Scott Alexander examines the Amish health care system, which costs much less than the American system while maintaining good health outcomes, and considers its implications for broader healthcare policy. Longer summary

Scott Alexander explores the Amish health care system, comparing it to the modern American system. He notes that the Amish spend much less on healthcare while maintaining good health outcomes, though they have slightly lower life expectancy. The Amish system relies on church aid and a simple insurance-like institution called Amish Hospital Aid. Key factors in their lower costs include collective bargaining, avoiding unnecessary care, not suing doctors, and price-sensitive consumption. Scott considers the applicability of this system to wider society and reflects on how healthcare costs have changed over time, suggesting a possible self-reinforcing cycle between rising costs and the spread of health insurance. Shorter summary