Health Insurance Explained: How Insurers Profit, Patients Lose, & Doctors Struggle!

We've been trying to cap anesthesia payments , and this is not new . This is not nothing . This has been a long-term debate . That's why healthcare is always on the agenda in political years like this year , and I thought I'd get on here and break down how health insurance works . We're going to do a five or six-part series .

I'll bring you on some experts that we've been interviewing over the last several weeks , so lots of good stuff . Tonight we're breaking down health insurance from the nuts and bolts for you guys as pre-meds , for residents , for patients or whatever's going on , but also for physicians .

We're going to talk about things that are important to yourself to be able to fortify yourself , protect yourself , protect your patients in this crazy world of healthcare . So the reality is , and why this is so important health insurance premiums have risen by 47% over the past decade , yet at the same exact time , we're turning 47% more .

That was inflation , 47% more for health insurance . So physician reimbursements are not going up . Physician reimbursements for substance use insurance are going downward right . At the same time you have insurance companies like the UnitedHealth Group , like the Manitoba and so forth , reporting billions , billions of dollars of profits every year .

So it's not just about the numbers , it's the economics of it . But our need to have the economics of it is to treat purpose . Healthcare is to do what , guys ? To keep us healthy , to serve patients right . And these sort of issues with insurance and with the economics affect our ability to provide care .

This is why I'm always so torn up preaching to pre-meds . You guys pay attention to the money , because where the money goes , that drives everything . Because the money is misallocated in healthcare , it causes problems for patients , it's restricting for physicians . So we're going to break it all down , guys . I'm going to hit the intro .

If you have any questions , anything to add to this discussion , put it in the here early . What up y'all ? Let's get it going . Here's the intro We'll get right into it .

We have to super frantically cover everything you guys need as students , as friends see , become future health care readers , and so understanding health insurance guys is so important . Every single medical school has a course in health insurance . Every single public government and they have a course in health insurance . But it's very brief , it's very quick .

We don't think about that . We just enough serving patients , but not understanding health insurance prevents us from serving patients with a bolus . We truly understand why the healthcare system is such a mess in America . If you guys don't know , healthcare in America is a mess . We rank almost last amongst modern industrialized countries in the world in healthcare .

Our health system is an absolute mess and we need to understand how it works and how much elevated we're going to get there . So we're going to start with the basics tonight and how insurance works , how money flows to that system , where things break down .

In order to talk about something in a complex way , we have to understand the vocabulary of it , and so one of the ways that insurance companies I'm not going to say get over , but one of the ways that makes insurance complicated is that they use a lot of words and you're confusing when you're trying to read your contract and your policy and see what's up .

So the first word is premium , and that is what you pay on a monthly or an annual basis to have access to insurance , to even have a chance for the insurance company to cover what are your costs in healthcare , and so every single month , you pay in . In 2023 , the annual average premium for a family was $22,000 .

That's up 43% from the past decade , so with a huge increase in the amount people are paying just to have access to insurance . Now , that's the word most people understand . The other word that is very complicated to people is the deductible . Who knows what a deductible is ? What B is a deductible ? Good afternoon , joel . What is a deductible ?

What does that mean ? If we're talking about a deductible , I was going to do that . Who's your favorite ? Tell me about your life right now . What is a deductible , guys ? So we pay every month to have access to the insurance , but the insurance company said well , wait a minute before we just go ahead and give you money .

We want you to put some skin in the gate , put some money out , and so the deductible is what you have to pay out of pocket before the insurance kicks in . So maybe you have a $3,000 deductible , $1,500 deductible , a $5,000 deductible , a $10,000 deductible , and you agree that I will pay all this money before the insurance company kicks in and pays something .

Yes , so the amount of your deductible is actually very important , and insurance companies leverage the deductible to trick you . To trick you , right . They say hey , listen , your premium is really high , would you like a lower premium ?

Well , to give you a lower premium , what we're going to have to do is raise your deductible , and so they'll say listen , instead of paying $1,000 a month , you go ahead and pay $900 . That's $100 a month saving . You're like woohoo . They're like , yeah , don't worry about this , but your deductibles are going up by two grand .

