More Medicine Doesn't Improve Health?

I just read this article by Robin Hanson in which he claims:

Quote:

But health policy experts know that we see at best only weak aggregate relations between health and medicine, in contrast to apparently strong aggregate relations between health and many other factors, such as exercise, diet, sleep, smoking, pollution, climate, and social status. Cutting half of medical spending would seem to cost little in health, and yet would free up vast resources for other health and utility gains. To their shame, health experts have not said this loudly and clearly enough.

He references several studies, including this one:
https://www.rand.org/pubs/reports/R3055.html

Here's what he says about it:

Quote:

From 1974 to 1982 this experiment spent about $50 million to randomly assign over two thousand non-elderly families in six U.S. cities to three to five years of a specific medical price, ranging from free to full price, provided by the same set of doctors. (See the 1983 Brook et. al. New England Journal of Medicine article, and the 1996 Newhouse et. al. book Free for All?) The experiment’s random assignments allowed it to clearly determine causality. Being assigned a low price for medicine caused patients to consume about 30% (or $300) more in per-person annual medical spending, though less for hospital spending and more for dental and “well care.” The RAND experiment was not quite large enough to see mortality effects directly, and so the plan was to track four general measures of health, combined into a total “general health index,” and also 23 physiological health measures. Their main result: “For the five general health measures, we could detect no significant positive effect of free care for persons who differed by income … and by initial health status.” This summary isn’t fully forthcoming, however. At a 7% significance level they found that poor people in the top 80% of initial health ended up with a 3% lower general health index under free medicine than under full-priced medicine.

He goes on, so I recommend people to read the article (he also discusses other studies).

The bottom line seems to be that when medicine was free people took advantage of that and got more treatment, but health didn't improve as a result.

For instance, here's his discussion of another study:

Quote:

Regions that paid more to have patients stay in intensive care rooms for one more day during their last six months of life were estimated, at a 2% significance level, to make patients live roughly forty fewer days, even after controlling for: individual age, gender, and race; zipcode urbanity, education, poverty, income, disability, and marital and employment status; and hospital-area illness rates. This same study, using the same controls, also estimated that a region spending $1,000 more overall in the last six months of life gave local patients somewhere between a gain of five days of life and a loss of twenty days of life (95% confidence interval). (I’m using a fifty days lost per 1% added mortality rule of thumb.)

A few notes: I wasn't sure where to put this thread, but since it relates to medicine I figured this would be the best subforum. I also don't claim any knowledge on this topic, but found the article both interesting and counter-intuitive so thought it might be worthwhile for discussion here. Finally, the article is from 2007, but I just read it now, and I don't think that it's age is particularly meaningful.

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