[extropy-chat] Effectiveness of Medicine (was: Robin Hanson on Cynicism)

[Robin Hanson]

At 12:08 AM 9/24/2005, Brett Paatsch wrote:
>>>In your essay [http://hanson.gmu.edu/feardie.pdf] you say
>>>"fear of death makes us spend  15% of our income on medicine from
>>>which we get little or no health benefit, while we neglect things like
>>>exercise which offer large health benefits".
>>>
>>>But I can't see where you answer the basic question what does Robin
>>>mean by medicine? You seem to assume that *everyone* just knows
>>>what medicine is. I think that is not a valid assumption. Your essay
>>>surveys work done by others but it is not clear that *they* have defined
>>>  medicine the same way as you or indeed as each other.
>>You baffle me.  The usual intuitive definition of medicine is "the stuff
>>that doctors do".
>
>This isn't my intuitive definition of medicine. That would be like thinking
>economics was stuff that economists do. Or music is what is produced
>by those people that call themselves musicians.
>To me, intuitively, medicine is about treating ailments.
>
>>You know going to them to get advice, some of which is
>>to take drugs, undergo surgery, and so on.  The RAND experiment
>>operationalized that in the obvious way - they gave folks money to
>>go to the doctor more.
>
>That's poor method in my opinion.  Give money to go to the doctor
>to uneducated poor people and of course they will use it. People like
>getting attention (Hawthorne studies).

You still baffle me.  How would *you* study the aggregate effectiveness
of "treating ailments"?   And if you think that people given money to
spend on medicine wouldn't spend it wisely to gain health, then why
would you think people spend their own money on medicine any more
wisely?  It seems as if you agree with my claim that money spent on
medicine doesn't produce much health.

>>>I'm obviously missing something here Robin.  I can't see any real
>>substance in the essay. To me you just don't cut down to anything
>>substantive.
>>I find it hard to imagine what would count as substance to you.
>
>Major things that people die of are heart disease, cancer and diabetes.
>All these diseases have given ground to medicine since the Rand study
>was done in 1979 or earlier.
>Insulin for diabetes. Angiograms then stents and bypasses for heart
>disease. Chemo and radiation treatment followed by treatment
>with stem cells.
>The Rand study didn't look at the young or the old. It excluded the
>frailest cohorts. The groups that would have been most likely to
>benefit.

The RAND study did as much as they could at the time.  They couldn't
look at free vs. full price medicine for the elderly because the elderly
already got free medicine from Medicare.  They did look at children.

I'd love to see a new experiment done like the RAND experiment, but
until that happens this is the only aggregate experiment data we have.
We do have lots of correlations-in-the-world studies done more recently,
many of which include the elderly.  I mentioned one in my paper; what is
your beef with that study?


Robin Hanson  rhanson at gmu.edu  http://hanson.gmu.edu
Associate Professor of Economics, George Mason University
MSN 1D3, Carow Hall, Fairfax VA 22030-4444
703-993-2326  FAX: 703-993-2323