In this 15 minute segment Dr. Casey Means and Calley Means once again expose a medical system incentivized by profit. We don’t have health care, instead it’s sick care. That’s where the money is. We are now a nation of the chronically ill and disabled, and very powerful forces want to keep it that way.
Casey and Calley outline how to reform this system. There are executive orders that the next President could issue on day one that could dramatically change the current situation and address the massive corporate takeover of our federal regulatory agencies.
1:36:28—1:51:00
Why Obamacare Is Harmful and How to Fix the Medical Industry
Calley: It’s all kind of rooted in the same thing, and that’s really what our big mission is. We need actually a new paradigm of how we view chronic disease.
It’s actually just a lie, that if you have a high cholesterol, high blood sugar and depression, you’re seeing three different doctors who aren’t talking to each other at all. That’s just wrong. It’s very profitable, but it’s wrong. You’re on three different lifetime plans.
You can really solve with the root cause, and that’s if the medical system was sane, right? With lower costs and unleash human capital.
We’re debating on the margins right now on the left and the right about how to change page 300 of Medicare Part D.
Unless we’re attacking the core incentive that was embedded by Obamacare, which was probably the deadliest law passed in recent history
What Obamacare did, it ingrained the incentive that the medical system makes more money when people get sicker though this populist idea of taking on the insurance companies.
That said, insurance companies can only make a 15 percent profit margin medical loss ratio. They need to pay out 85 percent of their spending.
But because now insurance companies can only get 15 percent, but by law enshrined in Obamacare, they can raise premiums to get that 15 percent.
What’s their incentive? Your incentive is for the pie to grow. Your incentive is for cost to go up.
So Obamacare actually incentivized insurance companies to have no cost controls.
What does no cost controls means? It means more people getting sick.
So we’re talking about inflation a lot right now. By far the top driver of inflation in America right now is health care.
And that’s happening because there’s no rein in on cost. There’s no rein on costs because everyone makes money when we get sicker. That’s how it all connects.
Casey: That’s 85 percent of their budget has to go to care. They take 15 percent by law from Obamacare.
The more that we spend on health care, the more expenditures for patients, the more their 15 percent grows.
Tucker: That’s crazy. So in a functioning system, of course, insurers would have the greatest possible incentive to keep illness down.
Calley: Obamacare out of a populist kind of, we’re going to we’re going to cap their profit margins.
But they lobbied again, they can raise prices to get that 15 percent.
So there is zero—And I mean this, every single institution impacts our health: insurance companies, pharma companies, hospitals, medical schools. They make more money when more Americans are sicker for longer periods of time, and they lose money when Americans get healthy.
Tucker: Just absolutely—
Calley: That’s the incentive. And then you go to Medicaid, which I talked about, there’s just a huge incentive for more and more poor people to get sick because that’s an annuity then to the pharma companies.
So until you attack that incentive, and as Casey said, people just don’t understand this.
Everyone kind of makes sense, and actually I think these things are very easy to change, but the problem is that it’s enshrined that there’s profit when people are sick. And then they use the Stanford and the Harvard and the NIH, it’s all this fancy club where people— It’s like uncouth to talk.
It’s so marginalized when you talk about nutrition among the elites.
Casey was yelled at by an attending surgeon, you didn’t go to nutrition school. Don’t talk to your patients about what to eat.
We do serious medicine. We commit surgery.
Casey: And it’s not in the guidelines.
Tucker: Why are the outcomes getting worse? Why is life expectancy going down?
Calley: The life expectancy is the tip of the iceberg. The underlying is just mass suffering, particularly among kids.
This rapid increase in childhood diabetes—If you have diabetes, by the time you’re 30, you die 15 years younger, and you’re suffering much more along the way.
It’s getting to almost the majority of young adults are pre-diabetic.
Diabetes is not an isolated condition. It’s cellular dysfunction, as Casey talks about in the book. It’s the root of so many other things.
Tucker: Okay, so let’s, . . . at breakfast, you said, “I’m going to make this positive. . . .So I’ve got two more questions for you, broad questions.
Here’s the first. Let’s say there’s a Means administration. You are given absolute power over the society, or power within the bounds of our system. You can do what a President can do.
What are the first steps you take to fix this?
Calley: DAY ONE, state of emergency for childhood chronic disease, fully within the Constitution for the President to declare a state of emergency for public health.
