Unmasking the Medical Debt Crisis: Strategies for Navigating Insurance and Healthcare Costs – Expert Insights with Robert Hertz

Intro: 0:01

Get ready to hear the truth, the whole truth and nothing but the truth about the United States healthcare system With your host of the Medical Truth Podcast, James Egidio.

James Egidio: 0:17

Hi, I’m James with the Medical Truth Podcast. Welcome, I’m your host. A CIP survey suggests that people in the United States owe at least $220 billion in medical debt. Approximately 14 million people, or 6% of adults in the United States, owe over $1,000 in medical debt and about 3 million people, or 1% of adults, owe medical debt of more than $10,000. My guest is an expert and wrote a book on medical debt titled Social Insurance versus Medical Darwinism. It’s an honor and a pleasure to have on the Medical Truth Podcast my guest, mr Robert Hertz. Robert, how are you doing, sir? Very good. Thank you very much, jim. Absolutely, absolutely. For the listeners and viewers of the Medical Truth Podcast, a little bit about who you are and what you do, or what you did.

Robert Hertz: 1:12

Okay, I am a retired insurance broker living in Minnesota and I used to sell health insurance and you might say I saw the sausage being made, the things you don’t want to see being made. One of them is legislation, the other is sausage. I was on the inside of the health insurance schemes and scams Not all. I tried to advise clients to avoid them. But I learned a lot about the industry and since then I’ve devoted myself to writing on different approaches public and private, to reduce medical debt and student debt. But we’re talking medical debt today Medical debt.

James Egidio: 1:51

I’m sure you’ve seen a lot happen in the last few years with COVID, I’m sure with when it comes to medical debt correct.

Robert Hertz: 1:58

COVID had less of an impact than I expected. One reason is that the government gave extra money to hospitals and told them not to charge full to patients who came in on an emergency basis. The government didn’t want the spectacle of some poor older person tumbling in and often dying from COVID and then their heirs being slapped with a big bill. The pandemic, or COVID, had a little less impact, but the other impacts remain and in some respects are getting worse now.

James Egidio: 2:27

What are some of the contributing factors as to why people get into medical debt? I guess that could be pretty much an obvious question. No, it’s a very good question.

Robert Hertz: 2:37

The main thing that gets people into medical debt is deductibles and or no insurance. The number of people with no insurance has been shrinking since the Affordable Care Act. It’s shrunk by almost 20 million, and that’s a great achievement. Even with the Affordable Care Act and with employer coverage, many people have a deductible that at the low end might be $500. Hardly anybody has a deductible that low again and at the high end can be $7,000 and maybe 10,000 per family. What that means is that if you go into a hospital, you pay the first $5,000 or $7,000 of the bill yourself, and many people, for right or wrong, don’t have $5,000 or $7,000 in a savings account, and so, presto, they’re in debt.

James Egidio: 3:23

Yeah, I know my wife recently experienced that she was going to go to a physician for a procedure and the deductible when she walked out of the office was like $3,000. So it wasn’t something that had to be done right away. The procedure $3,000. Well, it’s too tough yeah. And she’s a school teacher and supposed to have good insurance here in Florida. I would think so.

Robert Hertz: 3:50

Maybe she could change plans next year.

James Egidio: 3:52

but I’m on your side. They take a lot out of her check already, so it would be even more so. It’s really criminal in a way, but I know we had this visual on how medical debt starts when someone, let’s say, accepts medical care, goes for medical care. Here’s a listing of some of it, and I guess doctor visits and diagnostic tests are up to about what? 65% according to this statistic here.

Robert Hertz: 4:21

And this is valuable information. But what I am pretty sure of is that the 65 and other percentage refer to the percent of claims that resulted in debt, and not always the amount. The largest debts tend to be emergency room visits. In other words, if you owe your doctor $200, that’s no fun but you can live with that. But if you owe the emergency room $20,000 due to insurance problems or just weak insurance, that’s a bigger challenge to debt. What I’m trying to say is and I’ve worked with an organization that collects information on medical debt called RIP, medical debt and our research shows that the average debt might be $100, and people can live with that, but the debts at the high end are pretty scary.

James Egidio: 5:06

Yeah, so you say emergency rooms. What about surgeries?

