What America’s messed-up healthcare system means for your family, with An Arm and a Leg Podcast host Dan Weissmann | Podcast Episode 294

Are you, as a parent, coming to view American healthcare as a soul-sucking showstopper of happiness?
Don’t despair. Today’s guest, Dan Weissmann, has some great ideas and advice!

Dan sparked a movement when he began a podcast about the many ways average Americans – confronting a healthcare system that can be ruinous both financially, and healthwise – think of and approach family health and happiness.

The Arm and a Leg Podcast dives into some crazy stuff!
Listening to Dan’s show you can learn about:
A couple who discovered that their healthcare had unceremoniously dropped them just a few months before that child was due to arrive
The story of how we got insulin, and how, due to high cost, people who rely upon it are becoming modern-day rebel cowboys, figuring out how to create it themselves
Traveling Renaissance Faire folks who can teach you how to resolve disputes with your healthcare provider
Dan stops by today, to talk about how we got here and the true state of healthcare in America today.

Plus in Parenting News: We discuss the work of friend-of-the-podcast Devorah Heitner regarding what kids are really watching on YouTube, and how you can deal with it, in this article on her website. I also read her words from a recent Parenting Newsletter that I wrote on the dangers of YouTube for kids.

Also in the preshow I share that friends-of-the-podcast Jessica Lahey and KJ Dell’Antonia invited me onto their show, #AmWriting, to discuss what it’s like to overcome difficult circumstances and achieve your goals.
If you’d like some insight into your host, and why we have the show at all, this conversation is a great starting point.
Click here to listen!

And thanks for being here!

(Click weturnedoutokay.com/294 for show notes, including a complete transcript of our conversation today.)

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Today’s episode is sponsored by the amazing Janine Halloran, expert in teaching kids coping skills, and an incredible resource she has created to help your child handle even the biggest feelings!
Click copingskillsforkids.com/coping-cue-cards to check out Janine’s Coping Skills for Kids Cue Card Decks.

Complete Transcript of my conversation with An Arm and a Leg Host Dan Weissman

So there are some mistakes in here – it is software, as opposed to a real person, who did the transcribing – but I wanted to give you the transcription anyway, so you can read our words if you’d prefer 🙂

Karen: My guest today was always an investigator. You may have heard his voice on marketplace, the BBC, 99% invisible, all things considered the reveal podcast and elsewhere. And recently he has been working on a show. He started a show that means so much to me personally that it survived my recent digital reset, which is saying a lot. Um, it’s called an arm and a leg and it is about the nuttiness of American health care. On his personal webpage, my guest writes an arm and a leg. We’ll be entertaining, empowering, even useful as a reporter. I’ll bring my skill at finding and telling, revealing surprising stories, but the project’s big focus since I’m in this mess to is connecting and problem solving together. Additionally, today’s guest is the husband of a friend of the podcast, Devora Hytner who wrote the book screen wise and visited. We turned out okay back in episode 116 which I will link to in the show notes.

Karen: I mentioned Devora because during the first season of an arm and a leg, she and today’s guest move in a health care sense from the lovely and stable Sweden to the daunting and frightening USA. And they talk about what that transition has been like. I’m so excited to talk about this and so much more with today’s guests. Ladies and Gentlemen, please welcome Dan Weisman. Welcome, Dan. Thanks so much for having me. I’m so excited to have you here. I have been a huge fan of an arm and a leg, uh, pretty well since the beginning, since I first found out about it. And, um, I love it because it’s hopeful. It’s not like we’re all just in this and you know, it’s a plane that is, that is, that is headed towards the ground. It’s, it’s, it’s, it’s, it gives hopeful and helpful, uh, stories and I really am excited to dive into some of those today. Um, can you, I’d love to start with this. Can you explain about your healthcare situation and what it means that you went from quote Sweden to the USA in a healthcare sense?

Dan: Thank you. Thank you so much for saying nice things about the show. Oh, sure. Yeah. I mean did clarify at first, like we didn’t literally move from this.

Karen: No, exactly. Yes, yes. So that way it was not a literal move. It was, you guys are still sort of in Chicago, right? In the Chicago area.

Dan: Yeah. Right now we have it, we haven’t moved at all. Uh, in a physical sense. And um, and, and Sweden is, is, uh, is, uh, is kind of divorced term. Uh, she has said for a long time that if you have the right kind of job, it’s like you live in Sweden and, um, you know, when you get really great healthcare, you don’t have to think about how much it costs and stuff like that. Yeah. And, uh, and that I had, you know, w throughout, until recently, at least one of us had a job where, you know, we didn’t have to think about the cost of health insurance or health care very much because for you, you know, we had jobs that took care of that stuff for us. And Devorah of course, has been out on her own for as a running her own business for a bunch of years now.

Dan: So it was me doing that. And then a couple of years ago I was like, you know, I don’t think this job that I’m in, it’s not the job I should stay and you know, and it, you know, I had to leave. Yeah. And, um, you know, it’s a point in and that was a bit of a problem cause we didn’t have the next job lined up. Next, I’m a reporter. And those kinds of jobs, especially if you’re not ready to move to wherever, uh, they are. They, they do not, they’re not out there so much. Yeah. And so there were things to do to like, oh wow. You know, I, I, I’ve worked a lot of places I could freelance with lots of freelance work to do, but it didn’t solve the problem of like where’s the health insurance supposed to come from? Yeah. So that was a bit of a problem. And so I, I spent a while, like, we knew that we would be making a transition, like the saying, we kind of plan, can I, can I ask you to send it to us? Yeah. Like are we talking, you knew over a period of weeks, months, like how long in advance did you sort of start thinking about this? It’s a super good question.

Dan: Um, well for months. Yeah. And we knew we didn’t, we didn’t, hadn’t kind of set a date, but we knew like, yeah, this is, this is, I got to kind of find my next flooding. And we had known we’d kind of, you know, started socking away and ease and making plans. Um, you know, just say like, okay, well when, when the time comes, like we’re gonna Ha, it’s going to be, uh, we’re gonna have to, we’re gonna have a lot to figure out. You have to be ready to kind of be honest bridge for awhile and you are raising a child as well. So we are, we are, we are, our guy is 10 years old now, so just a couple of years where he was eight. Um, and yeah, I mean one way and another or the time came and know, we didn’t quite know where the bridge was going to head, but we were like, okay, we’re where we’re going.

Dan: Um, and we knew, you know, there’s a, there’s this thing called Cobra, which is, uh, for most people, if your job provides your health insurance, you can use this local Cobra to say, uh, I’d like, I’d like to, you know, keep my health insurance at my job normally offers, but I’m gonna pay for all of it now and you can do that for 18 months. So we kind of knew we would have that much time. Um, so it would be a lot more about water. It’d be a lot more expensive. Right? Yeah. Uh, well it’s more expensive than if your employer is paying for it. Yeah, I know to go on, cause I’ve, I’ve had friends who’ve done that and it’s Eh, your, your site cause you get to keep the same insurance. But now when you are the person paying for all of it.

