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Episode 2031 Transcript

00;00;01;14 - 00;00;05;22

Announcer

And now America's Healthcare Advocate, Cary Hall.

00;00;05;24 - 00;00;24;01

Cary Hall

Hello, America. Welcome to America's Healthcare Advocate show broadcasting coast to coast across the USA. Here on the HIA Radio Network. If you want to find out more about us, go to the website America's Healthcare Advocate.com. These shows are all posted on our 15 podcast platform and our YouTube platform.

00;00;24;01 - 00;00;49;29

Cary Hall

Our YouTube platform's got over 450,000 views as we speak. So we know a lot of you are following what's on YouTube. So we do the show here in the studio, live on the radio, and then we turn around and post that show on the podcast platform and on the YouTube platform. And I want to say hello to all the folks up in Wheeling, West Virginia, Steubenville, Ohio WVLY AM 1370 and FM 97.7.

00;00;50;01 - 00;01;13;07

Cary Hall

We got a couple of emails from folks up there and just want to say hello and thank you for putting us on the air, becoming part of the America's Healthcare Advocate family. You know, today is going to be an interesting show. The topic is national health care. And I think it's an important topic. And instead of me pontificating on my views about national health care, I'm extremely fortunate to have in studio with me today.

00;01;13;10 - 00;01;16;14

Cary Hall

Dr Firouz Daneshgari. Hello, doctor.

00;01;16;16 - 00;01;17;06

Dr Firouz Daneshgari

Good morning, Cary.

00;01;17;11 - 00;01;19;00

Cary Hall

Great to be here. Great to have you here.

00;01;19;01 - 00;01;19;19

Dr Firouz Daneshgari

It’s a pleasure to be here.

00;01;19;24 - 00;01;22;16

Cary Hall

And thank you for flying in here from Cleveland.

00;01;22;19 - 00;01;23;06

Dr Firouz Daneshgari

My pleasure.

00;01;23;07 - 00;01;43;24

Cary Hall

So we're glad to have him. So let me give you a little background on Doctor Daneshgari. And I think you'll understand why I'm excited to have him here. And he's going to be able to talk about his experiences in national health care programs like the UK, like Japan, like Germany. So we're going to hear what actually happens inside those programs and how they take care of their patients.

00;01;43;27 - 00;02;30;23

Cary Hall

So Doctor Daneshgari as an executive surgeon-scientist with an impressive track record in training, clinical experience and leadership in health care. He completed his medical and surgical training at prestigious institutions including Loyola-Marymount University in Chicago, University of Chicago, University of Colorado Health Sciences, University of Texas Southern Medical Center, and Case Western Reserve University. He is assistant professor of Surgery at the University of Colorado, and founding the first fellowship program in female pelvic medicine Reconstructive Surgery at the Cleveland Clinic, professor and chairman of Upstate Medical University, Suny, and professor and chairman at Case Western Reserve University, and a founding director of the Urological Institute at the University Hospitals of Cleveland.

00;02;30;25 - 00;02;48;15

Cary Hall

I think you can see he's slightly qualified and on top of all of that. He's a retired lieutenant colonel from the United States Air Force Reserve. Welcome, welcome, welcome. And he's showing me his ID card, and I. Yeah. So, it's it's, it's great to welcome a fellow blue suitor. So, well, to have you on.

00;02;48;15 - 00;03;08;06

Cary Hall

So we had dinner, you and I, just the two of us. And we got on to this topic, and I was blown away by your knowledge, more importantly, by your experience, what you've actually seen and how these systems work. So here's the thing, okay, this Medicare for all. And if you don't think that's an issue, it is an issue.

00;03;08;06 - 00;03;24;11

Cary Hall

And it'll become a bigger issue depending on who's elected in this particular election that's coming up. And here's the thing. People, you know, everybody thinks that, you know, that's going to solve the problem with health care in this country. Well, we're going to explain to you what really happens when you have a single payer national health care system.

00;03;24;11 - 00;03;27;00

Cary Hall

So without that doctor.

00;03;27;03 - 00;04;10;09

Dr Firouz Daneshgari

Thank you. Cary. You know, as you said, my, career trajectory, was really about being a Surgeon-Scientist. I went through the ranks as you mentioned, and I was fascinated and filled with enthusiasm. How basically I can advance the, knowledge and the science through my own work, the networks I had set up, the hundreds of people that I've trained and so forth, until I reached out to the observation that the sickest of all is our health care system itself, that is making our people sicker and frankly, making our, economy to suffer.

