“When markets fail, use markets.”
The above is a quote from Arnold Kling, the person who started this blog. I thought of that when reading Sally Satel, “Rethink Crisis Response,” Reason, October 2020. The whole October issue, by the way, is focused on fixing the police, and it’s excellent.
Here are the first 3 paragraphs from Satel’s article.
“Please just send one police car, please don’t have your weapons drawn, please take him to the hospital.” These are the words that many families with a mentally ill loved one have learned to say when crisis strikes. Sabah Muhammad and her siblings have spoken them several times since 2007, the year her brother was diagnosed with paranoid schizophrenia. He had been a standout student and star running back at his high school near Atlanta, but everything changed around his 18th birthday. “He would become catatonic, barely moving, just staring into space,” Sabah explains. “Sometimes he locked himself in his room for weeks, refusing food, except to come out of his room at 3 a.m. to make toast that he blackened to carbon ‘to get the poison out.'”
Mute and malnourished, he would not allow family to take him to a psychiatrist—but he desperately needed help. The only option in the Muhammads’ Atlanta jurisdiction was a 911 call to report a psychiatric emergency, which tended to bring the police, multiple squad cars with lights flashing, and the ominous specter of armed agents encountering a young black man in a delusional state. So Sabah and her family would call the police, and pray.
The data justify their dread. Between 25 and 50 percent of all people killed annually by police are in the midst of a mental health crisis when they’re slain, according to a report by the Treatment Advocacy Center (TAC), a Virginia-based nonprofit dedicated to improving treatment for people with serious mental illnesses.
Satel goes on to discuss why there should be other models: why it would make sense to call emergency responders who are skilled at dealing with people who have mental health problems.
I agree. Implicit, though, in her article seems to be the idea that the emergency responder should be a government official. But why? Even economists with more trust in government than I have tend to think that governments should provide public goods. But when someone has mental health problems, treating that person is a private good. The treatment is rival in consumption (the resources to treat one person can’t be used to treat another person at the exact same time) and excludable (it’s easy to withhold the service from someone who doesn’t pay.
It’s true that such private provision does not seem to exist now. My guess is that that’s due in large part to the fact that we are so used to calling 911 in an emergency and to the fact that the government doesn’t charge for the service. But if people, as Satel writes, “dread” having the government come with guns, people might not think that service that they pay zero on the margin for is so great.
That’s where Arnold Kling’s line comes in. Private provision doesn’t exist; start providing privately.
READER COMMENTS
Jens
Sep 23 2020 at 3:42am
I completely agree that the police are not the right authority to deal with people in acute mental crisis.
But, according to the arguments in the text, couldn’t the police itself or more precisely the service(s) they offer (protect and enforce) also be seen as a private good?
Or the other way around: Can what the police does, if it is universally active and following rules, not be called a public good (e.g.: “law and order”)?
And then one step further: Isn’t it just as easy to describe what a universally available authority provides for help in mental crises as a public good (e.g.: “Not being cruel”)?
So if you break public goods down to the individual services, treatment and actions (it’s always hard to share an identical place in time and space), are there still public goods at all and what is the point of differentiating between public and private goods at all ?
KevinDC
Sep 23 2020 at 9:36am
Good morning Jens!
You wonder about whether a few different things can be sensibly divided into public and private goods. Let me see if I can help clear things up a bit. The key element to focus on is the definition of public goods economists use. When we say public goods, we mean goods with both factors David mentioned – non-rival (the same good can be used by more than one person at once) and non-excludable (you can’t prevent those who don’t pay from using the good). So when you ask whether we can “describe what a universally available authority provides for help…as a public good”, the answer is no, or at least, not on that basis. A given service may be made universally available by authority, but that doesn’t make it a public good.
As to whether the services police provide can be considered a public good – it depends on how you’re looking at it. Certainly there are individual services provided by the police that are clearly private goods. Many functions of the police are available in the private sector – personal bodyguards and private investigators, for example. But the specific “public good” element usually attributed to the police is a general deterrent to crime. A personal bodyguard can deter someone from attempting to mug me in the park, and that specific instance deterrence is rival and excludable – my bodyguard won’t also protect you. But a neighborhood cop who patrols the park looking for muggers and who arrests all muggers regardless of who is being mugged provides a deterrent to mugging in general, and that general deterrence is non-rival and non-excludable. So, particular “protect and enforce” services police provide can be looked at as private goods in individual instances, analogous to bodyguards and private detectives. But the larger “law and order” element you identified falls more into the public good category because it’s non-rival and non-excludable.
As far as mental health crises go – individual instances of dealing with mental health crises are clearly rival and excludable, and are thus private goods. And it can’t really be plausibly argued that police services provide a general deterrent to people having mental health issues, so the idea that there is a public good element to police services for these kinds of cases doesn’t really hold up.
David Henderson
Sep 23 2020 at 9:54am
VERY well stated. I couldn’t have done it better. Thanks.
David Seltzer
Sep 23 2020 at 5:13pm
Kevin, excellent explanation and example of non-excludable and non-rivalrous public goods vis-a-vis private goods which are excludable and rival. Club goods are excludable but non rivalrous such as digital downloads.
Fazal Majid
Sep 23 2020 at 4:30am
The liability if an incident occurs may be what’s scaring potential providers away, plus private citizens do not have legal authority to involuntarily take people to a hospital. I’m not sure how bounty hunters are regulated. There were a lot of well-meaning but deeply misguided laws passed in the late 60s and 70s that made involuntary commitment all but impossible and had not-so-unexpected consequences like an explosion in the number of mentally ill homeless.
Vivian Darkbloom
Sep 23 2020 at 6:49am
I agree and I’m not very sure about what is being advocated here. Private persons imposing (private) medical/psychiatric treatment on other adults who don’t want to be treated?
As far as involuntary commitment is concerned, this does present some very difficult competing interests. But, again, what are we proposing here? That private persons be able to involuntarily commit other adults outside the legal system? Individual rights, relatively consistent standards and due process be damned? The line here between “providing privately” and *imposing* privately isn’t very clear.
KevinDC
Sep 23 2020 at 9:38am
David, when you say:
Did you mean to say even economists with less trust in government than you have?
David Henderson
Sep 23 2020 at 9:55am
No. While I believe in the concept of public goods, the more I’ve observed government, both from the inside and from the outside, the more skeptical I’ve become of the government’s ability to provide them.
KevinDC
Sep 23 2020 at 11:31am
Ah, I see what you were saying. I think what threw me off was the word “even” at the start of that sentence – I was anticipating a comparison, and I thought the comparison was the level of trust in government. So what I thought you were originally trying to say was, in effect, “you could be even less trusting of government than me and still think government should provide public goods, but these aren’t public goods.” But the “even” just referred to economists in general, so you what you were saying was “Even economists (with more trust in government than I have) tend to think that governments should provide public goods.”
But I share your view of public goods and their provision. The fact that markets are suboptimal at providing public goods does not entail government will be better at providing them.
Phil H
Sep 24 2020 at 3:27am
I basically agree with the point of this post, but the practical difficulty seems relatively clear: mental health and poverty correlate very strongly, so there is a problem of ability to pay. It may be that the cost of intensive psychiatric care could be brought down, but it’s always going to be fairly expensive, and before the market has had the chance to gradually force costs down, the initial market participants are likely to have high costs. That will necessitate high prices in a service directed at a low-income market.
The bright side is that in 2020, there is plenty of capital in the world. So if a good mental health service could be started, and investors were willing to let it lose billions for years, like Amazon, knowing that it will eventually become profitable, then this is now feasible. I hope someone does it.
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