Why has medical care become so complicated—and expensive?
Why has medical care become so complicated—and expensive?
Dr. Murray Sabrin joins the program to answer that very question, as it is one of the underlying topics in his new book, Universal Medical Care from Conception to End of Life: The Case for A Single-Payer System.
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All right. And with that joining me here today on The Brian Nichols Show special guests for your folks. Dr. Marie Saverin. Welcome to the program. Thank you, Brian. It's great to be with you. It's great to have you Dr. Sabir, and we're gonna be talking about your brand new book today. I'm so excited is universal medical care from conception to end of life. Now, right off the bat when we were talking beforehand, your average person hears this and they go, Hmm, this sounds like an interesting topic for a libertarian leaning podcast. But Dr. sabourin, you did something very sneaky. And the way you you titled your book, because you're appealing now to an entirely different audience who's going to be getting at you, not what they bargained for. But before we get there, let's introduce you to The Brian Nichols Show. Who are you and what got you looking into health care policy, Val things?
Well, last year, I retired after a 35 year career as a professor of finance in the NFL School of Business at Ramapo college. And before that, I worked at the American Institute for Economic Research for a bit and work in commercial real estate in northern New Jersey. So I have a background in finance, even though my PhD is in economic geography, on the geographic aspects of inflation. Murray rothbard, was an outside member of my dissertation committee, while I was studying at Rutgers. And I'm only one of two people in the history of the world who's had Rothbart as a member of a dissertation committee. So I started my career as a New York public school teacher. And I wrote in 1995, the book was published tax free 2000 how to create a tax free world that would put responsibility on people to generate their income and spend it as they see fit. And have the government take a minimalist role of either a law, the Constitution, but without taxation, in other words, have a have an association of individuals and the government that based upon fees and other things, or just privatized everything that would be another option, in other words, a totally non governmental approach to to a functioning society. And then two years ago, my book on the Federal Reserve was published why the Federal Reserve sucks, it causes inflation, recession, bubbles and enriches the 1%. And of course, we've seen that happen since the Federal Reserve was created in 1913. And so this book is my third book, I have another book coming out next month, called navigating the boom bust cycle and entrepreneur Survival Guide. And then I'm beginning to write my next book that will be published next year, and that's on medical insurance in the workplace. So since I retired, a little over a year ago, I've written two books, starting my third book, and hopefully the this book, particularly on medical care will have an impact. Because it is the 800 pound gorilla in the room, medical costs take up nearly 20% of the American people's income. And of course, the way it's structured today, it's a hybrid system of taxpayer funded programs like Medicare and Medicaid, third party payers paid by the employers to work with insurance companies. And one of the themes of the book is that were over insured, were not well, we don't have good nutrition, and therefore it's causing all these problems in medical care. And what I do in the book is something I don't think anyone else has done, I differentiate, differentiate healthcare from medical care. Health care is the responsibility of that person you look at in the mirror every morning, you are responsible for your health care, not the President, whoever that may be not the governor of your state, not the mayor, not Dr. Fauci, not the head of the CDC, you are responsible for your health care. And I learned that lesson A long time ago. So I've been doing what makes I think for a healthy life, eating right getting exercise, taking the proper supplements, hydrating, and, and having, hopefully good genes that will give me a long life. Both my parents made it their late 80s. And they didn't have the greatest nutrition. They barely survived World War Two in their native Poland. So given what I learned about nutrition and healthcare and medicine, why is a finance Professor writing a book? Well, ultimately, it comes down to who pays for medical care, and why people think medical care is a right is beyond me since I became a US citizen in 1959. I raised my right hand to defend the constitution and I couldn't find anything in the constitution then or since then, that the federal government is responsible for our medical costs. There's nothing in the constitution that authorizes the federal government to be involved in one of the most personal intimate relationships we have the doctor patient relationship.
Well, I think we're we're recording here today on Thursday, and this is episodes airing tomorrow being Friday. So everybody just heard how in depth Joe Biden really wants to be with your personal medical decisions, but
we'll we'll talk about that later.
