Why Socrates Hated Democracy, and What We Can Do about It.

Socrates: what a dummy. 

Around the world, people of all ages are finding reason to be wary of democratic government. While the western world places a high value on democracy today, this wasn’t always the case. Some of the greatest minds in the history of western civilization had strong critiques of democracy. Critiques that we would be idiots to ignore.

In the Republic, Plato writes that Socrates was debating (well, more so lecturing about) the nature of the ideal state. At one point he asks his associate, Adeimantus, who he would rather have managing a voyage on the sea. Some random passenger, or a well-trained, educated, and experienced captain? After the captain is selected as the obvious choice, Socrates then extends the metaphor to the state, asking why we would let just anybody try to manage the ship of state. He then goes on to propose a totalitarian regime as the ideal state, where the rulers have all been educated in ruling for decades before taking absolute power.

Socrates’ objections to democratic government can be found in other works as well. He praised Spartan monarchy as being well managed, and in several dialogues about the virtues he laments that so few people have them and how even fewer people are capable of understanding that. It is doubtless that he didn’t consider the general population as smart enough to manage things.

This is not the only criticism of the intelligence of the voting population we have from the cradle of democracy. In the later parts of the Republic, Plato suggests that democracy is one of the later stages in the decline of the ideal state. One which is so bad that people ultimately cry out for a dictator to save them from it. This idea was big for Plato, democracy would lead to tyrants.

Aristotle, for his part, listed democracy as the failed version of rule by the multitudes. “Timocracy”, rule by the propertied class or even just a more constitutional form of republican government was the ideal kind of rule by the many, in his mind. He would have seen Athens as an ever-decaying city, moving away from its original timocratic constitution as laid out by Solon.

The idea that democracy is fundamentally flawed even had sponsors in later, more liberal, thinkers. Voltaire, who supported all of the liberal freedoms of speech and religion, told Catharine the Great of Russia that, “Almost nothing great has ever been done in the world except by the genius and firmness of a single man combating the prejudices of the multitude”. His understanding of liberalism was separated almost completely from democracy.

If democracy was so bad then, why do we have it now? Why repeat the mistake?

Now, it is important to understand that the democracy in Athens was much different than the kind we have today Athens was much closer to a direct democracy than most of us would be comfortable with. It was also very restricted; only twenty percent of the population was ever enfranchised at the same time, all of them free white males over the age of 18 with parents who were also citizens.

Certain offices had a minimum wealth requirement. The quorum for the Assembly was 6000 citizens, so to increase attendance slaves with a red-dyed rope would herd people there from the agora, anyone caught with red dye on their clothes was fined. Many posts in the government were held by citizens selected at random to serve in them.

Socrates himself held office in this way once, and witnessed what amounted to an angry mob illegally putting generals to death on his watch. Then, of course, a jury decided by a slim majority to put him to death on flimsy charges. Plato tells us that a mere 30 votes, out of a jury of 500, killed him. 

The Death of Socrates

But, why do the critiques still matter if we don’t have Athenian Democracy?

Well, the fact that we have a different government than Athens doesn’t mean we don’t share similar problems. Socrates was worried about the problems posed by an uneducated and easily lead population having power over the state. A problem which continues to trouble thinkers like Richard Dawkins.


In the United States voters can be a little less than informed about what they are voting for. Half of American adults don’t know that each state gets two senators, two thirds don’t know what the FDA does. Jimmy Kimmel shows us how people don’t know much about Obamacare,  and the results of the lack of information voters have is demonstrably negative for them. These facts, combined the power of the offices in the hands of the voting public, would make Socrates reach for the hemlock.

What can we do?

There is one good, knowledge, and one evil, ignorance”. Thus spoke the anti-democratic Socrates. Education is the best hope for a democracy. A population which understands the traits needed in a leader, knows the difference between a con artist and a legitimate leader, and knows which path forward to take is the difference between an effective democracy and Socrates’ nightmare. While in our democracy the typical voter doesn’t need to worry about being placed in a position of power by lottery, they do need to understand enough to select the right person to have in power in their stead. 

