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[EPISODE]
Christopher Habig
Hi everybody, welcome to Healthcare Americana, the podcast where we explore the intricacies of healthcare, share inspiring stories, and bring you insights from industry leaders. I am your host, Christopher Habig, CEO of Freedom Healthworks. Today, as in every day, we have a very special guest, who is in particular a tireless advocate for patient freedom and privacy in healthcare, fighting the good fight against overreach in government programs across the board.
Please welcome Twila Brase, the co-founder and president of the Citizens’ Council for Health Freedom and a registered nurse. Twila, it is great to have you on this show. Welcome.
Twila Brase
Well, it's just great to be here. Thanks so much.
Christopher Habig
Twila, for those listeners who might not be familiar with you and your work, I know I usually don't start episodes out with saying, hey, tell us all about your background and how you got to this point. Usually, I like to dive into the juiciest, meatiest part of the conversation, but I think it's really important for our listeners to understand really who you are and the kind of work that led you up into founding, co-founding the Citizens’ Council for Health Freedom, because you've been
active across the board, kind of one of those Batman figures, right? Like operating in the background to make sure that we're all safe and we sleep well at night.
Twila Brase
Well, I suppose that is one way that you could say it.
Christopher Habig
You didn't think you were going to get a Batman reference today, and here we are.
Twila Brase
No. So, but yeah, so let me just say that I, you know, I was an emergency room nurse and then I became a school nurse for better hours. And then the Clintons decided to take over the healthcare system. And, you know, I've just had a privacy bone, I would say, for all of my life. And I just, I thought if they take over healthcare, they're going to take over the country. And I'm not willing to let America go.
And so that began my decision to start looking at making an organization. I felt called to do it every once in a while. I think, no, I don't need it. And then I'm like, no, I think I'm actually being called to do this. And so then I've been actually in the policy business for 30 years now. We have some very specific things that we work on to try to bring freedom for patients and doctors. And I use my expertise as a nurse.
You know, and my advocacy as a nurse, because I always advocated for patients, because, you know, I like to tell people that patients are vulnerable and it doesn't matter whether all you've got is a strep throat or, you know, you just chopped off your leg accidentally, right, and you're dying. And so as an emergency room nurse, I saw all of those, but what I do know about patients is they cannot get care unless someone is agreeable to giving it to them.
So they're all vulnerable. They are there because they cannot do it themselves. They cannot get it themselves. They need an order. They need a prescription. They need a diagnosis. They need understanding. And so it's really, really important in America to have a healthcare system that works for the patient, not a healthcare system that works for others or for special interests or actually requires the patients to work for them in order to get care, which is often what's happening at the data issue.
where if you don't fill out all the data, you don't, you know, dot all the Ts and answer every question no matter how intrusive, you might not be able to get the care that you want. So that's, you know, my background is really all about being an advocate for freedom and an advocate for the patients and doing everything possible to keep the freedom that's necessary so that patients can actually get the care that they need at an affordable price and in a timely manner because…
that's what you need. You can't wait for six months to get something that should have been fixed after a week. So that's a little bit of the background.
Christopher Habig
You mentioned something. Yeah, and I want to dive a little bit more into the Citizens’ Council for Health Freedom because there's a couple different initiatives coming out of that. One that our listeners might be familiar with is called The Wedge. So give us a give us really your view high level on really a lot of the initiatives that the Citizens’ Council for Health Freedom is working on right right now. And then how those efforts have sprung out into creating The Wedge, which
in your words, is a directory of really free market physicians out there that say, hey look, we're open for business, we are willing to provide care, might have an alternative payment model, but I'll let you fill in the blanks for our listeners.
Twila Brase
Well, I like to say at CCHF, Citizens’ Council for Health Freedom, we look for the Achilles heel in policy that we can help to take down this entire move to socialized medicine. And so when we look at the current healthcare system, you know, I decided quite some time ago that we're not going to try and fix this behemoth. We're going to create a parallel system of freedom outside of this, a system where the patients who are stuck in the current system, the doctors who are stuck there,
where they will transfer into the system of freedom, which is affordable care, confidential care, interference-free care. And so The Wedge, so we started The Wedge, we launched The Wedge in 2016, and we started with nothing. And now we're, I think we're almost to 500 practitioners on The Wedge.
