Contra Caplan on Mental Illness

Rebuts Bryan Caplan's economic argument that mental illness is 'unusual preferences,' not disease (a Szasz-style claim that psychiatry is rent-seeking stigmatization). Scott's core move: the preference/budget-constraint dichotomy breaks down outside trivial choices -- Alice's depression and Bob's flu present identically; the sleep-deprived and the interferon-machine thought experiments show 'changed preferences' that everyone (including the sufferer) treats as an affliction needing a biological cure. He defuses Szasz's relevance (95% of outpatients come voluntarily; transgender care is patient-decided), shows Caplan's 'alcoholics/patients are just deceiving us' move requires absurd paranoia (the AA-then-binge-then-suicide-attempt case; the 'are-we-sure-anyone-is-a-libertarian' reductio), and grounds the schizophrenia case in clinical reality (real external voices that psychiatrists specifically screen for; drug pharmacology; un-fakeable formal thought disorder).

Quality 75 · Excellent. Excellent floor (75). A rigorous, clinically-grounded demolition whose central insight -- preference-vs-budget is a false dichotomy once you leave shampoo-choice -- genuinely clarifies the disease/normal-variation debate, backed by sharp reductios and real psychiatric detail. Held at the floor as a 'contra' response to one paper. Scored on merit (2015).

Claude’s paradigm shift 54 · Moderate. Notable-edge (54). The preference/budget-breakdown applied to mental illness, and the deception-theory reductio, are fresh, non-obvious angles; the frame is reactive.

Real-world impact 2 · Minor. 2 -- minor/within-blog. A psychiatry / anti-Szasz argument; within-discourse, no material footprint.