Listening to NPR New Years morning I heard repeated references to health care as a product. Accordingly, the mandate has become a requirement to buy a product. Obviously a non-starter, right? No one can tell me to buy a Prius or a Big Mac.
No. I'm free to chose. There's a market out there and if there's a good product at a good price then I'll consider it. If not – well, forget it.
The logic is irrefutable.
But then, in the same NPR segment, a conundrum appeared. It seems that insurance works by calculating actuarial risk on a pool of customers – on their cars, their houses, or themselves. Risky pools mean higher prices. Fair enough. And yet, as the interviewee in the segment pointed out, in health insurance the market creates an incentive for healthy people to opt out and buy only on the way to the hospital. Does this all sound suspiciously like Credit Default Swaps?
What has happened to our reasoning?
I am beginning to suspect that we, in our free-market economy, have accepted a paradigm so completely that it is leading us astray.
Paradigm: pattern, model, example. The pattern of discriminating among ads and logos on the mall has become strong in our heads. Intoxicated by our freedom to choose, we weigh McDonald's against White Castle and perhaps wind up at In and Out Burger.
In an attempt to escape from this “logic”, let's try an old technique – the reductio ad absurdum.
If health care is a product, what about education? It is being sold that way, these days. What we know is that it is essential and expensive. We are also learning that it does not guarantee a job, and that going into debt on its behalf has become less attractive. How about child care? Working families increasingly depend on it, so it too has entered the marketplace as a product. What about marriage? Isn't it about love, procreation, and raising children and grandchildren? Well, sometimes it can be about snagging a trophy wife or a divorce-able cash-cow husband, about figuring out what is the best buy for me.
Do we approve? Of course not. Somewhere here we draw the line. But where?
Perhaps, rather than thinking about product, we should instead think about work. Instead of thinking about what we need, about what is best for me, we should instead think of what we can give, of what work we can do.
If we look at health care, we can see plenty of beautiful, real work going on. People get into that line of work because they want to help others, to care for them. The same is true in education, where devoted people spend their working lives trying to connect to another human being, one at a time, because that is the only way it works – really works. And what is the family values debate all about? Really, what we all want is a family that works, where both parents are devoted to the cause of rearing their children; where one working outside the home is sufficient to keep a roof over their heads and food on the table, and where the other can stay home doing the huge job of rearing the young.
The real bottom line is that all work that is worth anything is caring for others or making things that do. Love is not a commodity. We owe it to each other.
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