Thank you for joining me today. It is a delight i thoroughly enjoyed your book. It is a timely subject as you may know im a pharmacist the only one serving in congress is also important that everyone would agree with that. And i find it interesting that you start the premise that the Health Care System is broken. Almost 70 percent of america say it is broken. I do think it will be a domestic policy issue in the next president ial election in a recent poll that said 35 percent rate healthcare as extremely important and 53 percent of americans support a singlepayer now 65 percent supports the Government Insurance plan and i call that the steppingstone approach to medicare for all. The proof is in the pudding if you look at what happened the last election cycle two years ago, my party, one year ago, the Republican Party we were ousted as a Majority Party in the reason was healthcare that many of us campaigned on repeal and replace unfortunately we came close but did not get that done and that showed up at the ballot box. Exactly. It is unfortunate because donald trump won the presidency you had a house in the senate we word repeal and replace but it is a disaster turning the whole Health Care System upside down. But definitely we will see healthcare be out there and the issue we have to do that as a Cohesive Strategy to educate on why thats important we have a marketbased Health Care System and not controlled by governmen government. Host lets talk about obama care. The forward was written by senator coburn and he said the Affordable Care act has failed to deliver on its promises five years going into full effect market has risen 75 percent lower and middle income people have been forced into plans with deductible is 12000 what is your opinion . It will turn ten on march 23d i just cannot believe i thought for sure it would have been overturned in the Supreme Court in 2012 and 2015 but it was not. Senator coburn is right the American People do not like obama care because of high premiums, high deductibles Small Network of doctors and hospitals those that bought the platinum or gold plan thought they could keep their doctrine healthcare would be fantastic but unfortunately they said so it is overturned in the Health Care System. But most had options for medicaid and other looking at 4 Million People some who are ill legal could not get on obama care and not where the government is mandating and then to limit the choices. And it did take choice out of healthcare. We want a system to empower doctors and patients not federal or state government. So we thought we would be repeal and replace that obama care. And then republicans made a mistake what would happen with preexisting conditions that that would be a disaster and those that have employersponsored insurance with chronic conditions with the individual market, those of the people that we talked a lot about the federal government giving money to the states to set up the high risk pool so those people to get really good coverage they could afford for those that came out against the mandate and paid the penalty and three or 400 a month and then to pay the individual mandate rather them by health coverage. And i have to agree i love my party in support my party. We have to do a better job of that. But coming in with one vote of the senate are passing but they were never able to articulate that. As a former canadian for us to educate the American People with a full takeover leads to ration care long waiting list and people like senator sanders or senator warren say its free but it is not the average canadian family pays 13311 per year in hidden taxes for a system that denies them care. Host go into the premise of your book of medicare for all as you describe it is the shiny new toy that democrats have grabbed hold of and as we quite often say in politics , perception is reality. For a lot of people we have perceived this to be the answer. Exactly medicare for all with Bernie Sanders that is part of his platform for many years but it didnt come into the four until 2016 when he was running against Hillary Clinton for the democratic nomination. He was really on the stomp for medicare for all then with a singlepayer bill 2019 cosponsored by cory booker and Elizabeth Warren and the people that were in that race. So he told the American People we need the government to run the Healthcare System with universal coverage and of course it wont cost very much and everybody will have access to the very best care we can talk how much a singlepayer system really cost in america what it means for doctors and long waiting list where i am from or uk is the National Health service. Senator sanders is just adamant for singlepayer and i find it amazing and im sure you do he is at 30 percent in the iowa caucus one of the top candidates in New Hampshire and this week the number one candidate in california. But i was amazed in particular young people really buy into then whats better than free healthcare . It sounds like a great idea until you unravel the union. That should be interesting. Talk about a contrast of donald trump and Bernie Sanders. So the support is since you have first pointed out running against Hillary Clinton that in 2000 and continue to grow the support at 40 percent in 2019. That eliminates private Health Insurance. With urines on employersponsored coverage so when we see in the polls 