Robert Hertz: 5:10

Yeah, so surgeries might be on the outpatient. The surgeries in some cases can be planned for maybe not three years but a couple of years, and people can assemble some resources or get a commitment of help in advance. The emergency room visits and the emergency surgeries. Nothing can be done.

James Egidio: 5:31

Yeah, because that’s a situation where it’s just an emergency. So, when it comes to medical debt, who bears the burden? Let’s say in the United States, since it’s a very good question.

Robert Hertz: 5:43

It is diverse. I think a better way to answer it is first I’ll tell you who doesn’t bear the burden and then we’ll get to who does. Who doesn’t bear the burden are people, like me, on Medicare, medicare. The maximum debt on part A of Medicare is $185 a year. Part B you can have higher debts. It depends on whether you buy what’s called Medicare Advantage or Medicare Supplements, and that’s an important discussion. But I don’t want to slow us down.

Robert Hertz: 6:08

People on Medicare don’t bear debt Depends for drugs, although that has improved. The Biden administration passed some new rules on prescription drug coverage that have reduced medical debt for seniors. The second group of people who don’t bear medical debt are people on Medicaid, which is the federal and state program for people with low income who don’t have any other health insurance. Low income generally means under $18,000 for a person, under $35,000 for a family, so it’s pretty low. It keeps people out of medical debt because they would generally be hopeless in trying to pay off the debt. The third group of people who don’t experience much medical debt are those diminishing numbers with what you might call Cadillac insurance a $500 deductible or very little co -insurance, which is a related deductible. Those plans used to be the norm when I started selling insurance, and even as recently as, say, 2010, 2012, 2013,. But those plans are diminishing due to the cost of premiums and some minority people.

Robert Hertz: 7:12

The fourth group that doesn’t experience medical debt is what I might call the gamblers, and there’s a lot of them. The gamblers are people who don’t have an employer plan, or the employer plan is super expensive, and so they say this year I’m going to start off, I’m pretty healthy, I’m going to go uninsured, or I might buy the skimpiest I don’t blame them the skimpiest medical temporary plan. There are what’s called temporary medical insurance, and the gambling is that I won’t get sick Right, get by car, and three years out of four they might win the gamble if they start off healthy, but in the fourth year they might get walloped. So those are the people who don’t experience much debt. The rest of them, it’s a grab bag of who has high deductible and loaded up with coverage and get sick during the year. So who bears the burden then? Oh, it’s a good question. The burden is on the patient and they have some choices. If you would like me to get into this, I’d be happy to Sure, absolutely.

James Egidio: 8:04

We have a lot of time.

Robert Hertz: 8:06

The patient or I saw the patient has a bill and it’s $10,000 and they don’t have the money. What can they do? The first thing they can do is to contact the provider. Don’t try to run away. The provider will catch up to you. And don’t call the insurance company because in many cases they’ve already made their determination and we might come back to them.

Robert Hertz: 8:25

But at first you got to contact the provider and explain to them that this is the way the insurance has shaken out and you don’t have the lump sum, nor do you have an income which will allow you to pay it, say, in four months. And providers are used to hearing this and, between you and I, they mark up their bills in expecting for some of this to happen. Yeah, and in some cases the provider will agree to a monthly payment plan that you can live with. Now maybe that’s 200 months, and so after a year you would have paid off $3,000 and they might forgive the rest. So the first, when you’re bearing the burden, the first person is don’t assume it’s set in stone, don’t assume it cannot be improved.

Robert Hertz: 9:04

Now, some providers are hardnails. They’ll say I’ve got a collection agency on speed dial, we’re going after you. But that isn’t all of them? Yeah, so the first thing to do if you’re bearing the burden is to contact the provider and see if they’re willing to accommodate. I did that once when one of my sons had an emergency room visit and they had a procedure, a protocol all set and they sent me out a lot of paperwork and I provided copies of my son’s paychecks so they could verify how much he made, I think.

Robert Hertz: 9:32

I might even have to provide a tax return, but I didn’t have to pay anything, nor did he, while this protocol was being reviewed, and at the end they gave it they forgave it so they forgave the entire amount. Yeah, I think so, maybe all about $250.

