Stephen Dubner

But if you don't have the ability or the resources or the time to process all that sludge, you are at a big disadvantage. So getting back to the question I raised a minute ago, how can it be that we spend so much money on health care and don't get the best health outcomes? I would argue that sludge is probably a major contributor.

But if you don't have the ability or the resources or the time to process all that sludge, you are at a big disadvantage. So getting back to the question I raised a minute ago, how can it be that we spend so much money on health care and don't get the best health outcomes? I would argue that sludge is probably a major contributor.

But if you don't have the ability or the resources or the time to process all that sludge, you are at a big disadvantage. So getting back to the question I raised a minute ago, how can it be that we spend so much money on health care and don't get the best health outcomes? I would argue that sludge is probably a major contributor.

For instance, there is research showing that a huge share of older adults struggle to use medical documents like forms or charts. So what good is a world class system of clinical and research expertise if people can't properly access that system?

For instance, there is research showing that a huge share of older adults struggle to use medical documents like forms or charts. So what good is a world class system of clinical and research expertise if people can't properly access that system?

For instance, there is research showing that a huge share of older adults struggle to use medical documents like forms or charts. So what good is a world class system of clinical and research expertise if people can't properly access that system?

I went back to the economist Ben Handel and asked him how much he thinks sludge contributes to our very high cost of health care and our less than great outcomes.

I went back to the economist Ben Handel and asked him how much he thinks sludge contributes to our very high cost of health care and our less than great outcomes.

I went back to the economist Ben Handel and asked him how much he thinks sludge contributes to our very high cost of health care and our less than great outcomes.

Let's back up for a minute here to see where Handel is coming from. His interest in healthcare economics goes back to when he was getting his Ph.D. from Northwestern University. He managed to get his hands on a very large and detailed set of insurance data.

Let's back up for a minute here to see where Handel is coming from. His interest in healthcare economics goes back to when he was getting his Ph.D. from Northwestern University. He managed to get his hands on a very large and detailed set of insurance data.

Let's back up for a minute here to see where Handel is coming from. His interest in healthcare economics goes back to when he was getting his Ph.D. from Northwestern University. He managed to get his hands on a very large and detailed set of insurance data.

Handel found that just about every health plan offered to employees included what he calls a dominated option. That's a phrase that comes from game theory. And in this case, it means an option that is objectively worse than every other option. Theoretically, firms should not offer this option and no employees should choose it. But they did choose. And they do.

Handel found that just about every health plan offered to employees included what he calls a dominated option. That's a phrase that comes from game theory. And in this case, it means an option that is objectively worse than every other option. Theoretically, firms should not offer this option and no employees should choose it. But they did choose. And they do.

Handel found that just about every health plan offered to employees included what he calls a dominated option. That's a phrase that comes from game theory. And in this case, it means an option that is objectively worse than every other option. Theoretically, firms should not offer this option and no employees should choose it. But they did choose. And they do.

Here's how Ben Handel put it later in a research paper he wrote along with Joshua Schwartstein. There is strong evidence that people do not translate readily available information into knowledge that would help them make better decisions.

Here's how Ben Handel put it later in a research paper he wrote along with Joshua Schwartstein. There is strong evidence that people do not translate readily available information into knowledge that would help them make better decisions.

Here's how Ben Handel put it later in a research paper he wrote along with Joshua Schwartstein. There is strong evidence that people do not translate readily available information into knowledge that would help them make better decisions.

I mean, my first question there would be, you're saying these are employed people getting insurance through their employer. Why are the firms offering such bad choices?

I mean, my first question there would be, you're saying these are employed people getting insurance through their employer. Why are the firms offering such bad choices?