Jason Hartman hosts Dr. Cynthia Fisher of Patient Rights Advocate. They discuss medical care and the problem of hospital pricing transparency. They look at the consequences of pricing transparency and the difference in rates based on cash pricing versus insurance pricing. They look at how to Coronavirus has affected this aspect of insurance. They end the discussion as to whether or not hospitals have benefited or have been hurt as a result of the pandemic.
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Welcome to the holistic survival show with Jason Hartman. The economic storm brewing around the world is set to spill into all aspects of our lives. Are you prepared? Where are you going to turn for the critical life skills necessary to survive and prosper? The holistic survival show is your family’s insurance for a better life. Jason will teach you to think independently to understand threats and how to create the ultimate action plan. sudden change or worst case scenario. You’ll be ready. Welcome to ballistic survival, your key resource for protecting the people, places and profits you care about in uncertain times. Ladies and gentlemen, your host Jason Hartman
Jason Hartman 1:00
It’s my pleasure to welcome Cynthia Fisher. She is founder and chairman of patient rights advocate otherwise known as pra. She’s a life sciences entrepreneur. She’s founded a couple of other ventures, including via cord, which is a umbilical cord, blood stem cell banking service, and a cellular medicine company called via cell. Cynthia, welcome. How are you? I’m fine.
Dr. Cynthia Fisher 1:23
It’s a pleasure to be here. It’s good to have you. Where are you located? I’m in Boston, Massachusetts. Fantastic.
Jason Hartman 1:29
Well, I love that it seems like Finally, hospital pricing might actually become more and more transparent. Now. Trump did an executive order on that recently. I remember seeing that in the news. And but the process is not complete yet. Like I mean, if I go to a hospital’s website right now, am I going to see their prices like I should, like I do for pretty much everything else in my life. I can see the price before Right decided to become a customer. But somehow in medicine, it’s murky. Why there’s no reason for that.
Dr. Cynthia Fisher 2:06
You are so right about that, Jason. And nowhere in any other marketplace is the American consumer blindfolded to not see a price before we get care like we are in healthcare. And what’s even more legal
Jason Hartman 2:22
that way too. But that’s another discussion.
Dr. Cynthia Fisher 2:28
The other thing about healthcare is not only do we not get to see the price today, but on top of it, we get blindsided by prices, we never knew we’d have to pay right, and then finish that off with having to pay with a blank cheque, whatever the hospital chooses to charge us, and then we have no recourse because we never got to see the price in the first place. But like you said, in any other industry, we see the prices and we get to benefit from competition and we get to be empowered with our own choice. To purchase things we can afford, and the same thing can apply to healthcare. And so, yes, the President and the Trump administration did do an executive order and a hospital rule to make hospitals in January of 2021 have to show their real cash prices along with the negotiated rates. So the good news is they also have an insurance rule. So that can you imagine that we could actually see what our insurance company negotiated compared to other insurance companies and whether they’re giving us a good deal or not. So when we the consumer are empowered with insurance companies and hospitals having to show the real prices, that changes the game that
Jason Hartman 3:40
you you know, just out of curiosity, what’s the better price gonna be? Maybe it’s not always this way, but usually, is it gonna be the cash price or the price your insurance company’s paying?
Dr. Cynthia Fisher 3:51
Great question. Well, Dr. Larry Van Horne of Vanderbilt and economist looked at that very question and looked at historic claims data across the country to find out was a cash price better or was a negotiated rate better. And guess what he found? He found that cash prices if you pay directly to that care provider at a cash price those cash prices in general are 39% cheaper lower than the negotiated rates the best cost conscious company
Jason Hartman 4:27
is getting taken for a ride them. Now that surprised me. You know, I remember years ago I used to have a girlfriend that was a contract negotiator for an old insurance company I haven’t heard of in years but FHP was the name of them. And you know, that’s what she do you think that the pros would go in and negotiate great deals, but then again, the hospital has so much work, paperwork compliance work to deal with all of the insurance crap, I can see why they’d want to charge more frankly, but what do you say? Do that.
