[extropy-chat] Are vaccinations useless?

[Robin Hanson]

My conference is over, and I have read through this thread.

I see that Hal's heroic efforts have convinced some people of my claim
which this thread had been discussing, namely that medicine (as
usually understood) is at best responsible for only a small fraction
of the mortality reduction over the last few centuries.

I have also made two other claims that were mentioned in the
discussion.   I suppose many will remain skeptical about those claims
unless Hal puts in more heroic efforts.

First, I said that the evidence I have seen regarding the health
value of sanitation and water supply is not encouraging about that
explaining a big fraction of mortality reduction. And since it is hard
to understand how nutrition could be driving current mortality
reductions in rich countries, even though the rate of reduction has
been steady for a century, I am led to a state of high uncertainty.
But I should also say that I have only done a moderate amount of
reading in this area.

In contrast, I have done a lot more reading on the subject of my
second claim, that the marginal health value of medicine seems
near zero today, both in rich and poor countries.   This is also
the consensus among health economists.  Now for a few selected
comments.

Samantha Atkins wrote:
>Why would I care about a non-medical consensus on the efficacy of  medicine?

Why would you care about an evaluation of Chrysler cars that isn't
done by Chrysler?

At 03:12 AM 3/14/2006, BillK wrote:
>... if you include the huge scale of medical fraud, worthless
>treatments, unnecessary surgery, 'snake-oil' concoctions, useless
>supplements, etc. etc., then Robin may have a point that 'overall'
>there isn't much benefit. But I feel that including all this fraud is
>a mistake. There are many medical treatments and operations with
>obvious life-saving benefits. You just have to stay away from the
>hucksters and conmen

Most of those worthless treatments and unnecessary surgeries are
recommended and performed by respected and credentialed doctors.   How
are ordinary people supposed to distinguish them from the valuable
treatments?

Rafal Smigrodzki  wrote:
>BTW, the Rand study he quotes is junk.

The RAND study is the single most informative study we have about the
overall (marginal) health value of medicine in rich nations today.  I know
Rafal has complaints about it, but one can find imperfections in any
study.  I challenge Rafal to point to another study he thinks is more
informative.   We could then compare flaws.



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