WATCH, IN-DEPTH: Rep. Schweikert On C-Span Re: Healthcare Reform; "I May Be An Outlier" In Freedom Caucus

Arizona Rep. David Schweikert had "fun" this morning discussing healthcare reform in-depth on C-Span.

Although we have not yet watched/listened to this entire interview (he took many calls), we did catch the end where he says he

When asked what the Freedom Caucus wants, Schweikert gave a disclaimer that he "may be an outlier because I was a yes vote within the group". He then said that the group - of which he is a member - wants to lower costs and give states more discretion on how to use Medicaid expansion funds.

If you find some interesting tidbits, please let us know. The uncorrected closed captioning is below the jump.

HOST HOST: CONGRESSMAN DAVID SCHWEIKERT IS A REPUBLICAN FROM ARIZONA. MEMBER OF THE FREEDOM CAUCUS THAT WE HAVE HEARD SO MUCH ABOUT LATELY. ONE WHO SUPPORTED THE RECENT REPUBLICAN BILL TO REPEAL AND REPLACE THE AFFORDABLE CARE ACT. WHERE ARE WE RIGHT NOW IN THE POSSIBLE EFFORT TO MOVE FORWARD WITH SOME SORT OF LEGISLATION AGAIN ON THIS  Show Less Text
00:00:28		WHERE ARE WE RIGHTGUEST TOPIC? WHERE ARE WE RIGHTGUEST: I DON'T THINK IT EVER REALLY STOPPED. WHAT WAS INTERESTING IN THIS PROCESS, I SIT ON WAYS AND MEANS. I HAD THE VERY TECHNICAL MEETINGS TO FOCUS ON ENERGY AND COMMERCE. MONTHS SITTING THROUGH THE TECHNICAL MEETINGS. I THINK OUR MISTAKE WAS WE ROLLED OUT A EGG COMPLEX PIECE OF LEGISLATION TO A LOT OF OUR BROTHERS AND SISTERS IN THE CONFERENCE, THIS ISN'T THEIR AREA OF SPECIALTY. NOT TO UNDERSTAND SOME OF THE REGIONAL DIFFERENCES. I AM OUT IN ARIZONA. OUR EXCHANGES FOR INDIVIDUAL PURCHASERS AND SMALL GROUPS ISN'T SUBSTANTIALLY COLLAPSING. YOU HAVE ONE CHOICE IN ARIZONA AND I HAVE HAD COUNTIES WITH 116%. WITH THOSE IN THE BACKGROUND YOU ARE HEADING TOWARD A BETTER UNDERSTANDING WHAT EVERYONE'S NEED IS IN TRYING TO BRING TOGETHER A PIECE OF LEGISLATION THAT WILL GENUINELY LOWER PREMIUMS.  Show Less Text
00:01:32		HOST HOST: IN TERMS OF WHO IS DOING THAT AND HOW IT IS BEING CONDUCTED ON CAPITOL HILL, A TWEET FROM KYLE CHENEY OF POLITICO. FREEDOM CAUCUS CHAIR SAYS ALL HEALTH NEGOTIATIONS ARE WHITE HOUSE DRIVEN. THEY HAVE SEEN ITIF IT'S AT THIS POINT. IS THAT YOUR UNDERSTANDING OF THIS THAT IS MORE IN THE HANDS OF THE WHITE HOUSE?  Show Less Text
00:01:53		GUEST GUEST: I'M GOING TO GIVE YOU A SLIGHTLY DIFFERENT VIEW OF IT. THERE'S A LOT OF MOVING PARTS. YOU HAVE A FEW OF US WHO HAVE BEEN WORKING ON THE CONCEPT OF A RISK SHARING MODEL. TAKE A LOOK AT OUR HEALTH CARE SYSTEM. THE SICKEST 5% OF OUR SOCIETY REPRESENT 50% OF HEALTH CARE SPENDING. 50% OF OUR HEALTHIEST POPULATION ONLY USE ABOUT 3%. IT'S THIS HOCKEY STICK CURVE THAT SHOOTS UP AND THE TOP PIECE REALLY DRIVES PREMIUMS. WHEN YOU START TO LOOK AT THE INDIVIDUAL MARKET WHICH IS VERY SMALL IN A CONGRESSIONAL DISTRICT LIKE MIND IT'S ABOUT 2% OF MY POPULATION. MOST PEOPLE DON'T REALLY APPRECIATE THE VAST MAJORITY OF OUR SOCIETY GETS THEIR HEALTH CARE FROM THEIR EMPLOYER. MUCH OF WHAT WE ARE BANTERING ABOUT IS A VERY SMALL SLIVER OF OUR POPULATION THAT ACQUIRES THE CARE -- HEALTH CARE ON THEIR OWN. YOU HAVE FOLKS AT THE WHITE HOUSE WHO ARE TIME TO FIND LANGUAGE TO TIE ALL OF THOSE THINGS TOGETHER.  Show Less Text
00:03:13		HOST HOST: WHAT DOES THE FREEDOM CAUCUS WANT?
