 So this is Sam said, you know, he's got his podcast called majority report, just, you know, again, to give you a sense of the world in which we live. Now, his production values are very good. So you'll see that. But to give you a sense of the world in which we live, I have 16,000 something subscribers. Sam has 688,000 subscribers. So not just some minor, you know, second class, I mean, important guy within this world of commentary on the progressive side. And, and we're gonna, you know, see, see what he has to say. And by the way, think about what do you prefer? Medicare for all or Medicare for or just a public option. That is a part of Obamacare, which is if you can buy, if you can buy health insurance in the private markets, you can basically get it from the government. You pay something, you pay something, but you get it from the government. So it's guaranteed. Everybody gets health insurance. And the payment is really, really low. And if you don't have any money, you get it for free. Here we go. This is interesting. When we talk about Joe Biden's desire to add a public option. They hate Joe Biden, by the way, to the Affordable Care Act, even one that people could buy into as opposed to just being limited as the ACA is now to people who don't have an option of getting health insurance through their employer or any other way. And subsidies only being available up to a certain percentage of wealth. So the idea, again, is that the public option would allow anybody to get health insurance. It would be completely subsidized. So it wouldn't be capped. It would be completely subsidized. And it would be run by the government. That is, it would be an extension of Medicare, which is really, really important. And as you'll see, Sam is not a fan of this because he's a bunny fan. He was Medicare for. Contrary to a certain percentage of poverty. And the idea that, you know, costs are crazy. The real question is like, how do you cut costs? Well, here is the former Medicare administrator, Dr. Don Burwick. So the big issue is, with all these discussions about health care is costs. How do you, I mean, health care in the United States, supposedly, the Democrats, the progressives argue, is very, very expensive. Costs are through the roof. They're really, really expensive. So how do we cut costs? And he's going to refer to a testimony that Obama's health care expert made in front of Congress when Obamacare was being passed, who is going to argue that the public option would not cut costs, which is true. This is under Obama. He explains why the public option at a house hearing will not be sufficient for containing medical costs. I'm a little worried about the public option for a kind of technical reason. Insurance companies want to provide insurance to people that don't need it. That is such a bogus argument. I mean, insurance companies don't want to provide insurance to people that don't need it. Insurance companies want to know the what extent you're going to need the coverage and want to have visibility into that so that they can effectively price the insurance. But this idea that insurance companies work, you know, scour the universe and only insure people who don't need insurance. Well, we all need insurance. That's why we all buy insurance and we don't know whether we're going to need it or not. But the idea that insurance companies won't insure unhealthy people. They'll insure unhealthy people. They'll just expect to be paid for the risk that they're taking on. So this presentation of insurance is if, you know, insurance, auto insurance companies only want to insure people who will never have an accident. Well, no. They're willing to insure and they take into account that they will insure people who are going to have an accident. They just want to have an effective way to price that so that they continue to make a profit off of insuring people like that. So this is such a, it's a sneaky way of saying, oh, these insurance companies, they don't care about sick people. Of course they care about sick people. They just want to know how sick you're going to be so that they can price it so that they don't lose money overall on insuring the whole pool. That's how they make money. And so anything. No, they make money by creating a pool from whom they charge more and invest the money and the investment plus what they charge you is more than what you're going to get when you get sick. That's how they make money. They don't make money by insuring only people who are never going to get sick because nobody never gets sick and we don't know who's never going to get sick. I mean, it's like, you know, sure, insurance companies would rather their home not burn down. I mean, you would rather your home not burn down. And some homes have a higher risk of burning down and some homes have a low risk of burning down. And insurance companies would like to charge you enough to compensate for the risk that your house might burn down because it has a higher probability. And the other home might not is safer in some way. It's not in a fire zone. And therefore they will charge them less. And overall in their pool and given the ability to invest the money, they want to make money over time, not on any particular person who is insured. On some people, they lose a lot of money. But overall over the entire pool, they have to make money. That's how insurance works. But this is a way of couching insurance as if it's in a free market, there would never be insurance for people who have high fire risk. No, there would be. They would just be charged based on the risk. And yes, the insurance company would lose money on some of those. And they know that. But that's why they put it in a pool and that's why other people, they're going to make more money on, then they're going to lose on you and overall they're going to make money. It's just a sneaky way of presenting insurance that is half true, but plays into the populations kind of distrust and dislike of insurance companies. Under game risk. So the public option