A conversation with Kobe Blumenfeld Gantz all about Medicare, the issues, the problems, enrollment, and more. Recorded in Los Angeles, CA at the Bitcoin Meetup Group's annual conference, Bitcoin 2020.
00:00:38.000He's an incredible guy, his spirit, his love of this country.
00:00:40.000He's done an amazing job building one of the most powerful youth organizations ever created, Turning Point USA.
00:00:47.000We will not embrace the ideas that have destroyed countries, destroyed lives, and we are going to fight for freedom on campuses across the country.
00:01:25.000Before that, I had worked in software, working with the government, and have spent a lot of time looking at how large data sets can be used to help people, how the government can be more efficient, and there's a lot to explore there, in using information and providing better services to people, how we can create systems that help people with much better incentives to create better services for Americans.
00:01:52.000So you decided to start ask chapter dot com, first tell everybody what it is and then the why.
00:01:59.000So, or you could, whichever way you want to do it.
00:02:05.000So, I was very fortunate to grow up with my grandfather living with my parents and me when I was in high school.
00:02:12.000He was very healthy, mentally sharp and with it, but just as a function of his generation, he didn't really have access to the technology of the day and didn't really know how to interact with others in a meaningful way.
00:02:26.000And it wasn't because he was a Luddite.
00:02:31.000He was very, very technical for technology of his day.
00:02:35.000And he was fairly isolated in our home.
00:02:38.000And I always thought that was just kind of crazy, that we didn't have a good way to engage our elders and our seniors in productive life after this thing we call retirement.
00:02:47.000Of course, I didn't do anything with that at the time.
00:02:48.000I went to college, I went to grad school, worked in software for a long time.
00:02:52.000And then as my parents were getting older and going through a similar process, I observed them navigating Medicare and retirement at large and just saw how the system is really rigged against our elders when they're dealing with Medicare.
00:03:11.000and it was just such a challenging experience for them.
00:03:13.000They were working with a local Medicare advisor who was maybe well-intentioned but didn't have the data or the tools to be effective.
00:03:57.000It's not just this one, it's not one Medicare plan.
00:04:01.000Part A, B, C, D, all these letters, alphabet soup of Medicare.
00:04:04.000And most people assume that it's just automatic, that you turn 65 or you retire and you get Medicare.
00:04:09.000And that's fortunate or unfortunately, just not how it works.
00:04:12.000And so there's a whole industry of people out there who are there to support seniors in navigating this process.
00:04:20.000But as we're seeing with some of the DOJ investigations now into a lot of the Pretty much every American who's working with a Medicare advisor today is not getting the best guidance for their needs.
00:05:13.000I just kind of, I drone out when they do that, right?
00:05:15.000But they say, okay, call your Medicare Advisor hotline, whatever.
00:05:19.000You call it, you're like enlisting a real estate agent.
00:05:22.000What is the conventional or the most common experience that anyone has?
00:05:28.000So the way it works is most Medicare advisors are paid a lot more in terms of commission for one type of plan, it's called the Medicare Advantage plan.
00:05:36.000That's one of the two types of Medicare plans you can go down.
00:05:40.000And because they're paid more by these Medicare Advantage plans, they're going to push a subset of Medicare plans on the user.
00:05:46.000In the same way you might have an insurance agent push plans of any type, whether it's auto insurance, life insurance, whatever it is.
00:05:52.000But when you're dealing with someone's health and something that's so foundational, and also let's remember, it's not a welfare program.
00:05:58.000Medicare is a program that we've all been paying into.
00:05:59.000We pay into as part of Medicare payroll tax our entire lives.
00:06:03.000and so it's something people have paid into and deserve and have really earned through their whole careers.
00:06:08.000They're being, It's not what's better for the customer.
00:06:30.000I thought Medicare is largely covered by the government taxpayer.
00:06:34.000Yeah, we it's the short version is there are a lot of costs to the consumer on Medicare without going into too too nitty gritty detail.
