Iatrogenic

The Jolly Contrarian’s Glossary The snippy guide to financial services lingo.™ Go Premium Index — Click the ᐅ to expand: Glossary Comments? Questions? Suggestions? Requests? Insults? We’d love to 📧 hear from you. Sign up for our newsletter.

A side-effect. An iatrogenic illness is not one that the cure is worse than, but that the cure actually causes. Popularised by Nassim Nicholas Taleb in 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.

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.

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.

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.

“Why on God’s barren earth,” he wondered, “would I want to pay money to be in an association with people like you?”

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.”

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.

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.

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.

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?

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.

See also

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