Markets Fail: Information Asymmetry Explained

Broadcast from KSQD, Santa Cruz on 12-11-2025:

• Dr. Dawn presents colleague Dr. Paul Godin's essay on why US healthcare fails as a market system . She explains that healthcare violates every assumption of functional markets: patients can't compare options during emergencies, information asymmetry prevents informed decisions, demand is inelastic when one has an urgent medical issue, and trust is essential to medicine and in direct conflict with profit incentives. Since 1988's Knox-Keen Act allowed for-profit healthcare, private equity has acquired and stripped hospitals, while administrative costs consume enormous resources fighting over payments rather than providing care. She contrasts this with European models like Switzerland and Germany where everyone must participate, insurers must accept all patients, and profit on basic coverage is limited.
• She celebrates a vaccination success story: HPV vaccines have reduced cervical cancer by 50% over 30 years. The American Cancer Society now endorses self-collected vaginal samples for HPV screening, with an FDA-approved at-home kit from Teal Health allowing women to skip speculums and traditional Pap smears. Current guidelines recommend screening starting at age 25, with testing every five years after a negative result.
• Dr. Dawn issues a health alert about multiple hospitalizations in Santa Cruz County from foraged wild mushrooms identified incorrectly by phone apps. She describes cholinergic toxicity symptoms: sweating, excessive salivation, pinpoint pupils, and abdominal cramping—signs requiring immediate emergency care rather than waiting it out.
• She offers follow-up vaccine advice: "go in wet, then sweat." Hydrate before vaccination, then take a hot Epsom salt bath until sweat runs off your face. This helps eliminate adjuvants that cause post-vaccine fatigue and aches, which are often misinterpreted as catching illness from the vaccine itself.
• Dr. Dawn expresses alarm that Kennedy's reconstituted ACIP nearly voted to eliminate hepatitis B vaccination at birth. She notes infants exposed to infected mothers have 99% infection rates, with half becoming chronically infected and half of those developing terminal cirrhosis or cancer. Testing pregnant women misses infections acquired during pregnancy, and 12-16% of delivering women have no test records. Major insurers have committed to covering birth vaccination through 2026 despite the panel's actions.
• She offers holiday microbiome advice from researcher Karen Corbin: increase fiber intake through steel-cut oats, whole grain breads like Dave's Killer Bread, beans, apples, and alternative pastas made from lentils or garbanzo beans. Cooking potatoes ahead and reheating creates resistant starch that feeds beneficial gut bacteria, reduces inflammation, and even stimulates natural GLP-1 production.
• Dr. Dawn reviews research proving health insurance saves lives. When the ACA's Medicaid expansion became optional by state, researchers could compare outcomes, finding 8% lower mortality and 19,000 fewer deaths in expansion states over four years. An accidental IRS experiment—sending insurance enrollment letters to only 85% of penalty payers—showed significantly lower mortality among those who subsequently got insured. Studies of gunshot and auto accident victims found uninsured patients died more often despite receiving identical emergency treatment.
• She concludes with surprising cancer symptoms: chest pain specifically triggered by alcohol consumption may indicate Hodgkin's lymphoma, as vasodilation activates inflammatory chemicals in affected lymph nodes. Fractures from minimal trauma in people without osteoporosis warrant investigation, as 5% of cancers involve bone. Elevated calcium levels double cancer diagnosis risk in the following year and should prompt follow-up testing.