Fat Joe thinks you should know how much your healthcare costs

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A new study shows that H5N1 spread between cattle may be more complex than we previously thought. The Earth sets records for the hottest day on record, two days in a row. The 2024 Paris Olympics are in full swing. This is America Dissected. I'm your host, Dr.

Abdul-El-Sayed.

It's not every day that you get to interview a dude whose music you used to bounce to when you were younger. And it's particularly uncommon when the interview is about the price of healthcare. But that day, that day came for me. Fat Joe, or more. Joe these days, is the rapper responsible for absolute bangers from the mid-aughts, back when I was in college, like What's Love and Lean Back.

But these days, Joe's been leveraging his star power in other ways. Take a listen.

The idea is that posting prices would empower patients to make good decisions on certain services that they can plan for, like primary care visits, preventive procedures like colonoscopies and mammograms, and elective surgeries. And that would empower people to shop around and compare prices before they schedule a procedure, bringing prices down. as hospitals compete for business. The question, of course, is what proportion of health care can actually be planned, what experts call shoppable. Think about it.

There are some aspects of health care that you see coming, and some that you just don't. There's no way you could shop for emergency care if you had chest pain or needed your appendix removed. On the other hand, a colonoscopy or a knee replacement, they're not emergencies, giving you time to shop around. Estimates of just how much of the total amount of health care we consume is shoppable varies pretty widely, from as low as just a third to as high as almost three quarters. There's also another limitation to shoppability.

It's that you don't know the quality of the service you're getting. While hospitals have reputations, there's a lot that they do to try to bolster those reputations that have absolutely nothing to do with the health care they provide. It's why so many invest in massive atria, with people playing pianos and expensive art, which, if anything, detract from the same investments they could have been making in actual health care delivery. That said, price transparency has other advantages. It starts to chip away at the relatively opaque nature of the health care industry's price-setting practices, and it opens the door up to being able to fully understand how hospitals are setting their prices for everything, shoppable or not, and the role that the health insurance industry has in aiding and abetting it.

When I was on Capitol Hill a few weeks back to testify on our county's effort to eliminate medical debt, price transparency came up several times. And right now, there's a bill building steam that would realize the promise of price transparency. The, quote, Health Care Price Transparency Act 2.0, co-sponsored by Republican Senator Mike Braun and Senator Bernie Sanders, has earned bipartisan support. It would require that prices for 300 shoppable services be published immediately, with all prices negotiated between insurance companies and health care providers published by 2025.. It's what Fat Joe has been pushing for years now.

I wanted to understand how he came to this fight, his passion for price transparency, and where he'd like to see health care go in general in the future. My conversation with rapper, entertainer, and now health care price transparency activist, Fat Joe, after this break.

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All right. So we've got a guest, of course, who needs no introduction, but I'm going to ask you to introduce yourself with the tape, as we do here.

This is where I got to use my voice to help American people and help families out there.

You know, what does it look like to you in this country of ours, where too many people can't get healthcare?

So many people are afraid to go to the hospital due to the prices that it just only worsens the medical conditions. And that's why America is so unhealthy.

Why is it that we can't know the prices of something so serious as dealing with our health? And now, so what happens is, now that they are forced to say the prices, you can shop around to your local three hospitals that you believe in and see which one is cheaper. There's people right now, in this very day, in the hospital, using the same physicians. One is paying $8,000 for the same thing. One is paying $2,000..

One is paying $27,000 for the same procedure, same hospital, same doctors. And so, if this isn't a crime, I don't know what is.

I'm a Democrat, but I don't hear it enough from Joe Biden and them talking about healthcare, price transparency. You know, I don't hear it enough from the politicians. I don't hear it enough. This is something that I should be really hearing about in the convention right now. I'm watching on TV.

And no one seems to talk about this, and it's affecting all of America.

Now, if you don't make this choice, this seems to me to be like one of the no-brainer, obvious choices for you to make, then that means something's wrong. And I'm not going to go as far as you to say they're in the pocket of this and that, but, you know, it is what it is. What the politicians got to understand, it's the American people who voted you to get there. Don't forget them once you're there.

It's just there for you because you got sick. I mean, I went to grad school in England. I cracked the rib and I got great care, didn't have to spend anything and I've never paid a dime of taxes in the UK, right? I paid all my taxes here in the United States where, if I get sick, I got to end up paying thousands of dollars just to get care. In fact, this year alone, I had to get a surgery.

and with my insurance, with my government insurance, I still paid about $4,500 out of pocket. Now, I could afford it, but I can imagine a lot of folks in our communities just simply can't. You know, what would you like to see? You know, we got to make prices transparent. We got to do something about medical debt.

