Rumors, Myths and Truths Behind Obama's Health Care Plan

In this third episode of Stuff You Should Know's health care reform series, Josh and Chuck -- and special guest Molly Edmonds -- sort through the myths, rumors and truths behind President Obama's proposed health care plan.

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Episode Transcript

Speaker 1 (00:00):
Brought to you by the reinvented two thousand twelve Camray.
It's ready. Are you welcome to Stuff you Should Know
from House Stuff Works dot com. Hey, and welcome to
the podcast. I'm Josh Clark with me as always as
Charles W. Bryant and with Charles W. Bryant, and I

(00:23):
is our colleague and healthcare reform guru Molly Edmonds. I
think it would be and me. She was gonna say that, Yeah,
saw that coming. Yeah, well he's not the first person
to do that, Moll. You can send an email to
Stuff podcast dot com. You shouldn't an email, Molly. Thank you.
I'm here to keep you on track on all things
grammatical and healthcare format anything else. Yeah, that's good. That's

(00:47):
that's enough, right, perfect. So for those of you just
joining us, you should probably go back and listen to
the first two podcasts that we released in this special
Stuff you Should Know Healthcare Reform Sweet and this is
number three of four or Yes, we talked about what's
wrong with healthcare in the US, and the first one, right,
we talked about Obama's proposal just straight up facts, and

(01:10):
then this this one we're gonna talk about myths yes,
both from the left and the right. So you know,
those of you who are Bill O'Reilly fans, you can
sit down and have a mug of beer with people
who are fans of MPR. Say right, if you're libertarian,
you're just sorry you're out. Just go go do whatever
it is you guys do a nice chuck um, So

(01:30):
let's get started, kids, you wanna. I think one of
the things that that people keep maybe weekly throwing out
is that the US can't really afford to tackle healthcare
form right now? Is that that's a myth? Are we
doing that? Should we have some sort of ding said
it's a myth? And I agree with her. Well, you know,

(01:51):
the thing about it is is would you you may
not be able to afford like a new TV, right,
but if you had an old TV and it was
a tremendously bad value you I mean, if you're just
paying way more for that TV than what it's worth
to get it repaired a lot and not gonna yeah,
I mean, then you've got to do something about it
because you're just you're not getting a good deal on
your TV. Sometimes it's smarter to buy the new TV. Yeah,
And that is the position we are in right now

(02:12):
with health care form, is we pay way too much
money and get way too little care for for what
we have. So just if you like a good deal,
I think you should be behind health care form. So
let's let's recap real quick. Um, the US is spending
about two point four trillion dollars a year on healthcare.
That makes up a sixth of the gross domestic product,
and that's more than we spend on defense. Right. Um.

(02:35):
At the same time, we're not getting as much value
out of it. So they say, right, but we are
entrenched in two wars and the economies in the toilet.
You're saying, still, we should do something about it. Now,
how are we going to pay for it? That's another
that's another common criticism we keep hearing is how how
are we going to pay for this? Well, I think
the specifics stilling to be worked out, but I think

(02:58):
that it's important to remember that the president it has
pledged that will be deficit neutral. It's not going to
add appending to the deficit in the ten years, the
first ten years that it is in action, nor after that. So, um,
you know, it's it's something that we could possibly say
as a myth just because we don't know exactly how
I'll pay for it. But one thing I take them
with a grain of salt. Yeah, I liked your point
you made in here that the people are afraid that

(03:20):
the uninsured are going I'm sorry, the insured are going
to be paying for the uninsured. That already happens. Oh yeah,
I mean, there's an estimate that families are paying about
a thousand more in their premiums just because people who
are uninsured still show up and go to the hospital
and they get treated, and an individual pays about four more.
And so doctors and hospitals likely ship those costs to
us because I mean, they got to get paid for

(03:41):
it somehow, and they know insurance companies will pay. So
let's let's let's flesh that out a little more. Say
an uninsured worker day labor gets hurt on the job,
the boss comes and drops them off at the er.
The r BI federal mandate has to treat that man,
stabilize them, fix his wound whatever. Right, Um, he walks away,
he doesn't pay, he doesn't have any insurance and possibilities

