US healthcare sludge = hundreds of billions/year
Richard Thaler estimated the sludge cost of the US medical system alone is in the hundreds of billions of dollars per year.
Where this was said
Types of Sludge: Incompetent, Accidental, and Intentional
At 12:32 · chapter starts 9:30
Thaler begins with what he calls 'inadvertent and/or incompetent sludge' — design failures like Norman doors, where the physical affordance of a door handle tells your brain to pull when you need to push. These aren't malicious, just thoughtless, and the architects responsible deserve 'a special place in hell.' He then pivots to the unsubscribe trap: where one click signs you up for a service but cancellation requires a phone call, a wait, and a sales pitch. That, Thaler says, is clearly intentional. He cites gyms during COVID that required members to physically enter a closed facility to cancel their membership — nobody designs that innocently. He notes he has personally tried to convince subscription companies to stop these practices, and been told bluntly that it would cost too much. Thaler's rough estimate: healthcare sludge alone costs the US hundreds of billions annually, though almost none of it is formally measured.
Gyms Made Members Come In to Quit During COVID
During COVID lockdowns, some gyms required members to physically show up at a closed gym to cancel their membership. Richard Thaler's verdict: nobody designs that innocently — it is pure, strategic sludge.
US Healthcare Sludge Costs Hundreds of Billions Per Year
Nobody has a precise figure for the cost of healthcare sludge, but Richard Thaler puts it in the hundreds of billions per year for the US alone. The problem is that so much of it is consumed time — invisible on any balance sheet.
Similar snapshots
50% of U.S. adults report being lonely
The U.S. Surgeon General's 2023 report on loneliness found that half of American adults report feeling lonely, marking a widespread epidemic of social isolation.
Brain.fm increased focus brainwave activity by 119%
In a peer-reviewed study, Brain.fm's audio technology was shown to increase focus-related brainwave activity by 119%, according to the show's sponsor read.
Wealthier countries have highest rates of anxiety and depression
The Easterlin Paradox shows that wealthier nations — and the wealthiest neighborhoods within them — tend to have the highest rates of anxiety, depression, loneliness, and suicide.
More than 3 in 4 Americans report anxiety or depression
Mental health challenges are nearly universal — BetterHelp's own research found the majority of Americans experiencing symptoms right now.
Medicaid 5-year look-back rule
When applying for Medicaid to cover nursing home costs, there is a 5-year look-back period that can disqualify applicants who gave away or spent down assets.
Pipe broke → hydrogen sulfide studio air
A broken pipe filled the Bad Friends studio with what the hosts identified as hydrogen sulfide — microscopic fecal aeroparticles — that the crew denied smelling.
Robot surgery: 10x less blood loss
Fei-Fei Li's father's liver surgery performed by a da Vinci robot resulted in 10 times less blood loss than a typical open liver surgery, thanks to laparoscopic precision.
115M US adults have prediabetes
Approximately 115 million adults in the US currently have prediabetes, most of whom are unaware, according to the Lingo sponsor segment.
Drug overdose deaths: 110K to 80K to 70K
Drug overdose deaths in the US fell from 110,000 to 80,000 in 2024, and then to roughly 70,000 — the largest single-year drop the CDC has ever recorded.
