Stuff You Should Know - Health Care Systems Around the World

Episode Date: October 6, 2009

In this final installment of their 4-part suite on health care, Josh, Chuck and Molly take a tour of health care systems around the world, from France to Switzerland. Learn more about your ad-choices at https://www.iheartpodcastnetwork.comSee omnystudio.com/listener for privacy information.

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Save 10% off your first purchase of a website or domain. Brought to you by the reinvented 2012 Camry. It's ready. Are you? Welcome to Stuff You Should Know. From HowStuffWorks.com Hey and welcome to the podcast. I'm Josh Clark.

With me as always is Charles W. Chuck Bryant. Sliding into my seat. And with us is Dr. Molly Edmonds, M.D., S.Y.R., Ph.D., LLC. Right? Yes. Did I get all of those, Molly? I think so. This is the final installment of our four part health care reform suite.

We've reached the end of the final countdown. Can I just say speaking for Molly and I, thank God. Yeah, you're not speaking for me too. You think I like this Chuck? You ready to move on? Yeah. Okay. Okay, so we've talked about health care reform.

Well Molly, what was that statistic that you mentioned a long time ago in a podcast far, far away where you said like only one in eight Americans think that the health care system in the U.S. needs reforming? Eight out of ten people are happy with their health care as it is. Okay, so what we've kind of deconstructed is why health care reform is even on the table. We've talked about the uninsured, right? Yes.

We've talked about the fact that America has really, really terrible like mortality rates or disease rates, chronic disease rates, that kind of stuff. So that in and of itself makes the health care system worth fixing, right? But one thing that hasn't been brought up and I haven't seen it brought up in coverage too much is the fact that our health care system is actually keeping us from competing as well as we could on a global scale, right? Okay. Which is why we would compare ourselves to other health care systems around the world.

You know, the thing is that no one in this country wants to become like any other system in the world, but I don't know if you could find anyone who lives in another country who wants to trade place with an American when it comes to their health care. Well put. Well put. Let's talk about competitiveness and the health care reform system via Dr. Michael Royzen, who you guys might remember, right? Yes.

What is he? Dr. Royzen is the chief wellness officer of the Cleveland Clinic. And? My hero. And the co-author of the You the Owner's Manual book series, right? With Dr. Oz. Here is what he had to say. Because health care is a expensive thing in America and that we need reform for the

economy to function for jobs to be created and for us to be competitive with Europe and Asia for jobs and for us to not worry about a falling standard of living and for people to not worry, not have the stress of worrying about, will there be health care for me when I need it that I can afford? Okay. So if we're going to keep up with Europe and Asia like Dr. Royzen suggested we could by reforming our health care system, maybe we should kind of peek in on what other countries around the world are doing, whether for better or for worse.

Molly, you wrote this article, 10 health care systems around the world, right? Which is up on the site. Yeah. It's sort of, I think, a virtual hot air balloon ride through the world of health care. It was. It was a delightful one, too. It was beautiful. I liked it.

So many bloody bandages. Very peaceful. So was there any particular health care system that struck you as arguably better than the US? Oh, we. Or better than all the other ones, actually. We? We, we.

Let's talk about France. Oh, gotcha. Get it? Yeah. I do now. We means yes. I got you. It's like.

She means touch. She means touch. Yeah. Okay. France. They apparently have the best health care in the world. So says the World Health Organization, right? Yeah.

It's hard to argue with who. All right. Moving on then. What's next? No, that's actually, I think just because it's become a relic in the health care reform debate in the United States that who 2000 report of 191 countries health care system rankings is controversial. I think we should say that.

Yeah. We got everybody's like, oh, well, who said that? So. Okay. It must be true. But again, you can pick apart anything, but so let's just stick to the fact that France was rated number one in the year 2000 by the World Health Organization's rankings of 191 countries, right?

Right. Okay. So they'll put in money based on their income. You can't opt out of it. And then in return, they'll get about 70% of their health care paid for by the government. You can get same day appointments. You can choose any health care provider you'd like. But okay.

