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June 22, 2022

The Cost of Healthcare in America


I want to tell you a story about an average american citizen navigating through our country's health care system. It's not a story of tragedy nor drama, but simply an example of the frustrations that everyday individuals will encounter during our collective quest for good health. This is the story of a close friend of mine. Let's call her kate. During a routine health visit, Kate's primary care physician uncovered a concerning test result. She recommended that kate received further testing immediately to rule out a life threatening medical condition. Instead of saying yes, please refer me to a specialist immediately so I can treat this problem before it progresses.

Kate's first response was what will this testing cost? I don't think I can afford to see a specialist. Now. Kate was lucky enough to have medical insurance through her husband's employer. But like many americans, her family lived on a tight budget and had difficulty managing unexpected expenses. And seeing a medical specialist would potentially be expensive as is so common. Cage insurance plan camp came with a deductible that must be met before the company would put any money at all towards treating that, which is not deemed to be you know, routine or preventative In her case.

As deductible was $2,000, which meant that Kate would be responsible for the entire cost of an office visit. And any subsequent bills she had spent totaling two grand out of pocket. After that, her insurance would pay 80% of her approved medical expenses for the remainder of the year, Only to start Kate back at zero the next year. To mitigate this deductible cost. It was standard practice for Kate and her husband to postpone seeking treatment for any health conditions they felt were non life threatening enough until enough medical emergencies that occurred to eat away at that $2,000 requirement and allow their insurance to kick in.

This was $2,000 each of course. And often their health and problems got pushed aside for years until circumstances caused Kate or her husband to meet their deductible and finally, be in a position. Does he care without taxing their budget to the breaking point? In a case of case need for specialty testing. Her doctor advised her not to wait but being sympathetic to case financial concerns. The doctor offered to do the procedure herself in house as a primary care office visit is generally cheaper than CNN outside specialist. But was the primary care doctor really cheaper.

Kate's finances demanded that she find out for sure. But the answer to this question was far from simple. First, it required asking her doctor for a list of the specific medical codes connected each portion of the procedure she would need. It is typical for one combined medical bill to break down into several codes. For example, a code for a specialist consultation, a code for a doctor's time performing the first step of a procedure. Another code for the second step, a code for the equipment in room being used and a code for the lab that will process the test results.

Armed with three different codes. Kate called her insurance companies helpline to get assistance with finding the lowest prices in her area. After it wasn't in the insurance company's best interest to inform their clients how to spend less on health care. The insurance representative was helpful but taken aback as it was not common to have such conversations with the well informed clients. Most people are unaware of their ability to shop around for medical care. So they simply march in whatever direction they appointed without any further investigation or comparison shopping.

After taking charge of her own health care, Kate was directed to a database where she could input the procedure codes and see the negotiated price is set by insurance providers and clinics with her insurance network. Kate was surprised to find out that the results were not all over the map with no consistency from one clinic to the next. And this is unfortunately by design and sorry and this is. Mhm. As I said, this is a close friend. Um Mhm. Okay. Now the insurance company obviously could see an entirely different set of results based on the plan negotiated between insurer and there are an employer.

This story has a happy ending for Kate. First she found the least expensive doctor to perform her procedure which happened in explicitly to be an award winning specialist in the field and then the test results so that the additional medical concern was only a false remark. Kate was relieved to be declared healthy, but even more relieved that her condition had not led to further testing and procedures. That she would struggle to afford. The biggest cost for kate had been in her time and frustration dealing with the health system. Huh?

That is hold on please. Mhm. Not designed to be user friendly or even make any sense. Many people of course are not so fortunate for others. The cost of medical procedures, life threatening conditions, irrespective the complication of insurance coverage and the myriad of flies. If you want to call them that in America's health care system can lead to great pain, suffering financial ruin and often even death. Remember in the beginning when I said that kate story wasn't tragic and dramatic. Well, I lied fast forward a few years and okay.

Has been diagnosed with a terminal illness that age 47. It was a condition that would have been entirely preventable or treatable had it been caught early. But it went unnoticed because insurance companies have chosen not to cover standard blood tests that will identify people with genetic disorders that drastically increase their odds of developing aggressive forms of cancer. They did the math. And they decided it's cheaper to pay the bills for a few extra cancer patients than to spend money preventatively casting all of their clients. The problem with health care in America stems from a system that treats illness and wellness is just another object of commerce, a service to be marketed, sold and purchased.

It is a system that measures success not by outcomes, but by another metric altogether. Revenue generation. Health care in America in a little over a quarter of a century, has devolved from a once caring endeavor into the most profitable industry in the United States, transformation that by the way, progress sector by sector expanding into what we now know as the medical industrial complex. In centuries past medicine involved in intimate relationship between physicians and the patients that they treated. It was a relationship premised on trust, compassion and ethics that he had.

The principles of do no harm. In a relatively short span of time, the field of medicine has become a highly profitable business. A business riddled with unnecessary middlemen, kickbacks, malicious billing and skyrocketing cost. It is a dangerous and vicious game where industry stakeholders, often with no training in medicine, use fancy business degrees to devise these schemes to generate high profit margins yet substandard care. These schemes involve marking up the price of medical care, then secretly discounting it depending on who is paying two patients. For instance, arriving in the same emergency room with the same symptoms and diagnoses, receiving the same tests and services will be built different amounts depending upon their insurance coverage.

I sonogram of the heart cost anywhere from $1,000 8000. The United States, The 2014 negotiated fixed price in Japan and Belgium Under $150 to fully understand the absurdity of our health care system and the exorbitant cost, we need only compare the cost of care with other developed nations. It is through this analysis that it becomes blatantly obvious that the american health care system is rigged against the patients, turning satan medical attention into this crap shoot with less favorable odds than a las Vegas casino. It's a system that has created its own refugee crisis with a growing population of middle class americans fleeing the United States to avoid the avoid the unbearable and often fatal cost emanating from our for profit health care system.

In her book, an american sickness, Elizabeth Rosenthal documents stories such as a graduate student with diabetes who is searching for academic positions in other countries because even with insurance, she can't afford treatment in the United States or a teacher from Oklahoma who moved to brazil after a cancer scare, made him aware of his financial vulnerability. Then there's the college professor in michigan with a Canadian passport who took his child back to Canada for complex cancer treatment because the cost would have been unsupportable where he works. A professional half german half american family who with mixed emotions, relocated with their three sons of Germany.

After well over a decade of residency in Tucson Arizona because they were worried that they wouldn't be able to afford healthcare and university tuition at the same time in the United States. The honored heritage of public trust that was once the hallmark of medicine has morphed into a complex business model in a fragmented system that generates high profits and great casualties. But beyond the inflated price tags, insurance companies also have the power to decide for patients which services and treatments are and aren't medically necessary. Again, often with no medical training whatsoever, We've all heard stories of americans who are denied the healthcare coverage that they need, but the lesser known flipside is the very common practice of over treating patients.

Many people are being prescribed care that is not only unnecessary, but often puts their health in danger. This travesty begins in the hands of the many players who set the prices for medicine and then extends to the insurance companies who dictate which claims they consider to be valid and finally lands in the labs of doctors who work directly with patients and steer them somewhat blindly towards specific treatments. Well, I assume that most doctors are caring people with a genuine concern for their patients health far too many get corrupted by a system that allows them for easy avenues to pad their own pockets. Today.

The practices of over testing over diagnosing over treating and inappropriate care are now quite commonplace more so in some areas of medicine. One such example is the field of cardiology, most specifically the practice of ballooning and stenting, which involves the insertion of tiny inflatable devices into the arteries to spread open blockages that restrict blood flow. Now it's a life saving intervention that has been around for many decades. But until recently, this procedure was primarily limited to heart vessels. Now this procedure is becoming more routine with the ballooning stenting and lays a ring of harmless plagues and leg arteries becoming a cash cow.

Even a study showed that such stents provide little to no survival benefit. In 2014, a $37 million Dr Mark, a Baltimore cardiologist stands accused of allegedly placing unnecessary stents in as many as 273 patients to receive payments of over $100,000 per procedure. Dr. McKay's medical practice medical license was revoked in 2011, but he's by no means an outlier. Perhaps what is most alarming is how some physicians are recruiting their patients since few patients after all even know about these procedures, let alone decide to book them to have screening that measures the blood circulation in their legs.

