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Would indicate that. Almost 70 of the people in america say that the Healthcare System is broken. Right, i really think that healthcare is going to be the number one to musick policy issue in the president ial election. In a recent poll just came out from gallup that said the 5 of the American People pulled rate healthcare is extremely important as one of the issues and we seen in the polling 53 of americans support singlepayer and i know private coverage at all but now 65 supporting the public option which would be a Government Insurance plan to compete against private insurers and i call this a steppingstone approach to government run medicare for all. The proof is in the pudding. If you look at what happened the last election cycle two years ago my party, i guess it was one year ago, my party the Republican Party we were ousted as a majority and house of representatives and many people will make the armament that it was because the issue of healthcare and that many of us campaigned on repeal and replace and unfortunately we came close but we did not get that done. It was shown at the ballot box. Exactly, it was unfortunate because i think donald trump won the presidency and you had the house in the senate and by saying that we will repeal and replace the disastrous obamacare which it is a disaster and turn the whole Healthcare System down for a very few people but we are definitely going to save healthcare be out there and be the issue and we got to present a Cohesive Strategy to the American People and educate them on why it is important that we have a marketbased health care and not one controlled by government such as the federal government. Lets talk about obamacare for a second, the Affordable Care act. The forward to your book was written by senator tom calder and he made the same and there and he said the Affordable Care act has failed to deliver on the promises, five years after present obama signature legislative achievement went into full effect individual market premiums have risen 75 , many low and middle income people have been forced into plans with deductibles as high as 12000. Its really been an overturn in the Health Care System and it hasnt done what we wanted and still about 27 Million People in this country uninsured but most of them had option. They were eligible for medicaid and other, subsidies on exchange but the just didnt sign up and looking at about 4 Million People some of whom are a legal who couldnt sign up. We need a competition and choice. Families and individuals should be able to get the kind of health care that suits their needs and not one where the government is meant Ten Essential Health benefits but all state mandates that make health care more expensive and limited choices that people have. Host from my perspective ive always thought the greatest failing of obamacare, the Affordable Care act was that it did take choice and competition out of health care and away from patients and from doctors, where it should be. Guest right. We want a system that empowers doctors and patients, not the federal government, not state governments. That was really, i really thought we would be able to repeal and replace obamacare when the democrats took the house back in 2018 i think republicans made a mistake in not really explaining to the American People what would happen to those people with existing conditions because the democrats and 100. 9 americans have preexisting chronic conditions, they will lose her health care and its going to be a disaster. Most disaster. Most of those people have employersponsored insurance and theyre not going to lose their coverage. There are only six Million People with chronic conditions were in the individual market. Those of the people that we need to take care of and dr. Tom price when he was in the house, we talk a lot about getting the federal government to give money to the states so it could set up or expand and make better the highrisk pool so those people could get really good coverage that they could afford and they wouldnt lose it. The younger people who really came out against obamacare even with individual mandate and paid that penalty rather than buying insurance. The cost for a young person of 25, 28, three, or hundred dollars a month was to come with the people with preexisting conditions and they said im going to pay the individual mandate fine rather than by health coverage. Everyone else was supporting those people who are with preexisting conditions. Host i would have to agree with you. I love my party and support my party. I dont think messaging is our strong point and we needed a better job with that. But if you look at the American Health care act that came within one senators vote of passing you would see we did indeed come up existing conditions but we were never able to articulate that. Guest that is a problem. That is one of my jobs as a former canadian to educate the American People on what a full government takeover of our health care lead to ration care, long waiting list for care, a shortage of doctors and, of course, higher and your taxes. People like senator sanders, senator warren say Canadian Health care is free. Its not its not that the average canadian family pays 13,311 a year in hidden taxes for system that denies them care. Host right. Lets go into the premise of your book, medicare for all. Medicare for all as you describe it is the shiny new toy that the democrats have grabbed hold of and as we quite often say in politics, perception is reality. And for a lot of people they perceive this to be the answer until you get into the details. Guest exactly. Medicare for all single payer has been out there, Bernie Sanders main talking point about this as part of his platform but it didnt come into before intel 2016 when he was running against Hillary Clinton for the democratic nomination for president. He really got out and stump for medicare for all and then of course in 2017 you had a singlepayer bill, 2019 cosponsors, 16 like cory booker and Elizabeth Warren and all the people are in the race or out of it but were in it. He told the American People who need the government to run Health Care System. It will lead to universal coverage and, of course, it wont cost very much and everybody while access to the very best care. We can talk about how much a single payer