Single Payer Radio Dr Karen Berg Medicaid Cuts 08-07-26r1

WEBVTT
1
00:00:01.600 --> 00:00:04.719
Hello, and welcome to Single Pair Radio. I'm Paul Hoppey,
2
00:00:04.799 --> 00:00:08.800
broadcasting from the Haburn Building in Louisville on the WFMP
3
00:00:08.960 --> 00:00:13.560
one six point five Forward Radio Community network, where news,
4
00:00:13.679 --> 00:00:17.000
information and entertainment is available twenty four hours a day,
5
00:00:17.160 --> 00:00:21.280
seven days a week. I've used opinions expressed on our
6
00:00:21.320 --> 00:00:23.519
show or those of the speakers and not the station.
7
00:00:24.440 --> 00:00:27.600
Single Pair Radio is produced by Kentuckians for single payer
8
00:00:27.679 --> 00:00:31.440
health Care in conjunction with Physicians for a national health program.
9
00:00:33.240 --> 00:00:35.960
We produce this program because we believe healthcare is a
10
00:00:36.039 --> 00:00:39.679
human right. We advocate for a national, not for profit,
11
00:00:39.880 --> 00:00:43.759
publicly funded, single payer health care system, commonly known as
12
00:00:43.880 --> 00:00:48.079
Medicare for All. It'll we cover dental, vision, hearing, prescription,
13
00:00:48.399 --> 00:00:52.600
mental health, and long term care, covering everyone starting at birth.
14
00:00:54.399 --> 00:00:57.640
Catch our programs at two pm Monday, seven am Tuesday,
15
00:00:57.719 --> 00:01:01.520
and eleven am on Wednesday. We also stream our show
16
00:01:01.560 --> 00:01:05.480
on SoundCloud, Apple Podcasts, and others, so you can listen anytime.
17
00:01:06.599 --> 00:01:09.480
And remember, this is an all volunteer radio station and
18
00:01:09.599 --> 00:01:12.359
relies on your ideas and donations to keep us on
19
00:01:12.400 --> 00:01:16.719
the air. Before we start today's show, I'd like to
20
00:01:16.760 --> 00:01:19.799
take a moment to remind you that on November three,
21
00:01:19.879 --> 00:01:22.519
we're going to have what may be the most consequential
22
00:01:22.599 --> 00:01:26.000
election in our lifetime. It could very well be that
23
00:01:26.120 --> 00:01:29.840
the survival of our democracies at stake, So be prepared
24
00:01:29.840 --> 00:01:34.599
to vote and encourage others to do the same. Once again,
25
00:01:34.680 --> 00:01:37.079
doctors Mike Flynn and Gene Savely joined me as co
26
00:01:37.159 --> 00:01:42.079
hosts with their special guest. So let's get started. Doctor Flynn.
27
00:01:42.480 --> 00:01:47.400
Yes, this is Michael Flynn, retired surgical oncologist from the
28
00:01:47.519 --> 00:01:52.719
University of Louisville Department of Surgery. Let me begin with
29
00:01:52.799 --> 00:01:56.400
the usual disclaimer than any comments or I make or
30
00:01:56.840 --> 00:02:01.400
opinions I express represent my parsonal views and do not
31
00:02:01.480 --> 00:02:05.079
represent the views of the Department of Surgery or the
32
00:02:05.200 --> 00:02:07.319
University of Louisville. Jane.
33
00:02:08.360 --> 00:02:11.800
This is hu Jane Shadley. I'm going to retard surgeon
34
00:02:11.919 --> 00:02:16.120
in Campbellsville, Kentucky. The comments I make do not represent
35
00:02:16.199 --> 00:02:20.159
that of Taytor Regional Hospital or Jane Todd Crawford Hospital,
36
00:02:20.560 --> 00:02:23.199
Northern University of Louwelle Department of Surgery.
37
00:02:24.360 --> 00:02:31.840
Our topic for today are multiple their medicaid issues, reproductive rights,
38
00:02:32.840 --> 00:02:37.919
and all of the issues that surround the dysfunctional healthcare
39
00:02:37.960 --> 00:02:41.560
system in this country, and we have a very special
40
00:02:41.599 --> 00:02:46.439
guest today to help us discuss these issues. But before
41
00:02:47.039 --> 00:02:52.639
I introduce her, I let me challenge our listeners to
42
00:02:52.919 --> 00:02:55.599
double check our facts. We're going to be talking about
43
00:02:55.639 --> 00:03:00.479
a number of issues where there are multiple publications on
44
00:03:00.759 --> 00:03:05.919
just about everything. Some of the sources are the New
45
00:03:05.960 --> 00:03:08.800
England Journal of Medicine and the Journal of the American
46
00:03:08.840 --> 00:03:15.800
Medical Association. They've both had multiple articles on medicaid issues
47
00:03:15.840 --> 00:03:22.400
and reproductive rights. Wikipedia and just get on Google. So
48
00:03:22.439 --> 00:03:27.520
our specialty guest today is Karen Berg. Doctor Berg is
49
00:03:27.599 --> 00:03:33.120
a retired assistant professor of radiology at the University of Louisville,
50
00:03:34.000 --> 00:03:39.199
and she is a Kentucky Senate representative from the twenty
51
00:03:39.240 --> 00:03:43.000
sixth district. So, Karen, thank you for coming on today.
52
00:03:43.080 --> 00:03:47.960
We're really looking forward to this conversation, especially with your
53
00:03:48.000 --> 00:03:54.520
political background. As we have with previous guests, We're going
54
00:03:54.560 --> 00:03:57.759
to give you an opportunity to make whatever comments you'd
55
00:03:57.840 --> 00:04:00.639
like to make for as long as you'd like to
56
00:04:00.680 --> 00:04:06.199
make them, and then the conversation will begin. So doctor Berg, Karen,
57
00:04:06.400 --> 00:04:07.479
the floor is yours.
58
00:04:09.240 --> 00:04:12.759
Thank you very much for inviting me to be here
59
00:04:12.800 --> 00:04:16.839
this morning. This is a subject that is very near
60
00:04:17.000 --> 00:04:20.879
and dear to my heart. I am Karen Berg. I'm
61
00:04:20.879 --> 00:04:27.879
a retired diagnostic radiologist. I've had experience working both in
62
00:04:28.720 --> 00:04:32.680
not for profit medical systems like the University of Louisville
63
00:04:33.600 --> 00:04:38.519
private practice. I was a diagnostic radiologist at a small
64
00:04:38.560 --> 00:04:42.600
community hospital in Charlestown for many many years, where you're
65
00:04:42.600 --> 00:04:46.160
responsible for billing and collecting. And then I also have
66
00:04:46.360 --> 00:04:49.279
many years of experience with the veterans the VA Medical
67
00:04:49.279 --> 00:04:50.959
Center and how.
68
00:04:50.759 --> 00:04:52.439
We deliver healthcare with the VA.
69
00:04:52.600 --> 00:04:55.959
So I have a good, good background and understanding of
70
00:04:56.000 --> 00:05:00.959
healthcare delivery systems. And now I'm an elected state senator
71
00:05:02.040 --> 00:05:06.759
and most of what we are spending our time and
72
00:05:06.959 --> 00:05:10.439
energy on up in the legislature at this point does
73
00:05:10.560 --> 00:05:15.240
have to do with Medicaid and Medicaid oversight.
74
00:05:18.160 --> 00:05:20.879
All right, Jane, you want to begin the conversation.
75
00:05:22.000 --> 00:05:26.959
I guess Karen. We're very glad to have you. Appreciate
76
00:05:27.040 --> 00:05:29.800
all the work you've done in private practice and the
77
00:05:29.920 --> 00:05:34.399
University of Louisville and Jewish and BA. My first question
78
00:05:34.600 --> 00:05:38.959
is what is a big, beautiful bill going to do
79
00:05:39.600 --> 00:05:44.560
to medicaid in this country and to the state of Kentucky.
80
00:05:46.120 --> 00:05:51.839
That's that's an excellent question. What is what the Kaiser
81
00:05:51.839 --> 00:05:58.480
Family Foundation KFF has has predicted is that the twenty
82
00:05:58.560 --> 00:06:04.519
twenty five federal Reconciliation Law, which otherwise goes.
83
00:06:04.240 --> 00:06:06.120
By the one Big or the one.
84
00:06:06.079 --> 00:06:12.279
Bad beautiful Bill, basically over the course of ten years,
85
00:06:13.040 --> 00:06:21.000
takes nine over nine hundred billion dollars in healthcare dollars
86
00:06:21.120 --> 00:06:26.360
that have historically been paid by the federal government and
87
00:06:26.560 --> 00:06:31.519
transfers the responsibility of those costs to the state government.
88
00:06:32.199 --> 00:06:36.920
But does it without any alteration in tax structure.
