Speaker 1: Oh Canada, crapsing the economy, recession looming.
Speaker 2: What happens next? Watch what happens? Will happen right here.
Speaker 3: On fifty five KRC, the talkstation Ato six here fifty
Speaker 3: five car CD talk station and a happy Thursday to you.
Speaker 3: Out of the r with Irbdadation Next.
Speaker 2: Mer Jay Rattler.
Speaker 3: But right now I'm really excited and please welcome to
Speaker 3: the fifty five KRC Morning Show. Doctor Paul Winfrey, President
Speaker 3: CEO of an organization called the Economic Policy Innovation Center.
Speaker 3: He served a top management policy roles in the White House,
Speaker 3: US Senate as well as think tanks, and during the
Speaker 3: first Trump administration, he served as the Deputy Assistant to
Speaker 3: the President for Domestic Policy and Deputy Director of Domestic
Speaker 3: Policy Council. His research has been featured in The Wall
Speaker 3: Street Journal, New York Times, Washington Post, Investors, Business Daily,
Speaker 3: USA Today, in Congressional Quartery, among other publications. Also the
Speaker 3: author of the History and Future of the Budget Process
Speaker 3: in the United States. Doctor Winfree, Welcome to the program.
Speaker 3: It's a real pleasure to have you on, sir.
Speaker 4: Thanks for having me. I appreciate it. Well.
Speaker 3: When you read the news, you think the world is
Speaker 3: coming to an end. Oh my god, eight point six
Speaker 3: million people are going to be deprived of healthcare if
Speaker 3: these reforms go in that the Republicans are talking about.
Speaker 3: Let us start with it seems to me that many
Speaker 3: of the Democrats who are railing against requiring people who
Speaker 3: are able bodied in their prime work years to actually
Speaker 3: participate and work or do something for twenty hours a week,
Speaker 3: they shouldn't be on Medicaid. Can you remind my listeners
Speaker 3: who may be on this fence and about the issue,
Speaker 3: what Medicaid was originally designed to do.
Speaker 4: That's exactly right.
Speaker 1: I mean, if you break down the eight million person
Speaker 1: number or the eight million lost coverage number, one point
Speaker 1: four million of those folks are illegal immigrants. One and
Speaker 1: a half million of them are not eligible for Medicaid,
Speaker 1: but they've been retained on the program by regulations that
Speaker 1: are promulgated by the Biden administration. Another couple of million
Speaker 1: are people who don't even exist right now, but CBO
Speaker 1: says may exist in the future and maybe eligible for Medicaid.
Speaker 1: And everybody else are working age adults who are healthy
Speaker 1: and currently on the program and don't have any don't
Speaker 1: have any requirement to work. When the program was created,
Speaker 1: as you mentioned in the nineteen sixties, this was a
Speaker 1: program for the vulnerable folks, the disabled, the blind, pregnant
Speaker 1: moms and kids. And what we've seen over the last
Speaker 1: ten years is the program has evolved to benefit the
Speaker 1: healthy adults without dependence over the truly vulnerable, which is
Speaker 1: changing the way that medicine is delivered and ultimately making
Speaker 1: it harder for folks who truly need the Medicaid program
Speaker 1: to see to see doctors, and to get the healthcare
Speaker 1: that they ultimately need.
Speaker 3: So what they've done is they've undermined Medicaid's original intent.
Speaker 3: They put all these people on who weren't eligible for
Speaker 3: it originally. How is it that it expanded so much
Speaker 3: and people didn't say, well, well, whoa whoa, we're we're
Speaker 3: this is this has gone way on the scope of
Speaker 3: what was truly intended, yeah.
Speaker 4: To get this.