Dan: Right. Sorry to interrupt again, but I just wanted to absolutely know. It can feel very expensive cause you know, a good employer plan, um, you know, if it’s a good land it can cost a lot and depending where you work, um, you know, it depends on who’s working there and how old the people are who work where you work. And it can be expensive. Um, it can be, and it certainly feels really expensive. So, you know, we did the math and we looked at, uh, can we, do we want to replace it with Obamacare right away? And the answer was no right away because, you know, we’re adults and we have like, you know, we have our medical histories and we have in our cases, you know, I have like a little heart thing that I was born with and I see somebody every year just to chicken, make sure it’s okay, but like I looked at the statements, you know, I hadn’t had to think about what that all that, what all that cost.

Dan: Um, but I looked at the statements from the insurance and you know, it was like in the, basically like the one test or the two tests and the one doctor visit that, you know, I would go for every year, uh, that ran into the thousands and thousands of dollars. Um, and then there were other like providers that we kind of rely on being able to see and like Obamacare didn’t cover any of the specific people that we see in. In some cases we even cared about seeing those people. Like none of the Obamacare plans in Illinois where we live, um, covered the people that we kind of relied on. Seeings we were like, I guess we’re not doing that. Um, yeah, so it was, it was pretty crazy. So that’s, that’s a sense in which we had been, we’d been kind of in, in the Sweden of, uh, the lovely Sweden, Cozy Sweden of employer sponsored health insurance.

Dan: And then it was like, well, okay, now you can pay the entire premium and you can only do that for 18 months. And then you gotta find some other, you got to find some other health insurance. So we didn’t, we didn’t know what that was going to be. And um, so I had been thinking that I would make my own, I would, I would, I would use that time to get a new career so that by the end of the 18 months I’d have another job in some other field. And, and I spent a few months just kind of like pulling like girding my loins and like really doing a lot of reflection about what that might be. And I was like, okay, I still know what it’s going to be. But like basically January 1st, 2018 I am going to start looking for a new career. And then in December I was like, no, wait a minute.

Dan: There is this one thing I could try, which is uh, which is this, this issue. Like this is a, the question of the, of the cost of healthcare and how it shapes people’s lives. This is a story I had been pitching to the places that I’ve been working for years cause I cause I, well cause I kind of knew that it was a big driver in, in our lives even though we’d had our way of managing it. Like I had jobs and I liked my jobs but like, you know, there were some jobs I like better than others, but it was always like, okay man, this is the job with the health insurance that we operate now. So it was always a big, like this was not the very first time I’d been like, okay, where’s the health insurance coming from? And um, and just being aware that like we had, that we had, you know, we, we relied on that and, and um, being aware that like as a reporter you run into these stories and as a person you are in these stories, you know, on your Facebook.

Dan: It’s like your friend is like, hey, the doctor found this thing, my dentist found this tumor in my jaw and my insurance won’t cover. Cause they say it’s dental. Oh God. And so I’m getting, making a go fund me, right. Or the friend who’s like, oh, I had a seizure and now they, I have this like unknown undiagnosable thing and my insurance isn’t really covering it. Like, here’s my go fund me. Like that’s everywhere. Yeah. Yeah. And all of us know those stories are like, or you go to the doctor and the doctor’s like, oh, you never vitamin D tests, you gotta buy me. No, I haven’t had it, but I’ll go down the hall, I’ll give you a test. And I really, I haven’t had, and I get angry. And you know, you get to things later and one is a phone call from the doctor saying your vitamin D is fine. And then a couple months later is like, that test was $500. Yeah.

Karen: Yeah. And I mean, we, we have experienced this in our own lives. We’ve, we’ve seen other people, you, you know, you talk on a, there’s one particular episode where you talk about a guy who, um, who sort of has it, he gets a pretty bad cut on one of his fingers. Um, while he’s operating a saw and he is on the way to the emergency room going like, can I afford this? Can I, yeah. Like I have to make this choice. Right. But, but it’s, it’s scary to make. And I just, so I’m sure that everybody that you meet comes up to you and says, Oh, I’ve got to tell you this to this story. Right. And, um, I have a couple of those from just from our family. So the first one is, is more maddening and frustrating than it is, like financially awful.

Karen: But, um, I have a tendon disorder and I’ve had it for eight years. Um, I got it. Uh, it sort of, it was linked to a digestive issue that I had and the antibiotics that I took. And, and they have, you know, the theory anyway is that they’ve created, this is like the rheumatologists theory, my primary care doctors theory, et Cetera, that what happened was, um, the tendon problem was linked to the antibiotics. And I’m just one of those, those, it was, uh, it was one of the fluoroquinolones. I’m, I’m, it was called key flags. Was It cocky flags? I can’t remember. Anyway, anyway, the, the issue in it was fluoroquinolones. And of course nobody knew that at the time. And what was happening was I just had like, I lost the ability to walk more than a few steps. And I, I, um, when I regained that, um, you know, it took 18 months, but when I Rehab my legs, then I then I blew the tendons out in my thumbs and we’ve now got this sort of diagnosis where it’s recurrent defused tendinopathy, which basically means I can develop scar tissue anywhere at any time from overuse and stress.

Karen: And at its worst, when I was using my hands, like for I, I had like 5% use of a normal person’s hands, our health and our, my husband where our health insurance comes through his company and our healthcare changed. Uh, it, I believe it stayed that it was the same like brand, but it, they, they sort of redid their accounting and um, it became, it’s so killed me what it was called, it became the, your choice plan and, and you’re laughing already, right? So our choices were we’d get to keep all of our donors exactly. High water, what will it be exactly. Oh, so frustrating. So, um, we had one kid at the time who for example was going to, um, he, he was seen by a doctor at Children’s hospital in Boston, um, which, because they are the best at, you know, at what they do, um, they’re not quote efficient, which made them a tier three, the highest tier.

Karen: So, so the care that he got there would, could be as much as like a $1,500 copay versus like if we were going to get that care in some tier one place, it would be, I think it was a hundred or 200 for the same services. And so that was a killer. And plus I’m, I’m seeing different doctors and stuff like that, um, at the same time. And just to have it be called the your choice plan, it just felt like they were, it was, it felt like the most monumental insult. And in the end, I think what, I mean, what happened with me was I, I fought, thankfully I have not needed medicine. Like medicine hasn’t had, we’ve tried some different medications and they just haven’t helped. What really helps me is, um, moving stress out of my life, keeping exercise and good nutrition in my life and, um, you know, when I need it, like manipulative therapy and massage and physical therapy and stuff like that.

Karen: So for me it hasn’t been a big deal. We now have a son, one of our kids has a medical problem that the only place in the nation that can treat it is the expensive tier three, um, hospital in Boston. And it’s like, I think what’s most frustrating, this is what I really wanted to kind of talk about today with you, um, is that in, so we’ve, we’ve of course I can’t talk about what this is. I think, I think my son would be very upset, but, um, we, when we first found out about it, we went to a tier one surgeon and they for $100, they actually, I don’t even think it would cost anything cause it would be inpatient surgery. So for $0 million they would do a major surgery on our son with weeks and weeks of recovery and the chance for a rupture.

