7 Burst results for "Dr Brad Spell Berg"

"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

02:54 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"Snapped and triggers. And change your kirk. Think how quickly we went from. Don't don't ask. Don't tell to gay marriage legal and the civil rights. I mean we struggled from the civil war reconstruction and jim crow laws and the civil rights movement launched nineteen sixty five and things started to navy. Not as quickly as we all think should happen but it doesn't tend to be slow steady gradual change. It tends to be when something's ready for change on the ground matured enough things change. The fact is survey show. Americans are almost the end of their wilpon healthcare. They're tired spending amount of money. They have spent their tired of medical bankruptcies. We are to the point where enough people are frustrated. But i do think we could have a conversation in the coming years about meaning while that's definitely a conversation. I hope we have. And i hope it leads to some sort of meaningful reform and again at broken bankrupt and dying is the book. I think it's a great book a highly recommended and docked mellberg. Thank you so much for taking the time to talk about it today. Thank you very much leadership. That's it for today show. We hope you like what you heard. If you'd like a second full length politics guys episode every single week as opposed to just these occasional interviews. You can get that by becoming a patriotic supporter. Supporters also get ad free versions of every episode as well as other good stuff to get the details and to become a supporter. Just go to patriotdepot dot com slash politics guys. And if you can't afford to become a supporter to email me at mike at politics guys dot com and i will get you full access to that second episode every single week and if being a monthly supporter is too much of a commitment which is delighted to help us out occasionally. You can do that too through pay pal. You'll find a link on our website politics guys dot com slash support. And you haven't already subscribe to the show. That is a big help as well as leaving ratings and reviews and especially sharing your favorite episodes on social media. That's a big deal to us. And if you got a question comment correction gripe or whatever you can reach us at mail. The politics guys dot com for more great discussions. Check out our bipartisan politics. Sub reddit you'll find url in the show notes. we've also got a facebook page. That's facebook dot com slash politics guys page and were on twitter at politics. The executive producers of the politics guys are bruce. Johnson wilma marino. Endre massacre daniel toe and chris wilkerson today. Show produced by michael barone. Hausky we'll be back with a new show next week. We hope you'll join us..

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"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

