= 27d567bc2d48d9f40e9ccc20ea370b15)
adamzerner comments on Open Thread, Jun. 22 - Jun. 28, 2015 - Less Wrong
You are viewing a comment permalink. View the original post to see all comments and the full post content.
= 783df68a0f980790206b9ea87794c5b6)
Loading…= b715d02e85f7b3b4ae65ca3d3e450868)
Subscribe to RSS Feed
Powered by Reddit
= f037147d6e6c911a85753b9abdedda8d)
You are viewing a comment permalink. View the original post to see all comments and the full post content.
Comments (203)
I'd say an expert in any field has better intuitions (hidden, unverbalized knowledge) than what they can express in words or numbers. Therefore, I'd assume that the decision that it's not worth doing the examination should take priority over the numerical estimate that he made up after you asked.
It may be better to ask the odds in such cases, like 1 to 10,000 or 1 to a million. Anyway, it's really hard to express our intuitive, expert-knowledge in such numbers. They all just look like "big numbers".
Another problem is that nobody is willing to put a dollar value on your life. Any such value would make you upset (maybe you are the exception, but most people probably would). Say the examination costs $100 (just an example). Then if he's 99.95% sure you aren't sick, and 0.05% sure you are dying and sends you home, then he (rather your insurance) values your life at less than $200,000. This is a very rough estimation, but it seems in the right ballpark for what a general stranger's life seems to be valued by the whole population. Of course it all depends on how much insurance you pay, how expensive the biopsy is etc. Maybe you are right that you deserve to be examined for your money, maybe not. But people tend to avoid this sort of discussion because it is very emotionally-loaded. So we mainly mumble around the topic.
People are dying all the time out of poverty, waiting on waiting lists, not having insurance, not being able to pay for medicaments. But of course people who have more money can override this by buying better medical care. Depending on the country there are legal and not-so-legal methods to get better healthcare. You could buy a better package legally, put some cash in the doctor's coat, etc.
You need to consider that the people who'd do your biopsy can do other things as well, for example work on someone's biopsy who has a chance of 1% of dying instead of your 0.05% (assuming this figure is meaningful and not just a forced, uncalibrated guess).
If you confronted your doctor with these things, he'd probably prefer to just revoke that probability estimate and just say his expert opinion is that you don't need the biopsy, end of story. It would be very hard for you to argue with this.
It seemed to me that the proposition was made under false assumptions. Specifically, I value my life way more than most people do, and I value the costs of time/money/pain less than most people do. He seemed to have been assuming that I value these things in a similar way to most people.
Yeah, I understand this now. Previously I hadn't thought enough about it. So given that I am willing to spend money for my health, and that I can't count on doctors to presume that, it seems like I should make that clear to them so they can give me more personalized advice.
"Willing to spend money" meaning that you're willing to pay out of pocket for medical procedures? Or that you are willing to fight your insurance so that it pays for things it doesn't think necessary?
And doctors are supposed to ignore money costs when recommending treatment (or lack of it) anyway. If you want "extra attention", I suspect that you would need to proactively ask for things. For example, you can start by doing a comprehensive blood screen -- and I do mean comprehensive -- including a variety of hormones, a metals panel, a cytokine panel, markers for inflammation, thryroid, liver, etc. etc. You will have to ask for it, assuming you're reasonably healthy a normal doctor would not prescribe it "just so".
I'm willing to spend out of pocket. More generally, I value my life a lot, and so I'm willing to undergo costs in proportion to how much I value my life.
You're constrained by the size of your pocket :-) Being willing to spend millions on saving one's life is not particularly relevant if you current bank balance is $5.17.
Very rich people can (and do) hire personal doctors. That, however, has its own failure modes (see Michael Jackson).
Yeah, I know. It's just hard to be more specific than that. I guess what I mean is that I am willing to spend a much larger portion of my money on health than most people are.
Is that a revealed preference? ;-)
How do you know? Because you do things like flossing every day? Healthcare economics quite frequently mean that a person prefers to pay more rather than less to signal to themselves that they do everything in their power to stay alive.
People quite frequently make bad health decisions because buying an expensive treatment feels like they do something to stay healthy will it's much more difficult emotionally to do nothing.
I understand that for a lot of people, the X isn't about Y thing applies. That investing in health might be about signaling to oneself/others something. But I assure you that I genuinely do care. Maximizing expected utility is a big part of how I make decisions, and I think that things that reduce the chances of dying have very large expected utilities (given the magnitude of death). That said, I'm definitely not perfect. I ate pizza for lunch today :/