Karen: Okay. And for, um, the, the, the place where he is going, um, because thank God we can afford this. I mean like it’s pulling, it’s painful, but we can afford it. He is having a noninvasive nonsurgical treatments, uh, with a $1,500 copay. And it is, so it’s like how can, how can it be right that somebody would, would not have to go through all of the hospital stuff and, and still pay more. You know what I mean? And it’s such a killer. Yeah. Right. It says it sounds so efficient when you put it that way. No, exactly. Exactly. And when we’ve spoken to them, they basically say, when we spoke to the insurance company, what they say is, well that’s the prices that they charge. And you know, that’s, that’s why it has to be this way. That’s a really kind of a non-answer. And, um, so anyway, I guess the reason, one of the reasons I love your show is because there are stories like this from all over the country and um, people are really doing cool things. In some cases, you know, the, the, you’ve, you featured some people who are kind of standing up and, and finding new ways. Like for example, I would love if you would share about the, um, the most recent episode as we’re recording was the one about insulin and how there are people,

Dan: there are people working to create their own insulin. I mean, I know I don’t, I don’t want you to feel like you have to spend, you know, an hour kind of outlining this, but there’s some really cool stories like that, you know? Yeah, it’s pretty cool. I mean, you know, it’s a bit of a Moonshot, I would say. And I’m not enough of a scientist to judge, but they, uh, they’d been working on this for like four years. These are folks in Oakland, California. The project is called the open insulin project that runs out of a, uh, a kind of bio hacker maker space in Oakland. And, uh, the founder of the project is a type one diabetic and he a, and not a biologist or you know, doctor by training, but a smart enough guy apparently. And um, and yet they are, they just decided to like go figure it out to say like basically how hard could it be if, if, if we got, you know, necessary equipment together and they think they have.

Dan: And if we got some smart people, which they seem to be, to really apply themselves for awhile. This, this could be a solvable problem though. Like we don’t have to, cause there’s only three companies that make and sell, um, modern insulin and that’s all, you know, there’s kind of Hatton’s everywhere you look and there’s no generics and it gets more and more expensive all the time. So, uh, which is, you know, kind of its own thing. Um, so these guys were like, well, okay, you know, we’re gonna, we’re going to give this a shot. So they, they, they, they said at the outset about four years ago, they were like, we think this might be like a four or five year thing. And I talked to them too. They were like, we think, we think we’re on track. We think they’ve, they’ve, they’ve made a little bit of insulin, they say to process things, a lot of refining, but they really think that that’s, that they, they, they, they, they know how to do that. And so then the next steps are to, um,

Dan: is to kind of, you know, do that and then figure out how best to distribute the knowledge that they’ve produced and kind of start, start figuring out if the, like the legal and regulatory hurdles because they don’t know, you know, are the big Pharma companies that do make things. I’m gonna come after them with patent lawsuits. Will, what will the FDA have to say about this? And there are, um, there’s a million technical, like technical, legal and regulatory questions that they admit they don’t really know the answer to, but they are, you know, they’re just taking one step ahead at a time. Yeah. You referenced that the people who first developed insulin back in the 1920s, um, wanted it to be free for everyone. They wanted to give it, you know, give it away and they, because they needed better than they, I don’t know that they would said like, we will that giving you that to being free, no charge was, it was important to them, but they wanted it to be a commercial enterprise.

Dan: Exactly. Yeah. To make it and they, you know, it wasn’t like we have to figure out how to get those cars paid by somebody other than the patient, but they were like, yeah, this is not a commercial thing. This is like a, you know, for humanity ironically. Yeah, exactly. Yeah. Not a for profit kind of thing. And they, uh, you know, they had just scale this tremendous mountain of like figuring out like what insulin is and how to, and you know, where it comes from and how to make it and all this up and that it worked. And then they got, they got a basically stymie bay, this other roadblock, which was they couldn’t really make it at scale. Yeah. And it needed to be made at scale cause cause type one diabetes without insulin is a death sentence and generally a speedy one and a really unpleasant one.

Dan: And the only, the only treatment that anybody had was way to make it less speedy, which was by starving people to death slowly. Yep. Yep. And when you think about how many children have type one diabetes, I mean, yes. Oh yeah. Yeah. And it’s typically typically diagnosed in kids. Yeah. And so, uh, you know, they felt like it was really urgent to get somebody making insulin. So the, uh, the, this company that was a lot smaller then, but was still much bigger than this, uh, University of Toronto Research Lab, Eli Lilly, uh, had been watching their research and kind of sweet talking them all along and, uh, they event they’d been kind of putting off oily and then they were like, okay, we give up. Yeah, yeah, yeah. We’ve reached a point, you can’t make this on our own. And Eli Lilly, you know, had a lot more capital to put into the project of like, they had much bigger and better labs. They had tons of people. And I mean, interestingly, you know, they had, cause they had a profit motors, they were like, great, like we’ll learn to make this, we’ll do it, we’ll put all this capital in and then, you know, it’s gonna be like Brent and money and, uh, that is kind of, uh, how it eventually came to be.

Karen: So, you know, I, I, I want to ask you the question of if you’ve got any sort of favorite episodes, but I wanna cause I think that would be really fun to talk about. But I want to, before we go to that, um, I also want to ask you, and this might, I feel like this is a good place for it. Is Do you have, after all this investigating, I mean, you’ve now been doing this for like 18 months. Do you have, what are your thoughts on how we got here to this mess? Yeah, somebody did

Dan: tell me the story, like in one of the very first interviews I did and I’ve, I have now kind of read and talked to enough people and kind of seen enough. So I, this is the, this remains a kind of, um, you know, kind of secondhand account of their kind of histories that people have written. But I think it goes, I think it goes something like this that, uh, you know, once upon a time, like before we were to, uh, you know, things were different and insurance, you know, like health insurance, a relatively new thing. Um, by the time we got into World War Two, uh, and, um, but the other thing was that medicine was in a really different place. Like insulin isn’t discovered until like the early 1920s and penicillin doesn’t exist yet. At that point. You know, the polio vaccine doesn’t come along until the 1950s like this, this idea of big, uh, you know, science driven, like cures for things is kind of, uh, you know, becomes more, gets really wrecked rolling, you know, as the 20th century picks up a lot of speed.

Dan: Um, and you know, somebody could come along and poke holes. Like, I’m not, again, this is, this is, this is a kind of big generalization based on, it’s very generalized but, but yeah, so, but so medicine, um, both kind of like what doctors do and medicines like Pharma are getting more sophisticated as the, as the century rolls along and then insurance comes along and, and creates a situation where suddenly more people kind of have access to it and that that amps up a lot in the 60s when Medicare and Medicaid add basically old people and poor people to the, to the, to the pool of folks that also has been including lots of employed people that make, so by the, by the, you know, middle of the 60s, most people now have insurance and, and so there’s, and you know, again by the end of the sixties there’s more like now things that really start to pick up speed and there’s more and more interesting treatments.

