Saturday, August 1, 2009
Health Producerism as a Serious Medicine Strategy
This illustration is worth looking at closely, because it takes us back to the days when production was regarded as the fundamental economic strategy.
It was produced by The Grange, a farmers' alliance that peaked in the 19th century, it illustrates the tenets of producerism. If that word is unfamiliar, here's the Wikipedia entry on "producerism," it is more than a little critical, but as with most postings on Wikipedia, it's a start. In the middle of the picture is a farmer, and the caption reads, "I feed you all." That was the central argument of The Grange back then--and they were hardly wrong. Surrounding the farmer are others, also saying what they do. The soldier at top right says, "I fight for all." Next to the soldier, the minister says, "I preach for all." And so on. The artist is content to let each profession speak for itself in a terse but positive way, except for the man underneath the sign "general brokerage," aka wholesaler, second from the left at bottom. His caption says, "I fleece you all." That sums up the view of the Grange, and of producers in general, toward financiers, then and now.
It's a natural tension, of course, and there's plenty of need for both functions--producing as well as market-making. The challenge is to strike the right balance, so that markets are liquid, but also so that speculation doesn't become parasitism.
Back then, the clear preference was for producers. People who made things were valued more highly than people who financed things.
This producerist prefernce was manifest all through society, even as pressures were causing New York and Washington--financialist havens both--to gain power. Thus the 1912 Bull Moose Progressive Party platform--the third party that Theodore Roosevelt led in the three-way election that led to the victory of Woodrow Wilson. Yes, TR lost that election, but the 1912 marked the total victory of progressive thinking--the second- and first-place finishers, TR and Wilson, much as they disliked each other personally, were both progressives.
And so note, as indicator of state-of-the-politics progressive thinking back then, the focus on systematic education and R&D in these two Bull Moose planks:
The development of the creative labor power of America by lifting the last load of illiteracy from American youth and establishing continuation schools for industrial education under public control and encouraging agricultural education and demonstration in rural schools;
The establishment of industrial research laboratories to put the methods and discoveries of science at the service of American producers;
Producerism fell out of fashion in the 20th century, replaced by more money-minded schools of thought, such as monetarism and Keynesianism.
But the idea of producerism is not only powerful, it is also obviously necessary--in any century. And it applies to health care and medicine as much as any other industry. Whatever it is, you have to produce it first. You can't finance what you don't have. You can't speculate on what you don't have. And, returning to the issue of health care today, you can't get healthier on what you don't have. Indeed, you can't even ration what you don't have.
Posted by James P. Pinkerton at 12:04 PM