Robert F. Graboyes, MSHA, PhD

Health Economist | rfgraboyes@gmail.com | www.robertgraboyes.com



Quotes for Health and Economics


Self-interest: “Nobody spends someone else’s money as carefully as they spend their own.” – attributed to Milton Friedman


Secondary effects: "The bad economist sees only what immediately strikes the eye; the good economist also looks beyond. The bad economist sees only the direct consequences of a proposed course; the good economist looks also at the longer and indirect consequences. The bad economist sees only what the effect of a given policy has been or will be on one particular group; the good economist inquires also what the effect of the policy will be on all groups." – Henry Hazlitt


Physician: "I will prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone." – Hippocrates


Method: "The Theory of Economics does not furnish a body of settled conclusions immediately applicable to policy. It is a method rather than a doctrine, an apparatus of the mind, a technique of thinking which helps its possessor to draw correct conclusions." – John Maynard Keynes


Evidence: "When the facts change, I change my mind. What do you do, sir?" – John Maynard Keynes


Incentives: "Most of economics can be summarized in four words: 'People respond to incentives.' The rest is commentary. ... 'People respond to incentives' sounds innocuous enough, and almost everyone will admit its validity as a general principle. What distinguishes the economist is his insistence on taking the principle seriously at all times." – Steven Landsburg


Population: "Increasing population is the most certain possible sign of the happiness and prosperity of a state; but the actual population may be only a sign of the happiness that is past." – Thomas Robert Malthus


Theory: "Facts by themselves are silent." – Alfred Marshall


Costs: "If you think health care is expensive now, wait until you see what it costs when it's free." – P.J. O'Rourke


Technological imperative: “The dilemma of modern medicine, and the underlying central flaw in medical education … is this irresistible drive to do something, anything. It is expected by patients and too often agreed to by doctors, in the face of ignorance.” – Lewis Thomas


Therapeutics: "When I arrived at Harvard Medical School in 1933, nobody talked about therapeutics as though it were a coherent medical discipline, in the sense that pharmacology is today. To be sure, there were a few things to learn about: digitalis for heart failure, insulin, liver extract for pernicious anemia, vitamin B for pellagra, a few others. By and large, we were instructed not to meddle. Our task was to learn all that was known about the natural history of disease so that we could make an accurate diagnosis, and a reasonably probabilistic prognosis. That done, our function as doctors would be to enlist the best possible nursing care, explain matters to the patient and family, and to stand by." – Lewis Thomas


Technology and costs: "The explosion of medical technology in the late 20th century has forced physicians to think seriously about cost containment. When my father first practiced medicine in the 1950s, his pharmaceutical armamentarium included a handful of antibiotics and 2 or 3 antihypertensives. The most expensive diagnostic tests were plain film radiographs. It was easier to give patients the best health care money could buy, because there was not as much health care to buy." – Peter Ubel


More technology and costs: "Medical research has pushed the boundaries of what doctors can do for us in every direction. The Cooper Clinic in Dallas now offers an extensive checkup (with a full body scan) for about $1,500 or more. Its clients include Ross Perot, Larry King, and other high-profile individuals. Yet if everyone in America took advantage of this opportunity, we would increase our nation's health bill by a third. More than 900 diagnostic tests can be done on blood alone, and one doesn't need much imagination to justify, say, $5,000 worth of tests each year. But if everyone did so, we would double the nation's health care bill. Americans purchase nonprescription drugs almost twelve billion times a year and almost all of these are acts of self-medication. Yet if everyone sought a physician's advice before making such purchases, we would need twenty-five times the number of primary care physicians we currently have. Some 1,100 tests can be done on our genes to determine if we have a predisposition toward one disease or another. At, say, $1,000 a test, it would cost more than $1 million for a patient to run the full gamut. But if every American did so, the total cost would run to about thirty times the nation's total output of goods and services. ... Notice that in hypothetically spending all of this money, we have not yet cured a single disease or treated an actual illness. In these examples, we are simply collecting information. If in the process of the search we actually found something that warranted treatment, we could spend even more." – John Goodman, Devon Herrick, and Gerald Musgrave


Costs: "There is no such thing as a free lunch." – popularized by Milton Friedman (Robert Heinlein used the variant, "There ain't no such thing as a free lunch," or TANSTAAFL)


Mathematical methods: "In mathematics you don't understand things. You just get used to them." – attributed to John von Neumann


Managed Care: "The patient said to the doctor, 'It hurts when I do this.' The doctor said, 'Then don't do that.'" Henny Youngman