puts money in the pockets of doctors and other health-care providers.
Everyone understands this, and few object. After all, most physicians
bring to their fight against disease an admirable professionalism that
puts the health of their patients far ahead of their own desire for
income. But only the naïve would suppose that financial incentives never
cause medical professionals to commit medical fraud, to recommend
unnecessary surgeries, or to return dubious diagnoses.
disturbing body of evidence implicates an enterprising but unethical
minority of health professionals in the dubious practice of “disease
mongering.” “Disease mongering,” as one investigator has explained, can
take many forms — including unnecessary surgery and overly aggressive
treatment — but it always amounts to “a strategy employed by the health
care industry in exploiting patients to maximize profits.”1 For instance,
pharmaceutical advertising often persuades those with minor or vague
symptoms to purchase unnecessary medicines, so stretching “the boundaries
of treatable illness ... to extend the markets for new medical products.”
These disease-mongers work at “making healthy people feel sick” even as
they promote costly new cures for their “sponsored” illness.2
reason, leading medical authorities have criticized colleagues for
resorting to propagandists’ ruses in “selling sickness.” Some medical
professionals, these critics allege, form “informal alliances” with others
who share their economic interests and then “target the news media with
stories designed to create fears about [some] condition or disease and
draw attention to the latest treatment.” Media manipulation of this sort
often involves the use of “disease prevalence estimates framed to maximize
the size of a medical problem” and may include a “medical education plan”
that amounts to no more than camouflaged “marketing strategy.”3
alarming yet is the disease-mongering that takes place when health-care
professionals take in huge sums by subjecting patients to invasive
procedures not warranted by any real medical condition. One
cardiac-surgery unit in California, for instance, was implicated in 2003
with having raked in over $90 million by performing hundreds of
unnecessary open-heart surgeries.4 Similarly, in 2001 authorities in New
York investigated doctors accused of performing “needless and
inappropriate prostate surgery for mentally ill patients” subjected to
“assembly line” procedures.5
Sensational circumstances made the California and New York cases headline
news, but medical analysts suspect that physicians actually perform
hundreds of thousands of unnecessary surgeries every year outside of media
scrutiny. One study of myringotomies (insertions in the ear of tiny tubes
to prevent infections) concluded that “well over half” of such operations
were performed for “equivocal or inappropriate reasons” — including
“desire for profits.”6 Even more disturbing was a 2003 study finding that
in 75 percent of the 600,000 hysterectomies performed each year, this
highly invasive procedure has been “inappropriately recommended.” Further
analysis suggests that the physicians making such inappropriate
recommendations are responding to a payment schedule that financially
discourages “less invasive methods to treat female pain and bleeding” and
“encourages jumping to hysterectomy because it will pay more.”7
that disease-mongers sometimes use the media to persuade the insecure and
gullible to view “personal problems as medical,” it is hardly surprising
that many patients actively seek out inappropriate medical procedures.8
However, while ethical health professionals help these misguided patients
understand why they should not undergo the sought-for treatment, medical
profiteers do not. Such profiteering may indeed be discerned behind the
reports of thousands of cases of unnecessary and potentially dangerous
plastic surgery, usually performed on affluent urban women suffering from
“a body image disorder” not cured with a scalpel.9 Sufferers from the
man-made disease of obesity likewise turn their personal problems into
opportunities for medical profiteering when they resort to the surgeon:
experts estimate that five million Americans are likely to have their
stomach “surgically altered so as to keep food from being digested.”
Surgeons who perform such operations report “long waiting lists.”10
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
and malpractice in the health-care industry should not blind Americans to
the high quality of care that health-care professionals usually render.
