Thank you for joining me today. It is a delight i thoroughly enjoyed your book. It is a timely subject as you may know im a pharmacist the only one serving in congress is also important that everyone would agree with that. And i find it interesting that you start the premise that the Health Care System is broken. Almost 70 percent of america say it is broken. I do think it will be a domestic policy issue in the next president ial election in a recent poll that said 35 percent rate healthcare as extremely important and 53 percent of americans support a singlepayer now 65 percent supports the Government Insurance plan and i call that the steppingstone approach to medicare for all. The proof is in the pudding if you look at what happened the last election cycle two years ago, my party, one year ago, the Republican Party we were ousted as a Majority Party in the reason was healthcare that many of us campaigned on repeal and replace unfortunately we came close but did not get that done and that showed up at the ballot box. Exactly. It is unfortunate because donald trump won the presidency you had a house in the senate we word repeal and replace but it is a disaster turning the whole Health Care System upside down. But definitely we will see healthcare be out there and the issue we have to do that as a Cohesive Strategy to educate on why thats important we have a marketbased Health Care System and not controlled by governmen government. Host lets talk about obama care. The forward was written by senator coburn and he said the Affordable Care act has failed to deliver on its promises five years going into full effect market has risen 75 percent lower and middle income people have been forced into plans with deductible is 12000 what is your opinion . It will turn ten on march 23d i just cannot believe i thought for sure it would have been overturned in the Supreme Court in 2012 and 2015 but it was not. Senator coburn is right the American People do not like obama care because of high premiums, high deductibles Small Network of doctors and hospitals those that bought the platinum or gold plan thought they could keep their doctrine healthcare would be fantastic but unfortunately they said so it is overturned in the Health Care System. But most had options for medicaid and other looking at 4 Million People some who are ill legal could not get on obama care and not where the government is mandating and then to limit the choices. And it did take choice out of healthcare. We want a system to empower doctors and patients not federal or state government. So we thought we would be repeal and replace that obama care. And then republicans made a mistake what would happen with preexisting conditions that that would be a disaster and those that have employersponsored insurance with chronic conditions with the individual market, those of the people that we talked a lot about the federal government giving money to the states to set up the high risk pool so those people to get really good coverage they could afford for those that came out against the mandate and paid the penalty and three or 400 a month and then to pay the individual mandate rather them by health coverage. And i have to agree i love my party in support my party. We have to do a better job of that. But coming in with one vote of the senate are passing but they were never able to articulate that. As a former canadian for us to educate the American People with a full takeover leads to ration care long waiting list and people like senator sanders or senator warren say its free but it is not the average canadian family pays 13311 per year in hidden taxes for a system that denies them care. Host go into the premise of your book of medicare for all as you describe it is the shiny new toy that democrats have grabbed hold of and as we quite often say in politics , perception is reality. For a lot of people we have perceived this to be the answer. Exactly medicare for all with Bernie Sanders that is part of his platform for many years but it didnt come into the four until 2016 when he was running against Hillary Clinton for the democratic nomination. He was really on the stomp for medicare for all then with a singlepayer bill 2019 cosponsored by cory booker and Elizabeth Warren and the people that were in that race. So he told the American People we need the government to run the Healthcare System with universal coverage and of course it wont cost very much and everybody will have access to the very best care we can talk how much a singlepayer system really cost in america what it means for doctors and long waiting list where i am from or uk is the National Health service. Senator sanders is just adamant for singlepayer and i find it amazing and im sure you do he is at 30 percent in the iowa caucus one of the top candidates in New Hampshire and this week the number one candidate in california. But i was amazed in particular young people really buy into then whats better than free healthcare . It sounds like a great idea until you unravel the union. That should be interesting. Talk about a contrast of donald trump and Bernie Sanders. So the support is since you have first pointed out running against Hillary Clinton that in 2000 and continue to grow the support at 40 percent in 2019. That eliminates private Health Insurance. With urines on employersponsored coverage so when we see in the polls 59 percent or 53 percent support medicare for all but then if you say if you are going to lose your private insurance the number drops down at 37 percent. How do you feel about medicare for all of taxes go up . Support goes down its also 37 percent the American People dont understand what medicare for all means. It sounds great and it is great and then to keep their employersponsored coverage. Those that have it rated as excellent or good. Elizabeth warren says ive never met a person in my life who likes their Health Insurance. Who was she talking to . I like mine. So these are lies to the American People if no one likes it then why wouldnt we have a takeover . Host i have always noted that the people on medicare now generally has positive