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Speaker 1: It's that time, time, time, time, luck and load. So

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Speaker 1: Michael Very Show is on the air. I talked about

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Speaker 1: this a couple of weeks ago, and I don't know how.

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Speaker 1: I guess I didn't go deep enough into it, but

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Speaker 1: I knew it was only a matter of time, and

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Speaker 1: so did you. We all knew when the Democrats and

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Speaker 1: the mainstream media started to promote drag queens. You knew

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Speaker 1: what was coming next. Drag queens everywhere because it sort

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Speaker 1: of induces others. It becomes, in an odd way, a

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Speaker 1: bandwagon effect. Now you may say to yourself, I don't

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Speaker 1: understand that, because it doesn't make me want to be

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Speaker 1: a drag queen. But it was never intended to appeal

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Speaker 1: to you. It was intended to appeal to a certain

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Speaker 1: amount of a certain type of person. So when tattoos

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Speaker 1: became more commonplace, it was a rebel thing to do.

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Speaker 1: It's a crazy thing to do, it was it was

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Speaker 1: a it was a rebellion and it showed it you

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Speaker 1: were different. And so people would get tattoos as a

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Speaker 1: way of making a statement, piss off mom and dad.

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Speaker 1: And when you saw them, you knew that's a person

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Speaker 1: who doesn't care what you think, and it's it's as

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Speaker 1: much a uniform as any other uniform. But that's what

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Speaker 1: it was until everybody started getting tattoos. It got to

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Speaker 1: the point where people in their seventies are getting tattoos.

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Speaker 1: Little ladies are getting tattoos because their granddaughter comes home

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Speaker 1: from college. As grandma, let's go get a tattoo, you

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Speaker 1: and me, we'll get it on our ankle. It'll be

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Speaker 1: a butterfly. All right, maybe I'll do Your grandmother do

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Speaker 1: anything for the grandkids, you know that. And so now

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Speaker 1: you walk into a tattoo parlor and there's grandma over there,

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Speaker 1: sweet as she can be. He's been voting Republicans since Eisenhower,

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Speaker 1: and she's getting a tattoo. So they had to go right,

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Speaker 1: they ruined it for us. It's like hipsters. It's very

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Speaker 1: much like hipsters. It's like hipsters who you know, they

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Speaker 1: want the hot new thing, the craft beer or this

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Speaker 1: brand of clothing, or vacationing in this particular place. And

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Speaker 1: then when the normies do it, when the rest of

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Speaker 1: us do it, it ruins it. Or if you have teenagers,

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Speaker 1: your teenagers will use words that are teen vocabulary jargon,

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Speaker 1: and so what you do is you learn about it

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Speaker 1: and you throw it in real casually as if you

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Speaker 1: think you're super cool, and they hear it, and it,

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Speaker 1: I mean, destroys that term for them, and in my

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Speaker 1: house like dad, no, no, But what will happen is

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Speaker 1: Michael or Crockett one or the other, whichever one reacts

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Speaker 1: the most harshly to it, which is usually Michael t

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Speaker 1: my oldest crocodile. Go, I gotta tell you that props.

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Speaker 1: You did use it, right, I mean you did, you

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Speaker 1: did actually use it, right, I mean, I gotta give

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Speaker 1: you credit.

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Speaker 2: You did so.

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Speaker 1: Anyway, So when the when normalizing the drag queens became

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Speaker 1: the deal, it started making more popular drag queens reading

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Speaker 1: to kids in school. They didn't they didn't just want

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Speaker 1: to be left alone and not beaten up. See that

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Speaker 1: was the originals. It always starts there, leave them alone,

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Speaker 1: they're victims of crime. Okay, leave them alone, don't pick

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Speaker 1: on them. Okay, they're coming to read to your kid

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Speaker 1: in school. Whoa, whoa. That escalated quickly. Drag Queen's Story

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Speaker 1: Hour in the public library turned into drag Queen's Story

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Speaker 1: Hour in the school. And you were a bigot if

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Speaker 1: you balked at it. Okay, I'm a bigot if that's

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Speaker 1: what that means, because that's no place for that. Then

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Speaker 1: they put pornography in the school library. Then they said

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Speaker 1: that we wanted to ban books, and so the FBI

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Speaker 1: started investigating parents that went to school board meetings to protest,

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Speaker 1: bullying them, intimidating them gestapo tactics exactly what it is,

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Speaker 1: no different. We call them rumors because that's what they are.

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Speaker 1: They're grooming young children so that they can be objects

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Speaker 1: of their sexual enjoyment. It's sick and it's real. That's

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Speaker 1: what pedophiles do, and that's why it's so important for

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Speaker 1: all these people to do what they do in the school.

