On Freedom

by Timothy Snyder

Birth is the most important moment of our lives, but obstetrics is hard to make profitable, and so mothers and babies die who ought to have lived. Infant and maternal mortality is higher in the United States than in any other rich country—and the trend is in the wrong direction. Prevention is the most important part of health care, but it is hard to make money from keeping people well, so we let it go. We are an aging population, and preventive therapies—geroscience—can aid well-being and freedom. It is not clear, though, whether they will make money. Certain kinds of illnesses are more profitable than others. Death is profitable when efficiently managed, when families are drained of wealth during the last days of a loved one’s life. Commercial medicine profits first by depriving our lives of years, and then by adding to them a few days. And so Americans live shorter, sicker lives while spending far more money on health care than others in comparably rich countries. Without a positive idea of freedom, without some concept of the Leib, we do not see how strange this is. Being unable to see a doctor or afford medication when we are sick is not a mark of freedom. Nor is being dead.