connotations however if you add everybody into it. Right look at medicare today from 1955 from the Great Society we are spending 700 billion per year on medicare and part a could be bankrupt by 2030 upwards of 50 percent of people now have Medicare Advantage are supplemental because one out of three doctors are not taking new medicare patients because they are reimbursed at 40 percent below what they get with private coverage. Thats a very important statistic. So just think about medical doctors if they take 40 percent below what they are paid today they will quit and retire and the bigger point is traditionally with the government to determine that they can practice you may be the very best Orthopedic Surgeon and what happens in november we would just have to go on vacation. What about these other plans that are more moderate Solutions Like adding a public option or allowing more patients to buy into medicare and medicaid . How does that impact the Health Care System . 65 percent pulled support the public option Kamala Harris who said she could be the candidate but her candidacy dropped because of her waffling on medicare for all she supported it one day then the next day she didnt so she law support and senator warren of course up until very recently was a big supporter of pro government takeover now she says the first 100 days i would introduce a public option the third year i would bring medicare for all because all those people with a public option that is the Government Insurance plan and exchange of private coverage that they would want to be in medicare for all. Thats a complete lie and we know that talking to people but senator warren and joe biden and Pete Buttigieg devil switched one have all switched. Even mayor pete says he supports a public option if it doesnt work after a couple of years then he would go to medicare for all. Host talk about medicare for all. It isnt somewhat it really should be called what it is of a one size fits all government Health Care System. But other than the International Debate you cant see a specialist without be a referral and then he interrupted me and said sorry the singlepayer system in this country and it is terrific he said the Veterans Administration. And the fact that our vets have top care to the latest drugs and biologics are available so the American People understand that it is a disaster is that what we want . For people that are skittish and then to have a public option. And just recently when i had my check up to say i lose a month a lot of money and i have to make my salary but i get really good care. Talk about the sanders plan. But i know. But they were destroyed medicare as we know it. And that they would be into a new government run Healthcare System. So chairman of medicare for all is pushing to tell the American People she is from washington state. But senator sanders say medicare and medicaid would be eliminated but the only two programs left and then the second is the Veterans Administration and then when asked what would happen to the people that work in the Insurance Industry . And Elizabeth Warren when confronted said what will they do and she said work in the auto or life Insurance Industry there is no comparison with Health Insurance versus Auto Insurance and then Bernie Sanders to say i will set up a federal Training Program to inside to have a new career and that it would be incredibly expensive. Medicare for all for bids doctors that participate that with any service the government covers. And then to say i lose money on medicaid. If you take that away what does that mean to salaries of healthcare workers . People that work in hospitals. With a tremendous impact on the ability to keep your job it also means a federal government takes it over. And maybe 1 Million People that government has to expand tremendously and with a whole new bureaucracy and the up and to me a on dash to say i find it amazing American People will think its so wonderful. Do you know how long it takes the government to pay me when i go on vacation . It will be a disaster for people who work in hospitals. And under a singlepayer government system. And to travel many many miles and those to get the latest treatments. Host you are from canada you mentioned that. Being a canadian native you have seen government run healthcare. They fully took over the Healthcare System 1984. No private coverage is allowed for anything considered medically necessary. Cosmetic surgery, lasix surgery for your eyes the government is not involve the prices have gone down so in canada i look at the institute where we started a project 1988 and on 1993 the first year the average wait time to see a primary care doctor to go to the gp who refers if it is necessary in 1993 it was nine. Three weeks. Last year increased at 20. Nine weeks thats five months. And those that cross the border every month to pay outofpocket to get the mri or the ct scan or hip replacement or how her heart valve. And canadians have the escape valve but where will we go . Like doctor tom price say we will have to go offshore to continue to get the very best in medicine. And say i hope youre not becoming the inpatient american but to say that im sorry you cannot get an appointment or get a colonoscopy. Canadian say that will be nice. But for a lot of people they dont know any different. Most people going up or under singlepayer that happened slowly and then it fell in with 1984. Thats we talk about sanders and proposals. Thats what they have in canada. There is no private coverage for anything considered medically necessary. You can get private insurance and what they pay would never cover any of the cost. And then to have private room and a hospital, an ambulance and over five weeks weight and for the three weeks for every 1 Million People 16 mri machines versus 44 in the us. But bernie was to have free eye care, dental care, drugs, longterm care. So 30 or 40 trillion over ten years with bernies plan and even he agreed that would be the price. So now he has backed away from that and then would go up 20 trillion over ten years. And under a liberal Prime Minister to find out they cant