The Healthy Immune System as a Model for Social and Economic Organization
Physicians have the opportunity to intimately witness both the amazing achievements of normal human physiology and the horrible disease that results when that physiology falters. For the rheumatologist, it is the immune system that so astonishes and teaches.
The immune system is an ingenious system that has evolved over hundreds of thousands of years. It is a beautiful organizational model that has marvelously stood the test of time. In fact, the survival of the human species has depended on the successful development of the human immune system.
It occurs to the Social Clinician/Rheumatologist that the way in which the immune system is organized and works, and the ways in which it sometimes fails, might provide insights, regarding social and economic organization.
The following discussion is intended as an exercise in thinking imaginatively about potential models for social and economic organization. It involves considerable “over-simplification” and some “stretches,” regarding analogies with the immune system. But, if these can be excused, it provides a fresh and useful perspective on economic models.
Organizational Characteristics and Management Principles of the Healthy Immune System:
The human immune system is a very complex, yet elegantly simple system that is remarkably efficient and effective as it defends us from infection, protects us from malignancy, and helps us heal.
On the one hand, it is a very stable, conservative, disciplined, and predictable system. On the other hand, it is very dynamic, creative, flexible, imaginative, ever-changing, and ever-improving.
There are several key organizational characteristics and management principles that enable the immune system to accomplish its goals:
- It is ingeniously regulated and disciplined. It is neither over-regulated, nor under-regulated—just appropriately regulated.
- It is non-hierarchical. It respects all aptitudes. It is inclusive.
- It gladly acknowledges interdependency and relies on collaboration.
- It places trust/faith in its component parts, each of which is expected and entrusted to contribute selflessly, with self-direction and self-restraint. It delegates well.
- It is decentralized; and, yet, there is gradation of strength and responsibility and there is a clear central purpose.
- It is anticipatory. It is prepared in advance for potential problems.
- It strongly encourages diversity and heavily depends upon it.
- It is designed to be flexible, creative, ever-changing, ever-improving, always discovering.
- It is quick and decisive, yet careful.
- It is appropriately tolerant—neither too lenient, nor too strict. It favors moderation, but is capable of extremes when extreme is necessary.
- It is reliable and responsible.
- It is a thing of scientific and physiologic beauty.
The human immune system is one of the most ingeniously regulated and disciplined networks in nature. It has had to be—because, otherwise, our human species would not have survived. It is rich with checks and balances, feedback loops, compensatory mechanisms, back-up plans, and requirements that specific criteria be fulfilled before action is taken. For example, when a virus enters the body, the immune system’s defense reaction goes into effect only if true invasion, true threat, true danger is detected—and the extent of the reaction is commensurate with the level of the threat. The reaction itself involves execution of multi-step, collaborative processes. The reaction is further controlled by mechanisms that appropriately amplify or mute it, so that the reaction becomes neither too aggressive nor too weak. And, cascades of feedback signals eventually turn off the reaction when it is no longer needed. Ingeniously, the immune system has determined appropriate regulation and avoids over-regulation and under-regulation.
This high degree of appropriate regulation and discipline has proven to be necessary for the survival of the species. If the immune system were under-regulated, it would tend to over-react (e.g. create excessive, harmful inflammatory reactions) and might attack parts of one’s own body, in addition to attacking foreign invaders. An under-regulated immune system would be like a poorly regulated army with undisciplined platoons that individualistically and indiscriminately attack countries and even their own countrymen—thereby committing unwarranted acts of aggression against innocent people. If the immune system were over-regulated, it would be too slow and/or too weak in its detection and eradication of infection and malignancy.
