2502 - UnitedHealth's Greed; Nurses On Strike w/ George Joseph, Singrid Steinmetz

Summary

Podcast Summary: The Majority Report with Sam Seder - Episode 2502

Title: UnitedHealth's Greed; Nurses On Strike
Hosts/Guests: Sam Seder, Syngrid Steinmetz (ICU Nurse), George Joseph (Investigative Reporter)
Release Date: May 21, 2025

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1. Introduction and Political Landscape

Sam Seder opens the episode by outlining the pressing political issues of the day:

• House Republicans' Fiscal Maneuvers: The GOP is scrambling to pass a reconciliation package aimed at avoiding a debt ceiling crisis projected between July and October. This package includes tax deductions favoring the wealthy and significant Medicaid cuts. Seder highlights the stark disparity in tax benefits across income brackets, citing that 67% of tax cuts benefit the top 20% income earners.

  "67% of the tax cuts go to the richest 20% in terms of dollars."
  — Sam Seder [07:36]

• Impact on Medicaid and Housing: The proposed cuts are projected to strip health insurance and food assistance from 10 to 13 million people, causing potential hospital closures and destabilizing healthcare facilities.

• Senate's Separate Legislation: Concurrently, the Senate has passed a "no tax on tips" bill targeting specific income levels, which may further complicate the legislative process.

2. Medicare Sequestration Concerns

Seder delves into the implications of the reconciliation package not being deficit-neutral, referencing the Budget Control Act of 2011:

• Sequestration Trigger: Failure to meet deficit reduction targets would activate sequestration, leading to over $500 billion in cuts to Medicare by 2026.

  "This bill doesn't waive statutory paygo, so it will have a direct impact on Medicare and the federal budget."
  — Congressional Budget Office [15:05]

• Behind-the-Scenes Negotiations: Representatives express frustration over the lack of transparency and the rushed nature of the bill's passage, raising alarms about the long-term sustainability of Medicare.

3. Nurses on Strike: The Long Beach Medical Center

The highlight of the episode features Syngrid Steinmetz, an ICU nurse and member of the California Nurses Association, representing nearly 2,200 nurses at Long Beach Medical Center poised to undertake a one-day strike.

Key Issues Addressed:

• Patient Safety and Staffing Shortages: Steinmetz details critical staffing shortages leading to unsafe patient-to-nurse ratios. For instance, she explains scenarios where intensive care patients are left with insufficient nursing support, potentially compromising patient care.

  "If you have a patient who's on maybe seven life-saving drips and they have a drain and they're on machines, there should be one nurse to that patient. But because of the lack of staff, we have two patients that are like that."
  — Syngrid Steinmetz [29:01]

• Workplace Violence and Security Concerns: Nurses face verbal and physical assaults, with inadequate security measures in place. Steinmetz recounts incidents where violence erupted among family members of patients, rendering the work environment hostile and unsafe.

• Recruitment and Retention Challenges: Over the past three years, the hospital has seen a significant loss of experienced nurses, exacerbated by layoffs and uncompetitive benefits. Steinmetz emphasizes the long-term costs and inefficiencies of high turnover rates.

  "We're asking for a safe environment and a contract for recruitment and retention. We've lost about 30 to 50 nurses in the ICU every year."
  — Syngrid Steinmetz [35:52]

• Management's Response and Retaliation: The administration's decision to lock out nurses for four days instead of addressing their grievances is viewed as retaliation, further straining relations and impacting patient care.

Community Call to Action:

Steinmetz urges listeners to support the strike by:

• Advocating for Safe Hospitals: Emphasize the need for weapon detectors and enhanced security at medical facilities.

• Supporting Nurse Welfare: Push for better recruitment and retention policies to ensure patient safety and quality care.

  "They can say, we want to be in a safe hospital... if you’re coming to the hospital, you don’t want to worry that you’re in a double room with somebody and the person next to you brought a weapon in."
  — Syngrid Steinmetz [39:47]

4. Investigative Report: UnitedHealth's Malpractices

George Joseph, an investigative reporter for The Guardian US, presents an exposé on UnitedHealth's unethical practices related to Medicare Advantage plans and nursing homes.

Key Findings:

• Medicare Advantage Dynamics: UnitedHealth, through Medicare Advantage, pays nursing homes fixed sums per senior to cover their services. The intention is to foster innovation and reduce costs via private sector competition. However, internal communications reveal a strategy to minimize medical expenses by discouraging hospitalizations.

  "UnitedHealth executives discussing how for the nursing home population, if they can just drive down hospital rates this much, we're going to save X hundreds of thousands of dollars."
  — George Joseph [49:14]

• Patient Care Interference: UnitedHealth's involvement in decision-making processes at nursing homes leads to delayed or denied hospital transfers. Cases include:

  • Stroke Symptoms Delayed Treatment: A patient exhibiting classic stroke symptoms was mismanaged due to UnitedHealth's delayed authorization, resulting in permanent neurological damage.

    "The nurse is there waiting for guidance... by that point, just the transfer alone, it's already taken an hour, which means the patient missed what's called the golden hour."
    — George Joseph [53:36]

• Incentive Payments and Kickbacks: UnitedHealth offers premium dividends and shared savings to nursing homes for enrolling more seniors in their Medicare Advantage plans. This has led to unethical practices, including the leakage of confidential patient records to proactively solicit enrollments, circumventing federal regulations meant to protect seniors.

  "For every patient that joins UnitedHealthcare's institutionalized special needs plan, United will give a set fee... they have to get their loved ones onto these programs."
  — George Joseph [62:34]

Impact and Consequences:

• Undermined Patient Trust: Families are often unaware of the internal maneuvers affecting their loved ones' care, leading to a lack of transparency and accountability.
• Regulatory Concerns: The practices violate federal regulations, raising questions about the oversight of private insurers in the Medicare system.

5. Conclusion and Call to Action

Sam Seder wraps up the episode by emphasizing the need for:

• Increased Oversight of Private Insurers: Addressing the conflicts of interest inherent in systems like Medicare Advantage to protect vulnerable populations.
• Support for Healthcare Workers: Advocating for safer working conditions and fair treatment of nurses to ensure high-quality patient care.

Listeners are encouraged to engage with their communities, support strikes, and stay informed about the intricate dynamics between private insurers and public healthcare systems.

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Notable Quotes:

1. Sam Seder:

   "67% of the tax cuts go to the richest 20% in terms of dollars."
   [07:36]

2. Syngrid Steinmetz:

   "If you have a patient who's on maybe seven life-saving drips and they have a drain and they're on machines, there should be one nurse to that patient. But because of the lack of staff, we have two patients that are like that."
   [29:01]

3. George Joseph:

   "UnitedHealth executives discussing how for the nursing home population, if they can just drive down hospital rates this much, we're going to save X hundreds of thousands of dollars."
   [49:14]

4. George Joseph:

   "For every patient that joins UnitedHealthcare's institutionalized special needs plan, United will give a set fee... they have to get their loved ones onto these programs."
   [62:34]

---

This episode sheds light on the intersection of healthcare policy, labor rights, and corporate ethics, urging listeners to remain vigilant and proactive in advocating for equitable and humane treatment within the healthcare system.

Transcript

[Producer]

You are listening to a free version of the Majority Report. Support this [e-mail] and get an extra hour of content daily.

