I’ve been vacationing with family this week, and (re-) noticed a few things. When we played miniature golf, the winners were treated as if shown to be better skilled than previously thought, even though score differences were statistically insignificant. Same for arcade shooter contests. We also picked which Mexican place to eat at based on one person saying they had eaten there once and it was ok, even though given how random is who likes what when, that was unlikely to be a statistically significant difference for estimating what the rest of us would like.
>But people just can’t on average have this much evidence, since we usually find it hard to see effects of medicine on health even when we have datasets with thousands of people.
Is it true that medicine in total has little impact on health, or is it merely that medicine has no marginal impact on health?
>On this blog I often present weak clues, relevant to important topics, but by themselves not sufficient to draw strong conclusions.
What would be useful there is if you could describe an impartial process for seeking out this evidence. If the clues are weak, there must be clues in the other direction as well, of course - do you regularly present evidence for or against your positions, and make it easy to collate all the clues together on a particular topic?
Additionally, someone providing the evidence that they liked a certain restaurant indicates that the Mexican restaurant is probably not a total shithole, whereas any other restaurant which none of the group members might choose through abstract maximization might end up being terrible for unforeseeable reasons.
In social situations it's usually more valuable to *not* be the guy who suggested the horrible restaurant than it is to *be* the guy who suggested the great restaurant.
Hanson's theory is that our intuitive judgments reflect self-serving (far-mode) illusions, which put our character in a positive light. Harboring these illusions help us signal our goodness, righteousness, and suitability as ally.
Hanson's wrong. Signaling is a near-mode operation. (For an application of my view of status signaling, see "Verbosity affronts the court" — http://tinyurl.com/agft7ga )
“. . . because doing so might force them to drop treasuredintuitive judgements.” Why do many people *treasure* their intuitive judgments, as opposed to merely thinking them plausible enough to be worth acting on?
Fair enough for the most part. I definitely think of Posner as more associated with "pragmatism". His fondness for Oliver Wendell Holmes is held against him by many libertarians.
1. Sorry for the imprecision about Friedman: perhaps in memory I blended him with Hayek, who in any event is unquestionably libertarian, making the same point. Whether Friedman "supported" Pinochet is a matter of interpretation. What he did was meet personally with the blood-drenched dictator and wrote him a personal letter which formed the basis for Pinochet's economic policies. After reviewing the facts, I would say his stance toward Pinochet was that we on the left would call "critical support" (kind of analogous to Trotsky's stance on Stalin's regime, although Trotsky was far more open about attacking Stalin's murderous policies than Friedman was about Pinochet's).
2. Whether Posner was ever considered a libertarian depends on who's doing the considering. Perhaps "libertarian icon" was too strong, since some libertarians disown him, but much of the disowning is recent, following the changes in his economic analysis after capitalism's debacle. But to say flatly that Posner was "never considered" a libertarian is also too strong, inasmuch as many people consider him libertarian and Posner has described himself with that term. ( http://mises.org/daily/2470/ ) Posner is certainly more libertarian than an irreligious conservative would be expected to be--sometimes in a good way, such as opposing drug laws. I would say Posner is indeed much like Hanson in basic philosophy: a libertarianoid pragmatist.
Friedman didn't "support" Pinochet. He visited Chile and gave the same talk that he gave in communist country. He explicitly opposed the regime. It was Hayek who supported Pinochet. And I don't think Posner was ever considered a libertarian. He seems more like an irreligious conservative (though many conservatives may dislike his Keynesian macroeconomics). However, his focus on "efficient law" does sound similar to Hanson's prioritization of efficiency over liberty.
Michael Anissimov (keen Yudkowsky fan) now calls himself a 'neo-reactionary' and on the 'More Right' blog he enthusiastically explores ideas such as restoration of a monarchy and benign dictatorship. I'm pretty sure that was the plan all along, only now he's finally honest about it. The AIs will rule, with a monarchy of 'rationalists', and Yudkowsky as emperor.
People think they've benefited from medicine because there's more information available for the benefits of medical interventions than for their disadvantages. Medicine isn't special: it's just more measurable, so the (weak) relationship between consumption and the desired consequences can be proven objectively. How do you show that status, generally, is overconsumed, although it surely is, because of the biases of a profit-driven market economy?
The only place I've seen this bias made explicit is in Katja's latest posting on Meteuphoric, where she explains that in the marketplace of ideas arguments against moral crusades are undersupplied due to a tragedy of the commons. As far as I know, this important insight is novel, but it can be immediately seen to apply to markets generally.
If markets bias us to overproduce goods and services, what's the alternative? Not to markets; that's another discussion. ( http://tinyurl.com/ke2oj98 ) The alternative to oversupplying goods and services? It's obviously leisure. Yet the trend is to increase the time worked.
The bias for overproduction is exacerbated as markets reign more completely.
