1 00:00:02,000 --> 00:00:09,399 Speaker 1: It's that time time time, time, Luck and load. The 2 00:00:09,600 --> 00:00:23,200 Speaker 1: Michael Verie Show is on the air. Professor Charles Silver 3 00:00:23,400 --> 00:00:23,840 Speaker 1: is our guest. 4 00:00:23,880 --> 00:00:27,400 Speaker 2: He's a professor at the University of Texas School of Law, 5 00:00:27,400 --> 00:00:29,720 Speaker 2: which I happen to believe is fantastic because I'm a 6 00:00:29,760 --> 00:00:35,960 Speaker 2: graduate of same. His book is Overcharged, Why Americans pay 7 00:00:36,000 --> 00:00:40,320 Speaker 2: too much for healthcare. You mentioned that the problem began 8 00:00:40,880 --> 00:00:44,840 Speaker 2: with Medicare Medicaid in the sixties, part of Lyndon Johnson's 9 00:00:45,040 --> 00:00:46,839 Speaker 2: Great Society, which turned. 10 00:00:46,600 --> 00:00:47,360 Speaker 3: Out not to be. 11 00:00:47,840 --> 00:00:53,519 Speaker 2: It was two point zero of FDRs taking over of 12 00:00:53,560 --> 00:00:56,960 Speaker 2: the American economy and it's hard to strip that back 13 00:00:57,040 --> 00:01:01,440 Speaker 2: out of life when Medicare got involve So my dad's 14 00:01:01,480 --> 00:01:04,280 Speaker 2: eighty four, my mom recently passed, and I go in 15 00:01:04,319 --> 00:01:06,080 Speaker 2: and review every expense, everything that. 16 00:01:06,080 --> 00:01:08,880 Speaker 3: Comes in and all that this whole Medicare thing. 17 00:01:09,480 --> 00:01:13,560 Speaker 2: I have a show sponsor called Senior Health Services dot Com, 18 00:01:14,120 --> 00:01:18,119 Speaker 2: and he and his team help people who are trying 19 00:01:18,160 --> 00:01:21,160 Speaker 2: to navigate Medicare. And every day I get someone who 20 00:01:21,240 --> 00:01:23,240 Speaker 2: emails me and says, can you connect me with them? 21 00:01:23,640 --> 00:01:25,800 Speaker 2: And I forward it and sometimes I stay involved for 22 00:01:25,800 --> 00:01:27,600 Speaker 2: a little while just to see, you know, kind of 23 00:01:27,600 --> 00:01:30,959 Speaker 2: what they're working through. It's amazing to people that, all 24 00:01:30,959 --> 00:01:32,720 Speaker 2: of a sudden, I guess, when you turn sixty five, 25 00:01:33,040 --> 00:01:36,360 Speaker 2: you're getting robocalls and junk mail and all this Medicare, Medicare, Medicare, 26 00:01:36,560 --> 00:01:39,360 Speaker 2: And people had no idea. Now, all of a sudden, 27 00:01:40,040 --> 00:01:44,520 Speaker 2: I've been, you know, dumped into the Medicare playground. And 28 00:01:44,640 --> 00:01:47,919 Speaker 2: I don't know why, how does this even work? 29 00:01:50,040 --> 00:01:50,680 Speaker 4: Too well? 30 00:01:51,880 --> 00:01:55,720 Speaker 5: I just I recently hit that age myself, so I 31 00:01:56,120 --> 00:01:59,240 Speaker 5: can sympathize with those whose mailbox are crammed with Medicare 32 00:01:59,280 --> 00:02:02,520 Speaker 5: advantage flowers and things of that sort. I'm sick of 33 00:02:02,560 --> 00:02:06,360 Speaker 5: seeing them. And I'm not even using Medicare. I'm still working, 34 00:02:06,400 --> 00:02:10,679 Speaker 5: so I'm staying on my employer's healthcare system or healthcare insurance, 35 00:02:10,680 --> 00:02:16,320 Speaker 5: although that is very expensive and far too comprehensive. You know, 36 00:02:16,360 --> 00:02:21,040 Speaker 5: it's because of the mandates regarding what employer sponsored coverage 37 00:02:21,080 --> 00:02:24,320 Speaker 5: has to conclude that I wind up paying, you know, 38 00:02:24,360 --> 00:02:28,280 Speaker 5: way too much. Everybody does pay way too much for insurance. 39 00:02:30,280 --> 00:02:32,720 Speaker 5: But you know, Medicare, what can I say? It's a 40 00:02:32,800 --> 00:02:37,880 Speaker 5: program that was designed to succeed by massively inflating the deficit. 41 00:02:38,600 --> 00:02:42,160 Speaker 5: You know, everybody thinks that Medicare is something that you 42 00:02:42,240 --> 00:02:44,720 Speaker 5: earn over the course of your lifetime. We don't think 43 00:02:44,720 --> 00:02:47,799 Speaker 5: of it as welfare, and politicians who refer to it 44 00:02:47,800 --> 00:02:51,720 Speaker 5: as welfare are excoriated. But the amount that people pay 45 00:02:51,919 --> 00:02:56,440 Speaker 5: into Medicare is way, way, way smaller than the amount 46 00:02:56,480 --> 00:02:58,200 Speaker 5: that they get out for most people. 47 00:02:58,280 --> 00:02:59,840 Speaker 4: Now, there are obviously exceptions to. 48 00:02:59,800 --> 00:03:04,560 Speaker 5: That, but for most people, the way that the program 49 00:03:04,800 --> 00:03:08,919 Speaker 5: succeeds is by charging them less than the benefits that 50 00:03:08,960 --> 00:03:11,880 Speaker 5: they will get out of the system. Well, you know, 51 00:03:11,919 --> 00:03:14,760 Speaker 5: that's a nice arrangement. I'd like to have that, But 52 00:03:15,120 --> 00:03:17,160 Speaker 5: the problem is somebody. The money to pay for all 53 00:03:17,200 --> 00:03:21,000 Speaker 5: those benefits has to come from somewhere, and it only 54 00:03:21,040 --> 00:03:21,880 Speaker 5: only two sources. 55 00:03:21,919 --> 00:03:23,080 Speaker 4: One is general. 56 00:03:22,760 --> 00:03:26,640 Speaker 5: Tax revenue, so they use money in addition tax revenue 57 00:03:26,639 --> 00:03:30,639 Speaker 5: in addition to the employee tax to fund the program. 58 00:03:30,680 --> 00:03:32,160 Speaker 4: And the other is deficit spending. 59 00:03:33,080 --> 00:03:37,560 Speaker 5: And every one of these expansions of the Medicare program 60 00:03:37,720 --> 00:03:41,320 Speaker 5: is funded through the deficit. So you know, back when 61 00:03:42,440 --> 00:03:45,560 Speaker 5: Bush two was president, right he created Medicare part D, 62 00:03:46,760 --> 00:03:51,040 Speaker 5: the Prescription Drug Benefit Program. Well, the premiums even initially 63 00:03:51,240 --> 00:03:53,400 Speaker 5: for that program, we're only set at fifty. 64 00:03:53,160 --> 00:03:54,720 Speaker 4: Percent of the estimated cost. 65 00:03:55,400 --> 00:03:59,160 Speaker 5: Now they're down to twenty five percent of the estimated cost, 66 00:03:59,240 --> 00:04:01,880 Speaker 5: which means everybody but he loves Medicare party because it's 67 00:04:01,920 --> 00:04:05,040 Speaker 5: a great deal, right, I'm only paying twenty five percent 68 00:04:05,120 --> 00:04:08,280 Speaker 5: of the cost. But what you're really doing is taking 69 00:04:08,320 --> 00:04:12,400 Speaker 5: the cost of prescription drugs and rolling them into the deficit. 70 00:04:13,040 --> 00:04:13,960 Speaker 4: And the same thing. 71 00:04:13,800 --> 00:04:17,840 Speaker 5: Goes for Obamacare with all these premium subsidies. Everything that 72 00:04:17,880 --> 00:04:21,359 Speaker 5: the government does is designed to be popular by being 73 00:04:22,400 --> 00:04:26,720 Speaker 5: priced below its actual cost, and the result of that 74 00:04:27,000 --> 00:04:31,840 Speaker 5: in the long run has to be deficit increases and 75 00:04:31,960 --> 00:04:33,280 Speaker 5: inflation increases. 