00:06:43.000But the the majority of Americans do sign up for some kind of supplemental coverage, which they do have to pay something for.
00:06:50.000Sometimes that's in the form of premium, sometimes that's in the form of co-pay, sometimes it's in the form of paying for prescriptions, whatever it is.
00:06:57.000And so there are a lot of costs sometimes hidden in the system that can be really hard for people to navigate.
00:07:02.000So then where do you guys come in and you help with the three key Medicare decisions?
00:07:06.000When to enroll, how to get the most value from Medicare, and then also how to keep Medicare working for you.
00:07:45.000It's really the on-ramp, the accessibility to Medicare that are so challenging and are rife with misincentives.
00:07:51.000So things that we do to help, first and foremost, you know, it's probably not a surprise to say that health insurance companies are not the most technologically savvy or technologically forward organizations.
00:08:02.000And so what we do is build a lot of really good technology and improve the data quality.
00:08:06.000So as an example, if you want to know what your prescriptions are going to cost on a Medicare plan, you know, it's a reasonable thing to ask.
00:08:13.000There is not a single organization or company in the country other than Chapter for better or for worse, that can tell you that with precision.
00:08:20.000And the reason is because we have to integrate tens of billions of records of prescription data to know that answer.
00:08:28.000It's actually a very hard technical problem.
00:08:30.000So one is we do a lot of technology to in the background so that the senior doesn't have to do all that research.
00:08:50.000We're about to find out based on how the DOJ investigation I mean, there's no question that it's unethical.
00:08:55.000Whether it's illegal is a question, and that's what they're litigating now.
00:09:00.000But at a high level, you have a few big Medicare insurance brokerages who are being paid basically volume-based performance programs saying, hey, if you sell...
00:09:18.000So does everyone use a Medicare advisor or it's just most people?
00:09:22.000I mean, it's like closing out a house.
00:09:39.000complicated but the advisor makes the money from the government then the advisor makes the money from the insurance carrier so the flow of funds is the government pays a health insurance company united at night anthem whatever got it i see they pay you know they are the ones who are paying the medicare broker got it We're honored to be partnering with the Allen Jackson Ministries, and today I want to point you to their podcast.
00:10:01.000It's called Culture and Christianity, the Allen Jackson podcast.
00:10:05.000What makes it unique is Pastor Allen's biblical perspective.
00:10:08.000He takes the truth from the Bible and applies it to issues that we're facing today.
00:10:12.000Gender confusion, abortion, immigration, Doge, Trump, and the White House.
00:10:19.000In every episode, he gives practical things we can do to make a difference.
00:10:23.000His guests have incredible expertise and powerful testimonies.
00:10:26.000Each episode will make you recognize the power of your faith and how God can use your life to impact our world today.
00:10:33.000The Culture and Christianity podcast is informative and encouraging.
00:10:36.000You could find it on YouTube, Spotify, or wherever you get your podcasts.
00:10:40.000Be sure to subscribe so you don't miss any episodes.
00:10:42.000Allen Jackson Ministries is working hard to bring biblical truth back into our culture.
00:10:47.000You can find out more about Pastor Allen and the ministry at Allen Jackson.com forward slash Charlie.
00:10:55.000And so then you guys come in and you are trying to revolutionize the entire broker relationship where then people would then use you as a replacement for Medicare advisory.
00:11:20.000and we educate them on what their needs and concerns are and then we figure out what's right for them if there's a medicare plan that suits their needs even if it's one that we don't earn any money on we will still enroll someone in that medicare plan and because it's the right thing to do, we think it creates a long-term relationship with the customer.
00:11:37.000And it actually makes the end user the customer.
00:11:40.000A really simple way to think about in any market, where are the incentives, is who is the customer?
00:11:45.000If we were to go back to employer health insurance, the reason that it's tied to your employer is really a product of World War two.
00:11:54.000The government was trying to stem inflation and so froze wages.
00:11:57.000And the only way for employers to compete was to provide other benefits like health insurance, tax-free health insurance.
