The Thyroid Tango: Tiny Gland, Big Impact

All right, welcome back to what's going on with Earl Ingram.

It's always, you know, it's great to have with me, none other than Dr. Robert Craig, Executive Director of Citizen Action.

Good morning to you, Dr. Craig.

Always good to see you.

Good morning to you, Earl.

It's always great to see you.

Man, there's so much going on, Dr. Craig, you know, in so many different ways, you know, we can have a discussion this morning.

I certainly want to talk about some things going on with the budget.

I want to spend some time talking about what's going to be happening now that they've kind of changed the

opportunities for people to vote and just so many different things.

But the one thing that is really always on the, you know, on the top of all the different discussions is healthcare.

And as I said to you, and my life is an open book.

So, you know, I have nothing to hide.

I wanted to let people know I'm going to be having cataract surgery.

in the next couple of weeks, Dr. Craig, and I'm fortunate enough to have Medicare, and even with that, that's a $37,000 cost to have cataract surgery.

My cost is $300 because I have Medicare.

Dr. Craig, I don't know, you know,

to question what the cost of these surgeries are, but doesn't that seem to be quite a bit for cataract surgery?

Look, you should absolutely be talking about these costs, Earl, and I think your listeners and people around the country are questioning the cost.

That's why healthcare costs is testing as the most urgent affordability issue for people.

And we know, everyone knows, we have an affordability crisis.

whether the president likes the word or not.

He likes to repeat it over and over again like it's some novel word.

But within health care, this has been a long time coming.

And I'm sure your listeners are listening to very complex discussions of all of these underlying causes, right?

It's actually very simple.

The price is too high.

Remember James Carville, he's the economy is stupid.

Well, it's the price is stupid.

For any major health care service, we pay more than any other country in the world by substantial amount.

And I could give you an example for any service, but let me give you a hip replacement, okay?

Surgery, what that, what that, excuse me, knee replacement surgery, that's less than a hip replacement surgery.

So in Germany, which doesn't have the Canadian style health care plan, it has

regulated nonprofit insurance, but doesn't have the big corporate insurers, right?

In Germany, they pay $9,700 for a knee replacement.

So that seems, I mean, they know what they're doing, right?

Medicare pays $18,000.

for a new replacement.

And Medicare is the only pricing system we have.

There actually is a set price.

It's not left up to the hospitals and it's based on actual data.

So private insurance pays $27,000 for a new replacement in the United States.

I could do this for anything.

Dozens and dozens of examples.

So our hospitals charge three times more

than what is charged in Germany.

I can look at any other country too.

I'm just using Germany as an example.

And for what?

Our outcomes aren't better.

We don't provide more services.

There's not less follow-up.

There's more follow-up in Germany.

But the one thing we do that no other advanced industrial country does is we allow private industry to set the price and to set it secretly.

So the way

Because the reason you can't tell what the price of anything is with hospitals is they have secret negotiations with insurance companies.

And the reason hospitals keep getting bigger is to try to have more negotiating power.

And that's why insurance keeps combining into these massive conglomerates.

And that's why you've all these health systems.

Aurora is now part of a giant national system.

Freightart, I'm talking about Milwaukee, just merged with ThetaCare.

bale and health in Green Bay, merged with Gunders and Lutheran.

Marshfield Cleggs just merged with another big out-of-state health system.

They're all doing that, and in fact, that consolidation raises prices.

So as long as we allow, and I'm not even talking about pharma, where we do the research and they set whatever price they want, we get the monopoly, but just talking about hospital and doctor costs, because most doctors now work directly in hospital systems, health systems, they call them.

unless we legislatively do what every other country does and take pricing power away from them and set the price, it will be unaffordable.

And we have a bill that we've been working on with Senator Dordray.

I'm sure you know Dora.

Yes.

Pretty well, Earl.

And it's following a model of Indiana of all places.

A Republican place has this on the statute books.

In Wisconsin, here's what it is.

In Wisconsin, we have the highest

hospital costs in the Midwest and the fifth highest in the country.

So Wisconsin housing prices are more than three times what Medicare is.

So they're more than that national average, I just told you, where the newer place, it was $18,000 for Medicare, $27,000 for private pay.

They're higher.

They're three times, OK?

