Abdul El-Sayed — What's Brewing? Medicare for All

music] >> Medicare for all. Why should I care about it? What would it mean for the health care system? Can we even afford it? What happens to all those health insurance jobs? All that and more. So, what's brewing today? >> [music] >> Medicare for all. >> [music] >> So, let's just start from the top. Why should you care? In our current health care system, we spend 19 cents of every dollar spent in the entire economy [music] on health care. As a pretty crazy thing because if you think about it, in Canada, they spend about 11 cents on the dollar. Other countries that are similar to us in terms of wealth, they're spending between 9 and 14 cents on the dollar. We are wildly more expensive. And if you're not doing the math, 19 cents on the dollar is basically one in every five cents spent in the entire economy to provide health care. Not only is our health care system the biggest, most expensive, it's also getting more expensive faster than any other country in the world. So, not only is it a problem now, but it's going to be a bigger problem in the future. So, let's talk about what Medicare for all is and it is not. Medicare for all is guaranteed health insurance for every single American. [music] What does that mean? Imagine in your back pocket right now, if you have private health insurance, you probably have it through some corporation. That corporation charges you every 2 weeks or 4 weeks, usually in your paycheck. >> [music] >> And if you look at your paycheck, after FICA, which is the Federal Insurance Collections Agency, basically Uncle Sam, your health insurance premium comes out first. Literally, your health insurance CEO eats before you and your family do. That comes off the top. The full premium, you don't actually see the cost of because your employer probably pays for part of that. So, you're paying what? $1,000, $2,000 for a premium, and that's supposed to give you insurance. The operative part of that is sure, but in our current system, you really can't be sure about anything except for the fact that you're going to get your pocket picked. Now, that insurance system probably comes with a deductible, meaning that's the money you pay to get the insurance you thought you already paid for. The insurance doesn't really kick in until you pay that deductible. Now, the average >> [music] >> deductible in America is about $4,500 for a family of four. >> [music] >> That median family is making $80,000 a year. So, if you're doing the math, they're going to have to go without a paycheck for the thing that they have to pay for every paycheck. [music] That's the current system. Medicare for all, imagine you had another card right next to it. That card [music] is given to you the day you're born. It doesn't expire until you expire, hopefully after a long healthy life at 120. >> [music] >> And it's good for health care wherever you need to go. But, here's the most important part. No premium, >> [music] >> no copay, no deductible. And unlike your current insurance card, where there's an in-network and an out-of-network with different fees, there is no network because it's [music] good everywhere. Imagine the freedom that that would offer you. Now, I want to talk about some benefits [music] to the overall system beyond the security it would offer you without having to take money out of your paycheck. >> [music] >> Right now, our health care system isn't just the most expensive, but it's also getting more expensive >> [music] >> because of the role that insurance fails to play. Right now, we have about 700 insurers in the entire health care system. No one of those insurers, aside from actual Medicare, has the power to really negotiate with any of the providers of health care. That's everyone from clinics and hospitals and doctors to pharmaceuticals and medical device manufacturers. Medicare for all would be the de facto insurer for everybody. What does that mean? That means that it is in a position to negotiate on all of our behalves. Everybody knows about the term monopoly, but there's this other thing called a monopsony. A monopoly is when there's only one seller of a good. A monopsony is when there's one buyer of a good. And Medicare would be the buyer on all of our behalves. So, if there's only one buyer or seller of a good, guess what? That buyer gets to dictate the price. That means that Medicare would be in a position to start [music] reducing prices because it negotiates on all of our behalves. It would start to make health care far less expensive over time. And then there's the matter of an overhead. >> [music] >> If you look at an insurance provider, the overhead for that insurance provider is about 15%. That's money that's being spent at the C-suite or marketing. That goes away under Medicare for all. Medicare right now has a 3% overhead. So, 15% versus 3%. So, imagine the entire system lost or was able to shed that extra overhead. And then there's the billing costs. Just because we have 700 insurers, hospitals and clinics need to figure out who to bill and how to bill them. >> [music] >> That means there's all kinds of people that have to sit on both sides of that transaction that wouldn't [music] be necessary under Medicare for all because most of the billing would go right to Medicare. Now, if you're thinking about this, you might say, "Well, would doctors and hospitals still be able to make money?" Sure. Of course. But here's how this would actually work and would be better for the people who actually provide you care. If you look at how a bill happens, there's two fees that [music] get paid. Let's say you get hospitalized, you have to pay a facility fee and a provider fee. We've watched [music] as facility fees have gone through the roof, but provider fees have barely budged over the last several years. >> [music] >> But when