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Speaker 1: They don't want to be left alone. Used to they'd say,

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Speaker 1: just leave us alone, to leave our line. We're just

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Speaker 1: like you. We just want to be left alone. They

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Speaker 1: don't want to be left alone anymore. Now they want

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Speaker 1: to come and smirit in your face and they want

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Speaker 1: to dare you to have a problem with it so

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Speaker 1: that they can destroy you. That's their goal. You have

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Speaker 1: to fight back in the same way they're fighting. Well,

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Speaker 1: we now have liberal white women, which is the source

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Speaker 1: of most problems in this country in academia trying to

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Speaker 1: tell us that pedophilia is a sexual orientation. Listen to this.

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Speaker 3: Most of us show this comfort when we think about pedophiles.

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Speaker 3: But just like pedophiles, we are not responsible for our feelings.

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Speaker 3: We do not choose them, but we are responsible for

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Speaker 3: our actions, and we must make a decision. It is

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Speaker 3: in our responsibility to reflect and to overcome our negative

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Speaker 3: feelings about pedophiles and to treat them with the same

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Speaker 3: respect we treat other people with. We should accept that

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Speaker 3: pedophiles are people who have not chosen their sexuality and who,

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Speaker 3: unlike most of us, will never be able to live

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Speaker 3: it out freely. If they want to lead an upright life.

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Speaker 3: We should accept that pedophilia is a sexual preference.

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Speaker 4: Statistics indicate that there will be one or two of

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Speaker 4: you who are struggling with some form of pedophilic interest.

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Speaker 4: These people can't talk about their feelings because they know

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Speaker 4: that they will be hated for it. I truly do

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Speaker 4: believe that every person is longing for love at some

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Speaker 4: point in their life.

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Speaker 1: And what if this.

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Speaker 4: Love that you really wish for will forever be impossible.

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Speaker 4: That must be a really lonely situation.

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Speaker 5: To be in.

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Speaker 4: Yes, from an emotional point of view, I can kind

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Speaker 4: of understand that you would want to eliminate these people

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Speaker 4: from society. However, it doesn't make sense, and that's because

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Speaker 4: we're talking about biology. We're talking about a sexual orientation,

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Speaker 4: something that we simply cannot change. And on top of that,

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Speaker 4: every day new people are born with the same difficulty.

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Speaker 4: So it's not practical to eliminate these people from society.

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Speaker 4: They haven't done anything wrong.

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Speaker 1: This should not be a surprise. How many high profile

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Speaker 1: people flu to epstein out. Nobody made them. They didn't

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Speaker 1: arrive and find out later. I had no idea what

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Speaker 1: was going to happen. These people wanted to do this.

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Speaker 1: They're being protected. There is a powerful cabal protecting them,

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Speaker 1: and I think, by the way, blackmailing them. Joe Biden

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Speaker 1: had been smelling the hair of young girls for a

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Speaker 1: long time. His daughter wrote in her diary, which has

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Speaker 1: now been verified she did write it. It is her

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Speaker 1: diary that he would shower with her when she was

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Speaker 1: a teenager and it was creepy and she wished he

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Speaker 1: would stop. Do you know any other grown men who

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Speaker 1: get button naked in the shower with their teenage daughter, honestly,

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Speaker 1: and a guy that already has it, has a whole history.

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Speaker 1: But he's not the only creature. Est guers.

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Speaker 2: Sweat comes to the phar Sesso gasserplexed.

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Speaker 3: With he's got restraining orders from the middle schools.

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Speaker 1: From where to Mexican.

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Speaker 5: It's Tracy Bird.

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Speaker 1: Hey, y'all, if you drink, don't drive, do the watermelon

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Speaker 1: crawl and listen to the tsar of talk. My buddy

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Speaker 1: Michael Berry.

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Speaker 2: You know.

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Speaker 1: I got an email doing the break from our fellows.

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Speaker 1: I'm a Vietnam veteran. I'm not listening anymore. Your service

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Speaker 1: in Vietnam is appreciated, but I'm not sure how that's

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Speaker 1: relevant to where we're going. Let me see why he's

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Speaker 1: not listening anymore. He's not listening because I said that

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Speaker 1: if you get COVID or die of COVID after having

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Speaker 1: taking the vacts, and that is poetic justice. It's not

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Speaker 1: what I said. I said those who pushed the vacts,

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Speaker 1: that is Fauci and Biden. I do hope they get COVID.

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Speaker 1: I do hope it takes them down. You don't need

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Speaker 1: to tell me that's evil or devilish or not Christian.

