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Speaker 1: When you're ready to ride Metro, we want you to

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Speaker 1: know we're ready for you. Here are just a few

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Speaker 1: of the people at Metro to tell you how we're

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Speaker 1: doing our part to keep riders safe. Were cleaning before

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Speaker 1: half to the Great Queen. You have found Hans out

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Speaker 1: of souns of spaces, no masks, no Metro need one.

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Speaker 1: We have a few extras at Metro. We're doing our

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Speaker 1: part to keep the DC area moving. Find out more

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Speaker 1: at well mata dot com slash doing our part. So

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Speaker 1: he's Craig, the healthcare guru. Craig got Walls, who is

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Speaker 1: a benefits and healthcare expert as well as an attorney.

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Speaker 1: And we first became acquinted with Craig professionally speaking talking

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Speaker 1: about Obamacare back in the day and the realities of it.

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Speaker 1: And Craig makes his living being non political and realistic,

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Speaker 1: so as clients know what they can expect from the

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Speaker 1: world of healthcare. If you don't know Craig's act Greig,

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Speaker 1: how are you, sir? Um Well, how are you? Gentlemans?

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Speaker 1: We gonta healthcare. Thanks for the donuts brings in donuts.

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Speaker 1: What are you trying to do to us? You've trying

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Speaker 1: to please your most base desires, Joe. So there there's

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Speaker 1: absolutely no benefit for you having some sort of pie

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Speaker 1: in the sky vision of things when you're talking to

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Speaker 1: a client or the other way around, making it more

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Speaker 1: dire than it actually is, because they need to know

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Speaker 1: what it's actually going to cost. That's right. I I

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Speaker 1: retain my position based upon being accurate. There you go,

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Speaker 1: that's that's worth knowing. So listen on the campaign trail

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Speaker 1: thesday's particularly on the Democrats, fact well, exclusively on the

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Speaker 1: Democrats side. The term Medicare for all has great gained

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Speaker 1: great popularity. A number of the candidates are pitching it,

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Speaker 1: a number of folks around America. Polls would say think

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Speaker 1: it's a terrific idea, although a recent poll just came

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Speaker 1: out which we can talk about, in which it becomes

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Speaker 1: clear that what people think it is is not nearly

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Speaker 1: what that's the problem to what extent they what they

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Speaker 1: mean by medicare for all. Right, And we we've on

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Speaker 1: this show over the years, we've actually talked about a

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Speaker 1: few aspects of Medicare for all, um that you know,

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Speaker 1: where it's shown that it's it's maybe not as good

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Speaker 1: as people like it to be where we have that

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Speaker 1: cost shift going on. I mean, the kind of a

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Speaker 1: base understanding for this conversation is because Medicare and Medicaid

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Speaker 1: underpay the providers so significantly. So for every dollar of

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Speaker 1: healthcare need, Medicare typically pays eighty cents on that dollar,

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Speaker 1: which forces private employers to pay something in the neighborhood

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Speaker 1: of a dollar thirty for those services. So when people

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Speaker 1: look at the surface and they say, gee, you know,

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Speaker 1: Medicare costs us about the same per head roughly as

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Speaker 1: private health insurance, there there of course completely missing this

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Speaker 1: hidden tax behind the scenes, where fifty cents on every

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Speaker 1: dollar is is inflated over to the private employer's side

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Speaker 1: to cover the fact that Medicare underpays. And that's why

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Speaker 1: a lot of providers won't even take Medicare patients. That's correct.

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Speaker 1: We're we're well, roughly fifty percent of providers are not

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Speaker 1: taking new Medicaid patients. And it's somewhere in the neighborhood

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Speaker 1: of that are not taking new Medicare patients. And that's

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Speaker 1: because the government does pay a little bit more on

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Speaker 1: the Medicare side than they do for the Medicaid side.

