After all the spin masters have finished commenting on the implications and (later tonight) results of the Massachusetts special election, I still believe what we're witnessing is a general pushback against the insistence of progressive political elements that the social safety net we operate above is not sufficient for it's task, or in possession of enough prescriptions to assure our confidence in it. Of course all of this has to do with the level of individual and social risk we feel comfortable living with as a society. In the health care reform debate I wish we had been more explicit about what the tradeoffs involved here really are. Are we willing to trade a certain level of medical treatment development for the a guarantee of a government funded minimum level of care for individuals? The markets can't decide that question for us although they will eventually show after the fact the broad decisions of the population in terms of preferred purchases. Can we live with the individuals who either through fortune, or poor decision making, make a decision which results in their harm? Is the government responsible for constraining the many, to protect the few? Do the majority of citizens wish for such a government?
In my work I'm often forced to think about "What is safe enough?", and "How do we know we're done?" The strictly business types don't exactly welcome this line of questioning. They want to get to market. Who's right and protects the greater public good? I don't know, but I want to at least know the process so I can hold someone accoutable. Here's my process flowchart for addressing failure modes and effects analysis for medical device risk management. It doesn't tell you how to do a good job, but it gives you a framework to make decisions in.
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