Ask any car salesmen (or real estate agent) - How do customers make decisions? Answer: Emotions.
Ask any Chicago School Economist - How do customers make decisions? Answer: Rationally in their own best interests.
So what is wrong with this picture? The Chicago School economist, who is supposed to be accurately predicting consumer behavior in a free market, starts with a questionable premise: people are "rational" and "selfish." Moreover, because the economist has an advanced degree in the subject, the economist guides public policy, drives the intellectual debate, and persuades people that rationality and selfishness is an unshakable truth of every part of human interaction. Most of the time, we would be better off with a car salesman.
These economists prediction of rational self interested behavior is a driving factor in the development of public policy. It is also - after nearly 30 years of theory - largely unproven. Many attempts to prove it, using experiments and analytical data with real people, have shown that individuals are infinitely more complex than the rational self interest model suggests. But it still persists, in public policy, and antitrust law. Or, as Kenneth M. Davidson has noted, the "'rational profit-maximizing' theory is built on deductive reasoning, and isn't easily refuted with facts."
And it is a theory that has dark assumptions about what people do with the help they receive. First, a rational self-interested person won't work unless they must. The classic "free rider." Second, a rational self-interested person does not do things for others because it is moral (what benefit are morals anyway?) - they do it because of a salary or some other benefit. These assumptions mean the government can't help a rational, self-interested person without encouraging that person to be lazy, stupid, or greedy.
In the The Samaritan's Dilemma, Deborah Stone does not just explain how the assumption is wrong, but also how the assumption is harmful. Ms. Stone points out that now matter how altruistic a person's basic personal belief system is, policy pundits have made that altruism into something harmful.
Hence the dilemma: Can we help people without harming them?
The answer is, of course, yes. Government has done so in the past, and can continue to do so in the future. That we have to even ask the question is the tragedy. In a country founded on mutual dependency, with the mutual support of family as our guide, how can we have reached the point where mutual dependence is treated as immoral?
What is a hero, after all? The person who sacrifices, risks, and works to make other people better off. Think of the heroes of great movies, comic books, or novels. Those heroes does not exist under the paradigm of Chicago-School economics, where the heroes are like Ann Rand's fictional characters - people whose selfish interests come before that of friends, family, or the interests of society. People who are brilliant must be brilliant for themselves, for if they are trying to be brilliant for others, then there must be something wrong with them. Our real American heros: Washington, Lincoln, Martin Luther King, Jr., John Glenn, Rosa Parks - are all people who are considered the rare exception.
Deborah Stone critiques self-first economics on an intellectual level - but her real strength is in her stories of those, particularly in the health-care industry, who are fighting to help others despite drastic reductions in "economic" incentives. She points out that heros, and heroines, are all around us everyday. Far from being an anomaly, many people are working to make the world better just because it is right. This is where Deborah Stone's book shines, in the anecdotes and analogies that show the falsity in Chicago-school economic premesis.
Because she is primarily a political policy expert, Deborah Stone may be too hard on economics in general. In the book, she does not recognize those economists that have taken a much different view of the nature of human beings (particularly the behavioral economists who hope to study different aspects of economic behavior). However, her criticisms of Milton Friedman style economics damage arguments for privatizing all aspects of health care, schools, and public works. She shows how free-market rhetoric, and the political pressure to create an economy of self-interest, has undermined useful government programs that were helping people build communities, reduce crime, and alleviate suffering.
Too few people would read a book on public policy like this one. But its time we debated the underlying economic principles which form the modern basis of public policy. Deborah Stone's book is a good starting place for the debate.