+ Your AuthorsArchive @pegobry Fellow @EPPCdc. I occasionally write things longer than tweets. May. 25, 2019 10 min read

This is your regular reminder that France’s national health insurance scheme currently pays for homeopathy "medications."

It is astonishingly cynical but also perhaps a net positive for public health. France has historically had a big problem with overconsumption of meds, especially antibiotics. Consumers simply demand a prescription for a headache or a tummy ache. Prescribing a placebo "works."

Of course, though, you have to wonder, in a Republic supposedly based on the rule of law, about what essentially amounts to a big lie orchestrated by the government, involving health, science and taxpayer money. (You might even say a "conspiracy.")

To be clear: the government’s independent health agencies don’t make stuff up about homeopathy. But it is a lie by omission. It is taken for granted by ordinary people that national insurance will pay only for "legitimate" treatments.

Doctors willingly participate in the conspiracy because it’s easier to prescribe a patient a placebo for a tummy ache than explain that they should just tough it out.

Homeopathy is enormously popular in France. When Macron’s health minister, a professor of medicine, said on TV that homeopathy isn’t a legitimate treatment, the uproar was massive, with the press very much "teaching the controversy."

Here’s a professor of pharmacology, awkwardly acknowledging that homeopathy critics "are not wrong" but fretting that if homeopathy is no longer subsidized patients will overuse actual meds w negative impact on public health or turn to dangerous quackery. 

One of the things that foreigners don’t usually realize about France is that the country is positively enamored with pseudo-science.

France recently banned the retail sale of glyphosate, a popular weed killer, based on the conspiracy theory that it causes cancer. (The fact that all studies show the opposite just shows the power of the agribusiness lobby, Very Serious Politicians explained on TV.)

It should be no surprise that when it comes to pseudo-environmentalist craziness France is in the big leagues. Greens in the European Parliament say privately that the French Greens are wackjobs. Greens!

In French psychology, psychoanalysis, which ranks somewhere between astrology and phrenology on the scientific credibility scale, still dominates the field, with often disastrous public health consequences, as in the barbaric treatment of autism: 

(A documentary denouncing this was banned after a libel suit. POTUS would love our libel laws.)

A friend who is a teacher recently told me that Freudian claptrap is still part of public teacher training.

Why do we love pseudoscience so much? French people who are aware of the problem often point to the "Cartesian" mindset of French culture. You know the joke: a Frenchman is someone who asks "Sure, it works in practice, but does it work in theory?"

And yes, we do have a strong cultural bias against empiricism and pragmatism, which is definitely part of it. French education from K-12 to higher ed is very focused on theory, and the more prestigious your track the more true this is.

(Not that this is wholly bad. I am very proud of the fact that we’re also the last country where philosophy is a prestigious occupation!)

Another cause, I believe, is that France is also one of the most credentialist countries this side of Asia. Science is very much anti-expertise: the whole point is that the empirical results should judge the experts and not the other way around.

French people are bad at grokking this. This is a universal problem but it is particularly pronounced here.

We also have a big problem with freedom of speech. As noted above, French libel laws are uniquely broad, as are our hate speech laws. In France, the response to a problem is very much to make discussion of that problem illegal.

(Does France have a problem with racial discrimination? Not if it’s illegal to measure it!)

But while France has a specific junk science problem, it is a subset of the broader problem, again very French, which is our conspiracy theory problem. French culture is incredibly, incredibly prone to conspiracy theories.

Now, why is that? Well, there’s a widely-known finding that belief in conspiracy theories is inversely proportional to social trust. Makes sense. Another well-known finding: social trust and prosperity correlate very well.

It’s the famous problem of institutions that development economists have suddenly discovered five minutes ago.

Anyhow, the correlation is strong across the world, but there’s a big outlier. Yep. It’s us!

France is a rich country that has the levels of public trust of a developing country.

And now, why is *that*? Here’s my theory.

(I am French, I must have a theory!)

Well, I look at Russia, the *other* most conspiracy-loving country in the West. Why should Russians be so prone to conspiracy-thinking?

For 99% of Russia’s history, for the average Russian, the assumption that most institutions routinely lie and that powerful people engage in conspiracies against the public trust was actually quite reasonable!

Well, look back to where this thread began: subsidizing homeopathy by pretending (implicitly, but clearly) that it’s a legitimate medical treatment is literally a conspiracy against the public!

François Mitterrand engaged in numerous conspiracies: the whole "having a second family" thing, and wiretapping his opponents (as well as plenty of random people), and lying about his wartime record, etc.

During the 1995 presidential election runoff, Jacques Chirac commissioned a fake poll putting his socialist rival ahead of him with the aim of boosting turnout among conservative voters.

Everyone in France over 30 remembers the infected blood scandal: 

Well, ok, but this only pushes us back one level. French people are more likely to believe in conspiracy theories because their leaders are more likely to engage in conspiracies against the public. But why is that?

Well, what else do Russia and France have in common? The short answer is: an authoritarian state tradition. Alone among Western countries, France is a nation-state whose nation was built by the state and not the other way around.

