The Taproot Podcast - Tim Faust on How Medicaid Expansion Saves Lives and Money

Episode Date: August 4, 2025

In this eye-opening episode of the Discover Heal Grow podcast, host Joel Blackstock sits down with healthcare policy expert Timothy Faust to demystify America's complex healthcare system. They explore how Medicaid expansion actually saves states money, why cutting healthcare funding costs more in the long run, and the real economics behind healthcare policy. Key topics covered: The business case for Medicaid expansion How preventative care saves millions in emergency costs Why rural hospitals depend on Medicaid funding The hidden costs of means-testing and bureaucracy Real stories of how healthcare debt impacts economic mobility Why healthcare spending creates 4x more economic activity than defense spending Perfect for healthcare workers, policy enthusiasts, and anyone trying to understand why American healthcare costs so much and how we can fix it. 🎧 Listen now to understand the economics of healthcare that politicians don't want you to know. Newsletter: buttondown.com/error - His healthcare newsletter (mentioned in podcast) Book: "Health Justice Now: Single Payer and What Comes Next" - Available on Amazon and through Melville House Publishing Amazon: https://www.amazon.com/Health-Justice-Now-Single-Payer/dp/1612197167 Penguin Random House: https://www.penguinrandomhouse.com/books/580342/health-justice-now-by-timothy-faust/ Social Media: Twitter/X: @crulge - https://twitter.com/crulge or https://x.com/crulge Bluesky: @crulge.urinal.club - https://bsky.app/profile/crulge.urinal.club LinkedIn: 💀 T. - https://www.linkedin.com/in/faust/ medicaid expansion economics, healthcare policy alabama, rural hospital closures, medical debt crisis, healthcare cost savings, preventative care ROI, insurance industry reform, medicare for all economics, healthcare bureaucracy waste, medical bankruptcy prevention, assertive community treatment, healthcare market failure, single payer benefits, medicaid work requirements, healthcare economic multiplier  

Good morning my darling, I'm telling you this To let you know that I'm sorry you're sick Though tears of sorrow won't do you no good I'd be your doctor if only I could What do you want from the liquor store? Something sour or something sweet I'll buy you all that your belly can hold You can be sure you won't suffer no more.

I'd swim the ocean or the deepest canal, to get to you darling just to make you well. There's no place on earth I would hasten to go. To cool the fever, this I want you to know. Hey, I'm here with Tim Faust. Thank you so much for joining us on Taproot Therapy Collective's Discover Heal Grow podcast. We're going to talk about some of the effects of Medicaid,

how that system works. You have arcane knowledge of the secrets of Medicaid. Could you give us a little bit of your history and share some of that with us? Yeah. It makes things seem complicated. My name is Timothy Faust. I'm a healthcare writer. I write some articles. I write some policy. I wrote a book. I've told a lot of the past seven years. I've been traveling around the U.S. talking to folks about healthcare and how health policy shapes things in their life. Right? Healthcare policy is pretty

mentalized, right? What healthcare needs lookss looks like in Birmingham and Meraki, where I live, we've got different kinds of means, different kinds of factors. And health care moods in Milwaukee and Northern Wisconsin are different, you know, different kinds of circumstances, economic forces, environmental factors. And so getting an idea what health care looks like on the ground or a place to place has been really wonderful. I've gotten a chance to learn a lot about healthcare all over the country. A lot of your writing is about taking obscure and

sometimes absurd policy and then clarifying how we got here, and how those things work, or just some of the service gaps and the arbitrary nature of how these things are going. Can you tell us how you got into trying to translate the, I would say the intentionally obscure healthcare policy of the US into layman's terms? Because it seems like a very good way to democratize information and empower people to understand what legislation means for them.

How did you identify that as kind of an issue and go? In 2013 and 2014, I had a job in Florida and with people in the Affordable Care Act in Florida, Georgia and Texas. And you know, I didn't know a lot about health policy. I wanted to learn what was going on. And I knew that having insurance was important. I had been on Medicare a couple of years prior for an accident and it was crazy. So they gave me a chance to not go under a five-year credit card debt. And so I thought, okay, well, I'll get involved in this. Both three gap states chose not to expand Medicaid.

So I kept running into people who didn't qualify for an insurance, they didn't get money to give them a credit to buy insurance because they didn't make enough money to qualify for um, they didn't see the exedit and money to give them credits to buy insurance because they didn't make enough money with to call for subsidies but made too much money to qualify for Medicaid and that whole existence and a class of people who had those two players and two bosses for help getting health care uh can't really get anything i mean now to process that then i spent the next couple of years doing research, talking to folks. It's actually found that there was a meeting,

people would talk about health care and regular person race. I can do this. I've got some of the background, I've got some of the information, I read a lot, I really love health care. Why not go out there and talk to folks about health care language that more people can use. The system is very complicated for a lot of very silly reasons, right?

Like, yeah, the way you run healthcare in America, it was not a very new design has to be run, if you had any sort of matter you were designing it from scratch. You would never just sit down with a protractor and a spreadsheet and say, I want to design a system that works and then end up with anything that looks like what we do today. Absolutely not.

And it's a series of historical accidents and one-off agreements that got entrenched, piracy of the systems, most famously during World War II, there was a wage freeze. And so, in order to attract new workers and players to get an offering of insurance as an employment perk, we kind of had to become the backbone of how

a third device could get our insurance. There was a bunch of accidents over time. As a result, we got this very messy, very silly, very routine, hard to follow model. One of the things that I bump up against, because I'm a social worker, so I was on a sort of community treatment team, working with some of the most seriously

mental health people in the state, and billing Medicaid for that when I first started before we had the complex trauma practice. And like, what I find is that a lot of times the people at the top, you know, the politicians, or the sort of journalists with an axe to grind or a political agenda. They'll make these arguments that sort of like sound like they make sense, but when

you dig into them, you know, and most people just kind of think that that's true and they're like, oh, okay, you cut Medicaid, you save money or something. But when you dig into it, it's like that's what the voter base thinks that it works that way. But when you talk to those politicians, like they know that it doesn't really, they just know that people are susceptible to certain lines of argument. Like when I was on the assertive community treatment team, we took people who were chronically homeless and had been in and out of the state mental

facility for years with no improvement. And Medicaid's like, okay, we'll pay a higher rate for assertive community treatment because these people cost so much money, you know. And they're going to the ER all the time and they're saying, I'm the King of England and then the ER gives them a sandwich and says, here's a script that you can't afford for a disease you don't understand with support you don't have and money you don't have to fill the prescription for an antipsychotic and then they come back the next day or later that day.

