HealthyGamerGG - What's Wrong with American Healthcare

Episode Date: June 26, 2020

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Can you imagine if you couldn't even decide which video game? Like, you didn't even know, like, you've got some weird nebulous. You pay $2,000 a month, and it's determined by your employer who that money goes to. And, like, the video game company can do, like, can you just imagine? Like, I can't even figure out how to frame this. If electronic arts could enter into an agreement with your employer to determine how much video games cost, in which video games you play, can you imagine how bad that system would be?

Like, it would be a complete train wreck. Oh, my God. This is going to be so painful. Okay, so do you guys know, like, how American healthcare works? Like, does anybody have any idea? Like, what happens? Like, let's start with the basics, okay? Insurance, great.

That's a great place to start. So we're going to start here, okay? So this is what happens. So here's a person. Okay? Here is their doctor, and I can't really draw a stethoscope, but that is a stethoscope. And it seems to be on top of their head. So, you know, good luck with that to a chat, because my drawing is terrible.

All right. And then here's the insurance company. So here's the first thing to understand. So, you know, generally speaking, what happens. is, you know, when I want a good or a service, I pay money, and then I receive the good or service, right? Like, let's say that I walk into the grocery store and I say, I want to buy an apple, like I pick up an apple off the shelf, I go to the checkout counter and I say, I would like to purchase this apple. And then the other person says, okay, the apple will cost you $1. And I give them

the dollar. And then I receive the apple. And then I take a bite of the apple. And I say that the Apple is bad. And then I go back and I say, hey, this apple is mealy and it has a worm in it. I would like my money back. And then the person at the cash register says, I'm sorry, all sales are final and we can't accept an apple that has been bitten into. Go screw yourself. And then I feel frustrated and I walk out and I decide I'm never going to purchase an apple from them again. So that's good because there's like feedback between like my purchasing power can be controlled based on my preferences and experiences. So here's what happens in our healthcare system, okay?

So what I purchase, I give money to the insurance company. Okay? And then I go and I get a service, let's call the service yellow from the doctor. And then what happens is the insurance company pays the doctor for my service. So the first thing is that, this is like a messed up system from feedback because I don't actually control. Like there's no like generally speaking what we would want in a perfect world is the money and the service to be directly

related so I can like have feedback based on, you know, if I don't like the doctor, then I can go to a different one. But like that's not how it works. So like here's practically what it happens. Right. So I go see my doctor. You guys have to understand that I'm biased about this, okay? Because I'm a doctor. So I have a biased perspective. So I go to my doctor, let's say, I don't know if I'm the doctor, whatever, but so let's say that like, you know, a patient goes to their doctor. And the doctor says, we think that you need this medicine because I think this is what you need. And then the patient then tries to get the medicine, but their insurance company says, we're not going to pay for that medicine because this one is cheaper. So it's kind of like if you go to a store and then you ask someone,

hey, I want to barbecue tonight. What do you think I should get? And then like the grill master at the store, the butcher says, we have a really great this. Like I think this would be really good and it will really be what you need. And then you kind of like say, okay, I want to get like a rack of baby rack ribs. And then

some other guy comes in and says, yeah, we're not going to pay for the baby back ribs because you know, pig feet are cheaper. And then you're like, but the expert told me that I should get baby rack ribs. and then this other dude is like, yeah, man, sorry, like, we're not going to pay for that because the pig feet, we've done studies or we believe that, like, people who eat pig feet are just as

healthy as people eat baby back ribs. It's all shit anyway. It's all pork. It's all unhealthy. So, we're not going to pay for the baby back ribs. And that's really frustrating for me as a physician because what the insurance company does is they're, like, basically, like, they're the ones with the money. So it's kind of like, it's kind of like you go to the store with your mom. And your mom is like, you're like, hey, can I get this thing, mom? And you gave her your allowance and she's hanging on to your allowance. And she's like, no, man, like, you can't get that thing because I don't think it's a good idea and it's expensive.

