REPLAY： Health Care
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Summary
In this episode, we discuss healthcare, insurance, and the Democratic platform on the campaign trail. We discuss Bernie Sanders and his campaign platform on healthcare and what it means for the future of healthcare in America. We also discuss the difference between conservative and liberal approaches to healthcare, and why neither side is better than the other.
Transcript
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Hey guys, welcome to Relatable. I hope everyone is having a wonderful day. Today we're going to
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talk about a very exciting subject, which is healthcare and healthcare insurance. Isn't that
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fun? Aren't you so pumped to be talking about this? I am. Just kidding. I am excited to talk
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about it. I'm always excited to talk to you guys. The reason that we're talking about healthcare,
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even though it doesn't sound like that exciting of a topic, is because it's a very popular subject
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right now among presidential candidates, particularly Democratic presidential candidates,
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and has been for quite a few years. Because the fact of the matter is, frankly, people don't really
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know what healthcare coverage is, how it is distributed, how to pay for it. And so there's
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a lot of confusion about this industry. And I will say that I'm not going to offer all of the clarity
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that a human being can give on the healthcare industry. Why? Because I myself am not an expert.
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And like in all of these things, I am coming from a very well-researched perspective to gain all of
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the knowledge that I possibly can, the most truthful and holistic perspective that I possibly can.
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But I'm not a healthcare professional. I am not an insurance professional. And so I'm going to tell
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you all that I can from all of the research that I've gathered. But as always, please feel free to
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fact check me. Those of you who maybe are in this industry and know all about government subsidized
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healthcare and what that plan is, insurance, healthcare, all of this stuff. If you want to
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correct me, fact check me, send me an email, please do so. I love to learn more from you guys,
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but know that I'm at least at the very least going into this, having done a lot of research and trying
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to give you the full perspective that I possibly can, uh, from my position. And we are going to talk
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about what the Democrats think about healthcare. We say healthcare, we really mean healthcare coverage.
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We really mean insurance, how people are going to pay for healthcare. Healthcare really isn't the topic
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of debate. It's healthcare coverage, how people are covered, how people are insured, how people
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pay for healthcare. So that's also important. It sounds like a small difference. It's not.
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When people say healthcare is a human right, that's different, different than saying healthcare
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coverage is a human right. But, uh, you might hear me say healthcare sometimes just as a shortened way
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of saying healthcare insurance, but no, that's essentially what we're talking about. So you might be
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in high school, you might be in college. And if so, you're probably on your parents' insurance. You can
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remain on your parents' insurance until you're 26 years old. Maybe your parents don't want you to
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remain on their insurance when you get your first job, maybe when you're 21 or 22, but you might be
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on your parents' insurance. So you might not know all that much, uh, about how our insurance system
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works, or maybe you're in your forties, fifties, and sixties, and you still don't really know how
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healthcare coverage works. And that is all good. No matter what, we're going to go through the basics
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together. And we're going to talk about Medicare for all. We're going to talk about healthcare for all.
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We're going to talk about the current U S system and the very good sounding promise that Bernie
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Sanders and other democratic presidential candidates are offering that healthcare coverage will be free
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and it'll make our lives so much better. We are going to see if that is actually true. So first let
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us talk about what the U S healthcare, well, let me say something first. Let me say something first,
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because maybe you're listening to this episode on a recommendation of a friend and you are either in
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the middle, maybe you're even center left, maybe you're even far left. And if so, I welcome you.
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And I just want to give you a pat on the back and maybe even a hug. If you would let me for being
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here, knowing that this is a conservative podcast, you are opening up your mind to a different side of
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the debate. And I really respect that no matter what your views are. So let me just say though,
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that neither side, okay, neither side to you, my new liberal friend wants, uh, people to die.
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Okay. No one wants people to die. Republicans don't hate poor people. I promise you. There's
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a reason why Republicans give so much in charity in general compared to their liberal friends. Uh,
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there's a reason why there, it is typically, uh, Christians and conservative religious people
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that are running charities and organizations that actually directly help, uh, the marginalized
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and the poor and those who don't have healthcare coverage. It's simply a difference in what we
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believe the best methods are to care for the people that cannot care for themselves or who cannot afford
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to care for themselves. So we need to just establish that from the front because you hear a lot of
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people say, uh, you know, who are supporters of Bernie Sanders say, well, Republicans just hate poor
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people. They just want poor people to die. Oh, you're not pro-life. You're just pro-birth. Why?
