December 31, 2025 • 34 mins
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Speaker 1 (00:02):
It's that time time, time, time, Luck and Load.
Speaker 2 (00:10):
Michael Verie Show is on the air. Professor Charles Silvery
as our guest.
Speaker 1 (00:24):
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
(00:45):
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
(01:08):
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
(01:30):
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 and Medicare, Medicare, and people had
no idea, And 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 (01:50):
Too well?
Speaker 4 (01:52):
I just I recently hit that age myself, so I
can sympathize with those whose mailbox are crammed with Medicare
vantage 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 obviously
(02:59):
accept 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.
Speaker 3 (03:12):
Well, you know, that's a nice arrangement.
Speaker 4 (03:13):
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 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
(03:34):
one of these expansions of the Medicare program is funded
through the deficit. So you know, back when Bush two
was president, right he created Medicare part D, the prescription
Drug Benefit Program. Well, the premiums even initially for that program,
we're only set at fifty percent of the estimated cost.
(03:56):
Now they're down to twenty five percent of the estimated cost,
which 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
(04:18):
that the government does is designed to 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 (04:34):
There's just no getting around that.
Speaker 1 (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.
Speaker 2 (04:49):
You and I are relatively aligned.
Speaker 1 (04:50):
I was an acolyte of Professor Leino Graia, so you
probably understand where my views are with regard to politics
and the role of the government and the individual. 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
(05:13):
government is protecting you and aiding you. 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. And that's
(05:34):
where we get into the civil liberties. 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 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
(06:38):
why market forces are so important, because market forces are
constantly rewarding providers for figuring out how to serve patients better.
Speaker 3 (06:49):
Right, that's how you can get business.
Speaker 4 (06:51):
If you can figure out how to serve your customers better,
then you'll get more customers. And that's just something that
requires people who know the nuts and bolts really well
to be constantly reflecting on.
Speaker 3 (07:04):
How they're doing their jobs. 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, prior
(07:30):
authorization requirements, 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 aster 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 because it's hard
to do it right.
Speaker 1 (08:08):
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 healthcare?
Speaker 3 (08:21):
And listen to the Michael Berry Show.
Speaker 1 (08:23):
Good that. 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
(08:45):
to think the world of that law school, and I
gained a 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 un
understanding of why the healthcare system costs you so much. Overcharged,
(09:05):
Why Americans pay too much for healthcare? Professor Charles Silver
is our guest. Professor, 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
(09:26):
last two years of their lives. And you know, we
see this where it's just constant. 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
(09:47):
the cost to them that they're bearing, 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 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
(10:08):
to kind of to keep that at bay and to
make a good financial decision. Where is that going wrong today?
Because my guess is most people are overpaying for insurance
coverage that they won't need until much later.
Speaker 2 (10:23):
That's going toward people at their end of life.
Speaker 4 (10:28):
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 (10:46):
You know.
Speaker 4 (10:46):
One is, every moral theory that I know of says
you move money from.
Speaker 3 (10:52):
Richer people to poorer people.
Speaker 4 (10:54):
Well, older people are wealthier than younger people. That shouldn't
be surprising to anybody. They've had their whole lives to
work right and saved. They've paid off their cars, they've
paid off their homes. You know, they have other assets. Right,
They're on average, much wealthier than younger people who are struggling,
you know, raising families, you know, just getting jobs, dealing
(11:15):
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, excuse me, the system really deserves people
(11:41):
because it eliminates all caps on spending 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 (11:51):
Well, if people.
Speaker 4 (11:52):
Had to spend their own money, nobody would spend an
infinite amount in their last two years on healthcare. Have
to make hard decisions, right, These are not pleasant decisions,
but they would make decisions about how much healthcare they want.
Is it worth spending a million dollars to extend my
life by a month, Right, that's the kind of decision
(12:13):
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.
We get no bang for the buck. You know, we
have people, literally we have people who are receiving cancer treatments,
(12:35):
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 make no sense. Right, But
(12:57):
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 and just spends
(13:21):
endless amounts of money because it's other people's money. So
why does the government care?
Speaker 3 (13:26):
Right? And you know, we just have to come.
Speaker 4 (13:31):
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 a thousand decisions that each of
us makes. Right, When am I going to stop working? Well,
(13:54):
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, couple of years with my family or
traveling or whatever it is, right, I mean, 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
(14:17):
the end of my life, or do I want to
move to a house that's more handicap equipped and things.
Speaker 3 (14:21):
Of that sort.
