The whole concept of health insurance is flawed. Contract to pay $x when I die? Easy. Contract to pay auto accident damages? Not too hard.
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What are your ideas on how to reduce medical spending as a percent of GDP?
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The big picture of health care costs: misaligned incentives. Doctors, drug companies, etc want higher costs, insurance obligated to pay
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Patients don't care because they're not the ones paying.
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Maybe the answer really is "have a virtuous population", and maybe that's why Japan keeps their costs down.
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In other words, we'll always have some misalignment of incentives, but we need people to refuse to defect.
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Saying "we need to punish defectors more" in this case doesn't work that well because even finding and punishing defection has high costs
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Example: doctor decides to perform procedure of questionable value that he wouldn't perform on himself (but it works sometimes)
End of conversation
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