1 00:00:00,280 --> 00:00:02,840 Speaker 1: Brought to you by the reinvented two thousand twelve camera. 2 00:00:03,160 --> 00:00:07,560 Speaker 1: It's ready. Are you welcome to Stuff you Should Know? 3 00:00:08,160 --> 00:00:16,720 Speaker 1: From House Stuff Works dot Com? Hey, and welcome to 4 00:00:16,760 --> 00:00:19,520 Speaker 1: the podcast. I'm Josh Clark with me as always as 5 00:00:19,680 --> 00:00:23,560 Speaker 1: Mr Charles W. Chuck Bryant Head and Chuck Well said, 6 00:00:23,840 --> 00:00:27,120 Speaker 1: good well, it's a good good word it is for 7 00:00:27,240 --> 00:00:30,200 Speaker 1: this show. This is Stuff you Should Know, And actually 8 00:00:30,200 --> 00:00:32,239 Speaker 1: this is a special edition of Stuff You Should Know, 9 00:00:32,800 --> 00:00:37,120 Speaker 1: part one of a four part series. Yes, should I 10 00:00:37,120 --> 00:00:40,800 Speaker 1: break it? Health care? Health care reform. Everyone seems to 11 00:00:40,800 --> 00:00:45,800 Speaker 1: be really confused about what lies ahead in the United 12 00:00:45,840 --> 00:00:48,440 Speaker 1: States and our health care system. It's so confusing, Chuck 13 00:00:48,479 --> 00:00:50,959 Speaker 1: that I'm not even certain if healthcare is spelled as 14 00:00:51,000 --> 00:00:53,760 Speaker 1: one word or two. That's pretty much the level that 15 00:00:53,800 --> 00:00:56,800 Speaker 1: we're at an understanding the idea of health care, let 16 00:00:56,800 --> 00:00:59,320 Speaker 1: alone healthcare reform. Right, So we're trying to figure this 17 00:00:59,360 --> 00:01:01,520 Speaker 1: out and along with you guys, and maybe you can 18 00:01:01,600 --> 00:01:05,800 Speaker 1: learn something here. Yeah. So, um, I guess let's kick 19 00:01:05,840 --> 00:01:08,360 Speaker 1: it off. Let's get this ball rolling. Yeah, we're gonna 20 00:01:08,440 --> 00:01:10,959 Speaker 1: We're not gonna talk about future plans. We're gonna talk 21 00:01:10,959 --> 00:01:13,880 Speaker 1: about how it is today. Yeah. Well, in this podcast 22 00:01:14,280 --> 00:01:16,520 Speaker 1: in this edition, in this edition, Part one of four, 23 00:01:16,600 --> 00:01:19,039 Speaker 1: Part one of four. Yeah, it's about the current health 24 00:01:19,040 --> 00:01:21,960 Speaker 1: care system in the United States. And Chuck, have you 25 00:01:22,520 --> 00:01:27,640 Speaker 1: ever gone without health insurance? Yeah? How long? Oh? Man? 26 00:01:28,680 --> 00:01:32,920 Speaker 1: I seem to think that after my parents. Uh see, 27 00:01:33,360 --> 00:01:36,000 Speaker 1: I think it's the familiar story for everyone, sometime around 28 00:01:36,040 --> 00:01:39,280 Speaker 1: after college until I got my first real job, which 29 00:01:39,360 --> 00:01:42,280 Speaker 1: was at least seven or eight years later. Yeah, I 30 00:01:42,319 --> 00:01:45,080 Speaker 1: think I did a decade. Yeah, same same story, And 31 00:01:45,120 --> 00:01:46,800 Speaker 1: the parents are always on you, you know, like, oh, 32 00:01:46,840 --> 00:01:48,320 Speaker 1: you know if you had an accident, and I was like, 33 00:01:48,560 --> 00:01:53,080 Speaker 1: I'm yeah, exactly, And luckily it worked out the same here. 34 00:01:53,160 --> 00:01:55,840 Speaker 1: I don't think it works out quite so well for everybody, 35 00:01:55,920 --> 00:01:59,680 Speaker 1: but sadly you and I are lead charmed lives. Uh. 36 00:02:00,000 --> 00:02:03,520 Speaker 1: I guess we'll get to the uninsured soon enough. So Chuck, 37 00:02:03,600 --> 00:02:06,520 Speaker 1: let's go back to the beginning nineteen twenties. In Texas, 38 00:02:06,520 --> 00:02:10,960 Speaker 1: a guy named Justin Kimball, uh founded a company named 39 00:02:10,960 --> 00:02:13,839 Speaker 1: Blue Cross still around to day. As I understand, we share. 40 00:02:14,080 --> 00:02:16,400 Speaker 1: We understand because they have a floor right below us. 41 00:02:16,440 --> 00:02:19,000 Speaker 1: I believe that's right. That's where I've heard that name before. 42 00:02:19,120 --> 00:02:22,720 Speaker 1: We shared building. So he started an insurance UM a 43 00:02:22,800 --> 00:02:27,559 Speaker 1: program plan where UM women contributed. I think teachers specifically 44 00:02:28,000 --> 00:02:32,000 Speaker 1: contributed fifty cents out of every paycheck UM toward their 45 00:02:32,080 --> 00:02:35,960 Speaker 1: eventual maternity needs. Right, so when they went to the 46 00:02:36,000 --> 00:02:38,840 Speaker 1: hospital to have a baby, they were already prepaid. It's 47 00:02:38,880 --> 00:02:44,000 Speaker 1: not really insurance prepaid plan, but there was something that 48 00:02:44,080 --> 00:02:46,680 Speaker 1: came out of it that really gave birth to the 49 00:02:46,720 --> 00:02:53,000 Speaker 1: insurance industry in the US. If you'll forgive the metaphor, um, 50 00:02:53,040 --> 00:02:58,120 Speaker 1: not all of these teachers had kids, so you could 51 00:02:58,160 --> 00:03:03,000 Speaker 1: actually make money selling premium selling policies to people because 52 00:03:03,520 --> 00:03:07,080 Speaker 1: not everybody's going to get cancer. And that's how the 53 00:03:07,080 --> 00:03:10,080 Speaker 1: whole system still works today. It's a gamble, you know. 54 00:03:10,200 --> 00:03:13,119 Speaker 1: Ned Flanders once said on The Simpsons, actually wasn't Ned 55 00:03:13,160 --> 00:03:17,360 Speaker 1: Maud Flanders was explaining Med's position that UM they don't 56 00:03:17,400 --> 00:03:19,880 Speaker 1: have any kind of insurance because Ned considers it a 57 00:03:19,919 --> 00:03:23,560 Speaker 1: form of gambling. And it really is. On one side view, 58 00:03:24,000 --> 00:03:28,000 Speaker 1: the insured are betting that at some point in time, 59 00:03:28,400 --> 00:03:31,440 Speaker 1: some injury or illness is going to befall you, that's 60 00:03:31,480 --> 00:03:34,639 Speaker 1: going to cost more to treat than you've put in 61 00:03:34,639 --> 00:03:38,600 Speaker 1: in monthly payments towards your policy. It is total gambling. 