afford to do it. And no referral to a specialist. Because the demand for healthcare will far exceed the supply that can be given. Thats why it is at 30 your federal trillion that is probably on the low side. Host two of the most prominent examples from canada and uk. You still have the big outofpocket expense as well as denmark and finland and norway there are outofpocket expenses you have responsibility for. With a true singlepayer Health Care System. The United Kingdom has universal coverage the nhs started in 1971. It covers about 90 percent of brits. And those that have private coverage. But this is becoming more popular because just in december there were 4 million brits on a waiting list to get treatment and the Cancer Treatment should not be delayed more than 62 days they have not met that standard for over five years and more important under the who study brits are at the bottom of the wrong the most industrialized country of all cancer rates for survival that tells you about Life Expectancy with cancer under a government controlled system. You mentioned this is a big concern how much will this cost . 32 trillion over ten years . Trillion . Not million or billion they said that would include with a reduced administrative cost but that would be the increase of federal spending the total cost is somewhere 50 or 60 trillion over ten years and it wont to be free, taxes have to go up sanders has said the new income tax on anyone earning over 29000 thats very low income in this country and what had a lot of people seven. Five payroll tax Elizabeth Warren said it isnt paid by middleclass people her plan would not increase taxes anyone on the middle class but people pay the employer tax are the employees and they are middleclass. And the not tax on the wealthy and large Financial Institutions but if you doubled all the Corporate Income taxes and income taxes would it be enough to cover the plan so they would go up even further and it wont be free because you are facing these taxes. If you cant have your care rationed that is just the domino effect. And Prescription Drug pricing. And those proposals by the other side for Prescription Drugs and our concern to stifle innovatio innovation. I have seen nothing short of miracles and that is phenomenal. But there are other things that we can do with price controls do you see that stifling innovation . Not into research and development . We are totally stifled. Biologics and bio similars it is not in germany or england all of the countries do their r d in this country. All have price control and then to develop new drugs they dont make it through the system with 3 billion and to get it to market. So the innovator and incubator for all innovation if you think of Cancer Therapy and what is coming out for muscular dystrophy and alzheimers very few of the drugs going to trial make it. So we want to keep the pipeline in this country open those that manufactured them in canada people say they are cheaper but they have price controls but what people dont understand the prices review board and if they decide the latest new drug to treat muscular dystrophy but if nancy pelosi and her crew get that through the senate this would be a disaster for all of us who depend on the innovations so to save 7. 17 if you had a gallbladder situation you would have to have that removed the cost of that is the anesthetic now hospital costs are reduced as well. Host absolutely hepatitis c. When i came out of school in 1980 you would get liver cancer and that was a death sentence. But now we can cure that with a pill. People say that pill is 85000 but it does do the cure if a liver transplant is 500,000 in many you cannot get liver that can match so it is very inexpensive and you get rid of the hepatitis c. We have an alternative it was much better with no price controls so with those price controls to exist between eight through 15 drugs that would have come out on the market in the next two years would not if we put the price controls and to affect. Which drug is that . Is that a cure for alzheimers or diabetes . Even if it is one it is one too many. Exactly and those that would be developed people are just waiting and holding on that they can survive for when the next new drug comes out people that survive with hepatitis c because of that drug. You mentioned not all the drugs available in america are available in canada or United Kingdom. Right. People in canada you have to pay for your drugs not just the low end of the income ladder actually get free or reduced drugs but they pay at the pharmacy but in many cases the drugs they are getting because the latest are not on the formula they dont even know theres a newer drug that could cure leukemia or nonhodgkins lymphoma my uncle passed away from that back in 2003 now here in america to be approved by the fb fda in 1997 and when i talk to my uncle i said you should go to the Cancer Agency and see about getting that for your dad and he did the head of the Cancer Agency had never heard of it. He got back to him in two weeks and said that drug is not available here. You have to take your dad down to seattle. Its a big deal for when you are older and sicker so a lot of these new drugs are not available. Its almost like a religion. And then everybodys complaining the older you are. Lets talk about the other cost. Not necessarily monetary. Talk about the overcrowding that takes place and hospitals and Healthcare Systems in general. The average wait for specialist is 20. Nine weeks. Over five months. And care is rationed. So i said you dont detect colon cancer you to get a colonoscopy. But the farmer care doctor you are senior we have too many younger people to get a colonoscopy. But six months later my mom lost 30 pounds and hemorrhaging we got her to the hospital in the ambulance and two days in emergency room two days waiting for a lot bed died two weeks later from colon cancer after her colonoscopy. We spent 18 percent of gdp if you have a limit to spend there is not enough to go around so people have to wait and those that will weight the most are seniors. To get the appointment with an ophthalmologist