you go see your doctor or you go to a hospital, you don't really care that the hospital makes money. You want to make sure that the people who provide you care get paid [music] for what they do. And because the facility fees have grown so much, what's happened is that these big hospital systems have been able to consolidate and buy each other up. And they're able to negotiate sweetheart deals with other insurers. >> [music] >> Under Medicare for all, there are no sweetheart deals. There's one price per unit healthcare everybody [music] gets. So, what does that mean? That means that the big hospitals and the big healthcare companies aren't going to be able to nickel-and-dime the little guys the same way that they do right now. It means that the hospital consolidation that we've seen should slow down. And it means that if you want to be a provider who just puts up their shingle and starts to offer care, you have the opportunity to do that. [music] I also think that because Medicare for all would enable our government to start thinking about who we reimburse and why, >> [music] >> we could start to invest a bit more in the folks who provide us healthcare that keeps us healthy in the first place, not just the people who provide us healthcare after we get sick. So, if [music] you've been listening, there's a benefit to the overall cost of care, how fast the cost of care is growing, the security of providing everybody the care they need, and making sure that we're reimbursing for the right kind of care rather than paying sweetheart deals [music] into big hospitals and continuing the consolidation forward. This campaign has taken me to 90 different cities, 335 public events. There is not one of those events where I haven't heard from somebody in this state who is [music] being destroyed by the current system, whether it's a woman who's had cancer three times only to lose her life savings, [music] somebody who's worried about whether or not they'll ever be able to qualify for a home loan because they had $10,000 in medical [music] debt because they happened to get sick and go see a doctor, or it's somebody who is is raising a kid with special needs or a particular health issue who says, "I don't want their life to be destroyed simply because they were born with a chronic >> [music] >> ailment." None of this should be a set of questions that we ask ourselves at all. And Medicare for all would solve [music] these problems for so many people, these people and more. One of the craziest things we do in this country, if you think about it, is that we tie your health care to your job. So, ask yourself what happens if you want to get a new job. You have to transition your health care. For so many people, that's a big headache, especially people who have chronic illnesses where there's a continuity of care issue where they all of a sudden can't see the doctor that's been treating them for such a long time. But for a lot of folks who say, "You know what? I don't want to work a dead-end job. I've got an amazing idea for this new small business." They worry about whether or not that'll mean that their kid who might have asthma doesn't get the medication that they need. There is no reason for us to tie health care to a job. It doesn't actually make sense, and all it does is benefit folks who want to keep you in the jobs that they want to keep you in. I think we need to decouple employment from health care. Health care should be a thing you get in this country without having to worry about what you do for work. Also, ask yourself what it would mean for the economy. How many businesses don't get founded simply because the potential entrepreneur in waiting can't go without the health care that they get from their current job. Shouldn't be this hard. But more than anything else, it's just the peace of mind of knowing that whether you turn 26, >> [music] >> or you're going through a job transition, or you're stuck in a bad marriage, or you turn 65, >> [music] >> that you're not going to go without the health care that you need because none of us know when calamity will strike. And all of us need the security of knowing that we get the health care that we need when we need [music] it. I'll just tell you why I'm so passionate about Medicare for All. I went to medical school. I watched as our health care system was so focused on making sure that we could make money off of the highest paying patients, while trying to do our best to chew and spit out everyone else, that I realized I didn't want to practice in that kind of system. >> [music] >> Since the day I graduated med school, I made it my goal to build the kind of health care system that I, as a graduating medical student, would have been proud to >> [music] >> to work in. That was in 2014. It's 2026, and we're still in a position where our system is getting worse. It is time for us to decide that we really can have nice things. Now, what's standing in the way? Big corporations, hospital systems, pharma, big insurance. All of them make a ton of money off the system as it stands and so Medicare for all is a threat to [music] their bottom line. But I don't think that corporate greed should stand in the way of being able to build a health care system that befitting of all of us. And that's why I'm working so [music] hard to pass it. That also means that the big corporations are coming for me. They're coming for our campaign and they want to beat us. So, if you believe in Medicare for all like I do, you [music] want to be able to guarantee every person in this country the health care they need and deserve, [music] build a system that is becoming of the people who provide health care, address the massive consolidation in the system, [music] I hope that you'll support this race because I want to go out there and fight for you. Until then, let's keep brewing. >> [music]