Relatable with Allie Beth Stuckey - REPLAY： Health Care

00:00:00.000 Hey guys, welcome to Relatable. I hope everyone is having a wonderful day. Today we're going to

00:00:06.520 talk about a very exciting subject, which is healthcare and healthcare insurance. Isn't that

00:00:13.860 fun? Aren't you so pumped to be talking about this? I am. Just kidding. I am excited to talk

00:00:19.940 about it. I'm always excited to talk to you guys. The reason that we're talking about healthcare,

00:00:24.380 even though it doesn't sound like that exciting of a topic, is because it's a very popular subject

00:00:29.980 right now among presidential candidates, particularly Democratic presidential candidates,

00:00:34.800 and has been for quite a few years. Because the fact of the matter is, frankly, people don't really

00:00:40.860 know what healthcare coverage is, how it is distributed, how to pay for it. And so there's

00:00:48.940 a lot of confusion about this industry. And I will say that I'm not going to offer all of the clarity

00:00:56.300 that a human being can give on the healthcare industry. Why? Because I myself am not an expert.

00:01:01.260 And like in all of these things, I am coming from a very well-researched perspective to gain all of

00:01:06.880 the knowledge that I possibly can, the most truthful and holistic perspective that I possibly can.

00:01:12.600 But I'm not a healthcare professional. I am not an insurance professional. And so I'm going to tell

00:01:20.440 you all that I can from all of the research that I've gathered. But as always, please feel free to

00:01:26.660 fact check me. Those of you who maybe are in this industry and know all about government subsidized

00:01:33.640 healthcare and what that plan is, insurance, healthcare, all of this stuff. If you want to

00:01:40.620 correct me, fact check me, send me an email, please do so. I love to learn more from you guys,

00:01:46.700 but know that I'm at least at the very least going into this, having done a lot of research and trying

00:01:52.660 to give you the full perspective that I possibly can, uh, from my position. And we are going to talk

00:02:00.800 about what the Democrats think about healthcare. We say healthcare, we really mean healthcare coverage.

00:02:05.840 We really mean insurance, how people are going to pay for healthcare. Healthcare really isn't the topic

00:02:10.820 of debate. It's healthcare coverage, how people are covered, how people are insured, how people

00:02:16.160 pay for healthcare. So that's also important. It sounds like a small difference. It's not.

00:02:21.180 When people say healthcare is a human right, that's different, different than saying healthcare

00:02:25.180 coverage is a human right. But, uh, you might hear me say healthcare sometimes just as a shortened way

00:02:33.140 of saying healthcare insurance, but no, that's essentially what we're talking about. So you might be

00:02:38.480 in high school, you might be in college. And if so, you're probably on your parents' insurance. You can

00:02:43.480 remain on your parents' insurance until you're 26 years old. Maybe your parents don't want you to

00:02:48.140 remain on their insurance when you get your first job, maybe when you're 21 or 22, but you might be

00:02:52.440 on your parents' insurance. So you might not know all that much, uh, about how our insurance system

00:02:57.620 works, or maybe you're in your forties, fifties, and sixties, and you still don't really know how

00:03:01.780 healthcare coverage works. And that is all good. No matter what, we're going to go through the basics

00:03:06.200 together. And we're going to talk about Medicare for all. We're going to talk about healthcare for all.

00:03:10.000 We're going to talk about the current U S system and the very good sounding promise that Bernie

00:03:16.420 Sanders and other democratic presidential candidates are offering that healthcare coverage will be free

00:03:22.780 and it'll make our lives so much better. We are going to see if that is actually true. So first let

00:03:31.980 us talk about what the U S healthcare, well, let me say something first. Let me say something first,

00:03:37.080 because maybe you're listening to this episode on a recommendation of a friend and you are either in

00:03:42.140 the middle, maybe you're even center left, maybe you're even far left. And if so, I welcome you.

00:03:46.820 And I just want to give you a pat on the back and maybe even a hug. If you would let me for being

00:03:51.120 here, knowing that this is a conservative podcast, you are opening up your mind to a different side of

00:03:55.560 the debate. And I really respect that no matter what your views are. So let me just say though,

00:04:00.380 that neither side, okay, neither side to you, my new liberal friend wants, uh, people to die.