For the Greeks this was an education in grammar, logic, and rhetoric, arithmetic, geometry, music, and astronomy. All things seen as vital to taking part in public life and living the life of a free citizen, it was later the foundation of our modern Liberal Arts education. While the idea that “the best argument against democracy is a five minute conversation with the average voter” may still ring true, improving the education of the average voter weakens that argument.


“Democracy is the worst form of government except all those other forms”, so said Winston Churchill, noted champion of democratic ideals. Any government is only as good as its rulers. In a democracy, this means that the general population must be properly educated to rule themselves. Will the critiques of democracy given from its cradle be acknowledged? Or will we end up like Athens? A democracy in name, but in fact ruled by the unwashed mob? 

3D printing might save your life one day. It's transforming medicine and health care.

What can 3D printing do for medicine? The "sky is the limit," says Northwell Health researcher Dr. Todd Goldstein.

Northwell Health
Sponsored by Northwell Health
  • Medical professionals are currently using 3D printers to create prosthetics and patient-specific organ models that doctors can use to prepare for surgery.
  • Eventually, scientists hope to print patient-specific organs that can be transplanted safely into the human body.
  • Northwell Health, New York State's largest health care provider, is pioneering 3D printing in medicine in three key ways.

Imagine that a health emergency strikes and you need an organ transplant – say, a heart. You get your name on a transplant list, but you find out there's a waiting period of six months. Tens of thousands of people find themselves in this dire situation every year. But 3D printing has the potential to change that forever.

The technology could usher in a future where transplantable organs can be printed not only cheaply, but also to the exact anatomical specifications of each individual patient.

What other innovations could 3D printing bring to medicine and health care? The sky is the limit, according to Dr. Todd Goldstein, a researcher with the corporate venturing arm of Northwell Health, New York State's largest health care provider and an industry leader in 3D-printing research and development.

"It comes down to what people can think up and dream up what they want to use 3D printing for," Goldstein says. "Ideally, you would hope that 50 years from now you'd have on-demand, 3D printing of organs."

While that's still on the horizon for researchers, 3D printing is already improving lives by revolutionizing medicine in three key areas.

​Printing realistic, customized organ models

3D printers can take images from MRI, PET, sonography or other technologies and convert them into life-size, three-dimensional models of patients' organs. These models serve as hands-on visualization tools that help surgeons plan the best approaches for complex procedures.

They also allow doctors to customize patient-specific models prior to surgery. For example, Northwell employs 3D printing in several clinical applications:

  • Tumor resection models clearly highlight the tumor and surrounding tissue
  • Orthopedic models are useful for pre-surgery measuring and medical device adjustments
  • Vascular models identify malformations in organs, tumors, sliced chambers, blood flow, valves, muscle tissue, and calcifications
  • Dentistry oral implants and appliances can be created in just one day, significantly reducing wait periods for Northwell dentists and their patients

Using realistic models not only delivers better health results but also shortens operating times. That gives patients less time under anesthesia, and hospitals potential savings of millions of dollars over just a few years.

Being able to visualize procedures before they occur also helps to comfort patients and their families. Take, for instance, the case of Barnaby Goberdhan, a man who discovered that his young son, Isaiah, had an aggressive tumor in his palate. Goberdhan met with Neha A. Patel, MD, a pediatric otolaryngologist at Cohen Children's Medical Center, a Northwell Health hospital, to discuss the procedure and learn about it with help from a 3D-printed model.

"Having a 3D printed depiction of my son was really helpful when talking with the doctor about his surgery," said Mr. Goberdhan. "The doctor was able to do more than talk me through what they were going to do – Dr. Patel showed me. There is almost nothing more frightening and stressful than having your child go through surgery. There were several options Dr. Patel walked us through for the best way to preserve Isaiah's teeth and prevent additional cuts within his mouth. I wanted all of my questions answered so I could be less fearful and more prepared to talk my son through what he was about to face. I wanted Isaiah to feel prepared. With the 3D model, we both felt more at ease."