Dan: There’s one more thing that can be done. And you know, so, so this is a bit of a, this is a gift, you know, to I’m a one hand, it’s a gift to like people who need treatment. On the other hand it’s a gift to people who perform treatments and um, they’re like great. You know that like there’s a, there’s a market now for not just physician services but hospital services, other kinds of things. And so the market kind of develops and like they find that people, the insurers will pay for things and gradually prices creep up and there are more and more things to pay for. Again, like you get new drugs, you get new surgeries, people try new things. And so by the 80s you get the situation where people look around who are paying the bills, like heads of government and heads of corporations.

Dan: They’re saying like way this is getting kind of expensive because the more the more s mean, the two things that are happening is it’s like there’s more stuff for people to use. People are using more stuff, which is again, grid and, and prices keep kind of rising. And so it gets the 80s and it’s no longer like, hey, that used to cost a nickel and now it’s 6 cents. And now it’s more like, oh, this is a lot of my dollar right here and that. And at the same time, as I understand the history, you know, there’s, there’s a fair amount of consolidation on the industry side in that, like hospitals start to kind of consolidate into hospitals systems. Um, you know, other companies that are involved in the, in this whole enterprise start merging. And so that’s, and so by that, I mean, I can remember this is how old I am.

Dan: Like by the end of the eighties, I kind of remember hearing about it. It’s like, ah, this is, things are getting expensive. People are looking for ways and are, and that by the early nineties, right? You’ve things are at a place where it’s, it’s a big national issue where, you know, uh, Bill Clinton becomes president and bill and Hillary Clinton are like, great, we’re gonna, we’re gonna deal with healthcare because so many people are uninsured and things are so expensive and they totally fail. But they’re, you know, that’s more than 25 years ago now. And it was viewed then as a giant crisis that healthcare is unaffordable. Too many people were uninsured, it was too expensive and that and that and that. There were all these things that were being done. All the, there were a lot of little experiments. Um, like I remember hearing about h Mos. Yep. Um, in the early nineties, which was this idea that like, you know, as from the patients’ perspective, like you’re paying a lower premium and if you, as long as you just go to their doctors, um, and see people, they tell you to see, um, then nothing costs very much to you out of pocket.

Dan: But the downside is that like, if you want to see someone who’s not on their list, like they’re not helping you out at all. Yeah. It’s really expensive and people experienced. And that was a kind of, you know, that was one kind of homegrown, capitalistic attempt basically to like, okay, how do we deal with the cost question? And so that’s we’ve, we’ve been in this place for, you know, that’s what 30 years ago now at least where

Dan: the way I’ve come to see it is there’s a lot of people in a lot of different positions who view themselves as having a lot to lose. No matter what anybody’s kind of plan is. If you are running a Pharma Company, you’ve got a business model and a kind of model for running your business where it’s like we tell, we tell investors we’re going to make them a ton of money and we pour a lot of money into r and d and then we just like take a lot of money out of the market. We charge like crazy. And if you were to stop, if you were to have a reform, it stops doing that. That’s going to be a big problem because already our investors are going to pull out like our stock price is going to create. You’re like, I’m running that company. That’s my worst case scenario.

Dan: Right. And then similarly, insurers have built their business model to kind of work in the current system to kind of work around what exists, um, doctors and hospital systems, you know, similarly are like, well, if you do that, that could really hurt me and all of us to not, well, I wouldn’t say all of us, but like enough people, you know, view themselves as like being able to imagine things being right. So you’re telling me the story about, you know, you’ve got this, uh, there’s condition. You could, your insurance company Sung you one place for 100 bucks and the waste for 1500 bucks. You might, you know, I could probably spin you a story where I’m like, well, imagine if you could never go to the place where they have the effective treatment. Right? Like there’s just a, there’s always a story that someone can tell you unless you are at, I mean, you’re right. You’re at, when did you say, we’re like, this is not comfortable. It feel it and it’s not comfortable financially. There is a lot of money for me. Yep. And it’s not comfortable

Dan: emotionally, like it feels wrong. Yeah. Like it feels wrong to be presented with your plan called your choice. Do you want to like the crummy treatment, uh, for $100 that’s like not very, that like isn’t effective and carries a lot of risk and involves a lot of pain and, and convenience for your child. Right? Questionable quality. Yeah. Like in terms of like whether you’ve even done well or do you want to affect a treatment that you pay out the wise you for giving me, you’re already paying a lot for this health insurance because even if you know your employer is paying most of that tab of the insurance premium, that’s money they could be paying you.

Dan: Right. I mean that’s, that is, you don’t feel it coming out of your pocket, but no, you’re absolutely right. Yep. That’s it from their side and the employers side, it’s all coming out of their personnel budget.

Dan: And when the health insurance premium goes up, the, the employer is like, well okay crap. Like now what do I do? Do I do I pass that along to my employees and tell them, well your share the premiums going up because it’s all going up or do I change the plan? And I’m like well your benefits just got worse. Or do I not give people raises cause I’m just gonna pay this premium. Like yeah I only have this much money. And then some, some people are going to be like hey you know I don’t have any kids so you know, give me more money. And so there’s all these, as you say, there’s all these like stakeholders who are all pulling in [inaudible] they’re all pulling in their own direction and it’s like yeah, if somebody dropped that rope the whole thing falls apart or it could, right.

Dan: There’s always the end. And then again like if your consumer like the your, the, the hospital, we’ll be happy to tell you a story about like, well if you reform the payment system this way that we might not be able to provide this service for your family. Right. Or the Pharma company is like, well, we can never develop a cure for that. Those diseases now because you change the system. Like everybody has, everybody who has something to lose is going to tell you a story about what you will lose. Yeah. Yeah. And it’s like, I mean, you’ve described it so perfectly, it’s like you feel trapped, you know, they’ve really got us over a barrel here. We can either make our child suffer and possibly with even with great risk. Yeah.

Karen: Or we can, we can pay up basically and choice exactly your choice. And uh, it’s, it’s just so frustrating and it, it, it feels very bad. Yeah. Um, yeah. It’s so, so what I’d love to do is kind of talk about things that people are doing to counter this and, and I would love to actually put this kind of as a double question. So I’m, I suspect just from the, from the way that you sound today and also from the way that you sound on your podcast, that the ones you really like are the ones where people are, are doing cool things to, not to fight back necessarily. But to sort of, to, to, to feel like they can take a stand to, to sort of feel like I, you know, what’s another choice there? Um, anyway, what I’d love is for you to kind of share if you have any favorite stories like that from, from that you’ve have people that you’ve met over the course of your, a, of an arm and a leg. Well, thank you so much for asking that question. I mean, what comes right to mind are the renaissance fair. Oh good. Yay. I was hoping I went

Dan: to the, yeah, the people, people work at renaissance stairs, uh, you know, frequently don’t make a lot of money. Um, the, it’s not a job that comes with insurance because these are people like these fairs. It’s like there’s a network of these fairs or networks of these fairs all over the country that are seasonal. So it’s a real, it’s, it’s a gig economy. Um, you know, people work one place for two months and hop, you know, someplace else across the country for a couple of months. And so, you know, these are not full time jobs with health insurance. And even if people buy health insurance in place or get Medicaid someplace, well, that plan only covers them in the state where they get it. Um, and you know, uh, now I’m in, it’s, it’s, it’s wintertime. I’m in Texas in the summer. I’m in New York. Right? Yep. Um, and so that is a big, that’s a big issue.