(04:04):
here illegally say. Um, so what you're saying is the
hospitals will end up charging more for patients that have insurance.
They'll charge the insurance companies more, and then the insurance
companies turn around and charge more for people who have insurance.
They they charge more in premiums. Right, And then that's
the way that there's a tax, UH, an invisible tax

(04:26):
for the uninsured that covers the uninsured that's in place
right now. Right. That's that's the thinking by UM, the
think tank that came up with these numbers, that we
are already paying for people who show up without insurance.
And so if these people then had insurance, if this
plan works and we can get everyone insured, then that
would kind of cease that we're hoping that it would
control the costs a little bit. Yeah, that would be great.

(04:46):
So this is a one trillion dollar proposal over ten years, right,
So clearly just UM making sure everyone has insurance in
and of itself is going to be very expensive, right. UM.
Is it a myth then that there won't be higher
taxes for people who who, say, make a quarter of
a million dollars or more a year. I think that

(05:07):
it's impossible to say what we'll actually have in place,
but that is the president's current preferences that we tax
people who make more than two dollars a year. Okay,
and then I noticed the point that, um, that the
President and people like Nancy Pelosi have made is that
those people had been getting a lot of breaks over
the previous eight years, and so they think that this

(05:28):
is going to sort of balance that outout without getting
too political about it. But that's what's being said. True,
Chuck can't help himself. That's gonna started about libertarians. Nancy
Pelosi said, not me. So, Um, guys, this light in
the mood a little bit. Let's talk about death panels.
Let's bring a little comedy into this one. This is
probably the most pervasive myth I would say about healthcare form,

(05:50):
and arguably the most ass And I wouldn't you say,
I don't know. I think if you are told that
you might be put to death, you're gonna take it
pretty seriously. Yeah, you will take it seriously. But I'm
saying the I guess the the thought process behind that
interpretation of UM. The House Bill about end of life counseling,
that's what it's about, right, So basically in the House Bill,

(06:12):
it says UM medicaid or medicare can be reimbursed for
voluntary end of life counseling. Right. It doesn't say anything
about the patient signing signing a resuscitation order or do
not resuscitate order um or any any anything like that
has nothing to do with actually terminating a patient's life. Right.

(06:35):
It's like they would stick the pin in Grandma's hand
and like put it on the line, and if she
just falls asleep and it scratches across, then all of
a sudden there's a do not resuscitate order in the
one less old person we have to worry about getting
an organ transplant for because she voluntarily said I don't
want it. It It is a myth. And not only is
it a myth, uh, it is a career ruiner too

(06:57):
if you speak out too much. You guys heard about
Betsy McCoy, John Stewart, Is that the lady? He? Yeah?
Have you seen that, Molly? Yes, it's pretty someone that
came up with the term death panel? Right? Yeah? Am
I wrong there? I believe she's just the one. She
didn't coin it. She gets credit for coining if she
was so vociferous about it. Right, So you know what,

(07:17):
here's the thing without pointing fingers at who came up
with it. No one wants to die, right, I would
say most people people don't want to die, and they
also probably don't want to spend a lot of time
thinking about how they're going to die, right, And so
the fact that we're even bringing this conversation up just
makes it uncomfortable for some people. The fact of the
matter is is that we probably all have in our
head that we'd like to die, maybe peacefully, at home.