00;04;10;11 - 00;04;56;12

Dr Firouz Daneshgari

So this is this happened when I was the chair at, one of the major institutions. And because of the success I had, they asked me to serve on the board of that $3 billion enterprise. That is where my attention turned to this fact that our system is sick and needs to be saved. Not only to be saved just because it's not working for our people, is because we are sitting at probably the biggest opportunity or one of the biggest opportunities in our, in our history to create the next biggest chapter of generational value and wealth for our beautiful country, because the health care is the largest industry, in this country.

00;04;56;12 - 00;05;16;21

Dr Firouz Daneshgari

Last year we spent four and half trillion dollars on health care. And I'm going to repeat that four and half trillion dollars. And that is what our entire budget is spending. It was about 820 billion. So we are spending five times more than our defense budget. And the defense no one dares us dares to touch us.

00;05;16;27 - 00;05;18;28

Cary Hall

So far, so far, so far.

00;05;19;01 - 00;05;39;19

Dr Firouz Daneshgari

We're spending five times more than that on our health care. And our people are not getting the value. Number of Americans with chronic conditions is more than half of the Americans. We are spending more than 70, 80% of our spending on those chronic conditions such as obesity, diabetes, cardiovascular heart attacks, stroke, heart attacks, and the data.

00;05;39;19 - 00;06;11;13

Dr Firouz Daneshgari

Recent data shows our longevity. Our lifespan is getting shorter and shorter. One, more fact, and I'll stop on the spending we are spending. Last year we spent 13,500 per capita, per person per year. This compares to Japan that spends 4300 per capita. France has spent 5900 per capita, and UK has spent 5400. So we are literally spending more than two, sometimes three times on those peer countries.

00;06;11;19 - 00;06;27;25

Dr Firouz Daneshgari

And our results are worse than that. So we have an expensive and mispriced system. So going back to the issue of the health care, the question really, for the bigger question is what system of health care delivery is the best for us?

00;06;27;25 - 00;06;29;04

Cary Hall

So let's talk about yeah.

00;06;29;06 - 00;06;29;13

Dr Firouz Daneshgari

Yeah.

00;06;29;13 - 00;06;50;03

Cary Hall

So so how so we're spending more. They've got national health care in the UK. They've got national health care in Germany. They've got national health care in Japan. So let's just start with the UK as an example. And you know, what do you see there in terms of delivering care to patients compared to first of all choice.

00;06;50;09 - 00;07;00;14

Cary Hall

Right okay. And and care. Let's talk about let's talk about getting a hip replacement. Let's talk about stage two cancer. What happens when you get to stage three. Stage four end of life treatment. Doctor

00;07;00;16 - 00;07;29;00

Dr Firouz Daneshgari

For the future of conversation. You can build this whole monster of health care into three buckets. One is the payer. Who? Third one is the provider. Doctors, hospitals, physical therapy, everything. The second is the payer. The third is the consumer. So about 100 years ago, the European countries following the Bismarck, who was the chancellor of Germany, they elected to go what is called the single payer system in countries like UK.

00;07;29;06 - 00;07;45;09

Dr Firouz Daneshgari

They chose not only to be the single payer, but also single provider, because during the war, Churchill took over all the hospitals and they never let go of it. So there's a national health system, NHS in the UK that is there, and I had the pleasure of working there as a senior registrar.

00;07;45;09 - 00;07;46;27

Cary Hall

Yeah, it was a pleasure.

00;07;46;29 - 00;08;06;11

Dr Firouz Daneshgari

Well, the reason I went there actually is, goes back to the heart of your question at that time, as you know, I am double board certified. One is in urology. So I wanted to master the art of trans urethral resection of the prostate is a very technically challenging. And at that time, the numbers in the US were low.

00;08;06;11 - 00;08;29;06

Dr Firouz Daneshgari

So I went to UK, Leicester General, and the first day I walked in, the consultant hand me the thickest binder, you can imagine, and he said these are the people who are waiting for this procedure. Choose as many as you want to do, because my my aim was to do as many as I could to master my, you know, psychomotor abilities to do the procedure.

00;08;29;13 - 00;08;49;01

Dr Firouz Daneshgari

So I went through the list, I picked up as many as I wanted, or I frankly, I could do per week. So that woke up, woke me up that there is a thickest binder, waiting list for basically procedures, that here in the US, you could you could have done it, you know, next week or tomorrow.

00;08;49;01 - 00;08;51;23

Cary Hall

And so what you say “thickest binder”, we're talking about three inches four.

