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RAND Health Insurance Experiment critiques

5 Post author: Dustin 18 February 2012 05:52PM

I have neither the qualifications nor the access to properly understand these two paywalled critiques of the RAND Health Insurance Experiment.

Health Plan Switching and Attrition Bias in the RAND Health Insurance Experiment

The Rand Health Insurance Study: A Summary Critique

Has there been any talk about either of these on OB/LW?  If not, why not and could anyone with access to the papers make any comments about how much weight they carry?

I post this here because the RAND results are brought up so often in discussions here, I hope others find it to be an appropriate venue.

Comments (17)

Comment author: gwern 18 February 2012 07:44:30PM 12 points [-]
Comment author: CarlShulman 18 February 2012 06:44:32PM 4 points [-]

The attrition bias has been mentioned repeatedly, but I haven't seen a good response from Robin.

Comment author: Dustin 18 February 2012 07:52:17PM 4 points [-]

but I haven't seen a good response from Robin.

That is...disappointing.

Comment author: gwern 19 February 2012 01:15:40AM 9 points [-]

Robin's a ton of fun to read and he publishes some pretty good stuff - but the more I read of him, the more I get the impression he likes to look at an interesting idea (like the RAND study showing lots of medical spending to be useless) and then not do any followup or avoid confirmation bias.

Comment author: CarlShulman 19 February 2012 01:57:55AM 0 points [-]

His daily blog posts might not be the best way to assess that. It can be hard to fill that quota regularly. Do you have some other examples?

Comment author: gwern 19 February 2012 02:10:07AM 6 points [-]

Well, the majority of his apparent output is that blog, so I don't think it's unfair to point to it; and it being a blog doesn't mean he cannot cover followups and null results or results contradicting his pet theories like construal theory. If anything, those should be cheap posts to make - they have built-in interest as contradictions.

Besides that, there's... what? His papers, which I've already praised and which I point to routinely (eg. about 10 comments ago). As a professor, you'd think he'd have grad students, but in the many years I've been reading OB, I think there was just one double-post on a grad student's thesis, and he mentions his publications about as often, so either he's not publishing very much or he is remarkably modest about it.

Comment author: CarlShulman 19 February 2012 02:13:00AM *  1 point [-]

The point was that some posts get much less work than others because of the fixed pseudo-daily schedule. I agree that he tends to publicly ignore counterevidence, null results, etc. Any particular topics on the blog stand out for you?

Comment author: gwern 19 February 2012 02:23:11AM *  5 points [-]

Not off-hand; I haven't kept lists or done any explicit tests of him.

Some of his theses are so incredibly broad I'm sure there must be plenty of counter-evidence or null results, like his farmer-forager thesis, but none of them overlap with my own particular areas of interest such that I could confidently 'yes, that is clearcut confirmation bias' (like I can with some advocates of dual n-back or various supplements).

The only example I can think of right now is the topic of perpetuities/compound-interest charity: he had the thesis that they are helpful and also stymied by laws. I provided additional examples of the latter, which he happily posted to OB; I recently provided partial counter-examples to the former, the Islamic world's experience with the perpetual charities called waqfs, which he has - as far as I can tell - ignored twice now.

Comment author: CarlShulman 19 February 2012 02:26:17AM *  4 points [-]

I'm curious about the n-back confirmation bias and the evidence those folk neglected.

Comment author: gwern 19 February 2012 02:32:13AM *  8 points [-]

Oh, that's easily explained. By going through the Brain Workshop ML archives and then keeping on top of all subsequent emails, I've managed to compile a fair number of failures-to-replicate in http://www.gwern.net/DNB%20FAQ#criticism and also deeply troubling criticism of studies that were reported at complete face value in places like Wired (for Jaeggi 2008) or the Wall Street Journal (for Jaeggi 2011, which we criticized here).

And I know that the failures to replicate are not widely known because I also have a Google Alerts set up for dual n-back and I see how it's being discussed on blogs and forums, which invariably cite - if they cite anything - only the positive results. Then there are the people on the mailing list, who enjoy discussing positive results but ignore or insult the other results. (I fear Moody's essay has caused his name to be taken in vain more than once over the years.)

Comment author: CarlShulman 19 February 2012 02:42:43AM 2 points [-]

Thanks. What's your take on the claim that stereotype encouragement, along the lines of "you're part of a group that's good at math" or "this is a test that you'll be good at," can boost performance above baseline on high-stakes tests? I've heard this claimed with regard to men and Asian-Americans, but worried about publication and reporting biases.

Comment author: Khoth 19 February 2012 10:42:10AM 4 points [-]

Back when he was arguing against smoking being unhealthy, he was noticeably more reluctant to read anti-smoking papers than pro-smoking papers (eg, ignoring an anti-smoking paper because the author was a "partisan", but accepting a pro-smoking tobacco-industry-funded paper because it "looked professional")

Comment author: feanor1600 01 March 2012 01:46:07AM 1 point [-]

Without addressing the substance of the papers, I can say that in practice most health economists still think the RAND experiment is really important. Robin Hanson is not unusual in this regard, the RAND experiment was featured prominently in the 2 graduate health econ classes I have taken, and in recent textbooks and papers.

Comment author: Clarity 18 September 2015 08:47:05AM *  0 points [-]

What happens when health care providers are also health insurers? Hayen finds:

negative link between integration and costs. Regarding quality, evidence is mixed.