On today's show, we're joined by Ryan Thorpe of the Manhattan Institute and Chris Rufo of City Journal to discuss a new piece from City Journal on the massive amount of fraud going on in the Somali community in Minnesota.
00:00:56.000The Charlie Kirk Show is proudly sponsored by Preserve Gold, the leading gold and silver experts and the only precious metals company I recommend to my family, friends, and viewers.
00:01:09.000All right, welcome to hour two of the Charlie Kirk Show.
00:01:11.000I'm Andrew Colvett, executive producer of this show, along with Blake Neff.
00:01:17.000We're going to get a little deeper, more, I don't want to say philosophical, but this is going to be a smart, elevated hour because we're talking about some of these themes in American life, especially the modern American life, that kind of go under the radar, but they're having a profound impact on your taxes, the way your government spends money, some of the fraud that's happening.
00:01:35.000We just had a congresswoman out of Florida who was a grand jury returned an indictment charging her for stealing $5 million of COVID funds.
00:01:44.000So this is kind of a story in that realm.
00:01:48.000He's an investigative journalist with Manhattan Institute.
00:01:51.000He's got a new piece he co-authored with Chris Rufo at City Journal, and it's entitled, The Largest Funder of Al-Shabaab is the Minnesota Taxpayer.
00:02:00.000Al-Shabaab, of course, is a radical Islamic terrorist group in Somalia.
00:02:05.000We have a lot of Somalis in Minnesota, and we've hit this beat a few times that there's a lot of fraud of various kinds that goes on because it's an insular community.
00:02:16.000But this piece really lays out how a lot of it works.
00:02:30.000Well, so what we're seeing in Minnesota is that there's billions of dollars of fraud going on, particularly targeting government welfare programs.
00:02:40.000The fraud has gotten so bad that the U.S. Attorney's Office has indicated that there are entire government welfare programs where the fraud outstrips the legitimate claims.
00:02:51.000These large-scale fraud rings to date have largely been concentrated in Minnesota's Somali community.
00:03:00.000But this is an inconvenient fact that progressive politicians in Minnesota, and I would also say the mainstream media, has been unwilling or unable to acknowledge.
00:03:11.000And over the course of our investigation for City Journal, we developed several counterterrorism sources, law enforcement sources, who confirmed to us that some of these stolen funds, millions of dollars, are being sent abroad through Hawala networks, which are informal money transfer networks that are popular in Islamic countries.
00:03:32.000This money has then gone overseas, and some of that money has ended up in the hands of al-Shabaab to the point that one of our sources said the largest funder of al-Shabaab is the Minnesota taxpayer.
00:04:20.000So this is one, this is so incredible.
00:04:22.000We're having Curmu on next to talk about healthcare.
00:04:24.000And when he came out on the show with Charlie a few months ago, one of the things he said is he's like, he says, I think the number, the growth of autism in America is overstated because they overdiagnose it.
00:04:34.000And the example he said is he said, in Minnesota, Somalis are just scamming the autism system to get a ton of money.
00:04:43.000So, like with another program, autism claims to Medicaid in Minnesota have skyrocketed from $3 million in 2018, 3 million, to, I'm going to abbreviate it, 399 million in 2023.
00:04:56.000So they went up more than 100 times over in five years.
00:05:02.000And it mentions the number of autism providers went from 41 to 328.
00:05:06.000And then it says the Somali community has established autism treatment centers for culturally appropriate programming.
00:05:14.000One in 16 Somali four-year-olds has reportedly been diagnosed with autism.
00:05:20.000Are they just letting anything happen and they're not doing any policing whatsoever, Ryan?
00:05:24.000Well, it's very clear with these government programs that there weren't many checks and balances that were built into the system and that this was done by design.
00:05:34.000I mean, this was done purposely to help facilitate money going out the door, ostensibly to people in need.
00:05:41.000And what's interesting about the autism fraud case, the first indictment that's come down, the U.S. Attorney's Office indicates that more indictments will be coming, is that it is very clear the extent to which this fraud scheme penetrated the wider Somali community.
