A fake Youtube chef cut his hand in the kitchen…
this is what happened to his wallet.
KB is a 25… ish year old Youtuber, presenting
to the emergency room – which was a huge
financial mistake.
This video was brought to you by CuriosityStream.
My original plan for this video was to take
that scenario through multiple different healthcare
paths to show you all the options and costs.
I very quickly realized that wasn’t going
to work.
Even if I had done that, those numbers would
have been completely meaningless to you because
of how healthcare works in our country.
It’s not like ordering a Big Mac.
The numbers I would’ve given you would only
apply to other 25-ish year old men living
in [HARM TO ONGOING MATTER], it’s very unlikely
that it would be relevant to you.
So there’s really no point in digging up
those numbers.
Especially since the cost of a procedure not
only varies widely within the same city, but
sometimes on the same block.
A few stitches can cost anywhere from $200
to $3000.
I picked stitches because it’s pretty universal,
there is no gender, or race, or even class,
that is more prone to needing stitches.
I’ve personally needed stitches at least
five times that I can remember.
The obvious explanation for that wide range
is where on the body were you injured?
Stitches on your shin are going to be easier
and cheaper than stitches on your eye.
Except… no, some people pay less for eye
stitches.
And these price ranges exist across the board
for all procedures, if you walk into a medical
facility with a burst appendix, it’s going
to cost you anywhere from $1500 to $180,000.
I somehow doubt that one appendectomy could
be 120 times better than another.
Some cases are complicated and require extra
imaging or post-operative care, the point
is, you don’t know that beforehand.
When you get the bill, it could be anywhere
in this range.
So rather than just shouting numbers at you
and laughing about how ridiculous things can
cost, I want to explain why that range exists.
Many of you likely know parts of the answer
already.
The most obvious being that urgent care is
almost always cheaper than emergency care.
Both with and without insurance.
Urgent cares are a relatively new concept
in the US and provide a cheaper alternative
for non-life-threatening emergencies.
Like stitches.
Let me be clear, when in doubt, go to the
emergency room, you will never be turned away,
but if you walk into an urgent care with something
more serious, they might send you to the ER,
possibly delaying lifesaving treatment.
But odds are that if you only need four stitches,
it probably isn’t going to kill you any
time soon.
Emergency rooms cost so much more because
of the infrastructure and overhead required
to keep a large hospital running.
But also because of more nefarious reasons.
70% of hospitals in the United States are
privately operated but not run for profit,
which is surprising to most Americans.
Insurance companies, on the other hand, are
only run for profit.
So in order to attract more customers, insurance
companies have to offer better deals.
Which is somewhat difficult when a hospital
is non-for-profit.
Usually, if you’re not making a profit,
it means your prices are already as low as
they can be.
Enter the hospital chargemaster.
That’s not a chargemaster.
Pretend.
Every hospital in America has a list of prices
for every good and service they provide, which
until this year, was kept hidden from the
public.
Which is a huge problem in a capitalist system.
You can’t really make an informed economic
decision if there is no price transparency
or easy way to compare different costs.
Not that you would ever shop around during
an emergency anyway.
So the insurance companies went to the hospitals
– Side note, in some cases, the insurance
companies own the hospital outright, and while
the hospital is a non-profit… they aren’t.
– and said “hey, you’re currently charging
your customers $200 for this service, why
don’t you increase your chargemaster price
to $250, but still only charge our customers
$200, that way we can tell them we’re getting
them a discount.”
This should sound familiar to anyone who has
ever shopped on Black Friday.
Repeat that for every procedure or medication,
nationwide, and you have the first piece of
the puzzle.
When figuring out the cost of healthcare in
the US, you have to look at multiple variables,
we’ll add to this list as we go, but we
can start with the base cost.
The price of materials, labor, facilities,
and sometimes including those blue light chargemaster
rollbacks.
As we’ve seen, this base cost can range
from three to six digits depending on where
you go.
Which is the second variable – location.
Not only are we talking about state or city,
but street.
Add in provider type – are you going to
an emergency room, urgent care, or just your
doctor – and you have even more variation.
Since we’re only five minutes in, you probably
figured out that this list isn’t even close
to complete.
An unfortunate reality of our system is that
it also matters who you are.
