In Cities and the Wealth of Nations, Jane Jacobs tells how, in the 1920s, one of her aunts moved to an isolated North Carolina village to, among other things, have a church built. The aunt suggested to the villagers that the church be built out of the large stones in a nearby river. The villagers scoffed: Impossible. They had not just forgotten how to build with stone, they had forgotten it was possible.
A similar forgetting has taken place among influential Western intellectuals — the people whose words you read every day. Recently I wrote about why health care is so expensive. One reason is that the central principle of our health care is not the meaningless advertising slogan promoted by doctors (“first, do no harm”) but rather the entirely nasty first, let them get sick. Let people get sick. Then we (doctors, etc.) can make money from them. This is actually how the system works.
It is no surprise that doctors and others within the health care system take the first, let them get sick approach. It is wholly in their self-interest. It is how they get paid. If nobody got Disease X, specialists in Disease X would go out of business. What is interesting is that outsiders take the first, let them get sick attitude for granted. It is not at all in their self-interest, just as it was not at all in the self-interest of the Carolina villagers to think building with stones impossible.
An example of an outsider taking first, let them get sick for granted is a recent article in the London Review of Books by John Meeks, an excellent writer (except for this blind spot). The article is about the commercialization of the National Health System. Much of it is about hip replacements. How modern hip replacements were invented. Their inventor, John Charnley. How a hospital that specialized in hip replacements (the Cheshire and Merseyside NHS Treatment Centre) went out of business. And so on. Nothing, not one word, is said about the possibility of prevention. About figuring out why people come to need hip replacements and how they might change their lives so that they don’t. Sure, a surgeon (John Charnley) is unlikely to think or say or do anything about prevention. That’s not his job. But John Meeks, the author of the article, is outside the system. He is perfectly capable of grasping the possibility of prevention and the parasitic nature of a system that ignores it. Long ago, people understood that prevention was possible. As Weston Price documents, for example, isolated Swiss villagers knew they needed small amounts of seafood to stay healthy. But Meeks — and those whom he listens to and reads — have forgotten.