THE THIRD WAVE
As recently as 1972 few medical instruments were sold to non-physicians. Today a growing share of the instrument market is destined for the home. Sales of otoscopes, ear-cleaning devices, nose and throat irrigators, and specialized convalescent products are all booming, as individuals take on more responsibility for their own health, reduce the number of visits to the doctor, and cut short their hospital stays.
On the surface all this might seem no more than a fad. Yet this rush to treat one’s own problems (instead of paying someone else to do so) reflects a substantial change hi our values, in our definition of illness, and in our perception of body and self. Even this explanation, however, diverts attention from a still larger meaning. To appreciate the truly historic significance of this phenomenon, we need to glance briefly backward.
THE INVISIBLE ECONOMY
During the First Wave most people consumed what they themselves produced. They were neither producers nor consumers in the usual sense. They were instead what might be called “prosumers.”
It was the industrial revolution, driving a wedge into society, that separated these two functions, thereby giving birth to what we now call producers and consumers. This split led to the rapid spread of the market or exchange network—that maze of channels through which goods or services, produced by you, reach me and vice versa.
Earlier I argued that, with the Second Wave, we went from an agricultural society based on “production for use”—an economy of prosumers, as it were—to an industrial society based on “production for exchange.” The actual situation was more complicated, however.
For just as a small amount of production for exchange—i.e., for the market—existed during the First Wave, there continued to be a small amount of production for self-use during the Second.
A more revealing way of thinking about the economy, therefore, is to think of it as having two sectors. Sector A comprises all that unpaid work done directly by people for themselves, their families, or their communities. Sector B comprises all the production of goods or services for sale or swap through the exchange network or market.
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