Class Harmonies in Health Care? The Social-Democratic Way

Researchers in health care, like researchers in education, seem to assume that the current social structures are sacred. They simply research what is there, and assume that any problems must be resolved in terms established by that social structure. There are, of course, possible differences in the way problems are defined or solutions proposed, but there are limits to problem definition or proposed solutions can be forthcoming from the social-democratic point of view. That limit is the class of employers. Social democrats assume–probably without being aware of it–that all problem definitions and proposed solutions must fit into a social structure characterized by a class of employers.

Consider research on what has been called “patient-centred care” (PCC). This idea is similar to the idea of a “child-centred curriculum” that often circulates in school circles.

One researcher, Sara Kreindler  (“The Politics of Patient-Centred Care,”2013, in pages 1139-1150,  Health Expectations, volume 18) argues that there are at least three different groups that argue for PCC, with each one excluding the other two as legitimate representatives of the interests of patients: management, providers (doctors and nurses) and patient advocates outside the health-care system. Each group claims to represent the interests of patients, but they do so by excluding the other interest groups as legitimate representatives of the interests of patients.

Her solution to this problem is to claim that the aspire model (The Actualizing Social and Personal Identity Resources) provides a four-step model that permits the simultaneous recognition of each group’s identity while enabling a synthesis to emerge that incorporates the different views without trampling on each other’s social identity.  The groups are identified through a survey of staff, then each group discusses issues related to its own point of view without the influence of other groups. The third step involves the selection of representatives from each group to come together in order to come to a common vision of what PCC involves. The fourth step is to implement the common vision. Ms. Kreindler argues that it is the process that will lead to change; we should not second-guess the changes required to realize a PCC approach.

Ms. Kreindler, however, argues the following contentious view (page 1147):

While it may be counterproductive to define PCC in terms of taking power or focus away from certain groups, it remains very legitimate to talk about putting patients first.

In the first place, Ms. Kreindler assumes what she needs to prove: that a focus on patient care can exist independently of power relations. She does recognize such power relations when she makes the following assertion (page 1147):

Second, each subgroup discusses the issue separately, defining it in their own terms and using their own language (which may or may not include the term ‘patient-centred care’5). This is very important if staff groups are to have real ownership of the process and make a meaningful contribution; it is even more important for
patients, who have the least power and perceived expertise within the health-care system. Patient/family groups should have a neutral facilitator and not be led (or even frequented) by managers, to avoid the risk of co-optation either by ‘the system’ in general or by whatever subset of managers happens to run the involvement activity.

Ms. Kreindler never questions whether it is really possible to have equality between different “interest groups” in the context of the employer-employee relation and in the  context of the power of a class of employers. We see this problem when Trump argued that workers should go back to work on April 12–despite the biological possibility of many workers being exposed to the coronavirus as a consequence. Workers and many community members in a society dominated by a class of employers are, ultimately, things to be used, and this priority conflicts with any real concept of the patient coming first.

Ms. Kreindler’s belief that somehow managers, as representatives of employers, can somehow be treated at the same level of power as professional groups and patient advocates has little warrant. Since employers have control, in one way or another, over budgeting, finance, health facilities and wages, they ultimately call the shots concerning patient care. This situation does not mean that some of the power of managers cannot be limited. Such a limitation, however, is similar to the limitation of collective bargaining and collective agreements. Employers may be forced to grant some concessions, but this hardly means that they are not the primary power holders in the situation.

One of Ms. Kreindler’s implicit views is that the employers’ interests (represented by management) and the interests of employees can somehow be reconciled. An alternate view argues the contrary:

One highly useful example from the empirical literature that illustrates
the effects of process alienation is that of Whitehall I and Whitehall II studies
of Whitehall civil servants (Marmot et al., 1997, 1999). Forbes and
Wainwright (2001, p. 810) have commented, but do not develop further, that
the evidence and results from the studies appear ‘to be directly related to the
Marxian concepts of alienation and exploitation’. The research has identified
that among civil servants of differing ranks there are decidedly different
experiences of health that appear to relate to how much control a worker has
in their workplace. Looking more squarely at the studies a picture of how
process alienation is at play can be established. In both studies, there is a
clear social gradient in mortality (Marmot et al., 1984) and morbidity
(Marmot et al., 1991). In these studies we see how a worker’s health is
affected by the extent of their control (examples being, choosing what to do at
work, in planning, or in deciding work speed) within their working
environment (Bosma et al., 1997), and how on a variety of measures the health, whether physical (for men and women) or mental (mainly for men),
is influenced by the position or rank that they hold within the organization
(Martikainen et al., 1999). This chimes very much with the alienation that
arises out of the labour process where ‘[i]nstead of developing the potential
inherent in man’s powers, capitalist labour consumes these powers without
replenishing them, burns them up as if they were a fuel, and leaves the
individual worker that much poorer’ (Ollman, 1976, p. 137).

