Freakonomics Radio

456. How to Fix the Hot Mess of U.S. Healthcare

Apr 1, 2021
Zach Cooper, a healthcare economist from Yale, and Marty McCary, a Johns Hopkins surgeon and author, dive deep into the chaos of the U.S. healthcare system. They discuss the surprising amount of unnecessary medical care and the shocking rise in prescription rates. The duo critiques the high spending with low outcomes and explores how profit motives shape patient care. They argue for incremental reforms over sweeping changes, while dissecting pricing transparency efforts and the trust issues surrounding surprise billing that plague patients today.
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INSIGHT

U.S. Healthcare System Dysfunction

  • The U.S. healthcare system is dysfunctional, with pockets of excellence amidst widespread issues.
  • Two main drivers are pricing failures and unnecessary care, like a 21% rate of unnecessary medical services.
ANECDOTE

Elevator Incident at D.C. General

  • Marty McCary recounts a story about a fatal elevator accident at D.C. General Hospital.
  • The lack of preventative measures after the initial accident highlighted the fragmented nature of the system.
INSIGHT

Fragmented System, Misaligned Incentives

  • Many good people work within a flawed healthcare system, facing misaligned incentives.
  • The system's fragmentation prevents cohesive action, contrasting with the historical public trust in medicine.
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