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i'm

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kind of fascinated by health care in

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general we've done some episodes

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um on it you know i have a general view

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that that

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government has destroyed the health care

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system in the u.s

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that the free market has created so many

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fantastic

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solutions in so many different arenas

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um but we just don't allow it to do its

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job

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in healthcare because of the insurance

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companies and

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and how we put them in the center of

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everything

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in healthcare and obamacare just you

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know quadrupled the importance of

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insurance companies

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for free market and of course the

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government's not great for free market

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and you know here we are you know with

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covid

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um and i and i definitely would like to

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kind of keep this

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keep covet kind of at the center of this

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to some extent because i i know

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you know covet has now opened the door

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to telemedicine which is something that

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probably should have been done

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a long time ago uh the last thing i'll

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throw in to get all my things out and

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they can start addressing some of these

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is recognizing the importance of the

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internet

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and google i've been in the doctor's

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office

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on a couple of occasions where the

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doctor literally googled something

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in front of me and it didn't offend me i

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thought it was great that they didn't

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have such

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you know pride that they couldn't just

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go to google and google it right in

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front of me and so we need to recognize

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the changes that have happened and take

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advantage of these new technologies

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and they just seem to me that they're

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not being taken advantage of

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did i say enough oh you said a lot i

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mean

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you know that was that was a super hot

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take uh okay so

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so let's let's kind of go through these

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one by one

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uh i address this in the book that i

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just wrote the mega factory of

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healthcare

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uh about government overreach and and i

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really think that

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um when you're dealing with a

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generational problem

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like health care and this is not

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something that can be dealt with

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by a senator who's in uh who's in

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congress for six years

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it definitely can't be handled by a a

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congressman or congresswoman who's in

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the house for two years this is or even

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a president that's there for eight years

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right

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uh um this is generational issues and

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every time that

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they get involved uh whether republicans

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or democrats

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uh they screw it up right you know

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they can't uh they can't get out of

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their own way

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we saw in the financial markets how you

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know they got rid of

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some of the governmental overreach uh

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and it had its good

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points and its bad points but ultimately

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it created

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uh the greatest wealth of of uh

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any generation uh in the last hundred

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years how

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and a lot really last 30 years even more

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so

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that the the government regulations

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have um uh have confused

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and um slowed down

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the um the way that we have uh uh

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excelled as a nation and

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sp in healthcare and and and talk

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specifically about the insurance

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companies and how

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we've put them in in the center of all

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health care um so there's always this

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middleman

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there's either either the government is

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the middleman between you and your

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doctor or

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a huge insurance company is the

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middleman well i look at it from a

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little bit of a different perspective

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we look at incentivization and

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penalization

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and who's incentivized for care and

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who's penalized if care isn't given

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properly

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and and so what we've created

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is um is a a system by which

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uh insurance companies have been able to

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profit

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by ensuring that they don't pay

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as much as possible and what do i mean

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by that so

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they've created a model for what we call

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fee for service which

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is you get the physician group or the

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the hospital gets paid

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a certain amount or um every time

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every time patient visits and that has

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led to now what's called

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quality payments which is a loosely

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based

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upon a framework where

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the physician is trying to do the best

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possible quality

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but it's really checking off boxes on

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those visits

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ultimately what has happened

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is that uh the insurance companies are

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winning on both sides of that

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because patients are visiting less uh

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and and and not utilizing the system

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in the best way possible which which

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makes them

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less healthy you know i i i

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i think that you know the the insurance

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companies

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are uh are not the only ones

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to to blame in this mix um

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again i go back to the government

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regulations

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we have no real price transparency that

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has a lot to do with

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what are called reimbursement rates

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which are the rates that the insurance

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companies

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pay the physicians for services that are

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rendered

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you're not allowed to share openly what

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your reimbursement rates

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are from an individual insurance company

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and from a hospital perspective you're

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incentivized not to share

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because you're getting paid very well

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off of services that independent

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physician groups

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or smaller physicians are getting paid a

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lot less

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because of size and so you know

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the fact that we're not at a point where

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we're penalizing people

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for being transparent in their prices is

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also a problem

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so you know it it's it's cyclical

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you know as we continue to allow

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lobbying in health care as we continue

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to allow

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uh um allow

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this to be a political football it will

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be an issue yeah well look anytime you

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have the government sticking its nose

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into the private sector then the private

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sector is going to have

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an incentive to try to lobby

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the government so it's only natural you

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know

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you can't criticize in my opinion

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anybody for trying to lobby the

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government

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number one because they're doing it for

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the sake of their business and that's

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what business is supposed to do but but

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i always say the problem is if you're

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concerned about lobbying

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then get the government out of it and

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then there'll be no lobbying

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you know because you're always going to

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have lobbying you're always going to

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have the ability to

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to to talk to your congressman or what

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have you and you know unless you get

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get rid of campaign contributions you're

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going to have that issue

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so you know these

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i i always say that that the problem is

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the government

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having sticking its nose into things it

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shouldn't be sticking its

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nose into yeah i mean there's sticking

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your nose into things and then there's

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sticking your nose into things right i i

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think that there's a difference here

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you can restrict the amount of lobbying

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that goes on and the amount of jump

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from going from congress or going from

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governmental jobs into the private

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sector and healthcare

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just like you do in in the in the um

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in the dod in in in uh in

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private security and in in national

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security spaces right

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so but that we're not doing that in

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healthcare yeah i'm sorry i guess what

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i'm

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what i mean to say is that that's a

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band-aid

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to try to cover up what the real problem

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is and the real problem is

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the government being way too involved in

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healthcare so yeah you can stick a

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band-aid on it and say oh gee

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let's not let the lobbyists talk to them

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too much when they sit around

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deciding what to do with their

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healthcare next to like expand obamacare

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or

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don't let them lobby but

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in my opinion that's a band-aid we need

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some deep surgery here

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as you point out that is generational

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we've got a generational problem here we

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don't need band-aids we need

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to go in and we need a heart replacement

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surgery yeah i think that you know look

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trying to make wholesale changes as it

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relates to governmental overreach and

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health care

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is just going to be a failing endeavor

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right now we need to find

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the surgical strikes that we can we can

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work with in the current environment to

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make

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small steady progress

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in in changing the continuum uh

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educating consumers

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uh on both the quality of the physician

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group

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uh educating consumers on pricing

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educating employers

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on how to handle pricing for their

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employees

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and then providing care in a way that is

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much different technology has a lot to

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do with that

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but just a mindset of how we're

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presenting

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healthcare also needs to change and that

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really has to do with

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um with as you said

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it's okay to google things it's okay to

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utilize technology as a supporting

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uh um factor in how the healthcare is

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provided

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we're seeing a lot of that right now

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with um

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with ai diagnosis for um for

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different cancers for um directed care

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you know a lot of the things that we've

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seen in the last year with covid

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is technology that's been around for a

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long time but consumers weren't

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interested in it because there was no

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need for it

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the demand has skyrocketed and i don't

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think that

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certain things like telemedicine are

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definitely going to go away

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it's how we are going to deliver the

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telemedicine that's going to be really

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the game changer

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so i know that your book is very

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comprehensive and it includes kind of

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the history of healthcare

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in america what what's kind of the one

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00:10:20,630 --> 00:10:17,120
thing that you could point to