08:23 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"Do not support those are international models at consistently show. You can even look in. The united states at medicare versus single. Payer systems are much less expensive and much more efficient than private multi. Pair the the reason to have if private multi payer system is not price. The reason is culture. it's short it's a suspicion of government. We have to admit that if you're concerned is money i want to spend less money and i want to have more efficient healthier than you need a single person if your concern is i don't like being told what to do and i don't trust government to tell me. What do i want option. Then you need a computer system and if you're concerned both because a of the population in this great melting pot of a country has half the people on one side and half on the other than the solution is to do. Go and let them at it now. It seems to me on the other side of things that joe biden's proposals on healthcare are really almost. It seems to me like an obamacare. two point. oh he wants to expand that a little bit increase medicaid eligibility may be allow people get on medicare a little younger some more taxes subsidies tax credits that sort of thing but that strikes me as being kind of more of the same and not really getting it. Maybe some of these fundamental things that you're talking about other. That's exactly right. And i will be honest with you. Reading in between the lines of listening to what or vp biden has said and current candidate and has said. I'm not sure this is what five wants. I think this is what biden thinks he can get john. The history of healthcare reform in this country is not a happy yeah. Lots of politicians have broken their careers on health. So the reason i wrote this book changed the dial. The american people need to realize that they are getting catastrophically ripped off the average cost of a health insurance premium family coverage in the united states. Now according to a survey of two thousand employers is twenty thousand dollars per year Cost of a new car every year. Just purchase premium for family covered with two-thirds of the employer and one for you on average. Imagine if those costs were two thirds less and all that excess money went into the pockets of your worker and into your corporate portfolio to reinvest in your business here's an astounding fact. The republicans or very proud to pass a corporate tax cuts which they said with grow jobs and grow the economy total annual us corporate tasks elections three hundred and twenty billion dollars for year. Tell them out of money. Spent by those same companies on healthcare for their employees one point one trillion dollar. Yeah you want to grow the economy you really want. Wage increase of put more money into the pockets of americans move healthcare out of insurance benefits for from lawyers and move it into a national system. Now you mentioned this a couple of times that it is frustratingly difficult to even in light of these very good arguments that make sense to me for sure that it's tough to get things done on the national level. So what about the possibility of state at least some states acting on their own. At least partly you know you mentioned california in the book and of course california's oftentimes for better or worse. Up as a model of progressivism or trying out new things and you know now they have a democratic governor and democratic super majorities in the state legislature. You'd think if any state could do something big on healthcare the test some of this out it would be california and of course you have a personal interest in california given that you live and work there so it can. Can you speak to that a little bit. Yeah it's a great question and as you know. Spent an entire chapter on discussing. Just that concept. Why not try something out. State level highlighted and make sure it works workout all the national and it turns out that may not be legally possible. The reasons relate to primarily to the wall. I is section eleven fifteen at the social security. Act which is a medical waiver. Feds are able to essentially control house state. Allocate under the medicaid program and states are allowed to ask for a waiver. Federal rules so they can try out innovative demonstration projects those waivers our discretion of department the secretary of the department of health and services which means the administration if the administration is not in favor of the demonstration project. It doesn't matter if the state wants to. They cannot use medicaid funds. As part of the rich the second law is actually harder to because if the current administration wasn't in favor just wait for years for nude administration. And maybe they've the next one will be the second laws called orissa. Don't ask me to site with a letter stand for i. A- say essentially it's a law that governs sorry employee benefit package and what it says is that all only the federal government can't control and regulate employee benefit package. There's two funding sources that a state would need on a new health. Here's it would need medicare and medicaid and private health dollars to replace employer sponsored. Health and orissa makes it illegal for states. Modify those those. So if you had a very motivated president and very motivated federal administration that was willing to look past ignore not enforce orissa and was willing to grant and eleven fifteen waiver. You could pilot project like this not. it's not hostile. Yeah that that that seems tough but who knows it might be easier to do than actually pass significant healthcare reform and that leads me to my final question for you is given all this. How optimistic are you that. We're going to see any sort of significant movement toward the sort of healthcare system. That almost seems like every other rich country like us in the world has in terms of access costs efficiency and health outcomes. How likely do you think that is to happen in an in the near term future. Well it's not possible to save court. But i will say what any absolutism but i will speak in relative to much more likely today than five years. The history of our country is not one of gradual incremental change. History of our country is is an it doesn't matter what aspect you look at look at civil rights you can look at the rights of african americans. You could look at the white you could look at the rights of women voters you could look at. Lgbt rights it's years and years of point laying the groundwork having the discussion hockey in the media lobbying government writing books on tv and then suddenly something.

joe biden california united states orissa vp obamacare. secretary president
"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

