The Pretense of Knowledge and Affection

by Don Boudreaux on April 19, 2014

in Complexity & Emergence, Hayek, Health, Hubris and humility, Seen and Unseen

An excellent test of whether or not someone does or does not grasp the core Hayekian wisdom is supplied by his or her response to this passage found in yesterday’s New York Times:

“We understand that we doctors should be and are stewards of the larger society as well as of the patient in our examination room,” said Dr. Lowell E. Schnipper, the chairman of a task force on value in cancer care at the American Society of Clinical Oncology.

In practical terms, new guidelines being developed by the medical groups could result in doctors choosing one drug over another for cost reasons or even deciding that a particular treatment — at the end of life, for example — is too expensive.

People who truly understand the complexity of reality respond by shaking their heads in disbelief.  They are aghast that anyone thinks that an individual doctor could possess enough knowledge to know how to make all the appropriate tradeoffs implied in Dr. Schnipper’s proclamation.  They are aghast, too, that anyone supposes that an individual doctor could also possess enough concern for countless faceless strangers to be inspired to reliably make these tradeoffs.

Other people – those who either believe in the miraculous powers of good intentions or who do not understand just how enormously complex our society is – respond with warm glows, applauding humanitarians such as Dr. Schnipper for their ‘social consciousness’ or their intelligent, “Progressive” values.

So here’s a question: why would someone object (often in high moral dudgeon) to the allocation of scarce health-care services by prices and market competition but, at the same time, believe it acceptable for scarce health-care services to be allocated by the decisions of individual doctors, each of whom has some image in his or her head of how health-care resources ‘should’ be allocated?  The latter method of allocation is far more arbitrary than the first.  And – if for no reason other than that the fact that throttling market forces leads to the production of fewer and lower-quality health-care services –  the latter method is also more likely than is the first to deny many deserving patients appropriate amounts of health care.

(HT Alex Tabarrok)

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