How we got here and where to from now

To get an accurate picture of something we need to gather accurate information and then look at it from the experience of and point of view of as many different perspectives as possible. We can see wisdom as the strength, capacity and skill needed to assess and evaluate this complexity rather than escape into the certainty of a one frame view.

Aged care is an integral part of the society we live in and it cannot be separated from that society.  The criticisms of our society are relevant to aged care and provide insights into what is happening there.  To see how they apply to aged care we need to understand how they apply to society in general.  This web page traces ideas about society from the past.  It then examines changes that have developed recently much more closely showing how they replay the past and make the same mistakes. We are then in a position to examine aged care and the way it has been studied as it sits in this society.

History of markets and market theory

In the previous sections on this web site the focus was on the marketplace and on aged care as a failed market.  Here I simply summarise some theoretical perspectives and their background.

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From early history to mid 20th century

Markets have underpinned and supported human civilisations since the earliest times but they have grown in scope and sophistication over the centuries.

The growth of markets

Early markets depended on what shopkeepers could sell and tradesmen could provide on the one hand and what citizens were able or prepared to pay on the other.  Markets served citizens and the success or failure of participants depended on the need or desire  that the citizens had for the product and what they were prepared to pay for and accept.  Tradesmen and shopkeepers cooperated and often competed to serve the community.  Successful businessmen who served the community became wealthy and respected.

The extent to which the self-interested could exploit the vulnerable was soon realised.  In medicine Hippocrates  realised this in about 2500 years ago.  He and his successors created a set of ethical guidelines to protect the vulnerable from commercial and sexual exploitation – the Hippocratic oath. Later Christianity and other religions created an ethic of concern for the other and so for the vulnerable and disadvantaged.  There was a moral obligation to care for and protect them.

The guilds

In the middle ages professions and tradesmen formed guilds. These established principles and set up structures that guided and controlled the way industry developed products and the way services were provided. The guilds were in many ways cooperative more than competitive.  They were granted monopolies by rulers to serve citizens. They were expected to serve society in a responsible way and generally but not always did so.  The comradeship and sharing of skills and experience generated social capital.  The number and status of workers was regulated, preserved and supported.  


The growth and dominance of capitalism  and free markets in the 18th and 19th centuries exposed the limits of guilds and they gradually lost influence although remnants still persist in some places.  They were ill suited to rapid change and industrialisation.  Capitalism brought its own benefits and problems.  

I have not read Adam Smith, the 18th century philosopher (Youtube overview) but almost anyone can find quotes (A, B, C, D, E, F, G) on the many web sites that will support their particular position and belief.  This speaks for Smith's ability to look at the developing capitalism from multiple points of view seeing both its benefits and its failings.  There are two warnings that are particularly relevant today.

Relevance: The first that it was from self-interest and not benevolence that tradesmen provided products and services and that this self-interest was restrained by the knowledge and capacity of the customer - a warning to individual customers to be wary. In the second he warned that because of this self-interest any proposals coming from “this order of men” were seldom in anyone else’s interests and they should be most carefully considered before being adopted. This warning was clearly directed towards the community, which we would now call civil society, and its leaders - the politicians.

Implicit in this is the presupposition that the customer has the capacity and the power to decide and that civil society and its leaders also had the interest, power, capacity and will to critically assess any proposals from the market and either reject them or determine how they would be implemented.

Smith also realised that it was not evil people but people who believed in what they were doing that posed the greatest threat to society and were the most difficult to deal with. This was long before Stalin, Mau Tse-tung, Hitler or Verwoed – the 20th century leaders whose ideological castles inspired millions and then collapsed or were destroyed.  They are now seen as evil because of what they believed in and what they did as a consequence.

The problems that we are currently experiencing in multiple sectors can be traced back to the loss of the capacity of customers and civil society including its political leaders to control the market.  The argument is that a new belief, a belief in the infallibility of markets has created a radical shift in power from citizens to market.  This has enabled the market to control the way customers, civil society and politicians think and behave.  As a species we have not yet learned to carefully examine our beliefs from different perspectives then recognise and manage their flaws.  As a consequence both society and politicians have been trapped in these patterns of thought – a condition known as paradigm paralysis.  

The industrial revolution and free markets

The industrial revolution describes the period during which the world changed from one based primarily around agriculture and family businesses to the period of urbanisation and factories in the 17th and 18th centuries.  This was powered by technology, first coal driven, then later by oil and electricity.  Governments at the time adopted a hands off laissez-faire/free market approach.  