One problem with a near-mode or inside view of the effects of medical care--as when you ask your relatives--is in their having few clues about whether they've been harmed by medical care. If I can generalize from my own experience as a provider of psychological services, medical care in the U.S. is immensely iatrogenic (because American doctors, frankly, are money grubbers: the ignored case for socialized medicine). In psychological services, patients are, for example, often provided "supportive therapy," which is an exercise in creating psychological dependency and undermining patient autonomy. It's why I left the field after 12 years: pressures to deliver these kind of "services" became increasingly difficult to avoid.
Patients committed to a form of therapy usually think they've improved and ignore or don't notice the harm, and this is particularly true of the most iatrogenic supportive forms of "therapy" because the therapist is, in conventional terms, being "nice" to the patient.
There are individual studies with 1000x as many patients as the RAND study. E.g., http://www.nber.org/papers/...
The RAND study was too small for actual mortality differences to be significant. They constructed their "risk of dying" index after they saw their data, and that was only a 1% estimated mortality effect for the whole population. The "General Health Index" was the measure they decided on before they saw their data. Role Functioning is an very relevant measure - it is after all one of the main reasons people want to be healthy, to function in their usual roles. Most people aren't sick at any one time, yet the outcome we care about is sickness. That is a problem common to all these studies.
Good point. The 2% reduction was for the estimated risk of dying, and is mostly driven by the well-reported drop in blood pressure. With respect to actual deaths they didn't report their results because they lacked enough power to make it interesting. In any case, it seems like it is obvious that you wouldn't be able to notice even a huge effect on mortality. Fair?
The physiological measures in the RAND HIE had significant responses, though they aren't really things we care directly about. The other measures, in particular "physical health and role functioning," seem really dubious for this purpose, and mostly orthogonal to most claims that people want to make about health care (especially claims about not dying). It seems unsurprising that things that stop people from walking are not the kinds of things that they will stop treating when healthcare gets more expensive. As the authors of the RAND report say, "the majority of persons in a general non-aged population do not have measurable functional limitations; hence, the precision of these measures for testing hypotheses about effects of insurance plan on health status is somewhat restricted." Casually that seems like an understatement, though I would have to do more looking into the measures to really know.
If you ran 100 copies of the RAND experiment and got the same results each time, it would not make me any more confident that health care doesn't help avert death. If you ran the RAND experiment and 99 much weaker studies, it would help even less. I agree that if you had more relevant outcome measures and generally saw no effect it would be suggestive, but I still don't think it would bear on the claims people make about helpful treatment for acute problems.
It seems like the strongest argument by far is that not enough people actually die for so many people to nearly die. But it seems like this is probably explained by (1) people overestimate how good their treatment is relative to others, in keeping with their behavior in many domains, and (2) people using `saved' to mean `averted a 10% chance of death,' or even more liberally, also in keeping with their behavior in most cases.
Then that's perfectly compatible with many people having been saved by doctors.
Almost all the evidence we have is about marginal impacts.
>But people just can’t on average have this much evidence, since we usually find it hard to see effects of medicine on health even when we have datasets with thousands of people.
Is it true that medicine in total has little impact on health, or is it merely that medicine has no marginal impact on health?
>On this blog I often present weak clues, relevant to important topics, but by themselves not sufficient to draw strong conclusions.
What would be useful there is if you could describe an impartial process for seeking out this evidence. If the clues are weak, there must be clues in the other direction as well, of course - do you regularly present evidence for or against your positions, and make it easy to collate all the clues together on a particular topic?
Additionally, someone providing the evidence that they liked a certain restaurant indicates that the Mexican restaurant is probably not a total shithole, whereas any other restaurant which none of the group members might choose through abstract maximization might end up being terrible for unforeseeable reasons.
In social situations it's usually more valuable to *not* be the guy who suggested the horrible restaurant than it is to *be* the guy who suggested the great restaurant.
Hanson's theory is that our intuitive judgments reflect self-serving (far-mode) illusions, which put our character in a positive light. Harboring these illusions help us signal our goodness, righteousness, and suitability as ally.
Hanson's wrong. Signaling is a near-mode operation. (For an application of my view of status signaling, see "Verbosity affronts the court" — http://tinyurl.com/agft7ga )
“. . . because doing so might force them to drop treasuredintuitive judgements.” Why do many people *treasure* their intuitive judgments, as opposed to merely thinking them plausible enough to be worth acting on?
Fair enough for the most part. I definitely think of Posner as more associated with "pragmatism". His fondness for Oliver Wendell Holmes is held against him by many libertarians.
1. Sorry for the imprecision about Friedman: perhaps in memory I blended him with Hayek, who in any event is unquestionably libertarian, making the same point. Whether Friedman "supported" Pinochet is a matter of interpretation. What he did was meet personally with the blood-drenched dictator and wrote him a personal letter which formed the basis for Pinochet's economic policies. After reviewing the facts, I would say his stance toward Pinochet was that we on the left would call "critical support" (kind of analogous to Trotsky's stance on Stalin's regime, although Trotsky was far more open about attacking Stalin's murderous policies than Friedman was about Pinochet's).