00:03:17		GUEST GUEST: I THINK SUBSTANTIALLY A COUPLE THINGS. I AM NOT THEIR SPOKESMAN. I MAY BE THE OUTLIER BECAUSE I WAS A YES VOTE WITHIN THE GROUP. FROM MY BROTHERS IN THE ROOM BY HERE FOCUS ON WHAT ARE WE REALLY DOING TO LOWER THE COST OF HARD-WORKING AMERICAN FAMILIES THAT ARE ENTREPRENEURS. THE NEIGHBORHOOD PLUMBER WHO BUYS HIS HEALTH CARE FOR HIM AND HIS FAMILY ON THEIR OWN. WHAT ARE WE DOING TO LOWER THEIR COSTS AND AT THE OTHER END ON THE MEDICAID EXPANSION SIDE WHAT ARE WE GETTING TO OUR GOVERNORS TO ALLOW THEM TO BE CREATIVE? TO ALLOW THEM TO PROVIDE TYPES OF SERVICES. YOU ARE FAMILIAR WITH THE CONCEPT OF TELEMEDICINE. SHOULD A POOR PERSON HAVE THE RIGHT TO USE TELEMEDICINE? WE BELIEVE IT WOULD BE MUCH LESS EXPENSIVE TO SOCIETY AND PROVIDE A LOT MORE OPTION ALLEY. THOSE TYPES OF OPTIONS IF WE CAN DRIVE THAT FLEXIBILITY INTO THE LEGISLATION I THINK  Show Less Text
00:04:25		HOST GOING WE ARE HOST: GOING TO DO SOME GOOD STUFF.
00:04:27		HOST HOST: ARE THOSE THE SUGGESTIONS YOU WOULD BRING TO THE WHITE HOUSE?
00:04:37		GUEST GUEST: FROM THE RIGHT SIDE OF OUR CONFERENCE TO THE LEFT SIDE EVERYONE HAS BEEN SO ENGAGED. IF WE ARE ABLE TO PUT TOGETHER A BILL I BELIEVE IT WILL BE MUCH HEALTHIER FOR OUR COUNTRY AND ALSO BE MUCH MORE COMPETITIVE WITH OPTIONS. WE'RE ALMOST THERE.  Show Less Text
00:05:01		HOST HOST: REPUBLICANS, (202) 748-8001. DEMOCRATS (202) 748-8000. INDEPENDENTS (202) 748-8002. ANY IDEA OF WHEN IT MIGHT COME BACK?
