December 30, 2025 • 33 mins
Law professor and author Charles Silver joins Michael to break down why Americans pay too much for health care — from Medicare distortions and government inefficiency to runaway end‑of‑life costs and defensive medicine. They dig into market forces, personal responsibility, and what a consumer‑driven system could look like. A fast, sharp conversation for anyone who’s ever wondered why their medical bills make no sense.
See omnystudio.com/listener for privacy information.
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:03):
It's that time time, time, time, Luck and Load. Michael
Verie Show is on the air. Professor Charles Silver as
(00:25):
our guest.
Speaker 2 (00:25):
He's a professor at the University of Texas School of Law,
which I happened to believe is fantastic because I'm a
graduate of same. His book is Overcharged, Why Americans pay
too much for healthcare. You mentioned that the problem began
with Medicare Medicaid in the sixties, part of Lyndon Johnson's
(00:46):
Great Society, which turned out not to be. It was
two point zero of FDRs taking over of the American
economy and it's hard to strip that back out of
life when Medicare got involved. So my dad's eighty four,
my mom recently passed, and I go in and review
every expense, everything that comes in and all that this
(01:09):
whole Medicare thing. I have a show sponsor called Senior
Health Services dot Com, and he and his team help
people who are trying to navigate Medicare. And every day
I get someone who emails me and says, can you
connect me with them? And I forward it and sometimes
I stay involved for a little while just to see,
you know, kind of what they're working through. It's amazing
(01:31):
to people that, all of a sudden, I guess, when
you turn sixty five, you're getting robocalls and junk mail
and all this Medicare, Medicare, Medicare, and people had no idea. Now,
all of a sudden, I've been, you know, dumped into
the Medicare playground, and I don't know why, how does
this even work?
Speaker 3 (01:51):
Too well?
Speaker 4 (01:53):
I just I recently hit that age myself, so I
can sympathize with those whose mailbox are crammed with Medicare
advantage flyers and things of that sort. I'm sick of
seeing them, and I'm not even using Medicare. I'm still working,
so I'm staying on my employer's healthcare system or healthcare insurance,
although that is very expensive and far too comprehensive. You know,
(02:17):
it's because of the mandates regarding what employer sponsored coverage
has to conclude that I wind up paying, you know,
way too much. Everybody does pay way too much for insurance.
But you know, Medicare, what can I say? It's a
program that was designed to succeed by massively inflating the deficit.
(02:39):
You know, everybody thinks that Medicare is something that you
earn over the course of your lifetime. We don't think
of it as welfare, and politicians who refer to it
as welfare are excoriated. But the amount that people pay
into Medicare is way, way, way smaller than the amount
that they get out for most people. Now they're obviouslyceptions
(03:00):
to that, but for most people, the way that the
program succeeds is by charging them less than the benefits
that they will get out of the system. Well, you know,
that's a nice arrangement. I'd like to have that, But
the problem is somebody. The money to pay for all
those benefits has to come from somewhere, and in only
(03:21):
only two sources. One is general tax revenue, so they
use money in addition tax revenue in addition to the
employee tax to fund the program. And the other is
deficit spending. And every one of these expansions of the
Medicare program is funded through the deficits. So you know,
back when Bush two was president, right he created Medicare
(03:45):
part D, the Prescription Drug Benefit Program. Well, the premiums
even initially for that program, we're only set at fifty percent.
Speaker 3 (03:54):
Of the estimated cost.
Speaker 4 (03:55):
Now they're down to twenty five percent of the estimated cost,
which means means everybody loves Medicare party because it's a
great deal. Right, I'm only paying twenty five percent of
the cost. But what you're really doing is taking the
cost of prescription drugs and rolling them into the deficit.
And the same thing goes for Obamacare with all these
premium subsidies. Everything that the government does is designed to
(04:20):
be popular by being priced below its actual cost, and
the result of that in the long run has to
be deficit increases and inflation increases.
Speaker 3 (04:33):
There's just no getting around that.
Speaker 2 (04:36):
It's frustrating because then Medicare, the government is telling you
which doctors you can go to and which you can't,
which procedures you can do in which you can't, and
so you know, and look, it sounds like you and
I are relatively aligned. I was an acolyte of Professor
Leno Graias. You can probably understand where my views are
(04:56):
with regard to politics and the role of the government
and the individual. I'm probably more libertarian certainly than he was.
I'm over on the Rand and Ron Paul end of things.
But what I find frustrating is that people seem to
think that somehow government is protecting you and aiding you.
(05:17):
But in fact, what goes with that is, you know
why you don't feed the bears at the zoo, is
they're controlling you, and any government powerful enough to pay
for your medical surgery or medical procedures, powerful enough to
take it away, and then they start making decisions for you.
Speaker 1 (05:33):
And that's where we get into the civil liberties.
Speaker 2 (05:35):
And that's where I get very frustrated, because we've now
moved beyond healthcare and we've moved into a sort of
totalitarian authoritarian control of the individual.
Speaker 4 (05:47):
Well, you're you're certainly singing my song because you know,
you're a libertarian. I'm an adjunct scholar at the Cato Institute.
I don't think it gets much more libertarian than that,
I would say, so, so we're on the same page
as far as, you know, being very very concerned about
the governmental control. I think that governmental control is part
(06:14):
of the story, but I think governmental ineptitude is probably
a much bigger part of the story. You know, I'm
willing to say, oh, some of those you know, bureaucrats
who run these programs actually want to want to help people,
and may even believe they are helping people, but it's
actually very difficult to run the healthcare system. Well, that's
(06:37):
why market forces are so important, because market forces are
constantly rewarding providers for figuring out how to serve patients better. Right,
that's how you can get business. If you can figure
out how to serve your customers better, then you'll get
more customers.
Speaker 3 (06:56):
And that's just something that.
Speaker 4 (06:57):
Requires people who know that nuts and bolts really well
to be constantly reflecting on how they're doing their jobs.
Speaker 3 (07:05):
Right.
Speaker 4 (07:07):
The government bureaucrats, they don't do that. They don't even
know how the jobs work. They just exist mainly to
pay bills and to enact regulations that enable them to
deal with the burden that all this imposes on the
federal government. And the results for consumers are just terrible.
You know, all these problems that everybody complains about, prioritization requirements,
(07:31):
surprise bills, these things called facility fees that you know,
you go to an emergency room, the doctor says, oh,
you've got a fever, take some ass and go home,
and then you get a bill for ten thousand dollars
because you literally because you walked in the front doors.
It's just like a cover charge at a bar or
something like that, except a lot bigger. You know, none
(07:53):
of that stuff exists in the direct payment system. It
all exists because the government regulates the way healthcare is delivered,
and it does it in stupid ways.
Speaker 2 (08:06):
Because it's hard to do it right and government's not
in the business of efficiency. Professor Charles Silver is our guest.
The book is Overcharged, Why you Americans pay too much
for healthcareers?
Speaker 3 (08:20):
And you listen to the Michael Berry Show.
Speaker 4 (08:23):
Good not I.
Speaker 2 (08:27):
Professor Charles Silver of the University of Texas School of
Law is our guest. He was I have come to
learn in the course of our conversation at ut Law
almost ten years before I was there, and still is.
I did not know him, but I happened to think
the world of that law school, and I gained a
(08:48):
lot from being there, both associations and education. And this
book has been highly recommended to me by numerous folks
as to how to gain a better underderstanding of why
the healthcare system costs you so much? Overcharged, Why Americans
pay too much for healthcare? Professor Charles Silver is our guest. Professor,
(09:11):
Let's talk about young people by young I'm fifty three,
so I'm gonna throw myself into there. You know, I've
read that something like half the healthcare costs in this
country are expended on people within the last two years
of their lives.
