 Thank you for coming in for another exciting episode. I hear our theme music playing in the background, which is kind of cool. I have my other host here, Rick's the Fundmeister, Maurer. Nice to see you, buddy. Hey! It's good to be here again, Gordo. Nice to be here. And this is session two in series. We have Mary Maurer, who is an RN, and we're going to talk about the wonderful world of the cost of health care. Okay. The last time we talked to you, I just finished delivering 10,000 baby, so this is going to make me a little tired. I'm a little tired. Anyway, great to have you here, Mary. Thank you. We'll talk about the wonderful world of health care and why it's so damn expensive. Anyway, before I get into this, I always like to do a little something. I usually rant, but lately because of cryptocurrencies and Bitcoin and all this stuff, I've been asked to keep people abreast of what's going on. So anyway, so cryptocurrency note of the week. It almost hit Bitcoin itself, almost hit $4,000 per Bitcoin. Not for the faint of heart. I told people to not listen to me if you wanted to invest. That puppy dropped down to below $2,500 today. So it's now it's doing a trading at around $2,400. So in the course of one day, it dropped $600, so get ready for that. Might be time to invest if you're not already. Don't give any financial advice, Mr. Flight Leicester. Then there's Ethereum, Ethereum on the other hand is doing pretty good. It's at $338. It's up $78 in a week, so it's been moving along pretty good. So those two are the two that are kind of in the news right now. Interesting, Apple CEO slash, I'm sorry, Apple co-founder, Wozniak, remember him? He said he bought Bitcoin at $700 and he said he just bought it to just see what the technology was all about. But you don't have to buy it to see what the technology is all about. So he might see something in it. Anyway, like I say, it's not for the faint of heart. There's only about 3 million people right now invested in it. A lot of news. You're seeing it more and more in the news. So going to be exciting to see it unfold for the rest of this year. Yeah. Hey, my health care bill would not. Anyway, marriage, great to have you here. Thank you. Well, again, we wanted to do number two because we were getting into things that would be very interesting. But first, a little background on where you went to school, your degree, and. Yeah. Don't talk about my age, but I have been a nurse a long time. 10,000 babies. Let's say more than 25 years, yeah, and 10,000 babies worth. And I'm a registered nurse. I went to nursing school at Stanford University. And so I have a bachelor's in nursing. And I've worked at a local hospital here for over 25 years. Yeah. Plus you have the manly experience in other hospitals on the mainland and so on. And then the fundmeister himself has worked in the health care industry. Yes. I have been known to work in the health care industry. Well, you were employed. Let me put it another way around. I wasn't employed. You were employed by the health care. You might be. Overhead. That's your name. And hopefully, yes, I did contribute to overhead, but hopefully I added funds to pay for that overhead as well. Quite frankly, I'm not certain of any, certainly, local health care facilities who take Bitcoin. It has payment for their hospitals, but you just never know. I can help them with that if they're so inclined. There might be some transactions that take Bitcoin and convert it to a different currency that would be acceptable at a local health care facility. Maybe you should come out of retirement and advise people on how to do that. And maybe not. No. Anyway, so when we talked last time, we'd just gone through the, you know, how healthcare has just been evolving and changing with electronic medical records, no longer running around with stickers on your shirt, you know, those kinds of things. No, we do run around with stickers on our shirts after all these years, which is one of the things that I find just incredible that they still do that because it's such lost invariably one of those stickers will get stuck on the door as you leave or you forget to put one on the charge sheet and you go home with it. I don't do that anymore, but I'm pretty careful about it. But I mean, it happens, especially when you're running around. You've got a nurse that's got so many patients per depending on the unit that you're in. Right. So typically you could be taking care of four or five patients. Yeah, right. Right. And you've got and you're running from room to room everybody on your shirt. Yeah, so maybe, I mean, maybe people don't know what