2. Whether Posner was ever considered a libertarian depends on who's doing the considering. Perhaps "libertarian icon" was too strong, since some libertarians disown him, but much of the disowning is recent, following the changes in his economic analysis after capitalism's debacle. But to say flatly that Posner was "never considered" a libertarian is also too strong, inasmuch as many people consider him libertarian and Posner has described himself with that term. ( http://mises.org/daily/2470/ ) Posner is certainly more libertarian than an irreligious conservative would be expected to be--sometimes in a good way, such as opposing drug laws. I would say Posner is indeed much like Hanson in basic philosophy: a libertarianoid pragmatist.
Friedman didn't "support" Pinochet. He visited Chile and gave the same talk that he gave in communist country. He explicitly opposed the regime. It was Hayek who supported Pinochet. And I don't think Posner was ever considered a libertarian. He seems more like an irreligious conservative (though many conservatives may dislike his Keynesian macroeconomics). However, his focus on "efficient law" does sound similar to Hanson's prioritization of efficiency over liberty.
Antibiotics save lots of lives and the people whose lives they saved don't even know it.
Michael Anissimov (keen Yudkowsky fan) now calls himself a 'neo-reactionary' and on the 'More Right' blog he enthusiastically explores ideas such as restoration of a monarchy and benign dictatorship. I'm pretty sure that was the plan all along, only now he's finally honest about it. The AIs will rule, with a monarchy of 'rationalists', and Yudkowsky as emperor.
http://www.moreright.net/
People think they've benefited from medicine because there's more information available for the benefits of medical interventions than for their disadvantages. Medicine isn't special: it's just more measurable, so the (weak) relationship between consumption and the desired consequences can be proven objectively. How do you show that status, generally, is overconsumed, although it surely is, because of the biases of a profit-driven market economy?
The only place I've seen this bias made explicit is in Katja's latest posting on Meteuphoric, where she explains that in the marketplace of ideas arguments against moral crusades are undersupplied due to a tragedy of the commons. As far as I know, this important insight is novel, but it can be immediately seen to apply to markets generally.
If markets bias us to overproduce goods and services, what's the alternative? Not to markets; that's another discussion. ( http://tinyurl.com/ke2oj98 ) The alternative to oversupplying goods and services? It's obviously leisure. Yet the trend is to increase the time worked.
The bias for overproduction is exacerbated as markets reign more completely.
One problem with a near-mode or inside view of the effects of medical care--as when you ask your relatives--is in their having few clues about whether they've been harmed by medical care. If I can generalize from my own experience as a provider of psychological services, medical care in the U.S. is immensely iatrogenic (because American doctors, frankly, are money grubbers: the ignored case for socialized medicine). In psychological services, patients are, for example, often provided "supportive therapy," which is an exercise in creating psychological dependency and undermining patient autonomy. It's why I left the field after 12 years: pressures to deliver these kind of "services" became increasingly difficult to avoid.
Patients committed to a form of therapy usually think they've improved and ignore or don't notice the harm, and this is particularly true of the most iatrogenic supportive forms of "therapy" because the therapist is, in conventional terms, being "nice" to the patient.
There are individual studies with 1000x as many patients as the RAND study. E.g., http://www.nber.org/papers/...
The RAND study was too small for actual mortality differences to be significant. They constructed their "risk of dying" index after they saw their data, and that was only a 1% estimated mortality effect for the whole population. The "General Health Index" was the measure they decided on before they saw their data. Role Functioning is an very relevant measure - it is after all one of the main reasons people want to be healthy, to function in their usual roles. Most people aren't sick at any one time, yet the outcome we care about is sickness. That is a problem common to all these studies.
Good point. The 2% reduction was for the estimated risk of dying, and is mostly driven by the well-reported drop in blood pressure. With respect to actual deaths they didn't report their results because they lacked enough power to make it interesting. In any case, it seems like it is obvious that you wouldn't be able to notice even a huge effect on mortality. Fair?
The physiological measures in the RAND HIE had significant responses, though they aren't really things we care directly about. The other measures, in particular "physical health and role functioning," seem really dubious for this purpose, and mostly orthogonal to most claims that people want to make about health care (especially claims about not dying). It seems unsurprising that things that stop people from walking are not the kinds of things that they will stop treating when healthcare gets more expensive. As the authors of the RAND report say, "the majority of persons in a general non-aged population do not have measurable functional limitations; hence, the precision of these measures for testing hypotheses about effects of insurance plan on health status is somewhat restricted." Casually that seems like an understatement, though I would have to do more looking into the measures to really know.
If you ran 100 copies of the RAND experiment and got the same results each time, it would not make me any more confident that health care doesn't help avert death. If you ran the RAND experiment and 99 much weaker studies, it would help even less. I agree that if you had more relevant outcome measures and generally saw no effect it would be suggestive, but I still don't think it would bear on the claims people make about helpful treatment for acute problems.
It seems like the strongest argument by far is that not enough people actually die for so many people to nearly die. But it seems like this is probably explained by (1) people overestimate how good their treatment is relative to others, in keeping with their behavior in many domains, and (2) people using `saved' to mean `averted a 10% chance of death,' or even more liberally, also in keeping with their behavior in most cases.