00;00;01;14 - 00;00;05;16 Announcer And now America's Healthcare Advocate, Cary Hall. 00;00;05;23 - 00;00;25;17 Cary Hall Hello, America. Welcome to America's health care advocate show broadcasting coast to coast across the USA. Here on the HIA Radio Network. You can find out more about us by going to the website americashealthcareadvocate.com. Today is a multi-topic show or as still Darren Wilhite coined it years ago a potpourri show. 00;00;25;19 - 00;00;43;18 Cary Hall Cornucopia? See, I messed it up. It's cornucopia. So we got a lot of stuff tp cover today, I guess is what I'm trying to say. So we're going to talk about everything from diabetes management to Alzheimer's. and with our hosted caregivers, what the caregivers go through with a host of topics. So we're going to start off with one that was kind of interesting. 00;00;43;20 - 00;01;06;27 Cary Hall Recently, my wife and I went to Hawaii. And typically when we do that, we spend the night in Los Angeles, close to the airport. We're in our hotel room and I'm watching, the television and I see commercials coming on the air for a program called Medi-Cal. Medi-Cal is California's own health insurance plan. They have their own health insurance plan, that is available to a lot of people. 00;01;06;29 - 00;01;32;22 Cary Hall And it turns out that it's now available to people who are. And I'm quoting the commercial undocumented immigrants. So undocumented immigrants now have full health insurance. They're advertising for these people to get health insurance. Is State of California paid for by the taxpayers? For the state of California? I thought I was it first. I was kind of floored, I wasn't sure of is really what I was seeing was correct. 00;01;32;22 - 00;01;54;15 Cary Hall I can't imagine what that's going to cost the state of California, which, by the way, is currently in the red to the tune of $74 billion. That's B with the billion. and Medi-Cal is one of the big reasons why they're in the red, is because they offer this not just to the residents of California that are tax payers, but they offer it to now to people that are undocumented immigrants. 00;01;54;20 - 00;02;22;11 Cary Hall Now, why is that interesting? Well, I read across a letter to the editor in one of the many newspapers that I read, and she is talking about a sister who has Alzheimer's. Now, she already had one sister that had Alzheimer's. And during that period of time, she was able to get her into the Medi-Cal program and into a facility, where they could help her and take care of her because she had memory issues, Alzheimer's, etc. this time, that was 12 years ago. 00;02;22;13 - 00;02;45;26 Cary Hall She has the exact same problem again with a different sister, and she is trying to get her on to Medi-Cal. But what she found out was there's a two and a half year wait to get a special designation now to get her sister in for a care facility for Alzheimer's, paid for by the state of California. 12 years ago, she was able to get her sister into a facility, no questions asked. 00;02;46;03 - 00;03;11;09 Cary Hall Now she's finding there's a two and a half year wait. She draws the conclusion that one of the reasons for this is because they are offering free health care, free health insurance to people that are undocumented immigrants, of which California has a flood, as I'm sure many of you know, because basically all these folks are coming across the border and this is what's happening. 00;03;11;09 - 00;03;33;29 Cary Hall They're migrating into places like California, New York, other places that, are sanctuary cities, sanctuary states where they know they're going to get benefits, care, etc.. So now they're talking about this is going to add $3.1 billion to the already upside down California budget. I have to tell you, you really have to ask yourself the question, where is the sanity in all this? 00;03;33;29 - 00;04;07;06 Cary Hall Okay, so the conclusion that she draws, which is fascinating, is that people like her sister and her, who are in their 70s, who have paid their taxes, their families for years into the California system, the taxpayers system for the state of California are now being denied the access that they paid for, so that people who haven't paid for this, okay, that are coming across the border as undocumented immigrants now have access to health insurance, I don't know, seems a little upside down to me. 00;04;07;09 - 00;04;27;17 Cary Hall Okay. I mean, if California at the folks in California want to give health insurance to undocumented