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RobinHanson's avatar

Sorry for not responding here earlier; the blog software hid your comment & I’ve finally got it out. Thanks again for engaging with our book, and yes it is clear that you enjoyed it. :)

I agree that the US is an outliner in some ways, and it is interesting to think about how to explain those facts. Let me suggest that exceptional US spending on medicine and the military are due in part to the US telling itself key myths that it deservers credit for pioneering modern medicine, and for saving the world from fascism and communism. We feel that by spending more on these things, we support our claims of the great value of such things, and constantly remind the world of the gratitude we feel they owe us. We feel we are the best, but must keep spending more to stay the best.

Yes it is possible come up with many explanations for any particular empirical fact. But there’s a great risk of being overly ad hoc that way. The discipline that we try to hold ourselves to in our book is to explain many patterns at once with a small number of assumptions. Of course that approach could mislead by chance, or we could have failed to do it well.

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Matthew Hutson's avatar

Robin, thank you for bringing your post to my attention and inviting me to add comments here. You make several reasonable points.

there’s an intellectual contribution to make by arguing together for a large set of related claims. This is what I suggest is original about our book.

Indeed! That’s why I wrote “I can’t say that the book covers new ground, but it is a smart synthesis and offers several original metaphors.” (I probably should have added “much” before ”new ground.") FWIW, I would describe my own book as a smart synthesis that doesn’t cover much new ground.

We do not offer our thesis as an explanation for all possible variations in these activities!

That’s true, but my (relatively uninformed) perception is that excess medical care in other developed countries is a fraction of what it is in the US. If that’s the case, then by far the biggest factor in US medical bloat is something US-specific. And if status-signaling doesn’t have anything to say about that overwhelming factor, then it’s left begging for scraps of factors to explain. My analysis may be incorrect, but in any case I suspect other readers might have the same unanswered questions, and so I called it a hole in your case. You may have reasoning or evidence to plug the hole in a jiffy, but it was missing from the book. (Formally, it’s not a hole in the case that status affects some medicine, just in the case that it has a sizable effect on medicine, which I perhaps incorrectly assumed was the case you were making. I left it to myself to define “sizable.”)

Perhaps it wasn’t the ideal example of a hole, but I also had unaddressed counter-argumets for all of the predictions at the end of the chapter. For example, in the first ("Keeping Up with the Joneses”), it’s possible that people spend more on health care after moving to a richer neighborhood because they spend more on everything. Or if they spend more specifically on health care, maybe there are descriptive norms about how much it’s reasonable to spend on health care not for status but for health. You might hear from neighbors that a certain specialist or procedure is quite effective and worth the cost, then see the service as a practical expenditure.

Actually it is a reference to common idea of “The Elephant in the Room”

Ah, I assumed it was a double entendre because you cite Haidt’s book in the discussion of mind modularity. (In a draft of the review I included both entendres, but an editor remove the “elephant in the room” reference, perhaps because he felt that entendre needed no explanation.) I thought I recalled your mentioning Haidt's metaphor explicitly, but I can’t find the passage, so apparently I was confabulating!

Anyway, I enjoyed your book, and I hope that came across.

Matt

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