Technology and Fairness

I read an article about Craigslist and found a particular opinion very interesting. Here is the quote:

Universal search subverts craigslist’s mission to enable local, face-to-face transactions; it increases the risk of scams and can be exploited to snatch up bargains, giving technically sophisticated users an advantage over casual browsers

How interesting. Many Internet and new tech application tried hard to make things easier and more convenient for people, but in a marketplace like craigslist, that convenience and ability to “snatch up bargains” is not necessarily a good thing. By giving the power to a small group of people actually hurt other people.

Hospital Reservation System

We had a Shanghai Medical Card (issued by a public service platform 91985.com), and by paying a small annual fee, you can make hospital reservation online. It is extremely convenient for us, because it is so hard to make a reservation at the hospital gate (I talked about the long lines in this article Hospital is Badly Needed). When we make the reservation with a click of mouse to directly go to the Zhongshan Hospital nurse station to pick up our number, and by pass the lines to directly see a doctor, many others asked me where I got the ticket, and I taught them to use the website. I didn’t think too much about it when I enjoyed the “benefit of high-tech”, and wondered why other patient would rather spend 8 hours to wait in line instead of going online.

Inspired by the craigslist’s approach and seeing the long line myself, I now feel happy that Shanghai has forced the online reservation system to discontinue its service. It is not about application of new technology, it is about fairness in this society.

How Technology can Solve Social Problems

I am not anti-technology and anti-Internet person (look at my professional life!), but we can either let technology solve the root cause of the problem or just make a workaround to create unfairness.

In the hospital example, the key problem is the high demand for doctors vs the very limited supply of resources. If technology can solve this problem (more efficient patient handling, and diagnostic), that is great. When this is still the biggest problem, and it is getting worse, to allow some people like myself who can use Internet and know the trick to make reservation does not make sense.

Many people complained about there is no online train ticket reservation system. I believe it is partly because of this reason. When there is more supply than demand (there are just few days in the year), that makes a great sense (just like the airline industry). However, in times like Spring Festival, how can it be allowed for someone to make reservation online with 5 minutes to snatch those tickets, while millions of others waited in the train station days and nights but still cannot get a ticket?

Money and Fairness

We just talked about technology. Money is the other factor that can brake the fairness.

If a person has the money to afford a Rolex watch, it is OK, since that is part of the fairness of this market economy. It does not revoke other people’s right to buy a cheap watch.

In the race for the same social resources, like education, and healthcare, if someone can pay more money to get to the SAME hospital or the SAME school, that breaks the fairness. Again, in this case, I don’t think there is any problem if someone can AFFORD a private school, or private clinic, since their money helps to DEVELOP social resources, not SNATCHING from other people’s hand.

What do you think?

13 thoughts on “Technology and Fairness

  1. >and wondered why other patient would rather spend 8 hours to wait in line instead of going online

    Well, I can’t help but wonder why, in a so powerful nation like China, and furthermore in a large city like Shanghai, you still must wait in a queue for 8 hours before being able to see a doctor …

    I’m from Europe, and when I was in Shanghai in last June, I had to bring a (Chinese) friend of mine to a hospital in emergency … Man I could talk for hours about what I saw there … You enter, you pay, want to see a doctor ? get back to entrance and pay, need to do some blood tests ? back to the entrance and pay, need a “bed” (notice the brackets), you’ll have to find a place in the hall yourself and … of course you pay another 4th time ! That’s just very weird to me …

  2. Well. I forgot to point out that all the line and ticket stuff is about “expert treatment”, not common daily treatment. It is pretty straight forward for you to go to hospital and see a doctor, but it is not as good.

  3. Hi Wang Jianshuo,

    Kudos on your thoughtful postings, I enjoy reading them.

    Regarding this particular post, the “access” that technology gives is a very interesting thing, because-as you point out-only some people get that access, people who are defined by a kind of privilege. You focus on two aspects of this privilege: technology and money.

    My opinion is that they are essentially the same thing, perhaps with money leading the way. In most cases the bottom line is that without money you cannot get access to technology, for instance you cannot buy, or rent time on, a computer with internet access to make your reservation at the hospital, or other situation.

    The quandary raised by Craigslist’s experience is a superb case study, actually. It really highlights the unexpected consequences of the internet seen as a “free” (or perhaps “more free”) platform, an assumption which services like Craigslist were originally built upon. I guess one must always ask who is the “who” for which it is free.

  4. Interesting thoughts. I often hear arguments that because a certain resource so essential that it is not right to allow people to compete for it with money.

    But if there is not enough resource, there will be competition. If there is competition, there will be losers. Does it really matter what you are competing with?

    I think the ultimate question would be what is fairness.

  5. Well. We love competition in most cases, but there are few cases where it makes more sense to have a controlled market. “Essential resources” like salt, water, food are very sensitive. In an area with earthquake, does it make sense to sell a bowl of instant noodle at 500 RMB? Even if you sell it to that high, it still cannot solve the resource problem – only allow certain people to take advantage of others. So basic healthcare is such resources – when someone is dying, how much money he would pay for it? But to allow price to go as high as people willing to pay is not fair.

