Health Podcasts

Jim Manzi, founder and chair of Applied Predictive Technologies, senior fellow at the Manhattan Institute, and author of Uncontrolled, talks with EconTalk host Russ Roberts about the Oregon Medicaid study and the challenges of interpreting experimental results. Manzi notes a number of interesting aspects of the study results that have generally been unnoticed--the relatively high proportion of people in the Oregon study who turned down the chance to receive Medicaid benefits, and the increase (though insignificant) in smoking by those who received Medicaid benefits under the experiment. Along the way, Manzi discusses general issues of statistical significance, and how we might learn more about the effects of Medicaid in the future.

Austin Frakt of Boston University and blogger at The Incidental Economist talks with EconTalk host Russ Roberts about Medicaid and the recent results released from the Oregon Medicaid study, a randomized experiment that looked at individuals with and without access to Medicaid. Recent released results from that study found no significant impact of Medicaid access on basic health measures such as blood pressure and cholesterol levels, but did find reduced financial stress and better mental health. Frakt gives his interpretation of those results and the implications for the Affordable Care Act. The conversation closes with a discussion of the reliability of empirical work in general and how it might or might not affect our positions on social and economic policy.

Eric Topol of the Scripps Research Institute and the author of The Creative Destruction of Medicine talks with EconTalk host Russ Roberts about the ideas in his book. Topics discussed include "evidence-based" medicine, the influence of the pharmaceutical industry, how medicine is currently conducted for the "average" patient, the potential of genomics to improve health care and the power of technology, generally, to transform medicine.

Leigh Steinberg, legendary sports agent, talks with EconTalk host Russ Roberts about his career as a sports agent. He discusses the challenges of building a clientele, how sports agents spend their time, strategies for building a brand as an athlete, and safety issues currently affecting the National Football League.

Marcia Angell of Harvard Medical School and the author of The Truth About the Drug Companies talks with EconTalk host Russ Roberts about the impact of pharmaceutical companies on academic research, clinical trials and the political process. Angell argues that the large pharmaceutical companies produce little or no innovation and use their political power to exploit consumers and taxpayers.

John Cochrane of the University of Chicago and Stanford University's Hoover Institution talks with EconTalk host Russ Roberts about how existing regulations distort the market for health care. Cochrane argues that many of the problems in the health care market would go away if these distortions were removed. In this conversation, he explores how the market for health care might work in the United States without those distortions. He also addresses some of the common arguments against a more choice-oriented, less top-down approach.

Scott Atlas, Senior Fellow at Stanford University's Hoover Institution and author of In Excellent Health, talks with EconTalk host Russ Roberts about the U.S. health care system. Atlas argues that the U.S. health care system is top-notch relative to other countries and that data that show otherwise rely on including factors unrelated to health care or on spurious definitions. For example, life expectancy in the United States is unexceptional. When you take out suicides and fatal car accidents, factors that Atlas argues are unrelated to the health care system, the United States has the longest life expectancy in the world. A similar change occurs when measuring infant mortality--foreign data do not include as many at-risk births as in the United States and the measure of a birth is not comparable. In a number of other areas including cancer survival rates, access to hip replacement surgery and waiting times to see a physician, Atlas argues that the United States is also at or near the top. The discussion concludes with a discussion of access to health care for the poor and the failure of Medicaid.

Gary Taubes, author of Why We Get Fat, talks with EconTalk host Russ Roberts about why we get fat and the nature of evidence in a complex system. The current mainstream view is that we get fat because we eat too much and don't exercise enough. Taubes challenges this seemingly uncontroversial argument with a number of empirical observations, arguing instead that excessive carbohydrate consumption causes obesity. In this conversation he explains how your body reacts to carbohydrates and explains why the mainstream argument of "calories in/calories out" is inadequate for explaining obesity. He also discusses the history of the idea of carbohydrates' importance tracing it back to German and Austrian nutritionists whose work was ignored after WWII. Roberts ties the discussion to other emergent, complex phenomena such as the economy. The conversation closes with a discussion of the risks of confirmation bias and cherry-picking data to suit one's pet hypotheses.

David Autor of MIT talks with EconTalk host Russ Roberts about the Social Security Disability Insurance (SSDI) program. SSDI has grown dramatically in recent years and now costs about $200 billion a year. Autor explains how the program works, why the growth has been so dramatic, and the consequences for the stability of the program in the future. This is an illuminated look at the interaction between politics and economics and reveals an activity of government that is relatively ignored today but will not be able to be ignored in the future.

Dean Baker of the Center for Economic Policy and Research talks with EconTalk host Russ Roberts about the financial crisis. Baker sees the crisis as part of a broader set of phenomena--rising inequality and declining unionization. Baker is highly critical on both economic and political grounds of the policy attempts to stimulate the economy as well as the governance structure of the Federal Reserve. The conversation closes with a discussion of potential innovations to lower the budgetary cost of health care.

