Episode 922: The Rising Cost of Healthcare

Summary

---

Newt’s World (Gingrich 360):

Episode 922 – The Rising Cost of Healthcare

Guest: Brian Blaise, President of Paragon Health Institute
Date: December 21, 2025

---

Overview

In this episode, Newt Gingrich sits down with Brian Blaise, president of the Paragon Health Institute and former Special Assistant to the President for Economic Policy, for a hard look at the dramatically rising costs in the American healthcare system. They explore the roles of government policy, systemic fraud, market distortion, and regulatory failure in making healthcare unaffordable for many Americans. The conversation emphasizes the need for reform grounded in transparency, competition, and consumer empowerment.

---

Key Discussion Points and Insights

1. The Mission and Origin of Paragon Health Institute

Timestamps: [04:34]–[07:26]

• Paragon’s Purpose: Blaise shares that Paragon Health Institute was founded to fill a void in thoughtful, free-market healthcare analysis and reform.
  • Focus on analyzing how government programs actually function, not just their stated intentions.
  • Develops policy reforms based on “expanding choice, injecting market competition, and fostering innovation.”
• Legislative Impact:
  • Assisted with big reforms in Medicaid, including community engagement and work requirements for able-bodied adults.
  • Focused recent efforts on exposing issues with Obamacare and showing the downsides of expanding insurance subsidies.

2. Systemic Fraud and Incentive Failures in Public Healthcare Programs

Timestamps: [07:26]–[15:11]

• Medicaid and Obamacare Vulnerabilities:
  • Gingrich cites billion-dollar fraud in Minneapolis and $120 million in New Jersey as cases where bureaucratic incapacity enabled massive theft.
  • Blaise explains federal-state Medicaid cost incentives (“when states spend more, they get more federal money”), which invite waste and fraud.
• Phantom Enrollments:
  • Blaise highlights “phantom” Obamacare enrollees: “We estimate that about actually more than 25% of all Obamacare enrollment in 2025 is improper. And many of these enrollees don't have any idea that they're enrolled in the program.” ([11:05])
  • Insurers benefited massively from millions of people signed up for plans they don’t use or even know about.
  • “Turns out that the growth of zero claim enrollees went from 4 million in 2021 to almost 12 million people in 2024. So 40% of enrollees in 2024 in Obamacare didn't use their health plan a single time.” (Brian Blaise, [12:54])
• Inadequate Program Safeguards:
  • The GAO submitted 24 fake applications; 23 were approved. ([13:33])

Memorable Quote:
"It is so corrupt, Mr. Speaker, because the subsidy goes directly from the US treasury to the health insurance company and because of the Biden policy, the enrollee is paying nothing, so they're not aware that they're even enrolled in the coverage."
— Brian Blaise, [14:30]

3. The Distorted Healthcare Market & The Role of Consolidation

Timestamps: [19:14]–[29:09]

• Ineffective Market Structure:
  • Average family of four projected to pay $26,000 in annual healthcare costs in 2026 ([19:59]).
  • Hospital prices have risen three times faster than overall inflation since 2000 ([20:52]).
  • Medicare payment policy incentivizes consolidation: hospitals acquire doctor’s offices to bill at higher hospital rates.
  • 90% of spending passes through third-party payers; consumers have little control.
  • Blaise: “The more complexity, the harder it is on the small guys, because there’s fixed costs in complying with all of this regulation and administrative burden.” ([21:57])
• Obamacare’s Role:
  • Obamacare increased market consolidation, reducing competition among insurers and providers.
  • “97% of inpatient hospitals lack meaningful competition. So you now are building hospitals that don't have any competition and they're increasing their prices 15 to 30% instead of having competition drive costs down.” (Newt Gingrich, [26:35])
• Antitrust Challenges:
  • The Federal Trade Commission and DOJ can block mergers, but cannot keep up with the sheer volume of healthcare mergers ([29:09]).

Memorable Quote:
“Normal economics apply to the healthcare sector too, and where we've lost competition...that leads to upward pressure on prices. And it actually also worsens quality because you need to have competition for healthcare quality as well.”
— Brian Blaise, [27:46]

4. Hidden Prices and Lack of Transparency

Timestamps: [23:33]–[24:19]

• Gingrich and Blaise agree that even with more consumer control, patients cannot make informed choices without price and quality transparency.
  • The Trump administration initiated steps toward hospital price transparency; Blaise calls this “a work in progress.”