Some medical professionals will attend community health fairs and perform predatory screenings, resulting in referrals for these unnecessary procedures, patients are told these stents will improve their circulation or even prevent an amputation of the limb in the future, tactics of horse meant to scare patients into receiving care that serves only to improve the provider's bottom line. This isn't practicing medicine, it's prospecting. One study reported More than 1100 churches, synagogues and mosques in the United States alone served as these vascular screening centers. Despite a scientific consensus that people should not be screened in this way.

In an anonymous survey sampling of 3000 physicians across the country, Doctors responded that they believe 21% of everything done in medicine, it's unnecessary. Broken down. Physicians estimated that 22% of all prescription medications, 25% of all medical tests and 11% of procedures are unnecessary. The aforementioned stenting of leg arteries can generate $100,000 in a single day. While a physician performing cancer surgery only earns around 2000. So it's easy to see why some greedy medical professionals might focus their time and energy and providing care that doesn't actually help patients. Our for profit medical system incentivizes certain types of care over others, regardless of whether the patients need the treatments or procedures.

Consider another example. At least three trials have been published in top medical journals showing that treating appendicitis with antibiotics instead of surgery works, 75% of the time, with no increased risk to patients. And yet there are over 300,000 appendectomies performed every year. Each with a substantial price tag and whether patients choose antibiotics over surgery. Well, that largely depends on the way they're surgeons present these options. While there's much blame to assign from unscrupulous medical professionals. The greedy pharmaceutical industry and the feckless politicians who are more loyal to their donors than their constituents that they are elected to serve.

We too as patients and citizens bear some of the blame. We have become far too complacent left. Entrapped by a state of helplessness. It's time to use our voices and our votes to take a stand. We need to embark upon a new age of empathy where America's medical system ignores profit in favor of honest and genuine health care for its citizens and that my friends is the last word up front. I'm sean ST hart and you're watching ku save America stay tuned. We've got a great show as we continue this conversation about the cost of health care with our returning guest Don Lemon who is also known as the health care voice.

We'll be right back. The U. S. Supreme Court ruled recently on the government's use of the state secrets doctrine in an opinion that will make it easier for intelligence agencies to evade accountability in future individual rights cases. The case involves a detainee at the Guantanamo Guantanamo Bay who was subjected to numerous acts of torture at the C. I. A black site. The detainee had filed a request for information related to his treatment, a request that was of course denied to his legal team under the guise of protecting national security.

Seven members of the court joined parts with an opinion siding with the government. We're the only justice. Sotomayor and gorsuch dissenting the case has implications for other torture related cases and for government accountability more broadly as it expands state secrecy to powers based on a doctrine that was already overbroad, Overbroad and suspect in its origins. In the course of seeking the tribunal that would hear his claims, nobody asked the polish government to investigate the criminality of interrogations that took place at the C. I. A. Black site in Poland stare padecky.

Probably not saying that since much of the supporting evidence was located in the United States, Zambada Zubaydah had to petition a US District Court for an order compelling its production. Federal law allows for such a petition, but when it was filed, the U. S. Government objected, citing the state's secrets doctrine. The case worked its way after the Supreme Court and the court ruled for the first time in years on the scope and application of the doctrine now in related news privacy advocates are sounding the alarm after a draft opinion leaked from the U. S. Supreme Court suggesting the court is of course set to overturn the landmark roe v wade case legalizing abortion.

Now in seeking to further understand how this ruling might impact americans. A new report from the surveillance technology oversight project known by the acronym Stop lays out the many ways police prosecutors and private litigants will be able to utilize the existing surveillance infrastructure currently in use as a mechanism for tracking and enforcing state abortion bans. None of the tactics we will see used to target pregnant people will be new, says Albert Foxconn, executive director of stock. The surveillance technology oversight project. He continues, we've seen the same surveillance techniques developed in the name of immigration enforcement, national security, combating drugs and so many other law enforcement priorities that go way beyond what they were intended.

And the truth is that when you develop those techniques, you're at the whim of those in power and whatever they next decide to call a crime stop believes that the most likely abuse practice used to combat potential abortions would be something called a Geo fence warrant. Now this is when a law enforcement agency request bulk data from cellular devices that are based on your location during a set date and time. Thanks to how online technologies collect massive amounts of data about consumers. The data of turn obtained from a geo fence warrant could easily lead investigators to surveil woman who may be seeking or may have gotten an abortion despite no longer having a federal recognized right to terminate a pregnancy.

In addition, the surveillance technology oversight project warns us that pro choice states should be concerned about their participation in federal data sharing initiatives that allow multiple law enforcement departments to enter and share information into nationwide databases. Obviously, this sort of corporation is beneficial in many ways, for example, providing a greater ability to recognize murder patterns and catch serial killers, including combat terrorism. But these same data sharing services could be expanded to monitor and investigate reproductive care workers and people who are pregnant. It could become a similar situation to the controversial policing practices of the U. S. Immigration and customs enforcement agency and their newfound and legendary abilities to track and deport undocumented residents using these data collection and sharing schemes.

Stop also warns us that law enforcement agents have even stooped so low as to create fake social media accounts that trick people into revealing their interest or intentions. And this is another tactic that can be used to target women and assist with abortion investigations. The stop research um shows that while individuals can take steps to protect themselves and their data from prying eyes, structural change and legislation is still needed to shield less informed citizens on a broader basis for more information on how you can protect your privacy.

Please visit the surveillance technology oversight project via their website at stop spying dot org. That's stop spying dot org. And this wraps up this week's news that wasn't in the news briefing. We're gonna be bringing in our returning guest Don Lemon to continue our conversation about America's health care crisis. Uh first I've been getting a lot of questions about what I'm wearing and since close doesn't seem to be a satisfying answer to most people. I want to give a shout out tax a. S. O. S. The official attire of crusade America.

Uh ASOS has an amazing selection of clothing for both men and women, so please check them out at a S. O. S. Dot com. Finally I want to just give a shout out to my mother, Kathy Abbott, she's watching in Bangor Maine and I also want to wish my father and all fathers a happy father's Day, we're gonna take a really quick break and then we're gonna be back with dan Letterman, we'll be right back. Mhm. Okay, let's bring in our good friend Dan Lemon, he's the healthcare voice.

How are you today? Well, you know, I've been texting a little bit with your, I'm good, thank you and I hope you're better. Uh I was texting a little bit with your producer, I know that you accidentally called me Don and actually I wish I had a twin brother, we would have got along great dan and down, I'm sorry for that, I'm probably getting your last name, but if I can't make fun with you, I don't know who could, so, so Mhm. I'm I'm a little furious obviously in my monologue and was talking about a good friend of mine and I was there with you by the way and I can't imagine uh you know, doing a live tape, you know, monologue and then all of a sudden, you know, kind of being overwhelmed with a lot of feelings including warmth and love caring and we've all been there and uh we have sometimes these unexpected and unanticipated many meltdowns either under the best or worst of circumstances I'll just share with you that and then I'll sum it up.

I've been there as well. Thank you. Yeah. You know, I obviously worked on this monologue and I, mm hmm. So I knew what, what, what it was, it just, it, you know, very emotional because this is someone that I care very deeply about and there's, and I can also imagine all of the other people out there that go through the same nonsense every day in this country. And it, it really comes down two, these corporations that are deciding that it's more profitable for them two basically. How is it really not murder, right?

They know what they're doing when they deny care and impose these ridiculous loopholes that people have to jump through. I mean they know what's killing people, correct. Well, you have to ah, okay. You have to make an assumption that what you're talking about would pertain to people with what's a historically known as conscience. And then I'll add onto that some other, you know, very common words, integrity, human dignity, empathy. Uh, the list is short, but I think we all know what those words are and I'll even throw in the m word morality.

So, uh, you ain't you say? Well, you're really saying, well, people that actually make decisions like that, that are predictably or statistically going to have a bad outcome with say a certain percentage, clearly not everybody. And how do they go to sleep at night? What, you know, I'm going to put on these other headphones here because I'm having a hard time hearing you. Well, that's interesting because, uh, I was having a little difficulty hearing you, but then you got louder and we're good. Now. I can actually make an effort to speak louder if that helps.

Oh no, it's, it's, I can hear you perfectly now. I just had a different set of ears. So yeah. Um, you know, there's, there's different degrees of murder all the way from first degree to ah, you know, whatever the courts say, second degree, third degree, voluntary involuntary collateral damage, you know, uh, and this hasn't been going on, You know, just recently. This has just been building up as we've talked about before since 1970 for when it became legal to make a profit or any kind of profit as we see today off of the backs of accidents, illnesses, diseases and so on and so forth.