Ms. Kreindler assumes that in a relation characterized by economic dependence, hierarchical authority and detailed division of labour, the interests of management and health employees can somehow converge by putting the patient first. Her assumption reminds me of Professor Noonan’s assumption of class harmony at universities (see The Poverty of Academic Leftism, Part Five: Middle-Class Delusions). Both magically wand away the antagonistic interests of subordinates and superiors in public institutions.

In relation to the principle that patients come first, it is too much to believe that patients will ever really come first when human beings are evaluated on the same level as things: they are a cost, in money terms, and such costs, when set in the context of a society dominated by employers, must always be considered in relation to “alternative use of resources” for such things as buying medical equipment, medication, and so forth, internally, and in relation to the diverse expenditures in other government departments for the maintenance of a society dominated by a class of employers.

Related to this issue is the reason why a hierarchy of skilled and less skilled workers arises in the first place; such a hierarchy has advantages from the point of view of the class of employers. Charles Babbage (a pioneer in developing some principles of computer construction in the nineteenth century), published a book in 1832 titled On the Economy of Machinery and Manufactures, where he pointed out a major advantage for such a hierarchy. From Harry Braverman, Labor and Monopoly Capital: The Degradation of Work in the Twentieth Century, pages 79-80:

In “On the Division of Labour,” Chapter XIX of his On the Economy of Machinery and Manufactures, the first edition of which was published in 1832, Babbage noted that “the most important and influential cause [of savings from the division of labor] has been altogether unnoticed.” He recapitulates the classic arguments of William Petty, Adam Smith, and the other political economists, quotes from Smith the passage
reproduced above about the “three different circumstances” of the division of labor which add to the productivity of labor, and continues:

Now, although all these are important causes, and each has its influence on the result; yet it appears to me, that any explanation of the cheapness of manufactured articles, as consequent upon the division of labour, would be incomplete if the following principle were omitted to be stated.

That the master manufacturer, by dividing the work to be executed into
different processes, each requiring different degrees ef skill or ef farce, can purchase exactly that precise quantity ef both which is necessary for each
process; whereas, if the whole work were executed by one workman, that
person must possess sufficient skill to perform the most difficult, and
sufficient strength to execute the most laborious, ef the operations into which
the art is divided. 13

To put this all-important principle another way, in a society based upon the purchase and sale of labor power [the commodity the worker sells on the market, different from labour since workers, when they labour, have already sold their commodity], dividing the craft cheapens its individual parts.

Ms. Kreindler does not even consider the issue as relevant; indeed, I doubt that she is even aware of the issue. She blindly assumes the permanent status of a hierarchical division of labour.

Of course, there may be other conditions which involve a hierarchical division of labour than the allocation of diverse skills to different individuals for the purpose of cheapening the total wage bill, but this process undoubtedly forms part of the reason why there exists a hierarchical division of labour.

Some workers in that hierarchical division of labour may, on the other hand, be more autonomous than others. Doctors may, for example, be formally employees at hospitals, but their monopoly of certain skills may give them much more autonomy than other employees. Some or even many may form part of the middle class, but other employees in the hierarchy at work have less autonomy–such as nurses, nurses’ aids, food workers and custodians.

In this situation, the idea of patient-centered care will undoubtedly be focal point for diverging definitions of what constitutes such care. That in the struggle over such definitions patients may not be the real focus is possible. On the other hand, given the power advantage of management to regular employees, it is unlikely that their way of defining PCC will be on the same level as management’s definition. The same could be said of patient-advocate groups. Even if her intent is different, Ms. Kreindler’s assumption papers over differential power relations–to the advantage of management undoubtedly.