And the whole idea here is it's cash-based. So this is a directory, an online directory of cash-based doctors around the country, cash-based nurse practitioners. We also have like four cash-based pharmacies. We've got one surgery center and we've got a bunch of dentists who are starting to join. So people have been telling us that they're finding doctors and dentists on The Wedge. So The Wedge is at jointhewedge.com. That's where you can find it, jointhewedge.com. So the whole idea there is,
you know, we're not going to fix the system. We're going to create a new one. And that new one isn't actually so new. It's just like it used to work before the managed care plans, the health plans, the HMOs, all of these corporate entities saying that they're doing healthcare, but they're really, you know, doing their own business. And then patients and doctors are sort of the cogs in the system. So that's one of our initiatives. And it's really, you know, important to moving back to freedom.
Well, another Achilles heel is the whole data industry and the taking of all of your data because with your data and your doctor's data and your doctor's data decisions about, data about their decisions, they can control the doctor. And so we say, he who holds the data makes the rules.
Twila Brase
And so that phrase, he who holds the data makes the rules, is really important to understanding why we have to stop HIPAA. So we have a really big initiative to first and foremost inform the American public that HIPAA does not protect their privacy. It never did. It was never intended to protect their privacy. It was intended to take away their privacy.
And so under HIPAA, 2.2 million entities, according to a rule out of the US Department of Health and Human Services, 2.2 million entities can have access to your confidential information if they choose to share it. If your doctor chooses to share it to the hospital, the laboratory, the radiology facility, all the places where you want your data to be, if they choose to share it with all these 1.5 million business associates,
or business entities, they can. And they can do it without consent because of HIPAA. And so, and they can control your doctor, they can profile you, profile your doctor, make decisions about you saying why you can't get this care instead of that care because of who you are, because of everything in your life that they are collecting data on. So that's another initiative of ours is Truth About HIPAA. We've got an entire Truth About HIPAA campaign. Every April, we run that campaign all April. This year we had
Cartoons, five commissioned cartoons about HIPAA telling the truth about HIPAA. And we did a social media campaign using those cartoons. And the idea here is the American public has been snookered into believing that HIPAA protects them so they feel safe at the doctor's office and at the hospital. But they shouldn't feel safe. And we really have to get back patient consent rights. And one of the ways that that.
that that can happen is after you know you don't have any privacy, you can talk to your state legislators and get them to pass a law to give you state-based privacy. And that's what rules. HIPAA is really doesn't rule anymore if you have a real privacy law in your state.
Christopher Habig
That was a lot. So I want to go back and just kind of recap, you know, a lot from the...
CCHF as you call it there. So one, you know, if you are a practicing physician in the independent side of it, the direct care side of it, check out The Wedge. I've looked at the site before and it's like, okay, yeah, this is a good directory. So people can go up there and say, you know, I don't really want to fall in line with the hospital practices or whatever that is. There's got to be somebody out there. And there's a couple of little directories popping up. I think The Wedge is probably the oldest and most mature one at this point in time. You know, the issue of
privacy is always very, very intriguing. You see doctors opting for the DPC model because they're really just not even beholden to HIPAA anymore. I mean, sure, you need to have a password on there, but if somebody just Googles, when does HIPAA apply, then they'll look at this and say that HIPAA only applies to your physician's practice if you submit...
health information to a third party electronically for reimbursement. That's it. That's how HIPAA gets you right there. So I'm totally agreein' with you. I just wanted to break that down from a privacy standpoint. So they're sayin', hey, it's HIPAA compliant because this electronic software is taking your personalized data, shipping it off to somebody else in these clearing houses and who knows where it goes from there. And I think that's what you mentioned, that 2.2 million organizations across the United States can be a part of that clearing house
and that's where the HIPAA information is put. And we see breaches, we see data breaches all over the place right now, and it seems like the health information is targeted, it used to be credit card information and passwords, this kind of stuff, you know, a year ago, two years ago, and now we see pharmacies being hacked, we see hospitals, we see specialty groups, everybody's going hard, the bad people are going hard after health data, and so on that privacy, topic…
the question for you is, if I'm a patient and I'm sitting here saying, well, I think my health information was all exposed, are you attributing that to HIPAA guidelines or is there something else happening where people are just losing sight of security?
