Healthcare | The Complete Moderate's Guide

A fake Youtube chef cut his hand in the kitchen… this is what happened to his wallet KB is a 25… ish year old Youtuber, presenting to the emergency room – which was a huge financial mistake This video was brought to you by CuriosityStream My original plan for this video was to take that scenario through multiple different healthcare paths to show you all the options and costs I very quickly realized that wasn’t going to work Even if I had done that, those numbers would have been completely meaningless to you because of how healthcare works in our country It’s not like ordering a Big Mac The numbers I would’ve given you would only apply to other 25-ish year old men living in [HARM TO ONGOING MATTER], it’s very unlikely that it would be relevant to you So there’s really no point in digging up those numbers Especially since the cost of a procedure not only varies widely within the same city, but sometimes on the same block A few stitches can cost anywhere from $200 to $3000 I picked stitches because it’s pretty universal, there is no gender, or race, or even class, that is more prone to needing stitches I’ve personally needed stitches at least five times that I can remember The obvious explanation for that wide range is where on the body were you injured? Stitches on your shin are going to be easier and cheaper than stitches on your eye Except… no, some people pay less for eye stitches And these price ranges exist across the board for all procedures, if you walk into a medical facility with a burst appendix, it’s going to cost you anywhere from $1500 to $180,000 I somehow doubt that one appendectomy could be 120 times better than another Some cases are complicated and require extra imaging or post-operative care, the point is, you don’t know that beforehand When you get the bill, it could be anywhere in this range So rather than just shouting numbers at you and laughing about how ridiculous things can cost, I want to explain why that range exists Many of you likely know parts of the answer already The most obvious being that urgent care is almost always cheaper than emergency care Both with and without insurance Urgent cares are a relatively new concept in the US and provide a cheaper alternative for non-life-threatening emergencies Like stitches Let me be clear, when in doubt, go to the emergency room, you will never be turned away, but if you walk into an urgent care with something more serious, they might send you to the ER, possibly delaying lifesaving treatment But odds are that if you only need four stitches, it probably isn’t going to kill you any time soon Emergency rooms cost so much more because of the infrastructure and overhead required to keep a large hospital running But also because of more nefarious reasons 70% of hospitals in the United States are privately operated but not run for profit, which is surprising to most Americans Insurance companies, on the other hand, are only run for profit So in order to attract more customers, insurance companies have to offer better deals Which is somewhat difficult when a hospital is non-for-profit Usually, if you’re not making a profit, it means your prices are already as low as they can be Enter the hospital chargemaster That’s not a chargemaster Pretend Every hospital in America has a list of prices for every good and service they provide, which until this year, was kept hidden from the public Which is a huge problem in a capitalist system You can’t really make an informed economic decision if there is no price transparency or easy way to compare different costs Not that you would ever shop around during an emergency anyway So the insurance companies went to the hospitals – Side note, in some cases, the insurance companies own the hospital outright, and while the hospital is a non-profit… they aren’t – and said “hey, you’re currently charging your customers $200 for this service, why don’t you increase your chargemaster price to $250, but still only charge our customers $200, that way we can tell them we’re getting them a discount.” This should sound familiar to anyone who has ever shopped on Black Friday Repeat that for every procedure or medication, nationwide, and you have the first piece of the puzzle When figuring out the cost of healthcare in the US, you have to look at multiple variables, we’ll add to this list as we go, but we can start with the base cost The price of materials, labor, facilities, and sometimes including those blue light chargemaster rollbacks As we’ve seen, this base cost can range from three to six digits depending on where you go Which is the second variable – location Not only are we talking about state or city, but street Add in provider type – are you going to an emergency room, urgent care, or just your doctor – and you have even more variation Since we’re only five minutes in, you probably figured out that this list isn’t even close to complete An unfortunate reality of our system is that it also matters who you are The Affordable Care Act made it illegal for hospitals and insurance companies to charge