immigrants, that's certainly their business. But when you take away the benefits that are part of what the citizens of the state that have been paying taxes in this case, for how many years, 50 years they were employed, whatever the case may be. 00;04;27;17 - 00;04;46;21 Cary Hall And now she has a two and a half year wait to get her, her, her sister into a program where she has care. So what's she going to do with her for two and a half years? I don't know, it's certainly not a good situation, but that is an example of some of the things that are going on, in our country right now. 00;04;46;21 - 00;05;05;02 Cary Hall In this particular case, the state of California, which, sometimes those things are just a little bit different. I certainly think you would have to agree that this one is different. California seems to have a lot of problems these days. You know, my wife and I moved out of there 28 years ago. and it is definitely a different place than it was then. 00;05;05;04 - 00;05;30;05 Cary Hall And our second topic going to talk about today, brisk walking, may help cut the diabetes risk by nearly 40%. this is interesting. So I calculated what they said here. And this is kind of interesting is if you walk 75 to 150 minutes a week, that you can drop your, chances of getting diabetes by 40%. So I went out and calculated how much I walk each day. 00;05;30;08 - 00;05;47;16 Cary Hall So what I do is I take my dog, Twigs. She's a corgi out every morning we do a half a mile up a hill, down a hill, from my house. And then I work out three times a week. and one of my part of my workout is one and a half miles on a treadmill, which takes exactly 30 minutes. 00;05;47;24 - 00;06;09;27 Cary Hall So I calculated all that out, and I figured that, I'm doing about, 180 minutes a week, which is pretty good, right? So I just thought it was an interesting correlation. that by simply doing something because you think about this, you know, there's an epidemic of type two diabetes in this country, especially among seasoned citizens over the age of 65. 00;06;10;05 - 00;06;33;11 Cary Hall Your chances of getting of winding up with type two diabetes are significantly higher than folks who are in their 30s and 40s. But, you know, and we hear this diet and exercise, diet and exercise, diet and exercise. Well, here is something that is really simple, brisk walking. And they actually, in this particular article talked about this is brisk walking that you do when you do this. 00;06;33;11 - 00;06;51;28 Cary Hall And, and I do very brisk walking when I'm out with my dog and I do obviously on the treadmill, the same kind of thing. So I thought it was interesting, something as simple as that. They said research is show that speed is a factor in the prevention of type two diabetes. As you're walking. Speed indicator is an indicator overall health. 00;06;52;04 - 00;07;22;24 Cary Hall Apparently healthy people who can walk briskly are more likely to participate in daily physical activity programs, the researchers wrote. And these people, have better cardio fitness and a higher capacity for circular respiratory systems to deliver oxygen to the muscles throughout, continuous physical exercise and also brisk walking, decreases body weight, waist size and, body fat percentage. 00;07;22;24 - 00;07;43;01 Cary Hall Diet. I really wish it would decrease my weight size. I'm still working on that one and not doing all that well. Dave's laughing over here. He doesn't have that problem, but I do. So anyway, I thought you'd find that interesting. If you are a seasoned citizen, you might want to consider something as simple as getting, between 75 and 130 minutes, a month. 00;07;43;04 - 00;07;56;15 Cary Hall Excuse me? A week of walking. It's not that hard to do. I do it, okay? I'm a busy guy, but I do it. and I think it'd be a good idea for you to do it. All right, we're going to come right back after break. We're going to talk about, something it's kind of interesting here. 00;07;56;15 - 00;08;16;22 Cary Hall We're going to talk about these obesity drugs. We're going to talk about Ozempic, and we're going to talk about Wegovy. We're going to talk about, the good, the good. We're going to talk to the bad and the ugly. So stay tuned. We'll be right back after the break. You're listening to America's Health Care Advocate Broadcasting here on the HIA Radio Network Coast to coast across the USA. 00;08;16;25 - 00;08;46;26 Steve Kuker The golden rule treat others is you want to be treated. I'm Steve Kuker, and this is one of the founding