Going Under: Anesthesia Answered with Dr. Brian Schmutzler

How a Government Shutdown Hits Anesthesia, Hospitals, and Health Care

• Dr. Brian Schmutzler • Season 4 • Episode 6

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The Government shutdown is affecting medicine, but to what extent? Medicare IT furloughs delayed payments, hospitals and anesthesia groups face cash crunches, and telehealth reimbursement rollbacks. Dr. Brian Schmutzler and Vahid Sadrzadeh discuss how bad it could get if there is no resolution soon!

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SPEAKER_00:

This is going under anesthesia answered with Dr. Brian Schmutzer. I'm Vahid Sader Zanin, and we are brought to you by the Butterfly Network.

SPEAKER_01:

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SPEAKER_00:

All right, today we're talking about the government shutdown. That's right. That's right. And how it's affecting medicine in general and specifically anesthesia, of course. Um, and a lot of times, Brian, when there's a government shutdown, it's because of budget disagreements, it's because of key political issues that are happening. Why now? Why why why now?

SPEAKER_01:

Oh, you know, we're we're so we're so thrilled with our government officials. They're doing such a great job that you know it's all a political stunt. But you know, it it uh anyway, we're staying out of the political ring. We're staying out of the political ring. It's yeah, it's it's annoying overall. Um, so I guess uh from our perspective, so we probably have to describe so what's happening. So the the House passed a um budget resolution bill to continue funding the government because technically you're not supposed to fund the government if you're running a deficit, and we're always running a deficit because we spend more money than we bring in as a federal government. So the House passed the bill, but in the Senate they they don't have enough to bring it to cloture, which means you have to have 60 votes to get something even to the floor to vote on it. So they don't have enough votes to get to cloture, so they're not gonna be able to pass the bill unless some Democrats side with the Republicans, excuse me, and and pass the bill. Now what they've called it, and and I'm I I'm not a big political guy, this is just what I've been listening to, um, you know, from all the different sources. They they call this a clean um bill, a clean uh uh continuing resolution CR, meaning that there's nothing different in this bill than it there was the last time they almost didn't fund the government, which was I don't know, six months ago or something like that. So there's zero changes from then to now. So um again, big political stunt. And and everything I'm hearing from basically all all sources on all sides is that the first checks that won't go out would not go out by the 15th of the month. So everybody's expecting them this coming paycheck, yeah. Correct. So everybody's expecting them by the 13th or 14th to get it get it done.

SPEAKER_00:

And if they don't, well then checks don't go out. So one of the biggest things as as we're recording this, we're about a week in to the shutdown, and people haven't been noticing. You do a lot of air travel. Yep. People haven't been noticing right now, because again, they're not a paycheck into this. But if you start getting past the 13th, 14th, 15th and people start getting furloughed at that point, yeah. Right, you're gonna expect massive layoffs, right? How is this gonna affect you do a lot of air travel?

SPEAKER_01:

Yeah, I uh well, it's already bad. I'm sure it'll just make it worse. So I don't know, I mean it's TSA.

SPEAKER_00:

I didn't look at that. Right. Any government worker that is part of that. I mean, TSA is already understaffed. Understaffed.

SPEAKER_01:

Especially at South Bend Airport, where you try to leave at six o'clock in the morning and every airline has a flight out at six o'clock in the morning, and they have one open You know they do that on purpose to piss you off or what?

SPEAKER_00:

No, because everybody's working at that time. So they have the shifts, right? So like everybody's so if you go to O'Hare International, yeah, and you're coming in from international flight, like we did this two weeks ago. Yeah, fine, sure. Came in from Germany. Yeah, yeah, right. You get to O'Hare, you get to the line, and there's like a billion people but nobody checking anybody in. Getting there at the same time. All these flights are arriving at the same time. Why do they do that? Yeah. Because they want to funnel everybody while the staff is working those hours. That's what I truly believe, right?

SPEAKER_01:

Right. But here's the problem at South Bend is they only open one of the scanners. They have seven people running around doing whatever. We have two scanners. Right, but they only open one of the two scanners, even though every airline has a flight that leaves between 5 30 a.m. and 7 a.m. And there's one scanner open.