76 00:04:33,320 --> 00:04:35,000 Speaker 4: There's just no getting around that. 77 00:04:35,880 --> 00:04:40,680 Speaker 2: It's frustrating because then Medicare, the government is telling you 78 00:04:40,760 --> 00:04:42,720 Speaker 2: which doctors you can go to and which you can't, 79 00:04:42,720 --> 00:04:45,360 Speaker 2: which procedures you can do in which you can't, and 80 00:04:45,400 --> 00:04:48,520 Speaker 2: so you know, and look, it sounds like you and 81 00:04:48,560 --> 00:04:52,640 Speaker 2: I are relatively aligned. I was an acolyte of Professor 82 00:04:52,760 --> 00:04:55,839 Speaker 2: Leino Graia, so you can probably understand where my views 83 00:04:55,880 --> 00:04:57,920 Speaker 2: are with regard to politics and the role of the 84 00:04:57,960 --> 00:05:02,800 Speaker 2: government and the individual. I'm probably more libertarian certainly than 85 00:05:02,839 --> 00:05:05,479 Speaker 2: he was. I'm over on the Rand and Ron Paul 86 00:05:06,000 --> 00:05:09,880 Speaker 2: end of things. But what I find frustrating is that 87 00:05:10,040 --> 00:05:14,520 Speaker 2: people seem to think that somehow government is protecting you 88 00:05:15,240 --> 00:05:20,000 Speaker 2: and aiding you. But in fact, what goes with that is, 89 00:05:20,120 --> 00:05:22,560 Speaker 2: you know why you don't feed the bears at the zoo, 90 00:05:22,960 --> 00:05:26,320 Speaker 2: is they're controlling you, and any government powerful enough to 91 00:05:26,320 --> 00:05:29,680 Speaker 2: pay for your medical surgery or medical procedures, powerful enough 92 00:05:29,680 --> 00:05:32,480 Speaker 2: to take it away, and then they start making decisions 93 00:05:32,520 --> 00:05:35,320 Speaker 2: for you. And that's where we get into the civil liberties. 94 00:05:35,360 --> 00:05:38,839 Speaker 2: And that's where I get very frustrated, because we've now 95 00:05:38,880 --> 00:05:42,400 Speaker 2: moved beyond healthcare and we've moved into a sort of 96 00:05:42,440 --> 00:05:46,480 Speaker 2: totalitarian authoritarian control of the individual. 97 00:05:47,279 --> 00:05:51,120 Speaker 5: Well, you're certainly singing my song because you know you're 98 00:05:51,120 --> 00:05:54,680 Speaker 5: a libertarian. I'm an adjunct scholar at the Cato Institute. 99 00:05:54,680 --> 00:05:56,800 Speaker 5: I don't think it gets much more libertarian than that, 100 00:05:57,040 --> 00:06:03,359 Speaker 5: I would say, so, so we're on the same page 101 00:06:03,400 --> 00:06:06,720 Speaker 5: as far as, you know, being very very concerned about 102 00:06:06,920 --> 00:06:13,880 Speaker 5: the governmental control. I think that governmental control is part 103 00:06:13,920 --> 00:06:17,200 Speaker 5: of the story, but I think governmental ineptitude is probably 104 00:06:17,279 --> 00:06:22,320 Speaker 5: a much bigger part of the story. You know, I'm 105 00:06:22,360 --> 00:06:25,200 Speaker 5: willing to say, oh, some of those you know, bureaucrats 106 00:06:25,240 --> 00:06:28,360 Speaker 5: who run these programs actually want to want to help people, 107 00:06:28,400 --> 00:06:32,560 Speaker 5: and may even believe they are helping people, but it's 108 00:06:32,720 --> 00:06:37,640 Speaker 5: actually very difficult to run the healthcare system. Well, that's 109 00:06:37,640 --> 00:06:42,280 Speaker 5: why market forces are so important, because market forces are 110 00:06:42,480 --> 00:06:48,400 Speaker 5: constantly rewarding providers for figuring out how to serve patients better. 111 00:06:48,640 --> 00:06:50,880 Speaker 4: Right, that's how you can get business. If you can. 112 00:06:50,800 --> 00:06:53,800 Speaker 5: Figure out how to serve your customers better, then you'll 113 00:06:53,839 --> 00:06:59,120 Speaker 5: get more customers. And that's just something that requires people 114 00:06:59,120 --> 00:07:02,000 Speaker 5: who know that nuts and bolts really well to be 115 00:07:02,200 --> 00:07:05,600 Speaker 5: constantly reflecting on how they're doing their jobs. 116 00:07:05,720 --> 00:07:05,960 Speaker 4: Right. 117 00:07:06,920 --> 00:07:09,800 Speaker 5: The government bureaucrats, they don't do that. They don't even 118 00:07:09,840 --> 00:07:13,600 Speaker 5: know how the jobs work. They just exist mainly to 119 00:07:13,640 --> 00:07:19,160 Speaker 5: pay bills and to enact regulations that enable them to 120 00:07:19,920 --> 00:07:22,440 Speaker 5: deal with the burden that all this imposes on the 121 00:07:22,440 --> 00:07:26,440 Speaker 5: federal government. And the results for consumers are just terrible. 122 00:07:26,640 --> 00:07:29,400 Speaker 5: You know, all these problems that everybody complains about, prior 123 00:07:29,480 --> 00:07:35,120 Speaker 5: authorization requirements, surprise bills, these things called facility fees that 124 00:07:35,200 --> 00:07:37,960 Speaker 5: you know, you go to an emergency room, the doctor says, oh, 125 00:07:38,040 --> 00:07:40,520 Speaker 5: you've got a fever, take some aster and go home, 126 00:07:40,560 --> 00:07:42,440 Speaker 5: and then you get a build for ten thousand dollars 127 00:07:42,520 --> 00:07:45,600 Speaker 5: because you literally because you walked in the front doors. 128 00:07:45,600 --> 00:07:46,440 Speaker 4: It's just like a. 129 00:07:47,360 --> 00:07:50,320 Speaker 5: Cover charge at a bar or something like that, except 130 00:07:50,320 --> 00:07:54,440 Speaker 5: a lot bigger. You know, none of that stuff exists 131 00:07:54,480 --> 00:07:58,800 Speaker 5: in the direct payment system. It all exists because the 132 00:07:58,840 --> 00:08:03,800 Speaker 5: government regularly the way healthcare is delivered, and it does 133 00:08:03,840 --> 00:08:08,080 Speaker 5: it in stupid ways because it's hard to do it right. 134 00:08:08,280 --> 00:08:11,760 Speaker 2: And government's not in the business of efficiency. Professor Charles 135 00:08:11,800 --> 00:08:15,440 Speaker 2: Silver is our guest. The book is Overcharged, Why you 136 00:08:15,920 --> 00:08:19,040 Speaker 2: Americans pay too much for healthcare? 