principles of my firm, Senior Care Consulting. Since 2002, our value statement has included honor our mother and father, respect our elders, care for those in need, and treat your family as our own. We've been honored to help hundreds of families make one of the most difficult decisions they could ever make. 00;08;47;00 - 00;09;21;09 Steve Kuker Serving them in their greatest time of need. If you're looking for someone who can provide you experienced and objective guidance when searching for a senior care community, reach out today and discover the services of Senior Care consulting at 913-945-2800. Know your options and choose with care at seniorcareconsulting.com. 00;09;21;11 - 00;09;45;05 Cary Hall Welcome back. You're listening to America's Health Care Advocate show broadcasting coast to coast across the USA. Here on the HIA Radio Network. You can find out more about us by going to the website America's Health Care Advocate dot com. All right. Our second topic today, the obesity drug revolution just got real. This is out of the Wall Street Journal. Fascinating because it was actually in the exchange section of the journal, which comes out on Saturdays. 00;09;45;13 - 00;10;09;09 Cary Hall And it was investment advice. And they're advising here that a great place to invest or is in the companies that are producing these two drugs. Number one, Nova Nordisk which is producing Wegovi, and I can't remember the name of the, of the, of the drug producer that is doing Ozempic. But those two they were suggesting would be a great place to invest because there's an explosion of people using this. 00;10;09;09 - 00;10;36;10 Cary Hall So new data from a five year Novo Nordisk trial showing major cardiovascular benefits from its drug Wegovi will add pressure, to insurers to cover the new class of medications known as GLP-1’s and could eventually pave the way for Medicare coverage that will have significant implications for our society, where four out of ten adults are obese. 00;10;36;12 - 00;10;58;25 Cary Hall as well as for investors in this space, which is emerging as a dual play with Eli Lilly. And so Eli Lilly is the Ozempic, producer. And then Novo Nordisk is the is the Wegovi. So let's talk about this a little bit. it's a fascinating drug. I was offered this drug because I have a weight issue that I fight like hell. 00;10;58;27 - 00;11;20;08 Cary Hall and I'm not winning right now, but my my doctor offered this, and it was available, but it wasn't covered by insurance, so it costs $13,600 a year. That's the cost, roughly, of the of these two drugs. So, Wegovi is, is actually 13,000. I think Ozempic is around 12 or something. So they're not cheap. They're not covered by health insurance. 00;11;20;11 - 00;11;47;02 Cary Hall Now, if you're type two diabetic, Ozempic, which they'd be used for type two diabetes for years, is available and covered. But if you using it for weight loss, you're not covered. Okay. And so what they're saying here is because this study that's showing, significant improvement with people that may have cardiovascular issues, okay, that they may force the insurance carriers and then CMS and maybe the VA (we’ll see). 00;11;47;04 - 00;12;12;22 Cary Hall We're going to talk about those folks here in one of the upcoming segments. would force them to, approve this drug for medical coverage. So it's interesting. So they go on to say, in here, we always knew that the weekly anti-obesity injection helps patients lose weight, but now have, confirmation that the medication helps prevent strokes, heart attacks, as well as others. 00;12;12;25 - 00;12;40;18 Cary Hall Novo Nordisk said that patients in a long term trial of the first of its kind said there was a 20% reduction with heart attacks, strokes and cardiovascular deaths, combined with those who received, versus those who received a placebo. And those who actually took the medication. So that's pretty significant. Okay, so here's the thing you wanna go about and why this is a bigger issue for seasoned citizens than it is the other, other piece of the population. 00;12;40;20 - 00;13;01;12 Cary Hall You know, there are a lot of obese people under the age 65. But it becomes a bigger issue as you age, especially as it relates to cardiovascular. And some of the other issues that we have to deal with as seasoned citizens. Okay, so the average cost of a stroke or a heart attack in the hospital is between 70 and $200,000. 