But going back to something you discussed, and I was writing down some notes here, um, the idea that We are over insured. And under nutrition that's so profound. And I actually I tweeted this morning, so I went back and re listen to your appearance over on Tom woods. And you had said that as well, the health care versus medical care, I started out, back when I graduated from college, I got into PR and marketing for physical therapy and fitness facilities. And you do see that there is that very fine line of people who they look for just the medical answer, versus taking all those preventative steps and that proactive approach to trying to take care of yourself. And we see this abdication almost a personal responsibility to not just other people, but to this nanny state government. And now for your person who's listening to the program. And they first heard universal medical care what now they're starting to see it's coming together, this isn't a top down approach to medical care, but rather, we're gonna go ahead and remove the top of this entire entity and start focusing bottom up the patient doctor relationship. So Dr. Sabir, let's dig into that. To start off, I know that's one of the the overlying themes of your book is going back to this relationship with the actual doctor, not this faceless organization that you get assigned a doctor and they see you once a year and then patch in the back end. Have you on your way?
Yeah, well, this is I think, the sad reality of the evolution of medical care since when I was a youngster back in the 1950s. And when my parents took me to a doctor, and I think my first visit to a doctor, I believe was in 1955. Why do I remember in 1955, because that summer, I broke my arm in the Catskill Mountains when we're on vacation for the summer. And I came back in a cast. And no, I in fact, the cast was taken off before I came back to New York City. And I visited the my family's pediatrician, my younger brother was seeing him and so I went to see the doctor, and it was $5 for the visit. And then it went up to $7. And then $10, because of inflation, and so on, so forth. But the point is, that was direct payment, there's no insurance for my parents to pay for doctor's visits. And if we needed an antibiotic, we went to the local pharmacy, and we paid a few dollars for an antibiotic prescription. So there was no insurance for that. My father had a major operation in 1961, when I was graduating junior high school. And I recall a Blue Cross Blue Shield took care of the bills, I remember my parents saying this is going to break their, their bank, so to speak their savings for this operation. And from what I recall, it was a fairly modestly priced operation, and one of the top hospitals in Manhattan. And so that's my framework of what medicine was all about. And then that fateful day on July 30 1965, when President Johnson signed into law of Medicare and Medicaid, and ever since then, medical care has been distorted the with HMOs, Health Maintenance Organizations. And the way I look at medical care, it should be a four legged stool. One is direct primary care, which is growing across the country where doctors have a fairly low number of patients, the typical doctor in a typical partnership or a corporate physician, physician setting usually has about 2000 patients in direct primary care, they usually have between 800 and 1000. So they can give you more time and in the office to diagnose your problem and to recommend the course of treatment. And you have access to the doctor virtually 24 seven, you pay a monthly fee. It's very modest. And there are no there's no insurance involved, you pay that. So that will be the first aspect of everyone getting a direct primary care physician. And if you can't afford that, then you have stores like CVS and Walmart and I think Walgreens are establishing clinics in their, in their stores all across the country. So there are 1000s of 1000s of stores that can provide primary care to people who don't have the ability to pay for that 80 to $100 a month per person, or 150 $200 per family, which is pretty modest. When you think about all the benefits that you're getting. Plus they do provide testing at a very modest cost. Also you can pay out of pocket. So you don't need insurance for that. Then for people who don't have any means, in other words, people who are Medicaid today the which cost the taxpayers $600 billion a year, how do we get rid of that $600 billion price tag for Medicaid. And that is what I've been involved in in northern New Jersey when I lived there. What now in Southwest Florida is the volunteers and medicine model where medical professionals get together, open up a facility rely on voluntary contributions and provide medical care at no cost to two people in the community who can't afford it. This was started in Hilton Head South Carolina in the mid 1990s. By that the jack McConnell and he passed away a couple of years ago and they're thriving all across the country. So we have That model for low income folks who really can't afford direct primary care. And so you have that model for helping people who are on Medicaid today, what would be the next thing, I would say we have to have the super health savings accounts where you put money in tax free, they grow tax free, you take it out of tax free to pay for the big expenses. And that could also pay for catastrophic insurance policies. So you have all the infrastructure in place, all we need is a transition, including Medicare, transitioning people out of Medicare, especially wealthy people who can afford to buy their own policies without subsidies by working folks. And young people can start putting money away in a super h health savings account that we part