We’re looking at a scenario where there’s no more agriculture in California… up to 90% of the Sierra snow pack could disappear, all but eliminating a natural storage system for water vital to agriculture

Steven Chu, Nobel laureate, secretary of energy, and a really smart guy, says

“I am sitting at my window watching it rain in coastal southern California, ground zero for the biggest series of rainstorms in memory. The amount of rain and snow is probably sufficient to eliminate any threat of water shortages for the next three years. Aside from the local flooding and overall misery, this is very good news, both for the local California agricultural economy, and for food prices for the rest of the country. The widely expected disaster is avoided for a little while longer.”

Once again, many well-researched predictions, made by serious and intelligent people, have been rendered almost comical by the overwhelming capriciousness of nature. This is not to say Dr. Chu will not be correct in the long run. In fact, in any sufficient time period, he is almost guaranteed to be right, someday there will certainly be a severe drought, just not now.

Although tangential to health care policy, there is a deep lesson to be learned here. Predictions about complex systems are fraught with error, and are difficult under the best circumstances. History is rife with examples of expert predictions that turned out to be not only wrong, but downright silly.

Medicine makes you a skeptic pretty quickly. The human body is one such complex system. For complex systems, although desirable, easy, simple and reasonable explanations for things often don’t work. On occasion, simple solutions may work, but simple explanations often fail. People get sick, better, respond to treatment, or suffer complications based upon thousands of interactions far beyond our ability to understand. We use judgment and experience as an excuse to explain away what we don’t comprehend. As much as we do know, we don’t know far more.

Complex systems such as weather are inherently resistant to understanding and manipulation. Attempts to manipulate health care policy fall prey to the same demons. My recurring theme has been the plethora of unintended and negative consequences inherent in any attempt by a partisan, corrupt, and uninformed Congress to transform the transcendentally complex health care system based upon good intentions and magical thinking.