Speaker 4 (14:22):
Right, this is just another decision. 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
(14:44):
is too limited. They don't have access to the counselors
that individuals will talk to when making these kinds of decisions. So,
you know, we just have to get the government out
of this business. What I have proposed is, you know,
there is one other problem though that we haven't discussed,
which we do need to discuss, which is there are
(15:05):
some people who are too poor to afford fundamental health care.
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,
And we're not going to be having sick people dying
in the streets because they can't afford healthcare. So we
need to come up with a way to deal with that.
(15:27):
But the obvious way to deal with that is through
a negative income tax, the sort of thing that Milton
Friedman proposed. You know, 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 is once you give it
to them, it's hands off for the rest of it.
(15:48):
The government doesn't get involved in the delivery of healthcare.
Speaker 3 (15:51):
It just people make.
Speaker 4 (15:52):
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 1 (16:02):
Well, 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 2 (16:17):
But they've got a big screen TV in every.
Speaker 1 (16:19):
Room, and they've gotten, you know, a car they can't
afford that they're driving.
Speaker 2 (16:25):
They end up with the car that they can't afford,
and we end up paying for the healthcare that they
can't afford.
Speaker 1 (16:29):
The book is Overcharged, Why Americans Pay Too Much for Healthcare?
Speaker 2 (16:34):
Professor Charles Silver more and everybody knows who this guy is.
Speaker 4 (16:37):
Come on, man with them, Michael Barry, come on.
Speaker 1 (16:43):
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,
at Austin of Law. And we ended the last segment
with the discussion that at the end of the day,
(17:06):
the allocation of scarce resources and who will make that decision.
We're back at that point again in every family. You know,
you got eight kids and you've got one chicken. Mom
says you're not getting a second piece. So there's some
cartilage left on that leg.
Speaker 2 (17:25):
If you're hungry, you'll eat that.
Speaker 1 (17:28):
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. Will it be the
government or will it be the individual? And if it's
the individual, there will be those who say, well, I
want as much as my neighbor has, Okay, we'll earn
(17:49):
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 more
of me than there are of the rich people I
vote for. I want that well. The only alternative is
for the government to do it. Professor I harkened back
to a study. And it's been a while since I
(18:10):
read this book. It's interesting because I'm a believer and
let the marketplace decide. You know, healthcare is a one
area where we think everybody gets all the healthcare they want,
but we all end up paying for that. 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
(18:31):
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,
and they determined that out of I think it was
three thousand men who had prostate cancer, who were diagnosed
(18:54):
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
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
(19:17):
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
if we don't spend it there, you die. And it
strikes me that while that's the opposite of the capitalist system,
there does need to be an understanding that we're wasting
(19:40):
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 for their license, but God forbid one person not
be diagnosed with glaucoma. We're practicing defensive medicine. We're over
(20:02):
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 what I would consider smart effective healing because
everyone is 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
(20:24):
big portion of what we spend.
Speaker 4 (20:26):
Your thought, well, I'm 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,
(20:50):
the reason that doctors 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 real defensive medicine at all. There
(21:15):
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 services as well as when
(21:36):
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 a very strong desire to
(21:57):
help people.
Speaker 2 (21:58):
Right it should you know?
Speaker 1 (22:00):
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. And exactly self interest drives so many things.
(22:24):
That 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
(22:45):
where you and I can agree.
Speaker 4 (22:48):
I think we do agree on that, but we also
agree that I mean, these social programs have fundamentally undermined
the incentive to say and to be self reliant, you know,
the I think you know, I constantly read articles about
(23:08):
how many people are retiring and all they have to
live on is social security and medicare They don't have
much in the way of savings. And people say, well,
how could you possibly, you know, let that happen?
Speaker 3 (23:21):
Right?
Speaker 4 (23:21):
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 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.
(23:42):
Who wants to save? Saving is boring?
Speaker 3 (23:44):
Right?
Speaker 4 (23:46):
Consuming today is fun? So, you know, I think that
as long as we have these paygo 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,
(24:08):
you know, we're just getting ourselves into this world where
each of us expects everybody else 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 1 (24:26):
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 2 (24:38):
You make them slaves.
Speaker 1 (24:39):
They lose the very abilities, and we've seen with evolutionary
studies that teeth are not as sharp any 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 unders good by people. Our guest
(25:01):
is Professor Charles Silver, who would be with us for
one more segment. The book is Overcharged, Why Americans pay
too much for us that's it.
