Ben Handel

About 20 percent right now.

And most Western countries, 12 or 11 may be the high end of the next wave of

These companies, they all have to find a way to ration when you pick the plan.

It's not transparent at all, right?

You're not going to read page 97 in the booklet about this is what we do for prior authorization.

Right.

You're a consumer.

You see a basket of health plans that you're choosing and you see one is a lot cheaper than the other one.

And you think, well, I'm pretty healthy and I don't have a ton of money.

So this looks better.

Right.

Then after the fact, you actually go to get care and you experience this whole gamut of sludge.

Okay, this is going to be kind of a funny answer.

Let me just first say up front, I don't know the answer to this question.

However, I think it's equally plausible that sludge lowers spending, probably more plausible that it lowers spending, because the whole point of the sludge is to do less healthcare.

And so actually insurers with the sludge and all of these rationing mechanisms, they're probably contributing to lower costs, even though we don't necessarily like that experience.

It's a data set for one large employer with about 10,000 employees offering a menu of insurance options and basically had data on every medical claim, every interaction with a doctor.

I could observe the menu of options, the premiums people were paying.

I got really into the nitty-gritty details, and then I collected that up into studying insurance choice in a behavioral sense.

Insurance choice meaning picking your plan, correct?