Speaker 1 (09:27):
And you know, we see this where it's just constant.
Speaker 2 (09:29):
It's just one thing after another after another, and then
they pass and then you kick in the funeral industry,
and I mean it's these are all industries, like the
bridal industry and the birthing industry. When you look at
a person who is relatively healthy without a chronic condition,
and you're looking at the cost to them that they're bearing,
(09:50):
which really is the risk you're willing to assume. Right,
if you're never going to need a doctor, then you
don't need insurance. We just don't know which one of
us is going to be in a car wreck or
have a heart attack. So we're trying the same way
we leverage the risk on if our house burns down.
We're trying to kind of to keep that at bay
and to make a good financial decision. Where is that
(10:14):
going wrong today? Because my guess is most people are
overpaying for insurance coverage that they won't need until much later.
That's going toward people at their end of life.
Speaker 4 (10:27):
Oh, I agree that I think that story is right.
There are a bunch of thoughts that it prompts. One
of them is, you know, I've never been a fan
of taxing people who are relatively young to provide benefits
to people who are relatively old. That strikes me as
wrong on a variety of levels.
Speaker 3 (10:44):
You know.
Speaker 4 (10:44):
One is, every moral theory that I know of says
you move money from richer people to poorer people. Well,
older people are wealthier than younger people. That shouldn't be
surprising to anybody. They've had their whole lives to work, right,
They've paid off their cars, they've paid off their homes.
You know, they have other assets. Right, They're on average,
(11:06):
much wealthier than younger people who are struggling, you know,
raising families, you know, just getting jobs, dealing with college
debt and all that stuff. So my moral view is,
if we were going to move money in any direction,
we should move it from older people to younger people.
But our system does the reverse. We're robbing the poor
to pay the rich. I don't understand that. Another thing is,
(11:30):
excuse me, the system really deserves people because it eliminates.
Speaker 3 (11:39):
All caps on spending.
Speaker 4 (11:42):
You were talking about end of life care and how
we spend so much money in the last year or
two of people's lives.
Speaker 3 (11:47):
Well, if people had.
Speaker 4 (11:49):
To spend their own money, nobody would spend an infinite
amount in their last two years on healthcare. They would
have to make hard decisions. Right, These are not pleasant decisions,
but they would make decisions about how much healthcare they want.
Speaker 3 (12:03):
Is it worth spending a million.
Speaker 4 (12:04):
Dollars to extend my life by a month, Right, that's
the kind of decision they would have to make. Well, today,
because we removed all caps from the system, nobody has
to make those decisions. Instead, we just spend literally an
infinite amount of money on people who are in the
final stages of their illness.
Speaker 3 (12:24):
We get no bang for the buck.
Speaker 4 (12:26):
You know, we have people, literally we have people who
are receiving cancer treatments, new cancer treatments that cost a
million dollars, and all those treatments do is extend their
lives by about a month. And it's not even a
good month. It's not a month when you're going to
be out there on the golf course, playing with your
buddies and drinking beer, it's a month, like you're in
the hospital, right for the whole month. These things just
(12:50):
make no sense. Right, But the government cannot make those decisions, literally,
it cannot because the moment the government starts talking about
rationing care, everybody loses their minds. And you don't want
to be the politician that they're rallying against. Right, So
the government simply ignores the need to make these decisions
(13:14):
and just spends endless amounts of money because it's other
people's money.
Speaker 3 (13:17):
So why does the government care? Right?
Speaker 4 (13:22):
And you know, we just have to come back to
the world in which people are responsible for their own
end of life care. You know, it's a sad thing,
but it's true. We will all die at some point,
and the fact that we will all die at some
point affects.
Speaker 3 (13:41):
A thousand decisions that each of us makes. Right, When
am I going to stop working?
Speaker 4 (13:46):
Well, if I'm thinking I don't have much longer to live,
it probably will stop working so I can spend my
last you know, a couple of years with.
Speaker 3 (13:53):
My family or traveling or whatever it is, right, I mean.
Speaker 4 (13:56):
If you start to think about it, knowing that at
some point we will all die, it affects. As I said,
thousands of decisions that we make. You know, do I
want to live in this house that I'm in now
until the end of my life, or do I want
to move to a house that's more handicap equipped and
things of that sort. Right, this is just another decision.
(14:16):
It's a tough decision. I'm not trying to say otherwise,
but it's a decision that needs to be made, and
it needs to be made not by the government, but
by the people who are directly involved and who can
think hard about all these tough problems. There's no way
the government's going to make a good decision. Their incentives
are wrong, their knowledge is too limited. They don't have
(14:37):
access to the counselors that individuals will talk to when
making these kinds of decisions.
Speaker 3 (14:42):
So, you know, we just have to get.
Speaker 4 (14:44):
The government out of this business. What I have proposed is.
Speaker 3 (14:50):
That we can.
Speaker 4 (14:51):
You know, there is one other problem though that we
haven't discussed, which we do need to discuss, which is
there are some people who are too poor to afford
fundamental health healthcare. We do need to come up with
a way of dealing with those people, because when they
show up at the hospital needing healthcare. They're not going
to be turned away right now. We're not going to
be having sick people dying in the streets because they
(15:13):
can't afford healthcare. So we need to come up with
a way to deal with that. But the obvious way
to deal with that is through a negative income text,
the sort of thing that Milton Friedman proposed. You provide
everybody with a kind of amount of sustenance that they
can use for this purpose. You could put it into
a restricted medical account if you wanted, But the idea
(15:35):
is once you give it to them, it's hands off
for the rest of it. The government doesn't get involved
in the delivery of healthcare. It just people make decisions
on themselves with their own money, and life goes forward.
And I think if we did that, the healthcare system
would operate much more efficiently.
Speaker 3 (15:52):
Well.
Speaker 2 (15:53):
The great frustration, as you know, is that everybody gets
a vote, even people that make bad decisions, and that
many people make bad decisions. You know that we will
have a lot of people who say I can't afford
medical care because they don't save money.
Speaker 1 (16:08):
But they've got a big screen TV in every.
Speaker 2 (16:10):
Room, and they've got you know, a car they can't
afford that they're driving. They end up with the car
that they can't afford, and we end up paying for
the health care.
Speaker 3 (16:19):
That they can't afford.
Speaker 2 (16:20):
The book is Overcharged, Why Americans Pay too Much for Healthcare?
Speaker 1 (16:24):
Professor Charles Silver. But everybody knows who this guy is.
Speaker 2 (16:28):
Come on, man with them, Michael Berry, Come on. Professor
Charles Silver is our guest. It's a subject of great
interest to me and to many of you. The book
is called Overcharged, Why Americans Pay Too Much for Healthcare?
He is a law professor at the University of Texas
(16:49):
at Austin School of Law. And we ended the last
segment with the discussion that at the end of the day,
the allocation of scarce resources and who will make that decision.
We're back at that point again in every family. You know,
you've got eight kids and you've got one chicken. Mom
(17:10):
says you're not getting a second piece. So there's some
cartilage left on that leg. If you're hungry, you'll eat that.
And there comes a point where we have to decide,
with scarce resources, who will make the decision as to
where those resources will be deployed.
Speaker 1 (17:28):
Will it be the government or will it be the individual.
