I'm not sure if you've noticed, but:

6.65 THOUSAND DISEASES HAVE ZERO FDA-APPROVED TREATMENTS; AT CURRENT TRIAL CAPACITY, EXPLORING THEM TAKES ~443 YEARS. REDIRECTING 1% OF MILITARY SPENDING SCALES CAPACITY 12.3X, CUTTING THE TIMELINE TO ~36 YEARS AND PREVENTING 10.7 BILLION DEATHS. AT $0.0018/DALY, 50.3KX MORE COST-EFFECTIVE THAN THE BEST EXISTING INTERVENTIONS. INCENTIVE ALIGNMENT BONDS MAKE ADOPTION POLITICALLY VIABLE.

GOVERNMENT SPENDING IS OPTIMIZED FOR LOBBYING INTENSITY, NOT NET SOCIETAL VALUE. PROGRAMS WITH 100:1 BENEFIT-COST RATIOS GET BILLIONS WHILE PROGRAMS WITH NEGATIVE RETURNS GET HUNDREDS OF BILLIONS. INCENTIVE ALIGNMENT BONDS FLIP THIS BY CREATING A CAPITAL POOL THAT REWARDS POLITICIANS (VIA CAMPAIGN SUPPORT AND POST-OFFICE OPPORTUNITIES) FOR FUNDING HIGH-NSV PROGRAMS OVER LOW-NSV ALTERNATIVES. THE RESULT: PUBLIC GOOD BECOMES PRIVATE PROFIT FOR BOTH INVESTORS AND ELECTED OFFICIALS.

REPRESENTATIVE DEMOCRACY SUFFERS FROM AN INESCAPABLE PRINCIPAL-AGENT PROBLEM WHERE ELECTED OFFICIALS' INCENTIVES DIVERGE FROM CITIZEN WELFARE. WISHOCRACY INTRODUCES RAPPA (RANDOMIZED AGGREGATED PAIRWISE PREFERENCE ALLOCATION), WHICH AGGREGATES CITIZEN PREFERENCES THROUGH COGNITIVELY TRACTABLE PAIRWISE COMPARISONS AND CREATES ACCOUNTABILITY VIA CITIZEN ALIGNMENT SCORES THAT CHANNEL ELECTORAL RESOURCES TOWARD POLITICIANS WHO ACTUALLY REPRESENT WHAT CITIZENS WANT.

WHAT'S THE MAXIMUM COST TO ACHIEVE ANY POLICY CHANGE THROUGH LEGAL DEMOCRATIC CHANNELS? $25B FOR THE US, $200B GLOBALLY. FOR HIGH-VALUE REFORMS LIKE MILITARY-TO-HEALTH REALLOCATION, THIS YIELDS ROI EXCEEDING 400,000:1.

ONLY 15 DISEASES/YEAR GET THEIR FIRST TREATMENT EACH YEAR. WITH 6.65 THOUSAND DISEASES LACKING EFFECTIVE TREATMENTS, THE BACKLOG WOULD TAKE 443 YEARS TO CLEAR. INTEGRATING PRAGMATIC TRIALS INTO STANDARD HEALTHCARE INCREASES TRIAL CAPACITY 12.3X, CUTTING THAT TIMELINE FROM 443 YEARS TO 36 YEARS. THE AVERAGE UNTREATED DISEASE GETS A TREATMENT 212 YEARS EARLIER, SAVING 10.7 BILLION DEATHS AT $0.841 PER YEAR OF HEALTHY LIFE SAVED.

WE PRESENT THE PREDICTOR IMPACT SCORE (PIS), A NOVEL COMPOSITE METRIC OPERATIONALIZING BRADFORD HILL CAUSALITY CRITERIA FOR AUTOMATED SIGNAL DETECTION FROM AGGREGATED N-OF-1 OBSERVATIONAL STUDIES. COMBINED WITH PRAGMATIC TRIAL CONFIRMATION (BASED ON EVIDENCE FROM 108+ EMBEDDED TRIALS), THIS TWO-STAGE FRAMEWORK WOULD GENERATE VALIDATED OUTCOME LABELS AT 44.1X LOWER COST THAN TRADITIONAL PHASE III TRIALS. THIS ENABLES CONTINUOUS, POPULATION-SCALE PHARMACOVIGILANCE AND PRECISION DOSING RECOMMENDATIONS.

AFTER PROVING A DRUG IS SAFE, THE FDA REQUIRES 8.2 YEARS TO PROVE IT WORKS BEFORE PATIENTS CAN ACCESS IT. WE ESTIMATE THIS DELAY COST 102 MILLION DEATHS AMONG PEOPLE WAITING FOR APPROVED DRUGS (1962-2024). THE HUMAN COST IN DEATH AND DISABILITY OF BLOCKING GOOD DRUGS IS 3.07K:1 HIGHER THAN THE COST OF APPROVING BAD ONES.

