The Fatal Conceit

of Jonathan Gruber:

The Times reassuringly described Gruber as “the numbers wizard at MIT,” who has “spent decades modeling the intricacies of the health care ecosystem.” Gruber has “brought a level of science to an issue that would otherwise be just opinion.”

I might note that the Soviets used the term “science” for their own “scientific” planning commission. I drew little comfort from Professor Gruber’s scientific-planning credentials, especially when I learned “he’s the only person you can go to for that kind of thing.” Gruber, aided by his brilliant MIT graduate student assistants, is a one-man Gosplan, the name given to the Soviet Union’s state planning committee. That is not much of a recommendation. Science is better served by competing ideas not by a one-person monopoly.

Both Gruber and the USSR’s Gosplan planners believe their planning is “scientific” and executed by “the best of the best.” Both types of planning commissars suffer from F. A. Hayek’s “fatal conceit”—the belief that we can plan incredibly complex economic systems. As Hayek pointed out in his writings, such “scientific” plans inevitably fall apart under the weight of unintended consequences.

Actually, I’m not sure they’re all unintended.

25 thoughts on “The Fatal Conceit”

  1. That conceit doesn’t rest only with Gruber… almost all the Federal government wallows in it.

    For example lefties are finding out new and exciting ways Obamacare is destroying lives, hurting people medically and just plain failing (Sensible people predicted this from Day One). Just some of the latest examples – and from the NY Times:

    “Large numbers of doctors who are listed as serving Medicaid patients are not available to treat them, federal investigators said in a new report.

    “Half of providers could not offer appointments to enrollees,” the investigators said in the report, which will be issued on Tuesday.

    Many of the doctors were not accepting new Medicaid patients or could not be found at their last known addresses, according to the report from the inspector general of the Department of Health and Human Services……………….
    “For example,” the report said, “a number of obstetricians had wait times of more than one month, and one had wait times of more than two months for an enrollee who was eight weeks pregnant. Such lengthy wait times could result in a pregnant enrollee receiving no prenatal care in the first trimester of pregnancy.”

    And what is the remedy?

    “James Golden, director of managed-care plans at the federal Medicaid agency, said he was developing new rules and standards to ensure timely access to care for Medicaid patients.”

    MORE rules

    MORE standards…as if they are smart enough to manage a system with billions of decisions and unexpected events and human nature factoring into it.

    http://www.nytimes.com/2014/12/09/us/politics/half-of-doctors-listed-as-serving-medicaid-patients-are-unavailable-investigation-finds.html?ref=health&_r=1

    1. And said rules could soon be backed by force of law:
      “Your medical skills are required by the community — don’t be selfish. You will report to the hospital for your daily 16-hour shift. Failure to do so will result in arrest and prison. ”

      The Medical Conscription Act of 2014?

      1. Ugh, replied in the wrong place. For this, it’ll be interesting what is proposed and the mechanisms they try to employ. For example, they could use actual conscription. There is supposed to be a provision for conscripting people with particular skill sets in times of emergency. I imagine they’ll go to some more nuanced approach that doesn’t alienate a bunch of voters who suddenly have to find a new doctor.

        There’s the carrot and stick approach where the Feds pay more for Medicaid patients than they are currently and drop a surcharge on paying customers. I suspect due to the various accounting scams that went into Obamacare in the first place and the fact they aren’t offering anything near market rate, they won’t have a lot of carrots to offer (or the carrots they do offer won’t quite be there).

        And there’s the obvious ploy of forcing physicians to take on a fixed number of Medicaid patients in order to keep their licenses and/or stay out of jail. That’ll drive up cost even more for regular patients. And if doctors drop out of the industry altogether, then conscription is the next obvious thing to try.

  2. Not sure Rand? Remember those immortal words in Ronin…

    When there’s doubt, there is no doubt.

    The behavior is beyond conceit. It is inhuman, because the reality is even a child could understand this. I wish as a child someone had explained it to me so I’d be better prepared as an adult to deal with it.

    If it truly is inhuman, that makes sense in another way. If you’re looking for it through history up to now, you can actually see the strings being pulled. An angry roaring lion seeking to devour knowing he only has a short time left. We are living in the last days, just before the great tribulation.

    We have been warned. Playing Satan’s advocate, obviously this is just a case of observational bias on my part, eh? (Satan’s advocate? Sometimes I just crack myself up!)

    Their inability to fix things with rules is blatantly obvious to us. Isn’t it? Conceit is simply insufficient as an explanation. More than conceit, it requires blindness. Which incidentally, “he blinds the minds of the unbelievers.”

    This is absolutely blindness. Not just conceit.

    If not unintended, then it is nothing less than evil. Ignoring the useful idiots and focusing just on those that are amazingly coordinated in their evil, how could they not be having their strings pulled?