Speaker 2 (17:31):
And if it's the individual, there will be those who say, well,
I want as much as my neighbor has, Okay, well
earn the money to purchase that. Well, I don't earn
as much. I want to use the power of the
gun through at the direction of the government that I
either are more of me than there are of the
rich people I vote for. I want that well. The
(17:52):
only alternative is for the government to do it. Professor
I harken back to a study, and it's been a
while since I've read this book. It's interesting because I'm
a believer and let the marketplace decide. You know, healthcare
is the one area where we think everybody gets all
the healthcare they want, but we all end up.
Speaker 3 (18:11):
Paying for that.
Speaker 2 (18:11):
We don't say everybody gets all the food they want,
or all the cars they want, or all the houses
they want, or all the clothes they want, but for
some reason, everybody gets all the healthcare they want, even
at the point that it's throwing good money after bad.
So socialist system the opposite of what I propose. In Sweden,
they did a study and it was a multi decade study.
You may be aware of it. On prostate cancer in men,
(18:34):
and they determined that out of I think it was
three thousand men who had prostate cancer who were diagnosed
with prostate cancer and they chose not to treat the
prostate cancer. And they did about a twenty five year
study and the number of men who died of untreated
(18:55):
prostate cancer was something like thirty out of three thousand.
So they came to the conclusion with a government completely
government run system, that with scarce resources, it does not
make sense for us to treat prostate cancer per se
because nobody, very few people are going to die of
prostate cancer. Let's spend our money on other things that
(19:17):
if we don't spend it, there you die.
Speaker 1 (19:20):
And it strikes me.
Speaker 2 (19:21):
That while that's the opposite of the capitalist system, there
does need to be an understanding that we're wasting a
lot of money on studies because and this gets to
the second point of what you've written a lot about
medical malpractice and the fear of medical malpractice. I don't
think everybody needs a glaucoma test every time they go
(19:42):
for their license, but god forbid one person not be
diagnosed with glaucoma. We're practicing defensive medicine. We're over ordering tests,
which is a waste of our time and energy but
also money, and we're not actually doing we're not engaged in.
But I would consider smart effective healing because everyone is
(20:04):
afraid of being sued, and that has we get back
to our point. The book is overcharged, Why Americans pay
too much for healthcare? I think that's a big portion
of what we spend. Your thought, well, I'm.
Speaker 4 (20:17):
Going to disagree with part of that, but I agree
with a lot of it as well. In my world,
when you have a self interested explanation or something, you
probably don't have to look very far for any other explanation.
Self interest usually is a pretty good explanation. And the reason,
you know, some people say, oh, the reason that doctors
(20:39):
overtreat is because they're afraid of being sued. Well, there's
a simpler self interested explanation, which is every time they
treat somebody, they make money, and until you take the
profit out of these services, which will never happen, it's
very hard to determine that they're actually engaging in any
(21:00):
real defensive medicine at all. There are lots of studies
that are out there now that have found that I mean,
defensive medicine is kind of hard to define because it
can be both. It can be both the provision of
services that aren't needed and the avoidance of services that
are needed, because you get sued when you do deliver
(21:23):
services as well as when you withhold them. So it's
hard to figure out exactly what's going on with defensive medicine.
But as I said, I don't think we really need
to worry about it very much because we have a
self interested explanation, which is that the services are profitable.
And there's also you know, doctors have a lot of
confidence in their ability to help people, and they have
(21:43):
a very strong desire.
Speaker 3 (21:44):
To help people.
Speaker 1 (21:45):
Right at least that's what it should be.
Speaker 3 (21:48):
You know.
Speaker 2 (21:48):
You remind me of another great document written in seventeen
seventy six, and that from a Scotsman named Adam Smith,
who famously said, it is not from the benevolence of
the butcher, or the brewer or the baker that we
expect our dinner, but from their regard to their own
self interest exactly. Self interest drives so many things. That
(22:11):
guy is not standing on his feet behind the counter
at the donut shop for so many hours and didn't
get there at two thirty this morning because he's a
nice guy. He wants to make a profit off the donuts.
I get to enjoy the donuts in exchange for the
currency that I was given for the sweat of my brow.
It works, and I think we have to return that
to the process. And I think that's where you and
(22:33):
I can agree.
Speaker 4 (22:35):
I think we do agree on that, but we also
agree that I mean, these social programs have fundamentally undermined
the incentive to save and to be self reliant.
Speaker 3 (22:50):
You know, the I think, you know, I constantly.
Speaker 4 (22:53):
Read articles about how many people are retiring and all
they have to live on is social secure already in medicare,
they don't have much in the way of savings. And
people say, well, how could you possibly, you know, let
that happen, right? Why are you buying, as you put it,
those you know, big screen TVs for every room when
you should be saving for your later years. I think
(23:16):
the answer is that most people naively think, oh, the
government's just going to take care of me in my
later years, so I don't have to save, and they,
you know, the temptation to spend money now rather than later.
It's always there who wants to save. Saving is boring, right,
Consuming today is fun. So you know, I think that
(23:38):
as long as we have these pay go programs where
you know you can keep getting money out above what
you put in, that the incentives to save will forever
be undermined. And that's a terrible thing, I think, because
as you said, you know, we're we're just getting ourselves
into this world where each of us expects everybody else
(24:00):
to pay for everything that we need. If it's only healthcare,
they still expect to pay for everything that they want,
and that just drives costs through the roof without really
any offsetting benefits that make sense of it.
Speaker 2 (24:13):
Zoologists will tell you you are doing great harm by
domesticating certain breeds of animals, particularly if you intend at
some point to release them into the wild.
Speaker 1 (24:25):
You make them slaves.
Speaker 2 (24:26):
They lose the very abilities, and we've seen with evolutionary
studies that teeth are not as sharpenning longer, claws are
not as sharpenning more, they can no longer run as fast.
They grow to be like prison inmates, dependent on someone
else to provide for them. And I think that has
to be understood by people our guest is Professor Charles Silver,
(24:50):
who will be with us for one more segment.
Speaker 1 (24:51):
The book is Overcharged? Why Americans pay too much for rusty?
Speaker 3 (24:59):
Or take me need to Texas because I don't ready
to get out of this state. I think Michael Berry
Rocks show I like you.
Speaker 2 (25:09):
Professor Charles Silver of the University of Texas School of Law,
my alma mater, has graciously spent quite a bit of
time with us discussing an area of his academic expertise
and prowess. The book is Overcharged, Why Americans pay too
much for healthcare? And folks, I have to say, as
as you've heard me say many times, politics is interesting,
(25:32):
you know, the rooting for your team versus that team,
the Trump Dance, the reds and Blues and who shows
up and on. But my primary interest at the end
of the day is not my team winning and your
team losing. My primary interest is creating a structure where
the individual can thrive, where there is opportunity and fairness,
(25:52):
safeguard's rule of law, and that will, at the end
of the day, advance humanity. It always has. It's the
only thing that does not government. And so these sort
of policy discussions I understand, are probably less thrilling than
my usual screaming and hollering about.
Speaker 1 (26:10):
This or that indignity of the day. But this is
what matters.
Speaker 2 (26:13):
This is why we get involved in campaigns, is to
take control of the government and get it out of
our lives and create safeguards and reduce regulation and promote
the rule of law so that hardworking people can create
enough John Galt style for the rest of us to prosper.
And this stuff matters. So that's why we have these conversations.
(26:34):
Professor Charlesolver, overcharged, why Americans pay too much for healthcare?
Speaker 1 (26:39):
Professor Silver, I want you to be king for a day.
You have no.
