373. The Fragile Balancing Act: How Healthcare Fails America feat. Bethany McLean

Jan 12, 2024

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What is the correct balance between short-term profit and long-term resilience as far as healthcare is concerned? How does the 'panic, neglect' cycle underpin our societal and managerial flaws?

Bethany McLean is a journalist, editor, and author of several books. Her latest book, co-authored with Joe Nocera, is titled The Big Fail: What the Pandemic Revealed About Who America Protects and Who It Leaves Behind.

Bethany and Greg discuss the paradox of America's healthcare system—immense spending that does not equate to superior care, a disparity made glaringly obvious during the global COVID crisis. They dissect the financial interventions of recent administrations and biases that tip the scales in favor of the affluent, leaving small enterprises and the vulnerable in the lurch. Bethany gives a critical examination of the swift mobilization that birthed vaccines under Operation Warp Speed, an emblem of successful government-industry collaboration amidst a turbulent political backdrop.

*unSILOed Podcast is produced by University FM.*

Episode Quotes:

“I don’t know” isn't a weakness, it's a skill

48:42: The ability to say, "I don't know," in a way that isn't weak is a skill I hope our leaders can start to learn: "I don't know, but here's what we think. Here's what we're trying to do." I think, for all of us, not resorting to ideological divides as quickly as we do, and to really try and understand that where different people are coming from. I mean, I remember this whole ugly thing at the start of the pandemic: that you were a really bad person if you cared about the economy; that meant you cared about money over people's lives. And I was like, "The economy is people's lives.” I mean, what functioning society doesn't have a functioning economy? It doesn't happen there intimately bound up together.

Is the healthcare system failing to deliver value for its costs?

17:52: I sometimes think our healthcare system just needs to be ripped out by the roots and replaced because everything we do jiggers around the edges, just ends up making matters worse and creating more loopholes that financial players come and take advantage of. And none of it seems to do anything for either lowering the cost of health care or actually keeping people healthy.

Science isn’t the truth, it is a method of ascertaining truth

25:59: There was a fundamental misconception, stoked by people who said, "Follow the science," as to what science actually is, and as well as I do science, it's a method of asking questions. It's formulating a theory and then gathering evidence and seeing if the evidence supports or disproves the theory. And then, if it disproves the theory, you adjust the theory. But science isn't truth with a capital T. It's a method of ascertaining truth, of arriving at truth. And we wanted to believe that there was truth with a capital T. And I think that was one portion of the damage done.

Is the government short-sighted when it comes to looking at crises?

09:38: The government is shortsighted, and part of it goes back to the issue that the government only knows how to look at the last crisis, not how to prevent the next one…[10:16] I think our government has become fairly incompetent and unwilling to lead. And that's partly because we are so divided as a society that it's difficult to lead, but partly because people would rather score ideological points than actually exercise leadership.

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