[Sam Seder]

It is Wednesday, May 21, 2025. My name is Sam Seder. This is the five time award winning Majority Report. We are broadcasting live steps from the industrially ravaged Gowanus Canal in the heartland of America, downtown Brooklyn, usa. On the program today, Syngrid Steinmetz, ICU nurse and a member of the California Nurses association representing nearly 2200 at Long Beach Medical center who are going to go on a one day strike tomorrow. Then George Joseph, investigative reporter for the Guardian US on how United Health Care has secretly paid nursing homes that helped it gain Medicare enrollees and reduced hospitalizations. Also on the program today, House Republicans scrambling to vote for a deficit ballooning Medicaid busting giveaway to the rich blue state. Republicans secure a greater salt deduction. So far, however, no Republicans seem concerned about 10 million who will lose health insurance or food assistance. We're waiting for that, for that clique to hold out. Meanwhile, Senate passes a separate no tax on tips bill that is legitimately a no tax on Tipsville. Israel on verge of starving 14,000 children. Has cut off access to the two only operating hospitals in Northern Gaza. And then for good measure, fires upon a diplomatic mission visiting the West Bank. Their response. Sorry for the inconvenience. I'm not joking. Meanwhile, US leaks intel that Israel is prepping to strike on Iran. Representative Jerry Connolly dies five months after his taking helm of the government oversight minority leadership DOJ opens criminal investigation of Andrew Cuomo. Giving me a lot of mixed feelings. And the CDC's new strategy revealed for fighting disease spread. Don't tell anybody all this and more on today's Majority Report. Folks, thanks for joining us. We're having a little bit of technical difficulties today, so bear with us. The normal low quality of our video will be lower today.

[Producer]

But it is hump day.

[Sam Seder]

It is hump day.

[Producer]

Hello?

[Sam Seder]

Okay, so now I can't tell if she's in frame.

[Producer]

Yeah, but it's fine.

[Sam Seder]

Okay. I can't.

[Emma Vigland]

Well, you gotta trust your producer.

[Producer]

Yeah, there we go.

[Sam Seder]

All right, so we just have a little bit.

[Producer]

I'm honestly amazed that Matt figured this out.

[Sam Seder]

So it was a bit of a scramble. We had a big round of applause. Yep, Here we go.

[Matt Lech]

Mag.

[Sam Seder]

I'll do that right now. Hold on.

[Emma Vigland]

Maybe do this at the end of the show.

[Producer]

A little preemptive like my Tom.

[Emma Vigland]

Look, mission accomplished on the aircraft carrier right now.

[Producer]

Honestly, I mean, like this office is such a, like complex snake pit of wires and the only man for the job is Matlak.

[Sam Seder]

There's a lot of legacy where we actually, the heart of our operation is using an old tube radio that has to filter through a Sega Genesis. Exactly.

[Producer]

This is barely an exaggeration.

[Sam Seder]

It is barely an exaggeration. So the big story, of course is that the House is attempting to vote on the reconciliation package today. Now it will also have to ultimately go to the Senate and then bounce back and forth. There's a time crunch because the politicians don't want to work over the summer. And sometime between July and October we are going to have a debt ceiling crisis and they want to avoid that as well. On top of which, the Senate just passed a separate no tax on tips bill. Now this is actually a legitimate bill in that it literally focuses on tips for people making under $167,000. Now it seems a little bit on the high side in terms of like how much you're making on cash tips, but it is exclusively cash tips. I suspect there's a lot of opportunity for abuse for something like this and we'll see. But it's going to make the job a little bit easier for the Republicans in the House because they are not going to have to necessarily include it in the reconciliation package. There are a couple of rules on reconciliation and that involvement anything in that bill because it only requires 50% plus one in the Senate must deal directly with the budget. So you can't throw in there we're going to ban abortion or something to that effect. On top of which under that, that is known as the Byrd rule. On top of which the Byrd rule also says that within a 10 year window any deficit can exist outside of that 10 year window. And so that's why all of these budgets are done with a 10 year horizon. The deficit, this will balloon after those 10 years though the deficit dramatically, somewhere around like $4 trillion. They don't seem to be terribly concerned about the deficit. And the other thing they don't seem to be concerned about is the 10 to 13 million people who will lose Medicaid health insurance because of it. Here is a clip of Alex Lawson from Social Security Works who has been on top of this from day one with Representative Marionette Miller Meeks, Republican from Iowa. And was she from Iowa or Indiana? Iowa. And she apparently had said she was never going to cut Medicaid for her people and apparently now she doesn't want.

[George Joseph]

To talk about it.

[Representative]

Congresswoman, I was wondering if you would Just talk to us on your way over to the conference meeting.

[Matt Lech]

No.

[Representative]

Last time you spoke with, you lied to our face because you weren't going to vote for Medicaid cuts. But then you've actually voted for the largest cuts to Medicaid in the history of the country. Do you have any comments on that? Do you have any comments on the four hospitals in your district that are going to close because of your vote? Representative Miller Meeks, I'm wondering if you have any comment on the health care that 67,000 people in your district are going to lose. Does it concern you that you only won by 800 votes?

[Producer]

She was like two seconds away from prying open the doors and jumping down the elevator shaft before it arrived.

[Sam Seder]

Now, I just want to, I just want to say, like, you know, there's a couple of things that are really important to remember here. When you have 10 to 13 million people lose their health insurance on Medicaid, there are hospitals that rely specifically on Medicaid payments to function, and there's going to be a lot of closures of those hospitals, and apparently four of them are going to be in that district. And apparently she won by 800 votes. This is, I mean, it's hard to know. It's whether it's just they're so bloodthirsty for tax cuts. And, and again, we showed the images yesterday. Maybe we can pop this up just to remind people. Let's just do graph number. I think it's graph number one. And let's do graph number one. This clip number one. Rather just this graph. Can we pop that up just so that you know and are reminded, you know, like, who, who gets into these, who gets these tax cuts? Now this one's, I mean, 67% of the tax cuts go to the richest 20% in terms of dollars. Job creators, you can look at another one. I think the. Maybe it's three. Yeah, the center on Budget Policy Priorities that really sort of like lays it out specifically what kind of percentage each segment of the population based upon income will be getting. If you are in the first 20 percentile, the least wealthy in terms of income, you get a 0.6 tax cut. If you are in the middle 20%, you get a 1.2% tax cut. If you were in the fourth, 20%, which means that we're talking 60% of the people will get a 1.8% tax cut or lower. But if you are within the, basically the middle 20% of the, of the income distribution, you get a 1.8% tax cut. If you are between 80 and 90%, if you are one of the 80 to 90 percenters in this country, you get a 2.1% tax cut. But this is where it starts. You really start to feel the punch. If you make between 90 and 99% highest incomes in the country, you get a 3.4% tax cut. If you're in the top 1%, you get a 3.4% Tax cut. That's $52,000 you save. If you make over a million, it's 3.3% change in income. So at a million, it's like $80,000. And then it just keeps going.

[Producer]

I mean, and this comes as the concentration of annual income at the top of the spectrum is at its highest levels since the 1920s. And we know what that led to. And Trump is actively emulating that time period. His fixation on William McKinley makes it seem like he has this kind of Gilded Age vision, not in a. Not in a good way. Like, that's what he wants to drive us towards with the tariff policies as well, this protectionism, as opposed to just doing what we need to do to make our society better and more stable, which is to tax the rich and raise taxes on the rich and claw back that wealth that has gone to the top.