137 00:08:20,480 --> 00:08:23,480 Speaker 4: And the Michael Berry Show good not. 138 00:08:27,440 --> 00:08:30,640 Speaker 2: Professor Charles Silver of the University of Texas School of 139 00:08:30,720 --> 00:08:35,040 Speaker 2: Law is our guest. He was I have come to 140 00:08:35,120 --> 00:08:38,200 Speaker 2: learn in the course of our conversation at ut Law 141 00:08:39,120 --> 00:08:41,360 Speaker 2: almost ten years before I was there, and still is. 142 00:08:41,760 --> 00:08:44,679 Speaker 2: I did not know him, but I happened to think 143 00:08:44,679 --> 00:08:47,480 Speaker 2: the world of that law school, and I gained a 144 00:08:47,480 --> 00:08:53,760 Speaker 2: lot from being there, both associations and education. And this 145 00:08:53,800 --> 00:08:57,320 Speaker 2: book has been highly recommended to me by numerous folks 146 00:08:57,920 --> 00:09:00,160 Speaker 2: as to how to gain a better understanding of why 147 00:09:00,200 --> 00:09:05,599 Speaker 2: the healthcare system costs you so much. Overcharged, Why Americans 148 00:09:05,640 --> 00:09:10,440 Speaker 2: pay too much for healthcare? Professor Charles Silver is our guest. Professor, 149 00:09:10,640 --> 00:09:16,560 Speaker 2: let's talk about young people. By young I'm fifty three, 150 00:09:16,600 --> 00:09:19,240 Speaker 2: so I'm gonna throw myself into there. You know, I've 151 00:09:19,280 --> 00:09:22,480 Speaker 2: read that something like half the healthcare costs in this 152 00:09:22,600 --> 00:09:26,040 Speaker 2: country are expended on people within the last two years 153 00:09:26,040 --> 00:09:27,760 Speaker 2: of their lives. And you know, we see this where 154 00:09:27,760 --> 00:09:30,360 Speaker 2: it's just constant. It's just one thing after another after another, 155 00:09:30,400 --> 00:09:32,320 Speaker 2: and then they pass and then you kick in the 156 00:09:32,320 --> 00:09:35,040 Speaker 2: funeral industry, and I mean it's these are all industries, 157 00:09:35,080 --> 00:09:38,920 Speaker 2: like the bridal industry and the birthing industry. When you 158 00:09:39,040 --> 00:09:42,800 Speaker 2: look at a person who is relatively healthy without a 159 00:09:42,920 --> 00:09:48,440 Speaker 2: chronic condition, and you're looking at the cost to them 160 00:09:48,600 --> 00:09:53,360 Speaker 2: that they're bearing, which really is the risk you're willing 161 00:09:53,440 --> 00:09:56,000 Speaker 2: to assume. Right, if you're never going to need a doctor, 162 00:09:56,360 --> 00:09:59,200 Speaker 2: then you don't need insurance. We just don't know which 163 00:09:59,240 --> 00:10:00,720 Speaker 2: one of us is going to in a car wreck 164 00:10:00,800 --> 00:10:03,600 Speaker 2: or have a heart attack. So we're trying the same 165 00:10:03,600 --> 00:10:06,640 Speaker 2: way we leverage the risk on if our house burns down. 166 00:10:07,040 --> 00:10:09,960 Speaker 2: We're trying to kind of to keep that at bay 167 00:10:10,000 --> 00:10:12,199 Speaker 2: and to make a good financial decision. 168 00:10:13,160 --> 00:10:15,600 Speaker 3: Where is that going wrong today? 169 00:10:15,640 --> 00:10:19,720 Speaker 2: Because my guess is most people are overpaying for insurance 170 00:10:19,760 --> 00:10:23,040 Speaker 2: coverage that they won't need until much later. That's going 171 00:10:23,160 --> 00:10:28,600 Speaker 2: toward people at their end of life. I agree that 172 00:10:28,679 --> 00:10:30,720 Speaker 2: I think that story is right. There are a bunch 173 00:10:30,720 --> 00:10:33,640 Speaker 2: of thoughts that it prompts. One of them is, you know, 174 00:10:33,640 --> 00:10:34,520 Speaker 2: I've never been a. 175 00:10:34,480 --> 00:10:40,360 Speaker 5: Fan of taxing people who are relatively young to provide 176 00:10:40,520 --> 00:10:43,360 Speaker 5: benefits to people who are relatively old. That stricks me. 177 00:10:43,480 --> 00:10:45,880 Speaker 5: Is wrong on a variety of levels, you know. One 178 00:10:46,040 --> 00:10:49,920 Speaker 5: is every moral theory that I know of says you 179 00:10:50,040 --> 00:10:54,959 Speaker 5: move money from richer people to poorer people. Well, older 180 00:10:55,000 --> 00:10:58,960 Speaker 5: people are wealthier than younger people. That shouldn't be surprising 181 00:10:58,960 --> 00:11:01,840 Speaker 5: to anybody. They've had their lives to work right and saved. 182 00:11:01,920 --> 00:11:04,240 Speaker 5: They've paid off their cars, they've paid off their homes. 183 00:11:04,280 --> 00:11:07,760 Speaker 5: You know, they have other assets. Right, They're on average, 184 00:11:07,920 --> 00:11:10,680 Speaker 5: much wealthier than younger people who are struggling, you know, 185 00:11:10,800 --> 00:11:15,000 Speaker 5: raising families, you know, just getting jobs, dealing with college 186 00:11:15,040 --> 00:11:18,400 Speaker 5: debt and all that stuff. So my moral view is 187 00:11:18,440 --> 00:11:20,320 Speaker 5: if we were going to move money in any direction, 188 00:11:20,400 --> 00:11:22,680 Speaker 5: we should move it from older people to younger people. 189 00:11:22,760 --> 00:11:25,600 Speaker 5: But our system does the reverse. We're robbing the poor 190 00:11:25,679 --> 00:11:31,000 Speaker 5: to pay the rich. I don't understand that. Another thing is, 191 00:11:33,520 --> 00:11:42,600 Speaker 5: excuse me, the system really deserves people because it eliminates 192 00:11:42,720 --> 00:11:45,880 Speaker 5: all caps on spending. You were talking about end of 193 00:11:45,920 --> 00:11:48,520 Speaker 5: life care and how we spend so much money in 194 00:11:48,520 --> 00:11:50,480 Speaker 5: the last year or two of people's lives. 195 00:11:50,520 --> 00:11:52,400 Speaker 4: Well, if people. 196 00:11:52,160 --> 00:11:55,040 Speaker 5: Had to spend their own money, nobody would spend an 197 00:11:55,080 --> 00:11:59,160 Speaker 5: infinite amount in their last two years on healthcare. They 198 00:11:59,200 --> 00:12:01,400 Speaker 5: would have to make hard decisions, right, These are not 199 00:12:01,480 --> 00:12:05,480 Speaker 5: pleasant decisions, but they would make decisions about how much 200 00:12:05,520 --> 00:12:08,840 Speaker 5: healthcare they want. Is it worth spending a million dollars 201 00:12:08,880 --> 00:12:11,640 Speaker 5: to extend my life by a month, Right, that's the 202 00:12:11,760 --> 00:12:15,280 Speaker 5: kind of decision they would have to make. Well, today, 203 00:12:15,320 --> 00:12:19,360 Speaker 5: because we removed all caps from the system, nobody has 204 00:12:19,400 --> 00:12:23,040 Speaker 5: to make those decisions. Instead, we just spend literally an 205 00:12:23,040 --> 00:12:26,520 Speaker 5: infinite amount of money on people who are in the 206 00:12:26,559 --> 00:12:28,320 Speaker 5: final stages of their illness. 207 00:12:28,400 --> 00:12:30,079 Speaker 4: We get no bang for the buck. 208 00:12:30,640 --> 00:12:32,839 Speaker 5: You know, we have people, literally we have people who 209 00:12:32,840 --> 00:12:36,680 Speaker 5: are receiving cancer treatments, new cancer treatments that cost a 210 00:12:36,760 --> 00:12:40,559 Speaker 5: million dollars, and all those treatments do is extend their 211 00:12:40,600 --> 00:12:41,839 Speaker 5: lives by about a month. 212 00:12:42,360 --> 00:12:44,439 Speaker 4: And it's not even a good month. 213 00:12:44,679 --> 00:12:46,160 Speaker 5: It's not a month when you're going to be out 214 00:12:46,200 --> 00:12:49,280 Speaker 5: there on the golf course, playing with your buddies and 215 00:12:49,360 --> 00:12:51,920 Speaker 5: drinking beer. It's a month like you're in the hospital 216 00:12:52,559 --> 00:12:53,920 Speaker 5: right for the whole month. 217 00:12:55,120 --> 00:12:56,439 Speaker 6: These things just make no sense. 218 00:12:56,600 --> 00:13:01,320 Speaker 5: Right. But the government, the government cannot make the those decisions. Literally, 219 00:13:01,400 --> 00:13:05,560 Speaker 5: it cannot because the moment the government starts talking about 220 00:13:05,679 --> 00:13:08,680 Speaker 5: rationing care, everybody loses their minds. 