With the development of machines vast numbers of people were thrown out of work.  While economies grew the divide between rich and poor widened. There was widespread poverty and employees including women and children were exploited.  Adam Smith had great ideas about the market being balanced and controlled by man’s better selves but the market imposed its own rules leaving less and less room for humanity and better selves.  The unemployed, the disabled and the aged ended in prison, in the colonies or in the infamous workhouses or poorhouses described by Dickens.  They were funded by charity and sometimes by local government.  

Unions form

In the 19th century workers who had been displaced, revolted attacked and destroyed the machines that had put them out of work.  They were brutally suppressed.  In the later part of the 19th century the workers regrouped and formed unions. By working together, striking and using the power this gave them to bargain they succeeded in improving their conditions.

The Second Industrial revolution

The latter part of the 19th and the early 20th century is known as the Second Industrial revolution.  It was built on oil, iron, electricity and the assembly line in factories. There was widespread prosperity and wealth in the 1920s and union power ensured that there was a better distribution of wealth.  But free markets were characterised by boom and bust cycles culminating in the Great Depression of the 1930s and then the Second World War.  

Regulated capitalism

After these events a more regulated form of capitalist markets developed.  It was based on Keynesian economics. Laws restrained and controlled the ways markets operated.  It was accompanied by a move towards more equitable distribution of wealth, socialist ideas and more support for workers and those who were unable to care for themselves.

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Recent History 1980 to 2017

The reversion to free markets in the 1980s was accompanied by the development of a belief in management as the way to structure government and society. It has had a profound impact on the structure of society and has persisted to the present. Critics use the term neoliberalism to include both the approach to markets and the restructuring of society.  They believe that it is on the way out and there is much to suggest that it is imploding.  Intense unhappiness and distrust of the politicians who have adopted these policies reached a tipping point in 2016 and this has been reflected in elections. Citizens have lost faith in anything they are told by the establishment leading to an unstable situation which analysts have dubbed the Post-truth era.


This stability provided by Keynesian economics did not permit the same risk taking or the large profits for entrepreneurs.  Growth was not as rapid.  The economy was seen as stagnant. The backlash from the market and the return to free markets was initiated by Milton Freidman from the Chicago school of economics in the 1970s.  This became government and then later global policy under Reagan in the USA and Thatcher in the UK.  

In some ways neoliberalism was a backlash against socialism and a return to fundamentalist views.  Friedman saw social responsibility as socialist and so evil.  The prime responsibility was to make money for shareholders within the limits set by the law.  Serving customers and society were not a priority as they were simply assumed to benefit.  This extreme belief in an unfettered market and centralised management has been called neoliberalism.  It was labor and not the coalition that commenced the changes but the coalition moved much further in this direction and did so much more aggressively.

There are a number of driving forces.

•    Microeconomic reform is "change incentives facing private and public sector producers with the aim of inducing higher levels of productivity to support higher living standards".  It is directed at  “improving the global competitiveness and efficiency of Australian industry.  The policy has included labour market reform, deregulation, privatisation and corporatisation of government business enterprises, trade liberalisation, taxation reform and competition policy”.  The driving forces were competition, efficiency, choice, privatisation and liberalisation. Restrictions on the way markets operated were removed, including in those sectors that were previously restricted because they were vulnerable to exploitation.  The market was believed to be self-correcting and these restrictions therefore unnecessary.

•    Managerialism is the term used to describe “a belief in the value of professional managers and of the concepts and methods they use”.  It is a top down system of controlling and managing society.  It justifies “the application of managerial techniques to all areas of society on the grounds of superior ideology, expert training, and the exclusive possession of managerial knowledge necessary to efficiently run corporations and societies”. It has a long history but has flowered in the post-Friedman era and has been called “the organisational arm of neoliberalism”.  It has been transfused into every capillary in our society. Its impacts on education and medicine have been strongly criticised. There have been attempts to itemise it. It disempowers employees and binds them to the corporate mission so restricting their ability to express their humanity and behave as responsible citizens. Reese and Rodley’s 1995 book 'The Human costs of Managerialism: advocating the return of humanity' examines the costs for our humanity.

An insightful article is New Managerialism: The Impact on Education by Kathleen Lynch. Indicates that "New managerialism represents the organisational arm of neoliberalism. It is the mode of governance designed to realize the neoliberal project through the institutionalising of market principles in the governance of organizations"  throughout society. She uses Foucault’s concept of governmentality to show how managerialism not only controls our behaviour from outside but also enters into our consciousness so that we identify with it, aspire to its objectives and become its servant.  It “becomes a necessary characteristic of the person”. The article explains just how powerful this is and how profound the impact can be.

