Healthcare = ~20% of US GDP
US healthcare makes up nearly 20% of GDP and employs more people than any other industry, making its sludge unusually costly.
Where this was said
Healthcare Sludge: Listener Stories
At 14:03 · chapter starts 12:55
After Thaler's theoretical framing, Dubner grounds the conversation in raw human experience by reading out listener-submitted sludge stories, almost all of them involving healthcare. One listener's wife spent six months trying to get reimbursed for an RSV vaccine, caught between health insurance, pharmacy benefit managers, and the pharmacy chain. A psychologist working in a hospital had to mail a patient report — physically, by post — to another agency in the same city because electronic transmission wasn't possible and the patient had to pay money to access their own health information. A third listener described reconciling 17 pages of printouts in their own Excel spreadsheet and discovering $350 owed back from a provider due to a deductible recalculation. These stories make visceral what could otherwise be an abstract economic concept: sludge is not a metaphor, it is hours of wasted life.
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