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Speaker 1: I understand I have family members who died from taking

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Speaker 1: that shot. I feel pretty passionately about it. You're free

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Speaker 1: to have your opinion. You're free to forgive, forget, justify, judge,

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Speaker 1: but I'm not changing my position. My wife and kids

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Speaker 1: took that stupid thing. You think I want people to

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Speaker 1: die from that. But the bigger issue is not the

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Speaker 1: COVID shot. The bigger issue is this. As I wrote

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Speaker 1: to the guy, you misunderstood what I said. Here's what

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Speaker 1: I said, Here's what I intended. But if you say

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Speaker 1: you're not listening ever again because I said something with

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Speaker 1: which you disagree, I want to be as clear as

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Speaker 1: I possibly can. If I'm left with three people listening,

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Speaker 1: but there are three honest to goodness, truth seeking, honorable, honest,

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Speaker 1: open minded, thoughtful people, I consider that better. I don't

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Speaker 1: listen to other shows. But we've all heard it. We've

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Speaker 1: all heard the pandering, the jingoistic patriotism, the jingoistic manhood.

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Speaker 1: We've all heard it. If the only reason you listen

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Speaker 1: to our show is you agree one hundred percent with

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Speaker 1: what I say, why are you listening honestly for an

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Speaker 1: affirmation of what you already believe? That feels weird. The

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Speaker 1: old line, if we agree on everything, one of us

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Speaker 1: isn't necessary to me. The interesting parts are where we disagree,

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Speaker 1: Why I disagree and show I'm not gonna listen. Look,

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Speaker 1: I know this sounds arrogant, but why not be honest?

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Speaker 1: You not listening is not enough to make a difference.

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Speaker 1: Our show is not sold on ratings. Our ratings are great.

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Speaker 1: Our show is sold on the basis that people who

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Speaker 1: sponsor the show spend a lot of money on it

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Speaker 1: because they know that our listener it's a qualitative not

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Speaker 1: a quantitative buy. They don't want everybody groupon didn't end

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Speaker 1: Groupon didn't fall apart because nobody came to the restaurant.

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Speaker 1: Groupon fell apart because everybody came to the restaurant. It

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Speaker 1: was just all the wrong kind of people. Houston Week

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Speaker 1: is not a bust because people don't come out to

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Speaker 1: eat at a restaurant that would normally be one hundred

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Speaker 1: dollars per person for twenty dollars that goes to charity.

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Speaker 1: Houston Restaurant Week is a bust because you find out

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Speaker 1: that those people coming out there that you're not going

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Speaker 1: to make any money on, they're not samplers. That you

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Speaker 1: want to come back. They're the deal seekers. They eat

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Speaker 1: half their meal and send it back. They show up drunk,

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Speaker 1: they stand up and stagger through the aisles. They argue

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Speaker 1: with your staff, they humiliate your staff. They don't tip,

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Speaker 1: They spill things. They piss all over the floor in

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Speaker 1: the bathroom. The only thing worse than groupon not or

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Speaker 1: the Houston Restaurant week, or groupon not delivering people to

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Speaker 1: your restaurant is they delivered too many of all the

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Speaker 1: wrong kind. What makes our show special is that companies

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Speaker 1: partner with us because they get the kind of people

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Speaker 1: that you you would seek out that special person. How

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Speaker 1: often is it during a transaction that you enjoy the experience.

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Speaker 1: How often is it that you are providing air conditioning

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Speaker 1: services or plumbing or roofing or whatever else and you

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Speaker 1: feel the need when you're done to send me an

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Speaker 1: email because you just talked to the most interesting guy ever.

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Speaker 1: That's where our listener is. You passed up nine houses

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Speaker 1: to get there, and eight of those nine you don't

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Speaker 1: want to do that roof. You do not want to

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Speaker 1: have to argue. You do not want to worry he's

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Speaker 1: going to sue you. You do not want to know

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Speaker 1: where he's going to threaten. You don't where he's gonna

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Speaker 1: call the cops, you don't know, worry he's going to

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Speaker 1: show up or not show up tomorrow. So if you're

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Speaker 1: that person, you got me fed up. You don't get me,

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Speaker 1: And that's okay. I say this all the time. Not

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Speaker 1: every marriage works. Hey, we're not meant to be together.

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Speaker 1: I'm not offering what you're wanting in your wanting what

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Speaker 1: I'm not offering what I am offering you don't want,

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Speaker 1: which is to have your opinions challenged. I'm gonna say

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Speaker 1: things on the air that you might not agree with.