Oh well , deductible I don't know what that is . So , okay , go ahead , right , and so your deductible goes up higher .

And the something that's true is that insurance companies are for-profit companies designed to maximize profit , and the insurance model is that they collect all the money up front and we're going to get into this later and talk about this and how the money flows .

But they take in all this money and they have to keep all that money to profit and so they're going to use all these terms and policies to keep your money . Yes , yes . So with the deductible , a high deductible plan this is important . A high deductible plan this is killing people . Killing people .

A high deductible plan they will mortgage you into a high deductible plan . They will mortgage you into a high-definable plan to lower your premium , but then they're off the hook for so much of the services you need and the odds that people spend ten thousand a given year slow . So they're going to keep all that money over the last decade , okay .

So we're gonna talk about stats and facts . We can't talk about fiction , because opinions right , what ? What are they like ? We don't want opinion , we want the facts . Over the last decade , the average deductible for employee sponsored insurance so it's the cheapest , right , that's the most economical rebook has doubled , doubled .

The average deductible is $1,700 for a single person's coverage , so for a family , that's 4X . So the average deductible for a family in America is roughly $5,000 , $7,000 , even $10,000 . Meaning insurance ain't covering nothing , yo , nothing . So in the last decade , the average deductible has doubled and is now $1,700 per person per year .

How many of you guys have spent $1,700 in healthcare a year ? That means you're paying for all your insurance , your favorite insurance , and you're paying for all your care . Now , beyond the deductible , we have the co-paid , the co-pay . Who has heard of the co-pay ? I'm going to take this off until we get to the real complex stuff . I'll get back to the iPad .

I want you all to see my face . A co-pay , this means , hey , when I go to do a visit that the insurance technically should pay for , so I'm paying every month . They said again that they want me to share the burden of the finances , and so they said you should have a co-pay , so we're co-paying together . We're co-paying together . How fun is this ?

I know you pay me to pay for your health insurance , but we're going to co-pay together , right ? So it's a fixed amount . You pay for specific services . So , for example , the common thing that many of you know is hey , I want to go in and get my annual , my physical checkup . I don't know , maybe I'm feeling a little sick . I want to a physician .

And you go in and they say hey , listen , your co-pay is $15 , $30 , $50 , whatever it might be , to see this person , and the more specialized or more expensive a service is , the higher the co-pay it is . So you might go in for imaging that co-pay might be $100 , might be $200 .

You go see a specialist right that co-pay might be $80 , double , whatever your primary care business , whatever it is . So co-pays , right , is this what you're paying in a fixed fee for a service ?

The other nuanced term is co-insurance , which means hey , listen , I know you're paying me to insure you as the insurance company , but I think you should also insure your stuff too . And so , yeah , we'll pay for stuff , but we want you to pay for a percent .

And so what happens here is is , even though you pay a monthly premium in totality , the insurance company says , listen , is , even though you pay a monthly premium in totality , the insurance company says , listen , we're not gonna pay for all of this service , we want to only pay for a percentage of it .

So , instead of paying for 100% of your emergency department visit , for example , we're gonna pay for 80% , but you , the patient , needs to cover 20% of that visit . So , for example , you go and you go to the emergency department and it's a $10,000 visit . You and you go to the emergency department and it's a $10,000 visit .

You're going to be paying $2,000 out of pocket . Worse , what if you have to go for a massive surgery ? That's $100,000 , then you're coming out of pocket 20% of that . That's $20,000 , potentially no-transcript , and this is basically catastrophic coverage . Right , you go . You need a super long ICU stay . Something devastating happens In a year .

This caps your ultimate risk and liability as the person . Your out-of-pocket max is your safety net to grab you so you don't fall completely into the spares of millions of dollars of debt . That's the amount the insurance will cover after you meet that . They'll cover 100% of all costs . They'll pay whatever . They'll cover all that stuff .