Speaker 1: When Obamacare was created in twenty ten, and then it
Speaker 1: expanded the Medicaid program to the healthy adults in twenty fourteen,
Speaker 1: they knew that states would be disinclined to expand Medicaid
Speaker 1: to the healthy population because it would have added to
Speaker 1: their state budgets, and so what they did is they
Speaker 1: set up a new financing structure that rewards states for
Speaker 1: enrolling healthy adults. So for every one dollar that states spend,
Speaker 1: they get nine dollars from the federal government if they
Speaker 1: enroll in help healthy adults without kids, and they get
Speaker 1: a dollar thirty three for every dollar that they spend
Speaker 1: for every pregnant mom, disabled person, blind person, elderly person
Speaker 1: or child that they put on the Medicaid program. And
Speaker 1: so if you think about it that way, from a
Speaker 1: state's perspective, they're literally rewarded by the federal government for
Speaker 1: enrolling and shifting medicine towards healthy adults over people who
Speaker 1: truly need it. And and that those those incentives have
Speaker 1: become even more strengthened because of some Biden regulations that
Speaker 1: have been pushed out over the last four years that
Speaker 1: have just accelerated that and encouraged states even more to
Speaker 1: take up the Obamacare expansion. And that's that's that's really
Speaker 1: what we're talking about here.
Speaker 3: So the left has been advocating for universal health care.
Speaker 3: I mean it was supposed to Obamacare is supposed to
Speaker 3: do that. I know Hillary Clinton never to do it
Speaker 3: back when she was the first lady. But obviously it
Speaker 3: didn't go through then. But this sounds just like a
Speaker 3: nefarious backdoor mechanism to create that reality because more and
Speaker 3: more people are expanded put on Medicaid and are not
Speaker 3: in private insurance or or dealing with it on their own.
Speaker 3: Is that that kind of what's actually unfolding here, Bingo,
Speaker 3: you're exactly right.
Speaker 1: So the left has been talking for years about Medicare
Speaker 1: for all, right, Bernie Sanders has been talking about Medicare
Speaker 1: for all for years.
Speaker 2: You've got bills to do this.
Speaker 1: Democrats in the House, Aos, they also have bills to
Speaker 1: do this. The real trojan horse here is that it
Speaker 1: was never intended to be Medicare for all. It was
Speaker 1: intended to be Medicaid for all. And one of the
Speaker 1: big differences that seniors know between Medicare and Medicaid is
Speaker 1: that doctors get paid much less for seeing the vulnerable
Speaker 1: population in Medicaid than they do for Medicare or private
Speaker 1: health insurance.
Speaker 4: Or even Medicaid for the healthy.
Speaker 1: Adults because of the incentive structure to push medicine towards
Speaker 1: the healthy adults in the Medicaid program. What that means
Speaker 1: is that right now today there are about seven hundred
Speaker 1: and ten thousand disabled Americans on Medicaid wait lists to
Speaker 1: get things like home health care because the states have
Speaker 1: again been incentivized not to spend on that population because
Speaker 1: that's what the federal government has been telling them to do.
Speaker 1: And if they keep moving this in the tenet non
Speaker 1: expansion states expand Medicaid like Texas and Florida and Georgia,
Speaker 1: then we are going to become that much closer to
Speaker 1: a Medicaid for all system where there's just a takeover
Speaker 1: of healthcare and it's all run out of HHS.
Speaker 4: That's where we're going right now.
Speaker 1: Eighty million Americans are on Medicaid, a program that was
Speaker 1: originally intended to be for the truly vulnerable.
Speaker 3: And I know you've pointed out in your research, your
Speaker 3: in your writings on this that states exploit medical Medicaid
Speaker 3: with with what you referred to as loopholes, private provider
Speaker 3: taxes and state directed payments which you I think referred
Speaker 3: to as money laundering schemes.
Speaker 2: How do these work?
Speaker 3: And isn't this a reform that should be incorporated into
Speaker 3: what the Republicans are trying to do right now?
Speaker 1: So the Medicaid provider taxes. If if the private sector were.
Speaker 2: To do this, it would be illegal. People will go
Speaker 2: to jail.
Speaker 4: Literally.
Speaker 1: What happens is that the states tax medicaid providers, insurers,
Speaker 1: and hospitals in particular. They then re burse the same
Speaker 1: amount of money that they're taxing the hospitals and the insurance.
Speaker 1: So they pay the insurers and the hospitals to pay
Speaker 1: the tax. They then bill the federal government for the
Speaker 1: amount of that tax, and the federal government reimburses the state.
Speaker 4: The states then split the.
Speaker 1: Money that they get from the federal government with the providers,
Speaker 1: so they send it to the insurers and through higher
Speaker 1: capitation rates or higher premiums, and they send it to
Speaker 1: the hospitals through to higher payments.
Speaker 4: But here's the really wild thing that's going on here again.
