I foster collaboration between funders and researchers in order to identify and implement the most cost-effective ways to improve mental health and wellbeing.
From 2021-2023 I was Communications Manager at the Happier Lives Institute. From 2018-2021 I worked on CEA’s events team, helping to produce EA Global and EAGx conferences.
I practice Vipassana meditation for two hours on most days and Buddhist philosophy drives my commitment to reducing the suffering of others.
I noticed that much of the political tractability discussion has focussed on counterfactuals involving other diseases (e.g. malaria) but I'm more confused why the government prioritised treatment over prevention.
Oster's article argued that prevention would be a better bet than treatment and that was written in 2005 when Congress had approved the budget and the prices of the drugs had come down. You also highlight the importance of, "the evidence from those who had worked in the field that antiretroviral drugs and preventive measures could be deployed effectively and at reasonable cost, even in very poor settings". (emphasis added)
So both options had evidence of feasibility and efficacy, the money was already there, and it seems like, at that time, they didn't know which option would scale better or get cheaper quicker.
I'm struggling to see what Oster got wrong. Was the decision to prioritise treatment over prevention mostly driven by the emotional appeal of the 'Lazarus effect'?
That's good to know, thanks for clarifying. A democratic process is definitely better than a top-down approach, but everyone who participates in that process will be subject to affective forecasting biases too. That's why I favour using subjective wellbeing data, but I'm keen to hear about alternative options too.
Hi Henry. Thanks for your feedback! I'll let Joel respond to the substantive comments but just wanted to note that I've changed the "Appendix D" references to "Appendix C". Thanks very much for letting us know about that.
I'm not sure why Appendix B has hyperlinks for some studies but not for others. I'll check with Joel about that and add links to all the papers as soon as I can. In future, I plan to convert some of our data tables into embedded AirTables so that readers can reorder by different columns if they wish.
Thanks very much for writing this. It’s helpful to have a clear and succinct summary of the capabilities approach on the Forum and I thought the post was constructive and well-written. It provides a nice counterpoint to HLI’s post, To WELLBY or not to WELLBY?
However, the capabilities approach (as you describe it here) strikes me as deeply paternalistic. How do we decide which capabilities to prioritise without asking people how much they value them? We can’t just defer to Nussbaum.
In the post you say:
The third approach, which I personally prefer, is to not even try to make an index but instead to track various clearly important dimensions separately
and also,
If you don’t know precisely what to maximize for people, then picking staying alive and having resources is a very good start.
To me, it looks like you’ve decided what the priorities should be based on what you think is “clearly important”. But as this post shows, humans are terrible at ‘affective forecasting’ i.e. we underestimate the importance of things that are resistant to hedonic adaptation and difficult to mentally simulate.
The thing is, we don’t have to guess. We can look at subjective wellbeing data from longitudinal studies to identify which capabilities have the most impact on people’s lives. The Origins of Happiness is the best example I’ve seen of this and is packed full of surprising insights. If adversity or discrimination had no effect on your subjective wellbeing, then those terms would be meaningless.
I think the crux of our different views is that I don’t see subjective wellbeing as one of many functionings. Instead, I place high credence on the view that wellbeing is the intrinsic good. Everyone cares about lots of things (positive emotions, achievements, having kids, art, knowledge, freedom, religious belief etc.) but you need to make trade-offs between them and that requires a common unit.
I’m nearly always a 7/10 or 8/10 on the common happiness-type questions. I guess that this means that I could “improve” this, but honestly I’m not trying to do this at all.
Here, I think you’re confusing emotional states with evaluations of life satisfaction. Most people don’t want to feel happy at a funeral. Instead, we want to be satisfied with our current experience, free from desires for a different state of affairs. When you chose to have kids, I expect you were trading off positive emotions for greater life satisfaction and that’s a totally reasonable thing to do. There's a great clip of Daniel Kahneman discussing this here.
Using subjective measures to allocate aid means that targeting will depend in part on people’s ability to imagine a better future (and thus feel dissatisfaction with the present).
For me, dissatisfaction and suffering are synonymous so I would prioritise an unhappy billionaire over a happy rural farmer, even though this may seem counterintuitive to many. In practice, however, there are a lot of unhappy rural farmers and it’s much cheaper to help them. The reason I work at the Happier Lives Institute is that I want to understand what will really help them the most, rather than deferring to the common assumption that it must be income gains and lives saved.
(commenting in a personal capacity etc.)
That first point could be rephrased as "an exclusive SWB focus prioritizes providing resources to people who are less able to psychologically adapt to bad circumstances.". That seems like a good approach to me.
In the example you give, I'm not sure the previous circumstances are relevant to the question. In that situation, I would prioritise the person who was suffering the most (all else equal).
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If you found this post helpful, please consider completing HLI's 2022 Impact Survey.
Most questions are multiple-choice and all questions are optional. It should take you around 15 minutes depending on how much you want to say.
If you found this post helpful, please consider completing HLI's 2022 Impact Survey.
Most questions are multiple-choice and all questions are optional. It should take you around 15 minutes depending on how much you want to say.
This is a very half-baked idea, but most trust-based services (e.g. Uber, Airbnb, Trustpilot) seem to have settled on five-star ratings and/or reviews as a solution. Perhaps you could experiment with adding similar functionality to EA Forum profiles for orgs and/or individuals, although I'm sceptical the benefits would outweigh the potential downsides.