Congressman Eric Burlison told me he’d never heard anyone say “the medical cartel” out loud until he heard me say it at a podium.
(And that might just be the best summary of the entire problem right there.)
Burlison represents Missouri’s 7th District and hosts Fresh Freedom, which he started in his first year in Congress and has kept going into his second term. He spent a decade inside Cox Health before he ever ran for anything, so when he talks about what hospitals have become in Springfield, it’s cuz he knows.
Nate Lucas co-hosts.
Between the two of them they let me talk for twenty minutes about kickbacks, which is more runway than I usually get on the Hill.
Here is where we ended up.
The worst actors in American health care are the nonprofit hospitals. They wear the white hat in their communities, collect the tax exemption, and plunder the working class on the way out the door. On average they spend less than three percent of revenue on actual charity, maybe a little more if you count all uncompensated care (most of which they didn’t agree to in advance out of the goodness of their hearts).
If you still think they might be the good guys, remember that Providence hired McKinsey to help them hide their charity program from the poor people the ACA requires them to serve. They’re not just one of a few bad apples, trust me.
A hospital I’m trying to do surgery for a Catholic nun whose health plan I run just doubled the demand price for a knee replacement to $80K when we tried to negotiate down from their already outrageous $40K initial demand. If she doesn’t pay cash on the day of service, they won’t see her. She would qualify for Medicaid, but her plan WANTS to pay. They just don’t want to get raped.
But tell me again, El Camino Health in Santa Clara, CA, like every other whiney hospital I ever talk to, how you’re “barely surviving.”
Let me count the cranes.
The carriers and the PBMs (but I repeat myself) are running the same play from the other side. The entire value proposition of a network is that they can get you a lower price than you could get yourself. But the opposite is true almost everywhere.
And when cash beats the negotiated rate. I can’t remember anymore what the network is for.
On the podcast, Nate asked if I have PTSD from July 28, 2017. I do. We had bought off every vote we could find in the House and turned repeal and replace into something Frankensteinian we could barely defend, and then the Senate looked at it and knew the dog wouldn’t hunt. Several of them voted no.
I am glad it failed. It was a bad bill.
What we did do, surgically, in the tax bill the next year, was zero out the individual mandate penalty. That is the pattern. Republicans keep trying to do Obamacare but slightly less of it, and then they wonder why nobody is inspired.
They asked me for a thirty-second pitch to Republicans at the end. Here it is.
We’re going to lose if we don’t do something about the affordability crisis, and health care is the biggest piece of it. If we won’t help people with the number one thing that is life and death to them, we don’t deserve power. We should go home. Nobody needs us here.
Watch the whole thing below.