Contra Hanson On Medical Effectiveness - by Scott Alexander
This is a strong claim. It would be easy to round Hanson’s position off to something weaker, like “extra health care isn’t valuable on the margin”. This is how most people interpret the studies he cites. Still, I think his current, actual position is that medicine doesn’t work. For example, he writes:
Europeans in 1600 likely prided themselves on the ways in which their “modern” medicine was superior to what “primitives” had to accept. But we today aren’t so sure: seventeenth century medical theory was based on the four humors, and bloodletting was a common treatment. When we look back at those doctors, we think they may well have done more harm than good.
When we look at our own medical practices, however, we tend to be confident we are in good hands, and that the money that goes to buying medical care–in 2020, it was 19.7% of our G.D.P. –is well spent. Most of us know of a family member who credits their life to modern medicine. My own dad said this about his pacemaker, and I, too, am a regular customer: I’m vaccinated, boosted, and recently had surgery to fix a broken arm.
We believe in medicine, and this faith has comforted us during the pandemic. But likewise the patients of the seventeenth century; they could probably also have named a relative cured by bloodletting. Yet health outcomes are typically too random for the experience of one family to justify medical confidence. How do we know our belief is justified?
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