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 satisfaction. 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 http://hanson.berkeley.edu/ 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. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=11992