THE OPTIMAL BUDGET GENERATOR (OBG) ANSWERS: 'HOW SHOULD WE ALLOCATE THE BUDGET TO MAXIMIZE WELFARE?' USING TWO METRICS: REAL AFTER-TAX MEDIAN INCOME GROWTH AND MEDIAN HEALTHY LIFE YEARS. UNLIKE ISOLATED SPENDING TARGETS, OBG GENERATES INTEGRATED BUDGET RECOMMENDATIONS THAT ACCOUNT FOR TRADEOFFS BETWEEN CATEGORIES. THE BUDGET IMPACT SCORE (BIS) MEASURES CONFIDENCE IN EACH CATEGORY'S TARGET.

THE OPTIMAL POLICY GENERATOR (OPG) PRODUCES SYSTEMATIC POLICY RECOMMENDATIONS FOR JURISDICTIONS AT ANY LEVEL (COUNTRY, STATE, CITY), GENERATING PRIORITIZED ENACT/REPLACE/REPEAL/MAINTAIN RECOMMENDATIONS BASED ON QUASI-EXPERIMENTAL EVIDENCE FROM CENTURIES OF POLICY VARIATION DATA.

THOUSANDS OF JURISDICTIONS HAVE MADE DIFFERENT POLICY AND BUDGET CHOICES OVER DECADES, CREATING A NATURAL EXPERIMENT. OPTIMOCRACY APPLIES CAUSAL INFERENCE TO THIS CROSS-JURISDICTIONAL TIME-SERIES DATA TO IDENTIFY WHICH POLICIES PREDICT ABOVE-AVERAGE MEDIAN INCOME AND HEALTHY LIFE YEARS. IT THEN PUBLISHES EVIDENCE-BASED RECOMMENDATIONS FOR EVERY MAJOR VOTE, TRACKS POLITICIAN ALIGNMENT, AND FUNDS ALIGNED CANDIDATES VIA SUPERPAC, MAKING SUBOPTIMAL POLICY POLITICALLY EXPENSIVE WHILE PRESERVING DEMOCRATIC STRUCTURES.

QUANTIFYING THE GAP BETWEEN CURRENT GLOBAL GOVERNANCE AND THEORETICAL MAXIMUM WELFARE, ESTIMATING A 31-53% EFFICIENCY SCORE AND $97 TRILLION IN ANNUAL OPPORTUNITY COSTS.

SYSTEMS AUDIT ESTIMATING AN ANNUAL U.S. EFFICIENCY GAP OF $4.90T, WITH $2.45T RECOVERABLE AT OECD-MEDIAN PERFORMANCE ACROSS DIRECT SPENDING WASTE, COMPLIANCE BURDEN, POLICY-INDUCED GDP LOSS, AND SYSTEM INEFFICIENCY.

A system optimized for saving lives rather than avoiding lawsuits. 50,000+ observational studies analyzed. Meta-analyses for 90%+ of condition-treatment pairs. Treatment rankings for 100+ conditions. The current FDA approval process takes 10+ years and costs $2.6B per drug. During that time, between 11,000 and 115,000 people die who could have been saved if the drug had been approved immediately. There are roughly 1.16 quadrillion possible drug combinations we haven't tested. At the current pace, we'll finish testing them all in approximately never. The dFDA could accelerate clinical discovery by 80X. Which, if my math is correct, means we could map the entire space of possible treatments in about 45 minutes.

Redirect 1% of global military spending to health research. Save 416 million lives. 700× more effective than current spending. I sent this proposal to everyone with the power to implement it. They have enthusiastically ignored me. When your last name is Sinn, you take validation wherever you can find it.

Data-driven policy analysis. Articles like 'The War on Drugs Increases Drug Deaths' and 'We Spend More on Corporate Welfare Than Social Welfare.' 2 million people read these. The policy remains exactly the same. But I made some really compelling charts and I stand by them.

A DAO focused on clinical research. That's a lot of technical jargon, so let me translate: imagine if Wikipedia and a clinical trial had a baby that was raised by blockchain. The result is a platform where anyone can contribute to medical research without needing permission from a committee of very tired people in lab coats.

An autonomous agent platform where AI tries to solve global problems. The agents are very enthusiastic. Their success rate is still being calculated. But they never sleep and they never complain, which is more than I can say for myself.

A hub for digital health intelligence. At some point I decided that having multiple platforms was a good idea. The jury is still out on this decision.

Aggregated Pairwise Preference Allocation. If that sounds like something from an economics paper written at 3 AM after too much coffee, you are correct. It's a mechanism for democratic resource allocation. Whether anyone will ever use it remains unclear. But the math is elegant and that has to count for something.

Comprehensive documentation for the War on Disease initiative. I wrote a lot of words explaining how to save 416 million lives. The manual is very thorough. The implementation remains theoretical.

The Plutonium Kidz were born of a secret government program involving the testing of plutonium exposure on human subjects. Through these experiments three normal children were thus transformed into the Plutonium Kidz! The government program, regrettably, remains classified.