those stickers are, but every single item in the hospital that you use for a patient has a charge sticker on it. And that sticker is supposed to be peeled off and put on a charge card. Which is with your medical record? Yeah, with a patient's medical record. And then that's how they get built for the items that they use. Yeah. So if a $8 toothpaste gets stuck on the door, then you won't get real for the $8 toothpaste. Yeah. Yeah, even, wow. But I thought we had electronic medical records. Why are we not coming in with iPads and iPhones and just going Mary and just scanning everything? I don't know. Will somebody please figure that out? Because yeah, we've got electronic medical records. We're scanning patient's bands to make sure we have the right patient. The right med. Yeah, the right med. And yeah. And you have cows, computers on wheels. Yeah, computers on wheels. You've got those as well. You've got the PICS system for the drugs, right? Where you've got to put that in and get the drugs dispensed. Yeah, which is quite amazing technology. Post-it notes. Yeah, we still have stickers. Which is kind of an interesting, I guess because it's faster and it's clean. Yeah. But I think some hospitals have figured out how to bundle things together so that you've just got, you don't have to run for each little individual thing. It peels stickers off. It peels stickers off. So they're slowly, slowly getting in there. So that's one thing about the lost revenue streams that you've got really no way to account for them per sway. Per sway. Per sway. New word. Per se. Per se. I mean, the drugs are not handy. I mean, there's a lot that goes through that because you've got to track that through the systems and so on. So there's, it's not like there is, like I'm in there like, here's your toothpaste or here's your lunch or whatever. The drugs get control. Right. Yeah. They are controlled. Every little, every little thing from a vitamin to an aspirin to a narcotic is taken out of that PIXAS machine. The PIXAS system. Including needles. No. No. That's different. That's all different. Yeah, it learns it. So, talking about the high cost. Yeah. So you figure that someone comes in for whatever procedure it is and then all the things that happen. Mm-hmm. And you and I have talked about this and I'm not sucking up at all, but I think that the hub of all of this is they are in, is the nurse. The nurse, the nurse's aide and the team that's assigned to that patient. Right. You know, yes, we like you doctor so-and-so, but you know what's going on with the patient. Yeah. And we're keeping them safe and, you know, observing for any variances in their condition that need to be looked into and managed. Yeah. And all of this. Yeah. And you see that. I mean, as I got my rounds. Uh-huh. I think I'm sounding like a doctor. Yeah. So I've got my rounds and then I come in and I see you and whatever. But do the doctors really listen to the nurse for anomalies and things that have happened as far as treatment goes and- I think they do. Okay. I, yeah, I really think they do. I've never had a problem. Maybe when I was younger and I was more nervous about, you know, approaching a physician or speaking my mind or saying what I'm observing. Yeah. But now, no, I think that, I think they listen to nurses, even the young new ones. The young new ones? Yeah. Well, now that you're a seasoned young nurse, I mean- Thank you. So the seasoned young nurse, they have a tendency to pay attention. Yeah. Do the surgeons care about cost? Or the surgeon? I say surgeons because of- Yeah. My wife is in the OR, but does surgeons or physicians really care about cost? I don't think when they're in the heat of the moment of the operating room they're thinking about that. Yeah. They're really not. They just want to do the best job and the safest job. Yeah. So- And the most sometimes that's mixed in with a little bit of convenience for them too. Okay. Yeah. So a nice white Z-type surgery and a surgeon wants a particular tray set up a certain way, whether they use everything or not, that's got to come out. Yeah. Yeah. That's true. You get type of care and all of those kinds of things. Yeah. And they all have their own little quirks and ways of doing things and ways that they were trained that they feel more comfortable with. Comfortable with. Yeah. And we just get it while talking about you and I and how well you get taken care of. I think, Mary, that that comfortableness also then allows for a better outcome for that particular physician. Yeah. Sure. I think so. Yeah. For the most part. Yeah. For the most part. And I think that would be important