So we said 70%. How do they pay for the other 30% they'll have supplemental insurance with either a public or a private plan. And that is more similar to how we have in the US where that supplemental plan might come from your employer. So there are a couple of problems with the French system and it's not flawless. No. There is no flawless plan.

We should go ahead and say that. You lie. I saw one guy that said it like this. He said it's sort of like Medicare for everybody. With the French system? Yeah. I got you. And he was a pro.

So they make up the other 30% with private plans, right? Private or public. And that's the problem is if you have money, then you would probably opt for a private plan. So some critics would say that the French plan is to divide it by class. People who want really good care and can pay for it get it. Those who can't don't. But they do that in England too.

You can also get your private insurance. Right. Yeah. And we should say for a kind of a comprehensive rundown of England, Molly gave one in the third podcast. So we're not going to talk about those. We're going to skip one. We're going to skip one.

It's nice. Okay. It was a nice step on the balloon ride. But here's how France got its awesome rating, okay? It spins 3,300 per person on healthcare while the U.S. spins over twice that. So already they're using money pretty well. And if you get really sick, like you have just the worst form of cancer in the world, everything is paid for.

Yeah. That's what I saw that your article and some other stuff I read is that if the sicker you are in France, the better off you've got it or the easier and quicker your claims will get paid as well. Exactly. But it's not just the really sick who benefit because I think what's cool about France is they have the lowest rate of deaths that could have been prevented. The U.S. has the highest number of these preventable deaths that they say or if you had had an

early diagnosis or if you'd had an early treatment for incondition. I did see also in another article I read that one of the criticisms is that there's not great coordination between the GPs and the specialists in France. But if you're talking about problems, that's not the worst thing in the world. That's better than being denied for a pre-existing condition, I think. Wouldn't you say? I wouldn't say, yeah. You guys done with France?

Because I'd like to get back in the balloon. Okay. And just head on over a few kilometers, a few clicks, if you will, to Germany. Which is out of the healthcare systems in the article. This one's my favorite. And I'm not embarrassed to say that one of the reasons why is because of the ample access to spa days and even the public health insurance plans, right? Right.

And there's 200 of them, correct? And they're employer and employee funded, right? Yeah. And you know where that comes from is actually in 1883, old Otto von Bismarck was like, I had the spikiest old Otto. He was like, I want some healthcare like they had back in the days of guilds. And so he is basing all of this off the fact that when you were in your medieval guild for being, you know, the podcasters guild, right, you know, cloth makers guild, you

know, Germany, that was how they named them. They all paid for each other sick time. They all got together and it would be like us saying podcasters, let's have to pay for Josh's care when he has a stroke from smoking. We can't even get podcasters to unite under this roof. I doubt if we can get it all around the world and so you never know. Good luck with that. Good luck with that guild.

And follow the Bismarck model. This is a pretty old system and it's been around for hundreds of years, but it's because they're always willing to keep performing it. Yeah. I noticed that in another article from Berlin University, actually, it was kind of a rundown of the German healthcare system. All these different years kept coming up like they try new things like every year or two. And it seems like that's probably what you'd have to do.

I think the impression that a lot of people in America have whether supporters or opponents is that this healthcare reform is going to happen and that's it. And I think you make a very valid point that it has to keep evolving and changing as problems come up or as things prove very effective, you put more money into this or take funding away from that. Right. So one of their cool new initiatives are these disease management programs where if the patient gets more counseling from a doctor, like if a nurse calls them up at home to make

sure they're taking their meds, sticking with their diet, these people have much lower rates of hospital admissions and much lower rates of deaths than people who have the exact same conditions who aren't getting that counseling. So I think that's a pretty cool way to approach disease. I don't know. I could see like half the people in the United States thinking it's really nice to get a call and half the people would be like, stay out of my business, nurse. Right.

How'd you get this number? Right. I think the nurses and the doctors love the system. I would say that you read a lot of articles about how the German doctors feel underpaid. Yeah. They're the ones who protest the most often, right? Right. German doctors?

