1 00:00:03,720 --> 00:00:11,680 Speaker 1: It's that time time, time, time, Luck and Load. Michael 2 00:00:11,760 --> 00:00:25,240 Speaker 1: Verie Show is on the air. Professor Charles Silver as 3 00:00:25,239 --> 00:00:25,599 Speaker 1: our guest. 4 00:00:25,680 --> 00:00:29,160 Speaker 2: He's a professor at the University of Texas School of Law, 5 00:00:29,200 --> 00:00:31,520 Speaker 2: which I happened to believe is fantastic because I'm a 6 00:00:31,560 --> 00:00:37,680 Speaker 2: graduate of same. His book is Overcharged, Why Americans pay 7 00:00:37,760 --> 00:00:42,040 Speaker 2: too much for healthcare. You mentioned that the problem began 8 00:00:42,600 --> 00:00:46,520 Speaker 2: with Medicare Medicaid in the sixties, part of Lyndon Johnson's 9 00:00:46,760 --> 00:00:49,839 Speaker 2: Great Society, which turned out not to be. It was 10 00:00:49,920 --> 00:00:55,880 Speaker 2: two point zero of FDRs taking over of the American 11 00:00:55,960 --> 00:00:59,000 Speaker 2: economy and it's hard to strip that back out of 12 00:00:59,080 --> 00:01:03,480 Speaker 2: life when Medicare got involved. So my dad's eighty four, 13 00:01:03,640 --> 00:01:06,360 Speaker 2: my mom recently passed, and I go in and review 14 00:01:06,400 --> 00:01:09,280 Speaker 2: every expense, everything that comes in and all that this 15 00:01:09,319 --> 00:01:13,679 Speaker 2: whole Medicare thing. I have a show sponsor called Senior 16 00:01:13,680 --> 00:01:18,240 Speaker 2: Health Services dot Com, and he and his team help 17 00:01:18,400 --> 00:01:21,959 Speaker 2: people who are trying to navigate Medicare. And every day 18 00:01:21,959 --> 00:01:23,640 Speaker 2: I get someone who emails me and says, can you 19 00:01:23,720 --> 00:01:26,400 Speaker 2: connect me with them? And I forward it and sometimes 20 00:01:26,400 --> 00:01:28,400 Speaker 2: I stay involved for a little while just to see, 21 00:01:28,480 --> 00:01:31,560 Speaker 2: you know, kind of what they're working through. It's amazing 22 00:01:31,600 --> 00:01:33,160 Speaker 2: to people that, all of a sudden, I guess, when 23 00:01:33,200 --> 00:01:36,160 Speaker 2: you turn sixty five, you're getting robocalls and junk mail 24 00:01:36,160 --> 00:01:39,720 Speaker 2: and all this Medicare, Medicare, Medicare, and people had no idea. Now, 25 00:01:39,880 --> 00:01:43,959 Speaker 2: all of a sudden, I've been, you know, dumped into 26 00:01:44,040 --> 00:01:48,320 Speaker 2: the Medicare playground, and I don't know why, how does 27 00:01:48,360 --> 00:01:49,200 Speaker 2: this even work? 28 00:01:51,320 --> 00:01:51,920 Speaker 3: Too well? 29 00:01:53,120 --> 00:01:57,320 Speaker 4: I just I recently hit that age myself, so I 30 00:01:57,360 --> 00:02:00,440 Speaker 4: can sympathize with those whose mailbox are crammed with Medicare 31 00:02:00,520 --> 00:02:03,720 Speaker 4: advantage flyers and things of that sort. I'm sick of 32 00:02:03,760 --> 00:02:07,520 Speaker 4: seeing them, and I'm not even using Medicare. I'm still working, 33 00:02:07,560 --> 00:02:11,800 Speaker 4: so I'm staying on my employer's healthcare system or healthcare insurance, 34 00:02:11,840 --> 00:02:17,400 Speaker 4: although that is very expensive and far too comprehensive. You know, 35 00:02:17,480 --> 00:02:22,120 Speaker 4: it's because of the mandates regarding what employer sponsored coverage 36 00:02:22,160 --> 00:02:25,400 Speaker 4: has to conclude that I wind up paying, you know, 37 00:02:25,440 --> 00:02:29,320 Speaker 4: way too much. Everybody does pay way too much for insurance. 38 00:02:31,320 --> 00:02:33,720 Speaker 4: But you know, Medicare, what can I say? It's a 39 00:02:33,800 --> 00:02:38,880 Speaker 4: program that was designed to succeed by massively inflating the deficit. 40 00:02:39,560 --> 00:02:43,120 Speaker 4: You know, everybody thinks that Medicare is something that you 41 00:02:43,200 --> 00:02:45,600 Speaker 4: earn over the course of your lifetime. We don't think 42 00:02:45,639 --> 00:02:48,720 Speaker 4: of it as welfare, and politicians who refer to it 43 00:02:48,760 --> 00:02:52,600 Speaker 4: as welfare are excoriated. But the amount that people pay 44 00:02:52,800 --> 00:02:57,239 Speaker 4: into Medicare is way, way, way smaller than the amount 45 00:02:57,320 --> 00:03:00,480 Speaker 4: that they get out for most people. Now they're obviouslyceptions 46 00:03:00,560 --> 00:03:04,600 Speaker 4: to that, but for most people, the way that the 47 00:03:04,680 --> 00:03:09,359 Speaker 4: program succeeds is by charging them less than the benefits 48 00:03:09,520 --> 00:03:12,640 Speaker 4: that they will get out of the system. Well, you know, 49 00:03:12,680 --> 00:03:15,480 Speaker 4: that's a nice arrangement. I'd like to have that, But 50 00:03:15,840 --> 00:03:17,880 Speaker 4: the problem is somebody. The money to pay for all 51 00:03:17,919 --> 00:03:21,680 Speaker 4: those benefits has to come from somewhere, and in only 52 00:03:21,720 --> 00:03:25,120 Speaker 4: only two sources. One is general tax revenue, so they 53 00:03:25,280 --> 00:03:28,000 Speaker 4: use money in addition tax revenue in addition to the 54 00:03:28,040 --> 00:03:31,880 Speaker 4: employee tax to fund the program. And the other is 55 00:03:31,919 --> 00:03:36,880 Speaker 4: deficit spending. And every one of these expansions of the 56 00:03:36,920 --> 00:03:41,120 Speaker 4: Medicare program is funded through the deficits. So you know, 57 00:03:41,400 --> 00:03:45,640 Speaker 4: back when Bush two was president, right he created Medicare 58 00:03:45,680 --> 00:03:50,680 Speaker 4: part D, the Prescription Drug Benefit Program. Well, the premiums 59 00:03:50,720 --> 00:03:54,279 Speaker 4: even initially for that program, we're only set at fifty percent. 60 00:03:54,000 --> 00:03:55,240 Speaker 3: Of the estimated cost. 61 00:03:55,880 --> 00:03:59,600 Speaker 4: Now they're down to twenty five percent of the estimated cost, 62 00:03:59,640 --> 00:04:02,400 Speaker 4: which means means everybody loves Medicare party because it's a 63 00:04:02,440 --> 00:04:05,600 Speaker 4: great deal. Right, I'm only paying twenty five percent of 64 00:04:05,640 --> 00:04:08,840 Speaker 4: the cost. But what you're really doing is taking the 65 00:04:08,880 --> 00:04:12,760 Speaker 4: cost of prescription drugs and rolling them into the deficit. 66 00:04:13,400 --> 00:04:15,800 Speaker 4: And the same thing goes for Obamacare with all these 67 00:04:15,840 --> 00:04:20,120 Speaker 4: premium subsidies. Everything that the government does is designed to 68 00:04:20,120 --> 00:04:25,360 Speaker 4: be popular by being priced below its actual cost, and 69 00:04:25,400 --> 00:04:28,560 Speaker 4: the result of that in the long run has to 70 00:04:28,600 --> 00:04:33,520 Speaker 4: be deficit increases and inflation increases. 