Going Under: Anesthesia Answered with Dr. Brian Schmutzler
Going Under: Anesthesia Answered is a podcast with renowned physician and anesthesiologist Dr. Brian Schmutzler. Together with Award-Winning Co-Host and television journalist, Vahid Sadrzadeh, the podcast aims to answer not only your most pressing anesthesia questions but to provide the most up-to-date medical data available.
This weekly medical podcast will release a new episode every Thursday at 5 am. Thanks in advance for being a listener.
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Going Under: Anesthesia Answered with Dr. Brian Schmutzler
Obamacare on Trial — Again. Here’s What’s Really at Stake.
On this episode of Going Under: Anesthesia Answered, Dr. Brian Schmutzler and Vahid Sadrzadeh dive into the Obamacare debacle. and debunk the myth that health care and health insurance are the same thing. They aren’t—and that confusion fuels bad policy, higher costs, and less access.
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This is going under Anesthesia Answered with Dr. Brian Schmutzler. I'm Bahid Sadarzade. We're brought to you by the Butterfly Network.
SPEAKER_00:Alright, I'm gonna let you in on something that's completely changed the way I practice. I've been using butterfly butterfly probes for years. It's a portable ultrasound that plugs right into my compatible smartphone or tablet so I can start scanning at the bedside in seconds. If you use the older version, or even if you're new to the handheld ultrasound game, let me tell you why this new IQ3 is a game changer and really impressive. First off, having an ultrasound that literally fits in my pocket means I can move faster. Whether it's vascular access, procedural guidance, or just getting real-time insights for my patients. And the tech in this tiny device is pretty incredible. But biplane imaging lets me see short and long access simultaneously, which is huge for procedural guidance and honestly a great tool for learners. The new needle out of plane preset even shifts the scan plane digitally, so I can see the needle tip sooner, which makes a real difference when precision matters. And the image quality, honestly, the IQ3 holds up against some of the high-end cart systems I've used. That's impressive for something that's portable. If you're looking for a device that supports your practice, I can't recommend the Butterfly IQ three enough. And right now they're running a special offer. You can get$750 off the latest IQ three. Check it out at butterflynetwork.com.
SPEAKER_01:Oh, maybe for the surgeon in your life, for the medical anesthesiologist in your life. Yeah, that's a nice gift to get during the holidays. And as we draw near towards the holidays, um, we're talking about two things today. One, we're gonna talk about later on. Yeah. I'm upset about it. Yeah. You're upset about Obamacare?
unknown:No. No.
SPEAKER_01:I'm upset about the Notre Dame Fighting Irish. Yes, I am too. The SEC, the ACC, the Big 12 Commissioner. Uh-huh. It's all rigged. It's all rigged. It is. And I'm upset about it. You're upset about it. Just like our medical health care system, health insurance system. And you at home may be upset about Obamacare. Where is it headed in 2025? Are there gonna be some updates to this? Are we gonna see it repealed, replaced, revamped? We thought. Talk about the Rs. Yeah. Um, but first let's re-examine what Obamacare is. I know we had a conversation about this a little bit again. Yeah, yeah, the 15-year anniversary. Right. So let's talk about what is Obamacare and and what are they thinking?