Yeah. It says they're paid about two-thirds what American doctors make, but they pay less for a malpractice insurance and some of them go to school for free, med school. And you know, one cool fact that I did not manage to squeeze into this article, but those plans, those two inner plans that we were talking about, those plans get incentives if they get sicker people on their rosters. So instead of a system like in the U.S. where we deny people, where we tend to deny people, they get benefits for doing that in Germany.

That's pretty cool. I also saw where you can, in Germany, you can go straight to a specialist, like you don't have to go through your gatekeeper GP, which is kind of cool. Also there is a private insurance market for people who make over 48,000 euros a year. Oh, really? It's not compulsory for those people, actually. Long-term health insurance is compulsory for everybody, but basic health care coverage isn't compulsory for people who make over 48,000 euros a year.

So there's another, I guess, accompanying private insurance market, but that's still regulated by the government. There's like, you can't deny for pre-existing conditions, and apparently your rates are assessed when you enter that private system based on your risk, but that's it. There's a one-time risk assessment, and that sticks with you for the rest of your life. 2023 is already well underway, everybody, so don't wait any longer to level up your small business, and the way you can do that is by joining up with Stamps.com. That's right, because with Stamps.com, you're going to be able to print your own postage

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Start your journey at toyota.com slash let's go places. I miss the Deutsche Mark. I'm just going to go and say that. You miss the Deutsche Mark? Yeah. I miss the Deutsche Mark. What an odd thing to say. I miss the Frank.

I miss this whole Euro business. Yeah. But I hate to change money from country to country. I thought it was kind of thrilling. But then you're left with your leftover coins. Yeah. But then you take them and you give them to your cousins and nephews and nieces. You're such a giver, Chuck.

I actually haven't been to Europe since they introduced the Euro, so I'd probably love it. Speaking of redistributing money. Oh, I know we're going next. This is going to be kind of a long balloon ride. So let's just flash forward to when we land in Cuba. So Cuba, let's talk. They have health care for, well, you'd give this skinny because I have, I just read some

articles where they say it wouldn't look great. Well, you know, the famous example, I think Cuba, if you're a Michael Moore fan is when he took people to Cuba so they could get better care than they could in the United States and, you know, it was meant to embarrass the U.S. health care system. There are obviously a lot of critics, as with anything Michael Moore does, of how it was portrayed in the movie. And some people say that there is sort of one level for the people they're going to impress and then one level for everyone else.

Right. But I do think that even those people who are in maybe that lower echelon get an immense amount of preventative care. That's pretty, pretty cool. Well, that's, it sounds like they do do a pretty good job with preventative care because they kind of have to. Well, you guys were talking about Germany and doctors or nurses calling you up, going, how are you doing?

If you had a problem with that, you'd probably really have a problem with Cuba because any person is subject to a surprise visit from their physician. Once a year. Yeah. They just are going to stop by. They just show up at your door. See what you're doing? What are you eating?

They're like, well, we're here. What's under your mattress? And what's in your closet? Well, see, that's sort of the problem is that, you know, because they, they have good preventive care because they may not have, let's say a fridge or access to really fatty food or really great car. Okay. So it's almost like the, you know, what we would see is the deficiencies in Cuba have

created a culture whereby they walk a lot. Yeah. Right. They don't have fast food. Right. It's coming. They say that that might be sort of the next wave of obesity as Cuba is getting some fast food.

Really? Yeah. Well, as a result, Cuba, they have, I think they spend 260 bucks a person on health care. A year. A year. Yeah. All right. Because they're really good with preventative wellness.

Right. But I do want to point out, you know, sometimes I believe you brought it up, Josh. There's the thought that if we spend a lot less on health care, we'll really skimp on our innovation. But Cuba, surprisingly, is known for its innovation and medical breakthroughs. I have heard that. Yeah. They, the medical sector is their sixth largest in exports, obviously not to the U S, but

they really got put themselves on the map with some vaccines they've come up with first meningitis B and then hepatitis B. And so they're really making a name for themselves in terms of their pharmaceutical and mechanical medical equipment exports. Chuck, you referenced some articles that you'd read that in criticized the Cuban health care system. I think this is one of the systems where it all depends on what side you're reading. Definitely. Because I read a bunch of articles that said, and a lot of these people interviewed Cuban

