Try this at home. You need two pets of the same species.
Give one of them a tasty treat.
Give the other regular food.
What happens?
Dr. Frans de Waal did this with Capuchin monkeys. His 2 minute video went viral.
Inequity activists love to show it at conferences:
Animal Extrapolation
Apparently, monkeys love fairness: Capuchin’s possess “inequity aversion.”
Monkeys value equal pay for equal work. Furthermore, monkeys teach us that it is normal for mammals to express outrage at inequity. Throwing things and rattling cages are the direct result of inequity. The animal kingdom proves it.
I assume de Waal’s comment about Occupy Wall Street, at the end of the video, was a joke.
Anyone who knows animals knows that animals do not value equity. Monkeys do not have an aversion to inequity any more than they have an aversion to pay gaps, glass ceilings, or the top 1%.
Monkeys cannot identify inequity. Humans identify inequity. Animals see something they want and then they try to get it.
Attributing human characteristics to animals is called anthropomorphism. It is irresistible and wrong. Disney made a fortune with it.
Animals feed themselves first. Large pups get larger; runts get smaller and die. If one animal can steal food without fear of punishment from his owner, it will steal it.
Even if it is from his lifelong best friend who is skinny sick and old, a dog will steal food and growl when his friend tries to resist.
Pointing to the animal kingdom for support of equity is nonsense. People who teach otherwise are making us stupid, in the purest sense of the word.
At best, the video shows that animals often behave poorly. They can learn to throw food they dislike. But normalizing animal behaviour as a guide for human morality falls apart quickly.
Inequity vs. Envy
Humans value fairness. Children learn Not fair! soon after No!, Mama, and Dada.
Parents used to teach children about the Little Red Hen. The right to eat the bread comes if you help plant the wheat, mill the flour, and bake the bread.
Inequity activists believe that all animals deserve bread. Effort does not matter. What matters is that the bread exists.
Activists agree with Obama: “You did not build that.” Let’s hold a vote: Who thinks that we should take 50% of the little red hen’s bread?
The Fathers of Confederation in Canada, and the Framers of the Constitution in the US, knew the dangers of democracy. A democracy cannot exist unless voters believe that envy is bad, reward for effort is good, and throwing rocks through Wall Street windows is anarchy.
Doctors, Envy, and Relativity
What is the fairest way to pay doctors, while still incentivizing patient care?
Each approach has problems. Hourly pay rewards going as slow as possible; capitation rewards cherry-picking and not seeing patients; fee for service rewards volume and easy cases.
We could design hourly or capitated systems to include productivity targets and penalties. But targets and penalties are just another way of injecting fee for service thinking into the hourly or capitated approach.
Fee for service contains a repulsive concept for the inequity activists. Fee for service means that you get paid for work done.
Work harder, make more. Refuse to plant wheat, mill flour, or bake bread—you go hungry.
Fee for service is the closest thing to fair, for doctors, that still encourages productivity for patients.
Everyone bills the same fee, for a given service. You do not get a higher fee for replacing a knee if you happen to be weak, short, and slow. If you are unfit for surgery, you might have to avoid Ortho. Patient service trumps special accommodations for doctors.
Again, this offends inequity activists. We must make accommodations for those who find orthopaedics harder than the average orthopod.
Like kids in schools who can earn an A+ by having had twice as long to write a test, plus a coach sitting beside them to help with the answers, we should give the slow, short surgeons the same income as the speedy, strong ones.
Without question, the fee schedule has major problems. Some fees pay more for 15 seconds of effort than others pay for 45 minutes of grind. This needs to be fixed. But it does not make it unfair to get paid for work performed.
Cosmic Justice
Life is not fair. Those who think that they can make it fair and bring cosmic justice here on earth end up with coercion and tyranny.
That does not mean that we should tolerate patronage, privilege, and side deals. But whatever we hope to achieve, we have to start from the fact that some people will always get ahead, no matter how we try to set the rules.
Demanding a radical equality based on Capuchin monkey experiments makes us stupid.
The point of observing nature is not to learn how to be human. It is to learn that we are not animals, no matter how much we like the point that we think the monkeys can teach us. They are monkeys!
It is only a matter of time before the collectivist snow flakes demand that the Little Red Hen tale gets a trigger warning attached to it….just before it gets banned.
As a wag modernized it:
When refused cake…
“ Excess profits! “ the envious cow cried
“ Capitalist leech!” screamed the malevolent duck.
“ I demand equal rights!” yelled the jealous goose.
“ Share with the 99% !” grunted the coveting pig.