So in 2023 , the average out-of-pocket maximum for an individual $8,700 . Where it can be as high as $17,000, . Guys , how many of you guys have spent $8,700 in a year on healthcare ? The answer is no , right , you don't do that . And so you guys can see they have all these different terms . You think , okay , I'm paying this much for insurance .

Well , you're not paying that much . But then you have the factor in the deductible , the factor in the copay , the coinsurance , the out-of-pocket maximum , all these factors that make it so that things that should technically be covered , that you think are going to be covered by your insurance , aren't actually covered , and it becomes problematic .

Does that make sense to everybody ? You have to say yes . If it makes sense to everybody on here , okay . So now , now that we understand all the vocabulary , it's important that we understand how health insurance companies make money off of everybody , and so we have to break that down so we can see it and be very clear on it .

So let me bring the iPad back for us . Good to see everybody here , robert . What up ? Okay , we're back at the iPad . All right , everybody ready ? Okay , so now we're going to get into how insurance companies make money . It's super , super simple .

You are a person and you're like hey , listen , health insurance , health care is expensive , I want to be covered , so I need some health insurance . And the insurance company is like okay , cool , we want to insure you . And the way works is is insurance companies are right . Here in the middle , we have all these people .

The insurance company collects all these premiums up front for people , so it creates this big pot of money in the insurance company . The insurance company wants to maximize profits . So at the start of the year , the insurance company has 100% profit because they have all the money .

Every single time the insurance company pays for care for a person , their profits drop . Does that make sense to everybody ? They collect all the money up front . They get 100% . So at the beginning of the year , well , insurance companies , 100% profitable , all profit .

Over the year as people use services , they pull money out of the pool and the insurance company's profits drop . So as an insurance company , the way that I'm thinking I'm going to make the most money is that I have to collect as much money as possible up front .

So I want to make the most money is that I have to collect as much money as possible up front . So I want to have the most amount of people enrolled and I want to charge them the highest premiums possible to get all this money in my pool . So that way it's big . Big bottom line , or maximum profit line , is super huge .

I'm going to collect as much money as possible . I have as many people in there and having as much money in there as possible . The second part of this is that as the insurance company . So the first part is get money as much as possible . The second part is keep money . So we want to pay out of this pool as little as possible .

I'm going to get money , everybody . Give me your money . I'm an insurance company , I'll help you out and then I'm going to keep as much of the money as I can . That's the only way an insurance company can be profitable , does everybody understand ? So the insurance company's interest this is not debatable . The insurance company's interest this is not debatable .

The insurance company's interest is to be profitable , period . They are for-profit companies who are looking to maximize profits and the only way they can make money is to get as much money as possible and to keep as much money as possible in that pool and not pay out for services . So how do insurance companies cut costs on claims ? How do they do it ?

Y'all Insurance companies want to pay out as little as possible . So the very first thing they do and Mike put it in the box here they do low-risk , high-risk pools . So insurance companies will deny you if you have pre-existing conditions . Insurance companies want to have the healthiest pool of people .

I want all you young people to give me your money , because I know young people don't get sick , don't need to be in the hospital , don't go to the ICU , don't need medications , don't need all these things . So I know I'm going to keep most of your money and if you're old or if you're sick or if you have a condition , I want to deny you services .

I want to make sure that you don't get into my pool because you have a higher risk of pulling money out . And so what insurance companies are looking at is like I want to have all healthy people and no old people , and this is a sidebar .

But this is why Medicare and Medicaid struggle so much , because they have Medicare has the old people who are the highest utilizers and they have the smallest pool of money . Medicaid has , right , the lowest socioeconomic status people and it has people with disabilities .

So all these people are higher utilizers than the average individual and they have a smaller pool of money . So private insurance companies have big pools of money , lots of healthy people , and this is all a conversation for another day we'll get into .

But this was one of the arguments for making universal health care a thing , because then what you would do is take all the young people that go to private insurance companies and give them their money and don't pull any back and you put all of them into the Medicare and Medicaid pools and you make that pool much less risky .

And so you make Medicare and Medicaid much more sustainable , much more robust and much better for the people who need what the care of the most , and you take out the full property of these private insurance companies . But anyway , okay . So money in the pool , money out .

