Continuing my ruminations on how we can reframe and rename the subject of medical services for all, I've about settled on UNIVERSAL MEDICAL SERVICES as the most accurate name. Although somebody did suggest that PRE-EMPTIVE MEDICAL SERVICES might be more attractive to Republicans.
Anyway, I don't want medical insurance, 'cause there's nothing sure in life except that we are going to die, and I don't want care, "medical" or "health," 'cause care is an emotions that salves the conscience of him who feels it and does almost nothing for him who suffers. So, universal medical services for all is what we're after and what we should be promoting with all the candidates we meet and greet.
But, there's one more consideration that has to go into the equation. And that's the role of profit.
Which I why I have come up with the notion that profit is only appropriate when there's pleasure involved in a particular transaction. Which brings me to
THE PLEASURE PRINCIPLE OF PROFIT
A lot of people are inclined to believe that the economic system we refer to as "free market" is capitalistic because it assumes that people will make and trade things in order to make a profit.
I, however, tend to disagree with this simple explanation and prefer to focus on the fact that what capitalism calls for is a system of production and exchange (which people participate in rather spontaneously) which sets aside some of the wealth that's been created for use IN THE FUTURE, rather than consuming it on the spot or letting it go to waste. In other words, capitalism is first of all a concern for the future.
While capital in its visible manifestation is probably correctly equated with profit, profit is not only good, it represents an extra benefit that is experienced as the result of an exchange. Profit means that the recipient of a good or service is much better off than before he got it and better off than he expected. Profit is symbolic of pleasure.
So, the question I want to ask is whether and under what conditions someone who provides a good or service is actually entitled to a profit? I think most of our economists would say that, because profit is the motive, the reason why people do things, profit isn't just an entitlement, it's indispensible, if we want our economy to thrive.
But, what I want to suggest is that isn't necessarily so. If profit is actually a measure of how much pleasure the recipient of a good or service derived from, that would put a whole other face on our transactions, wouldn't it?
First because there are obviously some goods and services from which the recipients derive no pleasure at all. People in prison, for example, do not derive pleasure from being locked up. Indeed, the people who pay for keeping them locked up don't derive much pleasure from that transaction either.
So, if we employ the pleasure principle of profit, then we might conclude that prisons and other institutions, whose services the recipients don't like, should not be considered as generators of profit. When there is no pleasure, there is no way to accurately determine how big or how small the profit ought to be.
Which is not to say that those services which cannot be expected to provide pleasure should not be provided or paid for. Just that they should be delivered at cost. Making a prison a profit center almost certainly creates a potential for exploitation, or the extraction of outrageous "profits," simply because an appropriate profit cannot be determined.
Now, you may well ask how the pleasure principle of profit would apply to goods and services that are not intended to enhance pleasure and do not qualify as being necessary but unpleasant to the recipients, but serve, instead, to mitigate or make better a condition that causes pain or distress to the receiving individual. And my answer would be again, that goods and services which merely mitigate distress or return a recipient to a steady state, should not be in a position to generate a profit either.
If profit is related to the generation of pleasure, a benefit over and above the status quo ante, then goods and services which people would rather not have, but need, should be performed or delivered at cost. Which is not to suggest that costs, (past, present and future) shouldn't be fully calculated in order to insure that the provider is fairly compensated. They most certainly should be; at a much higher rate than they are now.
On the other hand, those medical services which are purely optional and designed to give the recipient a sense of pleasure, whether in the form of enhanced appearance, greater than normal physical prowess, or merely to satisfy a whim, should not only be profit centers, but they should be considered as distinct and different from those medical services which alleviate a particular disease, disability or injury when the level of compensation is considered and calculated.
If we don't make a clear distinction between medically necessary services and life "enhancing" procedures, the concept of universal medical service is probably not going to fly. Hardly anyone wants to pay for the enhancement of other people's pleasures. Common sense tells us that, if people just want to "feel better," they should pay for it themselves and provide the provider with a profit appropriate to his satisfaction.
Finally, the reason for more appropriate terminology for what we are after is pretty simple. The word "health" has been taken over by so much enterprise (health food, health spa, health club,health regimen, etc), aside from it being pretty obvious that healthy people don't require medical services as such, that more and more people are surely right to conclude, "I don't want to pay for that." A change in name might just change some minds.
Posted by Hannah at August 23, 2004 11:06 AM