James Egidio: 9:46

Wow. So when you say the provider, now there’s a difference between being render, having medical services rendered through a doctor at a doctor’s office, which is considered outpatient, and then someone gets treated at a hospital. So let’s say, for instance, I get rushed to the hospital for an appendectomy surgery, right, and the final bill is $20,000, which sounds about right? Yes, it does, yeah. And so I come back home after, let’s say, two or three days in the hospital because appendectomy is anymore, probably a short stay in a hospital and I get the bill what, maybe three or four weeks later, for $20,000. Yes, so as a patient, what can I do if I have no insurance?

Robert Hertz: 10:31

If you have no insurance, the first step is to contact the hospital financial aid department, and here’s why the Affordable Care Act in 2012, 2013, 2014 included a provision not widely known about that says if you have no insurance, your bill must be discounted if you have a modest income. Now, if your income was $200,000, and you were just a gambler to fluck but that’s not the case with very many people so if your income was $50,000, and you had no insurance, the hospital aid department might cut the $50,000 and a half. Now, that’s not the whole story, but it helps. Might cut it even further. And they don’t announce this in big letters. They’re certainly not a sign in the ER saying if you have trouble with your bill, call us. It doesn’t happen, Dr Michael A.

James Egidio: 11:16

No.

Robert Hertz: 11:16

Dr Michael A, the Affordable Care Act has that provision. Now let’s go a step further. Individual states have been adding to this call this emergency discount program for the last seven or eight years. By adding to it they might stretch the dollar income eligibility a little higher. There’s one case where there’s one state I think it might be Maryland or New Jersey where you can make up to $80,000 a year and still get a discounted medical bill. It may not be wholly forgiven, but it would be discounted If you’ve gone through all those steps and the bill is not some ludicrous bill like $200,000, which we can talk about, but if it’s within their normal range.

Robert Hertz: 11:57

Again you ask for the monthly payment. If even the monthly payment is unachievable, your last resort would be to declare bankruptcy. That costs about $2,000, but it wipes out medical bills and it stays on your record. But if you’re not going to work on a bank or work for the federal government, many I can’t say a number, but some employers will not, especially if they know why you were bankrupt will not place a bar on you for employment, which is what people are scared of.

James Egidio: 12:24

Dr Michael A yeah, yeah, and you’ll end up getting more. After declaring bankruptcy credit cards. For some reason or another, they miraculously start to get it.

Robert Hertz: 12:32

You can’t declare again for another two years. They got you where they want you, dr.

James Egidio: 12:35

Michael A Okay, so then you mentioned something about, let’s say, a bill like $200,000 or more. Let’s say you get diagnosed with cancer or something. The bill could run up to even a million dollars. $200,000 to a million what do you do in that case? Dr Michael A, the hospital will normally back down.

Robert Hertz: 12:53

They put that number out there because they don’t necessarily know what.

Robert Hertz: 12:57

I’m diversioning a little bit, but I think it’s important to know why they would bill that much. One reason is that they don’t know especially if it’s a rush treatment case how good your insurance is, and so they throw that number out there because you might have an insurance company that’ll pay it, but the number sits out there and maybe your insurance company won’t pay it or you have no insurance and so it’s staring you in the face. And if they won’t back down, what I recommend to people is that they what I call go public, go to your local newspaper and say what a hardship this is and tell the hospital you’re doing it, and I’ve seen situations that I’ve talked to people who are in the business getting medical debt reduced. The hospital may come back with a financial package before it even hits the newspaper. They hate that publicity because it exposes them in some cases of being real hard-nosed sons of bees, and they might incur greater supervision by the government, and so it’s a lot easier for them to just cut the amount back and shut you up.

James Egidio: 13:54

You did mention about calling the insurance provider, or even the provider themselves, the doctor’s office or the hospital the billing department at the hospital, for that matter. But why is it important to document every call that you make?

Robert Hertz: 14:09

That’s a very good question. In some cases it’s because of a chain of command issue. If someone who represents the insurance company is on the phone and you ask them $20,000 bill, doesn’t my coverage better than that? And they say that was for your emergency epidectomy. And you say it wasn’t emergency, it was planned and it was moderated a little bit. And they say, oh gosh, let me look at the claim again, because insurance companies aren’t perfect and nor are hospitals. They could have submitted the claim.