it has gone blind. False premise and false promise what i really enjoyed is what you just shared that mary louise was sweating profusely on the night of januah 2 the cdc and was told the 50 sexual was experiencing muscle spasms. She was given a shot of morphine and said home she died two days later february 1st her experience is common in canada with hospital staff unable to devote to emergency room patients it is piled high ambulances have to leave one hospital to go to another to get room. And to get into the er but they have been rocking that means people who are older in the hospital was something chronic they stay in the bed so younger people cannot get in because they should be in the assisted living facility. And a good friend of mine has been treating private patients in British Columbia is in a lawsuit over ten years with cases in the dc Supreme Court three years the government keeps putting more more money into it to stall because they dont want open the system to a private alternative and a lot of the people he takes care of our and the government that are opposed to opening the system. So the competition will solve so many of these problems there is no question some things need to be changed in the american Healthcare System the choice will bring down the cost and it will lead to universal coverage. Outside of monetary costs, costs, with fewer students going into the medical profession and what we struggle with right now in washington dc is the high cost of education and Student Loans. Especially pharmacist and Healthcare Professionals come out with a Student Loans and with the doctor shortage . They came out just recently and said 203,122,000 general primary care doctors and surgeons by 2030 that was before they consider if the government takes over the Healthcare System and those that are retiring early because of their own primary care doctor said all of the Electronic Health records i cannot Practice Medicine anymore so i will just retire. We are seeing that so often that government gets involved with Electronic Health record you cant work on your patient because you are working on your computer. There will be a shortage and that will be even greater. It is incredibly worrying about our supply of doctors and under singlepayer and in britain right now there is a shortage of 100,000 doctors , nurses and people who work in hospitals but those who were bribed to come back and the response was virtually nothing only a few came back. Because the us versus canada they say they do have debt and it is expensive but over time they make good money and save peoples lives and we dont want to destroy that incentive. Earlier in the conversation talked about mri machines and the cutting edge treatment does life exist like it does in america . Absolutely not when the government controls healthcare you see a radiologist to say our xray equipment is so old we cant rely on the results but the average way in canada for the mri is 22 weeks, thats five months canada has 16 mri machines for 1 Million People but one mri machine or 16 for 1 Million People . We have 44. And people in the eastern bloc have 20 or 24. More than canada in canada is highly industrialized as of that a shock you cannot get access . Or positron emission machines are a higher level and there are very few if you have cancer you cannot get the pet scan. One of the darker parts of the book you discuss the assisted suicide and the death panels. I found that to be very interesting and a little depressing to be honest. Tell me about that. Remember talking about rationed care the Death Penalty is too much because it scares people but there are death panels it is rationed care because the girl gone the government determines who will get care and how much so in canada in many cases they say you cannot get better you are older you should have assisted suicide because its cheaper for everybody and thats not the american way the relationship should be between the doctor and family and patient. Once government gets involved in the uk for example its Nice National Institute health and clinical excellence this division figures out what is the value of your life and the cost of the treatment or the pharmaceutical it is quality adjusted life years if the board decides you are retired and you are worth 30000 you can be cured with hep c with a cost that cost 80000 but because you are not worth that you dont have access to and that is what i fear will happen under the organization massachusetts that patterns itself on the nice program in the uk. So under singlepayer system this has to come in because its an additional way to deny care by determining if you are not worth that then you will not get a treatment then is determined for your worth. One last question of the other countries but the Life Expectancy of canada and uk compared to the United States. That can be misleading. The two things are Life Expectancy and infant mortality you always here we have a very high rate of infant mortality. The state of georgia has the highest. But when you compare the United States to france then compare apples to apples we are very highly developed neonatal units in this country and the baby has access to the latest treatment and ways to keep that baby alive they live in this country if you are in france a baby has to be considered a live birth if it weighs a certain amount and a certain length so many of these babies that dont make it in france or germany do make it here. You are not comparing apples to infant mortality is different they say Life Expectancy is declining its down at 79. 