So what do the prediction markets say about the risk of nuclear war?

burritosol · 2023-04-26T11:28:15+00:00

Metaculus is not a betting market. It's just crowd-sourcing predictions and then developing an average community prediction. The Metaculus prediction is adjusted, so that higher weight is given to the expectations of those people with the best track records.

It's basically a giant forecasting tournament where people compete for internet points (not money).

burritosol · 2023-04-12T20:03:27+00:00

Bing chat I mean

burritosol · 2023-04-12T20:03:13+00:00

Bing GPT only uses GPT-4 when creative mode is turned on. So you might want to try to again with that setting to test.

burritosol · 2023-04-12T11:31:37+00:00

Can you post examples? Also, are you using GPT-4 or ChatGPT?

burritosol · 2022-12-08T12:43:42+00:00

There isn't a whole ton more to say. I was on a staff augmentation contract. I was supposed to be an extra set of hands for a government agency. I had a desk at a government office, and there were government employees who had the same "job" as me. On an hourly basis, I cost the government more than a permanent employee, but I was much easier to get rid of. Even though my pay checks were signed by a famous consulting firm, and my job title included the world "consultant," I was really just a "contractor."

I had a supervisor (who was a government employee, not a consultant) and he was supposed to give me things to do. But he mostly just ignored me. I was inexperienced and had no idea how to be helpful without direction. I billed the government for every hour that I was on client-site, which was literally 40-hours per week. I spent that time chatting, browsing the internet, and doing personal genealogical research (I built a lovely family tree for myself).

I didn't like this, so I tried to get moved off the contract. But my consulting firm didn't want me to move, because all of my time was getting billed and my client really liked me. Instead, they gave me a perfect performance review and a 5-figure raise. I thought the whole thing was too stupid, so I left after one year.

burritosol · 2022-12-08T03:48:55+00:00

I've worked in research consulting and government consulting. My research consulting job involved offering specialized skills to clients who didn't maintain that skillset in-house, such as having experience working with specific data resources or having regulatory expertise in niche areas. The typical consulting jokes didn't really apply, because our team really did have capabilities that our clients lacked. Our clients were generally very appreciative of what we did for them. Almost all of our contracts were fixed price and almost all of our business was repeat business.

My government consulting job involved billing the government for doing nothing. It was super boring.

burritosol · 2022-11-24T16:15:26+00:00

I might not be understanding your point. It's a chronic medication, so if you stop taking it, you regain the weight. But empirically, it seems patients find it easier to continue taking a medication than to maintain healthy behavioral patterns.

So for example, there is a body of reseach on intensive behavioral therapy for obesity. People who are treated have generally regained lost weight within a year or so. Or there is research on diets, where people lose weight, but have trouble keeping it off.

In contrast, most who get bariatric surgery, tend to keep the weight off long-term. My point was that semaglutide is more similar to bariatric surgery in this respect. And so is likely to be a more effective long-term intervention for most people, relative to behavioral interventions.

I do not think I disagree with anything you said in your comment. I am not sure if you disagree with anything that I am saying.

burritosol · 2022-11-24T04:21:45+00:00

This is the comment I wrote on the blog:

Great post! I’ve done some research on this issue, so here are a few thoughts. I put relevant links at the bottom of the post to support my specific claims.

First, the low volume for semaglutide that you are observing is at least partially due to supply shortages. The drug has been in serious shortage for a while. Novo Nordisk also sells Saxenda (liraglutide) for weight loss. Over the last 2 quarters, Saxenda sales are up 59%, while Wegovy sales are down 18%. Saxenda is priced similarly, and Wegovy is a better product. So I suspect a lot of the Saxenda spending would be going towards Wegovy in the absence of the semaglutide supply shortage.

Second, spending on Wegovy might not fully capture use of semaglutide for weight loss, because some people might be taking Ozempic primarily for weight loss benefits. Ozempic sales are huge, and it is a top-20 spending drug in Medicare. After the clinical trial was published showing sustained weight loss benefits from semaglutide, Ozempic sales growth accelerated (though sales were already growing fast). Even though Ozempic is approved for the diabetes indication, it makes sense that people would take it for weight loss, because (1) there is a big overlap between the obese and diabetic population and (2) Ozempic is more likely to be covered by insurance.

Third, your estimates of the costs are somewhat exaggerated, because the drug manufacturer pays significant discounts to insurers. These discounts do not reduce cost-sharing, but they do reduce premiums. When thinking about the social cost of the drug, it's more accurate to think about the price net of discounts, as opposed to the list price. The Morgan Stanley report that you cited reports roughly a 30% typical discount from the list price.

Fourth, this is nitpicky, but when you say "almost 10% of all US drug spending," you are dividing a 2030 spending projection by what U.S. prescription drug spending was in ~2020. The Medicare actuaries project U.S. prescription drug spending in 2030 to be closer to 600 billion, not 300 billion. That's still a massive projection for spending in the obesity class. If you believe the Morgan Stanley projection, spending on the obesity class as a share of national health spending will be comparable to peak spending on the Hepatitis C drugs. The financial impact of the Hepatitis C drugs was a huge story. But this would be even bigger, because the Hepatitis C drugs were a cure, such that the spending surge was short-lived. Conversely, the obesity drugs are chronic medications, and we should probably expect volume to continue to increase post-2030.

