Whether one must work or not, these few days between Christmas and New Year’s Day are always odd — kind of like when abutting states leave space between one state’s “you are leaving” sign and the other state’s “welcome” sign. Where are we, and what laws apply?
In reason-for-the-season terms, our Savior has been born, but we still have a week of letting the year peter out. The theme of one holiday is motivation for new resolutions, and the theme for the second is the start date for them. What do we do between? Should we start early? Do we need the week to extricate ourselves from bad habits and harmful practices, so that we are fully removed before the new year begins? Or should we take this week as an opportunity for farewells to those habits and practices — one last binge?
Obviously, the answer must take human nature into account. How we look at things affects how we’ll do them. If a final binge of something unhealthy is intellectually an option, then we’re assuming some sort of value from it and setting it up as something we’ll miss.
This same principle applies to how our society sees its economic policy, inevitably with self-defeating results for those who don’t take human nature into account.
I don’t find it to be a challenge to my masculinity (though perhaps to my sanity) to admit that a tear came to my eye while listening to Keith Smith explain his business’s model to Russ Roberts on EconTalk. Smith is an anesthesiologist who teamed with surgeons and others to start the Surgery Center of Oklahoma, which posts its prices online and doesn’t deal with health insurance. Customers often find the out-of-pocket expense to be lower, even as the doctors find they make more money.
The tear-jerking moment was the description of a community that came together to cover the cost of a member’s surgery, which the doctors reciprocated by returning the fees for their own services (charging only for the supplies). The slanders of socialists aside, this is how a free market is actually supposed to work, and the do-gooders who seek to force the world to be fair actually subvert our better human angels.
Smith’s conversation with Roberts explains this well, at around the 55-minute mark. Most of the healthcare industry, Smith suggests, follows the cliché that a business is about maximizing profit. His center, he insists, focuses on maximizing value, to customers as well as to employees. This is capitalism properly understood: Businesses are run by human beings for human beings, and we calculate value more extensively than just cash. A free market should flow so as to maximize exchanges on mutually agreeable terms that include feeling good about one’s work and advancing whatever spiritual cause one implicitly or explicitly believes in.
What moderns tend to forget is that socialism, and even milder big-government progressivism, is fundamentally materialist. Proponents might sell their ideology with humanistic rhetoric, but its framing (how they look at things) has an anti-human effect.
Just so, Smith says he blames the federal government for the materialism of our healthcare system. How could it be otherwise? Politicians sell the policies on the grounds that they’re transferring wealth (i.e., money). Legislators and regulators can’t legislate and regulate personal fulfillment, only the terms of contracts (i.e., money).
But in healthcare, especially, so much of the value has nothing to do with money, and we are squeamish about the translation of non-monetary value into dollar terms. Consequently, the system is designed to disguise this translation. The sticker price of a surgery does not reflect the balance of values. It represents the accumulated inflation of a subsidized system that attempts to measure competing interests with fictional dollar amounts.
The EconTalk participants noted in passing that our current healthcare system makes everybody poor, in the sense that nobody can really afford to pay for the services they use. Everybody must be subsidized in one way or another to bring the price that must be proposed down to the cost that can be paid.
Like a New Year’s resolution completely at odds with the nature of the person making it (and therefore impossible for him or her to follow), government resolves that people’s health must not be treated as a material good, but should be held inviolable to the crass mechanisms of the market. This denies the humanity of the patient, the provider, and the payer and ensures that we will stagger along throughout the year giving excuses for why we can’t fulfill our promises until we simply give up.
Protesting the value of his deceased business partner, Ebenezer Scrooge insists that Jacob Marley was “a good man of business,” sparking the ghost’s famous reply:
“Mankind was my business. The common welfare was my business; charity, mercy, forbearance, and benevolence, were, all, my business. The dealings of my trade were but a drop of water in the comprehensive ocean of my business!”
As self-evident as Marley’s exhortation may seem in our modern culture, it is not self-sufficient. What do charity, mercy, forbearance, and benevolence mean? Not mere material infusion, surely. Surely also not a disengaged moral indulgence that is indistinguishable from indifference.
In the absence of a Christmas of some sort, a New Year’s resolution is simply a phrase stated because it sounds like something that ought to be said. That may be fine for a not-yet-dieting middle-aged professional, but it can be a devastating delusion on which to build an economic system.
Featured image: Original illustration of Scrooge talking with Jacob Marley in Charles Dickens’s A Christmas Carol.