The immune system is a non-hierarchical organization. There is no dominant central leadership that controls all. Responsibility and powers are widely and equitably distributed. There are T-cell lymphocytes, B-cell lymphocytes, and macrophages—all of which work together, contributing in their own unique ways, coordinating their activities. Some of the T-cells are “helper” cells, others are “suppressor” cells; some are “regulatory” T-cells, and some are cytotoxic “killer” T-cells. The specialty of B-cells is antibody production. Macrophages are the most primitive and the least sophisticated, but have tremendous strength. All components are highly valued and trusted as essential contributors, no matter how small their roles. All aptitudes, no matter how limited, are respected and have fair opportunity to contribute.
As Victor Hugo pointed out,this does not mean that the immune system is a field in which “all vegetation is on a level, with tall spears of grass and little oak trees.” Clearly, some components play larger roles, possess more power, and assume greater responsibility. But, these “tall oaks” are unable to function without the help of the smallest, most limited contributors. In that sense, the immune system is like a floral ecosystem whose health depends on inter-dependency, extensive collaboration, and contributions from all.
The immune system recognizes that its component parts must, collectively, exhibit an extraordinary diversity of special capabilities. For example, in anticipation of eventually encountering an enormous variety of infectious agents, the immune system is capable of generating a vast array of new, different individual B-cell lymphocytes (small white blood cells), each of which is capable of uniquely producing protective antibodies against one and only one infectious agent. When threatened by rubella virus, the immune system is able to generate one clone of specialized lymphocytes that is capable of producing antibodies against that specific virus. A different clone is prepared to handle the chicken pox virus. When a specific virus (e.g. rubella) invades the body, the immune system calls upon (activates) the specific clone of lymphocytes that has the capacity to produce anti-rubella antibodies and enables that clone to proliferate (rapidly reproduce, increase its numbers).
The immune system is able to generate lymphocytes of such enormous diversity because of an ingeniously efficient and creative process of ongoing rearrangements within DNA segments responsible for antibody production. Lymphocytes that develop the capacity to produce essential antibodies are selected and appropriately supported. Lymphocytes that produce antibodies that prove to be of little value, humbly, quietly, and voluntarily disappear.
The immune system is appropriately tolerant. It knows the difference between the intolerable (that against which it must react) and the tolerable (that which it should leave alone). In fact, one of its major responsibilities is to carefully distinguish between the tolerable and the intolerable. It bends over backwards to avoid over-reacting to situations that represent minimal or no threat; yet it reacts quickly, accurately, decisively, and proportionately against true threats. It is neither too lenient, nor too severe; neither too liberal, nor too conservative. It is soft and accepting when appropriate; but, strict and tough when necessary.
A theme of bold moderation is seen throughout the immune system. Indeed, one of the most instructive accomplishments of the immune system is its successful determination of appropriate levels of regulation, discipline, tolerance, individualism, and collaboration throughout the entire system. It has ingeniously avoided under-regulation/excessive individualism on the one hand, and over-regulation/insufficient individualism on the other hand.
Defective Immune Regulation (Immune Dysregulation Disorders):
Impressively, in the vast majority of people, the immune system works extraordinarily well. In a small minority, it fails to work properly and disease results. The rheumatic diseases (rheumatoid arthritis, lupus, etc.) and the malignancies represent models of such failure. These diseases occur, at least in part, because of a loss of appropriate regulation and discipline within the immune system. They serve as models of immune dysregulation (organizational dysregulation).
The rheumatic diseases are “autoimmune” diseases—meaning diseases that occur when a person’s immune system inappropriately attacks parts of that person’s own body. Autoimmune diseases result from under-regulation within the immune system. This under-regulation permits the rise of excessive and mis-guided individualism on the part of some components of the immune system. In lupus, for example, a clone of B-cells irresponsibly starts producing antibodies against the person’s kidney tissue. In rheumatoid arthritis, certain T-cells and B-cells elude regulatory control and team up to create an unnecessary and painful chronic inflammatory reaction within the spongy lining of joints. These are harmful immune system mistakes. This mis-guided activity prevails over better sense, and the whole organism suffers.
