Comment by patio11 | Hacker News Reader

Comment by patio11 | Hacker News Reader

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Infant mortality, for example, isn't well served by market mechanisms

I disagree more with this statement than any other statement ever made in good faith on Hacker News. Kids not dying is an outcome we urgently desire, right? There are a variety of products which support this outcome. One is "soap." Soap scarcity is a real phenomenon: some rooms that children are born in have no soap. Those rooms kill lots of children. Soap scarcity was a quite common phenomenon until very recently, historically speaking. The reason that I keep having to mention that soap scarcity is a thing at all is that market mechanisms are so effective at allocating resources to production and distribution of soap that educated Westerners could be forgiven for not knowing that it doesn't come from the same magical fountains supplying the infinite, free, clean drinking water often found co-located with infinite, free, effective soap.

In the real world, some kids will die this year for want of soap. Some people believe this is because the market has taken the soap from their rooms. These people are fools, because the natural state of nature is "no soap." Children die because, almost universally, someone has strangled the market that would otherwise be allocating soap towards their rooms.

There are more complicated reasons for child morality than lack of soap, but to the extent that they involve scarcity of resources, they largely reduce to the soap case.

I think one thing people often miss about markets is that they tend to allocate resources efficiently ... over time. Sometimes over lots of time! As someone recently reminded us all, the market can stay irrational longer than an individual can stay solvent.

There are definitely things markets don't allocate efficiently - but those are "public goods," and they rarely look like infant mortality.

Along these lines, I'd love to hear what you make of John Robb's argument that the concentration of wealth and influence in the hands of Goldman Sachs and their ilk amounts to a shift to central planning, with the predictably disastrous consequences.

> There are more complicated reasons for child morality than lack of soap

The most important one being a lack of information. Except in the poorest slums, where people can't afford soap.

If fact, they may be wasting their money on stuff which increases infant mortality. Infant formula may be marketed as being healthier than mother's milk, but without proper sanitation it's much worse.

> Children die because, almost universally, someone has strangled the market that would otherwise be allocating soap towards their rooms.

It's ridiculous to say that, unless you know of some place in the world where soap is insanely expensive. They'll die because their families were poor. The ultimate causes of poverty are complex, and probably relate to dysfunctional states which (among other things) don't create functional markets. But to say that the ultimate problem is "not enough markets" is silly. Would public education help? Does their government need to enforce anti-corruption laws?

You can't look at a government which does everything wrong, and say "the big problem is, they don't allow markets to flourish".

But some things (like immunization) can be done cheaply (if somewhat inefficiently) by something that's not a market.

Certainly there is a large contribution made by markets, but in the western world markets still failed to fully solve the problem, and it took government intervention in the mid 20th century to really push down the mortality numbers, which were still quite high despite the ready availability of soap. The biggest problem is that there were few doctors, hospitals, or vaccination facilities available in certain areas, especially rural areas and poor urban areas, where there wasn't enough money to attract such services. So there was a big push in the US, Canada, and Europe to subsidize healthcare penetration into such areas, by building rural clinics and posting doctors and nurses to such areas. That reduced rates of many previously endemic diseases, increased vaccination rates, and resulted in more children being born in hygienic settings with medical oversight.

A related problem, possibly just as big, was that there was very bad information available, especially again in rural areas; people just were not educated on best practices, and were wasting their money on snake oil while failing to take basic steps that actually work. The Canadian government started combatting that as early as the 1920s, by sending out public health nurses to give vaccines and help educate people in rural areas, and printing up pamphlets and books with information: http://www.archives.gov.on.ca/english/on-line-exhibits/healt...

> The biggest problem is that there were few doctors, hospitals, or vaccination facilities available in certain areas, especially rural areas and poor urban areas

A problem directly caused by earlier government intervention. Starting around 1910, the AMA managed to push through legislation in most states that solidified their cartel and gave them sole authority to license medical schools. As a result, half of existing medical schools were pushed out of business, and the supply of doctors contracted significantly.

A similar push forced most poorer (and predominantly black) hospitals to close, because regs were written so that only the wealthier hospitals could satisfy the requirements.

The motivation for all this was clear: it substantially increased the rates that doctors and hospitals could charge by restricting the supply. Naturally it was all done in the name of patient safety.

Since I already agreed that free enterprise is pretty awesome, I'm disappointed you felt obliged to given example where it works pretty well and ignored entirely the cases where it doesn't. I've seen you do better than picking one phrase to object to while ignoring the main point, and I wish you had done similarly here.

child morality -> child mortality in the last sentence.

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