Speaker 2 (26:45):
As this benevolent monarch, you have no political concerns. Reconstruct
our health care facility to provide an opportunity for the
most healing to occur and the individuals to take control
of their own health care.
Speaker 1 (27:00):
What does that look like?
Speaker 4 (27:03):
Wow, I'm nervous about being king for a day because
I don't believe in kings, I know, but.
Speaker 3 (27:09):
I'll try.
Speaker 4 (27:12):
I think we basically wipe away everything in terms of
these programs and the restrictive regulations.
Speaker 3 (27:19):
You know, have you ever heard of a certificate of
need law. I don't know.
Speaker 4 (27:23):
They're called con laws by for short, but con laws
regulate how many new healthcare providers can set up shops.
So if you want to open a hospital, you got
to get permission. But guess what the way the con
laws work, the existing hospitals have a vote and whether
you can open a.
Speaker 3 (27:44):
New hospital or not. I'm like giving.
Speaker 4 (27:46):
McDonald's a vote on whether Burger King can open a
restaurant right across the street. It doesn't make any sense,
but that's the way I would get rid of all
of those supply constraining regulations, and I would get rid
of all of these programs Obamacare, Medicare, whatever, and I
would go to a very simple wealth distribution program. I'm
(28:11):
not sure exactly how much money it should be. That's
something that has to have some work done. But you
know we're currently spending if you put all the healthcare
programs together, you know we're spending like seven eight ten
thousand dollars a person, you know, per American through these programs.
If we just took some of that money and started
(28:31):
plunking it into restricted healthcare savings accounts for people, so
every year, you know, there's just a little bit more
that's put in pretty soon, everybody would have enough money
to pay for their basic needs and to buy catastrophic insurance.
And I would let people buy just as much catastrophic
insurance as they want. I wouldn't have coverage mandates. You know,
(28:52):
right now, if you want to buy a policy on
one of the exchanges and you're a young man, you
know you have to pay for annual mammograms, right, but
you're not getting mamograms because you're a man, right right,
So you know, I wouldn't force people to buy any
particular amount of coverage, and I would let insurance companies
(29:15):
limit the total payouts, which you know, that's really where
things are screwed up right now. It's one of the areas,
right they have to spend unlimited amounts of money on people.
I would let people let design their own insurance programs.
And I think that you know, it's not gonna work perfectly.
Nothing ever works perfectly, right, but it would work so
(29:35):
much better and be so much more efficient than the
existing system, and it'd be way more consumer friendly. And
that's a huge improvement because I don't know anybody who
is happy with the existing healthcare system. I mean, this
terrible murder that just occurred has brought to the surface
the extraordinary hatred that people have to work insurance companies.
(30:01):
You know, that's just one symptom. We're spending twice as
much as any other country on healthcare, and we're getting
less and less healthy every year. You know, our life
expectancy is declining. We're just doing everything wrong that we
possibly can do. So wipe the slate, get rid of
all this stuff. Start out with a really simple direct
(30:23):
payment system and a cash transfer system to deal with
people who are so poor that they can't even afford
the basics, and just be satisfied with that. I said,
It's not gonna be perfect, but it'd be hard to
improve on all.
Speaker 2 (30:36):
Right, Yeah, And to get outside the purview of what
we've discussed, but to speak more to the process that
lands us where we are.
Speaker 1 (30:46):
Our criminal justice system.
Speaker 2 (30:47):
We spend more on imprisoning and prosecuting and chasing down
bad guys in any other country in the world, and
yet I think we do a far worse job, at
less effective job than most countries in the world.
Speaker 1 (31:00):
And I think meant much of that.
Speaker 2 (31:02):
I can you can see some similarities and patterns that
pervade those two industries. And by the way, then we
could move over into public education and education generally. There
are a number of different applications for where this process
has gone wrong, and it is frustrating. I very much
(31:23):
appreciate your time, Professor. I feel the better for it.
The book is overcharged, Why Americans pay too much for healthcare?
Professor Charles Silver of the University of Texas School of Law.
Speaker 3 (31:38):
Thank you, sir, Thank you, Michael Pleasure.
Speaker 2 (31:41):
And with that, might I suggest to each and every
one of you that while politics is an interesting undertaking,
and it is you know, winning elections, and he said this,
and we're going to show him, and you know, there's
it's a battle royale. And you know I argued with
my cousin at the Thanksgiving table. At the end of
(32:03):
it all, the reason for the arguments, reason for the
elections should be very redemptive, very practical, not just existential,
not just ideological. They're real to your life, and that
is creating a governmental system where individuals are free to thrive.
(32:32):
Government is not just. Government is not merciful. Government is
not protective. It is not good. Government is clunky, it's inefficient.
If you've stood in line at the DPS office to
get your driver's license and thought to yourself, you could
move this thing along.
Speaker 1 (32:52):
If you've seen someone.
Speaker 2 (32:54):
Who is on the clock and doesn't care about results,
if you've seen the worst of government in every aspect,
whether it's the inspector who doesn't seem to care that
they're coming back and adding these these regulations that are
going to cost this much more for you to build this,
and now you're going to walk away from the project
and leave the property vacant, and that's not good for anybody.
Speaker 1 (33:15):
These are the things that we should spend our time in.
Speaker 2 (33:18):
And I say this because politics has become sport and
it's become for many.
Speaker 1 (33:24):
People their favorite hobby.
Speaker 2 (33:26):
But let's not lose track of what we're trying to
do here, which is literal, not to exaggerate, save our country.
Speaker 4 (33:33):
Els has let goodblity, thank you, and good night.
It's that time time, time, time, Luck and Load. Michael
Verie Show is on the air. Professor Charles Silver as
(00:25):
our guest.
Speaker 2 (00:25):
He's a professor at the University of Texas School of Law,
which I happened to believe is fantastic because I'm a
graduate of same. His book is Overcharged, Why Americans pay
too much for healthcare. You mentioned that the problem began
with Medicare Medicaid in the sixties, part of Lyndon Johnson's
(00:46):
Great Society, which turned out not to be. It was
two point zero of FDRs taking over of the American
economy and it's hard to strip that back out of
life when Medicare got involved. So my dad's eighty four,
my mom recently passed, and I go in and review
every expense, everything that comes in and all that this
(01:09):
whole Medicare thing. I have a show sponsor called Senior
Health Services dot Com, and he and his team help
people who are trying to navigate Medicare. And every day
I get someone who emails me and says, can you
connect me with them? And I forward it and sometimes
I stay involved for a little while just to see,
you know, kind of what they're working through. It's amazing
(01:31):
to people that, all of a sudden, I guess, when
you turn sixty five, you're getting robocalls and junk mail
and all this Medicare, Medicare, Medicare, and people had no idea. Now,
all of a sudden, I've been, you know, dumped into
the Medicare playground, and I don't know why, how does
this even work?
Speaker 3 (01:51):
Too well?
Speaker 4 (01:53):
I just I recently hit that age myself, so I
can sympathize with those whose mailbox are crammed with Medicare
advantage flyers and things of that sort. I'm sick of
seeing them, and I'm not even using Medicare. I'm still working,
so I'm staying on my employer's healthcare system or healthcare insurance,
although that is very expensive and far too comprehensive. You know,
(02:17):
it's because of the mandates regarding what employer sponsored coverage
has to conclude that I wind up paying, you know,
way too much. Everybody does pay way too much for insurance.
But you know, Medicare, what can I say? It's a
program that was designed to succeed by massively inflating the deficit.