Gary Taubes, author of Good Calories, Bad Calories, talks to EconTalk host Russ Roberts about what we know about the relationship between diet and disease. Taubes argues that for decades, doctors, the medical establishment, and government agencies encouraged Americans to reduce fat in their diet and increase carbohydrates in order to reduce heart disease. Taubes argues that the evidence for the connection between fat in the diet and heart disease was weak yet the consensus in favor of low-fat diets remained strong. Casual evidence (such as low heart disease rates among populations with little fat in their diet) ignores the possibilities that other factors such as low sugar consumption may explain the relationship. Underlying the conversation is a theme that causation can be difficult to establish in complex systems such as the human body and the economy.

Abhijit Banerjee of MIT talks with EconTalk host Russ Roberts about Banerjee's book (co-authored with Esther Duflo), Poor Economics. The conversation begins with how randomized control trials (a particular kind of social experiment) have been used to measure the effectiveness of various types of aid to the poor. Banerjee goes on to discuss hunger, health, and education--the challenges in each area and what we have learned about what works and what does not. The conversation closes with a discussion of the role of the labor market in the private sector.

Todd Buchholz, author of Rush: Why You Need and Love the Rat Race, talks with EconTalk host Russ Roberts about the ideas in the book. Buchholz argues that competition and striving for excellence is part of our evolutionary inheritance. He criticizes attempts to remake human beings into gentle creatures who long to return to an Eden-like serenity. He argues that it is action, creativity, and planning for the future that makes us happy. The discussion includes the implications of our interest in the future for theater and story-telling.

Investigative journalist Brian Deer talks with EconTalk host Russ Roberts about Deer's seven years of reporting and legal issues surrounding the 1998 article in The Lancet claiming that the MMR vaccine causes autism and bowel problems. Deer's dogged pursuit of the truth led to the discovery that the 1998 article was fraudulent and that the lead author had hidden payments he received from lawyers to finance the original study. In this podcast, Deer describes how he uncovered the truth and the legal consequences that followed. The conversation closes with a discussion of the elusiveness of truth in science and medicine.

Gary Greenberg, psychologist and author of The Noble Lie and Manufacturing Depression, talks with EconTalk host Russ Roberts about the nature of addiction, depression and mental illness. Drawing on ideas in the two books, Greenberg argues that there are strong monetary incentives to define various problems as illnesses that psychiatrists "cure" with drugs. Greenberg argues that this distorts science and has strong impacts, good and bad, on how we view ourselves and the challenges of life. The conversation looks at the scientific basis for addiction and the role brain chemistry in depression. The conversation closes with a discussion of Greenberg's correspondence with the Unabomber.

Richard Epstein of New York University and Stanford University's Hoover Institution talks with EconTalk host Russ Roberts about the current state of the economy, particularly the regulatory climate. Epstein argues the current level of regulation is producing unusually high costs. He digs more deeply into the pharmaceutical industry and discusses various regulations and alternative ways to encourage drug safety and innovation.

David Brady of Stanford University talks with EconTalk host Russ Roberts about the state of the electorate and what current and past political science have to say about the upcoming midterm elections. Drawing on his own survey work and that of others, Brady uses current opinion polls to predict a range of likely outcomes in the House and Senate in November. He then discusses the role of recent health care legislation in the upcoming election as well as Obama's approval ratings. The conversation concludes with Brady's assessment of how Congress might deal with the demographic challenge facing entitlement programs.

Louis Menand of Harvard University talks with EconTalk host Russ Roberts about the state of psychiatry. Drawing on a recent article of his in the New Yorker, Menand talks about the state of knowledge in psychiatry and the scientific basis for making conclusions about mental illness and various therapies. Menand argues that the research record shows little difference between the effectiveness of psychopharmacology and talk therapies of various kinds in fighting depression. Neither is particularly successful in any one case. Other topics that are discussed include the parallels between economics and psychiatry in assessing causation, the diminished role of Freudianism in modern psychiatry, and the range of issues involved in using medication to avoid pain and hardship.

Arthur De Vany, of the University of California, Irvine, and creator of Evolutionary Fitness, talks with EconTalk host Russ Roberts about performance-enhancing drugs in baseball and Evolutionary Fitness, De Vany's ideas about diet and fitness. In the first part of the conversation, De Vany argues that there is little physiological or statistical evidence that steroid use increases home run totals in baseball. The second part of the conversation turns to De Vany's theories of diet and exercise. De Vany argues that our diet and exercise regime should take account of our evolutionary origins, an earlier time when we ate no grains and our exercise was a mix of intense activity punctuated by much milder activity. He argues that jogging is unhealthy and that we would live longer and feel better if we followed a different exercise routine than most Americans do today.

Mike Munger of Duke University talks with EconTalk host Russ Roberts about the limits of prices and markets, especially in the area of health. They talk about vaccines, organ transplants, the ethics of triage and what role price should play in allocating. The discussion concludes with a discussion of how markets respond to price controls, particularly minimum wages.

