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Speaker 1: Hi, This is new due to the virus. I'm recording

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Speaker 1: from home, so you may notice a difference in audio

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Speaker 1: quality on this episode of News World. One in five

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Speaker 1: Americans now has medical debt and collections, and rising healthcare

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Speaker 1: costs today threatening every small business in America. In his

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Speaker 1: recent book The Price We Pay, What Broke American Healthcare

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Speaker 1: and How to fix It, Doctor Marty McCarry, one of

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Speaker 1: the nation's leading healthcare experts, travels across America and details

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Speaker 1: why healthcare has become a bubble, Drawing from on the

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Speaker 1: ground stores, his research, and his own experience, The Price

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Speaker 1: We Pay paints a vivid picture of price couching middlemen

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Speaker 1: in a series of elucid money games. In need of

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Speaker 1: a serious shaker, Doctor McCarey shows how so much of

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Speaker 1: healthcare spending goes to things that have nothing to do

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Speaker 1: with health, and what you can do about it. Doctor

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Speaker 1: McCarry challenges the medical establishment to remember medicine's noble heritage

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Speaker 1: of caring for people when they are vulnerable. The Price

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Speaker 1: We Pay offers a roadmap for everyday Americans and business

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Speaker 1: leaders to get a better deal in their healthcare and

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Speaker 1: profiles the disruptors who are innovating medical care. The movement

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Speaker 1: to restore medicine to its mission is alive and will

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Speaker 1: a mission that can rebuild the public trust and save

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Speaker 1: our country from the crushing cost of health care. As

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Speaker 1: someone who has long been an advocate for healthcare reform

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Speaker 1: and price transparency, I am pleased to welcome my guest,

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Speaker 1: doctor Marty McCarry. He is a surgical oncologist specializing in

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Speaker 1: minimally invasive surgery and a professor of health policy and

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Speaker 1: Management at the Johns Hopkins University School of Medicine. He

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Speaker 1: speaks nationally on disruptive innovation and healthcare. Doctor Marty McCarry,

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Speaker 1: thank you for taking the time to help educate all

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Speaker 1: of us and the work you've done, the things you've learned,

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Speaker 1: what initially got you intrigue with this whole notion of

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Speaker 1: finding the people who are breaking through and helping with costs.

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Speaker 1: Good to be with you, Nute. You know, I think

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Speaker 1: that people have been frustrated with healthcare for a while now.

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Speaker 1: Costs are burdening every family and business, and it's really

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Speaker 1: one of the drivers of the US being less competitive globally.

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Speaker 1: But nobody really understands why, right and we blame little things.

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Speaker 1: And what was clear to me from my academic pursuits

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Speaker 1: at Johns Hopkins in health policy was that the fundamental

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Speaker 1: problem in healthcare is we have non competitive markets. And

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Speaker 1: you can try to set rules in those non competitive markets,

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Speaker 1: but the fundamental problem is they're not competitive. And if

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Speaker 1: you create competition, if you enable it, that takes care

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Speaker 1: of a lot of the waste and a lot of

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Speaker 1: spending has nothing to do with healthcare. But at the

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Speaker 1: same time, we have great people in healthcare, even in

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Speaker 1: these middleman industries within healthcare, that are saving money out

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Speaker 1: of the system. So how do you explain the fact

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Speaker 1: you've got good people working in this bad system? And

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Speaker 1: so I wanted to talk to those people and get

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Speaker 1: their perspectives and ask them where they think the waste

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Speaker 1: is and why healthcare costs so much. And in the

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Speaker 1: end I really left convinced that we have great people

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Speaker 1: working in American healthcare, but the system is set up

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Speaker 1: wrong and the solution is embarrassingly simple. So that was

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Speaker 1: the reason I wanted to chronicle stories. As you talk policy,

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Speaker 1: as you know better than anyone new, we have a

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Speaker 1: very opinionated mentality. Look at the way people get entrenched

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Speaker 1: positions around coronavirus, which is something that's evolving and we're

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Speaker 1: learning more about. And so we have this nation of

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Speaker 1: strong opinions, oftentimes with little expertise, but when you speak

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Speaker 1: from personal experience, that's very hard to argue with. And

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Speaker 1: I can speak as a physician and I can tell

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Speaker 1: those stories and did in this book of folks in

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Speaker 1: the broker industry telling me the story that no one's

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Speaker 1: talking about, that we need to be talking about is

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Speaker 1: how businesses are getting ripped off on their health benefits,

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Speaker 1: and story after stories, I wanted to share those stories.

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Speaker 1: And that's really the basis for doing this project. Are

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Speaker 1: you did a couple of studies where you ask doctors

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Speaker 1: and others what they thought the real cost of just

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Speaker 1: of an effective, efficient healthcare system will be and it's

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Speaker 1: a pretty big drop from overcome and spending. Could you

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Speaker 1: sort of walk through that from Hunter? The reason healthcare

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Speaker 1: costs so much From all of the research I've done

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Speaker 1: at Johns Hopkins and for this book, it's very clear

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Speaker 1: it's three factors. Number One, pricing failures that enables price

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Speaker 1: gouging and all this kind of waste in the system.

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Speaker 1: Number Two, it's doing unnecessary stuff. We ask doctors in

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Speaker 1: a national survey, what percent of medical care in your

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Speaker 1: observation is unnecessary excluding your own practice, simply looking around you,

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Speaker 1: and they said twenty one percent was the average answer.

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Speaker 1: They broke it down like twenty five percent of medications

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Speaker 1: and twenty two percent of diagnostic tests, eleven percent of

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Speaker 1: surgical procedures. When people in an industry are telling you

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Speaker 1: that one in five things they are doing is entirely unnecessary,

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Speaker 1: we need to listen to them. We've prescribed one opioid

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Speaker 1: prescription for every American three years ago. That was just

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Speaker 1: one medication that we had a wake up call on.

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Speaker 1: There's a lot of other medications. The average personnel in

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Speaker 1: the United States is on four medications. The average senior

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Speaker 1: is on seven. I mean, we live in the most

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Speaker 1: over medicated, the most disabled, the most obese and comorbid

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Speaker 1: generation in the history of the world. And at some

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Speaker 1: point we have to ask, are we going to simply

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Speaker 1: have a reactionary healthcare system that throws meds at people

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Speaker 1: in ten fifteen minutes of ointments, or are we going

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Speaker 1: to have a proactive system that addresses these underlying causes.