system would really cost in america, one would mean for doctors, what would me for long waiting lists such as in canada or in the uk of the National Health service. Senator sanders is just adamant for a singlepayer and i find it amazing and im sure you do that he is 30 in the iowa caucus at the top of the list of the candidates in New Hampshire and just in a recent poll this week he is the number one candidate in california. California is extremely liberal but i was amazed that a particular young people are really buying into whats better than the Free Health Care i mean it sounds like a fantastic idea into you unravel the onion. Host thats exactly right. It should be interesting talk about a contrast, donald trump and Bernie Sanders. Thats contrast. Guest that is a contrast. Host let me ask you about the numbers. Support has grown since it was first mentioned when Bernie Sanders was running against Hillary Clinton. The support was high. In 2000 and it continued to grow, in 2000 the support was at 40 . In 2019 it had grown to 51 . 72 of democrats were in 2 of were in favor of it. But however when you start to talk about those things that you brought up, eliminates private Health Insurance, then all of a sudden you see it plummet. Guest exactly. We have employersponsored coverage, about 180 million americans have their employersponsored coverage. When you see in the polls 59 , 53 support medicare for all, but then you say what do you think about medicare for all if you are going to lose your private insurance . The numbers drop down to 37 . How do you feel about medicare for all if your taxes are going to go up . Support goes down also to 37 . The problem is the American People dont understand what medicare for all means add a sounds great and its free but you have to get under the weeds, unravel the onion and explain what it will mean the health care and they wont be able to keep their employersponsored coverage, which in recent poll 71 of people who have esi like it. They rate it as excellent or good. When Elizabeth Warren gets up ive never met a person in my life who likes their Health Insurance. Who does she talk to . I like my insurance. These are lies to the American People with people think if no one likes it or i wouldnt have government take it over . , thats one thing ive noticed, people like medicare particular and medicare now generally when you say medicare it is positive connotations and people like it. However, add everybody into it and whats going to happen . Guest right. If a look at medicare today which came into being and 1965 under president johnson and the great society, we are spending about seven or 800 billion a year year on medicare. Medicare trustees had said that part a could be bankrupt by 2030. A lot of people i would say probably 50 on medicare today now at Medicare Advantage or medicare supplemental ache as one in three doctors is not taking new medicare patients because they are reimbursed at about 40 below what they get paid for treating People Like Us with private coverage. Thats a very important statistic. If the government took over the whole thing it would be far worse. Doctors would quit. Think about medical doctors if theyre going to be paid 40 below what they get paid today. They are going to quit and retire and i think the bigger point is that the best and brightest kids traditional have gone into medicine in this country and they are just not going to go into it. Also doctors would be employees of the government. Government would determine what kind of medicine they can practice, how much theyre going to be paid. You may be the very best Orthopedic Surgeon, i may be the worst but we paid the same and will have global budget. What happens in november the global budget that is set for us is done . We would have to go on vacation. Even if we couldnt afford it. Host what about these are other plans that are advertised as more moderate if you will, Solutions Like adding a public option or allowing the patience to buy into medicare and medicaid . How would that impact our Health Care System . Guest 65 of people polled recently support the public option. If you go back, when Kamala Harris early on i thought she could well be the candidate but she really i think her candidacy drop because of her waffling on medicare for all. One day she supported it, and the next in such a lost support and shes out. Senator warren of course up until very recently was a big supporter of full government takeover of health care. Now she says within the first 100 days i would introduce a public option. My third year in the president of the bring in medicare for all. All those people who have the public option which is a Government Insurance plan that would compete in the exchanges against private coverage would all love their government ensured so, therefore, they want to be in medicare for all. I just think its a complete lie and we know that in talking to people. But senator warren, mayor buttigieg, joe biden, theyve all switched to this were going to go to this public option, government plan first. Its a steppingstone approach. Even mayor buttigieg has said while he supports the public option, if after couple years is that working not everybody is in, he would go to medicare for all. Host when you talk about medicare for all, thats a misnomer because its not somewhat, medicare for all. It is a misnomer because it should be called what it is, and that is its a one size fits all government run Health Care System. Guest right. A couple years ago i was debating a princeton economics professor who unfortunately, sadly passed away a year and half or so ago that i sing an International Debate within talk about the canadian wait times, the ration care. You cant see a specialist without getting a referral, how hard it is to get a doctor he interrupted me and said we have an example of a single payer system in this country and it is terrific. What plan is that . He said the v. A. , the Veterans Administration. This was before all of the information came out about the fact our veterans were not getting top care. They are on waiting lists, veteran of access as you will know to the latest drugs and biologics are available for people with private coverage. We really have to educate people. The American People understand now the Veterans Administration is a disaster, and so is that what we want . These