Another silence in focusing on PCC is the need to look at the relation between health care and prevention of sickness, injury and disease. In a socialist society, health care would still be important. From  Calum Paton (1997),  (pages 205-216), “Necessary Condtions For A Socialist Health Service,” in Health Care Anal., volume 5, page 209:

A socialist health service in a non-socialist society may be forced to stress care and rescue rather than prevention, health maintenance or the promotion of better health and more equal health status. Nevertheless this may be an important role. Even in a utopian society of perfect health promotion and prevention, people are more likely to die of more complex comorbidities at a later stage in the life cycle. The concept of substitute mortality and morbidity is useful here. 5 As a result simplistic trade-offs which suggest that ‘the more primary care there is, the less secondary care will be necessary’, are unlikely to be true either in the here and now or in the perfect society.

To be cared for with dignity, and to suffer with dignity and to die with dignity–these would all be important aspects of socialist health care.

Ms. Kreindler’s focus on PCC also excludes a major issue dealing with health: its prevention. By focusing exclusively on patients, she ignores entirely the need to consider the prevention of disease, injury and sickness in the first place (at least in the article above). What are the social conditions that increase the likelihood that a person would become a patient in the first place? Undoubtedly, as we become old, we will likely become patients at some stage in our lives–there is no getting around this fact. However, there are social determinants of health as well, and consequently becoming a patient is also often a function of social conditions.

In a socialist society, prevention would be a major focus of social policy and would deal with addressing the social determinants of health problems, ranging from health problems linked to the workplace to health problems linked to environmental conditions, including food processing.

Today, though, many social determinants are largely ignored in favour of focusing on caring for those already sick. Consider breast cancer. It arises in many instances from environmental conditions, and yet most money is allocated to caring for those already inflicted with the disease rather than with preventing it from arising in the first place. From Faye Linda Wachs (2007), (pages 929-931), “Review. Pink Ribbons, Inc.: Breast Cancer and the Politics of Philanthropy. By Samantha King,” in Gender & Society, volume 21, number 6 (December), pages 930-931:

Recent studies reveal that simply removing known carcinogens from products and our environment could prevent thousands of cases annually (Brody et al. 2007). However, funding for such research is limited, while the monies for identifying and curing existing cases is the focus of most efforts. Indeed, many of the companies that fund survivorship continue to use known car cinogens in their products. King points to the fact that despite increased awareness, rates of breast cancer have increased from 1 in 22 in the 1940s to 1 in 7 in 2004. Even if one considers women’s increasing longevity, this still indicates an increase in the prevalence of breast cancer. Moreover, structural factors that affect risk and survivorship, such as socioeconomic status, remain woefully understudied.

Personally, the issue of cancer research funding versus caring for cancer patients hits home. In March 2009, I was diagnosed with invasive bladder cancer, and in June 2010 I was informed that I had a 60 percent chance of dying in the next five years (it never happened, of course). The extent of “inquiry” into why I had cancer was a sheet of paper when I was admitted into the hospital for surgery. Two questions related to the causes of the cancer were: Did I smoke? And did I or had I worked in areas that might contribute to cancer. Nothing more. Of course, scientific research is much more extensive and hardly limited to inquiry into specific personal cases. I did find, however, that no qualitative inquiry into possible causes of cancer indicated a lack of a certain kind of cancer research in the area.

Even worse, in December 2015, I was diagnosed with rectal cancer. In 2016, I asked the doctor why I had cancer again. His answer was: Bad luck.

Of course, I would have preferred never to have been a cancer patient at all–patient-centered or otherwise.

Social democrats in various spheres of society (such as the economy, education, health and unions) generally assume the legitimacy of the hierarchical division of labour in society. They seek reforms within such hierarchy–rather than challenging such a hierarchy in the first place. Ms. Kreindler does the same. She, like her fellow social democrats, assumes that such a hierarchy can, ultimately overcome its divisions and serve the public (such as in the idea of patient-centered care).

The focus of social democrats often result in neglect of the wider picture. In the context of health, Ms. Kreindler neglects not only the importance of the employer-employee relation and its power differentials, but she also neglects the importance of preventing disease in the first place. Being a patient is to be avoided, if possible–and that means balancing health prevention and the inevitable need for health care as we age (or are accidentally injured even in a socialist society).

Rather than assuming class harmony between different sectors of health care, we should seek to analyse the class discord in that field and how such discord can lead, ultimately, to a society without classes. Social democrats, however, by assuming the possibility of class harmony within existing economic, political and social conditions, oppose, practically (and often theoretically) such a move.