But you're like, but it's my money. And then your mom's like, no, but I'm like holding it for you. So I'm going to say no. So the first thing that I find frustrating about the healthcare system is that, you know, the insurance company actually has a vested interest in taking as much money as they can from the patient and then providing the least amount of care possible because that's like their incentive is not actually in helping patients. their incentive is in charging as much as they can,

and then like delivering as little health care as possible. Right? So it's kind of like, I mean, a simpler analogy is like, you know, I want to go and like I tell my patient, hey, I think you should like eat an apple every day. And then they're like, okay, so can I have the apple? And the insurance company is like, nah, man, we're going to get you a sack of potatoes.

And then you're like, but dude, I want an apple. And they're like, no, we think like potatoes. Like if you look at the calorie nutrition information, apples are 100 calories, a potato's 100 calories, so we're going to give you potatoes. And then as a physician, what I have to do,

because what happens is because potatoes are cheaper, right? So, like, even though the apple is better for the person than a potato, because potatoes have no vitamin C and they have scurvy, so I'm like, you should go eat an apple.

Then what I have to do as a physician is I have to send a form. The insurance company says, oh, you can get an apple. Absolutely. We wouldn't want to deny you an apple. All you have to do is send us a form. You have to fill out this one,

two-page form about why, the patient needs an apple, and then we'll give him the app. And so essentially what they do is they create an administrative burden for like doctors to give medicine to their patients that their patients need. And so then what happens is like doctors, like it's very frustrating to fill out forms and I have to fill out forms for all of my patients. And so then what happens is like they basically have they hire someone. So instead of paying for the apple, what they do is they hire someone to review all these applications and then make judgments about whether they're going to pay for it or not, depending on the clinical information.

Sort of makes sense. But then what happens is like they hire someone to essentially like block the Apple and basically pay less money. And they make it really hard for patients to get care. And then what happens by healthcare providers is we realize as doctors, like, I don't have two hours a day to fill out forms and fax them to the insurance company. So I hire someone to do that process form. So essentially what's happened is that like the patient is still getting the medicine.

At the end of the day, they're still getting the apple. But what's happened is we've increased costs on the insurance side because they have someone who's blocking the apple and we've increased costs on this side because I've hired someone to make sure that they don't block it. So we both hired an additional person to get the person the apple. So now we've just increased cost, just across the board, we've increased cost. We've increased costs. So the patient actually has to increase their premium.

Right? So now I have to bill the patient more. So this number goes up. This number goes up because of this and this. With no improvement in care. So one person says creating jobs, fine. So that's the first thing. Okay.

So then, so like this is just super messed up. because like it, you know, the insurance company, like, and actually there are some good reasons for this. So the counterpoint to this is that oftentimes doctors will do things. So doctors have a financial incentive to deliver the most expensive care to patients. And this actually gets worsened by the insurance company because what then everyone thinks is like, if I'm not billing the patient directly, if the insurance company is paying for it, I might as well do the most expensive shit. So like, if I can get away with CT, so let's say a CT costs about $200. Let's say an MRI costs about $900.

And if I'm billing insurance for it and I get paid $900, or like, let's say that my profit here is $300. And my profit here is $100. If I'm a physician, it's my incentive to order as many MRIs as I can as opposed to CT scans because I make more money with MRIs. So a CT scan is a CAT scan and an MRI is a magnetic resonance imaging. There are two kinds of imaging techniques. Now, the interesting thing is that if I was billing the patient directly, I would actually like consider that, right? So doctors do do that because like if I have a patient who's broke, I'm not going to charge

him like $900 to go bankrupt because that's just not generally speaking how the people in my profession work. Like if you've got a customer and they can't afford something, you're going to try to like keep that customer happy by doing like whatever you can. get away with. Right? So I very much consider my, my patient's financial needs in terms of trying to come up with like prescription plans and stuff like that. We try to, you know, help people out with that. And that sort of makes sense. Like, if you go to a store and you have like a relationship with that business, and the business is going to try to sometimes sell you the platinum thing. But if they can't

sell you the platinum thing, they're going to like try to at least sell you the silver. So I don't know if people can agree or disagree with that. But, you know, doctors definitely have, or healthcare systems definitely have a financial incentive to order more tests. Now, the problem is that, like, with the insurance premium, this guy's money essentially stays the same, right? Like, whether I do an MRI or a CT scan, they just pay a copay, and the cost that actually gets increased here is the insurance companies.

