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Hidden Brain

The Fee-for-Service Monster

Hidden Brain

Hidden Brain Media

Arts, Science, Performing Arts, Social Sciences

4.640.4K Ratings

🗓️ 7 September 2020

⏱️ 50 minutes

🧾️ Download transcript

Summary

The United States spends trillions of dollars on healthcare every year, but our outcomes are worse than those of other countries that spend less money. Why? Physician and healthcare executive Vivian Lee explains the psychological and economic incentives embedded in the American model of medicine, and makes the case for a different way forward.

Transcript

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0:00.0

From NPR, this is Hidden Brain, I'm Shankar Vedanta.

0:04.6

Let's say you're invited out to eat at a gourmet restaurant.

0:08.3

Your host has promised to cover the bill.

0:12.2

What do you decide to order?

0:14.6

This scenario unfolds in an episode of the TV show The Office.

0:19.6

One of the characters, Jim, needs a favor from his colleagues, Phyllis and Stanley.

0:24.7

So he takes them out to lunch on his dime.

0:40.4

Call it The Surf and Turf, Kanundra.

0:43.9

If you're paying for your own meal, you might choose the soup and salad.

0:48.3

But if someone else is paying, how much wine do you have?

0:52.0

It's tempting to ask for a lot more.

0:58.8

There's a hidden problem we're choosing The Surf and Turf and the side of lobster.

1:03.2

If everyone at the table does this, your host can end up broke and resentful.

1:09.2

It might be the last time you get asked out to eat.

1:14.6

Now consider The Surf and Turf Kanundra in a different context.

1:18.4

What happens when we look not at a restaurant?

1:25.6

But in a hospital.

1:28.0

Many people, I think, are under the mistaken impression that they're not really paying for healthcare.

1:32.2

Because the insurance company is paying for healthcare.

1:35.2

And as a result, I think one of the culprits in our healthcare crisis right now is the behavior of us individually as patients.

1:44.0

That we do tend to expect that more action is better. We're getting our money's worth.

1:50.8

There's no free lunch in healthcare.

...

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