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May 4, 2015 by Ted 25 Comments

RAND and the Moral Hazard: Healthcare Triage #10

As we've explained in previous episodes, insurance is complicated. Even John gets confused (watch the video!). But there's a reason we have all these deductibles, co-pays, and co-insurance. It's because of the moral hazard, and a very important research study known as the RAND Health Insurance Experiment. Watch this episode and learn all about it.

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Here's more info on the RAND HIE: http://theincidentaleconomist.com/wordpress/the-moral-hazard/

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen - Graphics

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Filed Under: Moral Hazard Tagged With: Hazard, Healthcare, Moral, Rand, Triage

Comments

  1. Overonator says

    May 4, 2015 at 3:32 pm

    I cringed when you said “it’s just a theory.” Theories in science are the
    highest form ideas can take, they explain why something happens, they have
    been justified by many tests.

    Reply
  2. sheepwshotguns says

    May 4, 2015 at 4:11 pm

    so the question comes down to… are the lives of poor people worth a few
    bucks in overall healthcare costs.
    and this debate isn’t over?

    Reply
  3. walkingmap says

    May 4, 2015 at 5:05 pm

    ARRGH, ” The Moral Hazard” is not a theory, it is an hypothesis. You, a
    Doctor (I presume), just conflated the everyday use of “theory” with its
    scientific meaning, and your words, “its just a theory” means what? So, the
    “Germ Theory of Disease” is the equivalent of the “Humors Theory of
    Disease”. You are doing a disservice to your wonderful informative videos
    with this slight.

    Reply
  4. kwiztas says

    May 4, 2015 at 5:07 pm

    That study sounds very immoral. Give free healthcare to some people make
    others pay the full amount. 

    Reply
  5. Mark Smith says

    May 4, 2015 at 5:39 pm

    Missing one thing- insurance companies are appalling bad at managing costs-
    an average American hospital bill has a ridiculous number of BS charges
    added on and they also work there prices to fit the insurance payout not
    their costs. Health insurance companies don’t care about costs- its your
    money not theirs and tend to follow a policies not designed for medical
    efficacy but according their accountants and executives very tiny brains-
    which is why they like medicines for psychiatric care over more effective
    alternatives. The pricing mess is just the way they like to put their poor
    management on to consumers. 

    Reply
  6. Ike Evans says

    May 4, 2015 at 6:31 pm

    5:38…. “They died more…”

    …and here I thought death was just a one time thing. It turns out, if
    you are poor, that… errrrr… must not be the case.

    Reply
  7. Matthew Kiefer says

    May 4, 2015 at 6:57 pm

    “this is why we have deductible co-pays and co-insurance”
    And here I thought it had nothing to do with science and everything to do
    with my insurance company being a money grubbing whore that wants to milk
    it’s customer base for every dime they can.

    Reply
  8. TheinnerCircl3 says

    May 4, 2015 at 7:07 pm

    Its the RAND corporation these are the guys that came up with mutually
    assured destruction theory.

    and employed that nut-job who were likely suffer some form of paranoia John
    F.ucking Nash , I mean the guy thinks that his co-workers were KGB agents
    because they are wearing red ties.

    Did anything good came from the RAND tink tank?
    no wonder some people became anti-science and anti intellectuals

    Reply
  9. svtcarboy says

    May 4, 2015 at 7:29 pm

    Moral hazard is not just about the amount of health care consumed, and the
    amounts of health care used. Cost sharing also encourages people to seek
    better values in health care, to obtain necessary care at lower prices than
    if one doesn’t share costs (and the costs can vary widely for the exact
    same test, procedure, or treatment). The problem is this information is
    not easily available to people, and THAT is where requirements and
    regulations can help.

    Reply
  10. Darakou Hasegawa says

    May 4, 2015 at 8:25 pm

    Is this RAND organization related to a certain lady novelist by any chance?

    Reply
  11. JNCressey says

    May 4, 2015 at 8:29 pm

    So basically, if you remove insurance then healthy people spend less and
    ill people die more.

    Reply
    • Viki says

      January 24, 2017 at 9:47 am

      I guess finding useful, reliable inaimrftoon on the internet isn’t hopeless after all.

      Reply
  12. FlyingFree333 says

    May 4, 2015 at 9:01 pm

    All healthcare should be free, a society that refuses to take care of its
    members doesn’t deserve to survive.