SPEAKER_00:

But there's eight people just standing around.

SPEAKER_01:

So I'm not sure it could get much worse. I mean, I guess there could just be nobody at TSA, and that would be worse.

SPEAKER_00:

Well, at what point does this affect our mail delivery system? At what point does it uh, you know, package delivery system, right? Like, I mean, things are people are going to lose jobs if we keep this sort of situation happening. Now, with all that being said, how does that affect medicine? Sure. Other than shipments, drugs coming in and out, pharmaceuticals, so there's a whole there's a whole bunch of things.

SPEAKER_01:

So the biggest overarching issue is that the IT department and Medicare is getting furloughed. So everything processing is delayed. So people aren't gonna get their Medicare payment. People facilities and and providers aren't gonna get their Medicare payments. Okay. That's the biggest issue. And most of the providers in the country count on Medicare as a hor huge portion of their of their revenue. So, for instance, in anesthesia, we you know, probably in general about half Medicare. So all those payments don't come to us. They're getting held up in processing because they furlough the IT people in the CMS.

SPEAKER_00:

When it gets resolved, because at some point this is gonna get resolved.

SPEAKER_01:

Yeah. You still get you get that money. Right. Yeah. It's just back paid. Yeah, right. It's just delayed. But still, you're talking about those livelihoods. Right, you've already got limited cash on hand, so you're gonna have to float that 15 days or 30 days or however long it takes to you.

SPEAKER_00:

And how do you how do you expect to uh you know explain that to the mortgage companies?

SPEAKER_01:

Oh, sure. Yeah.

SPEAKER_00:

I mean or whatever, right? Like all the vendors that are bringing you stuff, yeah. Yep.

SPEAKER_01:

How do you how do you explain that to them? Yeah, yeah. So and then here's the other issue is that facilities aren't getting paid by Medicare either. Most of the revenue that uh anesthesia companies generate comes from facilities paying them a subsidy. We've talked about this before, the the models that we use. We don't generate enough in anesthesia to pay for our services, so the facilities kick in. Well, if we aren't collecting Medicare, there's a higher amount that the facilities have to kick in, and the facilities aren't collecting their Medicare either. So there's gonna be a shortfall of money.

SPEAKER_00:

So I mean as this falls to the wayside, right? What what is being done about it? What is being done by nothing? Nothing.

SPEAKER_01:

They're sitting around fighting. They're still getting paid, though, of course. The the congressmen and senators. Correct. They're still getting paid. Which is a little yeah. I I'm just questioning it. Yeah. We're not getting into the political ring. I'm more than questioning it. They shouldn't get paid. If they if they're gonna shut the government down, they should take no salary.

SPEAKER_00:

But they still are receiving salaries while all this is going on. Yeah. Do you think it's gonna be resolved? I think so. And if the before the 15th, before this next paycheck goes out?

SPEAKER_01:

That's everything I'm hearing on it, yeah. From all the different sources that I read.

SPEAKER_00:

So um, have things like this happened before? Obviously, government shutdowns have happened before, but has it affected the medical industry before?

SPEAKER_01:

Yeah, I mean the Medicare thing happens every time they shut down the government. So that's not surprising. There were a couple of things in there. Um, so telehealth. So this this bill takes away the payments for telehealth that were instituted in um during COVID. So they really increased the amount of telehealth you could do, how much they paid for it, all that sort of stuff. Um even in anesthesia, we could even bill telehealth. So if I put a nerve catheter in, I could call and get telehealth um reimbursement. Um that sort of disappeared pretty quickly from anesthesia. But what I'm seeing, so I mean, I'm a patient too, right? So I have a a um primary care doc who mostly does functional medicine but also takes insurance, and um, they're no longer doing any telehealth visits.

SPEAKER_00:

That's interesting. I I've noticed that about a lot of providers. It was just in the last couple weeks.

