25. Health Economics

MIT 14.01 Principles of Microeconomics, Fall 2018
Instructor: Prof. Jonathan Gruber
View the complete course: ocw.mit.edu/14-01F18
KZbin Playlist: • MIT 14.01 Principles o...
In this lecture, Prof. Gruber uses the information taught in class to explain the real world example of health economics, and how it plays out in policy and practice
License: Creative Commons BY-NC-SA
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[@ArifulIslam-qw6lf]

These lectures are great! PLEASE UPLOAD 14.41 MIT!

[@THEios8]

I am very thankful to the fate that I found this course. It was a pleasure to listen to the material explained in such detail by Prof. Jonathan Gruber, and presented so organically and with so many great jokes. For the period of this course, I even felt like a part of this class, a part of MIT. Thank you for this opportunity and see you in the next courses!

[@otajonabduraxmonov3453]

I made it! Thanks a lot to MIT and to Professor Jonathan Gruber, it was just awesome, these 20 days was very exciting for me. I am very grateful for this open course, Love from Uzbekistan. If God Wills one day I will meet with Prof. Jonathan Gruber.

[@JosephZhang-s2d]

Thanks Prof. Gruber, this is the most interesting and practical introductory-level Micro class I have learned. Please update the Advanced-level Micro class. And, if it is possible, please upload the Econometrics Class with coding. MIT is the last bastion of Science! The only place I trusted, without any doubt! God Bless MIT! Long Live OCW!

[@noonegates2328]

Big thanks to Prof. Gruber and those guys who uploaded lectures so we can watch it

[@michaels8297]

Thank you! Glad we can comment to show appreciation

[@alejandrozamora4453]

Just finished these lectures, Prof. Gruber has a lot of insight to offer. Thank you!

[@bocui325]

Salute to MIT and Prof. Jon Gruber! Waiting for 14.41 "The job of economist is sort of being annoying and look for the basic flaws in arguments to understand them, to ask difficult questions, but to have responsible answers."

[@zakaryjaynicholls9867]

Excellent. Watch the entire course, I would strongly recommend prof gruber. 10/10

[@brianni8602]

This professor is awesome.Explained the complex US healthcare problem in 40 mins on both access and costs.

[@GameByGame]

He also intentionally lied to trick voters then bragged about it

[@jackgruber7811]

I made it! Would love to see the lectures for the other courses he keeps referencing. Thank you so much for uploading these! It makes a huge difference!

[@otajonabduraxmonov3453]

Hello, are you son of Jonathan Gruber ?

[@kamugishathierry7653]

@@otajonabduraxmonov3453 Thinking about it either.

[@QuasarKen009]

Interesting

[@johnkodhek]

Excellent introduction. Extremely grateful to all who made this possible. 👏🏾👏🏾👏🏾

[@nvjt101]

Awaiting 14.02 Macroeconomics since a long long time ❤

[@yutongchen4613]

love the lecture! The professor explained the topic in a very organized and clear way. I'm able to follow through the whole lecture without feeling tired and definitely learned a lot!

[@albertoquesadarivas5843]

thank you for the content! As a european interested in us policy and economics this was really enlightening

[@divyanshukunwar7849]

Thank you Professor Johnathan Gruber. It was great fun and honor to learn economics basics from you. Hope you read this and get to know that you were able to make one person from India more educated on economics. Also thanks to MIT for uploading these lectures on youtube. Yall are greatly appreciated

[@kd9k4h8d]

14.41 needs to come up soon, I got hooked

[@samyohangsubba3748]

Thank you Professor Jonathan Gruber, you are a sea of knowledge, thank you M.I.T. for making this educational course available to everyone, surely my outlook on the ongoing issues of society has changed, learned a lot. Thank you, Love from India.

[@peterg617]

Boom, completed! This coming from an older liberal arts grad. Thanks for making this available John and MIT!

[@kingsolomon0]

Thumbs up Proff Gruber , for making it easier for me to digest . Love from Kenya 🇰🇪🇰🇪🇰🇪🇰🇪.

[@ayrian25]

Great lecture as always ! Very thought-provoking, as there is no easy answer to these cost problems and acces problems in health care. Thank you Pr for explaining these issues in a simple manner, and making the course smooth and easy to follow, and thank you MIT for sharing it.

[@yeyem21]

Excellent course, very insightful and well explained. I really enjoyed it. Always wanted to study at the MIT so I guess this is my way to "get in".

[@hacklife8363]

Incredible series, thank you Professor Gruber! Would love to watch 14.41 some day.