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Because you don't believe in Medicare for all. Well, that's silly. And we're going to talk about
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why that's silly, but of course it's a lot easier to talk in talking points than to actually say
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what's true. But to you, any liberal friend that in the off chance you are listening to this,
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we do not want people to die. No one does. No one does. Well, maybe some random people do,
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but as a rule, no one does. Okay. So it's just a different methodology. And we're going to talk
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about why that difference is. So first to the basics, what is the U S healthcare system? It's a little
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bit complicated, uh, because we are different than that of most developed countries in that it's not
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a nationally paid health service. It's not a single payer health service. It's not a multi-payer health
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fund. Uh, the U S health system can be described as a hybrid system. So this means that it is somewhat
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of a complicated network of multiple payers involving private and government health insurance
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options. Uh, in 2014, 48% of us healthcare spending came from private funds. 28% came from
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households and 20% coming or came from private businesses. Uh, the federal government accounted
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for 28% of spending while state and local governments accounted for 17%, uh, for a large majority of
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Americans, uh, their employers actually pay for their healthcare to, uh, private insurance companies
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that cover their medical expenses after a certain deductible is met, uh, until then the medical
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expenses, uh, some of the medical expenses are paid out of pocket by the person who is being insured,
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also known as the policy holder. Now a deductible, uh, let me just explain what that is in case you
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don't know, if you don't know, there's no shame in that it's the amount of, uh, amount of money paid
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out of pocket by the policy holder. That's you, the person who is insured, uh, before an insurance
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provider will pay any expenses, the higher your deductible, the more you have to pay out of
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pocket, uh, before your insurance actually kicks in. And so if you have a $500 deductible, you will
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pay $500 out of pocket, uh, for your medical services or until, uh, your insurance company
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will start pitching in. That's not $500 for one medical service that is, uh, over time. And so you
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will have to reach $500 out of pocket, uh, before, uh, before the insurance company will actually start
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pitching in and helping you take care of those services. After that, you pay something called a
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co-pay, which is a fixed fee that, uh, you pay from then on. So some more vocab in case you don't
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know, a premium is how much you pay for insurance. It depends on the policy you get, which can depend
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on your age. It can depend on your health history, et cetera. So when you buy your insurance policy,
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uh, that's the kind of insurance that you get from a particular insurance company will outline
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under what terms and in what, uh, situations insurance will help you pay. It will tell you
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how much your premium is, how much your deductible is. Of course, there are all kinds of insurance
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besides medical insurance, but in this particular episode, uh, that's what we are talking about.
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Uh, since healthcare can be really expensive depending on how sick you are and the services you need,
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uh, insurance becomes very important. It becomes necessary. Hence the debate we are having and have had for a
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long time over, uh, how those who cannot afford insurance, those who maybe don't have jobs are
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covered or don't have jobs that provide them insurance are covered. Uh, America, this is a
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talking point. You hear a lot from the left. America is the only developed country without
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universal healthcare. Uh, this is how the world health organization describes this term. Universal
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healthcare means all people in communities can use the promotive, preventative, uh, curative,
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rehabilitative, and palliative health services. They need of sufficient quality to be effective
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while also ensuring that the use of these services does not expose the user to financial
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hardship. Well, there's just a lot of interesting caveat. You can see where the world health organization
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is coming from. There's a lot of interesting caveats in there that is not necessarily describe
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universal healthcare, maybe in a perfect world, but the whole quality and effectiveness
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and no financial hardship. We'll get into that. Um, we do have government run insurance companies
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are, we do have government run healthcare coverage. We have Medicare, Medicaid, children's health
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insurance program or chip. And we do have the VA, uh, one third of Americans are covered by Medicare,
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Medicaid, or chip. Uh, Medicare is a federal program that provides healthcare coverage. If you are 65
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or above or under 65, and you have a disability, no matter what your income is, uh, Medicaid is a state
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and federal program that provides, uh, health coverage. If you have a low income, uh, if you're
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eligible for both Medicare and Medicaid, dually eligible, you can have both. You can apply for both
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and possibly be granted both. Uh, they can work together to give you healthcare coverage and lower your
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costs. Chip is regulated by the federal government, but it's administered at the state level. So eligible
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children from families, um, at about between 200% and 300% at the federal poverty level. So that is
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about $44,000 to $67,000 for a family of four, uh, under certain circumstances, pregnant women can also be
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eligible for a chip coverage in some States. Now there are still people who are uninsured. We have these
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programs, but there are still people who are uninsured. Maybe they don't get coverage through their
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employer. They couldn't qualify though for Medicare or Medicaid. Uh, especially if you are a young, a young
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adult who is in a state, uh, that didn't expand Medicaid, uh, maybe they didn't apply at all. So there
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are people who are uninsured. There are people who are what you might call or what you might hear called
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underinsured, which is why a huge reason why Obama enacted the affordable care act, AKA Obamacare back
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in 2010. The purpose of this legislation was to make it more affordable to purchase health insurance.
