Rich talks about how our Health Care system, while uniquely strong in some areas, is not built for a pandemic like the current Covid-19
Engage the conversation on Substack at The Common Bridge!
Rich talks about how our Health Care system, while uniquely strong in some areas, is not built for a pandemic like the current Covid-19
Engage the conversation on Substack at The Common Bridge!
[inaudible].
Speaker 2:Welcome to the podcast, the common bridge with Richard helpy. Rich is a successful entrepreneur in the technology, health and finance space. He and his wife Leslie are also philanthropists with interest in civic and artistic endeavors, but with a primary focus on medically and educationally underserved children. My name is Brian Kruger, and from time to time I'll be the moderator and host of this podcast.
Speaker 3:All right, welcome to the common bridge. Today is March the 20th. It's a Friday night. I've got rich. I'm here again and rich. These are, these are historic times. Um, a while back you were talking about healthcare sort of in a different arena with different, um, uh, different end zones on the field. If you were, what do you think about that now with everything that's going on with the Corona virus, how has, how has that affected in, in a policy way?
Speaker 4:Great, Brian, thanks for the question and I think a lot of people are interested in, you know, how well prepared is our healthcare system. Um, we have the greatest healthcare system on the planet in terms of diagnostics and treatment. Um, our issue is not at the clinical level. Our issue is not at capacity. Um, we do have a bizarre financing set of methods. I refuse to call it a system because it's not. Um, so Brian, I think you're going to see several things in this pandemic. Number one, you're going to see what is a normal heroic reaction by the people that work in our healthcare systems. Um, they are getting very creative about how they are increasing the capacity for testing and for treatment of people that may be affected by the Corona virus. Um, capacity is rising. Uh, well is it rising to the point that it's going to intercept this outbreak? You know, probably not, but it's certainly there will be mitigation and they're good people that I think largely are making some, uh, very good decisions and part of this, uh, healthcare system, while they're doing the right thing, they're working at economic incentives that are contrary to them doing the right thing. We see, we see hospital systems and physicians offices giving more services, more taking more precautions, which all cost money, putting their lives on the line. Yet they may not be getting payment from health plans, um, at nearly a rate to overcome that. And what's what's occurring is that the cessation of elective surgeries and the cessation of routine care and the cessation of dental services, it doesn't mean that the healthcare financing system is going to relax and spend less money. But what it means is that the resources that are going into insurance premiums are being accumulated inside the health plan and that the health plans at this time aren't approving an elective surgery like a knee replacement would be a great example of, uh, an elective surgery. Um, so the economic disincentives, um, which I've spoken about earlier I think would be addressed by the simple plan that I put forward. And just to recap that, that would take all of the tax supported programs, Medicare, Medicaid, uh, uh, chip, uh, Tri-Care, uh, VA consolidate it to a single bureaucracy. Every citizen gets that and we pay for that on a sliding scale based on income, right on the 10 40. Secondly, a private market for those people that want more choices, they want faster care, quicker access, and the light. And an important element of that is that that would make sure that we have the capacity in the system because insurance means you're paying for capacity you may not need. And it's an essential element. And the third element was to make Medicare part D for prescription drugs available to everyone. And if you think about the vaccines and drug treatments that we hope will alleviate the suffering of this Corona virus, then that would be an essential part of everyone's peace of mind. And then finally for equality that the benefits if they're provided by your employer, that it would be taxable, like the compensation that it is. And if we have that in place today, think of the difference where today we have to divert financial resources to battle a pandemic. And yet we're in a system that rinses through various health plans and doles out money in a way that the health plans can dictate. And, and I'm confident that eventually they'll do the right things, but it's a lot of work to get there. Much more effective is to look at a pandemic and activate a set of protocols that would be universal for everyone. Sure. Similarly, if there are people that, uh, wanted to obtain a test or obtain a different type of treatment, they could do that. Um, I also want to talk a little bit about the differences in our health system and some of the others around the world. You probably seen statistics that are hospital beds in the United States on a per capita basis may appear lower than some other countries. We're hearing a lot about. Yeah, yeah, yeah. So you have to unwrap the numbers a little bit. The United States healthcare has been on a movement to do more of the procedures outside of inpatient hospital setting. Um, you're getting better quality, a better cost, less complications by doing surgery in a day at an ambulatory center than in a multiple nights they inside a hospital. So we believe that the hospitals in the United States are on the way toward becoming big intensive care units. And in fact, many of them are. So when you look at the ratio of ICU beds on a per capita, the United States is very favorable. Um, and again, coming back to the economic, the health plans we're paying for those outpatient surgeries. In fact, they led the effort to get care into a lower cost, higher quality environment. They don't now they don't have to pay those claims cause those electives aren't getting done. But I guarantee you that the premiums are not falling off at all.
Speaker 3:Right. So what you're saying is, as with most insurance of whether it's car insurance or health insurance, it's a gamble and the person is paying for that gamble. And you're saying that they're kind of th th they're moving the stack of chips or they're, or they're moving the victory, right, because you're paying for a gamble. And then when you go to cash in and say, look, I needed a knee replacement. They're saying, well no, no, we're doing something else with your money right now. Is that I,
Speaker 4:well, you can't get the knee replacement. Um, um, some of the state governors are, are, have issued executive orders saying no non-essential health care or dental services. Right.