if I were a patient having surgery, I would want my physician to be very comfortable to get the best outcome for me. Without worrying about cost. Cost. And this is where I get a little kind of confused. When I see all these clinics that are opening up now, whether you're XYZ, ABC, DEF, whatever. Yeah. And they're independent doctors, physician, surgeons who have broken away from the hospitals to create their own same day surgeries. Mm-hmm. Now these are in the, now they're in the business of being a profit center for them. Mm-hmm. And I'm just wondering if you're going to get the same level of care because they're in the cost-saving mode or in their revenue saving mode versus if they're in a hospital where they just get to use the facilities. Mm-hmm. That's a good question. It's a very good question. It makes you think that maybe not. It just makes you wonder. Yeah. I mean it's just the kind of thing I just wonder about when you go to the big name players around town. Right. Would I rather go to a big name player or do I want to go to someone that's broken off from the big name player and started up their career? Yeah. You know, famous cases in the news of people who have gone to clinics like that and the outcomes have not been good. And you, and I have often thought, oh, say you just gone to the hospital. It might have been better. It would have been different. Yeah. And I'm not saying, I'm not saying it's bad. I'm not saying it's good. No. I mean it's, it gives you, it gives you the recipient of the care, the affordability that you, you may want. Right. So there's that piece in there. Yeah. Uh-huh. No question is, is there a, an outcome monitor who's looking at all of those, whether it's in a hospital, clearly there are some outcome monitors in the hospitals, the joint commission on, on accreditation, things like that. Or they, do they have those? I'm not, I'm not aware of it. There may well be, but as a consumer, I would hope that I could have those same kinds of accreditation modules across the entire healthcare that we do have on the hospital. And a lot of them have to. I mean, there's no question about it. So I'm not saying, don't go to the clinics. There's a lot of things that they have to do just to get licensed. Exactly. All of the permitting and the things that they have to do there, and they've got qualified RNs, LPNs, and everybody else that's in there. But it's just one of my little things that I wonder about. Again, I could say, well, the big guys are processing so many people, maybe I don't get the personal care I would get if I went to the clinic. So there's that trade-off, right? It's like I'm going through the factory versus I'm going through the boutique. So I'm going to get the boutique thing that will give me more of a friendly type care and personal care that I would get there. So it's a difference. But it's all, I come back to this costing thing. It all costs money. Right. And all of that costing of money is consumed by us, whether it be in our insurance premiums or whatever. So with that, we're going to, believe it or not, we've already burned through half. Can you believe this? It just goes so quick. And we're going to dig a little deeper because we're going to talk about the role of the nurse in saving money. Oh, OK. Yeah. And so that's going to be an interesting conversation. And then Angus has something, so get ready for him. I know that he scares the hell out of you. Anyway, Berto the Techs are here with Rick's the Fundmeister and Mary Maurer, our R&D talking about the cost of health care. We're going to take a one minute break and we'll back. You're watching Think Tech Hawaii, 25 talk shows by 25 dedicated hosts every week helping us to explore and understand the issues and events in and affecting our state. Great content for Hawaii from Think Tech. 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Search Dive Heart.org and share our mission with others and in the process help people of all abilities imagine the possibilities in their lives. Welcome back and we just got Angus off of the beach and the real question today is who's lip syncing? Hey there, how you doing man? You're not supposed to touch me with that thing. I'll put a little rubber on a piece of technology that the cab is using and hopefully they'll be able to throw that picture up there. I went to Kahala Mall and then this cool thing, it's a foam on the wall. Identical, the biggest thing is they can expand it one day. Anyway that's my gadget of the week. What do you think I'm being sarcastic? Just a wee bit. And you tell everybody like I do every week, let your wing gang