[@KungFu_Medicine]

Wow thank you. I study international health sciences in Germany. You made me understand the complex multidimensional Healtjcare of Us. And I didn’t even wanted to understand that but you made it so easy alongside… wow

[@haruchan4277]

Thank you MIT

[@aravindkasarla2683]

Wonderful, Enjoyed every bit of the course. Take a bow professor.

[@steshanplaci6373]

This course is grately appreciated.. Much respect from Sri Lanka ❤️

[@sapanagehlot1752]

Big thanks to the professor john and there team, they are really doing a honorable work. Thank you so much professor

[@p.m.6594]

Absolutely brilliant course and the conclusion about economical thinking and being a conscious consumer, keep up the good work.

[@mihaelkatavic2316]

Really enjoyed every minute of this lectures, thank you very much for uploading this wonderful content.

[@rabusmccaleb7944]

Thanks for these lectures MIT!

[@prajeshniraula1053]

I felt sad because the lecture ended. Hope the other course that he mentions gets published.. Huge Respect to Prof. Jonathan Gruber. Would love to meet him someday. Never really got a chance to learn from the best. I feel sad for not being able to qualify for MIT.. Prof. Jonathan Gruber. if you ever decide to visit Nepal, I would be more than happy to assist you around the country with profound pleasure as it would be a great opportunity cost for me to assist you around.

[@Pseudosapien29]

If it's a great opportunity cost, you shouldn't be doing it. Outsource it. Lmao :'))

[@kamaleshkhanna4735]

@@Pseudosapien29 lol

[@user-xh6lx5xn3w]

Thank you, professor, but how do u explain the PPC of National Defence against Health Care.

[@adamsmith1300]

Great course, thanks

[@mohammadorfali8286]

amazing video , very informative. i m glad i took some time to watch it and learn.

[@konstantins.uvarin652]

Thank you! This was awesome, very insightful lectures.

[@muhammadsiddiqui2244]

I did it..I did it.....But it is not me.....it is Prof. Jonathan Gruber who made it.....

[@ethionews1354]

Awoseme lecture

[@tonydaysog9164]

Love it! “insurers are just bookies…they want a predictable distribution of risk”… so they can make money just off the top. 24:08 Wow..I had no idea: “there are as many mri equipment in LA as in all of Canada.” 35:49 I enjoyed this very much, but his cost control discussion about ACOs was not that different from other forms of cost controls such as price-fixing regulation or equipment or service rationing. It looks to me that an ACO as he described is either price-fixing or equipment or service rationing regime, except that it takes a local decision it making form. But it’s still price fixing or rationing. 40:10

[@ProWhitaker]

Thanks for the video

[@jasonleelawlight]

Thank you professor Jon and MIT! This class is amazing! I just made a comment about US health care under the previous video and then I realized this very last one is about health care, what a coincidence isn’t it? I will rethink some of the points I made given the additional info I learned in this one, and I love the ending that no matter what conclusions we draw we should always try to think logically and intellectually, and that should be our baseline.

[@mtllola9770]

Thanks MIT. These lectures are great!

[@ilyaglazunow]

25 brilliant lectures. Thanks to MIT and personally to the prof. Jon Gruber! I'm also among those who want to see 14.41 Economics was always kind of strange thing that economists do in their narrow circle, the truth is that I didn't have a good teacher)))

[@ImVedanshAgarwal]

Never enjoyed a course this much !

[@hiphopcafe1056]

I made it through! Thank you very much, great job.

[@kwamina_dare]

Super stuff!

[@melissasmind2846]

Excellent

[@doobieduh2628]

Finished! Thank you so much for the great course!😭

[@vincentjacques4905]

Thanks MIT

[@pradeepbhatnagar4848]

Thanks for Informative nd Awerness vdo lecture on Health Economics related to principle of economics.Glad to hear nd sincerely appreciated.Thanks.It is a vast field nd benefit the society by imposing Positive policies in my opinion in brief.Nice vdo.lecture.Thanks.

[@UltraRik]

that was really good

[@layb2479]

Wow, I made it too. Thank you Prof Uber, thank you MIT, thank you youtube for sharing this to the world. Some math topics were a little bit overwhelming for me but I certainly laughed at the joke:)

[@carlaperrotta7370]

Just seeing this, great lecture. , I dont think is fair the comment on the US is the best healthcare in the world, even for people who are insurance there is a huge disparity in quality; Why do health economists in the US never mention the huge pump of money by the government into the health system ( in terms of research funds) -and how unequal is the distribution of that gain. Fantastic lecture! thanks for sharing.

