II The moral concerns of market triumphalism

Despite the virtue of its apparent neutrality, market triumphalism raises a number of distinct moral concerns. One of the problems with the commodification literature is that these concerns are very often and mistakenly run together. It is a virtue of Sandel's book that he differentiates them. There seem to be three aspects of certain kinds of commodification that particularly trouble Sandel: ineffectiveness, unfairness and, as I have already mentioned, his main concern, corruption.

In the case of ‘health bribes’, Sandel is concerned about all three. Health bribes are cash incentives, benefits in kind or cash penalties used, for example, by doctors and insurers to encourage people to lead healthier lives. You receive a cash payment, shopping vouchers or a lower health insurance premium for achievements like taking your medication, losing weight or giving up smoking. The idea is that such schemes save the state and insurance companies potentially billions of dollars that would otherwise be spent on treating these people once they become ill. From the point of view of cost-benefit analysis, it is far cheaper to use cash incentives or penalties to prevent these illnesses than to cure them.

Sandel argues that, contrary to the claims of those who advocate the use of markets in health care, these schemes are ineffective. The health gains that they produce are usually only temporary. So, for example, the vast majority of smokers paid to stop smoking start smoking again very soon after the cash incentives stop (p. 59). Second, Sandel worries that these schemes may be unfair. On the one hand, people are rewarded for doing what others do anyway. On the other hand, it may be unfair that people are penalised for having a poor level of health as a result of factors outside their control, i.e. their genetic make-up or socioeconomic circumstances (pp. 57–58).

Sandel's third worry about these schemes is the most serious. Even if these schemes were effective and perfectly fair, Sandel would still object to them on the ground that they are corrupt. They corrupt the good involved in showing ‘a proper concern for our physical well-being [which is itself] a part of self-respect’ (p. 59). That good depends on our taking an attitude of care and respect towards our bodies. However, health bribes may discourage the formation of these attitudes, because they ‘bypass persuasion and substitute an external reason for an intrinsic one’ (p. 59). In this way, market norms displace the norms that should govern the good of health care, and by doing so they corrupt or diminish it.

Implicit here is a concern not only that the particular good associated with taking care of one's body is corrupted, but also that there is corruption on a grander scale: our collective failure to educate and persuade the unhealthy that it is a central aspect of a good life to demonstrate care and respect for their own bodies. This failure is a symptom of our concern, encouraged by Rawlsian liberalism, not to step on people's toes. But what Sandel does so well is to show exactly where this version of liberalism leads: market mechanisms are used to short-circuit the duties that we owe to our fellow citizens, with the result that we become estranged from one another.

Although these three concerns–ineffectiveness, unfairness and corruption–are distinct, they may be linked in particular cases. Sandel says, for instance, that the failure of health bribes to encourage people to develop the right attitudes towards their bodies may be one of the reasons they prove ineffective in the long run: ‘absent the attitudes that sustain good health, the pounds may return when the incentives end’ (p. 59).

III The problems of the moral concerns of market triumphalism

By distinguishing between these three moral concerns, and in particular by introducing the Aristotelian idea of corruption, Sandel has made a useful and I think lasting contribution to the commodification literature. There are, however, problems with the book. Perhaps because the book is aimed at a general audience and perhaps because Sandel saw it as a big part of his job to highlight a worrying social trend, much of the ink in the book is spilt in providing worrying examples of commodification. They certainly hold the attention, but one wonders whether he really needed quite so many. Not only is there a risk of overkill, but Sandel also leaves himself little space to defend his claims fully against obvious counter-objections which any intelligent reader – expert in the field or not – would have. By the end of the book the reader is left needing to hear much more.

To illustrate this point I will consider two of his arguments against market triumphalism: ineffectiveness and corruption. As we have seen, Sandel uses the example of health bribes to illustrate how market incentives may prove ineffective. Another example he uses to make the same point is the ‘late pick-up’. Sandel cites a study of an incentive scheme in Israel whereby parents were fined if they picked up their children late from day-care centres (p. 64, ftn 37, study by Gneezy and Rustichini, Reference Gneezy and Rustichini2000). The aim of the scheme was to encourage parents to be on time. However, the scheme had a surprising effect: instead of reducing the incidence of late pick-up, the number of late pick-ups actually went up. Sandel explains the result on the ground that the incentive scheme had the effect of displacing the norms that would normally apply to govern the interactions between parents and carers in these cases:

I doubt that efficiency theorists would be overly concerned with Sandel's argument that the market is an ineffective mechanism in these types of case. They could reply to Sandel in two ways. First, they would claim that the only way to measure effectiveness is through efficiency. Although it may well be true that the market is not the best way to promote health care or ensure that parents pick up their children on time this does not mean that the market has failed. The only end that markets have is the promotion of efficiency, i.e. to ensure that goods and services are allocated to those who are willing to pay the most for them. So, if parents would prefer to pay a fee rather than pick up their children on time, and if day-care centres are willing to pay overtime or lay on extra staff to accommodate these preferences, then the market-based incentive scheme is perfectly ‘effective’.