(02:39):
You know, everybody thinks that Medicare is something that you
earn over the course of your lifetime. We don't think
of it as welfare, and politicians who refer to it
as welfare are excoriated. But the amount that people pay
into Medicare is way, way, way smaller than the amount
that they get out for most people. Now they're obviouslyceptions
(03:00):
to that, but for most people, the way that the
program succeeds is by charging them less than the benefits
that they will get out of the system. Well, you know,
that's a nice arrangement. I'd like to have that, But
the problem is somebody. The money to pay for all
those benefits has to come from somewhere, and in only
(03:21):
only two sources. One is general tax revenue, so they
use money in addition tax revenue in addition to the
employee tax to fund the program. And the other is
deficit spending. And every one of these expansions of the
Medicare program is funded through the deficits. So you know,
back when Bush two was president, right he created Medicare
(03:45):
part D, the Prescription Drug Benefit Program. Well, the premiums
even initially for that program, we're only set at fifty percent.
Speaker 3 (03:54):
Of the estimated cost.
Speaker 4 (03:55):
Now they're down to twenty five percent of the estimated cost,
which means means everybody loves Medicare party because it's a
great deal. Right, I'm only paying twenty five percent of
the cost. But what you're really doing is taking the
cost of prescription drugs and rolling them into the deficit.
And the same thing goes for Obamacare with all these
premium subsidies. Everything that the government does is designed to
(04:20):
be popular by being priced below its actual cost, and
the result of that in the long run has to
be deficit increases and inflation increases.
Speaker 3 (04:33):
There's just no getting around that.
Speaker 2 (04:36):
It's frustrating because then Medicare, the government is telling you
which doctors you can go to and which you can't,
which procedures you can do in which you can't, and
so you know, and look, it sounds like you and
I are relatively aligned. I was an acolyte of Professor
Leno Graias. You can probably understand where my views are
(04:56):
with regard to politics and the role of the government
and the individual. I'm probably more libertarian certainly than he was.
I'm over on the Rand and Ron Paul end of things.
But what I find frustrating is that people seem to
think that somehow government is protecting you and aiding you.
(05:17):
But in fact, what goes with that is, you know
why you don't feed the bears at the zoo, is
they're controlling you, and any government powerful enough to pay
for your medical surgery or medical procedures, powerful enough to
take it away, and then they start making decisions for you.
Speaker 1 (05:33):
And that's where we get into the civil liberties.
Speaker 2 (05:35):
And that's where I get very frustrated, because we've now
moved beyond healthcare and we've moved into a sort of
totalitarian authoritarian control of the individual.
Speaker 4 (05:47):
Well, you're you're certainly singing my song because you know,
you're a libertarian. I'm an adjunct scholar at the Cato Institute.
I don't think it gets much more libertarian than that,
I would say, so, so we're on the same page
as far as, you know, being very very concerned about
the governmental control. I think that governmental control is part
(06:14):
of the story, but I think governmental ineptitude is probably
a much bigger part of the story. You know, I'm
willing to say, oh, some of those you know, bureaucrats
who run these programs actually want to want to help people,
and may even believe they are helping people, but it's
actually very difficult to run the healthcare system. Well, that's
(06:37):
why market forces are so important, because market forces are
constantly rewarding providers for figuring out how to serve patients better. Right,
that's how you can get business. If you can figure
out how to serve your customers better, then you'll get
more customers.
Speaker 3 (06:56):
And that's just something that.
Speaker 4 (06:57):
Requires people who know that nuts and bolts really well
to be constantly reflecting on how they're doing their jobs.
Speaker 3 (07:05):
Right.
Speaker 4 (07:07):
The government bureaucrats, they don't do that. They don't even
know how the jobs work. They just exist mainly to
pay bills and to enact regulations that enable them to
deal with the burden that all this imposes on the
federal government. And the results for consumers are just terrible.
You know, all these problems that everybody complains about, prioritization requirements,
(07:31):
surprise bills, these things called facility fees that you know,
you go to an emergency room, the doctor says, oh,
you've got a fever, take some ass and go home,
and then you get a bill for ten thousand dollars
because you literally because you walked in the front doors.
It's just like a cover charge at a bar or
something like that, except a lot bigger. You know, none
(07:53):
of that stuff exists in the direct payment system. It
all exists because the government regulates the way healthcare is delivered,
and it does it in stupid ways.
Speaker 2 (08:06):
Because it's hard to do it right and government's not
in the business of efficiency. Professor Charles Silver is our guest.
The book is Overcharged, Why you Americans pay too much
for healthcareers?
Speaker 3 (08:20):
And you listen to the Michael Berry Show.
Speaker 4 (08:23):
Good not I.
Speaker 2 (08:27):
Professor Charles Silver of the University of Texas School of
Law is our guest. He was I have come to
learn in the course of our conversation at ut Law
almost ten years before I was there, and still is.
I did not know him, but I happened to think
the world of that law school, and I gained a
(08:48):
lot from being there, both associations and education. And this
book has been highly recommended to me by numerous folks
as to how to gain a better underderstanding of why
the healthcare system costs you so much? Overcharged, Why Americans
pay too much for healthcare? Professor Charles Silver is our guest. Professor,
(09:11):
Let's talk about young people by young I'm fifty three,
so I'm gonna throw myself into there. You know, I've
read that something like half the healthcare costs in this
country are expended on people within the last two years
of their lives.
Speaker 1 (09:27):
And you know, we see this where it's just constant.
Speaker 2 (09:29):
It's just one thing after another after another, and then
they pass and then you kick in the funeral industry,
and I mean it's these are all industries, like the
bridal industry and the birthing industry. When you look at
a person who is relatively healthy without a chronic condition,
and you're looking at the cost to them that they're bearing,
(09:50):
which really is the risk you're willing to assume. Right,
if you're never going to need a doctor, then you
don't need insurance. We just don't know which one of
us is going to be in a car wreck or
have a heart attack. So we're trying the same way
we leverage the risk on if our house burns down.
We're trying to kind of to keep that at bay
and to make a good financial decision. Where is that
(10:14):
going wrong today? Because my guess is most people are
overpaying for insurance coverage that they won't need until much later.
That's going toward people at their end of life.
Speaker 4 (10:27):
Oh, I agree that I think that story is right.
There are a bunch of thoughts that it prompts. One
of them is, you know, I've never been a fan
of taxing people who are relatively young to provide benefits
to people who are relatively old. That strikes me as
wrong on a variety of levels.
Speaker 3 (10:44):
You know.
Speaker 4 (10:44):
One is, every moral theory that I know of says
you move money from richer people to poorer people. Well,
older people are wealthier than younger people. That shouldn't be
surprising to anybody. They've had their whole lives to work, right,
They've paid off their cars, they've paid off their homes.
You know, they have other assets. Right, They're on average,
(11:06):
much wealthier than younger people who are struggling, you know,
raising families, you know, just getting jobs, dealing with college
debt and all that stuff. So my moral view is,
if we were going to move money in any direction,
we should move it from older people to younger people.
But our system does the reverse. We're robbing the poor
to pay the rich. I don't understand that. Another thing is,
(11:30):
excuse me, the system really deserves people because it eliminates.
Speaker 3 (11:39):
All caps on spending.
Speaker 4 (11:42):
You were talking about end of life care and how
we spend so much money in the last year or
two of people's lives.
Speaker 3 (11:47):
Well, if people had.
Speaker 4 (11:49):
To spend their own money, nobody would spend an infinite
amount in their last two years on healthcare. They would
have to make hard decisions. Right, These are not pleasant decisions,
but they would make decisions about how much healthcare they want.
