Regulatory Differences

I recently discussed a puzzling regulatory difference: our applying work hour limits less to high than low status jobs. Many took me to be advocating fewer limits for low status jobs, and were eager to point out good reasons for work hour limits. But our not having a good reason for putting more work hour limits on high vs. low status jobs can equally well support adding more limits to high status jobs, rather than fewer limits on low status jobs.

John Cochrane similarly discussed a puzzling regulatory difference:

Ken Rogoff put in this little zinger

Medical care … fails to satisfy several of the basic requirements necessary for the price mechanism to produce economic efficiency, beginning with the difficulty that consumers have in assessing the quality of their treatment.

… really, Et tu Ken? It’s hard to know if the car mechanic is doing a good job. Get ready for the Federal takeover of the car industry. I can’t tell B grade exterior from A grade interior plywood, so we need a Federal takeover of home rehab.

Many readers probably take this as an argument for less medical regulation, and are eager to argue for or against that position. But pointing out that we have a similar difficulty assessing car mechanic and doctor quality can equally well argue for regulating car mechanics more, instead of regulating doctors less.

In general, people seem far more eager to collect respectable arguments for or against various specific regulations, than to consider the coherence of a pattern of regulations they endorse. They are satisfied to offer arguments for why janitors should have work hour limits, why musicians should not, why doctors should be highly regulated, and why car mechanics should not, all without much noticing or caring how much they treat similar cases differently.

This suggests that there is a lot of rationalization going on. That is, rather than choosing some principles and then consistently applying them, people instead pick various random policy positions and then search for justifications. There seems to be only weak pressures to even notice much less reduce how they and their arguments treat similar things differently.

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  • MooCow

    The reason doctors are more heavily regulated than car mechanics is because doctors are much more productive livestock and need to be fitted with a tighter collar so that the farmers can harvest more milk and meet. Have you not watched Statism is Dead part 3?

  • http://juridicalcoherence.blogspot.com Stephen R Diamond

    “Many readers probably take Cochrane as arguing here for less medical regulation, and are eager to argue for or against that position. But pointing out that we have a similar difficulty assessing car mechanic and doctor quality can equally well argue for regulating car mechanics more, instead of regulating doctors less.”

    Some of your stuff is disingenuous. “Probably take Cochrane as arguing …”? Cochrane was arguing against regulation. (Ask him if you don’t believe me.) And the argument that consumers can’t evaluate the product is stronger for doctors than auto mechanics, though it’s only a difference of degree. (When you think about it, it’s pretty outrageous that patients should be forced to choose their own doctors; and laughable that American patients want this dubious privilege.)

    • Ilya Shpitser

      Why is that outrageous? I would prefer to pick my own doctors.

    • http://www.uweb.ucsb.edu/~criedel/ Jess Riedel

      I would also like to be able to pick my own doctor. The number of medicare supplementary insurance advertisements touting potential insuree’s ability to choose their own doctors shows that Ilya and I aren’t unusual.

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        Sorry for the unclarity. I didn’t mean it was unusual: just (laughably) irrational.

    • Peter Twieg

      “though it’s only a difference of degree.”

      Why do you believe this?

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        It’s a question of degree because, although both mechanics and doctors are hard for many non-experts to evaluate, fewer are able to evaluate medical care than auto work.

      • Ken

        Stephen,

        Why is it harder to evaluate a doctor than a mechanic? There are numerous online websites designed to do just that: evaluate doctors.

        Here’s an easy way to evaluate your doctor: If his recommendations to heal you or make you healthier don’t heal you or make you healthier go to a different doctor. I’ve fired many doctors over the course of my life and will probably fire my current doctor. The reason is given above. I get the same advice, follow that advice and nothing changes, much less gets better.

        What’s really outrageous (and laughably so, but, also, naively sinister) is you thinking that some bureaucrat who has never met you or your doctor can determine whether or not you should go to that doctor. Once a government takes away a liberty, it is rarely given back, even when absurdities become common.

        The government should not have the capacity to dictate what doctor a person should see because bureaucrats cannot possibly have enough information about you and your situation to make a coherent decision. Try reading this to figure out why government bureaucracies fail without exception, whereas free individuals make the best decisions, even medical ones.

        After all who has the highest stake in getting a medical decision correct you or a bureaucrat? If you die or get worse or stay the same, what does it matter to some bureaucrat? Or even the doctor? You are the one that is affected the most. And you are in the best position to make the best decision. No one else can evaluate all the trade offs necessary for your own life better than you, including medical decisions.

        Regards,
        Ken

    • KPres

      My guess is Robert was (consciously or unconsciously) trying to steer your thoughts away from the fact that Cochrane is arguing against the medical regulations (a controversial opinion), because he instead wants to focus on the inconsistency in approach, rather then the particuar for/against position in the example.

      INOW, the disingenuous here serves a purpose.

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        But it isn’t entirely sincere to complain that people will take Cochrane to argue against medical regulation when that’s just what he’s doing.

        These comparisons are made today by regulation opponents, not its supporters. The arguments serve their purpose to oppose regulation because, in today’s political climate, nonregulation is the default.

    • Ilya Shpitser

      It’s not irrational to want to pick your own doctors:

      (a) People have an incentive to optimize their well being, an outside agency picking doctors for you will generally not have your own best interests in mind, but (at best) will try for some utilitarian end, or (at worst) just be corrupt.

