Concerns vs. Ideology

It strikes me that we often can’t seem to find solutions to policy issues in the developed world because too many of the stakeholders involved are unnecessarily strict with the application of their individual ideologies. For example, numerous socialist groups in the United Kingdom have been voicing concerns about debt econmies recently. But as far as I can tell we don’t really have an alternative to capitalist style debt based economies, and they certainly have a great many things going for them (e.g. high growth, easy access to jobs for university leavers etc). The solution then, is not so much to instigate a revolutionary overthrow of the entire debt based system, but to attempt to mitigate the bad things about debt economies, notably the boom/bust cycle.

What do I mean by this? Well, the GFC was in large part the result of Alan Greenspan following his neo-liberal ideology into the toilet. That particularly system of theories suggests that de-regulation leads to maximum growth and efficiency, and that self-interest will prevent banks from destroying themselves. We have all seen where that got us – a huge boom, followed by the biggest bust in economic history. Now my opinion is that neo-liberal ideology let us down a little, but that there are very strong and useful parts to it (notably the stuff from Hajek on why free markets are better than command and control systems). So let’s meet in the middle. Let’s keep a debt economy, but introduce ‘some’ regulation to reduce the intensity of the boom/bust cycle. This is essentially what we have in Australia with our bank regulations. Australia is a debt economy that operates in an even, consistent fashion. It is a healthy, effective means of dealing with the underlying concerns of both socialist and neo-liberal ideologies, rather than a wholesale adoption of either of their respective principles.

Now the key word that I want to talk about is concerns. In any policy issue, different stakeholders are going to have different concerns. What we need to focus on is understanding those concerns independently of the ideologies from which they are stemming, and address them equitably. In this way we develop a truly thriving bi-partisan society that is productively centrist. As an example of what I am talking about, I would like to talk briefly about approaches to the kidney supply in Australia. Right now Australia does not have enough kidneys for transplant. We currently make use of a system for collecting donors that involves procuring organs from cadaveric (dead) sources. This system employs anonymous altruism. The relatives of the deceased sign away their organs for transplant into individuals unknown. This system is not producing enough kidneys. Some inroads into the shortage have been made by utilizing live donors, but the number of people willing to undergo serious surgery without compensation is minimal. An alternative model has been suggested, largely by economists and the like, whereby living individuals are financially compensated for donating a kidney (we have two and can live with one). This model would, in theory, produce a dramatic increase in the number of available kidneys. Unfortunately, the proponents of the current model have rejected it, because it alienates individuals in society from each other. The current model fosters social solidarity – we take care of each other because it is the right thing to do, rather than because we are compensated, either financially or through reciprocity. Commercialising kidneys would result in people only helping each other when it allowed them get ahead – is this the kind of society we want to live in?

Now my impression here is that we have two ideologies – commercialisation and the gift of life doctrine (this is the name given to the system that emphasises anonymous altruism). Each has a particular concern – quantity of kidneys, and social capital respectively. Now refining the particular arguments of either side is not going to break the current stalemate. The ideological positions are incompatible, in a fashion similar to the positions of pro-life and pro-choice campaigners in the United States. The concerns of each ideology however, are not. We can find policy solutions that both improves kidney supply and increases social capital.

Here is my proposal in brief (for more information, you can borrow my honours thesis “Commercialism or Community? Approaches to the Kidney Supply in Australia” from the ANU library): let’s utilize kidney exchange in greater quantities. This is a system where people in need of a kidney who have found a willing live donor who is either blood or tissue type incompatible with them put their names down in a database and are matched with a couple in a similar situation in another part of the country. A 2 way kidney ‘swap’ occurs, where one donor kidney goes in the opposite recipient and vice-versa. Everyone is happy. Mathematical modelling of kidney swap has suggested that maximum efficiency can be achieved with pools of 300 donor pairs, which is possible in Australia. An effective, well-organised donor swap program essentially turns any donor into a good donor. Even an old person could potentially donate to a young individual, because a sixty year old recipient does not need a 20 year old’s kidney, and a suitable match could potentially be found. What this means in practice is that if I am diagnosed with kidney failure I can approach my social network – sports clubs, bingo groups, church, union etc, and ask if anyone is willing to be a donor. A donor is much easier to find, enabling more transplants. Moreover, perhaps more than one person volunteers, who can then be matched to another recipient elsewhere in the country. Having more live donors also increases the potential for cadaveric sourced kidneys to be transplanted into individuals without a social network to approach.

In terms of ideology, what this proposed model achieves is a shift from macro level anonymous altruism to micro level directed altruism. It overseas a shift from the construction of social capital on a societal level to the production of social capital on a community level. It thus addresses the concerns of both the commercialisation ideology – namely, increase the kidney supply – and the gift of life camp – improve social solidarity. By focussing on concerns rather than total ideologies, we arrive at an effective, bi-partisan solution that moves the country forward. Another good example of such an approach is the HECS system, which saw an effective resolution to the concerns of left-wing groups seeking better access to education, and right wing groups that wanted to see an efficient funding mechanism.  As much as ideologies are important discoursive mechanisms and important to our discursive democratic process, when it comes to policy solutions, I can’t help but think that a focus on the underlying, practical, and specific ‘concerns’ of ideological groups would be more productive that the constant partisan bickering we currently see between our major parties. What I am curious about though, is whether this is how things already work in the public service? If someone who works in said service could fill me in, I would be very appreciative.