of their retirement package. So when they do retire, they do have the funds to purchase any type of medical care they need, including long term care, they have policies for that as well. So it's all about cash payment. It's all about using insurance sparingly for the big ticket items such as a heart operation or long term cancer treatment. But in a free market, those prices would come down. And the best example this is a story I heard at the free market Medical Association conference last month in Texas, when I was speaking to a corporate executive whose company decided to do direct payment, and they got a truck to come to their company parking lot to do MRIs, and the charge was $400 per MRI. That same truck went down the street to the hospital, and the hospital was charging $6,000 for the same MRI. This shows you how overcharged that medical care is in the United States. And the co founder of the free market Medical Association, Dr. Keith Smith, he has a surgery center of Oklahoma, there are cash only
operation, and they provide us quality medical care at a fraction of the price of local hospitals. I'll give you an example. One of the doctors I interviewed for my book on universal medical care is a direct primary care physician in Fort Myers, Florida. I call the rep we had a lengthy conversation. And she told me about a patient who didn't have insurance, he needed an operation to local hospital quoted him I think a price of $20,000. She got him in touch with the surgery center of Oklahoma, he called them up and the whole operation including transportation and staying in Oklahoma, and Oklahoma for the operation was $5,000, which he paid out of pocket. So it shows you. So it shows you the free market drives down prices for consumers and provides quality care. And that's just one example of what's happening across this country where doctors and company I'm sorry, doctors and patients and companies are using the free market to deliver quality care at a fraction of the price that insurance companies are paying hospitals and doctors for through the current traditional third party payer system.
That's just astonishing to hear that number cuz that's just, you can't even think to like just have that that bill come in. Just Just because and this goes back to I think another part of your book that you raise up is we have this weird relationship between our employer and our medical insurance. Now, it's entirely on purpose. But we see that too often. That becomes now the way that a lot of people perceive what the problem with health care is. It's not a matter of these costs. But you know, it's just Well, I don't have the right job, I need to get a better job with better health insurance. But to your point, it's the fact that the health insurance is so over insured that's actually causing a lot of these problems to begin with.
Well, this is this is the sad situation. We know that this the linking of medical insurance with the work started big time during World War Two, when companies were prevented from raising wages because of wage price controls. So what they offered is a non tax benefit called medical insurance. And so that began the linkage of medical insurance with the workplace. No other insurance is linked to the workplace. We don't get auto insurance for the workplace. We don't get property casualty homeowners insurance, life insurance to the workplace. That's all done in the private market. And it works very effectively and efficiently. No one's complaining about the lack of insurance in those areas. And so we need to go back to that model where we only need insurance for catastrophic losses. And we pay out of out of pocket, which we reduced the cost of insurance dramatically. I mean for family for the the typical policy, I think is $20,000. And that is a lot of money, especially if you're a healthy family, you're not getting any benefit from that. So wouldn't be better to let's say pay $5,000 per catastrophic policy and pocket the 50,000 put in a health savings account, have it grow and use that money over time to pay your bills. And now you have a direct relationship with a doctor in terms of buyer and seller. In other words, using the approach that we use for other goods and services, healthcare is no more right than then then cell phone services are right. medical care is something that you contract somebody a professional with, in order to achieve a goal, which is better health, optimal health. And so there's no reason to have insurance pay for that. And the other point that needs to be stressed is given that we now have the ability to see prices transparently, the internet should allow every doctor, every surgeon every hospital, to post their prices, without the nonsense of so called posted prices, and that's not the real price have real prices posted. So people can know what they will be charged when they go to a doctor, or they need a procedure or they go into the hospital. And that would drive down prices. Probably 30 4050 60%, who knows, let the market decide what the price will be for all the services that people want. And people have to determine what are they what are the services valued at because right now, people don't care what what the price is because they're not paying for it out of pocket, except for a copay. 15 $20 wherever it is. But it's a sad situation that where this is the only area that I know, in the economy, where people have no idea what the prices of the service that they're getting,