For years, 3D printing surgical models was prohibitively expensive. Now, more affordable systems such as Formlabs' Form Cell give more hospitals across the country access to the technology in order to produce realistic, patient-specific models, usually within one day.

3D-printed prosthetics

Credit: Northwell Health

While 3D-printed organs are a long way in the future, today's technology is well suited for manufacturing prosthetics. 3D-printed prosthetics are often remarkably more affordable and personalized than their traditional counterparts. That's a big deal for many families, especially those with children who outgrow prosthetics and are forced to buy new ones.

One recent breakthrough in 3D-printed prosthetics came when Dan Lasko, a former Marine who lost the lower part of his left leg in Afghanistan, wanted the ability to swim with his prosthetic leg. Wearing prosthetics in water has been possible for years, but they typically slow swimmers down. No device had been able to go seamlessly from land to water or to help propel its wearer through the water.

To fix that, Northwell Health recently funded a project that developed The Fin – the world's first truly amphibious prosthetic. With The Fin, Lasko and his family can go straight into the pool from the locker room – or the diving board.

"I got back in the pool with my two young sons and for the first time was able to dive into the pool with them," Lasko said.

3D-printed prosthetics will help improve the daily lives of the nearly 2 million Americans who've lost a limb. That's promising because the increasing prevalence of Type 2 diabetes is expected to greatly increase the number of amputees in the U.S., according to a study published in the Archives of Physical Medicine and Rehabilitation.

​3D bioprinting

For years, 3D printers have manufactured various products: phone cases, toys, and even operational guns. To produce these objects, the machines heat a raw material, typically plastic, and build the object layer-by-layer according to a particular design.

3D bioprinting, a young field developed by researchers with Northwell Health, may someday perform the same process but instead with living cells in a raw material called bioink.

Daniel A. Grande, director at the Orthopedic Research Laboratory in the Feinstein Institute for Medical Research, an arm of Northwell Health, said he and his team first pursued 3D bioprinting by modifying 3D printers so they'd accept living cells.

"My initial concept of 3D printing was early studies that looked at modifying ink-jet printers, where we incorporate a bioink that includes cells within a delivery vehicle," Grande says. "That hydrogel can then be polymerized, or hardened, upon heat or UV-light stimulation, so that we can actually make a complex structure, three-dimensionally, that incorporates living cells. The hardened hydro-gel is then able to keep the cells alive and viable. It's also biocompatible, so it can be safely implanted in humans."

It's a promising enterprise, and it can radically change how we experience medical care.

"3D bioprinting's potential is almost limitless and has the potential to replace many different parts of the human body," says Michael J. Dowling, president, and chief executive officer at Northwell Health. "Researchers envision a future with 3D printers in every emergency room, where doctors are able to print emergency implants of organs and bones on demand and revolutionize the way medicine is practiced."

Dr. Todd Goldstein explains more about 3D bioprinting below:

Health care: Information tech must catch up to medical marvels

Michael Dowling, Northwell Health's CEO, believes we're entering the age of smart medicine.

Photo: Tom Werner / Getty Images
Sponsored by Northwell Health
  • The United States health care system has much room for improvement, and big tech may be laying the foundation for those improvements.
  • Technological progress in medicine is coming from two fronts: medical technology and information technology.
  • As information technology develops, patients will become active participants in their health care, and value-based care may become a reality.


In his book Health Care Reboot, Michael Dowling, Northwell Health's CEO, argues that "[the United States] is constructing a solid foundation upon which the new American health care is being erected." To those steeped in news of health care's administrative bloat, under-performing primary care, and low levels of insurance coverage, such a thesis may seem bold, wishful, or downright delusional.

But Dowling does not ignore the health care system's need for improvement. Rather, he believes that contemporary trends can foster such improvement if we recognize their value. He cites advances and disruptions in areas such as consolidation, education, payment reform, and mental health to support his progressive view that "better, safer, and more accessible care" is coming.

Among those trends is big tech's move into health care, or as Dowling puts it, technology may soon move us into the age of smart medicine.

