Latest / Underthrow / The Care-tel

Transcript

The Care-tel · Underthrow

• 0:00
  SPEAKER_02: Nearly every time someone complains about
• 0:02
  SPEAKER_02: a crazy medical bill it goes viral we've all been there invariably people in
• 0:07
  SPEAKER_02: the comments say the same thing this is what happens when you leave health care to
• 0:11
  SPEAKER_02: the free market it's a tidy tale the villain is greed the cure is government And
• 0:18
  SPEAKER_02: the case for single-payer is closed.
• 0:21
  SPEAKER_02: There's just one problem with it.
• 0:22
  SPEAKER_02: A free market in American healthcare doesn't exist.
• 0:26
  SPEAKER_02: And it never has.
• 0:27
  SPEAKER_02: At least not in our lifetimes.
• 0:29
  SPEAKER_02: You can't blame a villain that doesn't exist.
• 0:32
  SPEAKER_02: So let's follow the money and find out what's really going on.
• 0:36
  Follow the money.
• 0:46
  SPEAKER_02: In 2026, Americans will spend $5.3 trillion on healthcare.
• 0:52
  SPEAKER_02: That's 18 cents of every dollar the economy produced.
• 0:56
  SPEAKER_02: Now, ask who paid.
• 0:58
  SPEAKER_02: Medicare paid 21%.
• 0:58
  SPEAKER_02: Medicaid paid 18%.
• 1:02
  SPEAKER_02: Add CHIP, the VA,
• 1:03
  SPEAKER_02: TRICARE, and Obamacare, and public insurance covers about half the total bill.
• 1:09
  SPEAKER_02: Now, trace each dollar back to whoever finally writes the check, and the picture gets clearer.
• 1:15
  SPEAKER_02: Washington sponsors $30.
• 1:16
  SPEAKER_02: Those look like free market numbers, but we have to look closer.
• 1:19
  SPEAKER_02: The private sector that wasn't.
• 1:42
  SPEAKER_02: Start with your employer insurance plan.
• 1:44
  SPEAKER_02: It's a fossil from World War II.
• 1:47
  SPEAKER_02: Wage controls barred companies from raising pay, so they competed using benefits instead.
• 1:52
  SPEAKER_02: But Congress never changed that, so the tax code froze that accident in place.
• 1:57
  SPEAKER_02: The problem is, premiums your employer pays are untaxed.
• 2:01
  SPEAKER_02: That exclusion is worth hundreds of billions a year to somebody,
• 2:05
  SPEAKER_02: and it's a benefit that people who buy on the private market don't get.
• 2:09
  SPEAKER_02: But it chains your coverage to your job,
• 2:11
  SPEAKER_02: and it distorts the prices, hiding it from the one person who ought to see it.
• 2:17
  SPEAKER_02: Next, we have the individual market.
• 2:19
  SPEAKER_02: But the ACA,
• 2:21
  SPEAKER_02: Obamacare,
• 2:22
  SPEAKER_02: decides what every plan must cover,
• 2:25
  SPEAKER_02: how much premiums may vary from person to person,
• 2:28
  SPEAKER_02: and how much the taxpayer has to chip in.
• 2:31
  SPEAKER_02: Then, Medicare sets administered rates for hospitals and doctors,
• 2:36
  SPEAKER_02: and private insurers bargain in Medicare's shadow.
• 2:39
  SPEAKER_02: The government price is the anchor.
• 2:41
  SPEAKER_02: But what about supply?
• 2:42
  SPEAKER_02: Licensing decides who may treat you.
• 2:44
  SPEAKER_02: The FDA decides what you may take.
• 2:47
  SPEAKER_02: IMTALA decides who must be treated.
• 2:50
  SPEAKER_02: And in many states, certificate of need laws require permission to start a new clinic.
• 2:55
  SPEAKER_02: The entrepreneur has to get permission from a board where the hospitals already
• 2:59
  SPEAKER_02: in town get to object.
• 3:01
  SPEAKER_02: Nothing fishy about that.
• 3:02
  SPEAKER_02: Imagine opening a restaurant and needing sign off from the competitor across the street.
• 3:07
  SPEAKER_02: It's all anti-competitive and drives up premiums and prices to benefit insurers,
• 3:12
  SPEAKER_02: hospital systems, and the agencies that shield them.
