The less meaningful our lives become, the more tightly we cling to them.
That is why, in our global economic society, new institutions and provisions of institutionalized medical “healthcare” proliferate. They do so especially in the most commercially developed and advantaged countries. Those in power in the same economically developed countries then often dangle the carrot of such institutionalized healthcare in front of the faces of those who live in less developed countries. At the same time, the commercially powerful countries use the promise of healthcare as a stick to drive such disadvantaged countries ever forward, toward taking full advantage of all the touted advantages of planned, provided, medicalized healthcare.
If life in such healthcare-enticed and -driven countries becomes ever less meaningful the further forward those countries are driven along the healthcare road, so what? That’s a small price to pay for all the profits to be made by healthcare providers.
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I’ve told the story before. The first time I told it in print was in my first published book, The Stream of Thought (available through the “Shop” at the top of this blog website), which came out in 1984. It’s the story of how, a few years before that, in spring 1976, I hosted Ivan Illich for a visited to the University of Denver.
That was just the year after after his book Medical Nemesis: The Expropriation of Health had come out in its American edition, receiving a great deal of attention. Illich’s thesis in that book was that the modern institutionalized medicalization of healthcare had long ago passed the point of “specific counter-productivity.” Not to be confused with what economists call the point of “diminishing returns,” the point of “specific counter-productivity” is that point beyond which the process of institutionalization begins to work contrary to the very supposed purpose for which that institutionalization was established in the first place. Thus, Illich argues that the current institutionalization of medicalized healthcare, which was supposedly designed to foster health, is actually making society as a whole more un-healthy than it ever was before such institutionalized medicalization was initially instituted.
As I first described it in The Stream of Thought (in note 98, on page 644), on April 22, 1976, I hosted Illich as he gave an address at the University of Denver: “During the course of his ‘address’ [. . .] an individual identifying himself as a member of the ‘health-care profession’ working at a local hospital expressed enthusiasm for Illich’s ‘position’ and asked what he, the ‘health-care professional,’ might, as such a professional, do to rectify the ills to which Illich was pointing. Illich’s reply was, ‘Burn down the hospital!’ The frustration this reply engendered was obvious on the questioner’s face and in his demeanor.”
At the time I wrote The Stream of Thought, I shared that questioner’s frustration with Illich’s response. What’s more, for years I continued to feel the same way.
That was because my thought during all that time continued to be oriented toward the goal of changing the very institutions that, as I fully agreed with Illich, had progressed beyond the point at which they had become specifically counterproductive, making worse and worse what they were claimed to be designed to make better and better.
However, as my own thinking continued to mature, I came to a different perspective, one from which I was able to see that Illich’s response was, in fact, completely appropriate. Over the years I came more and more clearly to see what was genuinely at issue for him, and found myself to be in full, emphatic agreement with his position.
That issue, I came to see clearly, was not at all to change the present system, or any of its ever-proliferating institutions. The issue, rather, was to live in the irrelevance of that entire system — its irrelevance to anything that truly matters in human life individually or collectively. That is exactly what I explicitly argued for myself, in my recent book The Irrelevance of Power, just published two years ago, in 2020 (and also available from the “Shop” at the top of this blog website).
If we were to live in full awareness of just such irrelevance, we might well take advantage of whatever opportunities might present themselves at times to “burn down” the whole, irrelevant system — at least if we had nothing better to do, such as taking a stroll, snoozing, or eating a cookie. That, I came to see, was the real gist of Illich answer to the hospital healthcare worker’s question at D.U. in April 1976.
He thereby gave the most genuinely responsible answer possible.
Ivan Illich
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Yes, we suffer pain, we become ill, we die. But we also hope, laugh, celebrate; we know the joy of caring for one another; often we are healed and we recover by many means. We do not have to pursue the flattening out of human experience.
I invite all to shift their gaze, their thoughts, from worrying about health care to cultivating the art of living. And, today, with equal importance, to the art of suffering, the art of dying.
A little over fourteen years after I hosted Illich’s talk at D.U., he spoke again on the topics of health and healthcare. That talk occurred in Hanover, Germany, on September 14, 1990. What he said then became the basis for a short article he wrote called “Health as One’s Own Responsibility — No, Thank You!” The lines above are the closing two paragraphs of that article.
The whole piece is less than seven pages long, and it is easily available online at https://www.pudel.samerski.de/pdf/Illich_1429id.pdf. I recommend it highly. It is well worth reading carefully and thoughtfully. If you do want to do that, be sure when you read the article to keep clearly in mind what I said in the preceding section of this post.
It was only in February of this year that I became aware of that article myself, and I read it right away. Reading it is what occasioned my writing of this current post.