SPEAKER_00:Yeah, so so the whole reason behind having this conversation is, you know, there's been some um resurgence, another R-word, of talk about repealing Obamacare. So I figure we dig in briefly, talk about what I dislike about it and what I like about it, if anything, uh, and then and then give some some discussion about maybe what what we could do instead. So um, all right, what does Obamacare actually do? So affordable care. Obamacare is the Affordable Care Act 2010. Um there were a few things that it created. So it created this exchange system, which probably most people know, right? Where you can go on the exchange and you can get health insurance that is somewhat subsidized by the federal government but government, but is actually through a third-party insurance company. And then it's it's in some ways based on your income. So you get to pay less or more based on your income, and you can pick the silver, gold, platinum, whatever plan. Okay. So it created those exchanges, although they're still only state by state, which is ridiculous. Um, did a little bit of a Medicaid expansion, not a ton, uh made it so that that insurance companies could not deny you based on pre-existing conditions, which is something we'll talk about. Mandated coverage for anybody over the age for dependents up to twenty-six, okay, but also mandated coverage for everyone, every person. Um, and then the the mandated coverage uh if you didn't do it, you got penalized, and the penalize the penalty was escalating year over year. Okay. So all they all sound like good things for the most part, right? Except the devil's in the details and implementation, because for any of this to work, because they're running it through insurance companies, it's not just like the federal government is doing this, right? The implementation is through third-party, independent insurance companies with shareholders and bottom lines and profit-driven, right? So the whole thing hinges on the insurance companies being magnanimous. Do we think that happened? Based on our conversation about insurance companies? Yeah, exactly. Right? So, so yeah, great. I'll cover everybody, but I'll cover everybody by making sure that everybody else pays more money. This is this is the whole Ponzi scheme of insurance, right? Insurance in general, not just health insurance, every insurance. I'm going to make money because I'm going to bring in more in premiums than I will ever pay out in claims, right? So that's why insurance is sort of a especially for um higher income people, right? So you think about the thing I always think about is does Jeff Bezos need car insurance? No, right? If he wrecks a car, he's just gonna buy it. He's just gonna buy a new one, right? But he can't drive in I think every state without car insurance. It's illegal to drive without car insurance. Well, and you can't rent a car without car insurance, right? Well, right, but I mean you can't you cannot get behind the wheel of a car without car insurance. Yeah, right? Yeah. So does he really need that? Does Jeff Bezos need car insurance? No, no, but he's paid for it out of pocket. Right, but he's forced to pay for it, just like certain people don't necessarily need health insurance, but they're forced to pay for it, right? If you're if you're 22 and you think, hey, I'm invincible, I want to take that 500 bucks a month and I want to put it in a savings account, and why do I need health insurance? Or again, Jeff Bezos, right? Why does he need health insurance? Do you think though that like I mean, I get the car analogy?
SPEAKER_01:Yeah, I'm just playing devil's advocate. Yeah. Generally speaking, you need health insurance, right? I mean, how many people pay out of pocket for every procedure?
SPEAKER_00:A lot. Really? Yeah, well, before Obamacare they did, right? I mean, if you if you're independently wealthy, right? Why would you buy health insurance? You don't need health insurance. That's a wage money every year. You would just pay Right. If I if I need my knee replaced, if I get in a car accident, if I've got if I've got$100 billion sitting in the bank, then you wouldn't need, let's say, you have cancer chemotherapy, surgery, whatever.
SPEAKER_01:You can pay the$300,000 out of pocket.
SPEAKER_00:Exactly. Exactly. But it's it there's a mandate now, right? So there's a mandate. But okay, so if you're gonna do this and you're gonna say, everybody, you just created an entire class of demand for these insurance companies, right? Sure.
SPEAKER_01:So you created something out of nothing.
SPEAKER_00:What happens when you create demand? You need supply. And but still, what happens to the price of a product when you create demand? Right, that's all they did. They jacked up the price. So they said, Well, here's a problem. I've got to cover everybody, even if you have cancer, even if you have Parkinson's disease, even if you have the likelihood to get um, you know, dementia. I know all this, now I have to cover you. Well, what am I gonna do to cover my loss? I'm not gonna lose money as an insurance company, right? So, what am I gonna do to cover my losses? I'm gonna jack up the price, right? And so, in response to that, the federal government jacked up the subsidies. So, what do you think the insurance companies did? Jacked up the price. So, what did the federal government do? Jacked up the price. So they're just basically going back and forth jacking up prices. Yes, and guess who's making money? The insurance companies. Correct. Do you does anybody feel like healthcare's gotten better? Healthcare, not insurance, healthcare has gotten better since 2010. Has your access to healthcare gotten better? No. Has your ability to get something done gotten better? Has your ability to see a doctor gotten better? Any of that stuff? In patient's eyes. Correct, yeah. No. Yeah. Worse, right? In physician's eyes. Worse. Worse? Way worse. So prior authorizations have the the denial rate of prior authorizations has gone way up. The uh reimbursement rates have gone down. So look at that. The insurance companies are charging more money and paying less. Who could imagine that a multi-billion dollar company whose main goal is profits would increase profits? So, okay, I have a general question to ask you.