      (b) While on average it may be the case that people are not competent enough to do better than an outside agency in picking a doctor, in some cases they either are competent enough, or have connections they can use (medical professionals in the family, etc.) Why deprive such people of the choice?

      (c) Even if for most people an outside agency will do a better job of picking doctors, I would suspect most people would prefer to voluntarily opt in to a system which picks for them, rather than have it be forced on them (if given sufficient evidence that such a system does do a better job on average, which by the way may not be obvious).

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        a. Incentives mean much less than the economists have taught us, as both the scientific demonstration of huge irrationalities in decisionmaking and the experience of huge market failures has proven. Conduct is primarily a function of habit, not of belief and desire.

        b. The reason to deprive connected people of their choice is the same reason as to illegalize insider trading: their choice interferes with other people’s choices.

        c. People generally prefer voluntary choices all else being equal, but such choices aren’t always possible on the same terms. Why don’t parents insist that they choose their kids’ teachers? (Let’s play Robin Hanson’s game.) It’s clear that’s no way to run an efficient and effective educational system.Choice of personal physician is a value constructed by the physicians’ lobby.

      • Ilya Shpitser

        So to summarize the post below:

        a.) Who cares about incentives!

        b.) People for whom it IS rational to choose are spoiling it for the people for whom it’s not, and..

        c.) If we let people choose dr.s why not let children (or presumably cats, or the severely mentally disabled, since it’s all the same) choose this or that.

        If you accept a.) through c.), and you wish to play Hanson’s game, why let people choose jobs, or universities, or anything? There is nothing here specific about doctors.

      • Ken

        Stephen,

        Why don’t parents insist that they choose their kids’ teachers?

        Parents do all the time. Why do you think parents in rich neighborhoods don’t want their taxes to go to pay for other neighborhood schools? Why do you think people move after having kids to get their kids into better schools? Of course, the educational system would be much better if schools were privatized, but since the government has taken over and monopolized schools, privatizing schooling will be difficult.

        It’s clear that’s no way to run an efficient and effective educational system.

        It’s clear that you don’t know what you are talking about. It’s easy to imagine why schools should absolutely and without question not monopolize schools. Schools should be left to the free market precisely because you’re wrong. Parents are in a much better situation to determine the quality schooling and to affect that quality through private transactions (like removing their child from one school and placing him in another) than any politician or bureaucrat.

        Regards,
        Ken

    • Gulliver

      @ Stephen R Diamond

      When you need the services of an auto mechanic, do you play phone book roulette, or do you examine the reputations of candidates first?

      If given a choice of physicians, would you simply pick the first doctor you find, or would you check them out first?

      Why would you trust someone who has no personal stake whatsoever in your well-being to make the decision for you, without you having any alternatives to their choice?

      Why do you consider it irrational to want to have the option of choosing which industry experts, customers, victims and crowds to source, when the alternative is to be subject to the fiat of a single unelected reputation-evaluator who has no competitive incentive? How is the latter personally preferable to you?

      And since you subsequently argued that it is harmful to the common good (I assume in addendum to your argument that it’s personally irrational), could you please elaborate on how this is so. Is it because given a choice of advisers, health care customers will, on average, choose better health care providers and so fill those providers’ schedules faster? Or is your reason something else?

      • http://juridicalcoherence.blogspot.com Stephen R. Diamond

        You recommend using reputation to choose an auto mechanic, but then you disparage selection without competitive pressure. Where’s the competition or other strong incentive motivating contributors to the reputational stream to evaluate the mechanic objectively? Many will be merely rationalizing their own habits and choices. Others will be influenced primarily by their personal relationship with the mechanic. Doesn’t it seem awfully crude, once you clear your mind of economists’ conventional wisdom, that people seeking services in civilized countries still must seek out hearsay information to try to piece together who’s good?

        I would tend to trust the decisions of a skilled and accountable civil servant more than hearsay opinion. But this is a bit glib; much depends on the moral and morals of the government agency. The Soviet Union plunged from setting historical records for industrialization to a basket case because of internal demoralization. But China still exceeds everyone else in economic growth, a major factor being that major investment decisions are made by Communist functionaries rather than self-interested entrepreneurs.

        With some given a free choice, the consequence is unpredictable, which is the problem. What I’d want is an allocation of patients to physicians that matches the talents and expertise of the physician to the patient’s needs. What would happen if parents could choose their kids’ teachers? Does a parent know whether a particular teacher is best suited to gifted children, retardates, or unusual learning styles? What I’d expect from “free choice” is the same as I’d expect with physicians: the physician or teacher would be evaluated largely based on personal imperssions emphasizing affability, disrupting rational assignment of pupil or patient to the most appropriate personnel.

        Of course, motivation is required to do a good job in these administrative tasks. But the value of high motivation is highly over-rated. High motivation brings self-serving biases into play, and these wreck everything.

      • http://daedalus2u.blogspot.com/ daedalus2u

        Clearly what is needed is to let the free market sort this out with some sort of impartial evaluator that will rank teachers and doctors on how good they are. The best ones would be rated AAA, then AA+, then AA, then A+, and so on.

        We could call the rating agency Students & Physicians, or S&P. Then we have the teachers and doctors negotiate with and pay S&P to do the evaluation because S&P needs to make a profit too and only S&P knows how much it will cost to do the evaluation.