Speaker 3 (25:11):
Arrest me or take me to Texas. So talking about
to get out of this state.
Speaker 4 (25:16):
I think Michael Barry roths Michael very show.
Speaker 1 (25:19):
I like you. 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.
Speaker 2 (25:34):
The book is.
Speaker 1 (25:35):
Overcharged, why Americans pay too much for healthcare? And folks,
I have to say, as you've heard me say many times,
politics is interesting, 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
(25:56):
winning and your team losing. My primary interest is create
a structure where the individual can thrive, where there is
opportunity and fairness, 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
(26:16):
these sort of policy discussions, I understand are probably less
thrilling than my usual screaming and hollering about this or
that indignity of the day. But this is what matters.
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
(26:39):
the rule of law so that hardworking people can create
enough John Gault style for the rest of us to prosper.
And this stuff matters. So that's why we have these conversations.
Professor Charlesolver, overcharged, why Americans pay too much for healthcare?
Professor Silver, I want you to be king for a day.
Speaker 2 (26:58):
You have no.
Speaker 1 (27:00):
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 healthcare.
Speaker 2 (27:16):
What does that look like?
Speaker 4 (27:20):
Wow, I'm nervous about being king for a day because
I don't believe in kings.
Speaker 2 (27:24):
I know, but I know.
Speaker 3 (27:27):
I'll try.
Speaker 4 (27:29):
I think we basically wipe away everything in terms of
these programs and the restrictive regulations. You know, have you
ever heard of a certificate of need law?
Speaker 3 (27:41):
I don't know.
Speaker 4 (27:41):
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 the hospital, you got
to get permission. Oh okay, I guess what the way
the con laws work. The existing high hospitals have a
vote and whether you can open a new hospital, or
(28:05):
like giving McDonald's a vote on whether Burger King can
open a restaurant right across the street. It just 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,
(28:25):
and I would go to a very simple wealth distribution program.
I'm 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 per you know, per American
(28:48):
through these programs. If we just took some of that
money and started 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
(29:09):
just as much catastrophic insurance as they want. I wouldn't
have coverage mandates. You know, 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
(29:29):
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 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.
Speaker 3 (29:50):
I would let people let.
Speaker 4 (29:51):
Design their own insurance programs. And I think that you know,
it's not going to work perfectly. Nothing ever works perfectly, right,
but it would work so 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
(30:13):
healthcare system. I mean, this terrible murder that just occurred
has brought to the surface the extraordinary hatred that people
have toward insurance companies. You know, that's just one symptom.
We're spending twice as much as any other country on healthcare,
(30:34):
and we're getting less and less.
Speaker 3 (30:35):
Healthy every year.
Speaker 4 (30:37):
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 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.
(31:00):
I said, it's not gonna be perfect, but it'd be
hard to improve on all, right.
Speaker 1 (31:03):
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 2 (31:13):
Our criminal justice system.
Speaker 1 (31:14):
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. And
I think much of that can you can see some
similarities and patterns that pervade those two industries. And by
(31:36):
the way, then we could move over into public education
and education generally I mean, there are a number of
different applications for where this process has gone wrong, and
it is frustrating. I very much appreciate your time, Professor.
I feel the better for it. The book is overcharged
(32:01):
Why Americans pay too much for health care? Professor Charles
Silver of the University of Texas School of Law.
Speaker 3 (32:08):
Thank you, sir, Thank you, Michael Pleasure.
Speaker 1 (32:11):
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, it's
a battle royale, and you know I argued with my
cousin at the Thanksgiving table. At the end of it all,
(32:35):
the reason for the arguments, reason for the elections should
be very redemptive, very practical, not just existential, not just ideological.
Speaker 2 (32:50):
They're real to your.
Speaker 1 (32:51):
Life, and that is creating a governmental system where individuals
are free to thrive. Government is not just. Government is
not merciful. Government is not protective. It is not good.
(33:11):
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 if
you've seen someone 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
(33:33):
to care that they're coming back and adding 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 lead the property vacant, and that's
not good for anybody.
Speaker 2 (33:45):
These are the things that we should spend our time with.
Speaker 1 (33:48):
And I say this because politics has become sport and
it's become for many.
Speaker 2 (33:54):
People their favorite hobby.
Speaker 1 (33:56):
But let's not lose track of what we're trying to
do here, which is literal, not to exaggerate.
Speaker 2 (34:01):
Save our coney well, a gentleman. Ellus has left the building.
Speaker 4 (34:05):
Thank you, and good night.