62 00:03:38,680 --> 00:03:41,080 Speaker 1: The insurance company, on the other hand, is betting that 63 00:03:41,160 --> 00:03:43,600 Speaker 1: you will be hit by a bus and die immediately, 64 00:03:44,080 --> 00:03:46,119 Speaker 1: something along those lines where you're not going to need 65 00:03:46,160 --> 00:03:48,240 Speaker 1: any kind of care, right, or that you just lead 66 00:03:48,240 --> 00:03:52,240 Speaker 1: a healthy life and nothing nothing happens to you, which 67 00:03:52,280 --> 00:03:54,680 Speaker 1: is not gonna clearly not gonna happen. I think the 68 00:03:54,760 --> 00:03:58,120 Speaker 1: hit by the bus scenarios the absolute best that can 69 00:03:58,160 --> 00:04:01,840 Speaker 1: happen for a insurance company. But so, yeah, it's a 70 00:04:01,880 --> 00:04:04,400 Speaker 1: form of gambling and you're going head to head with 71 00:04:04,480 --> 00:04:08,040 Speaker 1: the insurance company, and sometimes it pays off, sometimes it doesn't. 72 00:04:08,800 --> 00:04:12,360 Speaker 1: But for the most part it it's a pretty good 73 00:04:12,920 --> 00:04:15,440 Speaker 1: system basically speaking. Yeah, and you pay for peace of 74 00:04:15,480 --> 00:04:17,760 Speaker 1: mind a lot of times. Is what a lot of 75 00:04:17,760 --> 00:04:21,120 Speaker 1: people say. You know, he sounds like a chill That 76 00:04:21,200 --> 00:04:23,640 Speaker 1: sounds like I'm selling interest. I believe that was from 77 00:04:23,680 --> 00:04:26,880 Speaker 1: Barton Fink. It was John Goodman said that he sells 78 00:04:26,880 --> 00:04:30,520 Speaker 1: peace of mind. Nice. Well, Chuck, let's fast forward a 79 00:04:30,520 --> 00:04:35,880 Speaker 1: little bit. By the nineteen forties, UM companies had already 80 00:04:35,920 --> 00:04:43,280 Speaker 1: begun offering employer uh space insurance plans. Yeah, it's a 81 00:04:43,320 --> 00:04:47,200 Speaker 1: great incentive to get the best and the brightest, definitely, 82 00:04:47,240 --> 00:04:50,600 Speaker 1: and actually still is because of this business, which is 83 00:04:50,640 --> 00:04:53,920 Speaker 1: a sector of US society obviously part of the economy, 84 00:04:53,920 --> 00:04:55,960 Speaker 1: which is what I wanted to say. But business is 85 00:04:56,000 --> 00:04:59,360 Speaker 1: a sector just like you know, populations of sector, governments 86 00:04:59,360 --> 00:05:02,800 Speaker 1: of sector, that kind of thing. Um business said we're 87 00:05:02,800 --> 00:05:08,039 Speaker 1: going to take the burden of healthcare on our shoulders. Yeah. 88 00:05:08,360 --> 00:05:11,480 Speaker 1: In ninety three, the i r S supported this and 89 00:05:11,600 --> 00:05:16,240 Speaker 1: encouraged it with a ruling that said, UM, employers can 90 00:05:16,320 --> 00:05:20,560 Speaker 1: pay for these programs, these plans for their employees out 91 00:05:20,560 --> 00:05:23,280 Speaker 1: of pretext dollars, which makes the whole thing really attractive. 92 00:05:23,320 --> 00:05:25,719 Speaker 1: And all of a sudden, the U S has what 93 00:05:25,839 --> 00:05:32,160 Speaker 1: amounts to a state sanctioned employer healthcare system, right, and 94 00:05:32,320 --> 00:05:36,360 Speaker 1: which still thrives today, which is good, same pretax dollars, 95 00:05:36,360 --> 00:05:38,680 Speaker 1: same deal with I R S. The chances are good 96 00:05:38,720 --> 00:05:41,840 Speaker 1: that you if you have insurance in the US, you 97 00:05:41,960 --> 00:05:45,520 Speaker 1: have it through an employer. Yeah. Most people have insurance 98 00:05:45,560 --> 00:05:48,240 Speaker 1: through their company and their employer UM. Not as many 99 00:05:48,240 --> 00:05:53,000 Speaker 1: people have the more expensive and harder to get individual insurance. Yeah. 100 00:05:53,000 --> 00:05:56,640 Speaker 1: I think fifty percent get it through the employer UM 101 00:05:56,760 --> 00:06:00,839 Speaker 1: and thirty get it through the government run program Medicaid 102 00:06:00,920 --> 00:06:04,360 Speaker 1: or Medicare, right. Medicaid Medicare were created in I think 103 00:06:04,440 --> 00:06:11,560 Speaker 1: ninety five by the Johnson Administration j and UM. The 104 00:06:11,720 --> 00:06:14,760 Speaker 1: s CHIP is the other big one for children, and 105 00:06:14,839 --> 00:06:18,480 Speaker 1: that's state run like Medicaid. Medicare is for the elderly 106 00:06:19,080 --> 00:06:25,040 Speaker 1: and the chronically disabled, and peculiarly UM people with with 107 00:06:25,160 --> 00:06:29,560 Speaker 1: kidney failure, renal failure. Yeah, Uh, Medicaid, as I said, 108 00:06:29,560 --> 00:06:33,839 Speaker 1: it's state run. UM is for other people with disabilities, 109 00:06:34,400 --> 00:06:38,200 Speaker 1: the poor you can't afford it, and pregnant women. And 110 00:06:38,240 --> 00:06:41,320 Speaker 1: then s CHIP is for kids, yes, and that is 111 00:06:41,560 --> 00:06:45,520 Speaker 1: UH covers uninsured children under the age of nineteen whose 112 00:06:45,520 --> 00:06:49,560 Speaker 1: families earned up to thirty six thousand, two hundred per year. 113 00:06:49,880 --> 00:06:51,680 Speaker 1: Look at you with the stat I've got a lot 114 00:06:51,680 --> 00:06:53,640 Speaker 1: of stats. I was gonna say, sinse that that's the 115 00:06:53,680 --> 00:06:55,840 Speaker 1: first of many, right, and then actually there was one 116 00:06:55,880 --> 00:06:57,880 Speaker 1: more that I don't know if you knew about the 117 00:06:57,960 --> 00:07:00,919 Speaker 1: high risk health insurance pools. And these are people that 118 00:07:01,000 --> 00:07:04,240 Speaker 1: have pre existing conditions that normally would not be able 119 00:07:04,240 --> 00:07:05,919 Speaker 1: to get insurance at all. And they what they do 120 00:07:06,040 --> 00:07:09,160 Speaker 1: is a group these people together, same concept as as 121 00:07:09,200 --> 00:07:11,720 Speaker 1: an employee employee based deal. Those are the ones you 122 00:07:11,760 --> 00:07:14,280 Speaker 1: see on little ninety nine cent signs. On the side 123 00:07:14,280 --> 00:07:17,560 Speaker 1: of the road, like need insurance kind of thing, you 124 00:07:17,680 --> 00:07:21,640 Speaker 1: just get lumped together. UM. So yeah, there's that. You 125 00:07:21,760 --> 00:07:24,920 Speaker 1: just pointed out one UM type of insurance, which is 126 00:07:24,960 --> 00:07:30,320 Speaker 1: group insurance. Most employer plans, probably all employer plans UM 127 00:07:30,320 --> 00:07:33,160 Speaker 1: are group insurance. And it works because it is a 128 00:07:33,200 --> 00:07:36,680 Speaker 1: group because you're and these are good because you usually 129 00:07:36,720 --> 00:07:39,480 Speaker 1: don't have to fill out the big questionnaire about your 130 00:07:39,760 --> 00:07:42,520 Speaker 1: eating habits and you're smoking habits and um, there's no 131 00:07:42,680 --> 00:07:45,680 Speaker 1: physical exam exactly, and pretty much anybody who wants to 132 00:07:45,720 --> 00:07:49,280 Speaker 1: take part can contribute and be insured. Any employee, I 133 00:07:49,280 --> 00:07:52,960 Speaker 1: should say, and usually their family kids, that kind of thing. UM. 134 00:07:53,000 --> 00:07:58,560 Speaker 1: A very small portion of the US population has UM 135 00:07:58,680 --> 00:08:01,280 Speaker 1: individual plans. And one of the reasons why is because 136 00:08:01,320 --> 00:08:03,640 Speaker 1: you have to go through a rigorous screening process. It's 137 00:08:03,680 --> 00:08:06,360 Speaker 1: not cheap. If you are found to have a pre 138 00:08:06,440 --> 00:08:11,320 Speaker 1: existing condition, Um, you can be denied insurance very easily, 139 00:08:11,520 --> 00:08:15,280 Speaker 1: I imagine, pretty heartbreaking. And yeah, it's it's really expensive. 