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Speaker 1: I'm gonna say things that you might agree with but

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Speaker 1: don't realize it and can't give voice to it. I'm

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Speaker 1: gonna say things that are gonna upset your wife or

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Speaker 1: your mother, or your secretary or your boss. Know that

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Speaker 1: in advance. That shouldn't come as a surprise. Even though

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Speaker 1: I haven't done it in a little while, because I've

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Speaker 1: gone soft of late. I'm gonna do that and I'm

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Speaker 1: gonna keep doing it, not to provoke, not because I'm

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Speaker 1: a shock job, because I believe the truth is more

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Speaker 1: important than people's feelings. If you can't tell the truth.

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Speaker 1: You can't be honest. If you can't offend, you can't

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Speaker 1: be honest. That was the essence of Thomas Paine's statements.

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Speaker 1: A series of them being completely honest is going to

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Speaker 1: upset people. And if you respond by saying, but I'm

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Speaker 1: going to not listen anymore, good, But I need you

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Speaker 1: to know I'm not listening. Okay, remote, can you redo

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Speaker 1: the role and not call out Bob tomorrow so we

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Speaker 1: don't have him as absent. We just we already know

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Speaker 1: he's moved school district. You're not with us anymore.

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Speaker 5: I grew up seeing and hearing about the horrors that

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Speaker 5: this kind of ideology can break upon a civilization.

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Speaker 1: Michael Gerry. As some of you know, because I talk

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Speaker 1: about my personal life on the air, it's all I

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Speaker 1: got to talk about, and I share how I interact

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Speaker 1: with the policies and politics that we talk about, because

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Speaker 1: at the end of the day, these aren't academic discussions.

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Speaker 2: Right.

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Speaker 1: If the government takes over our health care, that's going

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Speaker 1: to affect you. And just because you're young and healthy

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Speaker 1: and haven't needed health care yet or recently, you don't

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Speaker 1: realize that, and you see it as some sort of

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Speaker 1: arcane or ethereal existential discussion. But that's not where it

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Speaker 1: is for me. I have a brother who died of

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Speaker 1: the clot shot, A perfectly able bodied law enforcement officer

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Speaker 1: with over thirty years who died of the clock shot

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Speaker 1: January twenty fifth, twenty twenty two. My father, since he

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Speaker 1: was twenty years old and had to be discharged for

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Speaker 1: the Coastguard on his deathbed with a severe case of diabetes,

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Speaker 1: and they didn't know how to treat it back then.

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Speaker 1: They sent him home to die, and he read and experimented,

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Speaker 1: and here we are. He's eighty four and still alive,

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Speaker 1: still battling diabetes by the day.

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Speaker 2: He is.

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Speaker 1: In constant contact with doctors, and many of them have

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Speaker 1: told me your dad knows more about diabetes than diabetes

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Speaker 1: doctors do, because in an era before we had proper insulin,

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Speaker 1: he was managing his blood sugar that's unheard of. And

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Speaker 1: he still has his vision in all ten of his

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Speaker 1: fingers and toes well. He's a man of great self

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Speaker 1: discipline and the willingness to experiment on himself and get

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Speaker 1: enough sleep and not drink and you know, do the

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Speaker 1: things that are necessary. And then of course my mother

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Speaker 1: five years younger than him. My father was supposed to

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Speaker 1: go first, and my mother would nurse him until the

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Speaker 1: end of his life. And she up and passes on us.

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Speaker 1: And she ended up having als that basically just eventually

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Speaker 1: took over her body and left her unable to breathe.

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Speaker 1: Her lungs just wouldn't function, and it was a horrible,

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Speaker 1: horrible way to go. She died in hospice at our home.

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Speaker 1: I have been in and out of hospitals just with

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Speaker 1: these things so many times over the last few years

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Speaker 1: that I have come to learn a lot about the

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Speaker 1: medical care system. You know, I had a minor stroke

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Speaker 1: on August first, twenty sixteen. I you know, we've all

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Speaker 1: had our medical issues. I'm much better now about taking

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Speaker 1: care of my health and getting my checkups and all that.

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Speaker 1: But the policy issue of how we deliver healthcare in

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Speaker 1: a marketplace of people trying to heal you and provide

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Speaker 1: wellness and prevent all these things, it's gotten. It's all

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Speaker 1: messed up, and I don't think people really even understand

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Speaker 1: why it's all messed up. And so today I would

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Speaker 1: like to step back from the news of the day

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Speaker 1: and address this. There is a fellow who has been

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Speaker 1: highly recommended when I bring these questions up, named Charles Silver.

