Sally Pipes dispels myths surrounding single-payer health care proposals

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Sally Pipes dispels myths surrounding single-payer health care proposals

Health care expert discusses the Affordable Care Act, rising prescription drug costs and the Trump administration's plans for health care reform.

This is a rush transcript from "Life, Liberty & Levin," May 5, 2019. This copy may not be in its final form and may be updated.

MARK LEVIN, HOST: Hello, America, I'm Mark Levin. This is "Life, Liberty & Levin." We have a great guest, Sally Pipes. How are you?

SALLY PIPES, PRESIDENT AND CHIEF EXECUTIVE OFFICER OF THE PACIFIC RESEARCH INSTITUTE: Fine, thank you. Nice to be on with you.

LEVIN: I'll tell you why I wanted you here. You are a health care expert, among other things, I mean, a true expert. You've been studying this your entire life.

PIPES: Yes.

LEVIN: The role of government, the role of the private sector. It's time to get to the bottom of this. We hear these things thrown out about health care for all, universal health care, single payer health care, Medicare-for-All. Medicare is going broke. Medicaid is consuming state budgets.

So I want to start to get to the bottom of this because even with all the other things going on in this country that are very important, this is, too, because it involves our health and our fiscal health as a nation.

Sally Pipes, you're President, Chief Executive Officer of the Pacific Research Institute, a San Francisco based think tank founded in 1979. Fantastic organization. You've written a lot and you still write a lot about this subject of health care. So let's start from the beginning.

What is single payer health care?

PIPES: Right. Well, that's a very important point, because a lot of people have no idea what it really means. Single payer health care, Mark, means the government is the only provider of health care. All private coverage, private insurance, what people -- you have employer-sponsored coverage, whatever, is all banned under a single payer system and the government provides what is considered medically necessary for the population.

LEVIN: So all private health care goes away.

PIPES: Right.

LEVIN: All employer health care goes away.

PIPES: Right.

LEVIN: And the central government takes over the health care issue.

PIPES: Right, there will only be two other organizations that provide health care. One is the VA, the Veterans Administration, and the second one would be the Indian Health Services, but Medicare, Medicaid -- everything is rolled into one government program.

And as Kamala Harris, the Senator from California said, "Let's get rid of private insurance. Let's get rid of all of that. And have the government be in charge."

LEVIN: This thing that government being in charge, we don't even really know what that means. We don't know what Department would handle it. We don't know who would handle it. We don't know how they would make decisions. How, we, as patients would even get our health care? Do we have to contact the government in advance? Is the government going to put us on some kind of a rationing program? How are we going to see specialists? How we're going to get our medicine? What's going to happen?

Now you can go to the grocery store or go to the CVS or something to get your drug? We have no idea what they're talking about, do we?

PIPES: Well, I think I do because I'm a former Canadian who grew up under single payer, but what it means is whether you look at the Canadian system, which completely outlaws any private coverage for anything considered medically necessary, the British National Health Service, 90 percent of Brits are under the government program, which is turning 71.

But what it means is that the American people will have to, you know, go to their -- the book an appointment with a doctor, but doctors will be paid under Bernie Sanders' plan about 40 percent below what they get paid for treating patients today.

LEVIN: Well, let's stop right there. This is important. We're already having a shortage of doctors.

PIPES: Right.

LEVIN: And the fact it's predicted, am I right? That there's going to be even a worse shortage? Is that right?

PIPES: Absolutely. The American Association of Medical Colleges has predicted that by 2030, there will be a shortage in this country of 126,000 doctors. And not only that, you know, a lot of Medical students, the best and brightest kids have always gone into Medicine in this country, if they think they're going to be civil servants paid 40 percent below, are they going to go into Medicine, too? This is a very important point.

And the second thing is that under a government controlled program, governments are going to have to decide how much are they going to pay out for health care? And when people think something is free, they're going to demand a lot more of it. So they will have to go under a government-run program to waiting lists, and they will have to ration care. And it's the elderly who will be most harmed by rationed care.

LEVIN: Let's break this down a little bit. So basically, government intervention -- let's just take the Sanders plan -- and they're even more radical plans out there, we'll get to that in a moment. So that will have a negative effect on the population of doctors.

And people may not understand, if you're going to become a doctor, it is a lot of work. It is very expensive. There's a lot of schooling and these kids are studying day and night, and I know, I've seen it in my own family.