David Brady of Stanford University talks with EconTalk host Russ Roberts about American public opinion on changing the health care system. Brady discusses the impact of taxation on public opinion toward health care reform--if the poll includes a measure of the likely increase in taxes necessary to pay for expanding coverage, support for expanding coverage drops dramatically compared to generic polls that ignore costs. He also discusses the role of the party system and partisanship for the health care issue and more generally, how partisanship has changed over time. The conversation concludes with Brady's views on how much science there is in political science.

Steven Lipstein, President and CEO of BJC HealthCare--a $3 billion hospital system in St. Louis, Missouri--talks with EconTalk host Russ Roberts about the economics of hospitals. They discuss pricing, the advantages and disadvantages of specialization in modern medical care, and culture and governance of non-profit hospitals vs. for-profit hospitals. At the end they talk about the positives and negatives of a national health board patterned after the Federal Reserve.

Arnold Kling of EconLog talks with EconTalk host Russ Roberts about the death of his father and the lessons to be learned for how hospitals treat patients and our health care system treats hospitals.

Robin Hanson of George Mason University talks about the phenomenon of signalling--the ways people spend resources to convey information about ourselves to others. It begins with Hanson revisiting his theory from an earlier podcast that we spend too much on medicine because we need to signal our concern for friends and family. The conversation then moves onto apply Hanson's model of signalling to other areas of human behavior. This is a wide-ranging discussion covering not just medicine, but real estate transactions, the wooing of a spouse, the role of education in the job market, parenting, the economics of self-deception, and Robin's argument that we spend too much time on admirable activities.

In this bonus middle-of-the-week podcast, Henry Aaron of the Brookings Institution talks with EconTalk host Russ Roberts about health care costs. Researchers in a New England Journal of Medicine article have estimated that the US could save $209 billion if the US went to a single-payer system like Canada. Is this number reliable? Aaron takes a deeper look at the estimate and discusses the relevance of such estimates for health care policy.

This is a special mid-week podcast. It's a follow-up to an earlier podcast with Arnold Kling that raised the issue of administrative costs and potential savings from going to a single-payer system. It also ties in with recent discussions here at EconTalk about the challenges of accurate measurement in the social sciences. We hope you enjoy it. If not, come back Monday when our regular schedule resumes.

Arnold Kling of EconLog talks with EconTalk host Russ Roberts about the economics of health care and his book, A Crisis of Abundance: Rethinking How We Pay for Health Care. Kling discusses whether we get what we pay for when we spend money on health care, why health care isn't like cars, and why health care insurance isn't really insurance. The conversation closes with a discussion of innovation in America's health care system and why America is so unlike everywhere else.

Robin Hanson, of George Mason University, argues that health care is different, but not in the usual ways people claim. He describes a set of paradoxical empirical findings in the study of health care and tries to explain these paradoxes in a unified way. One of his arguments is that the human brain evolved in ways that make it hard for us to be rational about health care. He also discusses using prediction markets as a way of designing health care policy.

David Leonhardt of the New York Times talks with Russ Roberts about media bias, competition between old and new media, global warming, and the role of information as an incentive to provide better health care.

Richard Epstein of the University of Chicago and Stanford University's Hoover Institution talks about property rights, drug patents, the FDA, and the ideas in his latest book, Overdose: How Excessive Government Regulation Stifles Pharmaceutical Innovation from Yale University Press.

Author and journalist Virginia Postrel talks about how business competes for customers using style and beauty, going beyond price and the standard measures of quality. She looks at the role of appearance in our daily lives and the change from earlier times when style and beauty were luxuries accessible only to the wealthy. She also talks about her donation of a kidney to a friend and how that affected the intensity of her feelings about the policies surrounding organ donations.

Russ Roberts talks with Darius Lakdawalla of Rand and the National Bureau of Economic Research on the economics of obesity, how much fatter are Americans and why. How much is due to the spread of fast food vs. the falling price of food and the change in the U.S. workplace?

Russ Roberts talks with Stanford University's John Cogan about what's wrong with America's health care system and how to make it right.

Along the way they discuss economics of health care, the tax treatment of employer-provided insurance, the role of state-mandated insurance requirements and the political economy of health care reform.

Russ Roberts looks at the economics and science of intermittent explosive disorder—violent rage out of proportion to its cause. Was the recent study that discovered this problem good science or unreliable? Was the media coverage of the study accurate? How do state insurance regulations create incentives for intellectual dishonesty?

Russ Roberts and Richard Epstein, law professor at the University of Chicago, discuss the market for kidneys. Should people be allowed to buy and sell kidneys? How might a market for kidneys actually work in practice? Should mercenary motives be allowed to trump altruism? Epstein deals with these questions and more.

Russ Roberts and Alex Tabarrok of George Mason University talk about medical malpractice, why insurance premiums vary by state, price gouging by insurance companies, the politics of being a judge and an idea for a new TV show using a tried-and-true formula: American Victim.