Re: Is Medicine Healthy?

The Baileys (
Sat, 03 Apr 1999 15:58:05 -0500

Robin Hanson wrote:

>Amazingly enough, researchers have yet to measure a significant aggregate
>effect of medicine (doctors, etc.) on health.

>The studies that have looked at the aggregate health effect of medicine as
>typically practiced, averaging over all the things doctors do, have no
>found a significant effect.

>And it must surely give
>pause to those who hope that medicine will soon give us dramatically
>expanded life spans.

Some excellent points, however, before we scrutinize medicine, it might be better to begin with health care in general. Can we measure a discernable effect of health care availability and services on the longevity and health of a population? I don't have the data readily available but my understanding is that the increase in average lifespan of the population of the United States and other countries with relatively high availability of modern health care services is significantly higher than that of many Third World countries without such health care services. However, this does not necessarily mean health care is the primary driver of this trend. Generally, countries with robust health care systems are more educated and wealthier than less advantaged countries.

One way to test the importance of health services would be to take a group of people within the United States that does not utilize health care services (e.g., Christian Scientists) and compare them to a sample of those who do. It would be a complex task since there are probably other lifestyle factors that might contribute to lifespan effects within each group. It would be more interesting if we completely eliminated health care for a five year period and observed the effect on lifespan and death incidents in general. Certainly, there would be instances of increased death (e.g., childbirth, cancer victims, heart disease, etc.) However, there could be ameliorative effects from freeing 14% of the GDP to be spent on education, hunger, research, and other areas that might increase longevity (not that I'm naive enough to think that all of this money would be allocated to such endeavors)

As far as medicine is concerned, its obvious that it can provide immediate, short-term benefits. The relief that medicine provides from symptoms of different maladies is real. While the "mind over body" effect is relevant, it is doubtful it applies to my children who also experience relief from symptoms. Given that my two year old acts as if medicine were the plague when we attempt to give it to her nixes the "mind over body" effect as a way to discount the validity of all medicine. There might be come minimal lifespan effects to this short-term relief. The toll a sickness might take on your system if allowed to "run its course" might take some time off your lifespan. Additionally, the stress I would go through if I had to endure my children dealing with a particularly nasty flu virus without the assistance of antibiotics might shorten my own lifespan in some way. I don't know what the aggregate effects of medicine is over an entire life but I suppose any increase is a good thing. Whether we could spend 14% of the GDP to increase lifespan in a more effective and efficient manner is question that should be asked but I don't know the answer to it.

Doug Bailey