Dan: Like having reliable good insurance is a big issue for those folks. And, you know, some of these jobs are kind of dangerous. Walking on, walking on a robes, juggling things that are on fire. Um, you know, roasting a lot of Turkey legs in a confirmative condition. It’s just like, it’s not, you know, they’re not, uh, it, it’s, you know, on kind of a camp ground, um, you know, there’s not necessarily a hospital next door, even like running water everywhere. Yeah. So it’s, uh, you know, it’s, it’s, it’s quite an existence. And so for, for a long time, they, you know, have always had, I mean, this kind of like commitment to helping each other around in all kinds of ways. But, um, a bunch of years ago they were like, you know what, we should organize this. And they did. Um, and so what they’ve organized at first they were like, we raised money for each other when we were in trouble all the time.

Dan: Like, oh so and so’s car broke down, we need to get him to the next fair or like or so and so’s daughter has leukemia, we need to raise money. But they were like, for this healthcare stuff, you know, we should, we should have a system. And so they did, they developed one and the one part of the system is raising money. Like, so they develop this tradition of what they call rallies where they auction off sometimes just junk with a fun story behind it. And they did it up cause they all want to help each other out. And um, and that was great. And they were able to, and then they have been a formed a little tiny micro bureaucracy. I’m using conference call lines and email basically to figure out, you know, how to disperse that money. So, you know, it’s not like you raise it in one place and then only people there get it.

Dan: It’s like, well no, we should, we should figure out who needs help. And so people have forms to fill out and there’s a committee that evaluates things and things. I help people. But the most magical part of it is that over like a five year period, um, you know, the five years before I kind of do this story. They had, I haven’t kept track with them since, but I’m sure they’re doing the same thing now. But over about five years they had, they had paid down about $500,000 worth of medical bills, which is really impressive. Um, but what was more impressive was the fact that they’d made about $2 million worth of medical bills disappear. Wow. And that they had done that by basically employing somebody part time who was the kind of alum of their community and had, had been in trouble medically on the road and gotten this kind of help to basically like be a resource to teach people how to advocate for themselves.

Dan: And in some cases when people are really indigent, that means asking simple questions like, do you have a financial aid application? What are you, what do you do? Have a form I can fill up cause I’m medically indigent. And a lot of hospitals especially do have, you know, whole processes set up for that and a lot of these folks totally qualify. And in in other cases, you know, where that isn’t necessarily an option for an individual. Like figuring out what is an option. Like for instance saying like, well okay, uh, what if I paid you this much upfront? Would that work?

Dan: And even looking up the um, I guess met some Medicare posts, if you know where to look, you can find out what Medicare pays for a given procedure or given you know, clinical thing in your area. And you can look that up and you can say like, uh, so medicare pays this for a hip replacement. Could I pay you that? And you know, she teaches them also like the how to negotiate but like be really nice, be really persistent. You really patient, write everything down, like all that stuff, you know, and uh, you know, it does not always work. Nothing always works, but everything’s worth trying. It’s kind of what they’ve found. So you have to, they that’s 2 million bucks on a against, you know, they pay this person like $18,000 a year. Wow. That’s awesome. It makes the rest of her living selling real estate. Wow. I just, just, it’s like a, it’s a hopeful story of people taking this into their own. I think that’s what

Karen: I really like about it. If they’re not feeling powerless because they are, um, advocating for themselves. I love that word too. Advocating. Yeah. Yeah. Um, thank you. Yeah. Yeah. I, um, this is a show for parents of young children and in kind of coming up with the questions, I wanted to ask you the things I wanted to talk about. I, I started thinking about like two kind of scenarios for, for listeners, if, uh, if they have young kids, which as I said, most of them do. Um, and the first one was what, is there anything that parents of young children or children, I suppose even, you know, older children should be thinking about in terms of health care if their child is well, and then the second scenario was what, you know, what if something goes wrong in terms of their or in terms of their child’s health or their health, I guess, but, but I, I started thinking, you know, about their, their children’s health. Oh,

Dan: I mean, the thing that I’ve learned, and I think we all know this, but it’s, it’s really born out in, in the reporting that I’ve done and just what I observed from tell me, you know, everything completely depends on your individual situation. Right? And so it’s like, okay, well what’s your health insurance like? Yeah, yeah, that’s the first, next year. First question. Um, and then like what, you know, what are the limits of it? And so one, one question that that rolls back to is like, what are your options for health insurance? You know, do you get your job? Does your job offer more than one plan? Um, if so, how do you evaluate it? And one of the things that I, one of the things that I learned is that many of us have a really hard time effectively evaluating insurance options when we have them.

Dan: I talked to this economist who had done this whole study where he basically found that in most, in most scenarios, most people, including economists, when presented with even a simple grid of choices of like, this is the premium, this is the deductible. Uh, you know, which, which one do you think is a better deal for you? They, they would create scenarios where like one thing would actually be a better deal. The other, if you just knew how to do the math and did it and he would like put this up on a screen in front of a room full of economists and be like, which one would you choose? And a significant number of hands would go up for the free for a plan. It was like actually a bad deal no matter who you were, what your situation. Wow. It’s so confusing. It’s super confusing.

Dan: I mean there’s like, we’re just remind yourself like, what’s a deductible, what’s a copay, what’s co-insurance, um, what is an out of pocket maximum? And then how do all those things interact with each other? And then, uh, there’s a question of like, well, okay, you, there might be one set of those figures for people that you see for providers that are in network. What about providers that are out of network? How does it work there? Which is like, which, which providers do you plan on seeing? And then as someone, and I thought I was smart and I said to this other expert, like, I can do this, I can make this spreadsheet, I can do that. He was like, Oh yeah. Well what about, have you thought about the plans have a separate deductible for pharmacy or a separate deductible for the er or for this or for that.

Dan: And I was like, my spreadsheet just turned into mush. Yeah. Do any of that. Yeah. So it’s super, it’s super hard. But, um, if you have a, um, a choice, you know, you want to, you do want to make a chart or spreadsheet of some kind that looks at two scenarios and one of them is like what am I likely to pay for healthcare, including my share of any insurance premiums in a year that looks normal, where it needs the kind of year that I expect and hope to have. Maybe that’s a year where like you just have a well child visit, you know, and, and well and you have an a well adult visit and like you otherwise never see your doctor or maybe you know that like, Eh, I’ve got this thing and I see somebody every couple of months for it. Whatever it is. Like whatever, you’re a sinner or you’re like, I’m going to ha I’m planning, I’m pregnant.

Dan: So I think next year I’m going to be giving birth, right. Things that we noticed that I’m going to have a hip replacement. These things we know in advance. And so you know, you kind of, you run one column against that and you try to kind of Suss it out. Like what’s right, what’s a normal year look like for me for net? What does next year look like? If it’s normal, nothing unexpected happens and then you make another column and it’s like, what happens if I get hit by a bus? God forbid, you know, or there’s something catastrophic, something expensive happens. What, what happened? What did, what do my, how bad does it get under this plan versus under some other plan. And then you kind of like, Eh, look at those two columns. And again, what when this economist was making his little tests of people to see if they understood how to shop or help shop for health insurance, there would be plans that were like both more expensive in a normal year and more expensive in a really bad year for most people.

