Monday, September 01, 2008

The Real Tragedy of the Commons

The NHS is being steadily corporatised. Outsourcing, internal markets, money following patients, Choice™. These are all hallmarks of the free-market capitalist, and especially of neo-liberal thinking.

Dr Rant thinks there is much wrong with the NHS. However, the corporatisation of the NHS has not made things better. It has made things worse. Much worse.

So Dr Rant was interested to read a critique of one of the seminal texts on the subject, The Tragedy of the Commons. Dr Rant has long thought that Garrett Hardin's 1968 text was a load of bollocks:

"Picture a pasture open to all," Hardin wrote. A herdsmen who wants to expand his personal herd will calculate that the cost of additional grazing (reduced food for all animals, rapid soil depletion) will be divided among all, but he alone will get the benefit of having more cattle to sell.

Inevitably, "the rational herdsman concludes that the only sensible course for him to pursue is to add another animal to his herd." But every "rational herdsman" will do the same thing, so the commons is soon overstocked and overgrazed to the point where it supports no animals at all.

Hardin used the word "tragedy" as Aristotle did, to refer to a dramatic outcome that is the inevitable but unplanned result of a character's actions. He called the destruction of the commons through overuse a tragedy not because it is sad, but because it is the inevitable result of shared use of the pasture. "Freedom in a commons brings ruin to all."


Sound familiar? NHS doctors continually complain that politicians do not believe that they are trying to do the best for patients. (Clearly, some doctors are not, but we are talking here of the average doctor). And then we have the 'money follow the patient' brigade.

Given the subsequent influence of Hardin's essay, it's shocking to realize that he provided no evidence at all to support his sweeping conclusions. He claimed that the "tragedy" was inevitable -- but he didn't show that it had happened even once.

Hardin simply ignored what actually happens in a real commons: self-regulation by the communities involved. One such process was described years earlier in Friedrich Engels' account of the "mark," the form taken by commons-based communities in parts of pre-capitalist Germany:

[T]he use of arable and meadowlands was under the supervision and direction of the community. . . .

Just as the share of each member in so much of the mark as was distributed was of equal size, so was his share also in the use of the "common mark." The nature of this use was determined by the members of the community as a whole. . . .

At fixed times and, if necessary, more frequently, they met in the open air to discuss the affairs of the mark and to sit in judgment upon breaches of regulations and disputes concerning the mark. (Engels 1892)

[W]hat existed in fact was not a "tragedy of the commons" but rather a triumph: that for hundreds of years -- and perhaps thousands, although written records do not exist to prove the longer era -- land was managed successfully by communities. (Cox 1985: 60)

The only significant cases of overstocking found by the leading modern expert on the English commons involved wealthy landowners who deliberately put too many animals onto the pasture in order to weaken their much poorer neighbors' position in disputes over the enclosure (privatization) of common lands (Neeson 1993: 156).


Could this be why these free-market fundamentalists are destroying good clinical care in the NHS? Or could it just be that they know rich picking when they see them and are determined to ram-raid the tax payer for more big profits.

Hardin was partly right: right wing wankers are selfish bastards who only look after themselves. He just forgot that we are not all right wing wankers.

Hardin's argument started with the unproven assertion that herdsmen always want to expand their herds: "It is to be expected that each herdsman will try to keep as many cattle as possible on the commons. . . . As a rational being, each herdsman seeks to maximize his gain."

In short, Hardin's conclusion was predetermined by his assumptions. "It is to be expected" that each herdsman will try to maximize the size of his herd -- and each one does exactly that. It's a circular argument that proves nothing.



Interestingly, neo-liberals have been a bit quite of late, what with them having to break all their own rules and bail out large banks to keep the economy from going totally tits up. So if you are a little guy taxpayer and you get into difficulty, that's the market. Tough luck. If you are big rich banker, you get bailed out by, yes, the little guy taxpayer.

You can read the whole article here.

3 comments:

Devil's Kitchen said...

Dear Team Rant,

Please stick to medicine: you just look a bit silly when you try to attack economics. There are plenty of examples of the tragedy of the commons, e.g. fish stocks under the CFP, a number of prominent British landmarks that are now in danger of destruction through overuse, etc.

"Interestingly, neo-liberals have been a bit quite of late, what with them having to break all their own rules and bail out large banks to keep the economy from going totally tits up."

Really? So the fact that the government -- the same government that runs (or should that be "ruins") your precious NHS -- has used taxpayers' money to bail out a bank the main base of which was in the Labour heartlands is why we neo-liberals are being quiet? Hardly.

I agree that trying to insert a false market into a state-run, near-monopoly organisation is stupid. But then, that is what politicians do: they use state-run institutions to score points off each other.

If you want a health service that is not being constantly interfered with by politicians then you need to take it out of political control. Which means that you need to allow a free market.

Right now, there is no free market because I have to pay money to the NHS, whether I want to or not.

Let people opt out of NICs and let's see how long the NHS lasts.

And if you doctors are so wonderful and caring, then I am sure that you will have plenty of patients. Let's face it, GP care will barely change at all.

DK

Dr Rant said...

Thank you for dropping by, DK.

However, you're final comment makes my point for me:

"And if you doctors are so wonderful and caring, then I am sure that you will have plenty of patients."

You assume that my thinking is motivated by the selfish desire to protect my income/personal practice.

Financially, I'm very happy with the current changes to the NHS made by the government so far. Sure, many of my colleagues have suffered financially, but Dr Rant was one of the winners.

Financially, I'd be fucking over the moon if things stayed exactly as they are.

But, you see, I'm not motivated primarily by money. I'd be happy to go back to my old income if the damage done could be turned back too.

I'm not sure you will be able to understand such motives, or believe that they exist, although they are the motives of the majority of human beings.

That is the problem with neo-liberalism. It only works if everyone is like it's proponents, and it's proponents can't accept that anyone claiming to be different from them are deluded/lying.

niku said...

I'm sorry Rant, but saying "I'd be happy to go back to my old income if the damage done could be turned back too." ignores the fact you are trying to compare a really horrifically shit system with one you say is worse. No much different then trying to compare the smell from different chemical toilets.