Speaker 3 (12:03):
Is it worth spending a million.
Speaker 4 (12:04):
Dollars to extend my life by a month, Right, that's
the kind of decision they would have to make. Well, today,
because we removed all caps from the system, nobody has
to make those decisions. Instead, we just spend literally an
infinite amount of money on people who are in the
final stages of their illness.
Speaker 3 (12:24):
We get no bang for the buck.
Speaker 4 (12:26):
You know, we have people, literally we have people who
are receiving cancer treatments, new cancer treatments that cost a
million dollars, and all those treatments do is extend their
lives by about a month. And it's not even a
good month. It's not a month when you're going to
be out there on the golf course, playing with your
buddies and drinking beer, it's a month, like you're in
the hospital, right for the whole month. These things just
(12:50):
make no sense. Right, But the government cannot make those decisions, literally,
it cannot because the moment the government starts talking about
rationing care, everybody loses their minds. And you don't want
to be the politician that they're rallying against. Right, So
the government simply ignores the need to make these decisions
(13:14):
and just spends endless amounts of money because it's other
people's money.
Speaker 3 (13:17):
So why does the government care? Right?
Speaker 4 (13:22):
And you know, we just have to come back to
the world in which people are responsible for their own
end of life care. You know, it's a sad thing,
but it's true. We will all die at some point,
and the fact that we will all die at some
point affects.
Speaker 3 (13:41):
A thousand decisions that each of us makes. Right, When
am I going to stop working?
Speaker 4 (13:46):
Well, if I'm thinking I don't have much longer to live,
it probably will stop working so I can spend my
last you know, a couple of years with.
Speaker 3 (13:53):
My family or traveling or whatever it is, right, I mean.
Speaker 4 (13:56):
If you start to think about it, knowing that at
some point we will all die, it affects. As I said,
thousands of decisions that we make. You know, do I
want to live in this house that I'm in now
until the end of my life, or do I want
to move to a house that's more handicap equipped and
things of that sort. Right, this is just another decision.
(14:16):
It's a tough decision. I'm not trying to say otherwise,
but it's a decision that needs to be made, and
it needs to be made not by the government, but
by the people who are directly involved and who can
think hard about all these tough problems. There's no way
the government's going to make a good decision. Their incentives
are wrong, their knowledge is too limited. They don't have
(14:37):
access to the counselors that individuals will talk to when
making these kinds of decisions.
Speaker 3 (14:42):
So, you know, we just have to get.
Speaker 4 (14:44):
The government out of this business. What I have proposed is.
Speaker 3 (14:50):
That we can.
Speaker 4 (14:51):
You know, there is one other problem though that we
haven't discussed, which we do need to discuss, which is
there are some people who are too poor to afford
fundamental health healthcare. We do need to come up with
a way of dealing with those people, because when they
show up at the hospital needing healthcare. They're not going
to be turned away right now. We're not going to
be having sick people dying in the streets because they
(15:13):
can't afford healthcare. So we need to come up with
a way to deal with that. But the obvious way
to deal with that is through a negative income text,
the sort of thing that Milton Friedman proposed. You provide
everybody with a kind of amount of sustenance that they
can use for this purpose. You could put it into
a restricted medical account if you wanted, But the idea
(15:35):
is once you give it to them, it's hands off
for the rest of it. The government doesn't get involved
in the delivery of healthcare. It just people make decisions
on themselves with their own money, and life goes forward.
And I think if we did that, the healthcare system
would operate much more efficiently.
Speaker 3 (15:52):
Well.
Speaker 2 (15:53):
The great frustration, as you know, is that everybody gets
a vote, even people that make bad decisions, and that
many people make bad decisions. You know that we will
have a lot of people who say I can't afford
medical care because they don't save money.
Speaker 1 (16:08):
But they've got a big screen TV in every.
Speaker 2 (16:10):
Room, and they've got you know, a car they can't
afford that they're driving. They end up with the car
that they can't afford, and we end up paying for
the health care.
Speaker 3 (16:19):
That they can't afford.
Speaker 2 (16:20):
The book is Overcharged, Why Americans Pay too Much for Healthcare?
Speaker 1 (16:24):
Professor Charles Silver. But everybody knows who this guy is.
Speaker 2 (16:28):
Come on, man with them, Michael Berry, Come on. Professor
Charles Silver is our guest. It's a subject of great
interest to me and to many of you. The book
is called Overcharged, Why Americans Pay Too Much for Healthcare?
He is a law professor at the University of Texas
(16:49):
at Austin School of Law. And we ended the last
segment with the discussion that at the end of the day,
the allocation of scarce resources and who will make that decision.
We're back at that point again in every family. You know,
you've got eight kids and you've got one chicken. Mom
(17:10):
says you're not getting a second piece. So there's some
cartilage left on that leg. If you're hungry, you'll eat that.
And there comes a point where we have to decide,
with scarce resources, who will make the decision as to
where those resources will be deployed.
Speaker 1 (17:28):
Will it be the government or will it be the individual.
Speaker 2 (17:31):
And if it's the individual, there will be those who say, well,
I want as much as my neighbor has, Okay, well
earn the money to purchase that. Well, I don't earn
as much. I want to use the power of the
gun through at the direction of the government that I
either are more of me than there are of the
rich people I vote for. I want that well. The
(17:52):
only alternative is for the government to do it. Professor
I harken back to a study, and it's been a
while since I've read this book. It's interesting because I'm
a believer and let the marketplace decide. You know, healthcare
is the one area where we think everybody gets all
the healthcare they want, but we all end up.
Speaker 3 (18:11):
Paying for that.
Speaker 2 (18:11):
We don't say everybody gets all the food they want,
or all the cars they want, or all the houses
they want, or all the clothes they want, but for
some reason, everybody gets all the healthcare they want, even
at the point that it's throwing good money after bad.
So socialist system the opposite of what I propose. In Sweden,
they did a study and it was a multi decade study.
You may be aware of it. On prostate cancer in men,
(18:34):
and they determined that out of I think it was
three thousand men who had prostate cancer who were diagnosed
with prostate cancer and they chose not to treat the
prostate cancer. And they did about a twenty five year
study and the number of men who died of untreated
(18:55):
prostate cancer was something like thirty out of three thousand.
So they came to the conclusion with a government completely
government run system, that with scarce resources, it does not
make sense for us to treat prostate cancer per se
because nobody, very few people are going to die of
prostate cancer. Let's spend our money on other things that
(19:17):
if we don't spend it, there you die.
Speaker 1 (19:20):
And it strikes me.
Speaker 2 (19:21):
That while that's the opposite of the capitalist system, there
does need to be an understanding that we're wasting a
lot of money on studies because and this gets to
the second point of what you've written a lot about
medical malpractice and the fear of medical malpractice. I don't
think everybody needs a glaucoma test every time they go
(19:42):
for their license, but god forbid one person not be
diagnosed with glaucoma. We're practicing defensive medicine. We're over ordering tests,
which is a waste of our time and energy but
also money, and we're not actually doing we're not engaged in.
But I would consider smart effective healing because everyone is
(20:04):
afraid of being sued, and that has we get back
to our point. The book is overcharged, Why Americans pay
too much for healthcare? I think that's a big portion
of what we spend. Your thought, well, I'm.
Speaker 4 (20:17):
Going to disagree with part of that, but I agree
with a lot of it as well. In my world,
when you have a self interested explanation or something, you
probably don't have to look very far for any other explanation.