As you think about the kind of healthcare system you'd like to see, what does that look like to you?

But that's like a dream come true. It's sad because they got that in Canada, they got that all around the world, and we're the greatest nation on earth. We should have it. We shouldn't have nobody turn it away because they don't have the adequate insurance or the means of paying.

You know, and for now, I just want to keep focus on healthcare price transparency. Why, Joe? Because I want to be able to see who's going to give it to me cheaper. And once that's implemented and enforced, right, then you can shop around almost, you can almost Uberize the system to where whatever you need or whatever you want, you know, you can get it done, and it creates competition. That's what healthcare price transparency, what it really does, is creates competition.

Now we know what it is. We know what we plan. We have a choice. Where do we want to spend our money? This hospital, this hospital, or this hospital?

And they start thinking about the cost of different things, which means that even for the kind of care that folks get under duress, you can expect that you're going to get a fairer price, just because they actually have to put in the effort to think about it. One of the frustrations I think that both you and I are facing, and we haven't talked about it here, is the fact that people don't... You know, unfortunately, people who look like you and I don't vote as much as we should. And our community sometimes gets sick and tired of listening to politicians who often don't come from our communities, argue over things that aren't as clear in our own daily lives as this. And as you make your way about the community and you talk to folks, why is it that you think that that turnout is so low?

And what would it take for us to actually get our communities out and invest in the political process so we actually can get policy that looks like what it is that you and I are talking about today?

There's so many other countries out there that you can't even vote. So we got to be honored to be able to vote. So I've been voting since I'm 18 years old and encouraging everybody to register to vote and go vote. Before you can vote, you have to actually register to vote to be eligible. So it's a two-step process.

But I urge, it's power in numbers. When they see you come out, that's when they respond.

And, you know, that's a choice that we often make when people, when we don't show up, we are letting money win. And we get the politics that come with that. You know, one of the things I wanna switch tack a little bit here, just because you've made music your whole life, and that's a beautiful thing. And if I had any talent at all, you know, I might've done something different with my life. But the beautiful thing about music is you get to bring people together.

And I think one of the hard parts about this moment that we're in is people are further apart than we've ever been. You know, you think we access each other via these little machines that make us think that we're in front of each other, when actually, you know, they're dividing us more than they bring us together. And as someone who spent your career bringing people together, you know, what do you think that looks like in a digital era? Like? how do we start bringing people back together around the kinds of ideals that we're talking about today?

He said, get ahead and do something positive and see if anybody talks about you. The man's got a point, but we got to try to deflect from that and start to embrace each other and love each other. And because, you know, it really sucks that this country feels like it's split in half. And I just think we came too far. God is too great for us to let that happen to this great nation.

So that's as far as I can explain it to you.

Nothing can be good enough. And meanwhile, we're watching as our society continues to get split apart in smaller and smaller pieces.

The thing I love about your policy proposal here is that it is something that both, as you talked about, Democrats and Republicans can get behind, and potentially for different reasons.

You ain't got to be a character in the Game of Thrones for this. This is something that's a no brainer, man. This is helping the American people. You know, more people come up to me in the airport and commend me and give me praises for the work I'm doing with Power To The Patients, trying to get healthcare price transparency than they do in music these days. They say, Joe, this is it.

This is it. We're going to remember you for this, Joe. Get it done. See it through, Joe. And I say, I'm here.

I'm going to give it my all. I ain't backing up till it gets done.

in this world, everybody's just trying to get money, and as much money as they can. And so these people been living real good for a long time, and they're not willing to cut off the fat. You know, and so that's the problem we have. They don't want to... Imagine you own the company and somebody's selling you, you're making too much profit.

You're going to be like, wow, I thought this is what we was doing. Right? And so these guys have been making trillions of dollars, not even billions, trillions of dollars. And now you come along and you say, listen, guys, you know, to me it feels like you made enough money. You made a lot of money.

You made enough money for generations. Let's just cut it back, man, and help the people, because the people are crying. The price of groceries are up.

And so the American people are hemorrhaging. Something has to change.

for somebody. The little guy got to win sooner or later.

Like, there's a lot of things that you don't have to view. You want to, you know, sell Rolex is great. You don't have to have a Rolex, right? Nobody has to buy it. And if somebody wants it, they can, they can pay the price for it.