89
00:06:37.000 --> 00:06:39.519
So you know how like right now in Kentucky, our
90
00:06:39.560 --> 00:06:43.639
income taxes three point five percent, whereas your federal income
91
00:06:43.680 --> 00:06:47.000
tax can be thirty five percent. So what it does
92
00:06:47.120 --> 00:06:51.120
is it transfers nine hundred billion dollars of costs to
93
00:06:51.199 --> 00:06:54.639
the states, but it doesn't transfer any of the tax
94
00:06:54.680 --> 00:06:58.360
revenue with it. So all of a sudden, you're looking
95
00:06:58.360 --> 00:07:03.800
at states that are facing enormous costs that there are
96
00:07:03.839 --> 00:07:05.600
no way prepared.
97
00:07:05.399 --> 00:07:06.519
To deal with.
98
00:07:07.120 --> 00:07:14.360
The estimated ten year federal MEDICI reduction for Kentucky is
99
00:07:14.439 --> 00:07:23.199
somewhere between seventeen and twenty eight billion dollars billion dollars,
100
00:07:23.800 --> 00:07:28.720
So the rough midpoint we're expecting maybe twenty two billion
101
00:07:28.800 --> 00:07:33.959
dollars if the bill stays as it is. Those are
102
00:07:34.000 --> 00:07:39.240
the anticipated costs to the state of Kentucky over the
103
00:07:39.279 --> 00:07:44.279
next ten years.
104
00:07:44.319 --> 00:07:49.560
Well, that's more than the entire Kentucky budget, isn't it.
105
00:07:49.879 --> 00:07:52.199
Yes, it is. It's way more.
106
00:07:53.680 --> 00:07:59.079
We have right now our largest rainy day fund that
107
00:07:59.120 --> 00:08:02.480
we've ever had, and that's in the millions.
108
00:08:02.639 --> 00:08:03.839
That's not in the billions.
109
00:08:05.600 --> 00:08:10.399
You know, we're talking huge chunks of money.
110
00:08:10.839 --> 00:08:12.399
I don't know if most people understand.
111
00:08:12.439 --> 00:08:20.800
Medicaid is predominantly federally funded. Depending on which program and
112
00:08:21.079 --> 00:08:26.240
which state, the percentage of federal funding versus state funding changes.
113
00:08:27.079 --> 00:08:34.759
Kentucky, we are takers. We take more money.
114
00:08:35.879 --> 00:08:39.320
To supply medicaid from the federal government than we give.
115
00:08:40.120 --> 00:08:42.960
There are other states actually that are what we call makers.
116
00:08:43.440 --> 00:08:51.480
They make more money, and so we in Kentucky, being
117
00:08:51.639 --> 00:08:56.480
a poorer state, are going to be hurt much harder
118
00:08:57.120 --> 00:09:00.039
than some of the wealthier states. And the way it
119
00:09:00.080 --> 00:09:04.000
works out, truly is that the red states are going
120
00:09:04.039 --> 00:09:08.039
to get hurt the most and the blue states are
121
00:09:08.159 --> 00:09:12.480
going to fare the best. And that's because the blue
122
00:09:12.519 --> 00:09:16.399
states actually are makers. They make money. Red states tend
123
00:09:16.480 --> 00:09:21.679
to be takers. They take federal money. Right now, Medicaid
124
00:09:21.720 --> 00:09:25.960
can be matched anywhere from seventy percent federal to thirty
125
00:09:25.960 --> 00:09:29.600
percent state, all the way up to ninety percent federal
126
00:09:29.639 --> 00:09:34.480
and ten percent state depending on the program. But if
127
00:09:34.480 --> 00:09:38.440
the state doesn't put up that ten percent, then we
128
00:09:38.639 --> 00:09:43.320
lose the ninety percent federal match. So you have to
129
00:09:43.639 --> 00:09:51.120
fund it in order to get the federal money. Yeah,
130
00:09:51.200 --> 00:09:53.320
it's a complicated system, okay.
131
00:09:53.440 --> 00:09:54.480
In addition to.
132
00:09:57.080 --> 00:10:05.679
Limiting the access to healthcare by the underserved population, there
133
00:10:05.879 --> 00:10:11.120
is a significant risk to the rural hospitals that they're
134
00:10:11.200 --> 00:10:14.120
for an assortment of reasons, and Gene may may want
135
00:10:14.159 --> 00:10:17.679
to make a few comments about this as well. In
136
00:10:17.720 --> 00:10:24.559
addition to the healthcare issue of a hospital closing, there's
137
00:10:24.600 --> 00:10:28.519
an economic conquence consequence to this because this is often
138
00:10:28.559 --> 00:10:32.720
one of the major employers in a state. So can
139
00:10:32.759 --> 00:10:35.720
you what are your thoughts or I would really be
140
00:10:35.799 --> 00:10:40.279
interested in knowing what's in the heads of the legislators
141
00:10:40.960 --> 00:10:45.519
who live in these rural areas where these hospitals might
142
00:10:45.559 --> 00:10:46.159
be closing.
143
00:10:47.360 --> 00:10:49.639
Let me tell you they understand.
144
00:10:50.320 --> 00:10:56.600
Steve Meredith, who shairs health services, he's a Republican, He's
145
00:10:57.000 --> 00:11:02.639
an ex CEO of a rural hospital that did close,
146
00:11:03.320 --> 00:11:10.120
and he totally understands how important it is to keep
147
00:11:10.200 --> 00:11:16.639
our rural hospitals open and solvent they. I mean, first
148
00:11:16.679 --> 00:11:22.320
of all, they provide healthcare, where if they're gone, there
149
00:11:22.360 --> 00:11:29.159
is no healthcare. They are huge economic drivers for their communities.
150
00:11:29.720 --> 00:11:36.039
Some of the biggest employers in our rural areas are
151
00:11:36.080 --> 00:11:40.200
either your healthcare systems or your school, your public school systems,
152
00:11:40.720 --> 00:11:46.240
and without those the economy fails. I believe the number
153
00:11:46.240 --> 00:11:48.799
here in Kentucky right now that we're talking about we
154
00:11:48.879 --> 00:11:51.879
have eleven hospitals I think that are at risk of
155
00:11:51.960 --> 00:11:58.320
immediate closure, and something like fourteen and potential I.
156
00:11:58.279 --> 00:12:00.960
Think a bit more than that. Actually twenty, I would.
157
00:12:00.799 --> 00:12:03.000
Say, yeah, that may be total.
158
00:12:03.519 --> 00:12:08.159
Yeah. Now, let me make a comment that I've made
159
00:12:08.240 --> 00:12:11.080
on this program before and then asked you to respond
160
00:12:11.120 --> 00:12:16.799
to it. Now, twenty years ago, there was a general
161
00:12:16.840 --> 00:12:19.679
surgeon in Louisville, and you may remember him. I'm not
162
00:12:19.720 --> 00:12:22.600
going to mention his name, who had some visual issues.
163
00:12:23.919 --> 00:12:27.679
He retired and ran for office and became a member
164
00:12:28.399 --> 00:12:34.639
of the House of Representatives. Yes, well, he gave a
165
00:12:34.679 --> 00:12:39.279
talk at the Louisville Surgical society, and this is twenty
166
00:12:39.360 --> 00:12:44.919
years ago. And he made two very strong points. Number One,
167
00:12:46.320 --> 00:12:49.519
what we've all heard many times before that making laws
168
00:12:49.639 --> 00:12:50.879
is like making sausage.
169
00:12:50.919 --> 00:12:53.440
And one of the examples.
170
00:12:52.840 --> 00:12:56.720
He gave is that he had proposed I can't remember
171
00:12:56.759 --> 00:12:58.960
what it was, a bill or something, and by the
172
00:12:59.000 --> 00:13:01.360
time it had gone through all the committee system and
173
00:13:01.399 --> 00:13:02.679
everything else like that.
174
00:13:02.919 --> 00:13:04.639
He voted against these he couldn't.
175
00:13:05.720 --> 00:13:08.440
And the other thing he said, and he was very,
176
00:13:08.840 --> 00:13:14.720
very very clear about this, is that the politicians, the legislators,
177
00:13:15.200 --> 00:13:21.799
do not understand healthcare. They run their accountants, their lawyers,
178
00:13:22.080 --> 00:13:28.840
they run road services and grocery stores and lumber companies,
179
00:13:29.080 --> 00:13:33.039
and they simply do not understand healthcare.
180
00:13:33.559 --> 00:13:33.759
Now.
181
00:13:33.799 --> 00:13:36.679
So my question to you now, is that still true
182
00:13:36.960 --> 00:13:41.519
or are some of them recognizing some of the issues.
183
00:13:41.600 --> 00:13:44.080
It sounds like that it's getting a little bit better
184
00:13:44.120 --> 00:13:45.200
than it was then.
185
00:13:45.360 --> 00:13:47.360
I think it's getting a little bit better than it
186
00:13:47.480 --> 00:13:51.639
was back then, in part because I'm not the only
187
00:13:51.720 --> 00:13:53.759
healthcare provider that's up there at this point.
188
00:13:53.840 --> 00:13:54.440
We have.
189
00:13:56.000 --> 00:14:01.399
Several of the elected with deep in the health care system.
190
00:14:01.399 --> 00:14:07.200
But even more importantly, it is becoming such a large
191
00:14:07.360 --> 00:14:13.399
percentage of our state budget that you have to become knowledgeable.
