Scene: My farm host and I look up as a large bus passes us in this small farming town in central Italy. I point out that the bus is currently carrying no passengers, and this seems wasteful for such a sparsely populated area. He nods in agreement and explains that this bus line is a relatively new development, and a very expensive one. He says, “Preferirei che prendessero questi soldi e trovassero una cura per il cancro. Ma devi sapere che questo non fa business. È la malattia che fa business.”

This translates to, “I would rather they took this money and found a cure for cancer. But you must know that this does not do business. It is the disease that does business.”

Why does this bus line exist?
Is it to carry passengers from one place to another? Perhaps.
Here’s another possibility: it exists because some private company bigwig got some subsidies from the Italian government to expand their transportation offerings and the expenditure wasn’t all that proportionate to the needs of this, again, small farming town. Just a thought – I don’t know the answer. But, a large empty bus in a small farming town portrays to me a disconnect between a perceived need – a modern, hybrid electric public transport option – and the big things most working people have probably worried about for millennia: sickness, injury, and death.

The famous ’92 Clinton campaign adage was, “It’s the economy, stupid.”
Not “the environment,” or “sustainable energy,” or “space exploration, archaeology and anthropology.” The economy is almost always top of mind in voter polls. It often seems to gobble up every other concern. But our economy doesn’t respond to our needs except through the intermediary of something bought or sold. And from my vantage point here in this small farming town, people sell things at a very low profit margin, and they buy things only when they feel somewhat desperate. “La malattia” or “disease” is a big motivator.

I worked in the non-profit world of Cancer education and financial assistance for 6 years. Oncology drugs are the most profitable pharmaceuticals around, and sales revenue from those drugs more than doubled in the past 10 years. But the outlook for serious cancer patients receiving those drugs is appallingly bad. An oncology drug for Stage 4 cancer is considered exceptional if it increases life expectancy for 5 years. And people spend their life savings for that opportunity. In my opinion, if there is ever a cure for cancer, it will come from some independent research unrelated to Oncology, or a dedicated team of University research scientists. The pharmaceutical industry is stuck in the economic model of attending to cancer, and that model won’t incentivize a cure, it will only incentivize making the disease more bearable.

As I ponder the limitations of economics, I feel grateful to spend so much of my time playing music. Music is something of immense value to people, and yet it’s ubiquity and seamlessness in our lives makes it very cheap economically. It isn’t all that useful in the way hybrid electric vehicles are. It doesn’t buy cancer patients a few more years with their loved ones. But it’s not designed that way. It’s not economic. It’s art. It’s honest, directed, feeling. Maybe the art shows you a major tonic chord moving to the mediant chord and asks you to feel wistful. Maybe it shows you a large, empty bus, and asks you to feel derision. It’s additive, not economic. I wish more things could be like that.


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