Scott examines the possibility that bureaucracy sometimes serves as an intentional barrier to discourage unnecessary requests, particularly in healthcare, but questions how widely this concept applies. Longer summary

This post explores the idea that bureaucracy might sometimes serve as an active ingredient in plans rather than just being inefficient. Scott presents a hypothetical scenario where insurance companies use bureaucratic hurdles to discourage unnecessary use of expensive medications. He suggests that the time and effort required to navigate bureaucracy can act as a filter, separating those who truly need a service from those who don't. However, Scott expresses uncertainty about how widely this concept applies, noting that it doesn't explain bureaucracy in places like the DMV. He concludes that while this idea might explain some instances of bureaucracy, particularly in healthcare, it shouldn't be overgeneralized. Shorter summary

Scott Alexander discusses the ethical dilemma of writing doctor's notes for back pain as a psychiatrist, leading to reflections on 'bullshit jobs' and procedural inefficiencies in the economy. Longer summary

Scott Alexander discusses the ethical dilemma of writing doctor's notes for patients with back pain, despite being a psychiatrist. He explores the pros and cons of writing such notes, and shares his strategy of radical honesty. This leads him to reflect on David Graeber's concept of 'bullshit jobs' and how much of the economy might consist of similar procedural rituals that don't add real value. The post highlights the tension between following procedures and providing practical help, and questions why profit-focused companies would engage in such seemingly inefficient practices. Shorter summary