The Situation of the Health Care Debate
Posted by The Situationist Staff on March 14, 2010
A Harvard Law student wrote a worthwhile post on Law & Mind a few weeks ago about some of the dynamics behind the health care debate. Here is an excerpt.
* * *
How should an institution inspire collective action? What’s the best strategy? The conventional wisdom is that to solve a collective problem, the institution should reward contributors and punish free-riders. To prevent people from littering, fine them; to induce people to donate to charity, reward them; to move people to invent, lure them with intellectual property . . . . The implicit reasoning is that the typical human agent is a rational wealth-optimizer who won’t contribute to a public good unless he or she is incentivized to do. Yet, . . . the rational actor model isn’t an accurate depiction of human nature. Just as the average person doesn’t make the “rational choice” in an ultimatum bargain, the average person doesn’t jump to contribute to a public good on account of a mere carrot or stick. The conventional wisdom—that the optimal solution for the collective action dilemma is incentive-based—is a gross oversimplification; the almighty incentive is only one aspect of a rich, complex puzzle. Nonetheless, the conventional solution is unquestioned in our popular discourse regarding collective action.
Enter [Situationist Contributor] Professor Dan M. Kahan of Yale Law School. As he’s done for quite a while, Professor Kahan challenges the conventional wisdom. In the “The Logic of Reciprocity: Trust, Collective Action, and Law,” Professor Kahan argues that the traditional solution for a collective problem is often counter-productive, and offers an alternative theory that is grounded in an ecologically valid appraisal of the human animal.
Before exploring Professor Kahan’s theory, though, consider a recent example of the conventional wisdom’s influence on public discourse from an article in Slate entitled, “The Senator’s Dilemma,” published last week. There, Christopher Beam argues that the Democratic Party’s strategic stance with respect to health care reform can be viewed as a classic collective action problem. Although Beam’s characterization of the problem is surely correct, his policy prescription is conventional.
* * *
To read the rest of the post click here.
For a sample of related Situationist posts, “Rebecca Onie: Doing Something about the Situation of Medical Care,” “How Ted Kennedy’s Passing Influences ‘Obamacare’,” “ The Situation of Racial Health Disparities,” “The Disturbing Mental Health Situation of Returning Soldiers,” “The Racial Situation of Pain Relief,” “The Situation of Medical Research,” and “Infant Death Rates in Mississippi.” To read other Situationist posts discussing Dan Kahan’s work, click here.