Memorable Quote:
“20% of the economy and prices are hidden from patients and they're hidden from employers, because employers do a lot of their shopping in healthcare.”
— Brian Blaise, [23:46]

5. The Cost Explosion and Crowding Out of Wages

Timestamps: [24:19]–[25:12]

• Healthcare spending has risen from 13% to 18% of US GDP since 2000—a 38% increase in its share of the economy.
• Rising insurance costs crowd out wage increases for working Americans.
• Entitlement spending growth (Medicare, Medicaid, Obamacare) is driving federal budget imbalances and higher interest payments on debt.

6. Enforcement, Program Integrity, and “Uncatchable” Fraud

Timestamps: [33:09]–[36:11]

• The system’s complexity and the amount of money involved leave bureaucracy unable to monitor fraud.
• Some states have little incentive to monitor fraud when federal dollars are on the line. ([33:38])
• Notable Case: Two brokers in Florida enrolled homeless and fictional individuals, generating $230 million in insurance subsidies for themselves and insurers ([34:39]).
• Explosive examples include catheters and autism: dramatic, inexplicable increases in use or billing should trigger review, but are missed for months or years.

Memorable Quote:
“If Minnesota was spending its own money rather than the federal money, they would have large incentives to crack down on the fraud and abuse within the program. But when it's mostly federal spending, they have incentives to just look the other way.”
— Brian Blaise, [34:07]

---

Notable Quotes & Moments

• On Bureaucratic Incentives:
  • “The crooks have a lot bigger incentive to steal than the bureaucrat has to protect.” — Newt Gingrich, [08:02]
• On Phantom Enrollments:
  • “Insurance companies have gotten rich off this system without providing any health care services on behalf of millions of these enrollees.” — Brian Blaise, [14:44]
• On Market Dysfunction:
  • “We're asking families to buy the equivalent of a small car every year.” — Newt Gingrich, [19:46]
• On the Limits of Antitrust:
  • “It's also limited in just the capacity of the federal agencies versus the magnitude of the mergers and acquisitions that have been proposed.” — Brian Blaise, [29:09]
• On Consumer Power:
  • “We should move federal subsidies away from funding the system, away from just going directly to health insurance companies and give the money to the patients.” — Brian Blaise, [22:32]

---

Timestamps for Key Segments

• Introduction and Context: [03:10]
• Why Paragon Health Institute was Founded: [05:07]
• Big Medicaid, Obamacare, and Fraud Cases: [07:26]
• Phantom Enrollment and Zero-Claim Recipients: [12:24]
• GAO Test and System Loopholes: [13:33]
• Root Causes: Market Incentives and Consolidation: [19:59]–[27:46]
• Transparency in Healthcare Pricing: [23:33]
• Antitrust and Market Competition: [28:45]
• Failures in Enforcement and Program Integrity: [33:09]–[36:11]

---

Tone and Language

• Accessible, conversational, yet data-driven.
• Newt Gingrich is direct, often framing problems in historic or systemic terms, and injects humor (e.g., the “Breathing Insurance Recipient Bill”).
• Brian Blaise speaks authoritatively and succinctly, supporting arguments with recent data and research findings.

---

Conclusion

This episode offers a wide-ranging critique of how federal policy and perverse incentives have inflated healthcare costs, enabled fraud, and eroded both value and trust in the system. Blaise and Gingrich repeatedly stress that without empowering consumers, restoring transparency, and reversing anti-competitive consolidation, the American healthcare system will remain unaffordable and unsustainable.

Listeners are encouraged to learn more at paragoninstitute.org.

---

Transcript

[Brian Blaise]

This is an iHeart podcast.

[Trainer Games Announcer]

Guaranteed human 10 athletes will face the toughest job interview in fitness that will push past physical and mental breaking points. You are the fittest of the fit. Only one of you will leave here with an IFIT contract worth $250,000.

[Brian Blaise]

This is where Mindset comes in.

[Trainer Games Announcer]

Someone will be eliminated.

[Washington Post Advertiser]

Pressure is coming down.

[Brian Blaise]

Trainer Games on Prime Video Watch the trailer on trainergames.com want to score when.

[Better Picks Advertiser]

Your favorite player does well? You can't unless you download Better Picks who is giving away a free $10? Download the Better app, pick more or less on player stats, watch the games and win some cash. It's that simple. Must be 21 or older in a jurisdiction where Better Picks operates. Terms and conditions apply. Better Picks Sports just got better Support.

[Public Investing Advertiser]

For the show comes from Public, the investing platform for those who take it seriously. On Public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an it all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA SIPC Advisory Services by Public Advisors, llc SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures [e-mail] Disclosures A new year.