The Affordable Care Act made it illegal for
hospitals and insurance companies to charge
you differently based on your previous medical
history, but they can still charge you differently
for basically any other reason – including
gender and perhaps most obviously, your age.
For example, stitches on an infant are objectively
more difficult and therefore more expensive.
Bet that wasn’t the direction you expected
me to take the ageism argument.
Procedures aside, age is one of the biggest
factors that contribute to the cost of health
insurance.
Alright non-Americans, get your laughs out
of the way now.
[Laughs in Foreigner] Health insurance started
as a sort of membership program, known as
Health Assurance, you paid a fixed amount
every month and any medical costs you incur
were on them.
Your health was assured.
It didn’t take them very long to figure
out the formula for success.
Obvious abuses aside, that simple just model
wasn’t sustainable.
So over time, they have shifted more of the
cost of actually using medical services onto
the consumer, called it Insurance, and made
the system so complicated that most Americans
don’t even bother trying to understand it.
Lucky for you…
I’m not doing anything, I’ve got time.
The health insurance industry didn’t really
take off until World War 2, along with rationing
fuel and rubber, prices and wages were also
fixed by the government.
So companies had to get creative to attract
talent.
The most popular way was to offer benefits
on top of your salary, like paid vacation,
housing, or health insurance.
Today, 60% of Americans get their health insurance
through their employer.
This is thanks, in part to ObamaCare, officially
known as the Affordable Care Act or ACA, which
made it so that any company with at least
50 employees has to offer health insurance.
Though “offer” is a bit of a loose term.
Which is yet another factor – how much your
employer offers to contribute.
Your insurance premium might be $500 a month,
but your employer might only pay half of it…
or none of it.
In order to discuss how insurance actually
works, let’s take a look at something a
little more simple – car insurance.
In most states, if you own a car, you are
also required to have car insurance.
The more people who are paying into insurance,
the lower the cost for everyone – most people
accept this reality when it comes to car insurance.
But not health insurance, for some reason.
The Affordable Care Act did a lot of good
things, like mostly getting rid of pre-existing
conditions, allowing you to remain on your
parents’ insurance until you’re 26, and
a bunch of other stuff we’ll get to later.
But it also required everyone to have health
insurance, through the Individual Mandate.
The hope being that the more people who have
insurance, the cheaper it will be for everyone,
just like car insurance.
But the mandate was just repealed so, never
mind, I guess.
Everyone with insurance pays a premium, this
is like your membership fee and you pay this
regardless of whether or not you actually
use it.
If your premium is $100 a month and you never
get into an accident, that $1200 a year is
simply gone.
Because of this, a lot of people think of
insurance as a bit of a scam – If I didn’t
use it, I should get it back or something.
This is what I’m going to call Stage Zero
– you pay your premiums, you don’t use
it, and nothing happens.
Rinse and repeat, every year.
There are two tiers of car insurance, the
lowest being Liability, which only pays out
if you are at fault in an accident, and Comprehensive,
which pays for any damage to your vehicle,
whether it be a collision or an act of god.
But once you actually have an accident, you
enter Stage One, when you pay all costs out
of pocket until you reach your deductible.
This is the amount you have to pay before
your insurance will contribute.
For many car insurance plans, the deductible
is also your maximum out of pocket – or
MOOP.
Who the hell is Moop?
It’s the most you will pay to fix your car
in a given year.
After which, you enter Stage Two, when your
insurance pays all remaining costs.
Sometimes, there is a maximum annual or lifetime
benefit, after which you would be on the hook
for any remaining costs, but that’s fairly
rare.
So if you get into an accident that costs
$15,000, you would only pay up to your deductible,
say five hundred dollars, and your insurance
company would cover the rest.
Congratulations, having car insurance probably
saved you thousands of dollars.
But when it comes to health insurance, most
people only focus on the cost, if they never
go to the doctor they’re just throwing away
money every month.
This is important, so pay attention.
Not having insurance is only cheaper, if you
know that healthcare costs without insurance
will be less than your annual premium and
your deductible put together.
Remember, without insurance, you will be paying
regular chargemaster prices.
Some hospitals might be willing to work with
you and give you the “discount” price
if you’re uninsured, but you can never count
on that.