refugees that were now living in America, and they said things like there's two health care systems, one for health tourists, which apparently Michael Moore is a health tourist, and that's a big deal. I mean, it's got a camera crew following yourself around. Right. You're going to get treated differently. But there's health tourism is a big deal there, and you can go and pay cash. And so there's one system for Communist Party officials and health tourists, and then one

for the rest of Cuba. And they maintain that, you know, if you're the rest of Cuba, you can't get things like aspirin. You can't get antibiotics unless it's on the black market, and you don't have access to a lot of like basic medical care. You have to bring your own sheets to the hospital, stuff like that. Well, I think there's also a concern that they get these really great statistics by fudging their numbers a little bit.

Right. Like Cuba has really good rates of infant mortality. I thought that was interesting. But in the United States, you know, if a baby is born and only lives a very short period of time, we count that. Right. Whereas if it was alive for the same period of time in Cuba, they may count that as dead on arrival.

Right. And didn't you also say that some doctors allegedly will suggest abortions in the womb? You know, the government suggests they abort a fetus that might be developmentally disabled or something, right? Right. You know, there's just concern that they have great numbers, but because, you know, we don't really know much about what goes on inside the country, we don't exactly know how they get them.

Right. Cuba's really nice to visit. It can be hard to separate your opinions on the Cuban health system from your opinions just on Cuba, the country. Right. So I don't want to oversell Cuba. Okay. But I'm glad I got to visit the balloon.

I don't have any opinions on Cuba other than what I've heard from a couple of friends who have traveled there and said it was really awesome and the people were lovely and the country was beautiful and I said that politics aside, the country itself they love. It's illegal. It's illegal. Actually, not true. So you guys, let's head on over to China. Okay.

Well, here we are in China, and this place is kind of screwed up. I mean, I don't know if I'd want to get sick here. It used to be pretty good from what I understand in your article that there was a cooperative health care system, right? Right. And they dismantled it. And that just didn't go very well because, you know, no one knew where to send the bill and the places they were sending the bill didn't pay up.

And what the huge effect of this was that there's a giant divide between health care and cities and health care in the rural areas. Yeah. One of the, I guess, ideas for Chinese health care reform was that all farmers pay a dollar for health care in a year and they balked at that as being too expensive. Are the rural Chinese that poor, really, or is health care just not really taken seriously over there or what? Well, I think they were also saying that, yes, a dollar was high, especially for the

care they got. I was reading one article, I believe it was in the New York Times, about how you go to some of these rural clinics and stray dogs are walking the halls of the clinics. But it's not worth a dollar a year. Stray dogs in your hospital? So they bring dogs into American hospitals to perk up cancer patients and stuff? Yeah, nice, healthy ones, not ones that look like they're going to die. You don't know whether they're stray or not.

You're talking about the, like, they have different names at every hospital, I guess, but Love on Four Paws? Sure. That kind of program? Sure. Stray dogs. Love, too. Not in American, not in hospitals.

Well, okay, so China's, in addition to its ridding the hospitals of stray dogs initiatives, they're planning on building 700,000, I guess, probably pet unfriendly clinics in rural areas. Well, I mean, maybe they'll bring the nice dogs into those clinics, but yes, they are in the middle of funneling just a ton of money into their healthcare system in the hopes that they can eradicate this divide between Rich and Four. Over the next 10 years or so, 10 or 11 years? Yeah, but by 2011, 90% of the population will have health insurance. They're hoping.

Fingers crossed. $124 billion on it? Yes, $850 billion yen. You want? I don't really know how to pronounce that thing in China. You want. You want. That didn't sound like very much money to me.

No, it doesn't. To build 700,000 clinics? Yeah. Well, the other problem is, Molly points out that 40% of that money is supposed to come from the central government, which means provincial governments are going to have to make up the rest, and right now, no one knows if they're going to pay up, right? It's sort of the problem they had when they first dismantled them. Yeah.

No one wants to pay for healthcare. That's true everywhere. Yeah. But you know, in a place where they do pay? Are we going back to our balloon now? Yeah. Sure. Do we have enough gas?