Speaker 3:So what I'm saying is the gamble, you are the gamble that you made with a health insurance company is kind of, um, it's rigged against you on this point because you have no reason
Speaker 4:they decided they had moved the cheese. Right, absolutely. That is a good description of it. I'm aware in speaking with a number of colleagues in the industry that, um, there's some very creative things going on to increase capacity. You've seen the administration hard about the number of tests, the number of ventilators, right? Um, there's a lot of detail that goes into the testing. It's the swabs, it's the transport, it's the test itself and it helps us are looking for ways to speed that supply chain and then the automation of the testing and the capacity is rising and there's just, it's a very fluid situation now. So, I don't know how many there are growing in terms of the number of Tufts required, but they're doing very intelligent things about testing the people most likely to have the virus instead of testing everyone. And you know, an encouraging piece of news out of this, again, still way too early, is that it's maybe 15, 20% of those people exhibiting symptoms that actually have the virus.
Speaker 3:Yeah. So, so you and I hadn't planned to talk about this, but I did want to bring it up. Um, so when we get a news item the next day, it didn't happen. And I'm in Michigan right now and they say, you know, it spiked from a hundred to 303 days, but they've also tested about 6,000 more people. Um, the, the charge for the media at that point is to say this is spiking. And I think that might be a little bit responsible is, and that's what you're saying, right? They're testing a lot of people, but maybe only 20% of the ones that they thought had it had it. But it becomes a numbers thing at that point that they're testing more people.
Speaker 4:Absolutely. And yeah, more responsible journalism would say, yesterday we tested 200 people and we had 10 people with the virus. Right. And so a very small positive rate. Yeah. And then, you know, today we tested 2000 people and you know, we got a hundred, um, uh, positives and instead they want to report, Oh, the number of cases of positive went up tenfold.
Speaker 3:Right. And they used the word skyrocketing, right? They say it's skyrocketing, it's spiking and it's not really.
Speaker 4:And, and those, those aggregate numbers are important because there will be metrics developed of how many people we believe are exposed, how many people exhibit symptoms to how many people get tested, to how many people are positive to how many people require, uh, intensive care in the form of ventilators to, to be cured. And how many people aren't able to survive the virus. Um, those data sets are being built right now. Um, but it's, it's not a ball score. There's correlation and interrelation amongst the numbers and that's something we need to keep in mind. Um, I have been encouraged, um, by uh, some of the, uh, competent leadership. I hope that everyone we've elected and everybody that's working in public health or private health is a very competent person and doing the best they can. I hope that the president, the vice president, the senators, the governors, their representatives at the state national level, I hope they all lay down their partisan arms at the door and begin to work together in order to extinguish this virus. I think there's going to be some very interesting analysis after we are past the peak. I will tell you I've been doing a little research on a couple of timelines and it's astonishing what some of the media saying today and when you lay it against a calendar, I think people are going to be shocked and that is something that I will be talking about in a future podcast. The common bridge is about let's not give into partisan party politics. That policy should supersede that. Um, I know that not everyone is on board with that, that folks are still thinking they can win the pandemic. Um, which is just a bizarre concept. You know, we are going to use this to defeat our political enemy. It's, I can't even begin to understand that kind of logic at all, but there are people playing that game and as usual, your judgments be a little bit better than mine on that. So maybe we'll hold off on that and stay focused on the, uh, on this pandemic on Corona virus for the next, uh, episode or two because, um, we're getting a lot more listeners for this. I think they're, uh, glued to it as they are a lot of things with us. But I think some of the things that you're saying, uh, helps make people feel a little more comfortable but also has, I'm thinking about things in a different way to what Brian, if you remember on the common bridge, I've said we need our elected public servants to behave better. We need our media to be more responsible. And I can tell you unequivocally they have not been. And it's time for that to change. And, and the facts laid out are going to destroy much of the media narrative and it's going to call into question the behavior and the conduct of some people that we have elected. Yeah. And again, they're only doing what they believe will cause them to, and I'm holding up air quotes wind. And until we as a people demand better behavior in order to win and keep that office, we're going to keep getting it. So as always, I'm hopeful for a better day. Um, I think we're going to have a fascinating society on the other side of this pandemic. I think we're going to discover there's a lot of things that we did and a lot of things we desired that we've found out. We probably really did eat to do it. I'm talking pre virus. Sure. And there are things that we thought we desired that we really don't, you know, people are at home having conversations, having meals with their families, uh, staying in their communities, going for a walk in fresh air. Uh, there's a long list of things that caused our frenetic society to be frenetic and now we have been barred from doing that. And as an internal optimist, I think we're going to find a much better balance. We also look at the number of things that we can now do online and now with the impetus of necessity, we are doing more things online from visiting with grandkids to conducting business, to having a podcast, to having podcasts, right to advancing that. But again, just the, the, the teaser I will put out, um, I am going to lay out a couple of parallel timelines and let people reach their own conclusions. And in the meantime, uh, let's hope and pray that uh, the good people in our health system and the people in our government will, uh, be successful at limiting the damage from this awful virus. That sounds good, man. Rich, thanks a lot for your time. Uh, again, it's always appreciated and um, folks, thanks a whole bunch for listening out there. We uh, are impressed with, uh, the number of new listeners we get every week and um, tell your friends about it. While they're home and and come visit us at the common bridge. Thanks, rich. Thanks Brian. Always a pleasure.
Speaker 2:You have been listening to Richard healthy's common bridge podcast recording and postproduction provided by stunt three multimedia. All rights are reserved by Richard helpy. For more information, visit Richard helpy.com.