•    Incentivisation is “the practise of building incentives into an arrangement or system in order to motivate the actors within it”. Incentives and disincentives have been a key component of corporate managerialism and are used in multiple situations to motivate managers and in commercial contracts.  The carrot and stick approach was based on experiments in animals, principally rats.  Called behaviourism it was shown to improve learning and introduced into education in the 1960s.  But its critics soon realised that the children were motivated by the reward and not by social values. If inhibited reflective thinking.  Selfish selves grew at the expense of social selves.  As critics indicated it turned humans into rats and it was largely abandoned in education.  It has found a new home in managerialism. Human values and social selves are not usually an asset in the marketplace.

Incentives and disincentives have had much the same impact there, particularly in vulnerable sectors like health and aged care.  Attempts have been made to limit this by making kickbacks to doctors illegal as in the anti-kickback and Stark Laws in the USA. These laws have been modified to accommodate to the governments neoliberal agenda resulting in a lot of hairsplitting.  Health care corporations have lobbied against them and attempted to find ways around these laws.  Many of the massive health care frauds perpetrated in that country were driven by incentives and often kickbacks.  

•    Marketing and public relations:  For many brand and image are critically important and vast numbers of public relations experts make a living by creating images and presenting products and services as positively as they can. They don’t get paid for exposing issues of concern but are employed to help the companies minimise and suffer as little damage to their reputation as possible when they fail their customers.   Their role is to create business and bring more customers to the companies or in politics induce voters to select the candidates they assist.  Too often this leads them to mislead and deceive if they can get away with it.  What is created is tokenism -  words or ideas that are used for something that is absent.

They are in the business of image creation and are the drivers of consumerism and recreational shopping.  The national economy depends on citizens to spend rather than save in order to maintain the viability of industry and markeing drives this.  There is no shortage of financiers eager to lend money and encouraging people to go into debt.  An indebted society is at risk of market failure leading to instability.  The 2008 financial crash was largely the consequence of intense competition between US financiers to lend money regardless of risk – money the recipients could not pay back. This triggered a collapse in other countries with large debts.

Another problem is the way the difference between education and advertising is blurred so that much that is presented as education is thinly disguised marketing. The two largest and most successful but very dysfunctional hospital companies I investigated in the 1990s both considered marketing their most important activity.  Care was hardly mentioned.  In their internal documents, books, sold for education by one of these, were referred to as “books as hooks”.  Their intention was to fan anxieties and so bring people to free help services whose only purpose was to induce often normal people to enter hospital and receive costly but ineffective treatment.  Large numbers of marketing and community activities had the same intent.  Many companies engaged in similar activities.

As citizens we are constantly bombarded by advertisements of all sorts and however cynical we are we cannot help being influenced by the constant barrage from the media and from marketing.  

News is a product that has been fashioned and interpreted within existing world views as well as pandering to citizens interests and aspirations. It is difficult for journalists to be neutral and the perspective used informs and reinforces our world view.  In recent years this has been a neoliberal one.  All this has a profound impact on the way we see and understand the world – our world view.  The young are born into this marketed world and grow up within it.  For them it comes as a “given” and any change requires them to challenge that.

Consequences of neoliberalism

While there has been national economic growth this has been uneven within countries.  It has been at the expense of social structure and community values.  Legislation has reduced the power of unions and of workers resulting in a maldistribution of wealth. Large numbers of citizens are struggling and very poorly paid. This has been particularly so in health and aged care. Poverty is a major problem in the midst of wealth. Managerialism has taken control of citizens’ lives and of society’s activities, marginalising citizens and so leaving them uninformed and disengaged, but unhappy about what is done in their name.  There is a series of 35 academic articles in 2014 -15 under the auspices of Goldsmiths, University of London on the Open Government web site under the broad heading of Liberalism in Neoliberal Times which may interest some.

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Is neoliberalism on the way out?

There have been multiple analysis and intense criticism of neoliberalism over the years.  In a new book How Did we get into this mess? and in an article in The Guardian “Neoliberalism – the ideology at the root of all our problems”, George Monbiot blames neoliberalism for all our ills.   The Adam Smith Institute which he strongly criticised responded by pointing to economic rationalisms achievement in increasing wealth and lowering poverty across the world.

Criticism has steadily increased since the 2008 GFC (Global Financial Crisis) and critics have claimed that its time is up.  But the problem for critics is that we do not have an economic theory to replace it and a return to the relative stagnation of Keynesian economics is not popular in the market.  Neoliberalism is well entrenched globally and countries that step out of line will be penalised so it is going to be a slow process.

A search for “neoliberal” does not bring up protagonists because those it describes do not use the word.  We need only revisit what our politicians have been saying since the mid 1980s to get the message. Below are links to some criticisms.