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Speaker 1: And that third driver is care coordination is so poor,

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Speaker 1: And I think the most exciting thing I've learned in

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Speaker 1: the last five years was the movement of relationship based

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Speaker 1: medicine chen med for example in Florida, taking care of

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Speaker 1: seniors through Medicare advantage, doing whatever it takes to take

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Speaker 1: care of them, visiting them at home, putting them in

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Speaker 1: a program to educate them about how to eat well,

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Speaker 1: giving them a ride to their specialist appointment. Dropping the

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Speaker 1: burden of billing and coding from doctors so they can

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Speaker 1: just take care of people and guess what their outcomes

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Speaker 1: are phenomenal, They're much better. How do you initially figure

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Speaker 1: out where to look or what to ADK Since I

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Speaker 1: worked with the World Health Organization years ago on something

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Speaker 1: called the Surgery Checklist and that became popularized in a

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Speaker 1: book by a tool Gawandhi, I've had a lot of

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Speaker 1: opportunities to speak. And when you speak at these conferences,

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Speaker 1: you have an incredible opportunity to listen to everyday docks

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Speaker 1: running a small rural hospital. What are your struggles, what

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Speaker 1: could be fixed? And when you listen, it's amazing what

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Speaker 1: you learn. And so talking to folks who are trying

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Speaker 1: to find the cure for cancer within a pharmaceutical company.

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Speaker 1: Are they good? Are they bad? If we can get

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Speaker 1: rid of these labels and listen to people and have

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Speaker 1: them tell you what they believe the solutions are, it's

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Speaker 1: amazing what's out there. For example, in pharma, they universally said,

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Speaker 1: look at the middleman, the pharmacy benefit manager, this middleman space,

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Speaker 1: and how they're requiring us to pay these pay to

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Speaker 1: play fees just to be listed in their formularies. It's

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Speaker 1: not fair. We have to build in that price into

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Speaker 1: the price of the drug. And so you start hearing

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Speaker 1: these stories and I think ultimately you realize that it's

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Speaker 1: the lack of transparency that is really at the heart

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Speaker 1: of a lot of this stuff. Look, if we had

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Speaker 1: to shop for airline tickets with no prices on those websites,

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Speaker 1: airlines would be gouging us all over the place if

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Speaker 1: they had to bill us after the flight. And so

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Speaker 1: these are the opportunities right now. How can we create

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Speaker 1: the nutrition labels for healthcare? The industry argued, we can't

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Speaker 1: have nutrition labels. Hey, we're gonna have to increase the

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Speaker 1: price of food. People are going to be laid off.

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Speaker 1: These old arguments guess what. We got nutrition labels that

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Speaker 1: were not mass layoffs. They're not massive spikes and food prices.

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Speaker 1: But now we enabled competition and competition around ingredients, and

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Speaker 1: that's how we drove health in the area of food

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Speaker 1: for over a decade. Now, once you began pulling the string,

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Speaker 1: you begin finding all sorts of different things. There were

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Speaker 1: different patterns in different part of the health system. I

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Speaker 1: have to say, I've looked at this stuff for a

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Speaker 1: very long time, and some of your discoveries make a

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Speaker 1: lot of sense, and I believe them. But some of

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Speaker 1: them are so common sensical and so troubling that I

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Speaker 1: was really sort of shocked by them. I think the

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Speaker 1: one I was most shocked about NEWT was the game

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Speaker 1: of inflating medical prices for the purposes of offering secret

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Speaker 1: discounts to different insurance companies and groups. And that game

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Speaker 1: sounds like it has no casualties, that it's a system

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Speaker 1: that works. But when I approached hospital CEOs and said, hey,

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Speaker 1: this patient went to your hospital by the way, sat

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Speaker 1: in the emergency room for two hours, got an IV.

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Speaker 1: I know the medical codes, I know the billing process,

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Speaker 1: I know the medicine. Okay, how much do you think

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Speaker 1: that two hour IV cost? And they would embarrassingly think,

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Speaker 1: I don't know two thousand dollars. I said, no, it's

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Speaker 1: six thousand dollars. And you ought to be ashamed of

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Speaker 1: yourself because as patient went to collections and was sued

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Speaker 1: by your hospital, and immediately they say, oh my gosh,

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Speaker 1: that's wrong. I can't believe that I had no idea

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Speaker 1: I'm going to forgive this bill. And then I started

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Speaker 1: asking the question, how often does this occur? And is

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Speaker 1: it that we have diabolical people in healthcare trying to

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Speaker 1: ruin the lives of low income folks that can't afford

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Speaker 1: their bills? Are they just disconnected? And I left convinced

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Speaker 1: they were just simply disconnected. And so if you could

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Speaker 1: tell these stories, and what I discovered was this pattern

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Speaker 1: of about twenty to thirty percent of US hospitals that

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Speaker 1: when after patients viciously in court to garnish their wages,

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Speaker 1: put leans on their homes if they can't afford these

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Speaker 1: inflated bills simply because they were paying an honest price.

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Speaker 1: When you go to a restaurant and you say can

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Speaker 1: I see the menu, they don't say, who's your employer. Okay, well,

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Speaker 1: this is the menu for you, and you might be

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Speaker 1: paying five times what the next table is paying for

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Speaker 1: the same hamburger, but you are contractually bound to not

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Speaker 1: be able to see the other prices. That's what we

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Speaker 1: have in healthcare. So it became clear to me that

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Speaker 1: we've got good people. We just got to let the

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Speaker 1: markets work. The University of Iowa study looking at coronary

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Speaker 1: bypass surgery surveyed like one hundred hospitals from only fifty

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Speaker 1: three game a price, and the prices ranged from forty

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Speaker 1: four thousand to four hundred and forty eight thousand. Now,

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Speaker 1: my hundred, there's no direct correlation of quality. As you know,

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Speaker 1: I've been a big advocate of transparency and insisting that

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Speaker 1: the prices get posted in a way that people can

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Speaker 1: genuinely shot. I mean, wouldn't the four hundred and forty

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Speaker 1: eight thousand dollars hospital have a big problem? He should

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Speaker 1: be embarrassed at that price. I mean, that's an absurd price,

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Speaker 1: and that price came from a hospital that doesn't do

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Speaker 1: particularly exceptional in cardiac surgery outcomes. Cardiac surgery is one

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Speaker 1: of the few areas of medicine where quality metrics are

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Speaker 1: very mature, they're collected around the country, they're publicly reported,

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Speaker 1: and so that study was entirely enabled by the transparency

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Speaker 1: and that one operation in the entire field of medicine,

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Speaker 1: that was only one operation, and people have no idea,

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Speaker 1: And often times the hospitals have been hiding behind this

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Speaker 1: argument that oh, well, we provide a lot of charity care. Well,

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Speaker 1: guess what, almost every hospital in the country provides a

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Speaker 1: lot of charity care, and that charity care is often