And then you're going to tell them at the end of the process, you're basically working for the government either directly or indirectly, and we're going to cap your income. We're going to control your life.

We're going to cap your income, you're going to earn 40 percent less than you earn. So you're going to have a diminished number of doctors, while you're going to have a greater impact on the health care system, because people said, "Well, it's free. Well, I hurt my toe. Well, I'm going to go in here. I'm going to do ..." And it's going to clog the system.

PIPES: Well, absolutely. I mean, under Senator Sanders' plan, his plan is even more comprehensive than the Canadian plan because he wants to add free dental, free drugs, free long term-care, free hearing. They don't even have that under the Canadian health care system, and Charles Blahous at Mercatus has costed out his plan from 2017 at $32 trillion, over 10 years. No government program, Mark, ever turns out to cost what it is predicted.

Remember Lyndon Johnson, the Medicare and Medicaid under the Great Society, it came in at $3 billion in the first year. Medicare, they predicted by 1990, it would cost about $12 billion. It cost $110 billion.

So even at $32 trillion or $3.2 trillion a year. Currently, we're spending about $3.5 trillion a year on health care. There is going to be a huge demand and the cost will be much higher, and government is going to have to cut back and control. We will get waiting list. Care will be rationed. Taxes will have to be increased. And of course, that doctor shortage issue as well.

LEVIN: You were born in Canada. What happened to your mother in Canada?

PIPES: So my mother was a senior, and she felt that she might have colon cancer. And so now Bernie Sanders says in his plan, no person will have to get a referral to go to a specialist. But in systems like Canada and the U.K., you have to. That's how you help control cost.

So she went to her general practitioner, and said she thought she had colon cancer. He said, "Well, we'll do an x-ray." And so nothing showed up, of course, in the x-ray, and I said, "Mom, you don't colon cancer with an x- ray, you need a colonoscopy."

So she wanted me to call back, but I got her to call back and he said, "Well, you know, as a senior, we have too many younger people on the waiting list to get colonoscopy. Some people are waiting eight months to a year," and so she didn't get her colonoscopy. Six months later, she was hemorrhaging.

And she went to the hospital in an ambulance, two days in the emergency room, two days in the transit lounge, waiting to get a bed and a ward. She got her colonoscopy. But she passed away two weeks later, from metastasized colon cancer. That is rationing of care and you reduce costs by denying care to people.

That is very, very sad. And the same thing will happen, you know, in the United States, and look at the number of people in the VA who complain about the VA, the long waiting times. Vets are dying on gurneys waiting for care. There's fraud. The VA is a single payer system in this country, and people have to realize that's an example on a micro level of what would happen if the government totally took over our health care system.

LEVIN: Horrible what happened to your mother. And you said something in there, she was a senior.

PIPES: Right.

LEVIN: She wasn't prioritized.

PIPES: No, absolutely not.

LEVIN: If you're younger, you will be prioritized under certain circumstances. And so now we have the government making decisions about life and death, not individual human beings making decisions about their own lives. "I'm sorry, you can't get a colonoscopy." "Why not?" "Well, only the government provides them and approves them." "Okay, I need one." "Okay, But you're elderly." "Well, so what? Well, we have younger people who are waiting, so you have to wait."

Either you leave the country to get care somewhere else or you're stuck. Correct?

PIPES: Yes, absolutely. And today in Canada, about 200,000 Canadians out of a population -- Canada is a very large country, but with about 37 million people. Two hundred thousand Canadians go abroad every year to pay out of pocket for an MRI machine, MRI, a stent, a new hip, a new shoulder, because the waiting time is just too long, because the government sets that budget 11 percent in Canada of gross domestic product. And that's what they're prepared to spend.

So you have to get waiting list when as I say that demand is much greater than what the government is willing to supply.

LEVIN: There's really so much I want to discuss with you. Let's talk about this gross domestic product. You know, people go, "Great. Who cares?" Eleven percent in Canada. So they arbitrarily decide -- the government does. That's the amount of money we're going to spend -- 11 percent -- equivalent of 11 percent of the GDP on health care. In the United States, it's what percent?

PIPES: Just over 18 percent today.

LEVIN: It's just over 18 percent and I hear Bernie Sanders and others say, "We spend too much on health care." And first of all, I think to myself, as opposed to what?

PIPES: Right.