221 00:13:09,240 --> 00:13:10,360 Speaker 4: And you don't want to be. 222 00:13:10,360 --> 00:13:16,320 Speaker 5: The politician that they're rallying against. Right, So the government 223 00:13:16,440 --> 00:13:20,440 Speaker 5: simply ignores the need to make these decisions and just 224 00:13:20,520 --> 00:13:23,960 Speaker 5: spends endless amounts of money because it's other people's money. 225 00:13:24,000 --> 00:13:25,360 Speaker 6: So why does the government care? 226 00:13:25,840 --> 00:13:26,080 Speaker 4: Right? 227 00:13:28,280 --> 00:13:31,000 Speaker 5: And you know, we just have to come back to 228 00:13:32,080 --> 00:13:35,400 Speaker 5: the world in which people are responsible for their own 229 00:13:36,120 --> 00:13:40,320 Speaker 5: end of life care. You know, it's a sad thing, 230 00:13:40,400 --> 00:13:42,839 Speaker 5: but it's true. We will all die at some point, 231 00:13:43,600 --> 00:13:46,240 Speaker 5: and the fact that we will all die at some 232 00:13:46,320 --> 00:13:49,200 Speaker 5: point affects a thousand. 233 00:13:48,760 --> 00:13:50,800 Speaker 6: Decisions that each of us makes. 234 00:13:50,880 --> 00:13:54,400 Speaker 5: Right, When am I going to stop working? Well, if 235 00:13:54,440 --> 00:13:56,360 Speaker 5: I'm thinking I don't have much longer to live, it 236 00:13:56,440 --> 00:13:58,840 Speaker 5: probably will stop working so I can spend my last 237 00:13:58,920 --> 00:14:01,360 Speaker 5: you know, a couple of years with my family or 238 00:14:01,400 --> 00:14:03,880 Speaker 5: traveling or whatever it is, right, I mean, if you 239 00:14:03,920 --> 00:14:06,480 Speaker 5: start to think about it, knowing that at. 240 00:14:06,320 --> 00:14:10,520 Speaker 6: Some point we will all die, it affects. 241 00:14:10,160 --> 00:14:13,680 Speaker 5: As I said, thousands of decisions that we make. You know, 242 00:14:13,760 --> 00:14:15,640 Speaker 5: do I want to live in this house that I'm 243 00:14:15,640 --> 00:14:17,360 Speaker 5: in now until the end of my life, or do 244 00:14:17,440 --> 00:14:20,280 Speaker 5: I want to move to a house that's more handicap 245 00:14:20,320 --> 00:14:23,560 Speaker 5: equipped and things of that sort. Right, this is just 246 00:14:23,640 --> 00:14:26,880 Speaker 5: another decision. It's a tough decision. I'm not trying to 247 00:14:26,920 --> 00:14:29,840 Speaker 5: say otherwise, but it's a decision that needs to be made, 248 00:14:30,280 --> 00:14:32,520 Speaker 5: and it needs to be made not by the government, 249 00:14:32,880 --> 00:14:35,800 Speaker 5: but by the people who are directly involved and who 250 00:14:35,880 --> 00:14:38,960 Speaker 5: can think hard about all these tough problems. 251 00:14:39,000 --> 00:14:41,440 Speaker 4: There's no way the government's going to make a good decision. 252 00:14:41,760 --> 00:14:45,560 Speaker 5: Their incentives are wrong, their knowledge is too limited. They 253 00:14:45,560 --> 00:14:48,760 Speaker 5: don't have access to the counselors that individuals will talk 254 00:14:48,800 --> 00:14:50,800 Speaker 5: to when making these kinds of decisions. 255 00:14:51,440 --> 00:14:52,760 Speaker 6: So, you know, we just have. 256 00:14:52,760 --> 00:14:55,920 Speaker 5: To get the government out of this business. What I 257 00:14:55,960 --> 00:14:57,320 Speaker 5: have proposed is. 258 00:14:59,200 --> 00:14:59,640 Speaker 4: That we can. 259 00:14:59,720 --> 00:15:01,600 Speaker 5: You know, there is one other problem though that we 260 00:15:01,640 --> 00:15:04,160 Speaker 5: haven't discussed, which we do need to discuss, which is 261 00:15:04,160 --> 00:15:07,240 Speaker 5: there are some people who are too poor to afford 262 00:15:07,800 --> 00:15:11,120 Speaker 5: fundamental health care. We do need to come up with 263 00:15:11,160 --> 00:15:13,680 Speaker 5: a way of dealing with those people, because when they 264 00:15:13,680 --> 00:15:16,920 Speaker 5: show up at the hospital needing healthcare, they're not going 265 00:15:16,960 --> 00:15:19,320 Speaker 5: to be turned away. Right, We're not going to be 266 00:15:19,320 --> 00:15:22,240 Speaker 5: having sick people dying in the streets because they can't 267 00:15:22,480 --> 00:15:25,240 Speaker 5: afford healthcare. So we need to come up with a 268 00:15:25,280 --> 00:15:27,680 Speaker 5: way to deal with that. But the obvious way to 269 00:15:27,680 --> 00:15:30,160 Speaker 5: deal with that is through a negative income text, the 270 00:15:30,200 --> 00:15:32,640 Speaker 5: sort of thing that Milton Friedman proposed. 271 00:15:32,720 --> 00:15:34,760 Speaker 4: You provide everybody with. 272 00:15:34,720 --> 00:15:38,280 Speaker 5: A kind of amount of sustenance that they can use 273 00:15:38,320 --> 00:15:40,600 Speaker 5: for this purpose. You could put it into a restricted 274 00:15:41,160 --> 00:15:44,400 Speaker 5: medical account if you wanted, But the idea is once 275 00:15:44,440 --> 00:15:46,960 Speaker 5: you give it to them, it's hands off for the 276 00:15:47,000 --> 00:15:48,880 Speaker 5: rest of it. The government doesn't get involved in the 277 00:15:48,920 --> 00:15:50,120 Speaker 5: delivery of healthcare. 278 00:15:51,000 --> 00:15:52,200 Speaker 4: It just people make. 279 00:15:52,080 --> 00:15:56,400 Speaker 5: Decisions on themselves with their own money, and life goes forward. 280 00:15:56,440 --> 00:15:58,560 Speaker 5: And I think if we did that, the healthcare system 281 00:15:58,600 --> 00:16:01,000 Speaker 5: would operate much more efficiently. 282 00:16:01,320 --> 00:16:01,520 Speaker 6: Well. 283 00:16:01,560 --> 00:16:06,280 Speaker 2: The great frustration, as you know, is that everybody gets 284 00:16:06,320 --> 00:16:08,920 Speaker 2: a vote, even people that make bad decisions, and that 285 00:16:09,080 --> 00:16:12,400 Speaker 2: many people make bad decisions. You know, we will have 286 00:16:12,440 --> 00:16:15,080 Speaker 2: a lot of people who say I can't afford medical 287 00:16:15,120 --> 00:16:17,560 Speaker 2: care because they don't save money. But they've got a 288 00:16:17,560 --> 00:16:21,240 Speaker 2: big screen TV in every room, and they've got, you know, 289 00:16:21,280 --> 00:16:24,640 Speaker 2: a car they can't afford that they're driving. They end 290 00:16:24,720 --> 00:16:26,360 Speaker 2: up with the car that they can't afford, and we 291 00:16:26,440 --> 00:16:28,920 Speaker 2: end up paying for the health care that they can't afford. 292 00:16:29,200 --> 00:16:33,400 Speaker 2: The book is overcharged. Why Americans pay too much for healthcare? 293 00:16:33,440 --> 00:16:34,600 Speaker 2: Professor Charles Silverman. 