The reason I bring up this analysis is to demonstrate that even defensible decisions can have wrenching emotional consequences. Belichick's call might have been statistically correct, but it felt horribly wrong.
And this kind of contradiction isn't just relevant for football coaches. Just consider health care: the only way we're ever going to reduce medical costs is to restrict procedures that haven't passed evidence-based efficacy tests. Maybe that means 40 year old women don't get mammograms, or that we treat prostrate cancer less aggressively, or that we stop performing spinal fusion surgeries. Although there's solid evidence to question all of these medical options, such changes provoke intense debate. Why? Because our emotions don't understand statistics. Because when we have back pain we want an MRI. Because when it's our father with prostate cancer we want the most aggressive possible treatments. And so on.
The point is that there's often an indefatigable gap between the rigors of cost-benefit analyses and the emotional hunches that drive our decisions. We say we want to follow the evidence, but then the evidence rubs against a bias like loss aversion, and so we make an exception. We'll follow the evidence next time.
Wednesday, November 18, 2009
Health Care on 4th and 2
Here's a wonderful little post about what Bill Belichick's controversial decision in the Patriots-Colts game the other night shows us about rationality and human emotions, particularly as they relate to the health care issue:
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I'm a little curious, how are those examples statistically questionable? I suppose there might be alternatives that weren't mentioned, but the way it's worded it seems like they alternative for those procedures is to do nothing. I consider myself to be fairly rational, and if I'm wrong about the above assumption let me know, but with talk like that I don't know if I can really blame the people who freak out and claim the government will 'let them die' when their disease is looked at in a cost-benefit way.
ReplyDeleteKeep in mind I have the added emotion of having back problems myself (which have been killing me tonight), as well as the fact that my aunt has been helped greatly by a successful spinal fusion. But I think if universal health care has any hope of taking place in America, they must find a way to keep 95% (at least) of the current available procedures in place or have a similar replacement, or else people will never buy the idea. I personally could deal with taking away something like spinal fusions, even if I one day might need it to get rid of the discomfort I'm feeling, but when you get into things like cancer it's gonna be a suicide mission for reform.
In terms of statistics (i.e. the main point of your post, which I've strayed from), I think it's a valid idea, but when it comes to life and death it's an impossibly big pill for people to swallow. I don't know if I can expect people with prostate cancer to 'look at the big picture' and forgo treatment for the (financial) good of the whole. Again let me know if I'm misreading the excerpt, but my question is what are the alternatives?