RAND Health Insurance Experiment
Article
RAND Health Insurance Experiment is a recurring event in the Astral Codex Ten archive, appearing 2 times across 2 issues between April 24, 2024 and April 30, 2024. The archive places it in contexts such as “III. RAND Health Insurance Experiment This is considered the canonical study on the effect of health insurance”; “How Free Care Reduced Hypertension In The RAND Health Insurance Experiment”. It most often appears alongside Karnataka, Oregon experiment, Robin.
Metadata
- Category: Events
- Mention count: 2
- Issue count: 2
- First seen: April 24, 2024
- Last seen: April 30, 2024
Appears In
Related Pages
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- Karnataka (2 shared issues)
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- Oregon experiment (2 shared issues)
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- Robin (2 shared issues)
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- Robin Hanson (2 shared issues)
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- 2008 America (1 shared issues)
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- 9-11 (1 shared issues)
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- @agoodmanbacon (1 shared issues)
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- Baicker (1 shared issues)
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- beta-blockers (1 shared issues)
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- Bloodletting (1 shared issues)
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- CATO Unbound (1 shared issues)
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- Cochrane Collaboration (1 shared issues)
External Links
Source Context
Recovered passages from the original issue text. When the raw archive preserved outbound links inside the source passage, they are listed directly under the quote.
Source here. Note that these are age-adjusted data! In 2000, a stroke victim is only half as likely to die in the first two years after their illness as they were in 1980. Here we don’t have to worry about age effects at all; the graph is already adjusted for age. You can see similar survival rate increases for other conditions like congestive heart failure (5-year survival rate went from 29% to 60% since 1970), multiple sclerosis (standardized mortality rate went from 3.1 to 0.7 since 1950), type 1 diabetes (survival rate at 50 from about 40% to 80% since 1950) and nearly any other condition you look up. I’m harping on this because it’s in some sense the central example of medicine: you get some deadly disease like cancer, and you want to know if doctors can help you survive or not. All the evidence suggests medicine has gotten much better at this in the past fifty years. Robin’s going to have a lot of hard-to-interpret studies about what happens to your cholesterol score or whatever after you change insurance, and we’ll pick these apart, but to me this seems like a much less central example of “does medicine work?” than the fact that we’re curing cancer and increasing heart attack survival rates. III. RAND Health Insurance Experiment This is considered the canonical study on the effect of health insurance. In the 1970s, RAND gave thousands of people one of five types of insurance, ranging from very bad (barely any coverage until a family reached a deductible of $1000, ie $5000 in today’s dollars) to very good (all care was free). Then they waited eight years. Then they checked whether the people on the good insurance ended up any healthier than the people on the bad insurance. The paper I found measured five questionnaire-based outcomes plus five objective physiological measures, for a total of ten outcomes (Robin says he has a book where they discuss 23 to 30 outcomes, but I don’t have that book, so I’m sticking with the paper). The ten in the paper I read were: Physical functioning questionnaire
I find it unfair to present this claim without presenting my reasoning, which is that there’s a whole other paper, How Free Care Reduced Hypertension In The RAND Health Insurance Experiment, which does various sanity checks to this result, finds that it holds up, and finds related claims with lower p-values.