RAND Experiment II Petition

Whereas, the US now spends two trillion dollars a year on medicine, which is 16% of national income, a percentage that has doubled every thirty years, threatening to overwhelm federal taxes in thirty years and to dominate the economy in sixty years, and

our single clearest data point regarding the marginal value of this spending, the US-funded RAND health insurance experiment, where from 1974 to 1982, 7700 subjects were randomly assigned to 3 to 5 years of free or not free medicine, found no significant evidence of a substantial health effect of more medicine, confirming the usual results of continuing aggregate healthmedicine correlation studies,

We the undersigned petition the US to publicly conduct a similar experiment again soon, this time with at least ten thousand subjects treated for at least ten years, which should be feasible for a half billion dollars, or one part in forty thousand of annual medical spending.  Whatever other purposes such an experiment pursues, it should try to make clear the aggregate health effects of variations in aggregate medical spending, variations induced by feasible regimes of quality control, including free patient choice induced by a varying aggregate price.

I, Robin Hanson, support this petition.

(Comments on this post are only for further supporting signatures.  Other comments go here.) 

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  • michael vassar

    You know though, it seems to me that a cheaper option for testing the general efficacy of western medicine would be to simply provide cheap or free western medical clinics to a random sub-set of African villages where nothing similar is available. Natural charitable experiments of this sort surely exist already.

    • Peter Favaloro

      Mr. Vassar – that wouldn’t really test the marginal effect of medicine. The concern is not that western medicine is ineffective; the concern is that we already consume so much medical care in the US that we are well past the point of diminishing marginal returns.

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  • http://www2.blogger.com/profile/15437653761628928730 Kevembuangga

    I am not an American so the petition is irrelevant to me but may I suggest that the problem isn’t well stated.
    I’d rather insinuate that you could try to investigate WHY the French or even Cuban medical systems, while still costly and not perfect don’t incur this kind of downsides while being MUCH MORE efficient than the US medical care (costwise and excepting “outstandingly high tech” procedures).

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  • Tom Canham

    I, Tom Canham, think this is the most ridiculously retarded thing I’ve ever read.

    You misrepresent the data, misunderstand modern medicine, and have generally got it all wrong. Medicine treats illness; it is not prophylactic. And only good prophylaxis — you know, the simple stuff like eat healthy, get plenty of rest and exercise — can improve health. Doctors are like the plumber; you don’t call them when things are going well. But man, when things are in the toilet (heh) — you can’t live without them.


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    I also note that the crucial thing to include in a large replication of this study is a way to track the use and effects of the treatments that medicine is most confident about, within the two groups. Do even the uninsured receive them? Do other apparently undrelated health problems show up amongst those who receive them? Do net-harmful treatments simply counteract their benefits in a population?

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