SPEAKER_01:

Yeah, yeah. They're not doing it anymore. Correct, because they don't get reimbursed for it anymore. That was something that came out of the bill as well. Now, you can argue the benefits in the as with anything, there were probably benefits to telehealth, right? And getting reimbursed for telehealth, but it was being abused because you could get paid almost the same amount for doing telehealth as you could for an in-person visit. Is telehealth in general a good thing?

SPEAKER_00:

For some things, yes. Or do you think it was uh kind of one of those niche things we'll look back on in 25 years and be like, well, that was a COVID thing, and we don't really need, I mean, we didn't really need it anymore.

SPEAKER_01:

Well, I so I'm a big access guy, right? So how do we get more access to more people? So if you live in telehealth, middle right. If you live in middle of nowhere, Louisiana, and you can't get to a physician, but you have internet, you can have a discussion with them and and get you know whatever you need taken care of via telehealth. There are some things that can be taken care of via telehealth. Is it the end all be all no? Now with AI, maybe it is, right? Maybe maybe you let your AI bot on your computer do an exam on you and tell you what's wrong or whatever. But um, I don't think it's the end all be all. I think there's still a place for in in-person visits, but I think it's helpful.

SPEAKER_00:

I think we need to re-examine this AI conversation that we have because I think there's a lot of things that I've been thinking about. Now we're kind of off the government shutdown topic, but but no, no, we'll get back to it. I'm kind of going on a tangent here, but there there is a lot of things with this AI that I have questions about, and it has to do with telehealth, right? So I mean you're right, more access to more people. If you remember our previous conversations with those that we had at the butterfly conference, yeah, access is big. Access is huge. You know, I mean, the doctor that we talked to in England, he's trying to get more access, right?

SPEAKER_01:

Exactly.

SPEAKER_00:

So if you're cutting down the telehealth visits, what are you doing? Are hospital systems, and again, this can be a conversation for another day, but just thinking about this, could hospital systems be coming up with their own AI instrument to send out to more people to self-diagnose it, you know what I'm saying? Even though you don't want to self-diagnose and people are already self-diagnosing, but is there an instrument that these companies help, yeah. So I I I but if you're not having telehealth and if you're always referring things back to the payment system, how does this work in that whole scope of the payment system?

SPEAKER_01:

So so them eliminating the payments for telehealth, they never said you can't do telehealth, they just said we won't pay for it. So I think so. But who wants to take a loss? Exactly. So some people still do telehealth because it's the right thing to do. But um yes.

SPEAKER_00:

But they won't pay the the the hospital system or they won't pay the provider. Both. They won't pay either. So nobody's paying. So if you take a telehealth visit right now, nobody is gonna pay you for that 45 minutes that you're medicare, yeah. Medicare won't pay me.

SPEAKER_01:

Yeah. The the uh private insurance companies haven't followed suit yet, but they almost always do.

SPEAKER_00:

So that'll be dropping down the the line too.

SPEAKER_01:

Yeah, correct. Gotcha.

SPEAKER_00:

Okay. So they won't be getting paid at all for the telehealth.

SPEAKER_01:

Correct. Yeah, so you can do it. That's what the government always says. Yeah, you're you're welcome to do whatever you think is medical. But you're not getting reimbursed for it. We're just not gonna pay you for it, right? Use your medical judgment because I'm the one on the hook. If I don't do something because I'm not getting paid for it and a patient has a bad outcome, you think the government's the one on the hook for that? No, I am. So what about concierge medicine? Yeah, so if you if you're doing cash, then yeah, you just do cash for telehealth visits. If you want to. If you want to, right. Right. If you want to. But so I yeah, I think if you build out the AI infrastructure to do telehealth visits, you know, I'm sure that there are plenty of bots out there that you could literally like, I mean, you could you can see how glasses look on you. You can see what something looks like in your room at home before you buy it. I'm sure there's AI bots out there that can look at you, you know, diagnose and then uh determine a likely treatment that then gets reviewed by a you know, a provider of some sort.