So that actually goes up if I choose an MRI over a CT. So then what happens is doctors are like, okay, like the patient is paying the premium anyway. the premium is fixed, so we might as well order as much shit as we can because they're not paying for it. I'm not going to screw the patient. It'll be good for them. I don't have to worry about cost because the insurance company, greedy-ass insurance companies are taking the money anyway, so we might as well like order the most expensive shit. And that sort of makes sense, right? But at the same time, it actually still increased costs for the whole system. And then this cost gets passed back to him in terms of increased premium.

because the insurance company ain't going to go out of business. So they're like, okay, if the doctor's billing all this crap, one thing that we can do is we can go back to the prior auth. So if you want an MRI instead of a CT scan, you have to send us additional paperwork. And then I'm like, okay, that's fine. I'm going to hire another person to make sure that all the prior oaths go through. So now we've sort of increased, yeah, screwed up incentives all around.

Okay. So, yeah, I mean, the MRI can do. in a third party. That's fine. But the point is that the doctor, if the patient isn't going to have to pay for it, the doctor is going to, actually a doctor can't order an MRI. I mean, they can't profit from an MRI technically. So like when I order tests for my patients, I don't make any money off of them. So, but I still really don't give a fuck because the insurance company is going to pay for it. So I'm like, you guys are paying the premiums anyway. So like you might as well get the best healthcare you can.

My point is that all the costs end up, so I don't know if you guys get this, but all the costs are like landing on this dude. Poor guy. Okay? So, I mean, this is even getting worse. It's going to get worse. Okay. So,

then the problem is that health insurance is so expensive that, do you guys know who pays for most health insurance in this country? Who decides how do humans get, how do people in their, how does the average American get their health insurance? Employers, right? So now, oh man, things are about to get wild. Okay? So now we see a third problem. This is just going to get worse because the patient doesn't even have control over which insurance company they use.

That's determined by this guy, right? So it's like if the patient says, I don't like how much you charge me for my premium or I don't like that you're not paying for this treatment that my doctor recommends, the patient can't even switch insurance companies. They have no recourse. There's no sense of feedback in terms of choice within the health care market. So I don't know if you guys get this, but when you don't have a choice in a market, then you're screwed. Right. So like right now, I mean, people talk about how predatory video game providers are. And I think that video game providers are like, they're like kindergarten compared to like the NBA when it comes to like health insurance companies. Because at the end of the day, you still get to decide which video games you purchase.

And that choice about how much you spend on skins or micro transactions or games empowers you a lot and keeps costs low. Can you imagine if you couldn't even decide which video game? Like you didn't even know, like you've got some weird. nebulous, you pay $2,000 a month, and it's determined by your employer who that money goes to. And like the video game company can do like, like, can you just imagine? Like, I can't even figure out how to frame this. If electronic arts could enter into an agreement with your employer to determine how much video games cost in which video games you play, can you imagine how bad that system would be? like it would be a complete train wreck. And so now let's think about the employer's incentives, okay?

So what are the employer's incentives? There is no TLDR. The whole reason this is a DLC, the TLDR is the system is fucked. No, no, so their incentive is not to hire healthy people, right? So the insurance company wants as many healthy people as it can get, for as high the premium I can get. So yeah, absolutely.

So people are saying worst cheapest plan possible. So the worst cheapest plan possible to get the employees that they want. Right. So now what they're doing is they kind of like they figure out like, okay, so we're going to try to give the insurance company a tiny dollar sign. And we don't want to give them a big dollar sign. We want to pay them as little as possible. But there's something that's really bizarre. which is that since the employer has 500 customers, right, because they have 500 employees,

they actually get a better rate from the insurance company because they're buying in bulk. So that actually keeps costs down. The problem is that if you try to buy insurance directly from an insurance company, you get no bulk discount. So what this means is that you have to get insurance through your employer because it's going to cost twice as much. So I'll give you guys an actual number, okay? I pay about $2,800 a month for my family's health insurance. For the same plan that is not through my employer, I can't even get the same plan.