would be used by all the people who really need the insurance. But that, by the way, is not the insurance company. That's us as human beings gaming the risk. That is, if you offer me insurance, that is unrelated to the risk of me getting sick or insurance, that is unrelated to the risk of me getting a fire and you make it cheap, then of course I'm going to go with you rather than go to a commercial insurance company that's actually going to price the policy based on the risk. So if I'm obese and have a high risk there for diabetes and cancer and heart disease, then my health insurance is going to cost a lot of money. Should cost a lot of money because my risk of being getting a disease is high. And of course, if somebody else offers me a cheaper policy, certainly if they offer me a free policy, I'm going to go with that. So it's not insurance companies gaming the system. It's by the government introducing a free or low cost alternative that is not risk based. That is, does not categorize people based on risk. They are the ones that are creating an untenable insurance market. They are basically destroying insurance. And that's what Obamacare to a large extent did. It destroyed insurance. So what you're getting is not insurance. What you're getting is just a mechanism of redistribution of wealth from healthy people to sick people. That's not what insurance is. That's not what insurance is. As soon as you take risk pricing out, as soon as you offer an alternative that is not based on risk or you prohibit insurance companies from using risk as a criteria, it's not insurance anymore. It's just another mechanism of redistribution of wealth. So it's so dishonest because these are not idiots. And of course, what is he doing? He's blaming insurance companies. He says the way insurance companies game the system. No, it's a way government destroys the insurance market. How they make money. And so anything that can be done to game risk so that public option would be used by all the people who really need the insurance. And insurance companies would then try to find ways to have people who really need care go to the public option, which would be a good business case for them. And that's not good for the country. It's not what happens. It's not the insurance companies trying to get them to go on to the public option. That is what the incentives mean. That's what has to by necessity happen. If I tell you you pay because you're you're you're likely to be sick, you have to pay $1,000 and the government is giving you a policy for $100. You're going to go with the government policy. That's just market incentives. That's just human incentives. But it's much easier instead of saying government has just destroyed the insurance market to say greedy insurance companies are manipulating the public to force them into government policy. And by the way, if all the if all the sick people go into the public option, what happens? Prices in the public option go through the roof. It's not sustainable and cost of Medicare expand dramatically. So look, I mean, this is an extension of the argument as to why you can have private insurance if you have Medicare for all. It just needs to be supplemental to what is offered in the context of Medicare for all. So this is where the Democrats are going to come down. You've got to have Medicare for all. Everybody has access to Medicare and everybody's on Medicare automatically. You don't get to choose. And then if you want for special things and we'll see he struggles to figure out what those special things are. If you want for special things, you can buy, you know, gold plated insurance on top of the government Medicare that you're going to get. That is what Medicare for all. That's the only plan that works because the problem with the public option is exactly what they what this guy said. All the highest risk or the highest cost patients go to the public option bankrupt the Medicare system. It's bankrupt anyway. We'll get to that. And the insurance companies make a lot of money because they have all the healthy patients. That's exactly what would happen. But that's not the insurance company's fault. That's the fault of the people designing the system. And because if you have it compete with Medicare for all, the insurance companies are going to try. And I don't know if they'd be able to do it if Medicare for all existed and you still had competing insurance. I mean, I guess in my mind it's an open question for some it's not as to whether you would have enough people who enter into the Medicare for all program. So that the risk pool that is all the people who are involved in the program is the risk is dispersed amongst more people. Yeah, they need they need healthy and sick people in Medicare for all to make it somewhat work. It still doesn't work and we'll get to that but somewhat work. The whole nature of of insurance in terms of health anyways and not true. Well, the other and I mean this is just the way insurance works. It's a small number of people who are going to be responsible for the highest number of costs. That is true. But smart insurance, all insurance companies that is not regulated by government, prices risk in advance to the extent that they have information about the risk. If you speed, if you, you know, and I believe in a free market, there'd be even more ways in which they could they would put a, you know, you would get a discount. If you on your on your insurance, I think there actually are insurance companies that do this today. You would get a discount if you agree to have a GPS tracker on your on your car. And if you drove well, if they estimated that you're driving safely, you would get a discount on your car insurance. And if you were driving like a maniac, they would raise your premiums. The same thing with health insurance. They would actually evaluate your health. And to the extent that you were likely to be using a lot of health care, your premium would be higher than if you were jogging all the time. I guess if you assume