(07:40):
And the fact of the matter is now most people
die in a hospital or a nursing facility. Whereas would
prefer not to die, there are dying there. So what
we're trying to do is to respect well, not I
shouldn't say we like it's not me trying to do this,
but what these bills are trying to do is to
make sure that if you do have a wish about
how you die or who makes the decisions at that

(08:03):
time when you maybe can't speak for yourself, that those
wishes are respected. The a ARP has come out and
support of this because the fact of the matter is
is that even if we don't like to talk about it,
it's going to happen. Let's have the conversation and if
you have the conversation, have it paid for by Medicaid
and medicare, right, But you don't have to have the
conversation if you don't want to. It's completely voluntary. And
even if you have it, you're not going to leave

(08:23):
that meeting with a living will necessarily or um you know,
a d n R order. You're gonna leave just knowing
what your options are. But I wasn't gonna put my
opinion in, but that sounds like a really good idea
to me. Sure it is. And also um Stewart pointed
out on in the interview that you can just as
easily come out of it with a resuscitate at any
cost order. So it's it's not just specifically about DNA.

(08:47):
Why they call it death panel. They should have called
it life no matter what. Because the death panel scares
the tara elder, right, That's I think that was the
most one of the most odious things that come out
of this healthcare form debate was the panel. I mean,
it was just it was specifically geared to scare the elderly,
but you know, they already have enough things to worry about.
I mean, I think that some of the elderly spears

(09:09):
about this bill are founded when you hear there's going
to be cuts to Medicare and that there might be
incidences of euthanasia, which this is not true. The death
panel thing not true. But there will be cuts to Medicare.
You can't get around that. Sure, let's talk about that,
because that's a that's that's something that you raised in
this m article. That it won't affect Medicare is a

(09:29):
is a is a myth, right, it's a promise that
the President has made in terms of benefits that if
you are a Medicare recipient, that you will still have
the same benefits that you've always had. The fact of
the matter is a large part of the funding for
these proposals will likely come from Medicare because the way
that Medicare operates now is probably unsustainable. So by making

(09:50):
these cuts and incentivizing doctors to be more efficient in
the way they treat patients, when we're talking about bundling services,
bundling service, so actually we chuck and I spoke to
Dr Michael Roisen, who's the chief wellness officer at the
Cleveland Clinic in appropriately enough Cleveland, Ohio, uh and he's
also co author of the You the Owner's Manual book series.

(10:12):
And uh, he talked about bundling services. Uh. And it's
based around what's called accountable organizations. It's like a group
that's in charge of the health of an individual patient. Right.
Here's here's what he had to say about that. So
I like accountable organizations, meaning that I that someone pays
if you will, I, whether it's myself or um, the

(10:35):
Cleveland clinic where I work, pays for my healthcare and
I don't have to worry about it. And they get
a set amount of money whether I need um, sixteen
tooth extractions and four um if you will, revisions or
four total hips to total hips, two total knees, or
whether I need none. And the goal of them, of

(10:58):
those organizations would be then to keep me healthy so
that I don't need any major technology procedures. Teach me
how to brush my teeth in flash so I need
no teeth extractions. Right. So that's what that's what I
mean by pay for accountable outcomes. So if you couldn't tell,
Dr Royson's very hip on prevention rather than preventative care, right. Um.

(11:23):
And and he's he's also on board with accountable organizations.
And he's also evidently on board with tooth extraction. He is,
it's a good example. It's well, I mean, anybody can
approach a tooth extraction, right, But the point is is
there there has to be a group that is in
charge of the health care of the individual, right, and
then that way you can hold that group accountable. You're

(11:45):
paying that group and you say, keep this person well,
and if they do need treatment, this is your pool
of money that you have to extract from it, right,
like so many teeth. Now, here's the problem. And this
is where I think a lot of the fear comes about.
Is what happens when that money runs out? Can doctors
be trusted to say we're going to still keep treating
you or are they going to try to skinch on that?