politicians are really pushing because people seem skittish about medicare for all all single payer. Lets go and have a public option just to compete first. My own ob gyn said recently when a sad, i lose a lot of money on my medicaid patients are barely breakeven on medicare and i have to make my salary from people like you with private coverage but i get really good care. Host lets talk about two of the plans, the sanders plan and jayapal plans. Both of those, i know her and thats fine but they would actually destroy medicare. It would as we know it, and for Young Americans and rich or poor it would mean they would be into a new government run Health Care System. Guest exactly. Jayapal is chairman of the medicare for all caucus, she is really pushing to tell the American People shes in Washington State. Im from vancouver so sort of similar areas, british colombia and Washington State liberal but senator sanders and jaya pulsate medical be limited to, medicare bill limited, the Government Program would be for everybody. The only two programs that would be left would be the Indian Health services which i dont think its the best of care to our indian people and the second would be the Veterans Administration which is another example of this as i talked about that hasnt gone well. Ms. Jayapal admitted when asked, what would happen to all the people that work and enters into shia things like that . She admitted 1 Million People in the Insurance Industry would lose their jobs Elizabeth Warren when confronted she said, asked what will these people to . They could work in the auto Insurance Industry or the life Insurance Industry. No comparison to working in the Health Insurance versus auto insurance. Bernie sanders said one to 2 million will lose their jobs but im going to set up a federal Trend Program to return all of those people so within five years they will have a new career and you and i know that is just not going to work, it would be incredibly expensive. Host in your book you say medicare for all gives the government monopoly over the provision of Health Insurance and it forbids doctors who participate in the scheme from accepting private payment from any service the government covers. You just mentioned you went to your ob gyn and she said i lose money on medicaid i believe it was and then medicare i breakeven and then i make my salary off private. If you take that away whats the going to mean to the salaries of health care workers, not only doctors but pharmacists might i add . Guest pharmacist, health care, people who work in hospitals, all of these people. Its going have a tremendous impact on your ability to keep your job. It also means the federal government if its the federal government is taking the whole thing over, whos going to do all this work that the alleged to meet people in the Insurance Industry and in other need one main people in pharmacy and all of these things, whos going to be doing this jobs . The government will have to expand tremendously because doctors will have to be paid, there will have to be a whole new bureaucracy to pay doctors and, of course, my cousin as an ophthalmologist in vancouver, canada, and as he says i find it amazing that the American People think it would be so wonderful if the government is paying their bills. He said do you know how long it takes the government to pay me and when my budget is done in november i had to go on vacation . Its going to be, its really going to be a disaster for pharmacists, people who work in hospitals, doctors, even for hospitals. Its going to reduce the number of hospitals. A lot of rural hospitals will go out of business under a single payer government system. Host that is that what we not what we need. Guest we did more rural hospitals because people in rural areas have to travel many, many miles in order to find doctors and hospitals to get the latest treatments and things, so exactly. Host you are from canada. You mentioned that a number of times. Being a canadian native, youve seen it firsthand. You seen government run health care. Guest i grew up under the federal government folo took over the Canadian Health system in 1984. No private coverage is on for anything considered medically necessary. Most things are medically necessary in health care. A couple things that are not, cosmetic surgery if i want to make myself look younger and better, laser surgery, all procedures with the price is gone down not at because again is not involved in canada come as i say in 1984 the government took it over, i worked at the Fraser Institute where we started the project in 88 called waiting your turn a guide to hospital waiting lists. In 1993 the first year the average wait time from seeing a primary doctor to getting treatment by a specialist as i say, you dont call up your ob gyn, you have to go to a gp who then refers you if he thinks its necessary. In 1993, that wait time was 9. 33 weeks, just over two months. Last year, 2019, the average wait time had increased to 20. 9 weeks. Thats over five months. 608,000 canadians across the border every year and pay outofpocket for getting mri, scans, orthopedic surgeries, hip replacements, heart valve replacements, things like that because they feel their health is too important to have to wait so long. Canadians have an escape valve. Where are we going to go . Well have to set up my liberty ships of doctors like dr. Tom price and others will not be practicing offshore so we can get, continue to get the very best in medicine. The American People demand. America is a very wealthy country and my mom used to say i hope you are not becoming one of those inpatient americans which of course i am now. Canadians and brits when the doctor says im sorry, but connected able to get an appointment to get a colonoscopy for eight months to a year even though you think the problem, canadians say fine, that would be nice. 608,000 acrosstheboard but a lot of people are so polite and dont know anything different because most people growing up have grown up under singlepayer and a started slowly and it finally was all it in 1984. Host are a number of proposals but when were talking and thus we have been talking about the sanders and jayapal proposals. Is that what they have in canada . Guest thats what they have in canada. There is no private for anything considered medically necessary which is the majority of things. You