71 00:04:33,560 --> 00:04:35,200 Speaker 3: There's just no getting around that. 72 00:04:36,120 --> 00:04:40,880 Speaker 2: It's frustrating because then Medicare, the government is telling you 73 00:04:40,920 --> 00:04:42,920 Speaker 2: which doctors you can go to and which you can't, 74 00:04:42,920 --> 00:04:45,520 Speaker 2: which procedures you can do in which you can't, and 75 00:04:45,560 --> 00:04:48,600 Speaker 2: so you know, and look, it sounds like you and 76 00:04:48,680 --> 00:04:52,800 Speaker 2: I are relatively aligned. I was an acolyte of Professor 77 00:04:52,839 --> 00:04:56,200 Speaker 2: Leno Graias. You can probably understand where my views are 78 00:04:56,240 --> 00:04:58,360 Speaker 2: with regard to politics and the role of the government 79 00:04:58,400 --> 00:05:03,279 Speaker 2: and the individual. I'm probably more libertarian certainly than he was. 80 00:05:03,320 --> 00:05:06,559 Speaker 2: I'm over on the Rand and Ron Paul end of things. 81 00:05:06,560 --> 00:05:11,080 Speaker 2: But what I find frustrating is that people seem to 82 00:05:11,240 --> 00:05:16,839 Speaker 2: think that somehow government is protecting you and aiding you. 83 00:05:17,360 --> 00:05:20,279 Speaker 2: But in fact, what goes with that is, you know 84 00:05:20,320 --> 00:05:23,039 Speaker 2: why you don't feed the bears at the zoo, is 85 00:05:23,080 --> 00:05:26,560 Speaker 2: they're controlling you, and any government powerful enough to pay 86 00:05:26,560 --> 00:05:29,760 Speaker 2: for your medical surgery or medical procedures, powerful enough to 87 00:05:29,800 --> 00:05:32,880 Speaker 2: take it away, and then they start making decisions for you. 88 00:05:33,160 --> 00:05:35,360 Speaker 1: And that's where we get into the civil liberties. 89 00:05:35,360 --> 00:05:38,840 Speaker 2: And that's where I get very frustrated, because we've now 90 00:05:38,920 --> 00:05:42,440 Speaker 2: moved beyond healthcare and we've moved into a sort of 91 00:05:42,480 --> 00:05:46,520 Speaker 2: totalitarian authoritarian control of the individual. 92 00:05:47,320 --> 00:05:50,560 Speaker 4: Well, you're you're certainly singing my song because you know, 93 00:05:50,640 --> 00:05:54,720 Speaker 4: you're a libertarian. I'm an adjunct scholar at the Cato Institute. 94 00:05:54,760 --> 00:05:56,880 Speaker 4: I don't think it gets much more libertarian than that, 95 00:05:57,120 --> 00:06:03,440 Speaker 4: I would say, so, so we're on the same page 96 00:06:03,480 --> 00:06:06,800 Speaker 4: as far as, you know, being very very concerned about 97 00:06:07,000 --> 00:06:14,000 Speaker 4: the governmental control. I think that governmental control is part 98 00:06:14,000 --> 00:06:17,320 Speaker 4: of the story, but I think governmental ineptitude is probably 99 00:06:17,400 --> 00:06:22,440 Speaker 4: a much bigger part of the story. You know, I'm 100 00:06:22,480 --> 00:06:25,360 Speaker 4: willing to say, oh, some of those you know, bureaucrats 101 00:06:25,400 --> 00:06:28,479 Speaker 4: who run these programs actually want to want to help people, 102 00:06:28,520 --> 00:06:32,799 Speaker 4: and may even believe they are helping people, but it's 103 00:06:32,880 --> 00:06:37,760 Speaker 4: actually very difficult to run the healthcare system. Well, that's 104 00:06:37,800 --> 00:06:42,440 Speaker 4: why market forces are so important, because market forces are 105 00:06:42,600 --> 00:06:48,960 Speaker 4: constantly rewarding providers for figuring out how to serve patients better. Right, 106 00:06:49,000 --> 00:06:51,279 Speaker 4: that's how you can get business. If you can figure 107 00:06:51,279 --> 00:06:54,200 Speaker 4: out how to serve your customers better, then you'll get 108 00:06:54,240 --> 00:06:55,120 Speaker 4: more customers. 109 00:06:56,720 --> 00:06:57,920 Speaker 3: And that's just something that. 110 00:06:57,839 --> 00:07:01,880 Speaker 4: Requires people who know that nuts and bolts really well 111 00:07:01,920 --> 00:07:05,800 Speaker 4: to be constantly reflecting on how they're doing their jobs. 112 00:07:05,920 --> 00:07:06,160 Speaker 3: Right. 113 00:07:07,120 --> 00:07:10,000 Speaker 4: The government bureaucrats, they don't do that. They don't even 114 00:07:10,040 --> 00:07:13,800 Speaker 4: know how the jobs work. They just exist mainly to 115 00:07:13,840 --> 00:07:19,360 Speaker 4: pay bills and to enact regulations that enable them to 116 00:07:20,160 --> 00:07:22,640 Speaker 4: deal with the burden that all this imposes on the 117 00:07:22,680 --> 00:07:26,680 Speaker 4: federal government. And the results for consumers are just terrible. 118 00:07:26,880 --> 00:07:31,240 Speaker 4: You know, all these problems that everybody complains about, prioritization requirements, 119 00:07:31,880 --> 00:07:35,640 Speaker 4: surprise bills, these things called facility fees that you know, 120 00:07:35,680 --> 00:07:38,200 Speaker 4: you go to an emergency room, the doctor says, oh, 121 00:07:38,280 --> 00:07:40,800 Speaker 4: you've got a fever, take some ass and go home, 122 00:07:40,800 --> 00:07:42,760 Speaker 4: and then you get a bill for ten thousand dollars 123 00:07:42,800 --> 00:07:45,880 Speaker 4: because you literally because you walked in the front doors. 124 00:07:45,880 --> 00:07:49,160 Speaker 4: It's just like a cover charge at a bar or 125 00:07:49,160 --> 00:07:53,160 Speaker 4: something like that, except a lot bigger. You know, none 126 00:07:53,160 --> 00:07:57,480 Speaker 4: of that stuff exists in the direct payment system. It 127 00:07:57,600 --> 00:08:03,440 Speaker 4: all exists because the government regulates the way healthcare is delivered, 128 00:08:03,560 --> 00:08:05,640 Speaker 4: and it does it in stupid ways. 129 00:08:06,280 --> 00:08:09,720 Speaker 2: Because it's hard to do it right and government's not 130 00:08:09,840 --> 00:08:12,960 Speaker 2: in the business of efficiency. Professor Charles Silver is our guest. 131 00:08:13,280 --> 00:08:17,880 Speaker 2: The book is Overcharged, Why you Americans pay too much 132 00:08:17,920 --> 00:08:20,760 Speaker 2: for healthcareers? 133 00:08:20,800 --> 00:08:23,240 Speaker 3: And you listen to the Michael Berry Show. 134 00:08:23,160 --> 00:08:24,280 Speaker 4: Good not I. 135 00:08:27,960 --> 00:08:31,200 Speaker 2: Professor Charles Silver of the University of Texas School of 136 00:08:31,280 --> 00:08:35,599 Speaker 2: Law is our guest. He was I have come to 137 00:08:35,679 --> 00:08:38,760 Speaker 2: learn in the course of our conversation at ut Law 138 00:08:39,679 --> 00:08:41,920 Speaker 2: almost ten years before I was there, and still is. 139 00:08:42,320 --> 00:08:45,240 Speaker 2: I did not know him, but I happened to think 140 00:08:45,240 --> 00:08:48,040 Speaker 2: the world of that law school, and I gained a 141 00:08:48,040 --> 00:08:54,320 Speaker 2: lot from being there, both associations and education. And this 142 00:08:54,400 --> 00:08:57,920 Speaker 2: book has been highly recommended to me by numerous folks 143 00:08:58,520 --> 00:09:00,760 Speaker 2: as to how to gain a better underderstanding of why 144 00:09:00,760 --> 00:09:06,240 Speaker 2: the healthcare system costs you so much? Overcharged, Why Americans 145 00:09:06,240 --> 00:09:11,080 Speaker 2: pay too much for healthcare? Professor Charles Silver is our guest. Professor, 146 00:09:11,280 --> 00:09:17,200 Speaker 2: Let's talk about young people by young I'm fifty three, 147 00:09:17,200 --> 00:09:19,880 Speaker 2: so I'm gonna throw myself into there. You know, I've 148 00:09:19,920 --> 00:09:23,120 Speaker 2: read that something like half the healthcare costs in this 149 00:09:23,240 --> 00:09:26,720 Speaker 2: country are expended on people within the last two years 150 00:09:26,720 --> 00:09:27,320 Speaker 2: of their lives. 