00:05:17		GUEST GUEST: I'M NOT GOING TO SPECULATE BECAUSE EVERY TIME WE CREATE A DEADLINE YOU HAVE THE FOLKS HAVING TO DRAFT THINGS THAT ARE VERY COMPLEX TRY TO GO TOO FAST AND YOU FIND DRAFTING ERRORS. YOU WANT TO DO IT AS SOON AS POSSIBLE BECAUSE WE WOULD LIKE TO GET TO TAX REFORM. THINGS WE CAN DO TO GROW THE ECONOMY AND SORT OF EXPAND THE JOB BASE. WE NEED TO GET THIS HURDLE OUT OF OUR WAY. FOR THOSE OF US ON THE WAYS AND MEANS COMMITTEE WE HAVE ALSO STILL BEEN WORKING ON TAX REFORM.  Show Less Text
00:05:59		HOST HOST: FREEDOM CAUCUS MEMBER HERE TO TAKE YOUR QUESTIONS AND COMMENTS AS WE ARE TALKING ABOUT THE FUTURE OF HEALTH CARE. MARIO IS IN MURFREESBORO ROAD ON THE LINE FOR DEMOCRATS. GOOD MORNING.  Show Less Text
00:06:11		CALLER CALLER: GOOD MORNING TO YOU. GOOD MORNING TO ALL OF AMERICA. I SPENT A LOT OF TIME IN EUROPE. I AM RETIRED FOR THE LAST 20 YEARS. I'M 95 YEARS OLD. AND I'M IN REAL GOOD HEALTH. IN EUROPE YOU CANNOT HAVE YOUR OWN DOCTOR. EVERYBODY CAN GO TO WHATEVER DR. THEY WANT. EVERYBODY IS RUSHED TO THE HOSPITAL IF YOU NEED TO BE RUSHED TO THE HOSPITAL. HERE ARE MEDICAL SYSTEM IS A MESS. THERE IS NO REASON IF SOMEBODY NEEDS TO HAVE THEIR BELLY CUT OPEN THAT THEY HAVE TO GO TO A HOSPITAL AND DON'T KNOW HOW MUCH IT COSTS. OVER THAT -- THERE THEY DON'T WORRY ABOUT HOSPITALS. IT COSTS HAVE AS MUCH AS IT COSTS HERE.  Show Less Text
00:07:07		GUEST GUEST: I HOPE I AM NEARLY THAT SHARP WHEN I AM 95. I HOPE I MAKE IT TO 95. WHEN YOU LOOK AT DIFFERENT MODELS AROUND THE WORLD WHETHER IT IS THE SINGAPORE, CANADA, EVEN THE DIFFERENTIAL WITHIN EUROPE YOU ARE TYPICALLY LOOKING AT A RATIONING MODEL. CERTAIN TYPES OF PROCEDURES AND TECHNOLOGIES. IN EUROPE THEY HAVE ACTUALLY STARTED TO CREATE -- ITALY IS ENDING UP WITH A BIFURCATED MODEL WERE THOSE WITH RESOURCES ARE NOW PURCHASING THEIR OWN HEALTH CARE IN THEIR OWN VERSION OF CONCIERGE MEDICINE. A LOT OF TIMES THE FOLKLORE OF THAT TYPE OF DISCUSSION DOESN'T ACTUALLY MATCHUP WITH THE DATA AND INFORMATION WE ARE RECEIVING TODAY.  Show Less Text
00:07:57		HOST HOST: DIANE IS IN JAMESTOWN, NORTH CODA. REPUBLICAN.
00:08:02		CALLER CALLER: GOOD MORNING.
00:08:07		GUEST GUEST: I HAVE AN 18 MONTH OLD LITTLE GIRL WHO YOU CAN'T SEE WHO IS PUSHING HER FACE AGAINST THE GLASS.
00:08:14		HOST HOST: IT'S A GOOD DAY ON THE WASHINGTON JOURNAL.
00:08:17		CALLER CALLER: OK. MY QUESTION IS -- ARE YOU READY FOR ME?
00:08:24		GUEST GUEST: ABSENTLY. WE ARE LISTENING.
00:08:28		CALLER CALLER: WHY IS THE GOVERNMENT EVEN INVOLVED IN OUR HEALTH CARE? WHY DON'T YOU JUST LET IT GO BACK TO THE FREE MARKET? WANT IT JUST TAKE CARE OF ITSELF?
00:08:37		GUEST GUEST: LET'S DO A LITTLE WALKING THROUGH THIS. THE MAJORITY OF MONEY SPENT ON HEALTH CARE TODAY ACTUALLY COMES THROUGH GOVERNMENT. A LOT OF FOLKS DON'T REALIZE THAT. IF YOU LOOK AT LARGER EMPLOYERS, MANY YEARS AGO GOVERNMENT GOT INVOLVED AND SAID PRE-EXISTING CONDITION, THESE TYPES OF MECHANICS WILL BE PART OF LARGE GROUPS. THEN YOU START TO THINK ABOUT MEDICARE. THAT'S THE GOVERNMENT. MEDICAID. THAT IS GOVERNMENT. INDIAN HEALTH SERVICES FOR THOSE OF US IN THE SOUTHWEST. TRY CARE. THE V.A. YOU START TO ADD THIS ALL UP AND YOU REALIZE THE AMOUNT OF IMPACT GOVERNMENT SPENDING, GOVERNMENT RULES AND REGULATIONS HAVE HAD IN SUBSTANTIALLY DISTORTING THE MARKET. NOW WE END UP IN THIS DISCUSSION OF WHAT ABOUT THOSE INDIVIDUALS WHO WANT TO GO OUT AND PURCHASE AN INDIVIDUAL PLAN OR A SMALL GROUP PLANS? BECAUSE THERE IS SUCH AN FROM GOVERNMENT RULES AND GOVERNMENT SPENDING, WE HAVE DISTORTED THE MARKET. SO CAN YOU CREATE AN ENVIRONMENT WHERE THERE'S OPTIONS, ENOUGH FLEXIBILITY TO DRIVE DOWN PREMIUMS? AT THE SAME TIME EXCEPT THE FACT THAT THE VAST MAJORITY OF THE POPULATION RECEIVES ITS HEALTH CARE EITHER THROUGH THEIR EMPLOYER OR THE BENNETT CARE -- MEDICARE, THE V.A.  Show Less Text
00:10:06		GUEST GUEST: HOW DOES --
00:10:10		HOST HOST: HOW DOES VOTING WORK WITHIN THE FREEDOM CAUCUS?