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Speaker 1: supported and there's often a lot of taxpayer dollars and

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Speaker 1: donations that go to that charity care. So the idea

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Speaker 1: that we have to charge ten times what the other

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Speaker 1: hospital charges in order to support our charity care is

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Speaker 1: not supported by the data. Someone at Google, one of

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Speaker 1: the executives, had read my book The Price We Pay,

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Speaker 1: and said, I get this call a lot. We want

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Speaker 1: you to come and talk to us and explain to

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Speaker 1: us what we can be doing to fix this problem

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Speaker 1: and what we can do to get a better deal

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Speaker 1: on our own healthcare benefits. Well, I said, you guys

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Speaker 1: are Google. You have an incredible platform to create public

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Speaker 1: accountability without any government regulation involvement. When somebody types in

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Speaker 1: the name of a hospital instead of just putting up

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Speaker 1: the name and the address and the phone number. Why

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Speaker 1: don't you put up the name, the address, the phone number,

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Speaker 1: their average price markup the leaf Frog quality score, and

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Speaker 1: whether or not they perform on these five billing quality metrics,

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Speaker 1: including whether or not they sue patients. Billing quality is

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Speaker 1: medical quality? Explain that what do you mean We publish

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Speaker 1: an article in JAMMA are leading medical journals saying we

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Speaker 1: have to measure billing quality like we measure medical complications.

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Speaker 1: When you come out of a hospital, you can be

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Speaker 1: harmed medically, or you can be harmed financially. Financial toxicity

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Speaker 1: is a medical complication. And so when you come out

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Speaker 1: burdened with hundreds of thousands of dollars of bills for

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Speaker 1: services that were not amergent, they were simply not disclosed

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Speaker 1: to you in terms of a price beforehand, even though

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Speaker 1: they could have, and you leave with that, that's a

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Speaker 1: part of the outcome of the patient. And so when

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Speaker 1: we've ruin someone's life financially, we're violating our sacred oath.

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Speaker 1: And at minimum, we should be giving people choices. We

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Speaker 1: should be giving them the option. And if it turns

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Speaker 1: out that if you deliver a baby in Boston, you

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Speaker 1: can go to a hospital that charges forty one thousand

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Speaker 1: dollars or six thousand dollars for the exact same, uncomplicated delivery,

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Speaker 1: but you have no idea what you're walking into. Can

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Speaker 1: we empower consumers and proxy shoppers of consumers who are

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Speaker 1: employers and health plans to be enabled with information so

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Speaker 1: that they can go to hospitals with not only low

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Speaker 1: complication rates, but with low financial complication rates. Why couldn't

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Speaker 1: that be done on the consumer side, Why couldn't you

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Speaker 1: have a patience website where people who just basically rate

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Speaker 1: their experiences. It's in progress and one of the most

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Speaker 1: exciting things I'm a part of is a website called

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Speaker 1: sesame Care. There's another one called md save that was

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Speaker 1: started by former centator Bill Frist and some others. These

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Speaker 1: sites are trying to become the Kayaks and travelocities and

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Speaker 1: expedients of healthcare. Price transparency does usher in quality transparency.

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Speaker 1: If there's two TVs in town and one is sold

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Speaker 1: for five hundred and the other one for five hundred

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Speaker 1: and fifty dollars, your brain immediately asks, well, what are

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Speaker 1: the differences? What are the specs and the experience and

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Speaker 1: the quality. If there's one TV, your brain just thinks

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Speaker 1: do I buy it or not? And so price transparency

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Speaker 1: will usher in quality transparency. You even logically went to

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Speaker 1: that conclusion when you saw the variation in heart surgery prices.

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Speaker 1: Once forty eight thousand dollars the other's four hundred and

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Speaker 1: forty eight thousand dollars. Tell me about the difference, and

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Speaker 1: it turns out there was no difference in that case.

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Speaker 1: So to one extent, have the Trump administration's efforts to

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Speaker 1: require transparency, which of course the hospitals properly sued, to

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Speaker 1: what extent has that been a step in the right direction.

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Speaker 1: It's a game changer. It's the biggest news in healthcare.

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Speaker 1: I think in about a decade. When I first met

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Speaker 1: with folks at the White House, and the White House

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Speaker 1: asked what should we be doing on healthcare? What is

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Speaker 1: the biggest impact we can make and don't worry about

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Speaker 1: the special interests, just tell us what you believe to

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Speaker 1: be the biggest game changing thing. And we said, convert

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Speaker 1: non competitive markets to competitive markets. Well I was so impressed.

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Speaker 1: I mean, the staff there, the people, they basically said,

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Speaker 1: we want to do this, and they pushed ahead and

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Speaker 1: I was so blown away, and when they finally made

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Speaker 1: the announcement, I couldn't believe it. That night, I watched

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Speaker 1: the nightly news after having the privilege of standing with

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Speaker 1: the President and Secretary Azar and Sem and others for

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Speaker 1: this historic moment to convert non competitive markets to competitive

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Speaker 1: markets through required price transparency, not of charge master prices,

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Speaker 1: not just sticker prices, but real prices. That is, tell

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Speaker 1: us what the insurance discount is that you have with

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Speaker 1: the insurance companies. No more secret games, put it all

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Speaker 1: on the table. Amazing reform. That night on the evening news,

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Speaker 1: no coverage of the price transparency rule, but you had

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Speaker 1: this incredible moment and no coverage of it. People in

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Speaker 1: healthcare were not even following it. And then the hospitals

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Speaker 1: who said, look, we're going to sue. There's no way

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Speaker 1: we're turning this over. They argued that it would confuse

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Speaker 1: patients to have prices and that it would lead to

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Speaker 1: non competitive markets. And I thought, is this a Jedi

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Speaker 1: mind trick? Is this is laughable? They're in a free

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Speaker 1: fall in hospitals, who I love, We're just in this

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Speaker 1: bully mode of a trade organization that we're going to

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Speaker 1: block anything that we have to do. You know that

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Speaker 1: mentality well from all the folks that have met with

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Speaker 1: you over the years. And they filed the lawsuit on Monday.

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Speaker 1: The announcement was Friday. If they could have filed it

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Speaker 1: on Saturday, they would They filled it on Monday, went

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Speaker 1: to court. Judge threw it out a couple of weeks ago,

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Speaker 1: just saying this is ridiculous. Through it way out, comments

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Speaker 1: were incredible. You ought to be ashamed of yourselves kind

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Speaker 1: of verdict. And so this is going to take effect

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Speaker 1: in January. I think it's going to be a game changer.