SPEAKER_01:And this is um honestly, having this conversation, I feel like it could be its own podcast, to be honest. And maybe we should make it its own podcast before the end of the year and maybe a good lead into 2026. Yeah. You have chosen a path, but you're also kind of an entrepreneur when it comes to your your livelihood, right? Like you've gone down multiple pathways of hey, like, here's how to keep the doors open in this industry, right? But in different ways, yeah. Not everybody is doing that. Sure. Is 2026 still a good year to become a doctor?
SPEAKER_00:Uh depends what specialty you're going into. So if you're going into a specialty that's going to get replaced by AI, which some probably will, no, it's not a good time. If you're going into a specialty where you are uh hands-on, you're doing things that are procedure-based, I mean, maybe AI at some point with robots will get there, but right now, if you're a surgeon, if you're an EER doc, if you're an anesthesiologist, if you're uh, you know, anybody who does procedures, you're probably fine.
SPEAKER_01:And the reason I asked that question is because with so many limitations, with so many things changing in things that you can't control. 100%. Yeah. You can't control what insurance companies are doing, right. What Obamacare is doing, right? Correct. So you know, and I asked that kind of in the context of you become a doctor to treat patients, to cure disease, to research disease. Yep. Not to deal with insurance companies. 1980 was a different time. Yeah. Oh yeah. Becoming a doctor was sexy, right?
SPEAKER_00:I mean, I'm I'm saying that in terms of like you had full control over everything, yeah, exactly. And you you wrote a note on a piece of paper and you sent it into the insurance company.
SPEAKER_01:You were the CEO of your own thing.
SPEAKER_00:And the and if if they you sent it to an insurance company, they paid what you asked them to pay.
SPEAKER_01:2025 and 2026 is way different. Way different. Yep. There's a there so what is the impetus? What what is yes, you care about disease, yes, you care, care about treating patients, yes, you care about that, but ultimately is it a different game? Is it a different business?
SPEAKER_00:Oh, it's a hundred percent. It's different from when I started in practice 10, 12 years ago. I mean, it's it's different even since then. And so um what is beneficial about being in medicine, aside from the you know, the the the grat gratification that you get from helping people, okay? Which is I do not go into medicine to make money. Like that just there's some people do if your soul some people do if your sole goal is to make money, go do something else, right? Go go do trading, stock trading or day trading or investment banking, go do something else because you will you will hate every minute of your life if all you care about is money. So you you have to care about actually treating patients and what you do. That has to be the core of why you do that. Yeah, yes, and and or if you're in the science end of things, you care about the science, that sort of stuff, right? Okay, so that out of the way. Medicine will always provide a very solid income, right? And we were just talking earlier, like my my most listened to, most watched podcast was about how much the anesthesiologists make, where I don't tell you how much I make. Right. But yeah, so so you're always gonna make a very good living in medicine, okay? But not a good enough living that you want to spend 40 years with dealing with all the headaches, right? You you you don't want to go into medicine unless you actually care about patients. Now, guys who went into medicine in 1990, it's a lot different than it is now. Um, and so if you look at the statistics, and I think we talked about this before, 92% of every dollar that goes into the healthcare system goes not to a clinician, right? It does not go to the people who actually treat the patients, which is insane.
SPEAKER_01:So if you're coming out of school right now and you're right, you're looking at your options. Hey, I've got Marshfield, Wisconsin, yeah. I've got uh Mayo Clinic, yeah, I've got you know, whatever general around the corner, I've got this institution, I've got this hospital. Yeah, you want to take the one with the bigger signing bonus and the or the or the one with the salary that is because that's gonna be your main source of income, right?
SPEAKER_00:It's gonna be the salary. Right, right. So so I mean, in general, the amount of money that you're going to make is not going to be factors of 10 different, right? So if you look at it, you're you're gonna be within probably 10 or 15% no matter where you go. There's gonna be some differences based on call complexity, there's gonna be some differences based on rural versus um urban time all the stuff. Yeah, yeah, yeah. Right. But it's not gonna be a fundamental difference. So you want to go where your practice is going to be the best, right?
