Adam Smith Was Wrong!

I have recently been at a brilliant gathering of people, down in Sussex, called ‘Sparks’. I always find it to be one of the more helpful imaginariums which I spend time at and love the diversity of the people who come. What follows is some learning I’ve taken from my good friend, Mark Sampson and his fabulous PhD thesis.

 

Adam Smith famously stated: “It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.”

 

Like Mark, I disagree with him! I do not believe that self-interest is the basis for individual interaction and whatever we are told, the unrestrained free market is not benevolent!

 

We have allowed economic language not only to inform reality, but to create it. The language and vocabulary of economics is performative – it creates the world around us. Why would we think that self-interested economics will lead to goodness in society when we do not believe that in other parts of society or our own lives? It is not true of our relationships in our families nor in our friendships, so why do we allow a split mindset in how we think about work?

 

Some economists (Robertson and Summers) have argued that we should promote self-interest in policies and act out of this same motive in business, but altruism in other areas of our life, like our family and charitable work. This is ludicrous!

 

As Kate Raworth has so eloquently demonstrated, this current model of economics is dividing us, isolating us and slowly destroying us. It may, in some ways have gotten us to where we are, but it is neither capable nor kind enough to give us the future that will lead to a more connected and healed society and a more sustainable planet. Enlightenment thinking holds very little light for us now. And so, it is time to let it go, to lament its failure and discover together a new language and a more sustainable model for a reimagined future. Some of this requires exchanging the language of scarcity to one of abundance, renouncing the doctrine of growth for one of equilibrium, repenting of our obsession with competition and embracing relationship and collaboration and replacing self-interest with the notion of gift, reciprocity and mutuality.

 

This requires us to dig deeper into a spirituality and a paradigm shift in our thinking which embraces incongruity! The beauty of mutuality is that it recognises that there is personal benefit to the giver as well as the receiver in any gift-exchange interaction and it strengthens the bond of relationship. Since I watched the Christopher Robin movie, I’ve been thinking quite a bit about upsidedown triangles. Our current economies are built in pyramids, with those at the top “earning” and holding absolutely vast sums of money. What if we gave our most and prioritised those considered at the bottom as the most important? In the NHS we think a lot about ‘equality and diversity’ but often do little about it. For example, most of our waiting rooms and clinical environments are incredible unfriendly for people who have an autistic spectrum condition (ASC). What if, when designing these spaces, we didn’t tag on some kind of tick-box exercise afterwards to show we’ve considered people with ‘disability’ in a vague sense, but actually put them at the forefront of our thinking and planning? What if people living with ASC were at the very forefront of our planning decisions? Incongruous, perhaps, but a different kind of economy, which feels to me to be altogether kinder.

 

In my last blog, I explored how it is isolation (and competition caused by our need to try and overcome our human limitations) which cases poverty. What might we imagine together of an economy in which we prioritise relationships first, and worked together WITH those often left at the bottom of the pile or tagged on as an after thought? What might our planning cycles be like, if we slowed things down and really collaborated WITH our communities and truly considered all the benefits of mutuality? I believe we are at a moment in which the facades are well and truly down. We can see more clearly than ever just how broken our current economic system is, the true effects of putting our faith in the ‘free market’ to create a fair society and a sustainable planet and the realities of allowing our policies to be shaped on the notion of self-interest. It would be insane for us to continue with such a broken model, but it will take ongoing bravery to undo it’s myth in our minds, breakdown the strongholds of the many vested interests and to be part of a corporate reimagining of something based on mutuality and even incongruity!

 

In the end, I believe that when we deal with our root issues and become more healed, we are far more motivated by love than self-interest – and I see this every day! We are made in the image of God but allow ourselves to believe much less of ourselves. To quote Charles Eisenstein, “it is time for us to tell a more ancient and far more beautiful story which our hearts tell us is possible.” What if Milton Friedman was wrong and the business of business is not business? I know that may seem ridiculous, but what if the business of business is to ensure that every life matters, that we are more connected and living in a more sustainable way? What if it was the business of business to make real what really matters to us all? What else might a reimagined business of business be? And what effect might that have on how we think about economics and how we collaborate for a more mutually beneficial society and planet? I think we see this in many models and forms of business already. There are some wonderfully ethical and gentle businesses – I think this is especially true of smaller businesses where relationships are both vital and strong. It is the impersonal banking sector in particular, built on an economy of debt, with multi-lateral corporate giants that holds us prisoner.