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They also wanted to lower the cost of healthcare, reduce the growing costs of Medicare and Medicaid,
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uh, throughout the United States is what they, that's what they said they wanted to do. Uh,
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it promised to do this by offering consumers discounts. These were known as, or are known as
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tax credits on government sponsored health insurance plans. They wanted to expand Medicaid
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assistance, uh, the Medicaid assistance program to include more people who don't have it in their
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budgets to pay for healthcare. Uh, the affordable care act changed some of the rules insurance
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companies had to follow. So in the past, if you had a preexisting medical condition, you could be
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turned down by an insurance company for coverage or your cost of coverage could be really high, but
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under the affordable care act, you no longer could be turned down or charged more for preexisting
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conditions. Uh, so under, under ACA, under Obamacare, you only receive discounts to help,
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uh, to help offset health insurance costs. If your household income is between one and four times
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the federal poverty level, which is a number of the government uses to determine the minimum
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amount of money needed for food needed for shelter, other basic needs. Uh, you can, you can choose to
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apply these credits to your premiums to lower your monthly insurance bill, or you can wait until the end of
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the year and you can put them, you can declare them on your tax return. So, uh, Americans who, uh, who
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meets certain income-based criteria have to, by law under the affordable care act, have insurance, they
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have to have Medicare or Medicaid, or they have to pay a penalty. If they don't, uh, that will be levied when
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you file your tax return. So this requirement is commonly referred to as the law's individual mandate,
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which was very, and is, well, I guess it's not really anymore and we'll get to why, but it was
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extremely controversial. It was the most controversial part, I would say, of the affordable
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care act. Uh, Democrats said that they included this individual mandate, this, uh, mandate that says
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you will pay a penalty if you don't have insurance because they figured that it would force young and
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healthy people to enroll in the healthcare exchanges. Something they said would, uh, offset the higher cost
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of covering people with chronic diseases. They also assumed that people would take care of themselves
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better, um, which would theoretically reduce future healthcare expenses. That's what they said. But
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Republicans were extremely opposed to this. They believed that the penalties would be, uh,
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an unneeded burden on families who maybe weren't covered by private insurance, but didn't want or
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couldn't afford Obamacare, but now had to buy the coverage or else they'd get penalized. Uh, so they saw
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this as both counterproductive. They saw this as tyrannical. Uh, it's one thing they would say,
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I think to expand Medicaid so that more people are covered. It's another thing to force people
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who didn't have insurance to buy, uh, to buy a government plan that they don't want. Uh,
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they were afraid that this would harm low income families the most. And they were actually right
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about that. So, uh, Republicans were correct. According to the IRS, more than half the total penalty,
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uh, payments, uh, were by people who, uh, had, who, uh, were earning less, sorry, I got mixed up for a
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second, who were earning less than $50,000 a year. 86% was from people earning less than a hundred
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thousand dollars a year. So that is why, if you remember, you might not remember, depending on how
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old you are, uh, in 2013, Ted Cruz and a few other conservatives, it was mostly Ted Cruz put up a
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fight, uh, that ended in a government shutdown to try to defund Obamacare. It was unsuccessful.
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Uh, Ted Cruz took a lot of flack from both the right and the left for that, but it also is what
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kind of launched him onto the political scene. So he maybe saw that as a win in some ways. Uh,
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then in 2017, a Republican controlled Congress eliminated the mandate, which went into effect
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this year. Uh, so we don't know the results of that quite yet, but Democrats of course were upset by
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this because of how many people wouldn't be insured. And yes, that is true that some people
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wouldn't be insured because the mandate is no longer valid, but that's just because now they
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have a choice of whether or not to be insured. They're not kicked off. Uh, they just are not being
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forced to, to use, to be on Obamacare anymore. So advocates of Obamacare would say that it slowed
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the rise of healthcare costs and that it did this through providing insurance for millions and made
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preventative care free. Um, it's good because they would say that it requires insurance plans
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to cover essential health benefits, including mental health, addiction, chronic diseases.
