The MHA sends a link to on-line health care news on a daily basis.  Two weeks ago there was a link to the below article in the St. Louis Post Dispatch.  I contacted Kevin Horrigan, the author, and he granted me permission to use the article on the blog.  The article is titled “Keys to Success” and I thought he had a great take on nature vs. nurture and relating it to health care reform – a unique take that I enjoyed and felt was worth sharing.  Remember, this is a blog so opinion and perspective are O.K.


It was suggested here a week ago that opposition to federal health care reform was a lot like people inside the lifeboat using their oars to whack people who are still flailing in the water.

The wisdom of that suggestion was challenged by several correspondents, one of whom wrote that “we in the lifeboat have spent our working lives to ensure the lifeboat is in good repair with oars and lifejackets. The people you weep for live their lives like a slo-mo trainwreck. They would swamp the lifeboat and not even lift a finger to work the oars.”

I’m sure it comforts people in the lifeboat to think that somehow they deserve to be there and other people don’t. But let’s face it: The biggest part of why some of us are in the lifeboat and others aren’t is just sheer luck.

Warren Buffett, the famously folksy, incredibly rich guy, has a phrase for this. He says he won the “ovarian lottery,” being born in the United States in 1930, when the odds were 50-to-1 against.

The odds had shortened by the time I came along 19 years later. The world population was 2.5 billion at the time and the U.S. population was about 149 million. It was only 17 to 1 that I’d be a U.S. citizen, roughly 45-to-1 that I’d be a white male U.S. citizen, whiteness and maleness both being huge advantages in my lifetime.

So I had that going for me.

I chose parents who, while not college educated themselves, were adamant that their children would be. They sacrificed to send us to Catholic schools. I caught a lot of other breaks and wound up working for a big-city newspaper as I was going to graduate school.

Thanks to my parents’ insistence, I worked very hard, but so did a lot of other people. Scientists, as Malcolm Gladwell discusses in his 2008 book “Outliers,” increasingly have concluded that achievement has less to do with talent than it does with opportunity.

Many people, Gladwell notes, don’t want to believe this. When Jeb Bush was running for governor of Florida two years before his brother ran for president, he — grandson of two wealthy bankers, one of whom later became a U.S. senator, and son of a president of the United States — often referred to himself as a ‘self-made man.”

Furthermore, Gladwell writes, extraordinary achievement — on the order of Bill Gates or the Beatles — requires not only high levels of innate talent but also extraordinary opportunity that permits you access to the tools for whatever it is you want to get good at and enough time to put in 10,000 hours of practice.

To get really, really good at almost anything takes talent plus 10,000 hours of practice. Who’s got time for that unless he’s really lucky?

Buffett’s “ovarian lottery” and Gladwell’s opportunity rule both can be seen as corollaries to the work of John Rawls, an American political philosopher and author of the 1971 book “A Theory of Justice.”

You can test a vastly simplified version of Rawls’ theories at home, like a parlor game. Get a few gross of ping-pong balls, label them with a variety of demographic factors, put them in a hopper and invite a whole bunch of people over, liberals as well as conservatives. (My experience is that conservatives tend to bring tastier food, so invite a lot of them).

Tell them that the object of the game is to create rules for a society that they themselves would have to live in. But here’s the trick: Everyone starts from what Rawls called the “original position” behind a “veil of ignorance.”

“No one knows his place in society, his social status, nor does anyone know his fortune in the distribution of natural assets and abilities, his intelligence, strength and the like,” Rawls wrote. “I shall even assume that the parties do not know their conception of the good or their special psychological propensities.”

Forget about trying to create a fair society for the entire world. The United States has 5 percent of the world’s population, so if you’ve got 40 people at your party, only two of them would get to be U.S. citizens.

Limit yourself to the United States. For race, you distribute 40 ping-pong balls. Your guests can figure that they’ve got a 2-in-3 chance of getting a white ball once the veil of ignorance is removed. One in three gets to be minority, which could make things a little harder for them.

When you pass out the wealth balls, eight of your 40 guests are going to wind up controlling about 84 percent of all forms of wealth. It’s 4-to-1 against that you’ll be one of them. Plus, you’ve got a 1-in-5 chance of living in poverty.

You’re going to have ping-pong balls for intelligence, too. Half of your guests will wind up with IQs below 100. Anything less than 90 is below normal, which severely hampers their prospects, unless they get a very rare Derek Zoolander “incredibly good looking” ball to compensate.

In round numbers, four of your guests will get “unemployed” ping-pong balls. Six of them will get a “no health insurance” ping-ping ball.

Rawls suggested that with “original position” arrangements, no one would want to gamble that he’d be on the outs. Groups would design societies that were fair, particularly to the least advantaged.

As I recall from the Catholic education I lucked into, Rawls was not the first guy to think of this. In the fifth century, St. Augustine of Hippo wrote, “God does not demand much of you. He asks back what he gave you, and from him you take what is enough for you. The superfluities of the rich are the necessities of the poor.”

Copyright 2011 All rights reserved.

About Craig Thompson

I am a young professional with two great sons, and I work in the healthcare setting. I am employed in hospital administration and serve as Chief Executive Officer at Golden Valley Memorial Healthcare in Clinton, Missouri. At GVMH we care for our families, friends and neighbors. We're committed to providing the safest, friendliest and most compassionate care to all we serve.
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