7 May 2004
Disease-mongering and the profitability of pathology

Christensen, professor of English at Southern Utah University, and author of Utopia Against the Family (Ignatius Press), opens his essay by discussing how the Medical Establishment, Health Care Professionals and Media are "disease-mongering," pushing the use of psychotropic drugs and needless surgeries to people whose "personal problems" are not medical.

"Disease-mongering not only fills Americans with misguided hopes and shrouds them in ill-founded fears, but it also imposes tremendous financial costs. In the mid-Nineties, when the nation's total annual health care bill was already approaching a trillion dollars ($400 million of it paid by the taxpayer)," the RAND Corporation concluded that fully 'one-fourth to one-third of medical care is unwarranted or of debatable value.' And this leads to more and more questions, the first of which is:

"Does the profitability of pathology explain, for instance, why the United States now has the highest incarceration rate and the costliest prison system in the world?" Christensen follows up with analysis of the huge growth of the Prison-Industrial Complex which shows no signs of down-sizing even as crime rates drop.

Then Christensen brings into view a major Enlightenment figure, Bernard Mandeville, author of the 1714 work, The Fable of the Bees: or Private Vices, Public Benefits. "Mandeville viewed 'vice...[as] the very wheel that turned...trade.' As a modern Enlightenment scholar [Roy Porter] has explained, Mandeville believed 'it was greed, vanity and amour proper which actually kept the social merry-go-round turning - they provided work and created wealth.' 'Bare virtue,' Mandeville asserted, 'can't make nations live in splendor,' since 'few virtues employ any hands,' while 'plagues and monsters,' provide 'livelihood to the vast multitudes.'"

What is happening to the family over the past three decades, Christensen explains, is that it has fallen under the scalpel of Mandeville's disciples, who "have gone to work in turning family disintegration into a vast new opportunity to turn pathology into profit - with all of the skill of the best disease-monger or prison-builder.... "Like their distant cousins in disease-mongering medicine, these masters of social malpractice have understood very well the art of 'making healthy people feel sick,' they have understood how to forge 'informal alliances' with others who share their economic and political interests, and they have understood how to 'target the news media with stories designed to create fears about [some] condition' that they can then promise to treat. By the early 1970's, Americans were softened up to the idea of allowing their home to go under the scalpel for a mother-ectomy by a relentless bombardment from media commentators and feminist intellectuals. These well-placed disease-mongers explained to a bewildered public that instead of being the very center of a normal social life, the home was rather a 'prison of domesticity,' 'patriarchy's chief institution,' and a horrible dead-end for enlightened women seeking 'equality with men in the world of jobs and careers.

"At first the new Mandevillians in education and the media sought to persuade American families to submit to mother-ectomies voluntarily - like insecure women who seek out plastic surgeons or obese patients who ask doctors for a stomach stapling. But over time, the new Mandevillians won allies in government and adopted more coercive tactics: avoiding a mother-ectomy became more and more difficult as policymakers removed the tax protections previously afforded young families and utterly destroyed the traditional 'family wage' regime which has given a married man enough income to support his homemaking wife and his children.

"And just as the new Mandevillians anticipated, as mothers surrendered the previously unremunerated task of caring for their children to paid surrogates, rivers of new money began to flow. By 1997, the nation's nearly 44,000 child-care establishments were reporting total income of $8.4 billion with a total annual payroll of just under $4 billion going to 349,000 employees. New money - public and private - has likewise flowed into after-school programs and summer camps serving families whose homemaking mother has been surgically removed in a social operation even more unnecessary than most hysterectomies and myringotomies...Also joy-riding on the Mandevillian social merry-go-round are the food-service providers, who saw their income rise to almost $90 billion in 2002 as they faced less and less competition from unpaid homemakers cooking meals at home. And because the cash nexus is also the tax nexus, the Internal Revenue Service has especially enjoyed the increasingly frenetic whirling of the social merry-go-round: when money changes hands for child-care or meal preparation, the taxman collects revenues that were unavailable so long as homemaking mothers performed the tasks. The new tax money has helped to pay the army of new government workers licensing and supervising the new day-care centers and restaurants.

"But as profitable as mother-ectomies have proven for them, the new Mandevillians see even bigger money in an even-more radical social surgery - the father-ectomy, more commonly called a divorce..."

After describing the campaigns in the 1970's against fathers and for "no-fault divorce," Christensen describes how lawyers, therapists and others have profited immensely from divorce, pointing out that "America's divorce revolution has produced private for-profit child-support collection agencies. A single such company, Supportkids, has already claimed $40 million as its commission for collecting $120 million in child support. The size of such commissions has prompted a few journalists to ask: 'Do [such] companies profit children or mainly themselves?' But defenders of such companies have responded by arguing that 'the bounty-hunting industry might not exist if the government were more competent: the state is supposed to collect child support free of charge.'

"But then only the hopeless naive supposes that the state has ever done anything 'free of charge': American taxpayers are now paying a great deal to fund the government sector of the Mandevillian child-support system. Government officials must spend approximately one tax dollar for every four child-support dollars collected, amounting to nearly $5 billion a year. Of course, neither the family-court judges, nor the collections officials and accountants, nor the child-support computer analysts, nor their vendors are complaining about this expenditure. Since the Federal government now offers incentive fees to states to collect child support, state officials are particularly unlikely to express dismay at how the child-support system is burdening the taxpayer.....

"[T]he divorce industry generates profits from pathology for many besides its direct employees. Compared to children raised in intact families, children of divorced parents are much more likely to give work to pediatric and adolescent psychiatrists, juvenile detention and probation officers, social workers and remedial teachers. Divorce even drives up the incidence of domestic violence falsely associated with wedlock by the disease-mongering propagandists promoting the surgical dismemberment of families.....

"But even evidence that many Americans now actively subvert wedlock for monetary and political profit would not horrify obdurate Mandevillians. Rehabilitating the arguments that Mandeville himself put forward almost three hundred years ago, these theorists would insist that, like other vices, family failure stimulates the economy. They could even plausibly assert that the success of all American marriages and families would mean unemployment for an army of convenience-goods makers and marketers, of day-care providers, of after-school program employees, of divorce-court judges and attorneys, of child-support collection officers, and feminist-cause lobbyists.

"Similarly, they might warn that a strong resurgence in family life would throw tens of thousands of prison workers, detox specialists, pediatricians and abortion doctors, psychologists and therapists, juvenile court judges and officers out of work. These new Mandevillians might even characterize weak family life as an absolute necessity for sustaining the nation's economy...."

Christensen concludes his essay with an appeal to "public-spirited government leaders and honest journalists to start asking hard questions about America's Mandevillian family-failure industry." That task, he says, is just as important as exposing doctors who bill for fraudulent surgeries and the corruption in the Prison-Industrial Complex.