291
00:10:24,710 --> 00:10:20,640
where healthcare in america took a

292
00:10:28,150 --> 00:10:24,720
wrong turn and kind of has never

293
00:10:28,630 --> 00:10:28,160
come back i think it's the idea that you

294
00:10:31,750 --> 00:10:28,640
can

295
00:10:32,870 --> 00:10:31,760
have a system that is a three-legged

296
00:10:35,509 --> 00:10:32,880
stool without

297
00:10:37,350 --> 00:10:35,519
one of the legs and i i talk about this

298
00:10:39,430 --> 00:10:37,360
in a couple places in the book

299
00:10:40,870 --> 00:10:39,440
where we are incentivizing and

300
00:10:43,110 --> 00:10:40,880
penalizing

301
00:10:44,150 --> 00:10:43,120
physician groups physicians healthcare

302
00:10:46,310 --> 00:10:44,160
organizations

303
00:10:47,670 --> 00:10:46,320
we're incentivizing and penalizing

304
00:10:49,750 --> 00:10:47,680
insurance companies

305
00:10:51,269 --> 00:10:49,760
but we're really not incentivizing or

306
00:10:53,990 --> 00:10:51,279
penalizing patients

307
00:10:55,829 --> 00:10:54,000
except in their pocketbook uh when they

308
00:10:58,949 --> 00:10:55,839
when they go to visit a doctor

309
00:11:02,470 --> 00:10:58,959
right so we have set up a a

310
00:11:05,750 --> 00:11:02,480
a a whole ecosystem

311
00:11:08,310 --> 00:11:05,760
around um avoiding a doctor

312
00:11:09,430 --> 00:11:08,320
because people don't want to pay and on

313
00:11:11,350 --> 00:11:09,440
the on the

314
00:11:13,430 --> 00:11:11,360
delivery side we've created a whole

315
00:11:14,470 --> 00:11:13,440
system where you want to get the patient

316
00:11:18,470 --> 00:11:14,480
in

317
00:11:20,949 --> 00:11:18,480
for preventative care or to

318
00:11:22,949 --> 00:11:20,959
to um or to get them out of the hospital

319
00:11:23,670 --> 00:11:22,959
as quickly as possible and not readmit

320
00:11:27,829 --> 00:11:23,680
them

321
00:11:31,590 --> 00:11:27,839
but there's no there's no equality in

322
00:11:32,230 --> 00:11:31,600
where uh they want that delivery to

323
00:11:34,710 --> 00:11:32,240
happen

324
00:11:36,870 --> 00:11:34,720
and and so you know that's where i think

325
00:11:40,389 --> 00:11:36,880
it it really went wrong

326
00:11:42,550 --> 00:11:40,399
but i would think that insurance

327
00:11:44,790 --> 00:11:42,560
causes people to go to the doctor more

328
00:11:46,389 --> 00:11:44,800
often rather than less because it's free

329
00:11:47,990 --> 00:11:46,399
if i have insurance it doesn't cost me

330
00:11:50,389 --> 00:11:48,000
anything to go to the doctor

331
00:11:52,710 --> 00:11:50,399
and and so i'm more inclined to use it

332
00:11:54,389 --> 00:11:52,720
no yeah it's not necessarily going to

333
00:11:57,430 --> 00:11:54,399
the doctor it's going to seek out

334
00:11:58,629 --> 00:11:57,440
care in the wrong venues going to an

335
00:12:02,150 --> 00:11:58,639
urgent care

336
00:12:02,470 --> 00:12:02,160
to be your primary care doctor or going

337
00:12:06,150 --> 00:12:02,480
to

338
00:12:07,910 --> 00:12:06,160
emergency department isn't the best

339
00:12:10,389 --> 00:12:07,920
utilization of care

340
00:12:11,990 --> 00:12:10,399
if you can get it done with a higher

341
00:12:14,470 --> 00:12:12,000
level of quality at your

342
00:12:15,269 --> 00:12:14,480
your internist office but the engineers

343
00:12:17,110 --> 00:12:15,279
office

344
00:12:18,790 --> 00:12:17,120
may not have the flexibility to bring

345
00:12:19,350 --> 00:12:18,800
you in when they when you need to come

346
00:12:21,350 --> 00:12:19,360
in

347
00:12:22,870 --> 00:12:21,360
or there's just no availability of

348
00:12:25,030 --> 00:12:22,880
internists i mean

349
00:12:26,470 --> 00:12:25,040
it's cyclical right you have all these

350
00:12:29,110 --> 00:12:26,480
different specialties

351
00:12:29,670 --> 00:12:29,120
that the compensation is so high and it

352
00:12:32,870 --> 00:12:29,680
allows

353
00:12:34,550 --> 00:12:32,880
the physician to work less and and so

354
00:12:36,389 --> 00:12:34,560
because the room because they're making

355
00:12:37,430 --> 00:12:36,399
so much money off of the things that

356
00:12:40,550 --> 00:12:37,440
they're doing

357
00:12:41,670 --> 00:12:40,560
and and so patients are stuck uh trying

358
00:12:44,150 --> 00:12:41,680
to get appointments

359
00:12:45,110 --> 00:12:44,160
when they're not available and so so

360
00:12:48,310 --> 00:12:45,120
yeah there's no

361
00:12:49,030 --> 00:12:48,320
there's no uh um equal measure in the

362
00:12:51,910 --> 00:12:49,040
different

363
00:12:53,910 --> 00:12:51,920
parts of the system it's funny that

364
00:12:54,470 --> 00:12:53,920
we're not having this conversation about

365
00:12:56,550 --> 00:12:54,480
i could pick

366
00:12:57,750 --> 00:12:56,560
a whole host of things we'll just say uh

367
00:12:59,590 --> 00:12:57,760
electronics

368
00:13:01,750 --> 00:12:59,600
we're not talking about how difficult it

369
00:13:04,550 --> 00:13:01,760
is to go get a tv

370
00:13:06,230 --> 00:13:04,560
when you need a new tv or how hard it is

371
00:13:08,710 --> 00:13:06,240
to find this type of computer

372
00:13:11,670 --> 00:13:08,720
or to hook up to the internet or to find

373
00:13:15,430 --> 00:13:13,110
we're not having this conversation about

374
00:13:18,870 --> 00:13:15,440
that because we don't have

375
00:13:20,790 --> 00:13:18,880
the insurance companies between us and

376
00:13:21,990 --> 00:13:20,800
which television you're going to buy we

377
00:13:24,069 --> 00:13:22,000
don't have the government

378
00:13:26,150 --> 00:13:24,079
dictating that if you're going to sell a

379
00:13:27,269 --> 00:13:26,160
television it better have this feature

380
00:13:28,470 --> 00:13:27,279
and this feature in this feature and

381
00:13:29,030 --> 00:13:28,480
this feature in this feature in this

382
00:13:30,150 --> 00:13:29,040
feature

383
00:13:32,069 --> 00:13:30,160
otherwise you're not allowed to sell

384
00:13:34,150 --> 00:13:32,079
televisions

385
00:13:35,350 --> 00:13:34,160
the the reason when you don't have these

386
00:13:36,389 --> 00:13:35,360
efficiencies i mean you're explaining

387
00:13:37,430 --> 00:13:36,399
that oh you might not be able to get an

388
00:13:39,189 --> 00:13:37,440
appointment i mean

389
00:13:41,030 --> 00:13:39,199
that doesn't make any sense in a free

390
00:13:41,910 --> 00:13:41,040
market everything adjusts supply and

391
00:13:43,590 --> 00:13:41,920
demand

392
00:13:44,949 --> 00:13:43,600
well i'll just challenge you on that

393
00:13:47,269 --> 00:13:44,959
i'll challenge you in that

394
00:13:47,990 --> 00:13:47,279
because we do have the fcc in place and

395
00:13:51,110 --> 00:13:48,000
we do have

396
00:13:53,350 --> 00:13:51,120
the consumer protection bureau and we do

397
00:13:55,269 --> 00:13:53,360
we do have lemon laws in this country

398
00:13:57,110 --> 00:13:55,279
around those consumer electronics but

399
00:13:58,389 --> 00:13:57,120
also the biggest difference is when you

400
00:14:00,150 --> 00:13:58,399
walk into a best buy

401
00:14:01,990 --> 00:14:00,160
you know exactly how much a tv is going

402
00:14:05,750 --> 00:14:02,000
to cost before you walk out

403
00:14:06,310 --> 00:14:05,760
exactly right there exactly and why is

404
00:14:08,629 --> 00:14:06,320
that

405
00:14:10,230 --> 00:14:08,639
why isn't the price there when you walk

406
00:14:11,829 --> 00:14:10,240
into the doctor's office

407
00:14:13,750 --> 00:14:11,839
and it goes back to that price

408
00:14:16,949 --> 00:14:13,760
transparency issue where we're not

409
00:14:19,269 --> 00:14:16,959
we're not ensuring that the right price

410
00:14:21,670 --> 00:14:19,279
is being provided because they don't

411
00:14:24,230 --> 00:14:21,680
have any insurance

412
00:14:25,590 --> 00:14:24,240
when you say we are not doing that why

413
00:14:27,750 --> 00:14:25,600