00:10:17		GUEST GUEST: A LITTLE MORE INTERNAL. ONE OF THE GREAT BENEFITS OF FREEDOM CAUCUS IS YOU HAVE A NUMBER OF US ON THE MORE LIBERTARIAN SIDE. IT IS FIRST AN OPPORTUNITY FOR US TO SHARE. WHEN YOU ARE FROM A STATE LIKE ARIZONA I HAVE A LOT OF FOLKS WHO MAY BE MORE LIBERTARIAN IN THEIR THINKING. HOW DO I BRING MY PERSPECTIVE TO A GROUP AND SAY HERE'S WHAT MY FOLKS ARE THINKING AND HERE'S MY EXPERTISE. FIRST AND FOREMOST IT'S AN INFORMATION SHARING GROUP. IT WAS ORIGINALLY BROUGHT TOGETHER TO DO PROCESS REFORM. WE WERE THE PROCESS REFORMERS. WE WERE TRYING TO MAKE SURE THAT AVERAGE MEMBERS HAD A CHANCE TO OFFER AMENDMENTS AND ACTUALLY BE PART OF THE DEBATE. IN MANY WAYS THAT HAS BEEN A GREAT SUCCESS. INTERNAL VOTING MECHANICS, IF THERE'S A CONSENSUS I THINK YOU WORK TOWARD THE CONSENSUS AND MOVE FORWARD FROM THERE. A LOT OF IT IS ALSO WHEN YOU CAN BRING TOGETHER SO MANY PEOPLE YOU LEARN. WE ALL SIT IN DIFFERENT COMMUNITIES. WHAT'S REALLY GOING ON. THAT IS SOMETHING THE MORE LIBERTARIAN MEMBERS DID NOT HAVE UNTIL THE GROUP FORMED.  Show Less Text
00:11:40		HOST HOST: DEREK IS WAITING IN TEXAS. INDEPENDENT. GOOD MORNING.
00:11:51		CALLER CALLER: GOOD MORNING. APPROXIMATELY THREE YEARS AGO THE DALLAS MORNING NEWS DID A SURVEY ON HEALTH CARE BY ILLEGAL ALIENS AND THE COST TO HOSPITALS. THE FINAL COST WAS APPROXIMATELY $25 BILLION IN A YEAR. IT WAS BASICALLY DRIVEN BY THE ILLEGALS COMING ACROSS THE BORDER AND USING THE HOSPITALS FOR BIRTH CARE. THESE FIGURES, HAVE THEY BEEN BROUGHT INTO THE MIX TO SEE HOW MUCH WE ARE SPENDING ON ILLEGAL HEALTH CARE HOSPITALS IN WHICH THEY HAVE TO ABSORB? I WOULD FEEL THAT AMOUNT IS DRIVING PART OF THE HEALTH CARE COST.  Show Less Text
00:12:49		GUEST GUEST: ALSO BEING FROM A BORDER STATE, THIS IS SOMETHING FOR EVERYONE TO UNDERSTAND THE FINANCIAL BURDEN THAT IS TAKEN BY A STATE LIKE ARIZONA WHETHER IT IS INCARCERATION, EDUCATION, UNCOMPENSATED HEALTH CARE. YOU HAVE ASKED THE BORDER STATES TO CARRY THESE INCREDIBLE FINANCIAL LOADS AND THEN WHERE THE REST OF THE COUNTRY DOES NOT UNDERSTAND WHY THERE IS A CRANKY POPULATION. MUCH OF THIS FALLS