A doctor did a study on that group when I was there and they were like, do you realize that you've got 13 people, you've got three nurses, you've got a psychiatrist, and you've got all these social workers, which are pretty cheap. I think I was making like 35,000 a year at that point. And they see about 150 people a year, give or take 20. And that for every one of those people

that this 13 person team is able to see, you saved the state Medicaid system a million dollars, right? You know, so it's like, okay, well, this makes sense. You know, the politicians are saying that they want to cut this and all the stuff. Well, like, you know, you're paying me $30,000. I'm giving you a million times, you know, seven, eight people. I'm giving, like, if this is about money, this is a pretty clear thing. And yet they would come back and say, no, we need to cut it. We don't want to have this, because it's not really about the money. You know, it's about, you know, people assuming that they want the voter base to assume that it's

about the money. But really, a lot of people just don't want these systems to exist. I think. Well, I mean, I talked to a lot of episode and I'd say half of them are doing exactly what you say. And I was using, you know, like, buzzwords or marketing, I know, but they know people might like because it sounds reasonable. Say on behalf of them, yeah, I straight up any any logs or even works to have my liberal and I fired them themselves there that the deadlines that that they've been given. The return of Medicaid and those patients you talked about is that

private insurance will be an option for a lot of these people because they're too extensive to take care of. And the entire backbone of the way the insurance system in the US works is that health care costs a lot of money, so a lot of reasons we could talk about, and it's not very profitable to sell insurance to people who need it in the health care. As the empire of private insurance is, we all put money into a big pot, and then part of that pot is used to pay for health care for people who need it. Because health care costs millions and millions from year to year for a person, right?

Sometimes some really don't want to be out there at all and some of us should be hit by a car or you know, get pneumonia or cancer or something like that. And you need a lot of health care, you need a lot of money. But there's no way you could pay the 20,000, 50,000, a hundred thousand dollar like hospitalization machines and you're on. So the idea is we have to then, and when we need it, we take money out. But insurance companies, you gotta make money.

And the way they make money is by paying less on care and they'll receive end premiums. So if you have somebody who is poor and can't put a lot of money in the pot, or you're somebody who has anxiety, unless you've got cancer, Poor they can't put a lot of money in the pot or you're somebody who has a chronic illness You know you've you've got cancer. He's got a pediatric disarbor that that happens throughout time. You've got a mental health problem It's gonna cost a lot more

Perfectly the health care that he doesn't be able to pay for premiums We've seen that which for a long time didn't get a health care. They were excluded from insurance models, right? Now we have a standard saying that, you know, publicly you can't be turned down for buying insurance if you have a pre-existing condition. But there's lots of other ways to exclude people from getting insurance. Telling screenings, you started to see those after Obamacare. Well, just denying care altogether, right?

There's lots of ways to live around as paying for somebody's house care, even if you're, you know, in Syria, you can shout, say, I'm a little bit for it. And so because we really want these people to be abandoned for a variety of reasons, one was very expensive and costs a lot of problems for all of us. Two, I think it's fundamentally unjust to let these companies forget how to caring for people. We have programs like Medicaid, which pays for low income people,

people who are really sick, and Medicare, which covers senior citizens who tends to need a lot more healthcare than people under age 50 or whatever. And so we built these government programs that basically take care of people the private market would never be able to. And I'd say that there's a lot of people out there still who the private market can't take very good care of but they're still locked into the system. But it's a way of like recognizing that healthcare costs are entirely unaffordable for market people. You know, once you got 10 million dollars in the bank you probably can't pay for

that healthcare. And finding a way to both take care of them versus invest money into the parts of the country where real differences are made. Like if you live in a rural area, I live in Wisconsin, Wisconsin, you know, half of us live in rural areas, it's not profitable to build a hospital in a rural area. Right? Because you might get it, isn't growing up between any wood,

like you're supposed to deliver kids, you're not getting, you know, 10 births a day if you live in a rural area, because there's just not enough people in the area. So hospitals don't want to build facilities in rural areas. They want to close those facilities and put the money into a wealthy areas where there's more people, like suburbs. We shouldn't put stress on cities like Birmingham when you've got people driving from Mobile to come to UAB. It's going to put stress on cities like Birmingham when you've got people driving from Mobile to come to UAB.

It's going to affect the city eventually. A lot of the people that are in the city maybe feel safe from some of these cuts, but when the system is under strain, when there's service gaps, it affects everybody negatively. entire program. And Medi-Pay is the one insurer in the country that puts most of the money into rural high-skill providers or rural high-skill clinics. About 50% of rural clinics and rural hospitals are just barely breaking even or even in the web. And Medicaid is the one thing keeping them from closing. We saw in in states that didn't expand Medicaid, it was three times higher rate of real hospital closures than we saw in states that didn't expect Medicaid. It's like a backbone for how you pay for health care

in areas where it's not profitable to either offer or pay for your health care. Well, and I mean, when you're saying that they can't afford to take care of these people, I mean, I think you mean like private insurance cannot make money off of them. It's not profitable for private insurance. But like a lot of times, I think Medicaid expansion gets framed in kind of lefty language of human rights and that these people have a right to healthcare.

I definitely believe that. But even if you don't, I mean, when you just look at this model as a business, when you are not taking care of certain people in a country that you are tasked with running as a business, when you are not taking care of certain people in a country that you are tasked with running as a politician, you're going to make things more expensive when you don't take care of some people. I think there's a business case to be made too for why Medicaid, what cutting Medicaid is bad for everybody. So when people tend to serve healthcare, when they're on the hook for costs, they're totally

on the same level as everybody, they're just saying, get healthcare. That's why we've got a huge medical debt pattern in the US. One third of our families have spent on medical debt. So, some of them have medical debt over a thousand dollars. And yet there are in debt when there are sort of costs and that goes across the board. We see all kinds of people, even higher income people, have medical debt now. They just don't get healthcare, which means problems get worse and worse and worse and they faster until all of a sudden,

you're dying from stage four cancer, you get rushed to the ER, and they spend so much money to take care of that person at the end of their lives. Her husband, and someone they could have had a life, just because preventative care is not funded. We avoid these things, we're accessible. We avoid these things,

and then it is a more expensive problem to treat, you know. I want to have to now save money down the road. That's a, you know, the next basically people can live longer and better lives, which is good for all of us. Right. So then we've got a family member, you know, one in five people out of them are on Medicaid, about 20.1%. And it's a pretty variable mix.

Again, like some rules, you lose your job, some years you get a job, some years you get hit by a car, some years you don't see a doctor at all. It's like this pretty shifting, pretty remorseful population. You know, I was on Medicare for a couple of years in California, but I resumed Medicare a couple of years later in Texas. It's like, you know, our lives can change a lot, but they look very differently from year to year. And so people kind of float in and out of Medicare the same way they might float in and out of

as an internment or whatever, right? Mm-hmm. And if you happen to be on Medicare in the given year and you start getting a weird cost, which is definitely what happened to me. I had a weird cost. I knew it because I had already paid a bunch of money in health care.