For our car insurance example, that tipping
point would be $1700.
If you know that your car repair costs are
going to be less than $1700, it’s cheaper
to just go without insurance.
But you literally can’t know that.
You can’t predict if some if some random
tire is going to hit you.
Just as you can’t predict if you’re going
to cut yourself or your appendix is going
to burst.
So let’s say you’re playing it safe, you
have health insurance, and something unpredictable
happens…
Just like car insurance, you started in Stage
Zero.
You’ve been paying your premiums and have
been relatively healthy until now.
You go to the hospital and you enter Stage
One, you are paying everything out of pocket
up to your deductible, so far everything is
pretty simple.
But Stage Two is where things become a bit
more complicated – this is when you and
the insurance company split the costs of your
care, through two mechanisms.
A copay is a flat fee, like $25 every time
you go to the doctor.
That’s just to walk in the door, by the
way, if they do anything more than that, it
costs extra.
Usually through coinsurance, which is a percentage
rather than a flat fee, so for example, 20%
of all outpatient procedures.
Only copays and coinsurance count towards
your MOOP, premiums, prescriptions, and out
of network costs, do not.
Once you hit your maximum, you enter Stage
Three – when your insurance company covers
all remaining costs.
The Affordable Care Act prohibits any maximum
annual benefit or lifetime limits for health
insurance, though they can still exist for
dental and other insurance types.
So Stage Three has no maximum dollar amount,
but your MOOP is annual limit that resets
each year.
This is the next variable we’re going to
add to our list – When the healthcare cost
occurs.
If your appendix bursts with only one month
left to go in the year and you hit your maximum
out of pocket, if you still need continuing
care the next month – which is also technically
the next year – you will have to pay your
maximum out of pocket again.
Effectively doubling the cost of this single
event even with insurance.
There are many different types of health insurance
programs, all of which cost different amounts
based on what kind of care you want.
Or more likely, what your employer chose for
you.
The cheapest type is an HMO or Health Maintenance
Organization which operates through smaller
networks of providers.
Another very important term and concept.
Doctors and hospitals sign agreements with
insurance companies to be part of their network
and see their patients, sometimes at a reduced
rate, as I mentioned earlier.
If you’re on that insurance, you can only
see those doctors and hospitals.
If the doctor or the insurance company decide
they don’t want to work together anymore
– you don’t get a say.
If you like your doctor, or health plan, you
can keep your doctor.
He couldn’t legally mandate that your doctor
and insurance company continue to work together
forever – this is America.
So now your doctor is out-of-network.
If you see an out-of-network doctor, you will
very likely be on the hook for the entire,
non-discounted bill.
And you might not know it until afterwards.
It’s not uncommon to go to an in-network
hospital and be seen by a prohibitively expensive
out-of-network specialist at that hospital.
HMOs typically have lower premiums up front,
but higher out of pocket expenses later.
Everything is routed through your Primary
Care Provider, they make decisions about your
health and you can’t see a specialist without
a referral or pre-authorization from your
insurance company.
That doctor acts as a gatekeeper for your
healthcare… which would make the insurance
company the keymaster?
The other end of the spectrum is a PPO or
Preferred Provider Organization, where you
don’t have a primary care provider deciding
on what specialists you see or what care you
receive.
The premiums are higher but the out of pocket
expenses are lower.
They typically have a larger network than
HMOs and out of network care is significantly
cheaper, you don’t need a referral or pre-authorization.
So it costs more to have more control and
more choice in your healthcare.
That’s how capitalism works right?
More choices and competition leads to higher-
wait…
And then you have all sorts of programs in
between.
Like the Exclusive Provider or EPO, which
is similar to a PPO, but out of network costs
more and you might need pre-authorization
to see a specialist.
Then there’s Point of Service, which is
like an HMO but out of network costs less
and nobody abbreviates it.
It’s a mess and even the definitions I just
gave you vary from company to company and
state to state.
But in general, those are your options, yet
another variable to add to the list.
But wouldn’t it be great if we could just
cut out the middleman and pay for our own
health care?
Yeah, or you could- Shut up this is America.
Some people have the option of getting a High
Deductible Health Plan or HDHP, which have
extremely low premiums and extremely high
out of pocket costs.