There are many different factors responsible for malignancy (cancer). One contributing factor is over-regulation of the immune system’s cancer surveillance program. Normally, certain specialized immune cells (e.g. cytotoxic T-cells) continually search for new, budding cancer cells and destroy them before they get a foothold and become problematic. This, along with other mechanisms, helps protect us from malignancy. If these cancer surveillance cells are too tightly controlled, they cannot function with sufficient speed or effect, and cancer may develop.
Another factor that can contribute to malignancy is presence of environmental toxins that may “poison” cells involved in cancer surveillance, rendering them less able to protect us from malignancy.
In the case of leukemia and lymphoma (which are malignancies of certain immune cells) the problem is loss of internal discipline and regulation within those specific cells, such that those cells uncontrollably proliferate (replicate themselves) to the point of malignantly “taking over,” crowding out and harming normal neighboring cells.
Comparison of Economic Systems to the Immune System:
How do the organizational characteristics and management principles of the healthy immune system compare (or contrast) with those of the economic models listed below? Which of these models best resembles the model provided by the healthy immune system? Which models are analogous to diseases of immune dysregulation?
- Totalitarian Communism
- Theoretical Socialism/Communism
- Public Economy
Organizational Characteristics and Management Principles of Capitalism:
Unlike the human immune system, capitalism is not characterized by an emphasis on regulation. To the contrary, the capitalistic model largely views regulation as a detriment, an impediment, a threat to individual freedom, a “dirty word.” In particular, proponents of “laissez faire” capitalism and “market fundamentalism” argue for minimization of regulation and maximization of “individual liberty.” They argue that “the least government is the best government,” and they favor de-regulation, rather than regulation. Proponents of capitalism are so afraid of “over-regulation” that they err greatly on the side of under-regulation.
Unlike the immune system, capitalism does not particularly emphasize discipline and self-restraint. In fact, it strongly encourages, even depends upon, undisciplined and ever-increasing consumption—regardless of whether the consumer can truly afford the consumption; regardless of whether the environment can truly withstand such consumption. Capitalism encourages, even requires, reckless risk-taking (e.g. even borrowing money to purchase high risk stocks). Even the financially successful corporations exercise little discipline and self-restraint, as evidenced by their lavish headquarters, extravagant lifestyles, obscene compensation, and the excessive power of corporate owners and executives.
Indeed, the Great Depression of the 1930s, the massive savings and loan crisis/bailout of the 1980s, the corporate greed exemplified by Enron in 2002, the Great Recession of 2008, the current enormous credit card debt of Americans, the current obscene income equality, and the environmental destruction created by increasingly consumptive global capitalism, are all reflections of inadequate economic regulation, discipline, forethought, and self-restraint.
Instead of emphasizing collaboration, capitalism emphasizes a vulgar and erroneous concept of competition. Capitalism prefers independence and individualism to inter-dependence and collaboration. The closest it comes to collaboration is collusion (alliances and mergers to increase market share and domination of competitors). Organizationally and culturally, capitalism is “top down,” regarding power and income (though not necessarily regarding extent of real responsibility).
Whereas the immune system emphasizes appropriate levels of regulation and discipline throughout the entire system, capitalism is only selectively concerned about such matters. Capitalism insists on considerable regulation and discipline for some (e.g. low level workers), but very little for others (e.g. owners). For example, proponents of capitalism generate much discussion about “inadequate accountability,” “excessive expenditures,” and “inappropriately high salaries” in public school systems, but generate little discussion (or at least little action), regarding the obscenely high salaries, extravagant expenses, and fraudulent accounting in the private corporate sector.
Instead of using nature’s immune system, or nature’s floral ecosystem as models (both very positive models), capitalism uses one of nature’s most vulgar, violent, simplistic, and negative models—the “survival of the fittest” model, exhibited by predatory carnivorous animals. This predatory model is based on the vicious struggle between lions, wildebeests, and antelopes, and is characterized by attitudes of “it’s everyone for him/herself,” “don’t trust anyone,” and the biggest and most powerful are better (the fittest) and, thereby, deserve to win.”
