On Feigned and Factitious Diseases

England, land of malingerers

Dalrymple enjoys Hector Gavin’s 1843 work, which, he notes,

says something that has resonance in a land such as ours in which the numbers of sick people have so overtaken the numbers of the unemployed, to the delight of government statisticians, doctors, and the unemployed themselves.

Gavin writes:

Medical certificates must not be compared as a practice (as they have been) to that of alms-giving; in the best hands they are liable to great abuse; and however pure and disinterested the motives, much evil not infrequently results from them—none more than the inevitable depreciation of the medical character, which cannot fail to follow from their being given in a careless or lax manner.

Dalrymple comments:

This is enough to make one blush.

How many of the English are pretending to be ill in order to be able to live on handouts? In Britain, Dalrymple points out,

we have the remarkable situation where we have more invalids than after the First World War: 3m, of whom 2m could probably work.

It is, he says,

a fraud on a large scale: deeply corrupting of the recipients, who wrongly believe they are sick; the government, which shifts people out of the unemployment statistics; and the medical profession.

The entrepreneurial parasitism of benefit recipients is, he explains,

not recognised by naïve bureaucrats. The recipients know how to manipulate things to get the maximum benefit; they are reacting to incentives.

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