00:12:04.000And so we're still eating the cost of that decision half a century later, almost a century later at this point.
00:12:10.000But the employer in that case is the customer, right?
00:12:15.000The health insurance company sells to the employer, not to the employee, not to all of us as consumers of the health insurance.
00:12:44.000We are helping hundreds of thousands of Americans navigate Medicare.
00:12:49.000At this point, we've been around for a few years and growing.
00:12:52.000We're definitely the fastest growing Medicare organization in the country, one of the fastest growing companies in the country of any archetype.
00:12:58.000And so, yeah, we're helping a lot of people and our goal is to help every American.
00:13:33.000I was fortunate to be able to support the Marines in the Middle East and support a large number of areas of the government.
00:13:41.000Yeah, it's when the New York Times attacks you, then there's probably another, there's something of the opposite of the truth there, and so there's been some great people that have come out of that.
00:13:51.000So let's now talk a little more broadly about government waste.
00:13:55.000What is your philosophy on the inefficiencies of government and how we can try to modernize it?
00:14:10.000I think one of the least sexy but most fundamental improvements that the government needs to make and they're trying to make now is around, this is going to sound so silly, but HR policies.
00:14:22.000How do you hire the best people, incentivize the best people?
00:14:26.000They're groups of people trying to make good decisions.
00:14:28.000And you need to have a way for people to, for the government to hire the best people, to retain the best people, and to let go of people who aren't an appropriate fit.
00:14:37.000And I think that's one of the hardest things for the government to do, not only because it's the government, but it's, and it's not unique to the government.
00:14:43.000Any large organization has this challenge.
00:14:53.000And so the more on the HR, he who controls the HR will control the personnel and with personnel is policy.
00:15:00.000Where did we go wrong as a country just more broadly at the collapse of robust HR?
00:15:07.000How did we run human resources hiring, onboarding 40 years, 50 years ago, not just technologically, That's just been a general trend across pretty much every administration.
00:15:31.000And that often includes bringing on more people.
00:15:38.000There are a lot of different interest groups who promote different areas of investment for different groups of people.
00:15:46.000And that creates sort of different little fiefdoms in the government and in different agencies.
00:15:50.000And because the sort of political class, the political appointees change roughly every four years or every eight years with the administration change, but you have the civil servant class which doesn't change it creates this really interesting and often challenged relationship between people who are there for a very long time and people who are not and it's really hard i don't have a i don't have an easy solution for it yeah and so what what are some of the other massive inefficiencies you think in the government that technology
00:16:21.000absolutely um i think we the way that our government procures technology um is really stuck in the stone age and i'll give a couple of examples um so one is sort of a defense example and one is a medicare example um in the defense world um you have these cost plus contracts and so for people who aren''t familiar, cost plus is basically a way of contracting where a private company will say, hey, it's going to cost me a dollar to produce this widget.
00:16:47.000I'm going to charge the government three times my cost in this case.
00:16:52.000So I'm going to charge the government three dollars.
00:16:55.000I'm going to make two dollars a profit.
00:16:56.000And that's going to be a consistent way of doing it.
00:16:58.000The problem with that is it disincentivizes innovation.
00:17:01.000It disincentivizes investment into new ways of doing things because the company is always going to make the same profit margin.
00:17:09.000right and the government has there are a lot of rules and a lot of executive orders that have come out particularly in this current administration to move away from that model, but the civil servant class is still stuck there.
00:17:22.000And we're seeing that in Medicare as well.
00:17:26.000At HHS, there are a whole host of technology challenges and procurement challenges, some of which aren't that hard to solve that they're most technical problem, but they're very hard to solve because you have these people with different incentives and different sort of fiefdoms, as I was saying.
00:17:45.000to any sort of technological innovation or adaptation.
00:17:49.000And I guess that's part of why you started your business.
00:17:52.000And it just goes to show that the private sector is doing everything the government once wished it could do from SpaceX to, you know, Palantir you mentioned, right?
00:18:01.000Both SpaceX and Palantir had to sue the government to get this.