00:05:59.000The woman accused in this case would approach members of the Somali community in Minnesota who had children.
00:06:06.000She would sign them up for autism services.
00:06:09.000If the child wasn't autistic, she would get them a fraudulent diagnosis.
00:06:15.000And then kickbacks would be paid to Somali parents in the state who had signed up their children for fraudulent autism services.
00:06:24.000And the U.S. Attorney's Office noted that if the kickbacks were too low, the parents would threaten to pull their child from one provider and order and take them over to a different fraudulent provider in order to get more money that was being stolen from taxpayers through the scheme.
00:06:41.000So that's that's the autism was an example.
00:06:44.000Can you also describe this homelessness one, the Medicaid housing stabilization service?
00:06:51.000Can you explain how that fraud worked as well and any others that come to mind?
00:06:55.000Yeah, the housing stabilization services program was quite interesting because if you were to design a government program specifically to facilitate fraud fraudulent claims, it would probably look a lot like this program was designed.
00:07:09.000There were almost no checks and balances baked into this system.
00:07:14.000It was launched in 2020 with, I would say, a fairly noble goal.
00:07:19.000It was seeking to get people who are struggling with drug and alcohol addiction, mental illness, people with disabilities to help them find and secure housing.
00:07:29.000The U.S. Attorney's Office claims that fraudulent companies were set up.
00:07:34.000They were operating out of dilapidated storefronts.
00:07:39.000They would target people that were exiting drug and drug rehabs.
00:07:44.000They would sign them up for Medicaid services that they had no intention of providing.
00:07:50.000And then they would simply pocket the money.
00:07:52.000And yet again, we've seen the claims under this program absolutely skyrocket.
00:07:57.000When it was launched in 2020, government officials estimated it would cost about $2.6 million a year.
00:08:07.000And in the first six months of this year alone, claims were $61 million.
00:08:13.000At that point, the state stepped in and shuttered the program because they realized that they had a significant problem on their hands in regards to fraud.
00:08:23.000And the U.S. Attorney's Office has indicated in a press conference that he, the U.S. Attorney at the time, he believed there was more fraudulent activity in this program than there were legitimate claims.
00:08:35.000There have been eight indictments to date for HSS fraud.
00:08:40.000Six of the eight men who have been accused were of Somali heritage.
00:08:44.000Two were Nigerian, of Nigerian heritage.
00:08:48.000And they're accused of defrauding millions of dollars from this government welfare program.
00:08:53.000And yet again, it's been indicated that more charges will be coming.
00:08:58.000Is it as simple as it looks where I guess the stereotype would be it's Minnesota?
00:09:02.000You've got a lot of Swedes, Norwegians, sort of Nordic, high trust people, very used to doing pro-social behaviors.
00:09:10.000And it's almost like they're like an animal on an island that has no predators.
00:09:15.000So the thought that someone would just fleece a program or just lie about it is so alien to like they just have no defenses against this sort of behavior.
00:09:25.000Is there any interest in fixing this other than arresting people occasionally?
00:09:30.000Well, you know, I think that's a really good point.
00:09:32.000I think that does help explain some of what's going on.
00:09:36.000As I was reporting this piece out, the picture that was emerging was really of a perfect storm in Minnesota to facilitate fraud on a massive scale.
00:09:46.000You have a sizable Somali community that comes from a tribal clan-based society, and it has proven itself willing to cynically deploy accusations of racism as a shield in order to help cover up criminal behavior.
00:10:01.000You have a very generous, very progressive welfare state.
00:10:07.000And in many of these programs, checks and balances, they were specifically designed with very few in place.
00:10:14.000And then you have a progressive political establishment that is terrified of being seen as politically incorrect and also worried about alienating the Somali community, which is a sizable voting bloc in the state and has also established significant political connections.
00:10:34.000And so when those three things kind of collide, this is what you get.
00:10:41.000This is Lane Schoenberger, Chief Investment Officer and Founding Partner of YReFi.