[Washington Post Advertiser]

Is on the horizon and your 2026 savings start here. Right now you can access the Washington post for just $2 every four weeks. Head into the new year with six months of savings at this special intro rate. After that it'll cost $12 every four weeks. Cancel anytime. You'll get unlimited access to trusted journalism that helps you understand the year ahead and the world around you. Now's the perfect time to subscribe because great habits and great savings start together. Go to washingtonpost.com iheart that's washingtonpost.com iheart and start your year informed with the Post.

[Valpak Advertiser]

It's the most wonderful time of the year. And Valpak is here to make it even better. This month, as you sift through holiday mail, don't miss the blue Valpak envelope. From dining to holiday shopping, there's a slate full of savings in your mailbox, plus a chance to instantly win $100. That's right, you can find $100 Christmas cash inside. Want to save even more money on what you love? Go to valpak.com for local coupons and offers. It pays to open Valpak. No purchase necessary. Necessary for instant win voip prohibited prices are randomly inserted. See specially marked Valpak envelopes for details.

[Newt Gingrich]

On this episode of Newts World. I'm really pleased to welcome my guest, Brian Blaise. He's the President of Paragon Health Institute and former Special Assistant to the President for Economic Policy at the White Houses national economic council from 2017 to 2019, where he coordinated the development and execution of numerous health policies and advised the President, NEC Director and senior officials. He recently testified before the Senate Finance Committee on the rising cost of health care for all Americans. And I'm really pleased to be talking with him today because I think solving the issue of the rising cost of health care is one of the fundamental issues of our time. And let me say, when you talk affordability, affordability of health care is a dramatically bigger issue for the American people than the affordability of bacon or gasoline or things that we normally put in that zone. But health care today is extraordinarily expensive and a huge burden on the American people. Brian, welcome and thank you for joining me on this world.

[Brian Blaise]

Mr. Speaker, it is a privilege to be with you. Thank you for having me on.

[Newt Gingrich]

You know, before we get into health, which is, I think going to give them preeminent domestic issue over the next few years, tell me for a couple minutes about this. What you have developed at the Paragon Health Institute suddenly emerged and frankly, I have found the work of the Paragon Health Institute to be among the most insightful and most interesting work being done in Washington today. How did Paragon develop and what has your role been in that development?

[Brian Blaise]

Well, thanks. I appreciate you saying that. Conservatives and those of us who support the free markets haven't always been out front and leading on healthcare reform. And there was a real void in the free market community for an organization that would analyze how government healthcare programs were actually working, not just the intentions behind the programs, and then to develop a set of policy solutions that are consistent with our principles of expanding choice, injecting market competition, and really making sure that we have a regulatory climate that's conducive to innovation. So I launched the organization just about four years ago, and I've been really fortunate to work with some of the best free market health policy minds in the country. Really filled out a team that was based on a lot of the relationships that I had developed when I served under President Trump in his first term. And we set about thinking through what could be an agenda if President Trump returned to office and if there would be congressional majorities in 2025. So we focused on big ideas like how you could reform Medicare, how you could reform Medicaid, you know, how you could reform Obamacare. And we also thought through what an administration could do on its own. And, you know, after the 2024 elections, we really had an opportunity to reform government health programs. And the Medicaid provisions in the one big beautiful bill, they're really the most significant entitlement reform since you were speaker. I mean, when you were speaker, there was significant medic reforms, but the Medicaid reforms that passed in the reconciliation bill, implementing work and community engagement requirements for able bodied working age adults, and really reforming some of the underlying broken parts of the Medicaid program were really instrumental. And we've been focused the last four or five months on issues with Obamacare, problems with Obamacare, and fighting to make it clear to Congress sort of the role that Obamacare had in making health care unaffordable, and what is a better policy direction rather than just increasing more subsidies to health insurance companies.

[Newt Gingrich]

The whole process of the way in which bureaucracies and the lobbyists and the big corporations twist policies that on the surface sound perfectly good, but by the time they get implemented, they're so distorted to fit the interests of the big powerful players that they really undermine the whole process. And I think we just saw a really weird example of this in what happened in Minneapolis, where people came together to steal about a billion dollars. Not a million, A billion dollars in the city of Minneapolis alone. And most of that involves stealing from health programs and programs to help the poor. And these people were just looting the government. And the bureaucrats were so slow and so timid that they sat there passively while people stole about a billion dollars. And my understanding is that there are a number of areas now, including the recent case in New Jersey, where one of the New Jersey blues, I think, were required to pay back something like $120 million that they had fraudulently taken. I began to work on a theory that one of the core characteristics of big government socialism is that it inevitably involves fraud and corruption because the bureaucracies simply can't keep up with the drive and the entrepreneurship of the crooks. The crooks have a lot bigger incentive to steal than the bureaucrat has to protect. Well, what's your general sense about the depth of fraud and the depth of dishonesty buried in these programs?

