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Bill Harshaw's avatar

Reminds me of the "demonstration farms" model used by the early Extension Service (which was briefly described in Gawande's recent New Yorker article as a model for innovation in health care.

But reading T.R. Reid's book on health care, both France and Germany use smart cards to carry a person's health care history, an example of an innovation which must have been centrally managed. That's a reminder of what seems true for innovation in an American context is not necessarily universally true.

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Overcoming Bias Commenter's avatar

Of course he didn't. He meant that he hoped that we could trust the experts, because that's a pretty critical component in division of labor: the generation of expertise is expensive.

The problem comes with the fact that there's no economic incentive in the current climate for an expert to be right. There's economic incentive for an expert to be convincing, and there's incentive for an expert to push his particular expertise. And so there's counterpressure against experts, because we don't trust that they're telling us what's best for us, but rather what's best for them.

There's a good and entertaining analysis of this here.

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