151 00:09:27,320 --> 00:09:29,280 Speaker 1: And you know, we see this where it's just constant. 152 00:09:29,440 --> 00:09:31,240 Speaker 2: It's just one thing after another after another, and then 153 00:09:31,280 --> 00:09:33,760 Speaker 2: they pass and then you kick in the funeral industry, 154 00:09:33,760 --> 00:09:35,960 Speaker 2: and I mean it's these are all industries, like the 155 00:09:35,960 --> 00:09:40,240 Speaker 2: bridal industry and the birthing industry. When you look at 156 00:09:40,280 --> 00:09:44,840 Speaker 2: a person who is relatively healthy without a chronic condition, 157 00:09:46,040 --> 00:09:50,120 Speaker 2: and you're looking at the cost to them that they're bearing, 158 00:09:50,480 --> 00:09:54,800 Speaker 2: which really is the risk you're willing to assume. Right, 159 00:09:55,040 --> 00:09:57,080 Speaker 2: if you're never going to need a doctor, then you 160 00:09:57,120 --> 00:09:59,800 Speaker 2: don't need insurance. We just don't know which one of 161 00:09:59,840 --> 00:10:01,200 Speaker 2: us is going to be in a car wreck or 162 00:10:01,200 --> 00:10:04,320 Speaker 2: have a heart attack. So we're trying the same way 163 00:10:04,080 --> 00:10:06,760 Speaker 2: we leverage the risk on if our house burns down. 164 00:10:07,160 --> 00:10:09,960 Speaker 2: We're trying to kind of to keep that at bay 165 00:10:10,000 --> 00:10:14,000 Speaker 2: and to make a good financial decision. Where is that 166 00:10:14,160 --> 00:10:17,120 Speaker 2: going wrong today? Because my guess is most people are 167 00:10:17,200 --> 00:10:21,720 Speaker 2: overpaying for insurance coverage that they won't need until much later. 168 00:10:22,040 --> 00:10:26,160 Speaker 2: That's going toward people at their end of life. 169 00:10:27,040 --> 00:10:29,320 Speaker 4: Oh, I agree that I think that story is right. 170 00:10:29,360 --> 00:10:32,120 Speaker 4: There are a bunch of thoughts that it prompts. One 171 00:10:32,160 --> 00:10:33,960 Speaker 4: of them is, you know, I've never been a fan 172 00:10:34,800 --> 00:10:40,119 Speaker 4: of taxing people who are relatively young to provide benefits 173 00:10:40,120 --> 00:10:42,480 Speaker 4: to people who are relatively old. That strikes me as 174 00:10:42,559 --> 00:10:44,240 Speaker 4: wrong on a variety of levels. 175 00:10:44,320 --> 00:10:44,520 Speaker 3: You know. 176 00:10:44,559 --> 00:10:48,600 Speaker 4: One is, every moral theory that I know of says 177 00:10:48,640 --> 00:10:53,040 Speaker 4: you move money from richer people to poorer people. Well, 178 00:10:53,280 --> 00:10:56,920 Speaker 4: older people are wealthier than younger people. That shouldn't be 179 00:10:56,920 --> 00:10:59,719 Speaker 4: surprising to anybody. They've had their whole lives to work, right, 180 00:11:00,320 --> 00:11:02,559 Speaker 4: They've paid off their cars, they've paid off their homes. 181 00:11:02,600 --> 00:11:06,000 Speaker 4: You know, they have other assets. Right, They're on average, 182 00:11:06,120 --> 00:11:08,800 Speaker 4: much wealthier than younger people who are struggling, you know, 183 00:11:08,920 --> 00:11:13,000 Speaker 4: raising families, you know, just getting jobs, dealing with college 184 00:11:13,000 --> 00:11:16,280 Speaker 4: debt and all that stuff. So my moral view is, 185 00:11:16,320 --> 00:11:18,160 Speaker 4: if we were going to move money in any direction, 186 00:11:18,240 --> 00:11:20,440 Speaker 4: we should move it from older people to younger people. 187 00:11:20,480 --> 00:11:23,240 Speaker 4: But our system does the reverse. We're robbing the poor 188 00:11:23,320 --> 00:11:28,480 Speaker 4: to pay the rich. I don't understand that. Another thing is, 189 00:11:30,920 --> 00:11:40,440 Speaker 4: excuse me, the system really deserves people because it eliminates. 190 00:11:39,840 --> 00:11:42,000 Speaker 3: All caps on spending. 191 00:11:42,040 --> 00:11:43,720 Speaker 4: You were talking about end of life care and how 192 00:11:43,760 --> 00:11:46,160 Speaker 4: we spend so much money in the last year or 193 00:11:46,200 --> 00:11:47,360 Speaker 4: two of people's lives. 194 00:11:47,400 --> 00:11:49,280 Speaker 3: Well, if people had. 195 00:11:49,120 --> 00:11:52,280 Speaker 4: To spend their own money, nobody would spend an infinite 196 00:11:52,320 --> 00:11:56,040 Speaker 4: amount in their last two years on healthcare. They would 197 00:11:56,040 --> 00:11:59,040 Speaker 4: have to make hard decisions. Right, These are not pleasant decisions, 198 00:11:59,440 --> 00:12:03,320 Speaker 4: but they would make decisions about how much healthcare they want. 199 00:12:03,440 --> 00:12:05,080 Speaker 3: Is it worth spending a million. 200 00:12:04,760 --> 00:12:07,760 Speaker 4: Dollars to extend my life by a month, Right, that's 201 00:12:07,800 --> 00:12:11,360 Speaker 4: the kind of decision they would have to make. Well, today, 202 00:12:11,440 --> 00:12:15,319 Speaker 4: because we removed all caps from the system, nobody has 203 00:12:15,320 --> 00:12:18,880 Speaker 4: to make those decisions. Instead, we just spend literally an 204 00:12:18,880 --> 00:12:22,240 Speaker 4: infinite amount of money on people who are in the 205 00:12:22,280 --> 00:12:24,000 Speaker 4: final stages of their illness. 206 00:12:24,080 --> 00:12:25,679 Speaker 3: We get no bang for the buck. 207 00:12:26,200 --> 00:12:28,320 Speaker 4: You know, we have people, literally we have people who 208 00:12:28,400 --> 00:12:32,120 Speaker 4: are receiving cancer treatments, new cancer treatments that cost a 209 00:12:32,160 --> 00:12:35,839 Speaker 4: million dollars, and all those treatments do is extend their 210 00:12:35,880 --> 00:12:38,880 Speaker 4: lives by about a month. And it's not even a 211 00:12:38,920 --> 00:12:41,040 Speaker 4: good month. It's not a month when you're going to 212 00:12:41,080 --> 00:12:43,760 Speaker 4: be out there on the golf course, playing with your 213 00:12:43,800 --> 00:12:46,160 Speaker 4: buddies and drinking beer, it's a month, like you're in 214 00:12:46,160 --> 00:12:50,520 Speaker 4: the hospital, right for the whole month. These things just 215 00:12:50,559 --> 00:12:55,960 Speaker 4: make no sense. Right, But the government cannot make those decisions, literally, 216 00:12:56,040 --> 00:12:59,959 Speaker 4: it cannot because the moment the government starts talking about 217 00:13:00,200 --> 00:13:04,480 Speaker 4: rationing care, everybody loses their minds. And you don't want 218 00:13:04,480 --> 00:13:09,640 Speaker 4: to be the politician that they're rallying against. Right, So 219 00:13:09,920 --> 00:13:14,120 Speaker 4: the government simply ignores the need to make these decisions 220 00:13:14,160 --> 00:13:17,240 Speaker 4: and just spends endless amounts of money because it's other 221 00:13:17,280 --> 00:13:17,840 Speaker 4: people's money. 