07:58 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"So it really truly sure to have been bipartisan. Was clearly not. In retrospect i am a supported. The affordable care act. I think is still the critical void. Were country but if it was exactly as you said a bridge to something else and even president obama has said that he used it as star house. It was the way to get started on health care. Reform was never even the fundamental laws of the affordable. Care and remember. It's been a very good thing. Health insurance eugene million more americans than had insurance before but it had to achilles heel. The i was dependent on expanding a system. That's already ripping us off. So how often is it true that you're getting ripped off in a business and you decide. I'm liking this invest more money. Who leans into the report that does not make sense long number two and this gets the. Don't tread on me. Affordable act barbara character. Really could only work. As other countries have a private multi tier systems more with individual mandate. You must take into the system. Health insurance is like a pyramid scheme. Health care is so expensive and it requires dozens and dozens and dozens of healthy people. Pay premiums to cover the cost of one person who's unlucky enough sick and healthcare becomes too expensive and the healthy people say to themselves. I'll take my chance. I don't wanna pay into the kitty. I'm going to save my money. The healthcare system falls apart. The insurance scheme falls apart. You need to have the individual mandate you must force healthy people to pay into the plan. Cover the cost but people in this country. Aided the concept of an individual mandate and that is why private multi tier systems by themselves. Had not worked in the united states. They do not respect. Don't tread on me. Don't force me. A single payer system doesn't require an individual mandate it just levies taxes like every other tax. We pay our taxes. The government pays for healthcare. There's no individual mandate you can layer on top of that a private marketplace that people say well. I've already paid my taxes. But i like choice. I'm going to pay a little extra own my own discretion to purchase my own private to in the both the analogy i use is. You're driving on the freeway and there's a totally or an express lane next to you. You're paying your taxes for the public freeway lanes. You've already paid what you say today. The traffic is bad. I'm gonna pay some extra to get into the express lane next door. That's exactly the same concept australia and new zealand. You is single. Payer system covers everybody. Everybody pays taxes but whoever wants to can choose purchase a private plan to use instead. Now i think one thing we hear a lot especially from the progressive wing of the democratic party is it seems at least it seems simple on the face just said well. Let's just have everyone being medicare. It's pretty straightforward. It's a big system. We know how it works. We know that it works at. I believe considerably lower administrative costs. And so i wanted to get your thoughts on that. Why don't we just say medicare for all. Yeah that's a single payer system. I personally in favor of a single payer system you're correct. Medicare pays less than two percent of its cost administration and it has no profit. Private health insurance pays closer to ten percent on administration and sixteen percent a sorry three to four percent profit. The total around sixty percent a cost between administration profit. So it's much less expensive and much more efficient deliver care medicare but that's where you run into. Don't tread on me. There are enough americans who feel very strongly they want an auction. The don't want to be told you must use this. I don't see a reason why we can't learn. From what other countries have done. And the way i phrased this is love. You're a democrat. You think single payer's the way to go. You're publican you think. Private multi pairs way to go. Let's do them both and let him compete head to head. What could be more american than that. And i think if i if i recall correctly one of the problems at least. Initially with president obama's affordable care act. Was he actually wanted was call the public option of compete with these with these private insurance. But that was that was torpedoed. Pretty quickly. I guess because private private insurance realized that they just wouldn't be able to compete with that and so that would presumably be a problem going forward in that kind of competition. I think we probably know who's going to win. Well that your point. I think the problem with the public option competition is an keeps corporate profits and in australia. The there is a current debate oversubscribed very nicely in a box article a few months ago. Calm about why is the public spending so much money to subsidize the private market the private marketplaces sort of is not able to contain costs. As effectively as the single payer and and the public's actions subsidizing that press murphy now. I would point out. That's exactly what culture is about. Culture in a country is about people making choices for what their priorities are where their money should go. And if americans forty to forty. Five percent of americans say i don't care if single pairs less expensive i don't trust government. I want choice. I'm willing to spend more have that choice. That's a cultural choice and to me. The beauty of the australian system is that it does allow. it's not either or it's not you have single payer or multi payer. It's you have a choice. We can make ribs cultural divide between. Don't tread on me and united we stand and it seems to me. I mean president. Trump hasn't come out with a healthcare proposal but my sense of things on the conservative side is that the general thrust is that healthcare needs to be actually more market oriented in that they want to see less government and more competition and more transparency and the expectation is that like in markets in anything else if people there's transparency and there's good competition because i know that's a problem in healthcare. Sometimes now we're actually gonna get higher quality more efficiency and better outcomes What do you. What do you say in response to that. I think probably most commonly heard conservative argument about how we make healthcare better in this country those arguments and again remember. I'm the centrist. And i couldn't care less about all. Those arguments are simply not true. The the data simply.