That’s what happened during COVID. It was no congressional legislation. It was a state of emergency.
What’s happened with childhood chronic disease is a much, orders of magnitude, bigger state of emergency right now and more imminent emergency in America than COVID.
So you declare a state of emergency for child health.
We actually started a nonprofit, and we have executive orders drafted, and there is so much stuff you can do, but it’s attacking the incentives.
Just for starters, Biden’s talked about this, and President Trump’s talked about this, but I think the fact that you need a President in there who’s willing to take some heat from these ingrained industries.
You could sign a bill tomorrow saying pharma companies can’t charge Americans more than what they charge people in Europe.
We are spending, in some cases, ten times more on drugs. We are subsidizing the largest companies in Europe with our insanity.
That’s not a free market.
Tomorrow you can cut this ridiculous thing.
Tucker: You can thank the Republicans for that, by the way. The Republicans, I will say as a lifetime Republican voter, but they provided the ideological cover for that because they said—I was there when this happened in HillaryCare, Obamacare, so between 1993 and 2011, they made this case consistently through their think tanks that it was a choice between socialism and capitalism.
And if you were controlling costs, that was socialism.
Calley: It’s socialism for pharma to have Congress over a barrel. . . .
I was working for conservative think tanks trying to make that argument.
It’s totally bankrupt, and actually President Trump’s talked about that.
That’s an executive order he can sign the first day. I cannot emphasize this enough how important it is just for medical leaders to cite the science.
The executive order tomorrow could make it that USDA panelists cannot take money from food companies.
What an idea. Sign an executive order tomorrow that NIH grants can’t go to conflicted researchers. 80 percent of them currently go to conflicted researchers.
You could sign an executive order tomorrow that the FDA should stop being funded by pharma.
Casey: 75 percent of their funding comes from pharma.
Calley: 75 percent of the FDA’s funding doesn’t come from taxpayers, it comes from pharm, and there’s a revolving door, as we all know, where people go from the FDA to pharma.
Institutions in D.C., as we both know, are built to grow.
The FDA grows when the pharma’s influence grows. The FDA should be an independent organization. It’s not.
That’s an executive order tomorrow.
So you just rob the conflicts of interest out of these things.
Personnel. Assign doctors that we both know on to the USDA Nutrition Panel, and have the President, have the Secretary of the Treasury, because we’re going bankrupt from health care costs, have the Secretary of Defense, because 77 percent of young adults aren’t eligible to join the military, have them say: we are not banning any company, we’re not even giving public policy recommendations.
But we are saying, from a medical perspective, that we should reduce ultra processed food consumption among children.
That is a medically valid statement, and medical leaders need to start telling the truth.
I’m fine with the public policy chips may fall where they may, but the President, the Secretary of Defense, the head of the NIH, the head of the FDA should be saying a medical truth.
The most important dynamic in America, I believe, is when a child or a parent is sitting across from their doctor at the first stage of metabolic dysfunction, they’re shoved into a one size fits all process right now where they immediately get on a pharmaceutical treadmill.
The medical guidance comes the NIH, the FDA and their associated groups like the American Diabetes Association, the American of Pediatrics.
That guidance itself is corrupt, and says that Ozempic is the cure for obesity and satins and heart disease. Not that if a doctor was recommending the right things, we’d be a healthier country.
So you just have to go after the medical guidelines that would transform the country.
So you just to go after the medical guidelines. That would transform the country.
The last red tape, just going after incentives. I think it’s a huge deal that our information sources have been totally co-opted.
50 percent of TV news spending, you know, coming from pharma is a huge deal.
And why the hell is our media playing referee for defending pharmaceutical companies? Why?
Why are they suppressing any questions around that?
That’s a huge problem that our dominant information sources for the past generation have been able to be co-opted by an industry that just as a statement of economic fact, profits from Americans getting sick, just undeniable. Tomorrow, tomorrow, the President could sign—that was actually, DTC [direct to consumer] pharma advertising was an executive order from Reagan.
It could be an executive order tomorrow. It’s actually beautiful. You could cut 50 percent of mainstream media revenue and be on the moral high ground. That’s absolutely something
So stop recommending the bad stuff and stop subsidizing.
There’s also a host of things you can do before we get into any taxes, any bans, which I’m not even interested in talking about.