LEVIN: As opposed to what? A cake? Or cars? Or whatever. You spend what you need to spend. But here's my question to you. We say health care. That's a big industry. It's technology, it's buildings, its personnel. It is everything associated with it. So it's a very, very important part of our economy, right?

PIPES: Right, exactly.

LEVIN: So the idea that you say we spend 18 percent, we have to spend less, you spend what you spend. And one of the pressures on the increased "spending," quote, unquote, on health care, isn't it government?

PIPES: Well, exactly. Fifty percent of health care in this country is in the hands of government already. People say, "Well, America has this free market health care system and people are dying in the streets." Well, that's just not true. Fifty percent is in Medicare, the program for our seniors; Medicaid, the program for low income people; the VA, the Veterans Administration and the CHIP Program.

We have a lot of government in our health care system and government, whether it's at the national level or at the state level has a tremendous number of mandates on insurance companies and what they have to provide, which adds tremendously to the cost.

But you know, if you look at 18 percent, my mom used to say, "Well, you know, I hope you're not becoming one of those impatient Americans." America is the most wealthy country in the world. Americans, if they want an MRI, they think they have a brain tumor, they want it tomorrow or next week. They don't want have to wait like Canadians, eleven weeks on average, to get an MRI. And that's why so many leave the country and to get something that's important to them.

LEVIN: And they're counting on it. They're counting on a certain -- I bet the green eyeshade types in the bureaucracy in Canada are counting on a certain percentage of the population, getting health care somewhere else.

PIPES: Yes, exactly. And it's interesting being from Vancouver, one of my friends, Dr. Brian Day, an orthopedic surgeon runs a private clinic called the Cambie Surgery Centre. And of course, it's illegal to have private coverage.

The provinces -- the provincial governments actually run each health care system, the Feds provide funding and then the provincial governments raise taxes. Brian has been in a lawsuit, being sued by the BC government in the BC Supreme Court for three years because the government says what he is doing is illegal.

He is treating 60,000 patients a year and some of them are even politicians who don't want any private coverage. But they're using this system when they think -- his program -- when they think something is serious.

So here he is. They're trying to starve him of funding to support this case. But you know, if he treats 60,000 people and they're paying for it, the BC medical plan will pay part, but it's taking pressure off the government system where people are having to wait.

LEVIN: When we come back, these government-centric systems are about government. They're not about the welfare of the individual. They're not about individuals making decisions about their own lives. They're not about parents making decisions about children, or adult children making decisions about their elderly parents.

When we come back, I want to explore this because this is, in addition to a financial disaster, it is a human disaster.

Ladies and gentlemen, don't forget almost every weeknight you can watch me on LevinTV, LevinTV. Just join us at blazetv.com/mark, blazeTV.com/mark or give us a call at 844 LEVIN-TV, 844-LEVIN-TV. We'll be right back.

(COMMERCIAL BREAK)

LEVIN: Sally Pipes, I want to talk about the inhumanity of government run health care. The inhumanity of government run health care, is this, is it not? You can't see a doctor when you want to see a doctor. You can't see the doctor you want to see. You've got rationing. You've got waiting lines. You've got shortages.

Do you think the media are doing an adequate job explaining exactly what we mean when we talk about Medicare-for-All and single payer and everybody should have free health care?

PIPES: Well, I think the mainstream media is very bad because they aren't telling the American people the truth about it. And my role in life is to educate Americans on what it would mean for them, their health, and, and their long-term survival.

I mean, if you look in Canada, in 2018, the average wait from seeing a primary care doctor to getting treatment by a specialist, 19.8 weeks. That's almost five months. Back in 1993, that wait time was only 9.3 weeks. And it's not free. The Canadians pay on average in hidden taxes $13,000.00 a year for health care where they have to wait and it's a ration just like it wasn't the case of my mother and other elderly people.

So the mainstream media needs to talk about when Bernie Sanders says this is his Medicare-for-All plan and there'll be no referrals. And you can get an appointment whenever and you can, you know, you'll be able to get the very best care, no waiting times nothing. This is just not the truth.

LEVIN: Is Bernie Sanders lying?

PIPES: I think he is lying, because he is so committed to the concept of government entitlement. And then in his view, government is the best provider of everything, and everybody should be under a government --

LEVIN: Is not his proposal the most inhumane proposal?