But it unlocks the ability to create a Health
Savings Account.
An HSA is very similar to an IRA retirement
account, any money you pay into it is tax
free and as long as you only use it to pay
for your insane healthcare costs, it doesn’t
get taxed on the back end either.
But wait, it gets better.
Just like an IRA, you can invest your HSA
money, growing it potentially infinitely…
which you also don’t have to pay taxes on.
This is why they call them triple tax shelters.
If you’re like me, you’re already googling
how you can open one of these up, and I’ve
got some bad news for you.
You can only open an HSA if you have an HDHP.
If you’re on any other form of health insurance,
or even no insurance, this option is not available
to you.
And unless you’re perfectly healthy, that’s
probably a good thing.
The astute amongst you will have noticed that
I haven’t given you any numbers for these
programs… and there’s a reason for that.
Not all HMOs and PPOs are created equal.
Another good thing the Affordable Care Act
did was to establish a standardized tier system
for health insurance, so people looking on
the marketplace can actually price compare
and shop around.
The absolute lowest level is called Catastrophic
insurance, these are typically your HDHPs,
gamblers who are saving up their money and
hoping they never get sick or end up in a
car accident.
That’s about the only thing these plans
cover – emergency services.
In America, all health insurance plans, regardless
of type or tier, cover emergency services
in- or out-of-network.
Though once you’re stable you better leave
that out-of-network hospital or the bill will
give you a heart attack.
Which just repeats the cycle.
Catastrophic plans are like only having liability
insurance on your car, it really only helps
you in the worst of situations, otherwise
you’re on your own.
You also have to be under 30 to get it, which
means it doesn’t apply to me anymore so-
I mean, it does apply to me for the next five
years.
The four main tiers of the Affordable Care
Act are bronze, silver, gold, and platinum.
The better the metal, the more you pay in
monthly premiums, but also, the lower your
out of pocket costs when you actually receive
care.
The ACA defines these tiers by the average
coinsurance for the plan, they call this the
actuarial value.
For Bronze, the actuarial value is 60%, they
pay an average of 60%, and you pay 40% in
coinsurance.
In Platinum, you pay 10% and they pay 90%.
Again, this is the average, for some services
it might be 92% while others might be 85%.
At the end of the year you might find that
you actually paid 11%.
The actuarial value is the only definition
for the tiers – premiums, deductibles, and
MOOPs can be all over the place.
There’s really no way for me to compare
a Platinum HMO to a Silver PPO or a Bronze
POS.
Making this another determining factor in
your overall healthcare costs.
But for the sake of an example, let’s just
pick one: gold.
The average monthly premium for a gold-tier
plan is $597 a month for an individual and
$1252 for a family.
The beauty of family plans is that it usually
costs the same whether its two people or seven.
If you’re getting a gold plan through your
employer, they might be paying for some of
it.
If you got it through the health insurance
marketplace, healthcare.gov, you might be
getting subsidies to help.
But for our purposes we’re just going to
stick to the base cost.
So, let’s say you need those $3000 stitches.
An individual gold-plan deductible can range
from $1000 to $5000, but the average is $1320.
Remember, you pay that much before insurance
even kicks in.
The remaining cost is shared between you and
the insurance company at a 20-80 split, only
costing you an additional $336.
The average individual gold plan MOOP is $5878,
so we’re not even coming close to stage
three.
In the end, those $3000 stitches cost only
$1656, just over half, wow, it’s a good
thing you had insurance…
You forgot ab-
Son of- yeah, as most people do, I forgot
about the premiums.
On top of the stitches, you paid $7164 in
premiums, bringing your total health care
costs for the year to $8820.
Here’s the same scenario for the average
gold family plan.
As I’ve said, it’s impossible to know
whether an uninsured person with the same
$3000 injury would fair better financially…
But it is possible.
And while the person writing the $1600 check
while paying monthly premiums is going to
feel a lot more financially secure than the
person cutting $3000...
The economic realities of healthcare costs
in America don’t care about your feelings.
Now, I picked gold as an example because it
has an actuarial value of 80%.
Which is the exact same as Medicare.