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Speaker 1: But folks Medicare for older folks, Yes, exactly, and but

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Speaker 1: those numbers are growing. I mean, you're seeing more and

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Speaker 1: more providers saying I'm out, even though it's politically really

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Speaker 1: bad for me not to take government healthcare, I'm out

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Speaker 1: because I just can't afford it anymore. There's some difference

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Speaker 1: between Medicare for everybody and a single payer system that

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Speaker 1: is just universal healthcare, government healthcare that is basically the

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Speaker 1: same exact thing. Um So it's just a better way

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Speaker 1: to phrase it in front of a crowd. Well, it's

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Speaker 1: because they've heard over the years. Yeah, it's a generalized

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Speaker 1: I mean, if you want to get in the technicality

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Speaker 1: of it, Medicare is a single payer for healthcare. However,

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Speaker 1: virtually everybody that has Medicare also buys a little policy

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Speaker 1: on the side that helps to cover some of the

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Speaker 1: gaps in Medicare. So technically Medicare is not a pure

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Speaker 1: single payer system, although it's darn close, because single payer

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Speaker 1: would literally just mean one payer of claims across the country,

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Speaker 1: which is what you get in for example, the UK

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Speaker 1: with their with their health program. Very anybody who's rich

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Speaker 1: over there gets private health does the private thing because

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Speaker 1: it's so much better plush of the States. Yeah, just

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Speaker 1: a quick point of interest to pull from The Kaiser

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Speaker 1: Family Foundation found almost seventy percent of people think they

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Speaker 1: would still paid deductibles and co pace under such a plan,

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Speaker 1: which is not the case, and more than half believe

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Speaker 1: employers would continue to provide coverage, which is not in

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Speaker 1: Bernie's plan. No, that's yeah, and that would not be

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Speaker 1: the case. That's right. Um, So, just a couple a

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Speaker 1: couple of foundational facts about about Medicare that kind of

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Speaker 1: helps set the table for for just how uh misleading

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Speaker 1: the conversation about Medicare for all is. In nineteen sixty five,

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Speaker 1: when Medicare was passed, government experts projected that by it

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Speaker 1: would cost twelve billion dollars. In reality, it costs a

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Speaker 1: hundred and seven billion dollars in nine they missed by

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Speaker 1: a factor of eleven. So wow, about ten times as expensive. Yeah,

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Speaker 1: and um another fun fact that's medicare. Medicaid, when it

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Speaker 1: was originally passed at the same time, was designed to

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Speaker 1: cover the most unfortunate. It's it's the safety net for

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Speaker 1: the lowest two per of earners in the country. It

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Speaker 1: now coversent of earners nationwide, and in the western coast

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Speaker 1: of the United States and the three states Oregon, Washington, California,

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Speaker 1: one and every three babies born is born onto Medicaid.

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Speaker 1: That's safety net. So it's supposed to cover two percent,

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Speaker 1: and it covers a third on the West coast. Yes,

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Speaker 1: that's right. Now. One other fun fact about medical it

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Speaker 1: reminds me so much of the discussions we've had about

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Speaker 1: the high cost of Good Intentions program creep. It is inevitable.

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Speaker 1: If you like the big programs, just get one started.

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Speaker 1: Just get one started, you'll you'll get where you want

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Speaker 1: to be over time. This program is just for Joe

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Speaker 1: Jones of Poughkeepsie, New York, who is very poor and

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Speaker 1: very sick. Everybody thinks for poor Joe Jones, and then

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Speaker 1: you know, ten years later it's covering fifty million people

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Speaker 1: because too for people who do understand. In a month later,

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Speaker 1: you say about Joe Smith, he's very sick too, about

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Speaker 1: his kids? What about his kids or wife or whatever,

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Speaker 1: that guy who's almost as sick. Well, you're seeing it

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Speaker 1: in California right now. Right Remember, if we started off

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Speaker 1: with covering illegal aliens that are just children. Now we're

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Speaker 1: starting this year we're going to start covering illegal aliens

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Speaker 1: that are between the age of eighteen and twenty six.

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Speaker 1: Eventually it'll go beyond twenty six. Actually, the next step

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Speaker 1: will be we're gonna cover seniors, and then it'll be

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Speaker 1: so you're seeing you're seeing that play out in California

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Speaker 1: right now as we as we speak. Um. One other

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Speaker 1: fun fact about medicare what people don't understand. There's and

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Speaker 1: there's some good media on this in places like and

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Speaker 1: sixty Minutes that do these expose as on Medicare fraud,

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Speaker 1: waste and abuse, but it's not understood well enough. This

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Speaker 1: is a fact that people need to keep in their

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Speaker 1: mind for every time somebody calls into the Medicare Medicaid

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Speaker 1: hotline and says, hey, I see fraud going on right

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Speaker 1: in the parking lot down the street. There's the shop

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Speaker 1: that's set up. It's it's illegal, it's fraudulent. It takes