free, where are you being? Let me check your tonsils. Silliness never goes away. We needed more and more. Yes, no one knew who Angus really was. So we're talking about the high cost of healthcare. So now let's come into the, first of all I think nurses are highly underpaid. So first you go on the record. For all the things that you have to do from the patient to the family to the physicians to the medical operation that you work under. I mean you've got a lot of pressure. Your license is on the line. You've got the patient, the family, the doctor, the service provider, the radiology, all those different ones that are all looking at all of you. So with all of that happening, what are some ideas that we could have on how to reduce the cost of healthcare? Well, how are we ever going to change the fact that our population is getting bigger and bigger that doesn't have insurance. That's true. And older. And older. And that is sucking it dry. Oh yeah, big time. But also one thing I think about every day is when I walk into the hospital at most of the hospitals here in Hawaii it's like walking into the Hilton Hawaiian Village. Yeah. And so I kind of don't get why we have to be like a hotel. It must cost an awful lot of money. Yeah. To make it like that. I mean it's nice and your experience should be good and comfortable. But it doesn't need to be the Kahala Hilton. Yeah, it doesn't have to be so fancy. Without you paying a premium. Now if you want the Kahala Hilton then pay the premium. Right, right. Right? Yeah. But if not then you've got. Then you've got a Holy Cross. Then you should do it. The Holiday Inn or you've got a Motel 6. Yeah. We'll leave the light on for you. Yeah. Yeah. But. So that's true. We're going to go into some of these facilities and they are just impressive. Right. And it's nice but I just don't think that it needs to be like a hotel. So there's, now will the general, will our general population really want to accept the non-Kahala? Probably not. Type hotel. Yeah. But they might not do it. But it is there. They may have, you know at some point in time the bubble's going to burst. Yeah. Right. And I don't know whether, I don't care if you call it Trumpcare, Obamacare or whatever. Every one of those came with Cross. Yeah. And associated with that. Now what about waste? I mean I go into these facilities and. Oh yeah. The stuff that, what's the package gets open whether it's used or not. That's now. That's tossed. That's tossed. Yeah. Linen. Linen. Piled on and gets used or not used. Right. A lot of it's not used. But mostly supplies. Supplies. No. Tossed. We try to keep, we have a little area where we try to keep those open supplies that aren't used to give to a mission. Okay. But I, you know I think maybe even that has been axed recently. I think you're right because I was going to say what I've heard happened is that they don't want to give those to the missions. In case of a lawsuit. Right. That will come back the other way. It might have been contaminated and passed on. Right. And then you've passed it as a lawsuit because something provided a mission was provided there. So, so we're our own worst enemy. Yeah. Tort reform we need, which I talked about before, but then we've got this kind of thing. The operating room, we talked about that earlier and what happens in those kinds of things. So the hotel, the hotel, I'm getting depressed. You've got the hotel kind of mindset. What else can we look at? I mean, Well, it's just, I'm not sure because the whole demographics of the patient population has changed radically since I first started. There's so many, you know, Diabetes. Well, yeah, it's that. Right. Our health. We're all chunkier. Yeah, our diet. We're obese. We have diabetes. High blood pressure and all related to obesity. So that has to change, but that'll make a big difference. And then doing something about the uninsured, less fortunate, almost people. Wasn't that supposed to be taken care of with Obamacurin? I thought it was. Yeah, I mean, I'm not picking on it because I'm not by no means an expert at it. But, you know, these same people still show up at the hospital. Yeah, right. And did you know, did they sign up and register for Obamacurin because they're going to get a $700 tax fine? Who never filed a tax return in 20 years? I'm going like, yeah, so what am I missing here? Yeah, exactly. And it's just getting worse and worse. It's getting worse and worse. And it's not just in Hawai'i, it's everywhere. Right, yeah. Oh, man. And the quality of care, the quality of care is improving. Yeah, quality of care keeps going up. And then the, um, the demographics