INTO THE CONVERSATION OF THE LAW AND THE UNITED STATES IS IF YOU PRESENT WITH A HEALTH CARE NEED, YOU SHOW UP AT THE EMERGENCY ROOM, YOU GET COVERED. YOU GET CARED FOR. NOW THE ARGUMENT IS WHO ENDS UP PAYING FOR IT. WHEN YOU HAVE A LARGE UNDOCUMENTED POPULATION AS YOU DO IN TEXAS AND ARIZONA WHO DO UNCOVERED, IT IS THE REST OF US IN SOCIETY THROUGH UNCOMPENSATED CARE OR JUST LOSS OR TRANSFER COST TO THE REST OF OUR INSURANCE. THAT'S ONE OF THE THINGS WE WERE TRYING TO MODEL IN THIS HEALTH CARE. THE PROBLEM IS THOSE COSTS ARE STILL IN THE SOCIETY. SOMEONE WALKS IN WITHOUT INSURANCE. SOMEONE WALKS IN AS AN UNDOCUMENTED AND IF THEY RECEIVE SERVICES THE COST IS STILL THERE. YOU ARE JUST MOVING THE CHAIRS AROUND ON WHO PAYS FOR IT. THAT BECOMES ONE OF THE GREAT DIFFICULTIES AND IT IS ONE WE OFTEN DON'T HAVE VERY HONEST DISCUSSIONS ABOUT BECAUSE THE CHOICES DO NOT PROVIDE THE CARE. AS A SOCIETY I DON'T THINK WE'RE GOING TO DO THAT. HOW DO YOU FIND A WAY TO DEAL WITH THAT IN A MORE RATIONAL FASHION?  Show Less Text
00:14:42		HOST HOST: HAVE YOU GOTTEN A CHANCE TO SEE THE PROPOSAL THAT THE VICE PRESIDENT PRESENTED TO THE FREEDOM CAUCUS LAST NIGHT AND ANY THOUGHTS ON THAT?
00:14:56		GUEST GUEST: IT'S NOT COMPLETE AT BEING DRAFTED. THERE IS A HANDFUL OF US WHO HAVE BEEN WORKING ON THE RISK SHARING MODEL. REMEMBER OUR HOCKEY STICK EXAMPLE AND THE TOP THRESHOLD. IS THERE A WAY TO ACTUALLY DO SOME RISK MITIGATION THAT WOULD LOWER EVERYONE ELSE'S PREMIUMS? THAT LANGUAGE I HAVE SEEN. AND IT HAS COME ALONG WAY. I ACTUALLY THINK IT WOULD DO SOME PRETTY AMAZING THINGS. I BELIEVE THAT WILL BE PART OF IT. IT'S LIKE EVERYTHING. IT'S NOT REAL TELL -- UNTIL IT'S ALL ON PAPER. WE STILL HAVE A LOT OF LISTENING. THIS MAY BE A LITTLE DISHARMONIOUS -- I WILL MAKE THE ARGUMENT THAT WHAT WE HAVE GONE THROUGH THE LAST THREE WEEKS HAS BEEN REALLY HEALTHY FOR US. WE ARE LEARNING A WAY TO DO COMPLEX LEGISLATION AND LISTEN TO OUR MEMBERSHIP FROM BOTH THE RIGHT AND THE LEFT SIDE OF THE NEEDS THEY HAVE IN THEIR DIFFERENT REGIONS.  Show Less Text
00:16:10		HOST HOST: MICHAEL IS A REPUBLICAN IN MARYLAND.