222 00:13:17,920 --> 00:13:19,920 Speaker 3: So why does the government care? Right? 223 00:13:22,080 --> 00:13:24,720 Speaker 4: And you know, we just have to come back to 224 00:13:25,760 --> 00:13:28,960 Speaker 4: the world in which people are responsible for their own 225 00:13:29,640 --> 00:13:33,760 Speaker 4: end of life care. You know, it's a sad thing, 226 00:13:33,800 --> 00:13:36,240 Speaker 4: but it's true. We will all die at some point, 227 00:13:36,920 --> 00:13:39,480 Speaker 4: and the fact that we will all die at some 228 00:13:39,559 --> 00:13:41,120 Speaker 4: point affects. 229 00:13:41,200 --> 00:13:44,480 Speaker 3: A thousand decisions that each of us makes. Right, When 230 00:13:44,480 --> 00:13:45,720 Speaker 3: am I going to stop working? 231 00:13:46,360 --> 00:13:49,080 Speaker 4: Well, if I'm thinking I don't have much longer to live, 232 00:13:49,240 --> 00:13:51,240 Speaker 4: it probably will stop working so I can spend my 233 00:13:51,320 --> 00:13:53,400 Speaker 4: last you know, a couple of years with. 234 00:13:53,440 --> 00:13:56,240 Speaker 3: My family or traveling or whatever it is, right, I mean. 235 00:13:56,360 --> 00:13:58,959 Speaker 4: If you start to think about it, knowing that at 236 00:13:58,960 --> 00:14:03,199 Speaker 4: some point we will all die, it affects. As I said, 237 00:14:03,240 --> 00:14:06,360 Speaker 4: thousands of decisions that we make. You know, do I 238 00:14:06,400 --> 00:14:08,360 Speaker 4: want to live in this house that I'm in now 239 00:14:08,440 --> 00:14:09,959 Speaker 4: until the end of my life, or do I want 240 00:14:09,960 --> 00:14:13,040 Speaker 4: to move to a house that's more handicap equipped and 241 00:14:13,120 --> 00:14:16,720 Speaker 4: things of that sort. Right, this is just another decision. 242 00:14:16,840 --> 00:14:19,600 Speaker 4: It's a tough decision. I'm not trying to say otherwise, 243 00:14:19,640 --> 00:14:22,240 Speaker 4: but it's a decision that needs to be made, and 244 00:14:22,280 --> 00:14:24,760 Speaker 4: it needs to be made not by the government, but 245 00:14:24,800 --> 00:14:27,760 Speaker 4: by the people who are directly involved and who can 246 00:14:27,840 --> 00:14:31,160 Speaker 4: think hard about all these tough problems. There's no way 247 00:14:31,160 --> 00:14:34,000 Speaker 4: the government's going to make a good decision. Their incentives 248 00:14:34,040 --> 00:14:37,360 Speaker 4: are wrong, their knowledge is too limited. They don't have 249 00:14:37,440 --> 00:14:40,480 Speaker 4: access to the counselors that individuals will talk to when 250 00:14:40,560 --> 00:14:42,160 Speaker 4: making these kinds of decisions. 251 00:14:42,800 --> 00:14:44,520 Speaker 3: So, you know, we just have to get. 252 00:14:44,360 --> 00:14:48,680 Speaker 4: The government out of this business. What I have proposed is. 253 00:14:50,560 --> 00:14:50,960 Speaker 3: That we can. 254 00:14:51,080 --> 00:14:52,960 Speaker 4: You know, there is one other problem though that we 255 00:14:53,040 --> 00:14:55,520 Speaker 4: haven't discussed, which we do need to discuss, which is 256 00:14:55,560 --> 00:14:58,640 Speaker 4: there are some people who are too poor to afford 257 00:14:59,200 --> 00:15:02,480 Speaker 4: fundamental health healthcare. We do need to come up with 258 00:15:02,520 --> 00:15:05,080 Speaker 4: a way of dealing with those people, because when they 259 00:15:05,080 --> 00:15:08,320 Speaker 4: show up at the hospital needing healthcare. They're not going 260 00:15:08,360 --> 00:15:10,640 Speaker 4: to be turned away right now. We're not going to 261 00:15:10,640 --> 00:15:13,280 Speaker 4: be having sick people dying in the streets because they 262 00:15:13,320 --> 00:15:16,560 Speaker 4: can't afford healthcare. So we need to come up with 263 00:15:16,600 --> 00:15:19,000 Speaker 4: a way to deal with that. But the obvious way 264 00:15:19,040 --> 00:15:21,240 Speaker 4: to deal with that is through a negative income text, 265 00:15:21,520 --> 00:15:25,440 Speaker 4: the sort of thing that Milton Friedman proposed. You provide 266 00:15:25,480 --> 00:15:29,200 Speaker 4: everybody with a kind of amount of sustenance that they 267 00:15:29,200 --> 00:15:31,280 Speaker 4: can use for this purpose. You could put it into 268 00:15:31,320 --> 00:15:35,320 Speaker 4: a restricted medical account if you wanted, But the idea 269 00:15:35,320 --> 00:15:37,960 Speaker 4: is once you give it to them, it's hands off 270 00:15:38,200 --> 00:15:40,160 Speaker 4: for the rest of it. The government doesn't get involved 271 00:15:40,160 --> 00:15:44,200 Speaker 4: in the delivery of healthcare. It just people make decisions 272 00:15:44,280 --> 00:15:47,880 Speaker 4: on themselves with their own money, and life goes forward. 273 00:15:47,920 --> 00:15:50,080 Speaker 4: And I think if we did that, the healthcare system 274 00:15:50,080 --> 00:15:52,479 Speaker 4: would operate much more efficiently. 275 00:15:52,840 --> 00:15:53,040 Speaker 3: Well. 276 00:15:53,080 --> 00:15:57,800 Speaker 2: The great frustration, as you know, is that everybody gets 277 00:15:57,800 --> 00:16:00,440 Speaker 2: a vote, even people that make bad decisions, and that 278 00:16:00,600 --> 00:16:03,840 Speaker 2: many people make bad decisions. You know that we will 279 00:16:03,840 --> 00:16:06,119 Speaker 2: have a lot of people who say I can't afford 280 00:16:06,200 --> 00:16:08,320 Speaker 2: medical care because they don't save money. 281 00:16:08,520 --> 00:16:10,560 Speaker 1: But they've got a big screen TV in every. 282 00:16:10,360 --> 00:16:13,680 Speaker 2: Room, and they've got you know, a car they can't 283 00:16:13,680 --> 00:16:16,680 Speaker 2: afford that they're driving. They end up with the car 284 00:16:16,760 --> 00:16:18,720 Speaker 2: that they can't afford, and we end up paying for 285 00:16:18,760 --> 00:16:19,840 Speaker 2: the health care. 286 00:16:19,640 --> 00:16:20,480 Speaker 3: That they can't afford. 287 00:16:20,760 --> 00:16:24,960 Speaker 2: The book is Overcharged, Why Americans Pay too Much for Healthcare? 288 00:16:24,960 --> 00:16:28,640 Speaker 1: Professor Charles Silver. But everybody knows who this guy is. 289 00:16:28,680 --> 00:16:34,920 Speaker 2: Come on, man with them, Michael Berry, Come on. Professor 290 00:16:35,040 --> 00:16:37,560 Speaker 2: Charles Silver is our guest. It's a subject of great 291 00:16:37,600 --> 00:16:40,400 Speaker 2: interest to me and to many of you. The book 292 00:16:40,480 --> 00:16:45,520 Speaker 2: is called Overcharged, Why Americans Pay Too Much for Healthcare? 