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Speaker 1: Medicare Medicaid an average of more than four months to

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Speaker 1: even begin that investigation. Wow, and and and is how

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Speaker 1: is that even possible? Well, they just don't care that much,

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Speaker 1: or you've you've yeah, you've got to be somebody else's money,

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Speaker 1: somebody else's money jack and it's and um. It leads

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Speaker 1: us into our next point. Me in the private sector,

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Speaker 1: if you called somebody up and somebody's stealing from you,

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Speaker 1: it doesn't have click, yeah, it's it's it's rectified immediately

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Speaker 1: in most cases we know. So how big a problem

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Speaker 1: is waste fraud abuse Center? So waste fraud and abuse

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Speaker 1: in medicare, according to most experts, on the low end,

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Speaker 1: is thirty percent of all spend. On the high end,

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Speaker 1: it's half. On the low end, it's a third third.

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Speaker 1: Oh my god, fraud. I was expecting something like ten

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Speaker 1: percent and then being horrified by that third. So how

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Speaker 1: much is that? So? Right now dollars Medicare is just

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Speaker 1: under a trillion dollars per year just in medicare, So

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Speaker 1: you're talking three hundred thousand to four hundred thousand dollars

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Speaker 1: or excuse four hundred billion dollar billion with a B

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Speaker 1: billion with a four hundred billion dollars just in Medicare alone.

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Speaker 1: When we look at healthcare spend in the United States,

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Speaker 1: three point seven trillion per year in the United States

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Speaker 1: on healthcare, that fraud number, because of the huge government

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Speaker 1: portion of it, is estimated to be around and so

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Speaker 1: a lot of it would be driven by what we

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Speaker 1: were just talking about, because it's somebody else's money. Just

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Speaker 1: nobody looks into it, pay that much attention. Yeah, and

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Speaker 1: and the fraud is stunning if you've ever watched any

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Speaker 1: of these expose as. I mean, it's as simple as

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Speaker 1: at some point the smart person has to get in

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Speaker 1: on this. How do I get in a lot of

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Speaker 1: them do and then and then they pay off their politicians,

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Speaker 1: uh handsomely, and they get slapped on the wrist. Quite often,

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Speaker 1: they'll either a lot of it will it'll either be

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Speaker 1: a nefarious doctor, but more common it's somebody who's stolen

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Speaker 1: a doctor's identification. They go down to a strip mall.

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Speaker 1: They then pay a cartel or a mafia for a

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Speaker 1: bunch of senior citizens Medicare information and they just start

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Speaker 1: running claims. They start ordering durable medical equipment. They start

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Speaker 1: they start ordering claims and pay getting payments within weeks.

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Speaker 1: They get payments for things that never happened. And they

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Speaker 1: know that if they close that shop up and move

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Speaker 1: within four to six months, they'll never get caught moving around. Wow,

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Speaker 1: you know, I think we need to end the segment.

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Speaker 1: And you and I need to talk about a new

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Speaker 1: little business venture exactly. There are a lot of empty

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Speaker 1: strip malls around. Oh and I'm good with old folks. Hey,

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Speaker 1: can I just ask you your name and your data? Breath?

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Speaker 1: That's interesting. Florida's the headquarter of these things. As you

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Speaker 1: guys have heard, all right, well, we ought to grab

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Speaker 1: a break, actually, honestly and stunning, come back and do

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Speaker 1: a little more on this topic. Holy cow, and listen.

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Speaker 1: One of these days. Because our lefty or most are

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Speaker 1: leftist listeners often say, all right, dudes, we get there's folks,

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Speaker 1: what's your plan? I mean as if I'm supposed to

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Speaker 1: design the plan? But um, one of these days, perhaps

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Speaker 1: not today. We ought to pick your brain for how

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Speaker 1: you would run it if you're the health cares are

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Speaker 1: for the president. That's a good tease for a future show,

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Speaker 1: the Armstrong and Jetty Show. I was just thinking, you

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Speaker 1: want a decent conversation about healthcare? This one we got

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Speaker 1: going right here with with Craig got Walton. We've done

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Speaker 1: a long term, a long form podcast with Craig. They

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Speaker 1: got into it fairly decent. And even then, because it's

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Speaker 1: so complex, I'm sure you'd need a forty hour week

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Speaker 1: of these things to get into it. Yet next Wednesday

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Speaker 1: and Thursday, at some point in the debate, it's gonna

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Speaker 1: come up and they're each gonna have twenty seconds to

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Speaker 1: explain their healthcare plan and it's mostly gonna be slogan

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Speaker 1: without meaning anyway. Oh my god. So Craig, A lot

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Speaker 1: of supporters of UM of Medicare for All talk about

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Speaker 1: how how it's too efficient that has spent on claims

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Speaker 1: and only two presumably on overminstration overhead. Yeah, that's that's

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Speaker 1: an efficient government. That is an accurate statistic, and it does.