00:16:15		CALLER CALLER: GOOD MORNING. I AM A BIG SUPPORTER OF THE FREEDOM CAUCUS. I HAVE THIS FOUR-PART PLAN INTO THE RNC FACTOR INTO THE CAMPAIGN -- THE FIRST IS OBVIOUSLY TO HAVE A LOT OF OPTIONS FOR PEOPLE. FOR PEOPLE WITHOUT INSURANCE I BELIEVE THAT WE CAN FOSTER THESE COMMUNITY HEALTH ORGANIZATIONS WHERE THERE'S OVER A THOUSAND ACROSS THE COUNTRY. THE HOSPITALS WHO HAVE EMERGENCY ROOMS THAT ARE FULL, LOCAL AND STATE GOVERNMENTS CAN SUPPORT THEM. THE FEDS HELPING THE LOWER 20% OF THE ZIP CODES. FOR PEOPLE WHO DON'T HAVE INSURANCE, THEY CAN GO AND TAKE CARE OF PROBABLY 80% OF THEIR NEEDS ON A SLIDING SCALE FOR THEM. THE SECOND POINT IS INSURANCE ACROSS STATE LINES. MORE OPTIONS. THIRD IS RISK POOLS WHERE INSURANCE COMPANIES CAN HELP PEOPLE WITH CHRONIC DISEASES SO THERE INSURANCE COSTS ARE IN LINE WITH OTHERS. WE ALL SHARE IN THAT. AND OF COURSE TORT REFORM FOR THE NUTTY AND CRAZY LAWSUITS THAT ARE OUT THERE. THAT'S WHY FOUR-PART PLAN.  Show Less Text
00:17:45		GUEST GUEST: YOU ARE VERY VERY CLOSE ON A BUNCH OF THIS. ON YOUR FIRST POINT, THAT WAS ONE OF THE THINGS THE LEGISLATION DOES HAVE. ALLOWING GREAT FLEXIBILITY FOR STATES WITH THEIR MEDICAID POPULATION. ANYTHING IT WOULD MOVE IS SORT OF AN AGREED-UPON MECHANIC. TAKE A STATE LIKE ARIZONA. FOR 40 YEARS WE HAVE BEEN DOING SOMETHING RATHER QUIRKY. WE BY HMO POLICIES FOR OUR INDIGENT POPULATION. IF YOU COULD GIVE A STATE LIKE ARIZONA MORE FLEXIBILITY WITH OUR COUNTY HEALTH CARE APPARATUS WE BELIEVE WE COULD DO A SERIES OF CLINICS WHERE YOU COULD TOUCH A LOT MORE OF OUR BROTHERS AND SISTERS AND POPULATION SUBSTANTIALLY AT THE SAME COST. THAT WOULD REQUIRE GETTING AWAY FROM THE COMMAND AND CONTROL MODEL THAT MEDICAID AND HHS HAVE TODAY. INSURANCE ACROSS STATE LINES, FINE. I WOULD LIKE TO HAVE A LITTLE BIT MORE OF A REVOLUTIONARY THOUGHT. SHOULDN'T YOU BE ALLOWED TO HAVE HEALTH SERVICES ACROSS STATE LINES? THAT IS VERY CONTROVERSIAL IF YOU REALLY THINK ABOUT IT. TELEMEDICINE. I HAVE SEVERE ASTHMA. SHOULD I BE ALLOWED TO HIT THE BUTTON AND TALK TO AN ASTHMA EXPERT WHO IS NOT PART OF MY STATE, IS NOT LICENSED IN MY STATE BUT HAS TRUE EXPERTISE?  Show Less Text
00:19:11		HOST HOST: AND HAVE YOUR INSURANCE BE ABLE TO PAY FOR THAT CONVERSATION.
00:19:17		GUEST GUEST: EXACTLY. IF YOU ARE REALLY SAYING I WANT AN ABSOLUTELY FREE MARKET YOU START TO HIT AN IDEOLOGICAL DIFFICULTY OF I WANT TO PROTECT STATES ABILITY TO MANAGE THEMSELVES AT THE SAME TIME BECAUSE I LIVE IN AN INFORMATION SOCIETY SHOULD HEALTH CARE INFORMATION FLOW BACK-AND-FORTH? I THINK WE'RE ALMOST THERE ON RISK POOLS. I THINK YOU NEED TO THINK ABOUT LAWSUIT REFORM DIFFERENTLY. IT'S NOT REALLY THE SETTLEMENTS THAT YOU READ ABOUT THAT HAPPEN IN COURT. IT'S THE DIFFERENT WAY THE MEDICAL PROFESSIONALS PRACTICE. THAT IS THE SUBSTANTIAL COST DIFFERENTIAL. IF YOU GET ADDITIONAL TESTS THAT ARE SUBSTANTIALLY CHOSEN TO PROVIDE LITIGATION COVERAGE, THAT IS A COST DRIVER THAT ALMOST NO OTHER SOCIETY AROUND THE WORLD HAS. IS THERE A WAY TO EVENTUALLY SAY IF YOU OPERATE WITHIN THE MODEL OF CODE OF CONDUCT THAT YOU HAVE A LITIGATION BARRIER AND THERE IS SOME MODELING THAT SAYS THAT WOULD BE A SUBSTANTIAL DECREASE IN SPENDING AND TESTS THAT ULTIMATELY ARE NOT NEEDED.  Show Less Text
00:20:35		HOST HOST: A FEW TWEAKS TO MICHAEL CAPRE. RON IS AN INDEPENDENT.
