Self-recommending

by on April 19, 2011 at 7:14 am in Books, Economics, Uncategorized | Permalink

Poor Economics: A Radical Rethinking of the Way to Fight Global Poverty, by Abhijit Banerjee and Esther Duflo.

More Than Good Intentions: How a New Economics is Helping to Solve Global Poverty, by Dean Karlan.

Both are about the randomized control movement in development economics.  Here is my earlier post on RCTs in development economics.

ad*m April 19, 2011 at 12:10 pm

Now, how about RCTs in the US to determine what are the ‘best’ – most cost-effective, highest patient satisfaction – health care systems?

In other words, allow states to choose from the different proposed systems, including vouchers, single payer, fully free market, etc, so we can look at the outcome of different systems and pick the best?

Why limit this to developmental economics, we could do it right here and now…

Oh I forget…

mulp April 20, 2011 at 1:00 am

ACA provides a means for each State to implement their own universal coverage health care system. The date such plans are slated to be approved is 2017 or later,but Vermont and some others are asking Congress to move up the date to 2014.

Vermont legislators are investigating a single payer system covering everyone by 2014; I believe they are considering incorporating Medicare. Mass is seeking to have its current universal system be approved with minor changes and modified waivers to convert its current Medicaid and other Fed aid grants into the ACA grants and income subsidies. The 2017 date was based on an early draft of an amendment from a Western State Senator which wanted to develop their own State system based on current work done in the State, but when it was added,the 2017 date wasn’t changed to 2014 so a State could immediately implement it.

ACA includes funding for pilot programs which States or an administration could direct to RCTs, though the Republicans are trying to strip that funding; some funding was stripped from ACA but I believe that was money for States to research their State plans, but a number of the States didn’t request the funding, signalling they want the Federal government to setup insurance exchanges for them.

But this diversity of “trials” only seems random, but is hardly a random trial. The States most interested in the most reform of their health care are the States most convinced they can greatly improve quality at lower costs and are the most committed to seeing the systems work. If you look at the health care systems of the several dozen nations with universal coverage, they all get better outcomes at much lower costs than the US, and are fully committed to universal coverage.

Which does suggest the reason RCT’s can be used for health care systems – if you need to be committed to the system for it to work, you need to understand and accept the design decisions, but if the system is dictated by random lot, you don’t have the choice associated with understanding and accepting, and thus have no responsibility for its success.

k April 19, 2011 at 1:38 pm

won’t comment on the books – ha ha – but wish to point out a logical puzzle:

when tyler says something is self-recommending, it automatically becomes non-self-recommending.

unless tyler is a liar, in which case, it is “tyler recommending”.

but if tyler is a liar, something that is “tyler recommending” is a worthless statement.

given a positive opportunity cost to blog posting, it cannot be sensible for tyler to pronounce worthless statements.

so it must be self-recommending and tyler tells the truth! in which case, we are back to square one…

Rahul April 19, 2011 at 3:39 pm

Are RCT’s in Economics the next bubble? Too much hype, methinks.

cegonsoft April 20, 2011 at 3:43 am

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cegonsoft April 20, 2011 at 3:44 am

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Lee April 27, 2011 at 10:53 am

@Rahul – lots of hype but still far from dominant. The majority of aid spending still goes on projects that have not been evaluated and have unclear impact.

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