1 00:00:00,080 --> 00:00:02,840 Speaker 1: Ess or Charles Hilbery as our guest. He's a professor 2 00:00:02,840 --> 00:00:05,360 Speaker 1: at the University of Texas School of Law, which I 3 00:00:05,360 --> 00:00:08,360 Speaker 1: happened to believe is fantastic because I'm a graduate of same. 4 00:00:10,400 --> 00:00:14,800 Speaker 1: His book is Overcharged, Why Americans pay too much for healthcare. 5 00:00:16,079 --> 00:00:20,040 Speaker 1: You mentioned that the problem began with Medicare Medicaid in 6 00:00:20,079 --> 00:00:24,439 Speaker 1: the sixties, part of Lyndon Johnson's Great Society, which turned. 7 00:00:24,280 --> 00:00:24,919 Speaker 2: Out not to be. 8 00:00:25,520 --> 00:00:31,960 Speaker 1: It was two point zero of FDR's taking over of 9 00:00:32,000 --> 00:00:35,400 Speaker 1: the American economy, and it's hard to strip that back 10 00:00:35,440 --> 00:00:39,800 Speaker 1: out of life when Medicare got involved. So, my dad's 11 00:00:39,840 --> 00:00:42,559 Speaker 1: eighty four, my mom recently passed, and I go in 12 00:00:42,640 --> 00:00:45,040 Speaker 1: and review every expense, everything that comes in, and all 13 00:00:45,120 --> 00:00:49,360 Speaker 1: that this whole Medicare thing. I have a show sponsor 14 00:00:49,720 --> 00:00:53,239 Speaker 1: called Senior Health Services dot Com, and he and his 15 00:00:53,400 --> 00:00:58,000 Speaker 1: team help people who are trying to navigate Medicare. And 16 00:00:58,120 --> 00:01:00,200 Speaker 1: every day I get someone who emails me says can 17 00:01:00,200 --> 00:01:02,560 Speaker 1: you connect me with them? And I forward it and 18 00:01:02,600 --> 00:01:04,960 Speaker 1: sometimes I stay involved for a little while just to see, 19 00:01:05,040 --> 00:01:05,800 Speaker 1: you know, kind of what. 20 00:01:05,720 --> 00:01:06,560 Speaker 2: They're working through. 21 00:01:07,360 --> 00:01:09,360 Speaker 1: It's amazing to people that all of a sudden, I 22 00:01:09,400 --> 00:01:12,080 Speaker 1: guess when you turn sixty five, You're getting robo calls 23 00:01:12,080 --> 00:01:14,520 Speaker 1: and junk mail and all this Medicare, Medicare, Medicare, and 24 00:01:14,600 --> 00:01:17,200 Speaker 1: people had no idea, And now all of a sudden, 25 00:01:17,840 --> 00:01:22,240 Speaker 1: I've been, you know, dumped into the Medicare playground, and 26 00:01:22,400 --> 00:01:25,600 Speaker 1: I don't know why. How does this even work? 27 00:01:29,319 --> 00:01:34,280 Speaker 3: Well? Not too well. I just I recently hit that 28 00:01:34,360 --> 00:01:38,200 Speaker 3: age myself, so I can sympathize with those whose mailbox 29 00:01:38,240 --> 00:01:41,520 Speaker 3: are crammed with Medicare advantage flyers and things of that sort. 30 00:01:42,040 --> 00:01:45,240 Speaker 3: I'm sick of seeing them. And I'm not even using Medicare. 31 00:01:45,520 --> 00:01:48,880 Speaker 3: I'm still working, so I'm staying on my employer's healthcare 32 00:01:48,960 --> 00:01:53,680 Speaker 3: system or healthcare insurance, although that is very expensive and 33 00:01:53,760 --> 00:01:57,680 Speaker 3: far too comprehensive. You know, it's because of the mandates 34 00:01:57,720 --> 00:02:02,720 Speaker 3: regarding what employers ansored coverage has to include that I 35 00:02:02,800 --> 00:02:05,600 Speaker 3: wind up paying, you know, way too much. Everybody does 36 00:02:06,240 --> 00:02:11,320 Speaker 3: pay way too much for insurance. But you know, Medicare, 37 00:02:11,360 --> 00:02:13,840 Speaker 3: what can I say. It's a program that was designed 38 00:02:13,840 --> 00:02:18,919 Speaker 3: to succeed by massively inflating the deficit. You know, everybody 39 00:02:18,960 --> 00:02:22,600 Speaker 3: thinks that Medicare is something that you earn over the 40 00:02:22,639 --> 00:02:25,000 Speaker 3: course of your lifetime. We don't think of it as welfare, 41 00:02:25,040 --> 00:02:28,919 Speaker 3: and politicians who refer to it as welfare are excoriated. 42 00:02:29,560 --> 00:02:33,680 Speaker 3: But the amount that people pay into Medicare is way, way, 43 00:02:33,720 --> 00:02:36,680 Speaker 3: way smaller than the amount that they get out for 44 00:02:36,840 --> 00:02:40,680 Speaker 3: most people. Now they're obviously exceptions to that, but for 45 00:02:40,840 --> 00:02:44,919 Speaker 3: most people, the way that the program succeeds is by 46 00:02:45,040 --> 00:02:48,880 Speaker 3: charging them less than the benefits that they will get 47 00:02:49,040 --> 00:02:51,920 Speaker 3: out of the system. Well, you know, that's a nice arrangement. 48 00:02:51,960 --> 00:02:55,200 Speaker 3: I'd like to have that, But the problem is somebody. 49 00:02:55,240 --> 00:02:57,120 Speaker 3: The money to pay for all those benefits has to 50 00:02:57,160 --> 00:03:01,000 Speaker 3: come from somewhere, and it only only two sources. One 51 00:03:01,080 --> 00:03:04,640 Speaker 3: is general tax revenue, so they use money in addition 52 00:03:04,800 --> 00:03:08,799 Speaker 3: tax revenue in addition to the employee tax to fund 53 00:03:08,880 --> 00:03:12,959 Speaker 3: the program. And the other is deficit spending. And every 54 00:03:13,040 --> 00:03:17,079 Speaker 3: one of these expansions of the Medicare program is funded 55 00:03:17,160 --> 00:03:21,639 Speaker 3: through the deficit. So you know, back when Bush two 56 00:03:21,800 --> 00:03:26,200 Speaker 3: was president, right, he created Medicare Part D, the Prescription 57 00:03:26,320 --> 00:03:30,520 Speaker 3: Drug Benefit Program. Well, the premiums even initially for that program, 58 00:03:30,600 --> 00:03:33,240 Speaker 3: we're only set at fifty percent of the estimated cost. 59 00:03:33,880 --> 00:03:37,640 Speaker 3: Now they're down to twenty five percent of the estimated cost, 60 00:03:37,680 --> 00:03:40,360 Speaker 3: which means everybody loves Medicare Part D because it's a 61 00:03:40,400 --> 00:03:43,520 Speaker 3: great deal, right, I'm only paying twenty five percent of 62 00:03:43,560 --> 00:03:46,720 Speaker 3: the cost. But what you're really doing is taking the 63 00:03:46,760 --> 00:03:50,640 Speaker 3: cost of prescription drugs and rolling them into the deficit. 64 00:03:51,240 --> 00:03:53,640 Speaker 3: And the same thing goes for Obamacare with all these 65 00:03:53,680 --> 00:03:57,920 Speaker 3: premium subsidies. Everything that the government does is designed to 66 00:03:57,920 --> 00:04:03,120 Speaker 3: be popular by being priced below its actual cost, and 67 00:04:03,160 --> 00:04:06,320 Speaker 3: the result of that in the long run has to 68 00:04:06,320 --> 00:04:12,480 Speaker 3: be deficit increases and inflation increases. There's just no getting 69 00:04:12,520 --> 00:04:12,960 Speaker 3: around that. 70 00:04:14,560 --> 00:04:19,279 Speaker 1: It's frustrating because then Medicare, the government is telling you 71 00:04:19,360 --> 00:04:21,279 Speaker 1: which doctors you can go to and which you can't, 72 00:04:21,320 --> 00:04:23,880 Speaker 1: which procedures you can do and which you can't, and 73 00:04:23,960 --> 00:04:26,960 Speaker 1: so you know, and look, it sounds like you and 74 00:04:27,040 --> 00:04:28,440 Speaker 1: I are relatively aligned. 