00:20:49		CALLER CALLER: THE INSURANCE COMPANIES. THESE OTHER COMPANIES THAT DO IT SO MUCH CHEAPER THAN US. DO THEY HAVE INSURANCE COMPANIES?
00:20:57		GUEST GUEST: YES. THEY FALL INTO DIFFERENT PLACES. A COUPLE OF THE EUROPEAN COUNTRIES, A SUBSTANTIAL PORTION OF THE POPULATION ON THE UPPER INCOME SIDE IS EITHER DOING DIRECT HEALTH CARE CONTRACTS ARE BUYING DIFFERENT TYPES OF INSURANCE. IT'S COMPLEX. WHETHER YOU LOOK AT CANADA OR SINGAPORE THERE'S LOTS OF DIFFERENT MODELS OUT THERE AND MANY OF THEM DO HAVE ACTUAL INSURANCE COMPANIES.  Show Less Text
00:21:24		HOST HOST: DO YOU WANT TO FINISH YOUR QUESTION?
00:21:29		CALLER CALLER: MY PROBLEM WITH THE INSURANCE COMPANY IS IT'S A VERY BIG PART OF THE HEALTH CARE THAT YOU PAY. YOU ARE PAYING FOR THE INSUREDS. ENOUGH TO FEED YOUR INSURANCE MAN, HIS WIFE, HIS KIDS, HIS DOG , EVERYONE THAT WORKS FOR HIM AND ABOVE HIM.  Show Less Text
00:21:54		GUEST GUEST: IF YOU ACTUALLY LOOK AT THE ACTUAL MATH FOR MOST OF OUR INSURANCEERS, THE ACTUAL INSURERS CAUSED THE GOES TO ADMINISTRATION -- COST IS ACTUALLY VERY SMALL. I HAVE SEEN 5% OF THEIR ENTIRE BOOK. YOU LOOK AT NATIONALIZED AND SOCIALIZED SYSTEMS, THE PERCENTAGE THAT GOES TO THE ADMINISTRATION IS ACTUALLY GREATER. IT'S A CONSTANT PUSH OF WHAT ACTUALLY GOES OUT IN THE PURCHASE OF HEALTH CARE AND WHAT DOES IT TAKE TO MANAGE THOSE RESOURCES AND MODEL IT. WHETHER YOU HAVE A COLLECTIVIST SYSTEM OR A MARKET SYSTEM OR EVEN THE BIFURCATED THAT MANY OF US WANT WHERE SOMEONE'S ACTUAL PURCHASE OF HEALTH CARE, SOME IS PURCHASE OF INSURANCE PROJECT TO COVER YOUR RISK. IF YOU HAVE LOTS OF INFORMATION AND LOTS OF PRICE WHERE YOU CAN ACTUALLY SEE THE PRICES OF EVERYTHING FROM THE INSURANCE TO THE ACTUAL SERVICE YOU ARE PURCHASING, DOES THAT INFORMATION CREATE A MUCH MORE COMPETITIVE MARKET. RIGHT NOW, WHAT PRICE TRANSPARENCY DO ANY OF US HAVE? AND WHAT INCENTIVE DO WE AS HEALTH CARE CONSUMERS HAVE TO CHOOSE SURGERY AT THE SURGERY CENTER COMPARED TO GOING TO THE HOSPITAL? WE ACTUALLY DON'T SEE ANY OF THOSE PRICE TRANSPARENCY.  Show Less Text
00:23:41		HOST HOST: YOU HAVE LEGISLATION YOU ARE WORKING ON CONCERNING CROWDSOURCING. OF ENVIRONMENTAL DATA.
