September/October 1985 RAIN Page 9 in the name of transportation. Similarily, we are now investing 12 percent of our national wealth in "health care technology" that blankets most of our communities with a medicalized understanding of well-being. As a result, we now imagine that there are mutant human beings called health consumers. We create costly "health making" environments that are usually large windowless rooms filled with immobile adult bicycles and dreadfully heavy objects purported to benefit one if they are lifted. Beyond the negative side effect is the possibility that a service technology can produce the specific inverse of its stated purpose. The second element to be weighed was identified by Ivan Illich as "specific counterproductivity." Beyond the negative side effect is the possibility that a service technology can produce the specific inverse of its stated purpose. Thus, one can imagine sickening medicine, stupifying schools, and crime-making correction systems. The evidence grows that some service technologies are now so counterproductive that their abolition is the most productive means to achieve the goal for which they were initially established. Take for example the experiment in Massachusetts where, under the leadership of Dr. Jerome Miller, the juvenile correction institutions were closed. As the most recent evaluation studies indicate, the Massachusetts recidivism rate has declined while comparable states with increasing institutionalized populations see an increase in youthful criminality. There is also the unmentionable fact that during doctor strikes in Israel, Canada, and the United States, the death rate took an unprecedented plunge. Perhaps the most telling example of specifically counterproductive service technologies is demonstrated by the Medicaid program that provides "health care for the poor." In most states, the amount expended for medical care for the poor is now greater than the cash welfare income provided that same population. Thus, a low income mother is given $1.00 in income and $1.50 in medical care. It is perfectly clear that the single greatest cause of her ill health is her low income. Nonetheless, the response to her sickening poverty is an ever-growing investment in medical technology—an investment that now consumes her income. The third element to be weighed is the loss of knowledge. Many of the settlers who came to Wisconsin with John Deere's "sod-buster" had been peasant farmers in Europe. There they had tilled the land for centuries using methods that replenished its nourishing capacity. However, once the land seemed unlimited and John Deere's technology came to dominate, they forgot the tools and methods that had sustained them for centuries in the old land and created a new desert. The same process is at work with the modern service technologies and professions that use them. One of the most vivid examples involves the methods of a new breed of technologists called pediatricians and obstetricians. During the first half of the century, these technocrats came, quite naturally, to believe that the preferred method of feeding babies was with a manufactured formula rather than breast milk. Acting as agents for the new lactation technology, these professionals persuaded a generation of women to abjure breast feeding in favor of their more "healthful" way. In the 1950s in a Chicago suburb, there was one woman who still remembered that babies could be fed by breast as well as by can. However, she could find no professional who would advise that she feed by breast. Therefore, she began a search throughout the area for someone who might still remember something about the process of breastfeeding. Fortunately, she found one woman whose memory included the information necessary to begin the flow of milk. From that faint memory, breastfeeding began its long struggle toward restoration in our society. These women started a club that multiplied itself into thousands of small communities and became an international association of women dedicated to breastfeeding: La Leche League. This incredible movement reversed the technological imperative in only E. E. TAYLOR/Oregon Historical Society
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