For a plan that is worse than the plan that I have right now, if I buy it directly from the insurance company, it costs me $4,500. Yeah, I'm buying family health insurance. So family health insurance is expensive. $4,500 a month. Right? Absolutely. 50K in insurance premiums. So then what happens is there are all these kinds of weird like things because the employer sort of kind of doesn't give a shit, right? So they come up with all these weird like plans. And I don't know if you guys understand this, but the more complicated a financial instrument is, the more you're getting screwed. So like insurance plans have different ways of screwing you. Okay. So let's just think about a premium, a deductible, a co-pay.

Like, do you guys see like they're going to fuck you with each of these? The premium is amount. Okay, so this is dollars you pay per month. This is dollars you pay before they pay anything. This is dollars you pay no matter what. and then you have maximum dollars okay uh this is max dollars they pay after which you pay everything okay this doesn't even this doesn't even include pre-existing conditions so like you see how complicated this is? Like, this isn't an apple. Okay? So, like, let's use this in the grocery

store analogy. So in order to shop at our grocery store, you need to pay us $100 a month. The thing is, if you shop at our grocery store, we'll pay for your fruit. You have to pay us $100 monthly fee. Okay, great. But there's a deductible. How much is the deductible? It's $500. So we're going to pay for all of your fruit after you spend $500 here. And you have to pay us $100.00. And you have to pay us $100. a month anyway. Okay, fine. Even then when you come in after spending the first $500 of fruit and you're paying us $100, you have to pay up, you're paying me $100 and then you still have to pay the grocery store $500 before we'll pay the grocery store anything. After you pay the grocery store $500, when you go buy an apple, you have to pay a copay. So we're going to, when you buy an apple,

we're going to pay 80 cents and you're going to pay 20 cents. But the first 500 bucks, you have to pay all of it yourself. And then if you buy a thousand dollars worth of fruit, above that, we're not going to pay anything. So, like, that's just, like, bizarre. Like, there's so many variables in that equation. And then what happens is, like, it's confusing, like, because people don't even know what they're paying for. Like, it's bizarre. So I don't know if you guys, like, know anything about financial instruments, but, like, you know, the more complex the financial instrument, like, the worse it is for you. So annuities are, good example where they'll like, you know, there'll be some weird like life insurance instruments

that they'll like pay you some amount after some amount of years. And if you die, you get this. If this happens, you get this. And if this happens, you get this. The more ifs there are in the system, chances are, the more you're getting screwed. Chances are. Because sometimes you need ifs in the system. But then what happens is like, this is the decision making process. And then like, like, what is a good health insurance plan? So then like your employer is like, okay, well, then they like move all, they adjust all the levers, right? And then your employer is like, yeah, we have great health insurance. They'll cover $5 million worth of care.

But the question is, so they say that we have a $5 million policy. Great. But what's the deductible? $50,000. Oh, shit. What's the premium? $5,000. Oh, shit.

What's the copay? $100. Oh, shit. Right? So there are all these different levers, and it's just like confusing. Because if you're not happy with something like, I don't even know who you go to. Like the basic problem with this is that, you know, this person should be empowered to make the most decisions, right? This is what everything is about. It's not about this guy. It's not about this guy.

It's not even about me. Like I should, like these three people should have the least power in the relationship. This person should have the most power. Generally speaking, you want to give, if you want like a healthy market, you want to empower the consumer, right? Like you want the consumer or like, you know, good video games happen because gamers, like, generally speaking, I mean, some gamers buy shit games, but, like, part of the reason that I think we have so many good games now, and you guys are welcome to disagree with me. But I think that, like, part of the reason we have so many indie games is because people are out there, like, buying games that they want to play, and it supports indie developers.