president Medicare obama united states australia Trump democratic party murphy
"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

07:16 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"On fifty kids who need asthma care. Worrying zero-sum budget game here folks we need to make some tough choices where trillions in debt or running trillion dollar deficit and. Perhaps it isn't the right thing. Poke prod torture you know do expensive surgeries and give expensive drugs in for everyone at all times as opposed to looking at. How can we deploy our resources. Most intelligent keep people healthy in the first place. They don't end up meeting match up on the back end. If growing e commerce businesses your focus you need a platform that's focused on growth. That's where cleveland comes in. Clavier is the ultimate ecommerce marketing platform for online brands of all kinds and all sizes. Whether you're just getting started or running a well known brand. It gives you everything you need to send memorable branded emails text messages and more so you can build strong relationships that keep your customers coming back with flexible automation's powerful insights and super precise targeting. Cleo is a faster way to turn great ideas into great customer experiences. That's why it's trusted by more than forty thousand brands. Like living proof huckleberry and eight sleep in fact on average class customer see of forty one percent increase in overall revenue within five months. Clavier scales with you so you never have the switch. They support everything from garage. Startups to iconic billion dollar brands. Wanna learn more about how you can grow your brand with klay clavijo visit clavier dot com slash grow to get started with a free trial. Today that's k. L. a. v. i. y. o. dot com slash grow. You know the reminds me is something someone was once said to me. Well you know you're you want to ration health care and and my response was well we always ration health care. It's just a matter of how it's done right. Well yes and to your. If you ask the person who has the kimia should i spend and this is not a made up number two million dollars on chemotherapy for you. One patient to prolong life by six months. They're probably going to say yes. You could buy me six months and if you ask the taxpayers have to cough up the money. They may say spending a million dollars on one person by six months until they become that one person. It's easy to complain about healthcare ration until you go to the people and stayed with bill and then they complain about how expensive we need to make. And as i say in the book the easiest way to make that choice is to intelligent zionist. You're spending money front people out of the hospital. i waste and instead of spending a million dollars for chemo. What if we actually gave negoti out negotiate down crisis drums like every other country in the world so i don't have to choose between a million dollars or nothing choices instead. Fifty thousand dollars which is a lot more tolerable to assist them and ask everybody now. Do you worry that. And some people have said they can't be if we negotiate down. The prices of drugs and allow medicare negotiate. What that's going to do is it's going to take innovation in the in the pharmaceutical sector. And just drive it into the ground at a reasonable concern. No it's not. I'll tell you what that is a very blinkered you. Why is it that the rest of the world is able to spend such low amounts on drugs because we spend more if we negotiated down our price other countries in the world would have to spend a little bit more we would achieve closer parody because pharma would say well now that we're not making money ninety percent of profit doesn't come from the us the rest of the world's going to have to cough up a tad more. We are allowing the rest of the world. Have a subsidized discovery for them. Because we're the only country doesn't negotiate prices. This is insanity this is like you're going to negotiate and everyone around you is paying attempt the price you are because the vendors like well that's fine. I'm gonna make all my money from this sucker over here and and this should be a bipartisan. 'cause in fact that's exactly the sort of thing that president trump has been arguing about other countries and in various other forms in terms of nato and defense and so forth. So you would think that the left and the right could get together on this but of course. The pharmaceutical lobby is a pretty powerful thing. Yes so we hit on two courtrooms of the book. Look i'm a centrist. I'm actually a registered independent. I'm not political. I don't care whether you're on the left or the right word ripped off this country and there's lots of ways the both parties could come together and create a system and appeals to both part in fact as i point out the model that i think is the best model which is both single payer and private multi pair layered on top is successfully done in australia and president trump has actually publicly called out. How effective the australian healthcare system is there as your pointers. Lots of opportunity for bipartisanship if we can get people out of their seidl. So the the second point is that as you've pointed out both the democrats and republicans are interested in finding ways to reduce drug costs so it is difficult to understand why we can't come to an agreement on this concept of we need to negotiate down. Our prices helped hold other countries accountable to spend a little more collective right. We can start to to narrow that gap. That actually is a bipartisan concept. That we were so stuck in our ways. We can't get hats now up earlier. You mentioned this a plan to work in the. Us context had to find some sort of compromiser bring together the sort of don't tread on me and united we stand and i thought at least a lot of people thought that the affordable care act obamacare. Some people call it at least went partway to that direction. Because of course it you know it did some more public stuff by expanding expanding medicaid and other things but it also created marketplaces that did give people choices. And so i'm wondering what you think about what you thought about the affordable care act as sort of if not an end goal at least the bridge to something better. Yeah so. I think it's a great point. I think to your point. The affordable care act was based on a republican health. Plan.