00;08;51;23 - 00;09;17;25

Dr Firouz Daneshgari

Yep yep yep. So so this goes back to the issue of the single payer system. The single all the single payer systems. They have a budget and therefore they have to ration the care. There is no question anywhere else if you go to Canadian system, to any other single payer, they have to ration the care. The number two issue is, between these three payer and provider is the choice of the customer.

00;09;17;27 - 00;09;26;23

Dr Firouz Daneshgari

Right? The choice of the customer, where and how basically they can get their choice is extremely limited under the single payer system.

00;09;26;28 - 00;09;28;03

Cary Hall

That's just the beginning.

00;09;28;08 - 00;09;29;15

Dr Firouz Daneshgari

That's just a beginning.

00;09;29;17 - 00;09;46;22

Cary Hall

When we come back to the break, we're going to continue with this into this segment. And then the next segment we're going to talk about how do you solve the problem. Why is the free market system a better system? Stay tuned. You're listening to America's Healthcare Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA.

00;09;46;26 - 00;09;49;22

Cary Hall

Doctors in the House. Stay right there.

00;09;49;25 - 00;10;19;26

Speaker 3

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00;10;19;29 - 00;10;56;06

Speaker 3

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00;10;56;08 - 00;11;18;24

Cary Hall

Welcome back to America's Healthcare Advocate broadcasting coast to coast across USA. I'm your host, Cary Hall in studio with me. Doctor Firouz Daneshgari. We are very happy to have him here. A very accomplished, doctor, scientist, surgeon. Someone who's really experienced what it's like on the inside of National health care systems. We're currently talking about a little example of the UK.

00;11;18;24 - 00;11;37;12

Cary Hall

So we're going to go right back to that doctor. So now you're working at this hospital. And so you're, you're, you're, you're working all day doing these procedures to give you a three ring binder, a 3 or 4in high, filled with people. You just picked, who you wanted. There was no system to this. All these people have been waiting for.

00;11;37;17 - 00;11;39;22

Cary Hall

What was the average wait time before you got there?

00;11;39;28 - 00;11;48;13

Dr Firouz Daneshgari

Oh, depending on the procedure, the average time is anywhere from six months to four years. So, let me,

00;11;48;15 - 00;11;50;19

Cary Hall

Yeah, six months to four years?

00;11;50;19 - 00;12;13;07

Dr Firouz Daneshgari

Oh, 100% is. I'll give you another example of another single payer system that is our north, neighbors, the Canadians. Okay. Very good friend of mine. And he gets up in the morning and he has problems seeing. He goes to a doctor and say, oh, you had, you had cataract. You need surgery. His vision has dropped to 5020 and says, okay, what can I do?

00;12;13;07 - 00;12;31;27

Dr Firouz Daneshgari

He says, well, this is toward the end of our year. Our budget is finished. We are going to put you on the list for next year. And this is a guy who is running a big company, so he has a private insurance. So that is a fallback, remedy for these countries both in UK and can in Canada.

00;12;31;27 - 00;12;52;24

Dr Firouz Daneshgari

People who can afford it, they have private insurance. So there's a higher level of access there. So he goes to his private insurance and private insurance, says, yes, we know we can do this in about 6 to 8 weeks. And the price is going to be, over $5,000 per eye with a nonselective lens that we will put into your eyes.

00;12;52;27 - 00;13;16;25

Dr Firouz Daneshgari

So he picks up the phone, calls me. As you know, I have founded the company called Bowtie Medical, where we provide access to fair price, procedures and procedures. And so. So this was literally this was on Wednesday when his wife called me. I was in a trip in Colorado, so I arranged for them. They came to Ohio on Monday.

00;13;16;27 - 00;13;41;29

Dr Firouz Daneshgari

He examined his eyes. He has surgery on both eyes on Thursday. Friday morning he drove back to Canada, to Toronto for the cost of $1,700 per eyes. With the selective lenses, meaning the lenses that he chose. Right? Right. So he went back a few months later. He had a he running a major company, a major construction company.

00;13;42;02 - 00;13;49;06

Dr Firouz Daneshgari

He sold the company and he wrote me a very fat check, became an investor in our company.

00;13;49;08 - 00;14;11;10

Cary Hall

Well, that worked out to be really good. But the point of that story is so and I'm going to ask him, the same thing exists in the UK. You can you can use the government program, the national health care system, or you can buy private insurance. So talk about your experience and the doctor that you worked with who worked on and on the national health care system.

00;14;11;13 - 00;14;12;13

Cary Hall

But he also worked on the.

