Jun 21, 2010

Living Within Limits - Chapter 23

Commonized Costs - Privatized Profits

Known as the CC-PP game, Hardin points out the duplicity of society, where 'most men believe in laissez-faire for others, while seeking to escape it themselves'.  In truth, success more often comes to an ingenious man who 'fashions a bifurcation in the accounting system that channels the costs of his enterprise to society, while directing profits to himself.'  Asymetrical capitalism is not to be confused with the real thing.

Externalities (aka Pollution)

Unwanted effects imposed on the environment by industry.  Companies (individuals) are rarely punished or charged for damages, though they reap all benefits.  Even when they pay damages, it is almost always to human victims.  The true damage done (wildlife, ecosystem, etc.) are not accounted for.

Disaster Relief

Think Katrina.  Mammoth rescue projects were undertaken to rebuild the city of New Orleans, paid for courtesy the tax payer.  However, the ecological-economic rule that we are fighting against is this: the flood plain belongs to the river.  Thought it's cheaper to build houses on flood plans than rolling hills, there is the clear risk of flooding.  If home builders, or home owners, were to internalize the costs of repair/rebuild, they would NEVER have built these homes.  Instead, through twisted incentive systems and immense hubris, we continue to fight against the laws of ecology and economics, forever dooming ourselves to repeat our past mistakes.

Farm Subsidies (and other subsidies)

Prices of farm produce is manipulated through subsidies, resulting in higher profits for farmers and higher costs for customers (and taxpayers).  This system is further twisted by subsidies tobacco farmers, which elevates medical needs for smokers, which elevates medical costs for all, which leads us to the next, and biggest topic...

Lawyers Protect Individuals (Not Society)

Hardin believes that the reason medical costs in the U.S. have sky-rocketed is largely due to the legal system - our laws are simply too big a temptation for lawyers.  We have 20 times more lawyers, per capita, than Japan.  However, very few (if any) defend the rights of the general public (social good doesn't pay the mortgage).
Malpractice suits against doctors are common; settlements cost money (not to mention legal fees).  Malpractice insurance costs money.  Insurers insist doctors protect themselves against lawsuit by demanding excessive diagnostic tests... cost money.  The costs are paid for either by a) government, or b) employer - the bulk of costs are socialized.
Saving babies (Warning... Reader Discretion Advised)

'It is impossible to put a price tag on life... particularly the life of innocent newborn babies'.  With the system we have today, social medicine, we don't have to.  Premature babies of even drug-addicted mothers are given every possible resource to nurture.  However, premature babies are notoriously expensive to save, with costs of roughly $1,700 per day (back in late 1980's).

If parents were forced to pay for the cost of saving a child, would they then be more capable of putting a 'price' on the life of a innocent newborn?

Consider China...

Hardin brings up the example of China as a comparison.  First, in China, lawyers have no right to intrude into medical matters.  Second, medical costs for treating babies are borne (no pun intended) by parents.  Third, both Confucian and Marxist values places high-esteem on the well-being of the greater society.  These factors would lead to dramatically different outcomes for neonatal care.

Mortality vs Morbidity

There is also the consideration of mortality vs morbidity.  We abhor the idea of the death of a child.  Yet, we rarely talk about the suffering of this child.  There is probably reason to suspect that the child suffers greatly during the intensive care process.  Not only that, but most 'saved' preemies have medical challenges the rest of their lives, including defects in hearing, sight, intelligence, and cardiovascular systems (causing not only suffering, but further deterioration of the medical commons).

Opportunity Cost

And then, there is the never-mentioned issue of opportunity cost.  Instead of the money being spent on these difficult to tackle problems, what if they money was spent to treat lesser ailments?  Or perhaps education?  Opportunity costs are very real, and (cold as it sounds) return on investment is an important consideration.

If the parents in the previous example had other, healthy, children to consider/raise, how would that effect their decision?  Save the child at any cost?  Is that what you would do?
If a rural hospital in a county with a small tax base were required to do everything humanly possible for all the patients who might come to it, the end result would be bankruptcy, following which the hospital could do nothing for anyone, rich or poor.
Legislative Failure - Pork Barrels & Lawyers

Consider why social costs exist in a democracy.  Senator A wants to protect the farmers in his state, yet wants to vote against the farmers in other states.  Senator B and C are in similar situations.  Together, they agree to vote for each other's subsidies.  Poor senators D and E are outvoted.  Democracy at work, in all its glory.

What about the broken legal liabilities in the medical system.  Here is Hardin's explanation:
...the majority of state legislators are lawyers by training; lawyers constitute something of a tribe, and we should not be surprised to find that here, as in so many instances, the tribal loyalty is given preference over loyalty to the nation as a whole.

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