00;13;01;14 - 00;13;27;15 Cary Hall That might motivate that may motivate, insurance carriers to spend $13,600 to prevent that $200,000 or $70,000 claim for a stroke or heart attack. And it can be more than that. A bypass surgery typically runs around about $200,000. If it's a triple bypass, by the time you do the surgery, pay the hospital and then there's the recovery time, etc., etc., etc.. 00;13;27;19 - 00;13;48;03 Cary Hall So when you think about that, if it's $13,600 a year, to give you, Wegovi or Ozempic, it's very possible that the insurance carriers may decide this is something they want to take a look at. Here's the other side of this. This is this is what concerns me. Okay. What happens when you. I've got friends that are doing this and they look great. 00;13;48;03 - 00;14;08;08 Cary Hall They've lost weight. What happens when you stop taking this stuff? When you stop that weekly injection? You know, one of the complaints about dieting is that it's a yo yo situation, right? Well, what happens with this? Are you on this for the rest of your life? That concerns me. All right. Aside from the cost issue, are you on this for the rest of your life? 00;14;08;08 - 00;14;30;20 Cary Hall Does that mean every week for the rest of your life, you're going to be giving yourself one of these injections? And here's where I have a problem with that. In fact, Darren Wilhite, our producer here off of break, told me of a story of a woman who was on Wegovi and has had horrible digestive issues afterwards and now will never have a solid stool again for the rest of her life because of the side effects of this med. 00;14;30;23 - 00;14;49;22 Cary Hall What are the side effects of these two meds? There are no long term studies on on on that particular issue in terms of weight loss. I'm not talking about the diabetes people. It has been around for a significant amount of time for diabetes people. But what about this Wegovi, Okay. As an example, which is a new medication. 00;14;49;25 - 00;15;15;19 Cary Hall And what is what what about that particular issue, and how that's going to affect you? Number one, do you have to take it the rest of your life, okay, or you're going to gain the weight back? Number two, what are the side effects? What if we find ourselves ten years from now, five years from now, they start running after market trials like they've done with, a number of medications. 00;15;15;22 - 00;15;39;02 Cary Hall and this is typical what they do, they it gets approved by the FDA, it goes into the marketplace. They have to do a series. There's four steps they have to go through to get approval. That includes trials like the one that I just mentioned here. Okay. Which in this particular case showed a significant reduction. I think it was 26% reduction in people that were going to have heart attack and strokes due to obesity when they were on these medications. 00;15;39;02 - 00;16;03;22 Cary Hall Well, what happens when they do one of these aftermarket trials, five years now or three years from now when people bid on this stuff for an extended period of time, and then they start to uncover side effects of these medications, because let's be clear about something, okay? All these meds, I don't care what they are. If you're taking a blood pressure med a cholesterol, that they all have side effects, side effects of some kind. 00;16;03;24 - 00;16;21;13 Cary Hall Okay, so what we don't know here. We don't know what we don't know. So I, I, I'm a little cautious about this frankly. You know, could I go out and pay 13,000. Yeah I could if I wanted to do it. But, my concern is, number one, I don't know what I'm going to do if I stop taking it. 00;16;21;13 - 00;16;40;10 Cary Hall So it's all great and good that I got rid of the weight. But how do I keep it off? What? You know, I don't eat extravagantly, don't eat a lot of fast food. My wife's very diligent about the kind of meals we eat, but this happens as you age. Your metabolism slows down. Okay, so I don't know. Okay? 00;16;40;10 - 00;17;06;29 Cary Hall I just think it's interesting. I certainly think if you're out there considering this, you better have a significant conversation with your provider about what happens when you stop taking this stuff. And do they know, you know, other side effects, maybe you have other health conditions, maybe co-morbidities that are other issues. Before I jumped on this stuff, I would, give it serious consideration to find out what the side effects might be, at least what they know now. 00;17;07;01 - 00;17;28;13 Cary Hall Anyway, that's my take on the two obesity drugs by the way. they are great investment opportunities. That's directly from the Wall Street Journal. So Eli Lilly and, Nova Nordisk, are probably pretty good investment opportunities right now based on the way this, medication is flying off the shelves in pharmacies. All right. We'll be right back after the break. 