Dr. Cynthia Fisher 5:00
Well, what I say to that is, it’s not really the insurance company benefiting because the big insurance companies actually are getting us pain in advance out of our paychecks. Right. So we automatically get on average 30% of our paycheck are we pay 30% of health care, our employer pays 70%. And we’re paying for that coverage in advance of any care, right? That goes straight to the insurance companies. The people that really pay for health care are us, it’s we the American people, the consumer, the patient, the worker, and the employer. Well, and the taxpayer we get Yeah, I know what you mean. And and I think the real issue is that the the insurers negotiate a rate and then they provide that to our employer coverage, right. 180 1 million people are covered. And the real issue is the only way we can lower the cost of those negotiated rates, or lower the cost of the cash rates even more is to see the prices. And the best thing is, Jason, we are at a moment in time that’s unique and special. Right? We are in this cobit crisis where people’s lives have been devastated by being now many are unemployed, and many are worried about where do they get their next paycheck? Where do they get the next food on their table and money in their pocket. And in this time, healthcare, our broken healthcare system, and this health crisis has had a devastating effect on our economy. And yet, we’re going into one more stimulus as taxpayers that Congress is looking to add one more boost to our economy to get us
Jason Hartman 6:42
back to this next one. But go ahead. We’ve got Yeah. And so so this is a chance to use, you know, wrongly a credit wrongly credited to rahm emanuel. It’s Winston Churchill’s quote, which is, don’t let a good crisis. Thank you. And rahm emanuel doesn’t deserve credit. Okay. And so what we can do here you were telling me off air is pretty cool, right? Tell us what opportunity we have here to really fix the system with his next stimulus package.
Dr. Cynthia Fisher 7:17
Yes, in this next round of stimulus, it is absolutely critical to protect patients, employers and taxpayers. by insisting that health care price transparency is part of the COVID package. Simply what Congress can do is they can call defy the Trump administration rules, making healthcare prices transient and that empowers us the consumer to be able to shop and then we can shop for the best quality of care at the lowest price and bend down the curve of these runaway health care costs. Stop it, put it in reverse and benefit by reducing the cost Both carrying coverage. Mm hmm.
Jason Hartman 8:02
Okay, so I don’t know if you clearly answered the question, Cynthia that I asked at the beginning, maybe you did. So forgive me if you did. But we’re not all the way there on this transparency, right. distinguish that for us, like the prices? Are they posted on the hospital’s websites now that the law, the executive order?
Dr. Cynthia Fisher 8:21
Well, right now, the hospitals post a funny number, it’s called the charge master rate. You know, it’s not a real number
Jason Hartman 8:27
rate. What does that mean?
Dr. Cynthia Fisher 8:28
Yeah, it’s a very high rate. It’s not the negotiated rate. It’s not the cash rate. It’s a very high rate that isn’t a real number, and what we need, and that was required by health and human services to start posting their rates, and that’s the number they posted. What we really need them to do is post the real prices. What is the real cash price? What are the negotiated rates for that MRI, if I’m going to go get an MRI, what is it Okay, so this is this is
Jason Hartman 8:57
what you want to be in the next stimulus. Bill, do you want to? Okay,
Dr. Cynthia Fisher 9:02
absolutely. And we’re at this moment in time, like you said, Do not let’s not let a good crisis go to waste. These rules have already been baked. They’re already done. And all we need to do is make them permanent by putting them into law. And so if you think about it, it is next round of stimulus send nearly needs to say. We want to codify the rules for making hospitals and insurers reveal the real prices, and then negotiate rates before we get care so that the American consumer can be in control. And guess what Jason 88% of all American voters in the Harvard Harris Poll of last year, said they support these government mandates to know prices before we get care. And that in the last stimulus, the hospitals got over 200 Almost $200 billion. And now in this next stimulus, they’ve asked for 100 billion more, with no accountability, no oversight, no transparency. Well, you know, what will be the taxpayer are paying those hundreds of billions and trillions of dollars to our economy, to help bring it back, but to the healthcare system, in exchange for what the hospitals have gotten, and they want more. All we need to do is in this next stimulus, say give us we the people the American public, the right to see prices.
Jason Hartman 10:37
Why is the Executive Order inadequate? Why do we need another late another thing here? What went?