So the very first thing insurance companies do is they want to keep people who are high risk out . The second thing they do is , once people are in the pool , is they say okay , now you're in the pool , we're going to make sure that we minimize the amount of claims we pay out by denying claims .

Okay , so the way healthcare works and you access it as a patient is that you have to get pre-approval to go in for services . And so when you say , hey , listen , I'm a patient , you know my knees really didn't bother me . I love to go get imaging on my knee . The insurance company says what ?

Ah , well , listen , even though the MRI would tell us about the ligaments . And this is happening . My daughter took my knee out at Trampoline Park and I'm a physician . So I know , hey , listen , you know what ? My knee's jacked up . It's not broken , but there's definitely some ligament meniscus . There's something weird going on in there .

I need an MRI to see that kind of stuff . An x-ray won't pick this up . And so I went to my primary care provider . Hey , listen , my knee's jacked up . Oh yeah , this feels kind of jacked up . I said , listen , I need an MRI . They're like can't ? The insurance company has to order the x-ray first .

You also have to go to PT physical therapy for six weeks and then , after those six weeks , then they'll cover the MRI . And the reason the insurance company does this is what y'all ?

Because most people are like , oh okay , I'll get the x-ray out , I'm not going to get to that and I'm not going to fall through the PT , and they're hoping to avoid having to pay for the real energy I need , which is the MRI . So insurance companies want to deny claims .

Did you guys know that up to 20% of all healthcare claims are denied initially , and of those , over half patients don't appeal , and so , as a result , insurance companies need to keep that money in a particular way to pay out .

The other way that insurance companies save money and save payouts is they narrow their networks and so they limit who's an in-network provider , and by doing this and limiting this , they limit what guys ? Access to care . And what is one of the big things we always talk about ? Access to care , maximize access to care .

Well , insurance companies limit access to care . So that way , what If the provider's not in network , you have to see someone out in network because that's where you can get to and that's where you have access to what happens . You have to pay out of pocket for that , and so , again , saves them money .

The other way that insurance companies keep money in the pool , keep their earning interest , is they delay payments . So , for example , medicaid and Medicare have 90 days to pay out , and so this is what happens . I own so , as we friend with the discussion , I own an anesthesia practice , so I bill , I do insurance billing .

Right , I have to do all this stuff , and so the easiest example is Medicaid and California's Medi-Cal . When I bill Medi-Cal , I send them , I do the work , I've already done the work . I Medi-Cal , I send them , I do the work . I've already done the work . I put a patient to sleep . I've done all the care , all that stuff .

After I do the care , I have to fill out all this paperwork , I have to send it to Medi-Cal . Medi-cal looks at it . They have 90 days to respond , not 90 days to pay . They have 90 days to respond . So what they do is they take their sweet time , give me back to me and maybe it's called .

60 days after I submit , I get a letter back that says hey , you know what ? Is this ? A comma or a period ? Right now , right there , I can't see what that is . Can you clarify what that is and get back to us ? They send me that letter . So I'm like , oh gosh , let me send this back to them . So I sent back hey , it's a . They have what ?

Another 90 days to pay out . Oh , you know what ? We didn't get past this comma last time . We're confused about that . But now we're confused about this . Can you clarify this ? And then the days go on , the days go on , the days go on and it's delayed . And then , through these delays , what ends up happening is a lot of billing departments will settle .

They'll call the insurance company . They'll say hey , insurance company , we really need this cashflow . We didn't serve it six months ago . We've been waiting on this . What can you do ? And the insurance company goes well , it's really tough . You know you made a couple errors here in your billing and then this 50-page document you sent us .

But you know what we can do . Because we're such good guys , we're going to go ahead and give you , if you're willing to take it today , we'll give you 50% of what you build . For what do you think ? And if your business cashflow is king , well , having that paid for six months , hell gosh . All right , I'll take it , give me 50% .