Alternatively, efficiency theorists could argue that the failure of the market to ensure that desired goals are met (healthier people or more prompt nursery pick-ups), simply proves that certain goods such as health care or respectful relations between parents and teachers should not be subject to market-based mechanisms for promoting efficiency. In these cases, market mechanisms are inefficient. From the point of view of a cost-benefit analysis, if providing financial incentives to people to lose weight, take their medication, etc. is a waste of money because these schemes don't work, then the efficiency theorist would be the first to acknowledge that they should be dropped. This is an efficiency-based argument, familiar in the law and economics literature, for why certain goods should be market-inalienable, i.e. free from market processes or exchange.Footnote ⁴ Although Sandel is clearly not blind to these efficiency-based arguments for market inalienability (see pp. 31–32), he does not consider fully or in any systematic way the extent to which inefficiency, rather than deeper moral concerns, may explain the unease we feel about the various examples of commodification cited in the book.

Sandel could respond to this point by saying that he never meant to deny that efficiency theorists could construct plausible-sounding accounts of the disquiet we feel about these cases. He just wanted to show that efficiency, though plausible, is the wrong kind of reason for why we feel unease in many of these cases. The unease is a consequence of the fact that when markets extend their reach into domains like health care, or the relations between parents and teachers, they crowd out the norms that ought properly to obtain in these domains and corrupt or diminish the goods at stake.

This argument that market triumphalism corrupts particular goods and society at large is, as I have said, the central thesis of Sandel's book. Although it is a novel and interesting argument, it raises as many questions as it answers. I will focus on two of the most important questions raised. First, it is not immediately self-evident that money does corrupt goods or valuable ways of life. The fact that there is a market for paintings by Munch, Vermeer and Caravaggio, and that they fetch millions of dollars at auction, does not seem to diminish the intrinsic artistic value of these works or our engagement with them. The same can be said for going to the opera, theatre or the ballet – increasingly a very expensive business. Indeed, perhaps the fact that people are willing to pay so much adds to rather than diminishes our engagement with their value. Viewing a Caravaggio that I know is worth millions of dollars may motivate me to spend a little longer appreciating the work than I otherwise would. The fact that it cost me a lot of money to go to the theatre may mean that I concentrate more during the performance.

Moreover, the fact that these goods are expensive may open up possibilities for altruism. Sandel gives the example of the New York Public Theatre, which gives away free tickets to theatrical performances in Central Park. Paying someone to stand in a queue for you in order to obtain tickets, or buying these tickets from a tout, Sandel argues, spoils the purpose behind them, which is the making of a gift (p. 33). However, perhaps these gifts have the expressive value that they do at least in part because theatre is a commodity and a relatively expensive one at that? The monetary value of the gift may change its nature, and add to its expressive value.

Sandel might well reply that the fact that people attach value to things because of how much they are worth rather than their intrinsic merit demonstrates his point. That may well be a plausible and persuasive response, but in the book there is not enough of this kind of going back and forth between the thesis and obvious objections to it.

A further problem arises because even if Sandel is right that the deepest problem with market triumphalism is the corruption of certain valuable forms of life or ways of interacting with things and people, he does not explain adequately what weight we should attach to these concerns. As we saw above, Sandel claims that we figure out ‘case by case’ whether a good is corrupted by working out the norms that ought to govern it and whether they are likely to be displaced by commodification. What is less clear though is what the implications are if a good is corrupted by market norms.

Should we stop selling these goods, or should we only sell them below certain prices? Does the state have a duty to subsidise them or provide them for free? Sandel says very little about these questions. All that he seems to say is that commodification in cases like these is a cause for regret, but if it serves some social good, like improving health or educational attainment, then there may be good reasons to retain it. Where it serves no good end, then there is a case for removing the good from the market (p. 78). So, for example, Sandel argues that the market for hunting endangered species promotes inappropriate attitudes towards animals, but if the reason for having the market is that this is the only way to help conserve these creatures then commodification may be justified. However, if there is no good purpose achieved by this trade then it should be banned (pp. 79–84). Aside from saying that the satisfaction of perverse or debased preferences, such as killing these animals just for the sake of killing them, carries ‘no weight in any calculus of social utility’ (p. 84), Sandel gives very little direction on what counts as a social good. Nor does he adequately explain how concerns about the moral corruption of certain goods should be balanced against considerations of social utility, and what the policy implications of this balancing exercise should be. Indeed, for many deontologists, the very idea of this kind of balancing is morally problematic. It would have been helpful for Sandel to say more about these issues. As it stands, the reader may be left troubled by the corrupting influence of market triumphalism, but left very unsure about what, if anything, he should do about it.