you differently based on your previous medical history, but they can still charge you differently for basically any other reason – including gender and perhaps most obviously, your age For example, stitches on an infant are objectively more difficult and therefore more expensive Bet that wasn’t the direction you expected me to take the ageism argument Procedures aside, age is one of the biggest factors that contribute to the cost of health insurance Alright non-Americans, get your laughs out of the way now [Laughs in Foreigner] Health insurance started as a sort of membership program, known as Health Assurance, you paid a fixed amount every month and any medical costs you incur were on them Your health was assured It didn’t take them very long to figure out the formula for success Obvious abuses aside, that simple just model wasn’t sustainable So over time, they have shifted more of the cost of actually using medical services onto the consumer, called it Insurance, and made the system so complicated that most Americans don’t even bother trying to understand it Lucky for you… I’m not doing anything, I’ve got time The health insurance industry didn’t really take off until World War 2, along with rationing fuel and rubber, prices and wages were also fixed by the government So companies had to get creative to attract talent The most popular way was to offer benefits on top of your salary, like paid vacation, housing, or health insurance Today, 60% of Americans get their health insurance through their employer This is thanks, in part to ObamaCare, officially known as the Affordable Care Act or ACA, which made it so that any company with at least 50 employees has to offer health insurance Though “offer” is a bit of a loose term Which is yet another factor – how much your employer offers to contribute Your insurance premium might be $500 a month, but your employer might only pay half of it… or none of it In order to discuss how insurance actually works, let’s take a look at something a little more simple – car insurance In most states, if you own a car, you are also required to have car insurance The more people who are paying into insurance, the lower the cost for everyone – most people accept this reality when it comes to car insurance But not health insurance, for some reason The Affordable Care Act did a lot of good things, like mostly getting rid of pre-existing conditions, allowing you to remain on your parents’ insurance until you’re 26, and a bunch of other stuff we’ll get to later But it also required everyone to have health insurance, through the Individual Mandate The hope being that the more people who have insurance, the cheaper it will be for everyone, just like car insurance But the mandate was just repealed so, never mind, I guess Everyone with insurance pays a premium, this is like your membership fee and you pay this regardless of whether or not you actually use it If your premium is $100 a month and you never get into an accident, that $1200 a year is simply gone Because of this, a lot of people think of insurance as a bit of a scam – If I didn’t use it, I should get it back or something This is what I’m going to call Stage Zero – you pay your premiums, you don’t use it, and nothing happens Rinse and repeat, every year There are two tiers of car insurance, the lowest being Liability, which only pays out if you are at fault in an accident, and Comprehensive, which pays for any damage to your vehicle, whether it be a collision or an act of god But once you actually have an accident, you enter Stage One, when you pay all costs out of pocket until you reach your deductible This is the amount you have to pay before your insurance will contribute For many car insurance plans, the deductible is also your maximum out of pocket – or MOOP Who the hell is Moop? It’s the most you will pay to fix your car in a given year After which, you enter Stage Two, when your insurance pays all remaining costs Sometimes, there is a maximum annual or lifetime benefit, after which you would be on the hook for any remaining costs, but that’s fairly rare So if you get into an accident that costs $15,000, you would only pay up to your deductible, say five hundred dollars, and your insurance company would cover the rest Congratulations, having car insurance probably saved you thousands of dollars But when it comes to health insurance, most people only focus on the cost, if they never go to the doctor they’re just throwing away money every month This is important, so pay attention Not having insurance is only cheaper, if you know that healthcare costs without insurance will be less than your annual premium and your deductible put together Remember, without insurance, you will be paying regular chargemaster prices Some hospitals might be willing to work with you and give you the “discount” price if you’re uninsured, but you can never count on that For our car insurance example, that tipping point would be $1700 If you know that your car repair costs are going to be less than $1700, it’s cheaper to just go without insurance But you literally can’t know that You can’t predict if some if some random tire is going to hit you Just as you can’t predict if you’re going to cut yourself or your appendix is going to burst So let’s say you’re playing it safe, you have health insurance, and something unpredictable happens… Just like car insurance, you started in Stage Zero