“ Unfair!” Bleated the resentful sheep.
Picket signs with “ Unfair” scrawled on them were marched about the hen as obscenities were hurled at her….resulting in the farmer to come over and tell the little red hen not to be so greedy.
“ But I earned the bread” retorted the little red hen…” Exactly ! That’s what makes our system so wonderful” responded the farmer, “anyone in the barn yard can work as hard as they want but under our equity fairness regulations, the productive workers divide the fruits of their labour with those who are idle.
The little red hen never again baked bread….bread ceased to exist….on her death following starvation, the knowledge of the processes and skills required to create bread vanished altogether.
Karl Marx’s slogan was “ From each according to their ability, to each according to his need”….when that led to economic collapse when the principle was applied in the USSR….Lenin changed the slogan to “ He who does not work, neither shall he eat” ( a slogan he cribbed from Paul the Apostle ).
Wonderful. Your additions make this much richer–Thank you!
While I agree with the general point, I do not think that this is the best example to illustrate it, as it was never meant to be the example to use for the advocacy of radical egalitarianism. Mentioning “the Wall street protest” was just a joke.
What the experiment was meant to illustrate is that our sense of fairness and justice is the result of evolutionary processes, because in the end, we are also animals.
………… and I actually like that.
Hey, thanks for the gentle pushback, Zork!
I think many people agree with you. Describing a natural process and then giving it the imprimatur of being an evolutionary explanation seems to go a long way in building support with many audiences.
I agree that the debate about whether fairness and justice can be explained as nothing but the result of an evolutionary process would be a fun debate to have. Without anthropomorphizing the monkeys, I do not think that de Waal’s video does it.
Thanks again for taking time to read and comment!
Cheers
Fee for service works in procedure oriented specialties like surgery,as it is good for both the patient and surgeon.The key issue is …. who sets the fee ? That can only be determined by the consumer of the service who determines the value of that service.As with other ‘services’,e.g. law,the consumer would have to pay twice as much for the partner of the firm than a junior associate …. for their experience and expertise.
Hence the need for a parallel private system,like most other countries in the world (except North Korea).
Alternate payment mechanisms work in non-procedure fields(eg fam med,psych) because patients don’t feel like they’re being shunted out the door when they’re ‘time is up’.
I find the whole ‘relativity’ issue humorous …. docs fighting over the meat thrown into the room like animals (to use the present analogy).
How did we allow this to happen ?????
I pray that Dr Day’s case in BC is successful .
Great comments, Ram.
Price fixing does not work in any industry for any product or service. Prices always end up fixed too high or too low. No one has enough information and no one is smart enough to make it work (Hayek’s knowledge problem and the need for epistemic humility).
I’m not even sure APPs work well…
We need patient based funding in an environment with ample patient choice. This puts patients in the driver’s seat with doctors working hard to earn the privilege of serving them. This rankles many docs. We like having too few doctors and not having to rely on patient experience/satisfaction/outcomes in order to earn a living.
And that’s the crux of the issue. Outstanding patient service and quality comes with patient choice. Patient choice means that patients might choose a different doctor than me. But we cannot have it both ways. Either we believe in choice–NOTE: this could even be inside a single payer system–and accept that it means we must earn the right to work, or we support a rationed government monopoly that means we just have to follow guidelines and try to stay out of trouble. If we choose that latter, we lose much of our right to complain.
Thanks again!
The criticism of fee for service that always makes me wonder is the assertation that the emphasis on volume compromises overall quality.
It is usually followed by someone stating about how their patients are more satisfied and have better outcomes in their “different-practice-model” because they aren’t rushed out the door as you put it and they are given the full attention to all of their issues that they want/need/deserve. I always wonder about the feelings and outcomes of the other patients who simply never got seen due to the lower volume. Usually not reported as part of the study or opinion-piece.
In a system where there are enough providers to fully meet demand, you would expect the quality to go up with more time/attention/effort spent per patient. However, in a system where demand outstrips supply, then the overall quality may be better if we provided good care to many than exemplary care to the lucky few. We would all love the first description to describe our healthcare system, but I think we are still stuck in the second one.
-LD
Well said indeed.
You nailed it with, “In a system where there are enough providers to fully meet demand…” I might add that those providers need to be free to innovate and find ways to offer more care. While we have an absolute shortage of some docs in a few specialties, I think we are suffering more from a relative lack of physicians due to an absolute shortage of freedom to innovate. You never hear plumbers complain that there are not enough plumbers! 🙂
Thanks again for taking time to read and post a comment!
Cheers