[Sam Seder]

Now, there's one other element that has come out over the past 24 hours about this bill is that if it. If the bill is not deficit neutral in 2012, I think people remember this.

[Producer]

Or 2011, 2010, is what I'm reading here on the. On the PayGo stuff.

[Sam Seder]

The sequestration, though, I think was part of the Budget control Act of 2011. And that, I think you may be right. And what that does is it basically says, if you cannot come up with a certain amount of deficit reduction, sequestration is triggered, which essentially means we're going to cut, across the board, spending cuts. And here is representative Jim McGovern from Worcester talking to Representative Brendan Boyle, who was looking to the CBO to make an assessment as to whether or not sequestration will automatically kick in in 2026 and what the implications of that sequestration would be.

[Producer]

And this, he asked for this analysis because the Republicans were rushing it through committee, and he only received it hours before they ended up voting in the dead of night to pass it.

[Sam Seder]

Yeah, I mean, one of the things that they're doing with the CDC is they're saying, well, we won't let people know that measles is spreading horribly. And therefore, yeah, people will feel like there's no measles. The Republicans are taking sort of the same tact with this bill. If we pass it without actually finding out how much this is going to cost, then it won't cost that much.

[Producer]

Well, they need to make the king happy. It's also what Trump's COVID policy was like. If we stop testing, then there's no Covid.

[Sam Seder]

Keep the ship off the boat. Keep the ship. We keep the ship off the coast. Let them not dock. Yeah, go ahead.

[Whistleblower]

As you know, statutory paygo, which stands for pay as you go, is a law that requires tax cuts and spending increases to be offset, meaning that they do not add to the deficit. If at the end of the year congressional legislation collectively violates paygo, those deficit effects trigger across the board cuts to programs like Medicare. Does this bill trigger statutory paygo?

[Congressional Budget Office]

Yes, and it's not me saying it. It is the Congressional Budget Office confirming it as of a couple hours ago. And look, this is really the breaking news because when the Budget Committee kicked off this process approximately three months ago, there was a commitment by President Trump that there would be no Medicare cuts in this piece of legislation. And indeed, over the last several months, there's been no discussion on of Medicare at all. There has been of Medicaid, but not of Medicare. Well, here we are tonight because as you explained, because of the size of the deficits, because of the pay go or pay as you go act, that would trigger sequestration of Medicare and it would total over $500 billion. The official figure that CBO confirms is 535 billion in cuts to Medicare.

[Whistleblower]

And this bill doesn't waive statutory pay, though.

[Congressional Budget Office]

No, it does not.

[Whistleblower]

So this will have a direct impact on Medicare and the federal budget, which is, again, I think a lot of people who are not following this as closely as you are probably are not aware of and will be surprised to learn about tomorrow. Chairman Hill.

[Producer]

By the way, thanks to Obama and Nancy Pelosi, who really pushed for paygo legislation in 2010 and framed it as how they were the responsible party dealing with the deficit. And we have to put this, we have to push PAYGO so that we look reasonable to the American public. Was that the same exact year that Democrats lost 1,000 seats across the country?

[Sam Seder]

Well, to be fair, they lost those thousand seats over the course of the Obama two terms, but they did get.

[Producer]

Wiped out in the house 2010, they.

[Sam Seder]

Got completely wiped out.

[Producer]

And so under pay go, Jake Johnson has a really good write up of this in Common Dreams. Automatic Medicare cuts are capped at 4% but the CBO estimates that the Republican legislation would trigger roughly 45 billion in Medicare cuts in 2026 and a total of 490 in cuts to the program between 2027 and 2034. So it's, they're being sneaky about it. They're saying that they don't want that they're not going to touch Medicare or Social Security. But they understand that by triggering PayGo, they can do it in a roundabout way. It's all about hiding the ball. The initial attempts to do this with Medicaid also were like was part of their strategy where if they reduce the matching rate, they would trigger laws in the states that expanded Medicaid under the ACA to cut Medicaid themselves. It's just like, isn't it telling how they have to be so secretive about how they're trying to harm the American public?

[Sam Seder]

All of the mechanisms that they're using ostensibly, oh, we're going to put worker requirements on this. They know what it does. They know what these work requirements does. And it's not just because there's a lot of people who are not working. It's because the bureaucracy, the red tape, the mechanisms to institute this end up cutting funds from Medicaid. Same with snap. I mean, they do it for a reason. It is to make it harder for people to access this stuff. In a moment we're going to be talking to Syngrid Steinmetz, ICU nurse and a member of the California Nurses Association. They are going to go on strike for a day tomorrow at the Long Beach Medical Center. We will talk to her about that. First couple of words from our sponsors today. Oh, this is one of my favorite sponsors, fast growing trees. This is the time of the year when I think about planting things and I've got little seedlings growing on my countertop, ones of which I'll probably never do anything with, but I do it anyways. But if you want to plant plants that are the fast growing trees don't necessarily grow faster, but they're bigger. You get them, they're five, six years old. You can get these trees and they have such a wide selection. They are the largest online nursery in the entire US they have thousands of different plants. They got thousand different trees, whatever it is, 2 million happy customers. If you want fruit trees or privacy trees or flowering trees or shrubs or grasses, they've got it. There's you can find the perfect stuff to plant for your climate. They can help you design your garden or your yard. They have a 30 day alive and thrive guarantee it ensures your plants arrive happy and healthy. You don't have to go to a big box store and have like zero options as to what you can plant and then have to bring them back in the back of your car and they break and then they dump dirt all over the place. Fast Growing Trees makes it super easy and makes your growing successful. They have a 14 point quality checklist that ensures you're getting the best quality plants possible. You could talk to a plant expert like I say, about your soil type, your landscape design, how to take care of your plants, everything else you need. If you want to do some of your own research, they have a resource center that's full of tips and advice from plant experts to help you learn more about your yard's need. They have a zone finder so you can figure out what growing zone you're in. Now's the time Fast Growing Trees has the best deals, up to half off on select plants and other deals. Listeners to Our Show Get 15% off your first purchase when using the code Majority at checkout. That's an additional 15% off at fast growing trees.com using the code majority at checkout. Fast growing trees.com code majority now's the perfect time to plant, use majority to save today offer valid for a limited time. Terms and conditions may apply. We were talking today about the how our podcast has a lot of like legacy equipment and patched together stuff. That was why I was so hesitant about starting a merch store. I didn't want to have to deal with the website being a mess or our commerce system or figuring out processing, pay processing or how are we going to upload products etc. Etc. Well, that was all easily fixed by Shopify. For millions of businesses, the tool that helps you simplifies everything is Shopify and we are rolling in.