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Speaker 1: So when you talk about non competitive markets, what does

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Speaker 1: that mean? So right now, if you're an employer and

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Speaker 1: your employees are delivering babies at two different hospitals in

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Speaker 1: New York, one charges six thousand dollars, the other I

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Speaker 1: won't name them, but let's just say they're one of

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Speaker 1: the prominent systems seventy thousand dollars. You may want to

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Speaker 1: steer your employees to one that charges six thousand because

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Speaker 1: the experiences and the quality are equal. If there worth

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Speaker 1: seventy thousand, by all means, go there. But they're not.

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Speaker 1: It's the same doctors a lot of times, by the way,

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Speaker 1: rotating at different hospitals, and so you can't see those

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Speaker 1: things that in terms companies say, look, well, you're contractually

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Speaker 1: bound not to see any prices. These are our proprietary

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Speaker 1: contracts and you can't see them. This price transparency rule

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Speaker 1: by President Trump says no more of that. That's all

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Speaker 1: now public domain. It's going to really move employers and

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Speaker 1: proceeds shoppers to say, hey, look, you can deliver at

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Speaker 1: any place you want, but if you go to the

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Speaker 1: six thousand dollars hospital as an employer, we're going to

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Speaker 1: pay for diapers and wipes for a year for you

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Speaker 1: and send you a check for five hundred dollars. You

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Speaker 1: can go wherever you want. You've got free choice. But

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Speaker 1: we're going to incentivize the high value centers and the

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Speaker 1: doctors that do appropriate back surgery and send patients for

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Speaker 1: physical therapy, and the primary care clinics that talk about

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Speaker 1: cooking classes for diabetes, not just throwing meds at people,

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Speaker 1: and the places that recognize frailty as a medical condition.

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Speaker 1: And you're going to see this incredible unleashing of the

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Speaker 1: market towards what really matters to patients. That's great, that's amazing.

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Speaker 1: The other part of that which I've found fascinating the

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Speaker 1: medical technology device people normally signed contracts that make it

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Speaker 1: illegal for the hospital to tell you what they cost,

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Speaker 1: and it's a build into the system, and everybody seems

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Speaker 1: to think it's okay. There are so many things in healthcare.

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Speaker 1: You look at the me you think, well, of course

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Speaker 1: this is illegal, and you realize, no, this is the

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Speaker 1: way of doing business. I wrote about the practice of

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Speaker 1: pharmaceutical companies paying doctors based on quotas of how many

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Speaker 1: of their meds they prescribe. You think, well, certainly that's illegal.

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Speaker 1: Now that goes on, and it went on with lucentis

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Speaker 1: and I wrote about it in the book Unaccountable. These

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Speaker 1: there are things that people need to be aware of.

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Speaker 1: As a surgeon myself, I can go to my conferences

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Speaker 1: and talk. We can talk among ourselves about these reforms

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Speaker 1: that we need, or you can engage the public. And

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Speaker 1: that's what I've chosen to do through books and fox

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Speaker 1: and speaking and other things. We've got to educate folks

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Speaker 1: so that when they're told you need this done, they say,

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Speaker 1: what are the alternatives? And maybe I need a second opinion,

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Speaker 1: and how much is it going to cost? And can

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Speaker 1: I talk to a patient that had this done in

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Speaker 1: your practice? All of these games you're talking about, you

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Speaker 1: really have led me to the fundamental conclusion that the

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Speaker 1: solution to our out of control healthcare system is embarrassingly simple.

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Speaker 1: Get rid of secrecy at every level secrecy, kickback secrecy

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Speaker 1: in pricing, and restore the public trust through transparency. You know,

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Speaker 1: most hospitals in the United States were built by churches,

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Speaker 1: many were funded by philanthropists. They were floated by the

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Speaker 1: local community. Many of them operated in the red, like

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Speaker 1: my own hospital, Johns Hopkins. But it was okay, it

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Speaker 1: didn't matter who you were. They took care of you.

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Speaker 1: Is in the charter, soldiers from both sides of the

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Speaker 1: Civil War sat in our wards. You had surgeons paying

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Speaker 1: for the train ride of individuals to come and see

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Speaker 1: them because these people couldn't pay. One of the neurosurgeons

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Speaker 1: I write about never charged a teacher or a member

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Speaker 1: of the clergy, or a police officer or a firefighter,

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Speaker 1: anyone who was engaged in public service. That is the

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Speaker 1: great heritage of American hospitals. And now we've come to

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Speaker 1: this full circle game of secrecy and insider deals, and

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Speaker 1: that's where sunlight is the best disinfectant. The number of

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Speaker 1: lawsuits that hospitals filled and amazed me because almost all

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Speaker 1: who ought to raise money to provide charity care, How

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Speaker 1: can we made healthy a few and go banquet? The

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Speaker 1: number of people being sued by the hospitals was breathtaking.

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Speaker 1: Did that come as a surprise to you? Massive surprise.

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Speaker 1: I didn't know what was happening. And when I took

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Speaker 1: those cases back to the individual doctor who's involved in

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Speaker 1: the care, they were surprised. They were never told this

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Speaker 1: is what the hospital is going to do. They're going

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Speaker 1: to take their patient to court and sue them. When

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Speaker 1: they found out they were living the story of the

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Speaker 1: year last year was hospitals aggressively suing patients over high bills.

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Speaker 1: We broke that story in the journal the American Medical

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Speaker 1: Association last July, and I wrote about it obviously in

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Speaker 1: the book which circulated around that time. In its pre

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Speaker 1: release version, we told reporters, here's a hospital suing patients.

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Speaker 1: Write about them. You're a nonprofit hospital. You don't pay

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Speaker 1: millions of dollars in taxes because you're supposed to be

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Speaker 1: doing some public good for community benefit. Live up to

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Speaker 1: that mission. Look at this person's life that you ruined

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Speaker 1: over a bill that's overinflated. You ought to be ashamed

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Speaker 1: of yourselves. This is violating the sacred public trust in

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Speaker 1: the medical profession. And I go to these courthouses and

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Speaker 1: I would defend anyone who walks in. I would stand

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Speaker 1: outside of the courthouse and people who were sued that day,

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Speaker 1: and sometimes it was three hundred people in one day

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Speaker 1: sued by the local community nonprofit hospital over bills they

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Speaker 1: simply couldn't afford. These are not deadbeats by in large.

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Speaker 1: These were people. They've done nothing wrong, they have insurance,

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Speaker 1: they have a job, they work hard, and they get

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Speaker 1: taken advantage of by a high surprise bill and then

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Speaker 1: sent a court notice. Lawyers are not allowed to solicit

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Speaker 1: business at a courthouse on a day of court, but

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Speaker 1: I'm not a lawyer. When I found out I could,

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Speaker 1: so I started doing it. And I told people as

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Speaker 1: they walk in with my team there and I said, look,

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Speaker 1: I'm here as a doctor just to help out. We're

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Speaker 1: here with kind of our own advocacy work. If I

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Speaker 1: can defend you in court I'll do it for free,

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Speaker 1: and case after case got thrown out. We went up

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Speaker 1: there and we won one hundred percent of the time.