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Speaker 1: He is the McDonald Endowed Chair of Civil Procedure at

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Speaker 1: the University of Texas at Austin School of Law. I

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Speaker 1: don't know if he was there when I was there

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Speaker 1: in the mid nineties. I don't know him, but his

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Speaker 1: work has been widely widely discussed, particularly his book Overcharged,

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Speaker 1: Why Americans pay too much for healthcare.

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Speaker 5: Professor Silver, welcome to the program. Thank you, Michael, pleasure

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Speaker 5: to be here.

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Speaker 1: I must first ask you if you were on faculty

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Speaker 1: from ninety three to ninety six when I was there.

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Speaker 2: I was.

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Speaker 5: I started teaching at Texas in nineteen eighty seven.

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Speaker 1: Oh wow, okay, Well, I was Aleno Graula acolyte and

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Speaker 1: I was the first crop. There were two of us

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Speaker 1: that were sent to England to get an LLM degree,

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Speaker 1: So I was kind of checked out after my second year.

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Speaker 1: Once I had my offer, I was kind of checked out.

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Speaker 1: But I'm sorry that I never met you. I had

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Speaker 1: a wonderful experience at the University of Texas School of Law.

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Speaker 1: It's a great university law school, and I am the

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Speaker 1: better for it. So I think a lot of you

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Speaker 1: for being on factory there. It's a great institution. Let's

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Speaker 1: thank you.

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Speaker 5: I'm sorry I didn't get to meet you when you

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Speaker 5: were a student.

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Speaker 1: Indeed, the book overcharged why Americans pay too much for healthcare?

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Speaker 1: If somebody says, Michael, I'm going to come back and

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Speaker 1: listen on the podcast later, but give me one minute answer,

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Speaker 1: and then let's get granular and dig into this, what's

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Speaker 1: the one minute answer as to why we pay too

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Speaker 1: much for healthcare?

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Speaker 5: The one minute answer, we rely far too heavily on

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Speaker 5: third party payment arrangements, which means insurance companies, Medicare, Medicaid,

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Speaker 5: trycare Va, whatever they happen to be, instead of paying

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Speaker 5: for healthcare directly the same way we pay for pretty

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Speaker 5: much everything else, food, cars, housing. You know, we we

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Speaker 5: pay for the vast majority of things directly, meaning we

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Speaker 5: pay for them ourselves, and we don't have the problem

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Speaker 5: of excessive spending or inflation or costs or hidden bills

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Speaker 5: or surprise bills or phony charges.

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Speaker 2: All that works really well.

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Speaker 5: The one exception is the healthcare sector, where we rely

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Speaker 5: very very extensively on third parties to pay for things,

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Speaker 5: and that just screws everything up.

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Speaker 2: Now, the other thing is we have way.

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Speaker 5: Too much governmental involvement in the healthcare sector. There are

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Speaker 5: lots and lots of regulations that make things worse for consumers.

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Speaker 5: By and large, the regulations have the purpose of protecting

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Speaker 5: the producers, not the consumers, So we should do a

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Speaker 5: lot less in that way.

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Speaker 1: You did that. You were technically finished at fifty eight seconds.

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Speaker 1: You added an addendum to the end that I will

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Speaker 1: admit I will it is admissible in this case. But

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Speaker 1: you achieved the fifty eight seconds. I'm quite impressed that

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Speaker 1: you did that. So let's start drilling down on these things.

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Speaker 1: I got a minute left in this segment, but I

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Speaker 1: have dedicated some time to talk about this because I

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Speaker 1: think a lot of people are frustrated, especially when they

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Speaker 1: start getting all these bills and they go to emergency

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Speaker 1: room and the place is packed, and then they can't

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Speaker 1: get in to see a doctor, and then they wonder,

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Speaker 1: you know, why does something cost ten thousand dollars that

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Speaker 1: took twenty minutes. It just there's nothing else that requires this.

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Speaker 1: It all seems so frustrating to people, and I would

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Speaker 1: like to drill down and get into the actual reasons

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Speaker 1: why this works. Let me start by prefacing, and we'll

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Speaker 1: get to this in the next segment. Because I don't

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Speaker 1: want to have to cut you off. I want to

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Speaker 1: first talk about what if we were to do a

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Speaker 1: zero based budget, we were to go back to John

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Speaker 1: Locke's state of nature, and let's start all over and

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Speaker 1: have a cash only health delivery system. Let's do away

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Speaker 1: with insurance, and let's talk about who the winners and

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Speaker 1: losers out of that would be. And more important, if

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Speaker 1: I'm a consumer of health services, because I don't believe

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Speaker 1: that healthcare is a right. If I'm a consumer of

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Speaker 1: health services, would this be better or worse for me?

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Speaker 1: So hang tight right there. Our guest is Professor Charles Silver.

