Why does our healthcare system seem to champion the post-problem treatment rather than stopping issues in their tracks? It’s a question that weighs heavily on us, and in our latest episode, we, Dr. Jake Berman and Jenni Berman, aim to unravel the perplexing prioritization of profits over patient outcomes in the realm of health insurance. We dissect the confounding lack of preventative care coverage and its implications, drawing parallels between the care for our cars and our bodies – and illuminating how proactive maintenance could dramatically shift the health landscape.
As we navigate the complexities of health insurance coverage, we challenge you to reconsider where your health dollars are spent. We don't shy away from the tough conversations about the financial incentives that may sway physician recommendations and the overarching financial structures that could be placing your well-being on the backburner. With us, you'll get a candid look at the necessity of advocating for your health, the critical thinking required when evaluating medical advice, and the potential life-changing benefits of exploring health services beyond what insurance companies deem worthy. Join the conversation as we advocate for a healthcare system that celebrates prevention as fervently as it does the cure.
Check Us Out On Social Media - Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf Youtube: Berman Golf, Berman Physical Therapy TikTok: Bermangolf, Bermanwellness
Email us - drberman@bermanpt.com jenni@bermanwellness.com
Check out our website - https://www.bermanpt.com/ https://www.bermanpt.com/wellness/ https://bermangolf.com/
Why does our healthcare system seem to champion the post-problem treatment rather than stopping issues in their tracks? It’s a question that weighs heavily on us, and in our latest episode, we, Dr. Jake Berman and Jenni Berman, aim to unravel the perplexing prioritization of profits over patient outcomes in the realm of health insurance. We dissect the confounding lack of preventative care coverage and its implications, drawing parallels between the care for our cars and our bodies – and illuminating how proactive maintenance could dramatically shift the health landscape.
As we navigate the complexities of health insurance coverage, we challenge you to reconsider where your health dollars are spent. We don't shy away from the tough conversations about the financial incentives that may sway physician recommendations and the overarching financial structures that could be placing your well-being on the backburner. With us, you'll get a candid look at the necessity of advocating for your health, the critical thinking required when evaluating medical advice, and the potential life-changing benefits of exploring health services beyond what insurance companies deem worthy. Join the conversation as we advocate for a healthcare system that celebrates prevention as fervently as it does the cure.
Check Us Out On Social Media - Facebook: @bermanwellness , @physicaltherapynaples, @Berman Golf Instagram: @berman_wellness, @bermanphysicaltherapy , @Berman Golf Youtube: Berman Golf, Berman Physical Therapy TikTok: Bermangolf, Bermanwellness
Email us - drberman@bermanpt.com jenni@bermanwellness.com
Check out our website - https://www.bermanpt.com/ https://www.bermanpt.com/wellness/ https://bermangolf.com/
Speaker 1:
This is the Berman Method Podcast, featuring Dr Jake Berman and physician assistant Jenny Berman. We are here to treat problems and not symptoms. Disclaimer this podcast is for entertainment purposes only and not to treat anyone or to give medical advice. If you are interested in any information that we are giving and would like to use this for yourself, we recommend that you contact your primary care physician or reach out to us and ask us questions about yourself specifically. Enjoy.
Speaker 2:
Bum-ba-da-dum, bum-bum-bum, bum-bum-bum, bum-bum-bum, bum-bum-bum. The Berman Method Podcast, where we are focused on treating problems and not your symptoms, like the rest of corporate America. Dr Jake Berman, here with my co-host, jenny.
Speaker 1:
Berman, physician assistant.
Speaker 2:
When are we going to start videoing these things, because I think it would be a great thing to compile all of my intros in conjunction with your eye rolling and your looks that I get.
Speaker 1:
We've been talking about this, like every other podcast, for the last six months, and I've done nothing about it.
Speaker 2:
Yeah, how come nobody's reached out to us yet? Who's the videographers out there that want to help us get the viewership on this audio podcast?
Speaker 1:
I don't know.
