Stephen Dubner

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.

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.

Prime Minister Keir Starmer recently made such a move by abolishing an oversight body called NHS England. He said he wants to cut bureaucracy and duplication, or as he called it, stodge, a sludge by any other name, I guess. Coming up after the break, how does all that health care sludge affect physicians? I'm Stephen Dubner. This is Freakonomics Radio. We'll be right back.

Prime Minister Keir Starmer recently made such a move by abolishing an oversight body called NHS England. He said he wants to cut bureaucracy and duplication, or as he called it, stodge, a sludge by any other name, I guess. Coming up after the break, how does all that health care sludge affect physicians? I'm Stephen Dubner. This is Freakonomics Radio. We'll be right back.

Prime Minister Keir Starmer recently made such a move by abolishing an oversight body called NHS England. He said he wants to cut bureaucracy and duplication, or as he called it, stodge, a sludge by any other name, I guess. Coming up after the break, how does all that health care sludge affect physicians? I'm Stephen Dubner. This is Freakonomics Radio. We'll be right back.

Here is one of the biggest riddles of our time. How can it be that Americans spend more on health care than any other country, way more, but that we don't have the best health outcomes? There are a lot of answers to that question, a lot of different kinds of answers, and we've explored some of them before on this show. One answer you don't often hear is sludge.

Here is one of the biggest riddles of our time. How can it be that Americans spend more on health care than any other country, way more, but that we don't have the best health outcomes? There are a lot of answers to that question, a lot of different kinds of answers, and we've explored some of them before on this show. One answer you don't often hear is sludge.

Here is one of the biggest riddles of our time. How can it be that Americans spend more on health care than any other country, way more, but that we don't have the best health outcomes? There are a lot of answers to that question, a lot of different kinds of answers, and we've explored some of them before on this show. One answer you don't often hear is sludge.

But just think about how much of our time and money is turned into waste by our gigantic health care machine just because things don't work the way they're designed to work. Take something as simple as how health care providers communicate with their patients.

But just think about how much of our time and money is turned into waste by our gigantic health care machine just because things don't work the way they're designed to work. Take something as simple as how health care providers communicate with their patients.

But just think about how much of our time and money is turned into waste by our gigantic health care machine just because things don't work the way they're designed to work. Take something as simple as how health care providers communicate with their patients.

It's often confusing, sometimes contradictory or impenetrable, also wildly redundant, a blizzard of automated notifications and requests to fill out the form you've already filled out and that no one will end up looking at anyway. One effect of sludge is that it turns all of us into our own administrative assistants. Even simple email threads are no longer simple.

It's often confusing, sometimes contradictory or impenetrable, also wildly redundant, a blizzard of automated notifications and requests to fill out the form you've already filled out and that no one will end up looking at anyway. One effect of sludge is that it turns all of us into our own administrative assistants. Even simple email threads are no longer simple.

It's often confusing, sometimes contradictory or impenetrable, also wildly redundant, a blizzard of automated notifications and requests to fill out the form you've already filled out and that no one will end up looking at anyway. One effect of sludge is that it turns all of us into our own administrative assistants. Even simple email threads are no longer simple.

They've gotten sludged up by those long legal disclaimers that some people attach to their every email signature. So what could have been a nice, clean email thread becomes a sludge forest that you have to hunt through in order to find the actual message. And now try doing this on a screen the size of your palm.

They've gotten sludged up by those long legal disclaimers that some people attach to their every email signature. So what could have been a nice, clean email thread becomes a sludge forest that you have to hunt through in order to find the actual message. And now try doing this on a screen the size of your palm.

They've gotten sludged up by those long legal disclaimers that some people attach to their every email signature. So what could have been a nice, clean email thread becomes a sludge forest that you have to hunt through in order to find the actual message. And now try doing this on a screen the size of your palm.

This kind of sludge is not only frustrating, it's deeply inefficient and costly, and it leads to mistakes. There is, of course, one way to fight sludge by hiring someone to process it for you. As some academic researchers have pointed out, sludge favors the powerful, the wealthy and the healthy.

This kind of sludge is not only frustrating, it's deeply inefficient and costly, and it leads to mistakes. There is, of course, one way to fight sludge by hiring someone to process it for you. As some academic researchers have pointed out, sludge favors the powerful, the wealthy and the healthy.

This kind of sludge is not only frustrating, it's deeply inefficient and costly, and it leads to mistakes. There is, of course, one way to fight sludge by hiring someone to process it for you. As some academic researchers have pointed out, sludge favors the powerful, the wealthy and the healthy.