[ExI] Decision-making under scarcity/was Re: Charity

Stathis Papaioannou stathisp at gmail.com
Wed Jul 22 11:08:07 UTC 2009

2009/7/22 Dan <dan_ust at yahoo.com>:
> On Tuesday, July 21, 2009 9:16:26 AM Stathis Papaioannou stathisp at gmail.com wrote:
>>> And my point was that there's no clear line between elective
>>> and non-elective. It's arbitrary -- even if clinicians, bureaucrats,
>>> insurers, patients, you, me, and the Great Spaghetti Monster
>>> might agree that someone bleeding with a deep gash in his
>>> neck is clearly on the non-elective side of the line. Under a
>>> true voluntary system here -- i.e., one where there's no
>>> coercive interference -- the decisions would made, IMO, in
>>> the best fashion because there'd no third party coercively
>>> entering the relationship to impose its view of what should
>>> be done.
>> So who would make that decision, if you're bleeding and I'm
>> having a heart attack, and there aren't enough facilities to
>> treat both of us at once?
> I don't know, but we'll miss you. Just kidding! :)
> Seriously, this type of problem doesn't decide the issue. After all, such a decision would have to be made under any system where there're scarce resources -- here, facilities or medical professionals -- and a quick decision has to be made. Or do you think a voluntary system would always or more often than not make the worse choice while a coercive one would not?

Firstly, I don't agree with the way you keep referring to public
services as "coercive". It's also "coercive" when you have a job, and
you have to do what the boss tells you and allow him to keep a portion
of the fruits of your labour as profit - which you get no benefit back
from, unlike taxes. How is it that we disagree so completely on this:
I regard business as more coercive, less fair than most government
(even though I don't *like* or particularly *trust* government and
would ideally *prefer* to be rid of it as far as possible), and you
think the opposite, but claim this as a matter of fact rather than an
opinion on how best to run things?

Secondly, the "voluntary" system might deal with the problem of
allocation of resources by allowing patients to bid for the right to
be treated first when faced with an emergency. That would be the the
free market solution, and it would also dispense with the need for a
triage nurse.

Stathis Papaioannou

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