is it not happening because the free

414
00:14:29,590 --> 00:14:27,760
market has been destroyed in that

415
00:14:31,269 --> 00:14:29,600
that's no actually there's laws around

416
00:14:31,590 --> 00:14:31,279
it right up until the last couple of

417
00:14:33,430 --> 00:14:31,600
years

418
00:14:35,189 --> 00:14:33,440
laws that's destroying the free market

419
00:14:35,590 --> 00:14:35,199
that's my point yeah yes there's of

420
00:14:37,430 --> 00:14:35,600
course

421
00:14:39,670 --> 00:14:37,440
every element of business is regulated

422
00:14:41,750 --> 00:14:39,680
to an extent and probably overregulated

423
00:14:43,910 --> 00:14:41,760
but when it comes to health care

424
00:14:45,590 --> 00:14:43,920
it's off the charts the the the

425
00:14:46,870 --> 00:14:45,600
regulation of healthcare

426
00:14:49,910 --> 00:14:46,880
you just pointed out it's because of

427
00:14:51,430 --> 00:14:49,920
laws governments sticking its nose in it

428
00:14:52,310 --> 00:14:51,440
that we don't have prices at the

429
00:14:54,949 --> 00:14:52,320
doctor's office

430
00:14:56,150 --> 00:14:54,959
yet we have them at best buy yeah but

431
00:14:58,230 --> 00:14:56,160
it's the people who are

432
00:14:59,750 --> 00:14:58,240
who are lobbying to keep those laws that

433
00:15:01,829 --> 00:14:59,760
are the real issue

434
00:15:02,949 --> 00:15:01,839
i totally disagree it's the government

435
00:15:04,710 --> 00:15:02,959
doing it you need you

436
00:15:05,829 --> 00:15:04,720
you need the government out so what that

437
00:15:06,710 --> 00:15:05,839
you have somebody telling you you should

438
00:15:08,710 --> 00:15:06,720
do it this way

439
00:15:11,110 --> 00:15:08,720
as as a as a senator or congressman are

440
00:15:12,629 --> 00:15:11,120
you obligated to do what a lobbyist says

441
00:15:14,470 --> 00:15:12,639
i think you're talking about a band-aid

442
00:15:16,150 --> 00:15:14,480
the problem is the government

443
00:15:17,910 --> 00:15:16,160
putting these things in place not the

444
00:15:19,829 --> 00:15:17,920
lobbyists asking for it

445
00:15:21,590 --> 00:15:19,839
yeah well we can agree to disagree on

446
00:15:24,790 --> 00:15:21,600
this one but i know that the

447
00:15:26,550 --> 00:15:24,800
the healthcare organizations uh the huge

448
00:15:27,350 --> 00:15:26,560
hospitals and mega hospitals in these

449
00:15:29,110 --> 00:15:27,360
countries

450
00:15:31,030 --> 00:15:29,120
are really happy that there's not price

451
00:15:33,430 --> 00:15:31,040
transparency and don't want

452
00:15:35,269 --> 00:15:33,440
their prices having to be out there

453
00:15:37,189 --> 00:15:35,279
before you walk into surgery because

454
00:15:38,629 --> 00:15:37,199
people would bother okay and i blame the

455
00:15:39,430 --> 00:15:38,639
politicians that are giving them what

456
00:15:41,110 --> 00:15:39,440
they want

457
00:15:43,269 --> 00:15:41,120
that's who i believe i i blame the

458
00:15:44,629 --> 00:15:43,279
politicians too but i think that we need

459
00:15:47,670 --> 00:15:44,639
to recognize

460
00:15:50,550 --> 00:15:47,680
that that the that there is uh

461
00:15:52,829 --> 00:15:50,560
an impetus on the part of the hospitals

462
00:15:55,990 --> 00:15:52,839
where are the employers

463
00:15:58,790 --> 00:15:56,000
uh let's just step back here

464
00:16:00,949 --> 00:15:58,800
where are the big employers every single

465
00:16:02,230 --> 00:16:00,959
fortune 500 company

466
00:16:04,949 --> 00:16:02,240
in this country right now is

467
00:16:05,749 --> 00:16:04,959
self-insured where are they standing up

468
00:16:08,389 --> 00:16:05,759
and saying

469
00:16:10,470 --> 00:16:08,399
mr congressman mr senator i want my

470
00:16:14,870 --> 00:16:10,480
prices for all of my employees

471
00:16:17,189 --> 00:16:14,880
to be transparent that's not happening

472
00:16:18,550 --> 00:16:17,199
yeah well and that's the free market

473
00:16:20,949 --> 00:16:18,560
right there right

474
00:16:22,389 --> 00:16:20,959
right so government has destroyed the

475
00:16:23,829 --> 00:16:22,399
free market in healthcare if you want to

476
00:16:25,509 --> 00:16:23,839
say they did it because of lobbyists

477
00:16:27,189 --> 00:16:25,519
i'll go with them so it was lobbyist i

478
00:16:28,389 --> 00:16:27,199
don't care it's the government that did

479
00:16:29,269 --> 00:16:28,399
it it's the government that needs to

480
00:16:31,350 --> 00:16:29,279
change it

481
00:16:33,030 --> 00:16:31,360
yeah and i think it's one of those cases

482
00:16:34,710 --> 00:16:33,040
where it's very complicated

483
00:16:36,550 --> 00:16:34,720
and people can't understand it to go out

484
00:16:37,749 --> 00:16:36,560
and fight it and that's what i'm trying

485
00:16:39,269 --> 00:16:37,759
to educate people on

486
00:16:41,030 --> 00:16:39,279
and let me let me just say this i you

487
00:16:41,509 --> 00:16:41,040
know i kind of keep things a bit high

488
00:16:43,749 --> 00:16:41,519
level

489
00:16:45,189 --> 00:16:43,759
of as much as possible but you know i

490
00:16:46,069 --> 00:16:45,199
know the solutions are very difficult

491
00:16:48,150 --> 00:16:46,079
but it's like

492
00:16:50,230 --> 00:16:48,160
why have we allowed the free market to

493
00:16:51,910 --> 00:16:50,240
get destroyed in healthcare but not in

494
00:16:52,949 --> 00:16:51,920
automobiles and a thousand other

495
00:16:54,150 --> 00:16:52,959
industries that we could

496
00:16:56,310 --> 00:16:54,160
talk about again they're highly

497
00:16:57,910 --> 00:16:56,320
regulated all probably too regulated

498
00:16:59,430 --> 00:16:57,920
but for the most part you get the free

499
00:17:01,030 --> 00:16:59,440
market airlines etc

500
00:17:02,470 --> 00:17:01,040
lots of regulation but the free market

501
00:17:04,789 --> 00:17:02,480
seems to be able to work

502
00:17:05,909 --> 00:17:04,799
why the hell did we destroy it when it

503
00:17:07,990 --> 00:17:05,919
comes to health care

504
00:17:09,110 --> 00:17:08,000
and my only theory on how it got

505
00:17:12,549 --> 00:17:09,120
destroyed is

506
00:17:13,829 --> 00:17:12,559
the people who hate the free market

507
00:17:15,669 --> 00:17:13,839
okay and there's a lot of people out

508
00:17:17,590 --> 00:17:15,679
there that really hate the free market

509
00:17:18,710 --> 00:17:17,600
they really hate it when it comes to

510
00:17:21,189 --> 00:17:18,720
health care because

511
00:17:23,110 --> 00:17:21,199
they find it so abhorrent that someone

512
00:17:26,309 --> 00:17:23,120
could turn a profit

513
00:17:27,750 --> 00:17:26,319
off of the health of another and that's

514
00:17:28,630 --> 00:17:27,760
why you've got socialized medicine

515
00:17:29,830 --> 00:17:28,640
around the world

516
00:17:31,590 --> 00:17:29,840
and that's why you have so many people

517
00:17:32,070 --> 00:17:31,600
clamoring for socialized medicine in the

518
00:17:33,830 --> 00:17:32,080
u.s

519
00:17:35,669 --> 00:17:33,840
single-payer because they find it so

520
00:17:37,510 --> 00:17:35,679
abhorrent that somebody could turn a

521
00:17:40,789 --> 00:17:37,520
profit off of somebody's poor

522
00:17:43,029 --> 00:17:40,799
health but guess what free market

523
00:17:44,710 --> 00:17:43,039
for-profit principles is what's made

524
00:17:46,310 --> 00:17:44,720
america great in so many different

525
00:17:46,789 --> 00:17:46,320
industries yet we're keeping it from

526
00:17:49,990 --> 00:17:46,799
making

527
00:17:51,909 --> 00:17:50,000
healthcare great well uh

528
00:17:53,590 --> 00:17:51,919
again i'm going to challenge you on that

529
00:17:56,789 --> 00:17:53,600
because the biggest

530
00:17:58,950 --> 00:17:56,799
driver in in our turn around the last

531
00:17:59,990 --> 00:17:58,960
10 15 years in this country has been

532
00:18:03,350 --> 00:18:00,000
healthcare

533