59 percent or 53 percent support medicare for all but then if you say if you are going to lose your private insurance the number drops down at 37 percent. How do you feel about medicare for all of taxes go up . Support goes down its also 37 percent the American People dont understand what medicare for all means. It sounds great and it is great and then to keep their employersponsored coverage. Those that have it rated as excellent or good. Elizabeth warren says ive never met a person in my life who likes their Health Insurance. Who was she talking to . I like mine. So these are lies to the American People if no one likes it then why wouldnt we have a takeover . Host i have always noted that the people on medicare now generally has positive connotations however if you add everybody into it. Right look at medicare today from 1955 from the Great Society we are spending 700 billion per year on medicare and part a could be bankrupt by 2030 upwards of 50 percent of people now have Medicare Advantage are supplemental because one out of three doctors are not taking new medicare patients because they are reimbursed at 40 percent below what they get with private coverage. Thats a very important statistic. So just think about medical doctors if they take 40 percent below what they are paid today they will quit and retire and the bigger point is traditionally with the government to determine that they can practice you may be the very best Orthopedic Surgeon and what happens in november we would just have to go on vacation. What about these other plans that are more moderate Solutions Like adding a public option or allowing more patients to buy into medicare and medicaid . How does that impact the Health Care System . 65 percent pulled support the public option Kamala Harris who said she could be the candidate but her candidacy dropped because of her waffling on medicare for all she supported it one day then the next day she didnt so she law support and senator warren of course up until very recently was a big supporter of pro government takeover now she says the first 100 days i would introduce a public option the third year i would bring medicare for all because all those people with a public option that is the Government Insurance plan and exchange of private coverage that they would want to be in medicare for all. Thats a complete lie and we know that talking to people but senator warren and joe biden and Pete Buttigieg devil switched one have all switched. Even mayor pete says he supports a public option if it doesnt work after a couple of years then he would go to medicare for all. Host talk about medicare for all. It isnt somewhat it really should be called what it is of a one size fits all government Health Care System. But other than the International Debate you cant see a specialist without be a referral and then he interrupted me and said sorry the singlepayer system in this country and it is terrific he said the Veterans Administration. And the fact that our vets have top care to the latest drugs and biologics are available so the American People understand that it is a disaster is that what we want . For people that are skittish and then to have a public option. And just recently when i had my check up to say i lose a month a lot of money and i have to make my salary but i get really good care. Talk about the sanders plan. But i know. But they were destroyed medicare as we know it. And that they would be into a new government run Healthcare System. So chairman of medicare for all is pushing to tell the American People she is from washington state. But senator sanders say medicare and medicaid would be eliminated but the only two programs left and then the second is the Veterans Administration and then when asked what would happen to the people that work in the Insurance Industry . And Elizabeth Warren when confronted said what will they do and she said work in the auto or life Insurance Industry there is no comparison with Health Insurance versus Auto Insurance and then Bernie Sanders to say i will set up a federal Training Program to inside to have a new career and that it would be incredibly expensive. Medicare for all for bids doctors that participate that with any service the government covers. And then to say i lose money on medicaid. If you take that away what does that mean to salaries of healthcare workers . People that work in hospitals. With a tremendous impact on the ability to keep your job it also means a federal government takes it over. And maybe 1 Million People that government has to expand tremendously and with a whole new bureaucracy and the up and to me a on dash to say i find it amazing American People will think its so wonderful. Do you know how long it takes the government to pay me when i go on vacation . It will be a disaster for people who work in hospitals. And under a singlepayer government system. And to travel many many miles and those to get the latest treatments. Host you are from canada you mentioned that. Being a canadian native you have seen government run healthcare. They fully took over the Healthcare System 1984. No private coverage is allowed for anything considered medically necessary. Cosmetic surgery, lasix surgery for your eyes the government is not involve the prices have gone down so in canada i look at the institute where we started a project 1988 and on 1993 the first year the