.
 
PRAXIS
Proposed Project to the June ASC Convention
I have several proposed uses of applying general systems theory to 
practical social problems (based on applying the VSM).  I propose that 
our work group categorize efforts for social improvement as a way to 
organize material for the past which might prove useful in the 21st 
century.
 
I invite other ideas to consider.
 
1. V. Brazilian Health VSM 12 Layer Analysis 1.0
VSM1 of conception of Brazil’s health (including voodoo, African, 
primitive, native, evangelical Christian)
VSM2 of Brazil’s health: Organized Happy Society
VSM3 of Brazil’s health care system resources: Organizing the system
VSM State Level Health Care (Sao Paulo): Guarantee access to complex 
levels of care
VSM Basic Care Clinic (Basic Health Unit): Promote physical, mental and 
social well-being
VSM4A of Brazil’s unified health system (Sistema Unico de Saude): 
healthy populations and individuals
VSM4B Brazilian Private Health System: Healthy Individuals and Profit
VSM5 is in a particular State of Brazil: Sao Paulo: Guarantee 
Specialists Consultations
VSM6 is the municipality’s total health resources: Guarantee Primary 
Care Full Coverage
VSM7 is the health service delivery area of the particular program: AIDS
VSM8 is the particular program: AIDS: Universal Access and Empowerment
VSM9 is the clinic: Healthy and happy population
VSM10 is the Health Family Team: population full coverage: physical, 
mental, social
VSM11 is the interaction with a particular patient.
 
The DAY Stella and Jon gave this paper to ISSS with Allenna Leonard, the 
British ECONOMIST ran a story the NHS(E) needs to do what we proposed, 
essentially add more nurses. (attached)
 
230211 VSM NHSE
Brazil Health VSM 12 Layers
 
 
2. National Health Service (England) 230211 VSM NHSE
4 Recommended Actions (672 words).
Savings from Recommendations #1 and #4 pay for Recommendations #2 and 
#3:
 
1. Minimize NHSE-GP bureaucratic conflict: Because General Practitioner 
(GP) contracts are national rather than by city or county jurisdiction, 
hospitals, clinics, ambulances and behavioral health services are 
dis-organized as "Trusts".  Attempts to integrate patient care at the 
national-regional level, whether Coordinating Care Organizations or 
Integrated Care Systems, only add bureaucratic complication and the 
potential for confusion.  A GPs' scope of practice of 2,500 patients is 
more manageable the more dense and less scattered it is: better quality, 
consistency and continuity of care.  If GPs signed BMA-negotiated 
contracts at the NHSE city/county level, NHSE could re-align to become 
co-terminus with city/county boundaries, service delivery systems and 
bureaucracies.  Eliminating the need for Trusts would improve patient 
care communication between providers.
2. From Institutions to Home Support: Since local government is 
responsible for social care, the quality of home care is so inconsistent 
as to be a national disgrace.  Patients are being stranded and 
warehoused because of the lack of palliative support and in-home care. 
Hunt: "A hospital bed costs at least £300 a night, but a bed in a care 
home £100 a night and a homecare package typically £50, depending on 
hours worked."  Making home health work would require a national program 
to shift NHSE resources towards more palliative trained staff.
3. Make RNs Full Team Players beside MDs rather than their servants: 
nurses have come a long way since Florence Nightingale, except in 
England which has the worst nursing working conditions in Europe, the 
lowest pay, and over 10 per cent vacancies.  RNs may only have half as 
much education as MDs, but they provide the ongoing care that MDs 
"Consultants" must depend on if the patient is to get better.  This 
requires a shift from the patriarchy and the class-orientation that too 
often frustrates the ability of NRs to inform MDs of what they are 
ignoring at the patient's expense.  RNs and related allied health 
professionals should receive a 10 per cent across the board pay raise.  
Recognize the RNs' scope of practice includes supervision of home health 
and other alternatives to institutionalization as the health system 
shifts from ambulances, emergency care, surgery, hospitalization and 
focus on drugs to hide the symptoms to palliative care, recovery and 
better health outcomes.
4. Computers to Improve Patient Care
Considering NHSE is supposed to be one unified system, its IT system is 
chaos.  How can computer support 1) the patient, 2) the health team, 3) 
the management, 4) the future?  Political attempts to manage the NHSE 
using marketplace price competition have proven ineffective.  By 
shifting the mindset to a public utility model, NHSE can design the 
protocol for a computer program that enhances patient care.  NICE 
cumulative data provides a benchmark for establishing ongoing standards 
of care for daily review.  The computer program needs to be so 
human-oriented that it is a "computa" program.  It needs to be able to 
document, manage and evaluate: ongoing patient care; health 
professionals work distribution, scheduling and compensation; 
coordination of clinics, specialty medical services, surgeries and 
hospitalizations (including ongoing accountability to the primary care 
provider); quality control and comparisons to current best practices; 
education and training of health professionals; regulatory compliance 
with national and city/county standards on a daily basis; research 
protocols for individual patients as part of ongoing cohort studies 
(without violating privacy or confidentiality; and, assessing community 
health needs for the near term, and for future generations; concluding 
with the financial and management information systems (which dominate 
current computer design, and why this is designated as a "computa" 
program).
Today's health care challenges are: to improve health care provided, 
improve health outcomes, manage costs, and provide a supportive work 
environment.  The 1,4 million people who work in NHSE have a tremendous 
responsibility. The Government has a responsibility to make it possible 
for the NHSE to be the best health system in reality and not just 
theory.
 
3. Vermont League of Women Voters Resolution to end Privatization of 
public goods like health and social care
https://lwvhealthcarereform.org/wp-content/uploads/2024/02/VT-Concurrence-Statement-w-date.pdf
 
4. For the International Group as well:
The Iroquois Human Scale Global Governance Process: How a decentralized 
community-focused global governance process could work (attached)
 
Iroquois Human Scale Global Governance Process
 
 
Jon Li
Davis CA LWV Health Care Committee
Witness, Manatee FL LWV
US LWV Health Care Interest Group Monthly Newsletter Committee
Institute for Public Science & Art
Transforming US Care Organizer
 
____
End of Jon Li’s message
 
 
This is a “coexplorer project”  sponsored by the College of Exploration. https://www.coexplorer.org/cybernetics-archives/
I am also a member and trustee of both the International Society for Systems Sciences and the American Society for Cybernetics. In both these organizations I have interests and projects on archives specific to the those organizations. https://asc-cybernetics.org/wg-archives/        https://www.isss.org/home/  (links in the library are for members only)
They are related through me but are distinct from this “coexplorer project” and specific to each organization. I am also a member of the UK Cybernetics Society.
 
Peter Tuddenham