Iatrogenic

The Jolly Contrarian’s Glossary The snippy guide to financial services lingo.™ →Go uptown Index — Click the ᐅ to expand: Glossary Tell me more Sign up for our newsletter — or just get in touch: for ½ a weekly 🍺 you get to consult JC. Ask about it here.

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 — 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 anti-septic.

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.

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.

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 he would not recommend to his worst enemy, candidates suffered a presentation by the ECB’s 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 in March was just such a day.

“Why on God’s barren earth,” he wondered aloud, “would anyone want to pay money to be in an association like this?”

The best answer the fellow presenting — a member himself, of course — 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.” Now the “public liability” concerned was that of an amateur coach, 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.

Now here’s the thing. Coaching cricket is a pitiless pastime, in every possible way. You are not thanked for it, let alone 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 some of the little ingrates might grow to love the game, for it is a wonderful diversion from the encroaching enormity of growing old. 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 Basil, but yet has civil litigation uppermost in his mind — and not profound, undying gratitude — should Basil cop a short one on the bonce, should rot in hell. He should be grateful, as a default disposition, rather than opportunistically extortionate.

All the same, cricket is a perilous pastime. That 5½ oz leather-encased cork ball flies about at a decent lick. If it clocks junior, or he sprains his ankle, gets run over or somehow contracts hepatitis, then (a) that will do him, and the world, the world of good, long term, and (b) unless you, coach, are some kind of pederast or have been egregiously delinquent when supervising young Tarquin, his adequately socialised parents — even 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. It is too much of a faff. 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?

Yet all that might change, should you benefit from public liability insurance. Suddenly it isn’t your pocket that helicopter mum is going after. It is worth a claim. To be sure, the insurer will refuse the claim for as long as is commercially plausible, whatever its merits — that’s part of the funding model, for many of them — but in the mean time it will put up premiums, citing actuarial data, because of its assessed dereliction of obligation of the insured. Your own membership for the ECBACO might only go up a fiver, but in the mean time the insurance company is creaming it.

So, yes: public liability insurance encourages shitty behaviour from everyone concerned:

• You are disincentivised from taking suitable care because — hey, you’re insured, right?
• Helicopter mum is encouraged to be a dick and make a claim, since it’s not thou well-intentioned volunteer coach he’s going after but a faceless corporate insurer, and
• Faceless corporate insurer, being little more than a faceless corporate mode of extortion, will tell Helicopter Mum where to get off and gouge the poor old cricket association — and by extension you — by jacking up its premiums on account of its transparently negligent membership.

See also

• Antifragile: Things that Gain from Disorder by the perennially entertaining Nassim Nicholas Taleb