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Uh, they said that one good thing was that insurance companies couldn't deny people or raise costs for
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preexisting conditions, but those who are against it are going to cite the harm that it did. If you
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talk to any of them, that three to 5 million people lost their employment, employment based health
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insurance, because a lot of businesses found it, uh, more cost effective to pay the penalty and let
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their employees purchase insurance plans on the exchanges themselves. Uh, other small businesses
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found that they can get, uh, better plans through the state run exchanges. So a lot of people lost
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plans that they really liked. They lost the quality coverage that they actually preferred. And so this
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is where that big lie that I am sure you've heard was uncovered that, uh, Obama kept on saying,
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if you like your doctor, you can keep your doctor. Obama repeated that over and over again.
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Then in 2013, he, uh, said, well, that's not, that's not really what I said. That's it. No,
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we were just being misunderstood all along, but he did. It was a promise that Republicans knew that
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he could not keep with this plan. PolitiFact explains it like this. The affordable care act
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tried to allow existing health plans to continue under a complicated process called grandfathering,
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which basically said insurance companies could keep selling plans. If they followed certain
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rules. The problem for insurers was that the Obamacare rules were strict. If the plans deviated
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even a little, they would lose their grandfathered status in practice. That meant insurers canceled
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plans that didn't meet new standards. Obamacare required services that a lot of people are required
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coverage that a lot of people don't need like maternity care. That meant if someone had an insurance
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plan that didn't cover maternity care, that plan had to be canceled, which really was bad for a lot
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of people. So if you're a 60 year old guy, you don't need a plan that covers maternity care or
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pediatric care, because why would you, uh, your plan got canceled. If you were that guy, this happened to
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millions of people and replacing the affordable plan that you liked in favor of another plan costs a lot
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of money. Uh, Obama and his team lied about this over and over again, saying that there's nothing in
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the plan that pushes people off their healthcare coverage. That was demonstrably not true. That was
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a lie. And Obama actually did somewhat apologize later in 2013. He was in an interview with Chuck
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Todd and he said, okay, that wasn't entirely accurate. Maybe I exaggerated. Well, yeah, that's a big lie to
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tell. Um, and also I just want to note that you hear Obama, you hear Biden, you hear media pundits
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saying that Obama had a scandal free presidency, that there, uh, were no bumps in the road, that
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there's nothing that happened that was scandalous. Well, you might think that because of the media
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coverage of his presidency, both then and now, but the fact of the matter is this was a big deal.
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Then the fact that he said, if you like your doctor, you can keep your doctor. And then he admitted that
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he was lying about that. Of course he said he exaggerated it, but that's a lie. And maybe props
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to him for actually owning up to that. I mean, that's something, there's something to be said
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for that, but that's a big lie that affected a lot of people's lives. And really, I would say
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manipulated a lot of people into believing that this would be a good thing. And they ended up on the
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wrong side of it. And so there have been scandals, of course, in the Obama presidency, Benghazi,
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Fast and Furious, IRS, that's a different episode for a different day. But the fact of the matter is
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this was a big lie that affected people in a really negative way. There were a lot of people that were
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upset about this. In 2013, a Pew research poll found that the number of people who saw Obama as
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untrustworthy actually rose by 15 points in 2013. Uh, and that just proves exactly what we said,
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that people were paying attention and that they were mad. They didn't want to be, they didn't want
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to be lied to, uh, because here's the thing. People don't like their healthcare coverage mess with
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if they like it. They don't, they don't want to mess with. A lot of people do. A lot of people are
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satisfied with the coverage that they get, at least for the most part, at least not enough to hand it
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over to the federal government. Um, and then there was also the controversial contraceptive mandate,
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which required insurance companies and employers who provided health insurance to cover the cost of
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birth control. There are a lot of religious organizations who are opposed to birth control
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from a religious and moral standpoint. So forcing them to pay for it would be an infringement on
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religious liberty. The contraception mandate wasn't actually in Obamacare legislation originally,
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but it came later in 2011 through, uh, regulations. And there were only narrow exemptions for this,
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uh, for churches, but did not include religious nonprofits or religious corporations.