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Speaker 1: It looks phenomenally efficient to the even to those in

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Speaker 1: the industry when you first glance at that claim without

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Speaker 1: putting any thought into it. So in the medical world,

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Speaker 1: we talk a lot about medical loss ratio, and that's

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Speaker 1: nothing more than a fancy way of saying, what percentage

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Speaker 1: of the money we give you is spent on claims

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Speaker 1: versus overhead. So in the private market, uh, we spend

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Speaker 1: it's roughly eighty five to eighty seven cents on every

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Speaker 1: dollar on claims, meaning the other fifteen percent goes to profit, salaries, rent,

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Speaker 1: et cetera. Overhead. Well, in medicare. And this has been

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Speaker 1: twenty plus years. You've heard proponents of Medicare for all.

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Speaker 1: In medicare say, in private industry you're only operating at

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Speaker 1: an eight five percent efficiency level, while in Medicare you're

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Speaker 1: operating at percent efficiency. We're gonna save money when we

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Speaker 1: go Medicare for all, right, And if you don't live

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Speaker 1: in this industry and breathe it that, if those are

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Speaker 1: true facts, the problem is, remember where we started this

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Speaker 1: visit this morning. We are wasting thirty to fifty cents

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Speaker 1: of every dollar we get Medicare on fraudulent claims. So yeah,

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Speaker 1: if I just pay out a trillion dollars in fraudulent

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Speaker 1: claims every year, it looks super efficient. I'm only spending

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Speaker 1: two percent investigating those claims. Awesome. Of course, you can

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Speaker 1: have a high efficiency standard. You're not spending any money

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Speaker 1: guarding the public dollar. That reminds me of the claims

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Speaker 1: there there's been no proof of widespread voter fraud. You

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Speaker 1: don't investigate it. You've claimed you're saving money by eliminating

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Speaker 1: the police. And now everybody is so racked with crime

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Speaker 1: that they can't live their lives. Think, well, that is

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Speaker 1: so interesting it's it's. And then we talked about a

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Speaker 1: durable medical equipment is it's it's. Those are the physical

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Speaker 1: devices we give to people that have needs, you know,

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Speaker 1: braces and etcetera, for disabilities, breeding machines, whatnot. Those that

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Speaker 1: tends to be the largest area of fraud. Experts have

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Speaker 1: estimated that in the d M world, which is really

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Speaker 1: popular among seniors, obviously, of every dollar we give them

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Speaker 1: as fraudulent. So that why are you me not buying

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Speaker 1: and showing artificial limbs? Hey, trust me, There's a lot

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Speaker 1: of people in on this scheme, some of them blatantly,

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Speaker 1: some of them are more. For example, the largest history

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Speaker 1: to date, the largest defrauder of medicare ever was an

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Speaker 1: ophthalmologist on the East Coast, that Menendez. Menendez his buddy,

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Speaker 1: that's right. He was ordering something to the magnitude of

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Speaker 1: UM one and fifty percent more of a particularly expensive

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Speaker 1: eye test than the second most popular person who was

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Speaker 1: ordering it. And of course he he gave Menendez a

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Speaker 1: lot of money and he got a slap on the wrist,

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Speaker 1: and Menendez didn't go to jail at all. As you

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Speaker 1: remember a few years back, beautiful points, and I assume

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Speaker 1: it's not even counted as fraud. The fact that if

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Speaker 1: you need a knee brace, that you could buy it

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Speaker 1: at CBS for fifteen dollars. It's yeah, that's three hundred

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Speaker 1: dollars through the system you're doing. That's correct. That doesn't

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Speaker 1: mean count as fraud, even though there's something crazy going

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Speaker 1: on there so as people are throwing up their hands

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Speaker 1: in despair and weeping that our tears. Uh, if you

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Speaker 1: were to design a system, Yeah, what would it look like?

