Bastiat, public choice, and burnout

As I've said before on this blog, the reason I started reading and researching more was to resolve the cognitive dissonance inherent in being a libertarian social worker. How can work in the system one intends to undo? As always, I have found that those who have thought about the subject before me have done a more eloquent job of explanation than I ever could. It is with that in mind, that I present a quote I first read on EconLib's Facebook status.

“Socialism, like the ancient ideas from which it springs, confuses the distinction between government and society. As a result of this, every time we object to a thing being done by government, the socialists conclude that we object to its being done at all." -Frederic Bastiat

For me, this quote perfectly encapsulates the delinking of government action with morality in helping professions. If we could care for our sick and poor more efficiently and with greater ethics with private money, should we not do that? In fact, wouldn't it be more moral as a society to voluntarily aid one another rather than collect money by force to be administered impersonally to recipients?

This line of inquiry inevitably leads to the question of whether the resources would be there to care for those in need. I've heard reformers of the welfare system opine on both sides of the issue. Tyler Cowen, a George Mason economist, says that there is no "crowding-out" effect of government welfare and that charity would not cover the gap. Matt Zwolinski, a political philosopher, disagrees and cites some interesting data. I honestly have not reviewed the subject in detail, but I think that Matt's point on the depth of help in a private charity system is well-taken. I take this question as a matter of economics and history of the helping professions prior to WWI--one that I have not had time to research.

The positive case for private charity left unfulfilled, I then turn my attention to the negative case against public welfare. This line of inquiry inevitably leads me to public choice economics. Public Choice Theory simply applies the assumptions of economics (people act in their rational self-interest) to politics. Unlike the assumptions of progressives (and what few socialists there are left*), people who enter government are not canonized, beatified, and removed of all sin. In fact, the higher up you go in government, the more craven and sociopathic the person becomes.

I believe this insight applies to the mental health and substance abuse profession. It seems shocking to consider that those in the helping professions would act in their own self-interest because people enter into this profession with a genuine desire to help. However, once a person becomes disconnected from everyday practice, it is exceedingly difficult to make decisions without becoming cold towards their effects on consumers. (Hence, terms like consumers!)

As I write this, I had a bit of an insight. The diminution of other-interest and promotion of self-interest by a mental health worker would be met with cognitive dissonance, personal frustration, and professional difficulty. That sounds a lot like burnout to me. Could burnout be associated with or an outcome of self-interest in the mental health profession?

Back to the audacity of accusing MH professionals of self-interest. Our profession has a long history of doing horrible shit to people in the name of curing them or helping society--forced sterilization and lobotomies to name two. People did those things not only to help others but to enhance their own careers through publication, show positive outcomes to superiors, and assuage the public that the menace of mental illness would be defeated. Even in their supposed helping of others, they think merely of how they see the help happening and not how the other person experiences it. That's much harder to measure and appreciate. And it's incredibly difficult to control.

And that's only thinking about the clinical interventions themselves. Once we delve into organizational structure, funding, and administration, it will become obvious that those organizations and administrators who are given the most power in the helping industries have ulterior motives and are subject to incentives they do not appreciate or understand.

Will the helping professions ever change and respond to the challenges that public choice economics levies? Eventually, they will have to once the funding dries out and budgets burst. In the coming age of austerity, these insights will be vital. I hope, anyway.

*worst. pun. ever.