SPEAKER_01:Where you having Where you're getting people through the door or you're getting patients, whatever's important to you, right?
SPEAKER_00:If what's important to you is working as hard as possible and making as much money as possible, pick that job. If what's important to you is having the most time with the patients as possible, pick that job, right? There that it's out there, right? If you're if you don't care about location, pick the job that fits what you want the best, right? Most of us end up in a location because we care about location, and then you pick the best job within that location.
SPEAKER_01:So I believe next week is our last podcast before the end of the year. Correct. Yeah, yeah. Let's talk about this. Okay. Because I think this is a good topic. How to pick your job. Yeah, yeah. Well, I mean, it's and it's 2026, right? I mean, you're going into a new year. Is this the right path? Yeah, if you're just trying to decide. So one interesting though that you're saying that about choice and you know we we should talk about that. But Obamacare certainly is not making it easier.
SPEAKER_00:No, no. And and so the other thing I want to talk about is the fundamental difference between health care and health insurance. Okay. Health care in the United States is the best in the world. And you can make any argument you want about we're blah, blah, blah, and infant mortality and blah, blah, blah, right? Where does everybody else in the world come for their health care, right? You get a you get a high grade cancer diagnosis, you get a you know, a bizarre orthopedic diagnosis, you get any of that stuff. Healthcare is the treatment. Right. Healthcare is the actual care given, right? We have the best in the world. And everybody has access to health care, right? So if you because of in 19, the mid-1980s, Mtala, if you walk into an ER, it does not matter if you have any money or not. If you walk into an ER, they have to treat you. They have to treat you, period. Right. So the not only do we have the best health care in the United States, we have 100% access to health care if you can get to an emergency room. Okay, so let's put that aside. Health care is not what we're talking about. We have a screwed up health insurance system. And if you look, the reason this all came up with Obamacare again and repealing Obamacare again is because the big beautiful bill took away the subsidies for it. The Affordable Care Act, that is the opposite of affordable, had to have a bunch of subsidies, even though the, you know, the expensive, even though the independent CB, whatever it is, said, Oh, yeah, you're gonna save a trillion dollars over 10 years and blah, blah, blah. That's all, it's all bull. That's untrue. 100% untrue. It's like it's like 1984 Orwellian backwards speak, right? Where you say the thing that it's the opposite of to make people think that it's good. I I'm gonna speak from experience here. Yeah. I'm a business owner.
SPEAKER_01:Yeah. Guess what's expensive?
SPEAKER_00:Health insurance.
SPEAKER_01:Yes. Yeah. Uh-huh. And Obamacare is one of the most expensive. Yep. Sure is. Yeah. And it doesn't really give you that many options.
SPEAKER_00:It's not, it's, it's not good insurance.
SPEAKER_01:I'm not saying I have it. Right. That was an option. Right. And I'm telling you, it is more expensive. Yep. Doesn't provide the same coverage plan. Right. And it and it's not as flexible.
SPEAKER_00:And many, and many physicians and clinicians don't take it.
SPEAKER_01:They don't take the so they decide, they they choose to decide not to take that on.
SPEAKER_00:Those those Obamacare plans, right? So again, you can keep your doctor, you'll that's more right. You'll have more access, you'll have cheaper insurance. All of it is the exact opposite, which is what anybody who had any knowledge about business in healthcare said in 2010 when it passed. This is going to inflate costs, decrease quality of insurance.
SPEAKER_01:But the main point in doing this was to help insurance companies.
SPEAKER_00:Well, so the main the main point was they that it was sold as we are going to improve access to health care and health insurance. Has it done that? No, it's done the opposite. But most of the Congress and most of the political class in general is bought and paid for by the billions of dollars in the uh insurance industry. So yeah, was it yeah, 100%? So it was definitely given to insurance agents or insurance companies. And then on top of that, what happened, and it's brilliant by the insurance companies, but bad for all the rest of us, is they started creating vertical integration. So they took all this extra money they had, they didn't just sit on it or give it to their shareholders, they put it back into buying things. So now United Healthcare owns all of the means of production from start to finish. Cigna owns all of the means of production from start to finish. Blue Cross Blue Shea, right? So they own the pharmacies, they own the urgent cares, they own. I think some of them even own hospitals now. They own the PBN.