00:04:07.060 Okay. No one wants people to die. Republicans don't hate poor people. I promise you. There's

00:04:11.260 a reason why Republicans give so much in charity in general compared to their liberal friends. Uh,

00:04:16.560 there's a reason why there, it is typically, uh, Christians and conservative religious people

00:04:21.340 that are running charities and organizations that actually directly help, uh, the marginalized

00:04:26.140 and the poor and those who don't have healthcare coverage. It's simply a difference in what we

00:04:32.000 believe the best methods are to care for the people that cannot care for themselves or who cannot afford

00:04:37.600 to care for themselves. So we need to just establish that from the front because you hear a lot of

00:04:44.000 people say, uh, you know, who are supporters of Bernie Sanders say, well, Republicans just hate poor

00:04:49.080 people. They just want poor people to die. Oh, you're not pro-life. You're just pro-birth. Why? 0.98

00:04:53.820 Because you don't believe in Medicare for all. Well, that's silly. And we're going to talk about 0.94

00:04:57.880 why that's silly, but of course it's a lot easier to talk in talking points than to actually say

00:05:02.500 what's true. But to you, any liberal friend that in the off chance you are listening to this,

00:05:07.440 we do not want people to die. No one does. No one does. Well, maybe some random people do,

00:05:12.420 but as a rule, no one does. Okay. So it's just a different methodology. And we're going to talk

00:05:16.860 about why that difference is. So first to the basics, what is the U S healthcare system? It's a little

00:05:22.220 bit complicated, uh, because we are different than that of most developed countries in that it's not

00:05:28.360 a nationally paid health service. It's not a single payer health service. It's not a multi-payer health

00:05:34.560 fund. Uh, the U S health system can be described as a hybrid system. So this means that it is somewhat

00:05:41.240 of a complicated network of multiple payers involving private and government health insurance

00:05:46.760 options. Uh, in 2014, 48% of us healthcare spending came from private funds. 28% came from

00:05:55.460 households and 20% coming or came from private businesses. Uh, the federal government accounted

00:06:01.700 for 28% of spending while state and local governments accounted for 17%, uh, for a large majority of

00:06:10.320 Americans, uh, their employers actually pay for their healthcare to, uh, private insurance companies

00:06:16.740 that cover their medical expenses after a certain deductible is met, uh, until then the medical

00:06:23.800 expenses, uh, some of the medical expenses are paid out of pocket by the person who is being insured,

00:06:28.940 also known as the policy holder. Now a deductible, uh, let me just explain what that is in case you

00:06:35.580 don't know, if you don't know, there's no shame in that it's the amount of, uh, amount of money paid

00:06:40.040 out of pocket by the policy holder. That's you, the person who is insured, uh, before an insurance

00:06:45.100 provider will pay any expenses, the higher your deductible, the more you have to pay out of

00:06:50.560 pocket, uh, before your insurance actually kicks in. And so if you have a $500 deductible, you will

00:06:55.560 pay $500 out of pocket, uh, for your medical services or until, uh, your insurance company

00:07:02.020 will start pitching in. That's not $500 for one medical service that is, uh, over time. And so you

00:07:06.780 will have to reach $500 out of pocket, uh, before, uh, before the insurance company will actually start

00:07:12.660 pitching in and helping you take care of those services. After that, you pay something called a

00:07:18.200 co-pay, which is a fixed fee that, uh, you pay from then on. So some more vocab in case you don't

00:07:27.000 know, a premium is how much you pay for insurance. It depends on the policy you get, which can depend

00:07:31.600 on your age. It can depend on your health history, et cetera. So when you buy your insurance policy,

00:07:36.740 uh, that's the kind of insurance that you get from a particular insurance company will outline

00:07:41.520 under what terms and in what, uh, situations insurance will help you pay. It will tell you

00:07:47.260 how much your premium is, how much your deductible is. Of course, there are all kinds of insurance

00:07:51.740 besides medical insurance, but in this particular episode, uh, that's what we are talking about.

