From: Robin Hanson (hanson@econ.berkeley.edu)
Date: Sat Apr 03 1999 - 10:25:22 MST
Curt Adams writes:
>I do recall a study (sorry, can't find the reference) of Christian Scientist,
>who refuse most medical treatment. The study found that the loss of medical
>treatment reduced their lifespan about 7 years.
Let me know if you recall more about the cite.
>I would suspect that medical care that really makes a difference probably gets
>to almost anybody. Added money would mostly go to optional or speculative
>treatment; that might well not improve mortality.
But maybe most treatment is optional or speculative. If so, maybe we could
spend 1/3 what we do now and be just as healthy.
>It's implausible that the medicine we get (as opposed to additional treatment
>we don't normally get) doesn't help. People get things like appendicitis,
>pneumonia in the young, and gangrene which were major risks in the past
>but >very rarely die of them.
Sure we are lots healthier now than in the past. The question is how much
credit medicine deserves for that. Lots of other things have changed besides
medicine.
>> A recent analysis of 5
>> million Medicare patients, using regional spending variations of a factor
>> of two (controlling for lots of stuff), found that any mortality benefit of
>> spending in the last six months of life is less than a one part in a
>> thousand.
>
>That sounds like a biased sample. People who die within six months are
>people for whom treatment has failed. If medical treatment works, they
>won't show up in the sample. Am I missing something?
It is a random sample of all Medicare patients. It looks at 5000 hospital
regions in the country, and predicts total mortality in each region from
a long list of features, one of which is how much is spent there in the
last six months of life. I gave the URL for it - take a look for yourself:
http://nberws.nber.org/papers/W6513
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