Reacting to a post by Daniel Dennet expressing gratitude for the miracle of modern medicine Steven Landsburg muses about what really deserves thanks:
Add a word of thanks not just for goodness but for greed—the greed that inspired generations of inventors and investors, laborers and capitalists, doctors and nurses, technicians and scientists to envision and perfect such a thing as an artificial aorta, to educate themselves in the healing professions, and to show up for work every day. For the most part, they did it to make a buck.
We can be thankful too for the system that channels all that potentially destructive greed into life-sustaining brilliance. But we might temper our gratitude just a bit with a moment of wistful regret for the lives lost because of unnecessary imperfections in that system. As a society, we spend far too little on basic research in health care, largely because breakthroughs are under-rewarded. For one thing, our reliance on third-party payers (with the attendant loss of control over our own health care choices) makes us willing to pay handsomely even for relatively ineffective treatments, which diminishes the incentive for innovators to make treatments more effective.
For the sake of future Daniel Dennetts, I hope our legislators have the goodness and wisdom to devise a health care reform package that strengthens the incentive structure instead of weakening it still further. When they fail, as they probably will, there will be plenty of time for outrage. Meanwhile, things could be far far worse, and there’s much to be grateful for on this Thanksgiving day.