It's run on unicorn tears. Excellent. Okay. Do we have enough unicorn tears to make it to Taiwan, you think? Oh, I hope so, because Taiwan's got a pretty nifty system. I don't think it would work in this country, but... Dude, the smart card. The smart card sounds so convenient, although kind of nerve-wracking for someone like me

who has the tendency to lose things. Wait, wait, you guys. Can you only get one? So we get to Taiwan. Okay. Here we are. We're in Taiwan. I wanted to brief check before we got there.

No chatting along the way. Let's just all sit silently in our balloon basket. Just a silent flight. All right. So we're in Taiwan now. This is lovely. So back to the smart card. Yeah.

Before we were... Exactly. Okay. So you get a smart card. It's got your entire medical history on it. Right. And you can just show up to a doctor, give them your card, and they can pull up your entire medical history.

And that is how they will also build a government. So it's like your healthcare credit card that you never have to see the bill for. And it's your entire medical history. Now, of course there are people who say that's way too much information for any government to have about a person. I like the idea of the smart card. I wouldn't mind all my medical information being on one card because I'm a little distressed every time I go to the doctor and I see them pull out a paper file in the midst of thousands

of paper files. It seems very archaic to me. Well, I've moved quite a bit and I just hate having to kind of start over every time with every doctor. Right. And what do you do? I actually haven't changed doctors much. Do you get them to send everything to your new doctor?

I think you're supposed to. Really? Yeah. Maybe I shouldn't reveal how poorly I manage my health switchovers because I am a health writer. The smart card sounds weird. Well, yeah. Medical billing, medical information, it's a huge, huge problem in the U.S. just in administrative

costs and time. Yeah. And that's the thing that was cool about what Taiwan did is that in expanding coverage to cover so much more of the population, they cut all those costs because now they have no administrative costs essentially. Right. But the fact of the matter is that now Taiwan doesn't spend enough on healthcare to cover their costs.

Right. And the Taiwanese have gotten used to these really low healthcare costs and people are afraid to raise the taxes, the age-old story. Yeah. I saw where the average family premium is $650 a year in Taiwan. Yeah, I can't even pay the car insurance for that. So are we done with Taiwan? Is that smart card?

This place is really clean, by the way. Have you noticed? I have. And the food's good. Yeah. We're going next. Let's go to Russia. Okay, guys, thank you again for not speaking during the balloon ride, so we're in Russia

now. And unfortunately, this is not a good place to get sick, so no one drank the water here, okay? Okay, right. Wait, you can't drink the water in Russia? No. Oh, no. Giardia.

Okay. Really? Wow. I didn't know that. You think they would have had that worked out? No. So they got... Not in a place that has one of the four worst healthcare systems in the world.

Right. Is there another one we may have heard of that's in that list? According to foreign policy, the United States also makes that list. It was a foreign policy article, so it's not stellar. The World Health Organization that we mentioned earlier ranks them 130 out of 191. Wow. So, you know, they've got a fair bit of money. It seems like they should be doing a little bit better.

Right. And this is another system, sort of like China, where they dismantled their old Soviet system, which was pretty well admired around the world, and tried to create a public-private combo system. And basically, this system works well in theory, but sucks in practice. Yeah, financially, it doesn't work out, right? I don't even think of... I mean, financially, personally, you've got to show up with a pretty hefty bribe to see

a doctor in Russia. Yeah, I thought that was really interesting. I mean, a donation. That on paper or, you know, spoken, it's 90% of the population's covered, but the government doesn't really pay up, and so to keep operating, hospitals and doctors go, I need you to give me a donation, buddy, or else I'm not going to treat you. It's extortion for health care, which is nuts. Can we just be careful?

Because I don't want Vladimir Putin to listen to this podcast. You can come wrestle a tiger in the hand. Yeah, he'll take his shirt off. And listen to the word extortion, so let's make our stop here brief. I think what's good to know is that the World Health Organization, love it or leave it, recommends that countries spend about 5% of their total spending on health care, and Russia spends 3.4%. Okay, I don't want to alarm anybody.