        No one would trust the government to do this, so let a private company do it all behind closed doors.

        What could possibly go wrong?

      • http://entitledtoanopinion.wordpress.com TGGP

        daedalus2u, don’t insult our intelligence by making an analogy to a situation with a legally granted oligopoly and regulations dependent on ratings. We have general purpose reputation conveyers like Consumer Reports or even ratings on Yelp. Those may well be deficient, but that’s the ground to argue on until someone makes a proposal that would make your analogy fit.

      • Captain Oblivious

        Doesn’t it seem awfully crude, once you clear your mind of economists’ conventional wisdom, that people seeking services in civilized countries still must seek out hearsay information to try to piece together who’s good?

        Who says? There are any number of “rating” mechanisms available to consumers. For example, in the case of restaurants, there’s everything from gov’t-based health ratings (e.g. the “score-cards” that are posted in restaurants) to private tastiness/ambiance ratings (e.g. Zagat).

        For nearly any industry, these sorts of ratings are available. Curious about a car-repair place? Check the Better Business Bureau! Or Angie’s List! Curious about car features/quality? Check Consumers Reports! And there’s this thing called the Internet; you may have heard of it.

        Far from being deprived of information and forced to “seek out hearsay to try to piece things together”, we’re absolutely DROWNING in information in most industries. In some cases you could even make an argument that there are TOO MANY sources of information, leaving the hapless consumer unsure of which ones to utilize. Maybe I should start a rater-rating service, to tell people that Consumer Reports generally provides honest even-handed appraisals, whereas Car And Driver magazine is filled with nothing but glowing reviews designed to keep advertisers happy, not to inform consumers.

        If there’s a demand for a rating service, and it doesn’t exist, odds are there’s a law in place which (directly or indirectly) discourages that type of rating – generally passed at the request of the providers, who’d rather keep their customers in the dark. As usual, gov’t is the problem, not the solution. Why people want to give corrupt systems like governments even more power is totally beyond me.

    • roystgnr

      If you don’t want to be “forced” to choose your own doctor, I suggest writing your Congressman and asking him to choose for you. If this sounds like a stupid idea, imagine just how much stupider it would sound if his recommendation was legally binding.

    • David C

      I’m surprised, but after all this discussion I don’t think anybody on here has explained this properly. The reason it’s extremely difficult for consumers to evaluate their doctors is because it’s extremely difficult for doctors to evaluate themselves.

      If you go to a good mechanic, he will fix your car. If you go to a good doctor, he will make you healthier less than 20% of the time. If all consumers follow the same method Ken uses, which is probably roughly accurate, then they will be making errors more than 80% of the time. And when the consumer finally chooses a doctor, it could be because the doctor made them better, or because they just happened to get better despite the doctor’s many mistakes. That’s a huge amount of inefficiency.

      A similar problem currently faces evaluating teachers. But whereas we have a good idea of which best practices are likely to improve health outcomes, we have a much poorer understanding of which best practices improve education outcomes. A consistent position then would be to advocate more regulation of health than of education, but our current system regulates education more than it regulates health.

      And if the highly intelligent people on this forum haven’t even considered this line of reasoning, then you can just imagine where the average consumer is at in their thinking. I believe there’s a need for more laws restricting doctors to best practices to improve health. A simple way would be for an insurance system which refuses to pay for useless treatments. HMO’s had many similar systems which allowed them to control costs, but these were rejected by consumers. Many other countries have such systems in place too. Robin Hanson advocated something in the same vein here: http://www.overcomingbias.com/2011/06/outsource-med-eval-to-brits.html

  • Ari T

    Yeah, it’s all incentives.

    Its interesting to notice myself (and others) solving some coordination problems with very different philosophy without consciously realizing that big difference in approach yet same type of problem.

  • http://danieltarmac.blogspot.com Henry

    The fact that inconsistencies can be resolved in either direction is something of a cautionary tale for you. Is it really so bad if people are hypocrites if the undoing of their hypocrisy would tend to result in them adopting more authoritarian viewpoints?

  • Matt

    “[R]ather than choosing some principles and then consistently applying them, people instead pick various random policy positions and then search for justifications.”

    But that’s exactly the right way to go about thinking about politics (except for the “random” part, but I don’t think people’s policy positions are random). Our mental models of specific situations and people tend to be much more reliable than our abstract thoughts, simply because the former are more important and useful than the latter.

    At the highest levels of abstract thought, Mitt Romney believes in the Mormon religion, which is totally bonkers, at least when it comes to its truth claims about metaphysics and cosmology. On politics, he believes that scaling back environmental regulation will be good for the economy, which may or may not be true. And when driving his car, he believes that he should stay on the right side and stop at red lights, which is indisputable. I think a similar story holds for many of us: our modeling of situations we actually encounter is very reliable out of necessity, but our abstract beliefs are vulnerable to irrationality because they do not actually affect anything.

    So if I need to choose between the procedures of forming my political opinions on a case-by-case basis, or of choosing an abstract principle and then applying it to all situations indiscriminately, I will choose the former every time, even at the risk of ideological inconsistency. The point of politics is to figure out how people behave and how to shape society, not to build an abstract formal system. Thus politics is not like math, it is like science. Specific preferences are like data, and it is up to theorists to construct models that match those preferences. In science, it is important and nontrivial to make sure the experiment is set up correctly, but if you have done that then the resulting data cannot be wrong; if they conflict with theory then the theory is wrong.