294 00:16:35,360 --> 00:16:37,080 Speaker 4: But everybody knows who this guy is. 295 00:16:37,120 --> 00:16:40,960 Speaker 3: Come on man with the Michael Berry, come on. 296 00:16:42,600 --> 00:16:46,640 Speaker 2: Law professor at the University of Texas at Austin School 297 00:16:46,640 --> 00:16:50,160 Speaker 2: of Law. And we ended the last segment with a 298 00:16:50,240 --> 00:16:53,840 Speaker 2: discussion that at the end of the day, the allocation 299 00:16:53,960 --> 00:16:57,720 Speaker 2: of scarce resources and who will make that decision. We're 300 00:16:57,760 --> 00:17:02,240 Speaker 2: back at that point again in every family. You know, 301 00:17:02,320 --> 00:17:07,240 Speaker 2: you got eight kids and you got one chicken. Mom says, 302 00:17:07,359 --> 00:17:09,879 Speaker 2: you're not getting a second piece. So there's some cartilage 303 00:17:10,280 --> 00:17:14,200 Speaker 2: left on that leg. If you're hungry, you'll eat that. 304 00:17:14,880 --> 00:17:17,680 Speaker 2: And there comes a point where we have to decide 305 00:17:18,440 --> 00:17:22,159 Speaker 2: with scarce resources, who will make the decision as to 306 00:17:22,200 --> 00:17:25,320 Speaker 2: where those resources will be deployed. Will it be the 307 00:17:25,359 --> 00:17:28,840 Speaker 2: government or will it be the individual? And if it's 308 00:17:28,840 --> 00:17:32,679 Speaker 2: the individual, there will be those who say, well, I 309 00:17:32,800 --> 00:17:35,480 Speaker 2: want as much as my neighbor has, Okay, we'll earn 310 00:17:35,560 --> 00:17:37,439 Speaker 2: the money to purchase that. 311 00:17:37,880 --> 00:17:39,920 Speaker 3: Well, I don't earn as much. 312 00:17:40,119 --> 00:17:42,720 Speaker 2: I want to use the power of the gun through 313 00:17:42,800 --> 00:17:44,920 Speaker 2: at the direction of the government, that I either more 314 00:17:44,960 --> 00:17:46,760 Speaker 2: of me than there are of the rich people I 315 00:17:46,880 --> 00:17:50,320 Speaker 2: vote for. I want them well. The only alternative is 316 00:17:50,359 --> 00:17:53,280 Speaker 2: for the government to do it. Professor I Harken back 317 00:17:53,320 --> 00:17:55,760 Speaker 2: to a study, and it's been a while since I 318 00:17:56,600 --> 00:18:00,280 Speaker 2: read this book. It's interesting because I am a I'm 319 00:18:00,320 --> 00:18:03,880 Speaker 2: a believer and let the marketplace decide. You know, healthcare 320 00:18:03,920 --> 00:18:05,760 Speaker 2: is the one area where we think everybody gets all 321 00:18:05,800 --> 00:18:08,440 Speaker 2: the healthcare they want, but we all end up paying 322 00:18:08,440 --> 00:18:10,040 Speaker 2: for that. We don't say everybody gets all the food 323 00:18:10,080 --> 00:18:11,679 Speaker 2: they want, or all the cars they want, or all 324 00:18:11,680 --> 00:18:13,560 Speaker 2: the houses they want, or all the clothes they want, 325 00:18:13,680 --> 00:18:16,679 Speaker 2: but for some reason, everybody gets all the healthcare they want, 326 00:18:17,040 --> 00:18:19,520 Speaker 2: even at the point that it's throwing good money after bad. 327 00:18:20,240 --> 00:18:23,280 Speaker 3: So socialist system the opposite of what I propose. 328 00:18:23,760 --> 00:18:26,680 Speaker 2: In Sweden, they did a study, and it was a 329 00:18:26,800 --> 00:18:28,919 Speaker 2: multi decade study you may be aware of it, on 330 00:18:29,040 --> 00:18:33,679 Speaker 2: prostate cancer in men, and they determined that out of 331 00:18:35,040 --> 00:18:39,119 Speaker 2: I think it was three thousand men who had prostate 332 00:18:39,200 --> 00:18:43,160 Speaker 2: cancer who were diagnosed with prostate cancer, and they chose 333 00:18:43,240 --> 00:18:47,640 Speaker 2: not to treat the prostate cancer, and they did about 334 00:18:47,640 --> 00:18:50,760 Speaker 2: a twenty five year study and the number of men 335 00:18:50,840 --> 00:18:54,760 Speaker 2: who died of untreated prostate cancer was something like thirty 336 00:18:55,240 --> 00:18:58,280 Speaker 2: out of three thousand. So they came to the conclusion 337 00:18:58,440 --> 00:19:03,560 Speaker 2: with a government completely government run system, that with scarce resources, 338 00:19:03,600 --> 00:19:07,639 Speaker 2: it does not make sense for us to treat prostate 339 00:19:07,720 --> 00:19:11,000 Speaker 2: cancer per se because nobody, very few people are going 340 00:19:11,080 --> 00:19:14,040 Speaker 2: to die of prostate cancer. Let's spend our money on 341 00:19:14,160 --> 00:19:17,000 Speaker 2: other things that if we don't spend it, there you die. 342 00:19:17,680 --> 00:19:21,359 Speaker 2: And it strikes me that while that's the opposite of 343 00:19:21,359 --> 00:19:25,120 Speaker 2: the capitalist system, there does need to be an understanding 344 00:19:25,440 --> 00:19:29,840 Speaker 2: that we're wasting a lot of money on studies because 345 00:19:30,119 --> 00:19:32,000 Speaker 2: and this gets to the second point of what you've 346 00:19:32,040 --> 00:19:35,439 Speaker 2: written a lot about medical malpractice and the fear of 347 00:19:35,480 --> 00:19:36,639 Speaker 2: medical malpractice. 348 00:19:36,680 --> 00:19:38,080 Speaker 3: I don't think everybody. 349 00:19:37,760 --> 00:19:42,040 Speaker 2: Needs a glaucoma test every time they go for their license, 350 00:19:42,080 --> 00:19:45,080 Speaker 2: but God forbid one person not be diagnosed with glaucoma. 351 00:19:45,480 --> 00:19:50,800 Speaker 2: We're practicing defensive medicine. We're over ordering tests, which is 352 00:19:50,840 --> 00:19:53,399 Speaker 2: a waste of our time and energy but also money, 353 00:19:53,800 --> 00:19:57,879 Speaker 2: and we're not actually doing We're not engaged in what 354 00:19:57,920 --> 00:20:02,480 Speaker 2: I would consider smart, if active healing because everyone is 355 00:20:02,480 --> 00:20:05,840 Speaker 2: afraid of being sued, and that has we get back 356 00:20:05,840 --> 00:20:08,760 Speaker 2: to our point. The book is overcharged, Why Americans pay 357 00:20:08,800 --> 00:20:11,320 Speaker 2: too much for healthcare? I think that's a big portion 358 00:20:11,440 --> 00:20:12,320 Speaker 2: of what we spend. 359 00:20:12,480 --> 00:20:16,920 Speaker 5: Your thought, well, I'm going to disagree with part of that, 360 00:20:16,960 --> 00:20:20,439 Speaker 5: but I agree with a lot of it as well. 361 00:20:21,480 --> 00:20:24,919 Speaker 5: In my world, when you have a self interested explanation 362 00:20:25,240 --> 00:20:28,040 Speaker 5: for something, you probably don't have to look very far 363 00:20:28,119 --> 00:20:31,399 Speaker 5: for any other explanation. Self interest usually is a pretty 364 00:20:31,400 --> 00:20:36,360 Speaker 5: good explanation. And the reason, you know, some people say, oh, 365 00:20:36,440 --> 00:20:39,320 Speaker 5: the reason that doctors overtreat is because they're afraid of 366 00:20:39,359 --> 00:20:43,400 Speaker 5: being sued. Well, there's a simpler self interested explanation, which 367 00:20:43,480 --> 00:20:47,199 Speaker 5: is every time they treat somebody, they make money, and 368 00:20:47,880 --> 00:20:51,840 Speaker 5: until you take the profit out of these services, which 369 00:20:51,920 --> 00:20:56,000 Speaker 