can get private insurance like if youre canadian and want to come to use on vacation and you are afraid if you might get sick of course the canadian government, what they pay would not cover any of the cost here. People get private coverage for traveling. Theyll get private coverage for having a private room at hospital because thats not part of the system. An ambulance going to the hospital, things like that. Bernie sanders plan is even more comprehensive than the canadian plan. Over five weeks wait from seeing your primary doctor to a special the average wait time for neurosurgery is 33 weeks. We have for every 1 Million People, 16 mri machines versus 44 in the u. S. More interestingly 24 in lithuania. Its ridiculous but bernie wants to add free eye care, free dental care, free drugs, free longterm care. When charles blayhouse says 3040 billion over ten years for bernies plan and agree that would be the price until he didnt, changes minor said he didnt he told cbs evening news last night i just dont know how much my plan to going to cost. He has backed away from that but he knows its going to be very, very expensive. As we saw today the increase in the federal deficit and a bernies plan would go up 20 trillion over ten years at the highend. If you add more than canada tried to bring in free drugs several years ago under a liberal Prime Minister and he found out it was so expensive that they just couldnt afford to do it. Bernie wants to make our system in a more comprehensive and no referral to specialist but you have to have gatekeepers because the demand for health care will far exceed the supply of health care that can be given and thats why 3040 trillion increase over ten years is probably on the low side. Host probably the two most prominent examples of medicare for all system are canada and uk. There are other countries that have it. As i understand it, in canada and in the United Kingdom you still have an outofpocket expense and outofpocket responsibility, as well as in denmark, norway and finland. There still are some outofpocket expenses that you have responsibility for. Guest right exactly. Canada is one of three countries that has a true single or Health Care System. The other two are cuba and north korea. Think about what kind of health care you get in those countries. The United Kingdom has what we call universal coverage system. The nhs started in 1971. It covers about 90 of the brits. They allow private coverage to repairable and about 10 brits have private coverage in some of the companies in the uk are American Companies like the Blue Cross Companies and is a british but this is becoming more popular because just in december there were over 4 million brits on a waiting list to get treatment. The Cancer Treatment is supposed to be delayed from seeing a joe partitioned getting treatment more than 60 days. They have met in the uk that standard for over five years. And more important, under the World Health Organization a study, brits are the bottom of the run in most industrialized countries in all forms of cancer survival rates by views of the that tells you something about Life Expectancy with cancer under a a government, basicalla government controlled system. Host you mention just a few minutes ago and its obviously a big concern, how much is this going to cost . I have seen figures, 32 trillion over ten years guest trillion. Not million are good. Charles blayhouse said that would include if he had some produce a burst of costs and reduced drug costs but, so that would be the increase in federal spending over ten years. What would be the total cost of the plan would be somewhere of 50 60 trillion over ten years. It wont be free. Taxes will have to go up. Sanders has said it would have to be a new 4 income tax on anyone earning over 29,000 a year. That is very little income in this country and would get a lot of people. There would be a new 7. 5 payroll tax. Elizabeth warren to the payroll tax is not paid by middleclass people because remember her plan wouldnt increase taxes on anyone in the middle class but she did realize the people who pay the employer tax are the employees and are for the most part middle class. Then there would be a new tax on the wealthy, there would be new taxes on large financial institutions. If you doubled all the Corporate Income taxes in this country and all the personal income taxes it wouldnt be enough to cover this plan so taxes would have to go up even further. As i say it wont be free because you will be facing all these taxes and its not free because when you are suffering when youre in pain and cant work as a cost to having your care ration and nothing able to get access to timely care. Host one of the things we have been working on in congress has been Prescription Drug pricing. Something i very high interest in. There have been proposals by the other side, the other party that call for price controls. On Prescription Drugs. Our concern and my concern has been stifling innovation. I started practicing pharmacy 1980. I started when i was ten guest exactly. Host but the point is that over that time ive seen nothing short of miracles to research and development. Thats phenomenal. I want to make clear the function of manufacturers need to do better job with the pricing but other things they can do. With price controls. Do you see the stifling innovation . Do you see companies that putting money into research and development . Guest it would totally stifle innovation. You have to think about it. Where is most of the research and development into new drugs, biologics, biosimilars. Where is that innovation done . Its not done in switzerland or germany or england. All the companies whether novartis, glaxo smith kline, all of these companies do their r d in this country. Theres a reason for it. If you, both countries like canada, england have price controls. You would lose your shirt trying to develop new drugs as you know most new drugs dont make it through the system. Cost about 3 billion from an idea to getting a drugs through all the trials and getting it to market. Countries with price controls cant do this so we, we are the innovator and a debater of all innovator and incubator the great new innovations. If you think of the cancer all things come out for various muscular dystrophy, alzheimers, they are all taking place in this country and very few of the drugs that go to trial make it. Its very expensive and so we want to keep the pipeline in this country open. Countries like canada with price controls to import drugs. The import drugs from the United States are the manufacture than in canada but they are american drugs. People say their drugs are cheaper. They have price controls but what people dont realize is the canadian medicines price review board decides what drugs will be imported at what price and if they decide the latest a drug to treat muscular dystrophy is too expensive it doesnt get onto the formulary. There are additional cost. If nancy pelosi and her crew at h. R. Three get that through and got to the senate, this would be a disaster for all of us who depend on these great new innovations. For every one dollar spent a new pharmaceutical we save 7. 