140 00:08:15,840 --> 00:08:21,000 Speaker 1: It's it's very it's an expensive UM proposition, UM, whether 141 00:08:21,120 --> 00:08:26,920 Speaker 1: you're an employer or an individual, and increasingly an employee. Right, 142 00:08:27,120 --> 00:08:28,760 Speaker 1: So we'll get to that in a minute. What are 143 00:08:28,800 --> 00:08:31,080 Speaker 1: some of the types of insurance plans that are out 144 00:08:31,120 --> 00:08:35,120 Speaker 1: there in the US today, there's pretty much too umbrellas. 145 00:08:35,280 --> 00:08:37,640 Speaker 1: Right as far as models go, I would say, so 146 00:08:37,720 --> 00:08:40,240 Speaker 1: that I think you're talking about the f f S, 147 00:08:40,320 --> 00:08:43,319 Speaker 1: the fee for service model, and then the managed care model, 148 00:08:43,480 --> 00:08:46,559 Speaker 1: which so well you know which under the managed care 149 00:08:46,640 --> 00:08:48,640 Speaker 1: is when you hear about HMOs and p P O 150 00:08:48,760 --> 00:08:51,720 Speaker 1: s and pos and that those are all managed care. Yeah, 151 00:08:51,760 --> 00:08:56,080 Speaker 1: the big the I guess the main characteristic of fee 152 00:08:56,160 --> 00:09:00,040 Speaker 1: for service is and this is the original model for 153 00:09:00,160 --> 00:09:05,280 Speaker 1: insurance indemnity insurance. You you, you pay your monthly premium 154 00:09:05,400 --> 00:09:08,199 Speaker 1: and you're you're insured. You come down with the cold, 155 00:09:08,840 --> 00:09:11,719 Speaker 1: You go to the doctor, the doctor cures you. He 156 00:09:11,720 --> 00:09:14,400 Speaker 1: gives you a coke and says, drink this and you'll 157 00:09:14,400 --> 00:09:18,800 Speaker 1: be fine, right, and smoke the cigarette, right yeah yeah, um, 158 00:09:18,920 --> 00:09:23,280 Speaker 1: And uh, you pay the doctor, you file some paperwork, 159 00:09:23,760 --> 00:09:26,679 Speaker 1: your insurance company reimburses you, and you go along your merryway, 160 00:09:26,760 --> 00:09:29,599 Speaker 1: continuing paying your monthly premiums. Again, right, this kind of 161 00:09:29,640 --> 00:09:32,280 Speaker 1: old school model like what our grandparents probably hadn't right. 162 00:09:32,320 --> 00:09:34,400 Speaker 1: And then I think in the eighties that hm mos 163 00:09:34,440 --> 00:09:39,319 Speaker 1: came about, managed care became um much more popular than 164 00:09:39,400 --> 00:09:43,520 Speaker 1: the FFS model, and actually there's some UM plans that 165 00:09:43,600 --> 00:09:46,880 Speaker 1: kind of combined the two. But with managed care UM 166 00:09:47,080 --> 00:09:51,080 Speaker 1: with fee for service, the the emphasis is on treatment. 167 00:09:51,760 --> 00:09:55,840 Speaker 1: With managed care, there's more emphasis on prevention, supposedly, and 168 00:09:55,880 --> 00:09:58,240 Speaker 1: that's where it really that's one of the big sticking 169 00:09:58,280 --> 00:10:00,880 Speaker 1: points with this whole mess that we have in this 170 00:10:00,960 --> 00:10:03,720 Speaker 1: country is a lot of doctors and a lot of 171 00:10:05,800 --> 00:10:10,840 Speaker 1: managed care still don't practice enough preventative care, they say, right, So, 172 00:10:10,960 --> 00:10:13,560 Speaker 1: at the center of the managed care model is a 173 00:10:13,600 --> 00:10:17,160 Speaker 1: primary physician who's supposed to know you, know your family, 174 00:10:17,440 --> 00:10:20,839 Speaker 1: know your history, know that you eat more donuts than 175 00:10:20,920 --> 00:10:24,000 Speaker 1: you should, know that you lied on your insurance form 176 00:10:24,000 --> 00:10:26,920 Speaker 1: when you said you don't smoke, and is saying you're 177 00:10:26,920 --> 00:10:29,440 Speaker 1: gonna get the beats, you're gonna get lung cancer. Somebody 178 00:10:29,440 --> 00:10:32,160 Speaker 1: who knows you, who you've seen, and who who can 179 00:10:32,320 --> 00:10:36,280 Speaker 1: you you can trust to kind of guide and manage 180 00:10:36,280 --> 00:10:39,559 Speaker 1: your health. Right, they're kind of a dying breed too, sadly, definitely, 181 00:10:39,720 --> 00:10:42,000 Speaker 1: And um, there's a good reason why, Chuck, you read 182 00:10:42,040 --> 00:10:45,200 Speaker 1: that CNN article that was distressing. Actually it was an 183 00:10:45,280 --> 00:10:49,040 Speaker 1: editorial by Dr Vance Harris, I believe, and uh he 184 00:10:49,200 --> 00:10:52,320 Speaker 1: basically gave a rundown of why the primary care physician 185 00:10:52,440 --> 00:10:55,280 Speaker 1: is becoming a dinosaur, right, Yeah, it was pretty pretty 186 00:10:55,280 --> 00:10:58,640 Speaker 1: depressing actually. So he was saying that for every several 187 00:10:58,679 --> 00:11:05,040 Speaker 1: thousand dollars he saves the healthcare industry by using his 188 00:11:05,120 --> 00:11:09,360 Speaker 1: medical training to actually make diagnosis rather than really expensive 189 00:11:09,440 --> 00:11:14,040 Speaker 1: screenings like treatment as opposed to procedure. He said that 190 00:11:14,080 --> 00:11:17,079 Speaker 1: for every several thousand dollars he saves the industry, he 191 00:11:17,160 --> 00:11:23,360 Speaker 1: makes fifty bucks. Um, so he's there. It's a primary 192 00:11:23,400 --> 00:11:26,440 Speaker 1: care physicians are not making a lot of money. What's more, 193 00:11:26,520 --> 00:11:30,920 Speaker 1: there's a lot, uh, there's a lot of issues surrounding malpractice. 194 00:11:31,559 --> 00:11:34,240 Speaker 1: On one hand, you can say, well, the very fact 195 00:11:34,240 --> 00:11:37,600 Speaker 1: that there's malpractice losses out there, and they often add 196 00:11:37,679 --> 00:11:41,559 Speaker 1: up to astronomical amounts of money being paid out to 197 00:11:41,679 --> 00:11:45,160 Speaker 1: people who are found to have been the victim of malpractice. 198 00:11:45,679 --> 00:11:49,080 Speaker 1: Doctors are a little nervous about relying on their medical 199 00:11:49,120 --> 00:11:51,439 Speaker 1: training to make a diagnosis when there's an m R 200 00:11:51,520 --> 00:11:54,080 Speaker 1: I machine in the next room that they can just 201 00:11:54,120 --> 00:11:56,360 Speaker 1: say this is going to solve it one way or another. 