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Speaker 1: I encourage you to read the book Overcharged, Why Americans

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Speaker 1: Pay Too Much for Healthcare? Coming up? This is the

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Speaker 1: Michael Berry Show, Locked and Loaded, Loaded. Professor Charles Silver

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Speaker 1: is our guest, and as promised at the end, I

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Speaker 1: given him a moment to consider. Professor, what if we

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Speaker 1: go back the book is Overcharged, Why Americans Pay too

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Speaker 1: Much for healthcare? What if we did away with all

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Speaker 1: insurance and we went cash only? How would that change things?

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Speaker 5: It would change a lot of things for the better,

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Speaker 5: but some things for the worse, So a lot of

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Speaker 5: things would be better, you know, we wouldn't have to

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Speaker 5: worry about things like surprise medical bills where you don't

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Speaker 5: even know what something is going to cost when you

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Speaker 5: get the service delivered. There's actually a very large retail

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Speaker 5: health sector. So if you want to get laser by surgery,

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Speaker 5: for example, you have to pay for that yourself because

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Speaker 5: it's not covered by insurance typically, But you know what,

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Speaker 5: it's actually very affordable and the price for laser surgery.

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Speaker 5: Are you ready for this? The price has substantially declined

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Speaker 5: since LASIK was developed, and it's gotten much better too.

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Speaker 5: There are new forms of LASIK and all that has

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Speaker 5: happened because there is no overlay of insurance. Where in

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Speaker 5: the healthcare sector, except in the private payment sector, can

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Speaker 5: one find prices that have declined now. There are no

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Speaker 5: hospital services that I'm aware of that cost less now

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Speaker 5: than they used to. But in the private sector where

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Speaker 5: we purchase cosmetic surgery, I mentioned LASC. There's also the

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Speaker 5: Surgery Center of Oklahoma, which operates on a cash basis.

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Speaker 5: But there are lots of services that people can buy directly,

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Speaker 5: and those things that part of the market works incredibly well.

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Speaker 5: As I said, we don't have surprise bills. Everybody knows

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Speaker 5: what they're going to pay before the service is delivered,

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Speaker 5: and nobody gets billed for more than the price.

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Speaker 2: The prices are posted. We don't have to have you.

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Speaker 5: In the hospital sector, we have this federal Transparenty rule

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Speaker 5: transparency rule that hospitals routinely ignore that's supposed to require

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Speaker 5: them to post their prices. But in the retail sector

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Speaker 5: we don't have that, and everybody posts their prices anyway.

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Speaker 5: So a lot of things would work better if we

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Speaker 5: did that, But the one thing that would work worse

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Speaker 5: would be emergencies where you're facing a risk of a

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Speaker 5: catastrophic cost that you know people just can't afford to

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Speaker 5: bear on their own. That's where insurance has a role

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Speaker 5: to play. Catastrophic costs.

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Speaker 1: Yeah, Professor, I have long advocated that we should if

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Speaker 1: people would understand, for instance, I only have liability insurance

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Speaker 1: on my vehicles, and people say you have to No, No,

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Speaker 1: I pay cash for my vehicles. The only reason people

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Speaker 1: are over insured in most cases is because the person

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Speaker 1: holding the loan wants you to have insurance for more

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Speaker 1: than the value of what they're of what they've loaned

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Speaker 1: you money for in case the thing gets burned down

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Speaker 1: or trash, they want their money once. You don't have

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Speaker 1: to do that. In my opinion, I'm a safe driver.

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Speaker 1: I've never met an insurance claim. In my opinion, it's

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Speaker 1: a bad business deal. So what I tell people to

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Speaker 1: do is get catastrophic health insurance so when it hits

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Speaker 1: fifteen thousand and up, it's good. And then pay cash

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Speaker 1: and you'll be shocked how many doctors will discount what

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Speaker 1: you get and they're happy to have the cash. I

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Speaker 1: go to a doctor named Mary Tally Boden for all

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Speaker 1: my upper respiratory stuff, and she's a cash only doctor,

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Speaker 1: which is you know a lot of people are going

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Speaker 1: to and you go in and you make your payment

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00:28:11,440 --> 00:28:15,560
Speaker 1: and it's insanely cheap, and then there's no documentation. Later

434
00:28:15,640 --> 00:28:18,879
Speaker 1: there's no you know, insurance letter arrives. Do we pay this? No,

435
00:28:19,000 --> 00:28:21,520
Speaker 1: we wait to pay this. She's happier, she doesn't have

436
00:28:21,560 --> 00:28:23,840
Speaker 1: to have a bunch of billion clerks. You literally pay

437
00:28:23,880 --> 00:28:26,520
Speaker 1: the same way if you bought yogurt there. I think

438
00:28:26,600 --> 00:28:27,479
Speaker 1: this is the answer.