So, uh, we identified the last time that you and I were together that profit over people in the healthcare landscape of America with the huge corporations that are beholden to their stockholders and that includes hospitals, that includes medical device corporations and then the pharmaceuticals. So, you know, last week we had a gentleman who is the author of a book who was talking about just corporations, um, in general. I'm glad you brought him up today. And yeah, it was fascinating at how corporations have amassed so much power compared to what it used to be.

And that's just something that we're talking about here too, is in health care, a handful of corporations. And again, let's as well as you and I discussed, um, these companies that, that, you know, the argument for instance, against Medicare for all is, oh, well, you know, the pharmaceutical companies, you know, they need to make the profit otherwise they can't innovate or um, but that argument falls flat when you look at what other other countries are doing and also what people don't understand is a lot of the technology.

This, including pharmaceuticals, including vaccines. Um, they're fighting with tax funds. They're highly incentivized with tax funds. So we're kind of paying twice for many of these medical interventions. Um, so, and it should not be about profits. That's not what health care is. That's not, you know, I mean, like the cardiologist that I was talking about, who's going to these churches and synagogues, right, preying on people, these health fairs and saying, hey, you know, even though, well, of course they're not saying that there's no scientific evidence for this, but they're like, hey, you should, we should do the screening because it might prevent you from having to have a leg amputated in the future.

Well, when somebody hears that, of course, they're gonna want that screening and when that screening, of course comes back and says, you know, you really ought to have this procedure. And if it's if it's a procedure that the concern and that's that's what I wanted to ask. Why. Why would it be so easy? I mean, for like these tintin ballooning, why would insurance companies be so eager to pay for that? Especially when there's no scientific evidence to support that it's beneficial. And yet there's other things where they won't pay.

I don't understand that. It wouldn't it be kind of like, hey, we're not going to pay for anything that we don't have to. Well, I'm gonna answer your question uh a little perhaps unexpected or a little sideways. But first of all, let me talk about the uh, the screenings, uh, in the churches and the synagogues and so on and so forth. And uh at times, I don't know what the numbers are praying if you will and the fears of people. Well, that's just, you know, that's that's just it's just predatory, parasitic uh health care when the example that you gave or examples arise.

However, uh, I don't know what percentage of these screenings that you talk about are done to the the most ugly extent that you bring up. But let me say a couple of things as I organized my thoughts, I think health care, the concept of mass or large numbers of health care screenings, whether it be in churches, synagogues, nursing homes, assisted living and so on and so forth. The concept of preventative health in our country is a fantastic concept. And in fact, I thoroughly having, having worked in health care for a long time and having been a patient myself as we all have uh with with one thing or another, I fully support healthcare screenings.

I just happened to just for educational purposes, I drew up a little list of appropriate health care screenings, but then I'm gonna add where it can and does go sour. Okay. We have, for instance, today one of the highest incidences of colorectal cancer In young and people in their 40s. Now those who are in the know or who think they're in the know, and I'm I'm both These higher incidences of colorectal cancer and people now in their 40's are due to what's going into our bodies. There's no ifs ands or buts about it, plastic chemicals, you know, whatever.

Okay, so we're not going to change the nutritional food chain on this show. But doing preventative tests, I'll be silly ish and talk about the poop on the popsicle stick test. Let's see if there's any microscopic blood in a person's poop do it because colon cancer, you know, if it's gone too far, it's not a good outcome, it's really not a good outcome, you know, and I've met a lot of people with not good outcomes. And then my own stepbrother who didn't pay attention to regular abdominal pains and maybe some dark stool Died of colon cancer in his 40s, you know, maybe 20 plus years ago.

So let me move right along after colon cancer screening, breast cancer screenings, mammograms. You know, there's a great debate in our country about well how old should a woman be when a woman should have a routine mammogram? And I'm not gonna claim to be the expert on that. I'll let people talk to their doctors, they're nurse practitioners, they're physician assistants etcetera and find out what's good for them in terms of family history and so on and so forth. And by the way, there are some excellent articles out there that that do talk about if there is something visible in a routine mastectomy, it may not have to lead to an aggressive surgery, a mastectomy.

My my bad uh there sometimes is a wait and see kind of approach for some women, but you have to go to a trusted healthcare provider to make those decisions. Yeah, I've I've certainly read a number of those articles on the controversy as to when when to get those screens and we're not too. Um And what I kind of found fascinating about that is that a lot of times these vasectomies are themselves um performed sort of you know, unnecessarily. Um Right, and then there is the double mastectomy that is done prophylactically or preventatively when women have been identified as through genetic testing, that the probability of developing breast cancer and that's without any metastatic lymph node involvement.

Uh women are having double mastectomies because they saw what happened to their mother, their aunt, their sister. So again, it comes down to what you were talking about how health care used to be and still can be by the way. You know, we can't scare everybody away when you have a trusted healthcare provider based upon all the, you know, variables that can be involved with that. Uh then chances are that they do no harm. You have much greater odds of that. And I don't want to take up a lot of time anymore about the screenings, but again, cervical cancer screening very important for women.

I just want to add to on on breast cancer that and a lot of people might be surprised to hear this. But men can get breast cancer as well. Absolutely. Thanks for bringing that up and and test test to testicular cancer as well. Is another thing that that doesn't get a lot of screenings. That's a good point. I appreciate your your you're adding on to that. You know, we talked about in our health care system of infant mortality in our country versus other countries and you know, we have nothing, you know, to be proud of with our infant mortality rate, especially with the minority people.

So, again, in terms of screenings to improve upon those statistics. Uh you can have the screenings of pregnant women uh hepatitis B as an example uh and other high risk medical background problems. Then just to move along quickly. Diabetic screenings, especially for people who for whatever reason are either overweight or very over week or have what's known as morbid obesity. Um People again, screenings for people that have smoked or do smoke, But especially for people that have smoked with the history, even if they haven't smoked in 15, 20 years, there are there's a diagnostic test available for having an abdominal aneurysm.

Oh, where is there? Yes, there is. And uh and then by the way, there are some pretty sophisticated tests for ex smokers to do a chest x ray. That is a way above and beyond the technology of going to a place that um can do a routine test X ray, which they're rarely done now. But that technology is there. So let's go back to the synagogues, the churches assisted and doing the routine screenings. Because these topics are near and dear to my heart for for many reasons.

They're they're great. It's the problem. And by the way, I want to talk about the heart stents and I have no problem in sharing with you and the public. I have four stents in my heart. Okay, well, let me I probably didn't clarify this. These are not the heart stents. These are it's in the leg in the legs, right? And so fine. So now everybody knows I've got four stents in my heart and I'm 75 years old and here I am. You know, the, the heart stents are that that's a proven science, however, are good.

Although I have to tell you because I worked in health care when I had was having pains and you know, and I have to admit, I'm probably more sophisticated than a lot of people because I've worked in healthcare, but I've met a lot of health care providers who have others who have had other health care providers and they make mistakes, not on purpose, but, you know, so it's a different culture, but in the system provides for those mistakes that happen. I mean, you've got doctors that are overworked, you've got doctors that themselves system exactly what's the number one cause of it?

I mean, hospitals, you know, are the number one cause of death. Not that if you need to be, I'm just saying it's because they're overworked, do more with less. That's how all these medical errors take place. They've happened to me, by the way, and they happened to almost everybody in my inner circle. So it's not like, oh, these are outliers. No, it's happening everywhere. So, thanks again for, okay, So the heart stands behind the leg stance. All right. So, look, um, personally, I had pain in my calves.

I had pain in my eyes. Uh, I have a stent in each kidney. So I could have circulatory problems because why I'm a type two diabetic. I have hypertension. So actually I, I decided that, uh, I think I should have what's known as the Doppler. And sure enough, I have some issues, circulatory issues. However, I'm in good hands. Nobody's gonna say in fact, they have said, well now we're just gonna maybe we'll do this test every three years to see if there is a possibility that you might, but, but to scare people and tell them everything that you were talking about, it's tragic.