Dr. Cynthia Fisher 10:43
Well, guess what, guess what happened after the administration released its final rule making the hospital show what else? It’s the
Jason Hartman 10:51
American way litigation.
Dr. Cynthia Fisher 10:55
And actually, the hearing was just a couple of weeks ago, where we’re waiting for the judge. To come out with the verdict, but there’s they sued using the first amendment to say, wait a minute, we have the right as hospitals and insurance companies to have our gag orders and our secret hidden prices as part of our freedom of speech. It’s like an
Jason Hartman 11:17
amendment in reverse. That’s kind of funny. I would use, it seems like they should use the Fifth Amendment. They have the right not to incriminate themselves. Well, in fact, they even argue that prices will go up because they’ll collude if they see each other’s prices. But guess what, you know, that’s a ridiculous argument. Because we know as consumers in any market where we get to choose and shop, we can drive down the cost at a price we can afford and the prices that they would it would make it they will all want to beat each other’s prices. That’s the way the free market works. God bless it. And so if they post on prices, their competitors are going to look on their website and see hey, if you wanna hurt transplant and you go to that hospital we gotta beat them by $1 we gotta have a better view.
Dr. Cynthia Fisher 12:09
Exactly and we have actual empirical evidence where Physicians and Surgeons that have left the opaque world and wanted to do honest pricing that a guaranteed price like OSS, surgical in York, Pennsylvania or Texas free market or Oklahoma surgical, they post their prices online, you can get a knee replacement for 15,000 and then that’s stood they stand behind that price and I don’t know PE hospital system an hour away charges 75,000 that’s a huge difference
Jason Hartman 12:40
in complete absurdity but but you know, you’re gonna mess up your knee by going so far to get there so that’s why anyway
Dr. Cynthia Fisher 12:48
well, you know, the beauty is But wait, wait when we have free market though, Jason, you you’re a financial guy. You know that if we know from Oklahoma surgical, they’ve told us already a woman Georgia says I can get a procedure for a guaranteed price of 4000 a year center. I was told set 40,000 in in Georgia. Well, she used their online price to negotiate in Georgia. So she didn’t have to travel travel. She got to use it as negotiating leverage. And then we also expose, we know that they’re, they’re wrong with their argument that prices will go up. Because not only from the actual evidence of this happening in a small way in the marketplace today, but more broadly, we know that from the cache data that I told you about earlier, Larry Van Horne, that prices go down and when employers are able to direct contract with these price transparent surgeons and, and physicians, they’ve saved 30 to 50% on their health care coverage for all their employees, and they add the money back into the employee wages. This is an economic stimulus. It’s better
Jason Hartman 13:54
it’s better for everybody. You don’t have to convince us Cynthia, I mean, my audience stands the free market and They are for it. I want to switch gears for a moment, though. Let’s talk about COVID-19 for a moment. Okay, so how badly have the hospitals been hurt by this? Or have they we’ve all heard the stories about them misclassifying the deaths intentionally, you know, if someone was already going to die of diabetes, heart disease, lung cancer, whatever, but they happen to have a positive covid test, you know, they call it COVID-19 was the cause of death, which it wasn’t. And it seems to me that that would you know, the old concept is, and it’s true throughout every area of human life. And it’s so simple. What gets rewarded, gets repeated, what gets rewarded is repeated. So when the federal government came out and said, Look, we will just pay for anybody if they have COVID. Right, you know, and so, of course, the hospitals have a complete incentive to have everybody have COVID because they know The feds will just print the money to pay for it instead of having to do insurance work or go to collections to try to collect from the patient. So of course, they’re going to say it’s COVID. Right? I mean, that seems obvious, isn’t it?
Dr. Cynthia Fisher 15:14
Well, we’ve actually to your point, and actually had complaints come into email addresses and we’ve been contacted by patients that have been misdiagnosed and misclassified as covid. In fact, one had emphysema. And he went to the hospital, in his whole treatment in the emergency department, where he’s gone for treatments in the past with emphysema, his comparative prices from past visits where he’s had and struggled, same treatments were around 20 $500 but what he found instead is he got a $13,000 bill for suspected treatment for his COPD as as suspected covid so they added nearly over 10,000 more,
Jason Hartman 15:58
okay, so it is My question is, have the hospitals been hurt by COVID-19? Or have they used it as an excuse to just just just steal from the government?