Robert Hertz: 14:35

People don’t know that a hospital bill because there are so many of them every day, a major hospital has to send out a thousand bills a day. It’s based on codes. They are based on numeric codes and the code might be for appendectomy, 3407b, but all it would take was a human being, a little sloppy or just tired at the end of the day, to put in 30407, which has a $20,000 cost. So the first thing, the reason to call the provider and the insurance companies, first of all insurance see what the insurance company even asked them for, the code, what code? Resulted in a 20-thousand bill and once in a while they’ll say it was code 3407B. Then you call the provider. It’s a lot of work but it’s a lot of money and there are people who will assist you for a modest cost in making these calls. Anyways, you call the provider and they say it was just I’m making this up it was just for an appendectomy ultrasound and that’s $278, which has a cost of $5,000. You just saved $15,000. Since, redocument everything.

James Egidio: 15:31

Yeah, and then you also mentioned that good to be a nuisance with these people.

Robert Hertz: 15:36

Everybody knew what I knew, in which you’re now. They wouldn’t get away with the outrageous bills they sometimes send and they would have to accept more government oversight even to apply with existing laws. There have been surveys done of charitable care cases and they sometimes find that hospitals just ignored the affordable care act rules. They just sent everybody the $20,000 bill which, according to the Affordable Care Act, because it’s extra work for them, they have to ask you what your income is like. They did for my son’s situation. They have to verify the income. It costs them money. They have to hire not a lot of money, but they have to hire. Maybe what? Two or three extra people at $45,000 each. It’s a chunk of change.

James Egidio: 16:15

They resist doing it and so that’s where the nuisance factor comes in, I see Something really interesting too is my sister recently called up Florida Blue, which is the Blue Cross Blue Shield provider here in Florida. She’s not currently working, she’s teaching. She’s a school teacher. She’s not teaching right now, so her income’s gone down quite a bit. But we were on the phone, we were having a conversation not long ago and she said something about only having to pay $97 a month for Florida Blue insurance, which is almost like a complete coverage. It covers everything. I said why are you paying such a small amount? And she says because what they told her on the phone is something to do with the tax credit based on the Affordable Care Act. What does that mean?

Robert Hertz: 17:00

That’s a very good question. If you go through the Affordable Care Act, which usually means you don’t have employer coverage, in fact you can’t have employer coverage, Right, If you go through the Affordable Care Act. There’s a two-step process and it’s a real blessing. The greatest thing about the Affordable Care Act is called the subsidy, and I’m going to go through it because that maybe was really happening to your sister.

James Egidio: 17:23

That’s exactly what it was.

Robert Hertz: 17:25

Okay, you go through the Affordable Care Act, the two-step process. They calculate the insurance premium which you might call the gross premium, what the insurance company would charge just based on your age and the coverage that you want. Then they look at your annual income and the total premium is generally maxed out at 8% of your income. So if your income was $1,000 a month because you were part-time or because you just had a real low-paying job, the insurance premium you have to pay for a $600 policy is $8 of $12,000, which happens to be about 96 bucks a month. My math isn’t perfect, but you see where I’m going. Through the Affordable Care Act, your insurance premium is capped at a percentage of your income. So there are people, there are some improvements to the Affordable Care Act. There are hundreds of thousands of people today walking around with pretty decent insurance and paying zero. It’s a long story of how that happens.

James Egidio: 18:23

Sure, on the flip side of that, I’m not eligible for that type of insurance. I went with what’s called the SHARE program, so I’m using what’s called Metashare. I know there’s a couple other different programs out there. I pay like three years away from collecting Medicare eventually at some point at either 63 or 65. It’s 65. It’s five, it’s about four years away from that. And so what I did is I resorted to what’s called Metashare for $200 a month. Now I’m like on the.

James Egidio: 18:57

I look at it like being on the gambler side of what you illustrated earlier, where I’ll use that for anything catastrophic. And the way I do it personally with getting covered for anything else is let’s say, for instance, I want to use telehealth services for, let’s say, a common cold or seasonal allergies or something I need for an infection or something to get an antibiotic. I’ll use a telehealth service and pay out of pocket for under $100 a month. With Metashare it’s free. And then, when it comes to imaging studies, I found low cost imaging companies. Yeah, a company called Simon Medical, which is a national company, nationwide Simon Medical. I think it ultrasounds like $35.

Intro: 19:43

And the reason why I know about yeah.

