“The sum of statistical lives saved vastly exceeds the number of actual lives.
Think of all the things that have saved your life. Every breath you take, every heartbeat, every car and lightning bolt that didn’t hit you. Yet, you’re only alive once. Even if we restrict ourselves to the effects of government programs, the total statistical lives saved by all programs is far greater than the population.
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Wyse and Meyer only show one side of the ledger—the reduction in mortality among people who gain Medicare eligibility. On the other side are the statistical lives lost from the people the money is taken from, or the programs cut.
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Counting statistical lives saved or lost is a debased currency, because it counts each actual life multiple times. And citing only the good side of the ledger makes it impossible to evaluate.
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after the Medicaid expansion, total expenditures increased by more than $1 trillion. That spending also costs statistical lives
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the money could have remained in taxpayers’ bank accounts, which also could promote good health. Mortality declines with income. Even if the Medicaid expansion were a cost-effective way to improve mortality, you have to consider the other side of the ledger.
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The lifesaving medical measures with the biggest impact, such as vaccinations and antibiotics, are relatively cheap. The Medicaid expansion may have relieved financial stress and made the program’s beneficiaries more physically comfortable, which are better criteria for evaluating its impact.
Now consider the 2013 NEJM study trumpeted by conservatives, which examined various health measures. It found that Medicaid enrollment resulted in large and statistically significant improvements in patients’ subjective estimates of their health and quality of life, as well as significant reductions in their financial stress. But it did not find a statistically significant impact on mortality.
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The two studies are more valuable in combination than individually. The NEJM study had the advantage of random assignment and detailed individual data. The NBER paper had a much larger sample size and time interval. Both found significant benefits to Medicaid recipients, although they did not establish that these benefits were any greater than could have been obtained by simply giving each recipient several thousand dollars per year. Neither study convincingly answered whether Medicaid improved health or saved statistical lives.”
Work requirements on Medicaid will rob many people of health insurance because many will fail to do the burdensome paperwork to prove they are working.
Doctor has seen people die from preventable ailments because the people couldn’t afford to get care.
“Kennedy has politicized the U.S. vaccine approval process by summarily firing all 17 members of the Advisory Committee on Immunization Practices (ACIP)”
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“Typically appointed to four-year terms, Kennedy has taken the unprecedented step of prematurely sacking the entire panel. Two days later, he announced his selection of eight new members, many of whom are chiefly famous for espousing contrarian views with respect to vaccine safety and efficacy.
So what did Kennedy find wrong with the original ACIP panel? The secretary asserted that it “has been plagued with persistent conflicts of interests” stemming from members’ “immersion in a system of industry-aligned incentives and paradigms that enforce a narrow pro-industry orthodoxy.” At least in his Journal op-ed, the secretary offers no evidence of any unreported or improper conflicts of interest among those he just fired. It is worth noting that the fired ACIP members were vetted before they were appointed and that they each declare any conflicts that later emerge before each of the committee’s meetings.
What about RFK Jr.’s vague claims hinting at nefarious “immersion in a system of industry-aligned incentives and paradigms” on the part of committee members? If your automobile keeps stalling out, you take your jalopy to a trained mechanic for diagnosis and repair. If your computer system has been hacked, you seek help from qualified computer engineers. You earnestly hope that your mechanics and computer engineers are fully immersed in their respective systems of industry-aligned incentives and paradigms—that is, you hope they are experts who know what they are doing.”
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“The HHS secretary gives his game away when he characterizes his wholesale firing as being “above any pro- or antivaccine agenda.” With respect to his new ACIP appointees, Kennedy promised that “none of these individuals will be ideological anti-vaxxers.” That’s great. After all, an anti-vaccine agenda makes as much sense as anti–automobile repair or anti–computer debugging agendas. The agendas we want are pro–making cars run, pro–computers correctly ciphering, and pro–vaccines that protect against diseases.
However, in looking over the backgrounds of the new ACIP members, several of them can be fairly characterized as being at least anti-vaxxer-adjacent.”