[Brian Blaise]

It's massive. And it is because of the underlying incentives. I mean, the Medicaid program. At the core of the Medicaid program, the federal government provides an open ended reimbursement of state expenditures. So when states spend more, they get more money from the federal government. And so the people that were bankrolling the corruption and fraud in Minnesota, yeah, the Minnesota taxpayers bore some of that, but the majority of the cost was borne out by the federal taxpayer. It was people outside of the state of Minnesota. And when you have that set of incentives, when the interest groups pressure the state and say, look, you expand this program, don't view it as a welfare program, view it as an economic stimulus for the state, you're going to increase the size of it and we'll have money pouring in from outside the country. One of the problems that we found, and really the Biden administration, a lot of this grew out of COVID it grew out of Biden administration orientation to just maximize enrollment in these programs and abandon program integrity. But you see one of the most profound papers the paragon wrote, it's called the Great Obamacare Enrollment fraud. President Biden signed legislation that made coverage fully subsidized for people purchasing Obamacare in a narrow income band. What we saw is massive fraud schemes that benefited agents, brokers and insurers by manipulating applicant information on the application to have it appear that they had that income even though they didn't. Because that led to so much more money flowing to the health insurance companies and then back to these conglomerate broker and agent. We estimate that about actually more than 25% of all Obamacare enrollment in 2025 is improper. And many of these enrollees don't have any idea that they're enrolled in the program. These schemes got their information in order to sign them up for an insurance card. And they're not aware of their enrollment. They don't use the health insurance at all. And it's just produced a windfall for big insurance, big broker, big agent conglomerates. And those are the ones that lobby for the status quo policy to continue. They've spent hundreds of millions of dollars to continue to prop up a system that is defrauding hardworking American families.

[Newt Gingrich]

It seems to me that people with the best of intention set up what looks like it'll be a very good program. And then somehow in the process of writing either the law or the regulations, it gets perverted into the money going directly to an insurance company. And as you point out, maybe as many as one out of every four people who are supposedly getting covered by the COVID benefit subsidy don't even realize that they have an insurance plan. Never used it. Mostly they're healthy young people, and the insurance company pocketed the money. It's a little surprising that the insurance companies didn't kind of report this to the government.

[Brian Blaise]

So we quantified improper enrollment, and then we coined a term, phantom enrollment. So we're like, okay, all these enrollees, they're not aware that they're enrolled in coverage. We would then expect that a lot of them wouldn't use any health care services. The Biden administration refused to provide the information on what we now call zero claim enrollees. People covered, but didn't use the plan. So no doctor visit, no prescription, no lab test. Turns out that the growth of zero claim enrollees went from 4 million in 2021 to almost 12 million people in 2024. So 40% of enrollees in 2024 in Obamacare didn't use their health plan a single time. Now, insurance companies knew this. They knew that they were getting large number enrollees not using their coverage. But they pointed the blame at the government. They said, well, the government is the one responsible for these eligibility determinations. We just accept all of the enrollees that the government enrollment system has sent our way.

[Newt Gingrich]

The insurance company defense says the government made me take the money.

[Brian Blaise]

The government was responsible for the eligibility system you mentioned. I testified in front of the Senate Finance Committee. I also testified last week in front of the House Judiciary Committee, the House issued committee. The witness next to me was official from the Government Accountability Office. Starting in late 2024 into early 2025, they created 24 fictitious applications. So they submitted them to the Obamacare exchanges. So they were missing information that you would need to do a proper eligibility determination. And do you know how many of the 24 that got approved for coverage by the exchange? 23. So you would think, you know, normal government program, there's going to be some error rates. You might expect a handful to get through. But 96% of the fake applications that GAO created were able to get enrolled in an exchange plan with a subsidy that paid the entire cost. Now, the insurers, to your point, they know, but they're getting a lot of enrollees from certain brokers and agents. It's impossible to do that many in a given period of time. I think they should be held financially culpable. It is so corrupt. Mr. Speaker, because the subsidy goes directly from the US treasury to the health insurance company and because of the Biden policy, the enrollee is paying nothing, so they're not aware that they're even enrolled in the coverage. So the insurance companies have gotten rich off this system without providing any health care services on behalf of millions of these enrollees.