17 in hospital costs. It used to be if you got gallbladder removed, there are cost to that. You might not make it through the anesthetic or recover from an anesthetic. There are drugs that are supplanted surgeries and hospital costs are reduced as well. Host absolute. I did example of a time of hepatitis c. When i came out of school in 1980 if youre diagnosed with hepatitis c you were going to die. You would get liver cancer and that was it. It was essentially a death sentence. Now we can cure it with the peel. How phenomenal is that . Guest people say that pill from gilead is 85,000 but it does do the cure. If you have liver transplant would look at 500,000. Many times unable to get liver thats a match so its very inexpensive and you get rid of your hep c. Host you mention h. R. Three and we had an alternative, we Republican Party h. R. 19 which was much better at it at any price controls. Congressional Budget Office cbo scored h. R. Three with price controls it was estimated that eight to 15 drugs that would come out on the market in the next two years would not if they put those price controls into a fact. Which drug is that . Is that the cure for alzheimers . Is it a cure for diabetes . Even if its just one it is one too many. Guest right exactly. Ive even seen numbers 100 fewer drugs would be developed in this country. So many people with diseases like diabetes are just waiting and holding on hoping they will be able to survive and when the next new drug comes out that will allow them to be like people who had survived with hepatitis c because of the drug from gilead. Host one last thing before we move on. You mentioned that all the drugs available in america are available in canada or in the United Kingdom. Guest right exactly. People in canada, you have to pay for your drugs in canada. Only people at the very low end of the income ladder actually get free or reduced drugs but most people pay at the pharmacy. In many cases the drugs that they are getting because the latest drugs are not on the formulary they dont even know theres a newer drug that make cure their leukemia or the nonhodgkins lymphoma. My uncle passed away from nonhodgkins lymphoma back in 2003. When i talked to my cousin about my uncle, i said you should look and see what about getting retoxin for your dad. He did. Ahead the cancer aged had never heard of it. He got back to my cousin in two weeks and said that drug is not available here. You can take your dad down to seattle and go to the clinic there. You go over the border. Its a big deal for when youre older and you are sick of a lot of these new drugs are just not available. People dont even know about them but they think the canadian Health Care System is almost like a religion just like in the uk. You cant criticize it. Everybody is complaining and the older you are the more likely you are going to complain. Host lets talk about the other costs not necessarily monetary, wait times, you talked about wait times earlier in the overcrowding that takes place in the hospitals and Healthcare System in general. Guest in canada the average weight from seeing your primary doctor is 20. 9 weeks, over five months. Can you imagine an american i went to the doctor and and i fl that some problem i couldnt even go for my primary care doctor to getting treatment by gastroenterologist or whatever . I would be very upset americans just wouldnt tolerate it. Long wait times, care is rationed. Take the case of my mom who was a senior and thought she had colon cancer. She went to the doctor, had an xray and i said mom, he said i dont see anything. So i said you dont detect colon cancer with an xray. You need to get a colonoscopy. She said you call. No, im done in the states, you call. She did at the doctor told her unfortunately you are a senior, with too many younger people who are on the waiting list to get a colonoscopy who have symptoms that are serious. So six months later my mom had lost 30 pounds. She was hemorrhaging one morning. We got to the hospital in an ambulance. Two days in emergency room, two days waiting for a bed in a ward. She got her colonoscopy and died two weeks later from metastasize colon cancer. When government sets the global budget we spent 18 gdp, canada spends 11. People have to wait, the people have to wait the most the longest are our seniors. Its the same in the uk. Just 4000 people just revealed went blind with glaucoma because the waiting time to get an appointment with an ophthalmologist was just too long. By the time they finally got their appointment 1000 had gone blind. Host book again, false premise, false promise, and one thing i really enjoyed was the stories just like the ones you just shared, but one of the stories the talk to overcrowding, mary murphy was sweating profusely that trouble breathing when a friend brought her to the Regional Hospital in British Columbia on the night of january 302000, 2017. She was quickly seen by doctor come was told the 56yearold she was experiencing muscle spasms. She was given a shot of morphine and sent home. Murphy died two days later. Her experience is unfortunately common in canada were overcrowding often leads hospital staff unable to devote proper attention to emergency room patients. Guest exactly, Emergency Rooms are piled high with patients. When the sars situation was in canada back several years ago, ambulances were having to leave one hospital and go to another just to try to get someone to get in to the er. They have what they call bed blocking which means people who are older or in the hospital with