James Egidio: 19:44

And the reason why I know about Simon Medical is because I, when I had a medical practice I had owned a medical practice. It was a low cost fee for service practice, so I was finding all the bargains for all the patients. I can remember saving a patient over $10,000. I saved her over $200,000 on a surgery for, yeah, acetabulum hip reconstruction, and I worked out an agreement with the orthopedic surgeon and this was in Vegas when I lived there and had the practice there, and the surgery was $10,000. But that’s but on a smaller scale.

James Egidio: 20:25

Another patient who spent over $3,000 in an emergency room to be diagnosed with diabetes. I was able to save that patient. Oh my gosh, like it cost I don’t know $300 total with lab work and everything. Doctors visit prescriptions Because you made a stink no, not even because I made a stink, because I had the resources with the lab. Ah, I see that’s a much cheaper alternative. Yes, a much, much cheaper alternative. The medical industry itself is the cost is so high and so inflated, and this is, I think, one of the reasons why I personally believe we’re having an issue with medical debt in this country. For that reason, even Simon Medical MRI is like $250 compared to $2,500. Yeah, the hospital markups are terrible. Yeah, even at an imaging center outside of, let’s say, simon Medical not a hospital MRI or CAT scan, but in an imaging center they’re like $2,500. Sure.

Robert Hertz: 21:29

And the hospitals go around buying these providers so they can charge that amount.

James Egidio: 21:33

Yeah, yeah, and these are services for uninsured or underinsured patients. A lot of these services, and even lab work too. Lab work is very expensive. Again, I was able to save patients on a female complete blood panel thyroid and a CBC complete blood count. It was costing us out of pocket about maybe dollars and we would charge the patient about $125.

Robert Hertz: 22:00

I respect what you did. One of the big challenges and I’m sure you might have heard of this is that sometimes the patient and I was a patient last year, I had a surgery last year sometimes a patient is weakened, they’re tired, maybe they’ve been through the surgery and they haven’t got the gumption or the self-confidence to say to the doctor that complete blood count which I know I need. Why don’t I go down the street and I’ll have the results in two days and mail it to you? It’s so easy and because I’ve had good insurance, it’s easy for me. It’s so easy to say, all right, what’s next? Do the blood count? And so good for you that you had that. But the one-stop shopping thing, which is what hospitals sell, is pretty tempting.

James Egidio: 22:41

Yeah, we drew the blood right at the office so it wasn’t even a problem for a patient to get their routine blood work done at the office. When they came in I drew the blood for a mail. It was a complete blood count CBC, tsh, testosterone and a PSA for prostate-specific antigen blood test. Now normally those tests there would go for right around $1,500 to $2,000 for all that lab work and I was charging $175.

Robert Hertz: 23:12

Wow.

James Egidio: 23:13

Yeah, I had that practice for about 10 years. Yeah, I operated that practice for about 10 years, In fact. Actually in 2000, I wrote a book called Learn how to Start a Cash Only Medical Practice. It was marketed towards physicians, Right right, yeah. And it was outside of the concierge model. Because the concierge model says, okay, if you pay the doctor, I don’t know $4,000 a year or you get everything. Yeah, it’s not that you’ll just get everything, You’ll have the accessibility to that physician. But physicians are not going to be accessible 24 hours a day, seven days a week. After a while they’re going to get tired of that type of accessibility for someone who sneezes and calls the doctor at three or four o’clock in the morning. But so my question to you is getting back to these share programs what’s your take on those?

Robert Hertz: 24:05

I had done some reading on it and when I was in the insurance business up till about five years ago, I went to some seminars and had some exposure, and so the information on my opinions might be outdated, but I don’t think they are, because I haven’t been close to them in the last few years. The main thing is that they are uneven, and by uneven there are plans which are ethical and honest and will. If you have a claim, it will be submitted to the group as a whole, which I believe is what you’re referring to and other people will share in the expense because you’ll do the same for them, and it’s a fine idea. There have been companies not all by any means. If I went on to Google, I could find the one of the worst ones. There are companies where the founders just kept all the money, that all the premiums you paid, just went into their pockets and they bought big cars and big houses, and when it came time to get others to contribute, they did nothing. They’re not very regulated, which is maybe a blessing in some ways, but it means that you, the buyer, really have to kick the tires, maybe ask for, describe a claim you made recently and so on or that you paid recently. And if they’ve got a list of 20 of them, I think you’re in good shape. If they can’t send you one, then you’ve got to look the other direction. The other thing I hope I’m not going too fast here, no, because it’s an important thing the other challenge is again, you want this medical share for expensive things, which is smart, but the other challenge is how to deal with the hospital when the expensive thing happens. By how to deal with it From day one you go into the.