It's not like NHL 2015, then NHL 2016, NHL 2017, NHL 2018. It's like we've got cool games. like we've got, you know, what are a couple of, like, I've been playing North Guard recently and DRG and like, you know, there are like all these cool, like indie games, right? That, I mean, I really like because, and we also have like big budget games that are awesome, like, Breath of the Wild, like, that's an awesome game. Like, there are a lot of great games out there. God of War on PS4 is awesome. Jedi Knight Fallen Order, which is an EA game. Oh my God, EA, they're so evil. But Jedi Knight is a fantastic game. And so as long as your consumer, like as a, as a, as a, as a video game consumer. Yeah, Dark Souls, Hollow Night, Larian, awesome. Cyberpunk 27, 2007, 2007, whatever. All these games are cool. We also have like Starcraft Brood War.

Like that game is pretty awesome. People say good things about Diablo 3. I never really had a chance to play it. Love Diablo 2. Yes, 7255. So this is how the healthcare system works. Right? And it's a mess.

because I think the consumer doesn't actually have choice. You have to get health insurance through your employer because your employer gets a significant discount. And then the last thing is like, you know, like costs just get passed down. Costs just get passed down, passed down, passed down, to the patient. Because here's the thing. I don't know if you guys know this,

but health insurance companies are not going out of business. Doctors are not going out of business. Employers are not going out of business. And so no matter like what, how you squeeze, like if the doctor starts prescribing expensive medicine to the insurance company, the insurance company is going to increase their premium. Or sorry, if you prescribe expensive medicine to the patient and the insurance company has to pay for it, they're going to jack up their premium. And then employers are going to kind of jockey to sort of provide the worst health insurance they can to keep people employed. And oftentimes that they do their best to provide like no insurance or just absolutely. crap insurance. There are a lot of good employers out there who like try to provide good insurance.

And it's just, the costs are astronomical. It's like, it's not, you know, it's like really kind of crazy. So, you know, my health insurance, my employer paid a portion of. So when I say it's like 2.5K, that's something that I'm paying out of pocket through the nose because I'm on COBRA now. Don't even get me started there. But before that, I used to pay like half and my employer would pay half. And I just decided I wanted good health insurance because I had like, you know, a wife who's having kids and shit like that. So, and I'm lucky because I can afford that. And it's like absolutely astronomical. And so this is how it works. Here's the healthcare DLC. Questions. Yeah. Cobra is ridiculous. Yeah. So I didn't even get started on all kinds of other stuff,

like PPO, HMO, all that stuff. I mean, that stuff is even worse. Like, I don't even know like this whole okay so like one more rant okay so like the idea that so I try not to talk about politics and I really don't think this is politics but it's become a political issue so should everyone in this country have health insurance ideally the perfect environment would be one where the consumer in the healthcare provider have a direct relationship where it's like person doctor and then you just it's just two-way, right? Because then you have the most, so money, service. The second that you add a third person, things get really messed up. You guys see that? It's like, that's weird, right? So you pay this

guy, this guy pays your doctor. And it's like what, like this is increasing costs by like 30% or more, 40%. Right? So there have been studies that show that like, if you look at the cost of healthcare for like every $1, the insurance industry is like 30 to 40% of that dollar. And the thing that boggles my mind is basically the only thing they're providing is like risk catching. Right?

That's the main value of an insurance company is that you may not have the money to pay for cancer treatment. So essentially what insurance is, what insurance companies do is they say, we're going to charge you $1,000 a month. And then if you get cancer, we'll pay like 50 grand for your cancer treatment. And they do that with 20 people. And so they hedge risk so that if something catastrophic happens to you, it's like, it's insurance, right? So it's about hedging risk.

And what they really provide is hedging risk. And that's a valuable service. Don't get me wrong. But it seems like they cost 30 to 40 percent of like every dollar that gets spent. Like hedging risk and spending 30 to 40 percent. percent of your money on, like, hedging risk is ridiculous. Okay, so what was I going to rant? Oh, yeah, so uninsured.

Okay. So then the other interesting thing is people say, like, oh, like, you know, universal health care is good or universal health care is bad. Like, this is the other thing that I think a lot of people don't realize. So when someone without insurance, so that's say this person with insurance, you guys want me to keep going because this is, is this interesting to you all? Or should I stop? Okay.

