MIKE SINN

PAPERS

ACADEMIC PAPERS AND RESEARCH ON HEALTH ECONOMICS, POLITICAL ECONOMY, AND HOW TO MAKE THE WORLD MARGINALLY LESS TERRIBLE USING MATH.

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HOW TO END WAR AND DISEASE
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HOW TO END WAR AND DISEASE

GET 443 YEARS OF CLINICAL RESEARCH DONE IN 39, AVOID THE APOCALYPSE, AND MAKE HUMANITY FILTHY RICH THROUGH THE MAGIC OF LEGAL BRIBERY

THE 1% TREATY: HARNESSING GREED TO ERADICATE DISEASE
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THE 1% TREATY: HARNESSING GREED TO ERADICATE DISEASE

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.

INCENTIVE ALIGNMENT BONDS: MAKING PUBLIC GOODS FINANCIALLY AND POLITICALLY PROFITABLE
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INCENTIVE ALIGNMENT BONDS: MAKING PUBLIC GOODS FINANCIALLY AND POLITICALLY PROFITABLE

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.

WISHOCRACY: SOLVING THE DEMOCRATIC PRINCIPAL-AGENT PROBLEM THROUGH PAIRWISE PREFERENCE AGGREGATION
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WISHOCRACY: SOLVING THE DEMOCRATIC PRINCIPAL-AGENT PROBLEM THROUGH PAIRWISE PREFERENCE AGGREGATION

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.

THE PRICE OF POLITICAL CHANGE: A COST-BENEFIT FRAMEWORK FOR POLICY INCENTIVIZATION
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THE PRICE OF POLITICAL CHANGE: A COST-BENEFIT FRAMEWORK FOR POLICY INCENTIVIZATION

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.

UBIQUITOUS PRAGMATIC TRIAL IMPACT ANALYSIS: HOW TO PREVENT A YEAR OF DEATH AND SUFFERING FOR 84 CENTS
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UBIQUITOUS PRAGMATIC TRIAL IMPACT ANALYSIS: HOW TO PREVENT A YEAR OF DEATH AND SUFFERING FOR 84 CENTS

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.

THE CONTINUOUS EVIDENCE GENERATION PROTOCOL: TWO-STAGE VALIDATION (RWE → PRAGMATIC TRIALS)
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THE CONTINUOUS EVIDENCE GENERATION PROTOCOL: TWO-STAGE VALIDATION (RWE → PRAGMATIC TRIALS)

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.

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DRUG DEVELOPMENT COST INCREASE ANALYSIS

RIGOROUS ANALYSIS OF THE 105X INCREASE IN DRUG DEVELOPMENT COSTS FROM PRE-1962 TO 2024, USING BAILY (1972) ACADEMIC STUDY WITH CPI ADJUSTMENTS AND SENSITIVITY ANALYSIS

THE INVISIBLE GRAVEYARD: QUANTIFYING THE MORTALITY COST OF FDA EFFICACY LAG
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THE INVISIBLE GRAVEYARD: QUANTIFYING THE MORTALITY COST OF FDA EFFICACY LAG

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: A CAUSAL INFERENCE PROTOCOL FOR MAXIMIZING MEDIAN HEALTH AND WEALTH THROUGH PUBLIC GOODS FUNDING
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THE OPTIMAL BUDGET GENERATOR: A CAUSAL INFERENCE PROTOCOL FOR MAXIMIZING MEDIAN HEALTH AND WEALTH THROUGH PUBLIC GOODS FUNDING

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: A CAUSAL INFERENCE PROTOCOL FOR MAXIMIZING MEDIAN HEALTH AND WEALTH THROUGH PUBLIC POLICY
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THE OPTIMAL POLICY GENERATOR: A CAUSAL INFERENCE PROTOCOL FOR MAXIMIZING MEDIAN HEALTH AND WEALTH THROUGH PUBLIC POLICY

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.

OPTIMOCRACY: CAUSAL INFERENCE ON CROSS-JURISDICTIONAL POLICY DATA TO MAXIMIZE MEDIAN HEALTH AND WEALTH
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OPTIMOCRACY: CAUSAL INFERENCE ON CROSS-JURISDICTIONAL POLICY DATA TO MAXIMIZE MEDIAN HEALTH AND WEALTH

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.

THE POLITICAL DYSFUNCTION TAX
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THE POLITICAL DYSFUNCTION TAX

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

RIGHT TO TRIAL & FDA UPGRADE ACT
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RIGHT TO TRIAL & FDA UPGRADE ACT

ACT TO MODERNIZE MEDICAL RESEARCH AND TREATMENT ACCESS THROUGH AN OPEN-SOURCE FDA.GOV V2, GIVING PATIENTS THE RIGHT TO PARTICIPATE IN TRIALS.

UNITED STATES EFFICIENCY AUDIT
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UNITED STATES EFFICIENCY AUDIT

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.

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