One problem with monopolies is groupthink

Back in that - at the time - famous book “The Wisdom of Crowds” there was a long discourse on the perils of groupthink. Some inaccuracy creeps into the thinnking of an isolated group and becomes a foundational belief. The dynamics of ingroups mean that the belief becomes ever more extreme. There’s no reference - it’s within group groupthink - to outside reality to check this process of spiralling off into ever greater error:

Considering the fact this part of their website was updated in April 2024 after several maternity scandals, including at Shrewsbury and Telford NHS trust, where mothers and babies died or were left severely disabled in part because of the pursuit of “normal birth at any cost”, this policy was completely tone deaf. The Royal College of Midwives dropped its initiative to promote “normal birth” in 2017. British women have had the right to a caesarean birth on request since 2011, though some are still having to fight to have that request granted.

NHS midwifery did indeed become overcolonised by the “madwives”. Some number of would be mothers and their children were killed by that, umm, “overenthusiastic” insistence upon natural birth rather than the technological marvels that we spend £160 billion a year on the NHS to gain access to. Why?

The NHS is a closed system, does not face competition from those not subject to its groupthink. Therefore we gain that spiralling off into extremism of the thinking within the group.

This is a criticism at a much higher level of abstraction than whether taxpayers should be paying for other peoples’ healthcare or not. It’s that the one monopolistic supplier is a bad idea. Because Monopolies Are Bad, M’Kay? This groupthink leading to extremist error being only one of the reasons they are.

Tim Worstall