00;14;12;13 - 00;14;26;08

Dr Firouz Daneshgari

Oh yeah. So, so actually all the doctors and all this and by the way, in a UK, as you know, the surgeons, they don't call them doctors, they call them Mister’s Is because they belong to the Society of Surgeons and Barbers.

00;14;26;09 - 00;14;27;11

Cary Hall

Okay.

00;14;27;13 - 00;15;04;24

Dr Firouz Daneshgari

So the Mister Who was my consultant, there are they all allowed to go between one to half a day to a day to work in a private, hospital, private insurance, where people who have private insurance begin to get access to these doctors that otherwise they have to wait for, you know, six months or a year or two years, to do this, as you may know, recently, about a year or so ago, there was a major disaster at the UK set up where a child who had, sore throat, was bumped basically from one hospital to another hospital end up dying.

00;15;04;26 - 00;15;31;12

Dr Firouz Daneshgari

And that became a major political issue, for a former UK government. So make a long story short, through all this personal stories, one fact remains remains solid. And that is, a single payer system has no choice but to ration the care. Limit the choice. Number two, the single payer systems are not more efficient than a free market based systems.

00;15;31;18 - 00;15;51;25

Dr Firouz Daneshgari

The examples of this are throughout the world, throughout the entire Western Hemisphere. As you mentioned, I have had the privilege of being visiting professors in all five continents. I've been to China, I've been to Taiwan, I've been to Brazil. The very last trip that made me to really quit my former job and come and, build the Bowtie

00;15;52;03 - 00;16;14;06

Dr Firouz Daneshgari

was when I meeting, I had with the Minister of Health in the state of San Paolo, and he basically said they have a constitutional mandate to provide free healthcare to all the Brazilian citizens. But he said, we don't we can't afford it. I said, what's the solution? He pulled out his iPhone. He said, go and innovate. Go and figure out what's wrong with your system and fix it.

00;16;14;06 - 00;16;23;12

Dr Firouz Daneshgari

You guys have the, the best brains in the world. You have the most money. You have the most advanced health care system. Go and fix your system and you will lead the rest of us.

00;16;23;15 - 00;16;42;29

Cary Hall

And that was the doctor in Brazil talking about what should be done in this country. You know, here's the thing. All right. And just so we're clear about this, you know, whether it's Kamala Harris or or Pramila Jayapal or whether it's Elizabeth Warren or Bernie Sanders, this is on the agenda. I don't care what you're hearing. I'm telling you, it's this is never gone away.

00;16;43;06 - 00;16;59;20

Cary Hall

It's going to continue to be on the agenda. I think it's important to understand what you're getting if you get Medicare for all. And, oh, by the way, you are going to pay for it. It's not going to be free. You're going to be taxed and you're going to pay for it. You're going to tax your employer. You're going to tax you just like they do with Obamacare.

00;16;59;20 - 00;17;18;18

Cary Hall

We all pay for Obamacare, whether you use it or not. In case you don't know that, okay, the same thing is going to happen here. It's not going to go away. And and this issue is going to be there because the progressives and the Democrats that believe in this believe they want to put this in place, never mind that we can't pay for it.

00;17;18;20 - 00;17;39;11

Cary Hall

Social Security will be broke. According to the Social Security trustees. It runs out in 2033, Medicare in 2036. So, doctor, I have to ask the question. So let's say that the, you know, the the progressive Democrats are able to put this in play and we go to a national health care system. How the hell are we going to pay for it?

00;17;39;13 - 00;17;49;13

Dr Firouz Daneshgari

Oh we won't. Or we'll take our federal government to bankruptcy without the question is the, I'll give you the numbers again, by the way, I'm I'm apolitical, I know.

00;17;49;13 - 00;17;53;00

Cary Hall

Yeah. And he is. He told me over dinner last night. He's apolitical.

00;17;53;00 - 00;18;17;25

Dr Firouz Daneshgari

I'm looking at the health care simply from a professional standpoint. To me, the solution, as you know, they say the health care is a right, not a privilege. And I agree with that. The question is not that issue. The question is what is the most efficient way for us that we can provide the best quality health care at the most affordable, level for all of our citizens?

00;18;17;27 - 00;18;36;27

Dr Firouz Daneshgari

And that that is the question is not whether the writer is a privilege. What is the most efficient way for us? We can provide access to this beautiful thing here in this country, because we have built the most advanced one that all the kings and queens from all over the world. They want to come and get their care, but our own citizens can afford it.

00;18;37;02 - 00;18;58;11

Dr Firouz Daneshgari

So from a purely technical, professional fee, we have a solution in hand that that would provide an affordable, highest quality care for all of our people. And that is not a single payer system. Single payer system will take us to bankruptcy and will put us in a much more deficient, system that we are now.