NEO-LIBERAL MELTDOWN: The response to the Prime Minister’s essay by Robert Manne The Monthly March 2009.
Prime Minister Kevin Rudd’s essay blaming neoliberalism was aggressively attacked and discredited by his critics.

What is Neoliberalism? : A Brief Definition for Activists  Corpwatch accessed Jan 2017.  The beneficiaries of neo-liberalism are a minority of the world's people. For the vast majority it brings even more suffering than before: suffering without the small, hard-won gains of the last 60 years, suffering without end.

A Primer on Neoliberalism  Anup Shah  Global Issues (Blog) 22 Aug 2010.  “- - the globalization project, an ideal that sounded appealing for many around the world, was flawed by politics and greed; the inter-connectedness it created meant that as any flaws revealed themselves, the unraveling of such a system would have far greater reach and consequences, especially upon people who had nothing to do with its creation in the first place". (many links and quotes)

'Impulse Society' blames hyper-capitalism for America's social ills Book Review LA Times 14 Sept 2014
The article explains how the market is entering and dominating our psyche - "the market and Self are becoming one” – but it offers no real way forward.

Harper review would reduce us from citizens to mere consumers by Damien Cahill in The Conversation  October 7, 2014. This is a criticism of the draft report of the 2014 Harper review and in doing so it examines and challenges some of the core tenets of the neoliberal agenda.

Even the IMF Now Admits Neoliberalism Has Failed  Ben Geier   Fortune 4 Jun 2016.  There are signs that the political tide is turning against neoliberalism in the United States

Neoliberalism Is a Political Project : David Harvey on what neoliberalism actually is — and why the concept matters.  JACOBIN July 2016. This is a view from the US left

Commodifying Human Experience: An Interview with Jeremy Rifkin | Alternet  Accessed Dec 2016.  Jeremy Rifkin writes about what he sees as the next stage of capitalism –hypercapitalism, a totally different form of capitalism – we are losing our sense of responsibility and “the cultural diversity of thousands of years”.  

If we are reaching neoliberal capitalism’s end days, what comes next? by Allan Patience, Univ. of Melbourne The Conversation 4 February 2017
The author looks at the origins of neoliberalism and then examines the work of two strong critics from Europe who both see a dismal post-neoliberal future. He suggests that the time is ripe for “some creative imagining of a new post-neoliberal world” that will repair the harm done. He calls for a) “the enlivening of international civil society to balance the power of the self-serving elites now in power”, b) “new forms of democratic governance” to change the nature of politics, and c) for states to intervene in the free-market in the interests of all citizens. He suggests that if we want to escape the future predicted by the European writers then we need a “new and highly creative version of communitarian democracy”.

He refers to a 2007 article Resisting ‘globalisation‐from‐above’ through ‘globalisation‐from‐below’ by Richard Falk
This is an article that looks at some of the good and then the progressive bad of global neoliberalism. States are trapped in this and governments are unlikely to address the issue themselves.  The author suggests that the way out of it is “globalisation-from-below (which) tends towards heterogeneity and diversity, even tension and contradiction. This contrast highlights the fundamental difference between top-down hierarchical politics and bottom-up participatory politics”.

From public good to profit margin: how privatisation is failing our communities The Guardian 6 March 2017
In referring to the privatisation of the NDIS (National Disability Scheme) the article indicates that “In parts of Australia a quiet tragedy is slowly unfolding. Families already beset by adversity are seeing their last shreds of hope and comfort carefully dismantled”. It reports on the findings of "The People’s Inquiry into privatisation” an initiative of Public Services International and supported by Australian Unions and Per Capita. It is a response to the government's Human Services Inquiry. It has taken submissions from around the country. The article goes on to look critically at the extent of the privatisation of public services that has occurred across the country and the adverse consequences. It suggests that the policy is failing citizens and communities.

I'm no socialist, but markets need to work for the greater benefit of everyone by John Hewson Sydney Morning Herald 16 March 2017
Even John Hewson, economist, supporter of Margaret Thatcher’s policies and liberal party leader from 1990 until the party was defeated in 1994, now has reservations about what is happening. He suggests that we have forgotten that in the design and implementation of public policy and reform we are attempting to improve our society, not just our economy”. He points out that

  • the level of many benefits- - - and the base pension, are now well below most estimates of the poverty line — building a society where we consciously create an underclass
  •  we have transferred economic power and privilege from the public to some in the private sector without setting limits to that power.
  • we issue "social licences" - - for the delivery of many key services, without adequate regulatory structures to hold those licensees to account.
  • In mining (eg gas) licenses there must be a guaranteed return to our broader society, for the privilege given to just a few to do so? And similarly for our banks whose executives get obscene rewards for compromising the quality of services to their clients.
  • Competition policy has clearly failed when it results in the bulk of our society being ripped off.
  • Many are visibly underpaid for the contributions they make, while others are paid many, many multiples of the average wage

Hewson believes in markets but wants them “to work for the greater benefit of our whole society, not just to benefit a few”.

