Saum Sutaria, M.D.

Absolutely. In hindsight, it's 100% clear. If you think about when the legislation was put in, I'd say in 1950, we were like 4.5% of GDP in healthcare. At the time Medicare came about in 1965, that number was in the mid-sixes, mid to upper sixes at best. So who would have guessed that it would have risen to 17, 18, potentially in the future, 20%?

Absolutely. In hindsight, it's 100% clear. If you think about when the legislation was put in, I'd say in 1950, we were like 4.5% of GDP in healthcare. At the time Medicare came about in 1965, that number was in the mid-sixes, mid to upper sixes at best. So who would have guessed that it would have risen to 17, 18, potentially in the future, 20%?

I think, I mean, the US healthcare system in many ways is a story, an optimistic story of well-intended policies that now are questioned based upon the way the expenditures have increased. There's another thing that's important to understand, which is as the US healthcare expenditures increased as a percent of GDP, so did the rest of the developed world. So every developed nation

I think, I mean, the US healthcare system in many ways is a story, an optimistic story of well-intended policies that now are questioned based upon the way the expenditures have increased. There's another thing that's important to understand, which is as the US healthcare expenditures increased as a percent of GDP, so did the rest of the developed world. So every developed nation

that put in place programs, their version of Medicare and Medicaid, I understand more state-run than privately run, their expenditures increased. They started like us in the fours, and they've landed in the 11% to 12% range. We've just accelerated up to 17%, 18%. Think about it this way. From that time forward, the U.S.

that put in place programs, their version of Medicare and Medicaid, I understand more state-run than privately run, their expenditures increased. They started like us in the fours, and they've landed in the 11% to 12% range. We've just accelerated up to 17%, 18%. Think about it this way. From that time forward, the U.S.

economy relative to the healthcare economy, the healthcare economy has grown significantly. roughly 2% per year faster than the US economy. And the US economy has grown robustly, better than the rest of the world. So that's why the expenditures have gotten so high. And there have been periods where that's been slower, and there have been periods where that's been faster.

economy relative to the healthcare economy, the healthcare economy has grown significantly. roughly 2% per year faster than the US economy. And the US economy has grown robustly, better than the rest of the world. So that's why the expenditures have gotten so high. And there have been periods where that's been slower, and there have been periods where that's been faster.

Every time there's a new coverage event, Medicare or Medicaid, some of what happened with the Medicare Modernization Act in 2000, we'll get into that when we talk about drug costs. And then obviously the Affordable Care Act, which created significantly more coverage, that rate of increase for healthcare expenditures relative to GDP growth has widened.

Every time there's a new coverage event, Medicare or Medicaid, some of what happened with the Medicare Modernization Act in 2000, we'll get into that when we talk about drug costs. And then obviously the Affordable Care Act, which created significantly more coverage, that rate of increase for healthcare expenditures relative to GDP growth has widened.

Yeah, yeah. CMS, Center for Medicare and Medicaid Services, as it's called. Medicare covers people over the age of 65 and a bunch of special categories of people with severe chronic illness, take dialysis as an example, that it might be hard to find coverage on the private market over a long period of time given their needs. It is more than what I would describe as a safety net program.

Yeah, yeah. CMS, Center for Medicare and Medicaid Services, as it's called. Medicare covers people over the age of 65 and a bunch of special categories of people with severe chronic illness, take dialysis as an example, that it might be hard to find coverage on the private market over a long period of time given their needs. It is more than what I would describe as a safety net program.

It's a coverage program for people over the age of 65.

It's a coverage program for people over the age of 65.

Everybody qualifies for Medicare at the age of 65.

Everybody qualifies for Medicare at the age of 65.

The benefit doesn't vary.

The benefit doesn't vary.

That's right. And so Medicare, another interesting piece of context, think about life expectancy. I mean, we're going to get into life expectancy differences in the US. I mean, the fact is- What was life expectancy in 1965? Yeah, and I don't know what the exact number was in 1950 or 65. It wasn't what it is today.

That's right. And so Medicare, another interesting piece of context, think about life expectancy. I mean, we're going to get into life expectancy differences in the US. I mean, the fact is- What was life expectancy in 1965? Yeah, and I don't know what the exact number was in 1950 or 65. It wasn't what it is today.