00;17;28;13 - 00;17;46;01 Cary Hall You're listening to America's Health Care Advocate broadcasting here on the HIA Radio Network. Coast to coast across the USA. We've got more. Stay tuned. 00;17;46;04 - 00;18;06;17 Cary Hall Welcome back. You're listening to America's Healthcare Advocate show, broadcasting coast to coast across the USA, here on the HIA radio network, you can find out more about us by going to the website America's Healthcare Advocate dot com. So the next topic I'm gonna talk about is caregiving. And this kind of hit home for me when I saw this article, because my brother, has passed. 00;18;06;20 - 00;18;28;04 Cary Hall He was eight years younger than me, and he was in hospice care. And I flew to Indiana to be with him. And my sister went to Indiana after me and spent over a month taking care of him. And the mental consequences. Not so much what I went through because I was there for a short period of time. But what my sister went through just in that month, month and a half that she was up there was pretty obvious and pretty significant. 00;18;28;04 - 00;18;58;27 Cary Hall And so I ran across this article. You know, this becomes more significant as you age because is it going to be you taking care of a spouse? Is it a spouse taking care of you? Or is it one of your children having to take care of you? I had a woman call me the other day who was having a terrible time off the broadcast here with her mother, and who knows she's going to have to be a caregiver and is at her wit's end trying to figure out how she's going to deal with it because she's a mother of four, four children at home. 00;18;58;27 - 00;19;24;20 Cary Hall And she's got now this aging mother who's having all these problems. So this is what I wanted to talk about here. The health consequences of caregiving, especially for the sandwich generation. spouses and aging parents caregiver responsibilities can lead to far more than physical exhaustion. Demands can create a tug of emotional, mental, and physical health, issues that can compound the burdens they put on your bodies. 00;19;24;20 - 00;19;49;20 Cary Hall At least 40% of caregivers display symptoms of depression, according to a family caregiver alliance, and those who take care of someone with emotional or mental health problems, or more likely to report a decline in their own health. About 40% of those caring for someone with dementia suffer from depression, and more than double that rate in their peers who aren't caregiving. 00;19;49;20 - 00;20;11;19 Cary Hall So that's more than double the rate of people who aren't doing that, that are their peers. And so if you if a 45 year old child is taking care of an 87 year old person, it's got those issues. It's going to have significant impact on them. This is something we don't recognize, okay. And it's something that we don't do a lot about in this country. 00;20;11;19 - 00;20;28;26 Cary Hall And that's why I want to bring it out. And we're going to talk about this today and why how do you resolve that? How do you deal with that and what are the solutions to it? So I'm going to keep going. So they go on to say in here that you you never get an expiration date when you're a caregiver. 00;20;28;26 - 00;20;51;08 Cary Hall Think about that. Think about that. That really caught my attention. You never get an expiration date when you're a caregiver. If you don't pace yourself, you could really end up in a very bad way. Yeah, you could okay. You know, the the the issues that caregivers have to deal with that are physical issues. They have to deal with exhaustion. 00;20;51;11 - 00;21;13;13 Cary Hall they show a greater propensity for diabetes, heart attack, stroke, all these things that they have to deal with as caregivers, I never will forget. Years and years ago, I went to the house of, of a client who I was going to do health insurance for, and she ran a day care. Yet there was this man walking around the house, and I was like, who? 00;21;13;15 - 00;21;34;05 Cary Hall Who is that? Oh, that's my husband. Now, this woman was in her 50s and he was roughly the same age. And I said, he just wanders around. She said, yeah, if I don't keep him here and keep an eye on him, he just walks off and we don't know where he is. That's happened a couple times. So in addition to trying to run this business that she had, she was trying to take care of her husband. 