00;18;58;14 - 00;19;22;19

Cary Hall

And and they'll make the choices for you. This is the part you need to understand. You're not going to make the choices in a single payer system. You're you heard Doctor say how long it took to get a procedure, how the example of his friend in Canada, that's what you deal with. And even though they buy private insurance, in the case of the Canadian gentleman, he still came here and got it done for $1,700 now instead of $5,000.

00;19;22;19 - 00;19;44;06

Cary Hall

an eye. That's that's the glaring difference between a single payer system and a free market system. We come back from the break. Now we're going to talk about what's the solution here for, for us to make this work in our country. Stay tuned. We'll be right back after the break. You're listening to America's Healthcare Advocate broadcasting on the HIA Radio Network.

00;19;44;08 - 00;19;56;14

Cary Hall

Coast to coast across the USA. We'll be right back.

00;19;56;16 - 00;20;15;29

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA here on the HIA Radio Network. You can find out more about us by going to the website AmericasHealthcareAdvocate.com. You want to make a comment about this show? Feel free to do so. Send me an email or email opportunities up on the website.

00;20;15;29 - 00;20;34;26

Cary Hall

You can certainly do that. By the way, the show is posted on our YouTube platform and all 15 podcast platforms, so it's up there for anybody you want to tell about it. I think we make a pretty compelling argument here today with Doctor in Studio with us today. So again in studio with me, doctor Firouz Daneshgari. He is an expert in this field.

00;20;34;26 - 00;20;57;28

Cary Hall

He's talking about what his experience had been around the world. He has worked in these places. He's worked in Brazil, he's worked in the UK, he's worked in Japan, Thailand, Taiwan. He knows how they work and how they don't work. And that's why I wanted him here today. He's a very busy man, but I wanted him. I asked him to please take time and come and do this, because I wanted you to hear this from somebody that's been in the system and understands how it works.

00;20;57;28 - 00;21;17;19

Cary Hall

So let's go to now, you know, over dinner and then the show notes, which I was working on a 5:00 this morning, which is a little difficult after the Chiefs game last night. But having said that, you know, I, you know, you make the statement here that we could save $2 trillion by going to a completely free market system.

00;21;17;27 - 00;21;34;00

Cary Hall

Explain what you're talking about. And by the way, in case you're wondering, he's been invited to the EU to make this case in Brussels. Okay. There are people around the world that are listening to what this man is saying, which is why you're going to have the privilege of listening to it. Now, doctor.

00;21;34;02 - 00;22;01;26

Dr Firouz Daneshgari

Cary, kind of lay out the foundational facts. The facts are we have, built the most expensive healthcare system in the world. Again, we spent four and half trillion dollars per year. That is five times more than we spend on our defense budget. We spent 13,500 per capita. This compares somewhere between 4 to 6000, between Japanese and European systems.

00;22;01;28 - 00;22;34;16

Dr Firouz Daneshgari

So the very first question in my mind, this is about ten, 12 years ago, why why we are the most expensive system. And are we providing a better service? Our people are healthier. They live longer. The answer is no. Actually, to the contrary, our services are worse. There is more consumer complains about the system here, and our health outcome is going through the, to the drain more than 50% of Americans have 2 or 3 chronic conditions.

00;22;34;16 - 00;23;08;28

Dr Firouz Daneshgari

We spend over 70, 80% of our spending on dealing with the issue of obesity, diabetes, cardiovascular. So the foundational fact goes back to that, that despite this spending 2 or 3 times, we have created the sick care system. So the system that benefits from our people being sick. And the reason for that is that their health care is delivered through 5000 financial institutions called hospitals, that benefit from basic this secure, they are financial institutions.

00;23;08;28 - 00;23;34;03

Dr Firouz Daneshgari

They have to deliver a margin and they have adopted what is, is known as the more is better. So they focus on the volume rather than the value. Volume means every hospital. And the more surgeries they do, the more tests they do, the more, you know, procedures they do, regardless of what outcome it has or, whether that is needed or not, they make more money.

00;23;34;05 - 00;23;58;08

Dr Firouz Daneshgari

So it's a one way system between the seller and the buyer. The seller benefits from basically selling more and more and more and buyer has limited information or a choice in saying what I can or what I don't want and how much I pay for that. So that has resulted to 50%. Half of what is done in the American healthcare system is an absolute waste.

