On reflection, I suspect the main thing keeping me from convincing people that the second half of medical spending hurts as often as it helps is a reluctance to believe that "doctors kill." I should argue more like the
There's some discussion in the comments as to the reliability of the fired-nurse story. Could you please shed some light on that -- whether you actually ever met and talked to the fired nurse, how strong her evidence was that she was fired for the reason in the story, etc.? Did your wife actually know her, or know someone who knows her (who might turn out to be someone who knows someone who knows someone), that sort of thing? Thanks!
Being a newcomer to the blog (and a doctor): believe me, I apologize to all of you for my pointless life. If only I had known, I should have been a tenured university professor. In addition to my intended purpose of improvement of my understanding of quantum mechanics, of efforts to bring about the Singularity, and of human cognition processes, I have read some of the archives on medicine; hence this late thread entry. I didn't see any of the participants on this thread state that he/she was in a full-time, at-risk occupation for subsistence wages; medical practice is a job, for which the workers wish to receive as much remuneration as is legally and ethically possible. It is definitely true that some get much better results than others, while still receiving similar income; yet none is "tenured", with a guaranteed income regardless of production. While I realize that much more is spent on health care than on education, I had a thought when I read Dr. Hanson's comment in the thread that he teaches medical economics to his students semester after semester, and they never seem to learn what he is teaching. Then, it occurred that, by definition, all the doctors mentioned are products of the university educational system. Perhaps the Rand and other studies did not go far enough to find the root cause of the ineffectiveness of our health-care delivery personnel, even to the point of killing their own patients. Surely if they had understood economics better, they would realize that there are extreme diminishing-return issues when one kills his own customers. I say this somewhat (but not completely) tongue-in-cheek; perhaps every profession is fortunate to make a difference only once in a while, and then when examined economically, it is discovered that that one impact experience cost society beaucoups dollars. It's going to get worse: see this.
Doctor's often make serious mistakes that maim or kill people. I personally had a routine surgery when I was a teenager and now have a serious chronic illness that resulted from the doctor removing too much tissue.
I live in pain every day because of it. All the while all the doctor's that diagnosed me did not find the problem. I ended up finding the issue on my own on the web. I then went and confirmed the diagnoses with two separate physicians. All that being said, a doctor gave me a chronic illness during a surgery and it cannot be cured.
While I do believe doctor's try their best to help patients they are often not aware of the damage they are doing. Some doctor's are out to make a buck and will recommend surgery for the slightest of reasons. For example a region in the Midwest had 10 times more heart bypass operation that in any other county in the U.S. There didn't seem to be any reason for it except that this county's doctor's got huge bonus's for doing this type of surgery.
I guess that if you feel healthy and your doctor recommends surgery. Make sure you research it yourself to make sure it is necessary. Sadly even some doctor's will make a buck at the cost of a person's health or life.
Doctor's often make serious mistakes that maim or kill people. I personally had a routine surgery when I was a teenager and now have a serious chronic illness that resulted from the doctor removing too much tissue.
I live in pain every day because of it. All the while all the doctor's that diagnosed me did not find the problem. I ended up finding the issue on my own on the web. I then went and confirmed the diagnoses with two separate physicians. All that being said, a doctor gave me a chronic illness during a surgery and it cannot be cured.
While I do believe doctor's try their best to help patients they are often not aware of the damage they are doing. Some doctor's are out to make a buck and will recommend surgery for the slightest of reasons. For example a region in the Midwest had 10 times more heart bypass operation that in any other county in the U.S. There didn't seem to be any reason for it except that this county's doctor's got huge bonus's for doing this type of surgery.
I guess that if you feel healthy and your doctor recommends surgery. Make sure you research it yourself to make sure it is necessary. Sadly even some doctor's will make a buck at the cost of a person's health or life.
I’m inclined to think that any agent who holds views on a wide range of topics is likely to be biased if those views can be reliably predicted by the agent’s position on the left-right continuum, since there is no good reason to expect anything more than a weak correlation between the truth of a view on some random topic and the political horientation of those who subscribe to it. This applies to individual and institutional agents alike, and may explain why many of us are sceptical about the AEI.
Like Anders, I also find this issue interesting, and second his suggestion to start a dedicated thread.
The AEI issue is interesting, and might merit its own dedicated thread. We quite often evaluate the reliability information almost solely based on the originating organisation - and this organisation/reliability information is likely often picked up from others rather than arrived at by experience or deliberate evaluation. I remember a friend who almost hyperventilated when I mentioned dealing with a certain centre-right Swedish think tank. He had never read anything from them, but "knew" from his social democrat context that everything they did was biased and bad.