75 00:04:28,480 --> 00:04:30,279 Speaker 2: I was an. 76 00:04:29,600 --> 00:04:33,760 Speaker 1: Acolyte of Professor Leino Graias. He probably understand where my 77 00:04:33,880 --> 00:04:36,160 Speaker 1: views are with regard to politics and the role of 78 00:04:36,240 --> 00:04:40,800 Speaker 1: the government and the individual. I'm probably more libertarian certainly 79 00:04:40,920 --> 00:04:43,400 Speaker 1: than he was. I'm over on the Rand and Ron 80 00:04:43,440 --> 00:04:47,960 Speaker 1: Paul end of things. But what I find frustrating is 81 00:04:48,000 --> 00:04:52,520 Speaker 1: that people seem to think that somehow government is protecting 82 00:04:52,560 --> 00:04:57,320 Speaker 1: you and aiding you, but in fact, what goes with 83 00:04:57,480 --> 00:04:59,600 Speaker 1: that is, you know why you don't feed the bears 84 00:05:00,040 --> 00:05:03,440 Speaker 1: at the zoo is they're controlling you, and any government 85 00:05:03,520 --> 00:05:06,960 Speaker 1: powerful enough to pay for your medical surgery or medical procedures, 86 00:05:07,000 --> 00:05:09,400 Speaker 1: powerful enough to take it away, and then they start 87 00:05:09,440 --> 00:05:12,240 Speaker 1: making decisions for you. And that's where we get into 88 00:05:12,240 --> 00:05:15,920 Speaker 1: the civil liberties. And that's where I get very frustrated, 89 00:05:15,960 --> 00:05:19,160 Speaker 1: because we've now moved beyond healthcare and we've moved into 90 00:05:19,600 --> 00:05:24,160 Speaker 1: a sort of totalitarian authoritarian control of the individual. 91 00:05:27,120 --> 00:05:30,240 Speaker 3: Well, you're you're certainly singing my song, because you know 92 00:05:30,400 --> 00:05:33,520 Speaker 3: you're you're a libertarian. I'm an adjunct scholar at the 93 00:05:33,560 --> 00:05:36,200 Speaker 3: Cato Institute. I don't think it gets much more libertarian 94 00:05:36,240 --> 00:05:40,560 Speaker 3: than that, I would say, so, so we're on the 95 00:05:40,600 --> 00:05:45,479 Speaker 3: same page as far as, you know, being very very 96 00:05:45,480 --> 00:05:52,600 Speaker 3: concerned about the governmental control. I think that governmental control 97 00:05:52,880 --> 00:05:56,000 Speaker 3: is part of the story, but I think governmental ineptitude 98 00:05:56,200 --> 00:06:01,360 Speaker 3: is probably a much bigger part of the story. You know, 99 00:06:01,640 --> 00:06:03,920 Speaker 3: I'm willing to say, oh, some of those you know, 100 00:06:04,000 --> 00:06:07,280 Speaker 3: bureaucrats who run these programs actually want to want to 101 00:06:07,279 --> 00:06:10,440 Speaker 3: help people, and may even believe they are helping people, 102 00:06:10,960 --> 00:06:16,520 Speaker 3: but it's actually very difficult to run the healthcare system. Well, 103 00:06:16,760 --> 00:06:20,800 Speaker 3: that's why market forces are so important, because market forces 104 00:06:21,360 --> 00:06:26,479 Speaker 3: are constantly rewarding providers for figuring out how to serve 105 00:06:26,640 --> 00:06:29,599 Speaker 3: patients better. Right, that's how you can get business. If 106 00:06:29,640 --> 00:06:31,960 Speaker 3: you can figure out how to serve your customers better, 107 00:06:32,520 --> 00:06:36,640 Speaker 3: then you'll get more customers. And that's just something that 108 00:06:36,720 --> 00:06:40,679 Speaker 3: requires people who know the nuts and bolts really well 109 00:06:40,720 --> 00:06:44,520 Speaker 3: to be constantly reflecting on how they're doing their jobs. 110 00:06:44,640 --> 00:06:44,880 Speaker 4: Right. 111 00:06:45,839 --> 00:06:48,719 Speaker 3: The government bureaucrats, they don't do that. They don't even 112 00:06:48,720 --> 00:06:52,400 Speaker 3: know how the jobs work. They just exist mainly to 113 00:06:52,440 --> 00:06:58,320 Speaker 3: pay bills and to enact regulations that enable them to 114 00:06:59,080 --> 00:07:01,400 Speaker 3: deal with the bird and that all this imposes on 115 00:07:01,440 --> 00:07:05,480 Speaker 3: the federal government, and the results for consumers are just terrible. 116 00:07:05,680 --> 00:07:08,400 Speaker 3: You know, all these problems that everybody complains about, prior 117 00:07:08,480 --> 00:07:14,040 Speaker 3: authorization requirements, surprise bills, these things called facility fees that 118 00:07:14,120 --> 00:07:16,840 Speaker 3: you know, you go to an emergency room, the doctor says, oh, 119 00:07:16,920 --> 00:07:19,360 Speaker 3: you've got a fever, take some aster and go home, 120 00:07:19,400 --> 00:07:21,320 Speaker 3: and then you get a build for ten thousand dollars 121 00:07:21,360 --> 00:07:24,360 Speaker 3: because you literally because you walked in the front doors. 122 00:07:24,400 --> 00:07:27,600 Speaker 3: It's just like a cover charge at a bar or 123 00:07:27,640 --> 00:07:31,520 Speaker 3: something like that, except a lot bigger. You know, none 124 00:07:31,560 --> 00:07:35,800 Speaker 3: of that stuff exists in the direct payment system. It 125 00:07:35,920 --> 00:07:41,640 Speaker 3: all exists because the government regulates the way healthcare is delivered, 126 00:07:41,760 --> 00:07:46,000 Speaker 3: and it does it in stupid ways because. 127 00:07:45,560 --> 00:07:48,560 Speaker 1: It's hard to do it right and government's not in 128 00:07:48,640 --> 00:07:51,520 Speaker 1: the business of efficiency. Professor Charles Silver is our guest. 129 00:07:51,840 --> 00:07:56,360 Speaker 1: The book is Overcharged, Why you Americans pay too much 130 00:07:56,400 --> 00:07:56,960 Speaker 1: for healthcare? 131 00:07:59,520 --> 00:08:06,440 Speaker 4: Bar Michael Berry, change in the system? Back to. 132 00:08:11,440 --> 00:08:14,840 Speaker 1: Professor Charles Silver of the University of Texas School of 133 00:08:14,960 --> 00:08:19,600 Speaker 1: Law is our guest. He was I have come to 134 00:08:19,680 --> 00:08:23,000 Speaker 1: learn in the course of our conversation at ut Law 135 00:08:24,000 --> 00:08:26,400 Speaker 1: almost ten years before I was there and still is. 136 00:08:26,880 --> 00:08:29,960 Speaker 1: I did not know him, but I happened to think 137 00:08:30,000 --> 00:08:32,960 Speaker 1: the world of that law school, and I gained a 138 00:08:33,000 --> 00:08:38,400 Speaker 1: lot from from being there, both associations and education. And 139 00:08:39,520 --> 00:08:43,160 Speaker 1: this book has been highly recommended to me by numerous 140 00:08:43,200 --> 00:08:46,440 Speaker 1: folks as to how to gain a better understanding of 141 00:08:46,480 --> 00:08:51,840 Speaker 1: why the healthcare system costs you so much? Overcharged, Why 142 00:08:51,920 --> 00:08:55,880 Speaker 1: Americans pay too much for healthcare? Professor Charles Silver is 143 00:08:55,920 --> 00:09:00,800 Speaker 1: our guest. Professor, let's talk about young people. 