293 00:16:45,680 --> 00:16:49,119 Speaker 2: He is a law professor at the University of Texas 294 00:16:49,560 --> 00:16:53,480 Speaker 2: at Austin School of Law. And we ended the last 295 00:16:53,520 --> 00:16:56,440 Speaker 2: segment with the discussion that at the end of the day, 296 00:16:57,080 --> 00:17:00,760 Speaker 2: the allocation of scarce resources and who will make that decision. 297 00:17:01,520 --> 00:17:06,239 Speaker 2: We're back at that point again in every family. You know, 298 00:17:06,280 --> 00:17:10,840 Speaker 2: you've got eight kids and you've got one chicken. Mom 299 00:17:10,920 --> 00:17:13,239 Speaker 2: says you're not getting a second piece. So there's some 300 00:17:13,280 --> 00:17:18,080 Speaker 2: cartilage left on that leg. If you're hungry, you'll eat that. 301 00:17:18,760 --> 00:17:21,520 Speaker 2: And there comes a point where we have to decide, 302 00:17:22,280 --> 00:17:25,960 Speaker 2: with scarce resources, who will make the decision as to 303 00:17:26,000 --> 00:17:28,040 Speaker 2: where those resources will be deployed. 304 00:17:28,440 --> 00:17:31,560 Speaker 1: Will it be the government or will it be the individual. 305 00:17:31,880 --> 00:17:35,920 Speaker 2: And if it's the individual, there will be those who say, well, 306 00:17:36,280 --> 00:17:38,840 Speaker 2: I want as much as my neighbor has, Okay, well 307 00:17:38,880 --> 00:17:42,760 Speaker 2: earn the money to purchase that. Well, I don't earn 308 00:17:42,920 --> 00:17:45,240 Speaker 2: as much. I want to use the power of the 309 00:17:45,320 --> 00:17:47,920 Speaker 2: gun through at the direction of the government that I 310 00:17:48,040 --> 00:17:49,359 Speaker 2: either are more of me than there are of the 311 00:17:49,440 --> 00:17:52,800 Speaker 2: rich people I vote for. I want that well. The 312 00:17:52,880 --> 00:17:55,200 Speaker 2: only alternative is for the government to do it. Professor 313 00:17:55,200 --> 00:17:58,600 Speaker 2: I harken back to a study, and it's been a 314 00:17:58,640 --> 00:18:03,639 Speaker 2: while since I've read this book. It's interesting because I'm 315 00:18:03,680 --> 00:18:07,280 Speaker 2: a believer and let the marketplace decide. You know, healthcare 316 00:18:07,320 --> 00:18:09,119 Speaker 2: is the one area where we think everybody gets all 317 00:18:09,119 --> 00:18:11,600 Speaker 2: the healthcare they want, but we all end up. 318 00:18:11,480 --> 00:18:11,960 Speaker 3: Paying for that. 319 00:18:11,960 --> 00:18:13,680 Speaker 2: We don't say everybody gets all the food they want, 320 00:18:13,760 --> 00:18:15,440 Speaker 2: or all the cars they want, or all the houses 321 00:18:15,480 --> 00:18:17,239 Speaker 2: they want, or all the clothes they want, but for 322 00:18:17,240 --> 00:18:20,520 Speaker 2: some reason, everybody gets all the healthcare they want, even 323 00:18:20,560 --> 00:18:22,720 Speaker 2: at the point that it's throwing good money after bad. 324 00:18:23,440 --> 00:18:27,560 Speaker 2: So socialist system the opposite of what I propose. In Sweden, 325 00:18:28,080 --> 00:18:31,000 Speaker 2: they did a study and it was a multi decade study. 326 00:18:31,040 --> 00:18:33,560 Speaker 2: You may be aware of it. On prostate cancer in men, 327 00:18:34,320 --> 00:18:39,320 Speaker 2: and they determined that out of I think it was 328 00:18:39,440 --> 00:18:43,600 Speaker 2: three thousand men who had prostate cancer who were diagnosed 329 00:18:43,600 --> 00:18:47,320 Speaker 2: with prostate cancer and they chose not to treat the 330 00:18:47,359 --> 00:18:51,520 Speaker 2: prostate cancer. And they did about a twenty five year 331 00:18:51,600 --> 00:18:55,399 Speaker 2: study and the number of men who died of untreated 332 00:18:55,400 --> 00:18:58,959 Speaker 2: prostate cancer was something like thirty out of three thousand. 333 00:18:59,480 --> 00:19:02,840 Speaker 2: So they came to the conclusion with a government completely 334 00:19:02,880 --> 00:19:06,879 Speaker 2: government run system, that with scarce resources, it does not 335 00:19:07,040 --> 00:19:11,720 Speaker 2: make sense for us to treat prostate cancer per se 336 00:19:11,960 --> 00:19:14,199 Speaker 2: because nobody, very few people are going to die of 337 00:19:14,240 --> 00:19:17,480 Speaker 2: prostate cancer. Let's spend our money on other things that 338 00:19:17,520 --> 00:19:19,560 Speaker 2: if we don't spend it, there you die. 339 00:19:20,280 --> 00:19:21,400 Speaker 1: And it strikes me. 340 00:19:21,600 --> 00:19:25,760 Speaker 2: That while that's the opposite of the capitalist system, there 341 00:19:25,800 --> 00:19:29,040 Speaker 2: does need to be an understanding that we're wasting a 342 00:19:29,040 --> 00:19:33,320 Speaker 2: lot of money on studies because and this gets to 343 00:19:33,359 --> 00:19:35,359 Speaker 2: the second point of what you've written a lot about 344 00:19:35,600 --> 00:19:39,440 Speaker 2: medical malpractice and the fear of medical malpractice. I don't 345 00:19:39,440 --> 00:19:41,919 Speaker 2: think everybody needs a glaucoma test every time they go 346 00:19:42,040 --> 00:19:46,159 Speaker 2: for their license, but god forbid one person not be 347 00:19:46,240 --> 00:19:52,400 Speaker 2: diagnosed with glaucoma. We're practicing defensive medicine. We're over ordering tests, 348 00:19:52,760 --> 00:19:54,560 Speaker 2: which is a waste of our time and energy but 349 00:19:54,600 --> 00:19:59,240 Speaker 2: also money, and we're not actually doing we're not engaged in. 350 00:20:00,040 --> 00:20:04,600 Speaker 2: But I would consider smart effective healing because everyone is 351 00:20:04,640 --> 00:20:07,960 Speaker 2: afraid of being sued, and that has we get back 352 00:20:07,960 --> 00:20:10,800 Speaker 2: to our point. The book is overcharged, Why Americans pay 353 00:20:10,880 --> 00:20:13,399 Speaker 2: too much for healthcare? I think that's a big portion 354 00:20:13,520 --> 00:20:17,720 Speaker 2: of what we spend. Your thought, well, I'm. 355 00:20:17,560 --> 00:20:19,600 Speaker 4: Going to disagree with part of that, but I agree 356 00:20:19,640 --> 00:20:24,080 Speaker 4: with a lot of it as well. In my world, 357 00:20:24,160 --> 00:20:28,399 Speaker 4: when you have a self interested explanation or something, you 358 00:20:28,440 --> 00:20:31,200 Speaker 4: probably don't have to look very far for any other explanation. 