In this inbetweenisode Stacey Richter dives into the complexities of benefit design in American healthcare. Highlighting insights from recent episodes with Bill Sarraille (EP459) and upcoming episode with Scott Conard, MD, Richter explores the impact of cost containment measures and the moral hazard of insurance, emphasizing the importance of creating balanced and efficient benefit plans that align with plan values and avoid unintended consequences. 

She discusses the challenges and implications of high deductible health plans and copay maximizers/accumulators, urging plan sponsors to strive for pareto optimality and practical solutions. This episode is a call to carefully consider patient behavior, healthcare utilization, and the broader impacts of financial incentives in healthcare.

Going black and white or over-indexing to prevent outlier kind of stuff is probably not gonna end well. Not seeking a middle way can easily result in a solution that is possibly worse than the problem.

Moral hazard is actually a thing. There are lots of implications to patients not being able to distinguish high-value and low-value care. But if we know this, then, philosophically at least, how do we conceptualize a solve? What should we be doing? If we’re not doing black and white, what does the gray in the middle look like?

=== LINKS === 🔗  Show Notes with all mentioned links:   https://cc-lnk.com/INBW42

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00:00 Introduction to the Rabbit Hole

04:05 Where did Stacey’s rabbit hole spiral start?

05:40 What is the moral hazard of insurance?

09:31 EP358 with Wayne Jenkins, MD.

12:49 Why isn’t moral hazard mitigated in insurance?

18:16 EP459 with Bill Sarraille.

20:51 “How do we conceptualize a solve?”

22:24 Why should we be striving for Pareto optimality?

25:20 What is the theory of second best?