00;23;58;11 - 00;24;27;12

Cary Hall

The other question and talking about waste CMS says $60 billion is wasted every year by, Medicare and Medicaid. And and you compare that to private insurance. Private insurance on one side is about 1 to 2%, 60 billion represents 10% of the CMS budget. So we have, government health care in Medicare. We have government health care in the VA, which I've got a lot of experience with, unfortunately.

00;24;27;15 - 00;24;36;02

Cary Hall

And then of course, we have, we have, now we have Obamacare. So we've got three different systems, none of which do what you're talking about.

00;24;36;05 - 00;25;00;28

Dr Firouz Daneshgari

So that is correct. So let me actually, rephrase the issues. The issue is and as you said very correctly, we have had a, government sponsored health care in this country. And but the problem, again, the question is not from a scientist scientific perspective. You know, as you know, these days, they're distributing the Nobel Prizes. The most successful scientists ask the right question.

00;25;01;00 - 00;25;38;24

Dr Firouz Daneshgari

Right? The right question is not what is basically who pays for the services. The most important question is what is the most efficient way of delivering the services that people need to their hands? Right. Again, we have a comparison between the government and non-government. In my opinion, my technical professional opinion, a free market, a delivery system that, promotes interaction directly, interaction between the buyer that is consumer, that is you and I and the seller, and that is the health care system that is the most efficient way of bringing efficiency into the system.

00;25;38;27 - 00;26;11;06

Dr Firouz Daneshgari

Going back to the diseases of this secure system, we are generating more than half of the waste. Why we are generating the waste? Because the the machine is that delivering the system has no incentive being inefficient. That's number one. Number two is the consumer is not in the in the seat of the control. The third party payer, the federal government for the Medicare and Medicaid for one third of Americans, and the private insurance for two third of Americans for, you know, employer sponsored insurance.

00;26;11;13 - 00;26;38;01

Dr Firouz Daneshgari

They're paying for this waste out of the pocket of the consumer direct, out of the pocket without the knowledge or consent of the consumer. So the employer sponsored insurance that pays for two thirds of Americans, the employers are totaling the bill somewhere about $2 trillion. The Medicare is paying about 1.9 trillion for the Americans who use the Medicare and so forth.

00;26;38;04 - 00;26;58;23

Dr Firouz Daneshgari

And these money is paid from the wages of people who work and from our tax dollars. So I make an example. I say we have a gas guzzler system and the gas guzzler doesn't care who pays for the gas or who rides on the in the car. Right. We need to fix the engine very much like we did with, you know, car industry.

00;26;58;23 - 00;27;22;03

Dr Firouz Daneshgari

And so for Tesla. Tesla. Right. So I can go through the details of how this system has supported itself to basically, to extend this, situation. But this system has created the misalignments, the that is continues to add to the cost. So there is no light at the end of the tunnel. The cost is going to continue to go up.

00;27;22;05 - 00;27;47;21

Dr Firouz Daneshgari

The more involvement of the government is making it worse and worse, as the data shows. You know, the cost continues to go up. The Obama care not only didn't provide an affordable care made it more unaffordable, so they have to change the name of the act to the Unaffordable Care Act, in my opinion. And it hasn't solved the fundamental design problem that the existing system has.

00;27;47;21 - 00;28;10;23

Cary Hall

It threw money at it all. It was throw money at it, you trade... We started with the subsidies. The subsidies have grown. The number of people have grown. It's done in terms of getting people health insurance didn't have it. It's certainly done some good there. But the point is, it's not being done in an efficient manner or in a manner that incentivizes the hospitals and the doctors to deliver effective health care that controls cost.

00;28;10;23 - 00;28;31;14

Cary Hall

There's no incentive to do that because you're paid for every. The more procedures you do. You just said this. The more you get paid. So you're going in for procedure. Well, maybe let's get some X-rays. Let's do an MRI. Let's do a whole blood panel. And, you know, yeah, I'm sure a lot of those things are necessary, but how much of all of that is necessary?

00;28;31;20 - 00;28;52;24

Cary Hall

And when you look at the prices that hospitals charge, if you can find the prices, by the way, and you compare a typical hospital system with something like the Oklahoma Surgical Center, where every procedure they do is posted online, hip replacement 17,000. I don't know what it is, but I'm just going to use $17,000 versus the hip replacement through a hospital system $50,000.

00;28;52;24 - 00;28;55;08

Cary Hall

Those are the differences in the system.

00;28;55;10 - 00;29;24;16

Dr Firouz Daneshgari

So what you're pointing out, you're pointing out to the misalignment, the system, the first misalignment that over the past 20, 30 years, this hospital basic care system has created three out of four doctors. Now in the US, they work for either a hospital or a private equity firm. So the job has changed from being a care provider problem solver for the patient, for their patients, to protectors of the revenues for this financial institutions.