00:18:05,990 --> 00:18:03,360
more than any other industry we have

534
00:18:07,029 --> 00:18:06,000
grown that sector and created new

535
00:18:09,350 --> 00:18:07,039
sectors within

536
00:18:10,390 --> 00:18:09,360
healthcare that were never thought of

537
00:18:13,350 --> 00:18:10,400
before

538
00:18:13,990 --> 00:18:13,360
uh the affordable care act so you know

539
00:18:17,029 --> 00:18:14,000
to say that

540
00:18:19,350 --> 00:18:17,039
it really hasn't driven the free market

541
00:18:22,070 --> 00:18:19,360
i don't necessarily agree with you what

542
00:18:25,510 --> 00:18:22,080
i will say is that the over-regulation

543
00:18:28,870 --> 00:18:25,520
um is is something that

544
00:18:30,630 --> 00:18:28,880
uh in in the car industry it's

545
00:18:31,990 --> 00:18:30,640
it's underst you understand how the

546
00:18:34,390 --> 00:18:32,000
economics work

547
00:18:36,150 --> 00:18:34,400
in in the airline industry you

548
00:18:39,270 --> 00:18:36,160
understand how the economics work

549
00:18:42,310 --> 00:18:39,280
in healthcare it's very very complicated

550
00:18:45,350 --> 00:18:42,320
and the economics are really really

551
00:18:46,470 --> 00:18:45,360
hard to understand because that's how it

552
00:18:49,590 --> 00:18:46,480
was created

553
00:18:53,430 --> 00:18:49,600
by insurance companies by governmental

554
00:18:56,470 --> 00:18:53,440
uh um regulations um and by physicians

555
00:18:59,029 --> 00:18:56,480
because it goes back to your point of

556
00:19:00,789 --> 00:18:59,039
why are we profiting off of health care

557
00:19:03,510 --> 00:19:00,799
why are we profiting off of

558
00:19:05,190 --> 00:19:03,520
taking care of somebody in my previous

559
00:19:08,470 --> 00:19:05,200
job i used to talk about

560
00:19:11,110 --> 00:19:08,480
my dark heart of of my

561
00:19:12,549 --> 00:19:11,120
my dark capitalist heart my black heart

562
00:19:14,470 --> 00:19:12,559
i would look at every patient that

563
00:19:18,230 --> 00:19:14,480
walked in and out of our offices

564
00:19:20,310 --> 00:19:18,240
uh as a dollar sign and the physicians

565
00:19:23,029 --> 00:19:20,320
that i worked with

566
00:19:24,390 --> 00:19:23,039
looked at them as my patients i take

567
00:19:27,830 --> 00:19:24,400
care of them

568
00:19:29,830 --> 00:19:27,840
i wanna i want i wanna care for them

569
00:19:31,029 --> 00:19:29,840
and would right wanna write things off

570
00:19:33,669 --> 00:19:31,039
because that's

571
00:19:35,029 --> 00:19:33,679
how they how they took care of things

572
00:19:36,630 --> 00:19:35,039
and that's how they took care of their

573
00:19:39,190 --> 00:19:36,640
patients

574
00:19:40,630 --> 00:19:39,200
we have grown healthcare into a big

575
00:19:42,870 --> 00:19:40,640
business

576
00:19:43,990 --> 00:19:42,880
and it's a and you can see how big of a

577
00:19:46,070 --> 00:19:44,000
business it's been

578
00:19:47,430 --> 00:19:46,080
over the past year as we've gone through

579
00:19:50,070 --> 00:19:47,440
covid and

580
00:19:51,590 --> 00:19:50,080
and billions upon billions more than any

581
00:19:55,190 --> 00:19:51,600
other time in our history

582
00:19:57,029 --> 00:19:55,200
have been put into healthcare i t

583
00:19:58,710 --> 00:19:57,039
in in the spaces that we're talking

584
00:20:02,230 --> 00:19:58,720
about

585
00:20:04,950 --> 00:20:02,240
well i i have no problem with you

586
00:20:06,630 --> 00:20:04,960
looking at someone who walks in as a

587
00:20:09,029 --> 00:20:06,640
dollar sign

588
00:20:11,590 --> 00:20:09,039
because the profit motive is the

589
00:20:13,190 --> 00:20:11,600
greatest generator of innovations that

590
00:20:16,549 --> 00:20:13,200
the world has ever seen

591
00:20:17,830 --> 00:20:16,559
so our food companies look at people's

592
00:20:19,590 --> 00:20:17,840
dollar signs and there's nothing more

593
00:20:21,830 --> 00:20:19,600
important than somebody's health than

594
00:20:23,110 --> 00:20:21,840
than food and you know you have

595
00:20:26,470 --> 00:20:23,120
mcdonald's out there

596
00:20:28,630 --> 00:20:26,480
selling kind of crap food for you

597
00:20:29,669 --> 00:20:28,640
um and making a lot of money off of it

598
00:20:31,750 --> 00:20:29,679
and then you've got

599
00:20:32,789 --> 00:20:31,760
some organic companies out there selling

600
00:20:35,110 --> 00:20:32,799
some terrific food

601
00:20:36,470 --> 00:20:35,120
for you and also turning a profit off of

602
00:20:37,750 --> 00:20:36,480
it and people have you know can make

603
00:20:40,070 --> 00:20:37,760
their own decision as to

604
00:20:41,830 --> 00:20:40,080
which one to to go to and we need to

605
00:20:46,549 --> 00:20:41,840
rely on people to make their individual

606
00:20:47,590 --> 00:20:46,559
decisions but um you know of course

607
00:20:49,830 --> 00:20:47,600
you're going to look at people with a

608
00:20:51,669 --> 00:20:49,840
dollar sign and that's okay now

609
00:20:53,270 --> 00:20:51,679
if you guys treat everybody poorly and

610
00:20:55,270 --> 00:20:53,280
it becomes clear that

611
00:20:57,190 --> 00:20:55,280
those guy that hospital over there is

612
00:20:58,950 --> 00:20:57,200
just in it for the buck

613
00:21:01,110 --> 00:20:58,960
i'm not gonna go there anymore i'm gonna

614
00:21:02,070 --> 00:21:01,120
go to this other one that i really seem

615
00:21:04,390 --> 00:21:02,080
to get some value

616
00:21:06,310 --> 00:21:04,400
from my money that people could as you

617
00:21:08,390 --> 00:21:06,320
point out your biggest point which i

618
00:21:09,909 --> 00:21:08,400
is really we're in a thousand percent

619
00:21:10,950 --> 00:21:09,919
agreement on this is the price

620
00:21:14,549 --> 00:21:10,960
transparency

621
00:21:17,430 --> 00:21:14,559
got in almost every other industry

622
00:21:19,750 --> 00:21:17,440
but that you don't have in healthcare um

623
00:21:21,750 --> 00:21:19,760
that people can't shop around

624
00:21:23,590 --> 00:21:21,760
and they're not price conscious you know

625
00:21:24,630 --> 00:21:23,600
to your point they're not using the most

626
00:21:26,950 --> 00:21:24,640
efficient

627
00:21:28,870 --> 00:21:26,960
service for what their need is because

628
00:21:30,230 --> 00:21:28,880
they don't care what the price is

629
00:21:31,909 --> 00:21:30,240
the insurance companies paying for it or

630
00:21:33,510 --> 00:21:31,919
the government is paying paying for it

631
00:21:36,470 --> 00:21:33,520
or their employers paying for it and

632
00:21:38,230 --> 00:21:36,480
they don't realize it

633
00:21:40,230 --> 00:21:38,240
and you know i want to get back to a

634
00:21:41,190 --> 00:21:40,240
point that you made a couple minutes ago

635
00:21:44,230 --> 00:21:41,200
which is

636
00:21:46,230 --> 00:21:44,240
is the idea of of medicare for

637
00:21:47,510 --> 00:21:46,240
all or socialized medicine in this

638
00:21:49,190 --> 00:21:47,520
country

639
00:21:51,750 --> 00:21:49,200
i don't think people really understand

640
00:21:55,590 --> 00:21:51,760
what the economic impact would be on

641
00:21:58,310 --> 00:21:55,600
in the united states if that happened

642
00:21:58,630 --> 00:21:58,320
and i correlated at the same way that we

643
00:22:02,149 --> 00:21:58,640
would

644
00:22:05,110 --> 00:22:02,159
with the auto industry when gm

645
00:22:07,430 --> 00:22:05,120
shuts down a product line there is a

646
00:22:10,549 --> 00:22:07,440
huge economic impact to that

647
00:22:12,390 --> 00:22:10,559
to that in the areas in the country

648
00:22:15,909 --> 00:22:12,400
where those

649
00:22:18,390 --> 00:22:15,919
cars are manufactured the people who are

650
00:22:19,510 --> 00:22:18,400
the parts distributors the people who

651
00:22:21,590 --> 00:22:19,520
are uh

652
00:22:22,710 --> 00:22:21,600
making lunch for the people who work in

653
00:22:25,669 --> 00:22:22,720
