ne today is a business enterprise," Dr. Joseph Varon writes at the Brownstone Institute. "Patients are consumers, doctors are 'providers,' and healing has been crowded out by billing codes, liability fears, and the suffocating weight of bureaucracy. The vocation has been replaced by a job, and a job can always be abandoned."
In case you didn't catch the tone, yes, Dr. Varon bemoans healthcare traded as a "commodity" rather than delivered as a quasi-priestly "vocation."
A young socialist-minded acquaintance of mine puts it more plainly. "Healthcare shouldn't be a commodity," she says. "Everyone needs it. Without it, people die." And of course the whole socialist premise is based on opposition to the "commodification of labor" in general.
For any good or service, there are two alternatives to commodification:
First, do without that thing. In a world where doctors and other health practitioners do their work just because they love it, subsisting on whatever alms grateful patients happen to throw their way, the number of healthcare workers available will dwindle, not grow. More people will receive less care. More people will die younger.
Second, enslave those who can provide that thing and force them to provide it. The most obvious problem with that is the moral implication. Slavery is wrong. It's wrong if you expect the slaves to pick cotton, and it's wrong if you expect the slaves to perform surgery. A nearly as obvious problem is that slaves tend to care less about, and put in less effort to achieve, positive results from their forced labor. Would YOU hand a slave a scalpel and demand a heart bypass?
The evolution of money boosted humanity from a barter economy in which, if I had a cow and needed an appendectomy, I had to find a doctor who wanted a cow, to an exchange economy in which goods and services could be commodified and traded indirectly but easily.
Without large-scale commodification and money as medium of exchange, we'd all be -- and once were -- much, much poorer than we are now, even if enterprises were "worker-owned." Healthcare workers would still have to eat, even if they were outright slaves. And if they weren't, their collectives would spend a lot more time trading medicines, stitches, casts, etc. for chickens, goats, and shingles for the roofs of their little shacks and a lot less time actually practicing their "vocations."
If there's a down side to commodification, it's that an exchange economy makes it easier for governments to extort a portion of our economic production from us as taxes, then spend it. Instead of X bushels of grain or Y gallons of milk in "in-kind" taxes that have to be further bartered, they just grab Z dollars out of our wallets.
Taxation, of course, is something we should eliminate, along with the gangs that practice it. But that's a subject for another column. The point here is that we owe everything above our barest subsistence, and maybe even that, to "commodification" of healthcare and everything else.