[Producer]

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[Sam Seder]

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[Matt Lech]

Well, as you said, I'm a registered nurse. I've been there 30 years, 27 in the ICU. I'm the chief nurse rep. I'm on the bargaining team. So I'm very involved. Of course, I know people throughout the hospital. And we've been having issues with patient safety. We've been having issues with recruitment and retention. We've been at the bargaining table. We've talked about it. And the employer did not seem to want to address those issues. So we decided if we gave them the strike notice, maybe that would put a little pressure to get them to come. We also gave them 14 days notice because we wanted them to have the opportunity to get back to bargaining and add dates. So we gave it on a Thursday. Friday we had a bargaining session and the table across from us didn't have any of the employers there to negotiate. They called us multiple times and we told them, look, we'll bargain Saturday and Sunday. Sunday was Mother's Day. We'll bargain every day up to that day to try to resolve this and get a contract. And it just, they were, no, we're not coming. We're going to go hire nurses instead. So they went and hired the strike nurses. Some of the issues going on in the hospital as far as safety, we've had machetes brought into the hospital, guns with bullets, other little small things.

[Sam Seder]

I want to hear that, but I mean, tell us about the facility, because, you know, I'm across the country, don't know.

[Matt Lech]

Oh, okay. We're a very large campus. There's actually several hospitals on our facility. So we have Long Beach Memorial, which is an adult facility. We have Miller's Children's, which is a children's hospital, and then an extension of Miller's Children's, it's called the Village. And those are all outpatient clinics, very important because they try to keep the youth from actually being admitted to the hospital. So these nurses manage them, take care of them. They have protocols where they can actually adjust insulin doses and stuff. So these are highly trained and skilled nurses in like 14 different specialties. The hospital, you know, it's become a big thing, profits over patients. So they just laid off 78 nurses. 47 of them were from the outpatient clinic. So it's going to be detrimental to those children who need that help. As far as the tower, we're a very high specialty facility. We're a trauma level one trauma center. We have a stroke program. We have a very big cardiac program on our facility. And that requires a lot of specialty training. And if we can't recruit and retain our nurses, how do we have the skill set to take care of them? I myself an ICU nurse and in the icu, we have to take care of stroke patients, patients with drains in their heads. We have to take care of patients who have had any trauma. It could be an automobile accident, multiple gunshot or something as simple as a fall off a ladder. But all those depending on the age can have detrimental outcomes. If you don't have the nurses that are trained to take care of them, sometimes it makes it hard to do a patient assignment. I know people talk about acuity levels all the time. What happens with us, we have two patients, but if you have a patient who's on maybe seven life saving drips and they have a drain and they're on machines, there should have one nurse to that patient. But because of the lack of staff, we have to have two patients that are like that. And that's not safe for the patients.

[Sam Seder]

So you have a lot of. So I can understand here. So you have half the staff thing essentially you need for those type of patients.

[Matt Lech]

Not always. I'm just saying maybe, maybe we need 24 nurses on the floor, but we only have 22. So maybe two of those patients that should have been a one to one are now a two to one.

[Sam Seder]

Okay.

[Matt Lech]

And that, and that's, that's hard. That makes it stressful. Causes moral distress for the nurse because they may not be able to give the care they want and that's needed for their patient.

[Sam Seder]

Who owns the Long beach matter? Like who is the management that you're dealing with?

[Matt Lech]

Well, I guess it's the board of directors and our CEOs so. But you know, that's, you know, we've been through three CEOs in the last three years.

[Sam Seder]

And is it a, is it a nonprofit?

[Matt Lech]

It's a nonprofit.

[Sam Seder]

It's a nonprofit. Okay. And so are you guys still in contract or is the contract about to expire or.

[Matt Lech]

The contract has expired. We're hoping that this strike tomorrow will get the employer to come back to the table because ultimately we want to be in there taking care of our patients. We called for a one day strike. The hospital has locked us out for four additional days. So we won't be in there taking care of our patients. And I mean, I've been here 30 years, clearly I have a love for it. And to be locked out, that's very demoralizing. You're telling me I can't take care of the patients in the hospital that I want to, but you're willing to go and spend all this money instead of trying to get stuff like. We're asking for the workplace violence. We're asking for metal detectors at every entrance, or actually they're called weapons detectors. We're asking, in the icu, we're a locked unit. And we get, you're getting people like at their worst time, you know, they're being told that their loved ones brain dead or the injuries from an accident are going to be fatal. We can't do anymore. And that causes a lot of stress on these families. And we've had nurses and staff assaulted verbally and physically. We've had holes punched in the wall. I've seen family members assault each other. And we're on the seventh floor, security is on the basement. So it'd be nice to have a security guard. And we asked, and they're saying no. We're asking for training, we're asking for all the security guards and the staff to have de escalation training so that when these situations start happening, we can maybe, you know, clear it up and help these people understand the families, what's going on so that it doesn't get into a violent outburst.

[Sam Seder]

And, and is that the entirety of the, the ask from the nurses?

[Matt Lech]

The, the, it's really, it's the two things we want safe environment and we want a contract for recruitment and retention. I have to say since in the last three years, we have lost probably an average of 30 to 50 nurses in the ICU every year. Not just over the three years. That's a lot of training. It takes 12 weeks to train a nurse, and then you give them what we call a buddy for several more months to help kind of oversee them. They have somebody to go talk to. And what's happening is we don't have a. Like, we took away all the benefits for night shift nurses, so now they don't want to work on nights, they want to come to days. So our night shift is very inexperienced. And like I was saying, we have a very high skill set, and if you don't have nurses with experience, you can't fill those positions. We do rapid response. That's if there's an adult on one of the other floors that's decompensating, they'll call us and we go down and we've got like, order sets where we can start treating them. We have respect with the doctors. We can call the doctor and say, this is what's going on. And we get orders to try to stabilize them. If we can't stabilize them will take them to the higher level of care. We have stroke nurses, and they go to every single stroke in the hospital, adult stroke, and they help manage that patient until they either get to surgery or to a different level of care. We have nurses that do codes. So any adult code in the entire campus. So that could even be in the children's facility. We have a Todd cancer, which is where they do outpatient chemotherapy. Every one of those, we have to respond. Sometimes we beat the doctors there. And we're ordering. We're all what they call advanced cardiac life support. So we're, you know, ordering, give them epi, do this. You know, it's a lot of responsibility. And if you don't have the nurses with the skill set because you have such a young population in your department, it. It weakens the unit and the patients aren't getting what they deserve.

[Sam Seder]

So it sounds like the. The. The work that they're requiring of folks like you is difficult enough that a lot of people are leaving. They get used to the job. And you would think, I mean, I'm trying to walk through the calculation of management at this point. If they're willing to pay to train these people, they're willing to have a buddy there, which makes it obviously that less efficient. And then lose them and know that they're losing whatever percentage it is of the workforce after they've Been specially trained.

[Matt Lech]

They just, it's expensive.

[Sam Seder]

They must not care about people being trained because rather than like, you know, make also seems like patience. It seems like some type of very short term, year to year type of budget type of issue. Because I would assume long term you're going to. If you provide those benefits upfront, long term it's going to pay off because you're training costs.

[Matt Lech]

Exactly. And we're training them. We train them. People used to come to our hospital. We had. It was our train the educator for the critical care. And she used to say she's trained pretty much all of Orange county because the nurses would come in, they get a couple years, some would stay and some would leave because we had such an incredible training program. If you want to go into any specialty, we will train you. But during COVID we, we were obviously, we lost, I think 48 nurses in one year. And at that time it was $30,000 to train a nurse. And we were, I can remember talking to our management going, we have to do something. This was our CEO. And I'm like, look how much money. And I actually made little cards and hung them on two strings and I said this, this is what we just lost. And each one said 30,000 on it. So it didn't make sense to me that they didn't want to do something to try to prevent them from leaving. It's, you know, we have a very.

