Predictability and control are major discussion points in Ritzer’s The McDonaldization of Society. These are points that have both pros and cons in regards to “irrationality of rationality” as evidenced in both the health care system and the health care debate in the United States. The “irrationality of rationality” can be described as the downside to something that is seemingly perfect, or seemingly rational.
We must look at McDonaldization as both enabling and constraining (Giddens). The healthcare issue in the United States currently is sort of like a double edged sword, meaning that there is an upside as well as a downside to the situation. Predictability is what gives us peace of mind in everything we do. For individuals, businesses, and every day functions, predictability makes everything easier. With that said, society expects to have a rational and predictable healthcare system.
When someone injures themselves or becomes ill, they shouldn’t have to worry about how much the care is going to cost them, they should have peace of mind knowing that their health coverage is sufficient and predictable enough that they know what they will be charged. A healthcare firm in Chicago is doing just that; their main goal is “to give special attention to the needs of small businesses for lower and more predictable healthcare costs by promoting affordable, alternative health insurance solutions” (CCOC).
The only downside to this that I can perceive is if it becomes so irrational that it becomes restraining. If costs were to become standardized for certain procedures and specialties, they would have to be standardized across the board. If the entire healthcare system as an entity wasn’t working as a whole to have a rational reformation, then it would certainly lead to irrationality. Control is the largest factor in any way you put it in regards to both the healthcare system and the healthcare debate in the United States.
While the push for government control and standardized healthcare is underway, there are certainly pros and cons in that concept as well. Healthcare has been passed around like a hot potato between governing bodies and other corporations at will. This relates to a McDonaldization of Society concept seamlessly “Your best B&B’s are those where the owner is on premises…When the owner leaves and hires a manager, bad things start happening…” (Ritzer 190). Essentially what has happened is that healthcare was passed off to a “manager” and the owner is no longer on premise, thus the quality and overall status of the ealthcare has gone down. This is also something that can relate directly to the concept of “irrationality of rationality”. Being a rationalized system, medicine has moved away from human and toward nonhuman technologies. Doctors now serve as a “dispatcher” more or less (Ritzer 120). I can attest to this firsthand that this is precisely what is taking place. Over the past 6 months or so following a surgery, I have had a series of medically unexplained seizures.
Immediately following the first one I was hospitalized and underwent numerous tests. With no medically sound reason for why these episodes were taking place I was released. When it happened for the second time I went to see my primary doctor, thinking he may be able to help me. Wrong. I was “dispatched” as Ritzer would call it to a neurologist, cardiologist, gastronologist, and every specialist I can think of, to no avail. I went back to my primary doctor a second time after it happened again and was “dispatched” to the same procedure.
My primary care doctor is no longer a doctor to me unless I need a physical or any other routine visit, I am bounced around between specialists which I would have no problem doing if they didn’t have a revolving door of patients dispatched by their doctors and could effectively help me. Regardless this is certainly a downfall to the control system. In a sense this sort of control keeps the doctors as primary diagnostic checks, sending their patients to specially trained doctors for what they deem necessary. Another example of control is the control over physicians by technology through what are called “pathways”.
These pathways are sort of a “if so, then” type of procedure, a checklist if you will. Much like computer diagnostic and automotive diagnostics work a series of questions are asked all leading in different paths dependent on the answer to the previous question, to arrive to a final answer. This helps to provide patients with the most accurate care effectively and efficiently from their provider. While this rationalizes medicine, it certainly has its downfalls. A machine could do the same work as the doctor would do, asking a series of questions and providing a prognosis.
This lacks the personal care that a physician uses between the patient and in a sense lowers communication between doctors and patients. I certainly know that when I go to the doctor I want my doctor to listen to my symptoms and use his professional medical expertise to determine what is wrong, no run down a checklist of questions and symptoms. The healthcare system is a complete disaster in the United States, and the healthcare debate feuding the system isn’t going anywhere. The type of predictability and control that the government foresees taking place is out of the question.
The balance between rationality and rationality in both the healthcare system and the healthcare debate is something that will take time and hopefully happens in the near future. For being the “greatest country in the world” we certainly know how to take care of our own don’t we? Works Cited Giddens, Anthony. The Constitution of Society. Berkele: University of California Press. 1984 “HEALTHCARE & WELLNESS COMMITTEE”. Chicagoland Chamber of Commerce. 21 March 2010 . Ritzer, George. The McDonaldization of Society. Los Angeles: Pine Forge Press, 2008.