Coke should exist, but it shouldn’t be subsidized by food stamps.
It shouldn’t be recommended by the USDA as something okay for kids. It shouldn’t be funded billions of dollars by the federal government, right?
Things just shouldn’t be incentivized.
We have a whole host of executive orders to cut the recommendations, to cut the conflicts and cut the incentives.
Tucker: When do we get to put the corrupt doctors in jail?
Calley: You go to the motivations a lot. I think again, the systemic genius of the health system is that it gives people plausibly deniability.
I would say though, that there’s knowledge, and we do need to start holding people accountable.
Tucker: Your sister is like the perfect example. I so strongly identify with the world you grew up in because I know it so well.
You were the highest achiever in your neighborhood, and you find that the system that you’re living in is incompatible with your values.
It’s morally unacceptable to you, and you opt out, but you’re the only one who opts out. So that raises questions about like, everyone who didn’t opt out. I’m sorry, it does.
Calley: I’ve got dark stat for you. We talk about this in the book.
The highest suicide rate of any rate of any profession, any profession in America is doctors, and the highest burnout rate.
So what I see with that is that you don’t—working hard doesn’t make you super depressed and suicidal. Like missionaries aren’t committing suicide. . . .
They actually had a New York Times article recently that indentified what doctors are feeling to towards soldiers. It’s the same psychological dynamic that soldiers who get in the fight for the right reasons, but then are forced by their superiors to comment war crimes. It’s actually, the New York Times compared doctors to Abu Gharib, like soldiers who are forced to do horrible things or felt like they were forced.
That’s I think what’s happening to the medical profession. These are all good people. There’s much easier ways to make money. We actually are this magnet that attracts the best and the brightest from all over the world.
We saddled them with debt. They have no other skills, and then they have societal expectations from their parents and all these credentials, but they do feel trapped.
So I hope, it’s certainly inspiring to me. It changed my whole life, kind of learning from Casey’s story.
I hope more and more people realize that there’s light moving away from this system.
And I always go back to Elon. Remember when he said, you’re speaking out about all these issues you care about, but advertisers are flocking away from you.
And he goes, I don’t give a f**k.
That’s the attitude we need in the health care industry. We need some people with that type of attitude because that’s the same thing. All these children are dying, but they’re playing along with it.
I’m talking to senior people at pharmaceutical companies and insurance companies. Everyone knows what’s going on. It’s like, it’s hard, we don’t know what to do. We need some leadership.
But again, with simple executive orders, you can start changing these incentives.
Tucker: You’re right, and I think I’m too judgmental. I mean, I participated in an enormously corrupt system for my entire life. So until I was fired. I wasn’t half as honorable as you.
Would you add anything to that?
Casey: Yeah, I mean, I think what Calley is talking about with the incentives is absolutely key.
Why is 75 percent of the FDA budget coming from pharma?
But I think there’s a couple of other things we could also sort of do to really change things. I mean one is that we need to stop recommending added sugar to two year olds, 10 percent of our diet. So that’s easy, right?
The science supports that, and actually when we were creating the 2020-2025 food guidelines for America, the medical advisory board to that panel said that we should absolutely reduce sugar recommendations from 10 percent to six percent of total calories.
And it was rejected by the USDA, even though the doctors said to do it.
So all these conflicts, we need to get the sugar out of that, because then we’ll have better school lunches, and we will not be telling parents it’s okay to give your kid 10 percent of their calories at two years old from added sugar.
Also I think there’s something really interesting we can do by actually using the existing tax and legal system to incentivize healthy purchases because right now, the healthier things are more expensive, and that’s a problem. And that’s because of our farm bills. So we need to change the farm bills.
We also need to give people more flexibility to use tax free dollars to buy healthy products like organic food. Calley has started an incredible company called True Med, which is helping to allow this to happen.
Why is it that we can use our HSA, FSA funding to buy drugs, but we can’t use it to buy organic food? This is crazy. Like this should be what we spend our tax advantage dollars on. So things like that.
Creating more patient choice with HSAs, and we also need to talk about things like food marketing to children.
We’re one of the only developed countries that’s allowing our TVs, Nickelodeon, for 28 percent of the ads to children to be able to ultra processed foods that we know are associated with chronic disease.
There’s other things, I think, that would be very high yield that are just very basic.