that area

654
00:22:27,510 --> 00:22:25,679
and on and on and on if we were to

655
00:22:28,549 --> 00:22:27,520
reduce the number of payers in this

656
00:22:32,149 --> 00:22:28,559
country

657
00:22:32,950 --> 00:22:32,159
to one that would reduce a huge amount

658
00:22:36,470 --> 00:22:32,960
of

659
00:22:39,830 --> 00:22:36,480
people who are actually working

660
00:22:40,950 --> 00:22:39,840
to support the current industry that we

661
00:22:43,990 --> 00:22:40,960
have

662
00:22:46,390 --> 00:22:44,000
and the economic impact of that would be

663
00:22:47,430 --> 00:22:46,400
much higher than the savings

664
00:22:49,510 --> 00:22:47,440
quote-unquote

665
00:22:51,669 --> 00:22:49,520
that we could potentially see over the

666
00:22:53,750 --> 00:22:51,679
long run of having one payer

667
00:22:55,510 --> 00:22:53,760
i think it's a fallacy to think that we

668
00:22:59,190 --> 00:22:55,520
could have one payer in this country

669
00:23:02,310 --> 00:22:59,200
because no one is going to support

670
00:23:03,510 --> 00:23:02,320
a someone who is going to reduce the

671
00:23:05,590 --> 00:23:03,520
amount of jobs

672
00:23:08,630 --> 00:23:05,600
that will be in any given state let

673
00:23:10,549 --> 00:23:08,640
alone all 50 states well and also you

674
00:23:12,710 --> 00:23:10,559
have to have a ton of people now

675
00:23:13,830 --> 00:23:12,720
working for the government doing those

676
00:23:16,630 --> 00:23:13,840
things i mean

677
00:23:17,350 --> 00:23:16,640
yes maybe maybe it's simpler to have a

678
00:23:19,590 --> 00:23:17,360
single

679
00:23:21,350 --> 00:23:19,600
payer but you still got a ton of claims

680
00:23:23,430 --> 00:23:21,360
processing that has to happen

681
00:23:25,110 --> 00:23:23,440
and you still got the same issues of

682
00:23:27,669 --> 00:23:25,120
somebody in between

683
00:23:28,789 --> 00:23:27,679
the patient and their doctor and that is

684
00:23:30,630 --> 00:23:28,799
the government

685
00:23:32,310 --> 00:23:30,640
i mean the argument is that medicare is

686
00:23:34,070 --> 00:23:32,320
very efficient well medicare is very

687
00:23:35,990 --> 00:23:34,080
efficient because it deals with a very

688
00:23:37,669 --> 00:23:36,000
few amount of americans

689
00:23:39,190 --> 00:23:37,679
and it relates the total number of

690
00:23:41,430 --> 00:23:39,200
americans alive

691
00:23:42,870 --> 00:23:41,440
and so you know you're dealing with less

692
00:23:46,070 --> 00:23:42,880
claims less people

693
00:23:46,789 --> 00:23:46,080
but it also it leaves people out all the

694
00:23:50,310 --> 00:23:46,799
time

695
00:23:52,950 --> 00:23:50,320
so well medicare fraud is when you

696
00:23:54,789 --> 00:23:52,960
when i think of the word fraud related

697
00:23:56,549 --> 00:23:54,799
with another word

698
00:23:58,789 --> 00:23:56,559
it's medicare fraud is the one that you

699
00:23:59,190 --> 00:23:58,799
always hear about so it's probably the

700
00:24:03,029 --> 00:23:59,200
most

701
00:24:06,310 --> 00:24:03,039
percentage-wise defrauded institution

702
00:24:07,269 --> 00:24:06,320
in america yeah because it's the easy

703
00:24:10,470 --> 00:24:07,279
one to get

704
00:24:13,590 --> 00:24:10,480
because the people break it all the time

705
00:24:15,990 --> 00:24:13,600
because it's easy to find so

706
00:24:16,950 --> 00:24:16,000
so the so do we really want the

707
00:24:18,870 --> 00:24:16,960
government

708
00:24:20,470 --> 00:24:18,880
is i guess my point is is medicare

709
00:24:23,190 --> 00:24:20,480
really working as well as people

710
00:24:25,350 --> 00:24:23,200
say when when there's so much medicare

711
00:24:29,350 --> 00:24:25,360
fraud

712
00:24:30,789 --> 00:24:29,360
i don't know i i i i think that there

713
00:24:33,830 --> 00:24:30,799
are parts of it that work

714
00:24:36,870 --> 00:24:33,840
right you look at the pre uh

715
00:24:39,110 --> 00:24:36,880
great depression area and and how uh the

716
00:24:42,390 --> 00:24:39,120
elderly were treated in this country

717
00:24:45,029 --> 00:24:42,400
and you see how well we treat them now

718
00:24:46,390 --> 00:24:45,039
and you say okay i get why medicare is

719
00:24:49,190 --> 00:24:46,400
around uh

720
00:24:49,909 --> 00:24:49,200
um but then you see the the amount of

721
00:24:53,029 --> 00:24:49,919
fraud

722
00:24:56,230 --> 00:24:53,039
the amount of abuse the amount of uh

723
00:24:58,070 --> 00:24:56,240
money that we're spending on it and um

724
00:24:59,590 --> 00:24:58,080
you have to question it well and let me

725
00:25:01,430 --> 00:24:59,600
just ask you this question about

726
00:25:03,669 --> 00:25:01,440
medicare something i've never understood

727
00:25:07,909 --> 00:25:03,679
why is medicare

728
00:25:10,950 --> 00:25:07,919
for everyone why does bill gates

729
00:25:12,470 --> 00:25:10,960
get medicare you know i'm

730
00:25:14,149 --> 00:25:12,480
as you could probably tell very

731
00:25:15,350 --> 00:25:14,159
anti-government getting involved in just

732
00:25:17,350 --> 00:25:15,360
about anything

733
00:25:19,110 --> 00:25:17,360
but but you know to the extent i might

734
00:25:20,149 --> 00:25:19,120
agree with some government is you know

735
00:25:21,510 --> 00:25:20,159
the safety net

736
00:25:22,390 --> 00:25:21,520
and by the way i'm not even sure i agree

737
00:25:23,510 --> 00:25:22,400
with this because i'm not sure it's the

738
00:25:25,110 --> 00:25:23,520
most efficient thing but let's just

739
00:25:27,590 --> 00:25:25,120
assume that i agree with the safety net

740
00:25:28,549 --> 00:25:27,600
taking care of the poorest of the poor

741
00:25:31,669 --> 00:25:28,559
okay

742
00:25:32,310 --> 00:25:31,679
that i get why take over the entire

743
00:25:34,230 --> 00:25:32,320
industry

744
00:25:35,590 --> 00:25:34,240
why say that every single person in

745
00:25:38,950 --> 00:25:35,600
america over the age of

746
00:25:39,830 --> 00:25:38,960
whatever it is 60 65 goes into goes into

747
00:25:41,110 --> 00:25:39,840
medicare

748
00:25:42,870 --> 00:25:41,120
why wouldn't you just take care of the

749
00:25:45,350 --> 00:25:42,880
poorest of the poor because

750
00:25:47,190 --> 00:25:45,360
in the 20s john rockefeller wasn't going

751
00:25:48,630 --> 00:25:47,200
to take medicare

752
00:25:50,230 --> 00:25:48,640
he was going to pay for it out of his

753
00:25:53,350 --> 00:25:50,240
own pocket

754
00:25:56,870 --> 00:25:53,360
and that's the problem that we have that

755
00:25:57,669 --> 00:25:56,880
the ultra rich were ultra rich at the

756
00:25:59,590 --> 00:25:57,679
time

757
00:26:01,190 --> 00:25:59,600
right they came out of the depression

758
00:26:04,310 --> 00:26:01,200
and they still had their money

759
00:26:04,870 --> 00:26:04,320
uh albeit some of them had a lot less

760
00:26:11,269 --> 00:26:04,880
money

761
00:26:13,830 --> 00:26:11,279
and so they never

762
00:26:15,350 --> 00:26:13,840
thought that we would have generations

763
00:26:17,909 --> 00:26:15,360
of such a large

764
00:26:18,549 --> 00:26:17,919
uh as people have called them the one

765
00:26:22,310 --> 00:26:18,559
percent

766
00:26:25,590 --> 00:26:22,320
second what about the top

767
00:26:28,310 --> 00:26:25,600
20 in the country and and

768
00:26:29,990 --> 00:26:28,320
so i totally agree with you it's

769
00:26:30,950 --> 00:26:30,000
something that we would should probably

770
00:26:34,470 --> 00:26:30,960
address

771
00:26:36,710 --> 00:26:34,480
uh very soon but the problem is

772
00:26:38,149 --> 00:26:36,720
that that's not how the system has ever

773
00:26:41,590 --> 00:26:38,159
been designed

774
00:26:43,990 --> 00:26:41,600
and it would it you know you're

775
00:26:45,350 --> 00:26:44,000
you're you're you're talking about an

776
00:26:48,230 --> 00:26:45,360
area where

777
00:26:49,669 --> 00:26:48,240