Social Democracy or Social Reformism and Trade Unionism: Their Social Limitations and Methodology, Part One

This will be a two-part post, with the second part being a brief focus on the inadequate methodology of social democrats and trade unionists. The radical left need to take measures against such inadequate methodology. I demonstrate briefly their inadequate methodology by referring to John Dewey’s philosophy of human nature and contrast it with one implicit social-democratic view that limits consideration to the immediate human body without taking into consideration the wider context within which the human body operates and lives.

The first part focuses on a discussion I had on Facebook a few weeks ago about the issue of a law passed in Ohio, the United States, which prevents girls who are raped (sexually abused) from having an abortion. I am certainly opposed to such a law, but it is insufficient to simply condemn such a law. It is necessary to understand how such a law could be formulated in the first place if we are to prevent the emergence of such laws (and worse) in the future. Social democrats and trade unionists, however, often merely react with gut feelings that are inadequate to the task of opposing on a wider basis the roots of such laws (and policies related to such laws).

Below I paste a copy of the conservation on Facebook. It is instructive in how limited the view of social democracy or social reformism and trade unionism really is and how ineffective as a consequence their responses will be. It is also instructive how such limitations arise from a typical method that social democrats or reformists and trade unionists use.

To be sure, social democrats or reformists and trade unionists may prevent, on occasion, the formulation and passing of such laws, but since they never address the roots of such laws, they will inevitably be incapable of eradicating the conditions for such laws to arise in the first place.

Tina Faibish, who is the main discussant below, is president of local 552 of OPSEU (Ontario Public Service Employees Union).

Here is the discussion, including my reply. After my reply, there was–silence.

chicagotribune.com


The story of Should 11-year-old girls have to bear their rapists’ babies? Ohio says yes .An impregnated preteen girl in Massillon, Ohio, has drawn national attention to the state’s new, highly restrictive abortion laws.


15Tina Robin Faibish and 14 others
18 Comments
Kristen Bones Disgusting
Raymadawn Hamilton Hell no!!!!!!!
Liz Seaward Ash No they should not…this is disgusting
Natalie Ashlyne Brooke Michener Wtf these law makers have to go who the hell would do that to someone
Fred Harris Undoubtedly this is amoral [should be immoral]–but so too is having to work for an employer. And yet how many among the left really find working for an employer to be “disgusting?”
Tina Robin Faibish Fred Harris come on are you kidding me, you can not look at these two issues as if the level of unjust is similar or comparable because they are not!
Fred Harris Of course, social democrats simply ignore the day-to-day exploitation and oppression of billions of workers (this is so trivial) when compared to the issue of “11-year old girls having to bear their rapists’ babies.” This shows the extent to which the social-democratic left have been indoctrinated into accepting the employer-employee relation–which treats human beings as things.

So “moral”! Such phrases as “decent work,” and “$15 and Fairness” hide the immorality of being treated as things.

The social-democratic left want to present themselves as morally superior, and yet they ignore the persistent and day-to-day subordination of billions of workers to the power of employers.

By the way, I do have a daughter. And she has been treated unjustly in various ways–including being treated as a thing by employers. I neither ignore the other ways in which she has been treated unjustly–nor the way in which she has been treated unjustly as an employee. The social-democratic left, however, do not consider it unjust to have to work for an employer. Their trite phrases, such as “decent work” express their own biases.
Laura Betty Fred Harris really?
Fred Harris Really what?
Fred Harris I have a blog on the issue of the employer-employee relation and the bankruptcy of the social-democratic left–theabolitionary
Tina Robin Faibish Fred Harris this is your MO and why no one is listening. Your comparison is completely off topic, and undermines the legitimacy and outrage as it relates to this discussion. In other words, as valid as your point may be, this is not the appropriate place to reference a comparison that clearly does not exist!
Fred Harris Let us see. There was a topic on Hydro. Social democrats made many unrelated comments on that topic. But if I make a comment in a supposed unrelated topic, it is considered inappropriate.

As for no one listening to me–social democrats automatically do not listen to me–that is to be expected. But some people from India, China, the UK, the US, Canada have gone on my blog.

As for my “MO”: the MO [modus operandi—a typical way of approaching the world or of doing something] of social democrats is automatically to ignore the issue of the power of employers as a class.