PIPES: Absolutely. I mean, it he's not telling the truth to the American people. He never says how much his program will cost or how it's going to be paid for. I hate to say this, but even Nancy Pelosi, the Democratic speaker, when she looked at the Medicare-for-All plan in an interview with "Rolling Stone," she said $30 trillion -- that's over 10 years -- how are we going to pay for that? Even she understands that it would kill the taxpayers.

We'd have to have huge tax increases. There will be new taxes in Bernie's plan. You know, he is talking about a new payroll tax of 7 percent, an estate tax of 77 percent on the American people, a new tax on large financial institution.

LEVIN: This would impoverish the country, wouldn't it?

PIPES: It would.

LEVIN: And it would be a massive redistribution of authority from the individual in the private sector, to politicians, bureaucrats and the government, wouldn't it?

PIPES: Well, if you look at Pramila Jayapal, who is the House Member from Washington State who has got a single payer Medicare-for-All plan, too, even more comprehensive than the Sanders plan. She wants to bring in the whole -- takeover the health care system in two years. Bernie's plan is over four years.

But you know, she just said in the mainstream media after the CBO Report came out on May 1st that a million people employed in the insurance industry would lose their jobs. Well, what does this mean for the government? They're going to have to hire millions of people to run the process claims, to book appointments, to pay doctors, all of these things, which would be a disaster.

I mean, I often think everyone -- pretty much everyone hates having to face going to the DMV, which is a single government monopoly program. Is that what people want for their health care? Even the post office today, Mark, has competition.

The Post Office got a little bit better because they have FedEx and DHL and UPS and if I want something to get somewhere on time, I use one of those services. But this means that the health care system in this country would be like the DMV, no private coverage for anything.

LEVIN: Let me ask you this. Are there a lot of people running to Canada for health care?

PIPES: No, absolutely.

LEVIN: Are there a lot of people leaving the United States for the U.K. for their health care?

PIPES: Absolutely not. Let's think about Mick Jagger of the Rolling Stones when he was told he had to cancel his tour because he had a heart problem and it turned out he needed a valve replacement in his heart. He was in Florida at the time. He had it done at New York Presbyterian, one of the best hospitals in this country.

His younger brother in England said, "Well, thank goodness, Mick didn't have to stand in line under the National Health Service." I mean, he could have -- Britain does allow some private coverage and he could have gone there, but I bet he thought that the care that he could get and the treatment at New York Presbyterian would far outweigh the coverage in the U.K.

LEVIN: Why do you think there's so much appeal? I'm not saying majority of the public, but so much appeal with the left propaganda, which seeks to destroy some of the greatest institutions ever developed by mankind and replace them with theories and abstractions, and utopian promises that we all know are impossible because they are utopia.

PIPES: Right, Bernie Sanders when I found out that he honeymooned in the former Soviet Union, I mean, that tells you something.

LEVIN: A hot spot, isn't it?

PIPES: It is. I mean, that he believes that even when everything was failing in the eastern bloc in the Soviet Union, he thinks that is, you know, the way our society should be run. Remember, several years ago, Hillary Clinton wrote that book, it takes a village. Well, that village is government. And these people think whether it's Hillary or Bernie Sanders, or the new the darling of the mainstream media, Alexandria Ocasio-Cortez, the Member of the House from New York, she has a new plan.

She loves single payer. She thinks government should be the provider. But she also has come out recently and said, the VA is an excellent example of providing great health care, and it ain't broke, and so we shouldn't fix it.

But her new plan is the VA for all. Well, even the Democratic Member of the House from Massachusetts, Mr. Moulton, came out and said, "I'm a member of the VA, because I was in the military. And it isn't a great quality system." But these people are just out there telling the American people that they -- this should be the way it should be.

And look at the polls under like Kaiser, 71 percent, yes, but when you tell them, you'd have to pay higher taxes, and that you would lose your private coverage that support drops to 37 percent.

LEVIN: A lot of this is because the media just regurgitate what they're told by the hard left. They don't really take a close look at this. We're told all the time, "Look at Canada and the U.K. We're the only advanced industrialized society that doesn't have this or doesn't have that or look at Scandinavia and those countries there." And the fact is, their health care systems are a disaster for the people and we're going to explore this a little more when we come back.