[Sam Seder]

How many CEOs have you had?

[Matt Lech]

We've had three CEOs in three years.

[Sam Seder]

Yeah, I mean it sounds to me that somebody. My guess is, is that the CEO and maybe the C suite, maybe even the board, on some level, they get paid based upon a certain benchmark each year. And if it doesn't, nobody's thinking in terms of like calculating a benchmark that is runs five or ten years out. Because I imagine you have people that you've trained and stay there. You've been there for 30 years. I imagine there's some folks like yourself who've been there for a long time. Because once you get good at that job, you stay, you stay well.

[Matt Lech]

Especially when we would call. It's our family. We spend a third of our adult life with these co workers. And I can't speak for every department, but er, icu, nicu, you have to trust everybody around you because if your patient starts decompensating, you need people to come help you with that patient and you need somebody to go over and keep an eye on your other patient. And mind you, they have two patients. So it is I always tell people, like, if you go into a code, like a cardiac arrest, respiratory arrest, it's like watching a play. Everybody walks in, they do their part, and hopefully, you know, you get an encore and the patient makes it through the whole, the whole code. And it's to. To watch one. And what happens as you come in as a new nurse, you're more watching. Or maybe you go in and you do chest compressions, and then as you get a little more comfortable, you go in and you start pushing meds. So you. But it takes time to build up, jumping in and doing all that. Some of these things, like those roles. I was telling you, you need to have three to five years in the ICU before you're allowed to even do that. So if they're leaving at one and two years, how do we. We just don't have enough experience. Exactly. So we need a recruit and retention program that is competitive with the surrounding hospitals. UCI is a really big hospital, very close to us. They have phenomenal benefit package. They just bought out three hospitals and people are leaving and going there. And it's sad because it's like, this is my family, you know, know, please don't leave. Stay. We're going to get this worked out. I've been here 30 years, you know, it's only been bad, really difficult the last couple years because it just doesn't seem like. It seems like they're taking profit over patients. That's more important than the patient and the patient outcome.

[Sam Seder]

What is.

[Matt Lech]

That's really hard.

[Sam Seder]

What are they trying to do by locking you guys out for four days? Is it their way of saying, we can just bring in other nurses, or is it that they're trying.

[Matt Lech]

I think it's kind of like retaliation, you know, and they've sent mixed messages because they've locked us out. But then they'll go to a nurse that's not scheduled to work the strike day and say, well, do you want to come in the rest of the week? And that's an NRB violation. They cannot do that. It's either all or nothing. You can't pick and choose a couple of people to come in. So I, you know, I can't. It's hard for me to speak to that. We're just hoping that there's enough pressure from the community that the hospital comes back to the bargaining table and we can resolve these issues. Because ultimately, our biggest thing is patient care and patient safety. And safety for the nurses. We've had nurses that, like I said, they've been assaulted Hiding in a closet because a family member was looking for them. That's not okay. That's not a comfortable work environment. I shouldn't go to work and. And be worried that someone's going to hit me or punch me or start a fight in front of me. And so we are fighting for that.

[Sam Seder]

What can the community do to help you guys?

[Matt Lech]

They can say, we want to be in a safe hospital. I mean, if you're coming to the hospital, you don't want to worry that you're in a double room with somebody and the person next to you brought a weapon in. And if we don't have those weapon detectors, you can come in the front door and go into the er. The only door that has any type of weapon detector is the ER door. But if you come in the main lobby, you kind of zigzag around. You go into the er, you just go through a door, and that's it.

[Producer]

How have you been protecting yourselves or trying? I mean, without management support?

[Matt Lech]

Well, a lot of people have left because it was too. Too distressing for them. They couldn't even.

[Producer]

You right?

[Matt Lech]

No, I haven't left. I'm there.

[Producer]

No, I mean in terms of what. What.

[Matt Lech]

Oh, I admit, I witness it. I came out of an elevator with one family member, and the family was upset with what was going on. And they start. The two families that they were sisters and brothers started yelling each other. I went out because it's locked. They can't get out of the lobby unless they can badge it out or we click them in. I ran around to let the. Because the door. I went out had no phones. I ran around the other side of the lobby, let them know. By the time I got there, the person who had walked out of the elevator with me was on the floor. Her grandmother and her two sisters were kicking her. And I was like, what is going on? And, you know, security came up and they de. Escalated. But we need to get that before it hits that point. You know, we shouldn't. It's not fair to the family members. It's not fair to the coworker, the colleagues. We had another situation where I don't know if you're familiar, but Jehovah's Witness don't accept blood products. And we had a patient. I went to a rapid. She said, no. She knew she needed, but she said, no, no, I don't want any. When she got to where she couldn't make decisions for herself, her husband said, go ahead and give the blood product. But by then she was too compensated. And she went into cardiac arrest. And 45 minutes later we called it. And the brother was so upset that the patient's brother was so upset he came running in the room. We couldn't get out. And he is swinging his arms at his brother in law. And it's like I shouldn't have to most people don't have that type of an environment at their work. I shouldn't have to defend myself. I should be focused 100% on taking care of my patient and giving the best care I can for the best outcome.

[Sam Seder]

So folks should call the Long Beach Medical center, tell them support their nurses, provide security, provide them benefits so that they stay and can develop a relationship with the facility, their fellow nurses and their patients. Singri Good luck tomorrow.

[Matt Lech]

Thank you.

[Sam Seder]

Over the next four or five days and hopefully you'll get management to pay attention to what seem like incredibly reasonable asks for a work environment.

[Matt Lech]

Thank you, Sam. I appreciate that. I just wanted to also let you know, I mean we have CNA represents a lot of facilities and Alhambra Hospital Medical center in the city of Alhambra, which is probably maybe 30 miles from us, they're in bargaining and they're having the same safe patient care issues. So they're actually going to be striking tomorrow in Alhambra. So I wish them the best in their bargaining and that they can get a fair equitable contract as well.

[Sam Seder]

Great. Syngrid Steinmetz, thank you so much. And we'll link to the Long Beach Medical facility so that people can get in touch there as well.

[Matt Lech]

Thank you very much, Sam. We really appreciate that. And thanks for inviting me on your show.

[Producer]

Thank you. Thanks for coming on.

[Sam Seder]

All right. We're going to take a quick break and when we come back, George Joseph, investigative reporter for the Guardian US will be joining us. His latest piece out today is an investigation at UnitedHealthcare secretly been paying nursing homes that helped it gain Medicare enrollees and reduced hospitalizations. We'll be right back after this.

[Producer]

Sam.

[Sam Seder]

It FOREIGN we are back. Sam Cedar, Emma Vigland on the Majority Report. Again, we're having a we're doing a special tech day today where we have tech issues and and make it more adventurous. But fortunately for us here now, George Joseph, an investigative reporter for the Guardian US has a piece out today that is just wild, particularly in light of the fact that we've just gone through three or four months of doge trying to tell us that there's all sorts of like fraud and waste in government and a lot of that fraud and waste is like, focused on people who are using the system, like Medicare subscribers, as opposed to Medicare providers. George, welcome to the program.

[George Joseph]

Thanks for having me. Great to be here.