However, the documented and widely publicized abuses should remind
Americans of the temptations likely to emerge in any situation in which
one man’s illness swells another man’s income. And these temptations
frequently show up far from the hospital and doctor’s office.
profitability of pathology explain, for instance, why the United States
now has the highest incarceration rate and the costliest prison system in
the world? Many observers wonder.
much of the criticism of what has been dubbed the “Prison-Industrial
Complex” has come from leftists, all Americans have good reason to ask why
in 2000 the prison industry was the second-fastest growing industry in the
country (trailing only the gambling industry in its growth rate). Why does
a country inhabited by only five percent of the globe’s population account
for fully 25 percent of the world’s prisoners?12
does indeed seem askew in a country that in the Nineties spent an average
of $7 billion a year in building prisons and that by 2000 employed 523,000
of its citizens in building, guarding, or otherwise serving the prisons
that have now become the compulsory home of more than two million
sure, the nation’s leftist critics of the Prison-Industrial Complex too
often ignore the real social perils let loose by the cultural firestorm of
the Sixties. Still, just like the critics of medical disease-mongering,
the critics of the Prison-Industrial Complex raise legitimate questions
about the profits derived from social illness.
characterizing the nation’s correctional system as “the Prison-Industrial
Complex,” critics have identified a starting point for questions, for this
characterization purposefully echoes President Dwight D. Eisenhower’s
famous 1961 remarks about a “conjunction of an immense military
establishment and a large arms industry” which was then “new in the
American experience.” Because this conjunction posed the risk of a
“disastrous rise of misplaced power,” Eisenhower urged Americans to “guard
against the acquisition of unwarranted influence, whether sought or
unsought by the military-industrial complex.”14 Eisenhower issued this
warning at a time when defense contractors and their military,
congressional, and media allies were fanning public fears of a “missile
gap” supposedly giving the Soviet Union a perilous advantage over the
Untied States. But Eisenhower knew from intelligence reports that no such
gap existed and that those fostering groundless fears about it were simply
trying to win profits or career advancement from an unnecessary
enlargement of the military-industrial complex.15 In other words,
Eisenhower saw professionals tied to the military engaging in the same
kinds of dubious tactics deployed by disease-mongering professionals in
the health-care industry : both groups seeking to justify costly (and
profitable) responses to an exaggerated threat.
of the nation’s Prison-Industrial Complex invoke Eisenhower’s cautionary
analysis to buttress their own assertions that “the lure of big money is
corrupting the nation’s criminal-justice system.”16 Like Eisenhower, such
critics limn a problematic “conjunction” of political and economic
interests and a real danger of “misplaced power.” These critics view with
concern the way small-town mayors have “sought out prisons as economic
saviors” and then have grown “anxious to fill the beds of their
bars-and-concrete growth strategy.”17 These critics view with particular
concern the establishment of 100 for-profit prisons in 27 states.18 Even
defenders of the for-profit prisons acknowledge that many Americans wonder
“whether it is seemly to make money from incarcerating fellow citizens.”19
But, of course, correctional system money flows to recipients other than
the owners of for-profit prisons. As Atlantic Monthly writer Eric
Schlosser remarks, “The prison-industrial complex includes some of the
nation’s largest architecture and construction firms, Wall Street
investment banks, and companies that sell everything from security cameras
to padded cells available in a vast ‘color selection.’”20 The smell of
leftist ideology hangs over the assertion that “money motivates the United
States to keep millions behind bars, regardless of the crimes committed,
regardless of the inhumanity, and regardless of the overall damage to
entire communities.” 21 But the remarkable profitability of a
Prison-Industrial Complex now incarcerating a record number of Americans
should give pause even to those resistant to leftist doctrines. After all,
if medical professionals — widely (and usually justly) regarded as models
of integrity — sometimes allow financial incentives to lead them into
inappropriate health-care decisions, how can Americans intelligently
suppose that those associated with the nation’s correctional system are
always immune to the influence of such incentives?