As the novelist Maurice Druon, the main inspiration for Game of Thrones, narrated brilliantly, the French (administrative) state was literally born in conspiracy—King Philip the Fair’s decapitation of the Order of the Knights Templar.

Authoritarian state tradition and low social trust are two sides of the same coin. Low social trust means Leviathan is needed to hold a fractious country together, but Leviathan saps social trust by crowding out the bottom-up civil society that creates social trust.

Homer Simpson on the French state: the cause of, and solution to, all of life’s problems.

Pseudo-Deng is probably right that it’s too soon to tell about the consequences of the French Revolution for the world, but *for France* it is strikingly accurate to say that the French Revolution never happened.

As an administrative law prof of mine once said, "as a matter of administrative law, the French Revolution never happened." You just have stages of expansion of state power at the expense of traditional checks, often with a civil war in-between stages.

The Napoleonic Code was largely based on a law drafted under Louis XV and vetoed by the regional Parliaments, which the French Revolution overturned.

The French state is naturally inimical to religion, since it is a rival source of identity (and the state is the defensive custodian of the national identity it created); call it "Gallicanism" one day and "laïcité" the next.

France was also built on the dream of the restoration of the Roman Empire, and we pursue the dream, whether under the banner of "Christendom", "universal human rights", or "European Union".

The French sociologist Philippe d’Iribarne, in his landmark book The Logic of Honor, taking the phrase from Montesquieu’s (Straussian?) assertion that French absolute monarchs were not despots because they and the people were bound together by a higher principle of honor.

Montesquieu defined honor as "the prejudice of each person and of each position." One’s social role is assigned by tradition, and pride in one’s role as well as fear of losing status makes one honor-bound to play the role. Thus in Montesquieu’s day, thus today.

The Lasch critique of America is that it’s *too* meritocratic. America is actually too good at drawing up all the high-IQ people, draining human capital from 98% of the country and creating this self-contained noblesse-oblige-less aristocracy.

Some French conservative pundits repeat this criticique because in the past few years it’s become hipster to repeat anglo conservative ideas. But no, the thing about France is that it’s not meritocratic at all.

As studies show, standardized tests like the SAT are not perfectly meritocratic, but the most meritocratic thing we know how to do by far. This is why French (esp 🌹) elites respond to the notion of standardized tests by clutching their pearls and falling over the fainting couch.

If you started from a blank slate with the explicit goal of designing a system to reinforce aristocracy as much as possible while providing the thinnest veneer of plausible desirability, you would come up with the French system. Top to bottom.

E.g. French schools destroy poor high IQ kids. 

* plausible deniability, of course

Sorry, I’m drumpk.

And so France is still an Ancien régime society. Aristocratic rule is legitimized by the meritocratic rhetoric of the "concours", the Chinese imperial examination-inspired system of competitive tests *designed*, *to everyone’s knowledge*, to give a leg up to aristocrats.

Leaving us with the worst of both worlds: the cluelessness and incompetence of aristocracy turned bad, and the arrogance, greed and selfishness of the meritocracy.

(Don’t worry America, you’ll get there.)

And so France is ruled by the logic of honor. Life is about having status within the context of a system where that status is bestowed by the King/state. And so Montesquieu is right: the logic of honor prevents the King’s despotism, because he is the trustee of an interlocking..

... system that collapses if you touch one part of it. And so, you do, periodically (or someone else does it for you, bitte schön), and then you put the Jenga back together.

In France, it is a misdemeanor to insult someone "with the intent of wounding their honor". 10 000€ fine! And unlike with libel, truth is not a defense. True fact!

As a general statement about government, Bastiat’s line that the state is "the fiction by which everyone lives at everyone else’s expense" is the kind of libertarian bumper sticker that makes me 🙄, but referring specifically about France it is just *dead-on*.

(Because of course, since status is a zero-sum competition, there have to be losers. And since the aristocracy 2.0 (or 5.0 or Vista or whatever) has realized that civil wars are kind of a drag, it’s come up with the innovation of paying off the losers.)

(And, you know, police specifically trained in brutality.)

Which is why France’s middle class is willing to bear the highest tax burden in the world, because it’s the price of their status, which they value more than money.

And so, circling all the way back, a society of honor is going to be a society, to everyone’s knowledge, of doublespeak. Which creates a rational expectation of conspiracy since there’s an even greater incentive to do nasty things in secret, to maintain honor.

It’s going to be an anti-scientific, anti-empirical society, since you really don’t want to dishonor someone by pointing out that the facts disagree with their theory. It’s going to be a small-c conservative society.

Hence subsidies for homeopathy. Doctors get to write fake prescriptions, patients get to ingest fake meds, taxpayer money goes up in smoke. It’s bullshit and everyone knows it. But everyone’s honor is safe.

Here’s a French Member of Parliament from Macron’s party supporting homeopathy subsidies; points out 40% of French people use it.

But French healthcare is perfect. Perfect!

You can follow @pegobry.


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