SPEAKER_00:

Well, we want to a little off tangent. We're talking about the uh government shutdown and how it's affecting medicine, and that kind of spiraled into this whole conversation. But I do want to say this is as of 20 minutes ago. Yeah, the swing vote, Senate Democrats holding firm in the shutdown standoff. Yeah. They got another week, though. Right. Yeah. So I mean, but are they just gonna I mean, if they know they're gonna come to an agreement in a week, it's political theater.

SPEAKER_01:

It's just it's just posing.

SPEAKER_00:

For sure is. Uh no signs of backing away from their hard line stance of withholding votes from a bill to fund the government through late November, insisting the public opinion is on their side, even though the shutdown stretches into a second week. And Tim Kane, who is obviously the Virginia Democrat, says, quote unquote, nobody likes a shutdown. He he was an interesting guy.

SPEAKER_01:

Do you remember him with Hillary Clinton? Yes, I do. Yeah, he was he was interesting.

SPEAKER_00:

And then Gary Peters, a lot of yelling. Um he said uh well, quote unquote health care is still an issue that hasn't gone away, and that people will see very large increases in their premiums once enrollment begins next month.

SPEAKER_01:

Yeah, I I don't know how those two connect, and maybe I don't know enough about the bill, but I I'm not sure why they would see increases in their premiums. I mean, the the cuts in the health side was telehealth. Right. And then there were some specifics about who could be on Medicare and Medicaid, who could get snap, and we won't get into the politics of that because there's a lot of politics and the way that it's written can be interpreted a lot of different ways. But I don't think that they're I don't I don't see any reason why premiums would go up. That doesn't make any sense. Well, hopefully not. I I mean as a lot of this is just fear-mongering, right? And both sides do this.

SPEAKER_00:

It's it's just threatening one thing and just saying this is gonna happen and this is not gonna happen.

SPEAKER_01:

Well, and and if you yell something loud enough and enough times, they think it makes it true, right? It's just the echo chamber nonsense. But um, so the other things that'll happen with this government shutdown, so um there there's uh a freeze on funding and um approval of new devices and new medications. Okay. So I don't know what's in the pipeline and if there's anything that was like gonna come out right now. I I don't I don't dig deep enough into that literature, but so if if there was a either a medical device or a pharmaceutical, and this is big and funded by the government. Well, no, that so it has to go through approvals. So the there's approvals in the FDA for medications, and um, I can't remember what the medical devices go through, but so the all those approvals are on hold. So if something was in the pipeline to be approved, and let's say it was gonna be approved yesterday, that's on hold because there'sn't they aren't paying for the people who would do that. So if you know, maybe we're missing out on a couple of weeks or however long the shutdown takes of a new medication or a new medical device. So, you know, that's maybe theoretical, right? Does it really matter that this device or this medication is gonna be delayed a couple of weeks? Probably not. Right. But that is something that's gonna affect things. The other thing though is suppliers. So a lot of the suppliers get a lot of their funding and approvals and all that kind of stuff. There's a lot of government regulation that goes into suppliers. So you're talking about things like medications that are already out that you ordered and need to get in to do anesthesia, IV IV fluids, um you know, IV catheters, all kinds of stuff. There may be some delays in that. Now that will directly affect our ability to provide care. That's so that's that's a fairly big deal. So not good. I I mean, overall, a government shutdown is not good. Um Nobody likes a government shutdown.

SPEAKER_00:

Nobody likes a government shutdown, with the exception of they're not spending our money wildly and without any so but you think there is kind of uh uh there is judgment ahead before they get they let this get too out of hand.

SPEAKER_01:

I mean, that would be the smart thing to do, right? To to really have the government shut down and everybody feel that pain. Neither side really wants that, right? Don't they have to travel? Well, yeah. But well, you know, private jets, I'm sure, but um, but they're still paying themselves. So I I would argue, and again, this is this isn't really political, but it's more just rational. That if you're not if you're shutting down the government, like if I shut down the OR in my hospital and it was up to me, and I said, no, no, we're shutting down, you're not having anesthesia, I probably shouldn't get paid for that, right? I would assume not. Right. So if they're the ones making the decision, we're shutting down the government, then they shouldn't be paid.

