"rarely includes any alternative model"? Did you read the piece?
Here is the alternative model proposed by Skidelsky:
"These deep methodological issues do not render economic knowledge utterly useless, Skidelsky suggests. But they do mean economics as we know it may have to be thrown out. [...] We should instead take a more provisional, open, and flexible attitude toward economic phenomena and treat economics as (just) another social science, rather than one supposedly purified of uncertainty by its logical prowess. Concretely, this means we should abandon dreams of an immaculate science of economic life—and stop deferring to those who claim to speak in its name. More abstractly, in place of a discipline that neglects the 'mesoeconomic' level—the institutions, firms, unions, banking systems, social movements, digital platforms, states, and other social entities that shape our behavior—Skidelsky proposes an approach 'which is more modest in its epistemology and richer in its ontology.'"
Are you saying the article didn't mention global warming? You didn't read carefully enough. Climate is one of the things the author accuses the economist Diane Coyle of relegating to the "margin":
"All the same, her title cannot help but evoke other, perhaps more frightening monsters—ecological breakdown, deadly pandemics, secular stagnation, rising inequality, authoritarian resurgence—that her analysis relegates to the margins when it mentions them at all."
In the section on the book by Elizabeth Popp Berman, the author of the piece lays emphasis on the way the "economic style" has been involved in "downplaying, avoiding, exacerbating, and denying" dealing with carbon emissions:
"This was the first step in the marketization of pollution rights that ultimately led to cap-and-trade approaches to ozone regulation; economists would propose the very same approach to climate for years, leading to a spectacular failure of implementation in the United States and negligible impact on emissions in Europe to date. As the Intergovernmental Panel on Climate Change recently reiterated, the costs of this comprehensive failure have been staggering."
No idea where you got the notion that the author is Socrates-bashing or that the author “demands that we cannot ask questions.” The piece is so obviously a love letter to and defense of Socrates! You seem to have completely misread it.
The author obviously thinks persuasion is “a two-way street,” that asking questions is good, and that Socratic dialogue leaves people more enlightened: it helps make their ignorance more precise.
Of course it is part of the explanation. That administrative overhead — the bureaucratic army it pays for and marshals as a lobbying and negotiating tool — encourages hospital monopolization, which gives providers greater bargaining power, driving up prices.
The author doesn't say that's the whole issue. He also says the private system drives hospital consolidation, which in turn gives them higher bargaining power to demand higher prices. My point was, OP is wrong that the author "does basically nothing to interrogate why prices are high."
a) You must not have read the piece: "the bills are high because of who is paying them"; "insurance companies spend some eighteen cents for every dollar they collect in premiums on administration costs: 'marketing, determining eligibility, utilization controls (e.g., prior authorization of particular procedures), claims processing, and negotiating fees with each and every physician, hospital, and other health care workers and facilities.'"
No, I am not mistaken; you are confused. And your confusion is very pervasive in the technical community. You're not talking about randomization in general when you speak of a "treatment regime." You're talking about randomization in a causal experiment such as a randomized controlled trial. But "randomization" is a broader thing than randomization in a controlled experiment. The assumption of randomization is made for almost all classical statistical inference, which has nothing at all to do with causation.
Say you want to do basic linear regression: you want to estimate the slope for Y regressed on X. The most stringent form of inference works like this: you draw a random sample (X_i, Y_i), modeled as n independent and identically distributed realizations from the joint distribution (X,Y). Etc. This is certainly a stochastic model; we require randomization (or some approximation of it) to do inference. But it has nothing whatsoever to do with causality.
But it's not a limitation of the tool (the tool does provide gold-standard evidence); it's the stupidity of the researcher using the tool. (The tool works perfectly well and does, in fact, constitute the gold standard of causal evidence.) In your depression example, it's the stupidity of a researcher who fails to consider why a 1-in-6 success might be significant, or fails to consider that the umbrella disease "depression" can be multiply realized by different physiological mechanisms, which in turn require different treatments.
Your beef isn't with RCTs, or with the notion of RCT as evidence. Your beef is with researchers who don't know how to think.
Your complaint is like saying, we should stop considering hammers to be the gold-standard of nail-hitters because some idiots use them to try to turn screws.
>> Randomisation is a major part of traditional stats, and it is inherently a causal hypothesis
Yes, randomization is central to classical statistics, but no, it is not inherently causal. Drawing a random sample from a bivariate distribution (X,Y) is key to doing a lot (though not all) of classical statistical inference (think of estimating slopes in regression), but the randomization does not imply anything about the causal relationship between X and Y. When you speak of randomization in the context of "treatment regimes," you are thinking about randomized controlled trials, which the piece does analyze explicitly, in some detail. So in this sense the account given in the essay is not misleading.
Here is the alternative model proposed by Skidelsky:
"These deep methodological issues do not render economic knowledge utterly useless, Skidelsky suggests. But they do mean economics as we know it may have to be thrown out. [...] We should instead take a more provisional, open, and flexible attitude toward economic phenomena and treat economics as (just) another social science, rather than one supposedly purified of uncertainty by its logical prowess. Concretely, this means we should abandon dreams of an immaculate science of economic life—and stop deferring to those who claim to speak in its name. More abstractly, in place of a discipline that neglects the 'mesoeconomic' level—the institutions, firms, unions, banking systems, social movements, digital platforms, states, and other social entities that shape our behavior—Skidelsky proposes an approach 'which is more modest in its epistemology and richer in its ontology.'"