Dan: And so you know, you, if you, sometimes you can see it sometimes it’s like if you do the math, you’re like, you know what and is less good for me in either scenario. Um, in which case, great UV, you’ve just solved a problem. Like a problem. Like you’ve gotten a better deal. You may not like the numbers that you see at the bottom of those columns, even with the choice that you make. But that’s, I think that’s the most general purpose advice is like is, is do like when open enrollment time comes along, whether you are shopping on the Obamacare market or get your insurance from an employer or whether there is a couple of different employers in the mix in your household, like make the time, get a babysitter, you know, like open a beer and open a spreadsheet and the prepared to spend a couple of tedious, uncomfortable, confusing hours.

Dan: Yeah. Um, at least, but it’s it because you know, ultimately that’s the different, that that is your best opportunity. You may get to protect yourself to kind of figure out, well what’s, you know, and, and to know, like, to kind of know what you’re up against, right? So you can kind of calibrate the rest of your life around it. So you’re like, Whoa, looking at this, ah, I, I’m gonna, I’m planning, I seem to be pregnant. I’m going to gab a good next year. Like this is, this is what my insurance looks like. I think we better sock away 30,000 bucks. Yeah. You know, we’ve got to know where that’s coming from. Yeah. This is not the year to go to the Caribbean for a month. Right? Yeah, yeah, yeah. Or to, yeah. Right. Yeah. Right. Or make other expensive decisions. Right. Just to clarify, so Obamacare, I

Karen: like, I know what that is, but does Obamacare go by different names in different states? Because here in Massachusetts what we have is something called mass health. That’s not what my husband, that’s not our insurance plan, but that’s, is that Obama care in Massachusetts or is it, so I have, I got two different, yeah.

Dan: Uh, I believe so. Okay. Yes. And um, and I, if I understand this right, mass care. So different states configure Obamacare differently. What Obamacare does is it w among the things Obamacare does is it says like, there will be some place where you can go and anybody can buy insurance. Okay. And so providers will, you know that they’ll make sure that the providers are provide, our, our insurance insurers are offering plans. And those plans are available to anybody to buy and that the government will, if you, if you don’t make enough money to be actually able to pay the premiums according to the government’s version of the math, they’ll help you, they’ll kick in some of the premium. Um, and so some states, Massachusetts definitely I think maybe California is another [inaudible] have come have, have combined different things including Medicaid. Uh, which also got expanded under Obamacare to say basically like is it kind of all in one thing and you know, one way or the other we’ve got a, we’ve got an option for you. Okay. And at mass care, according to, I talked to the doctor who runs a podcast in Boston, it’s like a week ago and he was explaining Mascara to me. And that’s, it sounds like that’s a, it’s a somewhat more expansive safety net because there are, um, you know, there, there are, there states have different be configured versions of all.

Karen: Yeah, yeah. Actually under Mitt Romney, our Republican governor from a decade or so ago, 15 years ago. Yeah. He, um, he sort of created mass health. I don’t know what it’s, I don’t know what it was called them, but I understand that it’s called mass health or the mass health connect or something like that. And He, what he created here for Massachusetts has become a model for, for uh, eventual Obamacare. And it was the blueprint for Obamacare was romneycare. Yeah. Romneycare that’s right. I forgot it was called that. Um, yeah, it’s, he just even that like even just a definition of terms is something that you need to sort of sit down and really wrap your head around. So I love that. I love that advice. Like think, think in advance. This is another way to adult I guess to, to, to do that. Adulting. And you have, um, you have a great episode, um, about people who thought they had done the adulting right. And then they ended up, um, getting pregnant. And again, this is another one where I just, this one blew my mind. They, they worked hard to make sure that when they, when they eventually got pregnant that they, they knew where they were going to be going. The health care would be all settled. And then it kind of all blew up around them.

Dan: Yeah. Corey and Kaitlin [inaudible] in Minnesota a, yeah. Did all of the, they did all of this, they sat down for days actually evacuated on what their insurance options were and they knew they wanted to get pregnant. So they, they chose a plan based in choosing a plan. They did the math backwards and were like, wow. Then we should decide where we want to have the baby so then we can pick a plan with the covers that hospitalist, they did that and in fact it took them a long time to get pregnant. So they were paying into that plan for like a year and a half, you know, for more than a year when I got pregnant. And then they’re just about six months pregnant when they, they changed the account out of which they paid their insurance premium. And when they did, and they felt that the firm, uh, to pay a premium, they ended up sending it, the, that to the hospital and not to the insurance company because they were both part of the same company.

Dan: Same name. That’s right. That’s the same name. And they were just like, and they just had like a, you know, moment and, and Scott the got the payments sent to the wrong one. And I’ve since been told that, that that company was supposed to have systems in place to kind of figure out what’s going on, but they didn’t, it’s the hospitals like, I don’t know what we’re doing this money here. And the insurance side of the ordination was like, I dunno where these people’s payment is. Yeah. And then there was a second hiccup where that account that they were paying out of, uh, was heading sufficient funds to make their next payment. Yeah. And that, uh, they like, we have to be half out of there. And the big irony is a big irony is that a couple days later that account would have had plenty of money in it.

Dan: Not because they were putting money in at that time, but because the hospital was returning the payment they had mistakenly sent, oh, Mike, it was this entire like little Jenga Tower of things going wrong. And, um, and it resulted in them getting a notice in the middle of October. All this went down in basically the Septa in September and in the middle October they get a note from their insurance company saying, yes, so we’re dropping you. Yeah, we actually, we dropped you as if a month ago by our calculation. And she is seven months pregnant right at that, well, she’s six months pregnant that point. And she’s like, and they’re like, but we paid. Yeah, but we made twice like, what are you talking about? And they’re, you know, they go on this entire merry-go-round and it’s, it’s in fact a couple of days later, they get the notes from the hospital saying like, Oh, you know, we, you that money back cause we don’t have to do it.

Dan: Then you’re like, oh well that explains something serious like what is going on? Um, and they can’t get a straight answer from anybody. And nobody at the insurance company will talk to them. And, uh, this goes on for months and months and they eventually get help. And, and what were they, after a few weeks, they realized they’re getting nowhere and they’re like, well, okay, great. Well the baby’s not due til January. We have signed up for insurance for the next year. Uh, I guess we’re rolling the dice for the next couple of months and we’re just gonna call before every prenatal visit and see how much it costs. And maybe it’ll end up being less than the premiums we were going to pay. I really hope it works out and it doesn’t, cause they, uh, there’s bleeding and they go to the hospital, they go to a hospital twice, they go to two different hospitals, there’s ambulances, it’s like all the worst.