It's just beyond tragic. And here's where I was going at the beginning of my spiel here, screenings are excellent. It's when after the screenings, people take purposeful advantage of the screening and turn a small problem or no problem into a small problem. Or take a small problem and turn it into a large problem. And that the only incentive to do that is financial. That is tragic. And uh, so we'll go back to how do people sleep at night when they do that, You know, uh, having profits over people?

Well, that's a big, that's a big problem. Uh, problem is not even the big enough work. The last time I was with you, I shockingly said to myself and your audience, Medicare is built per year, approximately $60 billion dollars a year. We don't talk about about that. We could talk about waste. We can buy that wings is like overkill because of what, what we're talking about. And that are, that is two double physicians, they're extremely fearful of litigation. And so that's why we've seen over the years more and more aggressive and sometimes invasive procedures so that a mistake isn't made so that they don't get sue and it looks bad on their report card.

So then it gets balanced by. You have a lot of people who Over the last 10, 15, 20 years have made a career of seeing to it, that legitimate litigation over wrongful deaths, uh, huge mistakes in medicine. There has been caps put on how much now certain people, patients can receive for what you would call a legitimate sum of money in terms of, well, how much does a person's life work? What if they lost 20 years of salary? Uh, not do so much to, you know, you, the balance of this is philosophical human error versus just like, well, you're doing too much too fast too soon and why are you doing too much too fast or not doing, you know, because you're driven by your salary, I'm as frustrated as every other person that's listening to this, uh, as it can possibly be.

And you know, whenever you, whenever you talk with anybody who's worked in healthcare, you all, you always have to think about something. Do they work for a hospital? Do they work for a nursing home, etcetera? And the secrets? You know, you try and go through channels in a medical institution to solve problems. And sometimes what happens is if you don't go along to get along, you're a troublemaker and you get blackballed, not necessarily by being a whistleblower or a quasi whistleblower, which by the way, I would do it again.

I was at the V. A medical center where really bizarre things were going on and I didn't look for them. They were just like in front of my computer, just like you and me. And I just wasn't the type of person to sit back and say nothing. And when I did try and talk to channels, it went nowhere. I don't encourage people to be whistleblowers or quasi whistleblowers. I'm just saying that in medical centers and hospitals when mistakes are made. Yeah, it can be an educational process for learning or you just want to run out the door and say, I wish I never came to work today because of what I've seen and witness.

Short story, there's a tremendous crisis in labor in our country and it's not always about what we're not getting enough money. You can't find enough pilots. They earn a decent living. They knew years ago there was going to be a shortage of pilots. And then covid came. So now you see the news, everything that's going on at the airport. Same in hospitals with all the nurses that are burnt out and doctors too doctors too. Yes. Yes. And housekeeping. You have all these layers of people that form a system.

You know. So I had a friend recently that had a mild heart attack. This room wasn't cleaned up for three days and this is enough pretty, you know, allegedly good hospital mm. They changed his garbage pail once in three days. But the shades the floors and by the way I was discussing this with a physician, they can do something about that if they, if they wanted to because the hospitals are Medicare certified. You don't want to have infection control problems and be fined. It's avoidable. It has something to do with the concept of bottom line and do more with less, yep.

You know, if I were, if I were employing a little pat on the back for housekeeping, You know what you want to work in a hospital for $11 an hour, $14 an hour with a family of three. Doing wonderful work, keeping the room clean that you're sick in and recovering from surgery. Maybe they should, maybe they should raise the wages for housekeepers. I'm sorry, I'm laughing. But you know, you know, my personality, you know, to these things too. It's insane because um, well now I imagine part of the other problem and that kind of goes back to what I said to my mom like you, you've got people running hospitals.

They're not trained in medicine. They're trained in economics or often cases business management degrees and hey, that's great. But nothing against N. B. A. S. And all that. But when you run in a hospital, it you would think that you would be required to have at least some education in medicine to be able to make those decisions and and and and and you know way those risk factors. But again, it's becoming more and more of a business and very few doctors and nurses actually even work for hospitals anymore.

It's all contracted out. Yeah, I know. But we've seen it with Covid is that um, there are nurses now that weren't treated very nice at the hospitals that they were employed by and they got burnt out. And all of a sudden they're doing exactly what you're talking about. But it's caused a tremendous problem. You have traveling nurses Who are, this is not an exaggeration. They're making $200 an hour. And our registered nurses, of course, you know, you go in and uh Every, you know, every time you're in bed for 24 hours, you have a different nurse, they are expected to know exactly what's going on that they're expected to read your medical chart and and so you wonder, well, well, why are they, why are there so many medical errors?

Well, I said the last time I was with you, we can have the best health care system in the world. We got to the moon. But if you're gonna put money, you don't really get to the moon. Well, maybe the earth is flat. I don't know until I see a picture from out of space that I'm gonna go with flat weight. All right. So, we got to the why? Because we put our mind to it. And if we put a it's not gonna happen in my lifetime.

But if we put our mind to it to have the best health care system in the world, I'm telling you, we could we just, you know, we just you you yourself had brought up something which I really wanted to bring back. You know, if we took the best people from the countries, the industrialized nations in the world who have, you know, single payer health care or close to it. You know, whatever. We took the best from Canada Germany uh the Scandinavian countries. And you know, I had a task force, a real task force.

You know, we could do it. The problem is I think I sent you an article that there's so much money spent on health care That people are 2. 2 things are afraid of what we can't have Medicare for all tomorrow because we don't have the staff for it. I mean the system would be flooded and then you think medical errors are big now. So that's a real issue. But But we saw the writing on the wall 25 years ago, we just decided like global warming. Well, maybe another time or maybe when the economy is better.

We could have more social pro programs, you know, uh, it's, it's very sad. What would you like to ask me today before, before I run out of words, I've done a lot of, I've read several books about our health care system and a couple were dedicated and focused primarily on the affordable care Act and I didn't like, by the way, no, me neither now. And the more that I've learned about this and, and here's what, what surprises me, the narrative that we were sold as the american people or the belief was that the insurance companies and big pharma and all of these various, you know, sectors were opposed to the affordable care act that they fought tooth and nail against it, but the reality is, that's not the case at all.

They were heavily involved in it. They were, um, I remember and one of these books was written from someone that was actually inside the Obama campaign. So this is not a right wing, you know, Republican, that's just, you know, wants to make a fuss about it. And he was talking about this, this how it was orchestrated where there was going to even be these oppositional commercials that were aired, these public service announcements and the Obama administration and the insurance companies were both working together like, okay, well, we're going to say that we hate this about Obamacare and then you're going to target us.

I mean, it's insane how orchestrated this was and you know, the idea that, I mean, I take issue with the affordable Care Act just being called affordable, which is just not the case at all. Um, now look, it's done a lot of good in many areas, um, but um, it hasn't solved any of the core problems that it was meant to now sure there are more people insured, but what people have to understand is like with my friend being insured means nothing if you can't use the insurance that you have or you can't afford the insurance that you have and a lot of people are paying, what was it like?

Something like um, and I mentioned when we talked before, I forget the statistic, but it was something like, I think it was over 30 of people's household budget has to be put aside just for health insurance and health expenses in this country and that is, yeah, that, that's not every family, but obviously so and the affordable Care Act, of course we've seen is, um, you know, it's just incredible to me how there was no sincere effort really made with the affordable Care Act to actually bring forth a system.

It was, it really was just a financial handout to the, to the very industries that were supposed to be protected from, you've made your, you've made your case. Well, I was hoping that you'd say I was wrong and that everything's gonna be okay. No, I didn't, you know, the, the and he has done great things for, you know, a lot of people. But I for whatever reason, I saw the writing on the wall and I don't even know how bad it was going to be. But, you know, I've seen people that, you know, They wanted to buy into it, but it was $5, a month that, you know, they didn't have and uh, you know, rent and, and so on and so forth.

Uh, the, the Our government spends 24% of its money right now on, on health health care. That that that's a huge amount of money. People consumers, they spend A very large 8. 1% of their money. Well now think about that 88%. Well, if you're, Let's just say, you know, I'm just throwing this out. Let's say you're, you're a family of four and your income is $40,000 a year. uh, not 8% might have to go towards health care. Um, What? So, back to what we're talking about, our country spends more money on healthcare than any other industrial country in the world.

And if, and to add insult to injury, we don't have better outcomes. No, not at all. I mean, in certain select, you know what we have is, I mean, we truly have a caste system in health care and it's not just the haves and the have nots. It's it's the very house and the and the very have nots. And then that is a huge like different planets in terms of, uh, access to affordable quality health care and then everybody in the middle. So here, here's what's always troubled me for the last couple of decades and it's not going to go away.