359 00:20:31,359 --> 00:20:36,320 Speaker 4: Self interest usually is a pretty good explanation. And the reason, 360 00:20:36,600 --> 00:20:39,480 Speaker 4: you know, some people say, oh, the reason that doctors 361 00:20:39,480 --> 00:20:42,840 Speaker 4: overtreat is because they're afraid of being sued. Well, there's 362 00:20:42,880 --> 00:20:45,920 Speaker 4: a simpler self interested explanation, which is every time they 363 00:20:45,960 --> 00:20:50,760 Speaker 4: treat somebody, they make money, and until you take the 364 00:20:50,840 --> 00:20:55,560 Speaker 4: profit out of these services, which will never happen, it's 365 00:20:55,800 --> 00:20:59,520 Speaker 4: very hard to determine that they're actually engaging in any 366 00:21:00,200 --> 00:21:05,200 Speaker 4: real defensive medicine at all. There are lots of studies 367 00:21:05,280 --> 00:21:07,960 Speaker 4: that are out there now that have found that I mean, 368 00:21:08,080 --> 00:21:12,000 Speaker 4: defensive medicine is kind of hard to define because it 369 00:21:12,040 --> 00:21:15,679 Speaker 4: can be both. It can be both the provision of 370 00:21:15,720 --> 00:21:19,639 Speaker 4: services that aren't needed and the avoidance of services that 371 00:21:19,680 --> 00:21:23,000 Speaker 4: are needed, because you get sued when you do deliver 372 00:21:23,119 --> 00:21:26,400 Speaker 4: services as well as when you withhold them. So it's 373 00:21:26,440 --> 00:21:30,040 Speaker 4: hard to figure out exactly what's going on with defensive medicine. 374 00:21:30,040 --> 00:21:31,800 Speaker 4: But as I said, I don't think we really need 375 00:21:31,840 --> 00:21:34,240 Speaker 4: to worry about it very much because we have a 376 00:21:34,280 --> 00:21:37,760 Speaker 4: self interested explanation, which is that the services are profitable. 377 00:21:38,280 --> 00:21:40,359 Speaker 4: And there's also you know, doctors have a lot of 378 00:21:40,400 --> 00:21:43,520 Speaker 4: confidence in their ability to help people, and they have 379 00:21:43,560 --> 00:21:45,000 Speaker 4: a very strong desire. 380 00:21:44,760 --> 00:21:45,600 Speaker 3: To help people. 381 00:21:45,760 --> 00:21:47,760 Speaker 1: Right at least that's what it should be. 382 00:21:48,080 --> 00:21:48,320 Speaker 3: You know. 383 00:21:48,400 --> 00:21:52,360 Speaker 2: You remind me of another great document written in seventeen 384 00:21:52,480 --> 00:21:55,760 Speaker 2: seventy six, and that from a Scotsman named Adam Smith, 385 00:21:55,800 --> 00:21:58,280 Speaker 2: who famously said, it is not from the benevolence of 386 00:21:58,320 --> 00:22:00,600 Speaker 2: the butcher, or the brewer or the baker that we 387 00:22:00,680 --> 00:22:04,720 Speaker 2: expect our dinner, but from their regard to their own 388 00:22:04,840 --> 00:22:11,760 Speaker 2: self interest exactly. Self interest drives so many things. That 389 00:22:11,800 --> 00:22:14,520 Speaker 2: guy is not standing on his feet behind the counter 390 00:22:14,560 --> 00:22:16,680 Speaker 2: at the donut shop for so many hours and didn't 391 00:22:16,680 --> 00:22:18,960 Speaker 2: get there at two thirty this morning because he's a 392 00:22:19,040 --> 00:22:22,920 Speaker 2: nice guy. He wants to make a profit off the donuts. 393 00:22:22,960 --> 00:22:25,800 Speaker 2: I get to enjoy the donuts in exchange for the 394 00:22:25,880 --> 00:22:28,520 Speaker 2: currency that I was given for the sweat of my brow. 395 00:22:28,920 --> 00:22:31,359 Speaker 2: It works, and I think we have to return that 396 00:22:31,400 --> 00:22:33,399 Speaker 2: to the process. And I think that's where you and 397 00:22:33,440 --> 00:22:34,320 Speaker 2: I can agree. 398 00:22:35,520 --> 00:22:37,240 Speaker 4: I think we do agree on that, but we also 399 00:22:37,320 --> 00:22:43,480 Speaker 4: agree that I mean, these social programs have fundamentally undermined 400 00:22:43,840 --> 00:22:49,400 Speaker 4: the incentive to save and to be self reliant. 401 00:22:50,440 --> 00:22:54,360 Speaker 3: You know, the I think, you know, I constantly. 402 00:22:53,920 --> 00:22:57,880 Speaker 4: Read articles about how many people are retiring and all 403 00:22:57,920 --> 00:23:00,840 Speaker 4: they have to live on is social secure already in medicare, 404 00:23:00,880 --> 00:23:03,959 Speaker 4: they don't have much in the way of savings. And 405 00:23:04,080 --> 00:23:07,160 Speaker 4: people say, well, how could you possibly, you know, let 406 00:23:07,200 --> 00:23:09,680 Speaker 4: that happen, right? Why are you buying, as you put it, 407 00:23:09,760 --> 00:23:13,000 Speaker 4: those you know, big screen TVs for every room when 408 00:23:13,000 --> 00:23:16,120 Speaker 4: you should be saving for your later years. I think 409 00:23:16,200 --> 00:23:18,760 Speaker 4: the answer is that most people naively think, oh, the 410 00:23:18,800 --> 00:23:20,919 Speaker 4: government's just going to take care of me in my 411 00:23:21,040 --> 00:23:24,360 Speaker 4: later years, so I don't have to save, and they, 412 00:23:25,119 --> 00:23:28,359 Speaker 4: you know, the temptation to spend money now rather than later. 413 00:23:28,440 --> 00:23:31,960 Speaker 4: It's always there who wants to save. Saving is boring, right, 414 00:23:33,040 --> 00:23:37,159 Speaker 4: Consuming today is fun. So you know, I think that 415 00:23:38,040 --> 00:23:41,840 Speaker 4: as long as we have these pay go programs where 416 00:23:42,000 --> 00:23:45,320 Speaker 4: you know you can keep getting money out above what 417 00:23:45,359 --> 00:23:49,959 Speaker 4: you put in, that the incentives to save will forever 418 00:23:50,040 --> 00:23:54,040 Speaker 4: be undermined. And that's a terrible thing, I think, because 419 00:23:54,200 --> 00:23:57,000 Speaker 4: as you said, you know, we're we're just getting ourselves 420 00:23:57,000 --> 00:24:00,280 Speaker 4: into this world where each of us expects everybody else 421 00:24:00,320 --> 00:24:03,520 Speaker 4: to pay for everything that we need. If it's only healthcare, 422 00:24:04,280 --> 00:24:06,920 Speaker 4: they still expect to pay for everything that they want, 423 00:24:07,520 --> 00:24:10,440 Speaker 4: and that just drives costs through the roof without really 424 00:24:10,520 --> 00:24:12,840 Speaker 4: any offsetting benefits that make sense of it. 425 00:24:13,440 --> 00:24:18,080 Speaker 2: Zoologists will tell you you are doing great harm by 426 00:24:18,080 --> 00:24:23,080 Speaker 2: domesticating certain breeds of animals, particularly if you intend at 427 00:24:23,080 --> 00:24:25,399 Speaker 2: some point to release them into the wild. 428 00:24:25,480 --> 00:24:26,639 Speaker 1: You make them slaves. 429 00:24:26,720 --> 00:24:31,640 Speaker 2: They lose the very abilities, and we've seen with evolutionary 430 00:24:31,640 --> 00:24:34,919 Speaker 2: studies that teeth are not as sharpenning longer, claws are 431 00:24:34,920 --> 00:24:37,440 Speaker 2: not as sharpenning more, they can no longer run as fast. 432 00:24:37,800 --> 00:24:42,400 Speaker 2: They grow to be like prison inmates, dependent on someone 433 00:24:42,440 --> 00:24:46,040 Speaker 2: else to provide for them. And I think that has 434 00:24:46,119 --> 00:24:50,159 Speaker 2: to be understood by people our guest is Professor Charles Silver, 435 00:24:50,200 --> 00:24:51,840 Speaker 2: who will be with us for one more segment. 436 00:24:51,960 --> 00:24:57,560 Speaker 1: The book is Overcharged? Why Americans pay too much for rusty? 