Dan: And so they’re looking at like $30,000 in medical bills and got an insurance standing between them. And eventually somebody from the state does kind of intervene but only kind of halfway effectively. And they’re like, well, we can get you into some other plan. And they’re like, but none of the other plans cover both of the hospitals we’ve already been to. Like, this is still going to be, you know, $10,000 or more. For us the best we can do. Um, it was just awful. And then there’s a bit of a happy ending. The baby’s born January on schedule, very healthy. Everybody’s fine. I need them at the end of March and debrief the whole thing with them. And the next day at the end of the day, having digested my notes, I call the insurance company or I call them the morning bank, talk to them. At the end of the day, they call me back and I tell him, you’re going to, this is what’s going on, this is, this is the story that I have.

Dan: Your insurance company’s like, we’ll get back to you tomorrow. Uh, but they don’t. And instead I hear back from Corian, Katelyn and they’re like, guess who just called us telling us they want to make things right. It’s wowed insurance company. And so they, um, you know, last I heard they’re working with that old insurance company to do a bunch of very complicated unwinding to kind of undo every trend because all these transactions had cleared, you know, and the, the stop gap insurance they’d had had like paid a bunch, had paid a bunch of claims and now like the doctor’s offices have to work with that old insurance and like give that money back and, and hit up the new insurance company for that money. Like it’s gonna take a long time. Oh Wow. Before it’s all unwound wound. And these people mean they did everything right. They were so thoughtful and they followed up like maniac, you know, and they, and you know, they ultimately, you know, that got them to like that did knock down their kind of problem from like a $30,000 problem to a $10,000 problem. But that’s still a pretty terrifying dollars. Yeah. With a lot of money and yeah. And, um, and they put, you know, an amount of labor into it that it’s just unbelievable.

Karen: Yeah, yeah. Yeah. And, I mean, that’s, so a couple of things come up as you’re talking. One is they did their due diligence, just like you’re saying that our listeners need to do, you know, you, you, you want to understand what you’re going into and then, and it sounds like what they did that was, that was right, was they didn’t give up in terms of following up. And I mean, you, you describe on the podcast how on the episode, how they are, I mean, they’re, they’re having a baby for goodness sake. It’s like, this is not what you want to be doing. At least it was a happy, you know, in the, the anticipated event was a happy one. I, I can’t imagine doing like I would, I’d love to talk about is, um, just thoughts for people who are going through something that’s scary with their child and like, how do you keep up the, the hope and the, and the, the do, how do you do your due diligence when you’re in a place where something goes wrong? You know what I mean? Yeah. That’s I,

Dan: it’s a really, I mean, I don’t, I don’t, I mean, you know, there’s no magical, this is where it’s really like this is, that gets to bedrock, right? It’s just like, yeah, don’t give up.

Karen: Yeah. Don’t give up. And it’s, I think, I think, I think that is a,

Dan: that’s a, that that is a thing that a lot of parents find themselves, you know, doing one way or another that that’s a common experience of being a parent. It’s like you hit your bedrock and you’re like, okay, I’d never been here before. Giving up is not an option. What am I going to do? Yeah. You kind of find you date, you know, you find a way to dig deeper. You find a way to look, to ask people for help. You haven’t thought to ask some people, you know, find layers of faith. People just mean, but it’s, it’s one of those moments when you really mean, I w the scenario you’re describing is, is a nightmare. And, um, and the only way out is through. Yeah.

Karen: Yeah. Um, and, and I, I love that, you know, they’ve got you as a resource, right? I mean, I think that’s so good. That’s one of one of my favorite things about the, about what you’re doing. It’s not even just the show. It almost feels a little bit like a movement to me because, because I listened to the show with all of my problems and all of my frustrations and, and, and I’m sure that there are thousands of other people doing exactly the same thing and we all feel like we’re sort of participating in something that could be helpful. And that’s their, if, if like, if somebody in a really dire situation like, like Corey and Kaitlin could call you or write to you and say like, Hey, this is happening to me. You know, you would have some ideas and I hope, I hope

Dan: so. I mean, you know, I honestly, you know, I hear from a lot of people [inaudible] I’m mean Korean, Caitlin, where some of the first people who wrote in when the show came in and their story was so dramatic. Yeah. I was like, I’m totally following up on this. Yeah. Yeah. Like I, I mean I wish, I wish I was, I mean, yeah, I mean, and we like history is like send them, cause I’m very interested, but like, you know, I told one of my,

Dan: I’m pitching my colleagues right now, like we’re in the middle of season two and I’m pitching them like, well, what’s season three going to be about how are we going to address it? Hmm. And, and this is kind of what I’m thinking is that like this is a totally not elevator ready pitch, but it’s basically this, it’s like the cavalry’s not coming. So what can we do to help ourselves and each other out? Like what can we do? Because there isn’t, there isn’t a switch. No one’s going to hit the switch. Yeah. Even if, I mean, if you, if you think like, well, single payer, like we got to have single payer, like, and you know, I, I, I think that’s an idea worth looking into pretty, pretty closely, but you know, one, well that’s at least one election away. Yup. And to, um, you know, it’s unlikely to get, like, I just think about Obamacare, which attempted to make a bunch of, uh, big reforms and there are things that I think people tend and I appreciate, right, that like expanded Medicaid, lots of people now have some kind of insurance that didn’t have any access to before it, it made it made insurers offer insurance to everybody.

Dan: Even if you had a preexisting condition. That’s huge. Yup. Right. Tons of big things that people, and there’s, and it’s, you know, 15, 1600 page augers, tons of things tucked in there. Um, many of them are consumer protections. And, and yet, you know, the day that we’re talking, um, uh, an appeals court heard arguments about whether or not the law is constitutional, like all this, you know, that there’s still the law. It could be overturned. Yeah. Because there are, there are political actors where like, we want to overturn it. Yeah. And there are other actors who might want to open it. There are, you know, a couple, a year or two ago, right? I guess do two years ago, we were all that summer we were all on cause like is Congress going to overturn the affordable care act? I mean that law passed, you know what, nine years ago. Yeah. And here it is nine years later. Like there are still holes in the safety net. The bat law tried to create and there’s still lots of struggle and the struggle about whether to even have that law or not is still

Karen: still. Yeah. And then then you, so you have that and you also have a little bit of like a death by a thousand cuts where, um, so I, uh, went to a well care visit, you know, a, a physical for my, for myself and I got a letter, um, I had to sign to acknowledge that I had received this information basically saying if the doctor treats you in any way, you will longer a well visit. Yeah, exactly. Exactly. I was like, so you think, you know, I’m going into this and I’m like, I’m going to talk about this problem in the mold and the blah, blah blah. And then, and then you sort of get this feeling of like, wait a minute, if I do that, like I’m opening up a whole new can of worms here. So, so there’s, there’s so many, uh, you know, there’s so many different, um, I, I guess as you say, the cavalry’s not coming. And to me, what, when you said that initially my first thought was, well, we have to be the cavalry. Yeah, yeah. Like there’s ditch together. Our owns cavalry. Right, right. Yeah. Yeah. And, um, I mean, I, our time is short and, and really what, I guess the, the things I wanted to end on was, first of all, are you, are you hopeful that we will find a way out?