And so it's very expensive here, one of the most expensive places, not only in the country, in the world, here in Wisconsin for a middle class, very middle class, working class state.

So this bill would cap their prices, starting at 250% of Medicare, two and a half times, and then going down to double Medicare, which is still a lot more than Germany, right?

Or England, or Canada, or France, or Taiwan, or South Korea.

We'll try to get that passed if we have a better legislature, which we may have next session.

That's what we're also fighting for.

But the hospital industry is going to go crazy.

And they're going to say that the biggest lobbyists at the capitol, they spend the most, the hospital association.

They're going to say they can't possibly provide all of this for two and a half times the cost of Medicare when their peers around the world are providing the same services for dramatically less than that.

It's a system that is incredibly inefficient because there's no price transparency and there's no way to pressure the price other than our Democrat government setting a fair price based on the service.

So it's that simple.

And everyone who tells you there's some gimmicky solution to this, various pooling of buyers and all of that, none of that works because the hospital monopolies are massively powerful and you have to pay their price.

Okay, you have to pay their price.

There is no way around this, but it means taking on the hospital industry.

You can say that for us different issues are most of our four degree problems are about allowing monopolies to come in and have monopoly pricing power.

And then the other PN, we have that with the energy system too, but we go on and on.

And then them having the power to suppress wages.

So prices are higher than they should be, much higher, and wages are much lower than they should be.

You know, Dr. Craig, healthcare is one of those things that, you know, in the back of your mind, if you're healthy and young and

you don't even give that a second thought.

But at the root of healthcare is there's not one of us who is not gonna at some point in time have to use healthcare.

You know, I don't care how young we are, but at some given point in time, we're gonna have to do a dance with healthcare.

And as I was saying before, even

as much as I'm around and have a conversation with you about healthcare, as long as I'm healthy and don't have to deal with it, it's not something I'm thinking about constantly until you know that you're gonna be in that system, and now you're faced with it.

How do we awaken people, Dr. Craig?

And I know you guys are trying very hard to understand that this is, you know, they talk about death and taxes.

Well, they might as well add in at some point in time, you're going to be engaged in the health care system of this nation.

I don't care who you are.

And so all of us need to be engaged in what is happening with it.

I actually don't think the public is already there.

I mean, when the polling digs down, it shows that health care is the top affordability issue.

And the reason is, even people who are insured are afraid to go and get treatment for anything, because they don't know what the cost is going to be.

I mean, Medicare admirably, you know, you know what your deductible is.

It doesn't look upable if you're in traditional Medicare.

Medicare advantage is insurance dominated.

But they don't know.

They have insurance.

They don't know what the co-pays and deductibles are going to be, what the claims denials are going to be.

It's going to be thousands.

Six percent of our country is close to paycheck to paycheck.

They can't afford a surprise $1,500 bill.

So what they do is they pay the nose for insurance either directly or through their job, in which case they're getting less wages because your employer is paying so much in premium.

But then it's coverage that doesn't cover it all.

You don't know what your share is going to be, and it's not predictable.

You buy a car at least, you know what price you're buying it at and what the rate of the loan is, right?

And almost any other thing you buy, but that is by design.

It is deliberately complicated so you can't figure anything out.

Most people don't even challenge claims denials or very high copays and deductibles and a lot of them are wrong, but they feel overwhelmed and those who do try often give up, right?

So few people

I always get everything paid, Earl, but that doesn't mean we have a just society.

It means I happen to have the privilege of knowing a bunch about the health care system and what ought to be covered and what things ought to cost and getting everything pre-approved ahead of time, et cetera.

But even then, there's usually something that I unexpected that I had to deal with and correct their error.

It's not the nice people you call.

The system is deliberately that way.

as part of the system as well, and that's their job.

They've given a big binder with a script to try to figure out what that's going on, right?

So Dr. Craig, is this one of those instances where the Republicans see it through one's prism and a Democrat see it through another?

Or does it matter whether it is a Democrat or a Republican?

We still can't get out of this.

I would say that there's a pretty uniform position among Republicans that the market will take care of it, despite all evidence.

It's just ideological.

And it's also because they're reversed to spending money on social needs.

1.5 billion for the military, that's fine.

Or for completely lividized illegal wars, that's fine.