    Reply
  13. Ben Miller says

    May 4, 2015 at 9:22 pm

    Appendectomy? Yeah, probably, but only because I specifically WANT to get
    rid of mine. If I ever live far away from other people, which I’ve often
    considered, its much safer to not have one.

    Reply
  14. Jean-Eider Pierre-Louis says

    May 4, 2015 at 9:26 pm

    All I know is, I have schizophrenia. I went to an emergency room back in
    december of ’13 and I said IU didn’t have health insurance. They looked at
    me like I was crazy. Granted I am, but I have the money to pay for my
    healthcare. Anybody got answers to my problem?

    Reply
  15. Handel says

    May 4, 2015 at 9:34 pm

    Moral hazard doesn’t necessarily refer to the quantity of the items
    demanded. In the case of healthcare, the point is that if there is the
    option between a $50 drug and a $500 drug, there is no point in choosing
    the $50 one. E.g. hospitals charge exorbitant rates for things like
    toiletries because the consumers don’t feel the cost. 

    Reply
  16. corvus917 says

    May 4, 2015 at 9:50 pm

    I’ll always hate the English language for making the word hypothesis an
    alternative definition and synonym for theory. I really hope that this
    aberration of vocabulary doesn’t exist in other languages. I mean really,
    who in their right minds would muddle the distinction between those words?

    Reply
  17. Matt L says

    May 4, 2015 at 10:13 pm

    At first I was surprised that John hadn’t heard of co-insurance. Then I
    remembered he used to believe that a minute had 100 seconds.

    Reply
  18. Kenji Wardenclyffe says

    May 4, 2015 at 10:25 pm

    Australia is currently in a situation where the prime minister wants to
    introduce a similar system. A co payment on gp visits, tests, procedures,
    and medications – basically turning Australia’s medical system into a
    version of the American system. 

    Reply
  19. Holly Taylor says

    May 4, 2015 at 10:38 pm

    In England having the NHS means people don’t consider whether it’s totally
    ‘necessary’ before going to see the doctor about any symptoms. Could anyone
    from america explain the sort of healthcare they would consider
    unnecessary?

    Reply
  20. shraka says

    May 4, 2015 at 11:37 pm

    Poor health is bad for overall healthcare spending though. Preventative
    care costs a lot less than emergency care. Like a LOT less.

    And no country spends more on it’s healthcare than the U.S. despite most
    having similar or even better results and more coverage.

    Reply
  21. Adam J says

    May 4, 2015 at 11:38 pm

    I’m kind of upset you just used the words “just a theory” as in to say that
    because something has the term “theory” attached to it it is somehow not
    credible.

    … just sayin’

    Reply
  22. Blinky Lass says

    May 5, 2015 at 12:26 am

    I find it sickening that this is even a serious argument in the healthcare
    debate in the US. This argument is literally for gambling with people’s
    lives in order to save costs. Of course it works, because on average,
    people are more likely to be healthy than not, but it’s a disgustingly
    barbaric idea.

    It’s akin to saying, “Why wear hard hats in a construction site? It’s
    unnecessary for most people most of the time. People who wear hard hats
    become more reckless and cause more accidents. Plus, you can save on the
    costs of hard hats!” Probably trivially true, but is it worth causing more
    accidents to be fatal?

    Instead, this logic should be applied to government-subsidized banks and
    corporations that are run recklessly and incompetently because they will be
    bailed out on account of being “too big to fail”. That is the kind of place
    where the moral hazard argument should be used, not when human lives are at
    stake.

    Reply
  23. Joe Lima says

    May 5, 2015 at 12:58 am

    “Higher deductibles … may be good for health care spending but may be bad
    for people’s health.”
    Yes, now our high health care costs are bad so if the higher deductibles
    and so forth drive health care costs down wouldn’t that be good for
    people’s health? Remember the issue is not driving health care costs down
    just for the heck of it, it’s driving them down so that poorer people can
    afford it.

    Reply
  24. RizenLink says

    May 5, 2015 at 1:44 am

    Another good analysis of a complicated issue. There’s too much black and
    white when many people view current healthcare issues and it ends up
    excluding important factors. We need to look at everything and make the
    best choices to move forward.

    Reply

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