Scott Alexander, curated
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Highlights From The Comments On Hanson And Health Care

Quality
70
Strong
Claude Shift
48
Moderate
RWI
2
of 10

Follows up on

Contra Hanson On Medical Effectiveness — Essay · Apr 2024

Response to Hanson On Health Care — Essay · Apr 2024

Summary

Companion Highlights to Scott's exchange with Robin Hanson on whether medicine works. Unusually authoritative: Hanson himself clarifies his 'marginal medicine' position (five concrete ways to identify/avoid it; picks trilemma #3) and Scott apologizes for over-suspicion; Dr. Jacob Goldin (author of the IRS-outreach-insurance-mortality study) sends a detailed defense against Hanson's critiques, plus the Lindley's-Paradox discussion and a new cost-sharing/mortality study. Then the ear-infection/antibiotics debate, the statins-bust-Hanson point, poignant first-person perspectives (JSelinger on terminal HNSCC and mRNA vaccines; Vitor on diffuse heart-med side effects), and the US-maternal-mortality-checkbox statistical illusion. Scott's own recurring insight is strong: insurance studies structurally can't detect much of medicine's benefit (overtesting that catches 1/1000 cancers, pain relief, statins) because those aren't the measured endpoints, and the value of care differs by patient's values.

Why this score

Quality 70 · Strong. Strong companion, top of the band: genuine expert participation (Hanson, Goldin) plus a real Scott-authored argument about why insurance experiments systematically under-measure medicine's benefits; held below essay level as it is anchored in curation.

Claude’s paradigm shift 48 · Moderate. Moderate-notable: the 'insurance studies can't see these endpoints' framing sharpens the debate; no wholly new frame.

Real-world impact 2 · Minor. Within-discourse: shapes a substantive health-policy/EA debate; no direct material reach.