There are some that are interested in transparency, but not enough that will follow through and actually make the hospitals get away with the idea that the prices are secret because they're trade secrets, okay?

You can't know what the price of the cargo would be, it's a trade secret.

Can you imagine?

A car, I mean, that's what they're saying and getting away with.

Democrats are split, I would say.

There are some who are coming to understand

that this is a matter of giving control to revenue seeking industries, right?

And that are not acting the public interest.

In fact, it's common sense, if you're a realist, that any kind of institution like this will seek, will prefer its bottom line over everything else.

So maybe structures of charity, please, right?

This is just common sense, human experience, how these organizations will act.

The only bodies that ought to act in the public interest are those elected directly are Democratic representatives.

And so there are some Democrats who still believe that there's some way to get around having to take on the hospital industry, the insurance industry and pharma, or they can do little things like they can improve Medicaid a little bit and do this and that, right?

Allow people to buy into the state employee plan, which might help a little, right?

There's another group that's coming to understand that we have to intervene in the system and fundamentally restructure it.

And that means setting the price.

It could be Medicare for all.

It doesn't have to be Medicare for all, because not all the other advanced industrial industries have a Medicare for all system, but they do have where the government decides, as democracy decides, what needs to get covered and what the fair price for it is.

So as important as healthcare coverage is and as important as an issue as this discussion is, with the things that are going on today, you're concerned that they get pushed, that this critically important issue gets pushed to the back burner because of again, the war, the cost of the war, the price of gas, the price of food.

all those other things that people are dealing with on a daily basis and struggling with.

Are you concerned that health care gets pushed to the back bench?

Well, it's not going to happen at the federal level for a while.

It's not going to happen within the Trump regime.

even if the democrats take the house and maybe even the senate and the house is more in question now despite a blue wave because we're stealing it more seats by the supreme court um which we can get to but um it's going to come at the state level and wisconsin might have

a Democratic trifecta, that is a Democratic Senate and Strack Assembly.

They have to run the table, the maps aren't that good in the assembly, but it's a big, big Democratic election year thanks to the outrageous leadership of Donald Trump and people's real economic pain.

And then a governorship, but then what the role of groups like us, this National Wisconsin, we have active members across the state working on healthcare, working on other issues, is to push them now

to run on real solutions to health care to make it actually affordable for people, not just be able to say I'm for it and have some talking points and get elected.

No, serious plans that you will actually implement.

And then have a big fight at the Capitol when all hell breaks loose, when the hospitals go crazy and claim it'll be the end of life as we know it, no one's gonna be cared for, but they will do, because that is what they do.

And so it's all they do once their bacon is threatened.

And so,

And I think if that happens in Wisconsin, a lot of steps, electing this legislature, electing this governor, I mean, that's what, if you join citizen action, that's what we are working on because it takes people power to make this happen.

It won't happen by accident.

Then we've got to have an elected group that will actually pursue real solutions.

In other words, take pricing power away in some form.

And we can go into the various policies, but it's all about setting a fair price and giving people access to a reasonable price that's much more affordable.

I think if that happens in Wisconsin, that there's major progress next year with the new legislature and new governor, that sets up candidates for president because Wisconsin is a battleground state.

And they're all going to pay attention to what's going on in Wisconsin.

In fact, as you know, the Affordable Care Act came about in part because Massachusetts

had done an affordable care act plan under Republican Governor Mitt Romney, and Wisconsin, the Wisconsin State Senate had passed an actual single payer plan that was funded through the state Senate that led to a budget impasse for months because the Republicans wouldn't agree, and Governor Doyle would not agree.

That set up the presidential candidates, Obama, Clinton, Hillary Clinton, and Edwards, to all run on various versions of the Affordable Care Act.

So that's what we need to set up.

Then you could have national reform in 29 if you had a trifecta committed to that.

But I just want to say, a trifecta of people with a D after their name is a necessary condition, but not a sufficient condition because they also have to be committed to do this.

And then they need a lot of grassroots pressure behind them at their sales because it's going to be a big fight.

You can't leave them out there.

to be cut apart by massive TV ads lying about what they're doing, which is what happens every time you threaten, what is 18% of the economy?