  6. Internet is for few, unfair, but how about phone scheduling to all… wouldn’t that provides a chance to improve the hospital atmosphere.

    Lineup seems a very time and resource wasting method, and very unfriendly to older people. And also, it only gets you into the door of doctors’ offices, when it comes down to life and death, unfortunately, money still makes big differences… on what treatments/medicine one can get… therefore it dosen’t really make a strong case for fairness “in the race for the same social resources”.

  7. Competition is there not because we love it. It will always be there when supply does not match demand. Price control won’t get rid of competition. It only changes the way people compete to under the table with bribes, red bags, guan xi, and privileges. What’s worse, it creates extra demands and waste, masks the real supply problem, and discourages investment and makes the imbalance worse.

    Price control may work, but only in cases where some one is able and willing to invest enough money to make sure that supply matches demand. In case of healthcare in China, it is apparent that the government is not willing to invest enough money. Then controlling the price may seem to be righteous but in reality it is only hypocritical.

    I generally agree that price control make sense in emergency circumstances. But even in you earth quake example, there is still advantages to allow the two side to decide the price freely. If there is not enough instant noodle for everyone, then someone has to decide who get to eat and who does not. The fairest way may be to base the selection on how hungry someone really is. Allowing the price to float give people a chance to have some power to decide for themselves how hungry they really are, instead of letting someone else to decide for them.

    We use to believe that we can beat the law of nature. It was proved to be disastrous. Now we think we can beat the law of economics. I wonder what this will turn out.

  8. I fully agree that it is very important to ensure fairness (equality of access). I was really indignant when I read about how stock exchanges in the US allow institutional investors with superfast computers to profit at the expense of retail investors with normal computers: http://www.nytimes.com/2009/07/24/business/24trading.html

    That said, there has to be a tradeoff point somewhere – are we going to forbid online booking of appointments until 100% of the population is not internet-savvy? Clearly this also cannot be the case.

    I agree with the earlier comment about allowing phone bookings. To prevent abuse (such as that of train tickets), such bookings can only be made for a specific person and should not be transferrable. You can even require a deposit (eg. 50 RMB) which will be confiscated if you don’t call a day ahead to cancel your appointment. However, this last feature will only be useful for chronic patients who see the doctor on a regular basis.

  9. I’m from Europe, and when I was in Shanghai in last June, I had to bring a (Chinese) friend of mine to a hospital in emergency … Man I could talk for hours about what I saw there …

  10. Six people are born the same day. One runs faster than the others. One sees better than the others. One understands languages better than the others. One is stronger than the others. One is blind. One cannot speak. Life is not fair.

    To make “fair” we must blind the other five, we must cut the tongues from the other five, we must cripple the fast, we damage the strong, we must damage the brain of the one with understanding. Now life is fair? Maybe instead we should kill the blind, kill the one who cannot speak, cripple the fast, damage the smart, damage the strong, damage the eyes of the one who sees. Now life is fair? No. Life is not fair.

    Instead, the slowest invents a bicycle. Now he is fastest. The weakest invents a lever. Now he is strongest. The one who understands language, understands what the one who cannot talk is trying to say and invents ‘sign language’. Now the dumb can talk. And the dumb has feelings for the pain of the blind, trains a dog and invents braille. Now the blind can see.

    Years later everyone has a bicycle, but one boy is fastest. His friend cannot keep up, but wants to join him. The friend invents a motorcycle. Now the friend is fastest, but two can ride, so they go fast together. Others see this and get motorcycles too.

    Three others are born elsewhere. One is strong, one is fast, one is smart. They see what all the others have and they are jealous. They band together can shout “unfair”, and all the motorcycles are destroyed, then all the bicycles are destroyed, then all the dogs are destroyed, then all the books are destroyed. Then the three set upon the other strong one and he is destroyed. Now the three are strongest and have the power. They need motorcycles to watch over the others and make sure things are “fair”, so they have them built, but not for others because that is not fair — they do not share the same need.

    Life creates differences that are unfair. Mankind sees the differences as challenges to overcome and does so. Man’s victory over the challenges creates benefits that can be attained and shared by others. The desire to attain the victories inspires innovation and makes the victories available to still more people.

    “Fair” is a path that allows those too lazy to profit from their own labor to gain power over others and profit from their labor instead, thus ensuring they have power over other people’s lives and those people have little or no power over their own lives.

  11. Hi JianShuo,

    I enjoy reading your blogs.

    The online reservation should not be discontinued, instead, should provide more accessible way like free phone number (automated or operator behind) to use the service. This way, reduces the whole social cost of visiting doctors, and improves the quality of living.

    My 2 cents,

    Kevin

  12. @California

    Well said. In China, we can’t help but doing things that reduce everybody to the common denominator in the name of fairness and just. This hasn’t changed deep down in people’s heart in our 60 years of existence.

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