144 00:09:02,600 --> 00:09:03,959 Speaker 2: By young I'm. 145 00:09:03,800 --> 00:09:06,760 Speaker 1: Fifty three, so I'm gonna throw myself into there. You know, 146 00:09:07,040 --> 00:09:10,560 Speaker 1: I've read that something like half the healthcare costs in 147 00:09:10,640 --> 00:09:14,280 Speaker 1: this country are expended on people within the last two 148 00:09:14,360 --> 00:09:16,160 Speaker 1: years of their lives. And you know, we see this 149 00:09:16,240 --> 00:09:18,760 Speaker 1: where it's just constant, it's just one thing after another 150 00:09:18,800 --> 00:09:21,120 Speaker 1: after another, and then they pass and then you kick 151 00:09:21,120 --> 00:09:23,439 Speaker 1: in the funeral industry, and I mean it's these are 152 00:09:23,440 --> 00:09:26,360 Speaker 1: all industries, like the bridle industry and the birthing industry. 153 00:09:26,880 --> 00:09:31,920 Speaker 1: When you look at a person who is relatively healthy 154 00:09:31,960 --> 00:09:37,840 Speaker 1: without a chronic condition, and you're looking at the cost 155 00:09:38,200 --> 00:09:43,120 Speaker 1: to them that they're bearing, which really is the risk 156 00:09:43,480 --> 00:09:46,120 Speaker 1: you're willing to assume. Right, if you're never going to 157 00:09:46,200 --> 00:09:49,560 Speaker 1: need a doctor, then you don't need insurance. We just 158 00:09:49,640 --> 00:09:51,280 Speaker 1: don't know which one of us is going to be 159 00:09:51,320 --> 00:09:53,520 Speaker 1: in a car wreck or have a heart attack. So 160 00:09:53,559 --> 00:09:57,040 Speaker 1: we're trying the same way we leverage the risk on 161 00:09:57,080 --> 00:10:00,400 Speaker 1: if our house burns down. We're trying to kind of 162 00:10:00,559 --> 00:10:02,800 Speaker 1: to keep that at bay and to make a good 163 00:10:02,880 --> 00:10:08,440 Speaker 1: financial decision. Where is that going wrong today? Because my 164 00:10:08,520 --> 00:10:13,080 Speaker 1: guess is most people are overpaying for insurance coverage that 165 00:10:13,120 --> 00:10:16,839 Speaker 1: they won't need until much later. That's going toward people 166 00:10:16,920 --> 00:10:20,160 Speaker 1: at their end of life. 167 00:10:20,960 --> 00:10:23,400 Speaker 3: Oh, I agree that I think that story is right. 168 00:10:23,480 --> 00:10:26,560 Speaker 3: There are a bunch of thoughts that it prompts. One 169 00:10:26,559 --> 00:10:28,600 Speaker 3: of them is, you know, I've never been a fan 170 00:10:29,559 --> 00:10:35,440 Speaker 3: of taxing people who are relatively young to provide benefits 171 00:10:35,480 --> 00:10:38,120 Speaker 3: to people who are relatively old. That strikes me is 172 00:10:38,160 --> 00:10:40,920 Speaker 3: wrong on a variety of levels. You know. One is, 173 00:10:41,600 --> 00:10:45,360 Speaker 3: every moral theory that I know of says you move 174 00:10:45,520 --> 00:10:50,760 Speaker 3: money from richer people to poorer people. Well, older people 175 00:10:50,800 --> 00:10:55,320 Speaker 3: are wealthier than younger people. That shouldn't be surprising to anybody. 176 00:10:55,360 --> 00:10:57,800 Speaker 3: They've had their whole lives to work, right and save. 177 00:10:57,960 --> 00:11:00,360 Speaker 3: They've paid off their cars, they've paid off their homes. 178 00:11:00,480 --> 00:11:04,199 Speaker 3: You know, they have other assets. Right, They're on average, 179 00:11:04,400 --> 00:11:07,400 Speaker 3: much wealthier than younger people who are struggling, you know, 180 00:11:07,480 --> 00:11:12,000 Speaker 3: raising families, you know, just getting jobs, dealing with college 181 00:11:12,040 --> 00:11:15,720 Speaker 3: debt and all that stuff. So my moral view is, 182 00:11:15,760 --> 00:11:17,760 Speaker 3: if we were going to move money in any direction, 183 00:11:17,880 --> 00:11:20,280 Speaker 3: we should move it from older people to younger people. 184 00:11:20,400 --> 00:11:23,480 Speaker 3: But our system does the reverse. We're robbing the poor 185 00:11:23,520 --> 00:11:29,280 Speaker 3: to pay the rich. I don't understand that. Another thing is, 186 00:11:32,000 --> 00:11:41,720 Speaker 3: excuse me, the system really deserves people because it eliminates 187 00:11:41,920 --> 00:11:45,320 Speaker 3: all caps on spending. You were talking about end of 188 00:11:45,360 --> 00:11:48,160 Speaker 3: life care and how we spend so much money in 189 00:11:48,200 --> 00:11:51,719 Speaker 3: the last year or two of people's lives. Well, if 190 00:11:51,760 --> 00:11:54,760 Speaker 3: people had to spend their own money, nobody would spend 191 00:11:54,800 --> 00:11:59,160 Speaker 3: an infinite amount in their last two years on healthcare. 192 00:11:59,520 --> 00:12:01,920 Speaker 3: They would have to make hard decisions. Right, These are 193 00:12:01,920 --> 00:12:06,160 Speaker 3: not pleasant decisions, but they would make decisions about how 194 00:12:06,240 --> 00:12:09,560 Speaker 3: much healthcare they want. Is it worth spending a million 195 00:12:09,640 --> 00:12:12,960 Speaker 3: dollars to extend my life by a month, Right, that's 196 00:12:13,000 --> 00:12:17,000 Speaker 3: the kind of decision they would have to make. Well, today, 197 00:12:17,080 --> 00:12:21,320 Speaker 3: because we removed all caps from the system, nobody has 198 00:12:21,400 --> 00:12:25,319 Speaker 3: to make those decisions. Instead, we just spend literally an 199 00:12:25,360 --> 00:12:29,120 Speaker 3: infinite amount of money on people who are in the 200 00:12:29,160 --> 00:12:32,400 Speaker 3: final stages of their illness. We get no bang for 201 00:12:32,480 --> 00:12:35,320 Speaker 3: the buck. You know, we have people, literally we have 202 00:12:35,400 --> 00:12:39,560 Speaker 3: people who are receiving cancer treatments, new cancer treatments that 203 00:12:39,640 --> 00:12:43,559 Speaker 3: cost a million dollars, and all those treatments do is 204 00:12:43,640 --> 00:12:46,760 Speaker 3: extend their lives by about a month. And it's not 205 00:12:47,000 --> 00:12:49,800 Speaker 3: even a good month. It's not a month when you're 206 00:12:49,800 --> 00:12:52,640 Speaker 3: going to be out there on the golf course playing 207 00:12:52,679 --> 00:12:55,320 Speaker 3: with your buddies and drinking beer. It's a month like 208 00:12:55,400 --> 00:13:00,200 Speaker 3: you're in the hospital, right for the whole month which 209 00:13:00,280 --> 00:13:03,560 Speaker 3: things just make no sense. But the government, the government 210 00:13:03,720 --> 00:13:09,280 Speaker 3: cannot make those decisions. Literally, it cannot because the moment 211 00:13:09,400 --> 00:13:14,520 Speaker 3: the government starts talking about rationing care, everybody loses their minds. 