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Speaker 1: I always start that answer because I get that all

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Speaker 1: the time. I would start that answer was saying, you've

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Speaker 1: prefaced it perfectly. If I could design it and we

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Speaker 1: could snap our fingers and this is would be what

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Speaker 1: would happen. Because politically, I think it's it's too tough

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Speaker 1: to accomplish in the modern world. But we have to

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Speaker 1: back out of this of this place we've created since

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Speaker 1: World War Two where third parties pay for all of

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Speaker 1: our medical claims. We again, and we've we've mentioned it

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Speaker 1: here before, but we don't buy insurance for oil changes

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Speaker 1: on our car. We don't buy insurance when we need

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Speaker 1: a leaky faucet fixed on our home. We buy insurance

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Speaker 1: for the large catastrophic things that occur. The problem we've

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Speaker 1: got with health care in America is, for the most part,

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Speaker 1: we have somebody else, an insurance company, paying all of

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Speaker 1: our claims, all the way down to twenty dollar co pays,

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Speaker 1: So you don't really give a rip how much you're

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Speaker 1: spending on this stuff. You just go and you run

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Speaker 1: it up. So I love that analogy. So oil changes

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Speaker 1: would be five, but I wouldn't care. I wouldn't even

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Speaker 1: know I just paid my twenty dollar co pay five

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Speaker 1: oil change happened? Right? Your car? Insurance covers everything to

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Speaker 1: do with your car. I just met with my financial

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Speaker 1: adviser last week. He gave me an example. He had

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Speaker 1: like seven thousand dollars of damage done to his fancy

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Speaker 1: car and an auto accident, and his deductible was a

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Speaker 1: thousand bucks. So when he went to the place to

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Speaker 1: get the estimate, they said, well, it's gonna be this this,

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Speaker 1: and we'll give you a written stim And he goes,

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Speaker 1: why do I care, I'm just paying a thousand. They go, well,

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Speaker 1: we have to legally submit pay for work, and he goes, yeah, whatever,

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Speaker 1: And here's he doesn't care. All he cares is the thousands.

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Speaker 1: So how do you get there in our world? Well,

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Speaker 1: one thing you have to do is you you you

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Speaker 1: really should set up a system where you're giving people

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Speaker 1: a If you want to have an employer based system,

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Speaker 1: you give people a pot of money. Um, we call

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Speaker 1: it a health savings account or health reimbursement account. There's

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Speaker 1: different vehicles, but you'd give an employee a chunk of money,

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Speaker 1: maybe three thousand dollars, and say this is your money

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Speaker 1: that you can only spend on health expenses and whatever

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Speaker 1: you don't spend rolls over and you can accumulate it

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Speaker 1: year over year and then using a retirement and then

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Speaker 1: you put in something like a five thousand dollar deductible plan.

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Speaker 1: So now you've got an individual who the first five

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Speaker 1: thousand dollars of all their expenses they're responsible for, and

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Speaker 1: they've they've got three thousand of it in the bank.

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Speaker 1: Less the average expenditure of healthcare is eight d seventy

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Speaker 1: dollars per year per person. So this this, this takes

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Speaker 1: care of the vast majority of people. And then you

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Speaker 1: have insurance over the top to take care of the

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Speaker 1: catastrophic stuff they used to call major medical. All right,

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Speaker 1: well we're out of time, but listen. If you're a

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Speaker 1: medium to large company needs help from a great benefits person,

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Speaker 1: Craig got Wall is available. What's your website benefit dash

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Speaker 1: Revolution dot com or just get in touch with us.

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Speaker 1: We'll put you in touch with Craig Craig. Thanks man.

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Speaker 1: It's always so interesting, good stuff, and we all spend

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Speaker 1: so much money on this. Do you think all of us,

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Speaker 1: and I'm talking to you folks in Austin, you think

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Speaker 1: we'd be more expert in this? Yes. When you're ready

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Speaker 1: to ride Metro, we want you to know we're ready

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Speaker 1: for you. Here are just a few of the people

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Speaker 1: at Metro to tell you how we're doing our part

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Speaker 1: to keep riders safe. We clean you like Neville before

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Speaker 1: hot to the Great Queen. You've found hand sound of

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Speaker 1: thound of Spasistro, no mask, no Metro need one. We

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Speaker 1: have a few extras at Metro. We're doing our part

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Speaker 1: to keep the DC area moving. Find out more at

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Speaker 1: will Mata dot com slash doing our part