Medicare is a socialized health insurance
program that covers 59.9 million Americans,
most of which are over the age of 65.
It is the largest single provider of health
insurance in America.
I briefly covered Medicare and how it’s
funded in my video on welfare, along with
another program for poor people called Medicaid.
Medicaid is run at the state-level.
So while it covers 74 million people, they’re
spread across 54 different state and territory
programs that all set their own requirements
and pay outs.
A single person in Alabama must make less
than $771 a month to qualify for Medicaid.
The average panhandler makes $25 a day begging
for money on the corner – if they’re out
there every day this month...
Maybe take Halloween off, is all I’m trying
to say.
Medicaid benefits depend on your income level,
at the lowest you’re paying single digit
copays and at the highest, 20% coinsurance.
Just like Medicare.
But while Medicaid is a complicated welfare
program, Medicare is not.
It’s government-subsidized health insurance.
Every American who works pays into it with
a 1.45% FICA tax, which is also matched by
your employer.
If you contribute for ten years, you get full
Medicare when you turn 65.
Medicare is not free, it’s also not simple
– but since it currently covers 20% of all
Americans and presumably will cover all of
us once we’re old enough, it’s worth looking
into.
I need to start by saying that this is just
an overview.
Most of my audience is several decades away
from Medicare, so if you’re currently in
the process of enrolling, please speak to
a professional, this is just an introduction.
There are entire channels dedicated to explaining
Medicare – we’re just going to scratch
the surface.
Medicare has four parts.
Part A is for inpatient services like overnight
stays at a hospital.
For the vast majority of people, there are
no premiums for Part A. But there is a $1364
deductible and a complicated copay and coinsurance
table.
Medicare Part B is for outpatient services
like regular doctor visits.
This does have a monthly premium for most
people, but before I tell you what it is,
remember that you’re getting an actuarial
value of 80%.
$135.50 a month – regardless of who you
are.
But we’ve learned that low premiums usually
equate to a high deductible so- $185 deductible.
So because stitches are usually an outpatient
procedure, we can figure out that those $3000
stitches would cost you $748 out of pocket.
And $2374 a year in total expenses.
There are no family plans in Medicare, it’s
just for the individual retiree, and these
are by far the cheapest stitches we’ve come
across so far.
But there is a catch.
Medicare Part A and Part B, collectively referred
to as Original Medicare, have no maximum out
of pocket limit.
You pay the same 20% coinsurance to infinity
and beyond.
Which is why we need to talk about Medicare
Supplement Plans, also known as Medigap plans.
These add a MOOP, as well as reducing your
coinsurance.
This is an addon run by a private insurance
company that doesn’t get to decide what
or how much they cover, that’s dictated
by Medicare.
They do get to decide what to charge you though.
Alternatively, you can scrap Original Medicare
altogether and opt for Part C – better known
as Medicare Advantage.
This is a private insurance plan that takes
the place of Parts A and B (and sometimes
D) and acts as its own supplement, so you
get a MOOP.
You pay your premiums to them, rather than
Medicare.
Now the insurance company gets to make decisions
about your healthcare, instead of the government.
And it is required to give you that same 80%
actuarial value… in theory.
In practice, the HHS Inspector General recently
found that 56% of people on Medicare Advantage
were denied necessary treatment simply for
monetary gain.
I know, right?
I was just as shocked as you.
About 36% of people eligible for Medicare
opt for Medicare Advantage, so when you hear
someone complaining about Medicare…
There’s a decent chance they’re not actually
on Medicare.
And I’ll give you one guess as to which
Part ends up with the most waste, fraud, and
abuse…
It’s actually Part D, which is your optional
prescription drug coverage – but before
you get mad at me for the bait and switch,
both C and D are run by private insurance
companies.
I’m not kidding, Part C and D waste, fraud,
and abuse is rampant, you can find the powerpoint
presentations from HHS online.
The problem is that when the news tells you
about Medicare waste, they usually leave out
which Parts are causing that.
And when they talk about healthcare statistics,
they neglect to mention that a third of the
people are actually on private insurance.
The 59.9 million number I cited earlier is
Original Medicare and Medicare Advantage put
together.
There are 44 million people on just Original
Medicare.