00:10:46.000It has been an honor and a privilege to partner with Turning Point and for Charlie to endorse us.
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00:10:57.000Now, here Charlie, in his own words, tell you about YReFi.
00:11:01.000I want to tell you guys about whyRefi.com.
00:11:50.000We're joined by Ryan Thorpe from the Manhattan Institute.
00:11:53.000He has a great new piece about Mogadishu, Minnesota.
00:11:58.000And I want to get into this, Ryan, because how much of this is essentially Western culture confronting, I mean, let's just be honest, a very backwards, tribalistic African culture that has been imported into our country and they're just colliding and they don't understand each other.
00:12:22.000How much of it is a cultural breakdown, though, where Americans in Minnesota, they simply cannot fathom the cynical nature of these schemes and these cons?
00:12:32.000Well, I would say that sources I've spoken to in Minnesota have indicated that as a significant contributing factor in regards to these large-scale fraud rings that we're seeing, there is a cultural component here.
00:12:46.000You know, when you're talking about people of Somali heritage that have landed in Minnesota, these are people that come from a very tribal, clan-based society.
00:12:56.000They have likely spent time in a refugee camp prior to arriving in America, where I would imagine you have to be pretty resourceful in order to get by.
00:13:07.000They then come to a traditionally very high trust state with significant welfare programs, perhaps the most generous in the country.
00:13:18.000And quite clearly, by the criminal indictments that have been coming down, many people in the Somali community have figured out how to fraudulently obtain significant amounts of money.
00:13:30.000We're talking about billions of taxpayer dollars here that have been stolen, fraud rings that run to hundreds of millions of dollars alone.
00:13:39.000So I don't think you can discount that clash of cultures as a major factor in what we're seeing that's going on.
00:14:06.000Like, if you are going to, I mean, is there a significant move to actually denaturalize, to deport some of these people that are here on protected status or on a temporary status of some nature?
00:14:16.000Is there a way that you would dismantle this that would actually fix the problem?
00:14:20.000Or it feels like we're just going to be playing whack-a-mole for years here in Minnesota.
00:14:25.000Well, the sources that I've spoken to, these are political people, law enforcement, counterterrorism folks.
00:14:49.000But pretty much across the board, people that I spoke to said there really isn't a law enforcement solution to this problem.
00:14:56.000As you said, that's simply playing whack-a-mole.
00:15:00.000People pretty consistently told me that, you know, there needs to be a policy change here.
00:15:05.000And there clearly needs to be more accountability from the state government in Minnesota, which under Tim Waltz has been overseeing fraud after fraud to the point where the fraud has taken over entire government programs.
00:15:20.000So there has to be a policy solution here.
00:15:24.000Simply hoping for law enforcement to clean the mess up is naive.
00:15:32.000The most extreme thing of when you bring in people from a different culture, you bring in a different culture.
00:15:37.000And it really manifests the way that it's so large and so many people are involved.
00:15:42.000Like, we didn't even talk about the Feeding Our Future scam, another scam they did during COVID where they were pretending to feed thousands and thousands of kids, got millions of dollars.
00:15:50.000And it was, I think, one white Lutheran woman at the top of it, and then 50 plus people from the Somali community doing the rest of it.
00:15:58.000It really is just who you have any moral relationship to as people in your extended family, people in your clan, people in that community, and you have no moral relationship or otherwise with the government, with wider society.
00:16:12.000You've basically brought a people within a separate group of people who just don't feel any obligation to the rest of the citizenry, and they think it's totally valid to just loot that community for everything they have.
00:16:26.000And I think the only way, yeah, the only way you can deal with that is you basically need to impose far higher standards for any benefits you're going to dole out.
00:16:34.000Or you also have to say, frankly, why are we doing this in the first place?
00:16:39.000Why have we imported an alien culture that thinks it's their duty to just loot us?
00:16:43.000Now, isn't now with Trump's travel restrictions, because we had this in Trump 1.0, now 2.0.
00:16:48.000What's the status of immigration from Somalia right now?