 

The reason I am writing about this on this blog is that so much of our health and wellbeing is governed by our philosophy of economics and it is the language of economics which shapes so much of our thinking and reality. So, be careful how you speak about it, find some better words and let’s begin to shape a new future together for the sake of the wellbeing of humanity and the planet!

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Goldfish and What They Teach Us!

Last week, I had the privilege of listening to Prof Sandro Galea, from Boston State University talking on the subject: “What do guns, obesity and opiates have in common?!” It was an amazing walk through the world of epidemiology – and the answer? Well – all three things are hugely important problems, they are all complex and therefore simple solutions cannot fix them! 

 

Virchow, one of the earliest and most influential thinkers in the realm of Public Health famously said, “Medicine is a social science and politics is nothing else but medicine on a large scale.” Sandro Galea takes this idea and modifies this slightly, suggesting that, in fact, politics IS health on a large scale. In other words, if we don’t get health and wellbeing (of ALL people and the planet) written into every policy, then we will never tackle the huge issues of health inequality and environmental disaster. 

 

Sandro gave an amusing analogy about his pet goldfish. He told us that every morning, he goes downstairs and sees his lovely goldfish swimming in their goldfish bowl. He cares for them, makes sure they are well fed, doing their exercises, having time for mindfulness to build resilience and ensures their contraceptive needs are catered for. Sadly, one morning, he goes downstairs and finds all his goldfish are dead. He’d forgotten to make sure the water was clean. The fish were, in effect, swimming in a cesspit (needless to ask whether or not fish are meant for a glass bowl!).

 

He has developed several principles when it comes to thinking about epidemiology. Principle number 5 states: “Small changes in ubiquitous causes may result in more substantial change in the health of populations than larger changes in rare causes.” His goldfish illustration shows that the goldfish are surrounded by water and everything they do is influenced by the QUALITY of the water they live in; therefore water is a ubiquitous factor in influencing the fish and needs to taken into consideration EVERY TIME we want to improve the lives of the fish. His point is this: if we don’t care for the environment and the external factors that give us life and wellbeing, then our other little interventions are futile. The problem is that we spend so much of our time making interventions that we can measure and feel successful about, like giving people statins, getting kids to run a mile a day, encouraging breast feeding, getting people through the ED in a timely manner or even giving them smart technology to nudge them towards better health outcomes, but we pay little attention to tackling the much bigger issues of poverty, poor housing, or air pollution.

 

The biomedical model for tackling the huge issues of population health has failed and will continue to fail. Our politics and economic model is broken! We have simply not written health and wellbeing into every aspect of our lives and have developed patterns of education and work that are actually doing more harm than good and driving health inequalities and the health of our planet in the wrong direction. Therefore, where there is evidence that policy is actually making health inequalities worse, or damaging the environment, we must challenge them with the evidence base, and plain common sense!

 

I do believe that communities can together make a massive difference, and increasingly I recognise just how vital policy is in helping us shape a just and fair society and in stewarding an environment, which is sustainable for the future. Policy and law can be love-fuelled and compassionate, and they need to become so, because politics IS health and we need to re-imagine it as such.

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Health and Society – Can we make a Difference? Part 1 – Economics

Tweet If we want to make a difference to health and wellbeing in society, tackling health inequalities, whilst protecting the health and wellbeing of the environment and creating a fair and just save for humanity…..we have to ask ourselves some searching questions about whether or not our current economic models are really fit for purpose. [Continue Reading …]

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Social Movements and the Future of Healthcare

Tweet As the crisis in the Western World deepens, and the growing reality sets in that business as usual simply can no longer continue nor solve our problems, our systems must change the way they view, deal with and hold onto power. The NHS is no exception. If we want a health and social care [Continue Reading …]

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