437 00:24:59,400 --> 00:25:01,880 Speaker 3: Or take me need to Texas because I don't ready 438 00:25:01,960 --> 00:25:05,040 Speaker 3: to get out of this state. I think Michael Berry 439 00:25:05,200 --> 00:25:07,359 Speaker 3: Rocks show I like you. 440 00:25:09,440 --> 00:25:13,080 Speaker 2: Professor Charles Silver of the University of Texas School of Law, 441 00:25:13,119 --> 00:25:17,000 Speaker 2: my alma mater, has graciously spent quite a bit of 442 00:25:17,040 --> 00:25:21,600 Speaker 2: time with us discussing an area of his academic expertise 443 00:25:21,640 --> 00:25:24,760 Speaker 2: and prowess. The book is Overcharged, Why Americans pay too 444 00:25:24,800 --> 00:25:27,600 Speaker 2: much for healthcare? And folks, I have to say, as 445 00:25:27,880 --> 00:25:32,119 Speaker 2: as you've heard me say many times, politics is interesting, 446 00:25:32,400 --> 00:25:35,600 Speaker 2: you know, the rooting for your team versus that team, 447 00:25:35,680 --> 00:25:38,440 Speaker 2: the Trump Dance, the reds and Blues and who shows 448 00:25:38,480 --> 00:25:41,479 Speaker 2: up and on. But my primary interest at the end 449 00:25:41,520 --> 00:25:43,680 Speaker 2: of the day is not my team winning and your 450 00:25:43,720 --> 00:25:48,480 Speaker 2: team losing. My primary interest is creating a structure where 451 00:25:48,520 --> 00:25:52,480 Speaker 2: the individual can thrive, where there is opportunity and fairness, 452 00:25:52,760 --> 00:25:57,040 Speaker 2: safeguard's rule of law, and that will, at the end 453 00:25:57,080 --> 00:26:00,280 Speaker 2: of the day, advance humanity. It always has. It's the 454 00:26:00,280 --> 00:26:03,000 Speaker 2: only thing that does not government. And so these sort 455 00:26:03,000 --> 00:26:07,320 Speaker 2: of policy discussions I understand, are probably less thrilling than 456 00:26:07,320 --> 00:26:10,159 Speaker 2: my usual screaming and hollering about. 457 00:26:10,320 --> 00:26:12,960 Speaker 1: This or that indignity of the day. But this is 458 00:26:13,000 --> 00:26:13,760 Speaker 1: what matters. 459 00:26:13,960 --> 00:26:17,719 Speaker 2: This is why we get involved in campaigns, is to 460 00:26:17,760 --> 00:26:19,600 Speaker 2: take control of the government and get it out of 461 00:26:19,640 --> 00:26:23,879 Speaker 2: our lives and create safeguards and reduce regulation and promote 462 00:26:23,880 --> 00:26:26,679 Speaker 2: the rule of law so that hardworking people can create 463 00:26:26,800 --> 00:26:29,560 Speaker 2: enough John Galt style for the rest of us to prosper. 464 00:26:30,040 --> 00:26:34,399 Speaker 2: And this stuff matters. So that's why we have these conversations. 465 00:26:34,800 --> 00:26:39,359 Speaker 2: Professor Charlesolver, overcharged, why Americans pay too much for healthcare? 466 00:26:39,680 --> 00:26:42,280 Speaker 1: Professor Silver, I want you to be king for a day. 467 00:26:42,400 --> 00:26:43,040 Speaker 1: You have no. 468 00:26:45,160 --> 00:26:51,040 Speaker 2: As this benevolent monarch, you have no political concerns. Reconstruct 469 00:26:51,280 --> 00:26:55,040 Speaker 2: our health care facility to provide an opportunity for the 470 00:26:55,080 --> 00:26:58,680 Speaker 2: most healing to occur and the individuals to take control 471 00:26:58,760 --> 00:26:59,800 Speaker 2: of their own health care. 472 00:27:00,000 --> 00:27:00,679 Speaker 1: What does that look like? 473 00:27:03,119 --> 00:27:06,159 Speaker 4: Wow, I'm nervous about being king for a day because 474 00:27:06,480 --> 00:27:08,320 Speaker 4: I don't believe in kings, I know, but. 475 00:27:09,880 --> 00:27:10,440 Speaker 3: I'll try. 476 00:27:12,240 --> 00:27:15,840 Speaker 4: I think we basically wipe away everything in terms of 477 00:27:16,640 --> 00:27:19,760 Speaker 4: these programs and the restrictive regulations. 478 00:27:19,840 --> 00:27:22,399 Speaker 3: You know, have you ever heard of a certificate of 479 00:27:22,520 --> 00:27:23,639 Speaker 3: need law. I don't know. 480 00:27:23,840 --> 00:27:27,919 Speaker 4: They're called con laws by for short, but con laws 481 00:27:29,600 --> 00:27:34,119 Speaker 4: regulate how many new healthcare providers can set up shops. 482 00:27:34,119 --> 00:27:35,920 Speaker 4: So if you want to open a hospital, you got 483 00:27:35,960 --> 00:27:39,080 Speaker 4: to get permission. But guess what the way the con 484 00:27:39,160 --> 00:27:43,720 Speaker 4: laws work, the existing hospitals have a vote and whether 485 00:27:43,760 --> 00:27:44,480 Speaker 4: you can open a. 486 00:27:44,440 --> 00:27:46,880 Speaker 3: New hospital or not. I'm like giving. 487 00:27:46,880 --> 00:27:50,080 Speaker 4: McDonald's a vote on whether Burger King can open a 488 00:27:50,080 --> 00:27:54,240 Speaker 4: restaurant right across the street. It doesn't make any sense, 489 00:27:54,359 --> 00:27:56,480 Speaker 4: but that's the way I would get rid of all 490 00:27:56,560 --> 00:28:00,440 Speaker 4: of those supply constraining regulations, and I would get rid 491 00:28:00,480 --> 00:28:05,960 Speaker 4: of all of these programs Obamacare, Medicare, whatever, and I 492 00:28:06,000 --> 00:28:11,400 Speaker 4: would go to a very simple wealth distribution program. I'm 493 00:28:11,400 --> 00:28:13,880 Speaker 4: not sure exactly how much money it should be. That's 494 00:28:13,880 --> 00:28:15,840 Speaker 4: something that has to have some work done. But you 495 00:28:15,840 --> 00:28:18,560 Speaker 4: know we're currently spending if you put all the healthcare 496 00:28:19,080 --> 00:28:24,000 Speaker 4: programs together, you know we're spending like seven eight ten 497 00:28:24,080 --> 00:28:28,359 Speaker 4: thousand dollars a person, you know, per American through these programs. 498 00:28:28,359 --> 00:28:31,600 Speaker 4: If we just took some of that money and started 499 00:28:31,680 --> 00:28:36,199 Speaker 4: plunking it into restricted healthcare savings accounts for people, so 500 00:28:36,359 --> 00:28:38,400 Speaker 4: every year, you know, there's just a little bit more 501 00:28:38,480 --> 00:28:41,640 Speaker 4: that's put in pretty soon, everybody would have enough money 502 00:28:41,720 --> 00:28:45,600 Speaker 4: to pay for their basic needs and to buy catastrophic insurance. 503 00:28:45,600 --> 00:28:49,120 Speaker 4: And I would let people buy just as much catastrophic 504 00:28:49,160 --> 00:28:52,760 Speaker 4: insurance as they want. I wouldn't have coverage mandates. You know, 505 00:28:52,880 --> 00:28:55,760 Speaker 4: right now, if you want to buy a policy on 506 00:28:55,760 --> 00:29:00,160 Speaker 4: one of the exchanges and you're a young man, you 507 00:29:00,200 --> 00:29:04,880 Speaker 4: know you have to pay for annual mammograms, right, but 508 00:29:05,160 --> 00:29:08,840 Speaker 4: you're not getting mamograms because you're a man, right right, 509 00:29:09,040 --> 00:29:12,160 Speaker 4: So you know, I wouldn't force people to buy any 510 00:29:12,200 --> 00:29:15,640 Speaker 4: particular amount of coverage, and I would let insurance companies 511 00:29:15,760 --> 00:29:19,719 Speaker 4: limit the total payouts, which you know, that's really where 512 00:29:20,920 --> 00:29:23,200 Speaker 4: things are screwed up right now. It's one of the areas, 513 00:29:23,240 --> 00:29:25,880 Speaker 4: right they have to spend unlimited amounts of money on people. 