00:16:52.000To be honest, I haven't looked into that, so I would not be sure Somalia.
00:16:57.000Yeah, I'm pretty sure Somalia is on the new track.
00:16:59.000So I don't know if we're making this problem worse right now, or if we've sort of stopped the bleeding, or if there's backdoor ways for chain migration and family reasons.
00:17:08.000Before we close it up, I want to throw up, put up 298.
00:17:10.000It's the social contract in Minnesota.
00:17:12.000You have Ole, 30 years old, and all of his money is going to Al-Shabaab to Feeding Our Future to cause more chaos in Somalia so that more migrants move in to Minnesota so that they can give more money to them.
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00:19:38.000This is the average annual expenditures for health insurance per household consumer unit.
00:19:44.000And you can see that big jump there right when the Affordable Care Act was implemented into law.
00:19:50.000So healthcare is far outpacing the trend that we saw before the ACA was passed.
00:19:55.000So we call it the Unaffordable Care Act.
00:19:58.000And that really is the foundation for our discussion.
00:20:01.000So, Craymu, what is going wrong with American healthcare?
00:20:05.000So I would qualify that last bit a little bit.
00:20:08.000I would say healthcare spending isn't really growing over what you would expect before the ACA.
00:20:16.000We're looking at different metrics there, but if you use consistent ones, it looks pretty fine.
00:20:21.000The bigger issue is that we have, it just shouldn't be growing this way in the first place.
00:20:26.000It is a completely broken system in the sense that we have created incentives to make it worse.
00:20:32.000So we have a lot of things in healthcare, post-ACA especially, that are terrible in the sense that, for example, take the medical loss ratio requirement.
00:20:43.000This is the requirement that health insurers have to spend 80 to 90%, depending on the type of plan.
00:20:52.000So if they charge their customers X amount, they have to spend 85% of X.
00:20:58.000And the fact that they have to spend that amount is effectively a profit gap.
00:21:01.000So they have to make profits in other ways.
00:21:02.000And to make those profits, they look into other things like buying up the pharmacy benefit managers or buying up hospitals or sneakily changing the prices or even overpaying for drugs in order to meet the threshold of things they have to pay for.
00:21:22.000So you end up with costs just kind of running everywhere.
00:21:26.000You end up with incentives for vertical integration such that they're buying up everything else and the number of competitors that comes into the market is very, very small.
00:21:35.000Because again, who's going to invest in a company, a new company that has to spend 85% of its revenues every year?
00:22:31.000Unfortunately, you cannot start new ones.
00:22:33.000There are some existing physician-run hospitals that predate the ACA's ban going into effect, but you can't start new physician-run hospitals.
00:22:40.000So if you want to give up being a practicing physician, you can still start a hospital, but you can't both be a practicing physician and run the hospital.
00:22:50.000So I guess just big picture, there's a lot of debate.
00:22:52.000The GOP and Trump's first term tried to repeal and replace Obamacare.
00:22:55.000They failed thanks to our late senator here.
00:22:58.000But I guess people talk a lot about rising costs, but if there were targeted reforms that the Republican Party could start advocating, what do you think some of the best ones would be?
00:23:12.000So a lot of the problem is that we have good ideas that have been actually supposed to be put into effect.
00:23:19.000For example, price transparency is the law of the land right now.
00:23:22.000If you go to a hospital, they are required to provide you with a credible list of all the prices before any operation is done on you.
00:23:30.000You are supposed to be given a price that is reasonable and that you will end up paying because once they put the number out there, they have to charge that for you unless some reasonable complication comes up.
00:24:03.000What do you say about that at the end of the day?
00:24:06.000That sounds like a good chance to do populism, you know, have the Trump admin just sue a big hospital or like perf walk some random like official at like a really big hospital.
00:24:45.000So, for example, patients are actually entitled to all of your data.
00:24:48.000If a doctor generates some data and goes in your EHR, you are supposed to be able to get access to that.