• 3:16
  SPEAKER_01: I'm a boy.
• 3:16
  SPEAKER_01: I can't afford this.
• 3:18
  SPEAKER_01: General Surgeon knows best.
• 3:20
  SPEAKER_00: Mandated.
• 3:21
  SPEAKER_00: His retractable shield deflects competition and hides the true cost of care.
• 3:26
  SPEAKER_02: That arrangement has a name.
• 3:28
  SPEAKER_02: I call it the caretel.
• 3:32
  SPEAKER_02: The expense account effect.
• 3:36
  SPEAKER_02: So what's left of the healthcare market?
• 3:39
  SPEAKER_02: Out-of-pocket spending sounds like ordinary shopping.
• 3:42
  SPEAKER_02: Mostly it's deductibles and co-pays inside the insured system.
• 3:46
  SPEAKER_02: But you only pay a slice of a true cost you never saw.
• 3:49
  SPEAKER_02: So the real market leftover is only a sliver.
• 3:52
  SPEAKER_02: Cosmetic surgery,
• 3:54
  SPEAKER_02: LASIK, some dental and vision, direct primary care, and over-the-counter drugs.
• 3:58
  SPEAKER_02: These are but a few percent of the health care But in that sliver,
• 4:03
  SPEAKER_02: patients see real prices and providers compete for the patients.
• 4:07
  SPEAKER_02: LASIK has spent decades getting better, while its real price has held steady or fallen.
• 4:13
  SPEAKER_02: Everything else in U.S. healthcare runs on the expense account effect.
• 4:17
  SPEAKER_02: When someone else pays for your blood test,
• 4:19
  SPEAKER_02: you don't care whether it costs $50 or $500, but the lab sure does.
• 4:23
  SPEAKER_02: So after some wrangling with the insurance company,
• 4:26
  SPEAKER_02: an outrageous bill lands on the insurance risk pool.
• 4:30
  SPEAKER_02: The pool raises premiums.
• 4:31
  SPEAKER_02: But all the jacked-up prices stay hidden till you get your premium bill,
• 4:36
  SPEAKER_02: which not everyone does.
• 4:38
  SPEAKER_02: Remember, only those who pay on the individual market or full out-of-pocket expenses do.
• 4:44
  SPEAKER_02: Too few patients at the beginning of the chain have a reason
• 4:47
  SPEAKER_02: to ask what anything costs, so there is drastically reduced price competition.
• 4:53
  SPEAKER_02: The healthcare sector bloats and bloats, and we all bitch about the final bill.
• 4:58
  SPEAKER_02: Then, people look at all the wreckage and blame...
• 5:02
  SPEAKER_02: Capitalism.
• 5:04
  SPEAKER_02: What a market would look like.
• 5:08
  SPEAKER_02: Here's what reform looks like, starting with what matters most.
• 5:12
  SPEAKER_02: One, put the money back in the patient's hands.
• 5:15
  SPEAKER_02: Expand health savings accounts and pair them with real catastrophic coverage plans.
• 5:20
  SPEAKER_02: Insurance is for a car wreck or a cancer diagnosis.
• 5:24
  SPEAKER_02: Pre-paying for sniffles, stitches, visits, and labs is how a policy becomes an expense account.
• 5:30
  SPEAKER_02: Two, treat every health dollar the same in the tax code, no matter who pays it.
• 5:35
  SPEAKER_02: Either everyone gets privileged tax treatment or nobody does.
• 5:39
  SPEAKER_02: End the wartime tax privilege on employer coverage
• 5:42
  SPEAKER_02: and your insurance coverage follows you from job to job.
• 5:46
  SPEAKER_02: Three, make prices transparent by law.
• 5:49
  SPEAKER_02: If routine care comes out of your accounts, we'll all start to care what the blood test costs.
• 5:56
  SPEAKER_02: You'll need that figure before you agree to pay it.
• 5:59
  SPEAKER_02: 4.
• 5:59
  SPEAKER_02: Break the supply cartel.
• 6:01
  SPEAKER_02: Repeal all certificate of need laws.
• 6:04
  SPEAKER_02: Speed safe drugs to market.
• 6:06
  SPEAKER_02: Let more trained people practice.
• 6:09
  SPEAKER_02: 5.
• 6:10
  SPEAKER_02: Let insurers compete across state lines.
