Saum Sutaria, M.D.

Oh, I think it's, to your point, it's mostly larger companies that do that. But, you know, the definition of large isn't that large. I mean, there are entities- 500 people? Yeah, there are entities with less than 500 employees that self-insure at times. Not that common, but certainly as you get above that level, it makes sense. Let's for a second put the federal spending in context.

Oh, I think it's, to your point, it's mostly larger companies that do that. But, you know, the definition of large isn't that large. I mean, there are entities- 500 people? Yeah, there are entities with less than 500 employees that self-insure at times. Not that common, but certainly as you get above that level, it makes sense. Let's for a second put the federal spending in context.

I mean, close to with the direct and the tax in-kind contribution to healthcare the federal government is making, you're getting close to $2 trillion, $1.82 trillion. Defense spending, let's just put that in context. That's about a trillion. Social security, $1.2 trillion today.

I mean, close to with the direct and the tax in-kind contribution to healthcare the federal government is making, you're getting close to $2 trillion, $1.82 trillion. Defense spending, let's just put that in context. That's about a trillion. Social security, $1.2 trillion today.

That's correct.

That's correct.

Well, yeah. I mean, that may be what we collect, but obviously the government is spending closer to 6.8 trillion or something like that.

Well, yeah. I mean, that may be what we collect, but obviously the government is spending closer to 6.8 trillion or something like that.

Yeah. I mean, ultimately, that is, I think, the question when healthcare is such a large part of the economy, how sustainable is it what we're doing in healthcare expenditure? So you take all that money and financing, and then in the US, there's a system that it goes into, right? You got $4 trillion, a quarter, a quarter and half from government, and you're flowing it into a system.

Yeah. I mean, ultimately, that is, I think, the question when healthcare is such a large part of the economy, how sustainable is it what we're doing in healthcare expenditure? So you take all that money and financing, and then in the US, there's a system that it goes into, right? You got $4 trillion, a quarter, a quarter and half from government, and you're flowing it into a system.

And in our system, about two and a half trillion of that, plus some from the government, is flowing into private insurance. They're covering what we would traditionally call commercial insurance. But the private insurance community is also covering a bit of Medicare and Medicaid, increasingly large proportions of that.

And in our system, about two and a half trillion of that, plus some from the government, is flowing into private insurance. They're covering what we would traditionally call commercial insurance. But the private insurance community is also covering a bit of Medicare and Medicaid, increasingly large proportions of that.

Medicare Advantage or Manage Medicaid or other things like that, that allow for theoretically better choice, better benefits and other things, and maybe even cost control. And then there is a retail component. And then obviously the government does pay directly to providers through Medicare and Medicaid some amount of money, and that's about a trillion dollars.

Medicare Advantage or Manage Medicaid or other things like that, that allow for theoretically better choice, better benefits and other things, and maybe even cost control. And then there is a retail component. And then obviously the government does pay directly to providers through Medicare and Medicaid some amount of money, and that's about a trillion dollars.

So the split and flow, you can break it down pretty simply from that perspective. When I look at how the money's spent in a way that people can understand, I think of very simple rules. We'll get into this, which is administrative cost in the US is probably one of the biggest gaps to what we see in the rest of the world. And that can be good or bad.

So the split and flow, you can break it down pretty simply from that perspective. When I look at how the money's spent in a way that people can understand, I think of very simple rules. We'll get into this, which is administrative cost in the US is probably one of the biggest gaps to what we see in the rest of the world. And that can be good or bad.

You have to make a judgment about whether all that administrative spend is creating a better system with more choice and better outcomes. We're not, but we do spend that. And that takes up close to 10 to 15% of the total pool of dollars. When you think about that number on $4 trillion, that's a huge amount of money going into administration. We'll talk about that.

You have to make a judgment about whether all that administrative spend is creating a better system with more choice and better outcomes. We're not, but we do spend that. And that takes up close to 10 to 15% of the total pool of dollars. When you think about that number on $4 trillion, that's a huge amount of money going into administration. We'll talk about that.

For the remaining dollars, about a third goes into hospitals, hospitals and infrastructure-based care. About a third goes into physicians' offices and other clinic-type activities. And about a third goes into drugs. Again, simplification from that perspective.

For the remaining dollars, about a third goes into hospitals, hospitals and infrastructure-based care. About a third goes into physicians' offices and other clinic-type activities. And about a third goes into drugs. Again, simplification from that perspective.