But I was afraid this could go further into debt. I had to kind of ruin my credit by having to pay my bills and my credit card, but I didn't have insurance, so I didn't have a choice but to buy it. And I had my cough, so it got a little bit worse, it got a little bit worse. Until one day I woke up with a fever that was 103 or 104 degrees, which was much higher than what's supposed to be. And my window rashes moved with the EDI. They bring me and I had double pneumonia. I had pneumonia twice, two parts of my lungs, which to me, like I was threatening condition, just you're not like, you know, for some people, I already had something better as well, I had to get it as well at times, so I put a bit of concern. So they bring me in, they

keep me over and let me pump me fill with fluids. And when I leave, I leave to get it as no time. So today I put a big concern. So bring me in, they keep me open, right? They're probably filled with fluids. And when I leave, I leave to like a five or $10,000 hospital bill. And I would have completely ruined my life. Right? I was making, I was working three jobs and I was still making $14,000 a year. Um, cause it was during the financial crisis that I was working with a bunch of minimum wage jobs and when all with me, you know,

like four brothers and three girls kind of cobbling things together. And actually, while I was leaving, I woke up at the hospital and said, okay, well, you might be eligible for Medicare. You just expanded Medicare, let's do some paperwork. And thank God I was, because I was sending my birds up to zero,

and I was able to have, like the only reason I have the rest that I have, you know, I've got a race that I love very much. I've got a little family that I love very much. I've got a dog that I love very much. I can do what's interesting to me. If he calls, I will put under the burden of, you know, buying single medical records when I was 23.

I was able to do things and take jobs and go places that had made my life better and richer and more interesting. And I've made my friends' lives even better, have an impact and arise other people around me only because I wasn't thrust under all that at a vulnerable point in my life. And a working person who is part of the economy in a good way.

I mean, half the people, half the reason some of the brilliant people that I work with in therapy, um, are not going back to school, are not kind of pursuing the thing that they're totally interested in and capable of doing is medical debt. I mean, they're, they're, they're, the medical debt is what stops them from accruing the educational debt that they might be able to pay off, you know, with the job that they're definitely qualified to do, but they're stuck in a restaurant

or they're stuck driving an Uber. Yeah. It's the absence of the metal to metal costs. So what are the biggest causes of bankruptcy? I think actually the biggest cause of bankruptcy in the US. How much of your workforce are you losing when you're just taking the smartest people who may not be born with a ton of money, but are totally capable of doing this stuff and not giving them a pathway to, to go do it.

And you know, you mentioned some of the silly things in Medicaid. So we've got this such as they're like, you know, overriding beliefs that only some people deserve government programs or whatever. So you need to find the exact line of income, you know, $12,800 or whatever, a broad rich people don't receive benefits in the way which they do. That means you don't take a promotion, you don't take on their orders, you don't take on their work. I was talking to a guy in upstate Wisconsin

who's a comrade who makes shoes for people who have prosthetic legs. Great job. Super important. A job I never thought about investing until I talked to this guy. And he's got multiple sclerosis. So he needs Medicaid to get all his medications, cover his hospital bills.

He's a very lucky person. he wants to do his job. His job is important. It's very social, helps everybody. But if he takes on too many clients, if he does too much work, he stops being eligible for medical. He includes who would die because no private insurance will cover all the bills and the cost he can afford to get the healthcare he needs. So in the total, right, so he has several options.

Work fewer hours care he needs. So the total rate with serious medical options works even hours with guys, you know? And this time of model where we really limit public health care, public programs to just the poorest of the poorest. And most of them are working, I think, but 92 to 98% of people who are in Medicaid are working cow jobs or are in school or are caregivers full time for somebody at home

who has a convalescent or whatever. You know, you put a cap on their ability or I can get a full time for somebody at home or as a kind of a lesser. You know, what a cat. I'm not going to need to take on more hours or do more kinds of work. We'll restrict Medicaid to just, you know, the hyper poor or the super low income. It's kind of deceptive. That's not what you would have done

to a very interesting society if you had the option to do it from scratch. Well, I mean, in my lifetime, like I my lifetime, I've wanted to hear somebody advocate the need for broad universal programs, not just healthcare, but just these are the baseline of what you get as a citizen that pays taxes. I think even more so than the Republicans, I mean, the Democrats in my lifetime, it's like every time these things come up,

oh, we're going to do it responsibly. We're going to means test. We're going to meter. We're going to have caps. We're going to make sure that you're somehow eligible. We just can't have public education. We can't have public health care. Can you speak to the gas lighting

that it feels responsible if we have double, triple means tested filters to stop the wrong person from just being able to get diabetes medication and somehow only get the right people. How that is sort of the self-defeating model of legislation. Sure. Now, this whole notion of deservingness is a really complicated question that we grappled with definitely over the past couple of hundred years. But at the end of the day, like, you know, the obstacles you put in the way of somebody being in a good healthcare or doing a good other benefit programs, the fewer people who are eligible will die.

Like I would say, in my day job, I helped them with senior citizens of Medicaid. You know, people who are 65 who are super low income or have a disability. And I am applying for Medicaid in a lot of sense. I've done it professionally for a long time now. I've got software and we've got phone numbers and stuff. And if you still take somebody two or three weeks or even longer to apply for Medicaid, because of the fear that we let somebody in who has too much money or who is on the line and who doesn't actually deserve to get a public program, we put all this paperwork and all these obstacles in the way of getting health care.

And if you're a low-income person or you're a senior citizen or you've got a disability, rendering all of your bank statements, you know, your car appellments, your income, all of your social security checks, your social security card, getting all these things together. That's the imparity of the application. Like I don't, if you haven't looked in a Medicaid application and you're listening to this, just go look what you have to fill out, you know, to say that you are disabled, you know, like, or to get SSDI to apply for Medicaid. I mean, it's like you need almost like a team of social workers and a lawyer to apply for some of these programs in some of these states. And sometimes that's exactly what you need, right?

I mean, do you have social workers with letters who go through this? Because it's so complicated. You know, you say that your taxes are complicated, applying for medical, five times more complicated than a maternity leave tax form, even on a dollar a year. They're willing to grow everything in the entire life to make sure you don't make one dollar more

than the state thinks you should make if you deserve healthcare. And because of that, lots of senior citizens, lots of minimum computer, lots of disabilities fall through the gap. Not because they're not eligible for the program, because they don't have the ability to go back and forth over and over again to sell the temple work. And on top of that, you know, states don't invest money in making rapid searching process smooth. You know, in some states we don't even have a central building that goes connecting all these things together.