Speaker 3 (34:10):
H
It's that time time, time, time, Luck and Load.
Speaker 2 (00:10):
Michael Verie Show is on the air. Professor Charles Silvery
as our guest.
Speaker 1 (00:24):
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
(00:45):
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
(01:08):
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
(01:30):
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 and Medicare, Medicare, and people had
no idea, And 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 (01:50):
Too well?
Speaker 4 (01:52):
I just I recently hit that age myself, so I
can sympathize with those whose mailbox are crammed with Medicare
vantage 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 obviously
(02:59):
accept 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.
Speaker 3 (03:12):
Well, you know, that's a nice arrangement.
Speaker 4 (03:13):
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 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
(03:34):
one of these expansions of the Medicare program is funded
through the deficit. So you know, back when Bush two
was president, right he created Medicare part D, the prescription
Drug Benefit Program. Well, the premiums even initially for that program,
we're only set at fifty percent of the estimated cost.
(03:56):
Now they're down to twenty five percent of the estimated cost,
which 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
(04:18):
that the government does is designed to 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 (04:34):
There's just no getting around that.
Speaker 1 (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.
Speaker 2 (04:49):
You and I are relatively aligned.
Speaker 1 (04:50):
I was an acolyte of Professor Leino Graia, so you
probably understand where my views are with regard to politics
and the role of the government and the individual. 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
(05:13):
government is protecting you and aiding you. 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. And that's
(05:34):
where we get into the civil liberties. 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 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
(06:38):
why market forces are so important, because market forces are
constantly rewarding providers for figuring out how to serve patients better.
Speaker 3 (06:49):
Right, that's how you can get business.
Speaker 4 (06:51):
If you can figure out how to serve your customers better,
then you'll get more customers. And that's just something that
requires people who know the nuts and bolts really well
to be constantly reflecting on.
Speaker 3 (07:04):
How they're doing their jobs. 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, prior
(07:30):
authorization requirements, 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 aster 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 because it's hard
to do it right.
Speaker 1 (08:08):
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 healthcare?
Speaker 3 (08:21):
And listen to the Michael Berry Show.
Speaker 1 (08:23):
Good that. 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
(08:45):
to think the world of that law school, and I
gained a 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 un
understanding of why the healthcare system costs you so much. Overcharged,
(09:05):
Why Americans pay too much for healthcare? Professor Charles Silver
is our guest. Professor, 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
(09:26):
last two years of their lives. And you know, we
see this where it's just constant. 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
(09:47):
the cost to them that they're bearing, 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 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
(10:08):
to kind of to keep that at bay and to
make a good financial decision. Where is that going wrong today?
Because my guess is most people are overpaying for insurance
coverage that they won't need until much later.
Speaker 2 (10:23):
That's going toward people at their end of life.
Speaker 4 (10:28):
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 (10:46):
You know.
Speaker 4 (10:46):
One is, every moral theory that I know of says
you move money from.
Speaker 3 (10:52):
Richer people to poorer people.
Speaker 4 (10:54):
Well, older people are wealthier than younger people. That shouldn't
be surprising to anybody. They've had their whole lives to
work right and saved. They've paid off their cars, they've
paid off their homes. You know, they have other assets. Right,
They're on average, much wealthier than younger people who are struggling,
you know, raising families, you know, just getting jobs, dealing
(11:15):
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, excuse me, the system really deserves people
(11:41):
because it eliminates all caps on spending 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 (11:51):
Well, if people.
Speaker 4 (11:52):
Had to spend their own money, nobody would spend an
infinite amount in their last two years on healthcare. Have
to make hard decisions, right, These are not pleasant decisions,
but they would make decisions about how much healthcare they want.
Is it worth spending a million dollars to extend my
life by a month, Right, that's the kind of decision
(12:13):
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.
We get no bang for the buck. You know, we
have people, literally we have people who are receiving cancer treatments,
(12:35):
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 make no sense. Right, But
(12:57):
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 and just spends
(13:21):
endless amounts of money because it's other people's money. So
why does the government care?
Speaker 3 (13:26):
Right? And you know, we just have to come.
Speaker 4 (13:31):
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 a thousand decisions that each of
us makes. Right, When am I going to stop working? Well,
(13:54):
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, couple of years with my family or
traveling or whatever it is, right, I mean, 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
(14:17):
the end of my life, or do I want to
move to a house that's more handicap equipped and things.
Speaker 3 (14:21):
Of that sort.
