[extropy-chat] Health data

[Robin Hanson]

At 06:02 PM 6/16/2006, Damien Sullivan wrote:
>On Fri, Jun 16, 2006 at 12:02:14PM -0700, Eliezer S. Yudkowsky wrote:
> > ...didn't Robin Hanson just get through presenting the evidence that
> > increased healthcare spending does squat to decrease mortality?
>
>Did that cause anyone to decide to not go see the doctor the next 
>time they're sick?  Will you, Eliezer, skip the doctor's 
>office?  Will Robin refrain from taking his children there (assuming 
>his wife would let him)?

Eliezer S. Yudkowsky responded:
>It's certainly causing me to be more cautious around the prospect of surgery.

Rafal Smigrodzki responded:
>Eliezer ... says that the marginal spending on healthcare makes no 
>difference, and I heartily agree with him (and Robin). ... after 
>paying for vaccinations, blood pressure medications, kidney dialysis, and a few
>other interventions with very good cost-to-benefit ratios, there is 
>a whole lot of therapies, and a humongous number of diagnostic 
>tests, with almost no impact on health or survival. ... based on the 
>observation
>of my own practice patterns, this spending may account for at least 
>1/3 of the total spending, and could easily surpass the 50% mark. 
>... 1) Do go the doctor if you want to stay healthy but if you 
>happen to pay for it yourself, be very, very demanding about 
>justifications for every 1000$ that the good doc may have you spend 
>on his salary.

As a practical matter try to raise my standard of skepticism so that 
I induce about 1/3 as much medical spending as I would had I not know 
about this data.  This includes when to bother to go to the doctor, 
what tests to take, and what treatments to undergo.  I want a strong 
recommendation for each test or treatment, not just "we could try 
this" or "this has worked in some people" or "this is what we usually 
do."  For something large with substantial risks, I'd want to see 
real data for myself.   I think Rafal could endorse this strategy.

I do this primarily to save health, not money.   I get Kaiser, the 
cheapest health plan my employer offers, but that pays for far more 
treatment than I want.   I'd love for there to be enough people like 
me that we could get a health plan designed for us, as that should 
cost a lot less.   Alas, the prospects for that are slim - people 
want to *believe* in medicine, and are scared to seem uncaring if 
they cut back much for their family.



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