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{{g}}A side-effect. An [[iatrogenic]] illness is not one that the cure is worse than, but that the cure actually ''causes''. Popularised by {{author|Nassim Nicholas Taleb}} in {{br|Antifragile: Things that Gain from Disorder}}, one can gleefully extrapolate it to many other walks of life, and service industries. So Night Nurse  may causes drowsiness and you shouldn’t drive tractors or operate photocopiers when dosed up, but at least it doesn’t make the head cold you are trying to alleviate ''worse''. Many forms of medical procedure can do this: antibiotics, for example, encourage bacteria to develop resistance to the antibiotics making your original problem harder to solve.  
{{a|mgmt|}}A side-effect. An [[iatrogenic]] illness is not one that the cure is worse than, but that the cure actually ''causes''.  


There is a peculiar form of [[iatrogenic]], where, without the (mis)diagnosis, the body would recover and there would be no illness at all. This is why the “six second rule” isn’t quite the careless outrage the helicopter mums of North London imagine. It may be false, but ingesting constant amounts of bacteria - rather than sterilising the whole environment with antibiotics, the body develops its own immunities to the bacteria, so you don’t ''need'' antibiotics.
So, Night Nurse{{tm}} may cause drowsiness and you shouldn’t drive tractors or operate photocopiers when dosed up on it, but at least it doesn’t make your head cold ''worse''. Many forms of medical procedure can do this: antibiotics, for example, encourage bacteria to develop resistance to the antibiotics making your original problem harder to solve. Antibiotics are, in this way, [[iatrogenic]]. Long term, they make your problem worse.


This is rather like [[insurance]]. For most purposes, [[insurance]] is a waste of money — realistically you are never going to claim on your extended warranty if your toaster breaks down after 18 months because (a) you can’t find it and (b) ''the damn thing only cost twenty five quid'' — the bother of having to find the stupid warranty, read it — there is guaranteed to be some exclusion — and actually claim on it is more bother than just shelling out twenty five more quid on a ''new'' toaster — of a different brand: screw you, Morphy Richards — and being done with it.
This is why the “six second rule” isn’t quite the careless outrage the helicopter mums of North London imagine. It may be ''false'', but allowing dear little [[Basil Fotherington-Thomas|Basil]] to ingest constant, small, amounts of bacteria off the sausage he just picked up off the lino — rather than nuking young sir’s entire theatre of operations with Dettol before he lays as much as a sticky finger on it — encourages his antifragile body to develop its own immunities to the bacteria, so you don’t ''need'' so much Dettol. This is cheaper, too. And makes the sausages tastier.<ref>Or is that just me?</ref>


But there are [[insurance]] policies that, ''by themselves'', ''increase'' the likelihood of loss. Public liability insurance, for example.
Popularised by {{author|Nassim Nicholas Taleb}} in {{br|Antifragile: Things that Gain from Disorder}}, one can extrapolate [[iatrogenic]]s to many other walks of life, in particular those involving service industries, and it is rather fun to do so.  


A shaggy dog story. Against his better judgement. the [[JC]] is, for reasons that are now too ghastly to recount or even remember, an accredited level 2 ECB [[cricket]] coach. During that accreditation course, which I would not recommend to my worst enemy, candidates were presented to by the ECB Association of Cricket Officials — I know, right — about the benefits of membership of that august body.  Now every now and then the JC can come on all a bit misanthropic, and this rainy Saturday afternoon was just such a day.
So let’s have that fun!
===[[Ergodicity]]===
Much of this effect derives from the rent-seeker’s fascination with the particular over the aggregate: as an abstract matter, it is better to address ''this'' peripheral risk here, than ignore it: the cost of addressing it now (say an hour of petulant argument) pails when compared with the consequences later should this risk come about. Let’s unitise this: say the expected cost of this catastrophe, should it happen is one thousand times worse than the cost of dealing with it up front, and its probability of ever happening is one in ''two'' thousand.


“Why on God’s barren earth,” he wondered, “would I want to pay money to be in an association with people like you?”
That those consequences are ''unlikely'' is rather beside the point: it’s only an hour, after all. That is a bearable cost well spent to avoid a small chance of a large loss later. At some level of abstraction it’s not a cost at all: it lives within the ebb and flow of human  productivity in a day: we are not automata, we do glance up from our stalls and vainly peruse Expedia for last minute flights to Venice every now and then. What’s the odd hour, in the daily sludge?