192
00:14:14.279 --> 00:14:18.559
You if you are not knowledgeable about these delivery services
193
00:14:18.600 --> 00:14:23.600
and different options, then you're going to make big, bad mistakes,
194
00:14:24.159 --> 00:14:29.759
both in your budgeting and in your legislating. So yeah,
195
00:14:29.919 --> 00:14:36.279
I think there's more knowledge. There is still definitely a
196
00:14:36.480 --> 00:14:43.600
limit to the understanding of health care delivery systems, how
197
00:14:44.399 --> 00:14:51.000
payers are paid, how hospitals stay open, how patience. You know,
198
00:14:51.039 --> 00:14:56.320
there's this overwhelming thought process in Frankfurt that it's it's
199
00:14:56.399 --> 00:15:03.639
the patience that are doing the fraud in Medicaid. It's like,
200
00:15:03.879 --> 00:15:07.879
it's the problem is that people are signed up from
201
00:15:07.919 --> 00:15:12.440
Medicaid who don't deserve it, and that's what they think
202
00:15:12.480 --> 00:15:16.639
the fraud is. That has nothing to do with anything
203
00:15:16.720 --> 00:15:22.320
to do with the significant financial fraud that Medicaid deals with,
204
00:15:22.759 --> 00:15:28.600
which comes from providers. It does not come from patience.
205
00:15:29.399 --> 00:15:35.000
It comes from people building intentionally systems that they know
206
00:15:35.039 --> 00:15:38.360
they shouldn't be getting paid for, but doing it anyhow
207
00:15:38.399 --> 00:15:42.240
and taking the money. So, you know, the whole work
208
00:15:42.279 --> 00:15:46.159
about getting people off of Medicaid that don't belong on Medicaid,
209
00:15:46.799 --> 00:15:50.320
it's ass backwards. I'm sorry, but it is not under
210
00:15:50.480 --> 00:15:55.120
any circumstances going to solve the problems that we are
211
00:15:55.200 --> 00:16:01.080
facing as a country. It is it is a waste
212
00:16:01.360 --> 00:16:04.200
of money, because it's going to cost us a lot,
213
00:16:04.440 --> 00:16:07.440
a lot of money to implement these systems where people
214
00:16:07.480 --> 00:16:11.080
have to reapply every six months and they have to
215
00:16:11.200 --> 00:16:13.879
show that they've worked so many hours, and they have
216
00:16:14.000 --> 00:16:17.799
to show that, you know, that for somehow they are
217
00:16:17.879 --> 00:16:19.480
human enough that they deserve this.
218
00:16:21.840 --> 00:16:27.360
We we've done two programs on this single payer radio
219
00:16:28.440 --> 00:16:32.240
with a doctor Barbara Casper, you may remember her as
220
00:16:32.279 --> 00:16:37.320
an interness at UL and a lady named Amber who
221
00:16:37.399 --> 00:16:42.080
was a Medicaid recipient who didn't want her last name mentioned.
222
00:16:42.919 --> 00:16:46.879
And then what I one of the things I learned
223
00:16:46.919 --> 00:16:54.440
from her was some of the administrative hassles of having
224
00:16:54.559 --> 00:17:03.000
to establish eligibility were requirements and this stuff that really
225
00:17:04.680 --> 00:17:07.880
it really doesn't have a you know, it represents a
226
00:17:07.960 --> 00:17:13.200
fraction of all the people who are the children, the elderly,
227
00:17:13.480 --> 00:17:19.200
the disabled, who are eligible eligible for How do the
228
00:17:19.279 --> 00:17:23.119
politicians have any understanding of that?
229
00:17:23.519 --> 00:17:24.920
I don't know, I don't know.
230
00:17:25.039 --> 00:17:30.160
I mean, these are some just some basic numbers for Kentucky.
231
00:17:30.319 --> 00:17:31.279
Okay, for Kentucky.
232
00:17:31.440 --> 00:17:37.519
Yeah, fifty percent of our children are covered by Medicaid. Yes,
233
00:17:37.880 --> 00:17:42.519
one out of every two children. Seventy percent of our
234
00:17:42.599 --> 00:17:50.119
nursing home residents are covered by Medicaid. Medicaid also covers
235
00:17:50.720 --> 00:17:57.359
severely disabled people to help them either stay at home
236
00:17:57.440 --> 00:18:01.160
and out of institutions, or to help them with the
237
00:18:01.200 --> 00:18:05.880
cost of their medical expenses. There is a group called
238
00:18:05.880 --> 00:18:10.480
the expansion group, and it's the expansion group that my
239
00:18:10.759 --> 00:18:17.480
Republican legislators are trying to target, even though honestly they're
240
00:18:17.559 --> 00:18:21.039
targeting everybody because we just had a whole fiasco with
241
00:18:21.119 --> 00:18:24.160
whether or not the least specialty clinic could stay open
242
00:18:24.400 --> 00:18:28.640
or not. You know, that's not targeting expansion population, guys,
243
00:18:28.640 --> 00:18:35.759
that's targeting the most needy of our population. So with
244
00:18:35.920 --> 00:18:41.440
these expansion people, Okay, in order to be eligible for
245
00:18:41.559 --> 00:18:45.480
expansion Medicaid, you have to be one hundred and thirty
246
00:18:45.519 --> 00:18:47.279
eight percent of the poverty level.
247
00:18:47.559 --> 00:18:50.319
Which is not much money.
248
00:18:51.160 --> 00:18:56.559
A family of four making forty four thousand, three hundred
249
00:18:56.599 --> 00:19:02.599
and sixty seven dollars is the top top limit for
250
00:19:02.720 --> 00:19:07.519
the expansion population. A family of four living on forty
251
00:19:07.519 --> 00:19:15.640
four thousand dollars a year. Okay, Now, what this whole
252
00:19:15.759 --> 00:19:20.640
big bill is doing is trying to get people in
253
00:19:20.720 --> 00:19:26.400
that expansion population off of Medicaid by making the requirements
254
00:19:26.720 --> 00:19:31.079
so onerous that people can't meet them, that you have
255
00:19:31.160 --> 00:19:36.519
to reverify every six months, and guys, that cost the
256
00:19:36.720 --> 00:19:40.519
state money to implement because we have to have employees
257
00:19:40.559 --> 00:19:43.599
to do this for them. That you have to show
258
00:19:44.119 --> 00:19:49.440
that you've been working for three months prior to eligibility,
259
00:19:49.480 --> 00:19:52.880
even though the federal guidelines right now say one month.
260
00:19:52.920 --> 00:19:55.720
But Kentucky, because we want to get these people off,
261
00:19:55.759 --> 00:19:57.680
decided to know we're going to go with three months.
262
00:20:01.079 --> 00:20:04.079
The thing is, it is more.
263
00:20:05.519 --> 00:20:09.920
These Okay, there's so many arguments here. These are for
264
00:20:10.000 --> 00:20:14.920
the most part, people that work almost somewhere between seventy
265
00:20:15.000 --> 00:20:20.839
and ninety percent you're talking about the expansion Medicaid recipients
266
00:20:21.160 --> 00:20:27.839
in the expansion population. The vast majority of these people work,
267
00:20:28.799 --> 00:20:34.480
but they work at jobs that one do not offer healthcare,
268
00:20:35.640 --> 00:20:42.799
or two offer healthcare, but it is so expensive that
269
00:20:42.960 --> 00:20:49.000
they're employees who are earning minimum wage can't afford it.
270
00:20:49.799 --> 00:20:54.000
And we have found out and this just blows my mind. Honestly,
271
00:20:54.759 --> 00:20:59.440
some of the biggest employers in this country do that
272
00:20:59.559 --> 00:21:06.960
intention intentionally offer healthcare that they know is above their
273
00:21:07.079 --> 00:21:10.400
employees' ability to purchase.
274
00:21:10.720 --> 00:21:13.960
That's exactly what we learned from AMBER. And they put
275
00:21:14.000 --> 00:21:20.039
them on some sort of instead of a full time employee,
276
00:21:20.039 --> 00:21:22.880
they're they're they're working as fart times, right.
277
00:21:22.960 --> 00:21:24.720
They put them down to thirty two hours a week
278
00:21:24.759 --> 00:21:27.559
and you're not eligible, or thirty six and you're not eligible.
279
00:21:27.720 --> 00:21:30.599
And these are companies that are making billions.
280
00:21:30.200 --> 00:21:33.839
Of billions of dollars and then by doing that, they
281
00:21:33.920 --> 00:21:38.519
no longer have any responsibility to put in their percentage
282
00:21:38.519 --> 00:21:41.440
of costs for their employees for their health care. They're
283
00:21:41.480 --> 00:21:45.559
just sending them to the market, so that the government
284
00:21:46.160 --> 00:21:58.279
is subsidizing these employers making tremendous profits, using tax payer money.
285
00:21:58.200 --> 00:21:59.880
Exactly to do it.
286
00:22:00.039 --> 00:22:03.480
And it has got to be stopped.
287
00:22:03.759 --> 00:22:06.720
You know, I'm fond of saying that the Walmart's healthcare
288
00:22:06.839 --> 00:22:11.079
benefits that they offer to their employees are counseling on
289
00:22:11.119 --> 00:22:12.440
how to get on Medicaid.