us president trump Clavier asthma cleveland klay clavijo Cleo medicare bill k. L. a. australia
"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

07:50 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"You know i mean even mean when i go talk to a specialist outside my area i have on their expertise and so i think it's not fair or realistic to expect people with no medical training to come in in a price transfers situation and say you know what i'm going to select back surgery or i'm not how sir. That's not a realistic way for people to call. Where does the other costs. Go to go back. Yeah yeah definitely. We spend far more money on health care administration. This country and any other countries were in fact. If you compare single payer country we spent two and a half to three times more that amounts to perhaps up to five hundred billion dollars per year in excess administrative costs. That's not to deliver health and now we also waste and there's a variety of types of wasting of experts like don berwick kept calculate ways estimated that about one in every three dollars. Anton health in this country is waste. Where does that go middlemen tests. That weren't needed so somebody's making money selling you the drugs that work needed drug costs in this country are higher than any other country in the world three to four times three hundred four hundred percent higher than pure nation pure waste. Why are we spending more for the same drug than someone who lives in our neighboring country. So the money gets diffused across multiple. Middlemen what is an insurance company provide for you peace of mind. They don't deliver healthcare. Their prophet is waste to you. The cussing and i've heard a lot of people argue. That insurance itself is the problem that really. We should have more of a catastrophic model because as long as there are you know. Low or no co pays. If if there's a service people are going to demand if they don't need it and doctors be providers might be more likely to provide it because they think well you know. I don't wanna get sued and have somebody say. Why didn't you run these tests. I is that a is that a big part of the problem and in your view. I think it is certainly part part of the problem. The the challenge with catastrophic all coverage is. It works greater rich. But i don't think people and the patient stories in this book what will remind. Hopefully they had an impact for you. Oh yeah if you go in and have a surgery that you think you're fully covered for because you have great insurance. You're still going to end up with co-pays co-insurance premiums and you're going to end up getting hit with thousands of dollars medical bill. Most americans cannot simply absorb out of blue completely unexpected. Five to ten thousand dollars bill at their insurance doesn't cover so catastrophic coverage rate if you make a ton of money and if something bad happens unexpectedly absorb a ten thousand dollar bill if not. That's not a luxury in california right and there's a reason why in this country i've hundred thousand americans per year declare bankruptcy due to medical bill. You know what. That number is in western europe zero. Yeah that really. That really hit me when you you've talked when you off focused on medical bankruptcy united states. I knew it was a problem. But i wasn't really aware of the magnitude of it until i. I read that and really really surprised me on me. Now one of