And it's not that healthcare isn't, that we don't, all of us like life-saving treatments are all you, I'm sure you appreciate you can interact surgery, right?

Absolutely.

And that they use that against us.

Therefore, we don't want to take on the hospitals because my goodness, they saved my mother's life, et cetera, et cetera, right?

But it doesn't, we can't get along with you charging three times more than what they charge in other countries.

It's just, it's not sustainably more and people don't have access to it or they're bankrupted by it.

And so it's a leading cause of bankruptcy still.

So something, they've got it and they'll have to restructure their bloated bureaucracies and their complicated systems in order to actually deliver care at a reasonable price like any efficient industry would.

The reason automobiles took off in this country is because Henry Ford figured out how to make an automobile, the Model T, that people could afford, right?

And I'll tell you a story on this.

In Japan, they set a limit on what MRIs could cost.

MRIs are very expensive.

And one of the reasons for increased cost is because the hospital's monopolies are competing against each other and building excess capacity that they can make us pay for that we don't need.

So there are more MRI machines.

in most places in Wisconsin than needed, because they're trying to get the business away from someone else, but

then

they all charge you for this.

So in Japan, they said, we're going to limit the cost of an MRI to a certain amount.

And it was like half of what they were currently being charged.

And there was, oh, this can't work.

This can't work.

This is going to be terrible.

People won't get MRIs.

So what happened?

It forced the industry to figure out

how to redo the MRI technology and deliver an MRI that met the price.

And they were able to do it.

But they had to cost pressure on it.

You notice, remember when the Chinese figured out how to do an AI thing, it's called deep seek.

It's because we denied them the big semiconductors.

So they had to figure out their engineers worked harder to be able to succeed with less computing power, less energy.

If you don't have that pressure,

then the price is going to be bloated when you can just charge whatever you want because it's a secret process and you have the power to do it.

You know, Dr. Craig, the part of this that I find, and I don't want to use the verb, it's fascinating because it's not fascinating when this impacts and affects human life.

And so I don't want it to sound romantic, but I don't get

the fact that healthcare is a national issue.

And it's the same, people are facing maybe the same issues across the entire United States, but how can states themselves take on the gravity of the healthcare industry and change the dynamic in one state?

yet on a federal level, on a national level, that's where the problem lies.

How can it states independently summon the power to take on what is a national issue?

So we have a uniquely federalized system.

So I'm gonna say, I'm gonna partially agree with you.

That is the best solutions, the most effective solutions.

can occur at the national level, but often it's hard for that to happen.

I mean, the filibuster needs to go away, just for example.

A Supreme Court, a packed Supreme Court that will find it unconstitutional, regardless of what all past precedent is and what the Constitution actually says is a problem.

But states have a lot of power, and states that do more are more livable than those that aren't.

But I think the critical thing is, is that most big national federal action historically has come

after state started doing it.

So I think that's the biggest thing.

I think Wisconsin legislature and the new governor, a new legislature, could begin to restrain health care costs and make it more affordable.

Like, one of our proposals is to allow people to buy into the state's Medicaid program, badger care.

And if you're an individual, we get the ACA subsidies to afford it.

We call it a batch care public option.

It allows small businesses and small employers, only a third of which can afford coverage to buy into it.

That would be much cheaper than buying private insurance.

And then you'd have public coverage without the co-pays, deductibles, and the claims denials.

That would be an option.

That would be a huge step.

And why is it all better?

Because Medicaid sets the price.

My point is, all these reforms come back to saying the price.

It's not universal yet, but you've greatly expanded the number of people who have access to much more affordable coverage than before if you pass the BadgerCare public option.

There's also a part of the Affordable Care Act that allows you to increase public coverage beyond Medicaid expansion.

Minnesota does that.

So for BadgerCare in Wisconsin,

The eligibility level is, in other words, what you can't make more than to get it.

It's about $15,600 for an individual and $32,000 and a couple hundred dollars for a family of four.

So you make $33,000 a family for, you don't get badger care, right?

This thing called the basic health plan allows you to double that.

So it would be $64,000.

and hundreds of dollars up to that income level for a family of four and a low 30s for an individual.

That's a huge difference, Earl.

I mean, someone making the minimum wage, if they're an individual, it was waiting tables, bartender, a lot of the jobs people do in order to get by, especially nowadays in their 20s and 30s, you could then get badger care.