290
00:22:13.160 --> 00:22:13.440
Right.
291
00:22:13.559 --> 00:22:17.319
Well, that's one of the examples that Amber that two
292
00:22:17.319 --> 00:22:18.599
of the programs.
293
00:22:18.160 --> 00:22:22.319
And this is I mean, guys, this expansion population, they
294
00:22:22.319 --> 00:22:26.559
are not lazy. They are not people that are trying
295
00:22:26.599 --> 00:22:30.720
to get something they don't deserve. For the most part,
296
00:22:30.799 --> 00:22:36.759
these people are either working and cannot get covered through
297
00:22:37.160 --> 00:22:40.759
their jobs. And remember, guys, this includes self employed people,
298
00:22:41.400 --> 00:22:45.359
people who want to have their own business. Again, they
299
00:22:45.359 --> 00:22:49.640
don't have options for private insurance that people can afford.
300
00:22:50.160 --> 00:22:54.519
And then you have to understand with the private insurance market,
301
00:22:54.960 --> 00:23:00.079
the premiums on average now I think are twenty six.
302
00:23:00.160 --> 00:23:02.839
Thousand dollars a year. Oh wow.
303
00:23:04.319 --> 00:23:10.599
But the copays and deductibles, particularly the deductibles. If you
304
00:23:10.720 --> 00:23:14.640
have a policy with a seven thousand and eight nine
305
00:23:14.680 --> 00:23:21.119
thousand dollars and you will deductible, nobody can do that.
306
00:23:21.759 --> 00:23:24.200
You get sick in October, you've got nine thousand dollars,
307
00:23:24.200 --> 00:23:26.480
and then all of a sudden, in January another nine
308
00:23:26.519 --> 00:23:32.680
thousand dollars. This is not doable for the vast majority
309
00:23:32.799 --> 00:23:36.559
of people in the United States. So we have problems
310
00:23:36.880 --> 00:23:43.720
on the private health scare industry still making tremendous profits,
311
00:23:44.160 --> 00:23:48.960
tremendous profits, but we have so many people that can't
312
00:23:49.000 --> 00:23:50.039
access it.
313
00:23:51.839 --> 00:23:55.079
Let me point out that there are also people who
314
00:23:55.160 --> 00:24:00.960
are working in the medical industry of hospitals and assistant
315
00:24:01.000 --> 00:24:06.319
living who are all medicaid because they make minimum wage,
316
00:24:06.960 --> 00:24:12.519
so they don't have enough of income to pay for
317
00:24:12.559 --> 00:24:13.359
the insurance.
318
00:24:13.680 --> 00:24:13.960
Yep.
319
00:24:14.519 --> 00:24:17.039
Well, listen, not that I want to stop this.
320
00:24:17.119 --> 00:24:20.000
I think it's really important, but I'd like to I'd
321
00:24:20.039 --> 00:24:22.960
like to ask you to, you know, just to get
322
00:24:23.400 --> 00:24:27.480
some other issues on the table. Our listeners are not
323
00:24:27.839 --> 00:24:32.880
mostly medical people, so could you kind of explain the
324
00:24:33.000 --> 00:24:39.319
details of the Kentucky state anti abortion laws so that
325
00:24:39.359 --> 00:24:44.240
our listeners can understand. I mean, the consequences of that
326
00:24:44.319 --> 00:24:49.599
make it incredibly difficult for obstetricians and gynecologists to treat
327
00:24:49.599 --> 00:24:54.160
a woman with the complications of pregnancy. And I personally
328
00:24:54.319 --> 00:24:58.279
am a little confused about I mean, the way they're written,
329
00:24:58.319 --> 00:25:03.720
it's so vague, confusing, it's hard to know what to do.
330
00:25:04.079 --> 00:25:09.200
It's very difficult, very very difficult. What Kentucky did We
331
00:25:09.319 --> 00:25:13.519
passed this trigger band, which meant that as soon as
332
00:25:13.720 --> 00:25:20.920
Roe fell, we lost access to abortion in the state
333
00:25:20.960 --> 00:25:27.640
of Kentucky, with very very few exceptions. There is an
334
00:25:27.680 --> 00:25:34.519
exception for a topic pregnancies, and an exception for miscarriages
335
00:25:35.319 --> 00:25:37.799
so that you can go back and do a DNC afterwards.
336
00:25:38.400 --> 00:25:41.920
And then we have an exception for the life of
337
00:25:42.000 --> 00:25:49.240
the mother or it's not her health but preserving an organ.
338
00:25:50.519 --> 00:25:53.400
So and that's it.
339
00:25:53.680 --> 00:25:58.000
Now. It was my understanding that if a woman as
340
00:25:58.160 --> 00:26:03.599
say eight or ten weeks pregnant and has a miscarriage
341
00:26:03.839 --> 00:26:10.920
and ruptures are membranes and the ultrasound shows a little flicker, right,
342
00:26:11.920 --> 00:26:15.119
that is going to be a heart if it lives
343
00:26:15.160 --> 00:26:15.759
long enough.
344
00:26:15.920 --> 00:26:18.240
But it's not going to because the membranes are eruptured.
345
00:26:18.319 --> 00:26:23.039
It is still is still flickering. They can't do the
346
00:26:23.079 --> 00:26:28.279
appropriate treatment for that woman, right, well, I mean.
347
00:26:29.039 --> 00:26:32.039
No, And we've had cases in the state literally where
348
00:26:32.079 --> 00:26:38.480
women are bleeding effusively, yes, and doctors felt that they
349
00:26:38.680 --> 00:26:44.359
had to wait until there was no longer. You know,
350
00:26:44.400 --> 00:26:47.440
they call it cardiac activity. It's not cardiac activity. It's
351
00:26:47.440 --> 00:26:49.279
not even a four chamber heart at that point.
352
00:26:49.400 --> 00:26:50.000
It's flicker.
353
00:26:50.200 --> 00:26:54.400
It's a little flick of a flick of emotion, and
354
00:26:54.839 --> 00:26:58.720
we have to wait for that to be gone in
355
00:26:58.920 --> 00:27:02.880
order to take mom to the o R or the
356
00:27:02.920 --> 00:27:03.519
other option.
357
00:27:04.039 --> 00:27:05.119
We can wait.
358
00:27:05.000 --> 00:27:11.079
Until mom is so unstable from her blood loss, then
359
00:27:11.119 --> 00:27:15.160
we can take her neither. I mean, it's craziness.
360
00:27:15.759 --> 00:27:19.039
It is. It is not medicine.
361
00:27:19.440 --> 00:27:21.160
No, it's it's malpractice.
362
00:27:21.319 --> 00:27:22.200
It's malpractice.
363
00:27:22.720 --> 00:27:30.440
What about ruptured membranes in the second trimester? How does that?
364
00:27:31.759 --> 00:27:31.960
You know?
365
00:27:32.039 --> 00:27:36.599
What they what they want you to do. Honestly, I've
366
00:27:36.680 --> 00:27:41.640
had this in committee. They have said she can just
367
00:27:41.759 --> 00:27:47.279
walk around with that dead feet is in utero until
368
00:27:47.440 --> 00:27:53.440
it's spontaneously excavate, you know. But the problem is you
369
00:27:53.480 --> 00:28:00.000
get septic, and you get disseminated intravascular colaggilopathies, and you
370
00:28:00.720 --> 00:28:05.599
we don't take patience to the brink of death intentionally
371
00:28:05.720 --> 00:28:07.440
in an effort to try to bring him that back.
372
00:28:07.880 --> 00:28:11.880
We try to prevent what we know is going to
373
00:28:12.160 --> 00:28:15.480
happen if we don't intercede.
374
00:28:16.799 --> 00:28:18.559
Yeah, this is real.
375
00:28:18.759 --> 00:28:24.200
This is the other Another issue in my understanding, again
376
00:28:24.319 --> 00:28:27.799
which is limited, is if you have a fetal anomaly
377
00:28:28.039 --> 00:28:34.680
like an encephalic fetus, that's a fetus for our listeners
378
00:28:34.720 --> 00:28:36.640
to understand, that doesn't.
379
00:28:36.279 --> 00:28:38.400
Have a brain, no brain, no head.
380
00:28:38.559 --> 00:28:44.400
So if this goes to term, it dies, it doesn't
381
00:28:44.440 --> 00:28:49.599
live very long. And to perforce a woman to carry
382
00:28:49.839 --> 00:28:55.240
an encephalic fetus to birth, it's cruel.
383
00:28:55.480 --> 00:28:56.079
It's cruel.
384
00:28:56.240 --> 00:28:56.880
It's cruel.
385
00:28:57.599 --> 00:28:59.920
I mean, first of all, you have all the complications
386
00:29:00.559 --> 00:29:04.799
of pregnancy and childbirth with none you know, it's everything
387
00:29:04.799 --> 00:29:09.359
in medicine is a risk benefit analysis. You're taking all
388
00:29:09.400 --> 00:29:14.839
the risks with no benefit. The fetus is dead. Why
389
00:29:14.880 --> 00:29:19.359
would you want to take those risks? And the other hand,
390
00:29:19.720 --> 00:29:25.359
mom can have that that fetus dead, fetus removed from
391
00:29:25.359 --> 00:29:28.680
her uterus, she can heal, and she can go home
392
00:29:28.720 --> 00:29:29.960
and get pregnant again.