00:24:53.000You should be able to ask your physician and have your physician give that to you in some format that can be used by you, the patient.
00:25:00.000The same thing applies to the CMS's CLIA-certified labs.
00:25:03.000So, like IVF clinics, if a parent has some sequencing done in like one of their embryos, they should be able to get that data, but they don't.
00:25:13.000In fact, I think it was September 14th, if I'm recalling the date correctly, RFK put out a little video saying that patients are entitled to their data.
00:25:21.000And at some date in the future, there'd be a little, not a hotline, but like a little form online that you can go fill out to report when data is not provided to you when you ask for it.
00:25:31.000And they just don't, they don't do it.
00:25:33.000So it's not even things that are high cost that aren't being enforced.
00:25:37.000It's also things that are just good, like from a patient rights perspective, that just nobody follows the rules because there are enforcement mechanisms, to be clear.
00:25:47.000CMS can really start hitting hospitals very hard.
00:25:51.000They can hit providers in ways that make their pocketbooks scream, but they don't.
00:25:56.000And that is the big issue at the end of the day is that they have enforcement mechanisms that don't enforce them for all sorts of things.
00:26:01.000Another thing is, for example, site-neutral payments.
00:26:04.000So if you are running a hospital chain and you buy up a clinic, you can charge hospital prices at that clinic location, even if they're totally separate.
00:26:49.000There has to be an initiative, though, from probably the highest levels of our government to start enforcing some of these regulatory changes that are supposed to benefit the patients.
00:26:59.000A lot of the problems in the country, you could sort of trace back to illegal migration, illegal immigrants.
00:27:05.000How much of the rise in healthcare prices could you trace back to illegal immigrants on the dole or within the system?
00:27:14.000Or is that not a driver, in your opinion?
00:27:51.000And we could lower provider-side rents by allowing more physicians.
00:27:56.000But we have placed an effective cap on the rate of growth, not on the actual number of slots, but on the rate of growth in Medicare funding for residency slots.
00:28:05.000So the number of doctors who can actually come in and compete with the doctors and lower the rents and make it so they, you know, they're paid less, but they provide more because there are going to be more of them is limited.
00:28:37.000But they managed to somehow convince Congress this was an issue that would impact the quality of care when it makes no sense.
00:28:43.000And then they got these limits set in place.
00:28:45.000And now they argue to get away from the fact that they did this.
00:28:49.000They argue, well, we don't limit the actual number of residency slots, but they ignore that, yes, there's still limitations on the growth in the number of slots and the funding mechanisms available to create more slots outside of Medicare funding.
00:29:03.000So they created a broken system where we can't actually fix the issue with provider-side rents, which is roughly a third of all of the spending problem.
00:29:13.000Thanksgiving holds so many memories, and I'm sure it's the same for you.
00:29:18.000Right now, there's a girl finding out she's pregnant.
00:29:20.000In the next couple of weeks, she's going to make a decision.
00:29:23.000And whatever decision she makes will become her memory of this Thanksgiving for the rest of her life.
00:29:29.000What will she be thankful for a year from now?
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00:30:15.000I just, it's so, it's so enraging that specific fact on that we've basically intentionally capped the number of residencies by extension, capped the number of doctors we make in America.
00:30:26.000And then we'll also say, oh, we need to import.
00:30:29.000It's like part of the immigration hustle.
00:31:06.000So the ACA's medical loss ratio, the MLR thing that I mentioned a moment ago, where you have to spend 85% of your premiums leads to an enormous level of cost shifting.
00:31:18.000It leads to vertical integration where insurers will buy up every other part of the medical space.
00:31:23.000It leads to, it prevents AI and healthcare from actually being useful.
00:31:29.000And it gives a lot of leverage to doctors and doctors' cartels like the AMA and like the American Society of Anesthesiologists and all these other groups to continue to do things that increase costs.
00:31:53.000But the ACA's medical loss ratio thing is a much, much larger portion of it.
00:31:56.000It's closer to 40% of the actual problem.