  3. It really does go back to the beginning of the Progressive era. John Taylor Gatto wrote a piece in Harpers back in 2003 that summarizes the whole intention. It’s a reprint from Sep, 2003 and you can find it here.

    http://www.wesjones.com/gatto1.htm

    If you wonder about the smarmy elitism of these schools:

    Inglis, for whom a lecture in education at Harvard is named, makes it perfectly clear that compulsory schooling on this continent was intended to be just what it had been for Prussia in the 1820s: a fifth column into the burgeoning democratic movement that threatened to give the peasants and the proletarians a voice at the bargaining table. Modern, industrialized, compulsory schooling was to make a sort of surgical incision into the prospective unity of these underclasses. Divide children by subject, by age-grading, by constant rankings on tests, and by many other more subtle means, and it was unlikely that the ignorant mass of mankind, separated in childhood, would ever reintegrate into a dangerous whole.

    And certain universities will train the elites to manage the dross:

    6) The propaedeutic function. The societal system implied by these rules will require an elite group of caretakers. To that end, a small fraction of the kids will quietly be taught how to manage this continuing project, how to watch over and control a population deliberately dumbed down and declawed in order that government might proceed unchallenged and corporations might never want for obedient labor.

    So you have these morons being told continuously that they are the elite and know best. That they have been chosen for this grand role of shepherding the sheep. (The silver running the bronze in Plato’s terms.)

    I recommend you read the whole thing. It’s very well sourced.

  4. Its not just him. All economists fail from this conceit themselves. By wrapping a chaotic system in a thin veneer of equations they think they can accurately model it when actually they can’t.

    Curiously the same thing applies to climate.

  5. “It ain’t what you don’t know that hurst you. It’s all the things you do know that ain’t so.” — Will Rogers

    At lesast there’s a vigorous debate in DC over this conceit when applied to health care. Unlike other areas, like public education or space policy.

  6. The problem with FDR’s brain trust was that it was never implemented properly and they had the wrong people. Things have changed, this is the 21st century. We are much more superior to previous generations and have centuries of experience in implementing policies effectively. It also goes without saying that the quality of potential new brain trust members has increased substantially. We live in a modern era, where the average person has no knowledge of the complex interactions which govern our lives, and lets be honest, they couldn’t understand it if we told them.

    Poe’s law?

    1. I give it 0.6 Blighters. (If you read the comments at Megan McArdle’s excellent blog, you’ll understand.)

  7. Yes, but did Professor Gruber ever get back the $4 he has overcharged by that Chinese restaurant?

      1. So yes, my remark was meant as a joke.

        Professor Gruber’s taped remarks might end up upsetting the apple cart/gravy train/funeral carriage of the Health Care Act, but the burning question is he got his 4 bucks back after his, ahem, exchange with the restaurant owner.

        Yes, I know the 4 bucks is a different Massachussetts-elite person, but the general principle is the same.

        With regard to Professor Edelman, the way this is supposed to work is that you say, “You charged me $57 but your Web menu I based my ordering on listed $53, to which a proprieter of a family business would say, Oh, I am sorry about that, here is your $4 back along with a discount coupon for your next order from our restaurant.” You are only supposed to “escalate” to the “law in the Commonwealth of Massachussetts says you owe treble damages” when the restaurant owner disses you about making good on this difference.

        And when the restaurant owner goes by the name “Vlado” and the restaurant is named “A Little Taste of Belgrade”, you just keep it to yourself, if you know what I mean . . .

  8. He’s made millions off the taxpayers. Obviously he was important to the government and not a little advisor like the left wants us to think.

    1. Gruber is a piker compared to James Elmer Mitchell and John Bruce Jessen, the psychologists we paid $80 million to torture detainees. Do you think there’s any chance they’ll be called to testify before Congress?

      1. What does this have to do with my point? Does it mean you agree with me?

        And are you actually saying that they all are making too much money and we should reduce the size of government salary?

        No, it just means you want to throw in your BS to be a douche.

  9. “spent decades modeling the intricacies of …”
    As someone who has done computer and mathematical modeling I know better than to trust an unvalidated model. For that matter, I’ve seen even professional quality models occasionally give suspect results.

    When human behavior is involved, as would apply to health care systems, sane assumptions must include behavior driven by perceived self interest. While the effects of this may be impossible to properly quantify in magnitude, the general direction a rule pushes behavior can usually be estimated.

  10. Above I noted (as I have earlier) the effective creation of a new class of uninsured due to evaporating Medicaid benefits. Pre-Obamacare there were roughly 50 million uninsured people in the US (note the link (from 2010) claims Obamacare will reduce the number of uninsured by 32 million “when fully implemented”).

    Meanwhile from this link we have 57 million people on Medicaid in 2013, jumping up to 68 million in September 2014. Meanwhile there are still 41 million uninsured in the US as of early 2014.

    So we have 41 million uninsured still and 68 million in a category that is decaying to uninsured status in 2014.

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