393
00:29:30.119 --> 00:29:33.920
Yes, that's what we want.
394
00:29:34.279 --> 00:29:39.519
We want these women to survive and be able to produce.
395
00:29:40.000 --> 00:29:43.640
That brings me back again to that question about the
396
00:29:43.720 --> 00:29:51.720
politician's understanding healthcare, because this, the anti abortion legislation in
397
00:29:51.839 --> 00:29:56.880
Kentucky is so far off the mark that, at least
398
00:29:56.920 --> 00:29:59.480
in my opinion, as well as I could understand it,
399
00:29:59.519 --> 00:30:03.480
and I'm limited because I'm not an obstetrician or a gynocologist.
400
00:30:04.880 --> 00:30:14.400
It requires the physician dealing with the complications of pregnancy.
401
00:30:14.640 --> 00:30:16.559
To commit medical malpractice.
402
00:30:18.359 --> 00:30:21.880
It's a parent Is it not possible we could change
403
00:30:21.920 --> 00:30:27.759
these few things and and and get proper treatment for
404
00:30:27.880 --> 00:30:32.079
complication or pregnancy. Well, the legislatures not even listened to them.
405
00:30:32.920 --> 00:30:35.440
Some would and some will not. Uh.
406
00:30:35.880 --> 00:30:38.960
It really depends on who you are and what your
407
00:30:38.960 --> 00:30:39.599
background is.
408
00:30:39.640 --> 00:30:40.480
I will tell you that the.
409
00:30:40.519 --> 00:30:52.599
Legislator who who brought the the overall maternal bill that
410
00:30:52.680 --> 00:30:56.920
we passed several years ago, Nancy Tate, is not coming back.
411
00:30:57.720 --> 00:31:01.960
She has opted not to run for reelection, so in
412
00:31:02.039 --> 00:31:03.640
our absence.
413
00:31:03.279 --> 00:31:06.559
We may have some room to move.
414
00:31:07.440 --> 00:31:09.279
But I'll be honest, right to life in this state
415
00:31:09.440 --> 00:31:20.519
is extremely, extremely strong, and extremely close, very close to
416
00:31:20.839 --> 00:31:25.799
some of our more powerful electeds.
417
00:31:25.319 --> 00:31:28.000
In the state. And I could go into names if
418
00:31:28.000 --> 00:31:30.359
you wanted me to, but I don't know if I should.
419
00:31:30.599 --> 00:31:32.559
I guess I have to throw out this warning. I mean,
420
00:31:32.640 --> 00:31:35.160
we we are non political.
421
00:31:34.880 --> 00:31:38.759
Right right, so I won't use names. But you have
422
00:31:38.839 --> 00:31:44.799
to understand, guys, we have politicians elected, even from Jefferson County,
423
00:31:45.200 --> 00:31:50.200
who are in bed with these right to life physicians
424
00:31:51.480 --> 00:31:54.720
or these right to life lobbyists, and they take a
425
00:31:54.759 --> 00:31:56.599
lot of money for them, and they.
426
00:31:56.599 --> 00:32:02.400
Do their bidding the mother right what about the right
427
00:32:02.440 --> 00:32:04.720
to life for the mother? What about the truth is
428
00:32:05.599 --> 00:32:07.119
my religion? I'm Jewish.
429
00:32:07.720 --> 00:32:12.400
The truth is my religion requires that you in if
430
00:32:12.440 --> 00:32:16.920
you have to choose, you choose the mother over the fetus.
431
00:32:17.720 --> 00:32:21.119
According to Jewish law, that is what you're supposed to do.
432
00:32:21.960 --> 00:32:24.480
And in our laws in Kentucky prohibit that.
433
00:32:24.599 --> 00:32:30.160
At this point, well, let me pop something else onto
434
00:32:30.160 --> 00:32:34.680
the table while we're doing this, because we could, we could,
435
00:32:34.720 --> 00:32:36.759
and we may have talked about this some more. I
436
00:32:36.799 --> 00:32:44.039
think private equity companies in medicine now are involved.
437
00:32:44.200 --> 00:32:45.720
And you mentioned.
438
00:32:47.240 --> 00:32:52.160
What seventy percent of Medicaid recipients are in nursing homes.
439
00:32:52.359 --> 00:32:53.240
Well, it's my.
440
00:32:53.319 --> 00:32:57.119
Understanding that that almost seventy percent of nursing homes are
441
00:32:57.160 --> 00:33:00.720
run by and then is isn't that what you tell me, Jeane?
442
00:33:00.759 --> 00:33:01.960
I think that's.
443
00:33:01.880 --> 00:33:06.720
Correct, yes, and it's more than that. In south central Kentucky,
444
00:33:07.160 --> 00:33:11.519
every every nursing home in my county and surrounding counties
445
00:33:11.640 --> 00:33:16.079
is owned by a private equity. The interesting thing is.
446
00:33:16.039 --> 00:33:20.119
That they don't tell anybody, well of course, but they
447
00:33:20.519 --> 00:33:28.279
run physician practices, they run the hospitals, they run hospital systems.
448
00:33:28.319 --> 00:33:32.480
There was a hospital system in Boston that collapsed because
449
00:33:32.519 --> 00:33:36.559
it was run by a private equity company that that
450
00:33:36.559 --> 00:33:41.240
that that used that that basically sold the building that
451
00:33:41.319 --> 00:33:44.759
the hospital was in and then had the medical the
452
00:33:44.839 --> 00:33:49.960
medicals the medical company have to pay rent to be
453
00:33:50.079 --> 00:33:53.519
in their building. And then when it collapsed, the CEO
454
00:33:53.799 --> 00:33:56.480
of the private equity company turned some of these things
455
00:33:56.519 --> 00:34:02.119
into the condominiums. Anyhow, can you share some of your
456
00:34:02.240 --> 00:34:03.279
thoughts and.
457
00:34:03.079 --> 00:34:05.559
Again I think private equity and I'm going.
458
00:34:05.480 --> 00:34:10.400
To ask you again to how does did your fellow
459
00:34:10.519 --> 00:34:15.320
politicians understand. I think they did the implications of having
460
00:34:15.360 --> 00:34:20.559
a private equity company running a healthcare system.
461
00:34:20.840 --> 00:34:23.440
I think that the ones that are paying attention to
462
00:34:23.719 --> 00:34:29.800
understand that this is a very bad, bad thing that
463
00:34:29.920 --> 00:34:34.400
is happening in medicine. I mean, what these private equity companies,
464
00:34:34.440 --> 00:34:38.039
What they think is that they can buy practices, They
465
00:34:38.039 --> 00:34:42.800
can buy hospitals, they can buy outpatient centers and make
466
00:34:43.519 --> 00:34:48.360
money off of them, where the previous people, like the
467
00:34:48.360 --> 00:34:52.719
physicians that had run these centers couldn't. They think they're smarter,
468
00:34:52.880 --> 00:34:56.760
they know how to handle things better. Basically, though, what
469
00:34:56.880 --> 00:35:00.239
they do is they go in there, they figure out
470
00:35:00.400 --> 00:35:04.039
what makes a profit for us and what doesn't. It
471
00:35:04.079 --> 00:35:08.039
has nothing to do with the needs of the population,
472
00:35:08.280 --> 00:35:11.840
nothing to do with the needs of the patients, nothing
473
00:35:11.920 --> 00:35:16.519
honestly to do with quality of care. The bottom line
474
00:35:16.920 --> 00:35:21.800
is are we going to make money? And study after
475
00:35:21.920 --> 00:35:27.079
study after study after study has shown that the quality
476
00:35:27.199 --> 00:35:33.679
of healthcare delivery goes down in practices that are bought
477
00:35:33.800 --> 00:35:39.679
by private equity over and over and over again. I
478
00:35:39.719 --> 00:35:43.760
personally think we should outlaw it. I do not think
479
00:35:43.880 --> 00:35:47.400
that you should buy medical practices with the goal of
480
00:35:47.519 --> 00:35:55.119
doing nothing but making a profit that is unethical and immoral,
481
00:35:55.760 --> 00:35:59.480
and that it's happening in this country day in and
482
00:35:59.599 --> 00:36:03.800
day out. I think my fellow legislators understand it. They
483
00:36:03.960 --> 00:36:05.119
don't know how to stop it.
484
00:36:05.239 --> 00:36:09.719
Doctor Burghery, the Medicare for All movement across this country.
485
00:36:10.039 --> 00:36:15.039
The battle cry is patients over profits. Yesss this country?
486
00:36:15.159 --> 00:36:15.840
Yes right?
487
00:36:16.119 --> 00:36:20.360
And the goal the first goal, well, the first goal
488
00:36:20.440 --> 00:36:22.960
is due to no harm. But the second goal is
489
00:36:23.000 --> 00:36:30.360
to take care of people, to actually provide healthcare, not
490
00:36:31.000 --> 00:36:36.079
to make a profit off of people's illnesses.