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Complexity, markets, trust and regulation

A problem in the modern marketplace has been the multiplicity and complexity of products so that it is no longer possible or easy for customers to understand the issues or evaluate the product. This leads to uncertainty, distrust and calls for more regulation to which government responds.  It also leads to citizens disengaging from the issues so making them vulnerable.  Government regulation is a crude and blunt tool.  Increasingly competitive pressures lead to the exploitation of this vulnerability by for example the aggressive marketing of unhealthy products such as fast foods.

An interesting illustrative study in 2012 looked at the problem in food where “the choices lay individuals make about food have become increasingly complex: - - - - The role of trust in food has become increasingly complex because lay individuals cannot possibly be knowledgeable about all of the underlying issues surrounding food choices”.   This leads to a “dependence on food producers and regulators”. There is both “physical and psychological displacement of production from consumption, and all of the other disconnections and disembedding which follow in that stead’’.  It is “simpler for consumers to relinquish responsibility than address food issues about which they have little knowledge or control”. They disengage. This leaves “consumers vulnerable to misinformation and poor dietary choices” and so poor health outcomes.
The study found that rural customers were critical of regulation and more trusting of food because they were closer to the process of food production – embedded in it.  The authors suggested “reconnecting consumers to the methods and places of food production” so that they become more informed and trusting so less dependent on regulation.
•    Reconnecting Australian consumers and producers: Identifying problems of distrust  Henderson J et al  Food Policy · December 2012 DOI: 10.1016/j.foodpol.2012.07.005 

Aged care: It is possible to draw a parallel with aged care.  Complexity and managerialism have left the community uninformed, confused and distrustful and calling for more regulation.  They are vulnerable to misinformation and deceptive marketing and so make poor choices.  We can see this when choosing nursing homes and potentially in market provided aged care choices under Consumer Directed Care.  Our proposal for community aged care hubs can be seen as a way of embedding the community back into the aged care system and so making customers “more informed, and consequently, more trusting”. They will be able to choose more sensibly.

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The Post-truth era

The meaningless and ever changing promises and assurances that are never met, the backflips and recurrent political scandals and the continuing deterioration of living standards for many under neoliberalism have left us all disillusioned and distrusting.  We don't believe anything we hear anymore.   Things that they say and do are repeatedly contradicted and exposed often by guilty whistleblowers within the departments who are prepared to sacrifice their jobs to maintain their integrity. 


Centrelink, the government body responsible for helping and funding the poorer members of society, and vetting their entitlements has caused great unhappiness by demanding refunds across the country based on a computer analysis of government data that is widely believed to be flawed. The government says that the data is accurate while it is clear from many examples that this is not so.  The government is obstructing efforts by those billed for the refunds to show that they do not owe money. Centrelink staff who are aware of the errors in the system have been stopped from helping those who have been wrongly billed in order to right the wrongs being done.  Staff whistle blowers are speaking out about this abuse of power and their distress at their powerlessness.

Centrelink’s compliance teams are being told not to correct errors with its flawed debt recovery program, allowing the “unjust system” to generate millions of dollars in bogus debts, a new whistleblower has alleged. - - this was occurring hundreds of times a day.

“We are telling the [online compliance intervention system] help desk over and over that what we are doing is wrong. - -

Guardian Australia has independently verified the claims with another high-ranking source who recently left Centrelink

“Within the organisation it is well known that that there are errors in the program and compliance officers are directed to ignore incorrect debts without being permitted to correct them - - ."

Source: Centrelink staff told not to fix mistakes in debt notices – whistleblower The Guardian 19 Jan 2017

On one hand the government is reducing tax for the wealthy and big corporations in order to boost the economy and on the other they are seen to be deliberately taking money from the less privileged, often money that they are not entitled to reclaim.  This is not what we as a community of interdependent citizens can identify with or accept.

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Analysis of the post-truth era

Post-truth is a word that has become the buzzword for 2016.  It is defined as “relating to or denoting circumstances in which objective facts are less influential in shaping public opinion than appeals to emotion and personal belief”.   It comprises the large number of unsubstantiated and obviously inaccurate or false matters that are confidently reported or claimed on social media and which many believe and support.  Particularly worrying is the extent to which politicians have become part of this as exemplified by Trump in the USA and Brexit in the UK.  