“Tillis — who voted against the bill in a key procedural vote Saturday night and announced Sunday he would not run for reelection — delivered a scathing rebuke of the president’s agenda-setting bill in a Senate floor speech, explaining his position and pledging to withhold his vote unless his concerns about drastic cuts to Medicaid are addressed.
“What do I tell 663,000 people in two years or three years, when President Trump breaks his promise by pushing them off of Medicaid because the funding’s not there anymore, guys? I think the people in the White House … advising the president are not telling him that the effect of this bill is to break a promise,” Tillis said in his floor speech.”
“When you effectively give every prospective medical student a limitless pile of money to draw from, colleges are incentivized to hike costs. If we want to make medical school more affordable, the first step should involve actually incentivizing medical schools to stop overcharging students.”
“numerous studies going back to the year 2000 all indicate there is no particular reason to fear cell phones as a cause of cancer, and a new paper by Li Zhang and Joshua Muscat of the Department of Public Health Sciences at Pennsylvania State University examines the most up-to-date data from the United States to examine this question as if for the first time.
Most studies on this question so far have been case-control studies. This type of study is subject to biases (information bias and selection bias) because it selects subjects who already have the disease of interest (in this case, brain cancer). Although prospective studies avoid the biases inherent in case-control studies, they are expensive and difficult to carry out, especially for rare diseases such as brain cancer.
But now researchers can take advantage of the exponential increase in exposure to cell phones since their introduction in the mid-1980s. In the space of several decades, humans have gone from having no exposure—zero percent of the population exposed—to nearly universal exposure. This means that we can take advantage of what is referred to as a “natural experiment,” the approach that Li and Muscat take in their illuminating new study.
An earlier analysis of this type was carried out by the National Cancer Institute. That study showed no evidence of an association between cell phone use and cancer, but the data only went up to 2012. Possibly cell phones had not been in use long enough for an effect to show up. Li and Muscat extend the period of observation by nine years.
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The authors conclude that “these findings suggest that mobile phone use does not appear to be associated with an increased risk of brain cancer, either malignant or benign.””
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“in the face of this evidence, RFK Jr. insists on propagating this debunked claim, and he is sponsoring a study by a discredited researcher that he hopes will provide the answer he favors. This is an unforgivable waste of money that could be spent on addressing an important health issue. But it is also more than that.
From observing RFK Jr., and those he appeals to, we see that the belief in different bogus claims tends to be correlated. A belief that cell phones are causing cancer or that vaccines cause autism can serve as a sentinel indicator of the susceptibility to other false beliefs, such as those targeting pesticides and genetically engineered crops. It’s noteworthy that the prominent anti-biotech advocacy organization U.S. Right-to-Know is anti-vaccine in addition to being fiercely against glyphosate and other pesticides and genetically modified crops.
These, and many others, are zombie risks that never die. It doesn’t matter what the specific risk is. The credulity, the failure to take any commonsense evidence or distillations of the scientific evidence into account, the refusal to value the judgment of experts who have spent untold hours examining the issue, or the conclusions reached by institutions such as the National Institutes of Health, the Institute of Medicine, or the American Cancer Society, into account are the same.
RFK Jr. appears to have an implacable drive to do away with vaccines by undermining public confidence, disrupting insurance coverage, and making it too costly for pharmaceutical companies to produce them, as happened in the 1980s. Exposing his lies is literally a matter of protecting the lives of children and adults from the all-too-real infectious diseases that RFK Jr. doesn’t believe in.”
“Anyone following the rise of Robert F. Kennedy Jr.’s Make America Healthy Again movement can’t help but recall former First Lady Michelle Obama’s efforts to improve Americans’ diets — and the vitriol she faced in response.
Now, many of the same Republicans who skewered Michelle Obama as a “nanny state” warrior have embraced the MAHA movement.”
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” Kass said he was happy to find common ground with Kennedy and his MAHA brigade where possible. But he argued Kennedy’s HHS has done little to actually improve the health of the public so far, and was instead mostly taking steps that would do real damage, including by undermining the use of vaccines.”