491
00:36:36.400 --> 00:36:39.199
Let me give you an example. Just I can get
492
00:36:39.280 --> 00:36:41.039
two or three of them. But there was a nursing
493
00:36:41.039 --> 00:36:47.599
home in Florida that was owned by a private equity
494
00:36:47.639 --> 00:36:50.519
company and there was a woman down there who had
495
00:36:50.519 --> 00:36:53.760
a the Cuba de saulcer. And for our listeners, this
496
00:36:54.760 --> 00:36:58.000
was an ulcer on the lower part of her back
497
00:36:58.840 --> 00:37:01.360
and she got it because she was lying in bed
498
00:37:01.519 --> 00:37:06.039
all the time and not being moved. Uh, they didn't
499
00:37:06.800 --> 00:37:12.960
change the diaper enough, so it got infected by fecal contamination.
500
00:37:13.760 --> 00:37:20.840
For our listeners, that's poop. And she died and the family, understandably,
501
00:37:20.960 --> 00:37:28.119
being angry or hired a lawyer and they they ran
502
00:37:28.199 --> 00:37:36.559
into this complex of administrative a nightmare. One company owned
503
00:37:36.800 --> 00:37:43.400
the building, one company had the nursing home license, one
504
00:37:43.519 --> 00:37:50.760
company provided the professional staff, one company provided a custodial staff,
505
00:37:51.360 --> 00:37:54.440
and they and they, and there was no nobody. Nobody
506
00:37:54.679 --> 00:37:57.239
took There was no responsibility.
507
00:37:56.400 --> 00:37:58.719
For what who provided the medical oversight?
508
00:37:58.880 --> 00:38:00.960
Yes, exactly, accountability, that.
509
00:38:01.000 --> 00:38:06.320
Is the accountability and the and the care, the actual
510
00:38:06.599 --> 00:38:08.880
care of that person.
511
00:38:09.800 --> 00:38:13.679
All right, that's going on right here in south central Kentucky.
512
00:38:14.960 --> 00:38:20.559
Go ahead, and there's a another nursing home that had
513
00:38:21.440 --> 00:38:25.320
local physicians that were taking care of patients, and most
514
00:38:25.360 --> 00:38:28.639
of the physicians and the patients knew each other, the
515
00:38:28.679 --> 00:38:32.559
same way with the nurse practitioners that were involved. And
516
00:38:32.599 --> 00:38:37.519
those people all disappeared and they brought in physicians and
517
00:38:37.639 --> 00:38:40.639
nurse practitioners from out of town, which none of the
518
00:38:40.679 --> 00:38:44.239
patients or family knew. Now, that creates a real problem
519
00:38:44.280 --> 00:38:49.639
with continuity care and trust between patient and physician and
520
00:38:49.800 --> 00:38:50.840
nurse practitioner.
521
00:38:51.800 --> 00:38:53.039
Uh, this is.
522
00:38:53.039 --> 00:38:57.960
A it's becoming a real, real, really huge problem that
523
00:38:58.639 --> 00:38:59.679
we have to address.
524
00:39:00.360 --> 00:39:00.559
Cara.
525
00:39:00.639 --> 00:39:14.960
What about pharmacy benefit Managers.
526
00:39:08.679 --> 00:39:15.519
Because bbms honestly are the newest leech on healthcare. I
527
00:39:15.559 --> 00:39:23.000
mean an appsolute freaking leech on healthcare dollars. They insinuated
528
00:39:23.039 --> 00:39:27.679
themselves in between patients and their doctors, and they have
529
00:39:27.880 --> 00:39:35.559
now decided based on their profits, not efficacy, not how
530
00:39:35.719 --> 00:39:41.320
well a patient response, based on profit margins, which medicines
531
00:39:41.440 --> 00:39:46.079
they will allow to be prescribed and which they will
532
00:39:46.159 --> 00:39:51.679
which ones they will not. And guys, it's all on kickbacks.
533
00:39:52.119 --> 00:39:57.480
They're getting kickbacks from the pharmaceutical companies to make these decisions.
534
00:39:57.480 --> 00:39:59.199
You know, we used to when we first came up
535
00:39:59.199 --> 00:40:03.719
with hospital for mularies, it was based on how well
536
00:40:03.960 --> 00:40:06.960
the drug worked versus the cost of the drug.
537
00:40:07.519 --> 00:40:09.480
That was what we really cared about.
538
00:40:10.719 --> 00:40:16.320
None of that matters anymore. They none of that matters anymore.
539
00:40:16.920 --> 00:40:22.559
It is all how much money they can get.
540
00:40:23.000 --> 00:40:27.960
And there's a very fundamental reason for all this. We
541
00:40:28.039 --> 00:40:31.159
do not have a healthcare system in this country.
542
00:40:31.239 --> 00:40:32.199
They're not regulated.
543
00:40:32.320 --> 00:40:36.360
We have a health care industry which is focused and
544
00:40:36.880 --> 00:40:42.320
whether it's the nine hundred for profit health insurance companies,
545
00:40:42.400 --> 00:40:47.159
the partners, pharmacy benefit managers, the fact that Medicare and
546
00:40:47.239 --> 00:40:51.679
I still think that's true, cannot negotiate with the drug companies.
547
00:40:51.800 --> 00:40:52.920
You know, there's a couple of.
548
00:40:52.960 --> 00:40:54.760
Ten of them. Now I think I think it's tech.
549
00:40:55.159 --> 00:41:00.360
Yeah, I mean, it's just it's astonishing that this goes on.
550
00:41:01.000 --> 00:41:05.039
And again, I gotta go back to you with the politicians.
551
00:41:05.360 --> 00:41:08.400
Do they not understanding this or are they getting so
552
00:41:08.519 --> 00:41:13.360
much money in contributions and donations from this company that
553
00:41:13.400 --> 00:41:14.039
they don't care.
554
00:41:14.400 --> 00:41:18.880
The truth is the problem with PBMs is multifaceted. It
555
00:41:19.079 --> 00:41:24.000
needs to be dealt with with federal legislation. But our
556
00:41:24.280 --> 00:41:32.679
Congress is in capable of passing legislation of this caliber
557
00:41:32.840 --> 00:41:33.719
at this point.
558
00:41:34.039 --> 00:41:35.199
You know our current Congress.
559
00:41:36.079 --> 00:41:40.440
I'm talking about the House of Representatives in DC, not
560
00:41:40.679 --> 00:41:47.159
in Frankfurt. This Congress has passed fewer bills than any
561
00:41:47.519 --> 00:41:53.000
congress any sit in Congress ever in the history of
562
00:41:53.039 --> 00:41:58.159
the United States of America. They are completely dysfunctional. They
563
00:41:58.199 --> 00:42:01.559
have all sorts of bills written, the PBM bill being
564
00:42:01.679 --> 00:42:07.840
one of them, that they can't not get done.
565
00:42:08.440 --> 00:42:10.199
We've tried on state level.
566
00:42:10.239 --> 00:42:14.360
States are trying to manage pharmacy benefit managers.
567
00:42:15.920 --> 00:42:19.119
But it's tough. It's tough.
568
00:42:19.559 --> 00:42:22.000
I wrote a bill last session about step therapy. Are
569
00:42:22.000 --> 00:42:25.440
you familiar with step therapy. It's where the insurance company
570
00:42:25.639 --> 00:42:29.039
your doctor writes a prescription, and the insurance company can say, no,
571
00:42:29.400 --> 00:42:31.280
that's too expensive a prescription.
572
00:42:31.880 --> 00:42:32.639
We want you.
573
00:42:32.679 --> 00:42:38.039
To try this first, fail it, and then we'll give
574
00:42:38.079 --> 00:42:41.920
you the more expensive prescription. Like the doctor doesn't or
575
00:42:41.960 --> 00:42:46.639
the healthcare provider doesn't actually know what they want and
576
00:42:46.719 --> 00:42:51.280
don't actually have a reason for prescribing this over this.
577
00:42:51.920 --> 00:42:53.599
So I just wrote a bill that says they're not
578
00:42:53.639 --> 00:42:58.599
allowed to do that without getting the provider's input first.
579
00:42:59.079 --> 00:43:02.400
The provider gets to explain to them why step therapy
580
00:43:02.639 --> 00:43:06.719
is not appropriate as opposed to right now where they
581
00:43:06.840 --> 00:43:08.800
just do not fill the prescription.
582
00:43:09.639 --> 00:43:11.639
And I think we got to pass the past it
583
00:43:11.679 --> 00:43:12.800
in Illinois last year.
584
00:43:13.360 --> 00:43:14.920
We think we might be able to get it in
585
00:43:15.000 --> 00:43:16.920
Kentucky this year, and if we can, we can go
586
00:43:17.239 --> 00:43:21.639
national on that. But these are just middlemen who have
587
00:43:21.920 --> 00:43:27.519
just decided that they can make more money by not
588
00:43:28.119 --> 00:43:34.960
providing what the healthcare providers want for their patients. It's
589
00:43:35.039 --> 00:43:36.880
just another way for them to do it.
590
00:43:37.280 --> 00:43:44.159
Yeah. This term is called vertical integration, and CBS right
591
00:43:44.159 --> 00:43:46.880
now is the superstar of vertical integration.