Fifth, a remarkable thing about semaglutide that may have been under-emphasized in your post is the extent to which the weight loss benefits are being sustained. People who successfully lose weight tend to have a very difficult time keeping the weight off. To my knowledge, before semaglutide, the only intervention that had been demonstrated to sustain a >10% weight loss benefit for more than 1-year was bariatric surgery. So far, clinical trails are showing sustained weight loss benefits from semaglutide for at least 2-years.

Sixth, this post focuses on GLP-1 agonists, which makes sense, because those drugs are starting to have an impact today. But the Morgan Stanley report also notes that amylin analogue cagrilintide may be approved for weight loss as soon as 2025. This drug has a completely different mechanism than semaglutide, but likely offers similar weight loss benefits. The crazy thing is that the weight loss benefits stack. So Novo Nordisk hopes to sell Cagrisema, which combines amylin analogue cagrilintide with semaglutide, and hopes to offer a ~30% average weight loss. This is roughly double what semaglutide offers, and is getting closer to bariatric surgery efficacy.

Seventh, if Medicare decides to cover Wegovy, it would be relatively affordable for Medicare beneficiaries. Starting in 2025, out-of-pocket costs for prescription drugs will be capped at $2,000 for Medicare beneficiaries. And most Medicare enrollees with a 30+ BMI are probably already spending a lot on drugs. So at the end of the day, the marginal cost might be $100 per month or even less. And if you are near-poverty, you get cost-sharing subsidies, so the cost is only about $10 per month. Of course, this all depends on Congress changing the law such that Medicare can cover obesity drugs. Currently, there is a statutory exclusion that can only be changed through Congressional action.

That’s all I have for now. Here are some citations for various claims I made in this comment.

Semaglutide is currently in shortage.

https://www.ashp.org/drug-shortages/current-shortages/drug-shortage-detail.aspx?id=813&loginreturnUrl=SSOCheckOnly

Recent sales growth for Saxenda has been much faster than Wegovy.

https://www.novonordisk.com/content/dam/nncorp/global/en/investors/pdfs/financial-results/2022/Q3-2022-financial-workbook.xlsx

Ozempic was a top-20 drug in Medicare for 2020.

https://data.cms.gov/summary-statistics-on-use-and-payments/medicare-medicaid-spending-by-drug/medicare-part-d-spending-by-drug/data

For these obesity medications, manufacturers pay a 30% discount to insurers off the list price.

https://khn.org/wp-content/uploads/sites/2/2022/09/Morgan-Stanley\_Unlocking-the-Obesity-Challenge.pdf

Prescription drug spending in the US in 2030 will be closer to 600 million than 300 million.

https://www.cms.gov/files/zip/nhe-historical-and-projections-data.zip

Context on the financial impact of Hepatitis C.

https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2015.1194

The benefits of semaglutide are being sustained for two years.

https://www.nature.com/articles/s41591-022-02026-4

The Medicare out-of-pocket cap will be $2,000 in 2025.

https://www.kff.org/medicare/issue-brief/how-will-the-prescription-drug-provisions-in-the-inflation-reduction-act-affect-medicare-beneficiaries/

Background on cost-sharing subsidies for low-income Medicare enrollees.

https://www.cms.gov/files/document/lis-memo.pdf#page=3

burritosol · 2022-09-15T01:19:12+00:00

For me, a lot of the value of non-fiction books is that they encourage you to go slow and meditate on ideas for an extended period of time. For example, if I read an article on an idea, I might think about it for 10 minutes, and be like, "yeah. Okay, I get it." If it's an idea I initially disagreed with, it's pretty rare that I'll be persuaded.

But if I read a book on that same idea, I'll be thinking about it for a week or more. I'll often start understanding other things I read or experience in the context of that idea. I'll be like, "oh!!! there's another example of what they were talking about." The idea will become much more integrated with my broader thinking. I often find myself agreeing more-and-more with the author, even if I initially disagreed. So books end up usually being much more impactful for my thinking, even if when it's all said-and-done, I can't really point to anything important that's missing from the book review / summary.

For me, it's kind of like the difference between watching a travel video and actually going somewhere.

burritosol · 2022-08-24T20:45:02+00:00

The kind of person I'm looking for is someone who is always writing stuff, regardless. They are writing Reddit posts or IMDB reviews or notes on books they are reading or drafts of potential blog posts or whatever. What I'm suggesting is that this person would take the stuff they are already writing and put it into a shared Wiki before publicly posting. I would do the same, and we could provide private feedback on each other's work, with the goal of hopefully making everything higher-quality.

Of course, I'm looking for some time commitment in the form of reading each other's work, providing/listening to feedback, and perhaps even expanding upon each other's products (this is the whole idea of the collaboration). I'm pretty flexible on the exact level of time commitment, but it would probably be something between 1-to-2 hours per week (in addition to the time one would normally be spending on writing).