the. I really appreciated op. So many people who write about reform anything they write about it as if we live in some sort of series of test tubes or something like that but you understand. I really appreciate this. That we have to for any kind of reform take into account american culture and that you know something that my work in sweden or china or something might not work here in the us and you specifically mentioned too key cultural and you call them. Don't tread on me and modern maximal consumerism. And i was hoping you could talk about those little bit and why you believe they matter for. Healthcare reform in the us context absolutely. I'd like with your permission to add a third on the medical theme which is united. We stand okay. So let's start with the tension. I will get some to maximal tumors. Let's start with the tension between. Don't tread on me. And united we stand both of which are fundamentally foundational this country they go back to the revolutionary war and they have repeated the lead to disagreements and conflicts throughout the history of our country age rights versus federal individuals versus collected. Right we tend to be less trusting of government in this country. Then people in western. That's not a value judgment. That is simply a statement whether i agree with that or not is irrelevant. The fact is many americans simply. Don't trust and if you go to those people and say you must purchase a single payer plan there going to be upset because they want choice staple even choice and they believe in competition. And i've had people tell me what i've said The answer may not be as simple as single payer. We've had people tell me you're going to create classes of healthcare. How can you advocate for anything other than single payer and my response is look. I personally believe single payer's go. I've analyzed data objective. Harmful game but i can tell you for every one of those people who believe single payer's way go. There was an equal and opposite person. Who thinks it's not right. And if we dig our heels in hyper partisanship. It's it's don't tread on me verses united we stand and you have to pick a team and nothing's gonna get done and we're going to continue to be ripped off and the answer lies in resolving that. How do you create a system that allows the united we stand but still with a short so that people don't feel trapped in spring or because the american spirit is going to push back against and nothing's going now your point about modern maximal consumers. This is in a sense in a sense gets back with issue price transparency. And how do you know what you need what you want. The former chair of public health arbor was quoted at one point saying some years ago. The trouble with american healthcare is that americans are the people think death is optional. And if you tell an american well. I can do this this this and this. They're going to say yes. I want all the question is is that really the thing. Is it really. I give examples in the book where people physicians want to prescribe a drug cost. Two hundred fifty thousand dollars per course and improves blood. Count recovery by five hours compared to control but that's most effective thing we have and they want to use it. Where does that two hundred and fifty thousand dollars come from. It comes from my budget. So am i gonna spend it on now. One person to get five hour faster. Blood count recovery or my going to spend it.

