Healthcare is full of good intentions. It is also full of incentives.

In this episode of the Decode Econ Podcast, we sit down with Beth Munnich, Associate Professor of Economics at the University of Louisville, to discuss her research published in the American Economic Review on physician ownership of outpatient surgery centers.

The question is straightforward:

When doctors own the facilities where they operate, does behavior change?

The answer, as in most markets, comes down to incentives.

Outpatient (ambulatory) surgery centers have expanded rapidly over the past two decades. Advances in medical technology now allow many procedures to be performed safely without overnight hospital stays.

This shift matters for three reasons:

* Cost: Outpatient centers typically operate at lower overhead than hospitals.

* Access: Patients benefit from shorter stays and quicker turnaround.

* Market Structure: Increasingly, physicians are not just providers; they are also the owners.

Ownership changes the economic equation.

We also discuss teaching and advice for students and economists starting their academic journey.

Key Takeaways

* Physician ownership changes financial incentives in outpatient surgery markets.

* Incentives influence referral patterns and potentially spending.

* Healthcare markets are deeply shaped by ownership structure and insurance design.

* Rigorous empirical research is essential to move beyond speculation.

* Mentorship and persistence are critical in academic careers.

This episode is about how markets respond when incentives change.

And as Beth reminds us, incentives are always the key

Our goal is to amplify research and the people behind it, help us spread the word about Beth’s Research

Chapters

00:00 Introduction to Decode Econ and Guest Beth Munnich

00:12 Guest introduction and research overview

01:06 Why Beth Munnich was drawn to healthcare economics

01:35 The rise of outpatient surgery and its implications

03:22 The importance of data and research questions

05:18 Incentives and physician ownership in surgery centers

07:44 Potential outcomes of ownership incentives

08:31 Research findings on ownership and healthcare costs

10:40 Doctor behavior and the principal-agent problem

12:06 Insurance and patient financial incentives

12:38 Research process and data collection challenges

15:41 Long-term research journey and data acquisition

20:46 Economic lesson: Always incentives

22:06 Aligning incentives for better patient care

23:22 Beth Munnich’s teaching philosophy and course design

28:33 Target audience and topics of her new course

30:00 Flipping the classroom: Relevance first in economics education

31:35 Favorite subfields: Labor economics and social issues

32:42 Impact of research on teaching and curriculum

33:31 Career advice for students and early professionals

35:44 Path to a PhD and career in economics

38:02 Skills needed in modern economics

39:44 Misconceptions about academic life

41:38 Advice to younger self and career reflections

45:05 Mentorship and networking in academia

45:26 Connecting with Beth Munnich

46:37 Closing remarks and gratitude

resources

Beth Munnich’s website

https://www.bethmunnich.com/

Join Dr. Abdullah Al Bahrani and Jack Marx for a wide-ranging conversation on economic policy, leadership, and personal growth.

From Supreme Court tariff rulings to Kentucky’s long-term tax strategy, this episode breaks down what recent policy changes mean for consumers and households. The discussion also moves beyond economics into the role of emotional intelligence in leadership—because understanding policy is important, but understanding people is essential.

Episode Summary

This episode begins with reflections on midterms and the importance of engagement in learning. From there, the conversation turns to recent tariff rulings and the constitutional questions surrounding trade policy.

Dr. Al Bahrani explains how tariffs work, who legally pays them, and who actually bears the economic burden. The discussion explores what “refunds” would really mean for consumers—and why the answer may be more complicated than headlines suggest.

The episode then shifts to Kentucky’s gradual transition away from income taxes toward a broader consumption-based system. The conversation unpacks the strategy behind revenue triggers, the trade-offs involved in tax reform, and the long-term implications for households.

Finally, the discussion closes with a powerful reminder: economics is about incentives, but leadership is about people. Emotional intelligence, reflection, and passion are not soft skills—they are performance skills that shape both economic outcomes and personal growth.

Key Topics

* Tariffs and their constitutionality

* Statutory vs. economic incidence

* Kentucky’s tax policy transition

* Inflation and supply chain dynamics

* Emotional intelligence in leadership

* Reflection as a tool for growth

Notable Sound Bites

* “Illegal tariffs should be refunded.”

* “Passion drives understanding and motivation.”

* “Reflection is key to emotional growth.”

Chapters

00:00 Introduction and Midterm Reflections05:38 Kentucky’s Budget and Tax Strategy11:00 Emotional Intelligence and Personal Growth

Keywords

Economics, Tariffs, Kentucky Tax Policy, Emotional Intelligence, Leadership, Public Policy, Supply Chain, Inflation, Midterms, Economic Education

This week’s Posts

* Can Kentucky Cut Taxes and Still Compete?

* If Tariffs are Unconstitutional, Who Gets the Refund?

* Trump’s “Liberation Day” to Judgement Day

* Can You Read the Room?

From Income Tax to Sales Tax: What Kentucky Is Really Changing

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In today’s economy, intelligence isn’t enough. Employers aren’t just hiring credentials — they’re hiring people who can think under pressure, navigate uncertainty, and solve problems no one has clearly defined yet. In this episode, we explore the one skill that quietly separates top performers from everyone else — and why research may be the most underrated competitive advantage in the modern job market.

What if the most powerful career advantage isn’t technical skill — but the ability to think clearly when the answer isn’t obvious?

In this episode, alumni and faculty from the Haile College of Business share how research transformed their careers — not by preparing them for academia, but by sharpening the one capability employers consistently struggle to find: critical thinking under uncertainty.

From government affairs to consulting to international economic research, our guests explain how research builds confidence, adaptability, and the ability to tackle complex, ambiguous problems in real-world environments.

You’ll learn:

* Why research builds more than resumes — it builds decision-makers

* How critical thinking becomes a long-term competitive advantage

* Why discomfort and uncertainty are essential to professional growth

* How students can position themselves to stand out in an AI-driven economy

Whether you’re a student, professional, or leader developing talent, this conversation will change how you think about the value of research.

In a rapidly changing economy, the winners aren’t just informed, they’re prepared.

From Around the Web

Here are some posts this week that made us think

* When you get in your way! by Dr. Jeni Al Bahrani. How Forever 21 rose and eventually fell as a business.

* Puerto Rico by the Numbers by Monday Morning Economist. I love economic data dives into regions and policies that shape economies. Given Bad Bunny’s recent half-time show and everyone’s interest in PR, this is timely. As are all of Monday Morning Economist posts.

* Something is rotten in the state of … Economics- by Nominal News. I missed a fight. Economists are upset with Jon Stewart for dismissing the field of economics.

* Buying Futures, Renting the Past: How Speculation and Nostalgia Became the Economy by kyla scanlon. Another example of how she connects the dots between our social and economic realities.