Speaker 2:
So, anyways, david against Goliath, we are trying to spread the word, make you question what you think you know and just try to show you that there is another way. Just because your primary care physician says you need to take this medication doesn't mean you need to take this medication necessarily. Just because your insurance doesn't cover a specific doctor or even a specific procedure doesn't mean that you shouldn't pay for it out of pocket anyways, because you have to remember, at the end of the day, the insurance companies are all about maximizing profit, not your actual outcome. So that's what we're all about. But before we get all into this, just side note this has nothing to do with the podcast at all and I don't even know why I'm talking about it right now, but I figured I would ask you on the air if you knew any oil change places in town that accept our car insurance.
Speaker 1:
Car insurance for an oil change.
Speaker 2:
Yeah, I've been calling around. I've got to get my oil change and I've been calling around to a lot of these places and none of these oil change places except progressive, our car insurance.
Speaker 1:
What? Have you ever used insurance for your oil change?
Speaker 2:
No, but I thought, because I have car insurance, they should pay for Maintenance.
Speaker 1:
Oh, that's an interesting thought, that insurance should cover maintenance. But I don't know. I don't know of any in town that accept insurance for an oil change.
Speaker 2:
Why wouldn't car insurance pay for an oil change?
Speaker 1:
I understand what you're saying and it makes sense that theoretically it should cover oil change Maintenance care through car insurance. But I've never I don't think that's a thing I've never experienced that I wonder if any of our listeners have car insurance that covers oil changes.
Speaker 2:
And if you're listening out there, if you've got the magical, mystical unicorn car insurance that pays for oil changes, please let me know.
Speaker 1:
Yeah, I mean, I guess, compared to regular health insurance, does health insurance cover maintenance care, preventative care?
Speaker 2:
No, no, and that's where I was going out with that silly analogy there is. So often people don't see how similar it is. You buy a brand new car off the lot, you drive it off the lot and you want to keep it running as good as you possibly can, so you maintain it. You regularly maintenance it. You regularly get oil changes, you change your air filter, you change the fluids and the transmission and the running gear. You get tires.
Speaker 2:
This is a big expense that we actually got to pay for this week on your car is get some new tires. These are all regular maintenance that you have to pay out of pocket to keep your vehicle running optimal and as best as it possibly can for as long as it possibly can. The only thing that insurance covers is a catastrophe, right, catastrophic injury or a major accident. You get into an accident, then your car insurance comes into play and even then you usually have some type of crazy deductible and all sorts of loopholes that you have to jump through to get things to cover it. I mean, there's times where you can get into an accident and the deductible is so big to pay for whatever it is to get fixed that it's not even worth making a claim on your insurance and you just got to suck it up and pay out of pocket.
Speaker 1:
Right, right, and that's a normal, typical everyday thing. Okay, I'm going to go pay for an oil change. I'm going to go pay for these new tires. Yeah, it still hurts. It hurts to think about it, but we do it. But then we think about that with our own body.
Speaker 2:
Yeah, what's the difference? Health insurance is exactly the same as car insurance. Health insurance will not pay for you to do some preventative care. Health insurance does not pay for preventative care at all. It's all reactive. Okay, get sick Now let's pay for medication. Let's pay for surgery, right?
Speaker 1:
And even more on. That is. You know, reactive care can be dietary changes, nutrition changes for diabetes or pre-diabetes or whatever after the fact that you already have been diagnosed with that. But insurance doesn't want to cover that either.
Speaker 2:
Why not?
Speaker 1:
Because they don't get any money for it.
Speaker 2:
Yeah.
Speaker 1:
They are not getting any money for your dietary counselor or your functional medicine provider that you have, so they're not going to cover that type of care. They want to cover you becoming a diabetic and needing to take metformin or taking ozempic or taking insulin.
Speaker 2:
Yeah, and it's no secret that, just because we're talking about diabetes, this is a known fact that diabetes affects more often diabetes affects lower income and poverty-stricted communities than the affluent. That's no secret. That is a proven fact, statistical data across America that that is the case. Right, and insurance companies would much rather pay for the diabetes medication then to not have you take the medication at all because you're doing dietary changes. Why does that happen?