514 00:29:26,400 --> 00:29:30,400 Speaker 4: I would let people let design their own insurance programs. 515 00:29:30,440 --> 00:29:33,120 Speaker 4: And I think that you know, it's not gonna work perfectly. 516 00:29:33,160 --> 00:29:35,680 Speaker 4: Nothing ever works perfectly, right, but it would work so 517 00:29:35,840 --> 00:29:38,960 Speaker 4: much better and be so much more efficient than the 518 00:29:39,160 --> 00:29:43,640 Speaker 4: existing system, and it'd be way more consumer friendly. And 519 00:29:43,680 --> 00:29:47,600 Speaker 4: that's a huge improvement because I don't know anybody who 520 00:29:47,640 --> 00:29:50,400 Speaker 4: is happy with the existing healthcare system. I mean, this 521 00:29:50,960 --> 00:29:55,040 Speaker 4: terrible murder that just occurred has brought to the surface 522 00:29:55,360 --> 00:30:01,320 Speaker 4: the extraordinary hatred that people have to work insurance companies. 523 00:30:01,800 --> 00:30:05,600 Speaker 4: You know, that's just one symptom. We're spending twice as 524 00:30:05,680 --> 00:30:09,160 Speaker 4: much as any other country on healthcare, and we're getting 525 00:30:09,200 --> 00:30:12,840 Speaker 4: less and less healthy every year. You know, our life 526 00:30:12,880 --> 00:30:16,280 Speaker 4: expectancy is declining. We're just doing everything wrong that we 527 00:30:16,440 --> 00:30:19,720 Speaker 4: possibly can do. So wipe the slate, get rid of 528 00:30:19,760 --> 00:30:23,280 Speaker 4: all this stuff. Start out with a really simple direct 529 00:30:23,320 --> 00:30:26,640 Speaker 4: payment system and a cash transfer system to deal with 530 00:30:26,640 --> 00:30:29,400 Speaker 4: people who are so poor that they can't even afford 531 00:30:29,440 --> 00:30:33,720 Speaker 4: the basics, and just be satisfied with that. I said, 532 00:30:33,760 --> 00:30:35,240 Speaker 4: It's not gonna be perfect, but it'd be hard to 533 00:30:35,280 --> 00:30:36,640 Speaker 4: improve on all. 534 00:30:36,720 --> 00:30:40,800 Speaker 2: Right, Yeah, And to get outside the purview of what 535 00:30:40,840 --> 00:30:43,520 Speaker 2: we've discussed, but to speak more to the process that 536 00:30:43,640 --> 00:30:45,360 Speaker 2: lands us where we are. 537 00:30:46,160 --> 00:30:47,360 Speaker 1: Our criminal justice system. 538 00:30:47,400 --> 00:30:51,920 Speaker 2: We spend more on imprisoning and prosecuting and chasing down 539 00:30:52,000 --> 00:30:54,400 Speaker 2: bad guys in any other country in the world, and 540 00:30:54,520 --> 00:30:57,400 Speaker 2: yet I think we do a far worse job, at 541 00:30:57,520 --> 00:31:00,320 Speaker 2: less effective job than most countries in the world. 542 00:31:00,360 --> 00:31:02,040 Speaker 1: And I think meant much of that. 543 00:31:02,160 --> 00:31:05,400 Speaker 2: I can you can see some similarities and patterns that 544 00:31:05,560 --> 00:31:09,280 Speaker 2: pervade those two industries. And by the way, then we 545 00:31:09,320 --> 00:31:13,640 Speaker 2: could move over into public education and education generally. There 546 00:31:13,680 --> 00:31:18,200 Speaker 2: are a number of different applications for where this process 547 00:31:19,280 --> 00:31:23,680 Speaker 2: has gone wrong, and it is frustrating. I very much 548 00:31:23,720 --> 00:31:29,680 Speaker 2: appreciate your time, Professor. I feel the better for it. 549 00:31:30,080 --> 00:31:34,360 Speaker 2: The book is overcharged, Why Americans pay too much for healthcare? 550 00:31:34,720 --> 00:31:38,600 Speaker 2: Professor Charles Silver of the University of Texas School of Law. 551 00:31:38,640 --> 00:31:41,480 Speaker 3: Thank you, sir, Thank you, Michael Pleasure. 552 00:31:41,680 --> 00:31:45,160 Speaker 2: And with that, might I suggest to each and every 553 00:31:45,200 --> 00:31:49,000 Speaker 2: one of you that while politics is an interesting undertaking, 554 00:31:49,160 --> 00:31:52,720 Speaker 2: and it is you know, winning elections, and he said this, 555 00:31:52,880 --> 00:31:55,360 Speaker 2: and we're going to show him, and you know, there's 556 00:31:55,440 --> 00:31:58,880 Speaker 2: it's a battle royale. And you know I argued with 557 00:31:59,040 --> 00:32:03,880 Speaker 2: my cousin at the Thanksgiving table. At the end of 558 00:32:03,920 --> 00:32:08,959 Speaker 2: it all, the reason for the arguments, reason for the 559 00:32:09,000 --> 00:32:18,200 Speaker 2: elections should be very redemptive, very practical, not just existential, 560 00:32:18,760 --> 00:32:22,640 Speaker 2: not just ideological. They're real to your life, and that 561 00:32:22,840 --> 00:32:31,560 Speaker 2: is creating a governmental system where individuals are free to thrive. 562 00:32:32,560 --> 00:32:37,520 Speaker 2: Government is not just. Government is not merciful. Government is 563 00:32:37,560 --> 00:32:44,480 Speaker 2: not protective. It is not good. Government is clunky, it's inefficient. 564 00:32:45,480 --> 00:32:47,800 Speaker 2: If you've stood in line at the DPS office to 565 00:32:47,800 --> 00:32:50,320 Speaker 2: get your driver's license and thought to yourself, you could 566 00:32:50,480 --> 00:32:51,440 Speaker 2: move this thing along. 567 00:32:52,400 --> 00:32:54,240 Speaker 1: If you've seen someone. 568 00:32:54,240 --> 00:32:57,600 Speaker 2: Who is on the clock and doesn't care about results, 569 00:32:58,120 --> 00:33:01,600 Speaker 2: if you've seen the worst of government in every aspect, 570 00:33:01,800 --> 00:33:04,479 Speaker 2: whether it's the inspector who doesn't seem to care that 571 00:33:04,520 --> 00:33:07,760 Speaker 2: they're coming back and adding these these regulations that are 572 00:33:07,800 --> 00:33:09,560 Speaker 2: going to cost this much more for you to build this, 573 00:33:09,640 --> 00:33:11,360 Speaker 2: and now you're going to walk away from the project 574 00:33:11,400 --> 00:33:14,400 Speaker 2: and leave the property vacant, and that's not good for anybody. 575 00:33:15,360 --> 00:33:17,720 Speaker 1: These are the things that we should spend our time in. 576 00:33:18,880 --> 00:33:23,240 Speaker 2: And I say this because politics has become sport and 577 00:33:23,320 --> 00:33:24,480 Speaker 2: it's become for many. 578 00:33:24,320 --> 00:33:25,640 Speaker 1: People their favorite hobby. 579 00:33:26,040 --> 00:33:28,160 Speaker 2: But let's not lose track of what we're trying to 580 00:33:28,200 --> 00:33:33,480 Speaker 2: do here, which is literal, not to exaggerate, save our country. 581 00:33:33,480 --> 00:33:37,480 Speaker 4: Els has let goodblity, thank you, and good night.