The Conversation has published a number of recent analyses of the phenomenon.  I try to summarise

Advertising is driving social media-fuelled fake news and it is here to stay by David Glance The Conversation 9 November 2916

This article looks at the role that advertising (clickbait advertorials) plays in inducing users to click on them and be taken to fake news on social media.  There is an industry creating sites with names like “ and that feeds pro-Trump fake news”.  Profits come from traffic to the site generated as users share the news on social media.  Facebook and Twitter benefit from the advertisements.  In addition Facebook filters newsfeeds so that “users are only shown news that they agree with and will want to read” so confirming prejudices and compounding the problem. Mainstream media too often pick up the fake news and report it.   When tweets about Clinton and Trump were examined it was found that 20% were generated by robots which comprised 15% of the 2.8 million users sending the tweets,

The surprising origins of ‘post-truth’ – and how it was spawned by the liberal left Andrew Calcutt The Conversation  November 18, 2016

This article traces the origins of post-truth to academics and left leaning liberals who “sought freedom from state-sponsored truth” and instead built a “new form of cognitive confinement” discrediting "truth" – so blaming postmodernism and its focus on all truth being relative.  They stretched this further by implying that all claims to truth are relative to the person making them. They suggested there was “no position outside our own particulars from which to establish universal truth”. This the article claims created the belief that there was no such thing as objectivity, which was "nothing more than a professional ritual" for journalists.  The scene for the post-truth era was set over the last 30 years

Parallel with this in the creative economy where “branding” became more important and real than the product or activity that it represented (something that I criticise as tokenism) a representation that substitutes for the real thing which is absent.  In our societies a “system of managed perceptions and permanent PR” has largely replaced the real product or service in our minds.  This is driven by a new economy “happily living on thin air”.  Politics too has been driven by marketing and the creation of images and tokens – with policies marketed like brands so creating myths.  Politics was “less about the ‘truth’ than about how ‘truths’ could be spun - - - it was government by PR”.  We had “evidence-based” managerialism which had little to do with real evidence.  This “was soon recognised by the wider population as a tool for use in social engineering” and this generated a distrust of experts.

How tribal thinking has left us in a post-truth world Rob Brooks The Conversation 29 November 2016

What has happened in politics in the USA, UK and Australia “represent a dire crisis of public confidence in expertise, knowledge and evidence. And they present an uncomfortable challenge for universities and civil societies - - - the triumph of tribal conviction over knowledge.”  The article examines the way almost half of us get out knowledge from Facebook.  Social media becomes “echo-chambers” because “that is digitally targeted to align with our interests” and so tells us what we expect to hear.  As “humans cling to conviction as a signifier of belonging, we find it easier to huddle on our own sides of the last wall, than to venture into the vast, less familiar landscape of knowledge and discovery.  Hopefully we will “put this post-truth year behind us”.

Trump has embraced pseudoscience and its deceptive tactics in a post-truth world Michael J. I. Brown  The Conversation 12 December 2016  []

Trumps stream of falsehoods and conspiratorial theories is something that biologists and other scientists are very familiar with.  These scientists know these are political battles and about “winning news cycles and elections” rather than truth.  Science involves years of work and thousands of words.  Media battles entertain but don’t advance science.  Scientists are vulnerable to being discredited by labelling as “warmist” or “alarmist”.  “Trump has embraced pseudoscience and its tactics, and will be bringing it to the White House”.

‘Fake news’ – why people believe it and what can be done to counter it Simeon Yates The Conversation 13 December 2016 

This article looks at fake news as a threat to democracy and points out that much of it is simply propaganda (often from Russia) and there are many studies of this.   Looks at the role of social media and the propensity of traditional media to use fake news uncritically as a resource.  It looks at how social media amplifies and spreads misinformation, and plays on existing prejudices.  It comes back to our failure to educate citizens for the world we have.

The post-truth era of Trump is just what Nietzsche predicted Alexis Papazoglou The Conversation 15 December 2016 

The author, a philosopher suggests that the existential philosopher Friedrich Neitzsche predicted this in his critique of truth.  He suggested that with the demise of religion (perhaps we should include authoritative opinion) absolute truth became an impossibility and “the only alternative is a position called “perspectivism”.  There are “only perspectives on what the world is like”.  Perspectives “can vary wildly, and therefore so can the way people see the world”.  As was illustrated with the Trump debacle facts and truths often won’t have much impact on the perspective of others.  In this election we saw “two sides utterly immersed in their own perspective”. But “Nietzsche suggests that the more perspectives we are aware of, the better we can be at reaching a watered-down objective view of things” and “Listening to the other side and taking it into account – seeing the world through as many eyes as possible – is now more important than ever”.