(12:07):
And I mean, is that a real fear? I think
it's valid. You know, we would like to think that
doctors become much more efficient. There's evidence that there is
a lot of waste in the medicare system. And ideally
how this will work as doctors will say, yes, we
will become more efficient with this pool of money we have.
But you know, you just never know what case is
going to come up. That you can't treat a person

(12:27):
with that pool of money with So Molly, you just
brought up Another point is um rationing healthcare? Right? Um,
that's another huge fear among you know, not just the elderly,
but anybody like if if this bundling of payments goes
beyond just Medicare and it becomes a standard. UM, I

(12:48):
guess one of the ways it would become a standard
would be to have some sort of panel that approves
medical procedures, right right, and UM, there are some panels
in these bills, but they do not approve medical procedures.
Let's talk about those. These UM cost effectiveness panels UM
are just meant to come in and decide which treatments
are effective. There's no evidence that they would come in

(13:09):
and say you can only do this because it's cheap. UM,
it might be helpful to compare really quickly how Britain
rations healthcare. Let's do it. Okay, So they've got this
committee called UM ironically enough nice that stands for National
Institute of Health and Clinical Excellence. And then they're under
the NHS, which is their big public system. So let's

(13:29):
say that, UM, there's a drug that costs fifteen thousand dollars,
and it's going to improve your standard of life from
a point five to a point seven. They look at
everyone's standards of life from a zero to a one um,
and it's worth saying that everyone's uh quality of life
is considered important, whether you're seventy seven year old woman
or a twelve year old boy. So it's gonna improve

(13:51):
your standard of life from point five to point seven
point two, and it's gonna help you live fifteen years longer. Okay,
that's been proven in a study. So point two times
fifteen is three. So they get a multiplayer and then
so that's three. That's what they call three qualities quality
adjusted life here, so they're saying you're quality of life
has been adjusted for these three years. It's like a multiplayer.

(14:15):
So then they're gonna divide the total cost of the drug,
buy the multiplier and get a cost per year amount.
In this case, if the drug is fifteen thousand dollars
and your quality is three, the drug costs five thousand
dollars a year, and that's the number on which the
NICE would approve or not approve the drug. And NICE
basically approves anything, basically anything that's about forty five thousand

(14:37):
a year or below. So it's going to our system
on that. No, that that's not in the bill. You know,
when people talk about rational healthcare, Britain says, yes, we
have rational healthcare and that's how they do it. And
there's nothing like that in any of these proposals. Let's
talk some more about um. Actually, before we do that,
I want to bring up another point that that worries me,

(14:57):
and that is um that these these panels that approve
medical procedures could lead to a stifling of innovation. Right,
is that a possibility? Well? I don't think so because
if you look, I mean, even if you talk about Britain,
it's not like Britain's way behind us on medical innovation.
It's in some countries they've been able to do a
lot more with a lot less. So isn't that sort

(15:20):
of the true definition of innovation? So I think you
basically have to prove that it works. I mean, we
may not allow people to say this pill will take
you to Mars if it won't. But um, what if
they said this pill is dynamite? Do they mean dynamite
like explosive or just dynamite like awesome, awesome, Okay, I
mean they definitely would to prove something that was explosive

(15:41):
in my opinion, Um, but I'm no doctor than the Yeah.
Um so I think it's just um, you know, making
people prove the quality. One of the problems uh so
far is that we have a lot of care that
we don't necessarily know if it works, but it's really expensive.
And this is just ensuring that people have to prove

(16:02):
that it works. And instead of spending all this money
on marketing their drugs, drug companies might have to spend
more money on research and development, which I think we
can argue would benefit a patient more than marketing. Sure. Boy,
last time I was in the doctor, the pharmaceutical people
came came through there. Have you ever been to the
doctor on the They walk in and go, we got
some dynamite pills. No, well, who knows what happened behind

(16:23):
the doors. But they were literally like seven of them.
They were spaced out like every five or ten minutes.
And they came walking in with their their suitcase that
you know, it's just full of drugs, and they went
in the back and then they came out, and then
the next dude would go in sure, and then the
doctor finally comes out after the last one leaves and
his little uh, a little reflector was all skewed. He's like, next,
Doctor feel Good. Yeah, So is that how it goes down?

