Friday, October 9, 2009

An Economist, An Ethicist, and An Internist

No, this is not the start of some bad joke.  Instead, this is a short story about a panel presentation in a class on health policy yesterday.  I was asked to participate in this discussion yesterday with the main focus of attention being obesity. 

What was interesting about this presentation?  Well, the three of us on the panel really didn't have all that different views of what causes obesity.  A combination of factors that include the food environment, other parts of the market economy (like people's jobs), the "built" environment (like a lack of sidewalks for walking to school and exercise).  We all agreed that is was partly a matter of social factors and partly a matter of individual choice.

Did we disagree?  I think only on emphasis in terms of the policy solutions.  As an economist, I tend to rank consumer sovereignty and market efficiency as the top two considerations.  Not that I don't consider other things, but this is really what neoclassical economics is designed to focus on.  My ethicist colleague is interested in "respect for the individual" (this sounds a little more gentle than consumer sovereignty) but then asks how the least well off in society are affected.  Can an economist ask the question about the least well off?  Sure, it is just not easy to quantifiably rank the least well of in comparison with others. 

The discussion was interesting. Students gave it positive reviews.  We'll probably do it again.


  1. Kevin,

    My name is Barbara O’ Brien and my blogging at The Mahablog, Crooks and Liars, AlterNet, and elsewhere on the progressive political and health blogophere has earned me the notoriety of being a panelist at the Yearly Kos Convention and a featured guest blogger at the Take Back America Conference in Washington, DC.

    I’m contacting you because I found your site in a health reform blog search and want to tell you about my newest blogging platform —the public concern of health care and its reform. Our shared concerns include health reform, tort reform, public health, safe workplaces, and asbestos contamination.
    If you’re confused by the nation’s debate over health care reform, you are not alone. While nearly everyone agrees our health care system is in trouble, the nation is nearly at war with itself over what to do about it. Some say the entire system needs to be overhauled. Others urge caution, pointing to the costs of reform and warning of high taxes and “big government.”

    To increase awareness on these important issues, my goal is to get a resource link on your site or even allow me to provide a guest posting. Please contact me back, I hope to hear from you soon. Drop by our site in the meantime.

    Barbara O’ Brien

  2. Postbed on behalf of my friend, Maxine Udall (girl economist)

    “Can the economist ask the question about the least well-off?’s just not easy to quantifiably rank the least well off in comparison to others.”

    This is a Rawlsian question that economists have chosen to interpret as a maxi-min problem. In fact, it is an oversimplification to take this perspective since there may be some beneficial indirect effects to a moderate amount of income inequality.

    Amartya Sen (Nobel Prize in Economics 1998) has written extensively on this. He suggests that what matters in making the comparison is not preference-based. It is based on fairly objective norms related to functioning or capabilities that all individuals benefit from both directly and indirectly. He further suggests that meaningful comparisons can be made as long as one is willing to relax some of the separability requirements of a complete rank ordering. The inseparability or interdependence of well-being and agency objectives is in many ways is (IMO) key to determining the Rawlsian blisspoint where the least as well off as they can be made in a world where some inequality of final states is tolerated because it makes the least well off better off..... Read More

    A good source is Sen’s book, On Ethics and Economics, esp the chapter on Economic Judgments and Moral Philosophy. And Rawls book, Theory of Justice Revisited