[@PythononPapyrus]

Thanks!

[@morganjp5951]

Thank you !

[@JustHindiFootball]

thankyou for this

[@kamalsr707]

Its helpful 👍

[@phamlocky4009]

thanks

[@Cam-lh7nr]

Im in the uninsured but qualify for medicaid group. Trying to move up socioeconomically and really just cant see beyond on the bad incentive element of any subsidized program like healthdare or foodstamps.

[@jeff1ca]

There is actually a single solution to both of these problems. No-one will have the balls in the US to propagate it but Scandinavian countries will lead the way as usual.

[@ChickenCaesarSalad]

I bet you won’t mention individuals taking accountability for what they put in their mouth and their exercise habits. I bet the Scandinavian countries don’t have the same obesity-related illness problems that Americans have.

[@TanYoutube-hq5fv]

Bot summary In his lecture on health economics, Professor Jonathan Gruber of MIT delves into the complexities of healthcare policy in the United States, highlighting both the challenges and the attempts at reform through economic principles. Gruber begins by framing the issue with the stark financial figures that characterize the U.S. healthcare system: it is the most expensive in the world, consuming about 17.5% of the nation’s GDP and averaging nearly $10,000 per person annually. Gruber points out that despite this high expenditure, health outcomes in the U.S. are mixed when compared to other developed countries, which spend significantly less. The U.S. healthcare system shows striking disparities; while those with good insurance receive some of the best care in the world, the uninsured and underinsured experience much worse outcomes. Gruber uses statistics like infant mortality and life expectancy to illustrate these disparities, noting that such outcomes are often worse than those in countries with much lower healthcare spending. The lecture then shifts to a discussion of healthcare policy reforms, particularly focusing on the Affordable Care Act (ACA). Gruber details his involvement in developing health policy and explains key components of the ACA, including mandates, subsidies, and insurance exchanges designed to increase access and affordability. He discusses the mixed success of these reforms, noting that while they expanded coverage to millions, many Americans remain uninsured. Gruber also addresses the problem of healthcare costs, emphasizing that a significant portion of U.S. healthcare spending is wasteful. He discusses various approaches to cost control, including both regulatory measures used in Europe-such as price controls and restricted access to certain treatments-and incentive-based measures such as Accountable Care Organizations in the U.S. These organizations aim to control costs by providing a fixed amount of money for patient care, encouraging providers to focus on efficiency and effectiveness. Throughout the lecture, Gruber stresses the importance of applying economic thinking to healthcare policy. He argues that economic tools can help understand and address the inefficiencies and inequalities of the healthcare system. The lecture concludes with a call to action for students and future policymakers to engage deeply with these issues, underscoring that healthcare costs and policies are not just academic topics but central issues that will significantly impact the fiscal and social future of the country. Gruber’s overarching message is clear: while economic principles can guide improvements in healthcare access and efficiency, the U.S. still faces significant challenges that require innovative solutions and continued advocacy for policy changes.

[@shawnzg2587]

Great conclusion of the course with a joke! Thx MIT thx prof！

[@trollingisasport]

Price controls are absolutely essential if you want an affordable healthcare system in regards to medication, but the government should not just simply dictate market prices. There needs to be a system by which prices are negotiated with the pharmaceutical companies and costs such as the price of development need to be considered. The system must also require constant adjustment with at least bi-yearly reviews and adjust things accordingly. There also must be mandated generic drugs and incentives for pharmacies to offer them. It isn't always as black and white as command economy vs free market. Both the concerns of the people and the companies that are taking the financial risks to develop the drugs in the first place.

[@rezamoosavi71]

That was an AWWWWsome course

[@barath365]

Please upload 14.41

[@rickcabrera49]

Great lectures Prof. Gruber. Good to see a dismal scientist curse. Thanks!

[@SunShinepkg]

IS there a Masters in Health Economics In the U.S?

[@CyPorter]

Healthcare is so much better than in the 50's not just because the cost is higher. Advancements in medicine make today's healthcare much better.

[@keerthivasanb7931]

43:16

[@Flipskater13]

41:15 wow

[@robbyosborne9708]

I'll bet this professor's exams are pretty tough.