And so insurance companies end up paying quarters on the dollar instead of the entire figure . Right ? Imagine , imagine doing a job and your company's like hey , you know what ? I know ? We told you we'd pay you X amount of dollars per hour , but right now we ain't got it all .

But if you want to get paid , we'll give you half of what we should have paid you . It'd be terrible , right ? And so by doing all this , insurance companies maximize profits . So UnitedHealth , right ? Their CEO , terrible , forgive me . Everybody's sitting on the line , guys . No one deserves to get shot for nothing . Life is life and life is valuable .

I think it's an awful situation that that guy got shot . Awful situation , awful , awful , terrible . No good , no one should lose their life . But I think one of the positives that comes out of it is . It makes people question well , why would someone take someone's life ? It's such a huge act to do . What's going on ? What's he so embittered about ? Right corner ?

What's he so invictant about ? Deny , delay , depose Was that written on the bullets ? He might be mad about how they do insurance billing . It might have been failed by the system , and so UnitedHealth revenue was $324 billion in 2022 . That's a 12% increase from 2021 .

Yes , of that you're like well , listen , that's total revenue , but what's the profit on that $20 billion ? Unitedhealth Group made $20 billion , not in like all their whole lifetime . In one year they made $20 billion of profit . How does that happen ? We increase premiums . How does that happen ? We increase premiums and we cut costs on claims .

That's how we maximize 20 billion . So that means people paid in . Call it a hundred billion into the pod , right , we paid a hundred billion into here . That means they only paid out 80 billion . They keep 20 billion in that pot that should have been used for stuff that you need .

Yes , because that makes sense to everybody , and so I touched on this right and we're talking about this . But the problem is is it's not just a matter of okay , who's getting paid , who's getting paid whatever ? And we're going to get into this . It's freaking crazy guys . So how do claims work ? You go and you get care .

So you visit your doctor , you get a surgery , do whatever . You get the service . You come in emergency department . I'm sick , okay , doctor , I'm taking an oath , I'm going to help you . They give you service , they give you time , they give you supplies . Do all these things . Do they get paid that day ? No , they .

And when I say they , it could be the doctor , it could be the surgery department , the cardiology department , whatever department . They all have billing departments .

So the billing department is going to say , hey , listen , we did this , and they're going to look at the record and they're going to get all the different codes together and they're going to send a bill to whatever insurance company Once they submit that bill called submitting a claim right , let me take this off the screen .

They submit that claim , the insurance company gets that claim and , like I said , they review it and they have all back and forth based on how complete it is , how accurate it is . And what makes this super confusing and super complicated is that every insurance company has distinct , separate codes . Every insurance company has distinct ways , codes .

Every insurance company has distinct ways that they want the information presented , and so your billing department has to learn how each and every one of these insurance companies wants and serve it to them the exact way they want it .

As students , how frustrating is it when a teacher wants something in a certain format and it's entirely different and weird from what everybody else wants . Well , insurance companies do that , and then every single year , they update their policies and what they want to see in claims . So that way , what does the organization have to do ? The hospital have to do ?

The building department have to do ? They have to retrain on this , reorganize on this , and when you retrain what it takes , it takes time for that to happen . It takes resources and money and so forth , again draining resources out of the system .

These are called adjustments , insurance adjustments , but really it's just hey , I don't want to pay that much , I pay less . So they look for reasons to deny these claims . They adjust , they reduce how much you're going to pay out . So even if they do agree to pay out , they pay out less of . And the problem with this is it's not just bad .

People think it's the doctor's issue . It's not about a doctor getting paid . Doctors don't set reimbursement rates .

This is the most important thing that you guys can probably learn in this life as pre-meds when you become a doctor unless you take only cash and I'm actually going to have a doctor on next week I'm interviewing her for you guys and in her practice she only accepts private pay patients and people get upset at that , sometimes Like why don't you accept insurance ?

And what she will articulate to you guys . We'll talk a lot about power practice , a lot of good stuff for you guys to get next week , but one of the things that becomes clear is the headache , the expense and the sacrifice you have to make to deal with . Insurance isn't always worth it , and so you end up doing all this work and not getting paid .