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Speaker 1: How can you be in a court if you're not

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Speaker 1: a lawyer. I'm the patients medical expert. I said, how

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Speaker 1: can I help? And they said, well, if you have

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Speaker 1: a medical expert here to interpret the bill, then they

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Speaker 1: can say something. So I said, okay, sign me up.

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Speaker 1: Would it be possible to put together the four or

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Speaker 1: five steps that every person is about to be sued

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Speaker 1: by a hospital should take so that they in effect

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Speaker 1: know that automatically to file for discovery. Yeah. Actually we've

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Speaker 1: done that on our Restoring Medicine dot org website and

432
00:24:27,800 --> 00:24:30,439
Speaker 1: so people can find there what to do. People have

433
00:24:30,480 --> 00:24:32,040
Speaker 1: a lot of rights. One of the dirty secrets and

434
00:24:32,080 --> 00:24:35,160
Speaker 1: healthcare is that you can negotiate your bills before, during,

435
00:24:35,240 --> 00:24:37,760
Speaker 1: and after the care, and so people need to stand

436
00:24:37,800 --> 00:24:41,320
Speaker 1: up for themselves. Years ago, when we had the Center

437
00:24:41,320 --> 00:24:44,320
Speaker 1: for Health Transformation, we had a guy come and work

438
00:24:44,359 --> 00:24:48,199
Speaker 1: with us who was on the West Coast and his

439
00:24:48,359 --> 00:24:54,240
Speaker 1: specialty was taking really really be charges like Stanford would

440
00:24:54,320 --> 00:24:57,760
Speaker 1: charge you seven hundred thousand dollars for one hundred and

441
00:24:57,760 --> 00:25:02,320
Speaker 1: twenty thousand procedure, and every single time he would go

442
00:25:02,320 --> 00:25:06,560
Speaker 1: in and say, Okay, if you're not prepared to come

443
00:25:06,600 --> 00:25:10,520
Speaker 1: down to the reasonable price, I'm filing for discovery, and

444
00:25:10,680 --> 00:25:16,000
Speaker 1: every single time they would back off. The amount he

445
00:25:16,080 --> 00:25:19,439
Speaker 1: saved his clients was an enormous amount of money. And

446
00:25:19,520 --> 00:25:24,560
Speaker 1: his specialty was, interestingly, academic hospitals, which were the most

447
00:25:24,640 --> 00:25:29,960
Speaker 1: likely overcharge. It's a disgrace. The hospitals are supposed to

448
00:25:29,960 --> 00:25:33,439
Speaker 1: be a safe haven for people when they're vulnerable, not

449
00:25:33,560 --> 00:25:36,480
Speaker 1: a place to take advantage and gouge them. The most

450
00:25:36,520 --> 00:25:39,160
Speaker 1: important two things I can tell folks out there newt

451
00:25:39,880 --> 00:25:42,080
Speaker 1: is that if you get a bill, type it into

452
00:25:42,160 --> 00:25:44,840
Speaker 1: healthcare bluebook dot com or one of those reference based

453
00:25:44,880 --> 00:25:47,240
Speaker 1: websites and find out what the going rate is for

454
00:25:47,280 --> 00:25:50,400
Speaker 1: the same codes, and you take that number back to them. Okay,

455
00:25:50,440 --> 00:25:53,120
Speaker 1: that's how you find out the Bluebook price. The other

456
00:25:53,119 --> 00:25:56,120
Speaker 1: thing is, do not sign your financial life away when

457
00:25:56,119 --> 00:25:58,159
Speaker 1: you come to the hospital. You don't have to, by

458
00:25:58,160 --> 00:26:00,800
Speaker 1: the way, it's against the imtala law. Okay, you don't

459
00:26:00,880 --> 00:26:05,200
Speaker 1: have to sign your life away financially, everything you own,

460
00:26:05,240 --> 00:26:07,960
Speaker 1: all your property, your entire net worth under penalty of

461
00:26:08,080 --> 00:26:10,840
Speaker 1: law in order to get an I V in the

462
00:26:10,880 --> 00:26:14,639
Speaker 1: emergency room. Okay, you don't sign that document. Consent to

463
00:26:14,760 --> 00:26:17,840
Speaker 1: treat is something separate and it does not mean you

464
00:26:17,880 --> 00:26:21,480
Speaker 1: sign your home away, okay, And so hospitals should behave

465
00:26:21,520 --> 00:26:24,239
Speaker 1: better and separate those documents. Many times they don't. They

466
00:26:24,359 --> 00:26:26,480
Speaker 1: merge them and they're saying, you just have to sign this.

467
00:26:26,560 --> 00:26:29,000
Speaker 1: You say, we'll have some questions. I don't feel comfortable

468
00:26:29,119 --> 00:26:31,800
Speaker 1: signing my life away financially. They said, well, you just

469
00:26:31,840 --> 00:26:33,720
Speaker 1: have to sign it. It's a consent to treat. You

470
00:26:33,760 --> 00:26:36,200
Speaker 1: separate those two and if you need to, you write

471
00:26:36,200 --> 00:26:38,560
Speaker 1: on a piece of paper your own battlefield consent and

472
00:26:38,640 --> 00:26:41,720
Speaker 1: you say I consent to be treated at this hospital

473
00:26:41,800 --> 00:26:44,600
Speaker 1: by any doctor for any procedure, and you give that

474
00:26:44,640 --> 00:26:46,880
Speaker 1: to them and watch them not take care of you

475
00:26:47,480 --> 00:26:51,479
Speaker 1: with that document. Do you have several websites people should

476
00:26:52,000 --> 00:26:54,960
Speaker 1: be able to go to for this kind of thing. Yeah,

477
00:26:54,960 --> 00:26:57,560
Speaker 1: we've got that also on our Restoring Medicine website. My

478
00:26:57,720 --> 00:27:00,560
Speaker 1: medical students from Johns Hopkins around the country that work

479
00:27:00,640 --> 00:27:04,280
Speaker 1: with me and concerned citizens and nurses have said, look,

480
00:27:04,280 --> 00:27:06,040
Speaker 1: we want to be involved, we want to do something.

481
00:27:06,080 --> 00:27:08,880
Speaker 1: So we created this resource at Restoring Medicine dot org.