So, the organizational characteristics and management principles of capitalism do not resemble those of the immune system at all. Instead, capitalism’s characteristics (including its emphasis on individualism and minimal regulation) and many of its effects (e.g. excessive consumption, obscene income inequality, and environmental disaster/climate change) resemble the under-regulation and resultant excessive reactions seen in autoimmune diseases, and the dysregulation that results in malignancy. It is as if the proponents of capitalism have learned nothing from the immune system or ecology.
Organizational Characteristics and Management Principles of Totalitarian Communism:
Whereas the capitalist model errs on the side of under-regulation and excessive individualism, totalitarian communism errs ridiculously on the side of over-regulation, to the point of eradicating freedoms, sinking spirits, stifling creativity, slowing function, and suppressing citizen surveillance and correction of malignant policy. The totalitarian communist model is like an oppressively over-regulated immune system that has become so slow, stifled, and afraid that it cannot protect against infection or malignancy. Festering infection and ruthless malignancy result. Leaders of totalitarian communism have also modeled the loss of internal discipline characteristic of malignant cells. Since the totalitarian communist model has been such an obvious failure, it will not be discussed further.
Organizational Characteristics and Management Principles of Theoretical Socialism/Communism:
For many people, particularly Americans, the word “communism,” even the altruistic non-totalitarian version of communism mentioned by Marx, is associated with heavy negative connotations—in great part because of the above-mentioned abuses perpetrated by totalitarian communists, like Stalin. Understandably, for many, mere mention of the word “communism” evokes winces, worries, and fears.
Likewise, but to a lesser extent, the word “socialism” conjures up worries for many people—particularly among those who view it as a threat to their personal liberty. The word “socialism” has also suffered from a confused and varied understanding of what the word actually means. For example, the “democratic socialism” practiced in Scandinavian countries is quite different from the true definition of socialism. Accurately defined, socialism is “a political and economic theory of social organization that advocates collective or governmental ownership and administration of the means of production, distribution, and exchange of goods.” The People in the Scandinavian countries do, indeed, enjoy a very generous social safety net, including many public services—but, the economies in these countries are capitalist, and the “public services” are financed by the profits/taxes generated by the capitalist economy (including, for example, the huge profits generated by the private “arms industry” in Sweden and the oil industry in Norway). People in Scandinavian countries have been able to enjoy generous public services because transnational capitalist activities in these countries have generated huge profits/taxes, while the populations in each country are quite tiny.
Because they have become laden with so much prejudice, misunderstanding, and fear, the words “communism” and “socialism” have largely ceased to be helpful in discussion of economics, politics, and social policy. Often, the mere mention of “socialism” and/or “communism” is a discussion stopper. Since extensive, open-minded public discussion is desperately needed, it is probably wise, therefore, to avoid use of these two words and, instead, use words that have not become burdened with negative and fear-producing connotations—words like “Public Economy,” for example. Accordingly, this essay will not further discuss “socialism” or “communism.” Instead, it will focus attention on Public Economy.
Organizational Characteristics and Management Principles of Public Economy:
A Public Economy is a democratically determined economy that is truly of the people, by the people, and for the people. The people decide what their priority needs are and how the Public Economy can meet those needs in a kind, efficient, non-profiteering manner. In a Public Economy, people’s collective needs are met by publicly owned and operated industries—i.e. through vast Public Activity. For example, a public pharmaceutical industry would develop and provide all of the pharmaceutical products that people need, with no profit-making being involved. Even a public hygiene industry could provide the everyday hygiene products that people need (low-priced soap, deodorant, tooth paste, tooth brushes, razor blades, etc., as opposed to the exorbitantly high priced hygiene products currently provided by profiteering private corporations, like Proctor and Gamble and Gillette).