But when it comes to, you know, getting your appendix taken out, if it's bursting and about to kill you, or it's getting your insulin because you have diabetes, or it's being able to just afford a primary care visit just to get your numbers checked, those things shouldn't be exploited for a buck. And we've got a situation, now to your point, where a lot of these CEOs are making millions and millions of dollars, like tens of millions of dollars, to run a hospital system where every single one of those dollars, right? Whether it's on the insurance side or the hospital side, every single dollar is a dollar that somebody spent to provide themselves healthcare. I, you know, I just don't understand the mindset that tells you, yeah, it's cool for me to take 18 million of these or 20 million of these, right? When these people paid nickel and dime, right?

Trying to scrape out every last piece of a paycheck because they got sick, right? They had no other choice. It's like I either, I either stay ill or possibly die, or I pay the price that you're asking me to pay. And, you know, here we are, right? Here we are.

And we do this thing consistently. I guess, if you had the opportunity to sit, you know, person to person, with one of these CEOs and explain your position, what would you tell them?

Like what about the people, bro? That we're supposed to be helping and we're supposed to be caring about? What about the people, man? When is enough enough? I tell them in their face, when's enough enough?

You know, and it's pretty diabolical when you really go deep into it. So I just try to shine a light on it and bring positivity to it and try to motivate people to see it the way we see it, so that they can come together and do what they were sent to Washington, D.C. to do.

Like this is like, it's a no-brainer.

Let's pass this. Let's help the American people. A hundred million people are in debt. People are dying as we speak because of this. I mean, this is unfair.

And I think we're going to get it done. I think we'll get the Senator Braun and Bernie Sanders bill passed. I really think we're going to get it done.

They could be talking about anything and we still there. And so they realize they met some people that won't go away. So follow Power To The Patients on social media and we welcome you to find out what's really going on with healthcare price transparency.

As usual, here's what I'm watching right now. H5N1 has now spread to 170 herds and counting. In a new study published in the journal Nature, which tracked H5N1 spread between cattle and other species on nine farms in four states, demonstrates why containment may be a lot more complex than we think. Among the study's findings was the spread of the virus from cattle into wild birds, cats, and wild animals, including a raccoon and a skunk. It also found that upwards of 20% of cattle tested positive for the virus in nasal swabs, and some tested positive in urine.

Interestingly, asymptomatic cattle were the ones that were more likely to have virus in nasal swabs and urine than those with symptoms. And, contrary to popular conception that this is universally mild in cattle, in at least one outbreak, cow death rates spiked, with 99 cows dying on one of the farms in the study, more than twice the usual mortality rate. This paints a much more complicated picture of an outbreak that's likely spilling out of cattle in many more ways than we'd previously thought, suggesting that we really, really need to do more to stop it. On the subject of things we need to stop, the Earth took a cue from the Olympics last week, when, on Sunday, it set a record for the highest recorded temperature, and then promptly broke its own record the next day. Except these just aren't the kinds of records we really want to be breaking.

On their own terms, hotter days are dangerous. As we've covered on the pod in the past, heat events are the most dangerous of all the weather-related catastrophes, killing thousands and leading to untold consequences on everything from workplace injuries to reductions in student learning. But, more broadly, hotter days aren't just about weather extremes, but the cumulative consequences of a changing climate. That means higher probabilities that pandemic-causing viruses spill over into humans as habitats are destroyed, melting ice caps, obliterating coastlines, and pushing human populations into one another in a competition for resources, and collapses in biodiversity from oceans to the forests and beyond. Climate change is a particularly naughty problem, because it's the kind of problem we're really good at punting into the future.

The race for cheap and easy access to energy today seems to always take precedence over their consequences, quote, someday in the future. But as we set global heat records, I hope that reminds us that someday in the future was last week. Finally, the 2024 Paris Olympics are in full swing.

Marvel at the power it takes to clean and jerk nearly 600 pounds, or sprint 100 meters in under 10 seconds. Appreciate the fine control it takes to hit a bullseye from 230 feet with a bow and arrow. And awe at the balance it takes to do a flip on the balance bar 10 feet off the ground. In a world that keeps us paying attention to all that's wrong with it, it's okay to take a moment to appreciate all that's inspiring and incredible about the Olympics, more to know. I will be.

That's it for today. Thank you so much to Fat Joe for joining us. And if you have guest recommendations for the show, do share them with us at info at incisionmedia.co. And on your way out, don't forget to rate and review the show. It really does take us a long way.

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This show is for general information and entertainment purposes only. It's not intended to provide specific health care or medical advice and should not be considered as providing health care or medical advice. Please consult your own physician with any question related to your own health. The views expressed in this podcast reflect those of the host and do not necessarily present the views and opinions of Wayne County, Michigan, or its Department of Health, Human and Veteran Services.