(16:44):
All these at a myth or truth? You know, I'm
not I don't want to comment on doctor feel Good's
personal life. Yeah, And we can't get into farming too
much as a whole different but I think almost entirely,
isn't it Big Farmer hasn't been um made a part
of this almost at all, that it's not a part
of healthcare form. Well, this might be a way to
make them more accountable. Um is these panels that will

(17:06):
evaluate cost effectiveness of treatments. But let's re emphasize again
that these panels are not designed to say to you
you can't have the drug. It's just saying, we think
this drug is the most cost effective, why don't you
try that before trying one that is more experimental may
not work as well, so on and so forth. It's
not designed to get between a doctor and a patient. Okay, good,

(17:29):
And I guess the last point um that I keep
hearing about ration in healthcare. It's very delicate, but there's
a lot of people who say, you know, we kind
of need to ration healthcare. You pointed out that health
care is already ration by the health insurance companies, right,
you know, by um annual limits or lifetime maximums for

(17:49):
care UM and by denying coverage to people with pre
existing conditions. But um, I think this, this whole idea
that we may need ration care UM is kind of
based on an idea that the average patient abuses this
health care infrastructure. Right, that there's so much available and

(18:10):
we have so little conception of value to actually what
we're taking advantage of that will say no, no, I
want the m R I and that Cathy. I think
we touched on that in the first one didn't, And
I think that's that's fair for both sides to say
the patient probably wants more care and more care because
we have a lot of people who know what's out
there for them to take advantage of. And then I'm
sure you also talked touched on that doctors are paid

(18:30):
for every service they provide to a patient, and so
there's incentives on both sides for doctors patient for the
same thing. Even if it's not working, you feel better,
and so Medicare with this bundling is going to be
sort of the testing ground for trying to do this
within our system as a whole. That's the ideal. I
don't know if how it will shake out in the end,
but so can you say definitively whether rational ng healthcare

(18:52):
is number one a myth or truth that it's going
to happen. Well, if we take Britain's definition of what
rational health care is in terms of a UH panel
making a choice whether you can or cannot have the drug,
then no, there's nothing in these bills that would do that. Um,
whether eventually there would be you know, fewer services and
fewer of these people going in and getting every single

(19:12):
service they asked for, it's possible that might that might decrease,
but that could be a good thing. It could it
could be Ultimately. You can make the point that this
is very similar to UM, government prohibitions on drug use
or something or um, you know, you have to be
a certain age to buy tobacco or to buy alcohol. Um,
that's pretty much arbitrary. And this is actually a little

(19:33):
more focused saying no, we have this huge infrastructure, you
guys are costing us two point four trillion dollars a year,
a lot of it unnecessary. So I don't you could
argue the point that maybe somebody does need to step
in and say you can't do this because that's stupid.
That's true. But then on the other hand, you've got
someone who takes, you know, nine tests and the tenth
one would have been the one that worked. And if

(19:53):
they feel in any way that they didn't get that
tenth test because of you know, they already got nine,
then that's where people start to get worried. Is there
any mechanism to um sue the pants off of the
person who denied you that tenth test? Well that would
currently we've got the whole medical malpractice thing, right, But
if it wasn't a physician, if it was a government

(20:14):
panel or something like that, could you sue the government? Yeah,
it could get very hinky. You know, some of the
decisions that the Nice Panel makes are controversial. I mean,
they deny a lot of really expensive cancer treatments and
as a result, Britain has um you know, worst cancer
survival rates in the US. Does whether someone has tried
to sue, I don't think so, but um, because you

(20:35):
can pay in England right. Our colleague Lee Dempsey pointed
out yesterday that you can actually pay better care. That
was awful that everyone I just wanted to apologize to
leave for Chucks terrible, terrible impression of his British act.
He's actually not from England. He's from a small island
that's not been yet named Manoa, and they have a
very odd accent there. So, guys, um, I don't know

(20:57):
a good way to put this. Let's talk about abortion.
Is it a myth? That's a great icebreaker, by the way,
for your next dinner party, Josh, you should keep that
in your cral. You know. That's how a lot of
episodes of stuff Mom never told you start out. If
anyone's interested, Christa and I just go, let's talk about
abortion really, So we highly recommend you go listen to
that podcast. But women's issues it's a big thing, you know. Obviously,

