Expertise and Ego

I sincerely hope that ‘experts’ of all stripes — and not merely economists — take note of your admonition toward humility.

The kind of humility you advocate, however, is something one rarely sees among the ‘experts’ — within government and think-tanks and academia — who routinely proclaim to us all that they know “the truth” and that the proper role and responsibility for the rest of us is simply to shut up and do as they say.

That may not be completely fair: it may be that the apparent hubris of expertise is exaggerated by reporters and a news media that is besotted with the idea of ‘expertise’ and, therefore, amplifies the voices of the most self-certain while muting the voices of the humble.  It may be that many or most experts are, indeed, well  aware of their self-limitations but that their voices are not the ones that the media chooses to tell us about; or, it may be that the various caveats and disclaimers with which they accompany their assertions never make it through the filter of the reporters’ perceptions into the news stories and analyses written about them.

And, it may also be that those, in particular, who choose to go into government are self-selected from among the most hubristic precisely because their very self-confidence leads them to the belief that they should also have the power to impose their chosen “solutions” upon others.

Regardless of the reason, however, what is presented as ‘expertise’ for public consumption is, all too often, the farthest thing from your humble ideal:  it is, rather, most often arrogant; and it is, far too frequently, also condescending.

And that arrogance and condescension is exacerbated by the fact that such experts frequently extend their claims to ‘expertise’ beyond what is justified by their training and experience.  A medical researcher will discover some (perhaps tentative) connection between a chemical or a food and some health state, like heart disease.  They will then not only exaggerate their certainty, proclaiming that the evidence of such connection is irrefutable (Eat this and you will die!), but will also proclaim, with equal certainty, that a particular policy prescription — Ban that chemical! — is, by extension, mandatory; and they will claim that their policy prescription is simply a matter of “following the science” and, therefore, also wholly within their ‘expertise’, as if such policies have no other economic or practical or emotional or moral dimensions beyond the narrow realm of “science” that might require consideration.

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Health Care Payment Reform

From 25 years ago: My Proposal for Health Care Payment reform.

Still, I think, more rational than anything else I’ve heard. Agree with me or convince me I’m wrong — either is a good outcome if it means we end up with something that actually works without destroying either health care or our culture of liberty or both.

The original cover letter to the Concord Coalition and to various Senators and Congressmen

The original cover letter to then-Governor Howard Dean, of Vermont

The proposal

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Politicians “making decisions about your birth control”

As a consumer of resources, I love the idea of someone else paying to support my lifestyle choices. But, as a producer of resources — and as a liberty-minded citizen of the American republic — I abhor the notion that the government should oblige me to provide for the lifestyle choices of others.

Perhaps the availability of contraception transcends mere “lifestyle choice” and comprises a public good worthy of government compulsion. Perhaps it doesn’t. That is worth a debate and I won’t pass judgement on it here.

But I must insist that those debating the issue do so honestly. No one is threatening to take away your birth control. All they are asking is that they not be forced to pay for it.

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Breaking News: People want to get things and make other people pay for them!

Suppose you want me to pay for your health care — or for your mortgage, or for your car, or for your iPod, or for anything else you feel you really need but can’t afford — and I don’t want to do so. If you point a gun at me and tell me to give you the money, it would be armed robbery. Everyone knows you don’t take what isn’t yours by force just because you want it. That would be wrong.

So, instead, you convince your Congressman to take the money from me, as a “tax”, and to give it to you. Why does that suddenly make it right?

What if I still don’t want to pay? What if I refuse — what do you think is going to happen? Federal agents will point guns at me and tell me to give them the money. Is taking my money by force suddenly righteous, rather than outrageous, because you outsourced the job? Is that what democracy is supposed to be about — lending moral authority to what would otherwise be morally reprehensible?

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“Perpetrating the Autism Myth”

Perhaps later in the season they can do a follow-on episode of “Eli Stone” in which the crusading hero sues another vaccine maker, this time to force them to continue making the life-saving vaccines his clients desperately need after the threat of massive awards in bogus liability lawsuits has forced them out of the vaccine business.

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Health Care and Profit

The self-righteousness of those who proclaim that profit is the beast eating the health-care industry and that all would be wonderful if we could just remove profit from the system is both annoying and tedious.

It’s bad enough that they ignore the fact that the potential for profit is what entices investment and is the fundamental reason that our health-care R&D pipeline is so vibrant.

But it’s truly infuriating when such fulminations come from those working within the system. So far I haven’t heard of any who connect profit with their own take-home pay or who have taken a vow of poverty to make health care more affordable.

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How (Not) To Spend a Budget Surplus

Jack Connors, Jr. argues (12 Jun) that the current revenue surplus in Massachusetts should be spent on increased Medicare reimbursements rather than being returned to the taxpayers from which it derived…

…even if you grant that shoring up shaky government budgets is the better use for the excess funds, using them to increase reimbursements for Medicare — or to fund benefit increases for any other entitlement program — is the worst possible use for the money.

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