Plain English with Derek Thompson - Why American Health Care Is a "Broken System"

Why American Health Care Is a "Broken System"

12/13/24 • 83 min

16 Listeners

Last week, UnitedHealthcare CEO Brian Thompson was shot to death outside a hotel in Manhattan by a young man motivated by rage at the insurance industry. His rage is clearly felt widely. In the aftermath of the killing, many people seemed to delight in the man’s assassination. Their reaction was a grotesque illustration of something real: There is an enormous amount of anger and frustration about the state of American health care. And there ought to be. The U.S. is the most expensive health care system in the world, while for many people it delivers bad care at exorbitant prices.

But anger is not always a signal of accuracy. And while some of the most popular reasons to be furious at American health care are based on truth, many are based on misunderstandings and myths—especially about the insurance system.

This week, I wanted to present a calm and informed conversation with a health care expert to walk me through what I consider the biggest health care questions of the moment. Why are American health care costs so high? How much are insurers to blame? How do other countries handle health care differently? What can we learn from them? And what, if anything, should make us optimistic about the future of American health care?

Today we have two guests. First we have Jonathan Gruber, an economics professor at MIT and a key architect of several health care laws, including the 2006 Massachusetts health care reform and the Affordable Care Act. Jon walks me through the key drivers of health inflation and American anger at the health care system. The second, David Cutler, is an economics professor at Harvard who served as senior health care adviser for Barack Obama; he helps us think comparatively about the weaknesses and strengths of the U.S. health system and what reforms could help Americans live longer and healthier lives.

If you have questions, observations, or ideas for future episodes, email us at [email protected].

Host: Derek Thompson

Guests: Jonathan Gruber and David Cutler

Producer: Devon Baroldi

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If you have questions, observations, or ideas for future episodes, email us at [email protected].

Host: Derek Thompson

Guests: Jonathan Gruber and David Cutler

Producer: Devon Baroldi

Learn more about your ad choices. Visit podcastchoices.com/adchoices

Previous Episode

Is Crypto Entering a New Golden Age—or Just a New Era of Failed Promises?

The crypto industry seems poised for a new golden age. But what exactly does that mean? Who would benefit? And, oh by the way, what does this technology do other than serve as a set of assets to bet to the moon?

I have lots of questions about the state of crypto right now. Last week, Bitcoin traded above $100,000 for the first time in history. Its price has skyrocketed since Donald Trump’s win, as a wave of investors bet that the next four years will mark a new renaissance. And this isn’t just a time for optimism. It’s also a time for recrimination. In the last few weeks, several major tech figures, including the venture capitalist Marc Andreessen, have condemned democrats for what they describe as an illegal war on crypto.

Austin Campbell is finance vet, an adjunct professor at Columbia Business School, and the founder of Zero Knowledge Consulting. Today, we talk about the purported war on crypto, starting with the origins of "debanking" practices under Obama; we talk about why crypto now seems like a majority-republican technology in an industry that has historically been democratic; we talk about the biggest use cases of crypto around the world; and Austin tells me why he thinks many people in the industry still aren't thinking clearly about the future of finance.

Host: Derek Thompson

Guest: Austin Campbell

Producer: Mike Wargon

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Next Episode

The Productivity Paradox: Why Less Is More With Oliver Burkeman

So, here’s a scenario: It’s Monday. And you open up whatever calendar or planner or to-do list you use to organize the essential activities of the upcoming week. There’s a large project due Thursday. And an important meeting Wednesday. Your nine-to-five is chockablock with meetings, and your kid has a school function Tuesday, and there are holiday gifts to buy before Friday, and just when you’re pretty sure your week couldn’t possibly take one more featherweight of responsibilities, the HVAC unit sputters to a stop, requiring a call to the local heating and cooling guys, which obliterates four hours of Monday.

You can tell yourself that this week is cursed. Or you can tell yourself the truth: Feeling an imbalance between the time you have and the time you want to have isn’t really a curse at all. It’s a bit more like ... the definition of being alive. To see life clearly in this way is what I’ve come to think of as Oliver Burkeman brain. Oliver is the author of the books 'Four Thousand Weeks' and 'Meditations for Mortals.'

Today, in what's become a holiday tradition of sorts, we bring back Oliver to chat about doing more by doing less, the dubious benefits of scheduling, and the freedom that comes from accepting our limitations.

If you have questions, observations, or ideas for future episodes, email us at [email protected].

Host: Derek Thompson

Guest: Oliver Burkeman

Producer: Devon Baroldi

Learn more about your ad choices. Visit podcastchoices.com/adchoices