Dr. Cynthia Fisher 16:10
Well, it goes, I, you know, to your point, I think it works both ways. One is, on one hand without transparency, without seeing prices, without transparency of and validation that there really was COVID. Right. Testing is now now more prevalent, and we should actually have confirmatory, whether or not they could build for COVID. Right, not just quote unquote, suspect COVID. So you’re right. And I would say without that transparency without that accountability without the prices, then the government will be continued to be gamed, and patients are being gamed. So I’ll give you another example. We had another patient come to us who just got tested. She went to a tent outside an emergency room. And you know what her price was? She got billed by the hospital The government said they’re going to cover the test. Well, the government’s covering the test for 35 to $100 in the range depending on the test, the story logic blood stick test, but she got $6,000 of charges. When another patient here in the Massachusetts area went to a direct primary care doctor tested for $75 all in how do you have $75 versus 6000. So until we have transparency and we know what that protocol is, it should be expected these hospitals are going to gain and defraud the system and transparency will provide that but let me give you something else is okay. So but all
Jason Hartman 17:37
the way we can open we can or the winning or losing with COVID.
Dr. Cynthia Fisher 17:42
I’m curious if somebody gave if somebody gave you as a hospital, hundreds of billion $200 billion so far. Okay. That’s just for a couple of months of having a downturn over a couple of months, right. That’s 200 billion they want another hundred billion and a half handout and bailout. So I think they’re pretty much ahead of the curve on that. Plus they’re out fundraising have, you know, in every other email seems to be a fundraiser for a hospital, on top of what they’ve gotten from the government. But where they are hurting and I will give the hospital’s credit is one, you know, we have to be thankful for the physicians and the nurses on the front line that are putting their lives on the line in treating copan. What we’re learning as an organization is the COVID rates are really down. Most of the hospitals, the majority of hospitals in this country haven’t even seen COVID case. And where they’re hurting is that people are scared to go the hospital. They’re in fear of potentially getting coated and they’re staying and they’ve canceled the elective surgeries and they’ve cancelled general care. So that’s depleted their their income but I’d say the government bailout hasn’t well accounted for that. So they shouldn’t be complaining because they’ve gotten this bailout. But moving forward, the only way we As the American public can trust it is they assure us that there’s segregation on those who want to be need to be treated or tested for covid. And that we can go to a safe area for elective care. But more importantly, that our finances are safe from financial ruin from being price gouged or fraudulently billed as consumers. And the only way we can do that is back to COVID. phase four stimulus is getting to price transparency and empowering us by making Congress act to codify the Trump administration rules, giving us the power to shop and who we can
Jason Hartman 19:41
who could ever deny except the people who are profiting from it. That price transparency is not a good thing. Of course, it’s a great thing. So let’s hope that that happens. Cynthia, thank you for your hard work on this. give out your website.
Dr. Cynthia Fisher 19:55
Well, let me just ask one more thing, Jason. Is that for any of your listeners, snares, who are obviously they’re so financially astute and, and have a voice in this country to use their voice now in this moment of time and they can go to our website at patient rights advocate.org and go and click on the ability to communicate to their congressman and their senators, it will automatically go based on their zip code, and right in their own words, that they support price transparency, and they want it in the face for stimulus.
Jason Hartman 20:27
So where do they go? They go.
Dr. Cynthia Fisher 20:31
They go to patient rights advocate.org patient rights advocate.org patient is
Jason Hartman 20:39
still on our web rights is plural, right? An advocate is singular. Patients patient rights advocate.org, right?
Dr. Cynthia Fisher 20:49
Correct. And then they can go to our website and easily click on a button which will automatically send their words to their senators and their congressmen. Based on where they live and their zip code. That’s fantastic.
Jason Hartman 21:01
Good. So they don’t even have to figure out who their senators and congressmen are. So that’s, that’s excellent. Good, everybody. Please do that. Cynthia, thank you so much for joining us.
Dr. Cynthia Fisher 21:12
Thank you, Jason. It’s a pleasure. And thank you for all you do to help us as American people, you know, get the best health care at the right price. Absolutely.
Jason Hartman 21:26
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