THE BLOG
01/01/2013 09:26 am ET Updated Mar 03, 2013

A Lesson in Accountability as U.S. Goes Over Fiscal Cliff

These days it seems that the Internet, news stations and talk radio are all in a tizzy over the "shocking" news that the same people who deliberately created the fiscal cliff -- an onerous set of cuts and tax increases designed to be so drastic that it would force action -- because of their inability to compromise, were unable to hammer out a compromise in time to avert the consequences that they themselves created as an unthinkable alternative to inaction.

Frankly, I am surprised that people are surprised. It was almost inevitable that this would happen. Allow me to explain why... without pointing fingers at either political party or ideology, because in fact it is the system that is broken, in two fundamental and interconnected ways.

First, let me explain why I think the problem is systemic. A former colleague Greg Pawlson MD, MPH (now Executive Director, Quality Innovation, BCBSA) often made the assertion that whenever a system reliably and consistently produces the same results, one must accept that the system was designed to create those outcomes, whether or not those outcomes were the intention of the system's architects.

By returning to elected office a preponderance of those who were already in office, we have created a situation (like the children's game of Tic-Tac-Toe) in which a stalemate is seen -- by both sides -- as victory. What we have effectively created is a Nash Equilibrium.

In Game Theory a Nash Equilibrium (as I understand it) requires two (or more) opposing parties; each of whom chooses his or her moves based on the moves he or she sees the others make. Over time, the players settle into operations that work within that reality -- each continuing to respond predictably to the others. These can be healthy and beneficial systems or highly dysfunctional. One of the unique characteristics of a Nash Equilibrium: actors end up being punished for trying unilaterally to do something different. In healthy transactional settings, that's positive because win-wins keep reinforcing the system by creating positive outcomes. But when the system is not working -- even when change is desperately needed -- all of the players are so invested in preserving their positions that the larger purpose gets lost.

That sounds a lot like what we have seen and are continuing to see in Washington.

The 'locking up' of the system into self-preservation at the expense of the greater good is the fact that the players are being rewarded for their intractability. The fact is that American voters dissociate their actions from the consequences of their decisions. From the vast numbers who stay home on Election Day (passively sending the message that everything is okay with them) to those who separate their own individual vote from the overall national results.

We're so busy expressing outrage and pointing fingers that we are not accepting responsibility for our own part in reelecting the same fiscal-cliff-creating, legislation-stalling, economy-risking people that we gave the lowest approval rate in history. If doing the same thing over and over and expecting a different result is a definition of insanity, expecting people whom we overwhelmingly rewarded for acting in one manner to change that behavior is more than a bit naïve, as any parent knows or finds out quickly.

Consider this; each and every one of the reelected representatives -- no matter which ideology -- can only take their individual reelection as an endorsement of their previous actions and behavior; and the overall low approval ratings as a repudiation of the 'other people.'

We have no reason to be surprised, or even to be upset, with the continuation of that which we endorsed. Nor are we the innocent victims we'd like to pretend. Perhaps now -- just as I encourage consumers to reflect their values and exert their empowerment when they choose where and from whom to shop -- the voting public will start to accept our own complicity in creating and rewarding that which we say we do not want in our government officials.

After all, we're about to be held to account for our own failure (to hold our elected officials accountable for their actions). Again.

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