As for the topic of being forced to have babies after being raped–of course this should be opposed. My daughter accused the man (Juan Ulises) who lived with her mother of raping her. He was charged, but the charges were dropped because it was his word against hers. She maintains his guilt to this day–and I believe her. Is this on topic?

But social democrats simply ignore the issue of the power of employers which occurs every day at work. They like to consider themselves morally superior as I said above.

To paraphrase the mathematician, philosopher of education and philosopher of science, Alfred North Whitehead: it is very difficult to engage critically with something that you constantly experience every day as normal.

Feel free to delete me from the Facebook account.
Nina Keogh Tina Robin Faibish yup.
Fred Harris From Tina Robin Faibish “come on are you kidding me, you can not look at these two issues as if the level of unjust is similar or comparable because they are not!”

Children grow up to be adults–and in our society, things to be used by employers. According to the moral social democrats, their concerns take priority over the day-to-day treatment of billions of workers. 

Why are they not on the same level? Why focus on this particular occurrence in a particular state? That it is morally disgusting, I fully admit.

However, social democrats–by this person’s own admission–do not find the fact that billions of workers worldwide are treated as things on a daily basis to be of the same moral consideration. But what of the children of today? Is that not their fate tomorrow unless we stop permitting any person to be treated as a thing at work?

Is it moral to ignore the future of children?

Is it moral for the top 20 largest private employers to obtain $59 billion in profit (approximately $59 000 per unemployed person in Canada)? What of the children who suffer because of this?

Etc.

What of the over 200,000 Guatemalans who were butchered during the civil war (including children) in order to defend a system of employers?

Etc.

Or the “morality” of talking about employers paying their “fair share” of the taxes–after they have exploited workers in order to obtain the profits in the first place.

Yup.
Liz Seaward Ash Fred Harris one thing has nothing to do with the other…you’re delusional..
Fred Harris Note the lack of argument here and the lack of establishment of connections–and the resort to insults.

The issue of not permitting female children who are raped to have an abortion has to do with “property rights”–and that definitely has to do with the employer-employee relation and capitalism in general.

The struggle of women (and children) to control their own bodies forms part of a larger struggle to control our lives.

To say that they have nothing to do with each other is absurd–and shows the narrow-mindedness of the social-democratic left.

But that is to be expected–since the social-democratic left do not object to the general control of our bodies by employers but only particular forms. of it.

After all, do they not express such things as “decent work”–while simultaneously not criticizing the power of employers to control our lives at work in various ways. The social-democratic left like to “compartmentalize” our lives–separating out was is necessarily connected so that they can feel themselves morally–and intellectually–superior.

From the book Private Government: How Employers Rule Our Lives (And Why We Do Not Talk About It) (Ellizabeth Anderson–a woman, who probably would be considered delusional by the social-democratic left), pages 37-39

Communist Dictatorships in Our Midst

Imagine a government that assigns almost everyone a superior
whom they must obey. Although superiors give most inferiors a
routine to follow, there is no rule of law. Orders may be arbitrary
and can change at any time, without prior notice or opportunity
to appeal. Superiors are unaccountable to those they order
around. They are neither elected nor removable by their inferiors.
Inferiors have no right to complain in court about how they
are being treated, except in a few narrowly defined cases. They
also have no right to be consulted about the orders they are given. There are multiple ranks in the society ruled by this government. The content of the orders people receive varies, depending on their rank. Higher- ranked individuals may be granted considerable freedom in deciding how to carry out their orders, and may issue some orders to some inferiors. The most highly ranked individual takes no orders but issues many. The lowest-ranked may have their bodily movements and speech minutely regulated for most of the day.