jogging is good for you, you're healthy, you know, eating well, you know, we're keeping lean, we're building muscle. If you were actually practicing a healthy lifestyle, your insurance costs would be lower. Now it strikes me that even if you put aside the economics, isn't that just virtuous? If somebody behaves in ways that reduce their risk of disease, shouldn't they injustice, injustice morally? Shouldn't they have to pay less for ensuring their health in the future than people who don't? All insurance is risk based. Otherwise it's not insurance. It's not just we have a big pool, some are high risk, some are low risk, we don't know who they are. We just randomly have a big pool and somehow it works. It's not insurance. That's not the business of insurance. That's what government does. Because government can't price it differently. Government prices it all the same. So Medicare, I mean, is based on your income, not on your risk. The more income you have, the more you pay into the system. And yet you get the same benefits as somebody who paid little into the system. You get in whether you're healthy or unhealthy, makes no difference. You pay based on your income. So all it is is a way to penalize rich people. And it's not insurance. Medicaid is not unequivocally insurance. It's a massive redistribution scheme from rich to poor, from young to old. That's what Medicare is. Rich to poor, young to old. And you might be okay with redistribution systems. But don't kid yourself that Medicare is somehow an insurance. It has none of the characteristics. Of the characteristics of an insurance. But the point is we don't know who those people will be over the course of a lifetime. But you could know. You could know. You could take their blood pressure. You could take their weight. You could take their blood. You could. Oh my God. Now I'm going to say something completely unacceptable. You could even check their DNA and see how susceptible they are to diseases. Insurance companies asked you if you're willing to give your DNA. And if the DNA turned out to be on the healthy side, that is you are less susceptible to certain diseases, you would get really, really cheap coverage. And if your DNA sucked, then you would have more expensive coverage. But that makes sense. That makes sense. Now it's true. The risk is not your fault. Not there. So what? Insurance companies should take all the available information into account in pricing insurance. Now, even with DNA, there's no guarantee that you will be sick. Now there's also other options. You know, what about pre-existing conditions? Somebody on the left would jump up. Well, one thing that a free market would supply, and this makes complete sense, is you would be able to buy pre-existing condition insurance. That is insurance that covered you against losing your insurance policy if you had pre-existing conditions. For example, you could buy it before the baby was born. And again, even that insurance might be priced based on risks, based on the parent's lifestyle, based on the parent's DNA. So, I mean, once you have a free market, the options are unbelievable in terms of what becomes available to you. What becomes available to you. Right? By the way, studying somebody's DNA is not racist. It has to do with race. It has to do with your specific individual DNA. And if fat is associated with lack of health, then fat is associated with lack of health. We are objectivist. We look at facts. Nothing else. Facts. Not collectives. Not insulting people. Just looking at facts. All right. Let's see what Sam has to say. Now, once you've identified them, if you're the insurance company and you want to insure people, you want to make sure those people are not part of your risk pool. Why not? If you can charge them all, you might be able to still make money off of them. And you want to offload them. You can only offload them if there's some way to offload them too, like a state-run program that doesn't care about risk because it's not insurance. And if you offload them into a system where only a certain number of people are paying into the system because they're buying in as opposed to it being taxation on everyone, you'll have a higher percentage of people who will need the service and that's when insurance breaks down. It's amazing how even progressives understand some limited basic economic principles. In Senev's work, when they think it serves their cause, then in Senev's work. I guess they understand that when you offer something for free relative to offering something that's expensive and what they expensive is price based on risk and the free stuff is not based on risk, then everybody who is high risk will go through the free stuff that they get. But they don't get that when you offer homeless people free housing, they're going to be more homeless people because you've offered something free. So they're going to be more people who want the free stuff. So people are going to leave their homes, stop paying rent, become homeless in order to gain the free stuff that you're offering them, which is exactly what's happening in LA right now and in California because there's so much free stuff being offered that in the short run, it might be worth being homeless. So I think the question of private insurance is overblown. Everybody needs to pay into the system. They want to get a different insurance program. That's fine. But I also think you need to make like the vast majority of doctors and service providers also be part of the system. This is important because everybody talks about how much Medicare for all is going to cost. Everybody talks about increases in taxes. And I don't think that's the issue. Even from an economic perspective, I don't think the fact that taxes will have to go up is the issue. And I think you'll find that once Elizabeth Wan and Bernie Sanders offer their plans, they will have all kinds of ways in which taxes don't go up that much and they only go up on the rich. And if you take out all the premiums you have to pay for health