And 90% of them don’t use Medicare exclusively,
they get a Medigap supplement plan or a Part
D Prescription plan, or both.
Prescriptions aren’t usually covered by
health insurance.
Even in countries with universal socialized
medicine, dental, vision, and prescriptions
are usually separate.
And prescriptions drugs are even more of a
mess than healthcare.
Each Part D plan has a list of prescriptions
they cover called a Formulary, you’ll need
to look over that list when choosing your
plan.
I hope you accurately predicted what medicines
you’ll need in the future.
Americans pay the absolute highest prices
in the world for medications, sometimes by
an order of magnitude, and the main reason
is somewhat counterintuitive.
The UK has a single payer system known as
the National Health Service or NHS, every
British citizen is covered for almost no out
of pocket cost.
A total of 66 million people.
The government negotiates prices with drug
companies, knowing that they will be the only
supplier of that medication to 66 million
people.
So they get a pretty good deal.
There is no equivalent in the US, the government
doesn’t negotiate or even really regulate
prices – the best we have is Medicare with
44 million people.
And there’s a reason they pay the least.
Counter to the common capitalist perception
that competition and choice drive down prices
– at least when it comes to healthcare – market
share seems to have much more influence.
The more people you are negotiating on behalf
of, the lower your prices.
But also, it costs a lot of money to develop
treatments and medications, so most companies
want to make the largest return on investment
as they can.
But when you’re selling to the UK and Germany
for such low prices, where are you going to
make your money?
The country that isn’t negotiating on behalf
of 320 million people and has little to no
regulation regarding price ceilings.
Why do they charge so much?
Because they can.
The common argument against adopting a system
like the UK is that they are incredibly overtaxed.
So let’s get our calculators back out and
check.
The median household income in the United
States is $59,039, assuming just the standard
deductions for a single person, you would
be paying $10,804 in federal taxes – both
income and FICA.
I have a video all about income taxes if you
want to know the actual math behind that.
If you took that same income and went to the
UK, after converting to pounds and then back
again, you are paying $14,451 in national
taxes.
This includes your income tax and the National
Insurance tax, which is like our Medicare
tax but, significantly larger.
Side by side, if you make the median household
income in the US, you are paying 18.3% in
federal taxes, if you took that to the UK,
you’d be paying 24.5%... but remember, healthcare
is included.
If you want healthcare in the US, the average
annual employer-based premium across all types
and levels for an individual is $6896 a year.
So in reality, you’re paying 30% of your
income in taxes and health insurance – and
that’s not even considering what happens
if you actually get sick.
In the interest of being thorough, if you
double the median income to $118,078 and were
married with two kids – you would be paying
significantly more taxes in the UK.
However, your healthcare expenses don’t
really change, whereas the average employer-based
health insurance premium for a family is over
triple that of an individual.
So a US family is still paying more in taxes
and healthcare – even if they never go to
the doctor.
The UK does have a Value-Added Tax, or VAT,
of 20%.
But their cost of living is about 7% lower,
so once you consider sales tax in the US,
prices are pretty comparable.
A Samsung Galaxy S10 costs about $15 more
in London than New York.
And a Big Mac is a dollar fifty cheaper.
The quality of these products are pretty much
the same wherever you go, but for some reason,
we insist that US healthcare is the exception.
That has to be the last variable on our list,
American stitches are just inherently better
than UK stitches.
No, most people already know this, but the
UK, Canada, Australia, and most other industrialized
countries beat us in just about every healthcare
metric.
Life expectancy, infant mortality, maternal
mortality, the list goes on.
But generally, these numbers are close enough
that you can say that the US is basically
on par with everyone else.
But per capita, we’re paying double what
they are.
Objectively, the UK does have longer wait
times, from a few more minutes in the ER to
a week or two for a specialist.
But I want to challenge your assumptions here.
If waiting a little longer drastically reduces
cost, but doesn’t negatively impact healthcare
outcomes…
How important is it to be seen right now?
Can you zoom in and say the US is better in
a specific field like heart transplants or
post-op complications?
Sure, but overall, we’re not getting what
we’re paying for.
Which is why we’ve been arguing about how
to change this system since forever.
But we might actually do it this time.
I’m obviously not going to talk about all
of the proposals, because you’ll never hear
from most of these people ever again.