202 00:11:56,440 --> 00:11:59,240 Speaker 1: Although fo a fact. And then at the very least, 203 00:11:59,320 --> 00:12:01,079 Speaker 1: even if I'm said, I could say, well, the m 204 00:12:01,200 --> 00:12:04,840 Speaker 1: r I manufacturer screwed up. You know. Uh, there's a 205 00:12:04,840 --> 00:12:07,280 Speaker 1: lot of passing the buck because of that, supposedly, but 206 00:12:07,320 --> 00:12:12,080 Speaker 1: there's another way of looking at that correct well, medical malpractices. 207 00:12:12,400 --> 00:12:14,920 Speaker 1: You hear a lot about UM doctor saying that's driving 208 00:12:14,960 --> 00:12:18,920 Speaker 1: us out of business. We can't afford the premiums UM. 209 00:12:18,960 --> 00:12:20,960 Speaker 1: We have too many patients. We haven't to squeeze in 210 00:12:20,960 --> 00:12:25,480 Speaker 1: patients that that come in for you know, because they're worried. 211 00:12:25,559 --> 00:12:28,520 Speaker 1: I know, cyberchondria feeds into it. People read on the internet, 212 00:12:28,920 --> 00:12:32,840 Speaker 1: I've got reflux, I need to get a endoscopy, and 213 00:12:32,920 --> 00:12:36,079 Speaker 1: they go in there and demand one, which I mean, really, 214 00:12:36,120 --> 00:12:38,480 Speaker 1: it's it's there. It's your right. You're a patient and 215 00:12:38,520 --> 00:12:41,400 Speaker 1: you want to make sure that you have a healthy body. 216 00:12:41,480 --> 00:12:44,880 Speaker 1: It's tricky business, though, it is, because there what did 217 00:12:44,880 --> 00:12:48,800 Speaker 1: you call it, cyberchondria? Yeah, excellent, it's uh an argument 218 00:12:48,840 --> 00:12:54,400 Speaker 1: that's often used against pharmaceutical companies. Uh. Advertising on television, 219 00:12:55,160 --> 00:12:58,600 Speaker 1: you get the impression that they are educating the consumer, 220 00:12:58,720 --> 00:13:00,880 Speaker 1: just say hey, here's the words you use when you 221 00:13:00,920 --> 00:13:03,320 Speaker 1: talk to your doctor and get our pill. You know, 222 00:13:03,400 --> 00:13:05,480 Speaker 1: I mean, how how much of an effect has that 223 00:13:05,559 --> 00:13:11,200 Speaker 1: had on UM over prescription. I'm sure a bunch and 224 00:13:11,240 --> 00:13:14,240 Speaker 1: there's uh, there's so much information out there now, that's 225 00:13:14,280 --> 00:13:16,200 Speaker 1: the first thing I do. I diagnose myself on the 226 00:13:16,200 --> 00:13:19,240 Speaker 1: internet all the time, and I know a lot of people. 227 00:13:19,240 --> 00:13:21,280 Speaker 1: Do you really Oh yeah, man, what's you What do 228 00:13:21,280 --> 00:13:26,040 Speaker 1: you have? Like that? Reflux? Big time? You're not much 229 00:13:26,080 --> 00:13:29,720 Speaker 1: of a complainer, Chuck, shut up, really had no idea 230 00:13:29,800 --> 00:13:32,680 Speaker 1: you have reflex bad reflux, dude. Let's take it back 231 00:13:32,760 --> 00:13:35,040 Speaker 1: to uh can when you talk about my practice again 232 00:13:35,080 --> 00:13:37,760 Speaker 1: real quick, because I do have a study. UM, so 233 00:13:37,800 --> 00:13:39,640 Speaker 1: you hear a lot about how how those costs are 234 00:13:39,720 --> 00:13:42,679 Speaker 1: driving doctors out of business. And I'm not saying one 235 00:13:42,679 --> 00:13:44,400 Speaker 1: way or the other. I'm just gonna throw the study out. 236 00:13:44,440 --> 00:13:47,959 Speaker 1: The Americans for Insurance Reform they are a coalition made 237 00:13:48,040 --> 00:13:51,880 Speaker 1: up of Consumer Federation of America, Consumer Watchdog dot organ 238 00:13:51,920 --> 00:13:55,360 Speaker 1: a hundred other public interest groups. They release a study 239 00:13:55,679 --> 00:14:00,160 Speaker 1: UM this week actually that found that malpractice premium are 240 00:14:00,200 --> 00:14:02,679 Speaker 1: down and at the lowest they've been in thirty years. 241 00:14:03,520 --> 00:14:08,200 Speaker 1: UM malpractice claims are down since two thousand and in 242 00:14:08,320 --> 00:14:13,240 Speaker 1: states where the states have limited the consumer's ability to 243 00:14:13,280 --> 00:14:16,000 Speaker 1: sue for malpractice, premiums are about the same as in 244 00:14:16,080 --> 00:14:18,560 Speaker 1: other states. So I'm not saying they're not paying a 245 00:14:18,559 --> 00:14:21,400 Speaker 1: lot and it's not putting a dent. But they do 246 00:14:21,520 --> 00:14:26,320 Speaker 1: say that malpractice claims only constitute one fifth of one 247 00:14:26,360 --> 00:14:29,680 Speaker 1: percent of annual healthcare costs in the United States, So 248 00:14:29,720 --> 00:14:32,040 Speaker 1: that's kind of an obsolete argument these days. Well, it 249 00:14:32,160 --> 00:14:34,920 Speaker 1: may be a little overblown. I mean, of course, tell 250 00:14:34,960 --> 00:14:36,720 Speaker 1: the doctor that that has to pay a lot of money. 251 00:14:36,760 --> 00:14:40,360 Speaker 1: But from what I read, it's it's not the central 252 00:14:40,400 --> 00:14:42,640 Speaker 1: problem like some people say, like it needs reform, it 253 00:14:42,640 --> 00:14:46,560 Speaker 1: needs to be controlled by the government who knows. Okay, 254 00:14:47,320 --> 00:14:49,560 Speaker 1: I'm just here to report the facts, and you did 255 00:14:49,560 --> 00:14:53,640 Speaker 1: an excellent job. Thanks. Let's go back to UM talking 256 00:14:53,680 --> 00:14:56,720 Speaker 1: about where you get your insurance, right. We talked about 257 00:14:57,040 --> 00:15:00,400 Speaker 1: employer based plans. We talked about people who who get 258 00:15:00,440 --> 00:15:04,320 Speaker 1: the their insurance individually, right, people who get it from 259 00:15:04,320 --> 00:15:07,480 Speaker 1: the state. UM. And then there's another group known as 260 00:15:07,520 --> 00:15:10,680 Speaker 1: the uninsured. Yeah, and this is where it gets really hinky. 