Speaker 4: Because states get.
Speaker 1: Nine dollars from the federal government for every one dollar
Speaker 1: that they spend on the healthy population, they're incentivized to
Speaker 1: gain this in particular in the direction of the healthy population.
Speaker 4: And so what we're seeing right.
Speaker 1: Now play out in quite literally real time is that
Speaker 1: there's a pollution between state governments and the hospitals and
Speaker 1: the insurers to figure out ways in which they can
Speaker 1: increase premiums and prices for the healthy adult population to
Speaker 1: take advantage of these money laundering schemes. And what that's
Speaker 1: doing is it's quite literally redirecting the way that medicine
Speaker 1: is delivered so that the vulnerable folks don't want to
Speaker 1: be seen by doctors. Rather, the doctors want to see
Speaker 1: healthy folks because they get paid more for seeing them
Speaker 1: by the federal and state governments.
Speaker 4: And personally, I mean, just as a as a.
Speaker 1: Tax paying American, I think that that's wrong, and I
Speaker 1: don't want to see my own my own tax dollars
Speaker 1: go for things like that.
Speaker 2: That structure is just.
Speaker 3: I'm just mine. My mind is boggled by this, doctor Winfrey.
Speaker 3: And then that's the way it exists, creating zero incentive
Speaker 3: whatsoever for states to want to reign in or or
Speaker 3: ride heard over the medicaid dollars that are being spent.
Speaker 3: I mean, there's zero incentive there.
Speaker 1: Their zero incentive. And we've seen, I mean, your listeners
Speaker 1: know exactly.
Speaker 2: The states that have abused this the.
Speaker 1: Most without me even saying the names, California and New York.
Speaker 1: But California and New York have used these money long
Speaker 1: during scams to funnel more and more money back to
Speaker 1: the back back to the state governments from the Feil government.
Speaker 1: They've then used the profits from these money laundering scams
Speaker 1: to provide health insurance medicaid for illegal immigrants, but also
Speaker 1: to pay for things that have absolutely nothing to do
Speaker 1: with healthcare to fund budget shortfalls in their own states.
Speaker 1: And they're doing this on the backs of medicaid. They're
Speaker 1: literally using medicaid to funnel federal money back to the
Speaker 1: state to fund their budget, fund their budget shortfalls. And
Speaker 1: so Congress is looking right now at closing or at
Speaker 1: least limiting.
Speaker 4: Some of those loopholes.
Speaker 1: But really I think that they can go even even
Speaker 1: further than what than what they're doing well.
Speaker 3: And you know, it's sort of like I wish the
Speaker 3: American public who could listen to this particular interview now
Speaker 3: or at least have the understanding that doctor Winfrey here has,
Speaker 3: because then they would easily reject these screams and wailing
Speaker 3: and gnashing of teeth about all these eight million people
Speaker 3: are going to lose their medical benefits because as you
Speaker 3: describe it, of course clearly they shouldn't have them anyway.
Speaker 3: But the idea that this system has been so upside
Speaker 3: down that it incentivizes treating the healthy people to the
Speaker 3: exclusion of the original point of Medicaid.
Speaker 2: I think would rile people up and will be anger.
Speaker 4: That's exactly right.
Speaker 1: The Congressional Budget Office just last week put out a
Speaker 1: letter that said that if you reduced the f MAP,
Speaker 1: or the amount of the federal contribution for the healthy population,
Speaker 1: down to the rate that the philogarment paced for the
Speaker 1: vulnerable population, it will save about seventy one billion dollars
Speaker 1: a year. At the same time, only about two million
Speaker 1: people will become uninsured based on their estimates. If you
Speaker 1: divide the seventy one billion by the two million, you
Speaker 1: get about thirty thousand dollars a year that the federal
Speaker 1: government is paying to ensure the marginal person on the
Speaker 1: Medicaid program, even though the even though the federal government
Speaker 1: tells us that it only costs about eight thousand dollars
Speaker 1: to ensure a person on Medicaid. So one has to
Speaker 1: ask the question where did the other twenty two thousand
Speaker 1: dollars go? And the answer is that it's being channeled
Speaker 1: to the state governments and the insurers and the hospitals
Speaker 1: which is why those groups are the ones that are
Speaker 1: actually panicking about what Congress is doing right now and
Speaker 1: trying to incite a riot in Washington, DC amongst the
Speaker 1: vulnerable Medicaid recipients.