All right. So now this is going to blow y'all's mind. Okay. So let's say there's a hospital. Okay. So let's say someone with insurance goes to the hospital. Okay. And receives a service. How does their service get paid for? Okay. Insurance plus copay. Great. So now here's our insurance person, right? So this is what happens. So this hospital gets paid. So let's follow the money. Guys, remember always follow the money. So money. So money goes there. Right? So we're paying this and then this person is paying this. So who pays, at the end of the day, who pays for the health care that's provided? The patient. Absolutely. Okay, great. So let's say a person without insurance goes to the emergency room because they're having a heart attack. We're not even going to get into the whole part about preventive care and saving money and all that kind of crap. Okay? We're going to just avoid all that for a second. Let's say the, so who pays for the health care that the person without insurance? So who pays for that service?

Taxpayers. Okay, how? Talk to me. My tax money. How? How does your tax money pay for his health care? Nope. Doesn't have Medicaid.

Okay. Hospital takes a loss. Okay. So that's actually sort of true. So the hospital takes a loss. But you guys are right. you guys are right so now let's this is the part of the story that most people don't know so then the hospital goes to the u.s government and says u.s government we are taking a loss by caring for these people

and we're going to go out of business and we're going to have to shut down the hospital unless you guys pay us to stay in business because 20% of these people are uninsured and each time they come to the hospital it costs $50,000, we're going to have to close our doors unless you give us money. And then what happens, Twitter chat? Right? The government says, okay, we don't want you to close your doors because then there are going to be people dying in the street, so we're going to pay you money. And now wait for it, Twitter chat. Where does this money come from? Taxes. Right? And so this is the crazy thing. So there are a lot of people in this country who don't want universal health care, what they don't realize is they're paying for everyone's health care anyway.

Because hospitals are not going to take a loss. The other thing, oh, there's one other piece of deposit that you all, we forgot. So there are two ways in which this person gets. So questionable because, like, maybe they're printing money. Right? So maybe the, it's not coming through your taxes. Maybe the U.S. is just printing money. But when the hospital takes a loss, where do they make up the loss?

Where do they make up that a loss? Charging whom were? Absolutely, the insurance company. They make it up over here. So they increase the amount that they charge the insurance company, which in turn increases the amount they charge you. So like, I don't know if you guys get this, but the problem with our health care system is that this guy's getting screwed all the time.

Like all the time, no matter what happens, this is the guy who gets screwed. So to stay in business because the government doesn't give hospitals that much money, right? So like Medicaid pays like 30% or like 60% or like some ridiculous amount of costs. So in order for the hospital to break even, what they do is charge the insurance companies more. So like, I'll just give you guys an example. Okay. So for a particular health care system that I was studying, they charge, they collect, $250 on average for a 30-minute, 20-minute, for a 20-minute psychopharm appointment for a psychiatrist

from Blue Cross Blue Sheet. So when you go see your psychiatrist for 20 minutes and they'd give you a pill, they collect about $250 from Blue Cross Blue Sheet. For that same visit, for someone with Medicaid, they collect about $70. Like, why is there a $1? such a big difference. It's because the providers make up for this loss by jacking up prices to insurance companies, which then pass along those premiums to patients. And then everyone's saying 2.5K per month, 4.5K per month in insurance premiums, how the hell does that happen? That's how it happens, folks. This is how these ridiculous premiums get. This is how it happens. This is our healthcare system. So being uninsured is better? No, being uninsured is worse, because then the only

care you get is the emergency room. So like the whole point of insurance is that insurance provides preventive care so you never wind up in the emergency room. This is the thing that people don't get, is that like the guy who never takes his cholesterol medication or blood pressure medication, we're all playing for him anyway. So we have a choice. Either we pay for his heart attack or we pay five bucks a month for his blood pressure pills. Or we pay like $100,000 for his heart attack. Right? No, just don't buy health care as a terrible situation. What if you're rich without insurance? You get screwed. That's what's the thing in this country. People are getting screwed. Like even if you're rich and you pay for health insurance,

you're getting screwed anyway. Everyone's getting screwed. Like this is the dude who pays for everything. This guy. Right? It's like, anyway. What if you feel like that's what happens to people, right? So there's like so with with Obamacare which you know I really don't care about people's political affiliations like that the Obama care was like sort of a step in that I think it was a necessary evil is the way I'd describe it. But so what happened is that like they made insurance mandatory, which is kind of interesting because what they did is they forced all the people who don't need health insurance like young 23 year olds to buy health insurance to subsidize the cost. of the people who are like old and sick and need health insurance. Yeah, the system really is shit. Yeah, so like it's interesting.