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And then in 2014, there was a Supreme court case involving Hobby Lobby. You might know a little
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bit about that, uh, which is a corporation that is owned by Christians and the court ruled that
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closely held religious for-profit corporations did not have to provide, uh, birth control in their
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insurance plans for their employees. Uh, the Catholic organization, uh, little sisters of the poor
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endured years of court battles until May, 2016, uh, the Supreme court actually ruled in their favor and
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instructed the lower courts that had ruled against them to provide the government, uh, with an
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opportunity to find a way to provide services for the women who want birth control without involving
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the little sisters. So really everyone won, but of course the left is not necessarily happy with
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that because they don't believe that religious liberty should trump what they think is a right
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birth control. So this is from Beckett law.org in May, 2017, president Trump issued an executive
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order directing HHS and other federal agencies to protect the little sisters of the poor and other
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religious nonprofits from the mandate on October 6th, 2017, the government issued a new rule with a
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broader religious exemption. In June, 2018, the little sisters original case was finally resolved with
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an order by the U S court of appeals for the 10th circuit on November 7th, 2018 HHS issued a rule
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finalizing the little sisters religious exemption. So, uh, that means that now, at least for now,
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I mean, this can always be, uh, there can always be pushed back to this. There's always going to be
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people who are saying no religious liberty is not, is not a worthy exemption. It's not a worthy reason
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not to provide your employees with health insurance, but for now religious liberty did win a particular
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battle. But this is also part of the reason why Christians really didn't like evangelical Christians
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really didn't like Obama because they felt targeted, uh, by his policies. They felt again,
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that Christianity, that religious views were being mocked in some way and religious liberty was secondary
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to their agenda, particularly when it came to something like birth control. And so there was a lot of
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controversy over that. There's a many moral and policy reasons why people did not like Obamacare,
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uh, according to the Kaiser family foundation on December 14th, 2018, a federal district court,
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uh, judge in Texas issued a ruling challenge. You probably remember this not that long ago,
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uh, issued a ruling challenging the future of the 2010 affordable care act. The judge sided with
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Republican state attorneys general that ruled that since the 2017 tax bill passed by Congress,
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zeroed out the penalty for not having health insurance. That's that individual mandate. The
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ACA is invalid. Democrat attorneys general have already taken actions to appeal the judge's ruling
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in the case. And due to the government shutdown, the fifth circuit court of appeals has paused the case.
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So that was, uh, back a few months ago. This is from the Kaiser family foundation. So the question is,
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why does all of this matter now? The controversy of Obamacare, the fact that we even had Obamacare.
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The reason is because Obamacare was the primer for our current conversation about healthcare.
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It operated on the premise that healthcare is a right and therefore everyone must be covered or
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else. And it was the or else and is the or else that conservatives did not and do not like,
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because it ended up being that everyone must be covered how the federal government wants you to
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be covered or else you will lose your plan and you will be fined by the government. If you do not get
00:24:00.200
Obamacare after losing that plan. Now, like I said, in 2017, Republicans repealed the mandate. So people
00:24:06.380
would no longer, uh, no longer be fined who didn't sign up for Obamacare, but it's still all hangs in the
00:24:12.020
balances. We're talking about Medicare for all, and this is causing a lot of contention. So that is why
00:24:18.880
you hear Democrats, uh, say Republicans don't want you to have healthcare coverage, that they don't
00:24:23.740
care about poor people, that they don't care about people being taken care of because we didn't like
00:24:31.100
Obamacare and we don't like the idea of Medicare for all. And we'll get into why in a little bit,
00:24:35.720
but it's true that Republicans don't want you to be forced to have coverage that you don't want.
00:24:40.440
Republicans don't want you to be fined. Republicans don't think that forcing higher taxes
00:24:44.800
to pay for Obamacare, pay for Medicare for all, whatever it is, is a good idea. Republicans,
00:24:49.580
uh, don't think that the federal government needs to be involved in healthcare in this way.
00:24:54.040
Republicans don't want the federal government to infringe on religious liberty in this way.
00:24:58.120
Uh, so it's not so black and white as saying Republicans don't want poor people to be covered.
00:25:02.080
That's not true. We do not like this methodology. Um, or I should just say this method. And, uh,
00:25:08.300
yet this is what Democrats are now running on, especially Bernie Sanders. They're running for not just
00:25:13.260
healthcare for all, which could be a mixture of private and public options, but Medicare for all.
00:25:17.740
So everyone is on, uh, the same insurance, meaning we are all on Medicare. There is no choice. You get
00:25:24.060
no private health insurance, no matter who your employer is. We are all on government funded
00:25:29.280
healthcare, no matter what, uh, this would, the pro is it would indeed guarantee that everyone had
00:25:36.380
some kind of healthcare coverage, but it would also significantly lower the quality of care for
00:25:40.980
everyone involved. And we will explain why, uh, Democrats say this is going to lower the cost
00:25:46.680
of medicine. It's going to lower the cost of basic care. This, uh, is obviously going to eliminate
00:25:52.020
premiums. It's going to eliminate deductibles because it's going to be funded by the government,
00:25:56.240
which as you know, means it is funded by you and me. It is funded by taxpayers. It is not free for
00:26:02.520
anyone unless you are a part of the low tax bracket that essentially doesn't pay anything in taxes.