00:18:05.000So Palantir sued the US Army and won for the same Federal Acquisition Streamlining Act called FASA Statute, where basically the government was not allowing Palantir to compete on a very large defense contract because the government wanted to build it themselves.
00:18:48.000So it's, you know, if you're upset with Palantir, I think you also have to be upset with Microsoft for Microsoft Office, I think you also have to be upset with Amazon for AWS products, I think you have to be upset with pretty much any company that builds data analysis products, which is hard to be upset with because they actually do provide a lot of value to the world.
00:19:06.000No, yeah, so Palantir sued the army for not allowing Palantir to compete on a particular government contract that Palantir thought it was best suited for.
00:19:17.000And the government's claim was that it should be built by the government.
00:19:21.000And this is, I think, a much broader issue, which again we're seeing in pretty much every federal agency where the government is still trying to build software themselves, which doesn't make sense.
00:19:30.000I mean, the government can barely deliver the mail, no offense to them.
00:21:38.000rather than and that can take a month rather than let's give, you know, Accenture or Booz Allen or someone five years to build a worse version of.
00:21:50.000How many contractors are there in the federal government?
00:22:00.000It's hard to believe it was even possible, but the Democrat-run states are now more pro-abortion than ever and will only get worse unless you join me standing for life.
00:22:09.000This is Charlie Kirk, and we're saving babies right now with preborn.
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00:22:53.000That's 833-850-2229 or click on the preborn banner at charliekirk.com.
00:23:01.000It gets you have this permanent civil service bureaucracy.
00:23:04.000You have this permanent government contractor class and a DOD and CIA and the Pentagon, there's a ton of contractors that, especially in the Intel world, like, remarkable.
00:23:14.000And so then the civil service, we kind of know they're just slow and bureaucratic, but the contractors, that's a whole lot.
00:23:22.000They should be held to an even higher standard.
00:24:14.000How often do they shift from plan to plan?
00:24:17.000People it really depends on the details, but most people are eligible to make a plan switch roughly once a year, some people more than that.
00:24:48.000One is it's just a massively inefficient system today.
00:24:51.000If you think about inefficiency creating waste, you have people who are signing up for the wrong Medicare plan and different studies show different things, but roughly 70 to 90 percent of Americans are on the wrong Medicare plan for their needs.
00:25:07.000So if you think about the entire system, you have this massive inefficiency of what plans people are on, how they utilize those plans, and how the plans serve those end users.
00:25:22.000Like you have these Medicare plans that have all these benefits.
00:25:26.000but they're all locked in in the plans and they make them so hard to use and so seniors are offered these great hearing dental vision over-the-counter benefits but they can't actually use them so one thing we've done at chapter is we've built a free app that allows people to look up their Medicare plan, look up their over-the-counter benefits and just redeem them with a click of a button.
00:25:46.000And then magically a few days later, their free benefits show up at their door instead of having to spend weeks calling different carriers, calling different middleware providers to understand what's going on.
00:25:56.000And this is just one very small example, of course, of the inefficiency and the waste.
00:26:01.000But you magnify that across everything.
00:26:03.000And there's just no price transparency across the entire system.
00:26:37.000Every year, your employer can switch your healthcare or your Medicare plan can change.
00:26:43.000And so if you're a health insurance company and you want to create long term, you know, good preventative healthcare, you don't know that you're going to have that customer in 10 or 20 or 30 years, not to be charitable to the health insurance companies, but where's the incentive for them to make me healthier today rather than in 50 years?
00:27:05.000The longitudinal incentive just isn't there.
00:27:08.000And so the, it just, well, here's a, here's a provocative question for you.
00:27:11.000Why has no one done what you're doing yet?
00:27:13.000When I started the company, pretty much everyone in the industry I agree.
00:27:21.000Pretty much everyone in the industry told me I was crazy, that what I wanted to do was illegal, and that I would fail within the first three months.
00:27:29.000And so I think some of it is path dependence.
