Comments on: Megan on Med

By: Russell Johnston

Russell Johnston — Mon, 15 Feb 2010 18:27:26 +0000

I can’t quite understand why more people aren’t interested in WHY the effect might be neutral – the best bet is probably that drugs are vastly more harmful in their long term effects than we now know (or could know.) But maybe Doctors also tend to inadvertently “approve” bad life style choices by the rude things they don’t say. Or maybe we take better care of ourselves when we know others won’t.

Of course, there could also be a rural effect – the farther you are from a health clinic, the farther you are from shift work or a bar.

By: Russell Johnston

Russell Johnston — Mon, 15 Feb 2010 18:23:20 +0000

Let’s call the mystery factor “more money for food”

By: valter

valter — Sun, 14 Feb 2010 11:05:34 +0000

That was my first reaction, too.

Aren’t there any studies that at least use QALYs instead of mortality?

By: Lo Statuz

Lo Statuz — Sat, 13 Feb 2010 20:14:12 +0000

I’m not quite ready to buy Robin Hanson’s whole “showing that you
care” theory, but it does explain a lot. Maybe someone can be
persuaded to do some fMRI. If the same parts of the brain light
up when people think about medicine as when they think about
religion, and they’re different parts from what lights up when
people think about other health-related activities, that would be
suggestive.

By: Doug S.

Doug S. — Sat, 13 Feb 2010 18:08:29 +0000

What he said.

By: Ray Gardner

Ray Gardner — Sat, 13 Feb 2010 16:59:22 +0000

First problem among both sides of the debate is the purposeful confusion between healthcare and health insurance.

Second, and probably more important is the false notion that a publicly funded healthcare system would provide the same level of healthcare that is available today in the semi-private system.

Any argument that does not first (and always) address this second issue is at best incomplete, and worst, just plain wrong if not deceitful.

By: Michael Drake

Michael Drake — Sat, 13 Feb 2010 16:02:09 +0000

Robin’s claim is far broader. As he put it: “For many decades health economists have known that the best available evidence shows little or no relation at the margin between med and health.”

If true, that claim shouldn’t be startling just to those who believe in medicine; it should be startling to those who believe in economics. Just about anyone who can afford it purchases health insurance and spends money at the margin for medical products and services. Neither signaling nor rational choice nor rational ignorance would seem to explain this behavior.

It’s much easier to tell a rational choice or signaling story about health care denialism: isn’t it startlingly clever? wouldn’t it be economically rational for those who can already afford their own health insurance to lobby against measures that would tax their income for the benefit to others? Etc.

By: Chris

Chris — Sat, 13 Feb 2010 15:23:31 +0000

I’ll interpret your non sequitur to mean that you realize your study is inconclusive, but you do not wish to lose status by acknowledging it.

By: Dave

Dave — Sat, 13 Feb 2010 15:03:21 +0000

The study doesn’t address the most common use of insurance, to treat non- fatal disease.
Just as an example, my ophthalmologist couldn’t get a patient into the local nonprofit hospital to treat glaucoma as needed. So the guy will eventually go blind, but may live a long time.
Being affluent and well insured, my friends are always going to the hospital for joint replacements, tests, cardiac stents, cataract or gallbladder surgery or to have some suspicious breast lump excised. All these things improve quality of life but don’t markedly extend it.

On the other hand, if a non insured person needs emergency treatment or just wants to visit a family doctor she doesn’t need health insurance.

If he gets cancer or some really bad chronic problem ,a person usually goes bankrupt and, gets on Medicaid and gets treated that way. So, all this study shows is that the system we have now is pretty good at keeping people alive. I doesn’t not show that it keeps people healthy.

There are several studies out there that show that people don’t prioritize their health when it comes to spending their dollar. If there are increased co-payments or lack of insurance coverage, they reduce their doctor’s visits. Thus, if preventive care is effective, it will be more effective if paid for by a third party. Then that leads to the question of a persons responsibility for their own welfare, and destiny, etc.

By: Bill

Bill — Sat, 13 Feb 2010 14:58:40 +0000

Let’s call the mystery factor Toothpaste.