something, chronic i guess youd call it, they stay in those beds so younger people who need to have surgeries and things cant get into get a bed because they are blocked by these people who really should be in a seniors home or in assisted living facility. Its just amazing how the canadian Health Care System, the government system works. My very good friend of mine doctor day is an Orthopedic Surgeon has a private surgery in vancouver has been treating private patients which is illegal under the Canada Health act in British Columbia. He is being in a lawsuit for ten years, his case has been in the Supreme Court for three years. The government keeps putting more and more money into it to stall because they dont want to open up the system to some private alternative. A lot of the people he takes care of are people who are in the government who are opposed to helping out the system. Choice and competition will solve so many of these problems and theres a question there are some things that need to be changed in the american Health Care System that choice and competition will bring down the costs like in every aspect of our lives and it will lead to universal coverage. Host another thing outside of the monetary costs, doctor shortage. One of the things you mentioned about fewer students going into, young people going into the medical profession. One of the things were struggling with in washington, d. C. Is the high cost of education and student loans. Certainly physicians and pharmacists and other Health Care Professionals come out with high student loans. How are we going to deal with the doctor shortage. Guest American Association of medical colleges have come out recently and said by 2030, which isnt long at all, i never thought it would be 2020, it would be a shortage of 122,000 general primary care doctors and general surgeons by 2030. That is even before they consider where the government takeover of Health Care System, we seen a lot of doctors retiring early because of obamacare. My husband own primary care doctor sent him a letter last year and said all of this Electronic Health records to all of the stuff i cant Practice Medicine anymore. Im going to just retire and do my own research and things. We are seeing that so often but when government gets involved determining gift of Electronic Health records, you cant look at your patient because your working on your computer. The relationship that is to build. There will be a shortage and that shortage will be even greater. I think its incredibly worrying about our supply of doctors. Under singlepayer in britain right now there is a shortage of 100,000 doctors, nurses and people who work in hospitals. The British Government tried to bribe doctors who had left england because of the National Health service and a little bit opaque and along the work and tried to bribe them with money to come back and response was virtually just a few doctors came back. Because doctors are not paid very well in the uk versus the u. S. And then versus u. S. And canada as well. Our doctors are well paid and in debt and it is expensive but over time they make good money, they save peoples lives, and i think we dont want to destroy that great incentive. Host earlier you talked about the number of mri machines, and the cutting edge treatment if you will. Does that exist in canada and uk like it does in america . Guest no, absolutely not. With the government, the ten provincial governments control which were to be sent on health care, so you see reports, stories from radiologist sang our equipment, our xray equipment is so old we dont even think we can rely on the results. If you think the average wait in canada for an mri is 22 weeks, thats over five months, add the fact canada has 16 mri machines for every 1 Million People, and it is a large country with only 37 Million People but one mri machine 16 mri machines for one Million People. We have 44 machine for every 1 Million People. Countries in the eastern bloc have 2024, more than canada. Canada is highly and ushers country. Isnt that a shock you cant get access . A number of Positron Emission Tomography machines which are even higher, a machine than the mri machine, very, very few in canada where as here if you have cancer and he discovered something you would get a stamp. Host one of the darker parts if you will of the book, you discussed assisted suicide and the death panels. I found that to be very interesting and quite honestly a little depressing. Guest yes. Host tell me about it. Guest remember when sarah palin was running and she talked about ration care and death panels. I dont like to use the word death panel because it scares people but it really is, they are death panels. Its ration care because government is determining who is going to get care and how much care, and so in canada in many cases people are told you are not going to be able to get better, youre older, you should have assisted suicide because it will be cheaper for everybody. Thats not the american way. The relationship should be put with the doctor, the family and the patient. Once you start government getting involved, in the uk they have nice and its not a nice Division Within the nhs. Its a National Institute for health and clinical excellence. Nice has a division which figures out what is the value of your life and what is the cost of the treatment or the pharmaceutical. Quality adjusted life years. If the government board decides that you are retired, youre worth 30,000 but you could be cured with hep c with a drug that costs 80,000. But because you are not worth that you will not have access to it. This is what i fear will happen under in the u. S. Under the organization in massachusetts which is patterning itself on the nice program and did uk. This would also be away, so i get a singlepayer system this would have to come in because it will be an additional way of denying care to people by determining, letting it go not worth that, they do not get a drug or treatment that costs more than what we determine you are worth. Host one last question about the american system versus the other countries. You hear these statistics about how much, the Life Expectancy in canada and uk as compared to the United States. That can be misleading. Guest definitely. The two things are Life Expectancy and infant mortality. You are hearing on infant mortality we have a very low, we have a very high rate of infant mortality host and by the way the state of georgia has the highest. Embarrassing. Guest but the thing that when youre comparing the United States if it mortality rate to say in france, you have to compare apples to apples. We have very highly developed neonatal units in this country and the child, and a baby has access to the latest treatments and ways to keep the baby alive, tiny, tiny babies live in this country. If youre in france, a baby has to be considered, is considered a live birth if it weighs a certain amount and is of a certain length. Many of these babies dont, that dont make it in france or in germany do make it here. You are not comparing apples to apples because the system is in measuring the same. On Life Expectancy will say Life Expectancy is declining in this country. Its down to 79. 