insurance and you get to keep those, then what they're going to argue is if you just take that amount and you pay it into Medicare, then your taxes are not going to go up beyond what you're already paying for health insurance. So the issue is not with Medicare for all. What is going to happen to taxpayers as taxpayers? Now, you all know I think the issue is morality, but we're going to put even the morality aside. We're going to focus on what is the real economic damage of Medicare for all. And it's not taxes. All right, let's see what he says here because this is important. Easy to do, I think. You can't get accreditation unless you take a certain percentage of Medicare patients. And at that point, if everybody's paying in and everybody has access to the same doctors. Same doctors. In my mind, what happens with private insurance or not? Now notice, the way, what they want to do in what Medicare for all, if you have Medicare for all, then if there's no private insurance, then doctors have to be treated after treat Medicare patients because that's all there is. Now, what he's saying is even if you have a private insurance, what you have to do is force doctors and emphasize force, curse doctors into taking a certain number of Medicare patients later on in the clip. He will say that he means like 80, 90% of their patients should be Medicare patients. Now, what does this actually do? So notice that behind Medicare for all is a massive, massive scheme to curse doctors, hospitals, drug companies, biotech companies. All the entire medical production, the real damage of Medicare for all is not the taxes. The real damage is to the producers of healthcare. And this is something nobody ever talks about. Healthcare is something that has to be produced. Somebody has to produce healthcare, whether it's doctors, whether it's pharmaceutical companies, whether it's pharmacists, whether it's scientists, whether it's biotech companies, medical device inventors and companies, hospitals, nurses, healthcare has to be produced by all these people. Now, today, today, before we get Medicare for all, today we have about 121 million people. Let me say that again. 121 million people today are on either Medicare or Medicaid. It's about 53 million people over 65 who are on Medicare and about 68 million, 60 million people on Medicaid. 121 million people on Medicaid and Medicaid. Another 177 million people on commercial insurance. So today what happens is the people in Medicare and Medicaid, when they go see a doctor or they go to the hospital, Medicare and Medicaid pays the bill. Now what does that mean? That means that the doctor doesn't get what he wants. The doctor doesn't get what he negotiates. The doctor doesn't necessarily get enough money to cover his costs. What the doctor and the hospital get? And if drug companies, if Medicare negotiates as a plan with drug companies, same thing will happen with drug companies. What they get is what Medicare decides they get. And often what Medicare decides they get is below their costs. Indeed, the reason healthcare is so expensive for all of us who have private insurance. Because not only are we subsidizing Medicare and Medicaid for people through our taxes, we are subsidizing people on Medicare and Medicaid through the cost of healthcare. We are subsidizing it because the doctor, on average, gets 22% less for Medicare than from, than from private insurance. 22% less. Now in some specialties, they get 75% less. They get 25 cents on the dollar. So in general, when a Medicare patient comes to see a doctor, they get paid ridiculously low rates. Well, they need to survive. You know, getting a medical degree is, I don't know, seven years of college. It's residency. It's massive student loans. And these are really, really smart people who probably could have gone into, become lawyers, become programmers, become a whole array of different fields. They have to make a profit. They have to make a return on all the investment that they made in their profession. Well, Medicaid comes in and prices it below at a rate that's not profitable. So what do they have to do? They raise prices on the rest of us. So all of us who are private insurance are paying way more than we should to subsidize Medicare and Medicaid. Now imagine, now that is true in hospitals, where massively Medicare and Medicaid pay sometimes right now for, 40% less than what private insurance does. 40% less than what private insurance does. That's true in every aspect of the healthcare industry. Now what does Medicare for all do? Medicare for all, instead of taking 177 million people, subsidizing 121 million people, which is damn immoral, evil, disgusting, horrific, nasty. And the result is a very high cost of healthcare for those of us on private healthcare. But on top of that, once you have Medicare for all, everybody is now in the Medicare and Medicaid pool. That means every dollar spent on healthcare is 20, 40, 75% less than what we've been spent with private insurance, which means doctors now can't make up the losses from taking Medicare patients. Now they're just losing money. Now what does that do? That means doctors stop working, retire early, don't go to medical school, don't try. Why bother? You're not going to be paid for it. You're not going to get a return for it. And indeed, the political as healthcare costs expand and as more and more people retire and they go, well everybody's in Medicare, but they use more healthcare so the costs go up. What do you think is going to happen? The government's going to have all these expenses. What are they going to do? They're going to start cutting, but they're not going to cut explicitly. They're not going to say, we're not going to pay for your appendix. We're not going to pay for your cancer. What they're going to say is, we'll continue to pay, but we're going to pay the doctors less. We're going to pay the hospitals less. We're going to pay less for an MRI. We're going to pay less for the drugs. And what's that going to result in? Less profitability