SPEAKER_00:

When there's a, you know, when when when there's a shutdown with the NFL labor agreement, right nobody gets paid. Right. Right? I mean, it it's just the way it is. Yeah. Um it's just interesting, you know. I mean, like nobody really saw this.

SPEAKER_01:

I mean There's always a looming threat of government shutdown. There is because we we do we constantly do deficit spending. We haven't had a uh we haven't had had a balanced budget since um uh Bill Clinton was president. 96, I think, 95, 96. Newt Gingers was the House Speaker and and Clinton was the president. We had a balanced budget, no deficit. So will that happen again?

unknown:

No.

SPEAKER_00:

I thought our deficits is three trillion dollars. Well, that's the dextrillion.

SPEAKER_01:

That's not the deficit. I think our deficit spending is like 900 billion. The debt only debt is thirty-six trillion or thirty-eight trillion or something like that.

SPEAKER_00:

Yeah, that went up there.

SPEAKER_01:

Yeah, yeah.

SPEAKER_00:

That that escalated quickly, as they as the kids like to say. Actually, actually, actually, actually, actually, you don't need to be the genius, actually.

SPEAKER_01:

Yeah, man, it's crazy. So so I think there's gonna be a decent amount of pain, at least for these couple of weeks. We'll see what happens and whether they extend it, but there'll be a decent amount of pain in general, um, in medicine, and then I think in anesthesia too. I mean, it's just any time, you know, we had that whole change healthcare where change healthcare went down, and that was that was probably two and a half months of of minimal or no revenue. But you know, this is even even trying to deal with two to four weeks of of no Medicare revenue is crushing.

SPEAKER_00:

As we go into the final quarter of 2025, yeah speak fiscally and speak in general terms what grade would you give uh medicine in general in 2025? How do you think the health of medicine is doing in America today? That's what I mean by that. Like give give medicine in general a grade. Do you think it had a good year? Do you think it had a bad year? Do you think it's as we go into the final quarter?

SPEAKER_01:

So right now in America, you are able to receive the best care ever. You if you have any sort of illness, there is somebody out there that you can find in the United States that can treat you. So, I mean, if you're talking about in America, you know, you getting care, I think we have the best care anywhere now that we've ever had. Yeah, and it just keeps getting better because there's more innovation and all that kind of stuff. So but then are you asking me the state, if you're asking me the state of medicine as an industry, as a business, it keeps getting worse. I mean, we were talking about this. I can't remember who I was talking to about this today. Yeah. Yeah. So so private equity is a huge part of that venture capital where they're going in and buying in practices and driving down innovation, driving down reimbursements, and then increasing their own profits. So that's a huge issue. Um and I think the we continue to make dumb rules, um, and we continue to drive down, although in 2026 we're getting an increase for the first time in a while. Medicare is not giving us a cut, so that'll be good. Um, but we're getting an increase on the Medicare rates. Um yeah, but I think there are too many hands in the pot in medicine. Too many people taking Because there's money to be made? Because it's uh one-sixth of our GDP. Yeah, there's all kinds of money to be made. I mean, you you've got I'm trying to remember what the statistic is. I think we talked about this before. You look at the amount of spending in medicine and ninety over ninety-two percent is non-clinical care. Administrators, government regulations, all kinds of stuff like that. We have talked about this. 92%. So if you took out every clinician practicing medicine, you took away the entire ability of the medical industry, medical, what is it what uh what's the defense kind? Ah, what is it called? Like the medical industry in general, the whole thing. Nobody was actually seeing a patient. You would only save eight percent. That's the bloat in it, right? Because there's so much money. So every time you crazy, you know, you you got an additional administrator and this and that and this and that, and everybody's taking a little bit of money out of the pot. That's why it's so expensive. I mean, that's a huge part of it. What is the biggest percentage you think in that pot? Administrators. 100%. There's it's it's like 10 to 1 administrators to to clinicians. It's ridiculous. And they all are highly paid. Not all, but uh, you know, you get to a certain level, well highly paid. They're they wake way more money than most even surgical physicians.