Medical tech marvels

Dowling sees big tech's stride into health care as coming from two fronts: medical technology and information technology. On the medical technology front, the technology available to doctors has accelerated at an unprecedented pace, resulting in tools and techniques that are "the stuff of Star Wars."

"Some of the most advanced technology tools ever developed in any field are in use to care for patients. Look at any modern operating room or intensive care unit, and the technology to treat patients and keep them alive is remarkable," writes Dowling.

To pick one of many examples, Northwell Health's Cohen Children's Medical Center was the first pediatric program on Long Island to institute ROSA, a "robotic operating surgical assistant." Before ROSA, children suffering epilepsy would have to undergo a full craniotomy to target and monitor areas of seizure activity. With ROSA's assistance, surgeons can get the same results through a minimally invasive procedure, reducing the risk of infection and strain on the patient.

Even technology not designed for therapy has been co-opted to play small, yet supportive, roles in quotidian treatment. A study out of the Children's Hospital Los Angeles found that virtual reality can help reduce a child's anxiety and stress during basic procedures such as a blood draw.

Information tech plays catch up

Photo: Sisacorn / Shutterstock

Dowling characterizes the information technology front as "less impressive," pointing to the well-known difficulties of onboarding electronic health records. Beyond concerns of cybersecurity and interoperability, such systems have caused widespread burnout and dissatisfaction among practitioners thanks to their time consumption and complicated workflows.

But progress is being made. Apple recently added a Health Records app to its iPhone, giving patients from 39 health systems access to their medical records.

"This existing new reality is that a fat file, that until recently was stored away unavailable to the patient, now sits in its entirety on the patient's phone," writes Dowling. "For patients with chronic conditions who make frequent use of medical services, this leap forward enables them, whether a mile from their doctor's office or a thousand miles, to track and share with their doctor essential data on blood pressure, heart rate, glucose levels, and scores of other important clinical markers."

But to succeed, this information must be gatherable, accessible, and understandable to any patient. Big tech will need to streamline such systems for maximum user-friendliness, all while keeping operations on a device with which patients and practitioners are intimately familiar.

That device will be the smartphone and tablet. 77 percent of Americans own smartphones. Among Americans over 65 years of age — the demographic most in need of such advancements — 46 percent own a smartphone, a number that is likely to climb.

Big tech's vision of integrating information technology with health care is some ways off. Much experimenting must be done, and big tech needs to better collaborate with traditional health care stakeholders. Even so, these incipient steps may lead to a framework where practitioners can gather more data more quickly and with greater ease, while patients become partners, not passive recipients, of their health care team.

Accelerating value-based care

In the United States, value-based health care exists today as a should-we, could-we debate topic. Big tech's entry into the field could push value-based care closer to practice. As noted on the health care blog Tech Prescribed, integrating improved data acquisition with AI-powered platforms could turn value-based care into a manageable venture.

"As a result, we will see the move to VBC accelerate even further as more firms turn a profit through this business model. Good news for docs — this will make you the primary customer for provider technology and really improve your user experience as a side effect," writes Colton Ortolf of Tech Prescribed.

The Northwell Health entity Pharma Ventures was created both in response to collaborating with big pharma and as a means to promote value-based care. Pharma Ventures was designed "to link drug prices to drug performance" and "to serve as a super-site for clinical trials." The goal is to drive down costs while simultaneously improving patient experience. Such an initiative is only possible due to Northwell's integrated systems and system-wide electronic health records.

Entering the smart age of medicine

For Dowling, health care in the United States is laying an important foundation for the medicine of tomorrow. We're moving away from the view that health care is something the patient receives at a medical facility. Soon, health care will see the patient take an active role alongside a team of health care providers.

"The new American medicine is proactive and has physicians working in teams with nurses and other caregivers to reach out to patients and guide them along a pathway to health and wellbeing," writes Dowling.

By creating new machines, proliferating information, and making that information easier to obtain, big tech's dive into health care will be a fundamental element in this upcoming paradigm shift.