00:07:56.420 Uh, since healthcare can be really expensive depending on how sick you are and the services you need,

00:08:03.620 uh, insurance becomes very important. It becomes necessary. Hence the debate we are having and have had for a

00:08:11.120 long time over, uh, how those who cannot afford insurance, those who maybe don't have jobs are

00:08:17.900 covered or don't have jobs that provide them insurance are covered. Uh, America, this is a

00:08:23.280 talking point. You hear a lot from the left. America is the only developed country without

00:08:27.140 universal healthcare. Uh, this is how the world health organization describes this term. Universal

00:08:33.420 healthcare means all people in communities can use the promotive, preventative, uh, curative,

00:08:38.980 rehabilitative, and palliative health services. They need of sufficient quality to be effective

00:08:45.400 while also ensuring that the use of these services does not expose the user to financial

00:08:51.880 hardship. Well, there's just a lot of interesting caveat. You can see where the world health organization

00:08:56.660 is coming from. There's a lot of interesting caveats in there that is not necessarily describe

00:09:00.960 universal healthcare, maybe in a perfect world, but the whole quality and effectiveness

00:09:05.360 and no financial hardship. We'll get into that. Um, we do have government run insurance companies

00:09:13.460 are, we do have government run healthcare coverage. We have Medicare, Medicaid, children's health

00:09:19.020 insurance program or chip. And we do have the VA, uh, one third of Americans are covered by Medicare,

00:09:24.480 Medicaid, or chip. Uh, Medicare is a federal program that provides healthcare coverage. If you are 65

00:09:31.600 or above or under 65, and you have a disability, no matter what your income is, uh, Medicaid is a state

00:09:39.640 and federal program that provides, uh, health coverage. If you have a low income, uh, if you're

00:09:45.960 eligible for both Medicare and Medicaid, dually eligible, you can have both. You can apply for both

00:09:50.860 and possibly be granted both. Uh, they can work together to give you healthcare coverage and lower your

00:09:56.660 costs. Chip is regulated by the federal government, but it's administered at the state level. So eligible

00:10:02.520 children from families, um, at about between 200% and 300% at the federal poverty level. So that is

00:10:11.060 about $44,000 to $67,000 for a family of four, uh, under certain circumstances, pregnant women can also be 1.00

00:10:19.500 eligible for a chip coverage in some States. Now there are still people who are uninsured. We have these

00:10:25.900 programs, but there are still people who are uninsured. Maybe they don't get coverage through their

00:10:29.360 employer. They couldn't qualify though for Medicare or Medicaid. Uh, especially if you are a young, a young

00:10:35.660 adult who is in a state, uh, that didn't expand Medicaid, uh, maybe they didn't apply at all. So there

00:10:42.380 are people who are uninsured. There are people who are what you might call or what you might hear called

00:10:47.600 underinsured, which is why a huge reason why Obama enacted the affordable care act, AKA Obamacare back

00:10:55.820 in 2010. The purpose of this legislation was to make it more affordable to purchase health insurance.

00:11:03.040 They also wanted to lower the cost of healthcare, reduce the growing costs of Medicare and Medicaid,

00:11:07.800 uh, throughout the United States is what they, that's what they said they wanted to do. Uh,

00:11:12.800 it promised to do this by offering consumers discounts. These were known as, or are known as

00:11:17.500 tax credits on government sponsored health insurance plans. They wanted to expand Medicaid

00:11:22.140 assistance, uh, the Medicaid assistance program to include more people who don't have it in their

00:11:27.220 budgets to pay for healthcare. Uh, the affordable care act changed some of the rules insurance

00:11:32.580 companies had to follow. So in the past, if you had a preexisting medical condition, you could be

00:11:37.840 turned down by an insurance company for coverage or your cost of coverage could be really high, but

00:11:42.880 under the affordable care act, you no longer could be turned down or charged more for preexisting

00:11:48.240 conditions. Uh, so under, under ACA, under Obamacare, you only receive discounts to help,

00:11:53.940 uh, to help offset health insurance costs. If your household income is between one and four times

00:11:59.140 the federal poverty level, which is a number of the government uses to determine the minimum