The best answer this fellow could give was, “because you would benefit from our public liability insurance policy. That is where the lion’s share of your membership dues go.”
This is the individual “[[time-series probability]]”. It is a trip down the spidery, meandering path of ''one mortal [[Meatsack|meat-sack]]''. It is “just an hour” to fix it now against “God knows what” at some point down the line. It is to ask a [[legal eagle]] the question, ''do you feel lucky, punk?''


The public liability concerned was that of a coach, out on exercises with his team, when some accident befell one of the delicate little flowers in his charge, which might be attributable to the coach’s carelessness or lack of prudent regard.  
Assume [[rent-seeking]] [[legal eagle]], faced with an unchallenging hour earn his own keep, will not feel lucky. He has no interest in feeling lucky. to the contrary: all his personal incentives urge him to feel uncommonly cursed by ill fortune. He will spend that hour up-front every time. It is the prudent thing to do. It is ''insurance''. It will evaporate, unmonitored, into the ether of the daily grind.


Now here’s the thing. Coaching [[cricket]] is thankless, in every possible way. You are not paid for it. You certainly don’t grow rich from it — except spiritually, of course. You do it out of the goodness of your heart, a vague sense of moral obligation to the forthcoming generation, and a forlorn hope that the little ingrates might grow to love the game, which is a wonderful diversion from the encroaching enormity of growing old.  
But the “[[ensemble probability]]” — the same risk spread across a ''population'' of [[meatsack]]s, plays out quite differently. It scales badly. Say we run this same risk ''two thousand times''. Firstly, it’s harder to blow off  ''two thousand hours'' as “part of the ebb and flow of the daily grind”. That’s ''fifty working weeks''. It has its own daily grind —in each working day there’s a degree of googling and running off the the bathroom and so on — so call it more like ''sixty'' working weeks. And our catastrophic outcome: sure, it’s two thousand times more likely to happen, but since it was only a one-in ''two'' thousand shot, it’s still only likely to happen ''once''.  And even if it does happen, the loss is only half the cost of preventing it.


So any parent who gets a Sunday morning lie-in while you stand in a wind-swept field explaining the rudiments of the back-foot drive to little Horatio and has civil [[litigation]] uppermost in his mind, over the social betterment of junior, will rot in hell. He should be ''grateful'', as a default disposition towards Horatio’s minders, rather than opportunistically extortionate.<ref>He won’t be, of course — that’s just the cruel reality of the human condition for you — but he ''should''.</ref>
===Insurance===
This is rather like [[insurance]]. For most purposes, [[insurance]] is a waste of money — realistically, you are never going to claim on your extended warranty if your toaster breaks down after 18 months because (a) you can’t find it and (b) ''the damn thing only cost twenty five quid'' — the bother of having to find the stupid warranty, read it — there is ''guaranteed'' to be some exclusion — and actually claim on it is more bother than just shelling out twenty five more quid on a ''new'' toaster — of a different brand: screw you, Morphy Richards — and being done with it.


Yet, [[cricket]] is a perilous pastime. 5½ oz of cork flies about at a decent lick. If junior sprains his ankle, gets run over or cops a short one to the temple, then (a) that will do him the world of good, long term, and (b) unless you, coach, are some kind of pederast or have been egregiously delinquent in supervising Horatio’s backfoot technique, adequately socialised parents — even a neurotic North London ones — will shrug shoulders and figure that’s the price of being a lazy sod and letting other people look after their kids. Will they ''sue'' you? Of course not. For one thing, you are probably on the bones of your arse, and what judge is going to be in punitive frame of mind when considering a well-intended volunteer doing his best to look after someone else’s brat?
But there are [[insurance]] policies that, ''by themselves'', ''increase'' the likelihood of loss. Public liability insurance, for example. Directors’ and officers’ liability [[insurance]].