more, the Prison-Industrial Complex offers its supporters more than money;
it also offers them many non-pecuniary but very real political and career
rewards. Thus critics of the complex see politicians whose electoral
success reflects their success in currying favor with constituents who
profit from a growing Prison-Industrial Complex and in winning votes from
constituents whose fears of crime make them supportive of “tough on crime”
legislation. Critics also see many bureaucrats whose “fiefdoms have
expanded along with the inmate population.”22 Thus while one of the more
thoughtful critics acknowledges that “the prison-industrial complex is not
a conspiracy, guiding criminal-justice policy behind closed doors,” he can
still plausibly describe it as a troubling “confluence of special
interests” sufficiently powerful to give “prison construction in the
United Sates a seemingly unstoppable momentum.”23
of the Prison-Industrial Complex argue that it was precisely the expansion
of this complex in the Nineties that pushed crime rates down during that
decade. But after an exhaustive review of the data, two leading
criminologists have concluded that although it appears to have succeeded
in reducing property crime, America’s aggressive “incarceration explosion”
of the Nineties merits no better than “a Gentleman’s C” in suppressing
violent crime and that “even a D minus” would be “generous” in evaluating
its effects on drug use and distribution.24 Critics of that complex also
adduce evidence that its growth has been inordinate by pointing to Canada,
which also saw its crime rates fall in the Nineties (down by 1998 to their
lowest levels since 1969) with almost no expansion in its prison system.25
Indeed, since imprisonment is widely believed to harden young offenders,
American citizens may have realized no more real benefit from an overly
aggressive prison-building policy than American patients have realized
from the overly aggressive medical practices that have accompanied
cynical defenders of the Prison-Industrial Complex might acknowledge that
it has grown beyond any bounds defined by the public’s legitimate need to
control crime, yet insist that such growth has still benefited the nation
by stimulating the economy. Particularly in rural areas, some Americans do
indeed now regard “a surfeit of prisons” as “integral to [the country’s]
economy”26 This kind of thinking echoes in strange ways the 18th-century
argument advanced by Bernard Mandeville in The Fable of the Bees: or
Private Vices, Public Benefits (1714). Arguing that “it would be utterly
impossible, either to raise any multitudes into a populous, rich and
flourishing nature, or when so raised to keep and maintain them in that
condition, without the assistance of what we call evil both natural and
moral,” Mandeville viewed “vice ... [as] the very wheel that turned ...
trade.”27 As a modern Enlightenment scholar 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.”28
“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.”29
Mandeville’s logic does indeed sound like a justification for the kind of
profit-from-pathology social dynamics that have given America a burgeoning
Prison-Industrial system. Mandeville truly sounds like an advisor to a
small-town, 21st-century mayor lobbying for the construction of a prison
in his community when he reasons that “private vices by the dextrous
management of a skillful politician may be turned into public benefits.”
Moreover, he sounds even more like an apologist for 21st-century
disease-mongers when he rationalizes away the offenses of “physicians
[who] valued fame and wealth above the drooping patient’s health” and who
worried less about “their own skill” than about “the apothecary’s favour.”30
But as useful as they might prove to prison-builders or disease-mongers,
Mandeville’s cynically opportunistic views on building a social economy
out of vice provide an even better gloss on the morally dubious but
financially and politically remunerative activities of the profiteers who
have made the decay of the American family “the very wheel” that turns
their diverse enterprises.
time, American family life offered almost no opening for Mandevillian
enterprise. Living in nearly-complete economic autonomy, a 19th-century
agrarian family satisfied most of its needs through the labors of family
members, so staying clear of the money economy in which Mandeville saw
vice serving as an indispensable stimulant.31 By the mid-20th century,
though, the typical urban American family found itself fully enmeshed in
the cash nexus so dear to Mandeville’s calculating heart. By that time,
most American families relied heavily on factories for clothing,
automobiles, and household goods; public schools for their children’s
education; banks for financial services; and Hollywood and television for
entertainment. Writing in the 1950’s, the Harvard sociologist Pitirim
Sorokin expressed dismay that the American home had lost so many of its
productive functions that it was fast becoming “a mere incidental parking
place.”32 Somewhere the shade of Mandeville must have been smiling.
Nonetheless, the average American family of the Fifties or Sixties
resisted the gravitational pull of a fully Mandevillian world by
safeguarding certain family loyalties and honoring certain domestic
obligations. Most mothers still cooked family meals rather than relying on
restaurants or take-out; many still sewed some of their husbands’ and
children’s clothing. Almost all mothers cared for their own young children
rather than turning this task over to a paid surrogate. Fathers not only
provided for their wives and children financially but also performed many
home repair and maintenance tasks. Though it had surrendered much, the
American family still retained a residual core of its traditional autonomy
the last three decades, however, the nation’s shrewdest Mandevillians have
gone to work in turning family disintegration into a vast new opportunity
to turn pathology into profit — with all the skill of the best
disease-monger or prison-builder.