[Sam Seder]

Okay, so walk us through this. My understanding has always been that like 2/3 of our elderly in nursing homes are paid for by Medicaid and essentially have to draw down all of your assets, depending on what state it is, to 2 or $5,000. And some things count as assets and not. And then Medicaid will start paying for you in these states. But apparently also there's a dynamic between Medicare and these nursing homes. And where does United tell us about that dynamic? And then let's talk about UnitedHealth.

[George Joseph]

Sure. So there's traditional Medicare, which a lot of people are familiar with, but then there's a privatization initiative called Medicare Advantage. And actually the majority of seniors today in this general Medicare world are on Medicare Advantage. So what that means is large insurers like UnitedHealth are being paid fixed sums per senior to cover their services. The idea is, according to privatization advocates, that this will sort of through innovation and private sector competition and drive down costs. However, as the Wall Street Journal has previously reported and congressional reports have looked at, the system often costs much more because the insurers that are doing this program are finding disease codes that allow them to charge more to the government. What our story is looking at is the other side of the equation, which is how they can minimize medical expenses. Specifically, our reporting is looking at nursing homes where patients are enrolled in United Healthcare's Medicare Advantage plan and the behind the scenes tactics that the company used to allegedly delay or cut or avoid expensive hospital stays for those patients.

[Sam Seder]

Okay, so. And just to reiterate because, and so I have it clear, I mean, the biggest knock, the, the most traditional and obvious knock on Medicare Advantage has been that the private insurance companies are overcharging the government. And I think the reimbursement rates were something like 20% over typical Medicare. And I'm not, I don't know, other than like, we took their word for it when we wrote, when we wrote this legislation to develop Medicare Advantage. I mean, I personally think we should not. There's no reason to have this type of private thing. I mean, if you want to have supplemental, but. So the provider's been ripping off the government by inflating the cost of things. But the other side of that ledger is where your piece is. And it's one slice of presumably there's a lot of services that Medicare Advantage supposedly is providing. And what they're doing is they're trying to figure out how to. Basically they've paid for this person already and they're trying to reduce costs. And this is what innovation is. How can we get these people to stay alive without providing them health care?

[George Joseph]

So in the internal emails that we got as part of our reporting for the story, you can see UnitedHealth executives discussing how for the nursing home population, long term nursing home residents, if they can just drive down hospital rates this much, we're going to save X hundreds of thousands of dollars. So that sort of side of the ledger that you're talking about is very explicit in their internal communications. And so they do this by a variety.

[Sam Seder]

Hold on. Just before we get into how they do it, just so that people understand you're at a nursing home, but you have some type of acute health situation or something, the nursing home does not have the facilities for this. And so they'll move you. And sometimes that may be just like a floor up and maybe the next building over or whatever it is, but you're put into a different type of care that is going to be far more expensive. And just so that people understand, like what we're talking about. Is that right?

[George Joseph]

No, what we're talking about is a medical provider working at the nursing home. Like a nurse might think you need to go to the hospital because you were in serious medical emergency. In this case, United's program has inserted itself into that prep process such that they get to influence the decision about whether you get sent. So let's say you're showing signs of a stroke. Now United, which has a financial interest in having to pay for your stroke care, is in the process and deciding whether or not you go to the hospital.

[Sam Seder]

And they are incentivized to see you as maybe more healthy than you might be in that moment because it keeps you from incurring all those costs that they would theoretically be responsible for covering.

[George Joseph]

Well, that's certainly what several of the current and former nurse practitioners from UnitedHealthcare that we interviewed said.

[Sam Seder]

I mean, it, I mean, just walk us through a couple of those stories because it's so. I mean, how is it that they. It seems like it's a huge conflict of interest to have the insurance company that is responsible for paying for the care to determine that specifically. It's one thing for them to have a schedule of fees and say like, you know, hey, if you've got a hangnail, we're not going to pay for, you know, an MRI or something like that, but it's another thing to actually have their own staff on the ground, almost like running interference. It feels like, well, this is the.

[George Joseph]

Power of vertical integration. Because UnitedHealthcare is not only a major insurer, but also one of the largest companies employing or affiliating with thousands of doctors, tens of thousands of doctors and nurse practitioners across the country. So by having their own medical teams in these nursing homes, stationed in these nursing homes, or working as on call staff for nurses to consult to get advice or guidance on what to do, they were able to influence the decisions of when or if patients are sent to the hospital. The company, in response to our reporting says, oh, we don't make the decisions. That's up to the facility. But in practice, the protocols are that the nurses are pushed to reach out to the United Health medical providers who then, according to people we've talked to who work in the program, are supposed to be listened to. So yeah, so this is like the.

[Sam Seder]

Equivalent of the engineer and the construction firm are the same place. And the engineer is like, we can cut some corners here on this. And we get one big lump sum. Except for when you build a building and it falls, people, you know, it's clear. But on their end, their basic calculation, if these allegations from these whistleblowers are true and your reporting bears out, their calculation must be they're old anyways and nobody's going to notice.

[George Joseph]

That idea of their old anyways and no one's going to notice is actually almost verbatim what one of the former current UnitedHealth whistleblowers that we interviewed for the story said. Just to give you an example so you can understand how this works, we have a patient case based on leaked patient records where we got where an older patient in the nursing home is seen by the nurse at his nursing home and he has classic stroke symptoms. He has a drooping on the side of his face, he's slurring his words and he's complaining of numbness in his face. In a stroke case, you have to get to the hospital as soon as possible because cells in your brain are likely dying because of blood being blocked in your brain. Right? Every minute counts. And if you can get to the hospital soon, doctors can give you medicines or do certain kinds of procedures to prevent long term neurological damage to your brain. In this case, what happened was instead of immediately sending the patient to the hospital where he could get the care he needed, the nurse at his facility, because of this program protocol called a United Healthcare provider who was remote. And the provider, instead of immediately rushing a green lighting of the patient to the hospital instead was like, oh, I'm unsure what to do. Ended the call without clear guidance. The nurse is there waiting for guidance. The nurse finally gets frustrated and sends the patient to the hospital. But by that point, just the transfer alone, it's already taken an hour, which means the patient missed what's called the golden hour by doctors, the sort of period when it's most crucial to get to the hospital. After that, the patient had permanent verbal slurring and facial droop, according to audio recordings we got of him and photos from his family. So there are real long term consequences to these kinds of delays or denied care.

[Sam Seder]

I would also imagine, based upon my own personal experience interacting with a nursing home, that there's a different level between families, capacity and awareness of what's going on with their family members that are in there. So for every story like this where a family is on top of it, maybe there's a story or two or three that it just, they're not made aware of what, what, what's going on.

[George Joseph]

That's a fantastic point. A lot of the families wouldn't necessarily even learn that this kind of thing happened to their loved one, especially in cases where their loved one wasn't transported to the hospital. Because if something, if someone just stays in the, someone has a potential stroke and just stays in the nursing home and is given some medicine and that's it, basically, how would the family ever be notified that something happened or sort of clock the changes medically that happened to their loved one as a result? We have one story at the end of this report today, which is about a man named Donald Keep who showed stroke like symptoms, but after one of the interventions of a remote UnitedHealth staffer was not sent quickly or if ever, we can't tell, but definitely for about a day ever to the hospital. And his son didn't know about his father apparently having stroke like symptoms which the United Health log shows and not being rushed to the hospital. So he only found out when we told him. That would have never come out unless those patient records were leaked to us. And so like you said, this stuff is happening in the dark and families wouldn't know.