5: will never happen, it's very hard to determine that they're 370 00:20:56,040 --> 00:21:01,040 Speaker 5: actually engaging in any real defensive medice and at all. 371 00:21:01,880 --> 00:21:04,640 Speaker 5: There are lots of studies that are out there now 372 00:21:04,680 --> 00:21:07,800 Speaker 5: that have found that, I mean, defensive medicine is kind 373 00:21:07,840 --> 00:21:12,760 Speaker 5: of hard to define because it can be both. It 374 00:21:12,760 --> 00:21:15,800 Speaker 5: can be both the provision of services that aren't needed 375 00:21:16,480 --> 00:21:20,159 Speaker 5: and the avoidance of services that are needed because you 376 00:21:20,280 --> 00:21:23,080 Speaker 5: get sued when you do deliver services, as well as 377 00:21:23,080 --> 00:21:26,080 Speaker 5: when you withhold them. So it's hard to figure out 378 00:21:26,440 --> 00:21:29,440 Speaker 5: exactly what's going on with defensive medicine. But as I said, 379 00:21:29,440 --> 00:21:31,359 Speaker 5: I don't think we really need to worry about it 380 00:21:31,480 --> 00:21:34,680 Speaker 5: very much because we have a self interested explanation, which 381 00:21:34,760 --> 00:21:38,119 Speaker 5: is that the services are profitable. And there's also you know, 382 00:21:38,280 --> 00:21:41,399 Speaker 5: doctors have a lot of confidence in their ability to 383 00:21:41,400 --> 00:21:43,800 Speaker 5: help people, and they have a very strong desire to 384 00:21:43,920 --> 00:21:44,520 Speaker 5: help people. 385 00:21:44,640 --> 00:21:46,679 Speaker 3: Right at least that's what it should be. 386 00:21:47,000 --> 00:21:47,239 Speaker 4: You know. 387 00:21:47,320 --> 00:21:51,320 Speaker 2: You remind me of another great document written in seventeen 388 00:21:51,440 --> 00:21:54,800 Speaker 2: seventy six, and that from a Scotsman named Adam Smith, 389 00:21:54,800 --> 00:21:57,280 Speaker 2: who famously said, it is not from the benevolence of 390 00:21:57,320 --> 00:21:59,600 Speaker 2: the butcher, or the brewer or the baker that we 391 00:21:59,640 --> 00:22:03,800 Speaker 2: expect our dinner, but from their regard to their own 392 00:22:03,920 --> 00:22:10,960 Speaker 2: self interest exactly. Self interest drives so many things. That 393 00:22:11,000 --> 00:22:13,720 Speaker 2: guy is not standing on his feet behind the counter 394 00:22:13,760 --> 00:22:15,920 Speaker 2: at the donut shop for so many hours and didn't 395 00:22:15,920 --> 00:22:18,199 Speaker 2: get there at two thirty this morning because he's a 396 00:22:18,320 --> 00:22:22,200 Speaker 2: nice guy. He wants to make a profit off the donuts. 397 00:22:22,280 --> 00:22:25,120 Speaker 2: I get to enjoy the donuts in exchange for the 398 00:22:25,240 --> 00:22:27,880 Speaker 2: currency that I was given for the sweat of my brow. 399 00:22:28,280 --> 00:22:30,760 Speaker 2: It works and I think we have to return that 400 00:22:30,800 --> 00:22:32,800 Speaker 2: to the process. And I think that's where you and 401 00:22:32,840 --> 00:22:33,760 Speaker 2: I can agree. 402 00:22:34,960 --> 00:22:36,720 Speaker 5: I think we do agree on that, but we also 403 00:22:36,760 --> 00:22:43,000 Speaker 5: agree that I mean, these social programs have fundamentally undermined 404 00:22:43,359 --> 00:22:46,359 Speaker 5: the incentive. 405 00:22:45,840 --> 00:22:48,960 Speaker 4: To save and to be self reliant. 406 00:22:50,040 --> 00:22:53,720 Speaker 5: You know, the I think you know, I constantly read 407 00:22:53,840 --> 00:22:57,760 Speaker 5: articles about how many people are retiring and all they 408 00:22:57,840 --> 00:23:00,679 Speaker 5: have to live on is social Security and medicare. They 409 00:23:00,680 --> 00:23:04,440 Speaker 5: don't have much in the way of savings, and people say, well, 410 00:23:04,440 --> 00:23:07,399 Speaker 5: how could you possibly, you know, let that happen? 411 00:23:07,520 --> 00:23:07,680 Speaker 4: Right? 412 00:23:07,720 --> 00:23:10,040 Speaker 5: Why are you buying, as you put it, those you know, 413 00:23:10,720 --> 00:23:13,080 Speaker 5: big screen TVs for every room when you should be 414 00:23:13,080 --> 00:23:16,440 Speaker 5: saving for your later years. I think the answer is 415 00:23:16,480 --> 00:23:19,199 Speaker 5: that most people naively think, oh, the government's just going 416 00:23:19,240 --> 00:23:21,720 Speaker 5: to take care of me in my later years, so 417 00:23:22,040 --> 00:23:25,119 Speaker 5: I don't have to save, and they, you know, the 418 00:23:25,200 --> 00:23:29,040 Speaker 5: temptation to spend money now rather than later, it's always there. 419 00:23:29,160 --> 00:23:33,520 Speaker 5: Who wants to save? Saving is born right? Consuming today 420 00:23:33,640 --> 00:23:38,040 Speaker 5: is fun. So, you know, I think that as long 421 00:23:38,080 --> 00:23:41,840 Speaker 5: as we have these pay go programs where you know, 422 00:23:42,119 --> 00:23:45,560 Speaker 5: you can keep getting money out above what you put in, 423 00:23:47,240 --> 00:23:51,520 Speaker 5: that the incentives to save will forever be undermined. And 424 00:23:51,920 --> 00:23:54,320 Speaker 5: that's a terrible thing, I think, because as you said, 425 00:23:54,359 --> 00:23:57,240 Speaker 5: you know, we're we're just getting ourselves into this world 426 00:23:57,320 --> 00:24:00,280 Speaker 5: where each of us expects everybody else to pay for 427 00:24:00,359 --> 00:24:04,280 Speaker 5: everything that we need. If it's only healthcare, they still 428 00:24:04,359 --> 00:24:07,280 Speaker 5: expect to pay for everything that they want, and. 429 00:24:07,200 --> 00:24:09,360 Speaker 4: That just drives costs through the roof. 430 00:24:09,280 --> 00:24:12,320 Speaker 5: Without really any offsetting benefits that make sense of it. 431 00:24:12,960 --> 00:24:18,520 Speaker 7: Zoologists will tell you are doing great harm by domesticating 432 00:24:18,760 --> 00:24:22,679 Speaker 7: certain breeds of animals, particularly if you intend at some 433 00:24:22,760 --> 00:24:24,879 Speaker 7: point to release them into the wild. 434 00:24:24,960 --> 00:24:26,119 Speaker 3: You make them slaves. 435 00:24:26,200 --> 00:24:31,120 Speaker 2: They lose the very abilities, and we've seen with evolutionary 436 00:24:31,119 --> 00:24:34,359 Speaker 2: studies that teeth are not as sharpenny longer, claws are 437 00:24:34,400 --> 00:24:36,919 Speaker 2: not as sharpenning more, they can no longer run as fast. 438 00:24:37,280 --> 00:24:41,800 Speaker 2: They grow to be like prison inmates, dependent on someone 439 00:24:41,880 --> 00:24:43,280 Speaker 2: else to provide for them. 440 00:24:43,720 --> 00:24:47,200 Speaker 3: And I think that has to be understood by people. 