Stephen Dubner

One reason that healthcare sludge is such a big problem is that healthcare is such a big industry. It makes up nearly 20% of our GDP and it employs more people than any other industry. So I went back to Richard Thaler to find out more about healthcare sludge. Talk to Ben about that. Talk to Ben about that, he says. In the history of Freakonomics Radio, there's only been one ironclad rule.

Let's take that example and drill down a bit. Where does that sludge come from? Is the insurer just not working hard enough to keep their database updated? Maybe they don't have the commercial incentive to do so. Or are they intentionally making it harder to find a doctor because if the customer doesn't find a doctor, the insurer won't have to pay?

Let's take that example and drill down a bit. Where does that sludge come from? Is the insurer just not working hard enough to keep their database updated? Maybe they don't have the commercial incentive to do so. Or are they intentionally making it harder to find a doctor because if the customer doesn't find a doctor, the insurer won't have to pay?

Let's take that example and drill down a bit. Where does that sludge come from? Is the insurer just not working hard enough to keep their database updated? Maybe they don't have the commercial incentive to do so. Or are they intentionally making it harder to find a doctor because if the customer doesn't find a doctor, the insurer won't have to pay?

Or is the list maybe a mess because doctors are moving out of insurer networks because doctors have encountered so much sludge?

Or is the list maybe a mess because doctors are moving out of insurer networks because doctors have encountered so much sludge?

Or is the list maybe a mess because doctors are moving out of insurer networks because doctors have encountered so much sludge?

Let me just devil's advocate that for a second. Providing health care is obviously more complicated than providing technology. you know, a box of paperclips, even if the paperclips are coming from a factory in China that you have no relationship with, there are middlemen who make that really easy. And it's a commodity product.

Let me just devil's advocate that for a second. Providing health care is obviously more complicated than providing technology. you know, a box of paperclips, even if the paperclips are coming from a factory in China that you have no relationship with, there are middlemen who make that really easy. And it's a commodity product.

Let me just devil's advocate that for a second. Providing health care is obviously more complicated than providing technology. you know, a box of paperclips, even if the paperclips are coming from a factory in China that you have no relationship with, there are middlemen who make that really easy. And it's a commodity product.

And health care is not a commodity product on either the provider or the consumer side. So I think we can all understand why it would be a lot more complicated to find let's say a good specialist within my healthcare plan than it would be to find the paper clips that I want on Amazon.

And health care is not a commodity product on either the provider or the consumer side. So I think we can all understand why it would be a lot more complicated to find let's say a good specialist within my healthcare plan than it would be to find the paper clips that I want on Amazon.

And health care is not a commodity product on either the provider or the consumer side. So I think we can all understand why it would be a lot more complicated to find let's say a good specialist within my healthcare plan than it would be to find the paper clips that I want on Amazon.

That said, as you just noted, these healthcare firms are among the biggest firms in the country and healthcare is one of the biggest industries. So overall, how costly is all this sludge? Not just in dollars and time loss, but in healthcare not provided.

That said, as you just noted, these healthcare firms are among the biggest firms in the country and healthcare is one of the biggest industries. So overall, how costly is all this sludge? Not just in dollars and time loss, but in healthcare not provided.

That said, as you just noted, these healthcare firms are among the biggest firms in the country and healthcare is one of the biggest industries. So overall, how costly is all this sludge? Not just in dollars and time loss, but in healthcare not provided.

How much of this complication is due to the fact that the U.S. has such a different system of healthcare providers than just about every other wealthy country? Going back to what some people think of as the original sin after World War II when health insurance became something that companies buy for their employees rather than having some kind of national health service system.

How much of this complication is due to the fact that the U.S. has such a different system of healthcare providers than just about every other wealthy country? Going back to what some people think of as the original sin after World War II when health insurance became something that companies buy for their employees rather than having some kind of national health service system.

How much of this complication is due to the fact that the U.S. has such a different system of healthcare providers than just about every other wealthy country? Going back to what some people think of as the original sin after World War II when health insurance became something that companies buy for their employees rather than having some kind of national health service system.

One reason the US healthcare system is so sludgy is because it is primarily made up of private firms, a massive constellation of actors, each with their own incentives. So this makes any across-the-board sludge reduction hard. The U.K. system is at least more centralized, which means one move can affect millions of people.