When is this approach a bias and when is it just a prior? It seems to be very vulnerable to several bias-promoting processes like stereotyping, groupthink, outgroup bias, halo effects and availability biases. If group X has opinion Y, then adherents of opinion Z have an incentive to argue against everything related to X, and to promote this even when Z and Y are not the direct subject of discussion.
> the Laffer curve that you link to is not bad (false) numbers
Of course that is correct.
That their name is tied to an example of extremely poor math and economics may not be their fault at all; the WSJ could have been solely responsible for (what I consider to be) a ludicrous curve fit.
However, If my experience with the AEI consists entirely of 1 terribly misleading graph, which they may or may not be responsible for, isn't it fair for me to jack up my doubt percentage a bit? As I said before, I only guess that I'm going from 10% to 15% because of the source.
Bill - the Laffer curve that you link to is not bad (false) numbers. It is bad curve fitting. It really is not the same thing. There's a big difference between (say) a scientist with out-there ideas which have scant empirical support, and a scientist who falsifies his data.
Presumably you know that there isn't just one way to fit a curve to the data. Curve fitting 101. There's more than one curve. You need to add constraints, and those constraints are going to derive from your theory. So those constraints are going to import something of your theory. Also, the data as shown does - barely, weakly - support the idea that there's a downward slope on the right. You can see it in the dots, from Norway to the US. That might be just an accident. But it might not. I don't know. Do you know absolutely for sure?
On the matter of your bias, it doesn't have to be your bias. It might be somebody else's bias, somebody who has influenced you.
Also, @constant: I consider myself generally a libertarian; although certainly not a Libertarian. I highly doubt that their free-market bias is what's affecting me.
I would say that the Gartner Group is a thinktank (maybe? I'm not sure exactly what they are) that is much less reliable than even the AEI. I can't think of any others that deal with economic issues that I don't trust.
I think what really sullied there name for me is the Laffer Curve they drew in the Wall Street Journal; I seem to remember other instances of bad numbers from them, but I can't specifically recall them, so my bias may be unfair.
"of my wife, who I’ve met"
One would hope so.
"if doctors were washing their hands enough"
I wonder how many doctors if any are participating in UN Hand Washing Day today.
Vensa, the nurse was a close co-worker of my wife, who I've met.
I just found your blog, and this post, through Seth Roberts blog here: http://www.blog.sethroberts...
There's some discussion in the comments as to the reliability of the fired-nurse story. Could you please shed some light on that -- whether you actually ever met and talked to the fired nurse, how strong her evidence was that she was fired for the reason in the story, etc.? Did your wife actually know her, or know someone who knows her (who might turn out to be someone who knows someone who knows someone), that sort of thing? Thanks!
Being a newcomer to the blog (and a doctor): believe me, I apologize to all of you for my pointless life. If only I had known, I should have been a tenured university professor. In addition to my intended purpose of improvement of my understanding of quantum mechanics, of efforts to bring about the Singularity, and of human cognition processes, I have read some of the archives on medicine; hence this late thread entry. I didn't see any of the participants on this thread state that he/she was in a full-time, at-risk occupation for subsistence wages; medical practice is a job, for which the workers wish to receive as much remuneration as is legally and ethically possible. It is definitely true that some get much better results than others, while still receiving similar income; yet none is "tenured", with a guaranteed income regardless of production. While I realize that much more is spent on health care than on education, I had a thought when I read Dr. Hanson's comment in the thread that he teaches medical economics to his students semester after semester, and they never seem to learn what he is teaching. Then, it occurred that, by definition, all the doctors mentioned are products of the university educational system. Perhaps the Rand and other studies did not go far enough to find the root cause of the ineffectiveness of our health-care delivery personnel, even to the point of killing their own patients. Surely if they had understood economics better, they would realize that there are extreme diminishing-return issues when one kills his own customers. I say this somewhat (but not completely) tongue-in-cheek; perhaps every profession is fortunate to make a difference only once in a while, and then when examined economically, it is discovered that that one impact experience cost society beaucoups dollars. It's going to get worse: see this.
Doctor's often make serious mistakes that maim or kill people. I personally had a routine surgery when I was a teenager and now have a serious chronic illness that resulted from the doctor removing too much tissue.
I live in pain every day because of it. All the while all the doctor's that diagnosed me did not find the problem. I ended up finding the issue on my own on the web. I then went and confirmed the diagnoses with two separate physicians. All that being said, a doctor gave me a chronic illness during a surgery and it cannot be cured.
