You Can’t Heal What You Can’t Diagnose

I feel a bit sorry for mayors and governors currently trying to deal with a growing pandemic that has nothing to do with medicine. Rather, it is the pandemic of outrage aimed at a prevailing social context that is more obsessed with economic value, rather than the productivity and well-being of the overall population. The outrage may have been triggered by what appears to be deliberate brutality motivated by racism, but that trigger may be part of a larger context in which the very idea of a healthy society has gone by the wayside. I would like to suggest that there are two key aspects of this malady, which are unlikely to be addressed under the current conditions of governance.

One of these is poverty. When one considers how much of the world’s wealth is concentrated in the one percent of the one percent, it should be no surprise at the intimidating magnitude of the number of those than cannot earn a wage sufficient to provide food, clothing, and shelter. Indeed, wealth resides with those that do not have to worry about those three factors. To them productivity is simply a matter of manipulating instruments whose only design is to transform wealth into more wealth. Associating productivity with any particular “product” is irrelevant when the health of an enterprise is measured only by the value of the stock it issues on a major exchange. Until attention is redirected towards both productive workers and satisfied consumers, those that are not part of the one percent of the one percent will be ignored by any excuse for a social contract.

The other aspect is health; and, to some extent, it is related to the circumstances behind poverty and the consequences of those circumstances. During my lifetime I have observed the very idea of health care devolve from a public service to a network of private enterprises, all of which prioritize positions on stock exchanges over the effectiveness of all levels of practitioners and the effective treatment of those served by those practitioners. In other words health care, by virtue of having been industrialized, has become yet another puppet whose strings are pulled by the one percent of the one percent.

The idea of a social contract was originally conceived as a model for the relationship between the individual and the state. However, similar contracts must exist between an individual and those organizations with which that individual must interact. Interaction may involve provisions, employment, or ongoing relationships, such as health maintenance rather than treating maladies after they arise. For the one percent of the one percent, however, any instance of a social contract is nothing other than a fiction of convenience that will “keep the outsiders in their place.” Until countries around the world develop and maintain more equitable approaches to the management of wealth and health, those “outsiders” will continue to wallow in discontent. That discontent will continue to lead to frustration, that frustration will lead to pots that cause damage when they boil over too energetically.