[Newt Gingrich]

Well, it's sort of like a giant windfall profit disguised as an insurance plan.

[Brian Blaise]

In the insurance companies we support private health insurance. People should have private health insurance, but we want private companies to be competing for patients own dollars so that they're serving the patient. In Obamacare in 2025, 85% of all of the premium revenue is coming from taxpayers. So for insurance companies, the federal treasury is their main client. It's not individual consumers and patients.

[Trainer Games Announcer]

10 athletes will face the toughest job interview in fitness that will push past physical and mental breaking points. You are the fittest of the fit. Only one of you will leave here with an IFIT contract worth $250,000.

[Brian Blaise]

This is where Mindset comes in.

[Trainer Games Announcer]

Someone will be eliminated.

[Washington Post Advertiser]

Pressure is coming down.

[Brian Blaise]

Trainer Games on Prime Video January 8th Watch the trailer on trainer games.com have.

[Better Picks Advertiser]

You ever turned $1 into $10,000? I doubt it. But now you can. On Better Picks, download the Better app, pick more or less on player stats, watch the games and win some cash. It's that simple. Better Picks is available in 33 states including Texas, California and Georgia. Download the Better app today. That's better. B E T R and get a free $10. No deposit necessary. Must be 21 or older. In a jurisdiction where Better Picks operates, terms and conditions apply. Better Picks Sports just got Better.

[Public Investing Advertiser]

Support for the show comes from Public, the investing platform for those who take it seriously. On public you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index. With AI it all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year. You can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA SIPC Advisory Services by Public Advisors, llc SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures [e-mail] Disclosures A new year.

[Washington Post Advertiser]

Is on the horizon and your 2026 savings start here. Right now you can access the Washington post for just $2 every four weeks. Head into the new year with six months of savings at this special intro rate. After that, it'll cost $12 every four weeks. Cancel anytime. You'll get unlimited access to trusted journalism that helps you understand the year ahead and the world around you. Now's the perfect time to subscribe because great habits and great savings start together. Go to washingtonpost.com iheart that's washingtonpost.com iheart and start your year informed with the Post.

[Valpak Advertiser (alternate)]

Your ticket to big savings is that big blue envelope in your mailbox. Valpak. It's printing with deals from big name brands and your favorite local spots, dining services, stuff you're already buying, all for less. And you could score $100 or other instant prizes just for opening it. Or save even faster with mobile coupons you can use right [e-mail] Valpak there's definitely something in it for you.

[Newt Gingrich]

In the taste because the system is so out of whack. A friend of mine said we actually need a new bill entitled the Breathing Insurance Recipient Bill that if you're not breathing and we can't prove you're real, then the money doesn't go out.

[Brian Blaise]

Yeah, I would endorse that bill. CMS has put out information like there's people that are enrolled in multiple state Medicaid programs simultaneously. There are individuals that are covered by both Medicaid and by an Obamacare exchange plan. So CMS released data earlier this year that showed 2.8 million people are enrolled in multiple government programs when they should only be enrolled in one.

[Newt Gingrich]

That makes you wonder because they're not directly getting money, they may be getting enrolled several times. So I guess they have several insurance cards. It'll be interesting to see what the correlation is between fraud and Medicaid and Medicare and people who are multiply enrolled. And if that then becomes sort of an identity theft opportunity. Let me ask you because the system is currently so badly designed, the average family of four will pay $26,000 a year in health care costs in 2026. The system is so badly designed that we're asking families to buy the equivalent of a small car every year. You've done a lot of research on this, and I'm curious, what do you think are the two or three biggest places that we should be examining in order to help reduce cost?

[Brian Blaise]