592
00:43:47.480 --> 00:43:50.320
Yeah, well you and I healthcare is getting is pretty
593
00:43:50.320 --> 00:43:51.360
close to CBS.
594
00:43:52.800 --> 00:43:56.039
Yeah, and I honestly think we should break up vertical integration.
595
00:43:56.119 --> 00:43:58.480
I don't think it should be. I don't think you
596
00:43:58.519 --> 00:44:02.239
should be able to set that. You have to use
597
00:44:02.400 --> 00:44:05.960
our pharmacies, you have to use our hospitals.
598
00:44:09.559 --> 00:44:15.119
It's for the audience. CBS owns a health insurance company,
599
00:44:15.800 --> 00:44:20.440
they own some doctors, they own a pharmacy benefit manager,
600
00:44:20.920 --> 00:44:24.320
and they own a company called Signify Hell and they're
601
00:44:24.320 --> 00:44:25.679
all vertically integrated.
602
00:44:27.440 --> 00:44:31.840
Well, that's healthcare in this country. I mean, you know
603
00:44:33.280 --> 00:44:37.039
how many people are in private practice by themselves that
604
00:44:37.119 --> 00:44:39.920
don't work for a hospital or a hospital system or
605
00:44:39.960 --> 00:44:41.679
some other organization like that.
606
00:44:41.760 --> 00:44:42.280
It's awful.
607
00:44:43.039 --> 00:44:46.400
You can't do it. I just just in the last
608
00:44:46.440 --> 00:44:53.880
few months right here in Campbellsville, I know one, two, three,
609
00:44:54.000 --> 00:45:00.239
or four doctors and multiple nurse practitioners who had to
610
00:45:00.239 --> 00:45:02.639
get out of private practice. They couldn't they couldn't have do.
611
00:45:02.760 --> 00:45:05.559
It's impossible to them.
612
00:45:05.760 --> 00:45:07.320
It's very difficult. At this point.
613
00:45:07.639 --> 00:45:10.599
Well, let's.
614
00:45:12.760 --> 00:45:18.400
Well change again, horses in midstream here to kind of
615
00:45:18.400 --> 00:45:23.880
a different approach. This is a program sponsored by Kentuckians
616
00:45:23.920 --> 00:45:29.719
for single pair promoting Medicare for all, which we all
617
00:45:29.760 --> 00:45:30.679
are here.
618
00:45:30.639 --> 00:45:31.920
Without getting paid.
619
00:45:34.679 --> 00:45:39.679
The prospect of this become a reality in this political climate,
620
00:45:39.960 --> 00:45:44.360
at least to me, doesn't look very good. And so
621
00:45:44.519 --> 00:45:48.239
my question to you is, what suggestions do you have
622
00:45:48.360 --> 00:45:53.559
that could improve the recognition of the benefit of the
623
00:45:53.679 --> 00:46:00.000
value of this nonprofit, government run health insurance program by
624
00:46:00.960 --> 00:46:01.639
the public.
625
00:46:02.960 --> 00:46:07.480
And you're co politicians.
626
00:46:07.960 --> 00:46:13.199
Yeah, that's a big, big, big question. Yeah, that's that's
627
00:46:13.199 --> 00:46:14.440
a really big question.
628
00:46:14.559 --> 00:46:16.480
I could I could ask you to break it down
629
00:46:16.480 --> 00:46:17.519
into component pieces.
630
00:46:18.119 --> 00:46:20.239
Lets you do it whatever way you're comfortable.
631
00:46:24.800 --> 00:46:34.039
I think it is well established that our healthcare delivery
632
00:46:34.119 --> 00:46:40.800
system in the United States is broken. For most people,
633
00:46:41.639 --> 00:46:46.159
the cost of premiums and the cost of their deductibles.
634
00:46:46.960 --> 00:46:49.119
These are, you know, people.
635
00:46:48.840 --> 00:46:54.920
With private pay insurance. It's getting out of control. For
636
00:46:55.039 --> 00:46:59.599
the younger people, they honestly think it's a joke. You mean,
637
00:46:59.760 --> 00:47:01.960
I'm going to make this much money and then I
638
00:47:02.039 --> 00:47:06.639
have to pay this much for my health insurance and
639
00:47:06.679 --> 00:47:08.760
I only get to use it if I'm sick.
640
00:47:09.280 --> 00:47:11.119
I mean, they're thinking, I'm just not going to have
641
00:47:11.159 --> 00:47:11.920
health insurance.
642
00:47:12.559 --> 00:47:18.000
And what happens then the whole healthcare delivery system falls apart,
643
00:47:18.639 --> 00:47:24.519
because you have it costs money to run hospitals, it
644
00:47:24.679 --> 00:47:29.360
costs money to train doctors, It costs money to have
645
00:47:29.519 --> 00:47:36.639
nurses and equipment, and if there is nobody to pay,
646
00:47:37.360 --> 00:47:41.480
nobody who can pay for that, then the whole thing
647
00:47:41.519 --> 00:47:49.320
collapses and private insurance is not an option now for
648
00:47:49.559 --> 00:47:55.360
a large percentage of people in this country, that entire
649
00:47:55.519 --> 00:47:58.440
Medicaid expansion population, which isn't that big. It's I think
650
00:47:58.440 --> 00:48:01.199
it's like seven point six million people. I think. Don't
651
00:48:01.280 --> 00:48:03.079
quote me on that. That's off the top of my head.
652
00:48:04.199 --> 00:48:08.920
They will be uninsured. It's not that you know they're
653
00:48:08.960 --> 00:48:11.320
going to be able to switch to a private insurance
654
00:48:11.360 --> 00:48:16.239
they're not. We have got to fig We have got
655
00:48:16.679 --> 00:48:20.719
First of all, people have been terrified their entire lives
656
00:48:21.320 --> 00:48:25.559
because they have been told by the insurance industry that
657
00:48:25.719 --> 00:48:29.280
private health insurance is the only way to go, and
658
00:48:29.360 --> 00:48:35.880
if we do anything other than a completely capitalistic healthcare market,
659
00:48:36.400 --> 00:48:40.800
they will lose all the advantages that they have as
660
00:48:40.920 --> 00:48:44.599
Americans with the best healthcare system in the world. First
661
00:48:44.639 --> 00:48:47.159
of all, it's not the best healthcare system in the world,
662
00:48:47.159 --> 00:48:49.519
as far from the best healthcare system in the world.
663
00:48:49.559 --> 00:48:52.880
As far as our outcomes and for what we spend
664
00:48:53.639 --> 00:48:59.880
versus our outcomes, we are not competitive with other major
665
00:49:00.079 --> 00:49:06.000
countries at all. So the whole cost of the private
666
00:49:06.079 --> 00:49:14.159
healthcare market, which is a for profit business, is actually
667
00:49:14.480 --> 00:49:18.599
keeping people from getting covered. And then you go to
668
00:49:18.639 --> 00:49:24.800
the public side and the only you have options that
669
00:49:24.880 --> 00:49:29.559
are more affordable only if you're going to subsidize them.
670
00:49:30.000 --> 00:49:34.239
And then you have legislators who say, why should I
671
00:49:34.320 --> 00:49:40.039
subsidize this. Let them go and buy health insurance just
672
00:49:40.079 --> 00:49:43.760
like I do. It's not the answer because it's not feasible.
673
00:49:43.800 --> 00:49:44.519
They can't do it.
674
00:49:46.960 --> 00:49:47.199
Well.
675
00:49:47.320 --> 00:49:52.000
Again, I've asked Jane this question multiple times, is what
676
00:49:52.199 --> 00:49:56.320
is in the heads of the people in red rural
677
00:49:56.400 --> 00:50:03.119
Kentucky that keeps putting the legislatures into office. Let me
678
00:50:03.159 --> 00:50:07.800
tell you pass bills that are against their economic and
679
00:50:07.880 --> 00:50:10.639
health interest. Gene, you want to make a comment about
680
00:50:10.719 --> 00:50:14.760
that before we let Karen respond to my comment.
681
00:50:20.360 --> 00:50:21.360
Jane, are you there?
682
00:50:21.760 --> 00:50:26.360
Yes, Yes, I do, well, I don't think. I think
683
00:50:26.400 --> 00:50:32.599
it's like having cancer. You don't really think about it.