You’ve been paying your premiums and have been relatively healthy until now You go to the hospital and you enter Stage One, you are paying everything out of pocket up to your deductible, so far everything is pretty simple But Stage Two is where things become a bit more complicated – this is when you and the insurance company split the costs of your care, through two mechanisms A copay is a flat fee, like $25 every time you go to the doctor That’s just to walk in the door, by the way, if they do anything more than that, it costs extra Usually through coinsurance, which is a percentage rather than a flat fee, so for example, 20% of all outpatient procedures Only copays and coinsurance count towards your MOOP, premiums, prescriptions, and out of network costs, do not Once you hit your maximum, you enter Stage Three – when your insurance company covers all remaining costs The Affordable Care Act prohibits any maximum annual benefit or lifetime limits for health insurance, though they can still exist for dental and other insurance types So Stage Three has no maximum dollar amount, but your MOOP is annual limit that resets each year This is the next variable we’re going to add to our list – When the healthcare cost occurs If your appendix bursts with only one month left to go in the year and you hit your maximum out of pocket, if you still need continuing care the next month – which is also technically the next year – you will have to pay your maximum out of pocket again Effectively doubling the cost of this single event even with insurance There are many different types of health insurance programs, all of which cost different amounts based on what kind of care you want Or more likely, what your employer chose for you The cheapest type is an HMO or Health Maintenance Organization which operates through smaller networks of providers Another very important term and concept Doctors and hospitals sign agreements with insurance companies to be part of their network and see their patients, sometimes at a reduced rate, as I mentioned earlier If you’re on that insurance, you can only see those doctors and hospitals If the doctor or the insurance company decide they don’t want to work together anymore – you don’t get a say If you like your doctor, or health plan, you can keep your doctor He couldn’t legally mandate that your doctor and insurance company continue to work together forever – this is America So now your doctor is out-of-network If you see an out-of-network doctor, you will very likely be on the hook for the entire, non-discounted bill And you might not know it until afterwards It’s not uncommon to go to an in-network hospital and be seen by a prohibitively expensive out-of-network specialist at that hospital HMOs typically have lower premiums up front, but higher out of pocket expenses later Everything is routed through your Primary Care Provider, they make decisions about your health and you can’t see a specialist without a referral or pre-authorization from your insurance company That doctor acts as a gatekeeper for your healthcare… which would make the insurance company the keymaster? The other end of the spectrum is a PPO or Preferred Provider Organization, where you don’t have a primary care provider deciding on what specialists you see or what care you receive The premiums are higher but the out of pocket expenses are lower They typically have a larger network than HMOs and out of network care is significantly cheaper, you don’t need a referral or pre-authorization So it costs more to have more control and more choice in your healthcare That’s how capitalism works right? More choices and competition leads to higher- wait… And then you have all sorts of programs in between Like the Exclusive Provider or EPO, which is similar to a PPO, but out of network costs more and you might need pre-authorization to see a specialist Then there’s Point of Service, which is like an HMO but out of network costs less and nobody abbreviates it It’s a mess and even the definitions I just gave you vary from company to company and state to state But in general, those are your options, yet another variable to add to the list But wouldn’t it be great if we could just cut out the middleman and pay for our own health care? Yeah, or you could- Shut up this is America Some people have the option of getting a High Deductible Health Plan or HDHP, which have extremely low premiums and extremely high out of pocket costs But it unlocks the ability to create a Health Savings Account An HSA is very similar to an IRA retirement account, any money you pay into it is tax free and as long as you only use it to pay for your insane healthcare costs, it doesn’t get taxed on the back end either But wait, it gets better Just like an IRA, you can invest your HSA money, growing it potentially infinitely… which you also don’t have to pay taxes on This is why they call them triple tax shelters If you’re like me, you’re already googling how you can open one of these up, and I’ve got some bad news for you You can only open an HSA if you have an HDHP If you’re on any other form of health insurance, or even no insurance, this option is not available to you And unless you’re perfectly healthy, that’s probably a good thing

The astute amongst you will have noticed that I haven’t given you any numbers for these programs… and there’s a reason for that Not all HMOs and PPOs are created equal Another good thing the Affordable Care Act did was to establish a standardized tier system for health insurance, so people looking on the marketplace can actually price compare and shop around The absolute lowest level is called Catastrophic insurance, these are typically your HDHPs, gamblers who are saving up their money and hoping they never get sick or end up in a car accident That’s about the only thing these plans cover – emergency services In America, all health insurance plans, regardless of type or tier, cover emergency services in- or out-of-network Though once you’re stable you better leave that out-of-network hospital or the bill will give you a heart attack Which just repeats the cycle Catastrophic plans are like only having liability insurance on your car, it really only helps you in the worst of situations, otherwise you’re on your own You also have to be under 30 to get it, which means it doesn’t apply to me anymore so- I mean, it does apply to me for the next five years The four main tiers of the Affordable Care Act are bronze, silver, gold, and platinum The better the metal, the more you pay