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Family, Health, and Institutional Economics

Paper Session

Friday, Jan. 3, 2025 8:00 AM - 10:00 AM (PST)

Parc 55
Hosted By: Association for Evolutionary Economics
  • Chair: Ioana Negru, University of Lucian Blaga Sibiu

Health as a Communal Good

Craig Medlen
,
Menlo College Atherton

Abstract

In terms of outcomes and costs, the U.S. health system ranks as one of the worst in the advanced capitalist world. Monopolistic complexity riddles the whole of the system, from monopolistic restriction of doctors and medical personnel to inadequate insurance, to hospital capacity, to pharmaceuticals. Yet, in large part, the federal government pays the bills. The proposal herein—sketched out in desperate brevity—proposes that the federal government enter directly into health production establishing expanded medical educational facilities to produce more medical personnel, expanded hospital facilities, comprehensive health insurance and the direct production of pharmaceuticals. Such governmental involvement in health would serve as a case study in how public policy could aim directly at collectivist human needs, rather than deferring to market-determined outcomes dictated by individual choice and pecuniary means. Distinguishing collectivist needs from wants would also challenge the deference of mainstream economics to individual preference mappings trapped within the tautological concept of utility.

Beyond Traditional Boundaries: Same-Sex Couples and the Evolution of Social Security

B. Oakley McCoy
,
University of New England
Liudmila Malyshava
,
Skidmore College

Abstract

his study investigates the intersection of social security policy and its impact on same-sex couples in the United States. Rooted in the theoretical framework of institutional adjustment, this paper explores how the Social Security system has responded to the unique economic vulnerabilities and disparities faced by same-sex couples. Despite significant legal and societal advancements, including the codification of same-sex marriage, discrepancies in economic security and benefit eligibility persist, underscoring the need for continued institutional evolution. This research assesses the extent to which social security has adapted to encompass same-sex couples within its protective measures, identifying areas of progress alongside persistent gaps in coverage and benefits. By examining policy genealogy, legislative amendments, and contemporary challenges, the study highlights the critical role of social security in addressing broader issues of equity and inclusion within the fabric of American social policy. This paper contributes to the discourse on the necessity of institutional adjustments in the face of evolving societal norms and relationships, offering insights into the dynamics of policy reform and the implications for social equity and economic security for same-sex couples.

The ‘Joy of Motherhood’ as an Enabling Myth of Neoliberalism & Patriarchy

Paula Cole
,
University of Denver
Valerie Kepner
,
King's College

Abstract

A core enabling myth of neoliberalism is the ‘joy of motherhood’. This myth reinforces patriarchal and cultural norms pushing women into choosing motherhood (and doing the majority of caring necessary for social reproduction). As women gain economic freedom and gender equity, they challenge this myth and are less likely to choose motherhood. This decision is receiving substantial pushback & retaliation in attempts to maintain the power structures of neoliberalism and patriarchy.

U.S. Health Care Institutions and the Epidemic of Trauma

Alexandra Bernasek
,
Colorado State University
Teresa Perry
,
University of California-San Bernadino

Abstract

Several health outcomes in the US – physical and mental – are well-below those of other OECD countries (for example, life expectancy, maternal mortality and diabetes prevalence are higher than the OECD average) despite spending more than any other country per capita ($12,555 p.c in the US compared with the OECD average of $5,000 p.c.) on health (OECD, 2023). The health care institutions that are specific to US are a product of both financialization and monopoly, that characterize 21st century capitalism. The for-profit health care system including the private health insurance system, in the US prioritizes profits over people’s health. This system is simply not sustainable. The role that these institutions play in undermining people’s health is increasingly being recognized by public health scholars and medical professionals. In this paper we look at how mental health issues are dealt with in the US health care system. In particular, we focus on what many psychiatrists and psychologists are calling “an epidemic of trauma”. They identify trauma – both traumatic events and developmental trauma – as the basis for mental health problems such as depression, anxiety and addiction which can then manifest in physical health problems such as heart disease, cancer, and diabetes. We analyze the role played by health care providers, health insurance companies, and the pharmaceutical drug industry in understanding this “epidemic of trauma” and suggest how specific institutional changes can better meet the mental (and physical) health needs of Americans and create a more sustainable health care system.

The Formation of Altruistic Preferences: An Institutional Perspective

Ioana Negru
,
University of Lucian Blaga Sibiu

Abstract

Both neoclassical/mainstream economics and New Institutionalism share a common understanding of individual preferences and their formation: the preferences are exogenous and do not require further explanation. ‘Old’ Institutionalism does not take the individual as ‘given’ and presupposes that economic behavior cannot be explained solely by rationality theory, utility maximization and decision-making. The important question is what does explain preferences: is it existing institutions, wealth, technology, class, self-interest, or tradition? Negru (2007) argued that the Austrian view of rationality is broad enough to customize altruistic preferences and gift-giving actions. This paper wishes to demonstrate that a progressive type of capitalism requires institutions and/or incentives that nourish gift-giving and altruistic preferences in order to strive for a better society. The paper contextualizes this question in relation to Boettke’s vision of the future of Austrian economics (and further engagement with institutionalist issues) and Hodgson’s critique of the limited institutionalism in the Austrian tradition.
JEL Classifications
  • J0 - General
  • I0 - General