again i go back to the the politicians

778
00:26:53,029 --> 00:26:49,679
who are in charge of this they wouldn't

779
00:26:56,310 --> 00:26:53,039
go for it what about a system

780
00:26:57,990 --> 00:26:56,320
where um you know you're talking about

781
00:26:59,909 --> 00:26:58,000
medicare i mean it's always going to be

782
00:27:02,149 --> 00:26:59,919
more efficient if you had

783
00:27:04,390 --> 00:27:02,159
price transparency to just allow people

784
00:27:06,470 --> 00:27:04,400
you know a healthcare savings account

785
00:27:07,909 --> 00:27:06,480
that they can monitor on their own and

786
00:27:10,950 --> 00:27:07,919
wisely use

787
00:27:14,149 --> 00:27:10,960
and and shop around for services

788
00:27:16,710 --> 00:27:14,159
and um most people aren't aren't

789
00:27:18,149 --> 00:27:16,720
prepared to deal with a health care

790
00:27:19,190 --> 00:27:18,159
savings account they don't know how to

791
00:27:20,710 --> 00:27:19,200
deal with it

792
00:27:23,269 --> 00:27:20,720
they don't know how to deal with their

793
00:27:25,110 --> 00:27:23,279
own pocketbook in many cases

794
00:27:26,630 --> 00:27:25,120
and so we're going to put that in the

795
00:27:29,110 --> 00:27:26,640
hands of people who who

796
00:27:30,710 --> 00:27:29,120
are are fiscally irresponsible i don't

797
00:27:32,870 --> 00:27:30,720
know if i agree with that

798
00:27:34,630 --> 00:27:32,880
well if they're fiscally irresponsible

799
00:27:36,389 --> 00:27:34,640
that's their problem government's job is

800
00:27:37,669 --> 00:27:36,399
not to take care of people people's job

801
00:27:39,190 --> 00:27:37,679
is to take care of themselves

802
00:27:40,789 --> 00:27:39,200
so they'll have to learn how to use a

803
00:27:43,909 --> 00:27:40,799
health care savings account

804
00:27:45,750 --> 00:27:43,919
okay is there a system out there that

805
00:27:46,470 --> 00:27:45,760
you can point to around the world that

806
00:27:50,549 --> 00:27:46,480
says

807
00:27:53,990 --> 00:27:52,070
this is going to be the craziest thing

808
00:27:55,269 --> 00:27:54,000
i'm ever going to say but the israeli

809
00:27:58,070 --> 00:27:55,279
system of healthcare

810
00:27:59,750 --> 00:27:58,080
is pretty spot-on it's a socialized

811
00:28:00,230 --> 00:27:59,760
system but it's a socialized system with

812
00:28:04,950 --> 00:28:00,240
different

813
00:28:08,470 --> 00:28:04,960
based upon what you're paying into it

814
00:28:09,750 --> 00:28:08,480
and and you know i i i think that the

815
00:28:11,830 --> 00:28:09,760
biggest thing there

816
00:28:12,950 --> 00:28:11,840
is that and this won't go over well in

817
00:28:14,789 --> 00:28:12,960
this country

818
00:28:17,350 --> 00:28:14,799
is that people give up a certain level

819
00:28:18,230 --> 00:28:17,360
of privacy because all of their data is

820
00:28:21,070 --> 00:28:18,240
shared

821
00:28:22,230 --> 00:28:21,080
in a centralized system uh

822
00:28:25,350 --> 00:28:22,240
interoperability

823
00:28:27,830 --> 00:28:25,360
of health care records saves money

824
00:28:29,269 --> 00:28:27,840
interoperability of health care records

825
00:28:32,630 --> 00:28:29,279
saves lives

826
00:28:33,590 --> 00:28:32,640
and um and it's the privacy concerns

827
00:28:36,870 --> 00:28:33,600
around

828
00:28:37,750 --> 00:28:36,880
healthcare data are too large in this

829
00:28:40,389 --> 00:28:37,760
country

830
00:28:41,990 --> 00:28:40,399
um and we have too many rights in that

831
00:28:44,789 --> 00:28:42,000
area

832
00:28:45,590 --> 00:28:44,799
that that it it would just would never

833
00:28:47,590 --> 00:28:45,600
fly

834
00:28:48,630 --> 00:28:47,600
so what you're saying is in israel as a

835
00:28:51,750 --> 00:28:48,640
part of getting

836
00:28:54,149 --> 00:28:51,760
this kind of free health care you're

837
00:28:55,909 --> 00:28:54,159
signing a contract essentially that says

838
00:28:59,029 --> 00:28:55,919
that the government

839
00:29:01,029 --> 00:28:59,039
can see my private medical records and

840
00:29:04,470 --> 00:29:01,039
use them for the purposes of

841
00:29:06,950 --> 00:29:04,480
finding um

842
00:29:09,110 --> 00:29:06,960
treatments for various things yeah so

843
00:29:10,630 --> 00:29:09,120
for instance with kovid

844
00:29:12,470 --> 00:29:10,640
one of the ways that they were able to

845
00:29:14,149 --> 00:29:12,480
accelerate the distribution of vaccines

846
00:29:15,750 --> 00:29:14,159
was that they made a deal with pfizer to

847
00:29:17,510 --> 00:29:15,760
be able to get all the data

848
00:29:20,149 --> 00:29:17,520
on every single patient that had been

849
00:29:22,070 --> 00:29:20,159
administered the pfizer vaccine

850
00:29:24,389 --> 00:29:22,080
and what the response was did they get

851
00:29:27,110 --> 00:29:24,399
coveted afterwards what

852
00:29:28,950 --> 00:29:27,120
complicating uh factors that they have

853
00:29:31,990 --> 00:29:28,960
whether they were pregnant or

854
00:29:35,990 --> 00:29:32,000
obese or a smoker uh

855
00:29:39,830 --> 00:29:36,000
they had uh reams of data or

856
00:29:42,870 --> 00:29:39,840
megabytes of the gigabytes of data um

857
00:29:44,549 --> 00:29:42,880
about the individual israelis who had

858
00:29:46,470 --> 00:29:44,559
had the vaccine

859
00:29:48,310 --> 00:29:46,480
we just don't have the infrastructure in

860
00:29:49,029 --> 00:29:48,320
the united states to be able to do that

861
00:29:52,789 --> 00:29:49,039
here

862
00:29:56,149 --> 00:29:52,799
we can do it in health system sides

863
00:29:57,830 --> 00:29:56,159
some of them not most of them so

864
00:29:59,590 --> 00:29:57,840
going back to examples around the world

865
00:30:00,710 --> 00:29:59,600
i i don't particularly like the israeli

866
00:30:03,750 --> 00:30:00,720
example as you may have

867
00:30:04,950 --> 00:30:03,760
as you may guess is there any example

868
00:30:07,830 --> 00:30:04,960
out there

869
00:30:10,710 --> 00:30:07,840
where it's freer the the healthcare

870
00:30:12,149 --> 00:30:10,720
market is freer than it is in america

871
00:30:14,070 --> 00:30:12,159
my focus really hasn't been

872
00:30:16,470 --> 00:30:14,080
international it's been domestic

873
00:30:17,190 --> 00:30:16,480
uh um so i really haven't studied the

874
00:30:19,430 --> 00:30:17,200
different

875
00:30:20,310 --> 00:30:19,440
i know israeli the israeli health care

876
00:30:22,630 --> 00:30:20,320
system because

877
00:30:25,190 --> 00:30:22,640
i've spent some time there but i really

878
00:30:28,149 --> 00:30:25,200
don't know internationally uh

879
00:30:28,870 --> 00:30:28,159
fair enough you mentioned the affordable

880
00:30:30,470 --> 00:30:28,880
care act

881
00:30:32,070 --> 00:30:30,480
and i i think you mentioned it in a

882
00:30:34,310 --> 00:30:32,080
positive way but i'm not sure if i

883
00:30:35,830 --> 00:30:34,320
caught that correctly what what what do

884
00:30:36,789 --> 00:30:35,840
you make of the affordable care act

885
00:30:38,389 --> 00:30:36,799
which they also call

886
00:30:40,310 --> 00:30:38,399
obamacare which is the one that

887
00:30:41,510 --> 00:30:40,320
essentially i mean the two major

888
00:30:43,830 --> 00:30:41,520
elements that i think

889
00:30:44,950 --> 00:30:43,840
came from it please correct me or add to

890
00:30:48,149 --> 00:30:44,960
it is

891
00:30:50,230 --> 00:30:48,159
that uh everyone was mandated to

892
00:30:51,750 --> 00:30:50,240
buy yeah i was i misspoke when i said

893
00:30:53,190 --> 00:30:51,760
the affordable care act i meant the

894
00:30:56,389 --> 00:30:53,200
american reinvestment

895
00:30:58,789 --> 00:30:56,399
um act that came in the first uh

896
00:30:59,750 --> 00:30:58,799
uh hundred days of president obama's

897
00:31:01,600 --> 00:30:59,760
first term

898
00:31:03,350 --> 00:31:01,610
um okay yeah

899
00:31:04,950 --> 00:31:03,360
[Music]