in monthly premiums, but also, the lower your out of pocket costs when you actually receive care The ACA defines these tiers by the average coinsurance for the plan, they call this the actuarial value For Bronze, the actuarial value is 60%, they pay an average of 60%, and you pay 40% in coinsurance In Platinum, you pay 10% and they pay 90% Again, this is the average, for some services it might be 92% while others might be 85% At the end of the year you might find that you actually paid 11% The actuarial value is the only definition for the tiers – premiums, deductibles, and MOOPs can be all over the place There’s really no way for me to compare a Platinum HMO to a Silver PPO or a Bronze POS Making this another determining factor in your overall healthcare costs But for the sake of an example, let’s just pick one: gold The average monthly premium for a gold-tier plan is $597 a month for an individual and $1252 for a family The beauty of family plans is that it usually costs the same whether its two people or seven If you’re getting a gold plan through your employer, they might be paying for some of it If you got it through the health insurance marketplace,, you might be getting subsidies to help But for our purposes we’re just going to stick to the base cost So, let’s say you need those $3000 stitches An individual gold-plan deductible can range from $1000 to $5000, but the average is $1320 Remember, you pay that much before insurance even kicks in The remaining cost is shared between you and the insurance company at a 20-80 split, only costing you an additional $336 The average individual gold plan MOOP is $5878, so we’re not even coming close to stage three In the end, those $3000 stitches cost only $1656, just over half, wow, it’s a good thing you had insurance… You forgot ab- Son of- yeah, as most people do, I forgot about the premiums On top of the stitches, you paid $7164 in premiums, bringing your total health care costs for the year to $8820 Here’s the same scenario for the average gold family plan As I’ve said, it’s impossible to know whether an uninsured person with the same $3000 injury would fair better financially… But it is possible And while the person writing the $1600 check while paying monthly premiums is going to feel a lot more financially secure than the person cutting $3000 The economic realities of healthcare costs in America don’t care about your feelings Now, I picked gold as an example because it has an actuarial value of 80% Which is the exact same as Medicare Medicare is a socialized health insurance program that covers 59.9 million Americans, most of which are over the age of 65 It is the largest single provider of health insurance in America I briefly covered Medicare and how it’s funded in my video on welfare, along with another program for poor people called Medicaid Medicaid is run at the state-level So while it covers 74 million people, they’re spread across 54 different state and territory programs that all set their own requirements and pay outs A single person in Alabama must make less than $771 a month to qualify for Medicaid The average panhandler makes $25 a day begging for money on the corner – if they’re out there every day this month Maybe take Halloween off, is all I’m trying to say Medicaid benefits depend on your income level, at the lowest you’re paying single digit copays and at the highest, 20% coinsurance Just like Medicare But while Medicaid is a complicated welfare program, Medicare is not

It’s government-subsidized health insurance Every American who works pays into it with a 1.45% FICA tax, which is also matched by your employer If you contribute for ten years, you get full Medicare when you turn 65 Medicare is not free, it’s also not simple – but since it currently covers 20% of all Americans and presumably will cover all of us once we’re old enough, it’s worth looking into I need to start by saying that this is just an overview Most of my audience is several decades away from Medicare, so if you’re currently in the process of enrolling, please speak to a professional, this is just an introduction There are entire channels dedicated to explaining Medicare – we’re just going to scratch the surface Medicare has four parts Part A is for inpatient services like overnight stays at a hospital For the vast majority of people, there are no premiums for Part A. But there is a $1364 deductible and a complicated copay and coinsurance table Medicare Part B is for outpatient services like regular doctor visits This does have a monthly premium for most people, but before I tell you what it is, remember that you’re getting an actuarial value of 80% $135.50 a month – regardless of who you are But we’ve learned that low premiums usually equate to a high deductible so- $185 deductible So because stitches are usually an outpatient procedure, we can figure out that those $3000 stitches would cost you $748 out of pocket And $2374 a year in total expenses There are no family plans in Medicare, it’s just for the individual retiree, and these are by far the cheapest stitches we’ve come across so far But there is a catch Medicare Part A and Part B, collectively referred to as Original Medicare, have no maximum out of pocket limit You pay the same 20% coinsurance to infinity and beyond Which is why we need to talk about Medicare Supplement Plans, also known as Medigap plans These add a MOOP, as well as reducing your coinsurance This is an addon run by a private insurance company that doesn’t get to decide what or how much they cover, that’s dictated by Medicare They do get to decide what to charge you though Alternatively, you can scrap Original Medicare altogether and opt for