And how does that make your soul feel Right ? And so you can't survive on nothing . You have families before you have all these expensive doctor loans , all this kind of things , and so it makes it very difficult for people to accept care . So what happens is is you have patients now who are stuck with insurance companies trying to maximize profits .

So they raise premiums , raise premiums , raise premiums . They get harder and harder to afford . So what do people do ? They go without insurance or , what's most common , they go underinsured . So they know they need a certain amount of insurance . Oh , I need these services covered , but it's too expensive , I can't afford it .

So I'm underinsured and the care I really need is not covered and therefore , what do I do ? I don't access that care and therefore I get sicker than I need to be because I'm not getting the care I need and blomp , blomp , hurt patients . Additionally , the higher out-of-pocket costs .

And so again , physicians don't set the reimbursement rates , insurance companies do . Insurance companies set the rates . They handle it . How much should the MRI cost ? That's what it should cost , okay , sure , right . And for patients , they have these high deductible plans . So who suffers ? The patients , because they have to pay all this stuff out .

Right , and the statistic ? Now , this is crazy . These high deductible plans . I said earlier it's going to be a big thing , these high deductible health care plans . 31% of Americans have a high deductible health care plan , meaning their insurance is going to kick in in a significant way until they get to a super high dollar figure $5,000 , $7,000 , $10,000 .

How many of you guys have $10,000 laying around right now to just , oh , here's 10,000 , let me go , no sweat off of me , I can eat just fine without that . 10,000 , right , we don't . And so 31% , a third , of Americans are at risk for falling victim to the bankruptcy right . Healthcare is the number one bankruptcy tool in America . Healthcare why ?

Because these high-doctrine plans . It also limits access to care for patients I mentioned . When care is expensive , do we go ? Ah , you know what ? Yeah , this , this whoo , this , this toe is really hurting , but you know , I'm not going to go in . It's too expensive for me to go in . You know what my expensive for me to go in ? You know what ?

My sugars are out of control , but I can't afford my insulin , so I'm not going to get that care . You know what ? I really do need to see this doctor , but they're not network . Ah , I'm not going to worry about it , I'm just going to see my primary care provider . You know what ? I can't even see my primary care provider .

The copay is too expensive , the co-op is too expensive . I'm just going round and round and round around the bend with the patient suffering . We haven't even gotten to the fact that the physicians suffer because these physicians and this is what happens to healthcare you don't see private practice anymore where it's like one physician .

They hang up a shingle because it's all about negotiation , I mentioned . The insurance company set the rate and the insurance company decides who's in network , who's out . About negotiation , I mentioned . The insurance company set the rate and the insurance company decides who's a network , who's out of network .

So if you want to get paid in a real way from insurance companies , you have to play the game . So the insurance company says you want me to network ? Sure , you can network . You're saying that surgery , the open-door surgery . You say it costs 10,000 ? Okay , cool , that's fine to be a network . We're going to pay you $5,000 of surgery .

Do you want to be a network or not ? So they set the rate , guys . And so for physicians , you have huge med school loans , you spend an inordinate amount of your time becoming the physician , you work hard in a stressful , crazy environment all day and you don't get paid . What is right and just for you .

Like I said , physician salaries are not adjusted for inflation every single year . In fact , many physician salaries actually go down every year because of these pinches . And so what happens to the physician y'all ? They have to be more productive to make the same ways they used to make , not being as productive .

So we have to see more patients , they have to move faster . I mean , it's like your doctor is rushing . This is a pressure put on them by a healthcare system that is broken . And who has broken it ? Who broke the vase ? Insurance companies broke the vase .

Insurance companies serve no function in healthcare other than to provide a barrier , a buffer , a obstacle , to provide a wall between patients and providers . I don't know if you guys saw it today . I took a screenshot of it because I thought it was fantastic illustration of what is happening here .

But there was an article quoting the new CEO for UnitedHealth Group . You guys see this ? Who saw this ? I'm going to blow your mind right now . You guys ready ? So UnitedHealth CEOs got shot last week , killed . They now have a replacement CEO . Yes , this replacement CEO said here we go , you ready .

