Seeing as Kevin is wondering whether M&Ms have gotten smaller since the last time he looked, my imponderable for the day is this: Why is it that in Europe (at least in my experience) patients with a sprained ankle or whatever are typically issued with forearm crutches whereas in the U.S. you get underarm crutches. It seems clear to me that the underarm kind is inferior in every important respect. So why does it survive in the U.S.?
- Efficiency. Already ruled out. Underarm crutches are inferior.
- Revealed Preferences. Underarm crutches must be more efficient because otherwise people wouldn’t be buying them.
- Path Dependence. Some QWERTY-like event in the early 1900s locked American hospitals into the underarm regime.
- Cultural. De Tocqueville notes somewhere that American individualism thrives in the presence of underarm supports for gammy legs, while the ancien regime’s tendency to lean at the elbow meant that its collapse was both inevitable and unforseen.
- Marxist. The ruling crutches of any epoch are the crutches of the ruling class, etc.
- Evolutionary Psychology. On the Pleistocene Savannah, Underarm crutches provided a selective advantage to their users due to their greater length, enabling Underarm-using groups to hold off predators at a slightly greater distance and obtain marginally higher-hanging fruit than their Forearm-using competitors.
- Political Economy. A cartel of crutch producers in league with hospital crutch-wranglers and has cornered the market through aggressive undercutting of the competition and a complex system of kickbacks. Standard Crutch (New Jersey) pioneered this technique in the 19th century, bringing it to such a pitch of perfection that it was impossible to buy a forearm model without also getting three underarm models delivered to you.
- Libertarian. Though technically inferior, underarm models are ultimately beneficial because they encourage a quicker return to standing on your own two feet.
Alternative explanations (perhaps even informative ones) are invited.
fn1. Perhaps they are simply further away than before?