212 00:13:15,160 --> 00:13:18,480 Speaker 3: And you don't want to be the politician that they're 213 00:13:18,840 --> 00:13:25,480 Speaker 3: rallying against. Right, So the government simply ignores the need 214 00:13:25,559 --> 00:13:28,840 Speaker 3: to make these decisions and just spends endless amounts of 215 00:13:28,880 --> 00:13:31,640 Speaker 3: money because it's other people's money. So why does the 216 00:13:31,679 --> 00:13:37,600 Speaker 3: government care? Right, And and you know, we just have 217 00:13:37,760 --> 00:13:41,480 Speaker 3: to come back to the world in which people are 218 00:13:41,840 --> 00:13:46,720 Speaker 3: responsible for their own end of life's care. You know, 219 00:13:46,920 --> 00:13:49,640 Speaker 3: it's it's it's a sad thing, but it's true. We 220 00:13:49,720 --> 00:13:53,880 Speaker 3: will all die at some point. And the fact that 221 00:13:53,920 --> 00:13:57,640 Speaker 3: we will all die at some point affects a thousand 222 00:13:57,760 --> 00:14:00,840 Speaker 3: decisions that each of us makes. Right, When am I 223 00:14:00,920 --> 00:14:04,680 Speaker 3: going to stop working? Well, if I'm thinking I don't 224 00:14:04,720 --> 00:14:07,319 Speaker 3: have much longer to live, I probably will stop working 225 00:14:07,360 --> 00:14:09,360 Speaker 3: so I can spend my last you know, a couple 226 00:14:09,400 --> 00:14:13,400 Speaker 3: of years with my family or traveling or whatever it is, right, 227 00:14:13,400 --> 00:14:16,320 Speaker 3: I mean, if you start to think about it, knowing 228 00:14:16,360 --> 00:14:20,640 Speaker 3: that at some point we will all die, it affects, 229 00:14:20,840 --> 00:14:24,640 Speaker 3: as I said, thousands of decisions that we make. You know, 230 00:14:24,720 --> 00:14:26,720 Speaker 3: do I want to live in this house that I'm 231 00:14:26,760 --> 00:14:28,600 Speaker 3: in now until the end of my life, or do 232 00:14:28,680 --> 00:14:31,760 Speaker 3: I want to move to a house that's more handicap 233 00:14:31,800 --> 00:14:35,280 Speaker 3: equipped and things of that sort. Right, this is just 234 00:14:35,400 --> 00:14:38,880 Speaker 3: another decision. It's a tough decision. I'm not trying to 235 00:14:38,920 --> 00:14:41,960 Speaker 3: say otherwise, but it's a decision that needs to be made, 236 00:14:42,560 --> 00:14:44,920 Speaker 3: and it needs to be made not by the government, 237 00:14:45,320 --> 00:14:48,520 Speaker 3: but by the people who are directly involved and who 238 00:14:48,560 --> 00:14:52,240 Speaker 3: can think hard about all these tough problems. There's no 239 00:14:52,320 --> 00:14:55,160 Speaker 3: way the government's going to make a good decision. Their 240 00:14:55,200 --> 00:14:59,280 Speaker 3: incentives are wrong, their knowledge is too limited. They don't 241 00:14:59,280 --> 00:15:02,560 Speaker 3: have access of the counselors that individuals will talk to 242 00:15:02,720 --> 00:15:06,320 Speaker 3: and making these kinds of decisions. So, you know, we 243 00:15:06,440 --> 00:15:09,440 Speaker 3: just have to get the government out of this business. 244 00:15:09,880 --> 00:15:14,720 Speaker 3: What I have proposed is that we you know, there 245 00:15:14,800 --> 00:15:17,640 Speaker 3: is one other problem though that we haven't discussed, which 246 00:15:17,680 --> 00:15:19,560 Speaker 3: we do need to discuss, which is there are some 247 00:15:19,600 --> 00:15:25,480 Speaker 3: people who are too poor to afford fundamental healthcare. We 248 00:15:25,520 --> 00:15:27,960 Speaker 3: do need to come up with a way of dealing 249 00:15:27,960 --> 00:15:29,880 Speaker 3: with those people, because when they show up at the 250 00:15:29,920 --> 00:15:34,320 Speaker 3: hospital needing healthcare, they're not going to be turned away, right, 251 00:15:34,720 --> 00:15:36,960 Speaker 3: We're not going to be having sick people dying in 252 00:15:37,000 --> 00:15:40,960 Speaker 3: the streets because they can't afford healthcare. So we need 253 00:15:41,000 --> 00:15:42,920 Speaker 3: to come up with a way to deal with that. 254 00:15:42,960 --> 00:15:45,320 Speaker 3: But the obvious way to deal with that is through 255 00:15:45,320 --> 00:15:48,000 Speaker 3: a negative income text, the sort of thing that Milton 256 00:15:48,040 --> 00:15:52,360 Speaker 3: Friedman proposed. You know, you provide everybody with a kind 257 00:15:52,400 --> 00:15:56,600 Speaker 3: of amount of sustenance that they can use for this purpose. 258 00:15:56,640 --> 00:16:00,160 Speaker 3: You could put it into a restricted medical account if 259 00:16:00,160 --> 00:16:02,920 Speaker 3: you wanted, But the idea is once you give it 260 00:16:02,960 --> 00:16:05,640 Speaker 3: to them, it's hands off for the rest of it. 261 00:16:05,680 --> 00:16:08,440 Speaker 3: The government doesn't get involved in the delivery of healthcare. 262 00:16:09,800 --> 00:16:13,440 Speaker 3: Just people make decisions on themselves with their own money, 263 00:16:13,680 --> 00:16:16,680 Speaker 3: and life goes forward. And I think if we did that, 264 00:16:16,760 --> 00:16:20,880 Speaker 3: the healthcare system would operate much more efficiently. Well. 265 00:16:20,960 --> 00:16:26,040 Speaker 1: The great frustration, as you know, is that everybody gets 266 00:16:26,040 --> 00:16:28,880 Speaker 1: a vote, even people that make bad decisions, and that 267 00:16:29,040 --> 00:16:32,520 Speaker 1: many people make bad decisions. You know that we will 268 00:16:32,520 --> 00:16:34,960 Speaker 1: have a lot of people who say I can't afford 269 00:16:35,080 --> 00:16:37,360 Speaker 1: medical care because they don't save money. 270 00:16:37,600 --> 00:16:40,119 Speaker 2: But they've got a big screen TV in every room. 271 00:16:40,360 --> 00:16:43,520 Speaker 1: And they've got, you know, a car they can't afford 272 00:16:43,560 --> 00:16:44,440 Speaker 1: that they're driving. 273 00:16:45,480 --> 00:16:47,200 Speaker 2: They end up with the car that they can't afford, 274 00:16:47,320 --> 00:16:49,600 Speaker 2: and we end up paying for the health care that 275 00:16:49,640 --> 00:16:50,400 Speaker 2: they can't afford. 276 00:16:50,720 --> 00:16:55,240 Speaker 1: The book is Overcharged, Why Americans Pay Too Much for Healthcare? 277 00:16:55,280 --> 00:16:56,520 Speaker 2: Professor Charles Silverman. 278 00:16:57,120 --> 00:16:59,400 Speaker 3: We're gonna add a little bit about these whorehouses. 279 00:16:59,480 --> 00:17:02,160 Speaker 2: I know all Ramon wants to know what around the 280 00:17:02,160 --> 00:17:02,600 Speaker 2: world is. 281 00:17:02,480 --> 00:17:07,720 Speaker 4: Whistling bunghole spleen splitters, whisker biscuits, honkey riders, whoskerdoos, whosker 282 00:17:07,800 --> 00:17:11,120 Speaker 4: don'ts nips and dazers with it without the scooter stick 283 00:17:11,400 --> 00:17:14,000 Speaker 4: or one single whistling kiddy. Jason Michael. 