Rational Choice and Market Efficiency

Abstract

As Charles Dickens illustrated in Hard Times, economic conditions shape people’s health. Written in the mid-nineteenth century, the novel described life in Coketown, a standardized commercial center dedicated to rapid economic growth and efficiency. Town life revolved around pragmatic usefulness: You saw nothing in Coketown but what was severely workful … The jail might have been the infirmary, the infirmary might have been the jail, the townhall might have been either, or anything else … Relations between master and man were all fact, and everything was fact between the lying-in hospital and the cemetery, and what you couldn’t state in figures, or show to be purchaseable in the cheapest market and saleable in the dearest, was not, and never should be, world without end, Amen.1 For the Coketown elites, economic efficiency took priority over popular health. Smoke, dust, and a black mist enveloped the town. Most people lived in miserable homes, suffered deplorable working conditions, and rarely breathed pure air. Millworkers labored until an early death. Businessmen, teachers, and government officials justified these conditions by appeals to self-interest. Adopting a calculating mentality, Bitzer, a young clerk, proclaimed: ‘The whole system is a question of self-interest … I was made in the cheapest market, and have to dispose of myself in the dearest.’2