My Dentist, the Free Market, and Moral Cavities

Nick Cassella
Civic Skunk Works
3 min readJan 9, 2017

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When my dentist handed me a teeth-whitening pamphlet before I had even reclined in the dental chair, I thought of Michael Sandel.

Not because the Harvard professor has particularly memorable choppers, but because Sandel has spent a considerable amount of time questioning pursuits like this. Specifically, highlighting the drawbacks of a society where market values infect all areas of our life.

“Today,” Sandel writes, “the logic of buying and selling no longer applies to material goods alone. It increasingly governs the whole of life.”

My experience with the dentist is a perfect example. There is something deeply troubling about medical professionals treating patients, first and foremost, as consumers. This runs counter to the very promise made in The Dentist’s Pledge, the dental version of the Hippocratic Oath, whose first point reads:

…Let each come to me safe in the knowledge that their total health and well-being is my first consideration.

Yet, in that dentist’s office, dentistry’s primary responsibility had been displaced by profit motive. The norms of the profession have been commercialized — health isn’t the primary goal anymore; rather, making money drives all decisions.

While “economists often assume that markets are inert: that they do not affect the goods they exchange,” this assumption is naive. Market values are some of the most powerful forces on earth. They most certainly reconfigure priorities, and to my mind, they often do so in suboptimal and intangible ways (as dentistry proves).

When there is no respite from being sold something, people are forced to doubt the true motivations behind everything. Intent, from politicians to the dentist, becomes questioned. That’s an undesirable way to live.

Furthermore, in a market society, “where everything is for sale, life is harder for those of modest means.” Inequality is exacerbated, as money becomes the “sole value on which all choices are based.”

And in 2017, that reality hits too close to home for most Americans — the majority of whom have less than $1,000 in savings.

When you perceive the world through this lens, you begin to understand why both political parties endlessly spoke about the economy being rigged against “normal” Americans.

They were attempting to explain to voters why they were feeling so discontent. Trump blamed it on a variety of people and forces which were largely imagined or disingenuous. Clinton awkwardly admonished Wall Street and greedy politicians for the state of things.

Yet, looking back on 2016, Bernie Sanders was the only candidate who seemed to understand that part of our economic anxiety came from a world where everything is for sale.

He persistently delineated where markets belong and where they do not. In fact, his “socialism” was in many ways just a repudiation of a society governed by market values. And it turns out that the majority of Americans agreed with his policies that severed the connection between profit motive and “services” — namely, health care.

Progressives (and conservatives) dismiss the effects of a market society at their own peril. They can point to a successful stock market all they like and argue that GDP growth is sensational, but these expressions of economic success do not directly affect most Americans (53% of whom don’t have any money in the stock market).

To level with the American people, politicians need to ask Americans: do we want to live in a society where everything is for sale? Is this innate? Or is this a choice? And if it’s a choice, how do we correct this? How can we stop letting the market have the final say on every good and service?

These are not easy questions to answer. I don’t pretend to make it seem that way. But it is important we analyze our societal assumptions. Otherwise, we will eventually be obliged to pay doctors for benefits like unhurried appointments and 24/7 access. Oh wait, that already happens.

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Nick Cassella
Civic Skunk Works

I write about politics and economics—sometimes successfully.