I believe him when he says he doesn’t think all medicine is worthless, but there are definitely a lot of moments where it seems like he’s trying to downplay eve

I believe him when he says he doesn’t think all medicine is worthless, but there are definitely a lot of moments where it seems like he’s trying to downplay even clearly effective medical treatments as having uncertain effectiveness (e.g., cancer treatment) or not really medicine (like glasses), so I don’t really blame Scott Alexander for interpreting his position as close to “no medicine is effective.” (Edit: or you from suspecting ulterior motives.) And yeah, while I think these insurance and medical spending studies merit further consideration and follow-ups, there are a lot of factors which Scott Alexander points out beyond whether medicine works even if they are RCTs. The elephant in the room with people questioning public healthcare or public education is that wealthy people will always be able to easily access private replacements and many middle class families will be able to cobble the funds together, so the main people losing out will be the poor.