Speaker 1:
Again, they don't get reimbursed. They don't get money for the dietary as opposed to medications.
Speaker 2:
Exactly.
Speaker 1:
They make a profit off of medications.
Speaker 2:
Exactly so. One of the things that we've done over the past week is Jenny and I have both listened to a podcast on Joe Rogan, so Joe Rogan had a guest on there. This is his second or third time being a guest on the Joe Rogan podcast. His name is Brigham Bruehler and he is the owner of Ways2Well, which is a compounding pharmacy and holistic clinic in Austin, texas, and we'll link to the show notes to this podcast. We both highly recommend you listen to this podcast because it's three hours long and it is filled with facts. So links to every statistic that this guy says on this podcast. He links a fact so you can fact check every single thing that he says. And he's giving all of these explicit examples where it's just like oh my gosh, that's the reason why the healthcare system is the way it is. So one of the things that he exposes on this podcast is benefit managers. So it's the benefit managers that are between the pharmacies and the insurance companies, and the benefit managers are ultimately the problem, right? These are the middleman that is causing the problem. So I don't even wanna begin to go down this rabbit hole, because I'm sure that I'll say something wrong. What I wanna tell you guys is I'm just gonna say go listen to this podcast, go fact check all of the links that Bruehler attaches in his show notes and do the research yourself. What you need to understand is that, at the end of the day, health insurance is not health insurance anymore. It's managed care, it's managing your pathology while maximizing profitability, and it's as simple as that. And one of the things that I will say that was shown in the or talked about in this podcast were referring to and I actually researched it and checked it all out myself is, time and time again, historically, pharmaceutical companies will choose profits over patient outcomes, and this has been documented time and time again over history, where, when it comes for them to either choose profits or patient outcome, time and time again pharmaceutical companies will choose profits, and the example that they give is just like oh my gosh, that is extreme. There is no way that that could possibly be true, and it's true.
Speaker 2:
So back in the 1940s, a little tiny pharmaceutical company that nobody had heard of reached out to the Nazis and said hey, we need some participants for this thing. So the Nazis send 150 healthy Jewish women over for this clinical study, and six months later, the pharmaceutical company reaches back out to them and says thank you so much for sending these healthy women. They showed up in great working order. Unfortunately, none of them made it. We need more participants, so the Nazis send them some more women. This is all documented. You can Google this. That company evolved into Bayer, one of the biggest pharmaceutical companies on the planet. Right, right, it's like. What? Are you kidding me? Well, that happened back in the 40s. There's no way that anything like that could possibly happen again, and I'm almost paraphrasing this podcast. Now, so, fast forward to the 80s, the same company has some type of contamination issue, or maybe it wouldn't bear you.
Speaker 2:
Yeah, no, it was a different company, yeah another big company has a contamination issue with some type of blood clotting medication. Or again, go listen to the podcast. It will be worth your time to listen to it, because I'm going to get some things wrong and I'm going to try not to say more than I can actually do right now, on the fly, and this is in the 80s, and they had a blood clotting medication that they accidentally contaminated with the HIV virus Right right.
Speaker 2:
And again, instead of choosing patient outcomes, they chose profits. So they could have easily destroyed all of this medication. But instead of destroying it, they sent it out to third world countries, so Asia and Africa. This is all documented. You can Google this right now and come to find. I don't even want to keep going down this.
Speaker 1:
Well, yeah, I mean, that's exactly it. Now, these third world countries, the patients taking the medications are being contaminated with HIV because of contaminated medications that were sent and just because they didn't want to lose thousands and thousands of dollars by throwing away these medications.