us don berwick Anton health california sweden arbor china
"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

07:47 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"A good. Healthcare system is hilarious. We have the shortest lifespan of any industrialized nation. If you look at always oecd countries that thirty six thirty six countries from across the globe that fool healthcare and financial information including many four. We rank twenty six thirty six in lifespan. That is way worse than many countries. That are a lot or if you look at more howdy that is can be prevented by healthcare that can be stopped by good healthcare delivery from a survey of seventy five countries across the world. We rank thirty fifth. Now the good news. We're halfway the good news. Is that we you know kuwait is that we've lost to estonia when you look at how we perform on death on lightspeed. It's atrocious given that. We spent three point five million dollars per year on healthcare. That dollar amount if it was its own economy would be the fifth largest economy in the world. That is more money spent on health care. In the united states the higher gross domestic product at the and for that massive we live shorter lives. Something is wrong just because we have good technology and highly trained doesn't mean we have an effective magnet deliver and so in other words even after we adjust or the size of our economy and population. We're spending pretty much. However you want to measure it way more than all of our peer countries and were doing worse in terms of what i guess you would say the four main things that we'd be concerned about with healthcare access cost efficiency and effectiveness is at all the more worse off five fox were at the bottom on the literally at the bottom on all of those compare nation. Now your point is a good one. So let's look at cost. You look at great cost costs five trillion most china's that's less than a trillion and four times less money than us provide healthier four times. More people now you say but they're pores talk. Let's unjust those costs per person or per gdp. You can do it either way. If you're worried about wealth the way to do it is to adjust for ddp whether you adjust per person or per gdp we are still the most expensive country in the world and we spent two two and a half times more than european western european wealthy nation. That are living much longer lifespan. So even if you adjust person our gdp our costs to two and a half old more than wealthy period. So i think the question that a lot of people ask this point is well. This money has to be going somewhere. Is it You know for for for doctors to get out. No ferraris or hospital administrators are insurers. I mean who's someone's making money off of this and who is yeah and it turns out that a lot of people it's not one. Let's start with dr now. I realize that. I have a conflict right so people need to pack in very overt about this in the book. I'm a physician. So when i tell you what i'm going to tell you that. It is true that positions in the united states more make more money earth physician than physicians in most other countries. Here's the wrinkle. When you look at the cost of the healthcare system it isn't a matter of how much individual a matter of how much will collect and while we make more money. Physicians in the united states person and positions in in european countries or other countries. We also have fewer if you multiply the number of physicians on salary and this was done in a very nice editorial by the famous health economist annual published. In jama years ago it turns out were in the middle to lower third of the world in your nation in terms of cost or physician overall because reason physicians in this country. Make a lotta. Money is an henschel explicit effort unlimited number -sition. so it's supply. We have our fewer physicians per capita get paid more for half got it the rest of the money. Go and i'll i'll take one more point. There is however an imbalance in specialty care and primary care in this country specialists make more money than primary care doctors and specialists do procedures the more invasive the procedure the more elective the procedure. The more money you make that is a side effect of fee for service medicine and no other healthcare system in the world is like yeah. Yeah do more things than we'll pay you more money the more invasive the more money you'll get paid that is not an intelligent way on healthcare. Yeah i wanted to ask you about that because it really seems with most goods we want more of whatever it is but with healthcare. It's kind of weird. Because our ideal utilization of healthcare services for most people would be zero. Because we don't really care about how many tests we just care about our health outcome so it sort of very different than other markets It is different than most capital markets. But you can think of it like what should be a fire. How do you wanna pay firemen breach fire. They outright or would you rather pay them money because their goal is not have fires happen and as soon as possible we treat healthcare like commodities and the analogy using. The book is from the tv show seinfeld or there's an episode. Jerry seinfeld is worried that his car mechanic is ripping them all money. His friend georgia's well of course trying to rip you off. That's what they do. they tell. You need a new johnson rod in your car. How do you know what's johnson rod. Imagine going to your doctor. And this is why i always laugh when people say. The answer is price transparency. Right you go to your doctor. You go to meet an infection. And i say you know what you really need so soon and lynette legendary infection not amoxicillin. That's going to be a thousand dollars a day instead of five. How do you know. Do you have the expertise to know what surgery you need antibiotics. You should be treated with no. This is not a realistic solution. This idea that. Our solution of cost savings as price transparency. That works when you're buying a book right or a simple commodity that you don't need technical expertise to truly understand. Yeah i think it's a great point. Made me think what in the book i remember. Thinking that off. Two years ago. I went to an ophthalmologist. And he said well i could. I could give you these generic drops. But i've really found that this brand name is better but you're going to cost low bit more and my immediate thought was well okay. He knows in these are my eyes. So i'm going to pay a little bit more. But i didn't know how do.

united states oecd Jerry seinfeld jama china lightspeed kuwait amoxicillin estonia georgia
"dr brad spellberg" Discussed on The Politics Guys