482
00:27:08,920 --> 00:27:10,399
Speaker 1: And then a lot of this stuff is in the

483
00:27:10,400 --> 00:27:13,679
Speaker 1: book The Price We Pay? What do you think the

484
00:27:13,720 --> 00:27:18,840
Speaker 1: administration should do next? To continue the momentum towards reforming

485
00:27:18,840 --> 00:27:22,560
Speaker 1: and improving the health system. I've encouraged them to use

486
00:27:22,680 --> 00:27:27,480
Speaker 1: the power that they have to require public reporting, to

487
00:27:27,640 --> 00:27:31,439
Speaker 1: require not just public reporting around bet alcer rates and

488
00:27:31,640 --> 00:27:36,119
Speaker 1: surgical site infections, but also around billing quality. What is

489
00:27:36,160 --> 00:27:39,280
Speaker 1: your average markup? Do you sue patients? Do you provide

490
00:27:39,640 --> 00:27:43,680
Speaker 1: honest prices when people ask for elective non emergent services?

491
00:27:43,960 --> 00:27:47,679
Speaker 1: Do you charge patients for complications that are never events,

492
00:27:47,760 --> 00:27:51,320
Speaker 1: things that should never happen? A subset of complications that

493
00:27:51,359 --> 00:27:54,240
Speaker 1: we've identified in medicine as leaving a sponge behind or

494
00:27:54,280 --> 00:27:57,120
Speaker 1: things that should never happen? Do you charge the patients

495
00:27:57,119 --> 00:28:00,639
Speaker 1: for those things? And the patients want an honest price,

496
00:28:01,119 --> 00:28:02,679
Speaker 1: are they going to run the risk of getting a

497
00:28:02,720 --> 00:28:05,880
Speaker 1: surprise bill from an out of network doctor at an

498
00:28:05,880 --> 00:28:10,639
Speaker 1: in network facility without any disclosure. Okay, now you're shot

499
00:28:10,640 --> 00:28:12,639
Speaker 1: in the chest. Look, we're just going to take care

500
00:28:12,680 --> 00:28:14,680
Speaker 1: of you. Okay. As a surgeon, I can tell you

501
00:28:14,960 --> 00:28:16,639
Speaker 1: we're not going to be giving you any prices or

502
00:28:16,680 --> 00:28:18,159
Speaker 1: talking any of the stuff We're just going to take

503
00:28:18,200 --> 00:28:20,359
Speaker 1: care of you. That's what we should be doing. But

504
00:28:20,560 --> 00:28:24,240
Speaker 1: sixty percent of medical care is shoppable, and for that stuff,

505
00:28:24,280 --> 00:28:26,359
Speaker 1: we can clean up a lot of waste in the system.

506
00:28:26,400 --> 00:28:28,800
Speaker 1: And for folks who say we got to throw more

507
00:28:28,840 --> 00:28:31,600
Speaker 1: money into this broken system, I made with folks on

508
00:28:31,640 --> 00:28:33,480
Speaker 1: both sides of the aisle, and I tell them, Okay,

509
00:28:33,800 --> 00:28:37,080
Speaker 1: let me understand. You want to increase coverage to every American.

510
00:28:37,119 --> 00:28:40,680
Speaker 1: I love that idea. How are you going to do that? Okay,

511
00:28:40,840 --> 00:28:43,400
Speaker 1: throw more money into this broken system? Or the waste

512
00:28:43,480 --> 00:28:46,760
Speaker 1: right now is somewhere between thirty and forty and allow

513
00:28:46,800 --> 00:28:49,560
Speaker 1: that waste to increase behind the guise of a massive budget,

514
00:28:49,800 --> 00:28:52,520
Speaker 1: or are we going to cut the waste to make

515
00:28:52,520 --> 00:28:56,760
Speaker 1: healthcare affordable to expand coverage. You have an extraordinary story

516
00:28:56,760 --> 00:29:00,920
Speaker 1: of doctors in church parking lots performing thing sting and

517
00:29:01,000 --> 00:29:04,560
Speaker 1: charging Medicare for the procedures. Can you tell us that story.

518
00:29:04,960 --> 00:29:07,680
Speaker 1: Over treatment is a huge issue in the United States,

519
00:29:07,680 --> 00:29:11,320
Speaker 1: and people are suspicious of their therapy now because of

520
00:29:11,320 --> 00:29:15,560
Speaker 1: the problem we have with some fraction of healthcare overdoing things.

521
00:29:15,640 --> 00:29:18,200
Speaker 1: Most doctors do the right thing, or always try to,

522
00:29:18,880 --> 00:29:22,520
Speaker 1: but some fraction of doctors are responding to the perverse

523
00:29:22,560 --> 00:29:27,320
Speaker 1: incentive sometimes prompted or pushed by this new corporate medicine

524
00:29:27,360 --> 00:29:32,680
Speaker 1: effort to maximize profits over patients. And we saw it

525
00:29:32,800 --> 00:29:36,760
Speaker 1: in the churches in the area outside of Washington, DC,

526
00:29:36,920 --> 00:29:39,480
Speaker 1: a few miles from the Capitol building. We went there

527
00:29:39,560 --> 00:29:42,880
Speaker 1: to a church fair cosponsored by a doctor's group that

528
00:29:42,960 --> 00:29:47,800
Speaker 1: does procedures of stenting blockages and leg arteries that are

529
00:29:47,800 --> 00:29:50,640
Speaker 1: by and large unnecessary and has very little to no

530
00:29:50,760 --> 00:29:54,280
Speaker 1: science to support it. People come into church during a healthfare,

531
00:29:54,760 --> 00:29:56,920
Speaker 1: they're told, hey, we're going to take a look at

532
00:29:56,920 --> 00:30:00,000
Speaker 1: your circulation. The doctor says, hey, we see a little

533
00:30:00,080 --> 00:30:03,280
Speaker 1: funny looking partial blockage. We're going to do a follow

534
00:30:03,360 --> 00:30:06,240
Speaker 1: up study and angiogram. And then during the angiogram say

535
00:30:06,240 --> 00:30:08,480
Speaker 1: we found a blockage, but good news is we stented

536
00:30:08,520 --> 00:30:11,000
Speaker 1: it open, kind of like heart stents only, but of

537
00:30:11,040 --> 00:30:14,640
Speaker 1: the leg arteries. Well, guess what. Everybody's got some partial

538
00:30:14,680 --> 00:30:18,440
Speaker 1: blockage of their leg artery when they turned seventy or older, right,

539
00:30:18,480 --> 00:30:22,040
Speaker 1: I mean, it's practically ubiquitous, and just stenting all these

540
00:30:22,080 --> 00:30:27,800
Speaker 1: things is scientifically unindicated without symptoms. There's a national guideline

541
00:30:27,840 --> 00:30:30,440
Speaker 1: from the US Preventive Services Task COORSE that says people

542
00:30:30,480 --> 00:30:34,640
Speaker 1: should not be screened for these peripheral blood vessel blockages

543
00:30:34,720 --> 00:30:38,320
Speaker 1: because of overtreatment, and there's no science to really support it.