In contrast to the private capitalist corporations who provide products and services at predatory profiteering prices, the publicly owned and operated industries would not be seeking profit. Their goal would be to meet a democratically determined need and meet it in a most responsible and affordable way. A Public Economy would practice cost-based pricing, not price-based costing. That is, in a Public Economy, the price the buyer pays is based on the true cost of producing the product; whereas in a capitalist economy the price is based on “whatever the market will bear” and not on the true cost of production. In a Public Economy the price for the most essential and healthy goods might actually be set below costs, through subsidization, to assure that all people can afford basic necessities. For example, the healthiest foods (vegetables and fruits) would be subsidized to encourage healthy eating.
The goal of a Public Economy is to provide healthy goods and services that people need and democratically request, and to provide those goods and services at a fair, affordable price, with subsidization if necessary. It is a needs-based economy, not a profit-making economy.
The Public Economy model appreciates and seeks to emulate the organizational characteristics and management principles of the healthy human immune system. Just as the top priority of the immune system is to meet the immunologic needs of the organism, the top priority of a Public Economy is to meet the collective needs of the society. Like the healthy immune system, the Public Economy model emphasizes a collaborative, non-hierarchical, trusting structure. It gladly accepts inter-dependence. While decentralizing and distributing power and responsibility, it encourages central purpose and over-all coordination. It insists on respect and opportunity for all aptitudes, and employs all aptitudes. It expects self-discipline, self-motivation, self-direction, fairness, honesty, selflessness, efficiency, and accountability. It is anticipatory, in that it proactively prepares for potential problems. It recognizes the need for diversity, individual freedom, creativity, flexibility, change, and constant improvement. It places high priority on determination and implementation of appropriate regulation (not too much or too little) throughout the system. It is appropriately tolerant, but also appropriately demanding. It encourages bold moderation. It views all of the above as necessary, in order to achieve real freedom and true health for the entire society.
Public Economy—A Model for Social Beauty and Human Health:
Instead of choosing an economic system that is based on one of nature’s most vulgar, violent, and simplistic models (the “survival of the fittest” model of predatory animals), or is based on the model of a diseased/defective immune system, why don’t we base our economic system on one of nature’s most ingenious, elegant, well-honed, and instructive models—the healthy immune system? Since nature has provided a model of extraordinary physiologic and scientific beauty, why don’t we try to develop a model of considerable economic and social beauty? Perhaps, development of Public Economy would be a step in that direction.
There is, in fact, considerable urgency to make a transition from the current capitalist economic model to a Public Economy model. We are clearly in desperate need of more Social Beauty. There is an even more desperate need to halt the environmental destruction wrought by capitalism. Furthermore, it should be realized that the environmental toxicity created by capitalism is having an adverse effect on our immune system—making our immune systems sick, predisposing them to make the kind of mistakes that result in autoimmune diseases and malignancies. That is, capitalism may actually be contributing to the development of human “immune dysregulation” disorders (autoimmune diseases and malignancies), and a transition to a Public Economy model may reduce the development of such disorders. In short, transition from capitalism to a Public Economy may be essential for the survival of the human species and the Earth itself.
As marvelous as the immune system is, it is by no means perfect. Even the healthiest immune system makes mistakes. Part of its flexibility and creativity depends on a built-in potential for mistake-making. Similarly, a Public Economy will have its imperfections and will be difficult to practice flawlessly. But, both represent admirable and positive models that might inspire us and help us to practice living at our imperfect best.
A major point of this essay is to emphasize that a central task of any economic or social system (or any organizational model) is to make good decisions about regulation. How much regulation is appropriate? How can over-regulation, under-regulation and dysregulation be minimized? How is appropriate regulation brought about and maintained?
The healthy immune system has accomplished this task ingeniously and beautifully. Capitalism and totalitarian communism have failed miserably to do so. The Public Economy model places issues of economic regulation at the forefront of public debate and enlists the Public to thoughtfully and democratically make these decisions as wisely as possible.