This assessment method is reminiscent of the traditional approach to assessing new surgical techniques that, after more rigorous testing, have sometimes proven worthless or worse. For example, radical mastectomies were common decades ago randomized trials showed that much less extensive and disfiguring surgery followed by radiation was an equally effective treatment.

Of course, conducting randomized trials can pose greater challenges to evaluating a new surgery than evaluating a new drug. It can be more difficult to standardize a surgical technique enough to test it on a broad population, and it can be far more difficult to blind the patient for whom he is receiving treatment.

However, such feasibility problems do not apply to new payment methods, which are well-defined and standardized interventions and where it is not desirable to blind medical providers for the payment rules.

However, as in medicine, not all public interventions can or should have randomized ratings. Unique government projects – like the Big Dig in Boston or the Superconducting Super Collider in Texas – have no natural comparison group, either randomly or otherwise. In times of crisis or when political disagreements are more about ideology than impact, the assessment itself can be ill-advised.

But when – how it is often the case – There is the possibility of a prospective assessment and the Law requires The innovation center’s experience underscores the value and feasibility of randomized sociopolitical studies. They can be done many times at the same speed and at the same cost like any prospective study and may produce more convincing results. Random assignment, where the government uses the lottery to choose who can receive the program, can also be that the most beautiful Ability to assign an intervention on a limited basis.

Randomized testing may not yet be the standard for government assessment, but such things take time. For example the Food and Drug Administration was authorized in 1962, “substantial evidence“About the safety and effectiveness of a new drug, but it took the agency more than five years to get involved coincidentally Try as a reasonable standard.

Now that the Biden administration is right again highlight With all federal agencies required to make “evidence-based decisions” based on the highest scientific standards, really tough social policy testing may become as natural as it is with new vaccines. This would help ensure that government services are provided as effectively and efficiently as possible.

Amy Finkelstein is John and Jennie S. MacDonald, professor of economics at MIT. She is co-director of J-PAL North America, a research center at MIT that conducts randomized assessments.