Some guys just pointed at us, and they're starting to come over, so we should probably get back to our balloon. Okay? Let's go to a pretty happy place, Canada. Okay. Yeah, we had a lot of Canadians right in, so what about us? We have a lot of Canadian fans, and so we're going to talk about you all now up there in the great white north.

Okay, I'm going to let that one slide. We're here in Canada now. Thank you, Molly, for not speaking during the journey. I couldn't be quelled any longer. I was writing a personal's ad for a mountain. Okay. So let's see if we can find you one here, but first, let's talk about the health care system in Canada.

This is the one that the U.S. is often compared to if we go to socialize men or something. Because Canada, I always feel bad for them, because they serve as some sort of cautionary tale for what we don't want, but from what I hear, it's not nearly as bad as we've been told by some quarters. Me too. I've heard that too. Right. People are trying to treat Canada like the worst case scenario, and I think that this

is due to a lot of commercials, and from what I can understand, I mean, I haven't talked to these people myself, but it seems like people are very good about going and finding the people who did have just staggering long wait times and put them in the commercial. Right. I have some Canadian friends who I keep up with on the blog, and they've written me before and said, you know, it's not perfect over here. Wait times aren't nearly as bad as they're depicted, though, and we'll take it any day. And I think wait times were really bad back in the 80s and early 90s.

And then in the 90s, Canada invested billions of dollars to improve the statistics. And so now if you want to head over to a clinic, before you go over, you type in which clinic you want, and they will tell you what the wait time is. Oh, cool. So that sort of transparency, I think, is pretty hard to find in this country. And then the wait times, it's not for basic care, right, and usually for special elective surgeries and stuff like that. The waits are longest for knee replacement, sort of elective things, and I think that

one of the ways that Canada does keep their costs low in comparison to the United States is they don't buy every single new fangled machine that comes out. In the United States, we have a tendency to buy every single cool gadget, and that really can make our healthcare system seem like it's working really well. It really does provide us a great level of care, but it doesn't mean that the old machines were necessarily in bad shape. Right. But there appears to be something of an equally American sentiment among Canadians that they

do like their pretty machines like an MRI, a newer MRI, because you mentioned in the article there's, I guess, a subculture of rogue doctors who offer unlicensed illegal medicine for people who don't want to wait and can pay up, I assume, right? Right. I mean, I think that's sort of the message you can take from any of these systems is the people who have money will use it. We should also say that if you're going to compare a country with socialized medicine to what the fear of what the US might become, you shouldn't point to Canada, you'd be much

better off pointing to Britain, because while Canada does have a single payer government system of healthcare, the hospitals and doctors are private entities, they're private enterprises. Right. In Britain, they run the hospitals and pay their doctors, but in Canada, it's just single payer, and let's talk about what that means, because single payer seems like such a dirty word to people. Here's how Canada pays for their health insurance. The citizens fund their healthcare by paying income taxes and sales taxes, and then all

that money is sort of funneled through to the provinces and the territories, so it's not even like Canada as an entity is pushing out the money. Gotcha. You clear on that, Josh? I am. Do you want a fun fact? Yeah, please. Did you know that open heart surgery costs 30% less in Toronto than it does in Chicago?

Really? Yes. That's crazy. Also, prescription drugs tend to cost a lot less in Canada. From what I understand from Royzen during that phone interview, it's because Canada promotes far more competition among pharmaceutical companies. The same pharmaceutical companies that might be based in the U.S. are doing business here in the U.S.

Or based in Switzerland. This is why their costs are lower for pharmaceuticals. Right. And also, doctors and nurses make a fair bit less. So I don't know if doctors want to go to a Canadian system. Okay, kids, one last stop on our whistle stop tour. Make it a good one. I feel like doing some skiing.

Let's go to Switzerland. A little good chocolate. Okay, here we are in our last stop. We're in Switzerland. It's beautiful. You see the red crosses everywhere. The alps and the nice, smiling red, apple-cheeked faces. I'm going to stay neutral and not give you an opinion on this.

Okay. That's all that one coming. Their healthcare system is really expensive. Really, really expensive. And yet, Americans who are looking for alternatives abroad seem to love it. Both Democrats and Republicans. It's a pretty good system, but it's just expensive, right? Well, they have free choice, but they pay for that.