544
00:30:38,600 --> 00:30:41,960
Speaker 1: So we found that overtreatment is rampant. And guess who

545
00:30:42,000 --> 00:30:46,280
Speaker 1: funded all of this stuff? Medicare. The Medicare program cannot

546
00:30:46,360 --> 00:30:49,760
Speaker 1: possibly police all of healthcare, right and so with a

547
00:30:49,880 --> 00:30:53,920
Speaker 1: lack of any local accountability, these patients walked in blind

548
00:30:54,320 --> 00:30:57,200
Speaker 1: and got these unnecessary procedures. One of the doctors made

549
00:30:57,640 --> 00:31:01,080
Speaker 1: we think about fifteen to thirty thousand dollars per day.

550
00:31:01,640 --> 00:31:03,280
Speaker 1: There was one doctor we saw on the data that

551
00:31:03,320 --> 00:31:06,320
Speaker 1: made eighty to one hundred thousand dollars per day doing

552
00:31:06,400 --> 00:31:10,479
Speaker 1: probably mostly unnecessary like stents. We took this to the

553
00:31:10,520 --> 00:31:13,960
Speaker 1: Society of Vascular Surgeons, said, look, do something, here's data

554
00:31:13,960 --> 00:31:16,760
Speaker 1: we don't feel comfortable sitting on as a research team,

555
00:31:16,800 --> 00:31:18,680
Speaker 1: and sure enough they were able to act. In The

556
00:31:18,720 --> 00:31:21,240
Speaker 1: Wall Street Journal did a nice piece on it. But

557
00:31:21,400 --> 00:31:25,840
Speaker 1: this is the burden of unnecessary procedures in one particular

558
00:31:25,880 --> 00:31:29,160
Speaker 1: area of healthcare. That's just one area, all funded by Medicare.

559
00:31:29,240 --> 00:31:32,200
Speaker 1: Do we just want to throw more money into that system,

560
00:31:32,320 --> 00:31:37,080
Speaker 1: or do we want to start creating accountability and cleaning

561
00:31:37,120 --> 00:31:56,080
Speaker 1: up the waist. The numbers you were using come to

562
00:31:56,120 --> 00:32:00,120
Speaker 1: like three or four percent of the entire economy. Now

563
00:32:00,240 --> 00:32:03,040
Speaker 1: put in all of our concerns without paying for Medicare

564
00:32:03,320 --> 00:32:08,320
Speaker 1: and Medicaid for probably two generations, that's an enormous number.

565
00:32:08,600 --> 00:32:12,960
Speaker 1: We can keep throwing good money after bad into this

566
00:32:13,640 --> 00:32:18,360
Speaker 1: entirely broken system, where we can finally talk about cutting

567
00:32:18,360 --> 00:32:21,840
Speaker 1: the waste. If you look at our entire federal spend

568
00:32:22,320 --> 00:32:26,600
Speaker 1: on healthcare, you'll hear these numbers. It's one in five dollars,

569
00:32:26,720 --> 00:32:30,440
Speaker 1: or you'll hear what's nineteen percent of GDP. Let's talk

570
00:32:30,440 --> 00:32:33,080
Speaker 1: in very simple terms. Okay, I don't know anybody who

571
00:32:33,080 --> 00:32:35,800
Speaker 1: talks about buying a lawnmower for three percent of their

572
00:32:35,800 --> 00:32:40,400
Speaker 1: household GDP. The lawnmower costs eight hundred dollars. Right, Let's

573
00:32:40,400 --> 00:32:44,680
Speaker 1: just use simple terms. Medicare and Medicaid combined, that expenditure

574
00:32:44,760 --> 00:32:47,280
Speaker 1: is about what twenty four twenty five percent. Guess where

575
00:32:48,040 --> 00:32:51,640
Speaker 1: seniors are spending their Social Security checks? Social Security is

576
00:32:51,640 --> 00:32:54,640
Speaker 1: about twenty four percent of federal spending. Half of Social

577
00:32:54,640 --> 00:32:59,800
Speaker 1: Security checks are going to healthcare expenses, copast, deductibles, coinsurance,

578
00:32:59,800 --> 00:33:02,840
Speaker 1: and on coveraged services. The Defense Department, which many people

579
00:33:02,880 --> 00:33:06,520
Speaker 1: argue is the only line item larger than the Medicare spend,

580
00:33:07,560 --> 00:33:09,640
Speaker 1: is thirty one percent of federal spending. Well, guess what

581
00:33:10,160 --> 00:33:12,840
Speaker 1: fifteen percent of their budget goes to their own healthcare

582
00:33:12,880 --> 00:33:15,479
Speaker 1: system and their own health benefits, and that's separate from

583
00:33:15,520 --> 00:33:18,720
Speaker 1: the VA. That's about four point four percent of federal spending.

584
00:33:18,720 --> 00:33:20,480
Speaker 1: An interest on the debt is in part, interest on

585
00:33:20,520 --> 00:33:24,040
Speaker 1: the healthcare debt. And remember we pay for benefits for

586
00:33:24,120 --> 00:33:27,080
Speaker 1: what nine million federal workers? That costs money. You add

587
00:33:27,080 --> 00:33:30,719
Speaker 1: those together, we're spending forty eight percent of all federal

588
00:33:30,760 --> 00:33:34,360
Speaker 1: spending on healthcare in its many hidden forms. So when

589
00:33:34,360 --> 00:33:38,400
Speaker 1: people say we've got to increase spending on this healthcare program,

590
00:33:38,440 --> 00:33:41,480
Speaker 1: what are you proposing we go to seventy five percent

591
00:33:41,520 --> 00:33:46,080
Speaker 1: of all federal spending. Do we cancel all other national priorities?

592
00:33:46,200 --> 00:33:49,840
Speaker 1: Do we cancel the entire Defense Department? I mean, we've

593
00:33:49,840 --> 00:33:51,959
Speaker 1: got to use some logic at some point, And obviously

594
00:33:52,000 --> 00:33:54,320
Speaker 1: the solution here I believe in is cutting the waste.

595
00:33:55,080 --> 00:33:57,440
Speaker 1: I have the same feeling when people ask me in

596
00:33:57,480 --> 00:33:59,560
Speaker 1: the long one about how to balance the federal budget.

