
Sycophantry Masquerading as Bargains - cinquemb
http://www.overcomingbias.com/2015/12/sycophantry-masquerading-as-bargains.html
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potatolicious
This argument seems a little, I dunno if I have the right word for it -
pointless?

Picking on doctors seems popular when it comes to professional regulation, but
in reality we do this every day for everything that is non-trivial that we
can't fully understand ourselves.

So we bring doctors under state regulation (rather than self-regulation via
the AMA) - who will run this regulatory agency?

I hope your answer is "doctors" because any other answer is nuts, and would
remind me of the Cultural Revolution where the distrusted intelligentsia were
systematically ousted from positions of authority and replaced with
proletariats. And then millions of people died from insane agricultural,
industrial, and medical policy...

All professions that are non-trivial are _always_ going to be largely self-
regulating, because its members are the only people _qualified_ to regulate
it. Which isn't to say that this doesn't pose risk for corruption and
conflicts of interest, or that self-regulation shouldn't answer to the
population at large, but the idea that this delegation is somehow sycophantly
or somehow inherently bad is... silly.

The regulatory systems we establish - whether self-regulating or regulated via
state policy - _are_ a bargain. They're imperfect but there is no other way
about it, unless you want to go down the path of having architects dictate
medical policy or doctors dictate building codes. (though I do detect the
sentiment of "software engineers should dictate everything" a lot on HN)

This whole blog post has shades of anti-intellectualism that creeps me out a
bit - that assume that the intelligentsia must be malicious, and that they
have somehow subjugated the rest of society to their whims. We've heard this
rhetoric before, and it didn't lead anywhere good.

~~~
jjaredsimpson
>This whole blog post has shades of anti-intellectualism that creeps me out a
bit - that assume that the intelligentsia must be malicious

I don't agree. I think the point of the article is about the nature of the
exchange.

>in this supposed bargain, what we give the professionals is concrete and
clearly valuable, while what they give us (over what we’d get without the
deal) is vague and very hard for us to check.

and

>There is actually no bargain, there is just the rest of us submitting to
professionals’ prestige. Cheaper yet outcome-effective substitutes to
expensive professionals have long been physically available, and yet we have
mostly not chosen those substitutes due to our eagerness to affiliate with
prestigious professionals.

I don't see an argument to change regulatory structures in the article.

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imgabe
Predicting that everything will be done by "machines" is just kicking the can
down the road. Who built the machine? How do you know that they programmed it
with the correct knowledge to make accurate diagnoses (in the case of
medicine)? Some authority is likely going to have to certify that the machine
is built and programmed correctly. So, whatever authority we confer on doctors
know is just going to shift to whoever has to certify that the machines are
correct, which, again we consumers will not be able to accurately judge
ourselves.

In the case of a machine that tests for a rare disease, it could just
automatically say "no" every time and have a pretty high success rate. Someone
will have to verify that the machine is actually performing some kind of test.

~~~
JoeAltmaier
Still, it will take only 1 doctor (or committee) to verify the machine. Then
it can be replicated, and replace every other doctor in existence for
diagnosis. This will be a game-changer.

~~~
simonh
Even doctors themselves aren't certified by a single other doctor, or even a
single committee of doctors. There are many rounds of tests, monitored and
double-checked performance with actual patients, and examinations. It takes
years. It would start out as a support tool providing a second or third
opinion, then gradually be assigned more authoritative weight as it proves
it's accuracy and value.

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Hasknewbie
His premises are not very sound.

> We make similar bad “bargains” with a few kinds of workers, to whom we grant
> extraordinary privileges of “self-regulation.” That is, we let certain
> “professionals” run their own organizations which tell us how their job
> (...) is to be done, and who can do it.

The author speaks of "privileges" and "prestiges", but for doctors, his go-to
example, it _always_ was a prestigious (and privileged) profession, way before
any modern diplomas/regulations were introduced. (Self-)regulations and
certifications did not result in privileges, since they were already there. In
fact they attached quite a few strings where before there were none.

> (...) that they will only admit appropriately qualified individuals into
> their ranks, and that they will always act honestly (...)

Regulations/certifications are here to provide a minimum evidence of
competence in a given field. Are they a weak evidence? Absolutely. But it also
always beats the alternative, which is "just trust me". The point is that in
advanced societies anything critical, profession or otherwise, cannot be built
on trust, it has to be built on some kind of proof and accountability, however
imperfect. And the author here is not demanding or proposing different, better
proofs to the current system, he is just saying that enforcing such proof via
regulation is a privilege built on prestige.

> Notice how in this supposed bargain, what we give the professionals is
> concrete and clearly valuable, while what they give us (...) is vague and
> very hard for us to check.

This is the laziest part of the argument, and to be honest it feels as if it's
from someone who has never set foot abroad. Of course we can check it. We just
have to compare with countries where these regulations ("privileges") are not
enforced. You want to know how it looks like when pilots, architects, or
surgeons can practice without a licence (or fake it)? Just go to Congo or
Sierra Leone, and observe the number of accidents, failures, or outright
fraud. Notice also how all societies, when they modernize, move to the same
type of regulations, regardless of their cultural/religious/political
specificities.

> and yet we have mostly not chosen those substitutes due to our eagerness to
> affiliate with prestigious professionals

And of course there are countries that are (comparatively) considered "low
prestige", like Poland or Thailand, that attract a large number of medical
tourists because despite being lower profile the professionals there abide by
the same vetting mechanisms, and their doctors are on par with ours... So the
"it's just prestige" thing doesn't hold up.

> Cheaper yet outcome-effective substitutes to expensive professionals have
> long been physically available

The point of "exclusive" regulations is not to say that someone un-certified
couldn't do it, but that someone certified can, and that in critical domains
only them should. A surgeon is not certified because they're privileged, but
because they're the closest thing you can get to "guaranteed not to
accidentally stab you in the neck while operating". There is no free ride,
where there is a cheaper alternative, there is a cheaper guarantee, and in
some domains "cheaper" is not acceptable. The only example given is of nurses
Vs physicians, an unconvincing argument since both are a self-regulated
profession.

(I have to admit the name of their blog cracks me up every time.)

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dajohnson89
>"You give them something tangible and clearly valuable, and they give you a
vague promise on something you can’t see, and can’t even check if anyone has
ever received."

Nice analogy and all, but I find the condescending and disdainful tone towards
a widely practiced religious act inappropriate.

~~~
toth
The practice the author was referring too, paying indulgences is (thankfully)
not a "widely practiced religious act".

~~~
joshuacc
Indeed. Though it unfortunately was widely practiced at one time, the Catholic
Church now specifically prohibits money changing hands in exchange for
indulgences. Indulgences are still part of Catholic teaching, but can only be
obtained via some "good work" such as prayer, scripture reading, etc.

The post does misrepresent what an indulgence _is_ in Catholic teaching. But
the indulgence-sellers did that, too.