684
00:50:32.760 --> 00:50:35.920
You don't know much about it until you get it,
685
00:50:36.760 --> 00:50:41.360
and then it may be too late. Hopefully it's not,
686
00:50:42.119 --> 00:50:49.159
but most people are not really thinking about that. And
687
00:50:50.000 --> 00:50:54.920
I think there are other issues that are affecting their
688
00:50:55.000 --> 00:51:01.199
votes other than just playing economics. But that may be
689
00:51:01.320 --> 00:51:07.039
changing some of the inflation we're having, some of the
690
00:51:07.119 --> 00:51:11.719
costs for farmers. But the main issues are, I think
691
00:51:11.760 --> 00:51:16.679
in rural Kentucky are abortion, big government, uh, somebody telling
692
00:51:16.719 --> 00:51:21.599
you what to do, uh, somebody telling you that you
693
00:51:21.679 --> 00:51:24.519
can't go to church because there's an epidemic going on,
694
00:51:24.760 --> 00:51:28.800
just like what happened this morning in the Senate condemning
695
00:51:28.920 --> 00:51:35.719
doctor Fauci. Those kinds of things are are affect people
696
00:51:35.880 --> 00:51:41.599
more than direct healthcare. I think I think there may
697
00:51:41.639 --> 00:51:46.320
be some gradual change. It's just like the conversations we've
698
00:51:46.360 --> 00:51:50.599
had with Don Henderson in the past that he says
699
00:51:50.760 --> 00:51:53.639
he doesn't think anything will happen until there's a crisis,
700
00:51:54.119 --> 00:51:59.239
and that crisis may really be a crisis that will
701
00:51:59.320 --> 00:52:02.440
take us along long time and a lot of pain
702
00:52:02.559 --> 00:52:04.360
and suffering. To get over.
703
00:52:07.199 --> 00:52:08.320
Your thoughts about this.
704
00:52:08.559 --> 00:52:10.320
I just want to say that I think Genie left
705
00:52:10.320 --> 00:52:12.880
out a big one here for Kentucky, and it's the
706
00:52:12.920 --> 00:52:15.599
big elephant we call racism.
707
00:52:16.760 --> 00:52:19.400
Well, I can tell you I was born and raised
708
00:52:19.400 --> 00:52:25.559
in Taylor County. When I was a kid, there were
709
00:52:25.599 --> 00:52:32.719
bathrooms for colored and white. The schools were segregated. I
710
00:52:32.719 --> 00:52:37.000
can tell you coming back here and living here when
711
00:52:37.000 --> 00:52:41.119
I got through my residency that that is radically changing.
712
00:52:41.960 --> 00:52:49.239
Its radically changed, and I don't see much racism here
713
00:52:49.280 --> 00:52:53.280
in Taylor County and the surrounding county, So I.
714
00:52:53.199 --> 00:52:55.079
Have to agree with you on that. But but I
715
00:52:55.119 --> 00:52:57.239
will say that I've run int occasions all the time
716
00:52:57.320 --> 00:53:01.840
out in public where I see it. It's kind of
717
00:53:02.559 --> 00:53:07.960
I call it covert racism or latent racism. That's a
718
00:53:08.079 --> 00:53:11.559
vestige of when you what you said you went through
719
00:53:11.599 --> 00:53:13.599
when you were growing up. I think it's still here
720
00:53:13.719 --> 00:53:15.719
and I think it's a problem for our society.
721
00:53:16.320 --> 00:53:19.119
Well it may if it is, it's very very suppressed
722
00:53:19.199 --> 00:53:25.400
because at the hospital we have several Afro Americans nurses
723
00:53:25.480 --> 00:53:30.840
and doctors, and over the forty six years I've worked
724
00:53:31.239 --> 00:53:37.079
at Tairacial Hospital, I have never ever seen a problem.
725
00:53:37.880 --> 00:53:40.000
I'm not saying that there could be could have been
726
00:53:40.039 --> 00:53:43.960
problems that I don't know about, but it's it's it
727
00:53:44.239 --> 00:53:48.199
just blows my mind how different it is. Uh, there's
728
00:53:48.280 --> 00:53:57.920
interracial marriage and there's people socialized together. It is really
729
00:53:57.960 --> 00:53:58.800
really different.
730
00:53:59.639 --> 00:54:03.400
Now let us get back. My question was how do
731
00:54:03.519 --> 00:54:08.639
we get a recognition into the brains of the rural
732
00:54:08.719 --> 00:54:14.239
voters and the politicians about our dysfunctional healthcare system and
733
00:54:14.280 --> 00:54:18.480
the benefits of having a not for profit government run
734
00:54:19.920 --> 00:54:21.480
in health insurance system.
735
00:54:22.440 --> 00:54:24.639
Well, the first thing I think we should do is
736
00:54:26.039 --> 00:54:29.559
we have to change the government in Washington.
737
00:54:29.880 --> 00:54:32.440
Well, yes, Na, Frankfort as well.
738
00:54:32.880 --> 00:54:36.199
It right, but I don't think that we have to
739
00:54:36.239 --> 00:54:39.840
concentrate on that right now. There's no possible way we
740
00:54:39.880 --> 00:54:42.840
can change it right this man. But if we change
741
00:54:42.920 --> 00:54:49.800
that and to change Congress in November, we may be
742
00:54:49.840 --> 00:54:51.639
able to start working on it now.
743
00:54:51.639 --> 00:54:54.400
One of the reasons that I do this program because
744
00:54:54.440 --> 00:54:56.559
I'm not getting paid for this, and it's a lot
745
00:54:56.599 --> 00:54:59.079
of work getting people set up to come and do
746
00:54:59.119 --> 00:55:02.400
these things. Come down here is the hope that the
747
00:55:02.440 --> 00:55:06.239
information and the things that we talk about here will
748
00:55:06.320 --> 00:55:09.440
penetrate some of the brains of listeners.
749
00:55:09.480 --> 00:55:12.119
And I get.
750
00:55:11.920 --> 00:55:16.239
This report from you every month, Jeane, about who's listening
751
00:55:16.280 --> 00:55:21.000
to these programs, and apparently they're getting around to a
752
00:55:21.039 --> 00:55:25.320
lot of different places, so you know, hopefully somebody's listening
753
00:55:25.360 --> 00:55:26.960
and hopefully they're understanding.
754
00:55:27.480 --> 00:55:31.400
Actually I only get the report on one of the podcasts.
755
00:55:31.440 --> 00:55:33.440
There are multiple ather ones that I don't have the
756
00:55:33.519 --> 00:55:39.920
numbers on. But I think that we can gradually make progress,
757
00:55:40.559 --> 00:55:46.119
but we not until we change the government right now.
758
00:55:47.000 --> 00:55:50.079
And that's why I try to emphasize that point last
759
00:55:50.159 --> 00:55:54.039
night in our meeting that we have to we have
760
00:55:54.159 --> 00:55:58.199
to select who can win and get those people in
761
00:55:58.400 --> 00:56:01.559
office and then start working on this.
762
00:56:02.280 --> 00:56:04.679
Okay, guys, we've got about two more manutes to.
763
00:56:04.639 --> 00:56:08.599
Go, so wow, Karen, you want to make any last
764
00:56:08.639 --> 00:56:11.199
minute comments and then we'll let Paul take us out.
765
00:56:15.079 --> 00:56:22.800
Every human being deserves access to good quality healthcare, and
766
00:56:22.960 --> 00:56:27.960
in the United States, being really probably the or one
767
00:56:28.000 --> 00:56:33.639
of the wealthiest countries in the world, we don't seem
768
00:56:33.679 --> 00:56:38.920
to have conquered that. We actually are doing a much
769
00:56:39.159 --> 00:56:44.440
worse job than other countries that are much less affluent
770
00:56:44.599 --> 00:56:49.480
than we are, and we spend a ton of money
771
00:56:49.840 --> 00:56:57.039
on healthcare without getting the results that other countries get.
772
00:56:58.320 --> 00:57:01.719
So we have to read think what we're doing. We
773
00:57:01.960 --> 00:57:08.400
have to really allow people to open their minds, get
774
00:57:08.440 --> 00:57:14.440
over the fear that they intentionally put into you growing
775
00:57:14.559 --> 00:57:21.440
up that anything other than a private, for profit healthcare
776
00:57:21.559 --> 00:57:26.199
network would take something away from you. And they made
777
00:57:26.239 --> 00:57:30.559
that over and over and over again clear to everybody
778
00:57:30.559 --> 00:57:35.440
in this country through their advertisings and their campaign everybody thought,
779
00:57:35.920 --> 00:57:38.239
if we lose our private health insurance, we are going
780
00:57:38.320 --> 00:57:43.800
to lose our quality healthcare, and it is not true.
781
00:57:43.960 --> 00:57:50.960
We can have better health care for less money and
782
00:57:51.159 --> 00:57:59.000
cover more people if we just re think our healthcare
783
00:57:59.239 --> 00:58:01.440
distribution system.
784
00:58:01.679 --> 00:58:04.880
Thank you very much, Karen for those remarks, and thank
785
00:58:04.920 --> 00:58:08.159
you very much for coming on here today to do
786
00:58:08.239 --> 00:58:09.159
this program.
787
00:58:10.440 --> 00:58:12.960
I'd like to thank my co hosts and doctor Karen
788
00:58:13.000 --> 00:58:16.719
Berg for making today's show possible, and a special thanks
789
00:58:16.760 --> 00:58:20.440
to our listeners for tuning in. For more information on
790
00:58:20.480 --> 00:58:25.320
today's topic, go to our website at Kyhealthcare dot org,
791
00:58:26.360 --> 00:58:28.800
and don't forget. With a little more than eighty days
792
00:58:28.800 --> 00:58:32.079
to the November third election, let's all start getting fired
793
00:58:32.159 --> 00:58:35.440
up to go cast our vote. This is Paul Hoppey
794
00:58:35.519 --> 00:58:37.400
wishing you a wonderful rest of your day,