So let’s just focus on two.
Mayor Pete is proposing a Medicare opt-in
plan or “Medicare for all who want it.”
This is just a reskin of the classic “Public
Option.”
This would open up Medicare to anyone, if
you’re uninsured, you’re automatically
on it, if you get health insurance through
your employer, you can switch, but otherwise
nothing changes.
Unless your employer wants to switch to Medicare,
in which case you don’t have a choice.
It would also make a few smaller changes like
adding a Medicare MOOP and capping out-of-network
costs.
Most people wouldn’t see any changes to
their healthcare.
Which isn’t very exciting, so let’s talk
about the plan you all want me to – the
Medicare for All proposal from Kristen Gillibrand.
She’s not even running anymore.
You won’t let me just have- Fine, let’s
talk about Bernie Sanders.
Bernie’s Medicare for All plan would basically
turn our healthcare system into the UK’s,
with a single payer government health service.
But with dental, vision, and prescriptions
included.
Like the UK, there would be no premiums and
little to no out of pocket expenses.
It also abolishes private insurance.
No more employer-based health plans, no healthcare
marketplace, no deductibles, no premiums,
no channels completely dedicated to demystifying
Medicare.
You and your doctor will make decisions about
your healthcare, not a private corporation.
Instead, the government would be the third-party
payer.
How they would pay for this is always a point
of contention and oftentimes the question
is intentionally worded poorly.
How much are your taxes going to go up?
And you said…
How much are your costs going to go down?
No, different question, how much will your
taxes go up?
No, it’s how much are your costs, because
it’s-
This sounds like a dodge because she’s trying
to reframe the question.
Taxes will go up, primarily for the wealthy,
but likely the middle class as well.
But remember, even if your taxes went up by
50%, the fact that this expense no longer
exists means you are still better off – and
you won’t pay much more, if at all, when
you need medical care.
This would also reduce the overall bloat in
our system that contributes to the high cost.
Your HR person has to pick a health plan,
hospitals and doctors need to hire special
billing coders, the insurance company needs
claims specialists, and youtubers need to
make videos explaining it all.
I’m positive we can do better than this.
But if you insist on keeping your healthcare
expenses unnecessarily high, even under the
proposed Medicare for All, might I suggest
getting into vitamins and supplements?
An industry you can learn all about by going
to curiositystream.com/knowingbetter.
CuriosityStream is a subscription streaming
service that offers over 2400 documentaries
and nonfiction titles from some of the world’s
best filmmakers that you can access across
multiple platforms.
Learn all about vitamins and the industry
that sprung up around them in this documentary
hosted by fellow youtuber, Veritasium.
Even though I know most of us don’t really
need to take vitamins, I can’t seem to help
myself.
You can get access to their entire library
for as little as 2.99 a month, but if you
head over to curiositystream.com/knowingbetter
and use the promo code knowingbetter, you
can have the advantage of getting your first
month completely free.
As well as getting access to Nebula, the new
streaming service put together by youtube
creators to have a space to create videos
without worrying about algorithms and demonetization.
My channel, as well as many of your other
favorites, can be found there, including several
original series.
By joining CuriosityStream and Nebula, you’ll
also be supporting the channel.
Full disclosure, I have no horse in this race.
I am a service-connected, disabled combat
veteran, I get my healthcare through the Veteran’s
Affairs hospital – which isn’t a health
insurance program.
It’s a self-contained system and a bottomless
well of asterisks.
So I’m not complaining about the system
and talking about proposals for change for
my personal benefit.
I also had no reason to give myself all that
math homework.
It took me a month of daily research to figure
all of this out and present it to you and
that alone should tell you this is overly
complicated.
Luckily, I don’t do anything else with my
time.
So now, as you’re watching debates about
taxes and reading news articles about rising
premiums, you’ll actually understand what
they’re talking about, because now, you
know better.
If you hadn’t noticed, I made some improvements
to the set, so if you’d like to add your
name to the chargemaster, head on over to
patreon.com/knowingbetter, or for a one-time
donation, paypal.me/knowingbetter.
Don’t forget to copay that subscribe button,
check out the merch at knowingbetter.tv, follow
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the subreddit.
