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Small-Scale Question Sunday for August 17, 2025

Do you have a dumb question that you're kind of embarrassed to ask in the main thread? Is there something you're just not sure about?

This is your opportunity to ask questions. No question too simple or too silly.

Culture war topics are accepted, and proposals for a better intro post are appreciated.

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Let's talk about sources of information. GDP, CPI, Employment data, Inflation - important economic indicators of how the US is doing. Trump fired the BLS head after they published numbers he didn't like. I don't care about the real reason, the point is the perception. If for some reason, people decide the economic data has partisan spin (or is incompetent because it's being done by seriously underqualified people) and is no longer reliable, then what data will economic forecasters begin to rely on? Will they just shrug, report the Trump administration numbers with a giant asterisk? Will other independent orgs spring up to publish similar data but this time it's unbiased?

And are there any of you who think, "Good, the data was biased all along, it was never free from partisan meddling, it's just that now people are aware of it"? In which case my question still stands, what data do you trust and how do you get the right decision makers to use the right data to make sound decisions?

I feel like the question is most pressing with regard to medicine. If RFK's HHS and the CDC formally make recommendations that absolutely go against what the rest of the developed world considers settled science, what are doctors to do? Will insurers stop insuring proven interventions or procedures because the HHS is putting pressure against them? Will doctors no longer be allowed to administer medications even though they know they would work? Or would people instead start citing UK or the EU data on the subject? I guess really my question is, if US economic and public health guidance is no longer seen as trustworthy, which is seeming increasingly likely, where else would that data come from?

If for some reason, people decide the economic data has partisan spin

Under Biden, it was routine for BLS to publish jobs data, gather all the press and then "update" it to lower numbers a couple of months later which the mainstream press largely ignored (rare counter-example: https://www.msn.com/en-us/money/markets/revised-data-exposes-overstated-job-creation-claims-by-harris-biden-admin-revealing-818000-nonexistent-jobs/ar-AA1pc1Ez). Shenanigans like this is what makes people to decide economic data is being used for partisan spin purposes. Of course, since it wasn't Trump doing it, nobody in the chattering class gave a hoot about it. It is possible that "announce high numbers, than revise it to much lower numbers" is how the process works and in fact there's no way to make it work otherwise - I seriously doubt that, but let's assume it were the case. In that case, an objective non-partisan official should have spent a lot of effort to inform the public that's what is going on, and to make sure the corrections get at least as much attention as the original - incorrect - data has gotten, and that the initial estimates are reported as rough estimates, to be substantially corrected later, and not as objective truth. This is not what has been happening.

In general, I think the chances that Biden administration appointed an absolutely neutral, non-partisan purely technical person to a politically sensitive position which generates a lot of press attention, are close to zero. Thus, for Trump it's completely legitimate to dismiss that person, and appoint his own choice. Of course, it should have likely been done on day 1, but given as anything he does will be presented in worst possible light anyway, it doesn't matter too much. Will Trump's new appointee be better? Hard to say, the history gives equal chance both for a competent worked and a complete disaster. We'll see.

I guess really my question is, if US economic and public health guidance is no longer seen as trustworthy

Never had been. Only now, because Trump, it's being highlighted, and once the other side takes the power again, it will be deemphasized again. The quality of data will not improve from that.

how do you get the right decision makers to use the right data to make sound decisions?

Welcome to the basic problem of socialism. Yes, capitalist countries aren't free from it too, no more that airplanes are free from gravity. The data is dirty, and will probably get dirtier as the partisan politicization of everything continues. Would I like for it not to happen? Sure. Do I have any hope it is not going to happen? Nope. One of the reasons why I have no hope is that almost nobody speaks about it in terms "destroying the integrity of research is a problem". It's always "Trump destroying the integrity of research is a problem" - and once it's not about Trump, then there's no problem, right? And the other side, predictably, adopts the mirror stance, so now both sides are hard at work destroying it and everybody pretends it's somebody else's fault.

Will doctors no longer be allowed to administer medications even though they know they would work

That has long been the case. There are a number of medications which are approved in Europe but not in the US, for example.

That has long been the case. There are a number of medications which are approved in Europe but not in the US, for example.

While true this gets considerably confusing. Sometimes the more expensive drug is approved in the U.S. sometimes Europe. Sometimes the "more dangerous" drug gets approved here, sometimes there. Political considerations of all kinds pop up (like childhood vaccines). It gets weird.

Compounding matters is the fact that sometimes things are not approved for an FDA indication, unlikely to get approved by insurance, unlikely to get approved by your hospital/pharmacy, scheduled, totally legit but 100% sure to get you sued if anyone complains and so on...

My favorite example is Gabapentin, which has thirty seven million off label uses but only two official uses - and 9/10 competent physicians will get it wrong if you ask them.

Of course, the real situation is quite chaotic and a lot is based on a pile of ad-hoc decisions. FDA got lucky with Thalidomide - if you are very slow in approving everything, sooner or later some bad stuff will slip by faster regulators and it's time to uncork the champagne! - so they took it as the confirmation that not approving stuff is much better than approving stuff for many years after. But it's not based on some well-founded general scientific truth. And definitely doctors and what they think - at least if we're talking about rank and file doctors who actually talk to patients, not the ones that spend their days sitting in committees - have pretty little input into it and very little power in the process, as far as I know. It's not like "doctors were ruling it with their awesome knowledge and Trump came and started banning life-saving stuff because he's evil". It's "doctors did what FDA said to do before, and keep doing it under Trump, and will continue to do so long after Trump is forgotten".