261 00:15:10,760 --> 00:15:13,240 Speaker 1: The number of the uninsured is uh, kind of all 262 00:15:13,320 --> 00:15:15,320 Speaker 1: over the map right now. Well, yeah, and also it's 263 00:15:15,480 --> 00:15:19,400 Speaker 1: one of the central folk I of UM the insurance 264 00:15:19,640 --> 00:15:24,000 Speaker 1: or healthcare reform debates. Well that there's forty five actually 265 00:15:24,040 --> 00:15:26,960 Speaker 1: as far as August two thousand nine, UH Census Bureau 266 00:15:27,040 --> 00:15:30,880 Speaker 1: figures forty five point six million uninsured Americans and that 267 00:15:31,320 --> 00:15:33,680 Speaker 1: if you're a person who believes that healthcare is a 268 00:15:33,760 --> 00:15:36,680 Speaker 1: human right, you think that these people should be covered 269 00:15:36,720 --> 00:15:38,880 Speaker 1: in some form or fashion, right, right, And they're really 270 00:15:39,040 --> 00:15:43,920 Speaker 1: nitpicking this number because this number, the number of uninsured, 271 00:15:44,040 --> 00:15:46,280 Speaker 1: is largely what a lot of the financing is going 272 00:15:46,320 --> 00:15:48,640 Speaker 1: to be based on. Yeah, we'll trying to project like 273 00:15:48,800 --> 00:15:51,600 Speaker 1: a decade into the future. And if they don't get 274 00:15:51,640 --> 00:15:53,720 Speaker 1: that number right, you know, the money doesn't work out, 275 00:15:53,720 --> 00:15:57,000 Speaker 1: then that's when you're really screwed. Well sure, um, you 276 00:15:57,040 --> 00:16:00,880 Speaker 1: were saying that not everybody's on the same page. Who 277 00:16:01,000 --> 00:16:04,040 Speaker 1: the uninsured are? How many there are? Um, there's a 278 00:16:04,040 --> 00:16:07,600 Speaker 1: guy named Michael D. Tanner of the Cato Institute, and 279 00:16:07,720 --> 00:16:12,360 Speaker 1: he pointed out that actually, I'm more of a Brookings 280 00:16:12,360 --> 00:16:15,960 Speaker 1: Institute Fann. Cato is pretty good to be all about Kato. 281 00:16:16,360 --> 00:16:18,920 Speaker 1: I was, I've, I've, i've, I'm still am I, but 282 00:16:19,000 --> 00:16:23,200 Speaker 1: I like Brookings these days. So Tanner's Tanner points out 283 00:16:23,240 --> 00:16:27,480 Speaker 1: that UM about twelve million of the forty five point 284 00:16:27,560 --> 00:16:31,200 Speaker 1: six million people who are uninsured in the US UM 285 00:16:31,240 --> 00:16:34,560 Speaker 1: are eligible for Medicaid or s CHIP. They just haven't 286 00:16:34,600 --> 00:16:38,920 Speaker 1: signed up. It's a really good point. He also points 287 00:16:38,920 --> 00:16:41,680 Speaker 1: out that if they ever go in for treatment, that 288 00:16:41,760 --> 00:16:45,960 Speaker 1: should pop up um in in whatever patient data that 289 00:16:46,040 --> 00:16:49,800 Speaker 1: the administrator takes in, and they'll be automatically enrolled in 290 00:16:49,880 --> 00:16:53,280 Speaker 1: whatever program suits them. Right, So that takes care of 291 00:16:53,320 --> 00:16:56,760 Speaker 1: twelve million. One of the ones I don't necessarily agree with. 292 00:16:57,160 --> 00:16:59,160 Speaker 1: And I think people who think that health care is 293 00:16:59,200 --> 00:17:02,120 Speaker 1: a universal human and Wright would disagree with very much, 294 00:17:02,600 --> 00:17:05,200 Speaker 1: as he points out that about ten million of these 295 00:17:05,240 --> 00:17:09,679 Speaker 1: people who are uninsured in America aren't Americans. You're illegal. 296 00:17:09,720 --> 00:17:11,520 Speaker 1: And you know, it depends on when you start looking 297 00:17:11,520 --> 00:17:13,879 Speaker 1: at these numbers. I started looking around there, people are 298 00:17:13,880 --> 00:17:17,360 Speaker 1: throwing all everybody's got a number. It's because it's hard 299 00:17:17,440 --> 00:17:20,840 Speaker 1: to count and account for these people. Yeah, Uh, they're 300 00:17:20,880 --> 00:17:23,720 Speaker 1: generally illegal. Immigrants aren't gonna step forward and say, you know, 301 00:17:23,760 --> 00:17:26,359 Speaker 1: count me on your report. So that's one reason. But 302 00:17:26,520 --> 00:17:29,480 Speaker 1: he Tanner also makes one last point that, um, you 303 00:17:29,560 --> 00:17:32,080 Speaker 1: and I are kind of anomalies, Chuck and having gone 304 00:17:32,160 --> 00:17:35,479 Speaker 1: several years without insurance when we were younger men. Uh, 305 00:17:35,760 --> 00:17:40,080 Speaker 1: about fifty of the uninsured in the US go six 306 00:17:40,119 --> 00:17:43,680 Speaker 1: months or less without insurance. So really, this forty five 307 00:17:43,720 --> 00:17:46,760 Speaker 1: points six million Americans, even if the number remains the same, 308 00:17:47,240 --> 00:17:52,360 Speaker 1: who makes up this population is changing constantly, right, it's 309 00:17:52,359 --> 00:17:54,800 Speaker 1: a snapshot. Basically, I saw this one person put it 310 00:17:54,840 --> 00:17:56,480 Speaker 1: in one of the articles you sent me, So yeah, 311 00:17:56,520 --> 00:17:59,200 Speaker 1: exactly how many uninsured people there are and who they 312 00:17:59,240 --> 00:18:01,840 Speaker 1: are is kind of a big part of this debate 313 00:18:01,880 --> 00:18:06,080 Speaker 1: about whether you know health care needs reform. Actually, let 314 00:18:06,119 --> 00:18:09,440 Speaker 1: me let me correct myself. I haven't run across anybody 315 00:18:09,480 --> 00:18:13,960 Speaker 1: who says that healthcare doesn't need reforming. Of you. Now, 316 00:18:14,240 --> 00:18:17,480 Speaker 1: everybody agrees that there's something wrong, that it's broken, and 317 00:18:17,800 --> 00:18:21,280 Speaker 1: the World Health Organization would probably agree with well, hold on, first, 318 00:18:21,320 --> 00:18:23,320 Speaker 1: let's talk about some of the different arguments. There's some 319 00:18:23,359 --> 00:18:26,400 Speaker 1: people who say that public health care is nothing more 320 00:18:26,480 --> 00:18:31,560 Speaker 1: than just uh, a weak part of the American welfare state. 321 00:18:31,640 --> 00:18:34,479 Speaker 1: And why should my taxes pay for some other guys 322 00:18:35,480 --> 00:18:39,119 Speaker 1: health insurance when I'm paying through the nose? Um. The 323 00:18:40,080 --> 00:18:46,000 Speaker 1: you could say that competition might ease this this, you know, um, 324 00:18:46,040 --> 00:18:49,120 Speaker 1: giving people vouchers to go buy their own insurance might 325 00:18:49,160 --> 00:18:52,680 Speaker 1: make them a little more penny wise with how they 326 00:18:52,680 --> 00:18:58,800 Speaker 1: spend their money. Um. Really, ultimately, what seems to be 327 00:18:58,960 --> 00:19:02,840 Speaker 1: agreed upon by every buddy, is that the American healthcare 328 00:19:02,960 --> 00:19:08,440 Speaker 1: system is too expensive for what it provides big time. 329 00:19:08,720 --> 00:19:11,520 Speaker 1: So let's talk about if you mentioned the World Health Organization, 330 00:19:11,560 --> 00:19:14,600 Speaker 1: this was huge and this this still the study was 331 00:19:14,640 --> 00:19:19,800 Speaker 1: from two thousand and it remains a real um piece 332 00:19:19,840 --> 00:19:23,959 Speaker 1: of ammunition that's used many different ways in the debate 333 00:19:24,000 --> 00:19:27,239 Speaker 1: on healthcare reform. It was a groundbreaking study. And like 334 00:19:27,320 --> 00:19:29,760 Speaker 1: you said, we are the