900
00:31:07,190 --> 00:31:04,960
so okay but let's talk about affordable

901
00:31:09,590 --> 00:31:07,200
care act so the two major things that it

902
00:31:10,549 --> 00:31:09,600
that it did is it required every america

903
00:31:13,830 --> 00:31:10,559
if you want to

904
00:31:16,389 --> 00:31:13,840
to breathe the error of america

905
00:31:17,350 --> 00:31:16,399
yeah you have you you have to buy this

906
00:31:20,870 --> 00:31:17,360
thing

907
00:31:22,549 --> 00:31:20,880
number one and number two um

908
00:31:24,230 --> 00:31:22,559
you even if you have a pre-existing

909
00:31:25,509 --> 00:31:24,240
condition that can't be taken into

910
00:31:28,070 --> 00:31:25,519
consideration they still have to sell

911
00:31:30,310 --> 00:31:28,080
you health care at the same price

912
00:31:32,230 --> 00:31:30,320
correct so i agree with the second run i

913
00:31:34,789 --> 00:31:32,240
don't agree with the first one

914
00:31:36,070 --> 00:31:34,799
and uh tell me i mean how bad was this

915
00:31:37,430 --> 00:31:36,080
how bad is it the fact that we're

916
00:31:40,710 --> 00:31:37,440
mandating everyone

917
00:31:42,389 --> 00:31:40,720
to buy health insurance so what happened

918
00:31:44,470 --> 00:31:42,399
and i i think you need to take a step

919
00:31:46,310 --> 00:31:44,480
back and look at this on a macro level

920
00:31:48,710 --> 00:31:46,320
uh to be able to understand what really

921
00:31:51,509 --> 00:31:48,720
happened post the affordable care act

922
00:31:53,350 --> 00:31:51,519
we had organizations that got from large

923
00:31:56,310 --> 00:31:53,360
got from being large to being

924
00:31:57,350 --> 00:31:56,320
really really big because the economics

925
00:32:00,070 --> 00:31:57,360
of health care

926
00:32:00,590 --> 00:32:00,080
dramatically changed when you're talking

927
00:32:03,190 --> 00:32:00,600
about

928
00:32:03,750 --> 00:32:03,200
incentivization around quality you

929
00:32:06,389 --> 00:32:03,760
needed

930
00:32:07,190 --> 00:32:06,399
a lot of patience to and a lot of quote

931
00:32:10,630 --> 00:32:07,200
unquote

932
00:32:12,830 --> 00:32:10,640
covered lives to be able to to

933
00:32:13,990 --> 00:32:12,840
take advantage of a as a healthcare

934
00:32:17,830 --> 00:32:14,000
organization

935
00:32:20,310 --> 00:32:17,840
of the this new world order

936
00:32:21,430 --> 00:32:20,320
uh called the uh affordable care act or

937
00:32:24,549 --> 00:32:21,440
obamacare

938
00:32:25,830 --> 00:32:24,559
and so it went from making you know a

939
00:32:29,669 --> 00:32:25,840
large organization

940
00:32:33,190 --> 00:32:29,679
of being 50 to 100 physician groups to

941
00:32:33,909 --> 00:32:33,200
to three to a thousand three hundred to

942
00:32:37,110 --> 00:32:33,919
a thousand

943
00:32:39,509 --> 00:32:37,120
uh physicians in a group and so it it

944
00:32:41,350 --> 00:32:39,519
it consolidated a lot of the healthcare

945
00:32:44,470 --> 00:32:41,360
organizations in this country

946
00:32:45,750 --> 00:32:44,480
consolidation led to higher prices in

947
00:32:48,870 --> 00:32:45,760
many cases

948
00:32:51,230 --> 00:32:48,880
and what it also did was preemptively

949
00:32:52,789 --> 00:32:51,240
a lot of insurance companies on the

950
00:32:55,190 --> 00:32:52,799
non-self-insured

951
00:32:56,470 --> 00:32:55,200
uh raised rates because they felt like

952
00:32:59,029 --> 00:32:56,480
they couldn't compete

953
00:33:00,789 --> 00:32:59,039
with a quote unquote government plan

954
00:33:03,669 --> 00:33:00,799
ultimately it never worked

955
00:33:04,470 --> 00:33:03,679
because there was no exchange uh

956
00:33:06,710 --> 00:33:04,480
spinning up an

957
00:33:07,669 --> 00:33:06,720
insurance company is not a profitable

958
00:33:10,789 --> 00:33:07,679
endeavor

959
00:33:13,669 --> 00:33:10,799
and uh and you know there was

960
00:33:14,710 --> 00:33:13,679
just again this is a generational change

961
00:33:16,470 --> 00:33:14,720
that needs to be made

962
00:33:17,750 --> 00:33:16,480
and eight years later everything that

963
00:33:20,950 --> 00:33:17,760
was tried to be

964
00:33:24,149 --> 00:33:20,960
tried to or even four years later uh

965
00:33:26,950 --> 00:33:24,159
um congress uh overturned

966
00:33:27,350 --> 00:33:26,960
many of the things that they tried to do

967
00:33:28,870 --> 00:33:27,360
but

968
00:33:31,590 --> 00:33:28,880
isn't part of the reason why you had to

969
00:33:33,990 --> 00:33:31,600
be big is that if you're required

970
00:33:35,990 --> 00:33:34,000
to take on anyone no matter what their

971
00:33:37,909 --> 00:33:36,000
pre-existing condition is

972
00:33:39,509 --> 00:33:37,919
and i want to start mom and pop

973
00:33:40,950 --> 00:33:39,519
insurance company

974
00:33:42,070 --> 00:33:40,960
first of all you can't start mom and pop

975
00:33:43,269 --> 00:33:42,080
insurance company in america anymore

976
00:33:45,269 --> 00:33:43,279
because there's too many too many

977
00:33:47,430 --> 00:33:45,279
regulations it's just

978
00:33:49,110 --> 00:33:47,440
too much government capital requirements

979
00:33:52,630 --> 00:33:49,120
are too high too high

980
00:33:54,389 --> 00:33:52,640
but relative mom and pop

981
00:33:55,990 --> 00:33:54,399
one of the biggest problems if i got to

982
00:33:59,909 --> 00:33:56,000
suddenly take on a bunch of people

983
00:34:01,590 --> 00:33:59,919
with brain cancer where i need a pool of

984
00:34:03,909 --> 00:34:01,600
people i need a huge pool of people

985
00:34:05,350 --> 00:34:03,919
because i need these people's money

986
00:34:07,190 --> 00:34:05,360
to help pay for this person's brain

987
00:34:08,869 --> 00:34:07,200
cancer i'm not allowed to say no

988
00:34:10,470 --> 00:34:08,879
to the to these people with brain cancer

989
00:34:11,669 --> 00:34:10,480
i got to tell them insurance at the same

990
00:34:14,149 --> 00:34:11,679
price as the healthy people

991
00:34:15,669 --> 00:34:14,159
so i need a lot of healthy people and

992
00:34:16,950 --> 00:34:15,679
hence the reason why some insurance

993
00:34:18,149 --> 00:34:16,960
companies went out of business and hence

994
00:34:19,589 --> 00:34:18,159
the reason why you have to be eating

995
00:34:21,270 --> 00:34:19,599
such a large pool of people

996
00:34:23,349 --> 00:34:21,280
so let me correct something it's not the

997
00:34:24,710 --> 00:34:23,359
same price it's that you have to have

998
00:34:25,990 --> 00:34:24,720
them covered you could charge more if

999
00:34:28,629 --> 00:34:26,000
they had a preconsistent

1000
00:34:29,829 --> 00:34:28,639
pre-existing car hold on you're the

1001
00:34:33,109 --> 00:34:29,839
expert

1002
00:34:34,869 --> 00:34:33,119
wrong about that i don't think that you

1003
00:34:36,069 --> 00:34:34,879
can discriminate on price

1004
00:34:37,669 --> 00:34:36,079
based on somebody having cancer

1005
00:34:39,510 --> 00:34:37,679
otherwise i'd say okay oh you have

1006
00:34:40,310 --> 00:34:39,520
cancer a million dollars thank you very

1007
00:34:42,550 --> 00:34:40,320
much

1008
00:34:43,909 --> 00:34:42,560
so if you're looking at it at this as an

1009
00:34:45,510 --> 00:34:43,919
individual level

1010
00:34:47,430 --> 00:34:45,520
which there are very few people in this

1011
00:34:49,829 --> 00:34:47,440
country are buying insurance

1012
00:34:50,710 --> 00:34:49,839
individually i am not personally buying

1013
00:34:53,270 --> 00:34:50,720
insurance

1014
00:34:53,829 --> 00:34:53,280
i am part of a plan that's part of my

1015
00:34:55,669 --> 00:34:53,839
company

1016
00:34:57,270 --> 00:34:55,679
okay i buy individuals let's talk about

1017
00:34:59,109 --> 00:34:57,280
okay i buy individuals

1018