Teaching and learning in a post-truth world  Michelle Mielly The Conversation December 26, 2016

The developments in 2016 have ushered in a new “permission structure” enabled by social media.  This “enables individuals to bypass traditional authorities who once served as the standard bearers of acceptable political discourse”.  This emboldened “behind-the-scenes supporters of totalitarian thinking”.  In response Meilly presses for respect for others, being open to them and to different opinions as well as “the ability to include as many perspectives as possible in decision-making processes.”  Meilly describes role playing strategies that will help students to become aware of their own preconceived ideas and so educated for this world.

HyperNormalisation Nov 2016 BBC documentary by Adam Curtis on Youtube

This very long but interesting documentary revises and reinterprets the history of the last 40 years in ways that those of us who lived through them and listened to the official accounts would not recognise.  According to this documentary we have been misled and deceived as politicians, the economists and markets all followed their own simplistic theories and their own interests. They have manipulated us and everyone else in order to meet their objectives, which are seldom in the world’s best interests.  Even public movements and rebellions embracing new ideals have lost their way.  Their new worlds have not brought answers.  The world is clearly a very different one to the one we think we have been living in, but the documentary does not offer us a real one to replace it with and we are left wondering how many of the reinterpretations are any more real than the accounts that they replace.  But perhaps that was the intention because the challenge for us now is to actually come to grip as best we can with the real world that lies in there somewhere.

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If we look at the criticisms of Neoliberalism and the analyses of post-truth it is clear that in many respects the world we have been living in is not grounded in truth or on objective data – measurable facts and their logical common sense analysis.  Most of us have been living in a largely illusionary world.

The Canadian John Ralston Saul has been writing about this for years.  In his 1995 book “The Unconscious Civilisation”  he explains how our need for simple explanations and ideas through which we can structure our lives has lead us to grab at illusionary beliefs and fashion a world that is not real.  We develop patterns of thinking that shield us from the real world so are not conscious of it.  The post-truth debate suggests that the wider population, which is suffering the consequences, has now realised this. What we are left with is what is described as “anomy” – a distressing situation where the world lacks meaning and we don’t have a secure place in it.  Our response is to grab at straws – anything that offers a way out. 

In his later work On Equilibrium Saul looks at how we as individual humans can use our human qualities in combination to meet this challenge. Our vulnerability to ideology lies in our use of only one of these qualities. I argue that ideologies like neoliberalism similarly succeed by focusing only on a selected few attributes in our nature and in our social structure by taking them out of our rich armanentarium of potential behaviours and applying them to excess and in contexts where they are harmful.  Our perceptions of the world are distorted.

Groundhog days

There is nothing new in the post-truth era and Donald Trump’s victory.  The crisis in Germany following the great depression saw the rise of Hitler and fascism with the whole country following.  Communism started in Russia and then China, countries that were failing their citizens.  The anti-colonial movement following the second world war saw the collapse of colonialism and this threatened the ruling 10% in South Africa with an untenable situation.  Apartheid followed.  We should not be surprised at Brexit, Trump or Hanson’s success.  It is not new but the lesson of history is that this is a dangerous situation and, unless Trump is not what he seems to be and someone can pull something constructive out of this, it is likely to lead to tears.

Successful sociopathy and the post-truth era

Not all sociopaths are brutal killers and many live often successful lives in the community. 'Successful sociopaths' are people who have no conscience and while often intelligent and charismatic they seem to live in a superficial self-serving world which they manipulate to their advantage with little regard for truth.  They can often become very successful and then exploit the system causing great harm to others.  How many world leaders might qualify? 

Some have suggested sociopathy as an explanation for many of our social problems but I do not think that this adequately explains what happens. While they play a part there is a broader and more complex social dimension that they readily exploit.  They succeed in susceptible contexts.

Recent work has shown genetic and brain differences in sociopaths and research suggests that environmental factors influence whether these traits are expressed in sociopathic behaviour or not.  I would expect a post-truth era to provide opportunities for and so encouraged these traits. Sociopaths are likely to thrive.  It would be interesting to do genetic studies and brain imaging on Donald Trump!

•    Are You Good Or Evil - BBC Horizon Documentary 2015 Mathew Trotman You Tube

•    10 Professions That Attract the Most Sociopaths  Roy Klabin  Arts.Mic

Aged care in the post-truth era

Not-for-profits and an ethic of service dominated until 1996 when it was turned into a market and for-profits took control of the agenda. Data has not been collected and policy has been based on unproven ideology and opinion.  Belief has replaced evidence and experience.  Rhetoric and tokenism has replaced truth and objectivity.  Aged care is unlikely to get much attention in the post-truth era and may be at further risk of ill-informed decisions and emotional responses that fly in the face of reason and evidence.