597
00:34:00,040 --> 00:34:04,720
Speaker 1: It has to start with healthcare. If Medicare, Medicaid, trying Care,

598
00:34:05,160 --> 00:34:09,720
Speaker 1: Indian Health Service, and federal employee health benefits all continue

599
00:34:09,760 --> 00:34:14,640
Speaker 1: to automatically go up. In the current secretive system, it's

600
00:34:14,719 --> 00:34:17,320
Speaker 1: virtually impossible to see how you ever balance the federal budget.

601
00:34:17,440 --> 00:34:20,400
Speaker 1: But if you can actually get a system which is

602
00:34:21,239 --> 00:34:25,640
Speaker 1: competitive and transparent, and which evolves in ways that people

603
00:34:25,680 --> 00:34:28,920
Speaker 1: have a sense of control over their own health, I

604
00:34:29,000 --> 00:34:32,760
Speaker 1: suspect you could have a remarkable impact on total cost

605
00:34:32,840 --> 00:34:36,200
Speaker 1: to American people. Well, dude, I know you've thought about

606
00:34:36,200 --> 00:34:38,280
Speaker 1: these issues for a long time, and to be honest,

607
00:34:38,280 --> 00:34:40,279
Speaker 1: it's a huge honor to be talking to you about

608
00:34:40,320 --> 00:34:42,600
Speaker 1: these things because we've been at the forefront of them.

609
00:34:42,640 --> 00:34:45,479
Speaker 1: But I wish we could somehow get the message out

610
00:34:45,480 --> 00:34:48,440
Speaker 1: there that we're getting ripped off on healthcare. There's a

611
00:34:48,440 --> 00:34:51,400
Speaker 1: tremendous amount of waste, and trying to add little tiny

612
00:34:51,440 --> 00:34:54,320
Speaker 1: fixes by creating rules in a non competitive market or

613
00:34:54,360 --> 00:34:58,160
Speaker 1: not nearly as effective as transforming healthcare into a competitive market.

614
00:34:58,960 --> 00:35:03,440
Speaker 1: Transparency is deeply desired by the American people. They instinctively

615
00:35:04,160 --> 00:35:07,359
Speaker 1: understand the concept. When people ask me by to them,

616
00:35:07,400 --> 00:35:10,840
Speaker 1: do you realize the biggest monumental change in healthcare occurred

617
00:35:10,880 --> 00:35:12,880
Speaker 1: and hardly anyone knows about it, and that was the

618
00:35:12,920 --> 00:35:16,400
Speaker 1: President's executive order on price transparency. I really think what

619
00:35:16,440 --> 00:35:20,480
Speaker 1: you're doing is groundbreaking and will probably do more to

620
00:35:20,560 --> 00:35:24,640
Speaker 1: move us towards an effective and efficient health system than

621
00:35:24,680 --> 00:35:27,320
Speaker 1: anybody else I know in the country. So I'm thrilled

622
00:35:27,360 --> 00:35:30,000
Speaker 1: that you would take the time to share this with us.

623
00:35:30,320 --> 00:35:32,359
Speaker 1: Hughge honor to talk with you nude. Thanks so much

624
00:35:32,360 --> 00:35:44,160
Speaker 1: for the time, and now I'll answer your questions. Gary

625
00:35:44,239 --> 00:35:47,719
Speaker 1: from Minnesota said, I just listened to your podcast with

626
00:35:47,840 --> 00:35:50,839
Speaker 1: Gerard Robinson and would love to hear more from him

627
00:35:50,840 --> 00:35:53,680
Speaker 1: and solutions as to how we fixed what is wrong.

628
00:35:54,320 --> 00:35:56,759
Speaker 1: You know, I had exactly the same feeling. I thought

629
00:35:56,800 --> 00:36:00,520
Speaker 1: Gerard was so knowledgeable that we've asked him come back.

630
00:36:00,840 --> 00:36:03,000
Speaker 1: So in the very near future you're going to hear

631
00:36:03,080 --> 00:36:07,959
Speaker 1: exactly the podcast you're asking for. Paul from Florida, why

632
00:36:08,040 --> 00:36:10,840
Speaker 1: has the media adjusted it's reporting of coronavirus to just

633
00:36:11,040 --> 00:36:14,319
Speaker 1: new cases since March? The media has not done an

634
00:36:14,320 --> 00:36:18,279
Speaker 1: effective job in giving breakdowns to age brackets, way sets.

635
00:36:18,360 --> 00:36:21,759
Speaker 1: I have to say that I am highly confused by

636
00:36:21,800 --> 00:36:24,520
Speaker 1: the reporting system. I think that we're not being done

637
00:36:24,560 --> 00:36:27,520
Speaker 1: a very good service. I don't think that their standard

638
00:36:27,880 --> 00:36:31,960
Speaker 1: for what they're reporting is very good. I personally keep

639
00:36:32,000 --> 00:36:35,359
Speaker 1: track of how many people are intensity care and how

640
00:36:35,400 --> 00:36:38,640
Speaker 1: many people die. I don't even look at hospitalization because

641
00:36:39,000 --> 00:36:42,600
Speaker 1: in a number of places now, if you come up positive,

642
00:36:43,080 --> 00:36:45,839
Speaker 1: even though you have no symptoms at all, they'll put

643
00:36:45,880 --> 00:36:48,120
Speaker 1: you in the hospital for a day, and that makes

644
00:36:48,160 --> 00:36:50,319
Speaker 1: no sense at all. I wish they would get to

645
00:36:50,400 --> 00:36:54,319
Speaker 1: a simple, clear, consistent way of reporting, and I think

646
00:36:54,320 --> 00:36:56,960
Speaker 1: this is an area where the Center for Disease Control

647
00:36:57,360 --> 00:37:03,400
Speaker 1: has really done a terrible, terrible job. Thank you to

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Speaker 1: my guest doctor Marty McCarry. You can read more of

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Speaker 1: our reforms needed in our healthcare system and the price

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Speaker 1: Newsworld is produced by Gingwish three sixty and iHeart Meeting.

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Speaker 1: Steve Pelt Special thanks to the team at Gingwish three sixty.

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Speaker 1: Please email me with your questions at Gingwish three sixty

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Speaker 1: If you've been enjoying news World. I hope you'll go

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Speaker 1: it's all about. On the next episode of Newsworld, the

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Speaker 1: new Daniel Sovo novel The Order, the twentieth novel in

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Speaker 1: the Gabriel Alarm series, releases on July fourteenth. I'm pleased

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Speaker 1: to welcome my guest Daniel Sobo to hear more about

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Speaker 1: the novel than what he's working on next. I'm new English.

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Speaker 1: This is news Wall