part. The demographics is changing it. Yeah. So when we think about it then as we're coming down to this is that it really is up to us. If you want to control the cost of health care, then it's up to you. It's lifestyle. Absolutely. Yeah. Yeah. We're always telling each other we've got to stay healthy because we don't want to end up in a hospital. Yeah, I've not. No way. I mean, I don't want to end up in there, you know, as much as I hate to exercise, I got to do it. Um, you just, you just have to. Yeah. Um, unfortunately, unfortunately now when I get on an airplane, I'm always looking at the size of the people getting on the airplane. Yeah, I know. And I can guarantee you 50% or more need to be on the treadmill. Yeah. And maybe we got a chart. There we go. So the whole brainstorm. Okay. We got the cost of health care. Well, then how do we spread the costs around? You know, not based on wealth, but what about based on your lifestyle? If you're a smoker, drinker, whatever, then your days in the hospital cost this much. They won't pay anyway. I'm getting so impressed. Yeah. It's just a personal choice. It does a personal choice. And as long as we still give out the freebies. Um, and there have been some where if I'm a smoker, my, you know, health care and I'm not going to be on the treadmill. I'm not going to be on the treadmill. I'm not going to be on the treadmill. I'm not going to be on the treadmill. You know, health care, premium whether I'm insured through my employer. Otherwise, if I have some bad lifestyle choices like smoking, you know, that might cost me a little bit more out of pocket. But then there are other things about what gene pool do I have? And some of that. Your gene pool is pretty damn scary. Yeah. And, you know, and I inherited that from my parents. Well, they're not that scary. Yeah, they are. Okay. So, um, you know, some of it is choices I made. Some of it is choices that I really don't, you know, have a control over. So I think what we're biggest, I guess, bigger issues and, you know, that's another show. That's a whole other show. Yeah. We won't even get into it. Yeah. Yeah. So, Mary, when we're kind of, believe it or not, we're kind of winding down on this. Any last-minute thoughts? Well, I, I, we still live in a awesome country that has the greatest healthcare in the world. I'm so proud to be a part of it. Yeah. I love seeing the advances that we have in medicine. Yeah. And wonderful people going through nursing schools and medical schools. And, um, I, I wish everyone knew how hard they were to get to where they came from and where they came from. Yeah. How hard they were to get to where they are. Yeah. It's incredible. I do too. And you talk about healthcare and I'll, I'll move in quickly because Hamish was in the hospital. He's one of our viewer. Our viewer. So, um, Hamish was in and they couldn't check him out. And he says in Canada. Yeah. They talked about Canada's healthcare. They couldn't check him out of the hospital because there was no IV nurse available to put the IV in him so he could leave. So he stayed in the hospital for a couple of more days. Waiting for an IV nurse. Until the IV nurse was available. Yeah. Wait, you guys would have done that like. Oh, yeah. We needed an IV nurse. She would have been out. He would have been out. But not. So, so, so again, it's a great system here. It's a great system in Canada, but each of them and in Britain, except when they got hacked. Yeah. Um, but they all have their own anomalies. There's a pluses and minuses on both sides. But thank God we live in a country where we can get wonderful healthcare. Wonderful healthcare. That's true. And that's our key message from this is it's up to the individual. You are the ones. We're the ones that control the high cost of healthcare and it's up to us to bring it down. Yeah. Not wait on administrators. Good point. Exponential office. I like that. All right. Philosophical. That's a word. Anyway, this is Gardner on The Tech. Sorry, I want to thank you guys for joining us. Rick's the fun meister. Mary, thank you for number two. Yeah. I was serious. I'm happy you wanted this show. Oh, by the way. Oh, yeah. Yeah. We got you another solo cup since you didn't keep the last one. Anyway, you got number 121 in the series. If anyone finds like 116, it's worth at least a buck. Anyway, so that's the last one. The last one you're ever going to get. Yeah. Anyway, I want to thank you for joining us again today. Like we say at the In Every Show, one, two, three. How are you doing? How are you doing? How are you doing? How are you doing? How are you doing? How are you doing?