Tuesday, February 21, 2012

Antibiotic Resistance, the Anarchist Solution

Coercive, government-legitimizing beliefs and thoughts are habit forming. It often stops the addict from seeing easy solutions.
"Tighter controls on prescriptions, or a tax on antibiotics, might address the conservation problem."
"If the market doesn’t work, why not try the government?

Even many libertarian types agree that the commons problem seems to call for stronger state controls over antibiotics." (Pathway.)
Principle: the market is smarter than you. Smarter than me, too, but in this case I apparently don't have to be that smart. Solving the conservation problem is straightforward.

Solution in 50 words or less:
First, make sure its health insurance, not healthcare insurance. The insurer should pay up whenever the customer gets sick. (How does this [ctrl-f "Stanford"] happen without collusion from the insurance companies?)

Next, sell the rights to antibiotics, wholesale, to the insurer. They decide who gets what chemical, when, and how much.

The insurer has a a short-term financial incentive to use the antiobiotics, and long-term incentive to see that they still work later. The drug firms don't have to take on the market risk at all, but have an incentive to produce any chemical the insurers will buy. The insurers have an incentive to buy new chemicals that work, but only to use the cheapest that will work, and have the resources to professionally check that they work.

It aligns incentives for cooperation with the patient, all the way down the board. (Except the government, which sees an opportunity for overreach disappear.)

However, there is a flaw here; the third world.
"Laxminarayan likens antibiotics resistance to global warming: every country needs to solve its own problems and cooperate—but if it doesn’t, we all suffer. Coordinating a global response will require years, even decades; any serious revision to the patent system might have to go through the World Trade Organization."
They don't care about our insurance companies, and it's pretty easy to copy an existing drug. Resistance could develop there and then spread to here.
There's a straightforward non-combat solution, in globalizing the market better. This can't help in time, but is a nice illustration of how (principle:) past coercion destroys future non-coercive solutions, which implies that it is still worth ending current coercion to prevent this kind of thing from happening again.

Note, however, that all the solutions McArdle mentions have the exact same problem. (Are there any problems that markets have and governments don't? It seems unlikely in principle; they're both staffed by human beings.)

"The longer we ignore our problem, as Orwell did, the more likely we are to share his fate."
Who's 'we'? I'm on board with solving antibiotic resistance. By how much does that increase the odds that the problem will be solved, do you estimate?


Anomaly UK said...

How is awarding and enforcing a private monopoly not "stronger state control"?

Not that it's a bad idea, mind.

Alrenous said...

It uses the existing patent system...by which I mean you've reminded me that I shouldn't be implicitly supporting the current patent system.

Glad you like it, though.

So I guess the insurance company should make any customer sign a contract promising not to copy their drug. It amounts to a patent system, but is voluntary instead of imposed.

More generally, I don't believe security is necessarily a state monopoly, any more than other goods are. I probably should have mentioned it, rather than implicitly assuming it.

In any case, 'we' should try it, small-scale, and see what happens. Epistemically speaking.

Andrew Crawshaw said...

I think your solution is good; but it is a libertarian solution not an anarchist one. the reason I say this is that selling a monopoly to an organization etc etc, requires the backing/coercive power of the state, especially if when someone enters into health insurance that same person needs to sign a contract, so that they don't "copy" the product; anarchists are anti-state and anti-coercive. Not saying that it won't work, or be beneficial, but it stinks to an anarchist of indirect (through the market) tyranny. Whereas a libertarian would whole-heartedly agree with you.

Alrenous said...

Does that mean you believe citizens should be allowed to copy drugs?

Doesn't that mean you think citizens should be disallowed from promising not to, and if they negligently promise such anyway, shouldn't be held to that promise?

Andrew Crawshaw said...

"Does that mean you believe citizens should be allowed to copy drugs?" In a true anarchist society there would not be citizens, only individuals. and to answer your question by dismissing it, how would copying be disadvantageous to someone in an anarchist society?

I was responding so that you would not muddy the waters between anarchism and libertarianism (it seems only that libertarians do this and not anarchists)

"Doesn't that mean you think citizens should be disallowed from promising not to, and if they negligently promise such anyway, shouldn't be held to that promise?"

Citizens? we are not even talking from the same paradigm, so my answer might seem unsatisfactory to you. furthermore there are a lot more questions nested within these questions. it would take me an entire essay to disentagle.

So I will answer it as best I can, without directly attending to any of them.

I am for full voluntary
association full stop and any such "bad" behaviours that would cause (not in this case the "copying" of drugs - how would this work without patents?) problems that are adverse to a group with shared goals will be rooted out through social exclusion. These people might move onto other groups and keep getting excluded, but this kind of human behavior cannot be stopped in any society (without some form of tyranical state control, I mean that in its literal snese because you get people like that now, and the only way to get rid of them would be to imprison them etc), so anarchism should not be expected to solve it, either. Rules in states are based on the exception (like the above), so the rules become more restricting to everyone. You can bet that it will go the same way in a true Free-Market, when the state has to arbitrate disputes over property rights, especcially "Drugs" (chemicals can be functionally alike and have slightly different molecular structure, so what are you patenting? these are the kind of decisions that will have to be arbitrated). This is not to say that your solution is not a good one, only that it is not anarchistic.

I hope among all that gibberish I actually managed to answer your question.