The Emergent Logic of Health Law

The American health care system is on a glide path toward ruin. Health spending has become the fiscal equivalent of global warming, and the number of uninsured Americans is approaching fifty million. Can law help to divert our country from this path? There are reasons for deep skepticism. Law governs the provision and financing of medical care in fragmented and incoherent fashion. Commentators from diverse perspectives bemoan this chaos, casting it as an obstacle to change. I contend in this Article that pessimism about health law’s prospects is unjustified, but that a new understanding of health law’s disarray is urgently needed to guide reform. My core proposition is that the law of health care provision is best understood as an emergent system. Its contradictions and dysfunctions cannot be repaired by some master design. No one actor has a grand overview—or the power to impose a unifying vision. Countless market players, public planners, and legal and regulatory decisionmakers interact in oft-chaotic ways, clashing with, reinforcing, and adjusting to each other. Out of these interactions, a larger scheme emerges—one that incorporates the health sphere’s competing interests and values. Change in this system, for worse and for better, arises from the interplay between its myriad actors. By quitting the quest for a single, master design, we can better focus our efforts on possibilities for legal and policy change. We can and should continuously survey the landscape of stakeholders and expectations with an eye toward potential launching points for evolutionary processes—processes that leverage current institutions and incentives. What we cannot do is plan or predict these evolutionary pathways in precise detail; the complexity of interactions among market and government actors precludes fine-grained foresight of this sort. But we can determine the general direction of needed change, identify seemingly intractable obstacles, and envision ways to diminish or finesse them over time. Dysfunctional legal doctrines, interest group expectations, consumers’ anxieties, and embedded institutional and cultural barriers can all be dealt with in this way, in iterative fashion. This Article sets out a strategy for doing so. To illustrate this strategy, I suggest emergent approaches to the most urgent challenges in health care policy and law—the crises of access, value, and cost

Cortical Models for Movement Control

Defense Advanced Research Projects Agency and Office of Naval Research (N0014-95-l-0409)

Self-directedness, integration and higher cognition

In this paper I discuss connections between self-directedness, integration and higher cognition. I present a model of self-directedness as a basis for approaching higher cognition from a situated cognition perspective. According to this model increases in sensorimotor complexity create pressure for integrative higher order control and learning processes for acquiring information about the context in which action occurs. This generates complex articulated abstractive information processing, which forms the major basis for higher cognition. I present evidence that indicates that the same integrative characteristics found in lower cognitive process such as motor adaptation are present in a range of higher cognitive process, including conceptual learning. This account helps explain situated cognition phenomena in humans because the integrative processes by which the brain adapts to control interaction are relatively agnostic concerning the source of the structure participating in the process. Thus, from the perspective of the motor control system using a tool is not fundamentally different to simply controlling an arm

Adaptive intermittent control: A computational model explaining motor intermittency observed in human behavior

It is a fundamental question how our brain performs a given motor task in a real-time fashion with the slow sensorimotor system. Computational theory proposed an influential idea of feed-forward control, but it has mainly treated the case that the movement is ballistic (such as reaching) because the motor commands should be calculated in advance of movement execution. As a possible mechanism for operating feed-forward control in continuous motor tasks (such as target tracking), we propose a control model called "adaptive intermittent control" or "segmented control," that brain adaptively divides the continuous time axis into discrete segments and executes feed-forward control in each segment. The idea of intermittent control has been proposed in the fields of control theory, biological modeling and nonlinear dynamical system. Compared with these previous models, the key of the proposed model is that the system speculatively determines the segmentation based on the future prediction and its uncertainty. The result of computer simulation showed that the proposed model realized faithful visuo-manual tracking with realistic sensorimotor delays and with less computational costs (i.e., with fewer number of segments). Furthermore, it replicated "motor intermittency", that is, intermittent discontinuities commonly observed in human movement trajectories. We discuss that the temporally segmented control is an inevitable strategy for brain which has to achieve a given task with small computational (or cognitive) cost, using a slow control system in an uncertain variable environment, and the motor intermittency is the side-effect of this strategy

Evolution for our time: a theory of legal memetics

The purpose of this paper is to explore the significance for legal thought of recent developments in evolutionary theory which are associated with the notion of 'memetics'. 'Memetics' aims to account for processes of cultural transmission and change using a version of the 'genetic metaphor'. This is the idea that patterns of cultural evolution are closely analogous to those which occur in the natural world as a result of the interaction between genes, organisms and environments. At a further, more ambitious level, the initial metaphor gives way to a search for mechanisms which unite biological and cultural evolution. Identifying these general evolutionary mechanisms is part of a wide-ranging, interdisciplinary research agenda.legal evolution, memes, path dependence, employment contract, corporate governance

Learning in evolutionary environments

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