most expensive. We spend more 335 00:19:29,760 --> 00:19:31,919 Speaker 1: money on healthcare than anyone in the world. We spend 336 00:19:32,000 --> 00:19:34,960 Speaker 1: sixteen In two eight, we spent sixteen point six percent 337 00:19:35,040 --> 00:19:38,879 Speaker 1: of our GDP on healthcare, not just government spending, but 338 00:19:38,960 --> 00:19:41,959 Speaker 1: just across the board GEZ sixteen point six of the 339 00:19:42,080 --> 00:19:44,760 Speaker 1: market sixteen point six percent of the market value of 340 00:19:44,760 --> 00:19:48,080 Speaker 1: the United States, and that that year was spent just 341 00:19:48,200 --> 00:19:52,199 Speaker 1: on healthcare. That's more than defense. Buddy. We were in 342 00:19:52,240 --> 00:19:55,320 Speaker 1: Iraq and Afghanistan at that time. If you, if you 343 00:19:55,480 --> 00:19:59,320 Speaker 1: give me a number like that, I would say in response, Josh, 344 00:19:59,480 --> 00:20:01,560 Speaker 1: that of the during ninety one countries, say study, then 345 00:20:01,560 --> 00:20:03,400 Speaker 1: that probably means that we're at the top of the list. 346 00:20:03,400 --> 00:20:05,040 Speaker 1: Then for what you get for your dollar, you would 347 00:20:05,040 --> 00:20:07,080 Speaker 1: think we should be since we have the most expensive 348 00:20:07,200 --> 00:20:11,960 Speaker 1: and technologically sophisticated healthcare system in the world, top ten 349 00:20:14,080 --> 00:20:18,720 Speaker 1: to one. You would think, oh, where we should be? Yeah, 350 00:20:18,760 --> 00:20:21,280 Speaker 1: I mean I don't easy, yeah, but I'm gonna give 351 00:20:21,280 --> 00:20:24,320 Speaker 1: you some leeway and say, top ten. Okay, how what 352 00:20:24,520 --> 00:20:28,520 Speaker 1: is it really? Seven in the world out of a 353 00:20:28,720 --> 00:20:33,600 Speaker 1: d countries? You know who is just above us? Costa Rica? Awesome? 354 00:20:33,800 --> 00:20:38,000 Speaker 1: You know who's just below us? Slovenia. Wow, Yeah, that's 355 00:20:38,000 --> 00:20:44,919 Speaker 1: where the US ranks against Slovenia. But yeah, since we 356 00:20:45,000 --> 00:20:48,119 Speaker 1: have the most expensive health care system in the entire 357 00:20:48,240 --> 00:20:53,720 Speaker 1: world on the planet, we should by proxy have the 358 00:20:53,800 --> 00:20:56,919 Speaker 1: best health care system is rated by the World Health Organization. 359 00:20:57,080 --> 00:21:01,560 Speaker 1: You want to hear something else, chilling? Uh, Americans life 360 00:21:01,560 --> 00:21:05,920 Speaker 1: expectancy is lower than Canada, half of the Caribbean, including 361 00:21:05,960 --> 00:21:10,080 Speaker 1: Puerto Rico, in Cuba, Chile, all of Western Europe, some 362 00:21:10,160 --> 00:21:14,879 Speaker 1: of Eastern Europe, Israel, Jordan's, Singapore, Hong Kong, Japan, Australia, 363 00:21:14,880 --> 00:21:17,639 Speaker 1: and New Zealand are life expectancy is lower than all 364 00:21:17,640 --> 00:21:20,679 Speaker 1: of those countries. And I'm not necessarily saying that definitely 365 00:21:20,760 --> 00:21:23,359 Speaker 1: means that their health care system is so much better, 366 00:21:23,400 --> 00:21:27,399 Speaker 1: but it probably lends itself to to that argument. I 367 00:21:27,440 --> 00:21:30,000 Speaker 1: know the study you're referring or the article you're referring to, 368 00:21:30,119 --> 00:21:33,160 Speaker 1: Chuck and um. It references a study from the New 369 00:21:33,160 --> 00:21:36,640 Speaker 1: England Journal of Medicine from about ten years ago that 370 00:21:36,760 --> 00:21:39,880 Speaker 1: showed that the average black man in Harlem was less 371 00:21:39,920 --> 00:21:43,720 Speaker 1: likely to reach age sixty five than a man in Bangladesh. 372 00:21:44,160 --> 00:21:47,399 Speaker 1: That is messed up. That's not supposed to be. No, no, 373 00:21:47,720 --> 00:21:49,560 Speaker 1: not when you're spending the kind and we're not saying 374 00:21:49,600 --> 00:21:51,960 Speaker 1: because America is so much better. It's because we spend 375 00:21:51,960 --> 00:21:54,280 Speaker 1: the kind of money we spend in respect better results. 376 00:21:54,320 --> 00:21:55,920 Speaker 1: That's one thing that a lot of people have agreed 377 00:21:56,000 --> 00:21:59,680 Speaker 1: up on the um. The other point to this is 378 00:22:00,160 --> 00:22:02,280 Speaker 1: by the way we spent two point four trillion dollars 379 00:22:02,280 --> 00:22:06,720 Speaker 1: in two eight on healthcare. Right, healthcare spending and costs 380 00:22:07,040 --> 00:22:11,920 Speaker 1: continue to increase, but as someone else pointed out in 381 00:22:13,160 --> 00:22:17,520 Speaker 1: are mortality rate flattened, it hasn't gotten better since then. So, 382 00:22:17,680 --> 00:22:20,919 Speaker 1: in short, the US is not getting enough bang for 383 00:22:20,960 --> 00:22:23,239 Speaker 1: its buck as far as it's health care system. We're 384 00:22:23,280 --> 00:22:26,200 Speaker 1: not getting healthier, but we're certainly spending more money. What's 385 00:22:26,240 --> 00:22:29,680 Speaker 1: going on, Well, I mean, there's a Jesus there's a 386 00:22:29,720 --> 00:22:31,159 Speaker 1: lot of reasons. I know. One thing a lot of 387 00:22:31,160 --> 00:22:34,159 Speaker 1: people point at is the aging baby Boomerson out the 388 00:22:34,200 --> 00:22:35,800 Speaker 1: age where they need a lot of care in the 389 00:22:35,840 --> 00:22:38,879 Speaker 1: hospitals and buy doctors. Uh, there are fewer and fewer 390 00:22:38,880 --> 00:22:42,640 Speaker 1: doctors and nurses, so uh, they're not getting as good 391 00:22:42,640 --> 00:22:45,240 Speaker 1: at care. And there's more. Um. I think they just 392 00:22:45,280 --> 00:22:47,840 Speaker 1: called the medical errors in the article I read because 393 00:22:47,880 --> 00:22:52,200 Speaker 1: of understaffing. That's one reason you're what you're talking about 394 00:22:52,600 --> 00:22:56,440 Speaker 1: could actually be considered symptoms. And we should probably say, 395 00:22:56,640 --> 00:23:00,880 Speaker 1: just for c o A, that if you what Jerry 396 00:23:00,960 --> 00:23:04,720 Speaker 1: and Matt in here, you would get a totally different 397 00:23:04,720 --> 00:23:09,280 Speaker 1: podcast with all the same research. There are so many 398 00:23:09,320 --> 00:23:12,520 Speaker 1: ways of looking at this issue that all you and 399 00:23:12,600 --> 00:23:15,560 Speaker 1: I can do here, Chuck is try to get to 400 00:23:15,600 --> 00:23:19,320 Speaker 1: the central focus of it without you know, leaning into 401 00:23:19,480 --> 00:23:23,120 Speaker 1: partisan politics