    Similarly, it is important and nontrivial to choose our specific policy preferences rationally. I am ready to listen to arguments that removing work hour limits on auto mechanics would be good for the people involved, or that adding limits on doctors would be good for the people involved. But a priori I have no reason to expect that the optimal labor regulatory scheme will be the same for both professions.

  • KPres

    Just because the outcome of the regulatory regime is inconsistent doesn’t mean that the people who support or oppose regulations are. I imagine that those who have driven medical licensing and regulatory restrictions would love for auto mechanics to be similarly regulated, but it’s a tougher sell to the disinterested public, who mostly respond to emotional anecdotes. A bad radiator replacement just doesn’t inspire the same kind of reaction as misdiagnosed cancer, even though both procedures are similarly vague to a given consumer.

  • Matt

    This was probably on purpose, but you don’t seem to make an argument whether this type of hypocrisy has negative or positive effects. Do you feel there is a better realistic alternative?

  • Vaniver

    This suggests that there is a lot of rationalization going on. That is, rather than choosing some principles and then consistently applying them, people instead pick various random policy positions and then search for justifications.

    Is it possible to tell the difference between rationalization of randomly chosen positions and positions that are consistent according to a variable you’re not considering?

    I agree with you that most political arguments are rationalizations. But I don’t think it’s clear that, because someone rationalizes a position, the position is chosen at random.

  • http://daedalus2u.blogspot.com/ daedalus2u

    Huh? If you read what Ken Rogoff wrote about the failings of modern capitalism, it is all about the inability of modern capitalism to accurately price externalities such as pollution and AGW and the world that future generations will live in.

    In the US, health care spending doesn’t have the characteristics necessary for an efficient market to develop. People don’t know what health care they need, they don’t know what it costs, they can’t evaluate the care they get, and they are not paying for it anyway. None of this has anything to do with any government regulations.

    It turns out there are government regulations in home rebuilding, they are called building codes. If you want to build something you need a building permit and various inspections and/or use licensed professionals; plumbers, electricians, architects.

    There are licensing programs for auto mechanics, there are regulations that used parts cannot be used in safety-critical systems, cars must be registered, inspected and insured and only licensed drivers can operate them on public roads where driving regulations must be followed and those regulations are enforced by government agents armed with lethal force. Less regulation?

    Then Cochrane says that however bad the market is, government regulation is always worse. Really? Essentially every EU country with government run health care has better health care for its citizens who are all covered and it costs less per capita than what the US spends (and everyone is covered!).

    People may disagree about how good US health care actually is. People with good health care say it is great, people without it say it is terrible. People making money hand over fist say the current system is perfect, people paying through the nose for bad or no care say it is terrible.

    We know that markets fail under certain conditions. Many market failures occur in the presence of monopolies. The only way to protect consumers in a market where there is a monopoly on a necessity is through regulation from an even bigger monopoly, i.e. government regulation.

    I guess it depends on what you are trying to insure against.

    What is a person to do if they want to live in a place where people without health care don’t die in the gutter from contagious diseases? Can I buy insurance to prevent that? What if I don’t want to live in a place where there is massive air pollution? How can a market prevent that? Can I buy insurance that will compensate me (and my descendants) for AGW?

    What is a person to do if they want the world to be sustainable for future generations?

  • Ian

    @daedalus

    The US spending more on healthcare and europe spending less isn’t a matter of market failure or government regulation. It’s a matter of our beliefs about healthcare. If the US were to adopt a British style of government control of the healthcare industry, I think it’s likely that we would spend even more of our GDP on healthcare than we do now. Why? Because we’re proud of it! We innovate all the new surgeries and drugs, and doctors are extra high status here even compared to western European countries. And because of this pride, individual Americans will still clamor for more (and cutting edge expensive but still useless) healthcare for themselves (and everyone else) but now through the political system rather than through their employer or insurance company.

    You have to change people’s minds not the government policies. That is spun less you endorse totalitarianism from an intelligent p, rational dictator.

    • http://daedalus2u.blogspot.com/ daedalus2u

      Much of what we “spend” on health care goes to health insurance companies which they use to screen out the non-healthy so they can dump them from their pools. That doesn’t lower premiums for those that are left because they still pay more than the rest of the world.

      The money spent to find and dump high risk patients, health insurance company expenses (other than medical care), health insurance company profit and health insurance company overhead doesn’t pay for health care at all.

      It is easy for a health insurance company to increase profits, just dump patients when they need care. Premiums collected, sick patients not treated, cha-ching!

      • Veridical Driver

        If insurance companies where actually the profit making machines that you imagine, I would have some money invested in them.

        Single payer health systems are more efficient than private systems, but in ways that don’t fit in with the pro-socialized medicine propaganda used in the United States.

        Under socialized medicine, care is directed to maximize the quality-adjusted life years of the general population. This means that resources are put into keeping people healthy, rather than providing heroic care when they are elderly or critically ill.

        If the U.S. adopted a European style system of socialized medicine, people in the United States would be outraged by the results. Americans support socialized medicine, because they imagine it as private health care that is simply free. In real life, effective socialized medicine is based on an entirely different set of values than private care. Americans want high-tech medical miracles when their life is in danger, not the sort of health maintenance that is used under socialized medicine.