00:12:04.520 amount of money needed for food needed for shelter, other basic needs. Uh, you can, you can choose to

00:12:12.200 apply these credits to your premiums to lower your monthly insurance bill, or you can wait until the end of

00:12:17.420 the year and you can put them, you can declare them on your tax return. So, uh, Americans who, uh, who

00:12:23.700 meets certain income-based criteria have to, by law under the affordable care act, have insurance, they

00:12:30.840 have to have Medicare or Medicaid, or they have to pay a penalty. If they don't, uh, that will be levied when

00:12:36.680 you file your tax return. So this requirement is commonly referred to as the law's individual mandate,

00:12:42.760 which was very, and is, well, I guess it's not really anymore and we'll get to why, but it was

00:12:47.960 extremely controversial. It was the most controversial part, I would say, of the affordable

00:12:53.460 care act. Uh, Democrats said that they included this individual mandate, this, uh, mandate that says

00:12:58.580 you will pay a penalty if you don't have insurance because they figured that it would force young and

00:13:03.680 healthy people to enroll in the healthcare exchanges. Something they said would, uh, offset the higher cost

00:13:10.900 of covering people with chronic diseases. They also assumed that people would take care of themselves

00:13:15.900 better, um, which would theoretically reduce future healthcare expenses. That's what they said. But

00:13:21.740 Republicans were extremely opposed to this. They believed that the penalties would be, uh,

00:13:26.920 an unneeded burden on families who maybe weren't covered by private insurance, but didn't want or

00:13:32.320 couldn't afford Obamacare, but now had to buy the coverage or else they'd get penalized. Uh, so they saw

00:13:38.460 this as both counterproductive. They saw this as tyrannical. Uh, it's one thing they would say,

00:13:44.140 I think to expand Medicaid so that more people are covered. It's another thing to force people

00:13:48.260 who didn't have insurance to buy, uh, to buy a government plan that they don't want. Uh,

00:13:53.240 they were afraid that this would harm low income families the most. And they were actually right 1.00

00:13:58.640 about that. So, uh, Republicans were correct. According to the IRS, more than half the total penalty, 0.91

00:14:04.720 uh, payments, uh, were by people who, uh, had, who, uh, were earning less, sorry, I got mixed up for a

00:14:13.220 second, who were earning less than $50,000 a year. 86% was from people earning less than a hundred

00:14:19.620 thousand dollars a year. So that is why, if you remember, you might not remember, depending on how

00:14:24.600 old you are, uh, in 2013, Ted Cruz and a few other conservatives, it was mostly Ted Cruz put up a

00:14:30.260 fight, uh, that ended in a government shutdown to try to defund Obamacare. It was unsuccessful.

00:14:36.920 Uh, Ted Cruz took a lot of flack from both the right and the left for that, but it also is what

00:14:42.500 kind of launched him onto the political scene. So he maybe saw that as a win in some ways. Uh,

00:14:47.460 then in 2017, a Republican controlled Congress eliminated the mandate, which went into effect

00:14:52.880 this year. Uh, so we don't know the results of that quite yet, but Democrats of course were upset by

00:14:58.480 this because of how many people wouldn't be insured. And yes, that is true that some people

00:15:03.540 wouldn't be insured because the mandate is no longer valid, but that's just because now they

00:15:08.060 have a choice of whether or not to be insured. They're not kicked off. Uh, they just are not being

00:15:13.800 forced to, to use, to be on Obamacare anymore. So advocates of Obamacare would say that it slowed

00:15:21.560 the rise of healthcare costs and that it did this through providing insurance for millions and made

00:15:26.600 preventative care free. Um, it's good because they would say that it requires insurance plans

00:15:32.320 to cover essential health benefits, including mental health, addiction, chronic diseases.