00;21;34;05 - 00;22;06;07 Cary Hall And I thought, My God, what a what a burden. This woman's dealing with being a caregiver and, and trying to go on with her life. And this is a problem throughout this country that's getting more and more pervasive. And I say that because you've got 10,000 people turning 65 every, every day, every day, every day. And as we age, like this woman who called me from Washington, whose mother is withdrawing, refusing to leave home, you know, not not willing to take care of herself. 00;22;06;07 - 00;22;28;05 Cary Hall She needs a hearing aid. She's got significant hearing issues. She won't do anything about it. you know, it's not not maybe not going to the doctor doing what she should be doing. So she knows that down the line. She's going to have to be a caregiver for now. The good news is, in this particular case, she also happens to have enough money that she's going to be able to take care of herself. 00;22;28;08 - 00;22;48;20 Cary Hall Okay, but what happens to the average American who doesn't have that kind of money? They can't do that. And here I'm talking about those people that think Medicare is going to pay for this, okay. Or think Medicaid is going to pay for this. They're not okay. when you when Medicaid will cover you, when you go into a nursing home. 00;22;48;23 - 00;23;06;04 Cary Hall But you have to divest yourself of all your assets. And what a place to wind up. So this caregiving thing becomes a real topic. And if you don't have the money, what what should people do that are, you know, not in that situation that you're in your 40s and 50s and you're listening this and thinking, well, I don't have to worry about that now. 00;23;06;06 - 00;23;23;16 Cary Hall No you don't. But at some point you may well have to as as life goes on. So, you know, the prudent thing to do is to buy a long term care policy. You know, my wife and I bought one, I don't know, 20 years ago. Whatever it was, I think our daily benefit now is up to like 300 plus a day a day. 00;23;23;19 - 00;23;44;08 Cary Hall And this is the other thing that's not just to go into a facility that allows us to have someone come in. If you're the caregiver, to be able to get away, to just go buy groceries, or maybe go to a movie or just get away from it for a while. This is one of the things that my sister was dealing with when she was up in Indiana, taking care of my brother. 00;23;44;08 - 00;24;06;11 Cary Hall She couldn't get away. She was afraid to leave. Okay, because she was taking care of him. If you have a benefit set aside for this, maybe you have enough cash. You know, you've got enough retirement money, a couple million dollars. You don't have to worry about this. But for those folks out there, especially those of you that are younger in your 40s and 50s, a long term care policy is cheap when you're young. 00;24;06;14 - 00;24;25;04 Cary Hall Okay. you know, like I said, I've had mine for, I think I think Lori and I've had it for 20 years now. and I have a lifetime benefit. It's never I can't use it up. But you can buy a term policy in long term care. You can buy a three year policy or a five year policy. You can buy joint care writers, which allows let's say, the spouse. 00;24;25;07 - 00;24;44;18 Cary Hall You've got one spouse that's having a problem. You have a spouse just fine. Well, maybe there's only three years on it, but that you're the husband or the wife has got another three years on theirs. You can give them a year of your policy if you need to do that, as they're declining and they need help. So there's a solution to this, but you have to be bright enough to do something about it, okay. 00;24;44;23 - 00;24;58;16 Cary Hall And you also have to recognize that if you think you're going to be a caregiver, you're going to have your work cut out for you, not only what you're going to deal with physically, but what you're going to deal with mentally as well. And we're going to segue from that, right to a very interesting topic. I've talked about this before. 00;24;58;16 - 00;25;21;28 Cary Hall Biogen quit the Alzheimer's drug ADUHELM. Okay. So I've talked about this before. ADUHELM was the drug that was fully approved by the FDA okay. That was brought on to the marketplace, but did not only helped about 30, I think the number was 37% of the people. And it wasn't designed to reverse Alzheimer's. It was designed to slow it down. 00;25;22;00 - 00;25;41;21 Cary Hall And I remember when it came out and they had done the trials, and I remember reading an interview with the man who was on it, and he said, it has made a huge difference for me. I'm able to function at a level I wasn't able to function because it slowed it down so that he could function. 