They do. What do you mean by that? Well, I will tell you. Okay. You know how everyone here is offered to have a public health option? It's all private plans in Switzerland. It's not tied to your employment at all. You just can go into a marketplace, let's say, for lack of a better word, pick your

private plan and make it as fancy as you want. And it can cost a lot. You can't. Are you ready for the state? Yeah. $750 per family, per month, not for you. Yeah. It's a pretty steep.

So generally, Republicans like the choice you can have of private plans, and Democrats like the fact that even though that's expensive, everyone's covered because those who can't afford it receive subsidies from the government. But I don't know if you want to go from being the first expensive, most expensive healthcare system in the world to the second most expensive healthcare system in the world. One of the things I found significant in your article about Switzerland was that healthcare providers aren't allowed to make a profit off of basic healthcare. They make their profit off of elective surgeries, optometry, things like that.

Alternative medicine, just the right to get a private room in a hospital. That's a little bit extra. So yeah, everyone's private plan is essentially the same, and everyone pays the same. That's a key thing. It's not tied to how much money you make. Right. Regressive, not progressive. Wow.

Nice. I've got a little fact for you, too. One of the largest insurance companies in Switzerland pays out claims in five business days. Whoa. That's awesome. And people love it, they said. I'm sure.

Clearly. You guys want to go back to the studio? Not really. You got your chocolate? I kind of like to hear in Switzerland, to be honest. I want to stay here in Switzerland. I'm going to go back to the studio and wrap this up, right? Good knowing you.

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scale. No long term commitments or contracts. Just go to Stamps.com, click on the microphone at the top of the page and enter our code stuff. There's something about getting into a vehicle that opens a world of possibilities. You slide behind the wheel, close the door, start the engine and a little part of you immediately thinks, where to next? Where will this drive take me?

What adventures lie ahead? At Toyota, they're all about that where to next spirit. Toyota believes life is bigger when you get out there and discover more of it. That's why they make vehicles for every stage of life. So you never stop having experiences and creating memories like I'll never forget this one road trip. My wife and I took from San Francisco down to San Diego along the coastal highway. We stopped in Big Sur, we explored little towns along the California coast.

It was magical. And listen, even a short trip to the store may turn into a lifelong memory, especially if you're with the right people. Find out where to next and let the adventure begin. Toyota, let's go places. Start your journey at toyota.com slash let's go places. So I'm here with Josh, I couldn't let him go alone. We left Molly and her Mountie in Switzerland.

Let's say, those two are a handsome couple. They are. They're going to live out the rest of their days in the Alps. She promises postcards. Yes. That's it. And chocolates. Yes.

We have finished the fourth installment of our podcast suite, which means it's the end of our special health care podcast suite. I have hot air balloon lag. I know you do, buddy. We'll get you to the bed with some warm milk and a beer in a second. That sounds good. Um, Chuck, let's wrap this puppy up. Okay.

All right. And Molly, she's really here. We've really. Oh yeah. Yeah, she is. She's sitting right there. I was just daydreaming about the Mountie. I like the life you've pulled for us.

Yes. Um, thank you very much, Molly, for joining us. I don't know that we could have done this without you. It wouldn't have been the same, definitely. Agreed. No problem. Thanks for having me, guys. And thank you, of course, to Dr. Royzen, who gave us like an hour of his time quite generously

and for free. Sure. Lucky didn't have lives to say. He was expecting him to be like a Russian physician, be like, I demand a donation, but no, he didn't. And thank you for tuning in to listen to our four part series on healthcare reform. It's an important issue, which is why we tackled it. And hopefully you learned something from it, had some of your questions answered.

If you have more questions, you can visit Molly's wonderful articles on the site at howstuffworks.com. You can just type healthcare reform in the handy search bar. And if you have any questions that you want to direct toward me and Chuck, you can send those in an email to stuffpodcast at howstuffworks.com. For more on this and thousands of other topics, visit howstuffworks.com. Want more howstuffworks? Check out our blogs on the howstuffworks.com homepage.

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