(COMMERCIAL BREAK)

AISHAH HASNIE, FOX NEWS CORRESPONDENT: Live from "America's News Headquarters," I'm Aishah Hasnie. The clock is ticking for Attorney General William Barr. He has until 9:00 a.m. tomorrow to hand over the full and un-redacted Mueller report to Congress. The House Judiciary Committee says Barr is facing a contempt of Congress citation if he fails to comply. Democratic lawmakers are also working to have Special Counsel Robert Mueller testify soon.

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It comes as negotiators from both countries will meet on Wednesday. The tariff increase is set to go into effect on Friday, but has already been pushed back twice to buy more time for a negotiated settlement. I'm Aishah Hasnie. Now back to LIFE, LIBERTY & LEVIN.

LEVIN: Sally Pipes -- Vermont. They tried the Bernie Sanders experiment in the last what? Three years. What happened in Vermont?

PIPES: Well, in Vermont, Governor Shumlin, a Democrat signed the single payer bill which is you know, Bernie Sanders had been touting for years. He signed that bill in 2011. It was supposed to come into effect, you know, shortly but it hadn't been in 2014 -- December 2014. He had to withdraw that bill, because he said the people of Vermont cannot afford the cost of this single payer health care system.

In Colorado, you know, there was an Amendment 69 on the ballot, it went down 79 to 21. Even John Hickenlooper, the Governor at the time who was now in the race for the Democratic nomination, he urged the people of Colorado not to vote for it because --

LEVIN: Was that a single payer plan?

PIPES: It was and it would more than double the cost of the budget of the State of Colorado.

LEVIN: How about California?

PIPES: California, the Senate in 2017 signed a single payer bill. It had been costed out by the Senate Appropriations Committee $400 billion dollars a year. Think about that. Double the entire budget of the State of California.

The Assembly leader, Mr. Rendon pulled it and parked it and said, "We cannot afford this in the State of California."

LEVIN: New York?

PIPES: New York State has passed many times at the Assembly level the New York Health Act. Now the Dems have the Governorship under Cuomo. They have the Senate and they have the Assembly. The New York Health Act is back on the books. It actually has added long term care to it. It's even more comprehensive.

The original former bill was costed $130 billion a year. This is going to bring it up to about $160 billion a year. Even some public sector unions, Mark, are saying, "Hey, we don't want this. We have great health care through our union."

And of course, Governor Cuomo has said, "Well, he wants the Feds to be in charge of health care."

LEVIN: So he doesn't want to sign that.

PIPES: No, he doesn't want to sign it either.

LEVIN: And we look at the Federal situation, over $22 trillion in fiscal operating debt, over $250 trillion of unfunded liabilities -- from an Economics Professor in Massachusetts, who testified just a few years ago. You have the trustees of Medicare saying, "We're broken eight years."

PIPES: Right.

LEVIN: The trustees of Social Security saying "Oh, and we're broke in 18 years." There's no proposal for fixing Medicare. In fact, the opposite. Bernie Sanders says Medicare-for-All. So Medicare-for-All would destroy Medicare, it would eliminate Medicare. The government would step in, as we've been discussing, all the people who out of their paychecks all these years have been quote unquote, "contributing" to Medicare. Now you and I know it hasn't really been. It goes into a general fund.

PIPES: Right.

LEVIN: But let's play along. All the money that was supposed to go into Medicare, poof, that's all gone. And we're going to replace it with something because a 29-year-old, got elected from New York, or a Democratic socialist -- he likes to call himself from Vermont -- has a plan. These aren't new plans. These plans are a hundred years old, and they fail wherever they're tried.

PIPES: Well, well, absolutely. And you know, Senator Sanders has just recently come out in this Congress and said, you know, five years ago, the whole idea of Medicare-for-All was a fringe idea, but now it's in the mainstream, and we need to -- we need to move forward with it. I have the people behind me.

Well, the people that are behind him, obviously don't realize what Medicare-for-All would mean. And you know, even as you say, we all pay huge taxes to pay for the Medicare tax. And yet, so many seniors today find that their doctors won't take them because of the low reimbursement rates. So they have to go out and buy and purchase supplemental plans so that their doctor will get paid for the value of their service.

We have about 60 million people on Medicare today, and about 10,000 a day are being added to Medicare, because my generation, the baby boom generation is turning 65.

And so there's going to be a huge pressure on Medicare and it's not, you know, as I say, it's not working and yet Bernie Sanders and Alexandria Ocasio-Cortez, Pramila Jayapal, they want this system for the whole of our country. America is a country of entrepreneurship. People like choices. They don't want the government to be fully in charge.