00:15:37.600 Uh, they said that one good thing was that insurance companies couldn't deny people or raise costs for

00:15:43.100 preexisting conditions, but those who are against it are going to cite the harm that it did. If you

00:15:49.240 talk to any of them, that three to 5 million people lost their employment, employment based health

00:15:54.060 insurance, because a lot of businesses found it, uh, more cost effective to pay the penalty and let

00:15:59.500 their employees purchase insurance plans on the exchanges themselves. Uh, other small businesses

00:16:04.200 found that they can get, uh, better plans through the state run exchanges. So a lot of people lost

00:16:09.420 plans that they really liked. They lost the quality coverage that they actually preferred. And so this

00:16:14.820 is where that big lie that I am sure you've heard was uncovered that, uh, Obama kept on saying,

00:16:19.720 if you like your doctor, you can keep your doctor. Obama repeated that over and over again.

00:16:25.020 Then in 2013, he, uh, said, well, that's not, that's not really what I said. That's it. No,

00:16:31.320 we were just being misunderstood all along, but he did. It was a promise that Republicans knew that

00:16:36.600 he could not keep with this plan. PolitiFact explains it like this. The affordable care act

00:16:41.860 tried to allow existing health plans to continue under a complicated process called grandfathering,

00:16:47.160 which basically said insurance companies could keep selling plans. If they followed certain

00:16:52.020 rules. The problem for insurers was that the Obamacare rules were strict. If the plans deviated

00:16:57.400 even a little, they would lose their grandfathered status in practice. That meant insurers canceled

00:17:02.640 plans that didn't meet new standards. Obamacare required services that a lot of people are required

00:17:10.840 coverage that a lot of people don't need like maternity care. That meant if someone had an insurance

00:17:16.040 plan that didn't cover maternity care, that plan had to be canceled, which really was bad for a lot

00:17:21.140 of people. So if you're a 60 year old guy, you don't need a plan that covers maternity care or

00:17:26.320 pediatric care, because why would you, uh, your plan got canceled. If you were that guy, this happened to

00:17:32.100 millions of people and replacing the affordable plan that you liked in favor of another plan costs a lot

00:17:38.980 of money. Uh, Obama and his team lied about this over and over again, saying that there's nothing in

00:17:45.500 the plan that pushes people off their healthcare coverage. That was demonstrably not true. That was

00:17:51.820 a lie. And Obama actually did somewhat apologize later in 2013. He was in an interview with Chuck

00:17:57.700 Todd and he said, okay, that wasn't entirely accurate. Maybe I exaggerated. Well, yeah, that's a big lie to

00:18:04.120 tell. Um, and also I just want to note that you hear Obama, you hear Biden, you hear media pundits

00:18:11.620 saying that Obama had a scandal free presidency, that there, uh, were no bumps in the road, that

00:18:18.020 there's nothing that happened that was scandalous. Well, you might think that because of the media

00:18:23.500 coverage of his presidency, both then and now, but the fact of the matter is this was a big deal.

00:18:29.900 Then the fact that he said, if you like your doctor, you can keep your doctor. And then he admitted that

00:18:34.560 he was lying about that. Of course he said he exaggerated it, but that's a lie. And maybe props

00:18:40.160 to him for actually owning up to that. I mean, that's something, there's something to be said

00:18:45.340 for that, but that's a big lie that affected a lot of people's lives. And really, I would say

00:18:52.180 manipulated a lot of people into believing that this would be a good thing. And they ended up on the

00:18:56.520 wrong side of it. And so there have been scandals, of course, in the Obama presidency, Benghazi,

00:19:04.100 Fast and Furious, IRS, that's a different episode for a different day. But the fact of the matter is

00:19:07.660 this was a big lie that affected people in a really negative way. There were a lot of people that were

00:19:12.180 upset about this. In 2013, a Pew research poll found that the number of people who saw Obama as

00:19:17.720 untrustworthy actually rose by 15 points in 2013. Uh, and that just proves exactly what we said,

00:19:25.600 that people were paying attention and that they were mad. They didn't want to be, they didn't want

00:19:29.860 to be lied to, uh, because here's the thing. People don't like their healthcare coverage mess with

00:19:34.520 if they like it. They don't, they don't want to mess with. A lot of people do. A lot of people are

00:19:39.940 satisfied with the coverage that they get, at least for the most part, at least not enough to hand it

00:19:43.640 over to the federal government. Um, and then there was also the controversial contraceptive mandate,

00:19:49.140 which required insurance companies and employers who provided health insurance to cover the cost of

00:19:55.140 birth control. There are a lot of religious organizations who are opposed to birth control

00:19:59.740 from a religious and moral standpoint. So forcing them to pay for it would be an infringement on

00:20:05.500 religious liberty. The contraception mandate wasn't actually in Obamacare legislation originally,

00:20:11.720 but it came later in 2011 through, uh, regulations. And there were only narrow exemptions for this,

00:20:17.340 uh, for churches, but did not include religious nonprofits or religious corporations.