All that might change if you benefit from public liability insurance. Suddenly ''yours'' isn’t the pocket helicopter dad is going after.  It is worth a claim. Insurer is likely to refuse the claim — that’s the business model for many of them — but it will  still put its premiums up because of the assessed dereliction of obligation of the insured. Your own membership mght only go up a fiver, but the insurance company is ''creaming it''.
so insurance encourages shitty behaviour from everyone concerned:  ''You'' are disincentivised from taking suitable care because — hey, I’m insured, right? — ''Helicopter Dad'' is encouraged to be a dick and make a claim, since it’s not well-intentioned volunteer coach he’s going after but big bad insurance company, and insurance company, being big and bad, tells Helicopter Dad where to get off, and gouges the poor old cricket association for its insurance premiums.
{{sa}}
{{sa}}
*[[Insurance]]
*{{br|Antifragile: Things that Gain from Disorder}} by the perennially entertaining {{author|Nassim Nicholas Taleb}}
*{{br|Antifragile: Things that Gain from Disorder}} by the perennially entertaining {{author|Nassim Nicholas Taleb}}
{{ref}}
{{ref}}

Latest revision as of 11:40, 24 February 2022

JC sounds off on Management™
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A side-effect. An iatrogenic illness is not one that the cure is worse than, but that the cure actually causes.

So, Night Nurse™ may cause drowsiness and you shouldn’t drive tractors or operate photocopiers when dosed up on it, but at least it doesn’t make your head cold worse. Many forms of medical procedure can do this: antibiotics, for example, encourage bacteria to develop resistance to the antibiotics making your original problem harder to solve. Antibiotics are, in this way, iatrogenic. Long term, they make your problem worse.

This is why the “six second rule” isn’t quite the careless outrage the helicopter mums of North London imagine. It may be false, but allowing dear little Basil to ingest constant, small, amounts of bacteria off the sausage he just picked up off the lino — rather than nuking young sir’s entire theatre of operations with Dettol before he lays as much as a sticky finger on it — encourages his antifragile body to develop its own immunities to the bacteria, so you don’t need so much Dettol. This is cheaper, too. And makes the sausages tastier.[1]

Popularised by Nassim Nicholas Taleb in Antifragile: Things that Gain from Disorder, one can extrapolate iatrogenics to many other walks of life, in particular those involving service industries, and it is rather fun to do so.

So let’s have that fun!

Ergodicity

Much of this effect derives from the rent-seeker’s fascination with the particular over the aggregate: as an abstract matter, it is better to address this peripheral risk here, than ignore it: the cost of addressing it now (say an hour of petulant argument) pails when compared with the consequences later should this risk come about. Let’s unitise this: say the expected cost of this catastrophe, should it happen is one thousand times worse than the cost of dealing with it up front, and its probability of ever happening is one in two thousand.

That those consequences are unlikely is rather beside the point: it’s only an hour, after all. That is a bearable cost well spent to avoid a small chance of a large loss later. At some level of abstraction it’s not a cost at all: it lives within the ebb and flow of human productivity in a day: we are not automata, we do glance up from our stalls and vainly peruse Expedia for last minute flights to Venice every now and then. What’s the odd hour, in the daily sludge?

This is the individual “time-series probability”. It is a trip down the spidery, meandering path of one mortal meat-sack. It is “just an hour” to fix it now against “God knows what” at some point down the line. It is to ask a legal eagle the question, do you feel lucky, punk?

Assume rent-seeking legal eagle, faced with an unchallenging hour earn his own keep, will not feel lucky. He has no interest in feeling lucky. to the contrary: all his personal incentives urge him to feel uncommonly cursed by ill fortune. He will spend that hour up-front every time. It is the prudent thing to do. It is insurance. It will evaporate, unmonitored, into the ether of the daily grind.

But the “ensemble probability” — the same risk spread across a population of meatsacks, plays out quite differently. It scales badly. Say we run this same risk two thousand times. Firstly, it’s harder to blow off two thousand hours as “part of the ebb and flow of the daily grind”. That’s fifty working weeks. It has its own daily grind —in each working day there’s a degree of googling and running off the the bathroom and so on — so call it more like sixty working weeks. And our catastrophic outcome: sure, it’s two thousand times more likely to happen, but since it was only a one-in two thousand shot, it’s still only likely to happen once. And even if it does happen, the loss is only half the cost of preventing it.

Insurance

This is rather like insurance. For most purposes, insurance is a waste of money — realistically, you are never going to claim on your extended warranty if your toaster breaks down after 18 months because (a) you can’t find it and (b) the damn thing only cost twenty five quid — the bother of having to find the stupid warranty, read it — there is guaranteed to be some exclusion — and actually claim on it is more bother than just shelling out twenty five more quid on a new toaster — of a different brand: screw you, Morphy Richards — and being done with it.

But there are insurance policies that, by themselves, increase the likelihood of loss. Public liability insurance, for example. Directors’ and officers’ liability insurance.

See also

References

  1. ↑ Or is that just me?
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