it's insane, because I know, whenever I'm talking to friends, one of the first things they are looking for when they're going to a new place of business, is the health insurance, they're not even concerned about, you know, do they have access to like a gym, right or, or something like that, or, you know, let's, let's turn the conversation towards this personal responsibility, because I think this is where we are lacking wholeheartedly. Because your average person has a that's my point from earlier really abdicated any sense of personal responsibility, they just want to be told what to do and want to really have those big decisions in their life taken care of. But we really need to go back to fostering this approach of empowering people to be the best versions of themselves. And that includes the best physical version of yourself. I mean, Dr. Saber, I used to weigh 395 pounds, and I witness I was a big boy. And I lost around 180 pounds over the span of about two years, through just diet and exercise. But I did so because back when I in at the time, I was around 17 or so. And I had a pediatrician who was a family doctor. And and she just looked me straight in the eyes and said, Brian, after 10 plus years of being your doctor, I need to tell you that if you don't lose weight, you're putting yourself on a very self destructive path. And and that hit me personally, because number one, it was my home doctor who I knew. And I've seen them for a decade at that point. So I knew that she was saying this out of the kindness of she genuinely cared. But number two, all of a sudden, now it put the onus on me it's not, you know, okay, well, when the time comes that something bad happens that well, do I have money to help cover for this, but what can I do to help prevent this? And I think that's where we need to help change the conversation, we had to get people thinking that way. And I think part of it is leading by example showing that yes, you can do it. And then to show the other alternatives that are out there besides the the traditional insurance way that we've had things.
This is why I wrote the book, because we're what I see happening in America is we're going down a road, where the obesity levels are going through the roof, the diabetes of incidence of diabetes is going through the roof, heart disease is increasing dramatically. The cancer rates I think, are in pretty good shape. If I remember correctly, the data that I saw recently, but the point is, as the population ages, the baby boomers, my generation, if you're not in good shape, where the time you retire, you're going to be on meds and seeing doctors for most of your retirement. And when I the last years of my parents life, I went to visit them and one of their kitchen cabinets looked like a mini pharmacy. And that's the time I wish I had gone to medical school instead of graduate school because I would try to figure out what are all these medications doing to them. And, and again, it's a sad situation where doctors are prescribing medication if the medication if the medication and we don't know if they know exactly what's going on if you're going to see two three doctors for different ailments. And so this is and that's why the pharmacist is so important to let people know what the possible interactions are. But the point is, if you don't let me give an example, we just moved to Southwest Florida and finally got ahold of a general practitioner and my wife and I visited him last week. And he was amazed that since we're both 74 My wife is on some very minor medication and I have one medication, that I don't consider medication because it's official and So he was surprised that we're in such good shape for our age, because I'm sure he sees patients our age who have probably on several medications, and have trouble walking have trouble This was in trouble that. And so the point is, like an investment invests fruit over the long term, if you take care of yourself over the long term, you're going to be in good shape, when it comes to your senior years. And that's one goal I had, when I was growing up is that I want to be healthy in my senior year is because if you have to go to the doctor constantly, when in when you're in retirement, that means you really didn't do the right thing during your adult life in terms of eating right and getting exercise and, and taking the proper supplements. So again, this comes down to personal responsibility. And unfortunately, given our collective status, culture, people think that it's then it's not their responsibility to stay healthy, it's the doctor's responsibility to give them a pill to take care of whatever ailment they have. And that I think, is a big mistake that a lot of people have made. Because, again, when you walk around the malls when you walk around any park or something, it's amazing how many young people are overweight, and how many people in their middle years are 50 100 pounds or more overweight, and they can barely walk. And so this is what's driving up medical costs, because they need a lot of medical attention in order to deal with their ailments. And so, because of insurance, that those costs are spread across the communities, so they don't feel the brunt of the consequences of their own actions in terms of behaviors, that led them to not have a healthy lifestyle. So again, this is not to criticize anybody, but the point that the reality of living, that if you don't take care of your body, and you're the person that's responsible for taking care of your body, and I applaud you, Brian, for taking care of your body to make sure that it's in good shape. Because the projections of i 2030, which is not that far away, I think, well, over 50% of the American adults will be obese. And that has huge implications for medical costs down the future for Medicare and Medicaid. And so and of course, insurance costs. So we have to do something about changing the culture of the country where people take responsibility for their own well being.