439
00:28:27,520 --> 00:28:31,280
Speaker 5: Professor, Well, I agree with you because I go to

440
00:28:31,320 --> 00:28:35,240
Speaker 5: a doctor who works on the same basis. So my doctor,

441
00:28:35,280 --> 00:28:39,040
Speaker 5: I pay a monthly subscription fee too, but I can

442
00:28:39,080 --> 00:28:41,440
Speaker 5: go as many times as I want.

443
00:28:42,120 --> 00:28:43,120
Speaker 2: You know, I don't need to go.

444
00:28:43,120 --> 00:28:45,680
Speaker 5: All the time, fortunately, but if I need to go,

445
00:28:46,200 --> 00:28:48,360
Speaker 5: she usually can see me either that day or the

446
00:28:48,360 --> 00:28:53,280
Speaker 5: next day, and I get some tests performed in house

447
00:28:53,360 --> 00:28:58,120
Speaker 5: at no charge. And it's a great working arrangement.

448
00:28:58,360 --> 00:28:59,400
Speaker 2: Like you, I don't get it.

449
00:29:00,000 --> 00:29:03,080
Speaker 5: Don't worry about my insurance company, you know, not paying

450
00:29:03,160 --> 00:29:05,720
Speaker 5: for something. So I think I agree with you. The

451
00:29:05,800 --> 00:29:09,800
Speaker 5: cash payment is a very good approach for basic healthcare.

452
00:29:12,840 --> 00:29:17,480
Speaker 1: So let's have a little history lesson. Professor Charles Silver

453
00:29:17,600 --> 00:29:20,680
Speaker 1: is our guest. The book is called Overcharged, Why Americans

454
00:29:20,680 --> 00:29:24,080
Speaker 1: paid too much for healthcare. Let's go back to wherever

455
00:29:24,160 --> 00:29:26,400
Speaker 1: the starting point is. You want it to be, nineteen

456
00:29:26,480 --> 00:29:29,920
Speaker 1: fifty or nineteen seventy. Where did it start going wrong?

457
00:29:30,000 --> 00:29:32,800
Speaker 1: Because we all know it's wrong. Now, where did it

458
00:29:32,880 --> 00:29:33,760
Speaker 1: start going wrong?

459
00:29:35,040 --> 00:29:37,480
Speaker 5: Oh, that's easy. It started going wrong in the mid

460
00:29:37,560 --> 00:29:42,680
Speaker 5: nineteen sixties when Medicare and Medicaid came online. In my book,

461
00:29:43,760 --> 00:29:49,840
Speaker 5: I show how doctors and hospitals fees changed after Medicare

462
00:29:49,880 --> 00:29:53,840
Speaker 5: and Medicaid took effect in nineteen sixty five, and basically

463
00:29:53,880 --> 00:29:58,200
Speaker 5: both of those statutes initially let doctors and hospitals charged

464
00:29:58,640 --> 00:30:03,600
Speaker 5: whatever they wanted services, and so not surprisingly, they started.

465
00:30:03,280 --> 00:30:05,080
Speaker 2: Raising their rates immediately.

466
00:30:06,080 --> 00:30:09,600
Speaker 5: I mean, really immediately after the enactment of those programs,

467
00:30:10,160 --> 00:30:13,400
Speaker 5: we were to set with health care inflation that exceeded

468
00:30:13,440 --> 00:30:16,880
Speaker 5: the real growth rate of the GDP, and we have

469
00:30:17,000 --> 00:30:22,160
Speaker 5: been struggling with healthcare inflation ever since. But everything about

470
00:30:22,200 --> 00:30:24,560
Speaker 5: the arrangement is wrong. I mean, who in their right

471
00:30:24,640 --> 00:30:29,160
Speaker 5: minds let's people who are selling things set their own

472
00:30:29,200 --> 00:30:33,040
Speaker 5: prices without any market constraints. I mean, that's a recipe

473
00:30:33,040 --> 00:30:36,920
Speaker 5: for disaster, right, And then, of course that couldn't last forever.

474
00:30:37,600 --> 00:30:40,240
Speaker 5: So the government eventually did get into the price setting

475
00:30:40,360 --> 00:30:43,840
Speaker 5: business in Medicare and Medicaid. But of course we all

476
00:30:43,880 --> 00:30:47,520
Speaker 5: know that government price setting is terrible. It never works properly.