2 years but look at what makes Life Expectancy . The issue is the United States has the highest level of deaths from Car Accidents and obesity on a per capita basis the highest number of deaths from guns. They dont have death from Car Accidents they dont have death from guns is a very serious problem with obesity but we dont do that in europe or canada that many of these people that are very obese it leads to medical issues so you have to compare apples to apples and the survival rate five years out whether pancreatic cancer or colon cancer or Breast Cancer or Prostate Cancer we have the highest survival rate from the commonwealth we have the very best and we want to build on that. We dont want to become a third world country. Host one last thing talking about the onset of these programs of medicare for all how does that work . With the sanders plan if they were to implement medicare for all with that be sudden or over a period of time . We dont know but Bernie Sanders did say recently and met Elizabeth Warren are at loggerheads but he said she said she would induce medicare for all he said i would induce in the first week because you dont want to be stalling and taking time because then there is complications he does want to take the whole Health Care System immediately to ban all private insurers and people are put out of work how much were they have to expand the bureaucracy to have people doing billing in the federal government . Now i use fedex or ups but those who use the post office but they have a choice with the private system there is a reason why they are in business they wanted to get rid of dhl and have government be in charge and that makes me very nervous with the dmv or the post office those of the people making decisions about my health care and your healthcare . The doctors will be paid what they will be paid and if not paid what they are worth the thats a problem. We have established this premise for medicare for all this is not what they want. What will work so to take the criticism you dont have a plan. We have to communicate. Tell me how we fix this system that is broken. We want universal coverage coming through choice so during world war ii employers have the ability to write off the cost of healthcare and as employees we got healthcare taxfree. If i quit my job going to the individual market i have to buy my health care with aftertax dollars. So in the interim we need to reform the tax code so individuals can get their healthcare taxfree the same way we do. Of course we do make lower wages the taxpayers we make less money but i would like to level that Playing Field with Life Insurance through the employer we shouldnt be Getting Health Care to the employer. We need to make that change. We need to expand the Health Savings now employers offer hsas to put the patients in charge they are more careful when they spend their own money so with 180 Million People they have no idea what it cost they think its free and then they use more we can expand Health Savings accounts those that should put money into their hsa they should use that to help pay their premium if they are having difficulty but the doctor and patient in charge with medical malpractice reform remember when obama said this little pill doctors are doing unnecessary testing because they want to line their pockets with money doctors do that because they are afraid of being sued some cant afford the premiums unless they are in a large hospital practice so that cost 210 billion per year with a cap on economic damages we have to do these non economic damages so we stop this frivolous lawsuits and ambulance chasing lawyers to allow people on medicaid to get the hmo trumps medicaid work part is very important why should people get the promotion because they dont want to go off medicaid . They should not be on medicaid but working their way up the ladder they should buy Health Insurance across state lines we need Price Transparency that is a big issue and mr. Trump realizes that people want to know what things cost if they dont know them they can prepare one and compare there is an issue in georgia right now to keep new hospitals off the market and help other ones make money. So those are a few of the things that are part of my plan to keep the Diamond PlatinumSystem People come from all over the world people from the middle east come here to get tremendous treatments that they cant get in their own country. Why is that Americans Still dont trust the free market system . We talked about this this morning how is it socialism has expanded but Young Millennials think the government can do this better what about the post office or the dmv . What about the v. A. Health system or medicaid. I think it starts in Public Schools and even private schools that children are taught by teachers and professors who continually say capitalism is bad and socialism is good therefore we need more socialism they are being indoctrinated without ever hearing about freemarket ideas there is an organization that is comparable to the Federalist Society for law students if i debate doctors on campus at medical schools they are all for government takeover the student has ever heard the alternatives they will be snickering and laughing because they think that is all they know it will be more efficient and cheaper but they have no clue what that does for their ability to Practice Medicine it is a huge problem with identity politics. Somehow we have to take that back. With no easy undertaking. One last thing from personal experience people ask me how competition brings drug prices down we had a company come out with this idea that it was generic for four dollars i broke my back is that i will not do that guess what . One week later i was selling a 30 day supply of generics for four dollars. You have to help me i cant let that happen but sure enough it drove down the price of generic generics. Because most people today take generics because the original drug has come off patent and generic drugs are way more expensive than they are here but the fda needs to up the approval like regular sore throat sore colds high cholesterol they do work and are far cheaper bringing down the cost of drugs. I encourage everybody if you have the opportunity to do this and then the republicans take back the house to get real healthcare reform in this country. Thank you i am incredibly excited to introduce Timothy Faust i think one of the best agitators for the rights to health care i have ever had the privilege of hearing. Someone that can combine a masterful analysis of details while keeping a sharp focus on the important principles of why it matters of corporations can make more money