• All-payer rate setting [podcast]

    For some time now, we (Austin and Aaron) have been tossing the idea around of doing a podcast. There are lots of times we’d like to to more in depth than a blog post allows, or times when we’d like to debate an issue in a way that doesn’t conform well to blogging. So here it is.

    We’re still working out the kinks, so expect that the first few episodes will be a bit buggy. We’re also trying to figure out the best way to not step on each others’ toes. We are more than happy to hear feedback, so leave us plenty. When taping, we hadn’t yet decided on a name for it. But afterwards, we thought “Rational Arguments”, the name of Aaron’s old blog, might be a good choice.

    This first podcast is on all-payer rate setting. We’ve been getting lots of questions about it, and we try and explain what it is, why it might work, and why it might not.

    The feed for the podcasts alone is here. Other feeds remain unchanged.


    • How about “The Incidental Econversation”? Okay that might be awful, but I’m just spitballing here…

      But for some more serious feedback. I’ve done some radio work, and I think you guys face an uphill battle in turning your content into a great podcast. Engrossing narrative is key for radio and podcasts, from newscasts to pieces on scientific research. People don’t really listen to great NPR podcasts like Marketplace, Planet Money and Radiolab because the shows discuss interesting issues. They listen because the producers MAKE issues interesting by placing them in the context of a coherent narrative. Often, creating a narrative requires a considerable amount of production and editing work, more than you are likely able to do given your full-time jobs. Even shows that don’t seem heavily produced, like Fresh Air, are actually extremely edited to keep the content dense with the good stuff. And while people do listen to standard talk shows like Talk of the Nation, which don’t rely on narrative, these shows aren’t as successful in the podcast format, because the audience isn’t captive driving their cars.

      So, in terms of advice, I’d recommend trying to use narratives to describe concepts, ideas and events, in order to keep people engaged. For instance, say you wanted to devote an episode to the RAND HIE. I’d start it with something like “In 1968 a 26-year old graduate student in economics named Joseph Newhouse landed his first job, at a think-tank. His first major assignment was to lead the largest social science experiment in history….” Listeners are drawn in, and want to know how the story ends. If I were trying to describe all-payer rate setting, I’d start with an analogy of some kind. “Imagine if gas stations were run like hospitals. Instead of posting a single price for gas and having drivers pay it, each chain of stations would negotiate a price with each car manufacture. At Shell, Honda drivers pay $3.50 a gallon, Volvo owners $4.75, you get the idea. How would this change complicate things? In this world, the most profitable gas stations would be those with the most bargaining power, since they could negotiate the best rates. Similarly, the most profitable car manufacturers would be the biggest ones, not necessarily the ones make the best cars. This would distort decisions. Someone buying a car might decide to buy a gas guzzler from a large manufacturer rather than a fuel efficient car from a small manufacturer without bargaining power. …” This narrative forces the listener to use some imagination, drawing them in. Still, I imagine it will hard to develop engaging and long podcasts that are primarily focused on explaining an idea to laymen. The writing alone will take a while.

      When you’re using the podcasts for debates, I’d say be as concise as possible. Remember, unlike your blog posts, People can’t really scroll ahead when they get bored. Also, don’t be afraid of playing “smart guy / dumb guy” in debates for the sake of drawing out an argument. Remember, the idea isn’t to win the debate, it’s to explore a subject. It works great on Radiolab. You may want to check out bloggingheads content to see what you like about those debates.

      Hope this helps…

      • Great advice. You’re right about our limitations. We have to ask ourselves if we’ll continue to do this if, in a few months time, only 10 people are listening (to the extent we even know that). However, between now and then, I for one will learn a lot and, I hope, get better at speaking. Aaron is excellent on the radio. I need practice!

    • Nice first step…

      One question, one suggestion…

      Q: How often are you looking to do these? We’re creatures of habit and if we know every Friday afternoon is when your podcast comes out, we look forward to it.

      Suggestion: One of the very first things that drew me to Aaron’s “Rational Arguments” blog was his ability to bring a fairly wonky issue down to an easy to understand level. It was very reader friendly. One of the biggest differences between Rational arguments and the Incidental Economist is that, generally speaking, the content on IE is far more wonky.

      Who is your target audience? Who do you want to listen to these podcasts? If its the average joe who’s trying to follow along as things unfold, I’d suggest make sure you present the content in a way we can understand. If its more peers and industry people, then wonk away.

      Either way, could either of you have imagined ten years ago the average guy reading a health economics blog every day?

      Congrats on that and good luck with the podcasts…

    • Narratives are great and all — but unless they’re done masterfully, they can just make a podcast longer without making it better, discouraging listeners. I thought your first podcast was great, and I look forward to the next one. But if you’re worried about whether your audience is too small to make these worthwhile, you should pick some topics where you two have substantive disagreement, or where you are still trying to figure out your own opinions — that way, no matter how many people are listening, the dialogue is productive and valuable.

      • I can reconsider my opinions on anything almost anytime. I the proverbial two- or three-hand economist. Seriously, I’ll argue any side of any health policy issue, with one exception. I will never neglect evidence or distort research.

    • Nicely done guys,

    • Enjoyed the discussion guys! Will be adding this blog to my blogroll.

    • I really liked the discussion. I would be interested in your thoughts on the effects a fee for service system versus a capitated system with an all payer rate.

      In terms of the podcast, it seemed like there were a couple of points where there was some confusion over who should talk. I realize this can be difficult if you aren’t in the same room doing the podcast.