I saw an article a couple months or about a year ago, but like a Nobel Prize, like a Nobel laureate auctioned off his Nobel Prize to pay for his healthcare because he was broke and he couldn't afford it. So he literally sold his Nobel Prize to pay for his health care. Like, it's bizarre. How do you change this? the system. Oh, man. Okay. So like I said, the first thing to do, a better system would be this.

This is the first thing. So people talk about, you know, socialized medicine and Obamacare and stuff like that. The real solution is to create a scenario in which the consumer has power over their dollar. Because then when they're the ones, like the reason that everyone is screwing this guy is because this guy doesn't have control over his own wallet. Like, so the consumer, guy who doesn't have power in the equation is the one that's going to get financially screwed. Right? Like, so what you've got to do is give the consumer power to choose. You try to make it as, like, that's the real solution.

What that looks like, I'm not entirely sure. But I think the first thing is to not have an insurance-based system. So not have something where your insurance pays for your health care, but you pay for your health care. So there are a couple of good examples of this. So Singapore requires all of its, I'm a little bit dated on this, but Singapore requires all of its people to save a certain percentage of their income into a health care savings account.

The interesting thing is that when you, so you can pay 30 grand in premiums. Okay, you can disagree with this however you want to, but I'm just going to offer an alternative, okay? 30K in premiums to insurance or you can have 30K in an account so the big difference here is that when you are in control of the $30,000 you're going to be way more careful about how you spend it when your insurance has your $30,000 they're not going to give a shit they're just going to try to pay for as little care as possible

because they've already got your money it's like an HSA absolutely right so like I think the core So Singapore also has a couple of other things. Like they have a safety net and other kinds of insurance-based things. But I think it's kind of an interesting idea. I think at the end of the day, so I'll give you guys just another random example.

Okay, so this is what I really think is messed up. So in ancient China, and this could be wrong, so I was taught this by a Chinese medical doctor, but I don't really know if this is true or not. In ancient China, this is the way that healthcare reimbursement worked. You pay a monthly fee to your doctor. Any month in which someone in your family gets sick, your doctor does not get paid. Fascinating, huh?

Completely different. Completely changes perspectives and incentives. The incentive becomes keeping you healthy as opposed to paying for care when you're sick. Yeah, get sick just to fuck with him. Yeah, I'm sure there are all kinds of problems. Honestly, there's got to be all kinds of problems with that. Because what if your doctor tells you to do something and you don't do it? Does he still not get paid?

I don't know. Maybe he fires you then. I don't know. But like our whole, our whole healthcare system, it's not health care. It's sick care. It's just like the incentives are completely perverse. They're just like they're just all messed up. That's my health care rent. Like this, this is just ridiculous, guys. This is even more ridiculous. It's just all ridiculous. So I mean, like I think that having a single pair system is good in some ways because at least because, you know, the government, and there are going to be political statements about this, too, so it's not really my place.

But so we do know, oh, so here's actually data. So let's do data. Okay. So the administrative cost of insurance is about 30 cents on the dollar. So the cost of having a private insurance company in the system is about 30 cents on the dollar. Can anybody guess what Medicare and Medicaid's administrative overhead is compared to 30 cents on the dollar compared to private, efficient insurance companies. Great. I love it. Three to four cents on the dollar. Three to four cents. Their administrative overhead for administering health insurance is 10% of what a private insurance company is. And do you guys know what administrative overhead includes? So here's the beautiful thing. Corporate salaries are administrative overhead. right so like it's not my place to say whether the government is corrupt or not corrupt

like i really don't know about that but like i can give you guys some statistics and if you guys want references i have references let me see if i can find them that's going to be sure oh shit let's just google it so i'm not sure what i mean i'm seeing articles from the new york times and other things, but here we'll show you. Paywall. So I don't know if this is, I mean, these aren't cited well, but Medicare has an overhead of about 3% private insurance has 25% to 30% that's wasted. I don't know, it's Washington Post, so it's not a primary study.

