← Armstrong & Getty On Demand
Loading summary
Transcript54 lines
- [00:00]
A
This is an iHeart podcast. Guaranteed Human summer is here, which means we all want to look and feel our best. A GLP1 may be right for you. Visit orderlymeds.com to learn more about which GLP1 you could be eligible for. Getting started is fast, easy, and happens virtually through telemedicine from licensed professionals. Check it out for yourself. Go to orderlymeds.com podcast that's orderlymeds.com podcast. Taking care of yourself feels great. Compounded medications are not FDA approved. Eligibility required and determined by a licensed provider. Individual results may vary. See website for details.
- [00:35]
B
We've been talking to Craig Gotwells for years for a variety of reasons. He is a healthcare expert. That's actually what he does for companies is he helps them with their healthcare plans. So he's got to know exactly what's going on. And he warned us about the Affordable Care Act, Obamacare long before it started, how it was going to turn out. And he has been completely right. Craig got Wells welcome to the Armstrong and Getty Show.
- [00:57]
C
Thank you. Jack, how you doing?
- [00:58]
B
First of all, it's National French Friday. What's your favorite French fry?
- [01:03]
C
In and out, Extra crispy, hot out of the fryer.
- [01:06]
B
You can order them extra crispy, Jack,
- [01:08]
C
if you haven't done that, you haven't lived. Order them extra crispy. It's. It's like a whole new experience. I have totally different.
- [01:14]
B
I have never done that and I will, I guarantee you. And you know I mean it. I will do that today. Awesome. Well, that's cool. There's so many hacks around, in and out. I need to go onto a Reddit page or something and learn the hacks. Extra crispy. In n out French fries. Sorry to those you around the country who do not have an in now. Anyway, Craig, so one of the reasons I wanted to bring this up with you is first of all, I saw a graph on Twitter the other day with some sort of bulge in the middle that said the Affordable Care act is not so affordable anymore. And it reminded me just anecdotally the bills I've been getting for every time I take my kids to the doctor for anything, have gotten so much bigger than they used to be. I'm actually to the point now that if something happens to my kids, rather than going to urgent care or making an appointment, I wait and see how it's going to turn out because the bills are so high. It's like I don't want to go again. Am I. Is it just my imagination or is
- [02:15]
C
something happening no, no, you're, you're, you're on target. I mean, we, we are, we're headed toward a cliff of unsustainability here. I mean, we've been headed toward that cliff for quite some time. But you can't. Healthcare on a macroeconomic level, Jack. The breaking started in the 60s when we just dumped a ton of federal money into it with Medicare and Medicaid. And then in 2010, we dumped another ton of money into it with Obamacare, but we did nothing to structurally fix it. So we've got all this federal money sloshing around and you've got, you've created an oligopoly where there's very few large systems and large insurers that are providers with a whole parasitic class of ticks that are under, that are middlemanning the system to death. And it's just, it's killing us. Whether you have an employer plan or you have an Obamacare plan, or whether you're paying out of pocket for care, it's just become completely unsustainable.
- [03:09]
B
So you use the word oligarchy around healthcare. How come the Bernie Sanders and the Elizabeth Warrens of the world aren't worried about this?
- [03:16]
C
Well, because they. Because this is exactly what socialized medicine looks like. This is how this is. This is what they aspire to and how those folks in the ruling class get even richer. Healthcare is our number one employer in the country, and it's the number one lobby in the country. So healthcare is greasing the skids everywhere along the path.
- [03:35]
B
Okay, let's start, let's hold on there. Healthcare is the number one employer in the country and the number one lobby in the country.
- [03:43]
C
Wow.
- [03:43]
B
I don't think most people know that.
- [03:45]
C
No. And as we've mentioned before on your show, we're now at a point where it doesn't even matter whether you live in a blue state or a red state. 70% of all your health care is now paid for by taxpayer dollars. But instead of doing it in a, let's call it a quasi efficient method of Medicare, which it's not. But if you had. Medicare is more straightforward than what we have with Obamacare. You're looping in the pbm, the insurance company companies, the brokers, and all these middlemen that are all parasitic and profit upon your illness. Their job is to maximize profit. And again, if it were a free market, Jack, you know I would be entirely for it when we come to big drug and to big insurance. And it's not. It's an oligopoly. Not a free market and they're paying off the politicians because that's what happens when you have broken markets.
- [04:36]
B
Well, like I said, I've noticed my bills have gotten so much bigger over the years that I now hesitate to go. I think, you know, I want to wait and make sure this doesn't fix itself on its own before I go and get a $380bill for just dropping by and saying, take a look at this, which didn't used to happen. Is there any reason to think it's going to not get worse?