or anything like that. It seems to me 402 00:23:23,200 --> 00:23:25,840 Speaker 1: from what I saw come up time and time again 403 00:23:25,880 --> 00:23:28,720 Speaker 1: from UH sources on both the left and the right, 404 00:23:29,240 --> 00:23:34,520 Speaker 1: pro business, pro labor, is that the American health care 405 00:23:34,520 --> 00:23:40,159 Speaker 1: system is too sophisticated, it's too advanced, and patients have 406 00:23:40,480 --> 00:23:43,800 Speaker 1: too much access to it, too much, you could say, 407 00:23:43,840 --> 00:23:46,560 Speaker 1: frivolous access to it. So that m R I scam. 408 00:23:46,640 --> 00:23:51,719 Speaker 1: We were talking about demand, right, the patient demands it 409 00:23:51,920 --> 00:23:57,720 Speaker 1: because that money that goes towards your employer based insurance 410 00:23:57,760 --> 00:24:01,640 Speaker 1: policy comes out of your paycheck, right and when when 411 00:24:02,119 --> 00:24:04,520 Speaker 1: so right there, this is money you haven't even seen 412 00:24:04,720 --> 00:24:07,840 Speaker 1: it comes out before hit your your paychecks direct deposited 413 00:24:07,840 --> 00:24:12,440 Speaker 1: into your account. Right. Secondly, it's relatively cheap, and when 414 00:24:12,440 --> 00:24:14,360 Speaker 1: you go to the doctor, you're not actually shelling out 415 00:24:14,440 --> 00:24:19,560 Speaker 1: money nor so you have no real incentive to be 416 00:24:20,760 --> 00:24:24,840 Speaker 1: um cheap. What was the Simpsons huh episode you're talking about? 417 00:24:24,920 --> 00:24:27,040 Speaker 1: So you remember? Do you remember the one where the 418 00:24:27,800 --> 00:24:32,440 Speaker 1: home Homer and Lisa go into isolation tanks um, which, 419 00:24:32,480 --> 00:24:35,720 Speaker 1: by the way, I did recently and it was cool. Um. 420 00:24:35,840 --> 00:24:39,320 Speaker 1: And Homer's isolation tank is repossessed while he's in there, 421 00:24:39,760 --> 00:24:43,240 Speaker 1: and one of the laborers who's repossessing this thing tells 422 00:24:43,280 --> 00:24:45,240 Speaker 1: the other one to lift with his knees, and the 423 00:24:45,240 --> 00:24:47,800 Speaker 1: other guy goes, screw it. I've got health insurance, right, 424 00:24:47,840 --> 00:24:49,879 Speaker 1: And that's kind of the attitude some people take is 425 00:24:49,880 --> 00:24:51,520 Speaker 1: I'm paying for this, I'm gonna get my money's worth 426 00:24:51,560 --> 00:24:53,800 Speaker 1: out of it, exactly. So I got some heartburn, I'm 427 00:24:53,800 --> 00:24:57,040 Speaker 1: gonna go demand the camera down the throat instead of 428 00:24:57,240 --> 00:24:59,120 Speaker 1: trying to treat it and see if or not eat 429 00:24:59,200 --> 00:25:01,640 Speaker 1: chocolate and read right. Well, that that's the other thing 430 00:25:01,680 --> 00:25:05,919 Speaker 1: that it portrays is that we aren't taking responsibility for 431 00:25:05,960 --> 00:25:08,480 Speaker 1: our own health as Americans. We don't. And that's where 432 00:25:08,480 --> 00:25:11,760 Speaker 1: it has a start, buddy, definitely, And part of that 433 00:25:12,080 --> 00:25:17,040 Speaker 1: is putting that focus back on prevention again rather than treatment. 434 00:25:17,080 --> 00:25:21,440 Speaker 1: Because consider this, if you have a an advanced disease, 435 00:25:22,040 --> 00:25:25,679 Speaker 1: how much more rigorous is your treatment going to be? 436 00:25:25,880 --> 00:25:28,520 Speaker 1: How many more doctors business does that entail? How many 437 00:25:28,560 --> 00:25:31,320 Speaker 1: more UM scans does that, m R I scans does 438 00:25:31,359 --> 00:25:35,120 Speaker 1: that entail? How much more for medication? And don't get 439 00:25:35,119 --> 00:25:38,000 Speaker 1: me started in the pharmaceutical companies. Yeah, that's a different podcast. 440 00:25:38,200 --> 00:25:44,359 Speaker 1: Um how much more UM time and effort and just 441 00:25:44,520 --> 00:25:46,760 Speaker 1: cost is it going to take to treat an advanced 442 00:25:46,760 --> 00:25:49,479 Speaker 1: stage disease? Then it's going to be to prevent it 443 00:25:49,800 --> 00:25:52,800 Speaker 1: or treat it early on exactly. So like when they 444 00:25:52,800 --> 00:25:55,760 Speaker 1: recommend it, I think forty or so for women to 445 00:25:55,800 --> 00:25:58,399 Speaker 1: start getting your mamogram and for men to get the 446 00:25:58,400 --> 00:26:02,960 Speaker 1: old how's your father treatment from your doctor? Yeah, these 447 00:26:03,000 --> 00:26:05,600 Speaker 1: kind of things. People people avoid this stuff and then 448 00:26:05,600 --> 00:26:08,360 Speaker 1: all of a sudden, you have, like you said, holy cow, 449 00:26:08,520 --> 00:26:10,879 Speaker 1: got a tumor that's in an advanced stage because I 450 00:26:10,920 --> 00:26:13,399 Speaker 1: haven't taken care of myself and I haven't done the 451 00:26:13,400 --> 00:26:17,359 Speaker 1: regular checkups like I need to. And uh, it cost 452 00:26:17,400 --> 00:26:21,400 Speaker 1: a lot more so this infrastructure that we're talking about, 453 00:26:21,400 --> 00:26:24,679 Speaker 1: the health system infrastructure, it keeps growing and growing. Uh. 454 00:26:25,240 --> 00:26:27,920 Speaker 1: It costs a lot to manufacture an m R I machine, 455 00:26:27,960 --> 00:26:29,879 Speaker 1: and I keep I keep using that. But it's just 456 00:26:29,920 --> 00:26:33,880 Speaker 1: such an easy example. Yeah. Um. And as a result 457 00:26:34,000 --> 00:26:36,159 Speaker 1: of just not just the m R I machine, but 458 00:26:36,240 --> 00:26:41,320 Speaker 1: all of these different external factors and possibly corporate greed um, 459 00:26:41,640 --> 00:26:44,320 Speaker 1: from two thousand four to two thousand nine, the average 460 00:26:44,400 --> 00:26:49,399 Speaker 1: cost on healthcare premiums increased four times faster than the 461 00:26:49,440 --> 00:26:52,280 Speaker 1: average wage in the US. So, all of a sudden, 462 00:26:52,680 --> 00:26:55,120 Speaker 1: healthcare is just getting more and more and more expensive, 463 00:26:55,119 --> 00:26:58,240 Speaker 1: and not just for you and me, chuck, um, we 464 00:26:58,320 --> 00:27:02,040 Speaker 1: are premium From into two thousand nine, are the employee 465 00:27:02,080 --> 00:27:05,600 Speaker 1: contribution went from an average of fundred and forty three 466 00:27:05,640 --> 00:27:08,600 Speaker 1: dollars to three thousand, three hundred and fifty four dollars. 