SPEAKER_01:So it's like it's like taking Banana Republic brand, slapping a Kirkland sign on it and putting it at Costco. Well, no, no, it's not that.
SPEAKER_00:It's it's um, okay, so but it's but you understood the analogy. Yeah, absolutely. But it's it's not just that. It is also the Banana Republic saying, okay, well, I'm gonna own the land that Costco's built on. I'm going to own the Costco building. I'm gonna own the company that builds the building. I'm also gonna own the cash registers and the companies that make the cash registers. So they they are pulling money out at every set of means of production. And when you do that, you have no competition and then you have no reason to decrease cost. You just keep increasing costs because what are you gonna do? You don't have any choice, right? Right? So so I don't understand. There's a whole bunch of things that we could do here. But so number one, you can dissociate insurance from your job, right? There's no reason to have health insurance associated with your job. Once you pay for an insurance plan, you ought to be able to get that insurance plan. Doesn't matter if you should be at a workplace or not. Right. Yep. So so you you start at age 18, whenever you get off, it works.
SPEAKER_01:Like a discount if you work at a certain place.
SPEAKER_00:Well no, you have the insurance, or no, your employer can choose to cover any percentage of that insurance plan, right? So that's what employers do now. That's why your health insurance doesn't cost the same as an Obamacare plan, right? It's not$3,000 a month. Because they're covering it. That's part of your benefits. Your employer covers a portion of the of the cost. So it's still a$3,000 plan. You might just only be paying$1,000 a month because your employer is paying$2,000 a month. Okay. So again, you should be able to take that plan anywhere. Now the cost is going to change because if your employer's not paying for it, but as soon as you turn 18 or 26 or whatever, you get a plan, you ought to keep that plan, right? If if we're going to keep health insurance, it also should be should be portable across states, which the health insurers hate, right? The insurance companies don't want that. They want lack of competition in the state because that allows them to drive up cost. You know, the the um the champion of antitrust, Teddy Roosevelt. Yep, right. I there is no way that that this doesn't fit into antitrust. This has to be a monopoly or at least an oligopy, oligopoly, where it's m only a few companies who run all of it and you don't have any choice. Interesting.
SPEAKER_01:Well, so let's say they don't repeal it. Yeah. Let's say they replace it or rework it. What is the best of the reworking options? Like what do you think they do? How can they make it better?
SPEAKER_00:So, my personal opinion, and we've said this before, is that that health insurance companies shouldn't exist, and we should do this direct to consumer, right? But let's say that doesn't happen because it's probably not going to happen to get rid of all insurance companies. Um so what you have to do is you have to figure out a way to dissociate normal daily care with health insurance. And so what I would propose is high deductible plans that cover only catastrophic and large amounts of HSA distributions, right? So you put a ton of money in an HSA so that you can pay. And I think right now that the federal government only allows you like eight grand a year or something like that as a family. I would make it 60 or 70 grand a year. You could put away a ton of money, and your employer can help with that, and then you're paying for all of the things that you need to pay for in the short term. And then what that what that health insurance would cover is if you get in a car accident and you have a heart attack or you know, these big things, like you get a cancer diagnosis, right? These things that are going to be incredibly expensive, but it's not gonna pay for you to get your prescription, it's not gonna pay for you to see your primary care doc, right? We go back to the car analogy. Your car insurance doesn't pay for your gasoline, right? For your oil change, for your tire rotation. Well, I'm sure you do, but then but then your car insurance would be three thousand dollars a month, just like your health insurance, right? Yeah, so so we need to dissociate normal routine care from health insurance. There should be none of that if we're gonna keep the health insurance companies, get rid of all that. We should not be paying for any of that as a health insurance company. We you should be paying for that on your own, but you should be taking that money that you would have been paying in health insurance premiums and putting it into like a locked account, like an HSA. So, you know, if the federal government is gonna get rid of these subsidies, which maybe it does, maybe it doesn't, um, I think what you do then is you take some portion of that, whatever you would have planned to have paid, you know, less whatever, you know, let's let's take out the subsidies. Maybe it's five thousand dollars per year per person, and you drop that into a health savings account. Every single person over the age of whatever, 26 gets that money in a health savings account, boom, ready to go. How does everybody get what they want?
