Preference for Ignorance

Yesterday, I had a Tech Central Station column that said:

In the fields of health care, education, and assistance to poor countries, we rarely measure value properly. It seems as though we prefer to be ignorant about what succeeds and what fails. We know shockingly little about the cost-effectiveness of very expensive programs.

And today, the New York Times reports:

Some medical experts say Elyria’s high rate of angioplasties — three times the rate of Cleveland, just 30 miles away — raises the question of whether some patients may be getting procedures they do not need or whether some could have been treated just as effectively and at lower cost and less risk through heart drugs that may cost only several hundred dollars a year. Or whether, in some cases, patients might be even better off with bypass surgery — even though a bypass is a riskier, more invasive and more expensive procedure.

When it comes to treating blocked arteries, there are no definitive studies showing which approach most benefits patients in the long term.

The absence of cost-benefit analysis in medical decision-making is one of the main issues raised in my new Cato book Crisis of Abundance. On Tuesday, August 29th, Cato will be having a lunch forum on the book, where you can hear me as well as comments from Washington Post columnist Sebastian Mallaby and Democratic wonk Jason Furman.