The Pleasures of Prudence: How Over-Regulation Hurts Doctors, Teachers, and All Workers

 
 

Workers must have the freedom to develop real expertise and to exercise this rational mastery in pursuit of good ends. Only in the pleasures of prudence can we truly realize those excellences of which human beings are capable.

Why do we work? The book of Genesis tells us that we are meant to be fruitful, fill the earth, and subdue it through responsible stewardship and rational mastery. Through our work, we unfold God’s initial act of creation by using our distinctly human gifts of enterprise, dexterity, and ingenuity.

Good work takes many different forms. Farmers, carpenters, teachers, and tax attorneys can achieve rational mastery in their own distinctive ways in their own specific fields. In common parlance, we might call this “expertise.” In Aristotelian terms, it could be seen as a rarified form of the virtue of prudence. This explains why being good at our jobs is not just necessary, but also enjoyable. Prudence, as Aristotle tells us, is pleasant. The exercise of rational mastery is fulfilling in a way that few other things are.

Experts crave opportunities to exercise their skills and abilities. When they find them, this is a good thing for everyone involved because high-functioning experts tend to be both productive and personally satisfied. On the other hand, workplaces that are not conducive to the development and exercise of expertise tend to be both unhappy and inefficient. Unfulfilled workers become frustrated and bitter, and their productivity falls as a vicious cycle starts to form. Low productivity demoralizes workers, which lowers performance still further. Clearly, it is worthwhile to help workers be happy and thrive in their various vocations. But this is easier said than done. In some sectors of our economy, the destructive cycle of demoralization and poor performance has become glaringly obvious.

Egregious and disturbing failures run rampant in two of our largest and most critical sectors: medicine and education. Our health and educational systems offer poor returns on a high investment while leaving their own workers unsatisfied. So what’s the problem? Answering that question can teach us something about the nature of work while also indicating a possible strategy for practical reform.

The Challenge of Regulation

Health and education are vitally important to a thriving society. Everyone has an interest in ensuring that these fields attract talented people with a strong interest in promoting the common good. Unfortunately, over-regulation has increasingly stifled opportunities to develop and exercise prudence in these fields.

Political conservatives love to denounce the evils of over-regulation, generally relying on economics to make their point. Distorted markets, they explain, mean fewer new jobs, more bankrupt businesses, higher prices, lower-quality goods and services, and less innovation. Everyone is affected, mostly negatively.

It should be a compelling argument, but the public remains suspicious. This is understandable, and not all of their skepticism should be attributed to a poor grasp of economic principles. Given the size and bewildering complexity of our economy, it is impossible for a single individual to be a completely “conscientious consumer.” Once upon a time, people lived in small communities and did business with one another in an open and transparent way. Now we are at the mercy of massive, opaque commercial systems every time we eat breakfast or get a haircut. Nobody enjoys feeling like a hapless pawn, so people clamor for regulation to ensure that their peanut butter won’t be poisoned and their airbags will work.

It’s a difficult problem to which there can be no perfect solution. Unfortunately, the public’s instinct is to call for more regulation whenever serious problems arise in any sector of the economy. This emphatically is not the recipe for better health or improved learning.

The perverse reality is that essential, life-saving work is especially vulnerable to this threat. There’s a reason why we’re witnessing massive problems in those sectors of the economy that provide critical life services while inessential industries thrive. The public is mostly content to allow tech developers to ply their trade in a competitive free market, but where their health and their children are concerned, they crave reassurances that mistakes won’t be made. We create regulatory structures to eliminate mistakes, and in the process we prohibit expertise.

Good work is done by good workers, not by computerized systems. If we want better health and education, we need to give good physicians and teachers the room to do their jobs well.

Alienation Theory

It’s ironic how the modern workforce turns Marxist predictions on their head, subjecting higher-status professions to the kind of labor alienation that Marx attributed to the hapless, unskilled proletariat. Low-skill jobs can involve considerable drudgery, but today it is often the high-skill worker who is most obtusely hindered and harassed.