        Americans have fundamentally different expectations from the healthcare system than people in other countries. Government can’t do a good job of managing an effective healthcare system the way it does in Europe, because Americans have a definition of “effective” that is based on individual and not collective health.

      • http://un-thought.blogspot.com/ Floccina

        Much of what we “spend” on health care goes to health insurance companies which they use to screen out the non-healthy so they can dump them from their pools.

        I think that if you want to debate a subject like this you will need to be more specific than “Much of what we “spend””. How much is much? It is difficult to argue with much.

      • http://daedalus2u.blogspot.com/ daedalus2u

        How about 15%? Is that enough to count as “much”?

        The right way to think of it is that Blue Shield collects not two cents on the dollar but fifteen cents–and then sets thirteen of those fifteen cents on fire.

        Of course, that is only what the insurance company spends, by using excess paperwork to ration care they also increase the expenses that health care providers have to shuffle that paperwork around. What are the costs by the health care providers? Are they less? Kind of hard to figure out how they could be. The health care providers have to generate the paperwork they submit, the insurance company only needs to look at the bits of paper. If it is $0.13, then the total non-health care cost is 28%, more than a quarter of what is spent on health care.

        Does 28% count as “much”?

        There are some good comments at The Washington Post on how a 15% fee for administering a zero-sum fund is very expensive. That is what health insurance is, administering a zero-sum fund. Health Insurance companies take in premiums, pay out for health care and keep the difference. For that they need 15% in fees and profits?

  • Captain Oblivious

    I agree with the position that people aren’t qualified to choose their doctors (or mechanics)… in fact, I think we should apply this to other areas. For example, how many people are qualified to make the best food choices? Clearly most do not. I think there should be a gov’t agency in charge of reviewing each person’s budget, lifestyle, medical condition, etc, and choosing what food that person should be allowed/required to consume. Our lives would be healthier and we’d spend less time agonizing over food choices – overall I’m sure we’d be much happier!

    • http://daedalus2u.blogspot.com/ daedalus2u

      There already is extensive regulation of the food industry that limits choice. Food preparation sites are required to adhere to myriad sanitation regulations, at considerable cost, which gets passed on to the customer. Nutritional information is printed on packages too.

      When was the last time you were able to get meat infested with maggots? Nanny government regulations prohibit that option. If meat could support a good crop of maggots, you would know for certain that the meat was not adulterated with something that would kill maggots. Now, you just have to rely on other nanny government regulations that prohibit maggot killing adulterants.

      The nanny government food regulations require food to be recalled when it is found to have bacteria in it. Why not let people with good immune systems buy infected food at cheap prices? More options always mean more efficient markets. My understanding is that lots of food gets discarded when it gets old. Why? Just let poor people eat it. They won’t know the difference. It would probably make them healthy and strong, sort of like vaccination.

      • Veridical Driver

        The point that Captain Oblivious is trying to make, is that if we take your government technocratic arguments to their logical conclusion, the optimum form of government would be a totalitarian state. After all, there is virtually no human activity where you couldn’t make the same case that choice is better left to a panel of government experts.

        Most of us believe that at some point privacy, freedom, and human dignity are more valuable than the marginal benefits of more regulation and control. We also believe that the danger of authoritarian government might be greater than the danger of choosing a wrong doctor or eating some tainted spinach.

      • http://daedalus2u.blogspot.com/ daedalus2u

        What kind of “logic” thinks government technocrat regulation leads inexorably to a totalitarian state? It isn’t the “logic” of liberals.

        I guess it is the same kind of “logic” that thinks that too much government involvement in Medicare makes it worse than private care (even though it is 40% cheaper) but thinks states should be allowed to outlaw birth control.

        http://thinkprogress.org/health/2012/01/03/396407/rick-santorum-medicare-is-crushing-the-entire-health-care-system-in-this-country/

        http://thinkprogress.org/health/2012/01/03/396516/santorum-states-should-have-the-right-to-outlaw-birth-control/

        I understand some people have objections to abortion and are anti-choice, but anti-birth control? The statistical dead-heat front runner of the party that claims to be for small government thinks government should be big enough and able to outlaw birth control? Is that a decision that people are unable to make for themselves?

        Just who is looking for totalitarian control over people’s lives?

      • Veridical Driver

        daedalus2u:

        Once again you are arguing against an imaginary Republican strawman, and not what I was saying. When where we ever discussing birth control? How would Republican’s efforts to create more regulations be relevant to this discussion?

        Please address what I was saying: If we accept the logic that government experts can make a better decision than individuals about nearly all personal choices (healthcare, education, food, economy, etc.), then you are essentially advocating a totalitarian society.

        I realize that the term “totalitarianism” is generally viewed as a pejorative, but I am not using it in the pejorative sense. A totalitarian society is simply “a form of government in which the political authority exercises absolute and centralized control over all aspects of life”. The term “Totalitarian” is not a judgement of your ideology or its effectiveness – a social democracy can be totalitarian. It is a measure of state control. It is a judgement of what you see the scope of government to be – You see no problems with the state intervening in any significant personal choice.

        Many of us, however, see the erosion of personal choice and undesirable in itself. We think the ability to make personal decisions for ourselves has a high inherent value, a higher value than whatever efficiencies are gained by having everything decided by government experts. We also think that the dangers of concentrated power in the hands of technocrats is a greater potential danger to society than the danger of choosing the wrong doctor or eating the wrong spinach.

