Derek Thompson

In the biggest picture, the federal government has three dominant jobs, healthcare, social security, and defense. Those three areas account for between 60 and 75% of total federal spending every year. And according to the US Government Accountability Office, it's healthcare spending in particular that is growing the fastest and where the size of waste and fraud is likely the greatest.

In particular, the GAO has scrutinized excess payments made by the government to private insurance companies under the Medicare Advantage system. So I read that GAO report and I thought to myself, I don't know much about the Medicare Advantage system or the reasons behind excessive payments. So I want to talk to experts who do.

In particular, the GAO has scrutinized excess payments made by the government to private insurance companies under the Medicare Advantage system. So I read that GAO report and I thought to myself, I don't know much about the Medicare Advantage system or the reasons behind excessive payments. So I want to talk to experts who do.

In particular, the GAO has scrutinized excess payments made by the government to private insurance companies under the Medicare Advantage system. So I read that GAO report and I thought to myself, I don't know much about the Medicare Advantage system or the reasons behind excessive payments. So I want to talk to experts who do.

Today's guests are Michael Jerusso, an associate professor of economics at the University of Texas, Austin, and Tim Layton, a professor of healthcare policy at UVA. We talk about why it makes sense to look for savings in healthcare first, where excess payments come from, how so-called upcoding costs the US up to $100 billion a year, why it happens, and how to fix it.

Today's guests are Michael Jerusso, an associate professor of economics at the University of Texas, Austin, and Tim Layton, a professor of healthcare policy at UVA. We talk about why it makes sense to look for savings in healthcare first, where excess payments come from, how so-called upcoding costs the US up to $100 billion a year, why it happens, and how to fix it.

Today's guests are Michael Jerusso, an associate professor of economics at the University of Texas, Austin, and Tim Layton, a professor of healthcare policy at UVA. We talk about why it makes sense to look for savings in healthcare first, where excess payments come from, how so-called upcoding costs the US up to $100 billion a year, why it happens, and how to fix it.

It is a myth that there exists some pot of $10 billion just lying around, doing nothing, gathering dust, allocated for some dead person. Every dollar of federal government spending goes to a living person in a real place doing a thing. No bushels of cash are being shipped to Mars. And that means that every dollar we cut will have a recipient on the other end who is losing a dollar.

It is a myth that there exists some pot of $10 billion just lying around, doing nothing, gathering dust, allocated for some dead person. Every dollar of federal government spending goes to a living person in a real place doing a thing. No bushels of cash are being shipped to Mars. And that means that every dollar we cut will have a recipient on the other end who is losing a dollar.

It is a myth that there exists some pot of $10 billion just lying around, doing nothing, gathering dust, allocated for some dead person. Every dollar of federal government spending goes to a living person in a real place doing a thing. No bushels of cash are being shipped to Mars. And that means that every dollar we cut will have a recipient on the other end who is losing a dollar.

To take government efficiency seriously requires thinking about both sides of this equation. What do we get when we spend this dollar versus what do we lose when we take that dollar away? I'm Derek Thompson. This is Plain English. Michael Geruso, welcome to the show. Thank you so much. Happy to be here. Tim Layton, welcome to you as well. Thanks. Excited to chat.

To take government efficiency seriously requires thinking about both sides of this equation. What do we get when we spend this dollar versus what do we lose when we take that dollar away? I'm Derek Thompson. This is Plain English. Michael Geruso, welcome to the show. Thank you so much. Happy to be here. Tim Layton, welcome to you as well. Thanks. Excited to chat.

To take government efficiency seriously requires thinking about both sides of this equation. What do we get when we spend this dollar versus what do we lose when we take that dollar away? I'm Derek Thompson. This is Plain English. Michael Geruso, welcome to the show. Thank you so much. Happy to be here. Tim Layton, welcome to you as well. Thanks. Excited to chat.

Mike, so we've got Doge out there scouring the government for savings, and I wanted to bring on some economists to talk about where a search and destroy effort for wasteful spending might actually find billions of dollars in waste. So first question, why am I even talking to you? Why are we starting with health spending?

Mike, so we've got Doge out there scouring the government for savings, and I wanted to bring on some economists to talk about where a search and destroy effort for wasteful spending might actually find billions of dollars in waste. So first question, why am I even talking to you? Why are we starting with health spending?

Mike, so we've got Doge out there scouring the government for savings, and I wanted to bring on some economists to talk about where a search and destroy effort for wasteful spending might actually find billions of dollars in waste. So first question, why am I even talking to you? Why are we starting with health spending?

Right, like cutting NIH by $10 billion is a 20% cut, one out of every $5 that universities are getting for medical research suddenly gone. But in Medicare, you're talking at about 20%, but 1%. So that's why it makes sense to focus on these bigger buckets. Tim, we're talking about government acting essentially as the nation's largest insurance company, Medicare, Medicaid, Veterans Affairs.

Right, like cutting NIH by $10 billion is a 20% cut, one out of every $5 that universities are getting for medical research suddenly gone. But in Medicare, you're talking at about 20%, but 1%. So that's why it makes sense to focus on these bigger buckets. Tim, we're talking about government acting essentially as the nation's largest insurance company, Medicare, Medicaid, Veterans Affairs.

Right, like cutting NIH by $10 billion is a 20% cut, one out of every $5 that universities are getting for medical research suddenly gone. But in Medicare, you're talking at about 20%, but 1%. So that's why it makes sense to focus on these bigger buckets. Tim, we're talking about government acting essentially as the nation's largest insurance company, Medicare, Medicaid, Veterans Affairs.

And if we're gonna understand how to hunt for waste and even fraud in government health spending, I think we should understand a little bit about how government spending on healthcare actually works. So, Tim, let's say I go to the doctor with chronic leg pain.