• 6:13
  SPEAKER_02: If your carrier earns a reputation for denying claims,
• 6:16
  SPEAKER_02: you should be free to buy a plan from New Hampshire and forge a clear path
• 6:21
  SPEAKER_02: to form new kinds of mutuals and healthcare associations.
• 6:24
  SPEAKER_02: Six, help the poor with ownership.
• 6:27
  SPEAKER_02: Replace Medicaid with means-tested deposits into poor folks' health savings accounts.
• 6:32
  SPEAKER_02: Money that belongs to someone gets watched.
• 6:36
  SPEAKER_02: Seven, price the hardest cases honestly.
• 6:39
  SPEAKER_02: Fund high-risk pools for people with pre-existing conditions,
• 6:42
  SPEAKER_02: with premiums capped at a multiple of the standard rate.
• 6:46
  SPEAKER_02: Introduce reinsurance programs for crazy high interventions,
• 6:49
  SPEAKER_02: but only after getting rid of guaranteed issue and community rating.
• 6:53
  SPEAKER_02: Most of this was obvious 15 years ago when a certain party shoved Obamacare down our throats.
• 7:00
  SPEAKER_02: But none of the needed reforms ever happened,
• 7:02
  SPEAKER_02: because every item on that reform list takes something from the cartel.
• 7:07
  SPEAKER_02: Now, the selfsame party is whining for Medicare for all,
• 7:11
  SPEAKER_02: as if Canadacare and the British NHS are running just splendidly.
• 7:15
  SPEAKER_02: Watch this clip.
• 7:17
  SPEAKER_03: Actually, can I just do, I wanted to ask a question.
• 7:19
  SPEAKER_03: Please, please go ahead.
• 7:20
  SPEAKER_03: I wanted to ask actually two questions to the audience.
• 7:23
  SPEAKER_03: First, how many Canadians, would Canadians in the room please raise your hands?
• 7:29
  SPEAKER_03: We have about seven hands going up.
• 7:30
  SPEAKER_03: Okay, not as many as I thought.
• 7:32
  SPEAKER_03: Okay, of those of you who are not on the panel who are Canadians,
• 7:35
  SPEAKER_03: how many of you think you have a terrible health care system?
• 7:39
  SPEAKER_00: We see almost all of the same hands going up.
• 7:42
  SPEAKER_03: Bad, bad move on my part.
• 7:45
  SPEAKER_02: No one in these countries has to wait months for treatment, and of course it's all free.
• 7:52
  SPEAKER_02: Make them compete.
• 7:54
  SPEAKER_02: Those who want commie care have a simple pitch.
• 7:57
  SPEAKER_02: The market failed, so let the bureaucrats run it.
• 8:01
  SPEAKER_02: But the pitch is a lie.
• 8:02
  SPEAKER_02: The free market they decry was never even allowed in the waiting room.
• 8:06
  SPEAKER_02: What failed is our Frankenstein system,
• 8:09
  SPEAKER_02: half of which is paid for by the state directly,
• 8:12
  SPEAKER_02: and the rest of which is fenced in by the cartel.
• 8:15
  SPEAKER_02: Physicians swear an oath.
• 8:17
  SPEAKER_02: First, do no harm.
• 8:19
  SPEAKER_02: It's time that oath bound our government officials and their greedy corporate supplicants alike.
• 8:25
  SPEAKER_02: If you don't like big oligopolies providing your health care,
• 8:28
  SPEAKER_02: you surely don't want to give it over to a giant monopoly.
• 8:32
  SPEAKER_02: I'm Max Borders.
• 8:32
  SPEAKER_02: Let's criticize by creating.
• 8:40
  [music]
• 8:51
  SPEAKER_02: Underthrow is brought to you by Human Respect Labs,
• 8:54
  SPEAKER_02: committed to advancing the philosophy of human respect worldwide.
• 8:58
  SPEAKER_02: Whether you're helping spread the philosophy or building voluntary alternatives
• 9:02
  SPEAKER_02: to political power,
• 9:03
  SPEAKER_02: we support strong startup projects with up to $30,000 in seed funding.
• 9:08
  SPEAKER_02: Got an idea?
• 9:09
  SPEAKER_02: Visit humanrespectlabs.org to see if you qualify.
• 9:13
  SPEAKER_02: That's humanrespectlabs.org.