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Michael_S comments on Cost-effectiveness analysis: drug liberalization holds promise as a mental health intervention - Effective Altruism Forum

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Comment author: Michael_S 14 September 2017 10:52:08PM *  5 points [-]

Hey; I made some comments on this on the doc, but I thought it was worth bringing them to the main thread and expanding.

First of all, I'm really happy to sea other EAs looking at ballot measures. They're a potentially very high EV method of passing policy/raising funding. They're particularly high value per dollar when spending on advertising is limited/nothing since the increased probability of passage from getting a relatively popular measure on the ballot is far more than the increased probability from spending the same amount advertising for it.

Also, am I correct in interpreting that you assume 100% chance of passage in your model conditional on good polling? Polling can help, but ballot measure polling does have a lot of error (in both directions). So even a popular measure in polling is hardly guarantee of passage (http://themonkeycage.org/2011/10/when-can-you-trust-polling-about-ballot-measures/).

Finally, in your EV estimates, you seem to be focus on the individual treatment cost of the intervention, which overwhelms the cost of the ballot measure. I don't think this is getting at the right question when it comes to running a ballot measure. I believe the gains from the ballot measure should be the estimated sum of the utility gains from people being able to purchase the drugs multiplied by the probability of passage; the costs should be how much it would cost to run the campaign. On the doc, you made the point that Givewell doesn't include leverage on other funding in their estimates, but when it comes to ballot measures, leverage is exactly what you're trying to produce, so I think an estimate is important.

Comment author: Milan_Griffes 15 September 2017 01:54:09AM *  1 point [-]

Thanks for the comments!

am I correct in interpreting that you assume 100% chance of passage in your model conditional on good polling?

No, the best-guess input is an 80% chance of passage, conditional on good polling and sufficient funding (see row 81). What "good" means here is a little underspecified – an initiative that polls at 70% favorability would have a much higher probability of passing than one that polls at 56%.

you seem to be focus on the individual treatment cost of the intervention, which overwhelms the cost of the ballot measure.

Right. You could think of this analysis as trying to model whether psychedelic treatments for mental health conditions would be cost-effective if they were available today. For example, consider a promising intervention that would entirely cure someone's depression for a year, but costs $10,000,000 per treatment. We probably wouldn't want to run a ballot initiative to increase access to such a intervention, as it wouldn't be cost-effective even if it were easily accessible.

Comment author: Michael_S 15 September 2017 02:48:50AM 0 points [-]

Cool; had missed that row. Yeah, if it polls, 70% the chance of passage might be close to 80%. Conditional upon that level of support, your estimate seems reasonable to me (assuming the ballot summary language would not be far more complex than the polled language).

Yeah, I agree that it being an effective treatment is a necessary precursor to it being a good ballot law to pass by ballot initiative and part of the EV calculation for spending money on the ballot measure itself.

Comment author: Peter_Hurford  (EA Profile) 14 September 2017 11:45:00PM 1 point [-]

I believe the gains from the ballot measure should be the estimated sum of the utility gains from people being able to purchase the drugs multiplied by the probability of passage; the costs should be how much it would cost to run the campaign. On the doc, you made the point that Givewell doesn't include leverage on other funding in their estimates, but when it comes to ballot measures, leverage is exactly what you're trying to produce, so I think an estimate is important.

One potential way of thinking about this is that the ballot measure in itself does not accomplish much, it just "unlocks" the ability for people to more cheaply help themselves. This could be modeled as the costs of the ballot measure + the costs of people helping themselves over a stream of X years, put against the benefits of people helping themselves over X years. I would use 5 for X, assuming that a lot can change in 5 years and maybe drug legalization would happen anyway, but I think a higher value for X could also be justified.

This kind of (costs of unlocking + costs of what is unlocked over time) vs. benefits of what is unlocked over time is also how I model the cost-benefit of developing a new medicine (like a vaccine), since the medicine is useless unless it is actually given to people, which costs additional money.

Comment author: Michael_S 14 September 2017 11:52:15PM 1 point [-]

That seems similar to Milan_Griffes' approach. However, when we're comparing ballot measures to other opportunities, I think the relevant cost to EA would be the cost to launch the campaign. That's what EAs would actually be spending money on and what could be spent on other interventions.

We don't have to assume away the additional costs of getting the medicine, but that can be factored into the benefit (ie. the net benefit is the gains they would get from the medicine - the gains they lose from giving up the funds to purchase the drugs)