(21:20):
people who want women to have the right to an
abortion would like to see abortion be a necessary benefit
included by the government. What the what these bills provides
the government to come in and say these are things
that insurance plans have to cover to be considered valid
insurance plans. Right, the minimum coverage right. So there's a
big debate about a lot of things that be covered,
like mental health, how much will that be covered? Abortion

(21:40):
is the big one that is dicey because no, you know,
no um anti abortion person wants to pay for someone
else's abortion, right. So how the House is compromised on
this is that help promers can choose whether to provide it.
It doesn't necessarily have to be one of these essential benefits,
but it can be. And if you do get an abortion,
the thinking is that you would pay not with these

(22:01):
public subsidies that are available to people, but you'd have
to pay out of pocket for that unless it was
one of the abortions that's defined as um you know,
in the gray zone. The rape sort of abortion Senate
Senate Finance Committee bill as it stands now prohibits funding
accepting cases of rape, incest, or endangerment to the woman's
life right. And that's I mean, that's the bill. I mean,

(22:24):
that's the plan that a lot of like Congress people
for example, have The government alright currently pays for abortions
under those qualifications. And also the Finance Committee bill, which
is just released yesterday, And but you said it's not
the final version. Right, it's his mark, so it'll still
go through the Senate Finance Committee. It's the chairman's mark.
On abortion, they continue to say that the bill would
prevent abortion coverage from being included in a minimum benefits

(22:46):
package and uh in the health insurance exchanges where you
shot for the coverage, but the plans in exchange could
include uh, they could offer abortion coverage as long as
no government subsidies pay for it. And still the coverage
would be funded through member payments, which are segregated from
the federal money. So that's what the Finance committees. Yeah,
so that's consistent with how the House had it as well.

(23:09):
Is it um? And basically the thinking is that any
given area, you should be able to choose one plan
that has abortion covered in one plan that doesn't. But
they would be I saw this in your article too.
They would be um, the same plan except one covers
abortion and one doesn't, okay, But everything else is the same, okay,
and they'd be the same price, I imagine, right, I

(23:29):
would think, So, yeah, what for the total plan, the
total bill. If you're in the marketplace, those insurance marketplaces
we were talking about, you should have a choice of
a plan that has abortion and a choice of planet
that you would have, like a premium abortion pro plus
and then premium no abortion plus plan right next to
each other, and they should be the same the same cost,

(23:52):
just to give people a choice. I thought you talking
about the total bill, because to Senate finance bills about
a hundred and fifty billion dollars cheaper. Do you remember
how when we went into the market place and we're
looking at all those insurances there, I get it. So
you can be pro choice, choice, You can have the
choice to have the plan that has the choice. My
mind is melting all over the table. All right, um, guys,

(24:13):
can we talk about something that President Obama loves to say.
It's usually the first thing he kicks off with, if
you like your insurance plan, you can keep that plan.
Molly Edmond says that that is not necessarily true if
you start looking down the road and read between the lines, right,
you know. The thing is is, when um Obama went
out the summer did his town halls. I think that
if he had a nickel for every time he told

(24:34):
people that if you like your plan, you can keep it,
he would have enough to find healthcare reform. Right. But
I think if you were paying attention to the speech
he made, the famous speech to Congress, you will notice
that that phrase did not appear in the speech because
I think he's realized that he can't promise people that
their plan will stay exactly the same under these reforms.
We're saying you can keep it, though not necessarily that

(24:55):
would be the exact same plan that you're keeping. Well,
but that was how he was sort of pitching it is,
if you like your doctor, you can have your doctor.
And the fact of the matter is is that your
plan is going to change, all right, to build in
these consumer protections. So that's a great change. You know,
you won't be able to be dropped by insurance company.
They can't just discriminate for pre existing conditions UM. And
then your plan will have about five years probably to