        If you want to convince us of an issue (for example, that people should not be allowed to choose their own doctors), you not only have to convince us that it is more efficient, but that the efficiency is so great that it takes precedence over privacy, freedom, and human dignity. You also have to convince us that the efficiency is so great, that it is worth the risk of the abuse of government power on a massive scale.

        Sorry, but if I do a cost benefit analysis, the costs being my freedom of choice, my privacy, and the risk of the government using doctor choice as a method of social control – it does not outweigh the marginal benefit of allowing someone else to choose my doctor. The cost-benefit analysis is different to you, because you place a far smaller value on freedom, privacy, and human dignity, and you asses the risk of having an oppressive state as being very small.

      • http://daedalus2u.blogspot.com/ daedalus2u

        Rick Santorum is not an imaginary Repubican straw man. He and the other guy are in a dead heat as GOP presidential candidate front runners.

        You were implying that creeping nanny state government regulation like regulations on spinach hygiene and doctor choice will creep to a liberal socialist totalitarian state. Rick Santorum doesn’t want to “creep” to a totalitarian state, he wants to go there directly, but it isn’t socialism that Santorum is pushing, it is another -ism.

        I disagree with you as to what is a “significant” choice. I put an ability to choose or not choose to use birth control as a much more “significant” choice than being assigned a doctor or having the “freedom” to eat tainted spinach. I am quite sure that most people agree with me, even if you do not.

        I probably disagree with you as to what freedoms are most important. I believe that freedom of conscience, freedom of personal autonomy, freedom from physical assault, freedom from exploitation sort of the the freedoms laid out in the Universal Declaration of Human Rights are the ones that are the most important.

        http://www.un.org/en/documents/udhr/

        I appreciate that many self-proclaimed “freedom-loving” conservatives don’t. Or rather they don’t feel that such freedoms should be Universal, that only they and those they think are “more equal” than others should get to have them, and that some “freedoms” they want are even more important, such as the freedom to dump pollution into the atmosphere, in other words the “freedom” to externalize every cost and internalizing every profit.

        People who want to use Medicare are already limited to choosing among health care providers who will accept payment from Medicare. That already does limit which doctors a patient can choose, doctors have to agree to be chosen and agree to be compensated at the rate that Medicare decides.

        The same is true of all private health insurance companies. They also have “preferred” providers. Even if you have private health insurance you can always pick what ever doctor you want if you pay out of pocket. That is true with Medicare, it is true with every private insurance company, it is true for every payment plan that there is. Virtually all payment plans limit charges to what the payment plan considers reasonable, that includes only authorizing payment to providers considered competent.

        An extended warrantee for a vehicle is like insurance and every provider of every warrantee also limits who can provide the paid-for service under that warrantee. When vehicles are repaired under auto insurance due to an accident, the insurance company always requires that repairs be done by a shop that they authorize. But if you want to pay out-of-pocket, you can have the work done by anyone you want.

        I think your problem is that you are projecting and confusing what conservatives (like Santorum) would do if he got into power with what liberals would do. It is like Sarah Palin’s pants-on-fire blood-libel of “death panels”.

        You don’t understand what liberals would do, so you project the most extreme and evil thing that you can imagine; a fantasy that is of your own making and projected onto liberals. No liberal is suggesting what Santorum would do if he had the power to do so.

        It isn’t liberals who are trying to interfere with doctor-patient communication. Florida tried to bar doctors from talking to patients about guns.

        http://www.courthousenews.com/2011/09/19/39889.htm

        I don’t think I value freedom and human dignity any less than you do. I may be more afraid of losing freedoms to a totalitarian government, but not by regulation creep from spinach safety and illusory doctor choice, more from police powers, surveillance, paramilitaries, and propaganda fueled starving mobs.

  • http://suntzuanime.wordpress.com suntzuanime

    I have long been in favor of increasing regulation on mechanics. I gave up on driving last year largely because it was too much hassle to try to find a mechanic I could actually trust to work on my car.

  • Gulliver

    @ Stephen R Diamond

    Doesn’t it seem awfully crude, once you clear your mind of economists’ conventional wisdom, that people seeking services in civilized countries still must seek out hearsay information to try to piece together who’s good?

    Research is uncivilized? Single-stream information seems far more barbaric, IMHO.

    Why do you think information available to customers is hearsay, but information available to civil servants is not? Hearsay suggests the provenance of information is inaccessible to customers. But if information available to government agencies is of superior quality, then why not simply require them to make it public? Letting people make choices about whom they want tinkering with their bodies (or autos) need not preclude government agencies from informing upon the practitioners and endorsing good practices.

    If teachers were private employees, I would agree with the comparison. And in the case of private schools, I do. But public school teachers provide a public service justly distributed according at their employers’ direction (all of us) via their managers (elected officials and their appointees).

    With some given a free choice, the consequence is unpredictable, which is the problem. What I’d want is an allocation of patients to physicians that matches the talents and expertise of the physician to the patient’s needs.

    Me too. Where we apparently differ is on who is in the best position to make it happen.

    Why would a functionary be more rational or lest self-interested than anyone else? I find the ideal of the unbiased, objective, shinning, altruistic civil servant to be as rose-tinted as the laissez faire notion that the Invisible Hand will right all inequities. If people with power over other people could be consistently trusted to behave morally, human societies (civilized or otherwise) would not suffer many of the problems they do. I’m a physicist, though, not an economist, so I must concede to being unfamiliar with their “conventional wisdom” as you say.