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Not-for-profit (or nonprofit) sector over the years

Not all society’s activities have been or are directed to personal profits.  Both the community at large and groups within society have had other objectives in sport, art and in serving the community.  They needed funds for this and generated these by providing services, by charging membership fees, by community fund raising and by donations from the wealthy or from government.  A large and diverse groups of organisations emerged and the distinction between for-profit and not-for-profit is blurred so that it is difficult to classify or define.

The not-for-profit (nonprofit) sector

The nature of not-for-profit organisations

The Johns Hopkins Comparative Nonprofit Sector Project set out 5 objective criteria, which they claimed defined not-for-profits.  These were used to analyse the situation in different countries including the UK.  Others in the UK contested their appropriateness and usefulness when analysing historically or across countries.

It seems that it is difficult to compare the present with the past or to compare countries.  Too much is context dependent and is not captured by these definitions.  It might be better to think of it as a cultural way of thinking in the community that gave organisations objectives other than money and purely personal benefit. Many organisations that made some profit in the past and some that do so today embrace this cultural ethic.

Neoliberal thinking has had a profound impact on the sector.  It has forced not-for-profits to operate in a competitive marketplace competing with one another and with for-profits.  When examined as a cultural issue then there is a clear paradigm conflict.  The two modes of thinking are very different and contradictory. Increasingly many not-for-profits are adopting a strongly commercial focus with growth and survival replacing profit as the primary objectives.  While they may claim to have a mission they no longer fit into our general idea about the way not-for-profits are expected to behave.

To explore some of the academic issues surrounding the history and operation of the not-for-profit sector there is general material and material about issues in different countries - the USA (A-2004, B-2010), The UK, France(A-2000),  and Australia(A-1993, B Thesis 2010, C-2016).  

Human service not-for-profits

If we look at the human services not-for-profit sector, it can be seen as arising from the tradition of social responsibility and from religiously supported ideas of benevolence and mercy.  There was a need to serve and protect the vulnerable.  The wealthy were charged for services and the profits from this were combined with benevolent donations and community fundraising in order to serve the poor.  Most developed within religious communities or in cooperation with them.  

In many ways not-for-profits functioned as community welfare organisations taking from the rich to support the poor.  The ethic was one of stretching resources to serve need. Until the mid-20th century it was generally unacceptable for these sectors to be the focus of wealth creation.  Social pressures ensured that individuals did not benefit personally from what were charitable endeavours.  Government regulations supported this.  It was only when personal insurance and government welfare systems created an opportunity to make attractive profits that this changed.  Material on this web site looks at developments in the sector.

There is extensive material about not-for-profits on this web site. The conflicts they face in a neoliberal marketplace are explored on these pages - -  Dilemma for not-for-profits - - -  Driving cultural change - - -  Views among not-for-profits.

Here is some additional material that I have not studied or used elsewhere.

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Corporatisation of health and aged care in Australia

In the USA: There was increasing commercialisation of health care starting in the USA in the 1950s and 1960s when government introduced Medicare (for the elderly only) so creating a pool of funding to exploit.  This was fueled by neoliberal policies in the 1980s.  Doctors greed was blamed for the increasing costs of care.  The corporate killer whales were brought in to control the medical sharks which they did very successfully. They were bigger and greedier.  The pressures they introduced often compromised care and they made the system even more expensive.  Aged care was not far behind.   I have written a USA overview and many linked detailed pages about both in the USA in the past

In Australia: There is a long history of for-profit hospital care but they did not dominate the sector.

In the 1980s aged care companies in Australia went to court claiming that the restrictions in the sector were unfair.  They lost that case but then funded and supported the Howard Coalition Government’s victory in 1996.  Howard gave them everything they wanted but then backed down on a number of their plans because of a strong community backlash.

Australian doctors were well aware of the excesses in the USA and what had happened to the profession there. They stood up to government pressures in 1998 by refusing to enter into the sort of contracts that had disempowered the profession in the USA. In 2002 they used their market power to put Australia’s largest hospital company out of business when it introduced policies and practices that were ethically unacceptable.  While the profession has since accommodated to neoliberal policy and corporatisation it has tried to maintain sufficient market power to prevent the excesses that have occurred in the USA.  Aged care has consequently borne the brunt of neoliberal policies.  I wrote an Australian overview page and many linked supporting pages in the past.

The mining boom gave Australia a slight reprieve from global neoliberal pressures but the collapse of the boom has put pressure on Australia. The labour government initiated further neoliberal type changes in 2011 and then in 2013 the newly elected coalition Abbott government targeted aged care for even greater competitive market reform. The sector is now seen as a potential generator of capital in the global service industry by offering competitive services to countries in Asia including China. It will help address our balance of payment problem.

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