heart of a healthy home, the homemaking mother came under strong attack in
the Sixties and Seventies by Mandevillians who recognized how much ready
cash they could pocket if they could only take over the tasks that the
homemaker did without monetary compensation. Of course, to some degree
advertisers had been busy for decades coaxing mothers out of “the
handcraft age” in which they satisfied many of the household’s needs for
food and clothing through their own productive labors and enticing them
into a modern era in which they served chiefly as a household purchasing
agent. The considerable success of this advertising threatened to make
homemakers little more than the parking-lot attendant for the “mere
incidental parking space” which the home was fast becoming. This cultural
erosion of homemaking indeed helped create what one Seventies analyst
called “the festering contradiction of modern womanhood.”33 Social
physicians could have prescribed a curative restoration of productive
activities to the home and so renewed a homemaker’s pride in her crafts.
But where was the profit in that? No, the new Mandevillians recommended a
radical but quite unnecessary kind of social surgery: It is time, they
said, to cut the mother out of the home.
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.”34
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 had given a married man enough income to
support his homemaking wife and his children.35
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 total annual payroll of just under $4 billion going to
389,000 employees.36 New money — public and private — has likewise flowed
into after-school programs and summer camps serving families whose
homemaking mother has been surgically excised in a social operation even
more unnecessary than most hysterectomies and myringotomies. However, in
the social merry-go-round the new Mandevillians have not set turning
day-care providers, nor summer-camp operators, nor their political allies
have been complaining: they have been too busy counting their profits.
Also joy riding on the Mandevillian social merry-go-ride 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.37And because the cash nexus is also the tax nexus,
the Internal Revenue Service has especially enjoyed the increasingly
frenetic whirling of the Mandevillian social merry-go-round: when money
changes hands for childcare 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
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.
Naturally, just as they have done in promoting the mother-ectomy, the new
Mandevillians have done some very successful disease-mongering in “making
healthy people feel sick,” forging “informal alliances” with others who
share their economic and political interests, and “target[ing] the news
media with stories designed to create fears about [some] condition” that
they could then promise to treat. In the late Sixties and Seventies, just
as they filled the media with screeds about the awfulness of homemaking,
progressive disease-mongers began to characterize wedlock as an outmoded
institution, sexually repressive, professionally hobbling, and
psychologically suffocating. “I wouldn’t say that marriage and
self-actualization are necessarily mutually exclusive,” explained Laura
Singer, president of the American Association for Marriage and Family
Therapy during the Seventies, “But they are difficult to achieve
together.”38 Some of the more aggressive disease-mongering advocates of
father-ectomies began to warn of the dangers of domestic violence inherent
in marital relationships, even describing the marriage license as “a
Mandevillian legislators in every state soon enacted “no-fault” divorce
statutes that made the state — as one legal analyst noted — an ally of
“the spouse who wants to get divorced.”40 And by the early Eighties, a
profitable new industry was in high gear, raking in professional fees with
every turn of the disintegrative social merry-go-round. Profiteering
attorneys found high salaries through employment in a Mandevillian system
described by one observer as “‘a divorce industry’ ... of professional
meddlers who make millions of dollars every year off marital turmoil, much
of which they have a hand in creating themselves.”41 Indeed, although the
sponsors of “no fault” divorce statutes promised that their passage would
reduce adversarial litigation, legal analysts have seen an increase in
property-division and child-custody litigation under “no fault,” an
increase which caused one commentator to wonder “whether the legal
profession has not been the major beneficiary of the no-fault divorce
any well-versed Mandevillian could explain, the divorce industry churns
out economic benefits for many besides the courtroom lawyers. Therapists
and psychologists have also turned divorce into an economically rewarding
opportunity as they help “a dissolving couple system ... [to] achieve a
constructive divorce.”43 Real-estate agents likewise punch their tickets
on the divorce gravy train, since a divorcing family now needs two
residences rather than just one. Even advertisers see new opportunities in
making their consumer pitches to “a post marital society.”44
the true spirit of Bernard Mandeville, the divorce industry has created a
particularly lucrative opportunity for those who perform a service that
intact families simply do not need: collecting child-support from the
non-custodial parent (almost always the father) and delivering it to the
custodial parent (almost always the mother).45 In 2001, government
agencies, divorce attorneys, and private collection agencies collected $19
billion in child support.46 Fathers, of course, would have earned that
money for their families even if they had never been divorced. But only
divorce creates a profit for those who collect and deliver that money. So
profitable is this enterprise that, just as America’s incarceration boom
has produced private for-profit prisons, even so, 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.”47
only the hopeless naïve 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.48
Of course, neither the family-court judges, nor the collections officers
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.