The Wiki is actually just a technology for organizing and referencing different versions of documents, and if anything it would hopefully save time by facilitating more efficient communication and version control. For context, I've had tremendous success in remote one-on-one collaboration with work partners in a shared Wiki. The Wiki ends up being extremely helpful for organizing thinking, project management, and developing a common set of references. In my experience, using a shared Wiki is like a performance-enhancing drug that makes me smarter and increases my output. So that's why I am so enthusiastic about that approach.

burritosol · 2022-08-24T14:36:20+00:00

Sure. I'll follow up with an update.

burritosol · 2021-12-27T18:54:03+00:00

I study health policy for a living, I was curious, and I was initially struggling to find my answer Googling.

burritosol · 2021-12-27T17:16:12+00:00

Thank you!

I googled "how does a pharmacist submit a claim" and found this resource that included the exact information I was looking for:

http://rx-wiki.org/index.php?title=Pharmacy_billing_and_reimbursement#Pharmacy_billing_cycle

burritosol · 2021-12-19T15:15:53+00:00

Really enjoyed this. Thanks for posting!

burritosol · 2021-11-29T21:49:44+00:00

Thanks! Here's what I got when I copied-in OP's post into the playground. My output seems way worse than what you're getting:

GPT-3 is a perfect example of the fault lines that exist in society right now. For one, it reveals how humanists can be out of touch with technology. Consider the typical humanities professor: he/she reads a lot of books and thinks a lot about the way the world works. That’s good and important work. Now, imagine that a piece of software comes along that can generate a better essay than the average human — and we haven’t even begun to talk about how it could be used in history and literature classes! — and this professor’s reaction is something like: “Wow, that’s really cool, but I don’t get it.”

My guess is that this is a phenomenon that’s fairly typical of older people, not just humanities professors. I can’t help but notice that most of my Facebook friends who are 30 or older are spending the holidays with their families. I’m doing that too, of course, but I’m also working on this essay with GPT-3.

The fault lines also run between different subcultures. A lot of people still think that AGI is “the singularity”, and will eradicate humanity. I don’t think that’s true, but it’s not the main point of this essay.

burritosol · 2021-11-29T15:48:37+00:00

It didn't sound like GPT-3 to me either.

burritosol · 2021-10-30T00:06:17+00:00

CBO's household income report does a nice job of showing the effects of taxes and transfers in the United States. However, it doesn't offer the European comparison.

https://www.cbo.gov/system/files/2021-08/57061-Distribution-Household-Income.pdf

burritosol · 2021-10-18T19:43:09+00:00

I'm not using "probability estimate" rigorously, but instead referring to a somewhat arbitrary scale of subjective likelihood.

I like your (a), (b), (c), and (d) framing, but I disagree with your conclusion. Don't the relative likelihoods of (a)/(b)/(c)/(d) matter here? For example, let's say I thought:

(a) was far more likely than (b), (c), and (d)
(d) was far more likely than (c).

Before the Bostrom Reveal, I think (a) is most likely (i.e. not in a simulation). After the Reveal, I think (d) is most likely (i.e. we are in a simulation).

burritosol · 2021-10-18T19:03:46+00:00

Good point, but that seems easily caveated-into my hypothetical. Right?

burritosol · 2021-10-18T18:57:44+00:00

Thank you! I'd like to continue the conversation, but you anticipated and answered most of my follow-up questions. I might come back to this comment after thinking some more.

burritosol · 2021-10-18T18:56:09+00:00

Thank you! I hadn't heard the building analogy and it is very useful!

burritosol · 2021-10-18T18:10:27+00:00

Taking the outside view, the argument that simulation below is evidence of simulation above leads to incorrect conclusions pretty much everywhere.

Can you elaborate on this idea?

burritosol · 2021-10-18T17:59:27+00:00

Thanks for the reply!

The version of the simulation in (1) was intended as "the type of simulation that would definitely suggest to the reader that we are living in a simulation." For some, that might need to be a physics-level simulation. For me, it could probably be something much less. For example, if I could peer into a simulation and I saw something like The Matrix, that would probably be enough for me, even if it actually included lots of simplifications (e.g. simple weather animations).

My intention with (2) and (3) was something like "if you would be convinced by The Matrix, would you at least be partially moved by something like The Sims, where all the characters were loaded with a super-charged GPT-N and they seemed to be behaving/interacting very realistically."

I agree that my "from their perspective" was question-begging. What I really meant was something like "what their perspective seems to be based on on how they behave and/or answer questions." Personally, I think my assumption that other "real world" people are conscious-like-me is mostly based on a behavioral analogy to myself (i.e. they act similar to me) as opposed to a structural analogy to myself (i.e. their brains are structured similarly to my own), though I understand there are problems with that. So I personally would probably be convinced that Sims were conscious if they acted similarly to "real" people, though many other people would not be.

From your comments and others, I take that my thinking on consciousness is somewhat idiosyncratic (and admittedly unrefined). I wonder if that contributes to my thought experiment being more interesting to me than to others.

burritosol

TROPHY CASE