August 13, 2017

QotD: The measurement problem in government

Filed under: Britain, Government, Health, Quotations — Tags: , , , , , — Nicholas @ 01:00

Now take health insurance. (Or, if you live, like me, in a country with a national healthcare system that has a single comprehensive payer, the health system.) There are periodic suggestions that we should punish bad behaviour, behaviour that increases medical costs: Scotland has an alcoholism problem so we get the Alcohol (Minimum Pricing)(Scotland) Act, 2012. Obesity comes with its own health risks, and where resource scarcity exists (for example, in surgical procedures), some English CCGs are denying patients treatment for some conditions if they are overweight.

It should be argued that these are really stupid strategies, likely to make things worse. Minimum alcohol pricing is regressive and affects the poor far more than the middle-class: it may cause poor alcoholics to turn the same petty criminality observed among drug addicts, to fund their habit. And denying hip replacements to overweight people isn’t exactly going to make it easier for them to exercise and improve their health. But because we can measure the price of alcohol, or plot someone’s height/weight ratio on a BMI chart, these are what will be measured.

It’s the classic syllogism of the state: something must be controlled, we can measure one of its parameters, therefore we will control that parameter (and ignore anything we can’t measure directly).

Charles Stross, “It could be worse”, Charlie’s Diary, 2015-10-09.

No Comments

No comments yet.

RSS feed for comments on this post.

Sorry, the comment form is closed at this time.

Powered by WordPress