    You’ve explained why you believe that self-determination is irrational. But if you explained why you believe it’s deleterious to the common good, I’m afraid I’ve missed it. Are you saying that people trusted to make their own decisions about what advice to heed will inhibit their own contribution to society by choosing poorly in comparison to a centralized agency?

    • http://juridicalcoherence.blogspot.com Stephen R. Diamond

      If physicians were government employees, the government would be in a better position than anyone else to evaluate the doctor’s services. Direct supervision is a peculiarly effective form of “regulation.”

      You’re correct that we can’t simply assume that government control will obviate the problems of capitalism. Government can be better or it can be worse than the unregulated conduct of capitalists and corporations. But there are inherent limitations under private enterprise. There’s little “we” can do to control the “free” behavior of capitalists. (Libertarians will say that if you don’t like a corporation’s behavior, don’t buy its products, but this “solution” is so infected with prisoner’s dilemma as to be silly.) Public control has the advantage that it can be made better; the disadvantage that it may be allowed to become worse–whereas the privations and inefficiencies of capitalism are given by the system. People won’t accept the risk of public control unless free enterprise has made a complete mess of things–as it has. Just considering medical care, look at the deficiencies (e.g., the absence of decent specialized care in rural areas), the well-known inefficiencies, and the terrible results (even on measures of infant mortality and such). In an advanced country, I doubt that in any system but free enterprise would the fact that doctors practice “defensive medicine” be tolerated, the system failing even to recognize such abuse as an ethical question. The market isn’t an institution to which lives should be trusted.

      • kebko

        Exactly. Every culture has stories of consistent, high quality customer service from public employees. In my town, we dream up reasons to go to the DMV & the post office. At my post office, they don’t even put out a self-serve envelope scale because we all prefer to stand in line for 40 minutes in order to thank them personally for their consistent service.
        Public auto mechanics would be an absolute God-send.

      • Captain Oblivious

        In theory, a centrally-controlled system must be as good or better than a market-based system – because if the market happens to come up with the optimal solution, the centrally-controlled system can just do the same thing, and if the market has failed to come up with the optimal solution, the centrally-controlled system has an “axis of freedom” (no irony intended) to arrive at solutions that the market-based system cannot reach.

        HOWEVER, this assumes that the central decision makers have all the same information available to them as the entire market has (info which is normally communicated via price signals from one part of the market to another). AND it assumes that those decision makers have the “processing power” to fully integrate all those inputs and arrive at the best answer. These assumptions don’t always pan out (in fact, they sometimes fail spectacularly), which limits the centrally-planned system to poorer solutions than the market-based system.

        Communism and totalitarianism aren’t bad approaches in principle – only in practice.

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        Kebko,
        The post office was fine until capitalism got its hooks into it and demanded it turn a profit. Public enterprises required to play to the market are almost as bad as private enterprises. Fortunately, the post office has a history of public-employees unions, so the burden of this reactionary mishap is dispersed to the purchasing public rather than falling in its entirety on the workers.

        America is notorious in its implementation of civil service. Don’t imagine government agencies in Europe share the bad reputation of the American institutions. America’s love affair with capitalism is also responsible for the inferior functioning of its public agencies.

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        Captain Oblivious,

        “In theory, a centrally-controlled system must be as good or better than a market-based system – because if the market happens to come up with the optimal solution, the centrally-controlled system can just do the same thing, and if the market has failed to come up with the optimal solution, the centrally-controlled system has an “axis of freedom” (no irony intended) to arrive at solutions that the market-based system cannot reach.”

        Exactly.

        “HOWEVER, this assumes that the central decision makers have all the same information available to them as the entire market has (info which is normally communicated via price signals from one part of the market to another). AND it assumes that those decision makers have the “processing power” to fully integrate all those inputs and arrive at the best answer.”

        This argues for using a *simulated* market as a planning tool. What you lose is the high drive associated with real market competition. This high drive is extolled by capitalist ideologues, but it is part of he problem rather than the solution.

        Those who argue that socialism takes a chance with totalitarianism have a point. But capitalism produces totalitarian phenomena too (e.g., Nazi Germany), and we’ll be seeing that too as the capitalist jugernaut continues to bear down on society.

      • Captain Oblivious

        @Stephen R Diamond
        This argues for using a *simulated* market as a planning tool.

        You’re going to “simulate” a global economy of millions of businesses and billions of consumers… and not just account for the interactions of buyers and sellers of currently-known goods and services, but also somehow “simulate” the innovations that constantly occur in a REAL market economy. That’s a tall order; get your simulation working first and THEN we’ll talk.

        P.S. Is there ANY limit to the hubris of a central-planning advocate?

      • http://juridicalcoherence.blogspot.com Stephen R Diamond

        Captain Oblivious,

        By simulate, I mean what socialists have always meant when they’ve written about using the market as an administrative tool: you use an actual market economy, except the market serves only to provide data for the planners rather than having the dispositive say about resource allocation. I don’t mean some computer simulation. (Sorry, I should have anticipated the misinterpretation; the theory of market socialism was developed before the advent of computers.)

        This only confirms what you said in another posting: you can do anything in a planned economy that you can in a market economy. The planned economy gives you more degrees of freedom. But this extra freedom includes using a faux market to obtain planning data. For many things, the planners might seldom over-rule the “market.” The only thing you can’t simulate is the effect on people’s motivation, since people in such a system can’t accumulate productive property.