Twila Brase
Well, the interesting thing about HIPAA is so it allows all of this electronic sharing. It allows all of your data to be digitized into electronic health records. And so Congress made us vulnerable by saying that all of this could happen, making it easily shareable, easily accessible, easily put online. So that's one piece of what HIPAA did, but also, or yeah, well, what HIPAA does, but.
Also, what Congress did was it mandated electronic health records, and not just any electronic health record, but the electronic health record that is certified by the government to do what the government wants that machine to do. And so when you're in the doctor's office and you're looking at that computer, know that the doctor did not put that in there willingly.
But the fact of the matter is that Congress said if you don't have a government certified electronic health record in your office or at the hospital bed, then we will not fully pay you for every Medicare patient that you see. So they had the doctors in the hospitals over the barrel, as it were. And so by forcing everything to be digitized into electronic health records, they made all of us vulnerable. So this is a combination of HIPAA and the electronic health record mandate.
And if I may, I could lift up my book and just show you the book that I wrote. It's called Big Brother in the Exam Room: The Dangerous Truth About Electronic Health Records. I have it at hand. Should I show it?
Christopher Habig
Sure, and yeah, while most people will be listening to our voices only, that is always useful. I will plug our social media channels and our YouTube channel for those reasons right there. If you wanted to see the book, check us out, Healthcare Americana. We have all the socials, and you can check out our YouTube channel of Freedom Healthworks.
Twila Brase
Well, let me just say that I wrote a book about it called Big Brother in the Exam Room, The Dangerous Truth About Electronic Health Records, to show how these two things combined, the mandate for electronic health records and HIPAA, really took away our privacy, made us vulnerable, actually made us nationwide. It's like, it's not just a personal security risk, it is a national security risk. Because just imagine all those hackers getting access to our private information.
They can find out even if a leader has diabetes and you didn't know it. Did they have a heart attack and you didn't know it? Are they susceptible to something? Are they on a machine that is hackable? If you want to, you know, hurt somebody in the country that is there, that has political beliefs, you don't want, you know, hanging around. So, and so it's, so when you ask the question about HIPAA, yeah, HIPAA did it, but the electronic health record did it as well and the mandates and the money attached to it. That also put all of this in play, making us all vulnerable to the hackers.
Christopher Habig
It kind of a lead in because I wanted to talk about some of the federal programs. Medicare, Medicaid, you know, Medicaid is kind of shared at the state level in the federal level and not enough power to the states in my mind to be able to provide that safety net for citizens. You know, from your standpoint, you mentioned Medicaid or Medicare a little bit earlier as far as you gotta get these max reimbursements and it feels like there's so many physicians out there that are so beholden to these Medicare.
It drives me nuts when someone's like, yeah, we price X percent to Medicare. I'm like, that's funny money. If I went and bought a coffee and the coffee shop's like, yeah, our cup of coffee is 150 % of Starbucks, I'm gonna be looking at them like, what the hell did you just say to me? That doesn't make any sense whatsoever. But there's so much of that in healthcare where you're like, you're just making up numbers at this point in time.
Twila Brase
I agree with that, but I probably agree with it on a different perspective. Just looking at what the Medicare pricing is, given all the bureaucracy that Medicare has caused throughout the entire healthcare profession and the industry, that's a lot of people that are working in healthcare that do absolutely nothing for the patient. There are all these middlemen in order to follow all of these regulations and report all of this data
to the government or to the collaborators of the government. And so it's got to cost a lot, right? And so there are physicians that have closed up shop because of the electronic health record mandate, they couldn't afford it, right? Because of the regulatory requirements, they couldn't afford it. And they couldn't afford to charge their patients even more. And they just sort of gave it up.