LEVIN: And we want to keep emphasizing, this is inhumane because you're treating people like cattle, you're treating them like sheep. People are going to be categorized. New drugs are going to be difficult to bring to the market, let alone available to people even when they're brought to the market.

Senior citizens will be discriminated against, and decisions like that are going to have to be made. What the hell ever happened to Obamacare? I thought that was going to fix everything.

PIPES: Well, absolutely. Remember when Obama was a Senator from Illinois, he was a supporter of single payer. When he became the President and was behind Obamacare, the Affordable Care Act, he said he wasn't for single payer, because the American people like their employer sponsored insurance, which about 173 million Americans have employer sponsored insurance.

After office, of course, he's come out said he is again in favor of single payer. His two ideas for the health care system under Obamacare, one to wipe out all the uninsured, which, you know, right now, they're about 28 million still uninsured. He wanted to lower the cost of health care. None of that has happened. And Obamacare has been a failure because the premiums are too high. The deductibles are too high. People found out that the doctor and the exchange plan that they signed up for the metallic plan, their doctor wasn't on that plan.

We upset the whole health care system in this country in 2010 when Obamacare came into law, because for treating about anywhere between 11 million to 13 million people, we could have provided private coverage for all of those people.

LEVIN: Let's get it all for free.

PIPES: Yes, exactly. And so, you know, people couldn't afford to sign up. The average premium today on an exchange plan in this country is about $600.00 a month, the cost curve did not come down and the uninsured were not, you know, wiped out even with 80 percent of the exchange, people are receiving subsidies from the Federal government, but we are the taxpayers, we're providing that for funding.

LEVIN: It is always was interesting that when they fail their answer is more government, less freedom, more taxes, more of the same. We'll be right back.

(COMMERCIAL BREAK)

LEVIN: Now, Sally Pipes, the United Kingdom has a very old health care system since what? 1948? Give or take.

PIPES: Right.

LEVIN: And it's been around a long time. So you think they'd be able to perfect it by now, wouldn't they? How's that system?

PIPES: So the National Health Service turns 71 this July and it's been in financial --

LEVIN: Let me put that on my calendar. I'm just kidding.

PIPES: Yes. So but I mean, it has been in financial distress ever since. And today in the U.K., they say that the average number of days that you should wait between diagnosis by your doctor and getting cancer treatment should be 62 days.

LEVIN: All right, slow down.

PIPES: We haven't reached --

LEVIN: Two months, you're diagnosed with cancer.

PIPES: Right.

LEVIN: And there's really nothing you can do.

PIPES: No, unless you go abroad somewhere else, like come to America. But 62 days, you have time -- under the under the legislation, you have to be - - an ambulance has to be able to take you into the, into the emergency room, within four hours of picking -- getting a call to take someone. They haven't been able to reach that. They're thinking about getting rid of that four-hour time.

LEVIN: So you need an ambulance, you make a call and they have a rule that the ambulance needs to show up within four hours?

PIPES: Yes, at the hospital.

LEVIN: And they can't make it.

PIPES: They can't make it. There's so many ambulances, you know, trying to pick up so many people. There's just not enough supply. And so -- and today 236,000 Brits are waiting six months or more to get an appointment, to get a doctor and 36,000 are waiting nine months or more. They have a shortage of 11,000 docs in the U.K. and they're offering 25,000 pounds to get British doctors to come back to the U.K., because they have this huge shortage, plus 46,000 nursing shortage, which, you know, when you look at the Nurses Union in this country, it's the union that's really pushing for single payer.

Well, there are many jobs and the National Health Service, they should just go to the U.K. and see what it means to work long, long hours, and to be paid very low wages.

LEVIN: This so called NICE system that they have in Britain, what is that?

PIPES: So NICE is part of the National Health Service. It's called the National Institute for Health and Clinical Excellence, which is not the truth. What NICE does is it figures out, say Mark, you're 40 -- say you're 50 and you need a very expensive cancer drug. They say well, the value of your life is $200,000.00 and the drug costs $100,000.00. You would then be able to get that drug.

But if you are 65, 66 and you're retired, and they say the value of your life is $50,000.00 and you need that drug at $100,000.00, you are not going to be able to get it because the actuary says you're not worth getting it.