00:23:47		GUEST GUEST: THIS WAS SOMETHING WE STARTED ON A FEW YEARS AGO. THE ORIGINAL IDEA WAS TO CROWD SOURCE INFORMATION FOR FINANCIAL MARKETS. WE HAD SOME TROUBLE SORT OF EXPLAINING THAT, SO WE MOVED INTO -- WHAT WOULD HAPPEN IN YOUR COMMUNITY IF YOU HAD A NUMBER OF CITIZENS THAT HAD SENSORS ATTACHED TO THEIR PHONES, AND YOU CROWD SOURCED ENVIRONMENTAL DATA AND YOU COULD SEE IT ON A GIS MAP. YOU WOULD BE ABLE TO SEE AND SAY HEY, WE HAVE SOMETHING GOING ON OVER HERE. LET'S GO AND MITIGATE THAT. IS IT SOMEONE SPRAY PAINTING CARS IN AN URBAN AREA IN THEIR BACKYARD? THAT IS SOMEONE WHO IS NEVER FILED PAPERWORK, NOT A PART OF THE REGULATORY REGIME, BUT IS STILL POLLUTING THE NEIGHBORHOOD. CAN WE USE THESE SUPERCOMPUTERS IN OUR POCKETS TO MOVE TO A CROWDSOURCING INFORMATION MODEL AND AWAY FROM THE MODEL USED TO DATE WHICH IS VERY 1938-ISH WHICH IS TO FILL OUT LOTS OF PAPERWORK AND PHILIP FILING CABINETS. -- FILL UP FILING CABINETS. THEN, YEARS LATER, YOU EVER ABLE TO PUNISH SOMEONE IS TO CATCH THEM AT SOME POINT. WITH ALL THOSE SENSORS, YOU WOULD NEVER HAVE A FLINT, MICHIGAN, BECAUSE SOMEONE COULD CHECK THE WATER AND INSTANTLY KNOW THERE IS A PROBLEM RATHER THAN WAKING UP A FEW MONTHS LATER AND REALIZED THE PROBLEM HAS BEEN GOING ON.  Show Less Text
00:25:30		HOST HOST: ON THE LINE FOR REPUBLICANS. RICK, GO AHEAD.
00:25:34		CALLER CALLER: THANK YOU. I HAD TWO QUICK THINGS. WHAT ABOUT OPTIONAL LOANS FOR HIGH DEDUCTIBLE INSURANCE OR DIRECT CARE? A LOAN WOULD INCREASE PRICE CONSCIOUSNESS WHICH WOULD LOWER INFLATION WHICH WOULD ULTIMATELY INCREASE ACCESS. THE SECOND THING IS THAT I WANT TO PUT THE WORD OUT. IF THERE ARE ANY RESEARCHERS OUT THERE THAT ARE EITHER AFFILIATED OR UNAFFILIATED WHO HAVE ANY KIND OF REFERENCE TO CLINICAL INFORMATION TO PRESENT AT AN IN PERSON PUBLIC FORUM, EITHER TELL -- EITHER CHECK OUT THE INDEPENDENT RESEARCHERS ALLIANCE .  Show Less Text
00:26:17		GUEST GUEST: RICK, I NEED TO THINK ABOUT THAT A LITTLE BIT. I'M WORKING A BIT ON A MODEL. THINK OF THE HEPATITIS C DRUGS THAT CAME ONTO THE MARKET A COUPLE OF YEARS AGO. THEY WERE VERY EXPENSIVE, AND THEY HAD TREMENDOUS COSTS IN THE RESEARCH. HOWEVER, WE KNEW IT WOULD SAVE A FORTUNE OVER THE NEXT DECADE AND NOT HAVING TO PERFORM KIDNEY TRANSPLANTS. IN YOUR MODEL, WOULD THERE BE A WAY TO TAKE FUTURE SAVINGS AND USE THAT AS AN INCOME STREAM TO FINANCE LOTS AND LOTS OF FOLKS WHO HAVE HEPATITIS C IN THE LIVER -- TO FINANCE THE PURCHASE OF THE DRUG TODAY AND USE THOSE FUTURE SAVINGS AS A WAY TO FINANCE IT? THERE IS A FAIRLY ELEGANT WAY TO GET THERE TO DO WITH THE MASSIVE SPIKES OF REVOLUTIONARY PHARMACEUTICALS THAT COME ONTO THE MARKET AND FINANCE THEIR UTILIZATION, BECAUSE THEY SAVE A LOT OF MONEY IN THE FUTURE. THIS MIGHT BE A WAY THAT WE STOP THE STRESSORS ON OUR MEDICAID SYSTEM WHEN YOU HAVE THE SORT OF HEALTH CARE REVOLUTIONS THAT ARE AVAILABLE.  Show Less Text
00:27:24		HOST HOST: CONGRESS AND DAVID SCHWEIKER, A REPUBLICAN, THANK YOU FOR YOUR TIME.
00:27:29		GUEST GUEST: THIS HAS BEEN FUN.

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