00:31:58.000And if you eliminated the problem, you could immediately start embarking on a massive wave of innovation in healthcare because you would allow AI stuff to be slotted in to the prior off departments where insurers do the rejections or they accept a medical call by a doctor.
00:32:23.000We've made there no incentives to do it.
00:32:25.000So just so I'm understanding, because I want to make sure I'm understanding exactly what you're saying.
00:32:30.000If we send a dollar, if we spend $1 on health care, 85% of that has to go to the actual treatments, meaning that the providers are only allowed to take 15% of anything non-administrative.
00:32:49.000And what that means is that in order to meet that level, like at the end of a bailing cycle, what they'll do is they'll just pay more for stuff.
00:32:57.000So if a doctor says, like, I want to build blah, blah, blah, they can't build, blah, blah, blah.
00:33:11.000And in order to manage this fact, they transfer large portions of their medical claim revenue to their PBMs, their subsidiaries that aren't regulated directly by this regulation.
00:33:24.000So Cray Moo, it sounds like you said that these two buckets, they essentially lead to 90% of the problems with the ACA.
00:33:33.000So if you were consulting President Trump, JD Vance, would you just say deal with this 85% ratio issue?
00:33:40.000And it sounds like one of the, I forget what the other one is.
00:33:44.000So these issues are unfortunately statutory.
00:33:47.000There are, so statutory means that Congress is the reason for the issue.
00:33:52.000Congress has, in the case of the MLR, the medical loss ratio requirement that drives so much of the spending issues and so much of the lack of AI-related innovation in healthcare, the issue was given, Congress gave the HHS the opportunity to write up the rules.
00:34:15.000But in order to reform it, you can't just have the HHS rewrite the rules because of those limits put in place by Congress.
00:34:20.000If you actually wanted to fix this issue, you would have to very likely, unless you can get some Democrats to agree, and I really doubt you could, you would very likely have to suspend the filibuster, which is what something the Republicans should be doing right now, and then go and get Congress to change it.
00:34:34.000So were I to offer this advice to Trump, I would say push on the filibuster.
00:35:49.000So the big thing is, with respect to the pre-existing condition requirement, it does add a lot of costs.
00:35:54.000I mean, it obviously does because you have suddenly people who are high cost being covered and you're in the same pool as them and you got to cover them.
00:36:01.000But if you fix the medical loss ratio requirement and you allow health care providers, or sorry, if you allow health insurers to make better use of their prior authorization apartments, you can minimize the downside of those people because you can offer them more tailored care.
00:36:15.000You can offer them, you can say, hey, your doctor called for this, but we actually think there's a better option here.
00:36:21.000You can figure out what is more optimal to give them in terms of care and save a lot of that money that you would have wasted anyway.
00:37:43.000There are some untested legal theories here.
00:37:45.000Like Section 804 is the thing that allows you states to sign up to start importing drugs for their Medicare Medicaid programs from Canada at Canadian prices.
00:37:57.000If they were to be a little adventurous with this, they could expand that by changing two parts of the regulation so that states could import Canadian generics that don't yet have a generic equivalent in the U.S., thus lowering prescription drug prices a lot.
00:38:12.000It's totally on the table to do a lot of little fixes that are in untested legal territory if they want to try that.
00:38:21.000And they could meaningfully lower the cost of health care considerably beyond what they've done so far with the negotiations because the negotiations have actually been getting kind of duped on.
00:38:31.000Like a lot of the Trump RX stuff that they've done where they've tried to directly go to Pfizer and tell them, give us most favored nation rates.
00:38:39.000That stuff doesn't really work to cut prices very much.
00:38:41.000Unfortunately, like you think there's a lot of room there, but the issue is those companies aren't really giving you a great problem.
00:38:47.000I was texting Blake that, you know, I assumed that it was the subsidies for people who couldn't otherwise afford, or at least so they say, couldn't afford health care that was driving up the cost of health insurance for average American families.
00:39:00.000Yeah, we've all heard the story of the illegals who just go in for everything to be, causes overflow, causes all of these extra costs, and they never pay for any of it.