(25:16):
come up to speed with all these other plans. It'll
be grandfathered into that minimum set of benefits we were
talking about UM. But you know, in that marketplace when
they start UM competing for all these uninsured customers, we
don't know what current plans will have to do to
stay financially viable. Right, They may have to slash services,
they have to slash services. That kind of stuff happens anyway,

(25:38):
though your insurance plan probably isn't the same today as
it was five years ago without all this government competition,
that's true. And the thing is, if you don't know
how your plans change over the five years, you may
not notice how your plan changes when this happens to right. Yeah,
I don't know. Well, first of all, it didn't have
insurance five years ago, But I couldn't tell you what
it looked like last year. You know, you're living in
the mountains. That is the in my car, Okay. I

(26:01):
mean the only way you're gonna know is if you
go to the doctor and all of a sudden they
don't accept your insurance, or if something that used to
be covered um isn't covered anymore. But that's just so
speculative right now that it's impossible to say one way
or the other whether you know things will be the
same or not. I think a lot of this, from
what I'm reading, is like the outlines in place, But
who knows how all this is going to shake out.
Sometimes you have to wonder if we have to believe

(26:24):
the best about people are the worst about people. Well
that I think what it comes down to, I keep
running across you mentioned, um that this whole thing is
a ror check test or the public option is a
Rorschach test. And really what it comes down to is
can you trust doctors to not skinch on healthcare when
they're being paid and bundles skinch skinch you okay if

(26:46):
it's not it is said, I love it? Yeah. Um.
Can you can you trust that the government panels won't um,
you know, stifle innovation like it does, undercut the insurance
company so much or they can't stay in sure? Can
you trust Obama that this isn't really a planned to
ultimately create a single payer system? Right? And can you

(27:06):
trust individuals to take it upon themselves to like doctor
Royson is a big advocate of to to take on
preventative care, the burden for health is on the patient
as much as is the doctor or not. I don't
think that mindset is clear to a bunch of Americans. Well,
but I think that that's what they're using as an excuse.
I mean, someone who would be against a big public
option or really subsidized health care would say, this person

(27:27):
got themselves into this mess because they smoked or their
overweight or so on, and so looking at just what
the mistakes of one person made is like not seeing
the forest for the trees. So all these pieces are
working together in a way that we can't isolate blame
at anyone. But that's what this discussion has turned into.
Saying that you know, the worst is going to happen
about these people, agreed. And actually, when we spoke to Royson,

(27:50):
if I can bring them back again, um, he said
that apparently basically us not caring at all about our
health is costing this country me more than any other
sector of the health care of health care spending. Um.
He put it like this, of all healthcare costs are
caused by chronic disease that is caused by four factors tobacco,

(28:15):
food choices, and portion size, physical inactivity, and stress. So
we can reinvigorate primary care by paying physicians to teach
these things because what gets paid for gets done, and
what gets done gets taught well. So in fact, we
have a tremendous opportunity of paying physicians to do this

(28:37):
and saving a huge amount of money. In fact, if
all we do is a program, um, and I'll go
to the exact bill, it's called take back your health.
That does this for five diseases coronary disease, type two diabetes,
metabolic syndrome, breast cancer, and prostate cancer. We save after

(29:01):
paying for it. We save one point nine trillion over
ten years. So clearly, as Royson pointed out, Molly, you
are right. I mean, it comes in very large part
comes down to us changing our perception about our own
health and taking responsibility for him. Right, let's do one
last one, you guys mind, since we're not doing listener mail. Okay,

(29:23):
let's do it, Josh, are we moving towards socialized country
this one? Well, do you know the definition of socialized country, CHUCKA.
I do not, Josh, go state owned and operated industry.
So not only is the government paying your bills, they're
hiring your doctors and running your hospitals. So that's what

(29:45):
Britain does. And then there's also a fear of a
single payer system, which, um, you know, Obama has a
few choice quotes that people like to pull up saying
that he would like a single payer system. Right, that's
what Canada has, where all the bills just go straight
to the government, no questions asked, hi Wan, Right, doesn't
one actually let's say that, because we're gonna talk about
healthcare systems from around the world in the next one.
So most countries have some form of single pair, but