441 00:24:47,680 --> 00:24:50,199 Speaker 2: Our guest is Professor Charles Silver, who will be with 442 00:24:50,280 --> 00:24:53,840 Speaker 2: us for one more segment. The book is overcharged, Why 443 00:24:54,080 --> 00:24:55,960 Speaker 2: Americans pay too much? 444 00:24:56,520 --> 00:24:59,840 Speaker 4: Else, that's either risk me or take me to take 445 00:25:00,800 --> 00:25:03,440 Speaker 4: talk about it. He gets out of this state, I think, 446 00:25:03,560 --> 00:25:06,800 Speaker 4: Michael Barry robs I like it. 447 00:25:08,040 --> 00:25:11,640 Speaker 2: Professor Charles Silver of the University of Texas School of Law, 448 00:25:11,720 --> 00:25:15,760 Speaker 2: my alma mater, has graciously spent quite a bit of 449 00:25:15,800 --> 00:25:20,560 Speaker 2: time with us discussing an area of his academic expertise 450 00:25:20,600 --> 00:25:23,879 Speaker 2: and prowess. The book is Overcharged, why Americans pay too 451 00:25:23,960 --> 00:25:26,919 Speaker 2: much for healthcare? And folks, I have to say, as 452 00:25:27,440 --> 00:25:32,159 Speaker 2: you've heard me say many times, politics is interesting, you know, 453 00:25:32,480 --> 00:25:36,200 Speaker 2: the rooting for your team versus that team, the Trump Dance, 454 00:25:36,320 --> 00:25:38,640 Speaker 2: the reds and Blues, and who shows up and only. 455 00:25:39,480 --> 00:25:41,920 Speaker 2: But my primary interest at the end of the day 456 00:25:42,119 --> 00:25:44,480 Speaker 2: is not my team winning and your team losing. My 457 00:25:44,560 --> 00:25:50,439 Speaker 2: primary interest is creating a structure where the individual can thrive, 458 00:25:50,680 --> 00:25:54,520 Speaker 2: where there is opportunity and fairness, safeguard's rule of law, 459 00:25:55,760 --> 00:25:58,840 Speaker 2: and that will, at the end of the day, advance 460 00:25:58,960 --> 00:26:02,520 Speaker 2: humanity always has. It's the only thing that does not government. 461 00:26:03,000 --> 00:26:06,960 Speaker 2: And so these sort of policy discussions, I understand are 462 00:26:07,000 --> 00:26:10,960 Speaker 2: probably less thrilling than my usual screaming and hollering about 463 00:26:11,560 --> 00:26:14,359 Speaker 2: this or that indignity of the day. But this is 464 00:26:14,400 --> 00:26:18,360 Speaker 2: what matters. This is why we get involved in campaigns, 465 00:26:19,000 --> 00:26:21,000 Speaker 2: is to take control of the government and get it 466 00:26:21,040 --> 00:26:24,639 Speaker 2: out of our lives and create safeguards and reduce regulation 467 00:26:25,200 --> 00:26:28,040 Speaker 2: and promote the rule of law so that hardworking people 468 00:26:28,119 --> 00:26:30,879 Speaker 2: can create enough John Galt style for the rest of 469 00:26:30,960 --> 00:26:34,720 Speaker 2: us to prosper. And this stuff matters. So that's why 470 00:26:34,760 --> 00:26:40,520 Speaker 2: we have these conversations. Professor Charlesolver, overcharged, why Americans pay 471 00:26:40,640 --> 00:26:41,880 Speaker 2: too much for healthcare? 472 00:26:42,280 --> 00:26:45,000 Speaker 3: Professor Silver, I want you to be king for a day. 473 00:26:45,119 --> 00:26:45,800 Speaker 3: You have no. 474 00:26:47,640 --> 00:26:54,160 Speaker 2: As this benevolent monarch, You have no political concerns. Reconstruct 475 00:26:54,440 --> 00:26:58,359 Speaker 2: our health care facility to provide an opportunity for the 476 00:26:58,400 --> 00:27:02,120 Speaker 2: most healing to occur and the individuals to take control 477 00:27:02,240 --> 00:27:03,320 Speaker 2: of their own healthcare. 478 00:27:03,400 --> 00:27:04,240 Speaker 3: What does that look like? 479 00:27:06,800 --> 00:27:10,000 Speaker 5: Wow, I'm nervous about being king for a day because 480 00:27:10,320 --> 00:27:14,440 Speaker 5: I don't believe in kings, I know, but I'll try. 481 00:27:16,320 --> 00:27:20,119 Speaker 5: I think we basically wipe away everything in terms of 482 00:27:20,920 --> 00:27:24,240 Speaker 5: these programs and the restrictive regulations. 483 00:27:24,280 --> 00:27:26,960 Speaker 4: You know, have you ever heard of a certificate of 484 00:27:27,080 --> 00:27:28,280 Speaker 4: need law? I don't know. 485 00:27:28,480 --> 00:27:35,040 Speaker 5: They're called con laws for short, but con laws regulate 486 00:27:35,760 --> 00:27:39,320 Speaker 5: how many new healthcare providers can set up shops. So 487 00:27:39,320 --> 00:27:41,200 Speaker 5: if you want to open a hospital, you got to 488 00:27:41,240 --> 00:27:44,159 Speaker 5: get permission. Oh okay, I guess what the way the 489 00:27:44,200 --> 00:27:49,560 Speaker 5: con laws work? The existing hospitals have a vote and whether. 490 00:27:49,320 --> 00:27:50,040 Speaker 4: You can open a. 491 00:27:50,000 --> 00:27:54,800 Speaker 5: New hospital, or like giving McDonald's a vote on whether 492 00:27:54,840 --> 00:27:57,479 Speaker 5: Burger King can open a restaurant right across the street. 493 00:27:58,880 --> 00:28:01,320 Speaker 4: It just doesn't make any sense. But that's the way 494 00:28:01,400 --> 00:28:01,960 Speaker 4: I would. 495 00:28:01,720 --> 00:28:05,919 Speaker 5: Get rid of all of those supply constraining regulations, and 496 00:28:06,000 --> 00:28:11,440 Speaker 5: I would get rid of all of these programs Obamacare, Medicare, whatever, 497 00:28:12,320 --> 00:28:17,960 Speaker 5: and I would go to a very simple wealth distribution program. 498 00:28:18,040 --> 00:28:20,359 Speaker 5: I'm not sure exactly how much money it should be. 499 00:28:20,600 --> 00:28:22,720 Speaker 5: That's something that has to have some work done. But 500 00:28:22,760 --> 00:28:25,040 Speaker 5: you know we're currently spending if you put all the 501 00:28:25,119 --> 00:28:31,080 Speaker 5: healthcare programs together, you know, we're spending like seven eight 502 00:28:31,200 --> 00:28:34,800 Speaker 5: ten thousand dollars a person per you know, per American 503 00:28:34,880 --> 00:28:37,560 Speaker 5: through these programs. If we just took some of that 504 00:28:37,680 --> 00:28:43,400 Speaker 5: money and started plunking it into restricted healthcare savings accounts 505 00:28:43,480 --> 00:28:45,800 Speaker 5: for people, so every year, you know, there's just a 506 00:28:45,800 --> 00:28:47,200 Speaker 5: little bit more that's put in. 507 00:28:47,800 --> 00:28:49,280 Speaker 4: Pretty soon everybody. 508 00:28:48,920 --> 00:28:52,040 Speaker 5: Would have enough money to pay for their basic needs 509 00:28:52,040 --> 00:28:55,000 Speaker 5: and to buy catastrophic insurance. And I would let people 510 00:28:55,080 --> 00:28:59,440 Speaker 5: buy just as much catastrophic insurance as they want. I 511 00:28:59,480 --> 00:29:02,880 Speaker 5: wouldn't have coverage mandates, you know, right now, if you 512 00:29:02,880 --> 00:29:05,640 Speaker 5: want to buy a policy on one of the exchanges 513 00:29:05,800 --> 00:29:10,760 Speaker 5: and you're a young man, you know you have to 514 00:29:10,880 --> 00:29:15,960 Speaker 5: pay for annual mammograms, right, but you're not getting mamograms 515 00:29:16,000 --> 00:29:19,680 Speaker 5: because you're a man, right, right, So you know, I 516 00:29:19,680 --> 00:29:23,480 Speaker 5: wouldn't force people to buy any particular amount of coverage, 517 00:29:23,520 --> 00:29:27,520 Speaker 5: and I would let insurance companies limit the total payouts, 518 00:29:27,600 --> 00:29:32,040 Speaker 5: which you know, that's really where things are screwed up 519 00:29:32,080 --> 00:29:33,720 Speaker 5: right now. It's one of the areas, right they have 520 00:29:33,800 --> 00:29:36,120 Speaker 5: to spend them limited amounts of money on people. 