Our company will continue to prevent unnecessary and unsafe care after the fatal shooting of our previous CEO . We make sure that care is safe , appropriate and is delivered when people need it , and we guard against the pressures that exist for unsafe or unnecessary care to be delivered in a way that makes the whole system too complex and ultimately unsustainable .

Complex and ultimately unsustainable . Listen to what he's saying . We make sure that care is safe , appropriate and delivered when people need it . We guard against pressures . So the insurance companies are making the decision the clinical , the medical decisions that medical doctors have trained for their whole lives .

Insurance companies are deciding what care you need , when you need it and how you need it . Does that make sense to anybody ? Would it be great if the doctor who's actually seen you and who's gone to medical school got to decide what care you need when you need it , not the insurance companies . Would that be fantastic ?

And we're going to give you some really specific examples next time where I really start to break this stuff down , so you guys understand what's happening here and the real squeeze and the real logistics of this . It's nightmarish . It's worse than what you could imagine right now . I'm going to give you some real examples .

Maybe you're in trouble , maybe I don't , but I'm going to give you guys some real examples of how this game is played , how the patients suffer , how the position suffers and how insurance companies win the day . Have we had enough for today ? 36 minutes , minutes . Does everyone have a basic understanding of this system right here and how it goes .

We're gonna be back later this week , right ? This is a series . I'll probably do four or five episodes on this because it's that involved and that we haven't gotten to the anesthesia . It's the craziness . We're talking about anesthesiologists trying to overbill us crazy greedy anesthesiologists . But we're going to get into this , guys , because it's so important .

You guys are healthcare providers of tomorrow . You must understand the economics of healthcare and one of the reasons this system is so bad , it has gotten here , is because physicians and I tell my students all the time if you guys have heard me talk about this on the air do not be a martyr , do not be a slave , do not think that you owe anybody anything .

You owe yourself first and foremost . There is this culture in medical training that trains you to say I will give eternally for whatever and I take nothing in return . And it's just like the book the Giving Tree . I don't think you guys ever read this book , the Giving Tree . Who's ever read the Giving Tree ? It's the perfect example of healthcare .

In the Giving Tree , if you guys ever read it I'm going to summarize real quick . There is a young boy , there's a tree , it's beautiful . Oh , branches , apples , everywhere . You guys , you pre-meds , the future of healthcare , are the tree . You've got all this for life . You're excited to help people . I want to save my community . Oh , I want to do it .

You're all excited and you go through healthcare and the healthcare system is a little boy says hey , you know what , I could really use a refreshing apple . Could you give me an apple ? And you give them an app . Oh , thank you , tree . And they run off . Eat your apple . Oh , I'm so hungry . Apple , apple , apple , little apples are gone . They go .

Okay , that's all right . You know what ? I really could just use some shade from your branch . Oh , you know what ? I'm gonna take these leaves . I'm gonna build a wonderful little leaf outfit . Oh , great , now you have no leaves . Oh , it's okay , don't worry about that . How about your branches ? I'd love to use your branches to build myself a nice fancy house .

Is that okay ? Sure , take these branches , go ahead , little kid Healthcare . Take my branches and oh , now you're just a tree . Oh , you know what tree ? I know you're just a trunk there , but I really need an addition to my house . Can I take your trunk ? Oh , yeah , take that , no big deal . And now you're just a stump .

And then , even when you're worn down to just a stump like gosh dang , I catch a break . Healthcare sits on your gosh darn head and rests on it . That's healthcare . And rests on it , that's healthcare . Don't be a sacrificial lamb . Understand the economics . And for too long healthcare providers had been in this mode of . It's all about serving the patient .

It's all about giving everything I have . I can't think about money . To think about money is a sin . It makes me greedy , all kinds of things . And physicians and other leaders in healthcare , right the provider side , took their eye off the economics and said no , let the CEOs , let the business people , let them handle this stuff .

And at the end of the day , the people who suffer are the physicians and the patients . And it starts with the fact that physicians let control the reins go and said we can't talk about money , money , money , money .