And I mean, don't even get me started on the mental health aspect, cuz I can speak to when I was a 385 pound guy, my mental health wasn't the best, because it's tough. I mean, yeah, it's a different world when you are that overweight. So there's an entire side section of like healthcare in the mental health aspect that, you know, we could even open up an entire separate episode. But as we kind of go towards, you know, the tail end of the conversation, let's look at the alternative. And this is this is the the challenge I think we have as the free market proponents is that we have to now come in, and essentially replace the incumbent vendor if we're going to go through that business word. So we have right now, Medicare, Medicaid, and everybody's favorite Obamacare. So what can we do
show that these solutions not only are a viable alternative, but to actually start getting some things in place to almost make these old solutions kind of die off on their own?
Yeah, I think the first thing that can be done is that everyone who is not on Medicare, can start putting away money in a health savings account. Given that we would need some change in legislation to make those contributions, tax deductible, have the funds grow tax free, and be having them taken out tax free. So I think we can start there. And that's why I'm trying to reach out to as many talk show hosts like yourself, and podcasters. So people would read the book and see the detail that I put into this book, in terms of what the transition would look like over the next 510 years. Because it could be done pretty rapidly. The point is you need people to buy into the solution. And that's the difficult part. That's why I wrote the book. Here is the reason a free market universal medical care system would be beneficial to the patient and the doctor, particularly the patient because the patient is the recipient of the service. And what do we know in business rule? There are two rules. One the customer's always right, and rule two see rule number one, that means doctors have to be sensitive to what their patients need and want in order to get to optimal health and they have to explain things to them. That's why I use traditional doctors and I've been the long term friend, longtime friend whose nature pet and I see him for advice. Also, I recently spoke to him about certain things that we want to address in our family and he was forthcoming and available. So There are ways of getting to where we want to be in terms of optimal health. I don't know anyone who doesn't want optimal health. How do you get there? And of course, a single payer government system is not the answer. One of the doctors I interviewed in the book is a former Canadian doctor, who believed in the single payer government system in Canada, then he when he started practicing it, and he said, this is not patient friendly, this is not patient oriented. It's all about meeting the budget of the of the provinces. And so he's now practicing in the United States as a radiologist. And he said the Canadian system nearly killed his brother. And, and so therefore, he is very skeptical of the Canadian system. And he applauded me for writing this book as a blueprint. Remember, blueprints are not the final, final say in a building, it has to be changed and adapted. So I think I've started a created a blueprint that we can at least discuss and debate in this country as to where we should be going in terms of medical care. Instead, the Biden administration is expanding Medicare is expanding Medicaid, which is the wrong approach. What that means is that people will be more dependent upon the government. And one of the themes of the book is financial independence, I don't know any adult who grows up and says I want to be financially dependent. But But the point is, we have a system where implicitly, people are financially dependent on Medicare, Medicaid, Social Security, which is a whole nother topic. But the point is, I've always stressed this in my writings for the past 40 years, we need to have a culture of financial independence. And we have the nonprofit sector to help people can't help themselves or don't have enough income. In the free market. That's the beauty of America, the volunteer sector is, is one of the largest sectors in our economy. And I want to see it thrive and flourish. And, and then chapter one in the book talks about the the welfare state and the nonprofit sector, I have a whole chapter on the nonprofit sector. So all the things are integral, interrelated. The nonprofit sector is a free market approach to helping people who are in situations where they don't have enough income to meet their needs. And that's been true throughout American history, that mutual aid societies before the Great Depression were thriving. And so I want to resurrect that culture, that value in America. And this book, I hope can do that. And that's why I want all libertarians to buy not only one book, but buy several copies, especially the Kindle edition, which generates a lot of royalties for me, which will be used to support free market, educational organizations like the Macy's Institute, and the ron paul Institute, and nonprofit health centers, and I support three of them in New Jersey. Now that we're in Florida, I hope to support some in Florida. So this book will give me hopefully, the resources to leverage the value and the ideals of a free market system into into medicine, a medicine that will make this country a much better country for it for the 330 million Americans who want to have good medical care at affordable prices.