average wait time to see a primary care doctor to go to the gp who refers if it is necessary in 1993 it was nine. Three weeks. Last year increased at 20. Nine weeks thats five months. And those that cross the border every month to pay outofpocket to get the mri or the ct scan or hip replacement or how her heart valve. And canadians have the escape valve but where will we go . Like doctor tom price say we will have to go offshore to continue to get the very best in medicine. And say i hope youre not becoming the inpatient american but to say that im sorry you cannot get an appointment or get a colonoscopy. Canadian say that will be nice. But for a lot of people they dont know any different. Most people going up or under singlepayer that happened slowly and then it fell in with 1984. Thats we talk about sanders and proposals. Thats what they have in canada. There is no private coverage for anything considered medically necessary. You can get private insurance and what they pay would never cover any of the cost. And then to have private room and a hospital, an ambulance and over five weeks weight and for the three weeks for every 1 Million People 16 mri machines versus 44 in the us. But bernie was to have free eye care, dental care, drugs, longterm care. So 30 or 40 trillion over ten years with bernies plan and even he agreed that would be the price. So now he has backed away from that and then would go up 20 trillion over ten years. And under a liberal Prime Minister to find out they cant afford to do it. And no referral to a specialist. Because the demand for healthcare will far exceed the supply that can be given. Thats why it is at 30 your federal trillion that is probably on the low side. Host two of the most prominent examples from canada and uk. You still have the big outofpocket expense as well as denmark and finland and norway there are outofpocket expenses you have responsibility for. With a true singlepayer Health Care System. The United Kingdom has universal coverage the nhs started in 1971. It covers about 90 percent of brits. And those that have private coverage. But this is becoming more popular because just in december there were 4 million brits on a waiting list to get treatment and the Cancer Treatment should not be delayed more than 62 days they have not met that standard for over five years and more important under the who study brits are at the bottom of the wrong the most industrialized country of all cancer rates for survival that tells you about Life Expectancy with cancer under a government controlled system. You mentioned this is a big concern how much will this cost . 32 trillion over ten years . Trillion . Not million or billion they said that would include with a reduced administrative cost but that would be the increase of federal spending the total cost is somewhere 50 or 60 trillion over ten years and it wont to be free, taxes have to go up sanders has said the new income tax on anyone earning over 29000 thats very low income in this country and what had a lot of people seven. Five payroll tax Elizabeth Warren said it isnt paid by middleclass people her plan would not increase taxes anyone on the middle class but people pay the employer tax are the employees and they are middleclass. And the not tax on the wealthy and large Financial Institutions but if you doubled all the Corporate Income taxes and income taxes would it be enough to cover the plan so they would go up even further and it wont be free because you are facing these taxes. If you cant have your care rationed that is just the domino effect. And Prescription Drug pricing. And those proposals by the other side for Prescription Drugs and our concern to stifle innovatio innovation. I have seen nothing short of miracles and that is phenomenal. But there are other things that we can do with price controls do you see that stifling innovation . Not into research and development . We are totally stifled. Biologics and bio similars it is not in germany or england all of the countries do their r d in this country. All have price control and then to develop new drugs they dont make it through the system with 3 billion and to get it to market. So the innovator and incubator for all innovation if you think of Cancer Therapy and what is coming out for muscular dystrophy and alzheimers very few of the drugs going to trial make it. So we want to keep the pipeline in this country open those that manufactured them in canada people say they are cheaper but they have price controls but what people dont understand the prices review board and if they decide the latest new drug to treat muscular dystrophy but if nancy pelosi and her crew get that through the senate this would be a disaster for all of us who depend on the innovations so to save 7. 17 if you had a gallbladder situation you would have to have that removed the cost of that is the anesthetic now hospital costs are reduced as well. Host absolutely hepatitis c. When i came out of school in 1980 you would get liver cancer and that was a death sentence. But now we can cure that with a pill. People say that pill is 85000 but it does do the cure if a liver transplant is 500,000 in many you cannot get liver that can match so it is very inexpensive and you get rid of the hepatitis c. We have an alternative it was much better with no price controls so with those price controls to exist between eight through 1