It is not
necessary to see anything conspiratorial in the child-support network to
recognize that, just as in the Prison-Industrial Complex, this network has
created a dubious “confluence of special interests.” Political scientist
Stephen Baskerville has aptly pointed out, “fatherlessness and the
judicial bureaucratic machinery connected with it have grown up together.”
And within that Mandevillian machinery, “full-time lawyers, judges, child
support enforcement agents, and representatives of other organizations ...
have a vested interest in both removing children from their fathers and
making the fathers’ support obligations as burdensome as possible.”49 Even
a defender of that system acknowledges that “if all children lived with
both of their biological parents in the same household, every civil
servant who works in a child-support agency would be out of a job.”50
Since the government jobs of these civil servants usually pay well and
offer good benefits — unlike the low-pay, no-benefit jobs multiplying in
the service sector — it is hard not to wonder if such civil servants do
not share with Bernard Mandeville a certain distaste for social virtue.
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.51 Divorce even drives up the
incidence of the domestic violence falsely associated with wedlock by the
disease-mongering propagandists promoting the surgical dismembering of
need suppose anything conspiratorial or even anything consciously
Mandevillian in the growth of enterprises that profit from marital and
family failure. But just as in the explosive growth of the Prison
Industrial Complex and in the suspicious rise in doctors’ reliance on
certain costly surgeries, Americans must wonder about a disturbingly
Mandevillian confluence of special interests. Indeed, even if they trusted
those employed in the divorce industry and its spin-offs as much as they
trust physicians, Americans would still have reason to believe that this
industry has performed unnecessary father-ectomies for profit at least as
often as doctors have performed unnecessary hysterectomies and
myringotomies for profit. And since many Americans actually regard the
professionals at the very heart of the divorce industry — that is, lawyers
and therapists — with considerable weariness,53 they might well wonder if
the number of unnecessary father-ectomies performed for Mandevillian
profits does not actually run far higher.
those who profit from family failure do not deliberately subvert marriage
and family life, only rare virtue could keep their behavior entirely
unaffected by a vague awareness of how family disintegration enlarges
their bank accounts and increases their political power. At a minimum,
such an awareness fosters quiet acquiescence in policies that undermine
wedlock and family life. Such awareness also weakens support for policies
that reinforce marriage and family life.
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
Americans who look closely at the new economy of family failure will give
little credence to Mandevillian justifications for its growth. In the
first place, this dubious economy generates dollars only parasitically.
When Americans spend their money on divorce proceedings, on collecting
child support, or on giving therapy to children traumatized by family
disintegration, they are producing nothing of positive value — not
computers, not cars, not books, not steel or oil. They are instead
consuming dollars produced in truly value-added enterprises. When a state
legislator recently complained that money spent on building prisons was
“just money down a rat hole” because it was money unavailable for
genuinely productive pursuits,54 he might just as well be looking at the
burgeoning family-failure industry. For building new divorce courts does
no more to enrich society than does building more prisons. In fact the
multiplication of divorce courts inevitably presages the multiplication of
convenience foods, day care, and second homes that Americans buy when
family life weakens or fails look like very poor purchases. How many
fast-food meals compare to a lovingly prepared home-cooked meal? How many
day-care-center workers will ever give the children in their care the kind
of affection an at-home mother can? And how can a split family ever hope
to maintain in two homes the same level of physical or emotional comfort
that they could attain with comparable resources if living in just one
Nevertheless, of course, what is lost as the family-failure industry
grows, cannot be measured monetarily because so much of it cannot be
purchased at any price. Maternal love is not for sale in any day-care
center. None of the collection agencies chasing down child-support dollars
offers paternal devotion. And the carnal services sold as a pathetically
incomplete substitute for spousal love bear the name of prostitution.