00:35:00,950 --> 00:34:59,119
so you're in the minority you're in the

1019
00:35:02,230 --> 00:35:00,960
actual ultra minority of people in this

1020
00:35:04,870 --> 00:35:02,240
country and so yes

1021
00:35:05,750 --> 00:35:04,880
you would be community rated in uh based

1022
00:35:08,710 --> 00:35:05,760
upon

1023
00:35:09,910 --> 00:35:08,720
your experience and and the fact that i

1024
00:35:11,109 --> 00:35:09,920
have brain cancer

1025
00:35:13,109 --> 00:35:11,119
they're not going to charge me a penny

1026
00:35:15,270 --> 00:35:13,119
more because of my brain cancer

1027
00:35:17,109 --> 00:35:15,280
if you're on the exchange no they would

1028
00:35:18,950 --> 00:35:17,119
charge it based upon your economics

1029
00:35:20,790 --> 00:35:18,960
right so that that's very difficult for

1030
00:35:21,829 --> 00:35:20,800
an insurance company to have to take on

1031
00:35:23,990 --> 00:35:21,839
somebody with

1032
00:35:24,870 --> 00:35:24,000
brain cancer but then let's go forward

1033
00:35:27,990 --> 00:35:24,880
just to finish

1034
00:35:30,550 --> 00:35:28,000
before you would turn that person down

1035
00:35:31,670 --> 00:35:30,560
you would say but in the reality most

1036
00:35:33,750 --> 00:35:31,680
people are not getting

1037
00:35:35,510 --> 00:35:33,760
insurance individually most people are

1038
00:35:37,750 --> 00:35:35,520
getting insurance from their companies

1039
00:35:38,630 --> 00:35:37,760
and companies are rated based on their

1040
00:35:41,030 --> 00:35:38,640
experience

1041
00:35:41,750 --> 00:35:41,040
as a company they can't deny any

1042
00:35:43,750 --> 00:35:41,760
individual

1043
00:35:44,870 --> 00:35:43,760
coverage but they're going to have to

1044
00:35:46,870 --> 00:35:44,880
pay a bigger price

1045
00:35:49,349 --> 00:35:46,880
if their experience is worse than

1046
00:35:52,470 --> 00:35:49,359
another company and just so i understand

1047
00:35:54,069 --> 00:35:52,480
even before obamacare if i was working

1048
00:35:55,109 --> 00:35:54,079
at a company i just joined the company i

1049
00:35:58,069 --> 00:35:55,119
got my new job

1050
00:35:59,109 --> 00:35:58,079
i got my benefits and i've got brain

1051
00:36:00,950 --> 00:35:59,119
cancer though

1052
00:36:03,030 --> 00:36:00,960
you're saying that i would still get

1053
00:36:04,950 --> 00:36:03,040
covered and i would get covered

1054
00:36:06,230 --> 00:36:04,960
at the same price as everybody else even

1055
00:36:07,430 --> 00:36:06,240
pre-obamacare

1056
00:36:09,990 --> 00:36:07,440
right but the company would probably

1057
00:36:12,069 --> 00:36:10,000
have to pay more it would go into their

1058
00:36:15,270 --> 00:36:12,079
overall statistics

1059
00:36:17,910 --> 00:36:15,280
and next year when they go to renew so

1060
00:36:18,550 --> 00:36:17,920
what it does say is is that a company

1061
00:36:20,870 --> 00:36:18,560
couldn't

1062
00:36:22,790 --> 00:36:20,880
deny you getting health care if you were

1063
00:36:26,470 --> 00:36:22,800
a smoker or you are obese

1064
00:36:27,829 --> 00:36:26,480
which was happening so and you know that

1065
00:36:28,150 --> 00:36:27,839
that's another problem by the way is i

1066
00:36:30,150 --> 00:36:28,160
mean

1067
00:36:32,150 --> 00:36:30,160
americans have no incentive to take care

1068
00:36:32,710 --> 00:36:32,160
of their health i mean no financial

1069
00:36:34,310 --> 00:36:32,720
incentive

1070
00:36:36,069 --> 00:36:34,320
now you could say oh come on jim you're

1071
00:36:37,430 --> 00:36:36,079
being silly about financial incentive

1072
00:36:42,230 --> 00:36:37,440
people all care about their health

1073
00:36:45,430 --> 00:36:44,710
personal example i i've had acid reflux

1074
00:36:47,349 --> 00:36:45,440
and

1075
00:36:49,589 --> 00:36:47,359
you know i had to go in for the scope

1076
00:36:51,510 --> 00:36:49,599
and that kind of thing i guarantee you

1077
00:36:52,630 --> 00:36:51,520
if i had had to walk out of there and

1078
00:36:54,950 --> 00:36:52,640
pay the 10 000

1079
00:36:57,030 --> 00:36:54,960
bills it would make me think you know

1080
00:36:58,390 --> 00:36:57,040
jim maybe you should cut back on certain

1081
00:36:59,670 --> 00:36:58,400
foods and so on because

1082
00:37:02,069 --> 00:36:59,680
that sucked having to pay that ten

1083
00:37:03,030 --> 00:37:02,079
thousand dollars i mean it goes back to

1084
00:37:05,349 --> 00:37:03,040
what i was saying it's

1085
00:37:06,630 --> 00:37:05,359
it's two legs of a three-legged stool

1086
00:37:08,150 --> 00:37:06,640
and we're not incentivizing or

1087
00:37:11,270 --> 00:37:08,160
penalizing the individuals

1088
00:37:12,550 --> 00:37:11,280
and at all they're not part of the

1089
00:37:14,790 --> 00:37:12,560
quotient here

1090
00:37:15,829 --> 00:37:14,800
well i gotta wrap up i'm sorry that we

1091
00:37:17,990 --> 00:37:15,839
started uh

1092
00:37:20,069 --> 00:37:18,000
late but but just we're gonna promote

1093
00:37:21,349 --> 00:37:20,079
your book of course but just

1094
00:37:23,349 --> 00:37:21,359
let you have the final word as far as

1095
00:37:24,950 --> 00:37:23,359
you know what do you want people to know

1096
00:37:26,310 --> 00:37:24,960
what's the primary takeaway you want

1097
00:37:28,150 --> 00:37:26,320
people to know as far as to start

1098
00:37:30,790 --> 00:37:28,160
changing mindset in america that

1099
00:37:32,310 --> 00:37:30,800
could ultimately lead to some

1100
00:37:35,270 --> 00:37:32,320
improvements in our system

1101
00:37:37,349 --> 00:37:35,280
educate yourself on how the system works

1102
00:37:38,470 --> 00:37:37,359
educate yourself on the economics of

1103
00:37:41,430 --> 00:37:38,480
health care

1104
00:37:43,109 --> 00:37:41,440
how physician groups how hospitals how

1105
00:37:45,510 --> 00:37:43,119
insurance companies

1106
00:37:46,390 --> 00:37:45,520
make their money and that's the first

1107
00:37:48,550 --> 00:37:46,400
step

1108
00:37:50,390 --> 00:37:48,560
know who your doctor works for are they

1109
00:37:51,829 --> 00:37:50,400
independent do they work for a large

1110
00:37:52,710 --> 00:37:51,839
group do they work for an insurance

1111
00:37:56,630 --> 00:37:52,720
company

1112
00:38:00,069 --> 00:37:56,640
do they work for a hospital understand

1113
00:38:03,109 --> 00:38:00,079
that the the

1114
00:38:06,470 --> 00:38:03,119
whole all the pieces of the of the

1115
00:38:09,190 --> 00:38:06,480
of the um of the of the

1116
00:38:10,950 --> 00:38:09,200
factory as i like to call it because

1117
00:38:11,349 --> 00:38:10,960
understanding and educating is the first

1118
00:38:12,790 --> 00:38:11,359
step

1119
00:38:15,829 --> 00:38:12,800
you can't make any change until you

1120
00:38:17,750 --> 00:38:15,839
understand what you're working with

1121
00:38:19,670 --> 00:38:17,760
thank you again to eden walls please go

1122
00:38:22,230 --> 00:38:19,680
to amazon and buy his

1123
00:38:23,510 --> 00:38:22,240
book if you want to learn more the mega

1124
00:38:25,750 --> 00:38:23,520
factory of healthcare

1125
00:38:27,190 --> 00:38:25,760
available on amazon thank you to our

1126
00:38:28,150 --> 00:38:27,200
producer michael parker thank you all

1127
00:38:30,390 --> 00:38:28,160
for listening

1128
00:38:34,630 --> 00:38:30,400
we'll be back soon with another episode

1129
00:38:37,829 --> 00:38:36,069
thank you for listening to the truth

1130
00:38:41,349 --> 00:38:37,839
show with jim breslow

1131
00:38:43,589 --> 00:38:41,359
you can find us at hiddentruthshow.com

1132
00:38:44,390 --> 00:38:43,599
follow us on facebook twitter and

1133
00:38:47,750 --> 00:38:44,400
instagram

1134
00:38:50,390 --> 00:38:47,760
that hit the join us again next week for