Yeah, so that's a great question. I'd encourage the listeners to look up AI's chart of the century. They look at the rising prices by economic sector from 2000 to the present, and they compare that with the rise in inflation and the rise in wages. And the number one area of the economy that has seen price inflation over the last 25 years is hospitals. Hospital prices have risen three times faster than inflation. And there's a lot of government policies that push up hospital prices. A good example is how the Medicare program works. So the Medicare program pays a lot more for a service delivered in a hospital than delivered in an independent physician's office. What that leads to is incentives for hospitals and physicians for the hospital, hospital to acquire the physician office, because then they can just change the ownership on the office, change nothing else about it, and bill at a much higher rate. So it leads to less competition and more consolidation in the market. And unfortunately, Medicare has so much pricing power because commercial payers tend to link their prices to how Medicare pays. So one of the main areas we need to fix is Medicare payment policy that advantages hospitals over independent physician offices and leads to consolidation. You know, and then there's just a lot of complexity, a lot of this result of Obamacare. There's other existing government regulations that add the complexity. But the more complexity, the harder it is on the small guys, because there's fixed costs in complying with all of this regulation and administrative burden. So the rise in administrative complexity that has come from just the growth of government has advanced managed big hospital systems over smaller entities. And Obamacare. We talk about Obamacare's problems in the exchange market, but one of the things we don't talk about so much of a problem with Obamacare is how it increased consolidation and what that does on the supply side of the market. And the last one I would mention is consumer control. Consumers control so little of the financing in healthcare. 90% of our spending in healthcare goes through third party payers. You know, and President Trump, I think, is spot on where he says we should move federal subsidies away from funding the system, away from just going directly to health insurance companies and give the money to the patients so that the health sector has to respond to the patient and meet their needs, rather than whatever the bureaucracy thinks is best.

[Newt Gingrich]

Which gets back to my constant calling for transparency. Because even if you have the money in your pocket, unless you have information about price and quality, you have no way of knowing what you're buying.

[Brian Blaise]

20% of the economy and prices are hidden from patients and they're hidden from employers, because employers do a lot of their shopping in healthcare. You know, the Trump administration put out regulations in 2019 and 2020 to compel prices from hospitals and from insurers. And that is a work in progress. The Biden administration didn't prioritize it. It is going to be a priority for the president in his second term. I think it's something that we definitely need to build on, is getting Americans the right to know prices before they obtain health care.

[Newt Gingrich]

Well, if you want to have a sense of how big the challenge is, in 2000, health care cost 13% of the American economy. Now, in the last 25 years, our economy has grown dramatically, and health insurance has gone up to 18% of the US domestic product. So it's actually growing much faster than the economy. And in fact, there was a 38% increase in its share of the economy from 2000 to 2024. And it seems to me if we don't get an ability to get total cost under control, to give people real power over their own future and their own lives, this is just going to.

[Brian Blaise]

Become totally unmanageable for American families. The health care inflation and the more on health insurance, it's crowding out wage increases. Most Americans that don't get coverage for a government program, they get coverage from their employer or employer of someone in their family. And that is not a free gift from the employer that comes out of the compensation that that employee would have earned. So we're taking compensation out of wages into health insurance benefits. And it's also vital that we get a hold of this for the federal budget. I mean, there's two areas of the federal budget that are growing as a percentage of the economy. Healthcare entitlement spending and interest payments on the debt. And interest payments on the debt are a function of health care entitlement spending. And these programs grew exponentially under the Biden administration. Obamacare and Medicaid were out of control with the focus on the Biden administration of enrollment in any costs and really tons of corporate welfare coming into the program. So the Trump administration and the one big Beautiful bill, like I mentioned before, was really important in reforming aspects of the Medicaid program. It is crucial over the next several years that we restore some sanity to these federal health care programs.

[Newt Gingrich]

It seems to me, looking back that the Obamacare system, the Affordable Care act, which we all now understand was not affordable. It's actually the Unaffordable Care Act. But what it's done is it's actually reduced the amount of competition. There was testimony that many of the county level exchange markets have only two insurers who have 70% enrollment. 97% of inpatient hospitals lack meaningful competition. So you now are building hospitals that don't have any competition and they're increasing their prices 15 to 30% instead of having competition drive costs down. I mean, you look at Walmart or Target or Costco or any of the great systems that deal with customers on a competitive basis and the pressure on them to be honest, to be efficient, to be effective, is just astonishing. And none of that seems to apply to how we manage the largest single sector of our economy, which is healthcare.

[Brian Blaise]

Normal economics apply to the healthcare sector too, and where we've lost competition. And that's one of the clearest things from the literature. When markets get consolidated, when you have hospital systems merging together, when you have hospital systems taking over doctor's practices, that leads to upward pressure on prices. And it actually also worsens quality because you need to have competition for healthcare quality as well. Really what we need to do at a basic level is go through all federal programs and any policies that incentivize consolidation and reduce competition, we need to reverse. There's also a lot of state level policies that restrict competition. Say one other benefit of the one big beautiful bill, it created a Rural Health Transformation Fund. And that fund provides extra funding for states if they take actions that open up competition within their markets.

[Newt Gingrich]

When you look at our various antitrust efforts, whether it's media or it's manufacturing or other things, is there anything comparable that looks at these huge hospital systems or these huge insurance companies and measures whether or not their activities will end up being anti competition and inevitably leading towards monopolistic behavior?