521 00:29:36,680 --> 00:29:39,400 Speaker 4: I would let people let design their own insurance. 522 00:29:39,040 --> 00:29:42,960 Speaker 5: Programs, and I think that you know, it's not going 523 00:29:43,000 --> 00:29:45,560 Speaker 5: to work perfectly. Nothing ever works perfectly, right, but it 524 00:29:45,600 --> 00:29:48,719 Speaker 5: would work so much better and be so much more 525 00:29:48,800 --> 00:29:52,200 Speaker 5: efficient than the existing system, and it'd be way more 526 00:29:52,240 --> 00:29:57,080 Speaker 5: consumer friendly. And that's a huge improvement because I don't 527 00:29:57,080 --> 00:30:01,280 Speaker 5: know anybody who is happy with the exis healthcare system. 528 00:30:01,480 --> 00:30:05,760 Speaker 5: I mean, this terrible murder that just occurred has brought 529 00:30:05,800 --> 00:30:11,880 Speaker 5: to the surface the extraordinary hatred that people have toward 530 00:30:11,920 --> 00:30:16,920 Speaker 5: insurance companies. You know, that's just one symptom. We're spending 531 00:30:17,080 --> 00:30:20,840 Speaker 5: twice as much as any other country on healthcare, and 532 00:30:20,880 --> 00:30:24,160 Speaker 5: we're getting less and less healthy every year. You know, 533 00:30:24,560 --> 00:30:28,600 Speaker 5: our life expectancy is declining. We're just doing everything wrong 534 00:30:28,640 --> 00:30:32,120 Speaker 5: that we possibly can do. So wipe the slate, get 535 00:30:32,200 --> 00:30:34,520 Speaker 5: rid of all this stuff. Start out with a really 536 00:30:34,680 --> 00:30:39,240 Speaker 5: simple direct payment system and a cash transfer system to 537 00:30:39,280 --> 00:30:41,920 Speaker 5: deal with people who are so poor that they can't 538 00:30:41,920 --> 00:30:46,520 Speaker 5: even afford the basics, and just be satisfied with that. 539 00:30:46,800 --> 00:30:48,280 Speaker 5: I said, it's not going to be perfect, but it'd 540 00:30:48,280 --> 00:30:50,600 Speaker 5: be hard to improve on all right. 541 00:30:50,560 --> 00:30:55,320 Speaker 2: Yeah, And to get outside the purview of what we've discussed, 542 00:30:55,360 --> 00:30:58,080 Speaker 2: but to speak more to the process that lands us 543 00:30:58,520 --> 00:30:59,240 Speaker 2: where we are. 544 00:31:00,120 --> 00:31:01,360 Speaker 3: Our criminal justice system. 545 00:31:01,360 --> 00:31:06,080 Speaker 2: We spend more on imprisoning and prosecuting and chasing down 546 00:31:06,160 --> 00:31:09,000 Speaker 2: bad guys in any other country in the world. And yes, 547 00:31:09,240 --> 00:31:12,200 Speaker 2: I think we do a far worse job, at less 548 00:31:12,200 --> 00:31:14,880 Speaker 2: effective job than most countries in the world. 549 00:31:14,920 --> 00:31:16,680 Speaker 3: And I think meant much of that. 550 00:31:17,280 --> 00:31:21,840 Speaker 2: You can see some similarities and patterns that pervade those 551 00:31:21,920 --> 00:31:24,760 Speaker 2: two industries. And by the way, then we could move 552 00:31:24,800 --> 00:31:29,520 Speaker 2: over into public education and education generally. I mean, there 553 00:31:29,560 --> 00:31:33,600 Speaker 2: are a number of different applications for where this process 554 00:31:34,720 --> 00:31:39,320 Speaker 2: has gone wrong, and it is frustrating. I very much 555 00:31:39,360 --> 00:31:45,600 Speaker 2: appreciate your time, professor. I feel the better for it. 556 00:31:46,000 --> 00:31:50,560 Speaker 2: The book is overcharged, why Americans pay too much for healthcare? 557 00:31:50,880 --> 00:31:54,920 Speaker 2: Professor Charles Silver of the University of Texas School of Law, 558 00:31:54,960 --> 00:31:55,280 Speaker 2: Thank you. 559 00:31:55,240 --> 00:31:57,920 Speaker 4: Sir, Thank you, Michael pleasure. 560 00:31:58,160 --> 00:32:01,840 Speaker 2: And with that, might I just to each and every 561 00:32:01,840 --> 00:32:05,760 Speaker 2: one of you that while politics is an interesting undertaking, 562 00:32:05,960 --> 00:32:09,560 Speaker 2: and it is you know, winning elections, and he said this, 563 00:32:09,680 --> 00:32:11,160 Speaker 2: and we're going to show him, and. 564 00:32:11,480 --> 00:32:13,520 Speaker 3: You know, it's a battle royale. 565 00:32:13,640 --> 00:32:17,000 Speaker 2: And you know I argued with my cousin at the 566 00:32:17,040 --> 00:32:22,480 Speaker 2: Thanksgiving table. At the end of it all, the reason 567 00:32:23,400 --> 00:32:30,560 Speaker 2: for the arguments, reason for the elections should be very redemptive, 568 00:32:32,800 --> 00:32:37,360 Speaker 2: very practical, not just existential, not just ideological. They're real 569 00:32:37,520 --> 00:32:43,840 Speaker 2: to your life, and that is creating a governmental system 570 00:32:44,880 --> 00:32:50,800 Speaker 2: where individuals are free to thrive. Government is not just. 571 00:32:51,440 --> 00:32:55,600 Speaker 2: Government is not merciful. Government is not protective. It is 572 00:32:55,640 --> 00:33:03,040 Speaker 2: not good. Government is clunky, it's inefficient. If you've stood 573 00:33:03,040 --> 00:33:05,280 Speaker 2: in line at the DPS office to get your driver's 574 00:33:05,320 --> 00:33:08,120 Speaker 2: license and thought to yourself, you could move this thing along. 575 00:33:09,120 --> 00:33:12,400 Speaker 2: If you've seen someone who is on the clock and 576 00:33:12,480 --> 00:33:16,719 Speaker 2: doesn't care about results, if you've seen the worst of 577 00:33:16,720 --> 00:33:20,000 Speaker 2: government in every aspect, whether it's the inspector who doesn't 578 00:33:20,040 --> 00:33:22,719 Speaker 2: seem to care that they're coming back and adding these 579 00:33:23,560 --> 00:33:24,400 Speaker 2: regulations that. 580 00:33:24,360 --> 00:33:25,880 Speaker 3: Are going to cost this much more for you. 581 00:33:25,840 --> 00:33:27,360 Speaker 2: To build this, and now you're going to walk away 582 00:33:27,360 --> 00:33:30,000 Speaker 2: from the project and leave the property vacant, and that's 583 00:33:30,080 --> 00:33:33,240 Speaker 2: not good for anybody. These are the things that we 584 00:33:33,280 --> 00:33:36,960 Speaker 2: should spend our time with. And I say this because 585 00:33:37,640 --> 00:33:41,280 Speaker 2: politics has become sport and it's become for many people 586 00:33:41,320 --> 00:33:44,200 Speaker 2: their favorite hobby. But let's not lose track of what 587 00:33:44,240 --> 00:33:47,520 Speaker 2: we're trying to do here, which is literal, not to exaggerate, 588 00:33:47,880 --> 00:33:48,760 Speaker 2: to save our country. 589 00:33:50,120 --> 00:33:51,200 Speaker 3: ELS has. 590 00:33:51,600 --> 00:33:54,080 Speaker 5: Good men, thank you, and good night.