Speaker 2:
Yeah. So it was 20,000 people that were actually infected with HIV virus and then fast forward even more. So now you got these people in third world countries. At the time it cost $14,000 a month for medication If you had the HIV virus to try to keep you alive. You're not affording that in third world countries. There's very few people that can afford it in America. So then they had the race for all these mom and pop pharmaceutical companies to try to mirror the medication at an affordable price, and then this pharmaceutical company sued them to try to say, no, you can't create that, you can't do that. So tied them up in litigation for three years and then ultimately said screw it, you guys can do it. Because apparently there was outrage I didn't do my research on this, but you can do it. There was outrage from the American public and they just said, okay, go ahead, you can do it. And they ended up allowing the smaller companies to create this mirror drug essentially that they could afford in third world countries. Right.
Speaker 1:
I was just going to say, and now he's the doctor that was talking on the podcast, who owns a compounding pharmacy, is saying he's still, to this day, trying to do that. He's still trying to mirror medications that are out on like by pharmaceuticals at a price that people in the United States can actually pay for. They can actually afford to get them.
Speaker 2:
Exactly so. Fast forward. That was the 80s. Fast forward to now. Now we got the opioid problem right, pandemic yeah. Epidemic.
Speaker 1:
Is it pandemic or epidemic? I guess it's epidemic. Yeah, epidemic here.
Speaker 2:
So we got the opioid epidemic right and, statistically speaking, last year we had more people die from opioids than the whole entire Vietnam War. Mm-hmm, like that's crazy, absolutely crazy. So again, the pharmaceutical companies are maximizing their profits over patient outcomes. They know that these things are addictive. Yeah, the FDA still approves them, still prescribe them every single surgery. You're not going to leave a surgery without having prescription to opioids, right?
Speaker 1:
But yet they're trying to ban or deem certain supplements as not safe, even though there's no research saying that they're causing harm.
Speaker 2:
Yeah, and this could easily turn into an hour long podcast or two hour long podcast, and I don't want to take you guys down this rabbit hole. I just wanted to say that this was a really, really interesting Talk that we both heard, filled with tons of facts that you can just click on links and fact check it yourself and not just take my word, not take Jenny's word or take anybody's word. Do your own research, read it yourself and you're gonna be like, oh my god, nobody talks about this. The media outlets don't talk about this. Nobody talks about this.
Speaker 1:
The doctors don't even talk about this, because it affects profits right, right, and that's, you know, the whole point of us bringing this up and talking about this. As he gave the example of our Health insurance, we have to think of it like car insurance. Our health insurance is not going to cover the Supplements. It's not going to cover the preventative care, the nutrition therapy, the physical therapy that is actually worth something. It's not going to cover your regular maintenance. I mean, think about it. When we go and have A tummy tuck or a facelift, we know that's going to be out of pocket, that's aesthetic with. That's not going to be covered by insurance. We have to think about our insides, our gut health, our Blood sugar, the same way. That's not the things that our health insurance is going to cover, because it's not an injury, it's not catastrophic, very similar to our car insurance. Car insurance is not going to cover your regular maintenance, and so we just need to have a different mindset.
Speaker 2:
Yes, a majorly different mindset, and I think that this is a perfect time to mention this quote off of this podcast that he says and he goes so many people Bawk at spending a thousand dollars or two thousand dollars or five thousand dollars out of pocket for getting these tests that insurance companies don't pay for, for paying for these supplements that these Insurance companies won't pay for paying for these alternative Treatments that your insurance won't pay for you. So many people balk at spending that much money out of pocket. But, at the same time, how much money are you spending on your mortgage every single month? How much money are you spending on your car payment every single month? And You're only spending a fraction of your life in that vehicle, in the house. You're spending 100% of your existence in this flesh vessel that we call our body.
Speaker 2:
Why wouldn't you want to invest in your body? I mean, you're investing how many thousands and thousands of dollars a year on your house and your car that you don't even live in 100% of the time You're in your flesh vessel, your body, 100% of the time. It should be the exact opposite. You should be spending a hundred grand a year on your body. You only get one of them, you only get one right. It's proven time and time again. I can't tell you how many people I've met over the years in my office when they've got all the money in the world. I mean, they're grandkids. Grandkids could not spend all the money that they have in their entire lifetime, but when your health is gone, it's worthless.