Um, in 2025, you know, you're tracked by like 15 different ad companies. Like if your toddler clicks on an app, but we don't have a way to centralize the state's Medicaid system in some of these places. In some places, you got to apply in person. They don't even have a place you can marry or fact-staff or even do it online. There was a good study. So your debt is a state that just passed full requirements for Medicaid, which is another one with paperwork.

You're going to be on Medicaid, you got to work 80 hours a month, which again, everybody was already doing, but now the process of getting the film and filling it out and finding the paper to certify with an uploader, whatever, but it was actually in Georgia a couple of years ago. And they have like the spokesperson, this guy who was a mechanic, who was like, I work 80 hours, I mean, I work really 80 hours a month, if I can can do it anybody can do it and I would of course the next year She was to have been shows three times because the computer system breathed down or the paper after that like the Complexity into this the well whether our work to take

We're looking in some states, you know in my experience like three to nine months of approval time. It's not like okay You know, they didn't get the form mail it again. It's like you wait nine months before you find out that the form is missing, you know It's just you expand has to repeat the bad meter without having to go through other with them all Well, yeah form with two questions, you know, are you a US citizen and are you a resident of Alabama? you know, are you a US citizen and are you a resident of Alabama? Mm-hmm. It's a done. Um, I, and that sounds a lot of problems, but you know, we've got, you know, um, the insurance industry definitely wanna stop existing.

Uh, they send a lot of money to bring it to, to politicians, but it's Democrats and Republicans, um, to, to show why they're an necessary component. You know, fundamentally, you know, the job of the insurance company isn't just to pace it, it's to keep costs down, you know, keep costs manageable. But it's also going to cost skyrocket very faster in the US than they do in other countries, and they skyrocket totally unheard from 7-sec inflation. There's a study of MRI, you know, MRI is the big tube you run when you push the button and it scares you, it bothers you. It's one machine that went to MRI places in Washington DC.

And the literal, like exact same machine, like you can call it the same literal machine, can have a five-third cost for a risk based upon which insurer is paying for it, which doctor is around, and what their legal is. I mean hospitals employ an entire billing department of people who just go through and say, well that same service could kind of be construed as six different codes. So your job is to figure out which CPT code is the most expensive one to bill for that sort of meets the criteria for this knee surgery that could be four different things. You know every health care system has that room full of people. You've got this rule between hospitals that want to sell you as much money as possible

and insurers who want to pay as little money as possible. And so they've got, you know, across the country, probably tens of thousands, if not hundreds of thousands of people who's job it is to litigate every individual line item. And there's a word who's gonna pay us for it, how much it costs. And ultimately ultimately at the end of the day Well, these companies make more money over the year and the people who are screwed are people like you and me that patients

Who have to pay for the bills at the end of the day or can get these costs on salary or unjust Dempt upon them this whole matter. They're not cute costs round and it does not provide coverage to anybody So what's the point? In every other country, in the rest, every other country that has a functioning healthcare system, there's some central authority that regulates prices. Because last year, the IM check, prices were styrofoam completely unward from the actual cost of the maker.

The cost of the bills form under things like the AMA and things like that, they will start to operate like cartels. They are a monopoly and they set their own rates, which is not something that most professions can do. You see that in instance right now where rural care is being purchased by Irish-themed hospital systems which send close care who knows it's most not

profitable and shuffle it all into the suburbs usually. Then because we're in a game in town they jack up costs. The cost of your vitamin care hasn't changed you know. A good banter of those. The doctors aren't making more. Doctors are doing more paperwork and leaving the profession and we're getting brain drain in healthcare. But it's not like the doc, I mean doctors make a lot, but it's not like doctor like when the healthcare costs do this it's not like doctors salary are doing that. These things are generally going to enrich people

who most Americans do not like and do not wanna enrich with the policy decisions that are being made. Because of the backward bias and the system is arranged, if I'm a doctor in like a regular clinic, in your neighborhood, I charge, let's say, I don't know, $50 to get these shots or whatever.

If the hospital inspires me, that exact same service in the exact same building now costs $200, the rest of the hospital is better negotiating. The actual price of providing the care hasn't changed, but once the hospital inquires me, the costs come out of nowhere and it's die-rocketing. That's an example of how this whole matter looks. But once the hospital requests me, the costs come out of nowhere and it's die-rocketing. That's an example of how this whole matter works. In every other country, you've got somebody in the middle who says, hang on now, Medicare can pay $30 for shots, but the dollar still makes money, and this is the actual cost of

care. And we're going to keep, you know, real costs at, you know, 5% growth a year over this core cost and then adjust it based upon trends and our health care is provided and where costs come from. Every single country, even the ones that have market solutions, have this central press center. We don't have that in the US. We get it to the distribution of private insurance companies who have most things broken up because they're too small and Undoing because they're the paid worthy in the bed as you enter the door to hire premiums to build those costs down And that's a massive problem in American health care

And so a thing like a single payer I think like Medicare for all one guarantees coverage for all people But to it addresses those cost concerns by reallocating the spending that we have to pay for care that's essential, put a third price for it, but not get totally extradited by like the draining, you know, that extradition of how prices are set. Well, you know, like a lot of politicians

and a lot of voters claim to, if you really just cared about the cost of healthcare, there's a lot of things that you could bipartisanly do tomorrow. I would say one of those things is the bulk buying power. Because insurance companies say, hey, your drugs are expensive, we want to cover it, but we're not going to cover it at the money you're charging, so go ahead and give us a break on that. And they use that to negotiate. Medicaid doesn't. Medicaid just walks out. They don't use the bulk buying power of the US government to

say we're the biggest healthcare system in the country and we're going to, 20% of Alabama, we're going to play hardball with you to get the price of these drugs down. We don't do that. I mean, too, like you've got, like a lot of the way that these drugs are developed, people are like, well, Pfizer can charge a million dollars a pill because Pfizer paid to develop this stuff. No, they didn't. Half of these drugs, you took taxpayer money and then you paid a private company to make

the drug and then they own it. And then they get to say what the US taxpayer has to pay to get it. If I pay for something, I want to own it. If I build you a house, I want you to pay me for the house. But we have a lot of these giveaways to these companies that drive these costs up for everybody for no good reason. I mean, I don't think right, left, anyone who understands that would think that it's a smart system. Yeah, and probably a lot of the research that you're showing is very confirm that

unpaid or underpaid grad students at universities are actually doing this research, right? that unpaid or underpaid grad students at universities who actually do these experimental research, right? And then the research is packaged and served by the university to a private company who then takes those results and uses that to build health. So that's the core experimentation, the core like still going out with it even possible. That's by the means by the public sector.

