Munchausen by Proxyocracy

I See Bankrupt People!

(Guest Post by Matthew Ladner)

Byron Schlomach and I had fun co-authoring this piece for the Goldwater Institute:

The supernatural thriller “The Sixth Sense” features a young boy who assists the ghost of a young girl in exposing her mother as her murderer. The mother, suffering from an uncommon mental disorder known as “Munchausen by Proxy Syndrome” had slowly poisoned her daughter to death.

While actual Munchausen by Proxy Syndrome (MBPS) is very rare, something much like it is sadly all too common in American policy-making.

MBPS involves a caregiver deliberately making another person sick. The caregiver may exaggerate, fabricate, or even induce symptoms. The perpetrator achieves a twisted satisfaction from deceptively gaining the attention and sympathy of doctors and others. Because the caregiver appears to be so caring and attentive, often no one suspects any wrongdoing.

In politics, many of our longstanding, serious policy problems are similarly inflicted upon us by our alleged caregivers. Two obvious examples of this political slow-poisoning: runaway costs in heath care and higher education. Simply put, government policies have spun heath care and higher education costs out of control.

These damaging cycles of cost inflation are the direct result of the MBPS-like policies administered by the federal government. When citizens raise concerns that health care or a college degree are financially out of reach for many, politicians show their compassion by administering more of the bad medicine that created the problems in the first place.

Consider health care. The problem is people can’t afford it. Although history shows medical care prices do not inevitably rise, medical inflation more than doubled general inflation from 1960 to 2006. If medical prices had not raced ahead of general inflation, health care would represent 7% of the American economy rather than the current 16% and growing. While many politicians want to make the availability of health insurance the issue, the real issue is that medical care is becoming increasingly less affordable, reducing accessibility.

Americans went from paying the lion’s share of medical costs ourselves to depending on government (Medicare and Medicaid) and employer-provided health insurance to pay for us. Consequently, price has become no object and we have become uninformed and unwise shoppers for medical care. Providers have become wasteful, often taking advantage of this distorted market, competing on a non-price basis.

All of this has occurred because government tax policy has encouraged employers to pay us in health benefits instead of cash. Add Medicare and Medicaid bureaucracy to the mix, and you’ve got a perfect prescription for out-of-control costs and increasingly reduced accessibility.

What are politicians offering as a solution? The Obama administration offers more of what got us here in the first place: expanded insurance, expanded market regulation, expanded Medicare, Medicaid, and SCHIP. As we pay even less out-of-pocket, medical prices will only get higher and medical services will only get more expensive and less accessible.

Amazingly, higher education costs have been rising at a rate even faster than medical cost inflation. Since 1982, the average cost of college tuition and fees has increased by 439% while median family income increased by a mere 147%. Think of it as compound interest for putting college financially out of reach and/or crushing families with debt.

Again, President Obama has proposed more of the same: a $4,000 tax credit for higher education expenses. Sounds great, but based on decades of bitter experience we have every reason to believe that if Obama’s tax credit plan passes, universities would simply hike their tuitions and fees. Congress has been chasing its own tail on college affordability for decades: while providing ever-increasing subsidies, costs continue to go up, so it repeats the process again and again.

Please- no more Congressional medicine!

Obama’s policy plans will simply add more fuel to the fire, leaving our very serious affordability problems in higher education and health care unaddressed. This is not change that we can believe in, but more of the same.

Like the MBPS abuser, politicians often come across as compassionate as they indulge their pathologies. If our politicians suffer from MBPS, we suffer our own sort of insanity in allowing ourselves to be victimized by it year after year. Our form of insanity could be referred to as Battered Taxpayer Syndrome, and it is time to call a halt to it.

It is a fallacy for the public to judge our leaders by their stated intentions, rather than the results of their decisions. Why is health care so expensive in the United States? Why the crushing debt for college educations of no greater worth than those obtained decades earlier at far less cost? Sadly, it’s because of federal policies whose follies have been repeatedly reinforced.

Rather than Munchausen by Proxy politicians, we need leaders who will follow the Hippocratic Oath: first, do no harm.

13 Responses to Munchausen by Proxyocracy

  1. CodyPT says:

    As clever as the comparison of establishing public policy with “Munchausen by Proxy Syndrome” is, it is entirely off-base.

    You say MBPS involves a caregiver deliberately making another person sick. The operative word is “deliberately.”

    You go on to say that in politics, many of our longstanding, serious policy problems are similarly inflicted upon us by our alleged caregivers. The operative word here is “similarly.”

    No serious person really believes policy makers do what they do to deliberately make things worse. In fact, quite the opposite is true. They create their policies to make things better. Unfortunately, their poicies make things worse due to their quack, albeit well-intended, cures.

    No, policy makers don’t suffer from MBPS. They are just lousy caregivers who suffer from both a lack of creativity and a total understanding of the problem they are trying to fix.

    Using MBPS is a clever and entertaining literary comparison, but it is entirely false when describing the futile efforts of public policy makers.