Self interest usually is a pretty good explanation. And the reason,
you know, some people say, oh, the reason that doctors
(20:39):
overtreat is because they're afraid of being sued. Well, there's
a simpler self interested explanation, which is every time they
treat somebody, they make money, and until you take the
profit out of these services, which will never happen, it's
very hard to determine that they're actually engaging in any
(21:00):
real defensive medicine at all. There are lots of studies
that are out there now that have found that I mean,
defensive medicine is kind of hard to define because it
can be both. It can be both the provision of
services that aren't needed and the avoidance of services that
are needed, because you get sued when you do deliver
(21:23):
services as well as when you withhold them. So it's
hard to figure out exactly what's going on with defensive medicine.
But as I said, I don't think we really need
to worry about it very much because we have a
self interested explanation, which is that the services are profitable.
And there's also you know, doctors have a lot of
confidence in their ability to help people, and they have
(21:43):
a very strong desire.
Speaker 3 (21:44):
To help people.
Speaker 1 (21:45):
Right at least that's what it should be.
Speaker 3 (21:48):
You know.
Speaker 2 (21:48):
You remind me of another great document written in seventeen
seventy six, and that from a Scotsman named Adam Smith,
who famously said, it is not from the benevolence of
the butcher, or the brewer or the baker that we
expect our dinner, but from their regard to their own
self interest exactly. Self interest drives so many things. That
(22:11):
guy is not standing on his feet behind the counter
at the donut shop for so many hours and didn't
get there at two thirty this morning because he's a
nice guy. He wants to make a profit off the donuts.
I get to enjoy the donuts in exchange for the
currency that I was given for the sweat of my brow.
It works, and I think we have to return that
to the process. And I think that's where you and
(22:33):
I can agree.
Speaker 4 (22:35):
I think we do agree on that, but we also
agree that I mean, these social programs have fundamentally undermined
the incentive to save and to be self reliant.
Speaker 3 (22:50):
You know, the I think, you know, I constantly.
Speaker 4 (22:53):
Read articles about how many people are retiring and all
they have to live on is social secure already in medicare,
they don't have much in the way of savings. And
people say, well, how could you possibly, you know, let
that happen, right? Why are you buying, as you put it,
those you know, big screen TVs for every room when
you should be saving for your later years. I think
(23:16):
the answer is that most people naively think, oh, the
government's just going to take care of me in my
later years, so I don't have to save, and they,
you know, the temptation to spend money now rather than later.
It's always there who wants to save. Saving is boring, right,
Consuming today is fun. So you know, I think that
(23:38):
as long as we have these pay go programs where
you know you can keep getting money out above what
you put in, that the incentives to save will forever
be undermined. And that's a terrible thing, I think, because
as you said, you know, we're we're just getting ourselves
into this world where each of us expects everybody else
(24:00):
to pay for everything that we need. If it's only healthcare,
they still expect to pay for everything that they want,
and that just drives costs through the roof without really
any offsetting benefits that make sense of it.
Speaker 2 (24:13):
Zoologists will tell you you are doing great harm by
domesticating certain breeds of animals, particularly if you intend at
some point to release them into the wild.
Speaker 1 (24:25):
You make them slaves.
Speaker 2 (24:26):
They lose the very abilities, and we've seen with evolutionary
studies that teeth are not as sharpenning longer, claws are
not as sharpenning more, they can no longer run as fast.
They grow to be like prison inmates, dependent on someone
else to provide for them. And I think that has
to be understood by people our guest is Professor Charles Silver,
(24:50):
who will be with us for one more segment.
Speaker 1 (24:51):
The book is Overcharged? Why Americans pay too much for rusty?
Speaker 3 (24:59):
Or take me need to Texas because I don't ready
to get out of this state. I think Michael Berry
Rocks show I like you.
Speaker 2 (25:09):
Professor Charles Silver of the University of Texas School of Law,
my alma mater, has graciously spent quite a bit of
time with us discussing an area of his academic expertise
and prowess. The book is Overcharged, Why Americans pay too
much for healthcare? And folks, I have to say, as
as you've heard me say many times, politics is interesting,
(25:32):
you know, the rooting for your team versus that team,
the Trump Dance, the reds and Blues and who shows
up and on. But my primary interest at the end
of the day is not my team winning and your
team losing. My primary interest is creating a structure where
the individual can thrive, where there is opportunity and fairness,
(25:52):
safeguard's rule of law, and that will, at the end
of the day, advance humanity. It always has. It's the
only thing that does not government. And so these sort
of policy discussions I understand, are probably less thrilling than
my usual screaming and hollering about.
Speaker 1 (26:10):
This or that indignity of the day. But this is
what matters.
Speaker 2 (26:13):
This is why we get involved in campaigns, is to
take control of the government and get it out of
our lives and create safeguards and reduce regulation and promote
the rule of law so that hardworking people can create
enough John Galt style for the rest of us to prosper.
And this stuff matters. So that's why we have these conversations.
(26:34):
Professor Charlesolver, overcharged, why Americans pay too much for healthcare?
Speaker 1 (26:39):
Professor Silver, I want you to be king for a day.
You have no.
Speaker 2 (26:45):
As this benevolent monarch, you have no political concerns. Reconstruct
our health care facility to provide an opportunity for the
most healing to occur and the individuals to take control
of their own health care.
Speaker 1 (27:00):
What does that look like?
Speaker 4 (27:03):
Wow, I'm nervous about being king for a day because
I don't believe in kings, I know, but.
Speaker 3 (27:09):
I'll try.
Speaker 4 (27:12):
I think we basically wipe away everything in terms of
these programs and the restrictive regulations.
Speaker 3 (27:19):
You know, have you ever heard of a certificate of
need law. I don't know.
Speaker 4 (27:23):
They're called con laws by for short, but con laws
regulate how many new healthcare providers can set up shops.
So if you want to open a hospital, you got
to get permission. But guess what the way the con
laws work, the existing hospitals have a vote and whether
you can open a.
Speaker 3 (27:44):
New hospital or not. I'm like giving.
Speaker 4 (27:46):
McDonald's a vote on whether Burger King can open a
restaurant right across the street. It doesn't make any sense,
but that's the way I would get rid of all
of those supply constraining regulations, and I would get rid
of all of these programs Obamacare, Medicare, whatever, and I
would go to a very simple wealth distribution program. I'm
(28:11):
not sure exactly how much money it should be. That's
something that has to have some work done. But you
know we're currently spending if you put all the healthcare
programs together, you know we're spending like seven eight ten
thousand dollars a person, you know, per American through these programs.
If we just took some of that money and started
(28:31):
plunking it into restricted healthcare savings accounts for people, so
every year, you know, there's just a little bit more
that's put in pretty soon, everybody would have enough money
to pay for their basic needs and to buy catastrophic insurance.
And I would let people buy just as much catastrophic
insurance as they want. I wouldn't have coverage mandates. You know,
(28:52):
right now, if you want to buy a policy on
one of the exchanges and you're a young man, you
know you have to pay for annual mammograms, right, but
you're not getting mamograms because you're a man, right right,
So you know, I wouldn't force people to buy any
particular amount of coverage, and I would let insurance companies
(29:15):
limit the total payouts, which you know, that's really where
things are screwed up right now. It's one of the areas,
right they have to spend unlimited amounts of money on people.
I would let people let design their own insurance programs.
And I think that you know, it's not gonna work perfectly.
Nothing ever works perfectly, right, but it would work so
(29:35):
much better and be so much more efficient than the
existing system, and it'd be way more consumer friendly. And
that's a huge improvement because I don't know anybody who
is happy with the existing healthcare system. I mean, this
terrible murder that just occurred has brought to the surface
the extraordinary hatred that people have to work insurance companies.
