Care Economy: Ideas for Decentralized Healthcare
There’s a huge dissonance between what we need and what we’re programmed to want, or rather, what society asks of us in order to thrive. When I think about the healthcare system, I can’t help but feel frustrated by the fact that, well, in the most simplified sense, more sick people means more money. But today, as the world’s healthcare systems are on the brink of collapse while the COVID-19 pandemic has resulted in devastating shortages of medical resources and mass hoarding of supplies, the economy is hanging by a thread as front-line medical staff scramble to provide care to those that need it most and individual consumers fear for their own wellbeing. Moreover, large companies are struggling (even stubborn) to cancel large events such as the 2020 Tokyo Olympics, which makes us wonder if the greater good of public health matters more to our leaders than sunken costs. But where does this counter-intuitive behavior come from and why is it so hard to change? Many of us are aware that today’s society is geared towards incentives that aren’t always to the benefit of the world as a whole, and if we want to relate to each other differently and more authentically, we need to start thinking about what motivates us to think and interact the way that we do.
No one can deny that money has a mysterious, magical quality: the power to alter human behavior and coordinate human activity. However, looking at the world around us, it’s hard not to think that money is an evil magic. As it is today, it seems to be the enemy of our better instincts, destroying the earth and animating people to act with greed, coming to generate scarcity rather than abundance.
In the past, if people wanted to create more money, they had to dig for more gold, forge more coins. Today, the total value of financial derivatives is ten times the world’s gross domestic product; creating money has become a matter of simply manipulating symbols on a computer. Moreover, increasing one’s wealth can mean burning more fossil fuels, poaching animals and cutting down more trees. Both the detachment of the concept of money from its physical vehicles and the attachment of the symbol money to harmful narratives and things that don’t make our world better has consequences.
But money is a social construct. Though it affects our psychology, religion, philosophy and even science, changing the way we see the world and the way we see ourselves, we have the power to change it because money has no intrinsic value. In changing our interpretation of money, human identity might experience a metamorphosis as well. According to gift economy advocate Charles Eisenstein, we experience money as an extension of ourselves -- a proverbial limb; hence the feeling of being “ripped off”. So we must come to terms not only with the vital role money has evolved to play in human history and our lives today but also the fact that however we transform our concepts of money will have world-changing consequences.
If money can animate us, direct us, and bring us together, let us rework the narratives we build around it so that it becomes based on things that truly serve us, such as nature and collective wellbeing. In this way, making money also means multiplying these assets rather than depleting them.
I wondered…
What might a decentralized healthcare system look like?
How can we financially incentivize professionals & non-professionals to care for each other’s well-being and share one’s gifts?
Last year, I explored the possibility of a sort of Care Economy, a hybrid of elements of multi-level marketing, ideas from decentralized governance and mechanisms of conventional health insurance policies, in which people would be financially incentivized to care for one another without asking in return. Basically, it would be a distributed online health insurance policy shared by a network community of professional & non-professional (health)care practitioners that earn by sharing.
Care Economy
How does it work?
Members annually deposit a small fixed amount to join the network community.
Members pay insurance only by need; if one member must claim insurance, the community divides the cost among each member, which validates each claim based on a strict set of bylaws.
Members of the network community receive annual interest — the money for which comes from investing the initial deposits in social and conservation projects. The Care Economy currency will be backed by nature (e.g. air quality, water, forest density) and collective wellbeing. Money will then have a direct relationship to things with real value to us.
Members receive annual interest/compensation; Interest rates vary depending on member’s reputation level.
Reputation points determine members’ reputation level, which is a fixed range of points per level.
Reputation points are earned by giving unpaid care to other community members; points are calculated based on receiver’s rating of care.
Reputation points expire and levels reset annually.
This decentralizes health insurance, means lower insurance costs and incentivizes members of the community network to care for each other’s well being.