Speaker 4 (14:22):
Right, this is just another decision. 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
(14:44):
is too limited. They don't have access to the counselors
that individuals will talk to when making these kinds of decisions. So,
you know, we just have to get the government out
of this business. What I have proposed is, you know,
there is one other problem though that we haven't discussed,
which we do need to discuss, which is there are
(15:05):
some people who are too poor to afford fundamental health care.
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,
And we're not going to be having sick people dying
in the streets because they can't afford healthcare. So we
need to come up with a way to deal with that.
(15:27):
But the obvious way to deal with that is through
a negative income tax, the sort of thing that Milton
Friedman proposed. You know, 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 is once you give it
to them, it's hands off for the rest of it.
(15:48):
The government doesn't get involved in the delivery of healthcare.
Speaker 3 (15:51):
It just people make.
Speaker 4 (15:52):
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 1 (16:02):
Well, 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 2 (16:17):
But they've got a big screen TV in every.
Speaker 1 (16:19):
Room, and they've gotten, you know, a car they can't
afford that they're driving.
Speaker 2 (16:25):
They end up with the car that they can't afford,
and we end up paying for the healthcare that they
can't afford.
Speaker 1 (16:29):
The book is Overcharged, Why Americans Pay Too Much for Healthcare?
Speaker 2 (16:34):
Professor Charles Silver more and everybody knows who this guy is.
Speaker 4 (16:37):
Come on, man with them, Michael Barry, come on.
Speaker 1 (16:43):
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,
at Austin of Law. And we ended the last segment
with the discussion that at the end of the day,
(17:06):
the allocation of scarce resources and who will make that decision.
We're back at that point again in every family. You know,
you got eight kids and you've got one chicken. Mom
says you're not getting a second piece. So there's some
cartilage left on that leg.
Speaker 2 (17:25):
If you're hungry, you'll eat that.
Speaker 1 (17:28):
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. Will it be the
government or will it be the individual? And if it's
the individual, there will be those who say, well, I
want as much as my neighbor has, Okay, we'll earn
(17:49):
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 more
of me than there are of the rich people I
vote for. I want that well. The only alternative is
for the government to do it. Professor I harkened back
to a study. And it's been a while since I
(18:10):
read this book. It's interesting because I'm a believer and
let the marketplace decide. You know, healthcare is a one
area where we think everybody gets all the healthcare they want,
but we all end up paying for that. 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
(18:31):
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,
and they determined that out of I think it was
three thousand men who had prostate cancer, who were diagnosed
(18:54):
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
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
(19:17):
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
if we don't spend it there, you die. And it
strikes me that while that's the opposite of the capitalist system,
there does need to be an understanding that we're wasting
(19:40):
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 for their license, but God forbid one person not
be diagnosed with glaucoma. We're practicing defensive medicine. We're over
(20:02):
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 what I would consider smart effective healing because
everyone is 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
(20:24):
big portion of what we spend.
Speaker 4 (20:26):
Your thought, well, I'm 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,
(20:50):
the reason that doctors 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 real defensive medicine at all. There
(21:15):
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 services as well as when
(21:36):
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 a very strong desire to
(21:57):
help people.
Speaker 2 (21:58):
Right it should you know?
Speaker 1 (22:00):
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. And exactly self interest drives so many things.
(22:24):
That 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
(22:45):
where you and I can agree.
Speaker 4 (22:48):
I think we do agree on that, but we also
agree that I mean, these social programs have fundamentally undermined
the incentive to say and to be self reliant, you know,
the I think you know, I constantly read articles about
(23:08):
how many people are retiring and all they have to
live on is social security and medicare They don't have
much in the way of savings. And people say, well,
how could you possibly, you know, let that happen?
Speaker 3 (23:21):
Right?
Speaker 4 (23:21):
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 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.
(23:42):
Who wants to save? Saving is boring?
Speaker 3 (23:44):
Right?
Speaker 4 (23:46):
Consuming today is fun? So, you know, I think that
as long as we have these paygo 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,
(24:08):
you know, we're just getting ourselves into this world where
each of us expects everybody else 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 1 (24:26):
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 2 (24:38):
You make them slaves.
Speaker 1 (24:39):
They lose the very abilities, and we've seen with evolutionary
studies that teeth are not as sharp any 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 unders good by people. Our guest
(25:01):
is Professor Charles Silver, who would be with us for
one more segment. The book is Overcharged, Why Americans pay
too much for us that's it.
Speaker 3 (25:11):
Arrest me or take me to Texas. So talking about
to get out of this state.