I think I've got the primary analysis somewhere. I just have to dig it up, but yeah. Yeah, so that's what I'm saying. I don't think those are good sources, so I'd have to find the primary. I've seen, I mean, I've seen the primary studies that are done in, like, health affairs. So there's, like, New England, New England Journal of Medicine and Health Affairs, I think, are where I've read this stuff before, and those, I think, are pretty reputable sources. But y'all are also welcome to disagree.

You know, common media, I just don't trust as much as, like, primary, like, literature. Here we go. this is also a blog. But health affairs is a pretty good source. Yeah. So for common, yeah, so this is like CMS.gov. So this is a good resource, right? So Medicare spending grows by an average of 4.3%.

Private insurance. So this is a good source. This, so now Twitter chat, like if you guys want good sources, this is the good stuff, man. CMS.gov, baby. like not New York Times, not Washington Post, you go straight to CMS.gov. It's like that's where the good shit is. National Academy for Social Insurance, I don't know what that is. Yeah.

Okay, so Kaiser Family Foundation. That too is Kaiser. Says 2% of operating expenditures. Administrative costs are closer to 17%. Yeah, interesting. Anyway, if you guys want good data, like this is where you got to go. Like, you got to go to CMS.gov, right? Go to the primary source.

So those are the DLCs, my friends. A couple of other closing thoughts. One is, so just in terms of all the stuff that's going on with like sexual assault and misbehavior, we do have like a safe space for women on our Discord, which I recognize some people have issues with. and if we have it for women, why don't we have it for other communities and all that good stuff? Like, that's an important discussion. The short answer is that it seems like women get a lot of, you know, bad responses from people.

And so we do have a space for women to feel free to, like, you know, talk about issues and feel safe. You guys can check it out on our Discord. I think go to the announcement section and there's a way to join. and yeah. So, you know, if you guys are struggling with any of that stuff and you need a place to go, like that's one place that you can go, I still sort of, so we recognize the importance of that at the same time, I think a big part of our mission at Healthy Gamer is that, you know, I personally believe that our shared experiences at human being, as human beings trump at the

end of the day, any kind of gender or identity-based experience. I think that at the end of the day, what brings us together as human beings is like greater than what separates us. It's another way to put it. And at the same time, I fully admit and acknowledge that, you know, depending on your race, your gender or ethnicity or any number of other factors, your experience of life is going to be fundamentally different. And so, like, you know, balancing that as trick. and I think at the end of the day that we're all just people and I'm, you know,

Healthy Gamer is here to support people and sometimes some people need more support than other people. So that's kind of how we work. Thank you guys very much for coming. We've got a lot of exciting stuff kind of coming out. So a couple of closing announcements so we're going to have

someone Yvonne from Offline TV on Wednesday. we have Austin, who has like some dating shows and stuff on Twitch on Friday. Our coaching program is live and is going well, thankfully. So I think people are getting helped and stuff like that. We're going to be opening up new spots, I think, today. And then some more spots, maybe one more week from now where we may be kind of full after that.

But go ahead and sign up for the waiting list. We also started training our next batch of coaches, actually today. So we had our first coach training a couple hours ago. And so we're going to try to train them over the next couple of months. It does take time because we want to make sure that they're able to do their good job, a good job. And we have sort of a pretty hectic training schedule where they work with people. And we sort of supervise their coaching and make sure that they can do a good job.

So it takes a couple of months to train them about three months, four months. And yeah. And I think the last thing that is that we're working on sort of more different kinds of content, kind of stuff like this, but we probably won't necessarily stream at all, but like we want to do like kind of more comprehensive content. So we're kind of working on all that stuff. And we appreciate all the support. Last couple of thoughts is, you know, I get a lot of requests from parents.

And give me just once.