Irrationality In Health Care

A look at the American health care system through analysis of consumer and provider behavior. The health care industry in the US is peculiar. We spend close to 18% of our GDP on health care, yet other countries get better results—and we don’t know why. To date, we still lack widely accepted answers to simple questions, such as “Would requiring everyone to buy health insurance make us better off?” Drawing on behavioral economics as an alternative to the standard tools of health economics, author Douglas E. Hough seeks to diagnose the ills of health care today more clearly. A behavioral perspective makes sense of key contradictions—from the seemingly irrational choices that we sometimes make as patients, to the incongruous behavior of physicians, to the morass of the long-lived debate surrounding reform. With the new health care law in effect, it is more important than ever that consumers, health care industry leaders, and the policymakers who are governing change reckon with the power and sources of our behavior when it comes to health. Praise for Irrationality in Health Care “Hough does an extraordinary job of distilling the literature and providing key insights to help us understand how health care consumers and providers really behave, and how government can formulate better policy. A must-read for anyone interested in the burgeoning field of behavioral economics and age-old questions in health care.” —Thomas Rice, Distinguished Professor, UCLA Fielding School of Public Health “Hough explains and applies the emerging field of behavioral economics to patient and physician decision making, providing a rationale for seemingly irrational behavior, and its particular usefulness for designing health policies.” —Paul J. Feldstein, University of California, Irvine “Balancing rigor and policy relevance, Hough shows the application of behavioral economics to health policy in a most compelling way. I liked this book so much, I wish I had written it!” —Richard Scheffler, University of California, Berkeley

New, 21st anniversary edition, with a new foreword by Ben Goldacre, author of Bad Science and Bad Pharma, and an afterword by James Ball, covering developments in our understanding of irrationality over the last two decades. Why do doctors, army generals, high-ranking government officials and other people in positions of power make bad decisions that cause harm to others? Why do prizes serve no useful function? Why are punishments so ineffective? Why is interviewing such an unsatisfactory method of selection? Irrationality is a challenging and thought-provoking book that draws on statistica.

"What every leader needs to know about dignity and how to create a culture in which everyone thrives. This landmark book from an expert in dignity studies explores the essential but under-recognized role of dignity as part of good leadership. Extending the reach of her award-winning book Dignity: Its Essential Role in Resolving Conflict, Donna Hicks now contributes a specific, practical guide to achieving a culture of dignity. Most people know very little about dignity, the author has found, and when leaders fail to respect the dignity of others, conflict and distrust ensue. She highlights three components of leading with dignity: what one must know in order to honor dignity and avoid violating it; what one must do to lead with dignity; and how one can create a culture of dignity in any organization, whether corporate, religious, governmental, healthcare, or beyond. Brimming with key research findings, real-life case studies, and workable recommendations, this book fills an important gap in our understanding of how best to be together in a conflict-ridden world."--

Conflicts of interest, misrepresentation of clinical trials, hospital price-fixing, and massive expenditures for procedures of dubious efficacy--these and other critical flaws leave little doubt that the current U.S. health-care system is in need of an overhaul. In this essential guide, preeminent physician Nortin Hadler urges American health-care consumers to take time to understand the existing system and to visualize what the outcome of successful reform might look like. Central to this vision is a shared understanding of the primacy of the relationship between doctor and patient. Hadler shows us that a new approach is necessary if we hope to improve the health of the populace. Rational health care, he argues, is far less expensive than the irrationality of the status quo. Taking a critical view of how medical treatment, health-care finance, and attitudes about health, medicine, and disease play out in broad social and political settings, Hadler applies his wealth of experience and insight to these pressing issues, answering important questions for Citizen Patients and policy makers alike.

We talk about irrationality when behaviour defies explanation or prediction, when decisions are driven by emotions or instinct rather than by reflection, when reasoning fails to conform to basic principles of logic and probability, and when beliefs lack coherence or empirical support. Depending on the context, agents exhibiting irrational behaviour may be described as foolish, ignorant, unwise or even insane. In this clear and engaging introduction to current debates on irrationality, Lisa Bortolotti presents the many facets of the concept and offers an original account of the importance of judgements of irrationality as value judgements. The book examines the standards against which we measure human behaviour, and reviews the often serious implications of judgements of irrationality for ethics and policy. Bortolotti argues that we should adopt a more critical stance towards accepted standards of rationality in the light of the often surprising outcomes of philosophical inquiry and cognitive science research into decision making. Irrationality is an accessible guide to the concept and will be essential reading for students and scholars interested in the limitations of human cognition and human agency.

A groundbreaking investigation of the brain’s hidden logic behind our strangest behaviors, and of how conscious and unconscious systems interact in order to create our experience and preserve our sense of self. From bizarre dreams and hallucinations to schizophrenia and multiple personalities, the human brain is responsible for a diverse spectrum of strange thoughts and behaviors. When observed from the outside, these phenomena are often written off as being just “crazy,” but what if they were actually planned and logical? NeuroLogic explores the brain’s internal system of reasoning, from its unconscious depths to conscious decision making, and illuminates how it explains our most outlandish as well as our most stereotyped behaviors. From sleepwalking murderers, contagious yawning, and the brains of sports fans to false memories, subliminal messages, and the secret of ticklishness, Dr. Eliezer Sternberg shows that there are patterns to the way the brain interprets the world—–patterns that fit the brain’s unique logic. Unraveling these patterns and the various ways they can be disturbed will not only alter our view of mental illness and supernatural experience, but will also shed light on the hidden parts of ourselves. (With black-and-white illustrations throughout.)

In Markets Against Modernity, economist Ryan Murphy documents a clear continuity between the systematic errors people make in their personal lives and the gaps between public opinion and informed opinion. These errors cluster around specific divergences between how the modern world’s institutions function—including global markets, pluralistic democracy, and even science itself—and how evolution trained our brains to understand the nature of economic relationships, social relationships, and humanity’s relationship to the physical world. Murphy calls these systematic divergences Ecological Irrationality. Exploring them leads him to even more prickly questions—and to conclusions that may challenge the beliefs of those who understand that, for instance, modern vaccines are safe and effective. Do we actually want a less cohesive society? Is doing a task yourself financially prudent? And if we recognize an expert consensus, is there even a way to implement it and achieve the desired effects?

This comprehensive introductory text describes health systems in the United States and in other countries, with emphasis on their ability to deliver goods and services, their cost, and their operation within a legal framework. Included is a discussion of such major developments as prepaid group practice, automated multiphasic health testing, national health insurance, professional standards review organizations, comprehensive health planning, and malpractice arbitration. The author underlines the salient features of the various systems by presenting and discussing advertisements for health products and services. Flow diagrams, charts, tables, and discussion questions help the reader understand the complexities and interrelationships of health care systems. Extensive references and suggestions for further reading are also included.