From the new May-June 2013 issue of News & Letters:
by Htun Lin
California’s notorious Three Strikes Law took any human judgment out of sentencing by mandating 25 years to life for a third conviction, even for something as inconsequential as a stolen pizza or bike. California’s prison gulag grew astronomically as courts became machines denuded of a judge’s discretion.
The prison system itself became an even more abusive criminal monster, now under the supervision of the courts. The unintended consequences became so extreme that a new proposition just passed in California to give judges some discretion to reevaluate sentences for non-violent third strike offenses.
Mechanical justice took on a new angle with the advent of ubiquitous video-surveillance cameras at traffic stoplights. Computer-generated identification is a gold mine for municipal revenue enhancement, churning out tickets at $500 a pop for technical infractions like not coming to a full stop before turning on red.
New digital surveillance technology provides precise evidence of technical guilt. With no wiggle room, there is no way for human judgment to catch up.
The phenomenon of human beings losing a race with machines is especially pernicious in the healthcare workplace. The computer has become the virtual boss of everyone in the shop, by setting the pace of everyone’s job.
PROFIT MOTIVE FIRST AND LAST
Advanced digital technology, touted for its far-reaching precision, was originally promoted by HMO advocates during the healthcare reform debate as a way to enhance healthcare delivery. But when deployed by corporate interests, it is really about cost-cutting and revenue enhancement.
Doctors at the HMO where I work are not only facing ever-increased speedup, but also are monitored by the computer. Because their workloads have become so huge, often doctors are caught making a choice between charting duties or taking care of the next patient.
A doctor’s daily routine has been profoundly transformed through ever-increasing speedup and mechanization. Karl Marx warned us that the capitalist will increasingly transform every single profession in society, driving them into the ranks of proletarians, even professions hitherto considered sacred, from men of letters and jurists to teachers and doctors.
For HMO accountants and administrators, foremen of the modern healthcare assembly line, charting is a “cover your behind” legal matter as well as a way to speed revenue recovery. They instituted a sort of scarlet letter punishment method, publicly announcing that a doctor has been suspended due to a backlog of incomplete charts.
It was shocking to see so many doctors, whom I have known for many years as life-saving dedicated professionals, treated in such a demeaning way. Doctors too have joined the ranks of “indignant hearts” that once belonged only to nurses, housekeepers and other rank-and-file healthcare workers.
We frontline workers know that much of what is called charting has little to do with patient care, but is monitoring the legal and financial aspects of care. Real and chronic systemic deficiencies are covered up, while individual employees, whatever their skill level, become scapegoats.
Everyone—doctors, nurses, lab techs, aides, clericals—is sped up to the point where mistakes are inevitable. The mechanized investigation, discipline and training, instituted to deal with mistakes, has less to do with resolving them than with protecting the company’s legal and financial bottom line.
Punishment is meted out based on precise surveillance data, leaving no wiggle room. Human interpretation of data has been wrenched out of the process, as well as the spirit of the regulations and guidelines that were written supposedly with healthcare in mind.
Recently, the California Department of Health issued a sanction against Kaiser when its investigation, triggered by patient and staff complaints, determined that the HMO systematically denied patients access to prompt and adequate mental healthcare. Patients are corralled into group therapy to manage short staffing and other cost cutting policies.
The computer with its air of objectivity has come to dominate human beings. The usurping of human judgment pervades all of society, from healthcare and education to manufacturing and the judicial sphere. Human empathy and understanding have been replaced by automated thinking that mimics the computer. Reclaiming our own minds is a step towards human freedom.