6 million people are suffering from Alzheimer's now, so why did he get pulled? 00;25;41;24 - 00;26;10;26 Cary Hall This was a drug that helped 37% of the people that had Alzheimer's. Well, it was expensive. I think the cost the drug was running somewhere around 45 to $50,000 a year. It wasn't cheap, okay. And even though it had full FDA approval, CMS, the center for Medicaid and Medicare Services, refused to cover it. And the other great government run health care system in this country, the Veterans Administration, of which I have a policy and am a member, I don't use it, but I have it. 00;26;10;26 - 00;26;33;03 Cary Hall I have the card in my wallet. I'm approved for VA health care. VA refused to pay for it. So those people in the category, the age that we just talked about in the previous segment section here, where I talked about caregivers, those senior citizens who are typically the ones affected by Alzheimer's, there was an opportunity here, but they couldn't get the medication number one, because it wasn't approved by CMS. 00;26;33;03 - 00;26;53;19 Cary Hall Number two, because, yeah, if you're a vet, the VA wouldn't pay for it. My point in telling you all this, and I've talked about this before, is this clamor for government health care. Be careful what you wish for. Be careful what you wish for. This. 00;26;53;21 - 00;27;02;28 Cary Hall Drug made a difference for people. It was expensive. It should have been covered by Medicare. And it should have been covered by the VA. If it had been covered by Medicare. 00;27;03;00 - 00;27;10;12 Unknown The health insurance companies, but it covered it well, it would have been part of the program, but it wasn't. So when you talk about Medicare for all. 00;27;10;19 - 00;27;18;26 Cary Hall That's Medicare for all, okay. And what just happened there was your choice was taken away for you. You don't get to make the decision. 00;27;18;26 - 00;27;24;19 Unknown Your doctor doesn't get to make the decision. You if you think this is, you know, there are two or. 00;27;24;19 - 00;27;31;16 Cary Hall Three other bands in the pipeline right now. It looked very, very promising. We'll see what happens there. See what happens. 00;27;31;18 - 00;27;37;07 Unknown Bells and whistles. Good folks. that seems to be a few folks. 00;27;37;09 - 00;27;50;10 Cary Hall At VA decide they're going to. We'll be right back after the break. You're listening to America's Health Care Advocate Broadcasting here on the HIA Radio Network. Coast to coast across the USA. 00;27;50;12 - 00;28;00;04 Cary Hall Welcome back. You're listening to America's Health Care. Have a good show. Broadcasting coast to coast across the USA here on the radio network. A quick peace back to that Biogen situation. 00;28;00;07 - 00;28;26;17 Cary Hall This is it. You'll find this fascinating. The article goes on to say that investigation by the House Democrats in December of 2022 found the FDA inappropriately worked with Biogen officials. No it didn't. That's total baloney. Okay, I read the investigation, and I also read the rebuttal by the lifelong, FDA official who, by the way, happened to be a Democrat talking about their interaction with Biogen. 00;28;26;20 - 00;28;47;02 Cary Hall they did it. This was by the book, and it was done the right way. But I found interesting is the Democrats who purport to be the people that really want to take care of us and make sure that we have everything we need, provided by the federal government went out of their way to make sure that they killed this, in support of CMS and the VA. 00;28;47;03 - 00;29;07;10 Cary Hall That really is what they were doing here. They were carrying their water because they didn't want approval. They didn't want to give the approval for this. And the reason was simple. CMS said it was too expensive. It's too expensive. So we're not going to cover it. Government run health care, get used to it. All right. Now, speaking of health care, here's some good news. 00;29;07;10 - 00;29;43;06 Cary Hall Okay, new rule too quick and prior authorization. The Biden administration Wednesday finalized requirements to streamline the process for doctors, patients in hospitals seeking health insurance approval for Medicare for medical care and treatment. The rule aims to shorten the timeline for the so-called prior authorization process to as little as 72 hours, and it goes on to say those who get their health insurance through Medicare Advantage and, the Medicare and the Affordable Care Act, that would be Obamacare, ACA planned, by automating and processing these requests. 