Speaker 2:
It doesn't do anything for you, because you get to a point to where there's nothing on the planet that you can pay for to get your health back. That is the totaling of your car. That is, you are driving 80 miles an hour and you hit a brick wall. That car is totaled. You are not going to pay any body shop, any amount of money to rebuild that vehicle. That is the same exact thing. You could have easily spent money over the years Maintaining it and avoided hitting that brick wall together. What if it was something as simple as Updating your brakes, get new brake pads. If you just spent 500 bucks or a thousand dollars at the mechanic to get a new set of brake pads, you could have hit the brakes and it would have actually slowed your car down enough to where you wouldn't have Totaled your car. You'd still hit the brick wall, but maybe you didn't total it. Maybe you just Bent in the hood or scratch the bumper. That's the difference. That's what we're talking about right now.
Speaker 1:
I like it. I like the comparison, that's, but I don't know when else you want to go with that, as I mean, it's a perfect example. We have to put the money into our body to prevent the long term effects that we are headed down if we don't put the money into our body and money as in the focus, in the right areas, the focus on the nutrition, the focus on the therapy, the focus on the exercise, getting a coach to help you, guide you, show you what you're doing Wrong, tell you other recommendations, so that we don't total the car, total our bodies.
Speaker 2:
That would be nice. Another fun fact while we're screaming out facts here is it is legal for physicians to have ownership in places that they refer to. For example, a physician can have ownership in a pharmacy. So if a physician recommends or prescribes a medication to you and says, go to this pharmacy to get it, they're getting not. It's not a kickback because you're not getting paid per patient to do it, but you are. They do have investment in that pharmacy. The same thing is true in orthopedic surgery centers. So it is not uncommon for orthopedic surgeons to have equity in a surgery center.
Speaker 1:
Or a physical therapy office.
Speaker 2:
It's extremely common. Almost every single orthopedic surgeon in this town either owns outright or has significant ownership in their own physical therapy clinic. It's called a POPPS. Physician owned physical therapy clinic completely legal, right. So they have incentive to send you to. The cookie cutters are us, because that clinic is seeing four patients an hour. They're on an assembly line in there Do these stretches and exercises by yourself. Over there in the corner, maybe a technician that has no experience at all In exactly how to do the exercises might stand next to you and then when you fail that rehab, guess what?
Speaker 1:
Then you go to the surgery center that I own to so I mean, this is all legal stuff.
Speaker 2:
So I'm not bashing surgeons, I'm not bashing doctors, I'm not at all. I'm just trying to shed light that there's a reason why you're referred to a certain place. There's a reason why you're prescribed certain medications Oncologists. Here's another fun fact 65% of oncologists salary comes directly from chemotherapy, right, so they're profiting off of the drugs that they're giving you. 65% of their salary comes from chemotherapy. That's insane.
Speaker 1:
So you would think that they would want their patients to do anything except have to go through chemotherapy, when they're making money off of the drugs. I don't know. What do they have in the best interest the patient or their money?
Speaker 2:
It's profits, it's always profits. And again, this is no bash on oncologists, the crappy system that they are forced to be in, and it's all because of the insurance companies. It's all because of the reimbursement, or the lack there of being reimbursed, that they have to make decisions to pay their own bills. It doesn't mean that oncologists are greedy and they're trying to make money or orthopedic surgeons are greedy. It's the system. It's a systemic system. It's coming from much deeper than what we think of and that's the reason why you really should question everything. That's the reason why you should expect and want to pay cash out of pocket for services. I intentionally, when I switched to our dentist that we go to now, I intentionally didn't even say that we had insurance. I'm like I'm just a cash patient. I just want to get a different point of view or a different dentist. I'm actively seeking places just to pay out of pocket because I want to get the things that I want, not what the insurance company will reimburse for.