It's just being served to insurance companies at putting them grab a dollar, then it's turned into a product that's served back to us at expiration rates. And yeah, if you've got one route, you know, one payer, whether it's Medicare, Ferrari, or one national insurer, whatever, that's violent with drugs,

it can do a lot more to bring costs down. I said, listen, if you're gonna sell Robodee, if you're. I said listen if you want to sell Rebode if you want to sell instead if you want to sell rent heart beds or whatever and the rust Well, the one guy that buys it and so we're gonna extract a fair price You know when that makes sense in the market, but then that makes sense for us But the pills they have them 10,000 different insurers that only ensure, you know You know the 20,000 people who have very less negotiating power and very less bargaining strengths than that larger pair. That's, you know, that's not having that similar group

that can represent all that buying power set costs. Also, they'll be in other countries, and that's what works for them. And we just have to, we're just, we're just use model. Why don't we just- It's gonna be pretty inefficient. Because there's a lot of money,

and that's not doing it that way, right? We just spend about five trillion dollars in U. in UN House care, that number goes up every year and a huge chunk of that is industrial profit, lobbying values and those administrative costs that just create monolist administrators and work services that exist only because of the way the model is arranged. When Medicare, which is insurance for know, when Medicare, which is insurance for old people, and Medicare, which is so much for local people, was proposed in the 60s,

the early May launched that big, massive red-and-white campaign saying this is social medicine, couldn't take care of the agency, we need doctors, it's disastrous. And they tried that exact same talebook over and over and over again. Sometimes it works, sometimes it doesn't, but with the creation of Medicare and Medicaid, all the same, the doctors can probably foresee a lot more patients than they could have said,

or that totally adaptive argument. But with resistance to having any kind of oversight, any kind of accountability, across, you know, the millions and the metal with the iron is a sign of lobbying, means there was a pretty high resistance against changing things in those that make sense. Well, and like I've seen, you know, in my lifetime, the reason to cut healthcare, you know, a lot of the, when Medicaid gets cut, the argument is that you have to,

I just want to talk for a minute about how economies work, where money goes, you know, even if you don't agree with certain kinds of spending, maybe certain kinds of spending that you don't agree with could be more beneficial to you. Thinking of, what is it, who's the director of like Avatar? The James Cameron. Yeah, yeah.

So like James Cameron was, when they were telling him like, you've like committed to build, you know, you've built all this infrastructure in New Zealand to do all this prep work for these Avatar movies. You've got $4 billion or something in making these movies. They're like the most expensive movies ever made. What if they don't break even? What if they don't make money? He was like, you know what we do with the money when we pay movies?

We're paying artists, we're paying designers, we're paying crafts people, we give it to people who are using it and it's going back into the economy. So I've got a pretty good track record. I think the movies will make money, but if they don't make money, the money was well spent. And you know, a lot of times, you know, I've seen the military spending that is a lot of times

where the money goes when Medicaid gets cut, go from the 1980s where they're like, yeah, you know, we paid for a bunch of fighter jets that were way over cost and they kind of don't work. And like there was all this speculative technology and then it turned into, well, you just got to do no bid contracts for these wars and these military contractors will get to charge whatever they want and there's no provision for the government to kind of recoup anything

if there's waste or abuse. And now it's like we have to build metal or solid weapons and lasers that will never work at all. And when you're giving money to those systems as opposed to healthcare, you know, the money goes away. Like it goes to a hole in the desert where it's lit on fire and it will never really be returned to a local economy. When you're making Medicaid, you're making jobs. You're making skilled jobs in rural places.

You're, you know, a country, the US doesn't have a lot of manufacturing. When you fund this stuff, you're putting money back into not just let's give away free health care because we want to do social justice things, but you're giving it to nurses, to doctors, to techs, to social workers who can be employed to actually do something beneficial in this country. The most common job in Wisconsin is a home health worker. Most folks have paid entirely out of Medicaid. Wisconsin spends 11 billion dollars on Medicaid last year. That money doesn't get lit on fire in front of the desert. That money is, side of it is income, massive economic

drivers. Every dollar spent on house care is a dollar that at some portion goes to a doctor, nurse, or home health or whatever. It it keeps especially real, just like a silk. It is the economic backbone of a lot of parts of the state and a lot of parts of the country. You know, I sat around 10 years ago, so maybe it's out of date, is that every dollar spent on high-scale quotes for the use of economic activity. So it turns into sales, which would then spend a lot of things

and you know, you pay your rent, you buy your food or whatever. But after- You go to the restaurant that's closing, you go to the hardware store that is in your town, you know, you have money to keep your house from falling into disrepair. You know, you can hire a carpenter, you can hire a plumber. You know, you can create jobs with the money

that is being returned to the local economy. Well, every healthcare data creates firm data of economic activity, and every data spent on defense or military staff creates less than a data of economic activity. And if you were optimizing your funding to make the most money long term, you'd put it away on healthcare, obviously. So it's the truth that keeps a lot of local economies functioning is the fact that we can have, you know, a lot of toasts is the hospital is the biggest employer in town, both urban and rural areas, you know, most cities and most most cities in the US, so don't have a big university, or

hospitals are the largest employers in the city. Our big hospital is the university. So if you if you color it out, all everything that is UAB in downtown Birmingham, you don't have a lot of downtown Birmingham left Oh boy The money is that's keeping my roots jobs afloat but it's keeping all this I was always deeper I'm a man to pay for stuff. You know, I'm talking about but I've even a blue essential care Don't get paid very much by either public or private private health care. You know, I'm I so Home health workers make less than they would make if they worked at a gas station. It's very important.

I talked to a woman a couple of months ago who was a home health worker for her mother, who's disabled and elderly. And so she wants to do that job. It's very important. She wants to take care of her mother, but she makes very less money than less money than she would take you almost literally whenever job um of the state and a firm house broker is obviously extremely important to keeping people in their homes well again certain money because it's cheaper to do homebats and it was to put somebody and bring nice in home that was focused in profitability um but we don't care you know we it. We don't pay people who do essential care,

whether they're cell phone workers, home health folks, nurses, whatever. The money that's commensurate with you, value it, provide it. Without annotating our resources and the kind of really what I can do is rent to begin saying is like, lend out healthcare costs

and make people healthier long-term. Well, and two, I mean, if you're listening to this and you're like, I don't see myself ending up on Medicaid or, you know, I'm a therapist or a health care worker that doesn't take Medicaid, so I don't think this affects me and these kind of cuts over this long term that we've just passed on this bill and then the way that and the big, beautiful bill and then the way that that is going to de-incentivize states to fund Medicaid and probably result in a lot of

kind of secondary, you know, chilling effects and cuts. So this doesn't affect me. Yeah, I would make the argument that Medicaid existing and being funded is what puts the heat on private insurers to provide services. I mean, this is a pretty broad through line. It doesn't work exactly this way. But one of the ways that you track healthcare policy and benefits and what's going to is that, Blue Cross Federal follows Medicaid policy loosely, and then all of the state plans will follow over a couple of years what Blue Cross Federal is doing, the direction that it is going. And so even if you're not billing Medicaid,

even if you're not on Medicaid as a patient, cutting Medicaid will affect your healthcare and make it worse over the next decade. Can you say a little bit about that relationship and like how that works? Well, it's pretty complicated. I don't know that superinductors, I don't know that anybody do test wrong.