[Brian Blaise]

That's a good question. So the Federal Trade Commission and the Antitrust division at the Department of Justice, they do, I think some high quality work looking at mergers and acquisitions. There's been mergers between big insurance companies that have been blocked before. The problem is just the quantity of the mergers and acquisitions and the capacity of the antitrust agencies to really look at them. So it is just so limited in the scope of what they can look at. So I think it's an important tool to have. But it's also limited in just the capacity of the federal agencies versus the magnitude of the mergers and acquisitions that have been proposed.

[Trainer Games Announcer]

10 athletes will face the toughest job interview in fitness that will push past physical activity and mental breaking points. You are the fittest of the fit. Only one of you will leave here with an IFIT contract worth $250,000.

[Brian Blaise]

This is where mindset comes in.

[Trainer Games Announcer]

Someone will be eliminated.

[Washington Post Advertiser]

Pressure is coming down.

[Brian Blaise]

Trainer Games on Prime Video January 8th watch the trailer on trainergames.com nothing in life is free except this $10 that better picks is offering. Download the Better app, Pick more or less on your favorite player stats, watch the games and win some cash. It's that simple. Must be 21 or older in a jurisdiction where Better Picks operates terms and conditions.

[Public Investing Advertiser]

Better Picks Sports just got better Support for the show comes from Public, the investing platform for those who take it seriously. On Public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index with AI. It all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member finra, SIPC Advisory Services by Public Advisors, llc SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures [e-mail] Disclosures A new year.

[Washington Post Advertiser]

Is on the horizon and your 2026 savings start here. Right now you can access the Washington post for just $2 every four weeks. Head into the new year with six months of savings at this special intro rate. After that it'll cost $12 every four weeks. Cancel anytime. You'll get unlimited access to trusted journalism that helps you understand the year ahead and the world around you. Now's the perfect time to subscribe because great habits and great savings start together. Go to washingtonpost.com iheart that's washingtonpost.com iheart and start your year informed with the Post.

[Valpak Advertiser (alternate)]

Your ticket to big savings is that big blue envelope in your mailbox. Valpak. It's brimming with deals from big name brands and your favorite local spots, dining services, stuff you're already buying, all for less. And you could score 100 or other instant prizes just for opening it. Or save even faster with mobile coupons you can use right [e-mail] Valpak there's definitely something in it for you.

[Newt Gingrich]

You end up with some efforts to really look at what's going on. And consistently those efforts produce astonishing numbers of either people who are already dead but they're still getting money, or people who are getting money from two or three different places. I mean, are you surprised at the degree to which the bureaucracy has broken down in terms of being able to monitor and ensure honest activities?

[Brian Blaise]

It's a really good question because a lot of the things you hear from the Democrats are, well, don't throw the baby out with the bathwater. Just have better enforcement. And the problem with that line of thinking is when you have incentives that make cheating and fraud so profitable, it's very hard. The government, its enforcement capabilities are limited. They only have so many staff, they only have so much that they're going to go after in terms of enforcement. In some places, you're just playing whack a mole where you're cutting down one problem, but you're going to see a problem emerge somewhere else. Fundamentally, with respect to the Minnesota example that you brought up up, if Minnesota was spending its own money rather than the federal money, they would have large incentives to crack down on the fraud and abuse within the program. But when it's mostly federal spending, they have incentives to just look the other way. Same thing with what's happening on Obamacare. There's so much money for the health insurers, for the brokers, for enrollees to cheat when they all have large incentives to cheat and lie. You're going to get that. Now DOJ has come in and there's been a couple of major suits to get after some of these brokers. Two guys in Florida were basically paying homeless individuals to give them their identification. They enrolled them in Obamacare. Large subsidies then went to the insurers. The brokers then got a cut and commissioned those two guys. The amount of the subsidies that those two individuals produced was $230 million. So you're going to catch some cases like that. And that Money is gone, that money is gone that will never be recovered.

[Newt Gingrich]

The amount of money you just described, how could you physically do that?

[Brian Blaise]

So there's a lot of money in these subsidies and they went around pockets of South Florida and just enrolled massive numbers of individuals and some of them fictional. Like I mean I think the GAO report showed that there's like no program integrity control. Some things shock you about how bad government is. It to me is shocking that 96% of fake applications got through.

[Newt Gingrich]

That's why I was sitting here thinking you almost can't get your head around. That's why I think the Minnesota case where you had in one city a billion dollars being stolen in a very systematic way and you had a bureaucracy that just wrote the checks.

