I am currently reading The Master and His Emissary , which appears to be an excellent book. ("Appears" because I don't know the neuroscience literature well enough to say for sure, yet.) But then on page 186 I find: "Asking cognition, however, to give a perspective on the relationship between cognition and affect is like asking astronomer in the pre-Galilean geocentric world, whether, in his opinion, the sun moves round the earth of the earth around the sun. To ask a question alone would be enough to label one as mad." OK, this is garbage. First of all, it should be pre-Copernican, not pre-Galilean. But much worse is that people have seriously been considering heliocentrism for many centuries before Copernicus. Aristarchus had proposed a heliocentric model in the 4th-century BC. It had generally been considered wrong, but not "mad." (And wrong for scientific reasons: Why, for instance, did we not observe stellar parallax?) And when Copernicus propose...
Believe it or not, I'm actually in agreement with you on much of this topic. Where I think you err, rather, is this: in modern policy, patients are already seen as customers, and most policy debates hinge on whether to treat them as customers this way vs. that way. None of the major proposals (including those of Krugman, who IIRC you cited as showing outrage at the idea of seeing patients as customers) would change this.
ReplyDeleteSo it seems like a red herring: if you have an idea that would bring about a paradigm shift away from patient-as-customer, bring it up, but otherwise, the criticism is irrelevant. (One example of someone doing it right is Kevin Carson, who has concrete proposals for "mutualist medicine" and how it would bring back the social aspect of care.)
And, not that it matters, but actually practicing non-monetary mutualist medicine would contract GDP...