(30:08):
whether um, we've been promised a uniquely American system because
we are a uniquely American country too late at this point,
don't you think. I mean, even if we wanted to
switch to socialized medicine, we couldn't do it now. I
think you could over the course of May. But you know,
we're certainly not there with these proposals. There's no need

(30:29):
to fear these specific bills as any sort of move
towards um single pair or socialized medicine. Well, I think
one of the concerns though, is that this uh this
public option uh is will eventually run the other insurance
companies out of business and then we'll have a de
facto single payer system because the only man left standing

(30:50):
will be the public option, right is that is that
one of the fears the concerns that that is a concern. Um,
the public option is so in the air right now,
that would be hard for us to making a sort
of conclusion my whether that's a myth or not. You know,
the thing that just came out this week. Um, the
Senate Finance Committee one that's can get all marked up.
That went for co ops, so we know how will

(31:11):
a co op work in this system versus what would
a public plan be? So that right now is is
such a shadowy thing that I think we should have
avoid speculating on it. Okay, agreed, agreed. No, we don't
want to stir up any more fierce as the whole
point of this podcast was to allay them pretty much, right,
or at least say no, you're running. You should be
scared out of your mind. Here's my guess. I don't
think they could do anything to put every insurance company

(31:33):
out of business. No, that's what I think. I think
the one of these call me in ten years, if
there are no more private insurance companies in America, They'll
buy you a beer. Really, yeah, anyone out there? Yeah,
of course I'll be dead, and ten years you will
be because they've rash in your healthcare. Exactly. You faced
the death panel. No, I want to live. You signed. Sorry, guys,

(31:56):
that's about it, right, you got any more myths you
want to cover? I know him? Illegal immigrants? Yeah? Oh,
you thought you were getting away without talking about this. No,
this is a big one. As I saw actually in
the House bill. It's it's basically says, actually, it does say,
if you're born in the United States and you're not covered,

(32:18):
you're automatically covered. Does that amount to covering illegal immigrants? Now,
not necessarily the people who are you know, um, that
same day labor who went into the e er Right, Um,
we're not talking about him necessarily. But the children of
illegal immigrants would be covered under that language, right, So,
I mean that is technically correct that illegal immigrants would

(32:40):
be covered. Well, no, their children will be covered, right,
but they themselves, the children would be considered illegal. No,
they know, if you're born on American soil, you're an American.
Excellent point. There's no legist there. I mean, it's not, Um,
there's no no law that says that. But it's generally
thought that if you're born on American soil, you're American citizens. Okay,
So technically they wouldn't. It wouldn't cover legal immigrants, does

(33:02):
it in any other way? Well, the way it was
explained to me is that illegal immigrants would not be
able to receive any sort of subsidies because there'd be
too much Um, need for proof about where they were
born and where they all their paper ark would have
to be in order to get these subsidies. Um, but
as possible, they would be able to enter the exchange
and buy insurance because um, they would be you know subject.

(33:26):
I mean, there's nothing that would keep them out of
the market place. I want to pay. Then, welcome to
the to the game. Well, but some people aren't ready
to stay. Welcome to the game, right, Molly. I am
looking forward to your second career as a diplomat. Seriously.
Thank you again for coming in, and we'll see you
next time when we cover another one of your articles,
which just health care systems around the world and how
they compare to the US. Dr Royson's gonna be back, yes,

(33:48):
so we'll Chuck's goatee. We'll talk about different countries. People
are already emailing saying what about us in Canada and England,
and Chuck's been responding with pipe down. We're going to
get to you right. Keep your pants on it. If
you're looking for a place to move. I think that
that podcast will be really helpful. Okay. In the meantime, UM,
you can basically take advantage of Molly Edmonds giant sponge

(34:08):
like brain uh and learn everything you need to know
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(34:34):
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