It’s human nature to examine and question things and concepts that are new to us. Some people I tell about permuta are on-board from the jump. Some are a little skeptical. If they have the latter reaction, it’s usually because of scale. What I mean is that they can understand trading a book for a hat or website services for carpentry services, but what about a big ticket item like brain surgery?
“[Doctors] put all that time into schooling, and money into insurance,” someone said to me. “At some point a barter system fails,” they conclude.
I’ll try to keep my response short and thought-provoking. There are a lot of points that need to be considered.
- Cost is subjective and very relative. I live in the U.S. – U.S. costs for healthcare are not a gold standard. Whether the procedure is gender-reassignment, organ transplant, cancer treatment, or brain surgery, we can find options in other countries which are just as reliable at a fraction of the cost. Americans, I’ve found, still tend to think we are the only country with qualified doctors.
- Consider the real commodity. Whereas the web developer, carpenter, and travel agent should probably value their time/output equally when arranging trades, doctors basically deal in health. Health is their commodity, and as the saying goes: you can’t put a price on good health. As such, it does present a challenge in trying to find an exchange rate.
- Trade is non-exclusive. While a trade-only system can and does work for some people, no one says it’s all or nothing. Already, many of us do some transactions in cash, some with cards, some with a digital wallet like Venmo, and some in trade. The goal of permuta is to augment the trade/barter system and give it the same ease and credibility as the others.
- Consider all options. Getting back to the issue at hand – brain surgery – I often question modern medical practices because I know full-well that it is not the only medicine. Western medicine in particular goes straight to pharmaceutical blood-thinners, mood regulators, surgery – in short: symptom treatment. Sometimes it may help to step back and at least look into Ayurveda, traditional Chinese medicine, and other systems of holistic treatment.
- Be fair when comparing compensation systems. Brain surgery has been in practice for about 9000 years as far as we know. I’m pretty sure they weren’t billing it to the insurer back then. Today, most of us would pay for a major surgery with a loan or insurance. Loans are paid back over time. Insurance is a pay-in-advance gamble. Both are a commitment to prepayment or repayment over time.
Cash, credit, and/or insurance are not magical systems that make expensive things suddenly affordable. They only give the illusion of convenience. I do not personally find it convenient to pay for something I may never use, nor do I find it convenient to pay interest charges and middlemen when trying to dig my way out of a loan.
Still, the idea of bartering for brain surgery is an interesting one. I’ll close by saying that it will be a wonderful day and a testament to the credibility of the barter system when the first brain surgeon joins permuta and offers their services!