It is said you can trap a monkey by putting a nut through a small hole in a gourd. The monkey reaches in and grabs the nut, but then his fist won’t fit back through the hole. Greedy monkeys will literally let themselves be caught rather than let go of the nut. So far, no commenter on my essay seems willing to let go of the nut of effective medicine, held in the gourd of the second half of medical spending.
As an analogy, imagine you ran a software company, whose many offices had different wage levels and work cultures, with average work hours ranging from seven to fourteen per day. Surprised to see these offices were equally productive, you randomly changed wages, inducing changes in work hours. You again found offices that worked more did not produce more; after seven hours people got tired and added as many bugs as they fixed. If instead of just cutting wages to get only seven hours of work, you just told everyone "watch out for bugs," you would be in a monkey trap, refusing to let go of the nut of productive work in the gourd of extra work hours.
So begins my first reply at CATO Unbound. I go on to argue that it is a monkey trap that keeps health policy experts from endorsing my proposal to "Cut Medicine In Half." You might think that humans wouldn’t fall for such a simple trap, but consider our military policy of "Leave No Man Behind":
Depicted in the film Black Hawk Down, this mission resulted in the deaths of 18 soldiers. In fact, the strategy of enemy Somali militiamen focused on the American policy of not leaving any soldier behind; they knew that if they managed to shoot down a helicopter, the Americans would move in to defend the helicopter’s crew.
Since I suggest "showing that you care" signals explain our inclination toward excess medicine, and solidarity signals are said to explain "leave no man behind," perhaps monkeys are inclined to never let go of food as a signal to would-be thieves.