But basically, with private insurance, it's sort of sort of bottom. They want to pay as little as possible and cover as many people as they can who don't spend money on it. Right, that's the trade off. Well, if you've worked as a provider, we certainly assume how much effort it takes to get even

the dollar from the insurance company. And a lot of the time, the price of the after-paying decreases relative to inflation year over year. And when you pay that money, it drops. I don't think it's unreasonable to expect that we'll see insurance companies quite advantage of the lower standards and lower minimums to reduce the amount of money relative to the cost of high skill credit over time. So yeah, it was with people. All of a sudden also you got this massive base of low income uninsured people

who again, will get sick, will back up debt and will go to the ER at the end of the day and all of a sudden the ER just set the people who the hospital can't take care of. It's, it's, it's, it's shooting ourselves in the foot. And ultimately, it's in service of giving people who have a lot of money, even more money, right? All the money that's coming from Medicaid, you know, the one trillion dollar cut to Medicaid is being used to subsidize along with a lot of deficit spending, uh, given, I think it was like $3 trillion in tax breaks, which

disproportionately fell upon people making six figures a year into the into the millions. It's a direct to up them transfer of wealth from working people to the 1% and people who don't have very much money are the ones that suffer most directly as a result of the fact I have this down the road. And so just to speak to result of the fact I have a stomach. And so just to speak to some of the misinformation around why your representatives are cutting healthcare,

because I mean, a lot of the 20% of people on Medicaid in Alabama probably voted indirectly or directly to have it cut nationally and at a state level. So I mean, to kind of speak to some of the misinformation around this, like, you don't necessarily have to share my values as a social worker to understand that a lot of these arguments break down under scrutiny. Because when I hear things about like, well, you know,

somehow, you know, trans healthcare is taking away things, these kids are just getting transitioned in kindergarten if they say the wrong thing, or illegal immigrants are somehow getting all of the healthcare and taking it away from you. That's why your policy is not very good. I mean, those arguments are sort of predicated on this idea that there is just so much cheap and available healthcare in America, that if you go outside, you'll just trip over healthcare

services that people are just going to go in and just sort of get kidney dialysis for fun that don't need it or something. And that's why when I hear a lot of those arguments, it's like, this doesn't work. Have you ever tried to receive these services as somebody with Blue Cross? Can you say anything about that misinformation machine and how it functions? Yeah. In any point of that, no one's getting recreational health care. No one's going out there and getting heart surgery for fun.

People get health care for the most part, when they need health care. And people who don't go to the hospital a lot, need health care in a different kind of way, right? Maybe they need a social worker to help them figure out what's going on with their lives and kind of, uh, realign, uh, how they spend their time. But yeah, like, which is not as near as some game. In fact, so now, not only do you spend, uh, time for us here, the more providers you can have and the more quantitative hospital provider game. In fact, there's no money you spend on crime for us here. The more providers you can have, the more quantitative hospital providers there are. It is very productive.

And so, since it's flagrant, you know, this threat of undocumented or illegal aliens or whatever, that's one, that's not true. So, it's still an ace in the hole for healthcare to undocumented people, unless the state chooses to, and I think one of the first states to do that. So it's not happening at a bad month, not happening in Wisconsin. And it's our first week that's being thrown around to persuade people who don't know a lot about what's happening, and then we'll get them to vote against the things that shape their own lives. Well, they can see that it's getting worse. I mean, they look at healthcare and they realize that it sucks and they don't like it. And when, but the reasons that are getting worse

that are being sold to them are not real, you know. You're getting worse because everybody's a middle man and is trying to dodge with that money as possible. So people can pay it and then also then even as, as middle, but also as expensive care as possible. That's the whole tension there. And there's nobody even in the middle selling costs, guaranteeing care, making it a better place. But it's just a total, you know,

it's the guarantee has to go out there. Everybody's playing by a set of rules. We're trying to optimize for the environment line. And when everybody does that, you know, the bottom line memory is for the people who need help. It's a real exciting, as much money as possible for people who right now don't need a lot of healthcare. But eventually, you know, it all comes first, right? There's this phrase that they use in disability politics, they deal with temporary or whatever, which I like.

Because, you know, then again, one fifth of us, so half of medical costs in the US in a given year come from 5% of the population and one fifth of the population is a Medicaid. But that population changes a lot year to year, right? Some years you have a kid, a lot of people have kids that go into the NICU or has complicated pregnancies. People get hit by cars, there's accidents.

You can sat at work and break your arm or bust your leg. Like, you know, I met a guy who's a painter who paints houses and that's like his job. I return a little bit in the sailors and painting like at his job. Every service can happen to everybody and it did happen to a lot of us. There's a transient population that moves around year to year and nobody knows when it's going to come for them. So it's you investing in, you know, you're protecting yourself against the risk

down the term of the future of really how you can't deserve, which will happen, rare of us at some point. And it tends, maybe you can help me understand something that I've not quite understood. It tends to be the people that are like learn basic economics that talk about healthcare like it is a market.

And it lacks some features of a market like the ability to choose, the ability to have like multiple options. You know, if I'm having a heart attack in an ambulance, I'm not like, wait a minute, can I, or price visibility, you know, like a market you go in and you see these tomatoes cost $5 and these cost $7. So I'm going to choose between quality or quantity or whatever. If I'm having a heart attack in an ambulance, I'm not like, wait, how much is this going to cost me? What is the procedure that's going to be done?

Can I see the rates of the hospitals and the available doctors and then choose which one to go to? I don't understand how we can talk about health care like it's a market. It seems like markets need things like price transparency, multiple options, the ability to choose between them, like a market. So help me understand that one. Well, so there's a good push for price transparency. I'm going to give a general example over the past 10 years.