[Brian Blaise]

Think about that. If there's a five times increase in autism diagnoses in a very short period of time. And so the Minnesota example, they were paying parents to have their kids diagnosed for autism because then that led the provider to be able to bill higher amounts. The bureaucracy, if they are sophisticated and they say they're so good now, they should be able to analyze all this data. If you're having a five times increase in autism diagnoses and then a massive spending on all of these specific services for kids that have autism, that should have been caught, it should have been caught within, you know, a few months of that happening. Another example with Medicare a couple years ago, they paid for all these catheters. Huge surge like thousand percent increase in Medicare spending on catheters. They never went to patients. They should have caught all of this stuff early on.

[Newt Gingrich]

It's just wild. Look, this is a huge area, largest single sector of the economy. You will never balance the federal budget until you get this under control. And it's just wrong. It also gives the American people a more inadequate and a weaker health system and health care system. And the work you're doing at the Paragon Institute I think is a significant step towards opening up the facts and allowing the Congress and the President to really talk about big serious reforms. And Brian, I want to thank you for joining me. I want to encourage our listeners to keep following the work you're doing by visiting your [e-mail] and of course I want to wish you a very, very Merry Christmas.

[Brian Blaise]

Merry Christmas, Mr. Speaker. It really is a privilege to be with you.

[Newt Gingrich]

Thank you to my guest, Brian Blaze. New Towel is produced by gamers60 and iHeartMedia. Our executive producer is Garnesey Sloan. Our researcher is Rachel Peterson. The artwork for the show was created by Steve Pendley. Special thanks to the team at Gamers360. If you've been enjoying Newts World, I hope you'll go to Apple Podcast and both rate us with five stars and give us a review so others can learn what it's all about. Join me on [e-mail] I'm Newt Gingrich. This is new trove.

[Trainer Games Announcer]

10 athletes will face the toughest job interview in fitness that will push past physical and mental breaking points. You are the fittest of the fit. Only one of you will leave here with an IFIT contract for $250,000.

[Brian Blaise]

This is where mindset comes in.

[Trainer Games Announcer]

Someone will be eliminated.

[Washington Post Advertiser]

Pressure is coming down.

[Brian Blaise]

Trainer Games on Prime Video January 8th watch the trailer on trainer games.com nothing.

[Better Picks Advertiser]

In life is free except this free $10 that better picks is offering. Download the Better app, pick more or less on player stats stats, watch the games and win some cash. It's that simple. Must be 21 or older in a jurisdiction where Better Picks operates, terms and conditions apply. Better Picks Sports just got better.

[Public Investing Advertiser]

Support for the show comes from Public, the investing platform for those who take it seriously. On Public, you can build a multi asset portfolio of stocks, bonds, options, crypto and now generated assets which allow you to turn any idea into an investable index with AI. It all starts with your prompt. From renewable energy companies with high free cash flow to semiconductor suppliers growing revenue over 20% year over year, you can literally type any prompt and put the AI to work. It screens thousands of stocks, builds a one of a kind index and lets you back test it against the S&P 500. Then you can invest in a few clicks. Generated assets are like EFTs with infinite possibilities, completely customizable and based on your thesis, not someone else's. Go to public.com podcast and earn an uncapped 1% bonus when you transfer your portfolio. That's public.com podcast paid for by Public Investing Brokerage Services by Open to the Public Investing Inc. Member FINRA SIPC Advisory Services by Public Advisors, llc. SEC Registered Advisor Generated Assets is an interactive analysis tool. Output is for informational purposes only and is not investment recommendation or advice. Complete disclosures [e-mail] Disclosures A new year.

[Washington Post Advertiser]

Is on the horizon and your 2026 savings start here. Right now you can access the Washington post for just $2 every four weeks. Head into the new year with six months of savings at this special intro rate. After that it'll cost $12 every four weeks cancel anytime. You'll get unlimited access to trusted journalism that helps you understand the year ahead and the world around you. Now's the perfect time to subscribe, because great habits and great savings start together. Go to washingtonpost.com iheart that's washingtonpost.com iheart and start your year informed with the Post.

[Valpak Advertiser (alternate)]

Your ticket to big savings is that big blue envelope in your mailbox. Valpak. It's brimming with deals from big name brands and your favorite local spots, dining services, stuff you're already buying, all for less. And you could score $100 or other instant prizes just for opening it. Or save even faster with mobile coupons you can use right [e-mail] Valpak there's definitely something in it for you.

[Brian Blaise]

This is an Iheart podcast. Guaranteed human.