00:26:06.540
Uh, then you are getting something for absolutely nothing and everyone else is paying it for you.
00:26:10.560
But for the rest of us, we are paying for it. Uh, Kamala Harris, a presidential candidate jumped
00:26:16.260
on board with this idea a few months ago saying at a CNN town hall, uh, the idea is that everyone
00:26:21.600
gets access to medical care and you don't have to go to the process of going through an insurance
00:26:26.020
company, having them give you approval, going through the paperwork, all of the delay that that
00:26:31.660
might require. Uh, let's eliminate all of that. Let's move on. She said, sounds good. I mean,
00:26:37.220
I hate paperwork. And so maybe that sounds good to you too. Uh, but let's think about that for a
00:26:42.440
second. Going through the government, going through government bureaucrats for things is always so
00:26:48.860
efficient and helpful, right? Like think about your last trip to the DMV when you had to report
00:26:53.360
for jury duty, when you have to do anything that involves the government, especially the federal
00:26:58.100
government, the process is terrible. No, it's not efficient. It's not effective. Why? Because there's
00:27:04.020
no motivation for most government for, I won't say most a lot, not all, maybe not most for a lot
00:27:11.280
of government employees to be efficient and effective. There are hoops to jump through and
00:27:15.760
the government does not care whether or not you're happy with their service because they know you have
00:27:19.400
to use it. You got one place to go. There's no competition. It's not like an insurance company or
00:27:24.320
another company who cares about keeping or losing their customers and therefore making them happy.
00:27:29.360
Uh, the government does not care about that. Now Kamala Harris backtracked later, uh, because guess
00:27:36.220
what? This means that you are getting rid of the insurance industry entirely, which makes up 18% of
00:27:42.280
our nation's economy. And it obviously means kicking people off the healthcare plans they like. And so
00:27:46.720
that wasn't really well received. And so she had to kind of backpedal and say, well, okay, maybe I didn't
00:27:51.840
mean all of that. Uh, there's also the problem. This is the big problem, uh, of how hospitals are going
00:27:58.940
to stay in business. The reason is because hospitals get paid significantly less by Medicare than they
00:28:04.840
do by private insurance. Uh, this is according to the New York times, uh, for a patient's knee
00:28:09.920
replacement, Medicare will pay a hospital $17,000. The same hospital can get more than twice as much
00:28:16.800
or about $37,000 for the same surgery on a patient with private insurance. That's because Medicare
00:28:23.800
pays hospitals about 87 cents for every dollar of their costs compared with private insurers
00:28:29.880
that pay a dollar 45. Uh, so smaller rural hospitals, healthcare centers, uh, would probably
00:28:39.220
have to shut down in a Medicare for all system because they couldn't afford to provide the same
00:28:43.820
services, or you're going to see hospitals laying off, uh, droves of employees in order to just stay
00:28:49.760
afloat and to be able to pay for these services and to pay, uh, for, for the, for the treatments
00:28:55.560
that people have to get. Uh, that's the problem. That's the problem with Medicare for all that it
00:29:00.020
cuts revenue for these places so drastically, which means a few things. Hospitals will have to close
00:29:05.300
down or they'll just have to fire employees or, or, and really they will have to lower their quality
00:29:11.640
of care. Now proponents of Medicare for all say, no, no, no, that's not true. Hospitals can just cut
00:29:17.720
costs and cut profits without doing any of those things. It'll just take a little bit of sacrifice.
00:29:23.000
It'll be totally fine. But these are the same people who it shouldn't surprise us really don't
00:29:27.480
have a basic understanding of economics. These are the same people who believe that employers of
00:29:32.300
small businesses are just going to raise the minimum wage of their employees and take a huge
00:29:37.840
cut of their own profits without firing employees or automating, uh, employee tasks entirely.