Dan: Like through, yeah, right. Well, we will in the sense that like, we’ll survive and persevere. Yep. Right. I visited. So for the last episode of this, um, I mean one of the things that this idea that the cavern is not coming kind of comes from is I, I, I visited last week for our final episode of this season, a clinic in Goshen, Indiana, which is kind of like North Easterly Indiana. It’s a smallish town and it says clinic that serves a poor population and they do remarkable work. It’s a remarkable place. Um, it is small. It really, and there’s a, there the reasons it really can’t get much bigger. And within the sphere of, of the community they serve, they, they look at every problem. That’s when they can really address. The director talks all about sufficiency. There is sufficiency, but that by their determination and creativity, they’ll find a way and they do.

Dan: And it’s amazing. And there are limits. You can’t hit copy and paste on that thing and you can’t grow it. And I said to him, you know, I really liked this guy and I, I said to him, you know, I, I hear as the show goes on, I hear from one more people with problems are just really terrifying. Yeah. And make me mad, you know, [inaudible] happy. And uh, and I said, you know, I just, you know, it’s kind of put it to me. He was like, well, he told me a story about a conference he’d gone to a long time ago. And then in one workshop was led by a woman who was about asset based on your development was led by women who were led some public housing group. And she said, if there’s one thing you take away from this, I want you remember this, that whatever you look for and focus on will multiply.

Dan: And if you look for the problems in your community is things to address, you will find them and they will multiply and best case scenario, you’ll create a program for every one. In best case scenario, you’ll have a lot of programs that may work very well, do good work addressing these problems. And your community will still be as fragmented and messed up and poor as it was before. But if you look for the things that they do that are real pieces of hope and change, um, that, that really are transformation, they’re transformative in some way that are about growth. You’ll find that they also multiply. Oh, I love that. I have goosebumps.

Karen: I think, so that really resonates for me as a, as a, as a parent coach, as an educator for parents. Because the same can be said with kids, right? If we, if we focus continually on the negative, if, if we, if every time they do something wrong, we call them out on it or we tell them to stop or we draw so much attention to the t tantrums or whatever, um, we see more of them, they multiply. But if we instead starve those things that we don’t want to see of our focus and focus on the, on the positives, on the things that we do want to see, that’s what we ended up seeing. And it feels like such a leap of faith, but it’s so it’s crucial. It’s probably the one crucial, I would say the most important factor. Um, in fact, I would even say that in terms of, so my own situation in terms of getting better.

Karen: Um, five years ago I started to see a psychologist because I couldn’t use my hands at all and I was ready, you know, to walk out into the street and be hit by a bus. And, um, the first thing he said to me was, well, the first thing he said to me was, oh my gosh, I can’t imagine how awful that must feel. And I thought, this is my guy. He’s, he’s, he’s, he’s communicating exactly. He knows how I feel and he wants to help with that basically. But when we were, when we started working together, one of the first things he said was, the problems are, are not all in your, uh, limbs. The problem is in your, is in your mind is in your thinking. And I was like, what? That is bs. Like I don’t believe that at all. And I, and what happened as we started working together was I realized how incredibly true that was.

Karen: Like there would not be a podcast if I didn’t have the tendon disorder because I had to, I had to see my husband and a friend, uh, particularly one friend said, okay, you’ve got all this time, you know, yes, you can’t fold laundry. You can’t chop vegetables. You can’t do all the things that normal parents would do, but you can still do things like, what can you do? And that, uh, that is why we have we turned out okay. Um, and it would never have happened if I didn’t take that leap of faith and try to think, focus on something positive. I mean, I feel like it’s, so this is all, this is just really resonant for me.

Karen: You know, that’s a great story. Yeah. It’s, I think it’s true of, of more things than just healthcare and child rearing. It’s, it’s, it’s true of, you know, we’ve got to focus on what we focus on multiplies. I love that. I think that’s a great way to, to, uh, to end. I, the last thing I wanted to ask was like, uh, and I feel like we’ve just answered this right? Is, uh, I want, I wondered if you had any thoughts on what we, our listeners, me, you know, us, what, what can we do to kind of work our way out of this? I mean, I think that, you know, don’t give up and look for, look for the next step you can take. I mean, there are, there are things we do, we do, there are battles we can’t admit. Yup. Um, so, but like don’t give

Dan: up on the big picture. Yeah, yeah. Right. There are battles we can’t win, but though, but we got to keep fighting the

Karen: Yup. Yup. And hang on to that, you know, hang onto that. There’s a lot of people fighting with us, right. And pulling, pulling for us and, and, and walking with us.

Dan: Yeah. There’s just a lot. Yeah, there’s just a lot. I mean, struggle, struggle is real and struggle is eternal. And that is, you know, you, you talked about faith and this is, you know, the guy who, uh, runs this clinic, it comes out of a faith tradition and he says it, you know, in fee size. So, you know, my faith is, I’m trying to live into that story, the story of finding, looking for things that I want to multiply and I’m trying to live into that story rather than the other. Wow.

Karen: Yeah. Yeah. Cause cause it can be really easy to be pulled under by the, by the negatives if you know, unless you’re hanging on.

Dan: Yeah. I wish, I mean I, it feels, you know, part of me is like, that feels corny Dan. But like whenever this is what we got. Yeah. And I think the, the human inclination to, um, human tendency to look for hope, to look for the thing, to look for the next thing you know, which is different from denial. Yes. That’s, it’s a real thing like that, that, that, and it’s, and it’s a useful thing. Like I’ve, I know I’ve thought in my life like, oh well, you know, depression is like a rational worldview, but it’s not like the only rational world.

Karen: And it’s definitely not the most helpful. Yeah. Worldview. Yeah. I know I’ve been accused of being Pandora by my, a my 14 year old hastily. He’s like, how do you always look at the positive? And I’m like, well, it’s not really, it’s different than the, I don’t feel Pandora. Like I, I, I acknowledge, I understand the negative forces, but, um, but I find that it, it’s been incredibly helpful in my own life to, to find, you know, the positive things. Not to, not to not see the other things, but to focus, to choose what I focus on. I think it’s a matter of choice. So yeah. You’re, and it’s great to talk with you. Thank you so much for having me. Oh, Dan Weisman. It has been such a pleasure talking to you. I want to say thank you for helping us feel at least like we have company.

Karen: Like we’re all in this together. Thank you for staying positive. Your show means so much everybody. You can find dan@armandalegshow.com and while you are there, you gotta check out the show is patreon page because actually just the patron page is awesome. Um, if listener support you and patron and do they still get their names read out on the show? Is that still happening?

Dan: Yes.

Karen: So you’ll definitely, it’s my favorite part. You’ve read like hundreds of people’s names. Oh my God. I feel, I feel so good. I just really am grateful when you even say that. Oh my gosh. It’s so cool. It’s so cool. And thank you so much for listening today. Uh, if you are out there listening, you can find me at, we turned out okay. Dot Com. You can sign up for the weekly parenting newsletter by going to [inaudible] dot com slash weekly I am on Instagram at Twitter at turned out okay. And I have got finally a special thanks today for our producer. The man who among much else provides healthcare for our family among much else. He’s the 22 time winner of the husband of the year award. Benjamin Kolp. Thanks again so much for listening and we will see you next time.

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