284 00:17:15,920 --> 00:17:18,480 Speaker 1: Professor Charles silver is our guest. It's a subject of 285 00:17:18,480 --> 00:17:20,159 Speaker 1: great interest to me into many of you. 286 00:17:21,000 --> 00:17:21,640 Speaker 2: The book is. 287 00:17:21,600 --> 00:17:26,399 Speaker 1: Called Overcharged, Why Americans Pay Too Much for Healthcare. He 288 00:17:26,560 --> 00:17:30,119 Speaker 1: is a law professor at the University of Texas. 289 00:17:29,960 --> 00:17:31,560 Speaker 2: At Austin School of Law. 290 00:17:32,200 --> 00:17:35,240 Speaker 1: And we ended the last segment with the discussion that 291 00:17:35,320 --> 00:17:38,359 Speaker 1: at the end of the day, the allocation of scarce 292 00:17:38,400 --> 00:17:41,760 Speaker 1: resources and who will make that decision. We're back at 293 00:17:41,760 --> 00:17:46,000 Speaker 1: that point again in every family, you know, you got 294 00:17:46,000 --> 00:17:50,480 Speaker 1: eight kids and you got one chicken. Mom says you're 295 00:17:50,480 --> 00:17:53,280 Speaker 1: not getting a second piece. So there's some cartilage left 296 00:17:53,359 --> 00:17:57,440 Speaker 1: on that leg. If you're hungry, you'll eat that. And 297 00:17:57,600 --> 00:18:00,639 Speaker 1: there comes a point where we have to decide, with 298 00:18:01,320 --> 00:18:04,280 Speaker 1: scarce resources, who will make the decision as to where 299 00:18:04,320 --> 00:18:07,440 Speaker 1: those resources will be deployed. Will it be the government 300 00:18:08,040 --> 00:18:11,000 Speaker 1: or will it be the individual? And if it's the individual, 301 00:18:11,600 --> 00:18:14,199 Speaker 1: there will be those who say, well, I want as 302 00:18:14,280 --> 00:18:16,959 Speaker 1: much as my neighbor has, Okay, we'll earn the money 303 00:18:17,400 --> 00:18:20,800 Speaker 1: to purchase that. Well, I don't earn as much. I 304 00:18:20,840 --> 00:18:23,239 Speaker 1: want to use the power of the gun through at 305 00:18:23,240 --> 00:18:25,239 Speaker 1: the direction of the government that I either more of 306 00:18:25,240 --> 00:18:27,280 Speaker 1: me than there are of the rich people I vote for. 307 00:18:27,440 --> 00:18:30,280 Speaker 1: I want them well. The only alternative is for the 308 00:18:30,320 --> 00:18:34,159 Speaker 1: government to do it. Professor I harken back to a study, 309 00:18:34,160 --> 00:18:36,560 Speaker 1: and it's been a while since I read this book. 310 00:18:37,560 --> 00:18:41,719 Speaker 1: It's interesting because I'm a believer and let the marketplace decide. 311 00:18:41,800 --> 00:18:43,719 Speaker 1: You know, healthcare is the one area where we think 312 00:18:43,760 --> 00:18:46,280 Speaker 1: everybody gets all the healthcare they want, but we all 313 00:18:46,359 --> 00:18:48,000 Speaker 1: end up paying for that. We don't say everybody gets 314 00:18:48,040 --> 00:18:49,680 Speaker 1: all the food they want, or all the cars they want, 315 00:18:49,720 --> 00:18:51,280 Speaker 1: or all the houses they want, or all the clothes 316 00:18:51,280 --> 00:18:53,600 Speaker 1: they want, but for some reason, everybody gets all the 317 00:18:53,600 --> 00:18:56,359 Speaker 1: healthcare they want even at the point that it's throwing 318 00:18:56,359 --> 00:18:59,760 Speaker 1: good money after bad so socialist system the opposite of 319 00:18:59,800 --> 00:19:03,280 Speaker 1: what I propose. In Sweden, they did a study and 320 00:19:03,359 --> 00:19:05,560 Speaker 1: it was a multi decade study you may be aware 321 00:19:05,560 --> 00:19:09,080 Speaker 1: of it, on prostate cancer in men, and they determined 322 00:19:09,280 --> 00:19:13,920 Speaker 1: that out of I think it was three thousand men 323 00:19:13,960 --> 00:19:17,560 Speaker 1: who had prostate cancer who were diagnosed with prostate cancer 324 00:19:18,119 --> 00:19:22,080 Speaker 1: and they chose not to treat the prostate cancer. And 325 00:19:22,359 --> 00:19:25,280 Speaker 1: they did about a twenty five year study and the 326 00:19:25,400 --> 00:19:28,760 Speaker 1: number of men who died of untreated prostate cancer was 327 00:19:28,760 --> 00:19:32,240 Speaker 1: something like thirty out of three thousand. So they came 328 00:19:32,280 --> 00:19:36,240 Speaker 1: to the conclusion with a government completely government run system 329 00:19:36,440 --> 00:19:39,320 Speaker 1: that with scarce resources, it does not make sense for 330 00:19:39,440 --> 00:19:44,239 Speaker 1: us to treat prostate cancer per se because nobody, very 331 00:19:44,240 --> 00:19:46,760 Speaker 1: few people are going to die of prostate cancer. Let's 332 00:19:46,800 --> 00:19:49,040 Speaker 1: spend our money on other things that if we don't 333 00:19:49,080 --> 00:19:53,160 Speaker 1: spend it there you die. And it strikes me that 334 00:19:53,320 --> 00:19:56,400 Speaker 1: while that's the opposite of the capitalist system, there does 335 00:19:56,560 --> 00:19:59,440 Speaker 1: need to be an understanding that we're wasting a lot 336 00:19:59,480 --> 00:20:03,359 Speaker 1: of money on studies because and this gets to the 337 00:20:03,400 --> 00:20:05,760 Speaker 1: second point of what you've written a lot about medical 338 00:20:05,800 --> 00:20:09,160 Speaker 1: malpractice and the fear of medical malpractice. I don't think 339 00:20:09,200 --> 00:20:11,600 Speaker 1: everybody needs a glaucoma test every time they go for 340 00:20:12,800 --> 00:20:15,800 Speaker 1: their license, but God forbid one person not be diagnosed 341 00:20:15,800 --> 00:20:21,120 Speaker 1: with glaucoma. We're practicing defensive medicine. We're over ordering tests, 342 00:20:21,440 --> 00:20:23,159 Speaker 1: which is a waste of our time and energy but 343 00:20:23,200 --> 00:20:27,439 Speaker 1: also money, and we're not actually doing We're not engaged 344 00:20:27,520 --> 00:20:32,439 Speaker 1: in what I would consider smart effective healing because everyone 345 00:20:32,480 --> 00:20:35,480 Speaker 1: is afraid of being sued. And that has we get 346 00:20:35,520 --> 00:20:38,240 Speaker 1: back to our point. The book is overcharged. Why Americans 347 00:20:38,240 --> 00:20:40,440 Speaker 1: pay too much for healthcare? I think that's a big 348 00:20:40,480 --> 00:20:41,719 Speaker 1: portion of what we spend. 