SPEAKER_00:

Wow.

SPEAKER_01:

So oh yeah, there's they're all seven figures. CEOs of hospitals and stuff. It's a big waste of money.

SPEAKER_00:

I love this conversation. I mean we we we do have to talk more about these topics as the season and the series goes along because I think it's important. And bring people on. I mean, I know we had plans to bring some guests on this season. Yeah. Um, but it's really interesting. So you're in the newsroom. What are you hearing about the government shutdown? Um, funny enough, nobody's really talking about the government shutdown. Okay, interesting. It it's all about okay, there's a government shutdown happening, it's news. Yeah. Okay, well, how does it affect your daily life? Yeah, why I think it's a good idea. You know what I mean? Like even local news, you should be talking about that. I mean, we are talking about it. And actually, Senator Braun is stopping by the studio tomorrow to talk about AI. You know where he's from? Jasper. Is he really? And he's governor now, isn't he? Yeah.

SPEAKER_01:

Yeah.

SPEAKER_00:

He said senator. Oh, I'm sorry. He's Governor Braun. I'm sorry, that was my mistake. Yeah. I knew him when he was senator too. He's from Jasper, where my family's from. That's interesting. Yeah. So Governor Braun, yeah. Apologies on that. Uh, he is stopping by tomorrow to talk about AI. Okay. Might be interesting to talk to him about the government shutdown, too. You should. So um I you just don't really, in our newsroom at the moment, there's not really a I mean, we are talking about it. Well, nobody's felt much pain. Correct. Right? Like that's that's the issue. And everybody's, I think the biggest thing on everybody's radar right now is air travel. How is air travel gonna be? I mean, that's that's what all the news reporters are talking about, right? They're talking about the government shutdown. And if you're in Capitol Hill, yeah, you're talking about the shutdown and like what the senators are doing and what you know, what the dents are doing, what the GOP is doing, da-da-da. You're not really talking in depth about that in the newsroom. You're talking about, hey, uh is my mail gonna come? Yeah. Like it is when I go to TSA, are there gonna be long lines?

SPEAKER_01:

Should there be anybody there?

SPEAKER_00:

When I fly out, is there gonna be anybody there working there? Actually, it might be better.

SPEAKER_01:

Just free reign. Just let everybody run in. I like it. It's gonna be how it was 40 years ago. Just did whatever you want. Well, you used to be able to uh I used to carry a pocket knife, and they would have you pull the pocket knife out and make sure that it wasn't longer than the length of your palm, and then they let you go on the plane with a pocket knife.

SPEAKER_00:

They didn't even have security before. I mean they did, but they just I mean, my family's from Madison, Wisconsin. There was a very Dane County regional airport. Yeah. I don't ever remember going through security. Like if you were a family member, yeah, you would be able to walk in right up to the gate, see your loved one off, see your loved one get off the plane. Oh, yeah. There was no you don't need a ticket security. No, yeah. I mean, and and look how much it's changed over the last so I mean And to what end?

SPEAKER_01:

Do you think we really prevented that many attacks or or issues that would have occurred based on taking our shoes off and only having three ounces of liquid and all that kind of stuff?

SPEAKER_00:

There's a there's a funny if you ever watch Key and Peel, have you ever watched Key and Peel? There's a there's I'll send you a reel that's very, very funny and pertinent to what we're talking about. Um I don't know, maybe, right? I mean, like again, we're talking about ROI before off the air. And what is the ROI of having TSA, right? Is it a way for them to get more money with clear and TSA pre-check? Probably touchless, the way to go. I know. Have you done that yet? Yeah, it's good. Yeah, it's really good. I this is how okay, so now we're off into travel tangents, but I'm gonna tell you uh the countries we went into, you want to talk about no security, by the way, Florence, Italy. Like there is zero when you when you arrive from an other European thanks for letting all the terrorists know. I appreciate that. I hope our podcast is not resonating, right? We're all over the world. So we are, but uh, you know, when you go into Florence, Italy, if you're coming from another European Union country, you don't need to go through an additional step once you land. If you are coming from somewhere else, you go through security. But the point is, I love how they do things in Europe because if you've ever gone into Europe, they have passport control is all automated. Oh, nice. So it's basically if you're from these countries, you go in, Japan is like that too. You walk, you scan your passport, they have your passport, and they like you they facial recognition, yeah. You solo walk into this area, yeah, and it's like crisp, yeah, it's clear so you can see. Then they do the facial recognition, then they go whoop approved, right through. So this is funny.

