Scott Alexander challenges Robin Hanson's claim that medicine doesn't work by analyzing health insurance studies and presenting evidence of medicine's effectiveness. Longer summary

Scott Alexander critiques Robin Hanson's claim that medicine doesn't work, analyzing three major health insurance experiments (RAND, Oregon, and Karnataka) and other studies. He argues that these studies are underpowered to detect medication effects and don't support Hanson's conclusion, citing evidence of medicine's effectiveness in improving survival rates for various diseases. Shorter summary

Scott Alexander summarizes and responds to comments on his post about semaglutide, covering corrections, additional information, and user experiences with the weight loss drug. Longer summary

Scott Alexander summarizes and responds to comments on his previous post about semaglutide, a weight loss drug. The highlights include corrections to his original analysis, additional information on obtaining semaglutide cheaply, discussion of other weight loss drugs and treatments, challenges to Scott's predictions, debate over whether weight loss is maintained after stopping the drug, personal anecdotes from users, and mentions of some tangential debates in the comments. Shorter summary

Scott Alexander provides updates on the ACX Grants project, summarizing the progress of grantees and their ongoing needs. Longer summary

This post provides updates on the ACX Grants project, where Scott Alexander awarded grants to various individuals and organizations for innovative projects. The post summarizes the progress of each grantee, their self-assessed performance on a scale of 1-10, and any additional help or funding they are seeking. The projects range from scientific research and technology development to policy advocacy and social initiatives. Scott also reflects on lessons learned from the grant program and announces the creation of an ACX Grantees Discord for grantees to connect with each other. Shorter summary

Scott Alexander analyzes how FDA regulations contribute to drug shortages and high prices, using buspirone and insulin as examples. Longer summary

Scott Alexander discusses two issues in the pharmaceutical industry: the buspirone shortage and high insulin prices. He argues that both problems stem from regulatory issues, particularly FDA policies that inadvertently encourage monopolies and make it difficult for generic manufacturers to enter the market. For buspirone, the Generic Drug User Fee Amendments (GDUFA) of 2012 and 2017 have created a fee structure that favors large-scale monopolies. For insulin, the complex nature of biologics and the FDA's stringent approval process for biosimilars make it extremely difficult and expensive to produce generic versions. Scott criticizes the tendency to blame these issues on the free market, arguing instead that poorly designed regulations are the root cause. Shorter summary

Scott Alexander discusses potential Trump administration health-related appointments, focusing on FDA commissioner candidates Jim O'Neill and Balaji Srinivasan, and their potential to implement beneficial reforms. Longer summary

Scott Alexander discusses potential Trump administration picks for key health-related positions, particularly the FDA commissioner and NIH chief. He expresses excitement about the possibility of Jim O'Neill or Balaji Srinivasan being chosen for FDA commissioner, viewing them as principled libertarians who could implement beneficial reforms. Alexander outlines several policies these candidates might pursue, such as medical reciprocity with other countries and streamlining generic drug approvals. He also mentions John Ioannidis as a surprising potential pick for NIH chief, praising his work in improving medical research standards. The post concludes by noting that pharmaceutical industry stocks haven't moved much in response to these potential appointments. Shorter summary

Scott Alexander criticizes the idea that prisons have replaced mental hospitals, arguing for better community and forensic mental health care instead of long-term institutionalization. Longer summary

Scott Alexander critiques a Vox article that suggests America's criminal justice system has become a substitute for the gutted mental health system. He argues that this view is misguided, explaining that mental health spending hasn't decreased but shifted from long-term state hospitals to community care. Scott contends that the high number of mentally ill people in prison is due to shared risk factors with criminality, not a lack of mental health care. He emphasizes that most mentally ill people can live outside institutions and shouldn't be institutionalized preemptively. Scott advocates for better funding of community and forensic mental health systems rather than reopening state-run long-term mental hospitals, which he views as problematic. Shorter summary