Alienation theory examines how workplace conditions can artificially separate workers from those elements of the job that are naturally fulfilling. Marx worried especially about unskilled, assembly-line jobs, wherein workers perform repetitive tasks as part of a larger operation. In this environment, workers’ relationships to the final products of their labor are distant and heavily mediated. They are unable to take pride in what they produce, and they feel distanced from those rational, human powers that should be developed through work. Pushing a button over and over is work that could be done by a machine; thus, when humans do it, they feel “dehumanized,” as if they were only cogs in an industrial machine. Their humanity is subordinated to the company’s pursuit of profit.

Marx was deeply wrong on many levels, but he was right that a modern economy faces particular challenges when it comes to employing people in fulfilling work. This is why alienation theory has echoed through modern social thought. But it is not just bourgeois capitalists who threaten to turn us into cogs in a machine. Expanding governments have the same impulse, and since their powers are broader, they can often represent an even greater threat to human dignity.

Today, self-proclaimed champions of Marxist theory tend to support the growth of government. But as industry becomes increasingly mechanized, the bourgeoisie find themselves reducing staff and striving to realize the potential of their remaining employees through pleasant work environments and rational incentive structures. Meanwhile, medicine and education, with their heavy burden of regulations, are becoming archetypes of Marxist alienation.

The Alienated Healer and Micromanaged Teacher

Consider medicine. Physicians are some of the unhappiest people in America today, despite their relatively high salaries and prestige. Medicine is currently the second-most-suicidal profession, and about 90 percent of physicians say they would discourage others from entering. Primary-care doctors are particularly miserable.

It’s a little sad to think back to those freshman-year college courses in which half the students were bushy-tailed pre-med majors. Medicine seemed to offer a perfect blend of doing well and doing good. Doctors enjoy high salaries and white-coated prestige, but they are also healers of men, ministers to the suffering, and comforters of the afflicted. What could be better?

Almost anything, apparently. Thick, knotty rolls of regulatory red tape leave physicians overworked and unsatisfied. Processing insurance claims is so expensive that doctors must increase their patient loads to compensate, racing from room to room without time for serious consultation. The twin evils of malpractice suits and “patient satisfaction” scores put physicians under intense pressure to ignore expert instincts and do things by the book—or, worse, to yield to patient demands for unneeded tests and medications. Expensive, time-consuming certification requirements put further strains on their personal time, as do onerous new regulations requiring them to keep extensive electronic records. People who spent a decade in school learning to heal are now spending most of their days fighting with insurance companies and filling out paperwork.

In education, we see similar trends. Teachers no longer have time to impart a true love of their subjects to eager young minds. Instead, they must march to the relentless drum of standardized tests. From kindergarten through twelfth grade, students are flogged through relentless batteries of diagnostic tests; as much of a third of their school year may be consumed by testing. In moderation, tests may be helpful indicators of where schools or individual students need to improve, but this amount can only reflect the obsessive tendencies of regulate-to-success reformers. Like over-eager cooks who can’t go two minutes without lifting the lid on the simmering rice, our ministers of education flatter themselves that they are able to perfect the art of soul-craft through edicts and meticulous monitoring.

It’s a huge waste of everyone’s time and money. Worse than that, it is an assault on the true vocation of teaching. Teachers should be setting imaginations ablaze, opening windows to new worlds, and filling fledgling souls with sweet sounds and harmonies. Instead, they are calibrating children like instruments according to the precise specifications of their standard-issue user manuals. Surely this is not the sort of project that ever inspired anyone to enter the classroom.

As grim as the current situation may be, it is even more ominous to reflect that both medicine and education are in the midst of still more punishing top-down regulatory “reforms” that will almost certainly make their existing problems worse. Both Obamacare and the Common Core manifest all the defects of imprudent over-regulation. They impose a single model on an enormously complex society by calling for enormous bureaucracy but very little local control. The costs are enormous. The benefits are speculative at best. Worst of all, they leave worthy experts even more constrained and less able to manifest real expertise through a prudent fulfillment of a worthy vocation. As doctors and teachers become ever more enslaved to a tyrannical system, we will increasingly find our most talented citizens programming video games, designing websites, or otherwise finding employment in industries that enable them to develop their personal potential.

If real reform is possible, it can ultimately be made only by enabling the individuals who do the work for which each profession exists. Workers must have the freedom to develop real expertise and to exercise this rational mastery in pursuit of good ends. Only in the pleasures of prudence can we truly realize those excellences of which human beings are capable.

Rachel Lu teaches philosophy at the University of St. Thomas.

 

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