- [04:59]
C
Realistically, it's, it's, it's almost certainly going to get worse before we have any kind of change to get better. The question will be when it does get this much worse, will the people opt for something easy like Medicare or like I would say it's going to end up being Medicaid for all. Medicare is too expensive. It's got to be Medicaid, which is even worse. Or you just, you have to, you have to break the system so badly that you pull the federal government out of it and you have individuals go back to pure price transparency and buying their own health care. But I don't, I don't see that as the most likely option. I mean the only, the only path where that happens is if it's all done at the employer level because employers still control about 30 to 40% of health care. And if employers self insure their plans and get, get out of the oligopoly as much as they can, that's where we can make some real change. But we're working with one third of the pie, you know, as far as the money goes, even less than one third of the pie.
- [05:56]
B
Does Rand Paul's argument work? He always uses, because he was an optimal, is an ophthalmologist, he always uses the example of Lasik because it's outside of the insurance thing. You know, you pay cash for that and so it was competitive and you have people, you know, there's a reason for me to keep my costs down to get more customers where that doesn't exist. If you go into the doctor for anything else, does that model work as an example of what could be.
- [06:24]
C
It absolutely does. So, and that's, that's kind of what we're advocating for with what I do. And so how you would do that at the individual level, and I know this sounds counterintuitive to people, is we need to legalize because right now it's illegal to do it. Something like $25,000 or $50,000 deductible plans for individuals. And the only reason I say that is you really only want insurance for those catastrophic events that occur that you can't afford. And if you, if you, for example, put every American on a plan that either had a 25 or a $50,000 deductible, now if they're super low income, you put them into Medicaid, right? But those people that can, that can budget their own care, you would start seeing price and negotiation for things like urgent care, for things like common over the counter drugs, for things like your doctor visits. And it would all come down to a reasonable price because you would realize there's not just a federal slush fund that's, that's washing around that everybody's trying to feed at the trough of.
- [07:23]
B
I know you got these stats at the top of your head. What was back in the 60s when we came up with these socialized health plans? What was the original goal versus where we are now in terms of percentages of people covered?
- [07:36]
C
Yeah, I know you love this statistic. So when, when Medicaid was passed, Medicaid is for our low income, Medicare is for our seniors. And the difference is, you know, at least in theory, the way the actuaries set it up, we all pay into Medicare as we work. And then in theory the way it was supposed to be set up, as we're paying for our own care when we then retire, it doesn't work that way. It's not, it's broken, it's not funding enough, just like Social Security. But if you just look at Medicaid, the idea with Medicaid was we're going to cover the lowest 2% of earners in 1965. That was the projection that they said, you know, by about 1990, we're going to cover the lowest 2% of earners in our country. And now four out of every 10 babies born in blue states like California are born onto a Medicaid plan.
- [08:21]
B
Wow, from 2% to 40%.
- [08:24]
C
Yeah.
- [08:25]
B
I mean that's just stunning.
- [08:26]
C
Roughly 1/3 across the country for adults too, one third of all Americans are on a Medicaid plan.
- [08:31]
B
And so Medicare, CAID is the one where studies show you get worse results than if you didn't have any healthcare.
- [08:41]
C
There are reputable university backed studies that have shown that for certain heart conditions and diabetes care management and certain conditions, you actually might be worse off on Medicaid than if you had no insurance at all. Because you end up in such a long line to get care and it becomes such a headache and you end up with such, with a much smaller panel of doctors that it's actually worse than if you were able to scrape up enough cash to pay for these things on your own and the outside of that system.
- [09:08]
B
God, that's horrifying. And that could be all of us soon. So moving from the realm of, you know, your expertise, health care into a realm. I know you know a lot about the politics of it. I just, I think it's going to be a pretty easy sell for Bernie or Elizabeth Warren or whoever is, you know, running the campaign for this or whoever's the nominee for president for Democrats to, to say, hey, look, the bills are too high, the paperwork's getting you down. Let's just go Meta, you said we're gonna go Medicare for all, probably, or Medicaid.
- [09:40]
C
Well, they'll talk about, they'll say Medicare. They'll say Medicare. The difference is, and I have, I actually have these numbers right at my fingertips. The difference is the cost for one enrollee for one single person in Medicare is just about $12,000 per year per person. But the cost on Medicaid is only $8,000 per year per person because Medicaid is cheaper, because it has less doctors, because it's not as good. You, the country can't afford Medicare for all. I mean, we're talking 36, $40 trillion over a 10 year span. It's, we can't afford it. So I think ultimately what they'll do is they'll pitch Medicare for all, but it'll end up looking a lot more like Medicaid for all, where we really have this, this horrific system that nobody wants to be in if they can avoid it. And then you'll get a bifurcated system where those that have money will go out a, they'll pay cash prices, they'll negotiate deals directly with doctors and they'll do it on their own, like they
- [10:36]
B
do in England with nhs, like they do in England.
