"A QALY is a health metric. Most of Scott's giving targets economic mobility, education, and equity, whose value is largely non-health — income, opportunity, rights, wellbeing. The model therefore understates her total social impact; it answers one specific question. The largest dollar buckets (equity & justice at ~22%, education at ~18%) contribute little health precisely because no credible study ties those grants to QALYs, not because the giving lacks value."

Which other metrics could be included to balance these economically? - society-wide morale lift & improved individual output - international desirability & forex lift

Or just re-weighting giving to normalize out non-health targeted expenditures?

Oh, and f** Malaria. Go get 'em, GiveWell and all working to reduce Malaria deaths. Polio too, heartbreaking that we have not beaten this one down yet. Suspect spend per paralysis/mortality is very high on Polio right now, but probably most agree the spend is very worth it given the payoff of a Polio-free planet.

Interesting that I could _immediately_ tell the model visualization was built with Claude

Another thing that this does not measure is philanthropic effectiveness. If there are lessons to be learned in terms of what kinds of philanthropy works better than others, then those learnings may cause other philanthropic endeavors to have greater success. I've had a bit of experience working with several big foundations and seeking out effective ways to spend lots of money is an extremely hard problem and they're all aware of it, and they treat each investment as an experiment.

Of course, the effectiveness of each type of investment is not fixed, and will inevitably drop off. I believe the whole 'just buy malaria nets' first-order thinking was part of discourse for a while before people wised up.

Smells like EA. The "Evidence stance" measure in particular, which purports to gauge a study's rigorousness as a simple percentage, is rank pseudoscience.

Even if all her donations were a complete waste, one can argue every $1B taken from the oligarch class is a win - less money to buy media outlets and politicians.

Speaking for myself, just knowing there is someone in the billionaire class who is still an incandescent beacon of humanity, humility, and hope has in some nontrivial way increased the quality of my years since she started on this path.

She is an existence proof that a now-inevitable extreme inequality regime is not by construction maximally cynical and extractive.

Do you find the end figures believable against other claims? I found them overly pessimistic but thats a non-scientific vibe view. Even on the most optimistic setting the $ per QALY seemed excessive.

Many of MacKenzie Scott's interventions are early age. The multiplier effect on the economy and life adjusted years should be huge by both supression of excess pregnancies and avoided child death and disease. Every avoided pregnancy is economically that woman being productive back in the workforce or managing the family on a lower overhead. Every avoided child death is 40-50 years of productive labour from that child. The soap and vaccines is $low. The life tail is enormous. If you figure the QALY for the woman lower since she's survived into post puberty, I get that but for the kids, its 50x or more on the spend.

I just found the $ per QALY way low. But, perhaps people with experience of delivery of services and aid into marginalised economies can explain?

She wasn’t a passive housewife who inherited money in a divorce. She was an early Amazon investor and helped build the first stage of the company. She’d be a billionaire even without the divorce.