00;29;43;06 - 00;30;09;02 Cary Hall So let me kind of break this down for, you know, what they're talking about. And the the piece that kind of tells you that here is the piece that says Medicare Advantage, Medicaid and the Affordable Care Act. These are the government run policies. So you may be on a Medicare Advantage plan or, or, or one of these ACA plans, and you have to have a procedure done, but it doesn't fit into a protocol that can be automatically approved. 00;30;09;06 - 00;30;42;00 Cary Hall So there's a process right. And what that means is that physician that hospital has to submit for prior authorization, meaning it's going to be covered. Okay, to the insurance carrier. Except it's not the insurance carriers call whether it's covered or not. In the particular case of Medicaid, Medicare and ACA, that is a government decision. The government makes the decision in their guidelines on administering those policies, whether this medical procedure can be pre-cert-ed or not. 00;30;42;03 - 00;31;10;17 Cary Hall And the problem is that, as with many things in government, the process is burdensome, cumbersome, and takes way too long. So good news and thank you to the Obama administration for knocking it down to 72 hours. And they went on to say that the turnaround timeline of seven calendar days will occur for non-urgent procedures. So for urgent procedures when you need to have some type of urgent care. 00;31;10;19 - 00;31;33;16 Cary Hall Now I'm not going to an urgent care topic. You need a surgical procedure. That is, maybe you need to have a gallbladder removed or whatever the case may be. you're going to get approval for that in 72 hours. On the other hand, if it's a procedure that, maybe it's a hip replacement or a knee replacement or some other procedure that is not in immediate need, I don't need it immediately, but I need it. 00;31;33;19 - 00;31;55;02 Cary Hall they're talking about seven days. That is a huge improvement, I can tell you. having been a broker that did this for the last 26 years, that the enormous frustration that people feel when they go and get the doctor says, you need to do it. it's it's covered by the plan, but we have to get a pre cert before we can move forward and get that done. 00;31;55;04 - 00;32;30;00 Cary Hall the, the, the insurance carriers, the outside of ACA, Obamacare, Medicare and Medicaid are pretty quick to turn this stuff around because they have a very significant, automated process that does it. The government process. And this is what they're hinting at here when they say Medicare Advantage, Medicaid and Affordable Care Act plans, by automating, some of the of the procedure in processing the request, that means that the government typical if you if you understand how they work, they don't have the most up to date process to get this done. 00;32;30;05 - 00;32;52;03 Cary Hall Typically a carrier approves this kind of thing. And 90% plus of their claims in terms of payment are automatically processed and paid. That is not the case when you're dealing with the federal government. and in this particular case that applies specifically to Medicare, Medicaid, and the Affordable Care Act policy. So I thought that was interesting. I thought it was good news. 00;32;52;10 - 00;33;11;02 Cary Hall I mean, we always like to end up with a little good news. So that's what we're doing today. So you can anticipate, these changes will be in place fairly quickly. And if you are on one of those type of plans and you're going to be able to have these procedures approved in a much quicker manner than what they have been approved in the past. 00;33;11;02 - 00;33;29;01 Cary Hall So that kind of wraps it up for today. And now I leave you with this thought from Albert Einstein, the one who follows the crowd they usually get no further than the crowd. The one who walks alone is likely to find himself in places no one has ever been. Remember, friends, it's a funny thing about life. If you refuse to accept anything but the very best, you must often get it. 00;33;29;09 - 00;33;45;07 Cary Hall Thank you for listening to America's Health Care Advocate show, broadcasting here on the HIA Radio Network Coast to coast across the USA. 00;33;45;10 - 00;33;47;14 Cary Hall You.