The Tale of the Fancy Sea Creatures and the Pipes

Once upon a time there was a land on the ocean. The people lived off of the food from the ocean and were very happy. But as they grew bigger, they had a problem: they made a lot of waste! Yuk! Nobody likes waste. What could they do about all of this that stuff that nobody liked?

Some said that they should find a way to make less waste. They said that the people of the land were not smart and should be making less waste. But most of the people in the land didn’t like to change what they were doing. It’s hard to change. So they built a large pipe that pumped the waste into the ocean.

The land was clean again and the people were happy!As time went on, they had to build more and more pipes to handle their waste. Nobody ever tried to make less waste because they could just make more pipes and pump it into the ocean. This even built a very successful industry of pipe-workers. This helped the economy.

But then one day something terrible happened. The pipes pumping waste killed off several species of sea life. This made the environmentalists in the land cry out in protest. But as it stood, the number of species in the ocean are so vast that the killing off of a few of them was felt to be no harm. So the pipes kept pumping. The people still could be happy with a few less species.

And then came a day when something magical happened. New species of sea creatures formed around the pipes. These creatures fed off of the waste and thrived around these pipes. These new creatures became very big and very fancy, and this made the people of the land very happy. What were the environmentalists all worried about? So what if a few species had died off; there were new exciting species being formed! The people were so excited that they made even more waste and more pipes so they could make more new species of sea creatures.

What fun!

Now, these fancy new creatures were hungry. They ate all of the waste and wanted more. They ate most of the other sea animals and wanted still more. They couldn’t get enough food. So they sent lobbyists to the government of the land to get them to build more pipes and send more waste. The creature lobby was very rich, and so poured lots of money at the government of the land. This made the politicians very happy. So the happy politicians told the companies of the land to make more pipes and send more waste out to the sea. And the sea creatures were happy.

And so it went for many years: more pipes sending more waste making more fancy sea creatures eating more waste sending more lobbyists to make politicians get more companies in the land to build more pipes. Everyone seemed to benefit from this nice arrangement! Maybe they’d be happy forever!

But one day, some of the people of the land got tired of putting all of their money into building pipes to send waste. They thought their land should stop making so much waste and start putting those resources into schools, food, and fighting crime. The government was raising taxes more and more so that they could afford to make more pipes. This made these people mad because some people couldn’t afford any more taxes. Paying for all of this waste was too much.

But the lobbyists from the sea creatures put commercials on television saying how good the waste was. In fact, having so much waste made the land one of the best lands anywhere. They pointed out how many new sea creatures came to be because of this waste and how other lands couldn’t do this. The pipe manufacturers also made commercials telling about all of the jobs these pipes were creating. They all made so much sense!

They also sent more money to the politicians so they would ignore the people who couldn’t afford paying for the waste.

But then some of the people of the land ran out of money and stopped paying taxes. This made the government mad, and so it left these bad people to live in their own waste. Many of these people became sick in their waste, and some of them died. Finally, the cry of the people was loud enough that the politicians in the land took notice. They decided that all of this waste was a real problem. No other land had so many pipes sending so much waste. True, there were lots of fancy new sea creatures, but the people in the land were getting angry, and some were dying.

But the politicians started fighting. One group of the politicians decided that the pipe-making companies were the problem. They thought that the government should take over the pipe-making job and guarantee waste pipes for every home. Others thought that the government could never do as good of a job as the companies did. They said that those people who couldn’t afford pipes were dead-beats and probably deserved to die.

They held town hall meetings to talk about who should be making pipes, and people got very angry.

Finally, someone who wrote a waste-pipe blog suggested that perhaps the problem wasn’t the pipes, but instead it was the waste. He said that the people should find a way to cut back on the waste, and so need less pipes. The blogger was criticized sternly, because his suggestion would have very bad consequences. The new fancy sea creatures that made everyone so proud would die off if they cut back on waste, and the pipe-workers would lose their jobs and be very sad. Plus, people didn’t want the government telling them how much waste they could make. It’s a free country, and people should be able to make waste without the government rationing it.

But as the people of the land thought about what this blogger said, they saw the sense in it. Yes, the sea creatures and the pipe manufacturing companies put very moving commercials on TV about dying sea creatures and unemployed pipe workers. They were very sad commercials and they made a lot of people weep. But the people of the land realized that this land was for people to live in, not for pipe companies or fancy sea creatures. Yes, it would be sad to not have those fancy creatures, and they’d have to get new jobs for the pipe company workers, but it was the only way.

Oh, it was hard to cut back on waste and kill off the fancy sea creatures. People got very mad and lobbyist groups tried to change laws or pay off politicians. But this was a good and smart kingdom, and they didn’t listen to the creatures any more. And finally the day came when the sea was clean again and the people had enough money.

And everyone was happy.

Rob Lamberts is a primary care physician practicing somewhere in the southeastern United States. He blogs regularly at Musings of a Distractible Mind, where this post first appeared. His writings have been described by observers as – among other things – “strange, yet not harmful” – a description we think fits him pretty well.

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6 replies »

  1. I can’t stop appreciating you.
    Your comparisions were superb.
    The whole stuggle of the people is expressed in a simple way.I like your thought of imagining the present situation as “waste” “pipe” and “ocean”.
    Please carry on with such work as this would be an inspiration for many others.
    Good job….

  2. Rob,
    Your parable is interesting but fails to capture the essence, I think. The reason that “waste” is created in the real world is that the “land people” cannot recognize what is “waste” and what is not. Largely, it’s the information asymmetry between the physician and patient that creates such waste while the patient is not even aware of waste being created. In some cases, “pipes” actually work towards minimizing “wastes” – of course, purely out of their self-interest – by denying wastes being created in the first place, so that they can keep the up-front waste management fee without doing any work (meaning more profit).
    I don’t see that kind of dynamics depicted in your parable.

  3. “Also, the letters after my name are MD, not GOD!”
    That’s funny, because when I used to have access to a PCP (before he quit to become a bartender in Cuba), he infomed me that MD actually stood for minor diety.

  4. For those who didn’t catch it:
    Waste = Waste on HC
    Pipes = Insurance providers
    Sea Creatures = Businesses that thrive off of waste in HC, such as device manufacturers, drug companies, specialty physicians, HC bloggers (oops, omit that last one).
    HC blogger is, of course, Matthew Holt (grin).

  5. The current bill does not address the issue of cost-control, so this is completely relevant and unchanged. The bill talks about how things are going to be paid for, but does not do anything about what will be covered. Those creatures living on the waste will thrive just fine.

  6. Yes, it is a quaint post you have composed, but it is near the end of this reality as I type this, with the House to pass this creature of legislation.
    Sorry to have to write this here, but, maybe this site may become at least a bit irrelevant once the Democrats sell the lie enough that the public buys it, figuratively and literally, that Democrats have saved America.
    November of 2010 can’t come fast enough for me. Unfortunately, 2014 won’t come fast enough for the rest of this country to learn what is true, and what was farce, er, false.
    Just watch how so many of the salesmen/women for this snake oil disappear from public view before 2014. Take the money and run.
    I’ve been dismissed before, only to unfortunately hear later, “why didn’t you do something sooner!?”
    No red letter S under my shirt, Americans!
    Also, the letters after my name are MD, not GOD!