Speaker 4 (25:16):
I think Michael Barry roths Michael very show.
Speaker 1 (25:19):
I like you. 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.
Speaker 2 (25:34):
The book is.
Speaker 1 (25:35):
Overcharged, why Americans pay too much for healthcare? And folks,
I have to say, as you've heard me say many times,
politics is interesting, 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
(25:56):
winning and your team losing. My primary interest is create
a structure where the individual can thrive, where there is
opportunity and fairness, 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
(26:16):
these sort of policy discussions, I understand are probably less
thrilling than my usual screaming and hollering about this or
that indignity of the day. But this is what matters.
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
(26:39):
the rule of law so that hardworking people can create
enough John Gault style for the rest of us to prosper.
And this stuff matters. So that's why we have these conversations.
Professor Charlesolver, overcharged, why Americans pay too much for healthcare?
Professor Silver, I want you to be king for a day.
Speaker 2 (26:58):
You have no.
Speaker 1 (27:00):
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 healthcare.
Speaker 2 (27:16):
What does that look like?
Speaker 4 (27:20):
Wow, I'm nervous about being king for a day because
I don't believe in kings.
Speaker 2 (27:24):
I know, but I know.
Speaker 3 (27:27):
I'll try.
Speaker 4 (27:29):
I think we basically wipe away everything in terms of
these programs and the restrictive regulations. You know, have you
ever heard of a certificate of need law?
Speaker 3 (27:41):
I don't know.
Speaker 4 (27:41):
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 the hospital, you got
to get permission. Oh okay, I guess what the way
the con laws work. The existing high hospitals have a
vote and whether you can open a new hospital, or
(28:05):
like giving McDonald's a vote on whether Burger King can
open a restaurant right across the street. It just 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,
(28:25):
and I would go to a very simple wealth distribution program.
I'm 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 per you know, per American
(28:48):
through these programs. If we just took some of that
money and started 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
(29:09):
just as much catastrophic insurance as they want. I wouldn't
have coverage mandates. You know, 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
(29:29):
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 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.
Speaker 3 (29:50):
I would let people let.
Speaker 4 (29:51):
Design their own insurance programs. And I think that you know,
it's not going to work perfectly. Nothing ever works perfectly, right,
but it would work so 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
(30:13):
healthcare system. I mean, this terrible murder that just occurred
has brought to the surface the extraordinary hatred that people
have toward insurance companies. You know, that's just one symptom.
We're spending twice as much as any other country on healthcare,
(30:34):
and we're getting less and less.
Speaker 3 (30:35):
Healthy every year.
Speaker 4 (30:37):
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 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.
(31:00):
I said, it's not gonna be perfect, but it'd be
hard to improve on all, right.
Speaker 1 (31:03):
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 2 (31:13):
Our criminal justice system.
Speaker 1 (31:14):
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. And
I think much of that can you can see some
similarities and patterns that pervade those two industries. And by
(31:36):
the way, then we could move over into public education
and education generally I mean, there are a number of
different applications for where this process has gone wrong, and
it is frustrating. I very much appreciate your time, Professor.
I feel the better for it. The book is overcharged
(32:01):
Why Americans pay too much for health care? Professor Charles
Silver of the University of Texas School of Law.
Speaker 3 (32:08):
Thank you, sir, Thank you, Michael Pleasure.
Speaker 1 (32:11):
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, it's
a battle royale, and you know I argued with my
cousin at the Thanksgiving table. At the end of it all,
(32:35):
the reason for the arguments, reason for the elections should
be very redemptive, very practical, not just existential, not just ideological.
Speaker 2 (32:50):
They're real to your.
Speaker 1 (32:51):
Life, and that is creating a governmental system where individuals
are free to thrive. Government is not just. Government is
not merciful. Government is not protective. It is not good.
(33:11):
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 if
you've seen someone 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
(33:33):
to care that they're coming back and adding 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 lead the property vacant, and that's
not good for anybody.
Speaker 2 (33:45):
These are the things that we should spend our time with.
Speaker 1 (33:48):
And I say this because politics has become sport and
it's become for many.
Speaker 2 (33:54):
People their favorite hobby.
Speaker 1 (33:56):
But let's not lose track of what we're trying to
do here, which is literal, not to exaggerate.
Speaker 2 (34:01):
Save our coney well, a gentleman. Ellus has left the building.
Speaker 4 (34:05):
Thank you, and good night.
Speaker 3 (34:10):
H
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