[@quatreunhuit]

2:38 A lot of americans go to Mexico to consult dentists

[@josefloresmogollon4737]

10

[@lennon_richardson]

“Insurers are just bookies” 😂

[@wa1649]

It's 2023 and it's been nearly a decade since the ACA passed, here are a few updates for the uninitiated on the consequences of the policies suggested in the video: - Healthcare premiums are at a historical high, along with deductibles (both unaffordable to many Americans) - At the same time, we're at a historical profit era for healthcare insurance companies - All while claims are denied by insurance companies en masse (report today that denials take 1.3 second - yes second not a typo: kzbin.info/www/bejne/hqPCmqhjpbanhMU) So basically it turns out the brilliant ideas presented here probably did much more damage to the average American health than anything else... oh did i mention that we actually have a decrease in life expectancy several years in a row in America... Anyways, while prof. Gruber presentation captivates listeners, the lack of his insight into the negative effects of the suggested policies (such lack seems widely present in academia) is astonishing...

[@ahtheh]

This lecture was accurate, when we account for the fact that the purpose of this lecture was to teach a broken system. The fact that no one in the room was going to solve the healthcare problem by giving actual health care, was just accepted before the lecture

[@aidan6146]

If prices are high, then tech regulation and supply regulation aren't the answer. And price control isn't the answer. The information failure is damning, and so is the geographic monopoly. But if these were the issues, why focus on mandating insurance or providing money at a fixed subsidy or mandate from the government, when neither the government nor doctors know the answer? It sounds like this is a lack of information and geographical innovation, as well as over-regulation, consolidation/cartelization. And that insurance costs drive up the price administratively and at a premium when insured plans could just be done through the hospital directly with better information.

[@taaayll]

Um, okay, but defense spending is a non-issue I guess? I'd just like to understand how that fits into the big picture of government spending.

[@juansegovia3670]

Defense spending is a fraction of healthcare spending in theUS

[@its_jawsh6145]

This is a interesting lecture but as someone who’s worked in healthcare for almost 10 years his view as a economist screams through. His ideas would be perfect in a ideal world. Yet we don’t have a ideal world and he doesn’t mention the perverse incentives the ACA introduced. Frequent flyers in our ED are a perfect example. Disabled, poor, or mentally unstable people will rely on the ED for their primary care. I cannot put in words how INSANELY EXPENSIVE this problem is. People on Medicaid are frequent users of Emergency room care. Since they have no way to pay the cost is written off or a claim is submitted to medicaid that’s simply never paid. That is not a lie I’ve done insurance billing and we would send claims to medicaid and just never get a response and it becomes a loss. The consequence of these regulations has been the death of private practice for physicians. IT IS NOT financially pheasible for many physicians to open their own practice and hence the rise of medical groups. Doctors banding together to share the costs of the billing dept, technician salaries, privilages, insurance costs, etc. So those total losses don’t hurt as much. If a physician today opened a clinic and only saw medicaid patients then they would be bankrupt in a month. IT PAYS NOTHING. So yes we’ve removed some discriminatory practices from insurers but passed those practices to providers. So now providers are incentivized to see people with private health insurance and only take medicaid patients if it’s a partnership plan between a insur. company and state plan as it will actually pay the claim. Providers and hospitals now have incentives to see relatively few medicaid pts and to prioritize private coverage as that is what keeps the lights on and everyone paid. On the other side of that medicaid patients may not be able to see a PCP for up to 6 months. So why should they wait? The Emergency Room is just down the street and they have a runny nose and feel bad. This is just a glimpse into the absolutely fucked world of healthcare economics right now and the poor incentives offered by the ACA. Imo it was one of the worst pieces of legislation to be introduced. We insured 40 million people but at what cost? Insurance companies don’t discriminate against diabetics they just charge them insane amounts for coverage. The system sucks and the ACA did not make it better.

[@zachocracy]

Same John Gruber that co-authored the ACA and stated that americans are stupid and their fundamental misinderstanding of tax code wouldn't allow them to see that Obamacare was a tax. He also stated he wrote it in a "tortured way" so senators wouldn't have time to read it which Pelosi's response was "if you wanna know what's in the bill, then vote for it" Maybe learn the fundamentals of Gell-Mann Amnesia

[@americanpride8378]

yes one and the same kzbin.info/www/bejne/fWicYaNmgciamKs

[@frankfliv]

Do you have any substantive comments on his lecture here? Or just ad-hominem?

[@kamaleshkhanna4735]

He elucidates this in his previous lectures where it's clear that it's either get healthy people to cough up money (mandates /govt subsidy/social security) or dump the problem of adverse selection on private insurance and all people end up with no insurance.