So that's a huge advance.

But the whole point is,

these reforms create a public system that sets the price for certain populations, ultimately we need the federal government to do that overall, which can't happen until 2029, assuming a huge big wave election in 28, which hasn't happened yet obviously, it should require a lot

of work.

So Dr. Craig, because I've been around a little while and recall a time,

when my employer paid for my entire health care and my family's entire health care.

And they were paying less.

And the fact that we could we could certainly get these things done in hospitals.

I don't think it was we're struggling economically or financially.

So what transpired?

Who made it was a capitalism that caused it to go from where it was, where it was affordable and the system that was in place.

Somebody changed that system.

Is that what happened?

I mean, inflation I get,

but capitalism.

In other words, I'm not proposing we have to repeal capitalism in order to have affordable health care in the

United States.

Yeah, because we used to have affordable health care.

We used to have.

Japan has capitalism.

So it's a matter of the balance between public things that have to be guaranteed by the government.

And overwhelmingly, even majority of Republicans think it is the right goal.

It is the obligation of government to make sure everyone

has affordable health care.

But if you've given away too many powers to private actors, they will seek private advantage, period.

That's what they do.

So we didn't have a perfect system in the 80s, but in the 80s, we had a hospital rate review board that approved their rates.

And they got that repealed.

They said it wasn't necessary.

The market would take care of it.

And we had the state reviewing all new facilities and new major equipment investment to make sure it wasn't duplicative and wouldn't raise the price, like building an extra MRI machine when there's only one in town.

You don't need it more.

In this case, you don't want the other competing hospital system to get the business, right?

They don't want to cooperate with each other.

They should share the MRI machine.

but they're competing with each other.

In fact, that's why your reticle records, even though they're all done by the same company, Epic Systems in Madison, MyChart nationally, they don't communicate with each other.

Why?

Because the hospital systems want to compete with each other.

That should not be allowed, right?

Because in other countries, including little Costa Rica, they're universal medical records, so anyone can treat you and see your whole medical record right away and know what, know the history of all of your conditions.

Now you're sitting at freighter, and they don't know what happened in Aurora.

I mean, I'm serious.

They don't, because it's not in their system.

So you have to go, the patient has to go and go through a process where I get them over, and then they're like paper records.

They're hard for your doctor to read.

It's ridiculous.

So we just need a better balance between the things that democracy needs to do and the things where private competition is appropriate.

And once we get to the point where we did a poll with a national firm, a major survey in Wisconsin, 54% of people have skipped medical care in the last year because they don't think they can afford it and 95% of them have coverage.

95% have coverage.

Yes, now they can't afford it.

One of the things that happened with the big cuts in the Affordable Care Act subsidies, the tax subsidies,

is a bunch of people lost their coverage, and that's getting worse.

But a lot of people went down to higher deductible plans, which they can't afford to use.

So if you have a couple thousand dollar deductible and you're living paycheck to paycheck, you're only going to go if you're really sick.

And guess what?

You're going to be more expensive then, because it would be a lot cheaper to treat you early when the condition first starts.

That is what's going on right now in this country and in this state.

I think everyone should be asking their candidates for governor.

We've been doing it.

We had a forum with all seven Democratic primary candidates, what their plan is on health care.

And you should be listening concretely about what are they going to do specifically to set the price to take pricing power away from the predatory monopolies, the hospitals, insurance companies.

And then the third element is pharmaceutical industry.

You can create, as a number of states have done, a prescription drug price board.

that actually reviews excessive pharmaceutical prices and overrules them.

Maryland has that, New Jersey has that, Massachusetts has that.

A number of other states, I think Colorado has that, a number of states are moving in that direction.

But that's what you should be listening for because the problem's simple.

The price is too high because they're allowed to set it.

You know, Dr. Gregg, you can look at a place like India or a place

like China with all of those people and their healthcare systems work.

Is it safe to say that?

I'm not studying those two closely.

They certainly, but I'm saying that, but when I say the systems I've looked at at all, and there are people who are experts in this, there's a professor at Marquette who's, I've worked with a lot, Susan.

a political scientist who has studied comparative healthcare systems.

