ACADEMIC PAPERS AND RESEARCH ON HEALTH ECONOMICS, POLITICAL ECONOMY, AND HOW TO MAKE THE WORLD MARGINALLY LESS TERRIBLE USING MATH.
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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 $0.842 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) USES CAUSAL INFERENCE, DIMINISHING RETURNS MODELING, AND COST-EFFECTIVENESS EVIDENCE TO DETERMINE OPTIMAL PUBLIC GOODS FUNDING LEVELS THAT MAXIMIZE TWO WELFARE METRICS: REAL AFTER-TAX MEDIAN INCOME GROWTH AND MEDIAN HEALTHY LIFE YEARS. FOR EACH SPENDING CATEGORY, OBG ESTIMATES AN OPTIMAL SPENDING LEVEL (OSL) AND PRODUCES A GAP ANALYSIS SHOWING WHERE CURRENT GOVERNMENT BUDGETS ARE OVER- OR UNDERFUNDED RELATIVE TO EVIDENCE-BASED BENCHMARKS. THE BUDGET IMPACT SCORE (BIS) MEASURES CONFIDENCE IN EACH RECOMMENDATION BASED ON THE QUALITY OF CAUSAL EVIDENCE.

THE OPTIMAL POLICY GENERATOR (OPG) PRODUCES SYSTEMATIC PUBLIC POLICY RECOMMENDATIONS FOR JURISDICTIONS AT ANY LEVEL (COUNTRY, STATE, CITY), GENERATING PRIORITIZED ENACT/REPLACE/REPEAL/MAINTAIN RECOMMENDATIONS TO MAXIMIZE REAL AFTER-TAX MEDIAN INCOME GROWTH AND MEDIAN HEALTHY LIFE YEARS, 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.