00:20:21.620 And then in 2014, there was a Supreme court case involving Hobby Lobby. You might know a little

00:20:27.760 bit about that, uh, which is a corporation that is owned by Christians and the court ruled that

00:20:32.660 closely held religious for-profit corporations did not have to provide, uh, birth control in their

00:20:39.700 insurance plans for their employees. Uh, the Catholic organization, uh, little sisters of the poor 1.00

00:20:45.060 endured years of court battles until May, 2016, uh, the Supreme court actually ruled in their favor and

00:20:52.140 instructed the lower courts that had ruled against them to provide the government, uh, with an

00:20:56.500 opportunity to find a way to provide services for the women who want birth control without involving

00:21:01.840 the little sisters. So really everyone won, but of course the left is not necessarily happy with

00:21:06.620 that because they don't believe that religious liberty should trump what they think is a right

00:21:10.960 birth control. So this is from Beckett law.org in May, 2017, president Trump issued an executive

00:21:17.180 order directing HHS and other federal agencies to protect the little sisters of the poor and other

00:21:23.360 religious nonprofits from the mandate on October 6th, 2017, the government issued a new rule with a

00:21:29.160 broader religious exemption. In June, 2018, the little sisters original case was finally resolved with

00:21:34.800 an order by the U S court of appeals for the 10th circuit on November 7th, 2018 HHS issued a rule

00:21:40.780 finalizing the little sisters religious exemption. So, uh, that means that now, at least for now,

00:21:49.620 I mean, this can always be, uh, there can always be pushed back to this. There's always going to be

00:21:54.660 people who are saying no religious liberty is not, is not a worthy exemption. It's not a worthy reason

00:22:00.780 not to provide your employees with health insurance, but for now religious liberty did win a particular

00:22:06.520 battle. But this is also part of the reason why Christians really didn't like evangelical Christians

00:22:11.160 really didn't like Obama because they felt targeted, uh, by his policies. They felt again,

00:22:16.820 that Christianity, that religious views were being mocked in some way and religious liberty was secondary

00:22:23.460 to their agenda, particularly when it came to something like birth control. And so there was a lot of

00:22:30.380 controversy over that. There's a many moral and policy reasons why people did not like Obamacare,

00:22:36.300 uh, according to the Kaiser family foundation on December 14th, 2018, a federal district court,

00:22:43.680 uh, judge in Texas issued a ruling challenge. You probably remember this not that long ago,

00:22:48.280 uh, issued a ruling challenging the future of the 2010 affordable care act. The judge sided with

00:22:54.520 Republican state attorneys general that ruled that since the 2017 tax bill passed by Congress,

00:23:00.840 zeroed out the penalty for not having health insurance. That's that individual mandate. The

00:23:05.160 ACA is invalid. Democrat attorneys general have already taken actions to appeal the judge's ruling

00:23:11.420 in the case. And due to the government shutdown, the fifth circuit court of appeals has paused the case.

00:23:17.720 So that was, uh, back a few months ago. This is from the Kaiser family foundation. So the question is,

00:23:23.800 why does all of this matter now? The controversy of Obamacare, the fact that we even had Obamacare.

00:23:29.320 The reason is because Obamacare was the primer for our current conversation about healthcare.

00:23:34.380 It operated on the premise that healthcare is a right and therefore everyone must be covered or

00:23:40.400 else. And it was the or else and is the or else that conservatives did not and do not like,

00:23:47.820 because it ended up being that everyone must be covered how the federal government wants you to

00:23:53.140 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 1.00

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 1.00

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 0.64

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 0.55

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

00:39:01.060 have a great day and I will see you soon.

Relatable with Allie Beth Stuckey - January 15, 2020

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