In conception, I agree with that. We should know how much it costs to regret any kind of unit of healthcare. But when the providers put out the post-transparency lists, one, they'll do it as little as possible, right? The donor files are put out, they're very messy, very complicated. You're asked to spend a lot of time trying to listen to them,

but you can't figure out how much stuff costs. And two, there are so many factors shaping how you get health care, where you get health care, that you can't use. And people, when studying studies, there are studies of what happens when there is such cross-transparency, people don't go to a shop around because they can't, because you've got a doctor that you see, and you kind of delegate that trace of what care you get and

where you get it to that doctor. So, I'm not saying even if you've got a chronic condition that requires five different things, like do you really want to, let's say you've got something, let's say you've got cancer, you really want to strap around to five different hospitals that don't talk to each other to figure out where you get every particular unit of cancer care? Of course not, that's ridiculous. One, that's very rare that an average person can do navigating all this data, and two, like if you have cancer and you're getting really high rate cancer, like if you have cancer, you have to be very refining cancer. You have to secure the rest of the capacity

you have to navigate at this paper, that can do all the shopping around. So we've seen that people don't shop around things. If you tried to get this cancer treatment here and this one here and actually price that stuff out, if you could figure out what it costs, you had the wherewithal, you had the transportation ability. I mean, those providers will not let you treat in that way.

I mean, they will drop you as a patient unless you're kind of getting these services as a bundle, as a part of complex care because of the way that medicine works, you know, that it needs to be integrated. And, and you just, you know, the system needs to know, you know, what treatments you've had and have all that kind of document. You know, but it's a whole idea that you can just stop third care or do price transparency and figure it out. Ultimately, the case scenario is like this, right?

You've got a kid, the kid is very sick, there's two jobs you can do with the kid. One, we'll bankrupt you, but the kid will get better. The second one, you can kind of move forward, you can stay out of it, but the kid might not get the best healthcare they can, they might not recover. So how do you choose? How do you ask, how do you plan to doctor with shoes? What's the prosperity? You clearly use really perverse incentives.

Ultimately, we're being asked to choose between money or real life, like the pirates used to say. There is a lot of things like piracy happening and it's usually been grabbed by a pirate. But you can't ask somebody to make that decision. There's a lot of things like piracy happening. And it's usually good to get grabbed by a pirate. But you can't ask somebody to make that decision. That's not even a decision to make. The hostage was signed.

It isn't a market. You see whether or not you die lacks some of the essential features of a market also. I'm sure not to buy tomatoes this week. I can choose that I'm not going to make red sauce for my life. I can go ahead and make a salad or whatever instead. Can I really choose to go where I want my kid to make red cells for my life. I can go ahead and make a salad out of it instead. Can I really choose to go

whether I want my kid to live or die? No, I'm a captive audience. I mean, in fact, you shouldn't have to worry about whether you go bankrupt for your kid being sick or whatever. That's the duration of phasing upon a lot of people and you don't have freedom of choice. You can't have freedom of choice in healthcare.

I must say, one of the choices available is to die, which I don't think really counts as a market decision. The structure of services with shared healthcare are well beyond the capacity of an individual consumer to navigate. That's how we have new systems and carries to help make steps work for people. And they're not doing their job.

They're inadequate to get their job done. When, because they're too small, perversely, to get the cost and optimization process that they need, or the integrated healthcare that you need to provide. And two, because they don't have a mentor. Because they make a ton of money at the end of the year. You get a good healthcare, you know, I guess their parents and their grandparents, so they're in there, I don't actually know about them by hand, but they're making more money than God every single year,

hand over fist, and so at the end of the day, you're being denied the care you need, will you do it or are you losing your insurance? Everybody wins except for the person to part in the healthcare system. So just to kind of close out, could you tell us some of the like maybe stories you've collected about the kind of

absurdities and redundancies and when you introduce private equity into these systems and the perverse incentive structures? Because I mean, there is kind of some bleakly comic stuff, you know. I, one of my members of my family works, you know, approving SSDI in one of the offices. And one of the things that he still has to works, you know, approving SSDI in one of the offices. And one of the things that he still has to do, you know, to prove disability is to prove that somebody couldn't work as a magnetic tapewinder or a typewriter repairman. Those are two skills that, you know,

you have to rule out that the person is not able to do because there's such a burgeoning industry of typewriter repair where they may be able to get slimming if they weren't on disability. You know, there's some a burgeoning industry of typewriter repair where they may be able to get swimming if they weren't on disability. You know, there's some wild stuff in there. Do you have any of those? Can you read Gail's? I got one example. I got a daddy in New Jersey named Steve, and Steve has master of industry fate, right?

Very similar to when dad was eating himself. He weighed something like 90 pounds, moved over the wheelchair. The rise of Stephanie Seward at birth was 18 years. He's probably 32 or 33. So Steve's talking along through the two children, the seventh can be ruined. We spend our time on TV as we're after. And every, Steve needs help out.

Steve needs a pilot wheelchair. And Steve needs somebody to come over every month, every day, and help him feed himself, go with himself, go to the bathroom, stuff like that. It's just the way it is. It's nice. It's fine. Because of the little service that Steve can learn, and learn a dignified life, and do the work you have to do, everybody benefits. But every two months, Blue Cross sends a match to

his house to check and see if he's still reserving and still qualified for care. So I imagine there's some expense, you know, gotta pay her salary or his salary. That's great. And also the process of doing all the paperwork to check and done a check and should check is, it's time, so it costs, it costs money. But yeah, Steve is a service servant.

He hasn't suddenly cured active muscular dystrophy and then doing the work and use his hands and stuff. It'd be pretty miraculous if the nurse came and all of a sudden, a degenerative condition had gone away. They're spending a lot of money to assess every month if a miracle has taken place. It's something like he didn't

get any care because of it, right? It still takes Blue Cross half a year to approve a fix to his wheelchair if it breaks. It's not like they're doing anything about consider out of concern their investment in the long-term care. It's just a way of common care whenever possible. Because now Steve has to set up that appointment to have to sync up in time. in his long-term care, it's just a way of common care whenever possible.

Because now Steve has to set up that appointment, he has to sync up in time. And like sure, Steve's lucky that he can do these things, he's got heart. But some of the folks that they can't, there was an accident, or they missed their stand, or they can't get on their stand, or they can't get on their stand, or they're moving or whatever. And so they had a reason to miss the appointment, and all of a sudden, bam, they're not getting the care they need to that month. This happens all the time across the country.

