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Wei_Dai comments on Open Thread, September, 2010-- part 2 - Less Wrong
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In the case of infectious diseases, there are large unpriced negative externalities involved. Everyone doing what is individually rational, given true beliefs about transmission rates, is likely not socially optimal, because the expected individual cost of a risky action is less than the expected social cost. Giving people false beliefs about transmission rates can improve social welfare by shifting the expected individual cost closer to the expected social cost.
Are you talking about free rider problems with health care costs under a partly or fully socialized health care system or something else? STDs seem to be less of a problem than more easily transmitted diseases like flu for most negative externalities I can think of.
And also, if you take some risky action that increases your chances of get infected, that also increases the chances of everyone else getting infected (causally, via yourself getting infected and then infecting others).
I'm not sure I get your point here. Whether it's more or less of a problem doesn't seem relevant to the original claim that spawned this subthread.
It's relevant to using your negative externality argument to support the original claim. To be consistent you would have to argue that we should make even more effort to avoid spreading the idea that airborne diseases like flu have low transmission rates (if true) than the idea that STDs have low transmission rates. Are you advocating a general policy of deliberately misleading people about the risks of various activities in an effort to correct for negative externalities? I'm pretty sure more efficient and robust approaches could be found.
It would be consistent with Wei Dai's claim just to argue that we should make an effort to not reveal how low the transmission rate of influenza is among people who don't wash their hands; we know that hand-washing is a large factor in transmission, but actual transmission rate numbers are still low enough to fail to convince people to wash their hands.
From a brief study of those particular numbers (I worked on a team modeling the spread of H1N1), I feel like we already mislead the public about the numbers themselves by being truthful as to the societal benefits and somewhat optimistic about the individual benefits of hand washing. If you believe more robust methods are more efficient, by all means, advocate for them, but I'm reasonably happy with the current situation.
From another perspective, blood-borne pathogens are particularly worth focusing on because they are easier to control. If we could encourage the entire population of the world to behave safely (not reuse needles, use condoms for sex, etc.), it would be a fairly minor change for individuals, but could eradicate or nearly eliminate HIV over time. With the flu, safe behavior will limit the damage of seasonal infections, but it's not realistic to actually eliminate the virus. Thus, over the long term, I think the negative externalities of HIV might outweigh those of influenza.
I think government policy makers and public health authorities already use a variety of approaches to reduce negative externalities related to infectious diseases, including subtle misinformation, such as making efforts to correct people's beliefs about transmission rates when they are too low, but not when they are too high (anything really obvious wouldn't work in a free society like ours). But it seems clear that large negative externalities still exist. What other approaches do you have in mind, and why haven't they thought of it already?
I think we're starting from quite different assumptions about how society works. I don't believe that government policy makers or public health authorities are very rational. Even to the extent that they are rational, I don't believe that their incentives are such as to reliably lead them to decisions that maximize utility by the kind of utilitarian calculus you seem to be assuming. So to the extent that we agree negative externalities exist (and I suspect we differ a fair bit on what they are and to what extent they exist) I have very little expectation that government policy makers or public health authorities will tend to take actions that minimize them.
What did you mean when you said "I'm pretty sure more efficient and robust approaches could be found"? You're not offering any concrete ideas yourself, and apparently you weren't thinking of government health authorities when you wrote that, so who is supposed to find and apply these approaches?
Think 'market based'. Internalize negative externalities. To a first approximation this usually means reducing government involvement rather than increasing it. This is straying into politics though so maybe we should avoid further discussion of this topic.
Compared to the rest of this open thread, I don't think you have anything to worry about!
Seriously though, I think we'd both like to hear you elaborate upon your market-based idea. I don't think I got any useful information out of your blurb.
Let me first clarify the points I was making in this thread (which were not intended to lead to a debate about healthcare or politics in general). If you still feel we have substantive disagreements that we might be able to resolve through more explicitly political discussion I'm willing to continue the conversation unless there are strong objections from others.
First my points were not intended to imply any particular opinion on AIDS transmission rates specifically. My initial post was simply intended to point out that the utility of spreading the idea that AIDS transmission rates are low is dependent on the truth of the claim.
This was intended to be a more general point that exaggerating the risks of any particular activity is not a good general policy. In the AIDS case there are genuine costs to taking precautions against transmission, even if they are in fact greatly outweighed by the benefits. In a hypothetical world where transmission rates are negligible, maintaining that they are high would have negative utility.
Wei Dai responded by claiming that because of negative externalities associated with infectious diseases, exaggerating the transmission rate can improve social welfare. Now this is not incompatible with my original point, it is rather a claim of a mechanism by which exaggerating the risks of an activity can have positive utility. It is probably worth noting at this point that I am not a utilitarian so I am likely to disagree with utilitarians on what outcomes have positive utility but we can probably agree that in general internalizing negative externalities is a good thing.
I concede that it is possible in theory to imagine a situation where deliberately exaggerating risks has positive utility. The fun thing about negative externalities though is that it is very easy for an intelligent person to think of some and to propose plausible mechanisms by which any given action can be justified. I could easily argue for example that the credibility of science and scientists is undermined when they are caught making false claims and that the negative utility resulting from this outweighs any positive utility from individual acts of well intentioned deception.
Ultimately though I have what you might call a deontological normative belief about science that it should always pursue the truth and leave the task of judging when to strategically lie to others. I also suspect that this is a winning strategy for agents with imperfect powers of prediction but that is mere supposition.
Regardless, if negative externalities associated with infectious diseases are the real concern I'm pretty confident that you'd start with much higher expected value actions than lying about the facts in an effort to influence individual choices. If individuals are not bearing the full costs of their actions then there are more direct ways of changing their incentives such that the costs are better reflected than trying to influence their beliefs away from the truth by spreading false facts. This is the point at which I'd start to get into the politics of healthcare however and I don't particularly want to do that here.
I think you're on to something, but wouldn't that cause officials to overstate transmission rates rather than understate them?
What is especially strange to me is that the government pushed a fear campaign for HIV and promoted as a dangerous STD for the mainstream hetero community, but neglected to double-check their official statistics, which rather clearly destroy the STD theory. Perhaps it's just an honest mistake, but I don't think so. From what I have read, they have spent time trying to get honest statistics. So they overpromoted the STD message, regardless of the actual statistics.
Regardless of what HIV actually does or is, public campaigns to reduce needle sharing and reduce unprotected sex are probably net public goods.
However, on the other hand, if AIDS is really caused by drug toxicity, then at least some people are actively being harmed by spending energy in the wrong protections.
But I agree with your central point, and it applies to vaccines especially - they don't really have much of an individual benefit, but if enough people can be convinced to vaccinate, the entire epidemic can be curtailed or completely avoided.