LEVIN: Let me get this straight. So the government effectively --

PIPES: The government agency, yes.

LEVIN: Puts a value on life, a financial value on life.

PIPES: Right.

LEVIN: And the older you are, and the sicker you are, the less the value of your life. In other words, the more you need health care, the less you're likely to get it.

PIPES: Right, exactly.

LEVIN: And that's how they cut their costs.

PIPES: That's how you ration care and you cut the cost of the National Health Service, which is in the mainstream media every day in the U.K. about the long waits, the rationed care and the cost overruns --

LEVIN: But I just want to be clear about this. So they that they have their matrix, whatever it is, their model, and they make a decision and there's a cutting edge drug that might improve the quality of your life, prolong your life, and you're 71 years old. They say, well, we can only spend up to this much after that. Sorry, too bad.

PIPES: Right. Exactly. The quality adjusted value of your life is not worth the cost of taking care of you and providing that coverage in, and so --

LEVIN: I notice Bernie Sanders never talks about this. I noticed CNN never talks about this. I noticed MSNBC never talks about this. I noticed AOC never talks about this. I noticed no one ever talks about this.

PIPES: Right, and they don't want to talk about it, because they just want to say Medicare-for-All, single payer, everyone will get the very best health care and it will be free. And of course, we know that it'll be at least $3.2 trillion a year or it would probably be a lot more, really doubling what we spend on health care today.

LEVIN: So the price, the expense goes through the roof, and the quality goes through the toilet.

PIPES: Right. Exactly. And think about the expense if the government takes over the health care system, the Department of Health and Human Services is going to have to be expanded greatly, which is going to add a lot of money to the cost of government.

LEVIN: The government.

PIPES: I mean and the fact that they probably won't be able to attract the very best and brightest people that work today, like work today in the insurance industry because these people will become public servants.

LEVIN: Now, we've heard it said, but what's the alternative? Nobody has an alternative. But there are alternatives, aren't there? Let's begin this discussion. What are some of the alternatives?

PIPES: Well, I mean, universal choice can lead to universal coverage. You know, when you have people like Nancy Pelosi saying we need to ban short term limited duration plans which came into being this year, we need to get rid of association health plans where sole proprietors can group together and get better rates because they're a larger group.

These people want to cut various choices that are out there. We need to -- there are a lot of problems with the American health care system, but there are solutions.

LEVIN: Now, I want to pursue this as soon as we return. Folks don't forget, you can join us most weeknights on LevinTV, LevinTV by signing up a blazetv.com/mark, blazetv.com/mark or give us a call at 844-LEVIN-TV, 844- LEVIN-TV. We'll be right back.

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LEVIN: Solutions. So one of the ones you just mentioned is look, people should be able to use their dollars to purchase health care without being taxed for it.

PIPES: Right.

LEVIN: Set up these health savings accounts, just like we have mutual fund accounts or IRAs or 401(k) for pensions, and you're saying, look, the reason people put money into that is because of the incentives, well, we need those incentives when it comes to health care, correct?

PIPES: Absolutely. Putting doctors and patients in charge of their health care, not a state government or the Federal government. So we have about 22 million people who have health savings accounts. We should have a lot more because that cost of health care will come down when people can make decisions with their doctor about what the right treatment is. An HSA, you put that money away every month in your account.

LEVIN: Not taxed.

PIPES: Not taxed. And it can be carried forward every year, not taxed, but you have to combine it with a high deductible health insurance plan which is good because you want health insurance there for a catastrophic event, not for --

LEVIN: But here is the point. The burden is taken off the government. It's taken off the taxpayers and basically, again, like a pension plan, you know, we have all kinds of different types of pension plans, 401(k), IRAs, Roths and so forth, and what you seem to be saying to me is, we need to be creative like that when it comes to health care.

Now, next point, insurance competition. Why shouldn't insurance companies be able to offer all kinds of plans, limited plans, catastrophic plans, plans for college students, and so forth and so on. If we will get the mandates and the crushing regulations out of the way, we'd have more competition, which would bring down prices?

PIPES: Absolutely. Many -- I've had many people call me and say I'd love to set up my own insurance company. But you know, with all the mandates, I can't afford to do it. I can't survive. We have -- most states--

LEVIN: Why should a woman have to pay for a prostate exam?

PIPES: Or why should you have to pay for in vitro fertilization?

LEVIN: Why should a guy have pregnancy -- yes, exactly.

