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Monday, April 25, 2011

Will Wilkinson Is Dumbfounded

Paul Krugman makes a basic Aristotelian point, that commerce isn't and shouldn't be everything, especially in certain important relationships, leaving Will Wilkinson with his jaw hanging.

Since Wilkinson's ideological gag reflex is probably immune to rational criticism, it is likely to be more useful to ask what strange personality disorder makes someone so blind to the de-humanizing effects of excessive commercialization? Any suggestions?

16 comments:

  1. I confess that my reaction was similar to Wilkinson's. Obviously there is more to life than commerce, and certain relationships shouldn't be commercialized. I'm with you there. On the other hand, the doctor/patient relationship seems pretty commercial. I'm open to argument that it shouldn't be so, but to me it seemed almost as if Krugman wanted to pretend that a commercial relationship wasn't commercial so as to avoid the unpleasant policy implications.

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  2. Read your Aristotle, Edward. I believe this is discussed in The Nichomachean Ethics.

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  3. Gene,

    The Ethics is one of my favorite books. But I don't recall the discussion of which you speak. Which book is it in?

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  4. Sorry, it is Politics, Book I, chapter 9.

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  5. Gene, Krugman's point wasn't that commerce isn't everything, and that's not a point I would deny. His point was that that the idea "that doctors are just 'providers' selling services to health care 'consumers' ... is, well, sickening." Do you agree with that?

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  6. Yes, that doctors would be regarded as merely providers and their patients as merely consumers is at least very disturbing. When I teach, I certainly don't regard my students merely as consumers!

    Anyway, glad you didn't take offence at my little joke of turning the psychoanalytic tables on you.

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  7. the personality disorder is "autism"

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  8. Yeah, Krugman's "just" is doing all the work there. Of course, consumers, patients, students, doctors, teacher, Aristotle, et al are all also mammals, conscious beings with hopes dreams and fears, bipeds, etc. I don't believe anyone is denying this.

    Clearly what's wrong with me is my impaired sense of repugnance, but I narcissistically insist on seeing this as a feature rather than a bug.

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  9. "Of course, consumers, patients, students, doctors, teacher, Aristotle, et al are all also mammals, conscious beings with hopes dreams and fears, bipeds, etc. I don't believe anyone is denying this."

    However, treating a patient as "just" a consumer is to deny it in action, while still perhaps paying it lip service.

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  10. Gene,

    Ah, the Politics is a different story. I tried reading it in college, but didn't make it past his discussion in Book I of natural slavery.

    Reading Book I, chapter 9 now, it appears not to have anything to do with medicine per se, but to be a more generalized argument against wealth procured via trade and exchange. If *that* is the justification for Krugman's sentiments, then he probably ought to renounce economics altogether.

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  11. Ryan, what does autism have to do with this?

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  12. Bob- the belief that other people have the same information and values as we do when there is no reason for that to be the case is accurately (if offensively) characterized as autistic. I was annoyed by Krugman when he said what he said, but I understood why he said it despite his supposed profession.

    But perhaps it was "autistic" for me to have made such a cryptic remark before.

    FYI, this characterization is just following "post-autistic economics" and Nassim Taleb.

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  13. Over on the Cafe Hayek blog I posited a scenario where one was the owner of a rural hospital in a libertopian society. The owner receives an urgent call from the covering ED doctor that an indigent mother with pre-mature twins was bleeding out. They all three would die without immediate help and a likely huge financial commitment on you and your hospitals part.

    Almost ALL the libertarian commenters their chose to treat the patient over taking a rational market and cost based approach that might eventually put themselves out of business if a competitor chooses regularly to deny such care preferring to increase staff salaries and decrease premiums instead.

    What would Will do?

    PS I am a physician who has regularly seen this scenario play out on a smaller version when patients consider the advice of a physician and contrast it with a hospital co-pay they would rather avoid. Through chance eventually they will chose wrongly to save money against medical advice and have themselves or their children an adverse outcome. Sometimes as a physician I may find myself waging a $500 co-pay to a struggling family against a 1 to 1000 odds of something devastating possibly going wrong if I try to save them the money.

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  14. "Almost ALL the libertarian commenters their chose to treat the patient over taking a rational market and cost based approach that might eventually put themselves out of business if a competitor chooses regularly to deny such care preferring to increase staff salaries and decrease premiums instead."

    And this is an important point: government intervention is not the sole alternative to treating someone as just a customer. In fact, the more people are treated in their day-to-day lives as mere customers, the more they are going to call for government intervention to shield them from this treatment. Thus, the "rationalization" of medicine as a pure profit-and-loss based business has gone hand-in-hand with increasing government interventions into the medical market.

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  15. Sorry, folks, I tried to post a couple of comments from my iPhone, but my phat thumb hit 'delete' instead of 'publish.'

    In particular, Bob Murphy offered to bribe me to stop posting these comments; Bob, can you please post that bribe and the exact amount you are offering again, as the offer seemed attractive.

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