This government does not recognize a personal or private
sphere of autonomy free from sanction. It may prescribe a dress
code and forbid certain hairstyles. Everyone lives under surveillance, to ensure that they are complying with orders. Superiors may snoop into inferiors’ e- mail and record their phone conversations. Suspicionless searches of their bodies and personal effects may be routine. They can be ordered to submit to medical testing. The government may dictate the language spoken and forbid communication in any other language. It may forbid certain topics of discussion. People can be sanctioned for their consensual sexual activity or for their choice of spouse or life partner. They can be sanctioned for their political activity and
required to engage in political activity they do not agree with.
The economic system of the society run by this government
is communist. The government owns all the nonlabor means
of production in the society it governs. It organizes production
by means of central planning. The form of the government is
a dictatorship. In some cases, the dictator is appointed by an
oligarchy. In other cases, the dictator is self- appointed.
Although the control that this government exercises over
its members is pervasive, its sanctioning powers are limited. It
cannot execute or imprison anyone for violating orders. It can
demote people to lower ranks. The most common sanction is
exile. Individuals are also free to emigrate, although if they do,
there is usually no going back. Exile or emigration can have
severe collateral consequences. The vast majority have no realistic option but to try to immigrate to another communist
dictatorship, although there are many to choose from. A few
manage to escape into anarchic hinterlands, or set up their own
dictatorships.

This government mostly secures compliance with carrots.
Because it controls all the income in the society, it pays more to people who follow orders particularly well and promotes them
to higher rank. Because it controls communication, it also has
a propaganda apparatus that often persuades many to support
the regime. This need not amount to brainwashing. In many
cases, people willingly support the regime and comply with
its orders because they identify with and profit from it. Others
support the regime because, although they are subordinate to
some superior, they get to exercise dominion over inferiors. It
should not be surprising that support for the regime for these
reasons tends to increase, the more highly ranked a person is.
Would people subject to such a government be free? I expect
that most people in the United States would think not.
Yet most work under just such a government: it is the modern
workplace, as it exists for most establishments in the United
States. The dictator is the chief executive officer (CEO), superiors are managers, subordinates are workers. The oligarchy that appoints the CEO exists for publicly owned corporations: it is the board of directors. The punishment of exile is being fired. The economic system of the modern workplace is communist, because the government— that is, the establishment— owns all the assets,1 and the top of the establishment hierarchy designs the production plan, which subordinates execute. There are no internal markets in the modern workplace. Indeed, the boundary of the firm is defined as the point at which markets end and authoritarian centralized planning and direction begin. Most workers in the United States are governed by communist dictatorships in their work lives.

[End of quote]

If Ms. Anderson’s analysis is correct–why would it be surprising to limit the capacity of children (and their parents’) control over their bodies given the daily lack of control over the bodies of hundreds of millions of workers in the United States and billions worldwide (which the social democrats generally ignore)?

As I pointed out above, social democrats or reformists like to compartmentalize their discussions–a trick that enables them to omit issues that provide a wider context for the more narrow issues. They adopt what could be called a mechanistic philosophy to human society by assuming that human problems can be pigeon-holed into discrete parts. They look at society as if each area is distinct from another part. Aristotle, a Greek philosopher, however long ago argued that a hand, to be a hand, must be related to the human body. Social democrats, however, would like to have us believe that hands exists independently of the human body. They then accuse anyone who tries to widen the issue of illegitimately addressing issues that have nothing to do with these narrower issues. Indeed, note the reference to “delusional” by one of the social democrats. They glory in their own narrowmindedness and accuse all who fail to share in their narrowmindedness with delusions.

John Dewey, the philosopher of education, argued that acting intelligently, among other things, involves considering the wider context, or contextualizing the immediate situation that constitutes the immediate problem.

Social democrats or reformists generally refuse to consider the wider context of the class structure and class power of employers. They thereby propose, implicitly, that workers act unintelligently.

The fact that social democrats and radical leftists (such as Sam Gindin) fail to attack persistently the power of employers as a class entails the possibility of the rise of forces outside the workplace (such as the extreme right). After all, does not such right-wing politicians as Doug Ford (premier of Ontario) or Donald Trump glory in the dictatorship of employers? Do they not, like the social-democratic left, ignore such dictatorship? Do they not cover up such a dictatorship through rhetoric, like the social-democratic left?

One final point: Ms. Faibish posted the following on Facebook:

Workers at the Rainforest Cafe in Niagara Falls have been on strike for more than a month. What they’re fighting for proves the need for strong employment-standards legislation — and strong unions.

I made a comment by pointing out that it would have been helpful to give examples of locals that are strong unions. She did not provide any. Social democrats or reformists and trade unionists often use clichés without providing any support for such clichés. When someone questions their clichés, they then engage in–silence. This is not what the labour movement needs.

Rest assured that if you call into question the self-righteous left’s assumptions, they will engage in insults. That is to be expected. They refuse to face up to their own social limitations and the limitations of their own mechanistic methodology.