349 00:20:41,840 --> 00:20:45,960 Speaker 3: Your thought, well, I'm going to disagree with part of that, 350 00:20:46,000 --> 00:20:49,240 Speaker 3: but I agree with a lot of it as well. 351 00:20:50,160 --> 00:20:53,399 Speaker 3: In my world, when you have a self interested explanation 352 00:20:53,680 --> 00:20:56,240 Speaker 3: for something, you probably don't have to look very far 353 00:20:56,320 --> 00:20:59,359 Speaker 3: for any other explanation. Self interest usually is a pretty 354 00:20:59,359 --> 00:21:03,960 Speaker 3: good explanation. And the reason, you know, some people say, oh, 355 00:21:04,040 --> 00:21:06,719 Speaker 3: the reason that doctors overtreat is because they're afraid of 356 00:21:06,720 --> 00:21:10,520 Speaker 3: being sued. Well, there's a simpler self interested explanation, which 357 00:21:10,560 --> 00:21:14,040 Speaker 3: is every time they treat somebody, they make money, and 358 00:21:14,640 --> 00:21:18,320 Speaker 3: until you take the profit out of these services, which 359 00:21:18,359 --> 00:21:22,160 Speaker 3: will never happen. It's very hard to determine that they're 360 00:21:22,200 --> 00:21:27,760 Speaker 3: actually engaging in any real defensive medicine at all. There 361 00:21:27,760 --> 00:21:30,320 Speaker 3: are lots of studies that are out there now that 362 00:21:30,359 --> 00:21:33,199 Speaker 3: have found that, I mean, defensive medicine is kind of 363 00:21:33,240 --> 00:21:37,840 Speaker 3: hard to define because it can be both. It can 364 00:21:37,880 --> 00:21:41,199 Speaker 3: be both the provision of services that aren't needed and 365 00:21:41,240 --> 00:21:44,800 Speaker 3: the avoidance of services that are needed, because you get 366 00:21:44,840 --> 00:21:47,400 Speaker 3: sued when you do deliver services as well as when 367 00:21:47,440 --> 00:21:50,800 Speaker 3: you withhold them. So it's hard to figure out exactly 368 00:21:50,840 --> 00:21:53,120 Speaker 3: what's going on with defensive medicine. But as I said, 369 00:21:53,160 --> 00:21:54,919 Speaker 3: I don't think we really need to worry about it 370 00:21:55,040 --> 00:21:58,040 Speaker 3: very much because we have a self interested explanation, which 371 00:21:58,080 --> 00:22:01,199 Speaker 3: is that the services are profitable. And there's also you know, 372 00:22:01,320 --> 00:22:04,240 Speaker 3: doctors have a lot of confidence in their ability to 373 00:22:04,240 --> 00:22:06,439 Speaker 3: help people, and they have a very strong desire to 374 00:22:06,560 --> 00:22:07,119 Speaker 3: help people. 375 00:22:07,240 --> 00:22:09,119 Speaker 2: Right at least that's what it should be. 376 00:22:09,400 --> 00:22:09,639 Speaker 3: You know. 377 00:22:09,720 --> 00:22:13,440 Speaker 1: You remind me of another great document written in seventeen 378 00:22:13,520 --> 00:22:16,639 Speaker 1: seventy six, and that from a Scotsman named Adam Smith, 379 00:22:16,640 --> 00:22:18,960 Speaker 1: who famously said, it is not from the benevolence of 380 00:22:19,000 --> 00:22:21,119 Speaker 1: the butcher, or the brewer or the baker, that we 381 00:22:21,200 --> 00:22:24,960 Speaker 1: expect our dinner, but from their regard to their own 382 00:22:25,119 --> 00:22:31,640 Speaker 1: self interest exactly. Self interest drives so many things. That 383 00:22:31,680 --> 00:22:34,160 Speaker 1: guy is not standing on his feet behind the counter 384 00:22:34,200 --> 00:22:36,200 Speaker 1: at the donut shop for so many hours and didn't 385 00:22:36,240 --> 00:22:38,320 Speaker 1: get there at two thirty this morning because he's a 386 00:22:38,440 --> 00:22:42,040 Speaker 1: nice guy. He wants to make a profit off the donuts. 387 00:22:42,080 --> 00:22:44,760 Speaker 1: I get to enjoy the donuts in exchange for the 388 00:22:44,840 --> 00:22:47,320 Speaker 1: currency that I was given for the sweat of my brow. 389 00:22:47,680 --> 00:22:50,200 Speaker 1: It works, and I think we have to return. 390 00:22:49,880 --> 00:22:51,719 Speaker 2: That to the process. And I think that's where you 391 00:22:51,760 --> 00:22:52,760 Speaker 2: and I can agree. 392 00:22:53,840 --> 00:22:55,480 Speaker 3: I think we do agree on that, but we also 393 00:22:55,520 --> 00:23:01,359 Speaker 3: agree that I mean, these social programs have fundamentally undermined 394 00:23:01,640 --> 00:23:08,000 Speaker 3: the incentive to save and to be self reliant, you know, 395 00:23:08,160 --> 00:23:12,240 Speaker 3: the I think you know. I constantly read articles about 396 00:23:12,400 --> 00:23:15,399 Speaker 3: how many people are retiring and all they have to 397 00:23:15,480 --> 00:23:18,000 Speaker 3: live on is social security and medicare. They don't have 398 00:23:18,080 --> 00:23:21,159 Speaker 3: much in the way of savings. And people say, well, 399 00:23:21,160 --> 00:23:24,159 Speaker 3: how could you possibly, you know, let that happen? Right? 400 00:23:24,200 --> 00:23:26,359 Speaker 3: Why are you buying, as you put it, those you know, 401 00:23:26,960 --> 00:23:29,159 Speaker 3: big screen TVs for every room when you should be 402 00:23:29,200 --> 00:23:32,320 Speaker 3: saving for your later years. I think the answer is 403 00:23:32,320 --> 00:23:34,840 Speaker 3: that most people naively think, oh, the government's just going 404 00:23:34,880 --> 00:23:37,199 Speaker 3: to take care of me in my later years, so 405 00:23:37,480 --> 00:23:40,359 Speaker 3: I don't have to save, and they, you know, the 406 00:23:40,400 --> 00:23:44,000 Speaker 3: temptation to spend money now rather than later, it's always there. 407 00:23:44,040 --> 00:23:48,119 Speaker 3: Who wants to save? Saving is boring right? Consuming today 408 00:23:48,240 --> 00:23:52,280 Speaker 3: is fun. So you know, I think that as long 409 00:23:52,320 --> 00:23:56,159 Speaker 3: as we have these paygo programs where you know, you 410 00:23:56,200 --> 00:23:59,199 Speaker 3: can keep getting money out above what you put in, 411 00:24:00,800 --> 00:24:04,760 Speaker 3: that the incentives to save will forever be undermined. And 412 00:24:05,160 --> 00:24:07,399 Speaker 3: that's a terrible thing, I think, because, as you said, 413 00:24:07,440 --> 00:24:10,480 Speaker 3: you know, we're just getting ourselves into this world where 414 00:24:10,920 --> 00:24:13,400 Speaker 3: each of us expects everybody else to pay for everything 415 00:24:13,440 --> 00:24:17,080 Speaker 3: that we need. If it's only healthcare, they still expect 416 00:24:17,080 --> 00:24:19,639 Speaker 3: to pay for everything that they want, and that just 417 00:24:19,800 --> 00:24:23,200 Speaker 3: drives costs through the roof without really any offsetting benefits 418 00:24:23,200 --> 00:24:24,200 Speaker 3: that make sense of it. 419 00:24:24,640 --> 00:24:28,920 Speaker 1: Zoologists will tell you you are doing great harm by 420 00:24:28,960 --> 00:24:33,560 Speaker 1: domesticating certain breeds of animals, particularly if you intend at 421 00:24:33,600 --> 00:24:35,720 Speaker 1: some point to release them into the wild. 422 00:24:35,800 --> 00:24:36,840 Speaker 2: You make them slaves. 423 00:24:36,920 --> 00:24:41,480 Speaker 1: They lose the very abilities, and we've seen with evolutionary 424 00:24:41,480 --> 00:24:44,520 Speaker 1: studies that teeth are not as sharpenning longer, claws are 425 00:24:44,520 --> 00:24:46,879 Speaker 1: not as sharp anymore. They can no longer run as fast. 426 00:24:47,200 --> 00:24:51,439 Speaker 1: They grow to be like prison inmates, dependent on someone 427 00:24:51,480 --> 00:24:52,840 Speaker 1: else to provide for them. 428 00:24:53,160 --> 00:24:56,399 Speaker 2: And I think that has to be understood by people. 