In Chapter II of Through the Looking-Glass by Lewis Carroll Alice is talking with the Red Queen:
‘It’s a great huge game of chess that’s being played—all over the world—if this IS the world at all, you know. Oh, what fun it is! How I WISH I was one of them! I wouldn’t mind being a Pawn, if only I might join—though of course I should LIKE to be a Queen, best.’
She glanced rather shyly at the real Queen as she said this, but her companion only smiled pleasantly, and said, ‘That’s easily managed. You can be the White Queen’s Pawn, if you like, as Lily’s too young to play; and you’re in the Second Square to begin with: when you get to the Eighth Square you’ll be a Queen—’ Just at this moment, somehow or other, they began to run.
Alice never could quite make out, in thinking it over afterwards, how it was that they began: all she remembers is, that they were running hand in hand, and the Queen went so fast that it was all she could do to keep up with her: and still the Queen kept crying ‘Faster! Faster!’ but Alice felt she COULD NOT go faster, though she had not breath left to say so.
The most curious part of the thing was, that the trees and the other things round them never changed their places at all: however fast they went, they never seemed to pass anything. ‘I wonder if all the things move along with us?’ thought poor puzzled Alice. And the Queen seemed to guess her thoughts, for she cried, ‘Faster! Don’t try to talk!’
Not that Alice had any idea of doing THAT. She felt as if she would never be able to talk again, she was getting so much out of breath: and still the Queen cried ‘Faster! Faster!’ and dragged her along. ‘Are we nearly there?’ Alice managed to pant out at last.
‘Nearly there!’ the Queen repeated. ‘Why, we passed it ten minutes ago! Faster!’ And they ran on for a time in silence, with the wind whistling in Alice’s ears, and almost blowing her hair off her head, she fancied.
‘Now! Now!’ cried the Queen. ‘Faster! Faster!’ And they went so fast that at last they seemed to skim through the air, hardly touching the ground with their feet, till suddenly, just as Alice was getting quite exhausted, they stopped, and she found herself sitting on the ground, breathless and giddy.
The Queen propped her up against a tree, and said kindly, ‘You may rest a little now.’
Alice looked round her in great surprise. ‘Why, I do believe we’ve been under this tree the whole time! Everything’s just as it was!’
‘Of course it is,’ said the Queen, ‘what would you have it?’
Alice says that in her country you get somewhere by running very fast. And the Red Queen replies that in Looking Glass land it takes all the running you can do to stay in the same place, and if you want to get somewhere else, you have to run at least twice as fast.
Looking Glass land is, of course, Washington D.C. For the President, Senators, and Congressmen, while running all the time are staying in the same place.
This week the three will be running together grasping an Alice-like or reasonable idea that together they might reach the goal of reforming our present system, really a non system, a hodgepodge, of providing for the nation’s health-care and health insurance needs. Nobody believes they will.
But the real lesson of the Red Queen is something else. The lesson is that just to stay where we are, and not lose ground, let alone move ahead, we have to be running all the time. A kind of running in place as those joggers who wait interminably for a hole to open up in the early morning traffic before dashing across the street, to get where? Well, to the other side.
Things in Washington are also much like the situation described by the Sicilian Prince Giuseppe Tomasi di Lampedusa in his novel, Il Gattopardo: “If we want everything to stay the same, everything must change.” Again, a kind of running in place just to be able to stay where we are.
The line from Il Gattopardo could mean two things. One, that things will not stay the same if we do nothing, and that things could even get worse.
And, two, even if and when we do make changes, as, for example, the endless series of reforms that we have made and are still making to our health and education infrastructures, the result will be more of what we had before the changes, the same, and not visibly worse for the changes or reforms.
Should we abandon reforms altogether? Running with them while staying in the same place is clearly failure. Perhaps as the Red Queen suggests, if we were to run twice as fast? But who knows what she meant by that. Not Alice, seated propped up against a tree and clearly at the end of her rope.
We might look to the Red Queen for a slightly different principle, and it might be this: For any evolutionary system, in this case our system of providing health care through insurers, doctors, nurses, hospitals, health clinics etc. we might look less at the parts of the system and more to what we might do in order to maintain the fitness of the parts of this one system relative to the systems it is co-evolving with. For everything is evolving, and evolving along with everything else.
The principle? Well we may be running as Alice and the Red Queen, and at the end of the run be still in the same place. But things about us will have changed, and we along with them. Evolution is making sure of that.
This means that we ought no longer to look at our health care system in isolation from everything else, no more than we ought to look at our country and its problems in separation from the world. Health care exists in the context of a changing world, is a part of those changes, has problems stemming from those changes, and is only exacerbated by our refusal to adapt to those changes.
That might be what the Red Queen meant by running twice as fast. Real improvement in our health care, educational, and other systems will only come about as we treat all of them as evolving parts of a rapidly evolving world.