  • lemmy caution

    “rather than choosing some principles and then consistently applying them, people instead pick various random policy positions and then search for justifications. There seems to be only weak pressures to even notice much less reduce how they and their arguments treat similar things differently.”

    Look at the history of the regulations involved and you will find the reason for the differences. In particular, the 40 hour work week and overtime was implemented as a result of worker demands in the 1930s.

  • Thursday

    What you say in this post is true, people are inconsistent, but I do think you rely too much on a cynical/homo hypocritus model way too much for why they are inconsistent.

  • Michael Wengler

    It seems to me that regulation and law SHOULD be inconsistent.

    Regulation or law is not the work of a single intelligence building a rational structure and codifying it. Rather it is a political compromise between a gigantic number of intelligences each with somewhat to wildly different rational structures.

    We didn’t invade Iraq because Saddam bombed the world trade centers or because Iraq had bought yellowcake from Africa or because if we could bring democracy to one Arab country the others would fall like dominoes or because Saddam had personally insulted W’s father. Each of these reasons is cited by SOME people. But the REASON we invaded Iraq, if one reason that is sufficient can be cited, is because a sufficient political will existed to invade Iraq. That political will summed across many different people with many different motivations for putting their will in along with the rest.

    Same with laws and regulations. Maybe medicine and auto repair have some interesting similarities which to the argumentative suggest they “should” be regulated similarly. But obviously they have a wealth of important differences, differences important to the many people who currently combine their political will to support a much higher level of interference in the health market than the automotive repair market.

    • http://daedalus2u.blogspot.com/ daedalus2u

      This is a very interesting point. I can understand a rationale for laws and regulations being inconsistent with each other. I can think of no reason why laws and regulations should be inconsistent with reality.

      As a matter of fact, Saddam didn’t bomb the WTC and Iraq didn’t try to buy yellow cake in Africa. Iraq also didn’t have WMD (the other false allegation usually used to justify the Iraq war). There were other false justifications, “the war would pay for itself”, “it will be over in x weeks”, “they will surrender when we hit them with ‘shock and awe’”. I appreciate that many people falsely believed these things at the time, and some even believe they actually happened even when they did not.

      In logic, false premises can be used to prove anything. In politics, false premises can be used to justify any action.

      If you accept a political process based on false premises, what you are saying is that you accept a political process that can be used to justify anything. You are in effect saying that you want a fascist dictatorial tyranny. Maybe you are willing to quibble about who is in charge, but if you accept false premises, that only depends on who is willing to tell the most outrageous lies.

  • Dave

    This is a common theme here,logical inconsistency. The only explanation I can come up with is that people who worry about the hobgoblin of consistency are “Logic Chauvinists.”

    For example: “There seems to be only weak pressures to even notice much less reduce how they and their arguments treat similar things differently.”

    Where I come from the most important thing that controls the status of a working man is do you “know what you’re doing.” One time I caught a man putting a one way tread tire on backwards. That meant,even though the car would run,the car might spin out uncontrollably on a slick surface.That car belonged to my son. I told him to change it,and without a word or an apology he did.

    Another guy was a doctor who put in knee replacements upside down because he didn’t “know what he was doing.” Then later someone had to replace them. He also did free doctoring for a local football team and when he died they had a big ceremony honoring him.

    The situations are the same but merely pointing to the lack of logic along one syllogistic line is simplistic. Many other factors color the way the situation is perceived.

    One factor that differentiates these situation is status and power which in each case serves to both protect and increase the exposure of the offenders. Of course since the doctor faces more regulation but is but perhaps this is logical since he has more power to wiggle out of his mistakes. The mechanic’s mistakes more difficult to trace and he is more anonymous, thus there is less demand for regulation.

  • Scott Messick

    Pointing out these sorts of inconsistencies does seem to work (and there for come across) as an argument against regulation, among people who assume that more often than not, a relatively free market is better than a highly regulated one. It doesn’t matter whether we assume that because of ideological appeal or because of a heuristic derived from an understanding of economic theory, or something else. If an inconsistency is pointed out in the justification for a regulation, we’ll assume the argument is flawed and retreat to our prior.

    One step up, if we think the author’s prior favors the free market and expects ours should too, we’ll infer that that’s the direction they’re trying to push us in.

  • Jason

    a) We don’t spend 17% of our GDP on car repair (0.2% of GDP or $30 billion) or house remodeling (2% of GDP or $300 billion).

    b) Cochrane’s comment about home rehab is laughably out of touch. We actually do regulate how you put your house together. State governments tell you how long the nails holding your roof on have to be. You have to get a building inspector to come over and take a look if you want to put new plywood up. There are probably 50 separate regulations that would benefit from a Federal take-over of housing regulation.

  • Drewfus

    “I think there should be a gov’t agency in charge of reviewing each person’s budget, lifestyle, medical condition, etc, and choosing what food that person should be allowed/required to consume.”
     
    What would happen to our brains if the government started thinking for us?
     
    What would happen to the government if what would happen to our brains if the government started thinking for us, happened?
     
    What would happen to us, if what would happen to the government if what would happen to our brains if the government started thinking for us, happened, happened?
     
    Did you happen to think about these things before typing “- overall I’m sure we’d be much happier!”?