Capitalism has an ironic side effect after generations of progress: we forget about the minutia of production and the importance of capital risk and investment. If you are a software developer or website designer, you can appreciate the time and energy involved in a really awesome piece of software. If you are an engineer, you can appreciate the beauty and simplicity of Apple products. Many of us create things, whether big or small, and so we do have the potential to see all around us the wonders of the capitalist structure of production. Even if we don’t understand it all, we can deeply appreciate it.
One area I don’t fully understand is the medical-industrial complex. I don’t get to visit hospitals very often, but when I do, I get the same sense of awe and wonder and I just can’t help but marvel at the wonders of the marketplace. Yes, I realize that the medical industry isn’t exactly as “free market” as, say, the technology industry. But that doesn’t preclude a strong market component in the production of devices and substances in the industry. Somebody long before our visit to the hospital saw a problem that needed to be solved. They took huge risks of capital in order to help save lives or to make our lives generally less problematic.
This is no small matter. I have a pitiful amount of knowledge about the production of the equipment that fills the rooms and corridors of our hospitals and operating rooms. What I do know, however, is that incredible risk was taken for something for which there was no guarantee: success. With only profit and loss as the barometer in the marketplace, some forged ahead. There were undoubtedly many failures along the way, yet some of the best equipment and substances emerged for our well-being. Their purveyors weren’t necessarily even interested in medical devices in the first place. All it took was the skills to make really awesome microchips or perhaps the talent to manage a company of high-functioning people to create software that made procedures more efficient.
Leonard Read’s classic story, I, Pencil comes to mind. Millions of people, in small but important ways, contributed willingly to a process that saves lives (or produces pencils). Of course, some of them were intelligent people who were able to connect the dots and work purposefully toward solving a medical problem or need. But they represent the small percentage of those producers. By and large those who cooperated in the process weren’t boasting to their families at dinner about how they contributed to society’s health needs.
Despite the marvels of the marketplace advancement in health industry, there are two morally attractive but wholly dubious arguments regarding health care that we ought to guard against. The first is that health care is too important to be left up to the free market. Seriously? Take a stroll down the hallways of a local hospital and try to convince yourself that all this stuff can be produced through central planning, even if only for a single industry. If universal health care were indeed possible, its advocates take for granted that the marketplace itself provided the myriad luxuries provided in the medical industry. Universal health care is a direct result of the wealth created by the entrepreneurial spirit in the medical industry. Nobody was crying for “universal health care” 500 years ago.
A second but related complaint is that some people shouldn’t get rich off of other people’s ailments. Never mind the obviousness that whatever wealth is acquired it is in the solving of those ailments! What troubles the anti-market health care enthusiast can be sufficiently blamed on the word “care” in “health care.” The additional word introduces concepts such as intentionality or purposefulness or planning. The patient (who is a type of consumer, by definition, regardless of our sentimental objections to the term) must be cared for by her doctors and nurses. Yet if we consider the economics of the doctor-patient relationship, we realize that the success of the doctor depends on the quality of care they provide, both medically and emotionally. It’s an enormous asset to have a genuinely caring physician. What’s more important is competence and honesty, something a market is equipped to facilitate.
But should we even care whether the producers in the medical industry (or any other industry for that matter) are driven by rampant greed or Christian-like charity and good intentions for humanity? While it’s nice to think that laborers in factories, the CEOs of companies, and all who cooperated to bring those final goods into service are caring individuals, I’m personally more interested in the outcome: quality equipment and substances that do not fail. If the CEO of a company who can save lives is a greedy corporatist is inconsequential to whether my life is saved. The equipment must work.
To be sure, if somebody is getting wealthy because other people are being duped, defrauded, or misled, of course we take great issue with that (in any industry). But if you ask any woman about to deliver a baby if she cares that the inventors or producers of an epidural are wealthy, I doubt you’ll hear her disdain for such people.
It can’t be mistaken that there are truly caring entrepreneurs who want to discover and create solutions that save people’s lives. For that we must be grateful, and they can never receive enough praise. They saw a need and—regardless of motive—are working toward a solution. But we should neither forget nor discount the progress that occurs in the marketplace because any incentive whatsoever has helped produce a quality and desirable outcome.