00:27:31.000I think a lot of people who operate in the health insurance space and the Medicare space just frankly don't think about things in a new way that often.
00:28:03.000And I think it goes to this systematic issue that we have actually in our society that we don't have the right engagement, the intergenerational engagement.
00:28:10.000engagement with our I agree with our seniors.
00:28:13.000No, and it's just like I mean, I know we have a ton seniors that are watching this program and they're getting hosted by this stuff.
00:28:19.000So you guys are using artificial intelligence, is that right?
00:28:28.000We don't build foundational models ourselves, nor should we.
00:28:31.000But AI is really, really great at automating repetitive tasks in a high quality way.
00:28:37.000So what a lot of our competitors That's a good way of putting it.
00:28:39.000What a lot of our competitors do is they'll hire teams of thirty or forty or fifty people to listen to samples of phone calls, because we do a lot on the phone.
00:28:47.000And they'll listen to samples of phone calls and say, hey, is this Medicare advisor giving a good experience or a bad experience?
00:28:52.000But they're listening to one or two percent of calls.
00:28:54.000What we do is we have an AI listen to 100% of calls, flag issues, and much faster, much more real time and much lower cost.
00:29:01.000Which company is able to build that kind of model for you?
00:29:04.000We're always testing the latest model.
00:29:08.000So we use So is that a large language model?
00:29:37.000So it's an app, basically a backend program that allows us to programmatically communicate with that service.
00:29:47.000So instead of me logging into a web user interface, a chatbot, it says, hey, tell me about X. I can connect our two databases, for example.
00:30:13.000We're the ones building that or working with other parties building it.
00:30:15.000The OpenAIs of the world, the Anthropics of the world are not building it.
00:30:18.000I just think that's important because people only think of Jack GPT as what they see front-facing, but back-facing, they could be scanning phone calls to make sure seniors save money.
00:30:37.000Do you have a little bit of skepticism?
00:30:39.000Do you think we should have more government control?
00:30:42.000What is your philosophy when it comes to artificial intelligence?
00:30:44.000I think of AI in the same way I think about kind of any technology revolution, which I think makes me both an accelerationist and a skeptic at the same time, which is that I think it's a much bigger change, but in the same way that technology accelerates, it's not qualitatively different than the internet or than a cloud-hosted database.
00:31:07.000It is something that will make us much more efficient, much better, and allow us to do many more things than we used to be able to do.
00:31:15.000to your point on ordering chinese food I was never able to just click a button 30 years ago to get Chinese food to my door.
00:31:28.000What are your biggest concerns with artificial intelligence.
00:31:31.000I think people will rely on it far too much without human oversight or human intervention.
00:31:38.000And maybe in some contexts that's okay, but broadly I don't think that's okay.
00:31:43.000I think from a more metaphysical perspective almost or a religious perspective, I think it's very hard to have a thing that humans have built as compared to an omniscient being.
00:32:48.000I think that's very hard for the government to do as we just said.
00:32:50.000The government's not always the best with technology.
00:32:53.000I think a lot of it has to be free market and there do there do need to be some controls for what disclaimers do we allow, how do we source the data that goes into AI and how is it checked.
00:33:05.000I think I think knowing whether the information that we're looking at is whether it's correct or incorrect.
00:33:10.000And by what standard and by what standard exactly.
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00:33:49.000Learn more about TikTok's contribution to the U.S. economy at TikTok economic impact dot com dot That is TikTok economic impact dot com dot So yeah, do you give any credence or any of your brain space to singularity or the kind of more Armageddon darker takes on artificial intelligence?
00:34:29.000So, I mean, trust me, I'm not making any proclamations here, but a big argument sometimes on the right is, you know, it's Cyberdyne systems, Terminator 2, it's going to take over our grid.
00:34:42.000In some of the large language models, Gemini, there's some evidence to show prior that it has contempt for humanity.
00:34:56.000Yeah, the way I interpret it is the models are trying to give us what we want to hear often, and they're trying to figure out what we're trying to use it for.
