Single Payer Health Coverage Needed to Treat Epidemic of Affluenza
Michael C. Moynihan | January 3, 2008, 5:37pm
At the
Guardian's Comment is Free blog,
Affluenza author Oliver James
bemoans the rise of "Selfish Capitalism" (James's capitalization) which, he argues, is making us flat-screen television-obsessed Westerners "mentally ill." James claims, without offering any convincing data, that those living in the generous welfare states of Western Europe—whom he ridiculously calls practitioners of "Unselfish Capitalism"—are much less likely to suffer from depression than their counterparts in England and the United States. James doesn't provide a definition of "mental illness" or sources for his data, though it is, of course, likely that the "nationally representative studies in the United States, Britain and Australia" he vaguely references employ very different definitions and standards of what it means to be "mentally ill." And one could obviously argue that the American data set represents not an epidemic of illness but an epidemic of overdiagnosis. Regardless, James says that his case is rather more nuanced than a simple correlation between income inequality and depression:
In itself, this economic inequality does not cause mental illness. WHO studies show that some very inequitable developing nations, like Nigeria and China, also have the lowest prevalence of mental illness. Furthermore, inequity may be much greater in the English-speaking world today, but it is far less than it was at the end of the 19th century. While we have no way of knowing for sure, it is very possible that mental illness was nowhere near as widespread in, for instance, the US or Britain of that time.
This is absurd. James argues that the supposed "commercialization" of society, creating an insatiable appetite for consumption, is driving those who, say, can't afford an iPhone into fits of debilitating illness. But he speculates, without a shred of evidence, that in the 19th century the English-speaking world—a world of enormous hardship and disease—was a happier epoch. If you couldn't bank on extending life past a 50th birthday, I suppose it wouldn't be too depressing when your parents
die at 40. But health and longevity don't feature in his argument; he simply wants the government to be the arbiter of "when you already have enough income to meet your fundamental psychological needs."
It's worth reading (or rereading) Will Wilkinson in
reason's December issue, in which he convincingly demonstrates that the "alleged epidemic of depression [in the United States] simply doesn't exist":
According to [The Loss of Sadness authors] Horwitz and Wakefield, "There are no obvious circumstances that would explain a recent upsurge in depressive disorder." The ranks of the depressed are bulging, they argue, because the clinical category fails to make the elementary distinction between normal, functional sadness and true mental disorder. The depression data are littered with false positives-jilted lovers, white-collar workers who missed out on a promotion, and kids nobody asked to the prom. People who are suffering but aren't sick.
Full review
here.
Mr. Nice Guy | January 3, 2008, 7:11pm | #
joe-
I agree that Moynihan and KMW are the two Reason regulars that fail to impress me the most. I think most of it has to do with the fact that they, unlike Sullum (public health), Balko (crj issues), etc. who have an area they specialize in and have become experts, MM and KMW just shoot the breeze about whatever silly liberal practice fits their fancy.
"comparing levels of mental illness between different cultures is impossible, because the definitions vary tremendously"
I'm not so sure, at least not so sure this is "necessarily" so. Doctors have a set of phenomena they use as indicators of depression (sleeplessness, weight loss/gain, etc) that are not necessarily culture specific I should think. One can then imagine surveys measuring the self-reported or diagnosed amounts of these indicators.
"Affluence doesn't make people unhappy. People are always unhappy. Affluence just makes it possible for more people to bitch and complain in a way that we are forced to hear."
I agree fluffy. In Stardust Memories Woody Allen talks about how poor people, like in the BiCycle Theif, have to worry that they will be unable to feed themselves and family if they lose their bicycle, but that more affluent people, safe from such dangers, just make up other neurotic things to worry about (am I really happy? Is my marriage all that it can be? etc). However, depression properly understood is more than just being unhappy and bitchy.
"But actually, as bad as alcoholism was in pre-Communist Russia, it went off the charts in the 70s and 80s near the end of the Soviet era." Cesar, do you have any reference for such a claim? I can swear my old Russians Studies prof told me a few years ago that alcoholism rates were as high under Free Market Yeltsin as under the USSR...I'd also point out that the USSR was hardly egalatarian, that was just its rhetoric, so if the authors point is that inequality=mental illness pointing to the USSR does not refute it (of course if his argument is "commercialization" or what Marx would have called "commodification" then the USSR would be appropriate).