(30:01):
You know, that's just one symptom. We're spending twice as
much as any other country on healthcare, and we're getting
less and less healthy every year. You know, our life
expectancy is declining. We're just doing everything wrong that we
possibly can do. So wipe the slate, get rid of
all this stuff. Start out with a really simple direct
(30:23):
payment system and a cash transfer system to deal with
people who are so poor that they can't even afford
the basics, and just be satisfied with that. I said,
It's not gonna be perfect, but it'd be hard to
improve on all.
Speaker 2 (30:36):
Right, Yeah, And to get outside the purview of what
we've discussed, but to speak more to the process that
lands us where we are.
Speaker 1 (30:46):
Our criminal justice system.
Speaker 2 (30:47):
We spend more on imprisoning and prosecuting and chasing down
bad guys in any other country in the world, and
yet I think we do a far worse job, at
less effective job than most countries in the world.
Speaker 1 (31:00):
And I think meant much of that.
Speaker 2 (31:02):
I can you can see some similarities and patterns that
pervade those two industries. And by the way, then we
could move over into public education and education generally. There
are a number of different applications for where this process
has gone wrong, and it is frustrating. I very much
(31:23):
appreciate your time, Professor. I feel the better for it.
The book is overcharged, Why Americans pay too much for healthcare?
Professor Charles Silver of the University of Texas School of Law.
Speaker 3 (31:38):
Thank you, sir, Thank you, Michael Pleasure.
Speaker 2 (31:41):
And with that, might I suggest to each and every
one of you that while politics is an interesting undertaking,
and it is you know, winning elections, and he said this,
and we're going to show him, and you know, there's
it's a battle royale. And you know I argued with
my cousin at the Thanksgiving table. At the end of
(32:03):
it all, the reason for the arguments, reason for the
elections should be very redemptive, very practical, not just existential,
not just ideological. They're real to your life, and that
is creating a governmental system where individuals are free to thrive.
(32:32):
Government is not just. Government is not merciful. Government is
not protective. It is not good. Government is clunky, it's inefficient.
If you've stood in line at the DPS office to
get your driver's license and thought to yourself, you could
move this thing along.
Speaker 1 (32:52):
If you've seen someone.
Speaker 2 (32:54):
Who is on the clock and doesn't care about results,
if you've seen the worst of government in every aspect,
whether it's the inspector who doesn't seem to care that
they're coming back and adding these these regulations that are
going to cost this much more for you to build this,
and now you're going to walk away from the project
and leave the property vacant, and that's not good for anybody.
Speaker 1 (33:15):
These are the things that we should spend our time in.
Speaker 2 (33:18):
And I say this because politics has become sport and
it's become for many.
Speaker 1 (33:24):
People their favorite hobby.
Speaker 2 (33:26):
But let's not lose track of what we're trying to
do here, which is literal, not to exaggerate, save our country.
Speaker 4 (33:33):
Els has let goodblity, thank you, and good night.
Popular Podcasts
Stuff You Should Know
If you've ever wanted to know about champagne, satanism, the Stonewall Uprising, chaos theory, LSD, El Nino, true crime and Rosa Parks, then look no further. Josh and Chuck have you covered.
Dateline NBC
Current and classic episodes, featuring compelling true-crime mysteries, powerful documentaries and in-depth investigations. Follow now to get the latest episodes of Dateline NBC completely free, or subscribe to Dateline Premium for ad-free listening and exclusive bonus content: DatelinePremium.com
The Burden
The Burden is a documentary series that takes listeners into the hidden places where justice is done (and undone). It dives deep into the lives of heroes and villains. And it focuses a spotlight on those who triumph even when the odds are against them. Season 5 - The Burden: Death & Deceit in Alliance On April Fools Day 1999, 26-year-old Yvonne Layne was found murdered in her Alliance, Ohio home. David Thorne, her ex-boyfriend and father of one of her children, was instantly a suspect. Another young man admitted to the murder, and David breathed a sigh of relief, until the confessed murderer fingered David; “He paid me to do it.” David was sentenced to life without parole. Two decades later, Pulitzer winner and podcast host, Maggie Freleng (Bone Valley Season 3: Graves County, Wrongful Conviction, Suave) launched a “live” investigation into David's conviction alongside Jason Baldwin (himself wrongfully convicted as a member of the West Memphis Three). Maggie had come to believe that the entire investigation of David was botched by the tiny local police department, or worse, covered up the real killer. Was Maggie correct? Was David’s claim of innocence credible? In Death and Deceit in Alliance, Maggie recounts the case that launched her career, and ultimately, “broke” her.” The results will shock the listener and reduce Maggie to tears and self-doubt. This is not your typical wrongful conviction story. In fact, it turns the genre on its head. It asks the question: What if our champions are foolish? Season 4 - The Burden: Get the Money and Run “Trying to murder my father, this was the thing that put me on the path.” That’s Joe Loya and that path was bank robbery. Bank, bank, bank, bank, bank. In season 4 of The Burden: Get the Money and Run, we hear from Joe who was once the most prolific bank robber in Southern California, and beyond. He used disguises, body doubles, proxies. He leaped over counters, grabbed the money and ran. Even as the FBI was closing in. It was a showdown between a daring bank robber, and a patient FBI agent. Joe was no ordinary bank robber. He was bright, articulate, charismatic, and driven by a dark rage that he summoned up at will. In seven episodes, Joe tells all: the what, the how… and the why. Including why he tried to murder his father. Season 3 - The Burden: Avenger Miriam Lewin is one of Argentina’s leading journalists today. At 19 years old, she was kidnapped off the streets of Buenos Aires for her political activism and thrown into a concentration camp. Thousands of her fellow inmates were executed, tossed alive from a cargo plane into the ocean. Miriam, along with a handful of others, will survive the camp. Then as a journalist, she will wage a decades long campaign to bring her tormentors to justice. Avenger is about one woman’s triumphant battle against unbelievable odds to survive torture, claim justice for the crimes done against her and others like her, and change the future of her country. Season 2 - The Burden: Empire on Blood Empire on Blood is set in the Bronx, NY, in the early 90s, when two young drug dealers ruled an intersection known as “The Corner on Blood.” The boss, Calvin Buari, lived large. He and a protege swore they would build an empire on blood. Then the relationship frayed and the protege accused Calvin of a double homicide which he claimed he didn’t do. But did he? Award-winning journalist Steve Fishman spent seven years to answer that question. This is the story of one man’s last chance to overturn his life sentence. He may prevail, but someone’s gotta pay. The Burden: Empire on Blood is the director’s cut of the true crime classic which reached #1 on the charts when it was first released half a dozen years ago. Season 1 - The Burden In the 1990s, Detective Louis N. Scarcella was legendary. In a city overrun by violent crime, he cracked the toughest cases and put away the worst criminals. “The Hulk” was his nickname. Then the story changed. Scarcella ran into a group of convicted murderers who all say they are innocent. They turned themselves into jailhouse-lawyers and in prison founded a lway firm. When they realized Scarcella helped put many of them away, they set their sights on taking him down. And with the help of a NY Times reporter they have a chance. For years, Scarcella insisted he did nothing wrong. But that’s all he’d say. Until we tracked Scarcella to a sauna in a Russian bathhouse, where he started to talk..and talk and talk. “The guilty have gone free,” he whispered. And then agreed to take us into the belly of the beast. Welcome to The Burden.