Speaker 1:
Right, right. I mean, if we use our insurance for our teeth cleanings, we'd get two teeth cleanings a year, versus the two of us that go four times a year to get our teeth cleaned. So not going to. You know, again, it's that preventative care that we're paying out of pocket for, as opposed to what the insurance deems necessary. You know, and we have so many examples of this for ourselves, even dating back to when I had a miscarriage at 16 weeks gestation. So I was into my second trimester and had to have a D and E, which is essentially a surgery to deliver the baby, and our insurance deemed it that it was not medically necessary for us to have that procedure. So we ended up paying out of pocket for that procedure. And it's just like we are back in the same situation of what do we have insurance for. I mean, that was a catastrophic, traumatizing situation that we ended up paying for.
Speaker 2:
Yeah, and you know you may be shaking your head right now. Let me make it explicitly clear there was a dead fetus in Jenny's body that needed to be removed or it would jeopardize Jenny's health. Right Like if this was hundreds of years ago. This is what women died from. A baby dies inside your body and you don't pass it naturally. That then rots and it becomes subsist and it kills you, but the insurance company said that it wasn't medically necessary to have it removed.
Speaker 1:
Right right.
Speaker 2:
Like we're ripping our hair out, not to mention how emotionally catastrophic it was to us on an emotional level. Now, on top of all that, go ahead and pay however many thousands of dollars, it was for the actual procedure.
Speaker 1:
A lot, yeah, out of pocket. So it's just, you know, one of those things that makes you think what is the medical insurance doing? And again, Jake has already said it, they are all about profitability. So doing not what's in the best interest of the patient, but in the best interest of the company to make the most amount of money. And yes, the podcast go listen to it. I mean, he even brings in Aaron Rodgers' injury into it, which was very interesting in my mind. We see NFL players back on the field right away after an injury and we're like, oh, just shoot him up and get him back out there. But it was actually very interesting to hear his perspective about how NFL doctors are not open to the new research and the new medicine that's out there because they're not getting money from it. So that was very interesting. I'm just going to leave a little cliffhanger there, so you guys have to go listen to that story.
Speaker 2:
Yeah, that one really, really impressed me, because so often it's like how does somebody recover from a high ankle sprain in 10 days? Yeah, just shoot him up, numb it, get out there, run it off and if you can play through the pain then you're going to play. There's nothing healed about the injury. That is not even close to the case of what happened with Aaron Rodgers and his Achilles tear. So interesting. Highly recommend you listen to this podcast. It is not a waste of your time. Go to Ways to Well, I believe, is the name of the clinic, and we're actually talking this morning about one of my clients that I'm going to highly recommend that he look into some of the services that this clinic offers, because he's just an extreme case that has been dealt a crap sandwich and there's nothing in the Western medicine world that is helping him right now. So I mean, I'm drinking the Kugelade. We're definitely going to be doing some more research on this. Thank you for letting me rant on this.
Speaker 2:
Check the show notes for all the links. We'll have them there and think about it. Health insurance, car insurance they do the same exact thing. They will pay for a catastrophe. Maybe they're not going to pay for maintenance. So insurance companies are managing your disease while maximizing profit. It should be no surprise by now, and here's the actual facts to back it up. So thank you everybody for listening. Make sure you share this episode with as many people as you possibly can Like and subscribe to this podcast. Review us. We need some more reviews on there. If you love listening to my intros, make sure you say that Good.
Speaker 1:
Good, all right, have a great week. Ciao for now. See you.
Speaker 1:
Thanks for subscribing on your social media and podcast platforms to the Berman method Dr Jake Berman with Berman physical therapy and Jenny Berman, physician assistant with Berman health and wellness. You can find more information on our website wwwbermanptcom for physical therapy, berman ptcom forward slash wellness for the health and wellness. You can also find us on social media Facebook, instagram, and on your podcast platform, so be sure to follow us, like us, subscribe to us and, if you would like any further information, definitely visit our website and reach out to us. You may also find our free reports on the websites as well, where you can download this free information for yourself. Have a great day.