Response to Scott Alexander on Medical Effectiveness | Hacker News Reader

Response to Scott Alexander on Medical Effectiveness

overcomingbias.com

34 pointspaulpauper8 comments

It wouldn't surprise me if they started with the end goal "don't provide healthcare to poor people" and worked backwards from there to find justifications.

It would certainly explain the intentionally vague way he presents his arguments that confused Scott Alexander.

Because if he clearly stated the strong part of his argument, then it wouldn't support that goal, but the vague form does.

You want healthcare? Look here's a random bit of research in which it's not clear that the people even knew they had healthcare insurance, which proves that it won't help you.

Do we need to pin him down and for every bit of healthcare that he reluctantly admits helps people say "do you or do you not support this being provided to everyone, regardless of their ability to pay?".

I believe him when he says he doesn’t think all medicine is worthless, but there are definitely a lot of moments where it seems like he’s trying to downplay even clearly effective medical treatments as having uncertain effectiveness (e.g., cancer treatment) or not really medicine (like glasses), so I don’t really blame Scott Alexander for interpreting his position as close to “no medicine is effective.” (Edit: or you from suspecting ulterior motives.)

And yeah, while I think these insurance and medical spending studies merit further consideration and follow-ups, there are a lot of factors which Scott Alexander points out beyond whether medicine works even if they are RCTs.

The elephant in the room with people questioning public healthcare or public education is that wealthy people will always be able to easily access private replacements and many middle class families will be able to cobble the funds together, so the main people losing out will be the poor.

I think revised American heart association guidelines to be more specific and recommend walking 8-10k steps per day would probably do more benefit than a lot of pharmaceutical therapies.

But it's not an either / or thing. All of these should be uses holistically among with a good diet and other healthy lifestyle factors.

If you want to get a clear handle on the issues & professional biases in Scott vs Hanson, it’s most efficient to read the comments under each blogger’s post. If you can get past the meandering styles, the hundreds of commenters seem to have converged on some kind of understanding on how better to gauge the effectiveness of medicine

Is Scott Alexander qualified in this subject?

He’s a doctor (psychiatrist) so I imagine he has something worthwhile to say about medical effectiveness. He’s at least as qualified as the economists he’s responding to!

I don't disagree although as a physician he has a bit of conflict of interest in the discussion. I'm not sure it invalidates what he has to say but it's a context that might be kept in mind.

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