00:29:42.960
And it might be true in some cases that hospitals are charging too much. That's not going to solve
00:29:49.500
the problem of the many, the vast majority of, I would say hospitals that simply will not be able
00:29:54.660
to afford to function in a Medicare for all system. Uh, the New York times also says this,
00:29:59.920
those in favor of the most far reaching changes, including Senator Bernie Sanders,
00:30:04.200
who unveiled his latest Medicare for all plan as part of his presidential campaign have remained
00:30:09.240
largely silent on the question of how the nation's, uh, 5,300 hospitals would be paid for patient
00:30:15.860
care. If they are paid more than Medicare rates, the final price tag for the program could balloon
00:30:20.920
from the already stratospheric estimate of upward of $30 trillion over a decade. So what that last
00:30:28.700
part means is if hospitals are paid more than they currently are now under Medicare, that's going to
00:30:34.560
cost us taxpayers more. This is already going to cost us about 33, $30 trillion over a decade. And if
00:30:43.200
Medicare pays hospitals more than they do right now, so more than 87 cents for the cost of the actual
00:30:48.860
procedure, uh, then that's going to cost us a lot more than that. Uh, just another reminder, just another
00:30:56.200
reminder, nothing is free. Nothing is free. Healthcare will never be free. It cannot be free. College
00:31:02.500
cannot be free. Taxpayers are paying a lot of money for these so-called free services, uh, that many on
00:31:10.280
the left offer and they're not quality. Uh, the profit margins on Medicare for hospitals is incredibly
00:31:15.900
thin. As I've already said, a lot of hospitals, you lose money accepting Medicare patients. Uh, so
00:31:21.920
imagine if the entire system was Medicare again, you got to cut staffers to stay afloat, which creates
00:31:27.840
uh, significant limitations on care that you can offer to patients. There's a reason why in the UK and in
00:31:33.320
Canada, which both have universal healthcare, uh, people have to wait so long for major surgeries. In a lot
00:31:39.720
of cases, there just aren't enough physicians to go around because as we've already established, the
00:31:44.560
hospitals can't afford to pay their physicians because they're not getting enough money from
00:31:48.800
government run programs. Uh, Fraser Institute found that Canada has some of the worst wait times for
00:31:55.020
emergency rooms for basic sick care for elective surgeries. Uh, in fact, in 2016, Canadians waited
00:32:01.300
an average of five months for medically necessary specialist treatments. Uh, that's probably why
00:32:07.620
60,000 Canadians, uh, visit the United States and other countries for medical care each year.
00:32:14.020
Uh, in the UK, they've had 70 years, 70 years to figure out how to run a government controlled
00:32:20.960
healthcare system. Uh, and yet 80% of doctors in the UK say that they are understaffed. Uh, that
00:32:27.980
probably explains again, why over 50,000 non-urgent surgeries were canceled in 2018 when their systems
00:32:35.360
in the UK, when their system was overwhelmed by flu season. So that is what I would say. That's what
00:32:42.440
Bernie Sanders is hoping will happen over here. Not that people, I don't think that he wants people to
00:32:47.180
die. I don't think he wants people to not be taken care of, but that's the kind of system that he
00:32:50.960
wants. And that's the inevitable consequences of the system that he wants. Um, according to
00:32:56.060
heritage by 2030, Americans already, as of right now face a serious and potentially dangerous
00:33:01.460
physician shortage ranging between 15,849,300 primary care doctors and between 33,800 and 72,700
00:33:11.640
non-primary care doctors accelerated retirements, job-based burnout, growing demoralization fuel
00:33:17.680
that shortfall. Uh, so Medicare for all is only going to make all of that worse for the reasons
00:33:22.700
that we just listed. We will have low quality care. Why? Because our hospitals and doctor's offices
00:33:29.280
will be understaffed. Why? Because Medicare pays less for services than private health insurance does,
00:33:35.660
which means the profit margin on these services decreases significantly. Uh, when Medicare is
00:33:41.260
accepted and when profit goes down, uh, and when profit goes down, cuts are made to be able to keep
00:33:49.000
a business afloat. And when you make those cuts in a medical center, you've got fewer doctors, but you've
00:33:55.100
got even more patients, uh, because you are required to serve everyone because everyone is under the same
00:34:00.540
insurance plan. So you've got overworked doctors at understaffed centers who are just not able to offer
00:34:06.520
prompt or quality care due to the burden of work that they have. That is Medicare for all.