429 00:24:56,840 --> 00:24:59,159 Speaker 1: Our guest is Professor Charles Silver, who will be with 430 00:24:59,240 --> 00:24:59,960 Speaker 1: us for one more seay. 431 00:25:00,280 --> 00:25:04,440 Speaker 2: The book is Overcharged? Why Americans pay too much? 432 00:25:12,200 --> 00:25:15,840 Speaker 1: Professor Charles Silver of the University of Texas School of Law, 433 00:25:15,920 --> 00:25:19,960 Speaker 1: my alma mater, has graciously spent quite a bit of 434 00:25:19,960 --> 00:25:24,760 Speaker 1: time with us discussing an area of his academic expertise 435 00:25:24,800 --> 00:25:28,080 Speaker 1: and prowess, The book is Overcharged, Why Americans pay too 436 00:25:28,160 --> 00:25:28,840 Speaker 1: much for healthcare? 437 00:25:29,440 --> 00:25:31,720 Speaker 2: And folks, I have to say, as as. 438 00:25:31,600 --> 00:25:36,320 Speaker 1: You've heard me say many times, politics is interesting, you know, 439 00:25:36,640 --> 00:25:40,399 Speaker 1: the rooting for your team versus that team, the Trump Dance, 440 00:25:40,520 --> 00:25:42,720 Speaker 1: the reds and Blues and who shows up and on. 441 00:25:43,280 --> 00:25:46,080 Speaker 1: But my primary interest at the end of the day 442 00:25:46,320 --> 00:25:48,679 Speaker 1: is not my team winning and your team losing. My 443 00:25:48,760 --> 00:25:54,639 Speaker 1: primary interest is creating a structure where the individual can thrive, 444 00:25:54,880 --> 00:25:58,680 Speaker 1: where there is opportunity and fairness, safeguard's rule of law, 445 00:25:59,840 --> 00:26:03,760 Speaker 1: and that will, at the end of the day, advance humanity. 446 00:26:04,000 --> 00:26:04,880 Speaker 1: It always has. 447 00:26:04,920 --> 00:26:07,440 Speaker 2: It's the only thing that does not Government and. 448 00:26:07,359 --> 00:26:11,640 Speaker 1: So these sort of policy discussions, I understand are probably 449 00:26:11,720 --> 00:26:15,920 Speaker 1: less thrilling than my usual screaming and hollering about this 450 00:26:16,040 --> 00:26:17,800 Speaker 1: or that indignity. 451 00:26:17,240 --> 00:26:19,320 Speaker 2: Of the day. But this is what matters. 452 00:26:19,560 --> 00:26:23,480 Speaker 1: This is why we get involved in campaigns, is to 453 00:26:23,560 --> 00:26:25,480 Speaker 1: take control of the government and get it out of 454 00:26:25,520 --> 00:26:29,919 Speaker 1: our lives and create safeguards and reduce regulation and promote 455 00:26:29,920 --> 00:26:32,879 Speaker 1: the rule of law so that hardworking people can create 456 00:26:33,000 --> 00:26:35,880 Speaker 1: enough John Gault style for the rest of us to prosper. 457 00:26:36,400 --> 00:26:40,919 Speaker 1: And this stuff matters. So that's why we have these conversations. 458 00:26:41,400 --> 00:26:46,080 Speaker 1: Professor Charles Silver, overcharged, why Americans pay too much for healthcare? 459 00:26:46,480 --> 00:26:48,040 Speaker 1: Professor Silver, I want you to be. 460 00:26:48,480 --> 00:26:50,000 Speaker 2: King for a day. You have no. 461 00:26:51,840 --> 00:26:58,360 Speaker 1: As this benevolent monarch, you have no political concerns. Reconstruct 462 00:26:58,640 --> 00:27:02,560 Speaker 1: our health care facility to provide an opportunity for the 463 00:27:02,560 --> 00:27:06,320 Speaker 1: most healing to occur and the individuals to take control 464 00:27:06,440 --> 00:27:07,480 Speaker 1: of their own healthcare. 465 00:27:07,600 --> 00:27:08,439 Speaker 2: What does that look like? 466 00:27:11,000 --> 00:27:14,159 Speaker 3: Wow, I'm nervous about being king for a day because 467 00:27:14,520 --> 00:27:18,639 Speaker 3: I don't believe in kings, I know, but I'll try. 468 00:27:20,520 --> 00:27:24,280 Speaker 3: I think we basically wipe away everything in terms of 469 00:27:25,119 --> 00:27:29,879 Speaker 3: these programs and the restrictive regulations. You know, have you 470 00:27:29,920 --> 00:27:32,439 Speaker 3: ever heard of a certificate of need law? I don't know. 471 00:27:32,680 --> 00:27:36,959 Speaker 3: They're called con laws by for short, but con laws 472 00:27:38,720 --> 00:27:43,399 Speaker 3: regulate how many new healthcare providers can set up shops. 473 00:27:43,440 --> 00:27:45,360 Speaker 3: So if you want to open a hospital, you got 474 00:27:45,359 --> 00:27:48,600 Speaker 3: to get permission. But guess what the way the con 475 00:27:48,720 --> 00:27:53,480 Speaker 3: laws work, the existing hospitals have a vote and whether 476 00:27:53,520 --> 00:27:56,399 Speaker 3: you can open a new hospital or not, like giving 477 00:27:56,800 --> 00:28:00,560 Speaker 3: McDonald's a vote on whether Burger King can open restaurant 478 00:28:00,640 --> 00:28:04,479 Speaker 3: right across the street. It just doesn't make any sense. 479 00:28:04,640 --> 00:28:06,840 Speaker 3: But that's the way I would get rid of all 480 00:28:06,880 --> 00:28:10,920 Speaker 3: of those supply constraining regulations, and I would get rid 481 00:28:10,960 --> 00:28:16,760 Speaker 3: of all of these programs Obamacare, Medicare, whatever, and I 482 00:28:16,760 --> 00:28:22,440 Speaker 3: would go to a very simple wealth distribution program. I'm 483 00:28:22,440 --> 00:28:25,000 Speaker 3: not sure exactly how much money it should be. That's 484 00:28:25,040 --> 00:28:27,040 Speaker 3: something that has to have some work done. But you 485 00:28:27,080 --> 00:28:29,919 Speaker 3: know we're currently spending if you put all the healthcare 486 00:28:30,440 --> 00:28:35,600 Speaker 3: programs together, you know we're spending like seven eight ten 487 00:28:35,720 --> 00:28:39,320 Speaker 3: thousand dollars a person per you know, per American through 488 00:28:39,360 --> 00:28:42,240 Speaker 3: these programs. If we just took some of that money 489 00:28:42,920 --> 00:28:48,200 Speaker 3: and started plunking it into restricted healthcare savings accounts for people, 490 00:28:48,280 --> 00:28:50,440 Speaker 3: so every year. You know, there's just a little bit 491 00:28:50,480 --> 00:28:53,800 Speaker 3: more that's put in. Pretty soon, everybody would have enough 492 00:28:53,840 --> 00:28:56,760 Speaker 3: money to pay for their basic needs and to buy 493 00:28:56,840 --> 00:29:00,720 Speaker 3: catastrophic insurance. And I would let people buy just as 494 00:29:00,800 --> 00:29:05,480 Speaker 3: much catastrophic insurance as they want. I wouldn't have coverage mandates. 495 00:29:05,520 --> 00:29:08,160 Speaker 3: You know, right now, if you want to buy a 496 00:29:08,200 --> 00:29:11,280 Speaker 3: policy on one of the exchanges and you're a young man, 497 00:29:13,320 --> 00:29:17,600 Speaker 3: you know you have to pay for annual mammograms, right, 498 00:29:18,240 --> 00:29:22,479 Speaker 3: but you're not getting mamograms because you're a man, right right, 499 00:29:22,720 --> 00:29:25,960 Speaker 3: So you know, I wouldn't force people to buy any 500 00:29:26,000 --> 00:29:29,600 Speaker 3: particular amount of coverage, and I would let insurance companies 501 00:29:29,760 --> 00:29:33,840 Speaker 3: limit the total payouts, which you know, that's really where 502 00:29:35,160 --> 00:29:37,480 Speaker 3: things are screwed up right now. It's one of the areas, 503 00:29:37,560 --> 00:29:40,320 Speaker 3: right they have to spend unlimited amounts of money on people. 