beyond price, civic health declines when family life disintegrates. The
great 19th-century French economist Frederic Le Play understood the
indispensability of strong family life to a harmonious society. As one of
his disciples has explained, Le Play’s economics made “moral and social
harmony ... of paramount importance; for without these wealth itself may
be merely [an inducement] to feud, pride, bad blood, and envy, if not an
instrument of positive oppression.” Rather than attending solely to the
flow of money, Le Play made the family “the touchstone by which [he]
test[ed] institutions” and economic arrangements. Wiser than Mandeville,
Le Play viewed the strength of family life as a protection for ordinary
citizens, who he felt needed to be “shielded ... from being blown about by
every breath of economic influence.”55 The 21st-century Stanford economist
Jennifer Roback Morse is thus updating Le Play’s style of economics when
she asserts that “the loving family is surely the foundation of the moral
and cultural [element] of a free society.” “A limited government and free
market,” she explains, “cannot exist without a substantial component of
self-restraint among the citizenry. This internalized ethic cannot come
into existence in the absence of loving families taking personal care of
their own children.”56
while family failure may generate huge political and monetary profits for
shrewd Mandevillians, it eventually bankrupts society. For good reason,
even among those most zealously involved in the family-failure industry,
most keep Mandevillian justifications for their enterprises out of view, a
dirty little secret confessed only under duress. Many even avoid any
self-scrutiny that would entail sober reflection on what they are doing
and why. But just as government investigators and media reporters have
managed to expose the Mandevillian excesses of disease-mongering and
prison-building, public-spirited government leaders and honest journalists
need to start asking hard questions about America’s Mandevillian
family-failure industry. Because those reaping some of the biggest profits
from that industry now control many government offices and media forums,
posing those questions will require persistence and resolution. But the
reasons for asking those questions are no less urgent than those for
inquiring into the Mandevillian dynamics behind disease-mongering and
prison-building. Asked to comment on a coronary surgery which subsequent
investigation revealed to have been performed for profit and not for
legitimate medical reasons, one patient remarked only that such surgery
“hurts like hell.”57 Millions of Americans who have seen their families
dismembered by Mandevillian profiteers could speak with the same voice.
Payer, “How to protect yourself against disease-mongering,” Health
Confidential July 1993: 7-8.
“Disease mongering is a marketing ploy,” Pharmaceutical Journal 20 April
Moynihan, Iona Heath, and David Henry, “Selling sickness: the
pharmaceutical industry and disease mongering,” BMJ: British Medical
Journal 324 (2002): 886-890.
Blackstone, “Unnecessary open-heart surgeries performed at Redding Medical
Center in California on hundreds of people,” CBS Morning News, CBS News
Transcripts, 7 May 2003.
Clifford J. Levy and Sarah Kershaw, “Inquiry Finds Mentally Ill Patients
Endured ‘Assembly Line’ Surgery,” New York Times 18 March 2001: A1.
“Needless surgery, needless drugs,” Consumer Reports March 1998: 1-4.
Elizabeth Vargas, “Unnecessary Surgery Hysterectomies,” World News Tonight
With Peter Jennings, ABC News Transcripts, 22 August 2003.
“Disease mongering,” op. cit.
Conant and J. Gordan, “Scalpel slaves just can’t quit,” Newsweek 11
January 1988: 58-59.
Chisholm, “The land of the fat American is eating its way to an early
grave,” Sunday Telegraph (London) 22 June 2003: 10.
Faltermayer and Rosalind Klein Berlin, “Why Health Costs Can Keep
Slowing,” Fortune 24 January 1994: 76-81.
Hartman, “U.$. Prisons Mean Money,” Humanist November/December: 6-10.
“Prisons Fuel Profits,” New Internationalist May 2000: 8-15.
14Eisenhower quoted in Chalmers Johnson, The Sorrows of Empire:
Militarism, Secrecy, and the End of the Republic (New York: Metropolitan
Books, 2004), 39.
Eric Schlosser, “The Prison-Industrial Complex,” Atlantic Monthly December
Douglas Clement, “Big House on the Prairie,” Fedgazette (Minneapolis)
January 2002: 2-7.
“Prisons Fuel Profits,” op. cit.
Murphy, “Don’t Lock Out Private Prisons,” Fortune 11 June 2001: 54-58.
Hartman, op. cit.
Schlosser, op cit.
Ruth and Kevin R. Reitz, The Challenge of Crime: Rethinking Our Response
(Cambridge: Harvard University Press, 2003), 102.