So we have some action items, because I'm a sales guy and I got to put the action items down. They are number one, folks, if you're interested in learning more about hshs. I did an entire interview with Dean Clancy he was I think it was Bush, Reagan, I forget he was one of their top policy advisors, but he's also former VP of freedom works. He's leading HSS for all that's his big focus right now think is working with Rand Paul in the Senate. That's actually a number one action item. Number two, tell the stories of people who have faced socialized or universal health care from a single payer system tell their stories. And I appreciate you bring up your friend from Canada story because I think we need to tell more of those horror stories about what happens when you get what you want. And that is this single payer system. So that's number two. And then the final thing by the book by this freaking book, universal medical care from conception to end of life by Dr. Marie Saverin, it is I can't stress enough so important for us to make sure just like our friends over at the sound mind creative group who are doing their awesome docu series, follow the science on lockdowns in Liberty, It's on us to make sure that we're effectively and I would say, in many cases for the first time for people setting the narrative and showing them how we can do this, that you don't need to have nanny state government hold your hand in order to live a healthy life. But rather, if you just take a little bit more time to TLC, tender loving care yourself, and focus on making yourself a better person that you're gonna be in a better spot. So that being said Dr. Murray sabourin. With with that, folks, obviously, we want to make sure we can lead them to the book. I'll include the link to the book in the show notes, but where can folks go ahead and follow you they want keep up the conversation.
Well, what I'm going to be doing is I'm starting to work on my next book, I won't be writing as much as I otherwise would on my blog, Marie saverin.com. I'll be posting all the great interviews. I've had had one with Ron Paul last week that's on my LinkedIn, my blog. And I just hope that people realize that ever since I decided that libertarianism was the was the way to organize society back in the 1970s, I was hoping that there would be one libertarian books that would that would be a game changer for the country. I don't know if this is the one, but I'm hoping it is because with the royalties that the book can generate, I think we can leverage that to get our message out. So hundreds and hundreds of millions of Americans, which is over 300 million today will understand that freedom and liberty are our birthright, that medical care is something we should strive for in the free market. So we we the people determine what medical care should be and how much it should cost because ultimately, the consumer determines what the price is in a free market. People don't understand that. The politicians don't understand that most conventional economists don't understand it. And so by getting this book out into the general public, we can start a national conversation. One thing I'd love to do is debate. Bernie Sanders, single payer system, government, a single payer system, individual or family. That's the debate we should have in this country, not how much Medicare should expand how much Medicaid should expand, but whether we should have a single payer government system, which is what he wants, or a single payer, individual family system, which is what free loving people want to have, where we are in charge of not only our medical care but everything else in life, so that we do have the blessings of liberty. We do have prosperity, sustainable prosperity, and we can all live in social harmony instead of this backbiting that's going on today because of this, this contentious issue with COVID and the lockdowns and all the other things that's come about the cause of top down approach to medical care.
Well, you said you're hoping this might be the libertarian book why no one Dr. Ron Paul gave it his seal of approval. So I dare say you're on the right path if Dr. Paul thinks that this is in fact, the book. So with that being said, we will include all the links to not only the amazing universal medical care from conception to end of life in the shownotes but also all the links you can go ahead and follow all that Dr. Saban's gonna be doing but with that being said, Dr. Murray Saverin, thank you for joining us today in The Brian Nichols Show.
Thank you, Brian. This was a great opportunity and I really appreciate you giving me the time to explain how we can get from here to closer to a free market economy in the near future.
Transcribed by https://otter.ai
George Clemanaceau once remarked that "War is too important to be left to generals." By the same token, medical care is too important to be left to politicians, bureaucrats and insurance companies. Long-time finance professor Murray Sabrin makes an incontrovertible case for a free market universal medical care system in his new book, Universal Medical Care from Conception to End of Life. I urge all libertarians and limited government conservatives to read this book and help spread the message of medical freedom throughout the land. Our health--and very lives-may very well depend on embracing Murray's prescription for free market medical care.