While I do believe doctor's try their best to help patients they are often not aware of the damage they are doing. Some doctor's are out to make a buck and will recommend surgery for the slightest of reasons. For example a region in the Midwest had 10 times more heart bypass operation that in any other county in the U.S. There didn't seem to be any reason for it except that this county's doctor's got huge bonus's for doing this type of surgery.
I guess that if you feel healthy and your doctor recommends surgery. Make sure you research it yourself to make sure it is necessary. Sadly even some doctor's will make a buck at the cost of a person's health or life.
Doctor's often make serious mistakes that maim or kill people. I personally had a routine surgery when I was a teenager and now have a serious chronic illness that resulted from the doctor removing too much tissue.
I live in pain every day because of it. All the while all the doctor's that diagnosed me did not find the problem. I ended up finding the issue on my own on the web. I then went and confirmed the diagnoses with two separate physicians. All that being said, a doctor gave me a chronic illness during a surgery and it cannot be cured.
While I do believe doctor's try their best to help patients they are often not aware of the damage they are doing. Some doctor's are out to make a buck and will recommend surgery for the slightest of reasons. For example a region in the Midwest had 10 times more heart bypass operation that in any other county in the U.S. There didn't seem to be any reason for it except that this county's doctor's got huge bonus's for doing this type of surgery.
I guess that if you feel healthy and your doctor recommends surgery. Make sure you research it yourself to make sure it is necessary. Sadly even some doctor's will make a buck at the cost of a person's health or life.
"horientation"? now that's a weird typo.
I’m inclined to think that any agent who holds views on a wide range of topics is likely to be biased if those views can be reliably predicted by the agent’s position on the left-right continuum, since there is no good reason to expect anything more than a weak correlation between the truth of a view on some random topic and the political horientation of those who subscribe to it. This applies to individual and institutional agents alike, and may explain why many of us are sceptical about the AEI.
Like Anders, I also find this issue interesting, and second his suggestion to start a dedicated thread.
The AEI issue is interesting, and might merit its own dedicated thread. We quite often evaluate the reliability information almost solely based on the originating organisation - and this organisation/reliability information is likely often picked up from others rather than arrived at by experience or deliberate evaluation. I remember a friend who almost hyperventilated when I mentioned dealing with a certain centre-right Swedish think tank. He had never read anything from them, but "knew" from his social democrat context that everything they did was biased and bad.
When is this approach a bias and when is it just a prior? It seems to be very vulnerable to several bias-promoting processes like stereotyping, groupthink, outgroup bias, halo effects and availability biases. If group X has opinion Y, then adherents of opinion Z have an incentive to argue against everything related to X, and to promote this even when Z and Y are not the direct subject of discussion.
I thought that Megan Mcardle's recent comment on the Laffer curve was apropos.
The Laffer Curve and the supply siders pushing it seem to be the teacher's unions of the right.
(That's not meant as a compliment.)
> the Laffer curve that you link to is not bad (false) numbers
Of course that is correct.
That their name is tied to an example of extremely poor math and economics may not be their fault at all; the WSJ could have been solely responsible for (what I consider to be) a ludicrous curve fit.
However, If my experience with the AEI consists entirely of 1 terribly misleading graph, which they may or may not be responsible for, isn't it fair for me to jack up my doubt percentage a bit? As I said before, I only guess that I'm going from 10% to 15% because of the source.
Bill - the Laffer curve that you link to is not bad (false) numbers. It is bad curve fitting. It really is not the same thing. There's a big difference between (say) a scientist with out-there ideas which have scant empirical support, and a scientist who falsifies his data.
Presumably you know that there isn't just one way to fit a curve to the data. Curve fitting 101. There's more than one curve. You need to add constraints, and those constraints are going to derive from your theory. So those constraints are going to import something of your theory. Also, the data as shown does - barely, weakly - support the idea that there's a downward slope on the right. You can see it in the dots, from Norway to the US. That might be just an accident. But it might not. I don't know. Do you know absolutely for sure?
On the matter of your bias, it doesn't have to be your bias. It might be somebody else's bias, somebody who has influenced you.
oh my gosh... "their" not "there", I hate that error.
Also, @constant: I consider myself generally a libertarian; although certainly not a Libertarian. I highly doubt that their free-market bias is what's affecting me.
Robin,
I would say that the Gartner Group is a thinktank (maybe? I'm not sure exactly what they are) that is much less reliable than even the AEI. I can't think of any others that deal with economic issues that I don't trust.
I think what really sullied there name for me is the Laffer Curve they drew in the Wall Street Journal; I seem to remember other instances of bad numbers from them, but I can't specifically recall them, so my bias may be unfair.