00;29;24;17 - 00;29;55;24

Dr Firouz Daneshgari

That's the first misalignment. The solution to that is very simple a direct pay, direct pay for the primary care, direct pay for the specialty care called a direct primary care. The second misalignment is that the third party is paying for this waste out of our pocket. The solution for that is rather simple the direct pay through the HSA, HRA as in some other solution, the consumer chooses which doctor in which hospital I want to pay and I want to pay based on the quality and the level of the services.

00;29;55;26 - 00;30;18;29

Cary Hall

And so what happens when you come full circle is you hand the choice back to the consumer. You don't take the choice away from the consumer. You hand it back to the consumer. Because when it's your dollars, when those are your HSA dollars to your HRA dollars, you are going to look to see if the Green Imaging Clinic can do that MRI for a third of what the hospital is going to charge, the answer is they will.

00;30;19;04 - 00;30;40;25

Cary Hall

That's just an example of how this all works. We come back from the break. We'll continue this fascinating conversation with doctors. Stay tuned. You're listening to America's Healthcare Advocate broadcasting here on the HIA Radio Network, coast to coast across USA. Doctors still in the house don't go anywhere.

00;30;40;28 - 00;31;07;01

Cary Hall

Welcome back. You're listening to America's Healthcare Advocate show broadcasting coast to coast across the USA. My producer today, Mr. Sean Floyd behind the microphones, Mr. Dave Thiessen behind all the cameras. Man who puts all this stuff together, posted up on the podcast platform and YouTube, the website, AmericasHealthcareAdvocate.com 15 podcast platforms and YouTube component. Tell somebody about the show in studio with me, Doctor Firouz Daneshgari,

00;31;07;01 - 00;31;20;11

Cary Hall

we're very happy to have him here today. As you can tell, he is a bona fide expert. So we're going to continue the conversation. So we've really defined the problem. So there are three points to what you consider the solution. Let's go through those three points.

00;31;20;17 - 00;31;51;09

Dr Firouz Daneshgari

Sure. But I want to repeat the problem because I think that has been less spoken of in the national media. And so far the problem is not who is paying for it, whether the government or a person or the employer. The problem is, how can we make the existing system efficient? We have two centuries worth of data that shows a free market is the best mechanism to create efficiency, right?

00;31;51;09 - 00;32;16;08

Dr Firouz Daneshgari

I don't have to prove this to you or to the American people, right? The challenge here is, how could we put the essence of a free market into the health care, take it out of his current misery. The essentials of a free market is number one: There is an information symmetry. Means the buyer and the seller, they have transparent information to the same information.

00;32;16;08 - 00;32;38;19

Dr Firouz Daneshgari

As, you know, the stock market, they say, is a very efficient market because there are rules and laws against, you know, hiding the information inside trading and so forth. That is number one. Number two: The direct interaction between the buyer and the seller. Buyer is the consumer. You and I, more than 80% of our health needs are we can choose their shoppable.

00;32;38;19 - 00;32;52;15

Dr Firouz Daneshgari

There's another ten, 15% that we may not have a choice, but there are solutions. How to handle that. So the second thing is the consumer having control over the money, right. And choosing, what they want to buy.

00;32;52;15 - 00;32;53;13

Cary Hall

Not the government.

00;32;53;17 - 00;33;15;08

Dr Firouz Daneshgari

Not the government, not the third party, not the bureaucrats. No. No other person in this world, but by the laws of the universe, by God, religiously, whatever you think, at the end of the day, a person is in charge of their health and the decisions for that. That's number two. Number three is that the freedom of choice?

00;33;15;08 - 00;33;36;07

Dr Firouz Daneshgari

That is a fundamental thing about the American culture that would never, ever the single payer system will work for us in this culture because we are a very diverse country, right? And we have we have created the 5% of the world population, has created 50% of the world's, wealth. And that is where my immigrant hat comes in.

00;33;36;07 - 00;33;45;02

Dr Firouz Daneshgari

As you know, I'm an immigrant. I was born in Iran, and I pride myself. I said some immigrants are more American than Americans because they have seen the difference.

00;33;45;04 - 00;33;52;23

Cary Hall

So easy to repeat that because you said that a dinner and it's stuck with me. And I was going to ask him, but you said that it is very true.