But I can tell you that if you look at all of the European countries, and you look at the major Asian democracies, so South Korea, Taiwan, Japan, that's night and day compared to us.

I don't think there, maybe it exists.

I haven't seen great data on China, right?

China's not the most

But let me put it this way, what they all probably do better is look at the whole health of the person and what here's the problem we have.

We're the only country in the world that separates medical care from public health.

You ever wondered why the public health department has nothing to do with the big hospitals, right?

Because the more healthy people are, the less intensive care they'll need.

It's been separating the US for business reasons.

It's all connected everywhere else.

So if you take a system that is public health focused instead of acute care focused, I would call it, a lot of people call it sick care focused.

It actually reduces costs dramatically and improves outcomes.

Costa Rica is a middle class country.

It's a much poorer country than we are.

They have a higher life expectancy than we are.

We do.

Costa Rica has a higher life expectancy than we do.

Folks have looked up, but told one day the great, he's a doctor who's also a writer for the New Yorker, did a great story about this a couple years ago, but it's something you can easily find online because it was, and it's still being passed around.

And there's a research institute between Harvard's Public Health School and the Boston and Brigham Hospital, the Ariadne Institute that studies this.

what Costa Rica in particular, what Costa Rica did was they built a system of public health workers connected to clinics with doctors in them that canvass every single house every year.

And chart how people's health is, what conditions they might have.

If people have conditions that need follow-up, they're overweight.

They have some kind of diabetes or obesity.

Then there's follow-up, and those people get more follow-up and get maybe two to three visits a year, plus calls from the clinic.

So their health is managed.

They have a uniform medical record system, so they track people's health throughout their whole lifetimes at every house, at a regional level.

And the result is that their life expectancy is higher than we ours is, and they have far fewer per capita.

big fancy hospitals because they don't need them.

They don't need as many because they keep people healthy much longer.

And so it's a but why that's less profitable for businesses.

That's not some big profit thing in our system.

We put all the money towards sick care because that's where the profit is.

And that's where the hospitals make their profit.

And therefore we create a lot more sick people.

And though that's partly why it's so expensive.

But even given that

The price itself is astronomically high for each procedure, even given the fact that there are a lot more people getting the procedure than would need it if we had, if we invested in the primary health system.

And, you know, we did that in a place like Milwaukee, that's a huge jobs program.

We'd have to hire tons of public health workers.

who went door to door all the time and knew everyone in these neighborhoods and went by at least once a year and more often for people where there was someone in the house that had any conditions that need to be tracked.

You know, Dr. Craig, you know, all of that is so, this is just such a complex issue in healthcare.

And I think people, I can speak for myself.

The more I try to understand it,

the more lost I become.

I do know at the root of it is there are a lot of people making a lot of money.

And they set the price.

We don't know what the price is and they're done secret negotiations by two big monopolies, big insurance companies and big hospital

chains.

And billionaires have investments in those things.

And you saw, Earl, that even with that, it's a trashy system ascension, one of the largest healthcare chains in the whole country.

bought up all the Catholic hospitals.

It's in Milwaukee in the Southeast Wisconsin area, that they're going to telehealth in the ICU.

Did you see this story in the Milwaukee Journal Sentinel where there won't be a doctor?

Yes.

That they'll put a TV up to the person

in

the ICU.

In intensive care, no doctor.

So we'll go ahead and pay more than

Anyone else in the world for these services you made the bills aren't going down, right?

But there's no doctor in the room Unbelievable,

you know, you know dr. Craig it is It's an ongoing Conversation that I think we just need to keep hammering that because it's not going away and And again, I brought it up This morning because you know

Pretty soon, I'm going to be in the system, having some cataract surgery done, but that price just kind of blew my mind.

And are you, are you go, where do you go?

Freighter.

Freight, oh, the I Institute?

Yes, it'll be through Freighter.

But I had to have retinal detachment surgery there.

The I Institute is very high quality.

Yeah, I don't disagree.

I mean, I know pretty sure.

that it's going to be quality work and all those things.

I just thought about other people who probably were facing the same thing and couldn't get it done.

In fact, I met

a surgeon at the Eye Institute who told me that he used to do a lot of different eye surgeries, but with the aging population, there's so many cataracts now.

that they're just lined up.