And it's a very silly way, very stupid way, I think, of arranging a healthcare system. Well, I mean, one of the things that I think is the way that you get away with kind of crimes in the American political system is that you find something that's pretty bipartisan, that if you just ask 80% of the country on the street, 90% of the country, do you agree with this? They would be like, yeah, of course. If you do that, you're going to get this result. I want that result, so why would we do this thing? But then you find some way to split that constituency by picking something that's aesthetic or a

cultural value, religious value, or you know, some part of spectacle and aesthetics to make sure that these people can't have political capital because they won't agree, they won't vote for the same person. And you know, something like price transparency, like we had a price transparency in healthcare bill that sailed through Alabama and everybody was broadly in support of it. And they were saying like, you know, no more surprise billing, you know. So there's all this paperwork on me now as a therapist to tell the patient all these things that are already kind of self-evident and they would know like

you're if you're on a sliding scale with me and we have a sliding scale at my practice so if you make under $30,000 a year then I'm only $80 to see for you know complex trauma therapy we can generally get complex trauma treated with brain-based medicine pretty quickly or you, if you make $40,000 a year, I'm 85 or $90 to see. I don't have my sliding scale memorized, but so the price transparency bill was like, no surprise billing, you got to tell these people every three months, exactly how much they're going to pay. Well, it's pretty simple to understand a sliding scale or a private pay rate

because you know what the price is for every hour that you come see me. It's going to be this. But that bill doesn't apply to insurance. Insurance doesn't have to do that. It's only private pay services on a sliding scale. Like the insurance industry made sure that you don't have price transparency, that this law doesn't apply to them in Alabama. And so a lot of the time it's the people that are getting hit with a surprise with me because

they thought that they had mental health coverage for Blue Cross said, oh, actually you can't have rape counseling because you didn't get blood work this year and have a PCP visit for primary care. So your prior authorization can't be approved, something like that. What are like broadly bipartisan and just obvious things that most people would agree with that we could do tomorrow if anyone wanted to. I mean, I think through that to give you some very specific answers. But ultimately, you know, having a central authority

that can help bring down the infirmary costs and make a mistake. Right now, we've got a discrepan said between all the paperwork people have at the hospital and all the paperwork people at the insurance company. And these divisions, these jobs just, you know, man, man, man over here, as both sides find the way, it's just through the other. We can simplify that, you know? You can say, listen, Medicare pays 100 bios for your shots,

for glass for your shots, and the bills that operate as a function of that. You agree, I'm gonna pay 110% of Medicare or whatever. Well, there are things you can do to help streamline and regulate the way that pricing works. Now, you actually can tell what's going to cost, which I know you can't do. There are some things that I think are popular. You know, I've been talking about things like Medicare for all. Everyone with a job with people, remember how to extend them,

or infer them, things like Medicare for all. Everyone with a job with people, I remember how to extend them on further things like Medicare for all. It's not necessarily a universal, I pass an issue, but it's got a lot more support across the spectrum than people anticipate. There's just a lot of stuff that like, everyone knows they're being screwed. That's the thing I found whenever I talk to anybody, any part of the country, everybody knows they're being screwed and somewhere by the healthcare, like healthcare structure, with them or somebody that they love or somewhere that they're close to. Nobody was far. Nobody was wherever one or two of you was removed from somebody who's been really screwed over by this whole arrangement. And then big things and there are small things you can

do to hack away at it. Rob knows it's going to cost somebody the profit so we don't do it. But yeah, there's lots of kinds of regulations that are composed in big and small ways. What I'm working on right now in Wisconsin is the hospital is non-profit, if it gets all kinds of tax breaks. It's supposed to, in theory, spend money whether it's paying taxes on providing community care.

Or going out to the neighborhoods and small areas that are underserved and taxes on providing community care. Or when they're going out to the neighborhoods and small areas that are underserved and help them get them health care, providing charity care for really low-income people. And they don't, and there's no regulation whatsoever. So we've got hospitals that receives running just 30 million dollars more in tax breaks than they spend on community benefits.

That's a clear provision of this whole agreement that we have to why hospitals are nonprofit. And they don't do it, you know, they don't do it. And so as I mentioned at that, which is something we've talked about the rules, we've already established, I think we're seeing real brand momentum towards that over the next few years. I have kind of a theory that has to do with like the graphic user interface of things. That if something is like an optional service that you don't really need, they make it incredibly easy to do.

Whereas if something's a mandatory service that everyone has to do, then they're able to harass you through the user interface. At a gas pump, gas pumps, they don't work great. You have to put the thing in the right order and put the hose back. It can show you ads. It can blare advertise because you have to get gas, you're not going to drive away. But you know, you can easily, you know, doing insurance claims or insurance reimbursement or under even understanding your benefits as somebody who pays for them as a patient, somebody you network with insurance, like you, that stuff is the most complicated,

hard thing in the world to use. And, you know, there's no kind of universal app that just says like, hey, here's the doctors that cover you around here. Here's how much your benefits cover. Hey, your GPS says that it looks like you're at a clinic that's not covered. Do you want to file a prior authorization if you're doing a visit here? You know, here's places in your zip code. I mean, you can, but while it's incredibly easy to say, well, I can't afford this 1999 pizza from Pizza Hut, but this little app is going to go ahead and run my credit, let me finance that over six months. I mean, I can finance a pizza easier than I can understand my healthcare benefits.

You know, I actually know people that are providing the hospital, people that are paying for it, don't know how much that was in the cost until it goes through the entire machine. I asked even an insurance company how much does it cost to get you, you know, hand amputated or whatever. Impossible to know. There's so much building to you, loads of paperwork and processing that you can't even predict these prices ahead of time. It's just the whole model is too complicated to play out as simple as like, you know, a menu. And so you have to simplify it. How much of this stuff do you think is just stupidity and how much of, you know, the stupidity of bureaucracy and how much of it do you think is intentional?

It's not just a series of accidents that kind of roll down here, like a stone that I've been mastered with them, right? And sure, when I find a road to a pair of little as possible, the hospital is going to find a way to pairs with this path, whether it's a hospital, when I find a road that charges as possible. And so they've got like, it's like, you know, one guy who makes a move with a little bit of a kind of move and they go back instead of building this massive structure around it.

It's just, it's a road that circles fast and we try to push them around and land potions to come in the middle. Yeah. Well, that was wonderful and you really have a lot of experience. I appreciate your time there. Is there anything that we don't get to or you think is kind of a good cap to that?

That's absolutely a good point you're talking to. This is very fun. Is there anything that we can link to or help you promote? Some of your articles or you work on anything now, would you like people to be able to click on in the show notes if they want to find out more about what you do? I've read a newsletter that I write very infugable about healthcare issues.

Right now I'm focusing on stuff I've read. I'm working on some books that was found in there. I picked a really dumb name for it. It's pardonjohn.com slash error. I'll write the user name which says, I read everything to do with it. You can write to that if you wanted to. Well, great. Well, thank you so much.

I really appreciate your time here and it's been wonderful speaking with you. Tim Fowles, thank you so much for joining us and there'll be more that you can click on below if you want to find out anything else about what Tim does or how these things work. Thanks for having me. I love to hear their Democrats when they're partying all night long Love to hear their sacred scent when they're saluting their favourite song

Left, right, left, right, stomping down all through the night Left, right, left, right, stomping down all through the night Left, right, left, right, now I've got you in my sights Left, right, left, right, did you get the money right? Of course you know what we need Thanks for watching!