- [10:39]
C
But there are some countries, and I believe Canada is one of them, where that's illegal. Like, I don't think we'll go that far. Yeah, I don't think we'll go that far. But yeah, there are some of the socialized countries, Jack, where you can't pay cash for service. They don't let you buy a separate policy.
- [10:53]
B
And so Mike, that's crazy. So my concern is that people wouldn't know what it's costing. It'll just get rolled into just kind of general taxes which half the country doesn't pay. And so you won't have a concrete getting a bill understanding of what we're all paying for this.
- [11:10]
C
No. And what'll happen is it'll be like the scandals. And you spoke about them, I think it was maybe yesterday. But the scandals with the Medicare fraud we've seen in Minnesota and California, those will just get worse. Because, see, the. The real sin with Medicare and Medicaid is they've looped in the prescription benefit managers, the drug companies and the insurance companies are all part of it in the supplement space. And so there's a whole bunch of people getting rich and farming the federal taxpayer. Then you've got brokers that farm that as well. So you have this whole parasite class that's farming on it because again, because number one lobby in the United States, number one employer in the United States, they have the power, they have Congress's ear, and the taxpayer just gets steamrolled. But you're absolutely right. It'll. It'll be some of the Frankenstein hybrid, Medicare, Medicaid, and you'll. You'll have all those dollars just. We won't know what things really cost.
- [12:05]
B
And then there's no going back.
- [12:07]
C
Nope. And it'll. It'll just keep eroding our quality of life. Right. We'll have less cars, smaller houses, you know.
- [12:16]
B
Right.
- [12:17]
C
Like we see in France or whatever.
- [12:19]
B
God, that's depressing. Are you.
- [12:22]
C
I always do this to you, Jack.
- [12:23]
B
I know. But, you know, one of the hallmarks of conservatism, George Will taught me this. I heard him say this once. And I always remember recognizing what is, is one of the hallmarks of conservatives, whether it's good news or bad news, just recognizing what are the facts, and these are the facts. And I don't think there's any disputing it. Are you getting any fishing done?
- [12:44]
C
Very little. You know, I made a work transition a couple years ago and I've been working too darn much, but a little bit here and there and it's been all right. But not. Not like it was back in the old days when I was a sponsored bass fisherman and putting in 50 to 100 days on the water a year.
- [12:59]
B
100 days a year fishing. That had to be awesome.
- [13:01]
C
It was. But that's a little bit of a cheat because I'd get out on Folsom Lake and fish until 9am and then be in the office by 10. So I would count that as a day on the water.
- [13:11]
B
Cool. If people want your expertise, how do they get ahold of you?
- [13:15]
C
Got walls. Dot substack Dot com.
- [13:17]
B
Okay. And we will link that at our website. Can we do that? Hanson, really appreciate your time today. That was excellent, Craig.
- [13:23]
C
Of course, Jack, thank you. Yeah.
- [13:24]
B
That, that. The whole health care thing is so depressing. And he started talking about this. We've been talking to Craig for years. And it was before Obamacare is when the national debate was going on about Obamacare. He was predicting on where this was headed. And, and, and he's been right about all of it. And, you know, lots of conservative pundits were saying the same thing. But Craig, because he's so detailed and in that industry on how it was going to be such an easy sell at some point politically for socialized medicine because it gets more expensive and more complicated and more annoying to where people just throw up their hands. They might as well just have socialized medicine, at which point, again, we don't have the slightest idea what it's costing because you never pay any actual bills. It's just kind of factored into the overall cost of America, which, again, as he just pointed out, just kind of drags down the whole economy with smaller houses and smaller cars and just a more sluggish economy. And nobody will understand that. There'll be no, it's depressing. This is not what you want. Do you have it handy, Michael?
- [14:28]
C
We.
- [14:29]
B
We need it on a Friday. And then I'm going to. I'll stop being depressing, at least on this topic, I promise. Because it's just, It's. It's overwhelming to me. Armstrong and Getty. The most depressing radio show
- [14:43]
A
ever.
- [14:43]
B
I don't want to be that. I don't want to be that. We have something fun next. Promise.
- [14:47]
C
Stay tuned. Armstrong and Getty.
- [14:55]
A
Summer is here at Orderly Meds. We know this time is a reminder that life is full of new beginnings. Whether you're celebrating the nice weather, starting a new chapter, planning a vacation, or simply looking ahead to what's next, this season can be the perfect time to invest in yourself and your health. If you've struggled with weight loss and are curious about GLP1 medications, orderly meds can help you learn about your options. Through a simple virtual process, you can connect with licensed medical professionals who can determine whether treatment may be appropriate for you. Getting started is fast, convenient, and happens online from the comfort of home this summer, consider a new approach to feeling your best. Visit orderlymeds.com podcast to learn more. That's orderlymeds.com podcast orderlymeds.com podcast because every new season is an opportunity to take the next step forward compounded medications are not FDA approved, required and determined by a licensed provider. Individual results may vary. See website for details.