[Sam Seder]

And then the other part, tell us what a premium dividend and shared savings, essentially secret bonuses that UnitedHealth gives these nursing homes. I mean, it sounds like kickbacks to me. Essentially.

[George Joseph]

Those two payment streams are incentive payments, as United calls them, in order to incentivize the nursing homes to limit hospitalizations. So what they do is they will either measure the hospitalization rates for a nursing home's population. And if a nursing home hits a certain tier of a low rate, they'll qualify for a bonus. Or they will offer the nursing home a percentage cut of the medical expense savings that they earn by driving down overall medical expenses, which is largely based on avoiding hospitalizations. So that can range from a 30 to 50% cut, depending on the nature of the contract. These are all confidential contracts. And United declined to say sort of how much it has paid out over through these various contractual arrangements. But we know that hundreds of nursing homes across the country are involved in this program.

[Sam Seder]

That's nuts.

[Producer]

I mean, and this is in keeping with, just to zoom out about, obviously United Healthcare in the news because of the Luigi killing and, or alleged killing. But that's part of what some of the stories came out in the woodwork, which is that people are paying for their care, but they're being denied. Like we have lower insurance or uninsured rates than we did because of the Affordable Care Act. But people are paying for care, but they're repeatedly being denied it. And it feels like this is kind of the zenith. They're the top of that or the pinnacle of that strategy because these are also patients who are less likely to complain about it because they're older. Right.

[George Joseph]

It's, it's also the pinnacle or zenith of that strategy because often those cases are a nursing home or hospital calling the insurer and asking for something to be approved. Right. And then it's denied or it's partially approved and then later denied. In this case, the insurer conglomerate also has its own staff in the nursing home or adjacent to the nursing home and is influencing the decision. So you don't need a prior authorization if you, as the remote or in house staffer for the conglomerate, is making input in the decision about what happens to the patient.

[Sam Seder]

Your reporting also found that there was a program that offered nursing homes even larger sums if they incentivized seniors enrolling in more of their plans, I guess. Like what was special? Oh, institutional special needs plans. Tell us about those plans. But also tell us about the restrictions on attempting to sell to people in a nursing home and the mechanisms they used to pretend that they didn't do that.

[George Joseph]

So seniors in nursing homes have strict federal regulations which are supposed to prevent manipulative and aggressive solicitation efforts to get them onto various insurance plans. The sort of payment you're referring to, they're called cap rates. And what will happen is for every patient that joins UnitedHealthcare's institutionalized special needs plan. United will give a set fee, which is a pretty large fee, to the nursing homes. United says that this is not an incentive to encourage enrollments. That is what they say. But many people who have worked in nursing homes and for United, how do they.

[Sam Seder]

Wait, wait, but how? Like, that's like, I could say this is not a microphone, but I mean, what are they? What would I describe it as? This is just like, it's a sculpture that transmits my voice. I mean, it is. What do they call it? It's a vague. We just call it a vague. That's all.

[George Joseph]

What I can say is that for more nursing home patients being enrolled in the program, the nursing home is going to get more money from United because for every patient, they're going to get a per head fee that's going to be coming in monthly. And what that has incentivized, according to people that work in the Nursing Homes and UnitedHealth former sales employees, is for the nursing homes to leak confidential patient records to United sales teams so that those teams can then proactively and directly solicit elderly residents to get them onto their Medicare Advantage plans.

[Sam Seder]

So if there's something in their medical record that says, like, I, you know, I'm diabetic or something, I have other needs beyond the standard nursing home care needs. That becomes a flag essentially for potential sales saying, going in and offering some product to cover that. Is that what it is?

[George Joseph]

It's more of how do we get in touch with these people or their family members? And so if we can sort of get them, get them on the phone, get them to meet, we can sort of push them to sign up for our program.

[Sam Seder]

Well, it's basically just like a list of like, here's our, here's. They're paying for leads.

[George Joseph]

There are a bunch of nursing homes where we've seen documents like what you're referring to, where you'll see all the patients names, and then subsequently, after they've gotten those leads, the patients are enrolled into United. However, we. We did speak to one former United executive who noted that there was a home where she received complaints from a facility worker who said that families were complaining that their loved ones had been pushed onto these programs even though they lacked the cognitive capacity to make such enrollment decisions.

[Sam Seder]

You also write that one former UnitedHealth employee in Georgia admitted to the guardian that she got nursing home staff to leaker confidential resident records and then backdated the permission to contact forms to circumvent federal rules meant to protect those seniors from Those pitches. So in other words, these, we got these contact forms before they were admitted into the nursing facility when they would be under the protection. And I just want to remind people, like what we're looking at here is one end of the way that United makes money on, on Medicare Advantage. We know they overcharge, but that's more sort of like public on the, on that facing in terms of charging the government. But this is how they reduce costs or I guess increase enrollment. And we're only looking at one slice of their business. Right. Like nursing homes. I guess it's possible they only use these type of practices in one slice of the business and, and then everywhere else they have a culture of doing the right thing. I'm sure that's very possible in some fantasy world. Is there anything that we're missing here?

[Producer]

I mean it's really, it's a phenomenal piece. I'm sending, gonna send it around.

[Sam Seder]

It's great reporting. It's incredibly disturbing.

[Producer]

Yep.

[George Joseph]

Thank you. Thank you. I really appreciate it. It took a lot of hard work and knocking on people's doors to get this information. So I really.

[Producer]

And well sourced, we should say. I mean you spoke to over 20 people to give you this information.

[Matt Lech]

So.

[Producer]

Kind of bulletproof.

[Sam Seder]

Is there anything else that we should be that we should know coming out of this piece? And is there any. Do you have any indication that anybody in Congress is like, hey, wait a second, this seems to be somewhat problematic?

[George Joseph]

Well, I'll say two things on that. One is we're doing a follow up story tomorrow that we hope viewers check out, which is going to look at the stories of three whistleblowers who currently or formerly worked at UnitedHealthcare. And it'll give a more granular picture of their experiences and seeing patient care allegedly being denied or some of the allegedly grimy sales practices that we just discussed. On the elected officials point, we've also been reaching out to elected officials who work in the various federal health committees and oversight committees. And after that we'll be doing a story about what lawmakers say they will be doing about this issue, if anything. So that will be coming up very shortly.

[Sam Seder]

Well, George Joseph, we will link to your piece in the Guardian US revealed UnitedHealth secretly paid nursing homes to reduce hospital transfers. I mean, and there's so much more in there too than just that headline, I think reveals. Thank you so much for your time. Really appreciate it. Great work. Again, thank you.

[George Joseph]

Thanks to you all for having me on. I really appreciate it.

[Producer]

Of course.

[Sam Seder]

All right, folks, we're going to take a. We're going to take a. I guess we should have said the. The.

[Producer]

I almost laughed Grant.

[Sam Seder]

So just. I had to.

[Producer]

I saw.