And I've worked in healthcare contracts and doing healthcare , new hire contracts and I can tell you the statistics on the percentage of people most new hires as positions don't read the totality of their healthcare contract .

They don't know the ins and outs of their payments , they just know here's the bottom line , what I'm going to get and here are my basic benefits , and they don't understand the economics on the other side of it , to actually know what their true number is . And so a lot of new grads come out and they make way less than what they anticipated .

They didn't understand magnifiers , multipliers , deductors , they didn't understand all these matrices and revenue sharing . They didn't understand all these things . They get terribly screwed . And so it's so important , as young people , learn this and learn this .

Take this to mind as young people , money matters because money motivates and if you can have a handle on the money , you can see what's motivating people and you can change their motivation by moving that money around . But you got to have control of the money and for patients , we have to pay closer attention to where our money's actually going .

What is our premium , what is our deductible , where's our coinsurance , where's the money going and how much money am I getting back ? And we have to fight for that money and recognize no , it's not the insurance company's money , it's my gosh darn money and they stole it and they better give it back to me and pay for some gosh darn services around here .

Does everybody understand ? We have to pay attention . People have to be held account In our healthcare system . We got to stop acting like physicians are greedy . We got to stop acting like doctors . All we want to do is stack cash and do nothing . It's not a true sentiment .

And for you guys , as young people recognize , you're not a bad person to talk about the economics . And as someone who grew up without money , I can tell you not having money is not a good situation .

And as someone who's moved both on the business side of healthcare and on the provider side of healthcare , if we don't get the money situation fixed , we can't fix the care situation . Because that's the major hurdle , the major obstacle to providing effective patient care , patient-centric , high-level care , is the money . And who controls the money in healthcare y'all ?

Is it clear Health insurance companies ? Is it clear ? Health insurance companies ? So this is the basics . We're going to level up and go up a notch next time and we're going to go up another notch and we're going to talk about all the specifics . We're going to talk about why health care costs keep rising .

We're going to talk about the complex premiums paradox . We're going to talk about , right , all of the things that go in Pharmaceutical drugs . We're going to talk about what's happening in medical training , in the economics of medical training . We're going to talk about why doctors are struggling .

We're going to talk about the hospital , economics and what the hospital is doing and that side .

We're going to talk about all of this so that you guys can have an understanding of what is happening in healthcare , so you guys can be the future leaders to make the change , to make it patient-centric again , to make it physician-friendly again , so that physicians want to practice and over half of them aren't burnt out , wanting to quit , looking for other

opportunities because they know it's killing them slowly . And we're going to talk about , ultimately , what needs to change and how we're going to do it y'all , because it's always about action . Here you come to this channel . Yes , information , yes , but it's about the action . But we try to be informed . We don't see that information .

We are informed , we are aware , we know what's going on , we know the key things behind it , the background , and now we can take action to make things change . So we're going to talk about this . I hope you guys enjoyed this . If you've enjoyed this , take a second . Like this video right now . Take a second Comment .

Let that I didn't think about before me , that I couldn't see what was happening Right that now you've provided some clarity and some depth . You took the time . You didn't give me a 10-second reel .

You took the time to give me 43 minutes in part one of what is a multi-part series to really help me understand what is happening in healthcare and why people are sicker , both on the patient side and on the provider side , while insurance companies make record gosh darn profits every year . It is sickening .

It is a scam , I agree , but we have to be aware , otherwise we're going to fall victim to the same scam over and over again . Guys , I'm out of here . I'll see you guys . Keep a lookout . If you aren't already , subscribe to my channel , turn on live notifications so that way you know when I schedule this next live and you're ready to get it .

I'm going to have interviews , I'm going to have experts on here Because , again , it's not about opinion y'all , it's about facts , and what the facts tell us my opinion is is what I know . These are the facts of the case , right ? The truth , all right y'all . So thank you . I'm glad you guys enjoyed this . Let's hit the outro . Let's get about it y'all .

See you guys very , very soon , later .

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