You're sophisticated enough. Your friends are sophisticated enough. I am my family, my friends that we can somehow, through luck, skill education, you know, we're able to kind of navigate a little bit better than a lot of people. That's assuming we all have our marbles. We don't mean to be rude, But there's seriously, there's so many people, they don't have the skills. They don't, they don't have anybody talking for them, advocating for them. And because when folks who are privileged to have better health care, better access to health care, better quality to health care now, all those things are being suppressed because of what's happened recently with Covid and the system has just gone haywire.

Plus the corporations want to continue to make as much money. Yeah, that's more. But for people that, you know, uh, don't have this, this, the skills, the education or whatever they, they are the most vulnerable. And if, and if you, you know, even have mild cognitive impairment, we, and you just very mildly have difficulty in making decisions and doing problem solving And say you're 65, 70 years old and you're kind of, you know, don't have a big, very good support system. Well, you know, there's really tens of millions of people like that in our country and they can easily be taken advantage of by I hate to use the words the predatory, parasitic health care components that exist in the United States.

It's not pervasive. Mm, But $60 billion dollars in Medicare, you know, what, where did that come from? All right. Yeah. No. And okay, so there was a study recently and there's been several of these, but I think latest number is that something if we had Medicare for all During the COVID pandemic, something like 300,000 lives Would be would have been saved. 340 340. Now, I I would argue that that number is actually larger. I've seen other studies because I mean, we're forgetting that there's a lot of other components to To healthcare.

Um, so I'd be a little bit more broad in my assessment, but let's just go with a 340,000 figure. Um, part of the argument and part of the problem, I think with Obamacare is that a lot of people have, again, they're not, you know, you look at the mainstream media and you see a great deal of lauding of the affordable care act. I mean, you have, you know, and so people are convinced, like when you hear political politicians talk about it, for instance, like Hillary Clinton's thing was no, no, no Medicare for all that's never gonna happen.

But we should build on the affordable care act. And how realistic is that? Because and what would that look like? And and are they being, I don't believe that that Hillary Clinton or these other politicians are sincere in their effort to get us through a Medicare for all system. Just talk about all this incremental, you know, we have to build towards it. I just don't believe that they're sincere about that. Well, there's there's nobody that I know of in the political arena other than Bernie who I'm just gonna say that, you know, Bernie was my guy in terms of health care.

However, I would have appreciated as many people might have if he had said that we can have the best publicly publicly and public and corporate funded health care system in the world. Because as soon as you start tossing around the word free when people would say, wait, wait, it's not break. Somebody's gotta pay for. Well, it's true. So, okay. All right, I got that off my chest. Thank you. But there's no, there's nobody today that it's now the political look Hillary as we know there was a time when she really, and I think she was sincere about having a single payer healthcare system and she didn't.

Okay, So she didn't get burned over trying to pursue that. She got scorched, She didn't get baked. She got fried. She hit the third rail of donors, corporate donors, pharmaceutical donors that there was a wave of tsunami money up against her and she turned her, she turned her story over and a dime. And so you see all these people that showed up all the people that showed up at Bernie Sanders, you know, events throughout. Just a few people, pardon just a few people, not nothing that filled up stadiums of people or just a few people sort of, you know, I can make another joke now about who said they had a big crowd.

Yes, I know that you know that, that, that I have to say in in both 2016 and 2020. Um, you looked at that and you're like, wow things are really, I mean you couldn't help but be inspired. It was like I had never seen crowds like that turn out for a politician and yet somehow, what do I hear now? I mean, it's it's so ironic out here like, well yeah, but look at their age. So yeah, look at their age and look what's resonating in their brains and so money may not be the route of all evil love of money may not, but money is the problem.

I mean there's just everybody knows it's just like, you know when they say that you, you can't squeeze blood out of a turnip. Well somehow somewhere there's a metaphor there about health care that I'm not even clear about myself, but, but this is part of the problem with preventative health care as well. I mean, um, you know, I've, I've heard stories of people that for instance, with breast cancer, um, there's a patient that I read about who, who knew she had, she felt a lump, She had a family history of breast cancer.

She knew, and she knew that if she went to the doctor and she, this is a black woman of, she had insurance, but she put it off and put it off because she to her it was a death sentence and she couldn't take time off and eventually it got too late and it became sharmila, she died from, from this. And you hear these stories of people like I'm afraid to get even the preventative testing because I know that I can't afford to do anything about it. So it's better just to not know because I'm not gonna be able to afford to have the treatment.

There's kind of like indirectly getting to a point I made earlier that there wasn't enough people in her life to perhaps introduce her to some community resource center maybe funded by whoever two, you know, there are, you know, it's a double edged sword, we want, we want to see a single payer healthcare system that takes care of, let's just say almost everybody. But um, it's then you, we have all these tremendous nonprofits out there, all competing for fundraising and, and you know, who, who would not there.

But, but then, you know, about two years ago, I actually saw a registered nurse who worked in administration and she suggested that the woman that was just recently discharged from the hospital with a humongous medical bill started a Go fund Me, This is from an administrator of the hospital a Go Fund Me account. You know, sometimes, you know, I, there's there's a place for them. But sometimes I just feel like saying, well, what I would have told her, why don't you go start and go? You know what account?

Yeah, I'm sorry. You know, but you know, you see all of these GoFundMe campaigns and you've got and you've got these basically sad stories competing against sad stories and some corporate America loves that. Oh yeah. They considering these feel good stories, they're not, they're not feel good stories. I mean, the Girl Scout that had to go and and do her own bake sale because she, you know, wanted cancer treatment. That's not a heartwarming story the way the news, you know, you know, I'm like, you, anybody wants to practice whatever religion they want to believe in whatever they wanted.

You know, who cares? We look at people's behaviors. That's, you know, that that's, you know, and so no disrespect. I have a, a close acquaintance in another state who joined a, a religious health care insurance company funded by his religion, unfortunately, they had a stipulation and they still do well, if you had a pre existing medical condition, you can't come to us really? Okay. Yeah, there's well, and that was part of Obamacare as well, is that they were going to do enhance funding and this just never really came about.

They did the initial funding for it, but they didn't continue the funding, but it was for these medical co ops, which is just, I mean, another form of insurance that's, I guess supposed to be kind of trendy kind of like what you're talking about. It's just co op where and a lot of religions were involved in these co ops because part of it was that there was these objections like religious hospitals and stuff were saying, yeah, but you know, we don't, there's certain things we don't want to cover that we would be forced to cover under the Affordable Care Act.

And so what if we just use our religious exemptions and we'll start these little co ops that people can buy into. Um, which again, is basically just insurance. But, and a lot of them fell, they failed after the first few years. But um, um, same thing, you know, these and let's just be clear, the affordable Care Act may require insurance companies to cover you, even though you have pre existing conditions, it does not guarantee you're going to get treatment for those pre existing conditions. Um, that is a whole different story altogether.

Um, and you see a lot of insurance companies playing games with this was like, you know, we'll cover the pre existing condition, but it's still gonna cost you. And they, one thing that I found and this goes to this point, insurance companies will often go through loopholes, even though they're required to cover something, they will put doctors and patients through hell like, oh well we need to get a pre authorization and then of course they'll make little mistakes like, oh, you know, we we forgot to file this or that.

And what they're really doing is they're trying to run the game out because they're hoping that the patient dies before they actually have to come through with with, you know, the care, I mean, so eventually if you live long enough they'll eventually cover whatever. But they're planning on the fact that they're going to run out the clock on the patient. And this seems to be an increasing scheme that's being used. And again, that's where I went back to earlier when I asked you to me, I don't see how that's not murder because they know what they're doing.

It's intentional strategy. I mean, they're they're denying patients the care that they need just saying, well, if we wait long enough they'll die or if we wait long enough, the disease will progress to the point where the treatment that they want us to cover is no longer viable. So uh you have, what you're talking about is uh really, it's just human saturday, you have lower level employees falling in line with decisions that were made higher up the food chain, supported by other people higher up the food chain.

And um, and you know, it's it's kind of like um you saw one of these movies where maybe in Nevada, they had access, you know, to the joystick with the drone in another country and their ex, you know, ex you know, exploding it and, you know, collateral damage. And, you know, and of course some of these people that did that, you know, they did eventually go, gee doesn't feel very good to be doing that. But um, to deny purposely to deny access to quality and timely health care, strictly on the basis of, let's see if we can play this out and save a little money, what other what other better definition is there in terms of evil?