504 00:29:40,920 --> 00:29:45,080 Speaker 3: I would let people let design their own insurance programs. 505 00:29:45,120 --> 00:29:47,280 Speaker 3: And I think that you know, it's not going to 506 00:29:47,320 --> 00:29:50,040 Speaker 3: work perfectly. Nothing ever works perfectly, right, but it would 507 00:29:50,080 --> 00:29:53,520 Speaker 3: work so much better and be so much more efficient 508 00:29:53,720 --> 00:29:57,440 Speaker 3: than the existing system, and it'd be way more consumer friendly. 509 00:29:58,760 --> 00:30:02,320 Speaker 3: And that's a huge improvement because I don't know anybody 510 00:30:02,800 --> 00:30:05,960 Speaker 3: who is happy with the existing healthcare system. I mean, 511 00:30:05,960 --> 00:30:10,280 Speaker 3: this terrible murder that just occurred has brought to the 512 00:30:10,360 --> 00:30:17,240 Speaker 3: surface the extraordinary hatred that people have toward insurance companies. 513 00:30:17,920 --> 00:30:21,880 Speaker 3: You know, that's just one symptom. We're spending twice as 514 00:30:21,960 --> 00:30:25,600 Speaker 3: much as any other country on healthcare, and we're getting 515 00:30:25,640 --> 00:30:29,480 Speaker 3: less and less healthy every year. You know, our life 516 00:30:29,520 --> 00:30:33,080 Speaker 3: expectancy is declining. We're just doing everything wrong that we 517 00:30:33,200 --> 00:30:36,640 Speaker 3: possibly can do. So wipe the slate, get rid of 518 00:30:36,680 --> 00:30:40,400 Speaker 3: all this stuff. Start out with a really simple direct 519 00:30:40,400 --> 00:30:43,880 Speaker 3: payment system and a cash transfer system to deal with 520 00:30:43,920 --> 00:30:46,760 Speaker 3: people who are so poor that they can't even afford 521 00:30:46,800 --> 00:30:51,320 Speaker 3: the basics, and just be satisfied with that. I said, 522 00:30:51,320 --> 00:30:52,880 Speaker 3: It's not gonna be perfect, but it'd be hard to 523 00:30:52,920 --> 00:30:54,600 Speaker 3: improve on all. Right. 524 00:30:54,800 --> 00:30:59,560 Speaker 1: Yeah, and to get outside the purview of what we've discussed, 525 00:30:59,560 --> 00:31:02,320 Speaker 1: but just speak more to the process that lands us 526 00:31:02,720 --> 00:31:06,280 Speaker 1: where we are. Our criminal justice system. We spend more 527 00:31:06,400 --> 00:31:11,040 Speaker 1: on imprisoning and prosecuting and chasing down bad guys in 528 00:31:11,080 --> 00:31:13,760 Speaker 1: any other country in the world, and yet I think 529 00:31:13,760 --> 00:31:17,240 Speaker 1: we do a far worse job, at less effective job 530 00:31:17,880 --> 00:31:19,800 Speaker 1: than most countries in the world. And I think meant 531 00:31:20,000 --> 00:31:23,800 Speaker 1: much of that. You can see some similarities in patterns 532 00:31:24,280 --> 00:31:28,320 Speaker 1: that pervade those two industries. And by the way, then 533 00:31:28,360 --> 00:31:31,720 Speaker 1: we could move over into public education and education generally. 534 00:31:31,920 --> 00:31:36,280 Speaker 1: I mean, there are a number of different applications for 535 00:31:36,680 --> 00:31:42,200 Speaker 1: where this process has gone wrong, and it is frustrating. 536 00:31:42,720 --> 00:31:49,120 Speaker 1: I very much appreciate your time, Professor. I feel the 537 00:31:49,160 --> 00:31:53,320 Speaker 1: better for it. The book is overcharged Why Americans pay 538 00:31:53,440 --> 00:31:57,560 Speaker 1: too much for healthcare? Professor Charles Silver of the University 539 00:31:57,600 --> 00:31:59,160 Speaker 1: of Texas School of Law. 540 00:31:59,160 --> 00:32:02,120 Speaker 3: Thank you, sir, Thank you, Michael pleasure. 541 00:32:02,400 --> 00:32:06,080 Speaker 1: And with that, might I suggest to each and every 542 00:32:06,080 --> 00:32:10,000 Speaker 1: one of you that while politics is an interesting undertaking, 543 00:32:10,200 --> 00:32:13,800 Speaker 1: and it is you know, winning elections, and he said this, 544 00:32:13,880 --> 00:32:15,400 Speaker 1: and we're going to show him, and. 545 00:32:15,680 --> 00:32:17,640 Speaker 2: You know, it's a battle royale. 546 00:32:17,880 --> 00:32:21,240 Speaker 1: And you know I argued with my cousin at the 547 00:32:21,280 --> 00:32:26,720 Speaker 1: Thanksgiving table. At the end of it all, the reason 548 00:32:27,600 --> 00:32:33,680 Speaker 1: for the arguments, the reason for the elections should be 549 00:32:33,880 --> 00:32:40,960 Speaker 1: very redemptive, very practical, not just existential, not just ideological. 550 00:32:41,000 --> 00:32:42,320 Speaker 2: They're real to your. 551 00:32:42,160 --> 00:32:50,760 Speaker 1: Life, and that is creating a governmental system where individuals 552 00:32:50,960 --> 00:32:56,320 Speaker 1: are free to thrive. Government is not just. Government is 553 00:32:56,360 --> 00:33:00,640 Speaker 1: not merciful. Government is not protective, It is not good. 554 00:33:02,240 --> 00:33:07,560 Speaker 1: Government is clunky, it's inefficient. If you've stood in line 555 00:33:07,560 --> 00:33:09,960 Speaker 1: at the DPS office to get your driver's license and 556 00:33:09,960 --> 00:33:13,440 Speaker 1: thought to yourself, you could move this thing along. If 557 00:33:13,480 --> 00:33:17,040 Speaker 1: you've seen someone who is on the clock and doesn't 558 00:33:17,040 --> 00:33:21,400 Speaker 1: care about results, if you've seen the worst of government 559 00:33:21,480 --> 00:33:24,480 Speaker 1: in every aspect, whether it's the inspector who doesn't seem 560 00:33:24,520 --> 00:33:27,680 Speaker 1: to care that they're coming back and adding these these 561 00:33:27,760 --> 00:33:29,880 Speaker 1: regulations that are going to cost this much more for 562 00:33:29,920 --> 00:33:31,320 Speaker 1: you to build this, and now you're going to walk 563 00:33:31,360 --> 00:33:34,000 Speaker 1: away from the project and lead the property vacant, and 564 00:33:34,080 --> 00:33:37,320 Speaker 1: that's not good for anybody. These are the things that 565 00:33:37,400 --> 00:33:40,440 Speaker 1: we should spend our time on. And I say this 566 00:33:40,720 --> 00:33:45,120 Speaker 1: because politics has become sport and it's become for many 567 00:33:45,160 --> 00:33:48,280 Speaker 1: people their favorite hobby. But let's not lose track of 568 00:33:48,280 --> 00:33:51,000 Speaker 1: what we're trying to do here, which is literally not 569 00:33:51,080 --> 00:33:52,640 Speaker 1: to exaggerated, save our 570 00:33:52,680 --> 00:33:58,160 Speaker 4: Countrys am Els has left for you, Thank you, and 571 00:33:58,400 --> 00:33:58,880 Speaker 4: good night.