[Sam Seder]

Effing granular sound. Yes, that piece was pretty granular. Folks, it's your support that makes this show possible. You can become a [e-mail] our members really honestly are the ones who make us never fear one or another platform deplatforming us or having an issue pulling the plug one day. On the technical side, sometimes it's a little bit more dicey, but your support makes our ability to do this show every day easier and in many instances possible. So you can help support this program by going to jointhemajorityreport.com become a member. Also, tell your friends if you're on Twitch. First off, Poggers, second off, thanks for the hype train the other day.

[Emma Vigland]

We have 97,614 followers on Twitch.

[Sam Seder]

We gotta bring this up.

[Emma Vigland]

Let's go, guys.

[Sam Seder]

What's. What's going on with 300 people? Do you people not have 300 friends? Come on.

[Emma Vigland]

3,003.

[Sam Seder]

Oh, we need 3,000 more friends.

[Emma Vigland]

About 2300, actually.

[Sam Seder]

I have, like, I have two friends.

[Emma Vigland]

So the. I heard Mark Zuckerberg said that the ideal amount of friends is 15, so.

[Sam Seder]

15.

[Producer]

He said the. I thought he said the Average person.

[George Joseph]

Has three, but they want 15.

[Emma Vigland]

Oh, so we're gonna make AI guys to talk to.

[Sam Seder]

I was gonna say all of my friends are robots.

[Producer]

Yeah.

[Sam Seder]

Folks, on Twitch there you can also, you can, you know, if you're a prime member, you can just assign your prime membership, Twitch membership to us for the month. And it doesn't cost you anything. You've already paid for it. So you can help us out there.

[Emma Vigland]

On Twitch actually takes money from Jeff Bezos.

[Sam Seder]

Exactly that. Bezos put that money on the table. He's daring you to take it.

[Emma Vigland]

I'll shoot it in a space if you don't.

[Sam Seder]

It's either, like, I'm either gonna take this out back and burn it to see how. What the color the flame is, or it'll go to the majority report. Also, you can support this program by giving us good reviews on the itunes. Is that what we're calling it?

[Producer]

Yes, yes, yes.

[Sam Seder]

The podcast, the Apple platformers.

[Emma Vigland]

That was iTunes at 2014.

[Sam Seder]

Did it end in 2014?

[Emma Vigland]

I'm sure it's still going, but it's like, that's a lot.

[Producer]

It ended in 2014.

[Sam Seder]

Oh, for real?

[Emma Vigland]

I've been.

[Producer]

No, I think That's a good guess.

[Emma Vigland]

I've noticed.

[Producer]

I, I don't. When did, when did itunes, what are.

[Emma Vigland]

They calling on the Apple Music store?

[Producer]

It's discontinued in 2019.

[Sam Seder]

You know, they keep changing the names of everything. I can't keep up.

[Emma Vigland]

Give us a review on itunes. Give us.

[Producer]

Please give us a review on itunes.

[Sam Seder]

Yes, listen, if you subscribe to so.

[Emma Vigland]

Go to your local rundown mall and talk about right.

[Sam Seder]

Or, or, or write in, write, write in a letter to the editor on your favorite, you know, magazine and let the folks at Reader's Digest know that you listen to us. You can also join the discord majoritydiscord.com and pick up merch shop majorityreportradio.com we've got the, the max left stuff and the new trucker hats that are out and I don't know, somebody was pushing effing granular.

[Producer]

Oh, all right, we'll discuss it.

[Sam Seder]

Yes, leave us a review on your MySpace page or.

[Producer]

And friendster.

[Sam Seder]

Your friendster. Tell your friends. And also just coffee, co op, fair trade coffee, hot chocolate. Use the coupon code. Majority get 10% off.

[Producer]

Check me out. I was on the Vanguard yesterday. They brought me into the muck. Talked about some fun stuff over there. So check out the boys over at the Vanguard.

[Sam Seder]

I can't wait for the clip of you shitting on me to show up on the Vanguard.

[Producer]

I'm saving that for my book.

[Emma Vigland]

Tapper style.

[Sam Seder]

Exactly. That's when the big money starts to roll in. Matt. Yeah.

[Emma Vigland]

Chip Gibbonson of Defending rights and Dissents. Come and talk about the release of Badr Khan Suri and why he thinks these setbacks are significant for the Trump administration's agenda and what that might mean in case they decided to double down. So check this out. Patreon.com leftrucking to get access to the post game.

[Sam Seder]

See you in the fun half. Three months from now, six months from now, nine months from now. And I don't think it's going to be the same as it looks like in six months from now. And I don't know if it's necessarily going to be better six months from now than it is three months from now, but I think around 18 months out, we're going to look back and go like, wow, what, what is that going on? It's nuts. Wait a second. Hold on, hold on for a second. Emma. Welcome to the program. Matt. What is up, everyone? No, M. Keen, you did it.

[Matt Lech]

Fun hack.

[Producer]

Let's go, Brandon.

[Sam Seder]

Let's go, Brandon.

[Matt Lech]

Fun hat.

[Sam Seder]

Bradley, you want to say Hello. Sorry to disappoint everyone. I'm just a random guy. It's all the boys today.

[Matt Lech]

Fundamentally false.

[Producer]

No. I'm sorry.

[Matt Lech]

Women.

[Sam Seder]

Stop talking for a second. Let me finish.

[Matt Lech]

Where is this coming from, dear?

[Sam Seder]

Yeah, but. Dude, you Want to smoke this? 7a. Yes. Me is me. Yes. Is this me? Is it me? It is you.

[George Joseph]

Is this me? Hello? It's me.

[Sam Seder]

I think it is you. Who is you. No. Sound out every single freaking day. What's on your mind?

[Matt Lech]

We can discuss free markets and we can discuss capitalism.

[Sam Seder]

I'm gonna go smart. Libertarians. They're so stupid. Though common sense says. Of course.

[Producer]

Gobbledygook.

[Sam Seder]

We nailed him.

[Producer]

So what's 79 plus 21?

[Sam Seder]

Challenge. Man. I'm positively quivering. I believe 96. I want to say 8 5, 7, 2, 1 0. 3, 5 5, 011 half.

[Emma Vigland]

3, 8, 9, 11.

[Producer]

For instance, $3,400. $1,900. 5, 4.

[Sam Seder]

$3 trillion. Sold. It's a zero sum game.

[Producer]

Actually. You're making me think less.

[Sam Seder]

But, but let me say, this poop you call satire, Sam goes satire on.

[Matt Lech]

Top of it all. My favorite part about you is just.

[Sam Seder]

Like every day, all day, like everything you do. Without a doubt. Hey, buddy. We see you. All right, folks, folks, folks.

[Producer]

It's just the week being weeded out. Obviously.

[Sam Seder]

Yeah. Sun's out, guns out. I, I, I don't know.

[Producer]

But you should know.

[Sam Seder]

People just don't.

[Emma Vigland]

Like to entertain ideas anymore.

[Sam Seder]

I have a question. Who cares?

[Emma Vigland]

Our chat is enabled, folks.

[Sam Seder]

I love it.

[Matt Lech]

I do love that.

[Sam Seder]

Gotta jump. Gotta be quick. I gotta jump.

[Matt Lech]

I'm losing it, bro.

[Sam Seder]

2 o' clock, we're already late and the guy's being a dick. So screw em. Sent to a gulag.

[Producer]

Outrageous.

[Sam Seder]

Like, what is wrong with you?

[Matt Lech]

Love you. Bye.

[Sam Seder]

Love you. Bye bye.