  2. Greg Forster says:

    Everything you say before the second to last paragraph is true, Cody. But in the second to last paragraph you assert that the problem is just that they’re lousy caregivers due to ignorance and uncreative thinking. The operative word there is “just.”

    While I would never disagree that our government overlords are ignorant and uncreative, I don’t think that is the only problem. And that’s where the value of Matt’s post comes in.

    Why is it that after a policy produces decades and decades of ubiquitous and clearly demonstrated failure, our overlords remain ignorant of the problem? Yes, you’re right, they aren’t causing the problem on purpose; they don’t even see the problem. But why don’t they see the problem when anyone with even one eye open can clearly see it?

    Matt’s post points to the answer. Seeing them ignore the obvious year after year, decade after decade, it is difficult to avoid reaching the conclusion that they don’t see the problem because they don’t want to see it. There is a part of them that, unconsciously, doesn’t want to see the problem, and the unconsious part that doesn’t want to see the problem has more power over their will than the conscious part that does. It’s true that they don’t “deliberately” (to use your word) want things to be worse. But that’s only because the word “deliberately” implies conscious intention. Our overlords’ real motives, however, are hidden even from themselves. They’re self-deluded.

    All this is armchair psychologizing, of course, which doesn’t contribute much to policy debates. The only question that counts in a policy debate is which policy in fact works, not motives. So if we were having a conversation about which policy works, all this analysis would be out of place. But there are other things to be talked about besides just policy, and the manifest cognitive dysfunction of education reform opponents is an interesting subject, even if it’s one that doesn’t belong on the policy side of the discussion.

  3. matthewladner says:


    I agree with Greg. There is only so far you can credibly stretch the notion that “they don’t know what they are doing” in the face of decades of blindingly obvious evidence.

    Politicians have been blathering about college affordability for decades. That’s good- it gives everyone a warm fuzzy, appeals to our notions of equality of opportunity, etc.

    But SOMEWHERE along the line SOMEONE might wanted to have asked why the problem just gets worse and worse despite more and more federal dollars IF anyone was actually interested in the underlying issue, don’t you think?

  4. Beat you to the Munchausen’s Syndrome by Proxy analogy by about ten years.

    The supposition that benign intentions motivate politicians falls to historical and current evidence. The US “public” school system DID NOT originate in benign motives, but in anti-Catholic bigotry. The BIA schools deliberately sought to expunge Native American culture.

    In Hawaii, juvenile arrests for drug possession, drug promotion, robbery, and assault fall in summer, when school is not in session. Juvenile hospitalizations for human-induced trauma fall in summer. Corruption in school construction contracting is widespread across the US and well-documented.

    In what democratic theory of government does the instrument of organized violence (the State) contribute to collective actions which people would undertake without coercion?

    The choice politicians make, of a bureaucratic, inefficient, and abusive system over a system controlled by parents and responsive to individual differences in children’s interetsts and aptitudes, is very deliberate.

    Munchausen’s syndrome by proxy is exact.

  5. Patrick says:

    Politicians know exactly what they’re doing. Its just the payoff matrix in politics doesn’t reward doing the right thing for the country, it rewards you for doing what’s right for the most politically influential.

    If you don’t do it, someone else will.

  6. matthewladner says:

    I will be happy to stop posting ralphing images when Congress stops making barf-out policy.

    Here’s a feeling old moment for you: as it turns out, the ghost girl was played by Mischa Barton, who is now a young Hollywood beauty queen type:,_Mischa/gallery/3812091/

  7. John Hock says:

    And here she is in somewhat less glamorous circumstances . . . .

  8. CodyPT says:

    The word “deliberately” was not my choice of words. It was taken directly from Matthew’s opening piece…”MBPS involves a caregiver deliberately making another person sick.”

    If you believe policy makers suffer from MBPS and choose to deliberately hurt the country, then you are overlooking the effects of ignorance, lack of foresight, shortcomings in preparative research, lack of creativity, trading votes on issues, compromise to get something passed, getting re-elected by pleasing your constituency….factors that are all or partly at work in contributing to policy-making in the very pragmatic and rough-and-tumble world of governing.

  9. matthewladner says:


    I wasn’t arguing that politicians literally suffer from MBPS. Rather that that their ignorance, lack of foresight, shortcomings in preparative research, trading votes on issues, compromise to get somehting passed, getting reelected by pleasing constituents and (sadly) bad faith often creates a spot-on imitation of MBPS.

  10. Academics are another story. They shun effective means of educational service delivery quite deliberately to impede the progress of quick students. The batch process emphasis, which treats students as a “class” and measures academic progress in units of time (a “year of Algebra” makes as much sense as a “pound of friendship” or a “square foot of suspicion”) frustrates slow students and bores bright students. Selecting inefficient methods deliberately to make work for employees (which happens) is as malicious as breaking children’s bones to enhance their returns from street begging.

  11. […] Ladner presents Munchausen by Proxyocracy posted at Jay P. Greene’s […]

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