I'm just, I'm not saying necessarily from a religious standpoint, but I mean, it seems like a good word. You know, I've thrown out the words, uh, a lot, I have to think about it when I do it now. You know, people with sociopathic and psychopathic personality disorders, these might be the same people high up in the food chain, who who because of having either an average or better than average IQ. But if they have these personality traits or tendencies or disorders, as I just mentioned, you can be very successful with this personality disorder traits.

So then you have the people that are following orders underneath them and there's no rhyme or reason. But if your work dependent, I'm not making excuses. No, I get what you're saying though. If your work dependent, your, your spouses at home disabled, you've got kids to feed, you've got this expense, that expense. If somebody says to you, you know, well, let's, let's, you know, your, your job is to be the gatekeeper. I guess you get just like desensitized for lack of a better word, you become immune between what's going on in your brain and what's going on in your heart.

What's, you know, some sense of empathy for damages that you're causing other people, not only physically but emotionally. I mean, what a strange world we've become. You know, it reminds me, um back when I was younger in California, one of the first jobs I ended up having um was a telemarketing job and it was at this place that was selling this, um, you know, all this way that you can buy this list to get properties that you can get for cheap. You know, um, I had, I think I only lasted a job a few weeks because, but what really got me was a woman called and she was telling me her story and of course we were supposed to follow a script, right?

And so this woman is telling me this story, she's like I'm calling you from a pay phone and you know, I am on disability, I'm living in this group home and I'm willing to literally she was telling me that she was willing to almost become homeless to be able to afford this and I couldn't do it. I I just went off script and I and I was I was trying everything I could to talk her out of it without making it seem like I was trying to talk her out of it because he's called monitored and I'm like, oh my God, when my you know, but I did not want her doing this and it just I couldn't do it.

It just didn't matter to me, I'm like no I can't do that. So it's hard to understand how and and that's just with somebody that no. So now my supervisor later said, well how do you know that this woman wouldn't have, maybe maybe she would have gone homeless for a little bit, but she has this list, which I thought was absurd because if you're homeless, I don't know what good this list is gonna do and obviously you're not gonna be able to buy properties if you don't.

But his rationale for it was well, but this woman might buy the list and she might buy some of these properties really cheap and next thing you know, she might be doing really well for herself and you know, but you kind of talking a lot of it you've just destroyed your life and I thought that is the most absurd thing but I assume that this is how people rationalize it. They don't know how that would work in healthcare context where it was like well I mean I suppose maybe if you're super religious and you're like hey this person's gonna get to see God soon maybe that but sorry listen I've been there but well first of all this isn't a side.

I I sold magazines on the telephone and and that was fine. So but okay so imagine if you will I mean imagine if you will you know working in a medical center and you know that an organization called the Joint Commission on Hospital accreditation is coming in, imagine if you will you work for a federal facility and somebody's coming in from the Inspector general's office, oh imagine somebody's coming in from the G. A. O. Government. You know how they and imagine the audacity of supervisors, you know talking to their people that they supervise and say well now we we can't have anybody you know talking doing complaints.

You know we don't want to lose our accreditation. Okay guess what this goes on. So you know it's you can't you can't complain to anybody for you know because if chances are if you wanted to complain to an accrediting agency about something that everybody knows about. Very few people are talking about or they're talking a lot about it, but they're afraid that, you know, they're not going to get their promotion or whatever. Um, this, this is what, what, what more in terms of health care, what, what more do we need to know that there's a crisis in reality.

There's a crisis and ethics, there's a crisis and integrity and it's not over, you know, how much a shoe costs that's manufactured In the United States and somebody may be making $18 an hour making shoes okay. We're talking about people's health care, We're talking about do no harm. And chances are if people are telling you that at a meeting that you can't really don't say anything to the Joint Commission on Hospital accreditation, chances are, they've been told about the problems for the last two years. And now they're afraid that it's some big shot's gonna come in.

I mean, there's the crisis and, and, and here's where it happens. And we're just talking about health care now, it happens at the federal level, the state, the county and the private sector. It's like, um, this is what healthcare, uh, why money? Because all these federals, county state, they don't have budgets, they don't want to be punished by the way, as you've said about every profession and there are tremendous people working in health care absolutely. You know, we don't, you know, and there's people that have tremendous ethics and tremendous integrity.

That's what keeps, that's what keeps us afloat despite the flaws. But the funds do cause unnecessary pain and suffering to people. And uh, that's what this country is going to have to try and come to grips with. Ah my friend that I mentioned in my monologue and I tried to not tear up when I talk about this again, but she has to continue working because if she loses, if she loses her job, then she loses her health care and she loses her health care, then she loses access to the tree that she's getting, which is, which is a, you know, it's a new form of treatment that she's getting that's saving her life, is keeping her alive.

What kind of system you, I mean, just imagine that this is somebody who has cancer, terminal form of cancer, who has to continue working and will continue having to work for the rest of her life until the day that she dies so that she can have the insurance to keep her alive. I mean, it is absurd and angering to me and yet we have to say that she is one of the lucky ones, right in this country. She's one of the lucky ones. No, I, I know what you're saying.

Well, sure. And the, uh, the person who lost their job and their healthcare during Covid, we saw what you're taught. You know, we can see that how it was multiplied over and over and over again about, um, that the severe lack of, of human empathy towards people that lose employment to no fault of their own and then lost their health care coverage. And then now they've got to figure out where do I go? You know, go through all the hoops and just that and the other um, you know, some people figure it out and many don't, you know, they total cobra.

Well, that's pretty expensive. Um that there's, you know, the affordable care act, you know, ah hopefully, you know, the programs that serve people that have lost their jobs and now don't have income. Hopefully many of them do get some type of insurance, but that then of course, guess what now? Uh are you in network? Are you going to a provider that accepts uh this type of insurance as opposed to what they did here? Uh, So when I said, we have a caste system in health care, uh, that's really, that's an understatement in terms of the haves and the have nots and they're very haves and the very that's and everybody that's clumped in the middle with this patchwork of unnecessary administrative spending is again part of the problem.

And um, you know, if Yale and Harvard or whoever, if they say that this is what our country could save theoretically by having a single payer healthcare system, then um, you know, let's take a mental sledgehammer and continue that message and to make it happen. You know, people are worried about losing their jobs and health care or insurance companies and that, that's a real, you know, kind of, you know, fear that some people have, but certainly were where, you know, we don't we don't need to, for instance, when we wanted to get rid of the coal industry and some of the states and everybody lost their jobs, ah and it started getting, you know, welfare, which perhaps they were already ashamed and embarrassed of the word because of the culture that they grew up in.

Uh, and so they said, what, what happened to the people in the coal industry? Well, so what, how about, you know, just being an intelligent country and government, we're gonna support you for the next five years would be a drop in the bucket money, You know, Well, we we will retrain you or, you know, you can join, you know, whatever, uh, you know, some people maybe should get, you know, it sounds like socialism, maybe they should, you know, people that get displaced should get a, you know, a guaranteed the income to live on, you know, if you're disabled in this country, you know what people get for months, Right?

And this is by the way, just for the audience, I am going to be doing an episode on socialism coming up on. So, you'll be surprised where I come out on that, I was just saying that I'm gonna be doing an episode of the show on socialism. Um, and in exposing some of the myths around that. So, um, let's see where I come out on that argument, surprise or will you be so are you gonna, are you gonna just out of my own curiosity, are you gonna call it socialism?

You're gonna call it democratic socialism. I'm just gonna call it socialism? Um, okay, here's the thing with labels, by the way, right? People think of socialism and what they think of is they think of the definition that has been assigned to them either through culture, their experience or their political biases. We don't need, we can call, we can even take capitalism if we wanted to and reform that and still call it capitalism. So when I say socialism, I'm not, there's no set definition for this stuff, Right?

I mean, these are economic philosophies. Um, we can have a discussion and we need to have a discussion about what kind of society we want to live in and then worry about what the hell to call it. But the socialism that when I say socialism, I'm talking about, the philosophy of care, the philosophy of morality, the idea and this is where it differs in America, right? America is all about this rugged individualism. This hey, you know, lift yourself up by the right and the fact is that's that's not how it works, that's not how human nature is whatsoever.

