Love Your Monsters_ Postenvironmentalism and the Anthropocene - Michael Shellenberger [42]
A rather small set of technologies has made an incalculably positive contribution to human betterment in the past couple of centuries. Cheap, widely distributed energy sources would be among these. Engineered systems for delivering clean water to, and removing dirty water from, people’s living spaces is another. So is the advance of agricultural technologies, which has allowed agricultural productivity to keep up with (and of course to permit, as well) exponential population growth, in a continuing repudiation of Malthusian pessimism. So is an array of basic medical technologies, from vaccines and antibiotics to obstetric forceps and Cesarean sections.
The fact that these technologies are not perfect, may have adverse environmental impacts, are sometimes misused or overused, and are accompanied by some degree of risk, does not in any way undermine what they have helped to achieve.
Yet technologies are something of an embarrassment to postwar liberal ideological tendencies. An effective technological intervention can advance liberal social goals without requiring the sorts of social change that liberals desire. Science can guide politically progressive policies toward such goals, but technology threatens to make the policies unnecessary.
Consider the entrenched inequities in birth outcomes that continue to be a stark symbol of injustice in the United States. Infant mortality among African Americans is roughly twice what it is among whites. The overall rates of US infant mortality have long been unconscionably high relative to other rich countries, mirroring America’s greater levels of socioeconomic disparity. From this perspective, America’s unaffordable, high-technology medical system ought to be an affront to liberal sensibilities.8
But there are, it turns out, two twists to this tale. First, over the last few decades, infant mortality rates among poor and minority babies in the United States have declined at about the same rate as among the babies of more well-to-do parents. So, while the disparities remain distressingly resistant to change, the absolute outcomes have improved more or less equally for everyone. These declines are apparently explained almost entirely by prenatal, neonatal, and obstetric technologies that benefit poor and well-off alike.
The second twist is that substantial efforts to address unequal birth outcomes through public policies have largely failed. More than forty years of science-based progressive policies aimed at increasing the quality of prenatal and maternal health care and nutrition among poor women in the United States have had little or no positive effect on birth outcomes nationwide.9 The causes of high infant mortality rates among poor people are complex, and deeply embedded in broader problems of socioeconomic inequity that continue to resist political solutions and policy intervention.
The technological path may seem less ethically and psychologically satisfactory than the political path because it leaves unaddressed the underlying social failures that contribute to inequity. This may create some reasonable sense that the technological path provides us with an excuse for not taking the political path — that the available means distract us from the more important end, from doing what is right, which is to solve the problem by making society better, by reducing inequality, rather than by separating the problem from its social context through a technological fix.
Yet, when the essence of a problem is amenable to capture by a technological intervention, real progress can sometimes be made very rapidly, whereas political paths to solving a bigger, underlying problem will almost always be much slower, more uncertain, and less effective. This is what we are seeing in the infant mortality case.
The technological path also offers political opportunities. Technologies that solve a problem can also act as an organizing tool to bring diverse political and institutional players together. Consider, for example, how the vaccine industry, medical practitioners, health insurers, government