The Politics Guys

07:56 min | 9 months ago

"dr brad spellberg" Discussed on The Politics Guys

"Government among walk into the guys a place for bipartisan. Rational and civil debate on american politics policy a michael barone hausky a political scientist at northern kentucky university. My guest today is dr. brad's melber actor. Melwork is chief medical officer at the los angeles county university of southern california medical center and the associate dean for clinical affairs at the keck school of medicine at usc. He's also the author of the recently released book broken bankrupt and dying how to solve the great american healthcare ripple which will be talking about today mellberg. Welcome to the show. Thank you for having me so a lot of people probably most people. I would think would agree that there are some pretty serious problems with the american healthcare system. But what. I found interesting first off about your book is it seems to me that you argue that even calling you. The system is is kind of a reach. And i was thinking about that and it seems to me that we have. I would say a minimum of six systems. If if you've even call them that we have the employer provided insurance. I guess half of all americans get insurance. They're medicare medicaid individual insurance market The military veterans health systems and healthcare. Care for the uninsured. And so i thought maybe this will be a good place star. Kit can you talk a little bit. How this sort of non system or system of systems kind of really sort accidentally came about. Yeah i mean it's a great point and two to expand upon the six systems that you -scribed employer. Funded insurance typically utilizes private insurance essentially contract and there are myriad private insurance companies each of which sells myriad health plans you end up with dozens and dozens and dozens of health insurance hairs or healthcare airs which results in chaos administrative chaos as enormous amounts of waste as i described financial. Waste money just getting set. Fire to every year and personal timely. Why did we end up here. All unlike other countries in the world that have actually sat down and purposefully designed a healthcare system for their country in many different ways. There are private multi payer systems. That were eventually rational. Designed the us system was never intentionally not. It is in back and ask history. The reason why we have employer based health insurance is through laws passed in nineteen forty two that were designed to prevent post world war two in relation and to raise funds to enable the government to pay for were to. They had nothing to do with healthcare but the consequences of those laws was a freeze in employee salaries in the nineteen forties right at the time when companies were competing to hire people manufacturer the arms to fight the war while people were gonna ever seen so there a huge competition the job market and to prevent inflation government six wages but they did not spanish so employee benefit became the way companies competed with each other to lure in employees so they start pouring money into their benefit packages and at the same time we irs created tax break or insurance premium and so subtly both the employer and the perspective of flavor delighted have money moved from salary into insurance out your benefits because they'd get attached on both ends from that package and those laws effective those laws was that in the united states employer sponsored health insurance went from eight million to eighty million in a decade while. That was the beginning of our larry. Ously complicated us healthcare system. And then later you pile medicare and medicaid and on top and just further fragmented so really then people who complained or have problems with government. Getting involved in healthcare really government is to blame in a way for getting involved in that very strange way in the aftermath of world war. Two for what we have or don't have in a sense and it was an accident. It was an intention. The laws had nothing to do with health was a side effect. Laws got traded employer sponsored health insurance. I i would also point out to really points about government involvement in health care. Most people are concerned about government's delivery of that is like in the uk where the government owns. The hospitals employs the physicians and employees nurse. Many fewer people are concerned about one. Government hayes for healthcare. When you talk to people who are on medicare they generally love medicare. that's the government paying the insurance costs but paying private doctor. Who's an awesome and actually delivering care point one point number two if you look at international. Healthcare system systems in which government either provides or. he's for healthcare generally outperformed system in which there is a private marketplaces fragment and multiple different companies are participating in a fragment or we need to get people has this hyper polarization or one sided single payer and a half missing pair and on the other side. No we won't accept that it has to be private multi pair monica sector. What we need to as more from our neighboring countries throughout the world and our two months what model makes most and when we do look at these comparisons as you point out in the book there are a lot of ways in which the. Us doesn't come out really well but one thing i hear especially from my friends on the right. All the time. And i tend to agree is is about how incredibly advanced american healthcare is in for me being someone who was born and raised in cleveland. You know we always. When i was growing up there was always the world leaders. And other folks. Coming to the cleveland clinic. Get their cardiac surgery and that sort of thing and and obviously it's not just cleveland. I it seems to me that one way one thing we can point to with pride in the american system is at we are on the cutting edge in a lot of ways and is that is that the case would you. Would you agree with that. So yes we are on the cutting edge but that doesn't mean we have help okay. That's incurred oxygen. I'm going to resolve. This is a really important point. And i'm very happy that you brought up in america. We have the most healthcare allocate world and our physicians nurses are amongst if not the most highly trained world. Yeah we catastrophically underperformed out here. You can measure this by any way you want to say that we have.

government cleveland us michael barone dr. brad keck school of medicine associate dean for clinical af Melwork los angeles county university northern kentucky university scientist medical officer