Um, you know, if you go back to our hunter gatherer days, what was the most important thing. Competition or cooperation? It was cooperation. If you and I are back in 100 gathering days, let's say that, You know, we've got 20 of us right? Where you go out dan. And, and you, you get a successful hunt for the day and the rest of us don't, it's in your best interest to share what you've brought back with the entire group because tomorrow I might be the one that gets the hunt and you don't.

So if if we don't, if the idea is if you're not sharing with everybody, then it's, it's almost selfish not to you because you don't know that you're going to be successful hunting tomorrow. So this idea of taking care of each other is at its root kind of a selfish idea. But cooperation and social cooperate. We're social animals were meant to socially cooperate. So this idea of America, this lift yourself up by the bootstraps and that people can be self built. It's just absurd. Yeah. Used to be called the protestant work ethic.

That is part of what you're talking about. I will send you and introduce you to our may have already uh, forget the guy's name that talks about in general. Donald trump. I'm kidding in general. When just power alone is utilized to get to the top. Uh, it fails because of what happens at the bottom. And, and that has happened A lot with major corporations have only lasted for about 30 years. Uh, because they just forgot about what's going on underneath. Right? And, and that's the thing, I mean, like when you mentioned the hospital workers, you know, the people that clean the rooms, you know, it's easy to say, well, the doctors are the most important. Okay.

But you put a doctor in a room that hasn't been cleaned and all of the training in medical experience in the world isn't gonna do much if you've got a patient's being exposed to bacterium's and viruses, you know. Um, so it really has to be a team effort and, and, and that's what people tend to forget. I mean, you tend to ignore the people in the lower classes. You know, like the caste systems, you know, like the people that clean their rooms, but they're just as important and crucial to the system as the doctors are.

Some of the best listeners in the hospitals and assisted living homes. And what matters are the people that come in and clean their rooms daily there frequently. The best, the best ears that somebody has had perhaps all day. It's, and so anyhow, so, so back to that, this whole idea of, of working together and, and, and so forth. Um, the same goes for the, I want other people if I'm getting the best health care possible. I want everyone else to get that same care. It's to my benefit, right?

And I don't know how we, I think this is probably the one issue that has americans most divided when it comes to talking about Medicare for all because you've got people like, well, why should I have to pay? I'm in good health, I take care of myself, why should I have to pay for, you know, jay and john over here when they get sick, You know? And these are the people like, well, what about, you know, I've even heard this absurd idea of, I, I'm not sure if I'm calling it the right thing.

I may be confusing it, but it's something like social health insurance accounts where you basically, you're given a lump sum for your entire life. Oh yeah, I remember that concept. Um, and I'm like, um yeah, that's just know that Yeah. The piggy bank. Oh, it's empty now. What? Yeah, I guess. Well, yeah, I mean and that right. The fact that people have to use, I mean, if you go on, go fund me now, it's just enough to make you want to just curl up in a ball and cry all of these people.

I mean, and it's just, is this really, we're told that we've got the best system in the world really go on, go fund me. And they're tragic. These stories are absolutely tragic. And yet this is even in the era of the affordable care act, right? There's nothing affordable about health care in this country and it's not even a matter of, you know, people will say well, but quality again, as as as you mentioned earlier, we spend more than most than every other developed country. And yet we're not getting anywhere near the same outcomes other countries are getting on.

You know, there's a, in the book that I'm reading, there's a book called how we do harm and it's written by a doctor who talks about the um the problems with our health care system and the need for a and he also talks about not just the need for a comprehensive insurance program, but a need to reduce medical errors. Um you know, he, one of the things that is proposed is this idea of, and I mean, I have this view of education in general that it should be um funded by the taxpayer funded, but why are we not when it comes to your doctors and nurses?

As you say, these are people that we need. And there's a shortage right now. And yet the cost to become a doctor or even become a nurse is just enough to put you in debt. So it's not a big surprise why people are not wanting to go into these professions. So why, why why not have programs? And there's, there's one hospital in new york that is doing this. Um I think it's new york university and why I think it is and there program for medical students, it's completely of no cost, there's no tuition.

I did, I did hear about that. I know how cool is that, right? And they're doing that now. They had a grant that they had been investing in trying to get up and so they intend to do this forever. But what if we just had a program where we said, hey, look, well, you know, no cost to you to become a nurse or to become a doctor, you know, the education would be covered and you know, you can go to a community that that is a need of doctors that has a shortage of community maybe where most doctors don't want to be, you know, these vulnerable communities and go there for a period of time or how about just not a new idea by the way, it's just that it never caught on fire.

Everything that we're really talking about is it's not new, It just hasn't caught on fire. The only thing that's caught on fire is how can we make more money? And do you think that covid is changing the narrative on this a little bit, Do you think, well you think that would have been a perfect tipping point as people talked about? Well, if if this isn't the best best example in the world, what would be and you know, I I'm not, I'm not a genius. Uh, But when I was writing about this kind of stuff 15, 20 years ago, unfortunately, I, I talked about the bubonic play and and other things that have spread like rapid fire and and what the consequences would be if we didn't have systems in place to to deal with these kinds of things.

And so here I thought, well here's, I would write, I'd say well if if something happened to a wealthy family and their Children got exposed to something contagious by somebody uninsured or who couldn't go get care because of finances who's gonna whine and complain the most, you know, and what I'm gonna do, they'll they'll blame them. Well, they didn't work hard enough and that's why they don't have or or then they'll say why didn't the government do something? What? Yeah. And I'm not saying I like or don't like Bill gates, but you know, he came a fantastic podcast about what what's one of the best industries in the world to prevent in the United States to prevent fires from spreading to have a good fire department, regular training, drills, preparation.

No, you're hot spots, obviously, I'm not talking about California as much, but but it's true and if we had designated systems in place for the next pandemic, by the way, we all know it's well we just when if we had systems in place like we are prepared for fires like the great Chicago fire, there wasn't systems in place if there were and now there are you go to any major city just a city, I'm not talking about? You know what we know is causing all the fires in California.

And You know, we were told 25 years ago that this could happen was sleeping at the wheel. So, but in cities we have great fire departments. Well in big cities you can have great centers and and if there's no pandemic going on with all these people that are in place, they can be doing other things in health care. So you know, listen was about maybe 30 years ago we had a governor in California, I'm sorry. I take that back about 30 years ago we had a governor in Colorado was talking about The huge expenses that people over 60 are going to incur in our country because as they get older they're going to cost more money by the way.

It's, it's very true. But you know, people start worrying about death panels and rational, you know, we're gonna have ration care. We have no finer example today of ration care for no matter what your age is. And the death panels by the way we call them insurance companies. Thank you. There they are. And listen, this has been, this has been uh rewarding for me personally. I hope I hope all your listeners have, you know enjoyed or didn't get teary eyed listening to the whole show and and you know, people are going to say, well fine, they're just experts in talking about, what's wrong, what are you going to do about it?

And I'll say this to anybody that's listening. What are you going to do about it, vote go to support people that at least in the beginning, uh, they say that this is what our country wants and this is what our country needs and hold their feet to the fire. Once they get in office, That's number one. And then we have to, we have to get money out of the politicians who can accept money from all the healthcare corporations in the pharmacy until, until that, you know, becomes because it's legal now.

And once there's a line in the sand saying, no, you're not gonna do that. Then, um, you know, then we can then we can move forward. So that's the second thing. And uh, The 3rd thing is, is let's not lose hope. Let's let's continue to, even though people think that this is a very hopeless situation because of how the systems have become contaminated by money and by greed. Um, they have been, but how you got that flag behind you and it means something to a lot of people, no matter what their religious, spiritual, ethnic agnostic, atheist, whatever doesn't matter beliefs are.

Um, we, we can, we can have the best health care system in the world. And, uh, and there's nothing more patriotic than caring about your Yeah, I mean, it's despicable to all the things we've talked about that are tolerated and uh, you know, it shouldn't have to come to uh well until it happens to you, then you'll wake up or your neighbor or somebody. Oh my gosh, how could that be? Well, okay, so I'm off my soap box. Is there anything last minute question? Common concern that you would like to ask?

We call it a night? So my friend was able to um you know, I talked about her ability to kind of do some comparison shopping even though that was incredibly hard to do. Right? But are there resources, are their websites? Are there places that an average person can go to to inform themselves more or to learn about? I mean how what resources exist out there other than yourself um to sort of navigate that system. Okay, well, you know, this isn't is this isn't not my personal pity party here.

