X-Message-Number: 11992
Date: Wed, 23 Jun 1999 11:47:04 -0700
From: Robin Hanson <>
Subject: Why Cryonics Isn't Popular (Maybe)

A cryonet reader privately questions my claim that medicine has 
a low marginal value.  

The clearest evidence we have on this is the RAND Health Insurance 
Experiment [Newhouse et al, "Free for All?" '93].  From  74- 82 ~2000 
families were randomly assigned different levels of health insurance 
copayment.  Those given free care spent (but did not pay for) 25-30% more.  
They wore more glasses and had more teeth filled.  But beyond that no 
significant differences were observed in deaths, self-reports of health, 
physical functioning, 20 physiologic measures, health practices, and 

One disputed borderline-significant difference was lower blood pressure.  
Assuming it was a real effect, they estimated that free care reduced 
mortality by 1%.  That extends lifespan by 7 weeks, which is less than the 
"reduced activity days" free care folks suffered from dealing with the 
medical system.  This contrasts with effects of ~3,6,14,15 years of 
lifespan respectively which is may be attributed to smoking, city vs. 
rural life, income, and exercise [Lantz et. Al. JAMA 6/3/98].

The results of this experiment are consistent with most other studies 
on this topic.  While the medical literature is full of randomized trials
indicating large benefits when best practice is applied to the patients
deemed most likely to benefit, the marginal benefit of average practice
on average patients seems to be very close to zero.  

Robin Hanson  
RWJF Health Policy Scholar             FAX: 510-643-8614 
140 Warren Hall, UC Berkeley, CA 94720-7360 510-643-1884    
after 8/99: Assist. Prof. Economics, George Mason Univ. 

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