The business of misery
by Bob on Novermber 27, 2007
There are actual businesses which survive and depend on other people's misery or misfortune.
A hospital is but a brief encounter with such a model. But the business transaction is short, usually. Nursing homes for the elderly is not such a short term model and satisfies our criteria.
There are many organisations, which by and large mean to do well, or at least their charter meant them to do good deeds, but which much later, perhaps unwittingly, have become a factory with very little output, dealing and surviving off money given them by the state and foundations for people in trouble.
A homeless shelter and the homeless shelter system is another type of model. Here there is an awkward synergy between the actual homeless and the providers of the shelter service. Without a rather steady population of homeless unfortunate people, the hundreds of people on the staff and supporting services would have no jobs. It's an odd balance. So, although altruistically such an organisation wishes that people in distress rise out of homelessness and tries to help them out of it, it nevertheless can't help but implicitly encourage people to remain in the system. And people who are in such distress can easily become institutionalised and creatures of many habits, including the homeless shelter routine.
Another kind of model is long term psychotherapy, which these days, few people can afford and few insurance companies will pay for. The problems are usually never really totally solved for the patient, which is expected and not a failure, per se. But the psychotherapist, who these days looks at his cash ledgers rather than his holy book, or medical oath, is dependent on his patients for income. Again, although the therapist would be happy in theory to see one fully recover, which is hardly possible in most cases, he is locked into an accounts receivable menagerie of people. That's why most medical insurance companies won't cover long-term psychotherapy, despite its being needed sometimes. Their point of view is that it's never-ending. They favour so called "short term therapy" which may or may not have value to the patient. That's why medicines are so popular in psychiatry, at least for medical insurance companies, despite the fact that the medicine are expensive too.
State long-term hospitals are another model as are prisons. Whole industries and communities are built up around these places and, again, have an odd synergistic relationship with the incarcerated or chronically ill.
One is reminded of G.B. Shaw and his brilliant and insightful play, "The Doctor's Dilemma". It was money-wise easier to kill a patient than to heal him. That was the dilemma. An ethical and societal problem Shaw posed through his stage characters. Shaw also got into vivisection in his preface, but that's another issue entirely.
The upshot is that this relationship between the distressed and the proivider of services to him is a slippery moral and ethical slope. The other problem is that is doesn't appear to be an obvious quagmire. There are statistical reports to prove the outcomes being good.
Like Disraeli said once, and Mark Twain picked up on, there are three kinds of lies: lies, damned lies, and statistics.
There's an old adage in many cultures about the poor. For a poor and hungry person, just don't simply give him food, but show him how to grow crops and make food from nature. Then he can survive on his own without charity.
But one also wonders if surviving on one's own is a really laudatory goal. People need people. Not isolation. And the poor person and mendicant reminds us of our fortunate circumstance, and yet gives us an opportunity to be kind and charitable, making us better people.
So oddly enough, we too seem to need distressed people so we can show real charity. Our world is full of such curious moralistic and symbiotic relationships.