00;33;52;23 - 00;34;15;15

Dr Firouz Daneshgari

It is very true. If you look at the immigrants, the reason the living in the US is the dream of almost everyone around the world is because this country provides this essence of the freedom that the immigrants come in and they, you know, the American dream, and therefore we do fight, you know, more for preservation of this foundations that has saved us.

00;34;15;15 - 00;34;41;08

Dr Firouz Daneshgari

And that is, to me, is the free market coming back to the free market issue is, number one, is the basically separation of the doctors from the hospitals. The doctors cannot be the protectors of revenues of the hospital. That means the consumer can pay directly to the doctors in the primary care. That is called direct primary care. In the specialty care called direct specialty care, you can make it the direct payment.

00;34;41;10 - 00;35;05;29

Dr Firouz Daneshgari

The second piece is the transparency of the information. So as you mentioned in the previous segment, like the Oklahoma Surgery Center or Smith Medical now and so forth, there are ambulatory surgery center. The prices are published. You go and pay up front. Right. Number three is this that would eliminate basically this whole building process, which is a joke, you know, 30 days later you receive this is not a bill.

00;35;05;29 - 00;35;29;19

Dr Firouz Daneshgari

And then after that using the thicker. The next one, which in my opinion provides the freedom for the employers is what the Trump administration has started, called the associations of healthcare that would basically provide the freedom of choice for the employers and a freedom of movement, for the employees. So let's say I'm an electrician, right?

00;35;29;22 - 00;35;49;26

Dr Firouz Daneshgari

And I work for this company. Now. I get a job with another company. And, you know, they pay me more things. With the creation of associations, the Association of Electritions and the Chamber of Commerce and so forth, they can basically self-insure the health benefits for their employees and therefore provide the portability of the health benefits.

00;35;49;26 - 00;36;11;20

Cary Hall

If you look at the Pareto Contrarian remodel, if you look at the Berkeley Captive model, those models are hugely successful because of what you just said. Okay, it's a direct payer experience. You know, it's self-funded, they control the whole thing and they get to choose. So, you know, you have that plan. You can go to the Oklahoma Surgical Center.

00;36;11;20 - 00;36;34;21

Cary Hall

You the employer can say to your employees, if you go to Oklahoma Surgical Center, you have no deductible or coinsurance. Nothing will pay for the whole thing. You incentivize people to make good choices. And that's what we're really talking about here. The the problem here. Just, you know, this always centers on the health insurance companies. I'm not an apologist for the insurance industry by any stretch of the imagination, but understand where the problem lies.

00;36;34;26 - 00;36;56;21

Cary Hall

You just heard this defined eloquently, if I may say so myself, by Doctor, today I'm talking about the problem lies with the hospital systems. Have you noticed there are no primary care providers that are independent almost anymore. The same thing applies to to the orthopedic centers. Urology go through it. They're either owned by the hospitals or they're giant conglomerates. And that's the way that it works.

00;36;56;21 - 00;36;59;08

Cary Hall

So it's not what it used to be, right?

00;36;59;08 - 00;37;34;20

Dr Firouz Daneshgari

Correct. So let me actually, we are in the political season, hopefully one of the, you know, the next president will pick up this, this proposal, we can provide unlimited access to primary care, which is more than 90% of a need of a person in the population for less than $100 per month to all Americans. And frankly, if I was the president, I would sign an executive order to make a unlimited access to primary care for less than $100 a month, for all the Americans.

00;37;34;20 - 00;37;45;20

Dr Firouz Daneshgari

And now, with the advancement of the virtual delivery models, the virtual care, telemedicine and so forth that can penetrate to all the rural areas, to the medical deserts and so forth.

00;37;45;23 - 00;38;03;02

Cary Hall

Thank you. This has been absolutely amazing. You will be back. I'm gonna impose on you to come back and and get you to come back and talk. But I've never had anybody on this show that could deliver this message like this. You know, I've attempted to do this and I've used some of the examples, but not the way doctor does.

00;38;03;08 - 00;38;26;11

Cary Hall

This is completely different. So I really want to thank doctor for coming. I said he's very busy. You can tell by all the things that he does, including being the CEO of Bowtie Medical. But we'll we'll talk about that in another show. And now I want to leave you with this thought from Doctor Albert Einstein. The one who follows the crowd, they usually get no further than the crowd, the one who walks alone is likely to find himself in places no one has ever been.

00;38;26;13 - 00;38;48;09

Cary Hall

Remember, friends, it's a funny thing about life. If you refuse to accept anything but the very best, you most often get it. Thank you for listening to America's Healthcare Advocate broadcasting coast to coast across the USA. Goodbye America.

00;38;48;11 - 00;38;50;16

Cary Hall

You.