Part C – better known as Medicare Advantage This is a private insurance plan that takes the place of Parts A and B (and sometimes D) and acts as its own supplement, so you get a MOOP You pay your premiums to them, rather than Medicare Now the insurance company gets to make decisions about your healthcare, instead of the government And it is required to give you that same 80% actuarial value… in theory In practice, the HHS Inspector General recently found that 56% of people on Medicare Advantage were denied necessary treatment simply for monetary gain I know, right? I was just as shocked as you About 36% of people eligible for Medicare opt for Medicare Advantage, so when you hear someone complaining about Medicare… There’s a decent chance they’re not actually on Medicare And I’ll give you one guess as to which Part ends up with the most waste, fraud, and abuse… It’s actually Part D, which is your optional prescription drug coverage – but before you get mad at me for the bait and switch, both C and D are run by private insurance companies I’m not kidding, Part C and D waste, fraud, and abuse is rampant, you can find the powerpoint presentations from HHS online The problem is that when the news tells you about Medicare waste, they usually leave out which Parts are causing that And when they talk about healthcare statistics, they neglect to mention that a third of the people are actually on private insurance The 59.9 million number I cited earlier is Original Medicare and Medicare Advantage put together There are 44 million people on just Original Medicare And 90% of them don’t use Medicare exclusively, they get a Medigap supplement plan or a Part D Prescription plan, or both Prescriptions aren’t usually covered by health insurance Even in countries with universal socialized medicine, dental, vision, and prescriptions are usually separate And prescriptions drugs are even more of a mess than healthcare Each Part D plan has a list of prescriptions they cover called a Formulary, you’ll need to look over that list when choosing your plan I hope you accurately predicted what medicines you’ll need in the future Americans pay the absolute highest prices in the world for medications, sometimes by an order of magnitude, and the main reason is somewhat counterintuitive The UK has a single payer system known as the National Health Service or NHS, every British citizen is covered for almost no out of pocket cost A total of 66 million people The government negotiates prices with drug companies, knowing that they will be the only supplier of that medication to 66 million people So they get a pretty good deal There is no equivalent in the US, the government doesn’t negotiate or even really regulate prices – the best we have is Medicare with 44 million people

And there’s a reason they pay the least Counter to the common capitalist perception that competition and choice drive down prices – at least when it comes to healthcare – market share seems to have much more influence The more people you are negotiating on behalf of, the lower your prices But also, it costs a lot of money to develop treatments and medications, so most companies want to make the largest return on investment as they can But when you’re selling to the UK and Germany for such low prices, where are you going to make your money? The country that isn’t negotiating on behalf of 320 million people and has little to no regulation regarding price ceilings Why do they charge so much? Because they can The common argument against adopting a system like the UK is that they are incredibly overtaxed So let’s get our calculators back out and check The median household income in the United States is $59,039, assuming just the standard deductions for a single person, you would be paying $10,804 in federal taxes – both income and FICA I have a video all about income taxes if you want to know the actual math behind that If you took that same income and went to the UK, after converting to pounds and then back again, you are paying $14,451 in national taxes This includes your income tax and the National Insurance tax, which is like our Medicare tax but, significantly larger Side by side, if you make the median household income in the US, you are paying 18.3% in federal taxes, if you took that to the UK, you’d be paying 24.5%… but remember, healthcare is included If you want healthcare in the US, the average annual employer-based premium across all types and levels for an individual is $6896 a year So in reality, you’re paying 30% of your income in taxes and health insurance – and that’s not even considering what happens if you actually get sick In the interest of being thorough, if you double the median income to $118,078 and were married with two kids – you would be paying significantly more taxes in the UK However, your healthcare expenses don’t really change, whereas the average employer-based health insurance premium for a family is over triple that of an individual So a US family is still paying more in taxes and healthcare – even if they never go to the doctor The UK does have a Value-Added Tax, or VAT, of 20% But their cost of living is about 7% lower, so once you consider sales tax in the US, prices are pretty comparable A Samsung Galaxy S10 costs about $15 more in London than New York And a Big Mac is a dollar fifty cheaper The quality of these products are pretty much the same wherever you go, but for some reason, we insist that US healthcare is the exception That has to be the last variable on our list, American stitches are just inherently better than UK stitches No, most people already know this, but the UK, Canada, Australia, and most other industrialized countries