SPEAKER_01:Uh I mean, you're the you're not, right?
SPEAKER_00:I mean, you just can't please everybody. You get rid of the health insurance companies that takes away whatever trillions of dollars a year that they're bringing in, right? I mean, they have profits in the tens of billions each, and there's what, five major ones in the United States? So, yeah, uh, but you get rid of the insurance companies. Everybody except the insurance companies gets what they want, and I don't really care what the So then who who makes the kind of pricing, right?
SPEAKER_01:Health insurance companies go away.
SPEAKER_00:Yeah, why why would you need pricing? Pricing is just like anything else in an open market, right? You don't need somebody to tell you how much it costs to get a total knee done. Right. What is the cost of the market cost of whatever cost, right? And I should walk in and I should say, Oh, hey, Dr. Cien, you're gonna do my total knee for ten thousand dollars, as opposed to doctor, and I'm making up a name, Dr. Smith. He wants to charge me$30. Who am I going to? As long as Dr. Cien is a competent surgeon, I'm going to Dr. Cien. Right. Market forces, free market. That sounds good. Yeah. Sounds great. Will it happen? No, it's not gonna happen. The the insurance company, even if we could set up the infrastructure, the insurance companies have too much control over our federal government to ever be shot down, to ever be be moved away. And if we could ever get the health insurance thing done, then I would go after all the other insurances after that. Car insurance and I mean malpractice insurance isn't as bad as the other ones because they actually cover something, right? Like most of them are forced then contractually to cover your the defense of your malpractice. Um, but all the insurance companies are a big Ponzi scheme. I mean, insurance you know, just doesn't make really a whole lot of sense. Well when you when you put when you put a company in between a person and whatever, that company is taking money out of the power. Sure. So all you're doing is paying money. They have an incentive to increase your cost to get more money, and decrease your coverage. So why would insurance is just dumb?
SPEAKER_01:Making a bigger profit. Interesting.
SPEAKER_00:Yeah. What do you think? What do you think we should do with Obamacare? What do you think we should do with the health care, health, not health care, health insurance industry or covering the cost of health care?
SPEAKER_01:Health insurance is very tricky. Um the the 90 I mean, how many people can really afford it? I mean, let's just go down to that mark, right? And let's go back to the basic, right? Is health insurance a privilege or is it a necessity?
SPEAKER_00:Health care is a necessity. Health insurance is a is not. So I I go back to Bezos. Does Jeff Bezos need health insurance? No. Correct. You should be able to choose your health care. Oh gosh, yeah.
SPEAKER_01:Exactly. You should be able to choose. You should be able to choose your health insurance. Correct. Or not. Or not. And what is well, maybe I turn this to another question on you for the people who can't afford health care without health insurance, what do they do?
SPEAKER_00:Well, they they go and they set up a payment plan and get covered by it. So so here's almost like buying a car. Exactly. Right. What do people who do what do people who can't afford car insurance do or what any other insurance, right? But everybody seems to buy a car. Everybody has a car, right? So so here's the other thing that I would propose, and this one will be incredibly uh controversial. But so if an insurance company denies uh whatever surgery or medicine or whatever, denies any claim, a health insurance company denies any claim, and that patient has a bad outcome because they chose not to do it or not to buy it because they couldn't afford it, that health insurance company should be torturously liable, right? So just like medical malpractice, they should be liable for that, number one. Number two, if it was clearly known that that patient absolutely needed that and there's a way to prove it, they should be clim criminally liable for that.
SPEAKER_01:I I think it um you asked me what my opinion was. Yeah, yeah, yeah. I think it should be a choice, right? I mean, uh it should be a choice of somebody if they wanted insurance.
SPEAKER_00:Yeah, but how do you think we fix healthcare?