00:35:08.000There are plenty of people who are prompting and asking questions of these models who may have contempt for humanity or who may ask questions that indicate contempt for humanity.
00:35:16.000So that's where I think it's lear very easy to imitate or to ape these conversations.
00:35:23.000It's very hard to truly have an AI that makes these decisions.
00:35:28.000At what moment do we know if it's reached singularity?
00:36:41.000I'm Shobra Shabbas from a Christian perspective.
00:36:44.000I have a belief that the entire spread of the simulation argument in Silicon Valley is there.
00:36:53.000It's the politically correct way to say you're a theist because it's a lot of technologists that actually want to say they believe in God and the way they do it is like we live in a simulation.
00:37:03.000If you think about it, if you say we live in a simulation, it's a cutesy way of saying that this is designed and there's intentionality behind it.
00:37:39.000different points in my life I've observed Shabbat.
00:37:42.000And to me, it's as much about the discipline and the forced introspection and the forced alertness of what's going on in my surroundings and sort of the approach And there's just a lot of value to humanity and to society to have those things, whether you believe in this entity or not, I almost think is not the only question.
00:38:11.000There's also just what's the value of it, and there's tremendous value to it.
00:38:32.000to term you used earlier it's fine we're going to go from horse buggies to you know cars is there something different about this though that makes it seem less technological and is to your words more of a metaphysical or theological debate the reason i i think it is less qualitatively different is because people were saying the same thing about the internet.
00:38:58.000People were saying the same thing about prior technologies.
00:39:01.000So I do think that AI is and has proven to get much better, much faster than prior technologies.
00:39:08.000And I think the next thing after AI will also get better faster than AI did if there is a next thing if we're not you know hitting the singularity quantum computing yeah quantum computing which is very exciting exactly and and AI I think will help the insolvable illness yeah I think will actually help with quantum computing those together yeah could be very powerful absolutely in closing here ask chapter.com when did you start the company in 2020 And you guys have how many employees do you have now?
00:39:49.000I get texts and emails pretty much every day from our members thanking me and our team for support.
00:39:55.000One example is last week a woman emailed in saying that we saved her $31,000 on her prescriptions because she was on a plan that didn't have any of her prescription coverage.
00:40:07.000Yesterday a friend texted me that she was visiting her parents for the weekend and her dad was just raving about chapter because he had spoken with one of our advisors and he had so much peace of mind.
00:40:22.000And so there's both the dollars and on average we save people $1,000 to $2,000 a year, but there's also just the peace of mind and the security that comes because it is Medicare is not just it's not just healthcare it's not just financial it's really the on-ramp to retirement and people need this security yes and that's amazing and you guys could grow limitlessly at this point is that right i mean millions and millions and millions of people could potentially use it last question why do you think conservatives lose on
00:40:52.000healthcare i i know you're non-partisan but just if you were to give an independent analysis why is it that conservatives lose so terribly on this topic do they i don't i don't know if anyone wins on healthcare i guess the democrats kind of do by you know by saying free healthcare free stuff.
00:41:11.000Do you think that, what is your take on the push towards Medicare for all, single payer, this whole make the whole medical system like the VA?
00:41:28.000But in general, I also don't think it's the best idea.
00:41:31.000It's hard enough to manage a massive program of Medicare.
00:41:35.000Medicare for all would basically be Medicare Advantage for all, and Medicare Advantage has a lot of issues.
00:41:41.000But to your point earlier, I think the to your question, I think it really comes down to just Republicans or Conservatives are often seen as more focused on cost cutting and Democrats are often seen as more focused on providing more services.
00:41:56.000And this isn't a normative statement, it's just what they are.
00:41:59.000And I think that's that's largely why.
00:42:00.000But no one's really created a shared vision for what the future of healthcare should be, for what the future health system should be.
00:42:07.000I don't think either party has done a particularly good job at it.
00:42:09.000Ask chapter dot com, Kobe, anything else you want to mention about this that we didn't get a chance to cover?