PIPES: Get the kind of plan that suits your needs and those of your family. We don't have that right now because most states have 45 to 50 mandates on a plan and then under Obamacare, that brought in 10 essential health care benefits that have to be provided by a coverage by an insurance company in an exchange.

Young people don't want all of these things and that's why short term limited duration plans are good. You can get a plan for 12 months, renewable for three years, and there are no essential benefits.

LEVIN: And then people say, what if people don't buy their own insurance? And I would argue this, okay, we may have to deal with that, but you don't destroy the entire health care system to deal with the exceptions.

PIPES: Right. I mean, if you look at -- the Republicans lost the House in the 2018 election, I think they lost it because they couldn't talk about preexisting conditions. The Democrats said 120 million people have preexisting conditions, they'll lose their coverage, because they can't afford it. Well, that that can't happen under the law.

LEVIN: Well hold on, when we come back, what do we do about your ideas and preexisting conditions? We'll be right back.

(COMMERCIAL BREAK)

LEVIN: So your solutions -- these solutions are let individuals take more of what they earn and put it aside for their health care, rainy day, whatever it is, just like their pension money. That's number one. And the way the government can help there is get out of the way.

PIPES: Absolutely.

LEVIN: Stop taxing them to pay for somebody else. Number two, in terms of competition, we could have an explosion of competition of insurance companies, all kinds of policies if the Federal government and the states would get out of the way.

PIPES: Right.

LEVIN: So people don't necessarily need a platinum plan. Some do, some don't. But I know in my own case, I don't need gynecological care. And I know other people don't need care that men would typically get and so forth. So stop treating health care as welfare for somebody else. And then a third solution would be what?

PIPES: Well, tort reform is a big part. You know, the cost of medical malpractice in this country is about $210 billion a year.

LEVIN: Every year.

PIPES: According to PricewaterhouseCoopers, doctors do practice defensive medicine because they are afraid of being sued. And so it's very important that we change this and limit punitive damages and noneconomic damages.

LEVIN: Okay. And what about the supply of doctors? The government gets involved in that, too, I found out that they control in terms of medical schools, really how many doctors can graduate over on this country? Is that true?

PIPES: Well, that is true and then now, there's a big push saying, you know, medical -- studying Medicine should be free. That is not going to solve the problem. We want the best and brightest kids to go into Medicine and you have to cover the cost of that education.

LEVIN: It seems like most of these problems are government created.

PIPES: The government --

LEVIN: Driving up the price of Medicine, creating a dislocation. But what about preconditions? Preexisting conditions?

PIPES: Preexisting conditions is -- I think it was the main issue and the reason why the Republicans lost the House in the November --

LEVIN: So how do address that?

PIPES: So the people on the left, progressives said 120 million Americans have preexisting conditions. Of course, there are different levels of preexisting conditions. But --

LEVIN: Right, I have heart disease versus I broke my toe.

PIPES: Right, exactly. And so there are only about six or seven million people who have preexisting conditions who are in the individual market. Let's take care of those people. Let's get the Feds put money into state high risk pools so that those people could get good coverage.

LEVIN: Get coverage.

PIPES: And it would take the pressure off young people who don't buy coverage because it's too expensive. They don't want -- they're not going to have a heart attack. They want catastrophic coverage.

LEVIN: And your point seems to be look if we take care of that, that pool of people, let's also address the rest of it. We don't need to destroy the system to take care of six or seven million people. We don't need to destroy this magnificent health care system in order to accommodate Democratic socialists and centralized government. And here's the little secret. Nothing is free. And if somebody wants to offer you something for free, run fast.

PIPES: Or remember P.J. O'Rourke, if you think health care is expensive now, just wait until it's free, because it's not just the cost. It's all of these ration care, waiting lists, higher taxes, and doc shortages. Those are very real costs that will happen.

LEVIN: Isn't part of the problem is people don't know what they have until they actually lose it, and then it's too late.

PIPES: Once you get one of these programs, look at Britain, look at Canada.

LEVIN: They can't get out.

PIPES: There's a lot of discontent. But even conservative politicians are afraid to do something about it.

LEVIN: Even conservative politicians in our country today refuse to get rid of Obamacare. Sally Pipes, it's a great honor.

PIPES: Thank you, Mark. Terrific.

LEVIN: Thank you very, very much. Appreciate it.

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