Right? And so now what you have is a consolidated industry as a result of Medicare and Medicaid and all of the regulations. And so some entities are going to survive that. And they're going to survive that by bigger prices. They're going to survive that by charging the government for uncompensated care at the charge master price, even though they never get that from any other insurance company, because the insurance companies refuse to pay that amount of money,
but the government does not. And so they have that charge master price to get that extra money from the government, but they also have that charge master price because I was listening to a doctor recently who said they have to charge that much in order to be able to say that they have given a sufficient amount of uncompensated, free, charitable care to be a nonprofit organization. So I think there is more than meets the eye in what these prices are.
But the fact of the matter is when you get to a DPC practice and they don't have all of those regulations or fee for service practice and they don't have all of those regulations, they just take cash, then everything becomes very simple. And the money becomes very simple and the prices and the costs become very simple. And that's where we have to get back to.
Christopher Habig
I love the simplicity argument in healthcare. You have spent the majority of your career battling what you said earlier, like government takeover in medicine, fighting the ACA policies. Curious to see what works and what you've seen when you educate patients. It feels like one political party has no ideas and the other political party has just bad ideas across the board. From an American public standpoint,
when somebody hears Medicare for all, they're thinking, that's great, I don't have to worry about anything, and I don't have to be, I don't have to take care of myself, that kind of thing. And we hear that mostly from the Democrats on the left. But the right, what is a rallying cry that the Republicans and the conservatives who say, look, you need to take care of yourself, you need to have free market principles. It just seems like there's just no sexy marketing material coming out of there. How does your group educate patients to say, look, this is what you need to do? And put it on a billboard so that it actually sticks on somebody.
Twila Brase
Well, part of what we do is we give presentations and in those presentations, we lay out a few key facts about Medicare that should be very eye-opening to the point that some elderly people have told me, well, I probably won't be around by the time that happens. And so because Medicare is going bust and even though they gave it five more years of life and now they say, you know, it won't be until 2036 where it will be insolvent and unable to pay you know, part of his bill. So even though they say that, right, those numbers.
Christopher Habig
It makes you feel good. It makes you feel good. It's only 12 years away. great, great.
Twila Brase
Yeah, yeah, that's right. Right. The fact of the matter is the whole system is headed toward rationing care to seniors, you know, and if you are a healthy senior, well, good for you. But if you are going to have any kind of major medical problems, as soon as you really become vulnerable, where you really can't argue or advocate for yourself, it's going to be a dangerous time for you. It's going to be dangerous anyway, because the Medicare Advantage organizations are already rationing medically necessary care to seniors.
They're already doing it. There have been three government reports saying that they are doing that. It's medically necessary care, it's approved by Medicare, and the health plans say no. And this is one of the reasons that I, you know, one of the big things that I do in presentations is I say go to Original Medicare. If you have a choice, get over to Original Medicare where at least you have freedom.
And in the meantime, we're going to try to get people who are not dependent on Medicare an escape route from Medicare. And so, you know, we got an executive order in 2019 to actually have that escape route. And people kind of look at that and they go, well, why? And so I explained that, you know, your life is going to be rationed away from you. And they wonder how they would be able to afford it. But the escape route has to do with the fact that they should have a real health insurance policy. A real health insurance policy.
So today we don't have real health insurance policies. We've got health plans and health plans are the corporate version of socialized medicine. They were dreamed up by Ted Kennedy, who was a single payer advocate. They were pushed by Hillary Clinton, who wanted HMOs for all across the country. And then Obama put them into place through the Affordable Care Act. And all of us now have a qualified health plan.
A corporate version of socialized medicine. And that means that the health plan actually controls the dollars, the data, and the decisions. And that's exactly what socialized medicine does. And see, the problem is that people don't see the trap that they're in. So we talk about real insurance, true insurance for insurable events. This kind of insurance is affordable. You stick it in a drawer somewhere. You hope you never get into the car crash, have the...
you know, end up in a coma or get cancer, but if you do, it's there and you paid a very small amount for it because it's only for insurable events and you pay for everything else with cash. And you know what that does? It brings down the price of everything else to the cash price. Every price is transparent. You'll never have to wonder what anything costs. Every practitioner will be competing against the others for your business.