Robert Hertz: 25:34

When you go to a hospital assuming you’ve got, you’re not on the stretcher, you’ve got you’re going out on your day of surgery the first place they send you is sometimes the billing off because they can log you in and so on. And you say I’ve got metashare and they say does that mean your private pay? And you say, ideally this will be covered by the other people. They say I’m not sure if that’s private pay or not and this may not be a big deal. But then they don’t quite know how to code you and they also don’t know quite how to charge you.

Robert Hertz: 25:57

They may have a billing schedule for private pay and another billing schedule for partial insurance and it may not bother you the day that you go in the hospital, but when it’s over, are they going to send you the $200,000 bill that they reserve for a kind of a foreign insurance company who doesn’t know what they’re paying? And that does happen. The hospitals do reserve the big bills for passive insurance companies or maybe the military or somebody who’s not going to challenge them. They may send you that bill and you send that to your cohorts like the church members of the medical share company. Nope, we’re not going to pay that. But again, a good company will tell you how that’s handled.

James Egidio: 26:34

Yeah, I was just going to say so. It goes back to the credibility of the company and also maybe how long they’ve been in business too, correct?

Robert Hertz: 26:42

It could be, although I don’t think any of them will have been. Yeah, there’s a few of them that may have been in business eight years, but a lot of them less. It’s not like.

James Egidio: 26:50

Signor or Retina. Yeah, better shares been in business, I think 50 years or something like that. That’s a very good sign.

Robert Hertz: 26:57

That means they haven’t been hit by government regulators. I think you’re on good track and they can give testimonials that are real and they didn’t make up the afternoon.

James Egidio: 27:08

Which would be fraud. I’ll switch over to discussing with you a little bit about single payer systems and healthcare and house pay for with taxes and that user fees, and what I want to do. Once you illustrate that, I want to give a good example of that and support of that as well. So go ahead, okay, talking about single payer systems and insurance with taxpayer dollars.

Robert Hertz: 27:33

People ask what is single payer? What I say? You’ve been on Medicare or you’ve been on Medicaid. You are actually in a single payer plan. Single payer plan collects taxes from the broad citizens history involuntarily. You don’t have a choice about paying your Medicare tax, about paying your income tax, which is what covers part of Medicare and all of Medicaid. That’s where those companies, that’s where those programs get their money. So it’s taxpayers supported.

Robert Hertz: 28:00

When you need to use it, the cost you deductible, coinsurance or whatever is dictated legally for all situations. So if you’re deductible under Medicare is $185. It’s $185. Whether you go to Mayo Clinic or Joe’s Dialysis down the street is the same deductible and so it’s predictable. And Medicaid and Medicare do have some subtlety in that a small number of providers won’t take them. They have to tell you in advance. If the provider says I’m not a participating provider for Medicare, you have to ask him what’s your fee schedule. But they have to be explicit on that before you start your care. So that maybe gets us started. They are public programs with fixed deductibles and fixed costs to you. They are often are funded by a combination of a premium and your taxes.

James Egidio: 28:50

I see. So it’s almost like the same system that you would encounter, let’s say, in Europe. Correct, that’s right. So a lot of people would say that are listening to this and watching, would cringe and say socialized medicine. And I always thought the same thing. I’m like, oh my gosh, it’s the worst thing you can do is have socialized medicine. And I marry my wife, who’s from Italy, right, and just recently she gets online and she wants to still maintain her health insurance in Italy when she goes back there to visit Because she can do that. She’s still a citizen of Italy and she’s not a citizen of the United States, but she has her green card here. We just went through the whole process, through immigration, with our interview.

Robert Hertz: 29:31

Oh yeah, that’s a process.

James Egidio: 29:32

Yeah, and her insurance here. Like I was saying earlier, she had to pay a $2,500 deductible right Just to meet that deductible in order to get a procedure done. It’s not anything emergency. But then on the flip side, she’s getting this Cadillac insurance and not paying much in the way of income taxes, because she does have to pay some income taxes from some income she generates from in Italy, but it’s so minimal. It’s $7 a month. But the insurance is absolutely incredible. She’s covered like 100% on everything, including any illness or injury that takes place outside of Italy while she’s traveling Not while she lives here in the United States, but while she travels.