2 years but yet you look at what makes Life Expectancy. The issue is the United States has the highest level of deaths from Car Accidents, obesity is a big one on a per capita basis we have the highest number of death from guns and things. In other countries they dont have the deaths through Car Accidents at the level that we do. They dont have death from guns. The United States is a very certain problem with obesity but you dont see that in many countries, in europe or canada but many people who are obese leads to many medical issues and do some cases a shorter lifespan. You have to compare apples to apples in all of these things. If you look at the cancer survival rate five years out whether its pancreatic cancer, colon cancer, breast cancer, prostate cancer, we had the highest survival rates from the World Health Organizations. We have the very best and want to build on that. We dont want to go down and become like a third world country. Host one last thing. You talked about this earlier, the onset of these programs of medicare for all. What does that look like . How does that work . The sanders plan, the jayapal plan, what would that look like . Guest we dont know but Bernie Sanders did say recently when used in this huge debate he and Elizabeth Warren route log write letter, youre a liar, your outlay. Sanders said because she said she would introduce america for all in your three of her presidency. He said i would introduce medicare for all in the first week of my presidency because you dont want to be stalling and taking time because then there will be all kinds of complications. He wants to just take over the Health Care System immediately, and all private insurers. People would be out of work. Who knows how doctors would get paid. How much you have to expand bureaucracy to get people to get, have people doing building in the federal government. If yes people do like the post office, no, i use fedex or ups by people have a choice. Some people use the post office the people have a choice of the private system and theres a reason fedex and ups and dhl are in business. What these people want is to get rid of the dhl and have government be in charge and that makes me very nervous when i go, what i think about the dmv or the post office. Are those going to be the kind the people who would be making decisions about my health care, your health care, about how will be paid, what they will be paid . If they are not pay what they are worth thats a problem. Host okay. Weve established this about medicare for all. We obviously know the American People are not going to put up with this. This is not what they want. What will work . Conservatives often take criticism that you dont have a plan. And we do have a plan, but we have to communicate it. Tell me, tell me what works. Tell me how we fix the system at the beginning of the book is the Health Care System is broken. Guest we want universal coverage and that will come through competition and choice empowering doctors and hospitals. During world war ii we got into this mess, the employers got the ability to write off the cost of the healthcare and we as employees got our healthcare taxfree. If im fired or quit my job and go into the individual market, i have to buy my health care with aftertax dollars which makes a lot of people decide they dont want to buy health coverage. I would to intimate them we need to reform the tax code so individuals could get their healthcare taxfree in the same way we get our healthcare. But, of course, we do make lower wages because when the employer is paying, employers to have money. Taxpayers do, so we make less money but we get her healthcare taxfree. Id like to level the Playing Field overtime get rid of the tax exclusion so we dont get her car insurance, our Health Insurance or Life Insurance to our employer we shouldnt be getting our healthcare through idler but its what got us in the nest we need to make that change. We need to expand Health Savings accounts. About 27 Million People in this country of hsa and employers offering them, puts doctors and patients in charge. People are more careful and to spend their own money. As Milton Friedman used to say, health care, they have no idea what it costs. They think its three or the little copay and people think its free to use more of it. We want to expand Health Savings account. People aged 65 and over should be able to put one into the hsa. People should be able to use their hsa money to help pay the premium if theyre having difficulty. But the doctor and patient in charge if we need to do medical malpractice reform. Remember when president obama said this little pill, doctors giving people pills, doctors are doing unnecessary testing and is very expensive. Because they want to line the pockets with money. Doctors practice defensive medicine because they are afraid of being sued. Particularly neurosurgeons and obstetricians. Some of them drop out because they cant afford the premiums unless theyre in a large hospital practice. Price Waterhouse Cooper says the cost defensive medicine 210 billion a year. Texas capped noneconomic damage and that 16,000 doctors went back into texas to Practice Medicine. We have to do these punitive damages and not economic damages, put control in so that we stop all this frivolous lawsuits of an ambulance chasing lawyers going after people. We also need to block grant medicaid, allow people of medicaid to feel better, get an hmo. I think trumps medicaid work part is a very important part. Why should people