But um I have had difficulties in accessing quality health care Over the last 20 years. I know physicians who feel the same way having said that nurses and it doesn't matter and friends and family. I mean by the way, let me just say something that everybody should know if you ever anybody ever ends up in the hospital. If you do have somebody close to you that can, you know, keep in touch with you and your health care team and make sure that, you know, unintentional, accidental errors don't take place.

It's always good to have somebody like that to answer your question. Are there resources available? I guess there has to be. And uh, I just, I'm kind of like drawing a blank ask me that question one more time and then I'm gonna take notes and then we will, we will revisit this because you know what I've been doing a little bit pro bono, one patient, one family at a time is I just literally I'll go to google or I will ah I hate giving out names and telephone numbers I always did of organizations that say they're going to help because things can change in a minute.

They can change in an hour and there's nothing worse than somebody being in a bind and then then somebody, you know, one of my, I'm sorry, one of my complaints about the field of home health care in my profession is you have people giving out, you know, community resources like this here, here's a list of names and telephone numbers for you to call. Well, chances are these patients and families, they're already under stress. Now you're going to say here, check these out, call these folks, you know, so I would, you know, Pat on the show, I would never put that burden on people.

I would call up the organizations and find out am I gonna get jerked around because if I'm getting jerked around, you know, what's gonna happen to the patient of the family, You know, then there's organizations like 2, 1, 1 good organizations funded by, I'm starting to think funded by United Way And it may not be the # 2 1, 1 in everybody's community. But there's something like that information and referrals to find out. For instance, we were talking about a free mammogram or uh, a breast cancer foundation that will help somebody and guide them through treatment.

You know, there's really are a lot of good organizations out there, but it's for me, uh, to give out at this point in time, mass education, which, which could be totally bogus because everything changes, especially, you know, the best example I can think of and I've heard this and I have to verify this. You know, pardon me for my sick humor. But I hear like, you know, everybody will call it the suicide hotline number. And then I hear, I hear they get numbers to call or this that and the other and then they call those numbers and it's like sometimes they're like getting misinformation with a suicide hotline.

I don't know if that's true. I might, I might test that system one day to see, you know, whatever or you call up the Veterans Administration, if you're feeling like you're suicidal call this number, I'd like to see what happens because Suicide is one of the 10 causes of death in the United States, let me just, especially among Children, two Children, let me say this, somebody has made a decision to kill themselves with or without warning. They're going to do it. So if you're a victim of a family member of suicide, you know, why don't we see it?

Why didn't we know? It's easy to say it's not, you know, it's really not your fault. But guess what if, if an adult has made a decision or a suffering adolescent, you didn't see it. Please. You know, that's the time to go get some help and figure out that, you know, there's a reason why you don't now. They're called secrets. Everybody has them. Yeah. And austin to, you're so close to a situation you're not seeing, you know, it's become normalized over time. So you're not always seeing the signs.

Whereas somebody outside the family um, might be able, you know, might more readily recognize some of the symptoms of course, of course. But back to community resources and helping people, you know, I was just kind of daydreaming out loud with you. Um, it might be worth revisiting in a different time frame, a different format. Ah you know, you, you want to, you want to do educational classes and so like access to community resources for, you know, all these organizations who, by the way are suffering. There's probably not a organization around that isn't hurting.

Whether it's the american heart association, lung association and multiple sclerosis Association cancer. Everybody is struggling. I'll tell you it's a little secret. I called up the ombudsman program where I lived because they were advertising on tv and I called him up and I left a message. This is the ambas um program. These people go into nursing homes and try and do problem solving. I never got my call returned. What does that tell you? And I said, hi, this is dan Lemon. I'm a retired licensed clinical social worker and blah blah blah blah blah blah blah.

I never got called that, but they're spending money on tv to advertise their services. What happened? I don't know, you know, a lot of you hear a lot of um negative things about non profit organizations and um being the co founder of one. I just wanna make dispose that. Um, but I've been to a lot of the problem is, and there is a, the administrative apparatus that that sort of exists if you're a nonprofit is just a huge burden. I mean, there needs to be a lot of reforms done in that area because it is smaller that you are as a nonprofit, these dealing with the government and doing these filings and all of that other stuff.

I mean, again, as a small organization that becomes a huge and expensive burden. But there are so many nonprofits trying to do such a great job and unfortunately everyone is competing for what money, right, you need money to do. I mean a nonprofit needs money to do what they do to, to serve their mission. And who are they relying on that money from? More often than not, it's the general public. And so it's sort of contradictory when you think that, you know, an organization that's, let's say does a food bank or deals with the homeless?

Well, when economic times are good, those nonprofits might be well sustained. But during the times of like a great depression or, you know, times of economic strains on the average people, those donations suddenly kind of dwindle. Right? And so now they, so it's, it's a very vicious cycle. And there are a lot of nonprofits that are trying to do their best. And a lot of them are going under two and Covid has impacted nonprofits particularly hard. And yet private corporate donors to certain organizations. Really, if I just read this correctly, the larger the larger organizations are, you know, corporate donors and private donors too.

I mean, if we were to google how much money goes into donations to nonprofits, it's huge. I mean, it's huge. I forget what the number is, but it's, it's really huge. So yeah. But um, I, uh, again, I've done, you know, probably, well, not, probably I've done over 4000 home health care visits, uh, as, as part of my part time career. And again, uh, you can't go into somebody's home and give them a list of numbers to call because something, something not good is going to happen. And then you're going and then the organization that, you know, sending in, you know, good nurses and nurse case managers, physical therapists, you know, it's not good.

Um So I would always be leery about giving out numbers unless they've been verified. And then if they tell you well, yes, this is a good number, but we need to refer you to somebody else right now. Okay then call that number and she is that good because you know, free advice is great. But uh sometimes you know, you gotta uh you've got to follow the proper administrative trails. Uh and there's a tremendous amount of well meaning people that say we do this but they can't for whatever reason and you need to know before, you know, you refer them to somebody.

Um So let me think more about that. I like the idea of of a team, a coordinated team down the road with a physician, an advanced registered nurse practitioner and somebody in the social services doing one of your courses and a team approach about accessing health care. What what do you do if there's a problem? You know, these people that were afraid to, you know, complain about the hospital. You know, people are so afraid of retaliation, pardon? And the nursing homes too. Oh, I know. Oh, perfect example.

You know grandma wasn't taking very good care of well let's tell the administer no. You know, because everybody's afraid that now something even worse is gonna happen in health care, you know, I don't know. Yeah, you're good help. Yes. Thank you so much for joining us today. Um And again, we're gonna have you back because health care is going to be a strong focus of this podcast because it is such a crucial issue and it's a very complex issue as well. Um So please leave us a comment down below and let us know what you think and if you've got any questions so that in future episodes we can ask dan.

Um we're gonna put dan's um mind and experience to good use. Um Again, thank you dan. Um I want to thank all of you out there for listening. We will be back next Tuesday, I believe. Next Tuesday we're gonna be talking about capitalism and socialism before we hang up. I will, I'll just say if somebody has a pencil and paper, if you want to give me a call and chat about something here And you're not interested in ripping me a new one Or trying to say you are a magazine subscription, you can, yeah, you can call me at one 561 503 1403.

Dean Lehrman again. That's if you want to talk serious. I mean, if you're if you think like, you know, uh I've got the wrong agenda for our nation. That's okay. Just don't call me and that's what the comments are for. Yeah. Yeah. Right. All right. Thank you. Goodbye. Yes. Be safe. Be healthy and please be kind to people. We'll see you next week. Next Tuesday crusade of America. I'm sean ST Heart. Have a great week.

Dan LehrmanProfile Photo

Dan Lehrman

CEO , The Healthcare Voice

Dan Lehrman ( retired Medical and Mental Health Licensed Clinical Social Worker) returns to his roots ( now in public arenas) of advocacy and activism, for the uninsured, the underinsured and of course, for dedicated healthcare providers and their support staff. Dan, well versed in almost all patient locations of care, has had extensive Federal ( Veterans Healthcare Administration) and private sector experiences. Over the years, Dan has talked with or interviewed over 100,000 patients or family members, and an uncountable number of healthcare providers. He is known as a humorist, but admits “ Not everyone thinks I am funny.”