Schlosser, op. cit.
G. Miller, “The American Gulag,” Yes! A Journal of Positive Futures Fall
Bernard Mandeville, The Fable of the Bees: or Private Vices, Public
Benefits (1714), in Eighteenth-Century Poetry and Prose, ed. Louis I.
Bredvold et al. (New York: Ronald, 1973), 324-356.
Porter, Flesh in the Age of Reason (New York: W.W. Norton, 04), 143.
Mandeville, op. cit.
Carlson, From Cottage to Work Station: The Family’s Search for Social
Harmony in the Industrial Age (San Francisco: Ignatius, 1993).
Pitirim A. Sorokin, Social and Cultural Dynamics: A Study of Change in
Major Systems of Art, Truth, Ethics, Law, and Social Relationships, rev.
and abridged ed. (1957; rpt. New Brunswick: Transaction, 1985), 700.
Ewan, Captainsxa of Consciousness: Advertising and the Social Roots of the
Consumer Culture (New York: McGraw-Hill, 1976), 164-166.
Germaine Greer, The Female Eunuch (New York: McGraw-Hill, 1971), 216-220;
Kate Millett, Sexual Politics (Garden City, Doubleday, 1970), 33, 126-127;
and Christopher Lasch, Haven in a Heartless World (New York: Basic, 1977),
Allan Carlson, Family Questions: Reflections on the American Social Crisis
(New Brunswick: Transaction, 1988), 116-125.
Census Bureau, Statistical Abstract of the United States: 2002
(Washington: U.S. Government Printing Office, 2002), Table 546.
quoted in Martha Weinman Lear, “Staying Together,” Ladies’ Home Journal
September 1991: 60-64.
39 Jan E.
Stets and Murray A. Straus, “The Marriage License as a Hitting License: A
Comparison of Assaults in Dating, Cohabiting, and Married Couples,” paper
presented at the annual meeting of the American Sociological Association,
8 July 1988.
Weitzman, The Divorce Revolution: The Unexpected Social and Economic
Consequences for Women and Children in America (New York: The Free Press,
Charles Edgley and Dennis Brissett, “A Nation of Meddlers,” Society
Lynn D. Wardle, “No-Fault Divorce and the Divorce Conundrum,” Brigham
Young University Law Review 1 (1991): 79-142.
Barbara F. Okun and Louis J. Rappaport, Working With Families: An
Introduction to Family Therapy (North Scituate: Duxbury, 1980), 202.
Martha Farnsworth Riche, “The Postmarital Society,” American Demographics
November 1988: 23-26, 60.
90% of those ordered to pay child support are fathers. See U.S. Bureau of
the Census, op. cit., Table 539.
Nadya Labi and Deirdre van Dyk, “Deadbeat Profiteers,” Time 2 September
Bryce Christensen, “The Strange Politics of Child Support,” Society
November/December 2002: 69.
Stephen Baskerville, “The Politics of Fatherhood,” PS: Political Science
and Politics 35 (2002): 695-697.
50 See Jo
Michelle Beld, “Revisiting the ‘Politics of Fatherhood,’” PS: Political
Science and Politics 36 (2003): 714.
Bryce J. Christensen, ed., When Families Fail ... The Social Costs
(Lanham: University Press of America, 1991).
Christopher J. O’Donnell, Angie Smith, and Jeanne R. Madison, “Using
Demographic Risk Factors to Explain Variations in the Incidence of
Violence Against Women,” Journal of Interpersonal Violence 17 (2002):
1239-1262; see also Martin Daly and Margo Wilson, “Child Abuse and Other
Risks of Not Living With Both Parents,” Ethology and Sociobiology 6
Howard Troxler, “Lawyer jokes won’t vanish with a mere PR campaign,” St.
Petersburg Times 8 July 2002: 1B; see also Philip Rieff, The Triumph of
the Therapeutic (Chicago: University of Chicago Press, 1966), 243-261.
in Clement, op. cit.
55 See H.
Higgs, “Frederic Le Play,” The Quarterly Journal of Economics 4 (1890):
412, 419, 422.
Jennifer Roback Morse, Love & Economics: Why the Laissez-Faire Family
Doesn’t Work (Dallas: Spence, 2001), 229-231.
in Blackstone, op. cit.