Ep. 89 From Fortress to Frontier in American Health Care, with Bob Graboyes

Robert Graboyes, PhD

According to our guest, American health care is stuck in a fortress mentality that stifles innovation, constrains medical advances, and yield low quality care. That fortress was erected more than 100 years ago but, in many ways, is being circumvented by creative actors who are seizing opportunities to make changes outside of the political process.

Bob Graboyes is Senior Research Fellow at the Mercatus Center at George Mason University. He holds a PhD in Economics from Columbia University and has held a number of academic positions in higher education in Virginia. He is the author of “Fortress and Frontier in American Health Care,” a booklet which offers many examples of individuals adopting a risk-tolerant frontier attitude to compete with insiders and pave the way to the future without having to rely on political reform. Prior to focusing his career on health care, Bob Graboyes was regional economist/director of education at the Federal Reserve Bank of Richmond.


Robert Graboyes Twitter


Robert Graboyes. “Fortress and Frontier in American Health Care” (2014, Mercatus Center)


Ep. 83. The Faulty Economics of Health Insurance: Arrow Revisited (part 2, with Bob Murphy)


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  1. Marc Fouradoulas on 08/19/2019 at 6:17 PM

    Please post the link to his article comparing the legal profession and medical profession.

  2. Anthony M. Perry, MD on 08/30/2019 at 7:07 PM

    Although it is true that there is a great disparity of knowledge between patient and doctor, I still believe that the patient has adequate resources to be the decision maker. In deciding what medical goods and services to seek and accept he uses all sorts of resources, but in most cases the most important one is the advice of a physician who he comes to trust as having his best interest at heart. He must make that judgement in the same way he makes any other judgement about expert advice he seeks, by personal encounter and reputation of the expert.

    But even then the patient is in charge. One type 1 diabetic patient of mine, who I treated from adolescence to mature adulthood with her own grown children, once told me that she thought the key to success in her health was to find a doctor she trusted and to follow his advice. Yet she feared hyperglycemia so much that she constantly overdid her insulin and virtually every visit involved my cajoling her to follow my advice.

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