SPEAKER_01:Health insurance, sorry. I don't know if we can fix health care. I I don't know if we can. Um I don't know if we can. It's a big question. It is. Health insurance should be sorry. Health insurance and coverage and care should be the choice of the individual. Yep. Okay. Okay. I'm gonna that's what I believe inherently is if there's going to be health care companies, health insurance companies, yeah, it should be in the hands of the person who wants it or denies it. Yeah, yeah. Period. Yeah. I shouldn't have to be penalized because I didn't buy it. Because I didn't buy it. Right, right. It should be j just like everything else. If I don't want a car, I'm not penalized for not buying a car.
SPEAKER_00:But you're penalized for not buying car insurance if you have a car. In fact, you can't even drive without auto insurance.
SPEAKER_01:Uh do I believe in universal health care? I believe that everybody should be able to get health care if they want it or need it.
SPEAKER_00:If they need yes, not if they want it. Correct. Because you can make the argument that somebody who wants a purely customer doesn't need it. Right. I'm not gonna pay for so I'm not gonna pay for somebody's nose job. Somebody who needs health care. Yes. So urgent and emergent situations, yep. And even primary care, if you have something that could lead to a merchant. Correct. Yes, you should be able to get care.
SPEAKER_01:You should be able to get it. That doesn't mean that everybody needs health care, insurance. Insurance, I'm sorry. I keep using the word insurance, and this is why you went over it. Yeah. I should I shouldn't have to need health insurance. Yep.
SPEAKER_00:I should be able to choose that for myself. But you also should be paying for it, right? So you should be paying to go see a primary care doctor. If you don't choose not to get health insurance, so okay. You should have to pay to see that primary care doctor.
SPEAKER_01:So this is the first year. Yeah. And this may be TMI. Yeah. But this is the first year that my wife and I have decided to go to an independent physician.
SPEAKER_00:A DPC, direct primary care, where you pay a monthly fee to see that person. Yeah. I think that's a great idea. And I think it's a great idea to do direct care, no matter whether it's primary specialty, or surgical. And guess what? I love it. Yeah. You text him anytime. Yeah. I love it. Yep.
SPEAKER_01:Because A, it's it's almost like you're not going through a middle person. Yeah. Now somebody does rebilling, somebody does the whatever, right?
SPEAKER_00:But you're choosing to see that person. See that person. And you make decisions together, and it doesn't matter what the insurance company says.
SPEAKER_01:I'll say this. I like that as a start.
SPEAKER_00:Yeah. Isn't that what I just recommend? Yeah.
SPEAKER_01:And now more people are starting, more physicians are starting to go down that path. Yep. Yeah. What do you guys have in mind? Comment below. Yeah. I want to know what you guys think about. I'd love to hear that. Yeah. I'd love to hear what people think is the uh is the end.
SPEAKER_00:I'll be all.
SPEAKER_01:I remember we went to the um to the conference in February last year. Yes. And you asked that question. Oh no, no. This was this was in the summer. This was in the summer you asked that question. Where were we? We went to I don't remember what DC. Went to DC for the uh bio uh the um bariatric surgery conference. Yep, and I asked that question. You asked that question, nobody had an answer.
SPEAKER_00:Nope. Nope. Just like me. Just stunned. But then they came back to uh maybe maybe we should just have patients pay doctors and make decisions directly with their doctors, which oh gosh, isn't that what I said? Exactly. So let's talk Notre Dame real quick. Um so let's do let's do it separately.
SPEAKER_01:We're gonna post it on a separate reel. All right, cool. Yeah, we're gonna post it on a separate wheel, but we're gonna do it. Um we're gonna talk Notre Dame because we're both upset about it. Next week is the final podcast of the year, yep, 2025, and we're gonna talk about should you become a doctor in 2025. I love it.
SPEAKER_00:All right, and the college football playoff is just as corrupt as the health insurance company. That I believe. All right.
SPEAKER_01:Can't wait to use that bite. Yeah. This has been going under Anesthesia Answered with Dr. Brian Schmutz from Vahid Sadrzani. We're brought to you by the Butterfly Network, and we'll see you in the next one.