Speaker 3: I can only imagine the lobbying frenzy that's going on
Speaker 3: right now in DC given this as a topic of
Speaker 3: conversation with reconciliation.
Speaker 4: It's absolutely incredible.
Speaker 1: Let me give you another just a quick fact here
Speaker 1: that really surprised me when I discovered.
Speaker 2: It a couple of months ago, and.
Speaker 1: That is is that the highest compensated healthcare insurance CEO
Speaker 1: in the country is a Medicaid managed care provider. He
Speaker 1: covers Medicaid recipients. Eighty eight percent of his beneficiaries are
Speaker 1: on Medicaid, the rest are on the other twelve percent
Speaker 1: are either on Obamacare subsidized plans or Medicare advantage plan.
Speaker 1: They cover about five point two million people in America.
Speaker 1: This is the highest compensated health insurance CEO in the country.
Speaker 1: And you know, like I don't you want to speak
Speaker 1: for other people, but I personally believe that, you know,
Speaker 1: we shouldn't be creating a system where you can get
Speaker 1: rich off of providing.
Speaker 2: Welfare to people, right.
Speaker 4: I think that that's wrong and also one.
Speaker 1: In which one hundred percent of your revenue is connected
Speaker 1: to the federal government. Right, Like we should, you know,
Speaker 1: we should have a better profit motive for people who
Speaker 1: could make money by actually improving people's lives and making
Speaker 1: them healthier.
Speaker 3: Amen to that sounds like a lot of the problems
Speaker 3: we're have with non governmental organizations just generally speaking. I mean,
Speaker 3: they exist to create jobs for the people that work
Speaker 3: within the organizations and taking federal taxpayer dollars and really
Speaker 3: I think going out into the world and literally accomplishing
Speaker 3: nothing except perhaps letting the money loop back a little
Speaker 3: bit to line the pockets and politicians in DC.
Speaker 2: BINGO. I mean, that's exactly right.
Speaker 1: And you know, one of the things actually, you know,
Speaker 1: that we've been talking to some of the members of
Speaker 1: COMMRESCE about is that there's pretty good data on how
Speaker 1: when you expand Medicaid and other welfare programs, democratic turnout
Speaker 1: in democratic counties goes up. And the reason for that
Speaker 1: is because the healthcare industrial and welfare industrial complex uses
Speaker 1: these NGOs that are that are that are far left
Speaker 1: in many cases, like planned parenthood and others to help
Speaker 1: them enroll people. And then and that gives those same
Speaker 1: NGO's access to you know, names and addresses, which allows
Speaker 1: them to go out and and increase turnout right and into.
Speaker 4: Put into boot harvest and uh. And so you know,
Speaker 4: by by expanding.
Speaker 1: The welfare state, not only are we creating a culture
Speaker 1: of dependency, but we're also creating a culture that feeds
Speaker 1: one party, one political party over the other.
Speaker 4: And that's intentional.
Speaker 1: They that's they they know that that's what they're doing.
Speaker 3: We are you didn't you didn't come looking for an
Speaker 3: argument today, doctor Paul Winfrey. Unbelievable, so so revealing and
Speaker 3: so nefarious. If I can boil down this entire concept
Speaker 3: of what's gone on, what's what's unfolded over the years
Speaker 3: with Medicaid, EPIC, ep I CE, epic for America dot org.
Speaker 3: Really valuable website you've got going there and the work
Speaker 3: that you're doing there is just is so important.
Speaker 2: Doctor.
Speaker 3: Thank you so much for spending time with my listeners
Speaker 3: and enlightening them and me on the how bad this
Speaker 3: is out there. And let's keep our fingers crossed and
Speaker 3: we do get some reform paths, because this is a
Speaker 3: this is a sinking ship round. This is just one
Speaker 3: part of the of the budget and clearly we have
Speaker 3: outspent ourselves to a degree that I think it's an
Speaker 3: existential threat to our existence as a country.
Speaker 4: Thank you very much for having me.
Speaker 2: I really appreciate it. It's been my pleasure, sir. Thank you.
Speaker 3: Eight twenty one fifty five kr C Detalk station Jeez
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