for doctors, hospitals, drug companies, healthcare providers, producers of all kinds. Less profitability for them, if any. Some of them go out of business. Some of them retire, which is like going out of business. Others just lower the quality. You can see that in Puerto Rico where there's a shortage of doctors. What happens? Huge waiting lines. They only have 10 minutes per patient. They can't treat you properly. They can't give you the time, proper time. The doctors are trying. They're good doctors. They really make an effort, but they can't. They're making something like 15 bucks per patient. How many patients a day do you have to see if you're only going to make 15 bucks per patient? A lot. A lot. Now, quality of care goes down. MRI facilities shut down. Hospitals shut down. And because there's less profit, if any, there's almost no research being done. And what happens with Medicare for all, which is much worse, much, much, much worse than the taxes, is the entire production of healthcare collapses. It collapses, particularly if you don't want immigrants, immigrant doctors who are willing to work for cheap. It completely is gone. This is why there's shortages of doctors in many European countries. This is why you have to wait in line. This is why healthcare is rationed. And this is why there's no medical innovation or barely any medical innovation outside the United States. There's no profits to be had. Why would I innovate if I can't benefit from it? So Medicare for all is not just a problem that our taxes are going to go up. Who cares? I mean, I care. But as long as I can get good healthcare, if they're to pay higher taxes, I don't care. What's really, really, really bad about Medicare for all is that it will cause a complete collapse. Well, at least a slow, steady, systematic deterioration in the production side. And that's the side progressives. And on the right have no conception of somebody said on the chat that there's now an article in the national review, a conservative approach to Medicare for all. Yeah, collectivists don't care. They don't understand economics. They don't care about producers. They don't care what it does to doctors. They don't understand the role of the mind. They don't understand why doctors need freedom. Hospitals need freedom. Drug companies need freedom. Medical device inventors and manufacturers need freedom in order to continue to innovate, to continue to expand, to continue to produce great products. What else happens? Well, doctors now only have 10 minutes to see you. In those 10 minutes, they can't really think. All they do is follow government guidelines for particular treatments of the particular symptoms you seem to have. There's no in-depth analysis. There's no innovations. There's no thinking outside of the box. There's no, if you've ever seen the series House, years and years ago House, there's no houses. Nobody can afford a house. Well, you can't afford a house because it's Medicare for all. Everybody gets the same. Everybody seems the same doctors. That's what Sam said. The whole idea of socialized medicine, the whole idea of Medicare for all is disgustingly immoral. It's destructive. It's anti-life. It's anti-healthcare. And everybody suffers. Everybody suffers. And it's again, not because taxes go up. It's because production, both in quantity and in quality, plummets, goes down because you can't pay for it. And because centralized planning, centralized payment systems, which are basically centralized planning, dictate one-size-fit-all medicine. So the whole dream of life extension, the whole dream of living long, healthy lives is the idea of personalized medicine. Medicine that is personalized to you, to your DNA, to your particular health needs, that there is no one-size-fit-all. Medicare for all is one-size-fit-all medicine. Socialized medicine is one-size-fit-all medicine. And it is a disaster and it would cripple progress and it would make it impossible for us to achieve that personalized medicine that would allow us to live a long, long time into the future. Now there are many philosophies that would offer that to an individual. There are religions that offer it. There are forms of government that offer it. Not forms of government. That's politics. That's a different branch. That comes later. Well, yes, but governments in some areas, in some instances, would define for you choices or dictate to you how to live your life. But I'll retract governments and just say religions are philosophies. How does objectivism differ from the philosophies that many of us have been exposed to in our youths, philosophies based upon religions, theologians, dogmatists? The very first difference. Objectivism tells you that it is not right. It is not proper to men to take anything on faith. Religion is a matter of faith. You accept a religion emotionally or because you were born to it. You have not chosen it rationally. What objectivism will tell you is that reason. Man's reason is his basic means of survival. That is the most important faculty which he has and he has to guide his life and make his choices by means of his rational faculty. He has to make his own choices, but he has to know how to make them. It is immoral for him to act on his emotions, to be guided by the whim of the moment. That objectivism holds as very wrong, very immoral and morality in fact consists of following your reason to the best of your ability. So that rationality is the basic virtue from which all the others proceed. Using the super chat and I noticed yesterday when I appealed for support for the show, many of you stepped forward and actually supported the show for the first time. So I'll do it again. Maybe we'll get some more today. If you like what you're hearing, if you appreciate what I'm doing, then I appreciate your support. Those of you who don't yet support the show, please take this opportunity. Go to uranbrookshow.com slash support or go to subscribestar.com uranbrookshow and make a kind of a monthly contribution to keep this going.