SPEAKER_01:

They tried to do this in Mexico when we were going. Yeah, they have it in Mexico, but it doesn't work. Oh, it doesn't? Not for kids, it doesn't work. It doesn't work at all. The last three times on the far left. Yeah, the last three times we've gone. They just you like try to go in there and they're like, no, no, it doesn't work.

unknown:

What?

SPEAKER_01:

Come on. That Mexican that Cancun Airport?

SPEAKER_00:

Yeah. Cancun airport is interesting. It's interesting. Um, I I don't know. I you know, that's besides the point that we're getting at. We I feel like we could do way off. I feel like we can do 10 podcasts on travel, but because we do it so much, but I'm saying like if we were to adopt something like that in the United States, I think it's great. That would be helpful. Things would go way faster. But again, you've seen the long lines in New York. Oh, yeah. TSA pre-check. Yeah, I mean, it's crazy. For sure. We need touchless. So so I it'll be interesting to see if these things are affected over the next couple of weeks.

SPEAKER_01:

I'm gonna be very unhappy because I have travel coming up. I really, really am going to be unhappy.

SPEAKER_00:

But that's that's America, though. I mean, no matter what you think, I think there's been this kind of I don't know, let's say over the last 15 years, right? There has been. This, I don't know if it's a stigma or if it's a thought process. Oh, like nobody's traveling anymore. It's expensive to do things. Have you ever gone to an airport? It's packed. Yeah, oh yeah. It is packed. Yeah. I'm sorry. Yeah. You're gonna tell me nobody's traveling. Everybody's traveling. Went to Florence and like you can't even walk through the streets, it's so packed. People are traveling. Oh, 100%.

SPEAKER_01:

Yeah, they're spending money. I I think the inflation on travel has not kept up with the overall inflation. So I think people are making more money, and even though it's expensive to travel, it is expensive. So the cost of travel has not increased as much as wages have. Correct. So it's easier to travel. More people are able to travel because it's less expensive in relation to the amount of money they're making. Which I like traveling, so it's fine.

SPEAKER_00:

Not when TSA is shut down though.

SPEAKER_01:

So so I'll I'll do as we close this out, I assume. Uh I will make a push that everybody reach out to their senators and get this thing finished and passed because it's not worth it for the pain that it could potentially cause. And it and like I said, it it'll be a a big, big issue for medicine.

SPEAKER_00:

Government shutdowns are always a pain. And to quote Tim Kane, nobody likes a government shutdown. We'll end it there.

SPEAKER_01:

We aren't he the one who was like screaming on stage. No. Is that Walls?

SPEAKER_00:

No.

SPEAKER_01:

Who was the wall? I can't remember. Please don't get me started on Walls.

SPEAKER_00:

I lived in Minnesota for years. Um you're talking about uh uh uh Kane. No, D no, not we're talking about you're talking about the guy in 2004. Yes, who was like, we're gonna go to Iowa, and then we're gonna go to Minnesota, and then we're gonna win in a thing, and then woo! Yeah, that guy. I can't remember that guy's name. Comment below if you remember. I can't remember that guy's name. He literally ruined his entire political career two seconds. Oh, the good old. I said it like Ric Flair. Woo woo! Well, this has been going under anesthesia answered with woo, Dr. Brian Schmutzler. I'm Fahid Saderzani. We are brought to you by the Butterfly Network. We'll see you in the next one.

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Dr. Brian Schmutzler

Host
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Vahid Sadrzadeh

Host