467 00:27:09,320 --> 00:27:14,359 Speaker 1: That's just our contribution. This isn't including employers contributions, which 468 00:27:14,600 --> 00:27:17,879 Speaker 1: is affecting their bottom line, and as healthcare costs rise, 469 00:27:18,400 --> 00:27:22,199 Speaker 1: they're losing a competitive edge in the global market in 470 00:27:22,240 --> 00:27:25,320 Speaker 1: an increasingly globalized world, and all businesses have budgets. They 471 00:27:25,359 --> 00:27:28,320 Speaker 1: work on budgets that also might affect the rays you 472 00:27:28,400 --> 00:27:31,440 Speaker 1: might or might not get because of the budget and 473 00:27:31,440 --> 00:27:34,119 Speaker 1: how much they're having to spend. I know, my father 474 00:27:34,160 --> 00:27:37,119 Speaker 1: in law has a small business and did he has 475 00:27:37,160 --> 00:27:39,280 Speaker 1: a really small business, like he only has a handful 476 00:27:39,280 --> 00:27:42,400 Speaker 1: of employees, but he has a health insurance program. And 477 00:27:42,520 --> 00:27:44,720 Speaker 1: one of the ladies that works with him is one 478 00:27:44,720 --> 00:27:46,760 Speaker 1: of these people that does not take care of herself. 479 00:27:46,840 --> 00:27:49,800 Speaker 1: She has like three or four surgeries a year and 480 00:27:50,000 --> 00:27:53,040 Speaker 1: it's driving him out of business. Dude, this one lady. Yeah, 481 00:27:53,080 --> 00:27:56,000 Speaker 1: and let me tell you something else, but buddy, the 482 00:27:56,000 --> 00:27:59,760 Speaker 1: World Health Organization estimates that between nineteen and of the 483 00:27:59,800 --> 00:28:03,520 Speaker 1: to dollars spent on healthcare here spent on administrative costs. 484 00:28:04,760 --> 00:28:08,440 Speaker 1: Administrative costs. And another reason that it's so expensive is, uh, 485 00:28:08,680 --> 00:28:10,440 Speaker 1: there's been a big shift I don't know if you've 486 00:28:10,480 --> 00:28:14,440 Speaker 1: noticed in for profit hospitals as opposed to the old 487 00:28:14,600 --> 00:28:17,640 Speaker 1: nonprofit model, the community model, and that's kind of helped 488 00:28:17,680 --> 00:28:19,840 Speaker 1: drive up prices too. So they say, well, sure, not 489 00:28:19,880 --> 00:28:24,200 Speaker 1: only that, but the uninsured drive up prices. Um, the 490 00:28:24,200 --> 00:28:29,919 Speaker 1: the Medicaid Medicare are notoriously terrible. I'm paying out billing 491 00:28:30,000 --> 00:28:34,399 Speaker 1: to physicians. Hospitals have started to use something called balanced building, 492 00:28:34,440 --> 00:28:39,080 Speaker 1: where they um start building patients for procedures they didn't 493 00:28:39,080 --> 00:28:42,120 Speaker 1: know they weren't covered for, and the insurance companies refusing 494 00:28:42,120 --> 00:28:43,760 Speaker 1: to pay, and all of a sudden, you've got a 495 00:28:43,800 --> 00:28:46,720 Speaker 1: collection agent all over you because the hospital didn't say, oh, 496 00:28:46,760 --> 00:28:49,600 Speaker 1: by the way, this doctor right here, who you're you're 497 00:28:49,600 --> 00:28:51,960 Speaker 1: about to see is out of your network, so you're 498 00:28:51,960 --> 00:28:54,120 Speaker 1: gonna have to pay for him out of pocket. There's 499 00:28:54,160 --> 00:29:00,480 Speaker 1: just there's we have big problems here, kidding, So Chuck, 500 00:29:00,720 --> 00:29:04,160 Speaker 1: how do we solve this? I have no idea. Other 501 00:29:04,200 --> 00:29:06,920 Speaker 1: people to thank heavens for that. Well, one of those 502 00:29:06,960 --> 00:29:10,360 Speaker 1: people is a man named Mr Barack Obama. You may 503 00:29:10,360 --> 00:29:13,080 Speaker 1: know him as President Obama. He's got a plan for 504 00:29:13,280 --> 00:29:16,480 Speaker 1: healthcare reform, and we're gonna cover that in the next 505 00:29:16,520 --> 00:29:20,440 Speaker 1: installment of the podcast, Barack Obama's Healthcare Reform Plans Soup 506 00:29:20,520 --> 00:29:24,120 Speaker 1: to nut. But again, this is kind of a weighty 507 00:29:24,280 --> 00:29:27,080 Speaker 1: topic and we're gonna need some help. So we're gonna 508 00:29:27,080 --> 00:29:31,400 Speaker 1: recruit Molly Edmonds, right, Molly Edmunds of Stuff Mom Never 509 00:29:31,440 --> 00:29:36,720 Speaker 1: Told You, popular sister podcast and all our our healthcare writer. Well, yeah, 510 00:29:36,720 --> 00:29:39,920 Speaker 1: she's been completely submerged in healthcare for the last three weeks, 511 00:29:39,960 --> 00:29:42,000 Speaker 1: health in general. She's our health writer, she is, but 512 00:29:42,080 --> 00:29:46,200 Speaker 1: she's been studiously studying healthcare reforms. So she's gonna come 513 00:29:46,200 --> 00:29:49,040 Speaker 1: in for the next few uh podcasts to help us 514 00:29:49,040 --> 00:29:52,000 Speaker 1: sort through things. We can rely on her a little bit. 515 00:29:52,040 --> 00:29:55,160 Speaker 1: And we also spoke to Dr Michael Royson, who is 516 00:29:55,240 --> 00:29:59,080 Speaker 1: the chief Wellness Officer of the Cleveland Clinic and more 517 00:29:59,120 --> 00:30:02,640 Speaker 1: famously known as co author of the You the Owner's 518 00:30:02,680 --> 00:30:06,120 Speaker 1: Manual series of books. With Dr got him on the phone. Yeah, 519 00:30:06,160 --> 00:30:08,400 Speaker 1: he was awesome. So it's gonna be like a whiz bang, 520 00:30:08,680 --> 00:30:11,840 Speaker 1: super big healthcare reform podcast and hopefully by the end 521 00:30:11,960 --> 00:30:15,840 Speaker 1: you will know as much as Molly Edmonds, which is substantial. 522 00:30:16,080 --> 00:30:18,520 Speaker 1: So stay tuned for the second episode, which will be 523 00:30:18,560 --> 00:30:20,880 Speaker 1: out in a week. And in the meanwhile, you can 524 00:30:20,920 --> 00:30:23,680 Speaker 1: go to how Stuff works dot com, type in healthcare 525 00:30:24,080 --> 00:30:26,960 Speaker 1: in our handy search bar and you're going to find 526 00:30:27,040 --> 00:30:31,680 Speaker 1: a slew of really thoroughly researched and well written articles 527 00:30:31,720 --> 00:30:34,520 Speaker 1: by Molly Edmonds, and if you want to send us 528 00:30:34,520 --> 00:30:36,960 Speaker 1: an email about healthcare or anything else, you can shoot 529 00:30:37,000 --> 00:30:41,320 Speaker 1: that to stuff podcast at how stuff works dot com. 530 00:30:41,320 --> 00:30:48,400 Speaker 1: Perfect for more on this and thousands of other topics. 531 00:30:48,520 --> 00:30:51,479 Speaker 1: Does it how stuff works dot com. Want more how 532 00:30:51,600 --> 00:30:54,240 Speaker 1: stuff works, check out our blogs on the house. Stuff 533 00:30:54,280 --> 00:30:59,120 Speaker 1: works dot com home page. Brought to you by the 534 00:30:59,160 --> 00:31:02,800 Speaker 1: reinvented two thousand twelve Camry. It's ready, are you