James Egidio: 30:13

Yeah, and she opted for that. Now that means there’s no appointments or anything. She could be seeing the same day. Now, if she had to go where she didn’t have to come out of pocket with anything, she would normally have to wait maybe two or three days in Italy. And a lot of people will say that’s the same model in Canada, where you have to wait two or three months in Canada, in the Canadian system. But in Italy it’s not like that, thank goodness 90, and even for someone who visits Italy as a tourist, you can get hit by a car or get sick with the flu while you’re in Italy, go into a clinic as a US tourist, a tourist from the United States, and walk out with no bill. That’s right, yeah, so their system. It’s definitely a good system, fantastic system.

Robert Hertz: 31:01

Let me explain how they do that. A single payer plan relies on a variety of taxes to get the money. They need to pay claims. They have to pay hospitals, they have to pay doctors, they have to pay drug companies Same as here In America, unless you’re on Medicare. The capital that’s needed to pay those claims, which is a lot of capital, you know you need $50 million to start even a modest insurance company and a national insurance company might need $2 trillion just to pay everybody. So where do they get the money? They get it mainly from taxes. They have in many cases higher income taxes than America. They certainly have higher sales taxes. They call them value-added taxes. They can be 10 or 15% of the price of everything or garner everything, and so those big taxes. The third is they regulate the fees that doctors and hospitals can charge. Yes, and so it’s a package. We know we’re going to get a trillion dollars of income. We know that the people in our national program are going to have pick a number 100,000, has to be a bigger number are going to have 200,000 hospitalizations, and so we know that we can pay $54,000 for each hospitalization. The hospital cannot charge extra. The person is not exposed to extra.

Robert Hertz: 32:13

Now, where the complaint comes about all socialized medicine is ironic, but where it comes from is what happens when a public system tries to severely economize, which has been true mainly in England and Canada. These countries decided they didn’t want a budget deficit, and so when it came time to their single payer plan, they said we’re only going to pay for 90,000 surgeries a year. The next 10,000 people have to wait or we’re not going to. In those countries, almost all doctors are employees of the government, and so Canada had a program where they weren’t hiring any new doctors for two years. They took their budget deficit seriously, unlike America, so I hope that’s not a too long-winded explanation.

James Egidio: 32:52

No, not at all.

Robert Hertz: 32:53

They sound a little bit out of left field but I think people should remember the happiness that you get from American health insurance is partly dependent on the willingness of America to have an annual debt. Medicare runs a debt. Medicaid runs a big debt. Income taxes don’t cover it all.

James Egidio: 33:10

No, their system in Italy is amazing. And the doctor the quality of the doctors in the medical care is amazing. She was telling me, like an MRI or a CAT scan there is, I don’t know, maybe three or $400, which is what I would normally get here for a patient who’s underinsured or uninsured. But it’s amazing In your book, a lot of this stuff we talked about today can be found in your book called Social Insurance vs Medical Darwinism, correct, yes, and that can be found on Amazon, right, and I’ll put a link up on my website to that book. And then your blog is called www.TheAntiDebtAgenda.com. That’s www.TheAntiDebtAgendacom.

Robert Hertz: 33:51

That’s a monthly and I have an article every month about some aspect of debt college student debt, medical debt, consumer debt, personal debt. I cover the waterfront, nice.

James Egidio: 34:03

I really appreciate your time. It’s been a lot of hurt, absolutely. Thank you so much for joining me on this episode of the Medical Truth Podcast. Thanks for your work and remain a good listener of yours, thank you. Thank you, and I’ll actually post this on Substack, also on Rumble. You can find me on Rumble. I’m actually getting ready to launch a medical news show here in the next couple months called Medical Truth News. So I have all the latest news on the pharmaceutical industry and everything else that’s out there that we hear about all the time.

James Egidio: 34:36

But, thank you so much for your time. Appreciate it All right.

Intro: 34:41

Thanks for listening to the Medical Truth Podcast. For the latest episode, go to wwwmedicaltruthpodcastcom. You can also find the Medical Truth Podcast on Rumble YouTube, as well as the major podcast platforms like Apple Podcast, spotify, substack and iHeart.