477
00:30:47,560 --> 00:30:52,520
Speaker 5: It's really hard to set good prices, to set prices accurately,

478
00:30:53,200 --> 00:30:57,120
Speaker 5: and moreover the government really doesn't have the right set

479
00:30:57,200 --> 00:31:00,680
Speaker 5: of interests. You know, I want it's not just the

480
00:31:00,720 --> 00:31:03,160
Speaker 5: price that matters to me, it's the convenience. Right, How

481
00:31:03,200 --> 00:31:05,000
Speaker 5: long do I have to wait to see my doctor?

482
00:31:05,480 --> 00:31:08,080
Speaker 5: How friendly is my doctor? How good is my doctor.

483
00:31:08,120 --> 00:31:10,960
Speaker 5: There are all these things. Different doctors should have different prices,

484
00:31:13,120 --> 00:31:15,800
Speaker 5: and markets can work all that stuff out, but governments

485
00:31:15,920 --> 00:31:19,440
Speaker 5: just are notoriously unable to do that, and so as

486
00:31:19,480 --> 00:31:24,120
Speaker 5: a result, we've had this terrible system, and because it's

487
00:31:24,160 --> 00:31:29,240
Speaker 5: so terrible, it's constantly in need of patching. I mean,

488
00:31:29,400 --> 00:31:32,120
Speaker 5: every time I turn around, there's a new bill, a

489
00:31:32,160 --> 00:31:34,960
Speaker 5: new proposal being put on the table for some kind

490
00:31:34,960 --> 00:31:38,560
Speaker 5: of regulation to fix a problem that only exists because

491
00:31:38,600 --> 00:31:41,920
Speaker 5: the government created it. It's never going to be fixed.

492
00:31:42,600 --> 00:31:46,120
Speaker 5: It's impossible to fix it. We really need to just

493
00:31:46,400 --> 00:31:50,720
Speaker 5: scrap these arrangements and go back to a simple cash

494
00:31:50,760 --> 00:31:55,440
Speaker 5: based system for fundamental care, and then things will start.

495
00:31:55,480 --> 00:31:58,560
Speaker 5: It will immediately be out of the spending crisis. The

496
00:31:58,720 --> 00:32:03,640
Speaker 5: prices will moderate because hospitals and doctors and drug companies

497
00:32:03,640 --> 00:32:05,920
Speaker 5: and all that will have to deal with the realities

498
00:32:05,960 --> 00:32:09,280
Speaker 5: of the limited budgets of consumers. They'll also have to

499
00:32:09,320 --> 00:32:13,360
Speaker 5: face competition. That's hugely important. You know, one I mentioned

500
00:32:13,360 --> 00:32:16,040
Speaker 5: the retail health sector. You know, one of the reasons

501
00:32:16,120 --> 00:32:19,360
Speaker 5: lasik is cheap is because there are a lot of

502
00:32:19,440 --> 00:32:22,880
Speaker 5: laser providers and any ophthalmologists can enter the field who

503
00:32:22,880 --> 00:32:26,440
Speaker 5: wants to so there's a lot of competition, and competition

504
00:32:26,560 --> 00:32:29,640
Speaker 5: is good for consumers. So we need to get rid

505
00:32:29,720 --> 00:32:35,840
Speaker 5: of these competition frustrating regulations. Let's increase the supply. Let

506
00:32:35,960 --> 00:32:39,480
Speaker 5: you know, foreign doctors who can pass American exams come

507
00:32:39,520 --> 00:32:41,560
Speaker 5: in and treat people. We need to just open the

508
00:32:41,560 --> 00:32:46,400
Speaker 5: floodgates for providers because we have this artificially created shortage.

509
00:32:46,600 --> 00:32:50,320
Speaker 5: You know, that's one of the waves that doctors and

510
00:32:50,400 --> 00:32:56,479
Speaker 5: hospitals have increased their revenues. It's by preventing new entrants

511
00:32:56,480 --> 00:32:59,680
Speaker 5: from coming in and you know, outcompete. So we have

512
00:32:59,680 --> 00:33:00,480
Speaker 5: to get of all that.

513
00:33:01,440 --> 00:33:05,280
Speaker 1: Professor Charles Silver at the University of Texas School of Law,

514
00:33:05,440 --> 00:33:08,920
Speaker 1: my alma mater, is our guest. His book is Overcharged.

515
00:33:09,760 --> 00:33:15,640
Speaker 1: Why Americans pay to dang much for healthcare? I added

516
00:33:15,680 --> 00:33:17,800
Speaker 1: the dang, but I think we all feel it more

517
00:33:17,840 --> 00:33:19,920
Speaker 1: with Professor Silver coming up