00:34:12.120
So just understand that even though this sounds great, even though this sounds like a compassionate
00:34:17.420
proposal, it is not. It is an expensive, inefficient, ineffective proposal offered by someone, Bernie
00:34:24.360
Sanders, who has accomplished exactly nothing in his political career, who has never once demonstrated
00:34:29.240
even a basic understanding of economics, who was, and probably still is, a fan of the Soviet
00:34:34.580
Union and Venezuela. That is not an exaggeration by the way he has expressed deep founded admiration
00:34:40.700
for both of those tyrannical regimes, who is a socialist who demonizes the 1% who himself is a
00:34:46.520
part of the 1% because he is worth over a million dollars and even owns three homes. And he donates
00:34:52.740
how much to charity did we learn from his tax returns? I think 1% of his salary to charity. And so I'm
00:34:58.560
just not really buying the whole thing that he's doing everything he can for the least of these. Uh, but
00:35:03.660
that's what socialists and those who advocate for socialism do. They opt maybe with good intentions.
00:35:08.780
Many of them, they opt for lazy forms of so-called compassion, um, which is the government taking care
00:35:15.120
of people. So they don't actually have to put any work or effort into helping people themselves. As I
00:35:20.480
always say, socialism helps people feel virtuous without ever having to get off the couch. But the
00:35:25.840
question is, so the question is, that's not the answer. So what is the answer? Do conservatives
00:35:32.280
have a better plan than Bernie Sanders? Um, there is something called the healthcare choice proposal,
00:35:38.280
um, that was presented by conservatives. Patients would be able to choose the coverage arrangement
00:35:44.040
that works best for them from a wide array of options. This includes direct primary care,
00:35:49.300
short-term limited duration plans, catastrophic coverage, or what they call gold-plated Cadillac coverage.
00:35:55.340
A proponent say that this would make coverage far more affordable, uh, lowering premiums by up to 32%
00:36:01.880
according to the center for health and economy. Uh, moreover, it would ensure that everyone would
00:36:06.940
access a quality private coverage arrangement of their choice. So everyone who gets a government
00:36:12.580
subsidy, uh, for healthcare would now get to a control now have control over those dollars.
00:36:19.400
They would be able to apply them to a plan that they choose rather than one that the government
00:36:24.360
chooses for them. It would also do away with Obamacare subsidy structure in which insurance
00:36:29.780
companies receive taxpayer subsidies dollar for dollars. They raise prices. So with this, uh,
00:36:34.760
federal funds would be placed on a budget and sent to states to help people access a quality private
00:36:40.120
coverage arrangement of their choice, including the poor and the sick. Um, a heritage foundation study
00:36:45.580
found that when states, uh, have been given even a little bit of freedom from Obamacare's mandates,
00:36:51.580
they have been able to lower projected 2019 premiums. So we'll see about that, uh, in one state up to 43%
00:36:58.760
while still ensuring that the sick retain access to care. There are 90 leading conservatives that have
00:37:05.380
already endorsed the healthcare choice proposal as the path forward to a kind of a new solution rather
00:37:12.400
than Medicare for all. Now, uh, Democrats will tell you though, that Medicare for all is extremely
00:37:18.260
popular. So Republicans just need to stop talking and to just give in. AOC actually tweeted this not
00:37:23.240
too long ago that it's insanely popular and they're somewhat right. Uh, there is a Kaiser family
00:37:28.720
foundation that found that 71% of Americans are for Medicare for all. When you tell them that this
00:37:35.400
will mean that healthcare will be guaranteed for everyone, they think, great, I want healthcare
00:37:39.180
guaranteed for everyone, 71% of Americans. But when you apply that, uh, or when you explain that this
00:37:46.420
means, uh, everyone will be on a single plan and this would eliminate insurance companies. Those who
00:37:53.960
approve drop to 37%. When you explain this will lead to some delays in certain medical treatments,
00:38:01.220
uh, those who approve drops to 26%. So basically Medicare for all sounds great and is approved of by a lot of
00:38:08.920
people until they learn how it works and what the repercussions will be. Uh, that is the truth for
00:38:13.520
almost all democratic, uh, policies, by the way, they all sound great. They all sound compassionate
00:38:19.940
and free and righteous and good until you weigh the costs, until you look at the effects and the
00:38:25.380
consequences and the limits on freedom and quality. But again, as we learned in our social justice episode,
00:38:30.300
when it comes to equality of outcomes, the left rarely weighs the cost on the other side. And when it comes
00:38:36.880
to Medicare for all, the cost is really high. So I hope that helped explain some of this for you.
00:38:42.080
There's a lot more that we could get into as always, but I hope that this gave you kind of a
00:38:45.840
good understanding when you're watching these presidential debates coming up, uh, about what
00:38:50.000
the heck they're talking about and what the truth is behind this, a grandiose plan of Medicare for all.
00:38:56.580
The fact of the matter is it's not something that we want to be a part of. So hope that you guys