He's like

doing 30 cataract surgeries a day and they're lined up for him from early in the

morning.

And the real issue, Dr. Craig, is cataract surgery is not major surgery.

Right.

So you have to ask the question why such high cost for removing basically a lens.

Of your people, you

know, we know it have to be that $200,000 for the car they would or oh, yeah And that's what's going on here the and these nonprofit hospital chains are massing massive fortunes in in their reserves Which they never spend on on us.

They just keep amassing them the kind of like Harvard and Yale and their

trillion dollar endowments.

They're complete empire builders.

But they're highly inefficient systems that don't need to be this expensive.

Plus, there's a lot of care that's expensive that didn't need to be if we had a decent public health system in this country, which we totally divested.

So for the sake of conversation, for the for-profit hospitals, somebody owns

a stake in those, how do they, who owns the stakes in the hospitals?

Well, most of our hospitals in Wisconsin are non-profits, but I remember.

Okay,

so the non-profits, Dr. Craig, why are they so profit-oriented?

Because non-profits act just like for-profits if you let them.

And then stay off.

They don't pay property tax code, right?

And they don't pay property taxes.

They're structured as charities.

They void all this taxation.

One of the interesting things is they often claim that they do charity care and return for being nonprofit.

Well, there's a lot of research that shows that they

They give a lot less charity care than the value of their nonprofit status in terms of not being taxed and not giving to the schools and everything else, the streets and everything else, but it's been going down dramatically every year.

And so, and in fact, the nonprofit hospitals are worse that way than the for-profit hospitals, according to data.

They're, if you go to health affairs, they're, and you can just look it up there, a lot of articles about this.

So they're,

there was once a walking journal said the headline my experience in walking journal Sentinel was they get new health reporter they do a story like this and then the hospitals obviously go and complain to big advertisers and then they never do it again but there was a headline story by a new health care reporter on a Sunday Sunday journal Sentinel that the headline was non-profit and name only

And that didn't happen again.

I just say, I assume there was a firestorm and calls to the publisher.

So Dr. Craig, there are for-profit hospitals in the state of Wisconsin.

Not very many.

The big ones are all not for-profit.

But they act like for-profit.

So the for-profit hospitals don't have to adhere to the same standards with the price.

with the cost that they charge you for doing the service?

None of them do.

It's the Wild Wild West and their price is all very radically for the same procedure, double for this and half for this.

The price is not the price because they control the information.

It's very anti-democratic, but ultimately, they have an incentive to charge

whatever they can and to force us to pay.

So if I'm going to a for-profit hospital with Medicare, the for-profit hospital is not going to be able to push the price any higher for Medicare.

No,

Medicare sets the price.

That's the difference between it and private insurance.

So that's why we need to use, and Medicaid does as well, badger care.

So that's the systems we need to use, or we need to

set the price.

We set the price to utilities.

We energies may have co-opted the public service commission, but it has to go and get approval.

Right.

And so there's some possibility.

That needs to be reformed too, because they've taken over their regulators, which is often a problem.

But we we already have a pricing system Medicare.

What what the bill we're working on with Dora Drake would say, and I got to go sooner or something at the top of the hour.

But I was going to say, would

cap their prices at a percentage of the cost of Medicare.

We're going to let them pay double, charge double Medicare, which is more than they need.

That will save us massive amounts.

It would reduce the cost of health care dramatically in Wisconsin.

They're going to go crazy because they're going to claim they can't deliver it at that, but it's still much more than any other advanced healthcare country charges get paid.

But that's what we need to do.

We need to intervene and set the price and take it away from them because they cannot be trusted to do it.

And you can just see by the numbers, by the average cost to know it.

There's no reason on God's green earth that it should be three times more expensive than the same procedures as any other advanced industrial country in the world in this country other than they get away with it.

And they have inefficient wasteful bureaucracies that overpay for everything.

So we'll leave it there, Dr. Craig.

As always, great information.

My head is spinning.

And ma'am, we'll just keep hammering away and getting more and more information about this so people will.

All right.

Thanks again, Dr. Craig.

Been a pleasure.

Thank you.

Dr. Craig of Citizen Action.

Dr. Craig, we'll see you next time.

That's a wrap for what's going on with Earl Ingram.

See you next time.