Twila Brase
And they might even be competing and saying, my price is $10 more because I'm actually better. I've got 30 years of experience. That guy over there, he's only got one year of experience. Let's get the market to work in medicine because that's the only thing that's really going to work for patients. And they've got to have transparency, no interference from outsiders, confidentiality so they can feel the trust that they need. And they have to have doctors who have their joy back.
Doctors don't have their joy today. As a matter of fact, I was at a conference, a free market conference, and I asked this one guy why he was going into DPC. And he got down to the point where he said, well, it was either that or suicide. And he was serious. He was serious. There's a lot of doctors, they have no joy. They do not feel like they're doing what they need to do for the patients. They feel like what they're doing is unethical. They have a hard time sleeping at night because of how others are controlling what they do for patients.
So we've got to get back to a free market, medically ethical system in healthcare. And that's why we started The Wedge. We're breaking off.
Christopher Habig
Absolutely, absolutely. From the health plan standpoint, I want to get your take on this because so many health plans are tied to employment. Now, I'm an advocate that those two things should be separated, but we've got to be careful because I don't want that employment benefit to be separated and then it backslides and actually strengthens the ACA. What options are there in your mind for those individuals who say, you know what, I don't want to be dependent on this job over here. You've got job lock, you've got all kinds of different things going on.
I don't want to be completely dependent on that in order to be able to have that one or two percent risk of these bad things happening. Where can I get a health plan? What am I supposed to do without strengthening the ACA from an individual standpoint?
Twila Brase
Well, this is something that we're hoping that states will move towards. There are six states already, I believe, that have what they call health benefit plans. And in the law, it says these are not health insurance. And by putting that into the state law, it means that they are not under the Affordable Care Act. Now, these are not true indemnity insurance. Indemnity insurance policies pay you, the patient, and then you pay your doctor, you pay your hospital.
And so we need to get back to those. That's real insurance, right? Where there's a private contract between you and the insurer. The insurer says, yep, this is what I'm going to do. And when you need it, you just let me know. And this is part of my contract with you, right? We don't have that today. We got all this third party, you know, middlemen and making decisions about what you need and what you don't. So, you know, we'd love Congress to do it. We actually have asked Congress to do it to just bring us back to real insurance, catastrophic major medical policies, very affordable, just there for insurable events.
But we haven't gotten that yet. And so we're really asking states to do more of what states have begun to do by putting this kind of proposal into, you know, at the legislature and then making it law.
Christopher Habig
I would add another thing to your list there and ask Congress or the states to say, look, primary care is not going to be covered under insurance and see what that does. I think that would have a huge ripple effect for people being able to drive prices down, access up, as we see at Freedom Healthworks every single day as we continue to stand up more and more DPC practices across the country. Twila, as we wind down our show here, I mentioned earlier in this episode of this notion of a healthcare hero, kind of the
Batman, you know, fighting all the villains during the evening time and nighttime when everybody's asleep and not even knowing what's going on behind the scenes.
In your mind, if you're putting on the Batman cape and Batman cowl right now, who's your number one villain out there?
Twila Brase
Oh, number one villain. There are so many to pick from, but I would say it would be as a group, those who call themselves Republicans or conservatives who are in office, and they are following the left's line of thinking. They aren't moving towards health freedom at all. And so they have kept the public hopeful that things would change, but they're not actually trying to change things.
And so I think as a group, those who stand up for freedom but really aren't working for it, and they have the power in an elected position to do something more.
Christopher Habig
Twila, I want to thank you for coming on the show. That's Twila Brase, a registered nurse and also very, very adamant patient advocate, co-founder, president of the Citizens’ Council for Health Freedom. Twila, thanks for coming on the show.
Twila Brase
You're welcome. Thanks so much.
Christopher Habig
And also a big thank you to our listeners. Thanks for tuning in to Healthcare Americana as usual. We hope you enjoyed today's episode and really feel more empowered to make informed healthcare decisions. There's a lot of work we still have to do. Our job is not done yet, because remember, your freedom and healthcare matters. Until next time, I'm Christopher Habig. Thanks for listening.
[OUTRO]
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