Can Health Care Lead to Happiness?

If JK Rowling had lived in America, chances are she might never have written Harry Potter--as she famously did while on public assistance in the UK. She would probably have been so worried about health insurance for herself and her children that she would have continued working an unsatisfying job, unable to take a chance on the imaginary boy wizard with glasses who lived in her head. The loss for the world would be dramatic, but the loss for her personal happiness would be perhaps even more severe.

As the fight for health care reform ramps up in Washington, it's important to keep JK in mind, extreme case though she may represent. We need to consider the benefits beyond physical well-being to our society--and particularly for the women in it--of a secure social safety net, particularly health care but also subsidized day care and fair family leave policies. Not only does a safety net mean a healthier population, but it means a more creative, innovative, and happy one. And that would be a crucial gain for women, who more often fulfil the social role of providing for relatives, families, and children. That role requires the kind of financial stability which may render an outside-the-box pursuit of happiness elusive.

This is all particularly relevant given the the media's interest in picking apart what makes women happy, and what doesn't. A few months ago, conservatives quickly seized upon a Wharton School of Business study as evidence of feminism's failure. The study's results indicated that overall and across demographic lines, women reported being less happy now than they were several decades ago, despite better standards of living and opportunities. A closer look at the survey's results and even its authors' own interpretation doesn't in any way indicate feminism's shortcomings. As countless feminist scholars and writers from Faludi hooks and Wolf on down have documented, the entry of women into equality in many areas has led to backlash in other, less tangible ones: psychologically damaging media portrayals, the rise of the beauty myth and diet industry, the endless expectation to be both perfect employees and ideal family anchors, and the feminization of poverty among them. Our own written feminist history then, points out that huge obstacles to happiness remain for many women.

Therefore this study, and the U.S's middling showing in world happiness surveys, should remind us of the work that feminism has yet to do. And that work is creating a society in which women's personal and career choices are genuine ones, not made of necessity or desperation. Just as reproductive justice aims to support women no matter what choices they make with their bodies, feminism means fighting for a safety net that opens up other life choices.

But first of all, it's important not to take the Wharton study, "Padadox of Declining Female Happiness" at 100% face value (Another professor at UPenn offers a critique of the language of the report and particularly the way it was picked up by Ross Douthat here). As the writers themselves openly acknowledge,  there are a number of factors that make it impossible to gauge objective happiness and whether that happiness has decreased. For one, we live in the post-psychotherapy era, and so people are more comfortable telling a researcher about their frustrations or even their depression. This particularly applies to women. It's not that we all used to walk around in Betty Draper-esque zombiedom pretending everything was peachy -- but certainly deeper discontentment among women wasn't openly acknowledged. Second of all, as the authors themselves particularly note, the increased number of choices we've won for women, not just between child-raising and working but in all areas of life, from school to career to where to live, may have resulted in increased anxiety about making those choices. I'd note that that the social weight on different choices has not dissipated as much as it should, so while we are free to decide how to dress, act and raise kids if we want them, the stigma attached to certain "unfeminine" or "too feminine" paths can create stress. The authors also observe that women are now comparing their happiness to higher expectations raised by the women's movement as well as comparing it to the perceived happiness of the whole population, not just other women like them. These changed points of reference may make women assess their lives differently and more critically.  So in fact these results may be an example of feminism's success in teaching women what is possible.

But whether or not women's happiness has appreciably decreased, guaranteed health care coverage is a way to help it increase. The gains made by feminism have opened huge doors to women in the workplace and academy--but we haven't yet caught up on the services side. We haven't made necessary supports like childcare, health care and sick leave off all that much easier. And meanwhile our economy has shifted towards contract, freelance and part-time jobs, union power has decreased, the wealth gap has increased, while family structures have shifted to more single and juggling households. This means that for many, the struggle to pay the bills has become all-consuming, leaving less time to follow our dreams--whether that's to start a business, learn painting, teach a class or switch careers.

Matt Yglesias wrote in May that universal health care would stimulate entrepreneurship. Without it, he says, we have "job lock" where people stay in one career place because they are scared to lose insurance. Without job lock, we'd have more new businesses and more people willing to join new businesses. He added that as well as the economic benefits, we'd get more artistic endeavors from part-time workers, citing Canadian rock music as an example. As the Rowling story proves, allowing more creativity to flourish at worst boosts happiness for one person--at best it provides increased pleasure for millions who experience that person's output.

I'd add that crucially, in addition to encouraging more entrepreneurs and artists in general, universal health would free up a different segment of the population to start businesses or other creative endeavors.

For instance, there's been a recent media frenzy over "mompreneurs" who combine parenting with starting businesses that are often aimed at other parents like themselves. But most of the women profiled in these stories tend to be from one socioeconomic demographic. They either have spouses whose income and insurance allow them the freedom to experiment--or they themselves have worked in a lucrative industry long enough to have amassed their own capital, investors and networks. But what if a host of other parents--single moms, low income moms, more moms of color, and even dads--could also have the flexibility to start businesses aimed at people like themselves? Again, that freedom would give a jolt to their own happiness as well as the happiness of those they serve.

According to two Business Week surveys (here and here), key factors beyond financial ones that contribute to a nation's happiness are health care, education, tolerance, gender equality and freedom of choice. And the fact is that those different factors feed directly into each other--particularly into freedom of choice. The optimistic and ambitious spirit in America, in my mind, may be what puts us ahead, in happiness measures, of some countries with better social services than we have (that and the terrible weather in places like the UK). But right now, that spirit only becomes reality for some Americans and it needs to be accessible to all. Universal health care with a public option will open up far more doors than the one to the doctor's office.