00:39:37.000It grows faster than the rate of inflation by a considerable margin, too.
00:39:40.000So the majority of the cost growth is just way away from these things.
00:39:46.000And there's been no detectable change in trend related to the subsidies either in terms of like prices of drugs and whatnot.
00:39:53.000They're just negotiated on too like long-term a scale and too large a scale for this stuff to really matter all that much.
00:39:59.000And the government has their rates they get through with CMS stuff like Medicare and Medicaid that aren't going to be meaningfully changed if they get the subsidies.
00:40:07.000Like they're not going to lose negotiating leverage the moment they start financing plans a different way.
00:40:12.000So ultimately this stuff doesn't make much of a difference.
00:40:15.000The big stuff is systemic incentive related stuff that has been put in place for too long and needs to be changed at a more fundamental level.
00:40:23.000Yeah, I have an anecdote for you, and I wonder if there's a root cause that I'm not aware of.
00:41:15.000And here's what else they know is that you've already hit your $5,000 or $6,000, $8,000 deductible.
00:41:20.000And the incentive structure for the client, the patient in this case, is off because you know it's not going to cost you anything more out of pocket.
00:41:28.000So the whole system just has to absorb this cost.
00:41:34.000What you're describing is actually related to the MLR issue again, the medical loss ratio thing.
00:41:38.000So medically necessary care is the majority of care, but it's a slim majority.
00:41:45.00030 to 40% of the care, and I'm leaning more towards the 40% side, that we give out in this country just isn't necessary.
00:41:52.000So many things don't need to be done, and we don't have the ability to say no to doctors in a very meaningful way because there's no incentive to.
00:41:59.000There are incentives to say yes to doctors, to overpay for care.
00:42:04.000And they only recently added prior authorization, that's the rejection department basically, to Medicare, fee-for-service plans.
00:42:11.000But they need to make that a more extensively used thing everywhere.
00:42:15.000They need to be able to say no more often.
00:42:17.000They need to be able to target care better.
00:42:18.000They need to make individualized guidelines.
00:42:21.000And I don't mean in some hockey, personalized medicine sort of way.
00:42:24.000I mean in a, we need access to massive amounts of data in order to properly tailor everything for individual patients in a way that like still provides them with all the care that they personally need without having them go over by like getting five times more well visits than they actually need or getting a mammogram when they're in the lowest decile of risk or something like that.
00:42:45.000Like it's that sort of thing is just far too common and it is the big issue.
00:42:50.000And that is why if you were to fix that MLR requirement, you would basically be able to start cutting back on medically unnecessary care and allocating care better.
00:43:00.000And you'd be incentivized to figure out people who are currently underserved, who you're not currently incentivized to go out and find, and to bring them into the doctor's office.
00:43:10.000So for example, there are a lot of young people these days, not a lot in absolute terms relative to the old, but like an increasing number of young people who get colorectal cancer.
00:43:19.000And we have wonderful algorithms for finding those people young, but nobody implements them in the prior authorization stage because there's no financial reason to.
00:43:28.000There are financial reasons not to, but no financial reason to.
00:43:32.000We have totally distorted the incentives away from promoting health for people and towards promoting cost because that's just how it is.
00:43:40.000I mean, that's just, we've made some very, very bad decisions in designing these systems.
00:44:07.000But when we talked about autism, rising autism rates, one of the things you told us is you said, I think this is basically just it's a matter of diagnosis.
00:44:16.000And one of the things you said was the Somali community in Minnesota is scamming the autism system, way inflating their rates to just scam everyone.
00:44:24.000And our segment just before you was we were talking to Ryan Thorpe about the Somali scam.
00:44:29.000They're sending all the autism dollars to al-Shabaab in Somalia.
00:44:33.000So I wanted to congratulate you for calling that shot months in advance.
00:44:38.000And I wanted to thank you again for coming on and giving us your time.
00:44:41.000Craymu, we got to get you in touch with some people that can actually implement some of this stuff.