decline taking a promotion because they dont want to go off their medicaid . These people are willing and able to work and those who are, they should be not an medicaid. They should be working their way up the ladder. People should be able to buy Health Insurance across state lines. We need Price Transparency that is a big issue and mr. Trump realizes that it is, trump realizes, people want to know what things cost and if they dont know, they cant compare. American people like to compare. We need to get rid of, this is an issue in georgia right now, the certificate of need law keeps new hospitals off the market and helps those hospitals stay in business and make more money. We need to get rid of those like we did in florida. Those are a few of the things that are part of my plan to bring about, keep america as the Diamond Platinum Health Care System in the world. People do come here from all of over the world not just a canada but people from the middle east and get tremendous treatment that they cant get in their own country. Host why is it that Americans Still dont trust the free market system . I dont get it. Guest we were talking about this this morning. How is it that social is as expand in this country and that the Young Millennials are all thinking the government can do this better. Do they go to the dmv . Do they look at people at the v. A. Health system . Do they look at people in the Medicaid Programs . I think its partly because in the Public Schools and even a private schools today, children are being taught by teachers and professors who continually say that capitalism is bad, socialism is good. As Milton Friedman would say, therefore we need more socialism. They are being indoctrinated without ever hearing about freemarket ideas. I founded an Organization Called the Benjamin Rush institute back in 2008. Its comparable to the federal society for law students, and the idea is to have debates on campuses. If i go and debate doctors on campus at medical schools, they are all for government takeover of healthcare. The students have never heard of the alternative. Ill be talking and debating and they will be laughing because they think that thats all they know i do think it will be more efficient how it will be cheaper, everyone will be covered. They have no clue about what it would mean for their ability to Practice Medicine. Its a huge problem in this country with identity politics, with the government taking over everything. Somehow we have to take that back. Host we have, and its no easy undertaking, i will tell you that. Just one last thing from personal experience if you will. I give the example because people ask me how his competition going to bring drug prices down . When i was practicing pharmacy with a company come out with this idea of a generic, 30 day supply generics for four dollars. I broke my back and i said im not going to do that. I cant even buy the medicine for that. Guess what . A week later i was selling a 30 day supply for four dollars. I called my supplier and said youve got to do something. You have to help me. I cant let that happen. Sure enough it drove down the price of generics. Guest those people today in america take generic drugs and i really, the original drug has come off patent and generic drugs in canada are way more expensive than they are here picked the fda needs to quicken up its approval of new drugs and new biologics. They also need to shorten the time that it takes for a generic to get through. Because generics are much more efficient and for many, many, for most people who have regular sore throats and colds and various things, high blood pressure, high cholesterol, the generics are real copies of the patented drugs and to do work and they are far cheaper and that brings down the cost of drugs. Host again, false premise, false promise. A great book, a timely book, a very much needed book. I encourage everyone if you have the opportunity to read this. Thank you so much try to thank you so much. It was terrific and i hope youre running again and youre reelected and you will help the republicans take back the house so we can get Real Health Care reform in this country. Host thank you. Its been a privilege. Tonight on the communicators, american economics liberties project founder sarah miller on Big Tech Companies as monopolies and impact of corporate concentration. Now theres essentially a couple of strategies if youre a tech startup you are you going to cell to facebook or sale to google . Whats that that is it is worth the building of innovators in Silicon Valley to actually innovate according to market needs and according to ipos. Instead everyone is guessing how can i develop something that facebook will buy or google will buy . That is not necessarily really how we want an economy on Innovation Sector to function. Watch the committee gives tonight at eight eastern on cspan2. You are watching a special edition of booktv now airing during the week of members of congress are in their districts due through pandemic. Tonight biographies. Enjoy booktv now and over the weekend on cspan2. Television has changed since cspan began 41 years ago but our Mission Continues to provide an unfiltered view of government. Already this year we brought your primary election coverage, the president ial impeachment process and now the federal response to the coronavirus. You can watch all of cspans Public Affairs programming on television, online or listen on our free radio app every part of the National Conversation through cspans daily Washington Journal Program or through our social media feed. Cspan, created by private industry, americas cabletelevision companies, as the Public Service and brought you today by your television provider. Cspan has roundtheclock coverage of the federal response to the coronavirus pandemic and its all available ondemand at cspan. Org coronavirus. Watch white house briefings, updates from governors and state officials, track the spread throughout the u. S. And the world with interactive maps and watch ondemand anytime unfiltered at cspan. Org coronavirus. Youre watching a special edition of booktv now airing during the week while members of congress are in their districts due to the coronavirus pandemic. Tonight, biographies. Enjoy booktv now and over the weekend on cspan2. Good evening

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