beat us in just about every healthcare metric Life expectancy, infant mortality, maternal mortality, the list goes on But generally, these numbers are close enough that you can say that the US is basically on par with everyone else But per capita, we’re paying double what they are Objectively, the UK does have longer wait times, from a few more minutes in the ER to a week or two for a specialist But I want to challenge your assumptions here If waiting a little longer drastically reduces cost, but doesn’t negatively impact healthcare outcomes… How important is it to be seen right now? Can you zoom in and say the US is better in a specific field like heart transplants or post-op complications? Sure, but overall, we’re not getting what we’re paying for Which is why we’ve been arguing about how to change this system since forever But we might actually do it this time I’m obviously not going to talk about all of the proposals, because you’ll never hear from most of these people ever again So let’s just focus on two Mayor Pete is proposing a Medicare opt-in plan or “Medicare for all who want it.” This is just a reskin of the classic “Public Option.” This would open up Medicare to anyone, if you’re uninsured, you’re automatically on it, if you get health insurance through your employer, you can switch, but otherwise nothing changes Unless your employer wants to switch to Medicare, in which case you don’t have a choice It would also make a few smaller changes like adding a Medicare MOOP and capping out-of-network costs Most people wouldn’t see any changes to their healthcare Which isn’t very exciting, so let’s talk about the plan you all want me to – the Medicare for All proposal from Kristen Gillibrand She’s not even running anymore You won’t let me just have- Fine, let’s talk about Bernie Sanders Bernie’s Medicare for All plan would basically turn our healthcare system into the UK’s, with a single payer government health service But with dental, vision, and prescriptions included

Like the UK, there would be no premiums and little to no out of pocket expenses It also abolishes private insurance No more employer-based health plans, no healthcare marketplace, no deductibles, no premiums, no channels completely dedicated to demystifying Medicare You and your doctor will make decisions about your healthcare, not a private corporation Instead, the government would be the third-party payer How they would pay for this is always a point of contention and oftentimes the question is intentionally worded poorly How much are your taxes going to go up? And you said… How much are your costs going to go down? No, different question, how much will your taxes go up? No, it’s how much are your costs, because it’s- This sounds like a dodge because she’s trying to reframe the question Taxes will go up, primarily for the wealthy, but likely the middle class as well But remember, even if your taxes went up by 50%, the fact that this expense no longer exists means you are still better off – and you won’t pay much more, if at all, when you need medical care This would also reduce the overall bloat in our system that contributes to the high cost Your HR person has to pick a health plan, hospitals and doctors need to hire special billing coders, the insurance company needs claims specialists, and youtubers need to make videos explaining it all I’m positive we can do better than this But if you insist on keeping your healthcare expenses unnecessarily high, even under the proposed Medicare for All, might I suggest getting into vitamins and supplements? An industry you can learn all about by going to CuriosityStream is a subscription streaming service that offers over 2400 documentaries and nonfiction titles from some of the world’s best filmmakers that you can access across multiple platforms Learn all about vitamins and the industry that sprung up around them in this documentary hosted by fellow youtuber, Veritasium Even though I know most of us don’t really need to take vitamins, I can’t seem to help myself You can get access to their entire library for as little as 2.99 a month, but if you head over to and use the promo code knowingbetter, you can have the advantage of getting your first month completely free As well as getting access to Nebula, the new streaming service put together by youtube creators to have a space to create videos without worrying about algorithms and demonetization My channel, as well as many of your other favorites, can be found there, including several original series By joining CuriosityStream and Nebula, you’ll also be supporting the channel Full disclosure, I have no horse in this race I am a service-connected, disabled combat veteran, I get my healthcare through the Veteran’s Affairs hospital – which isn’t a health insurance program It’s a self-contained system and a bottomless well of asterisks So I’m not complaining about the system and talking about proposals for change for my personal benefit I also had no reason to give myself all that math homework It took me a month of daily research to figure all of this out and present it to you and that alone should tell you this is overly complicated Luckily, I don’t do anything else with my time So now, as you’re watching debates about taxes and reading news articles about rising premiums, you’ll actually understand what they’re talking about, because now, you know better If you hadn’t noticed, I made some improvements to the set, so if you’d like to add your name to the chargemaster, head on over to, or for a one-time donation, Don’t forget to copay that subscribe button, check out the merch at, follow me on Twitter and Facebook, and join us on the subreddit