GLENN: A very good friend of the program and one of the more decent men I know, Riaz Patel is joining us now. Riaz has been away for a while and been out of the country, had a new baby, has been spending time with his family, and unfortunately has lost his dear family here recently. Riaz, how are you doing recently?
RIAZ: I'm okay. Hi, Glenn. Nice to hear your voice. Hello.
GLENN: Good to hear you. Good to hear you. I wanted to talk to you today a little bit, Riaz, about -- you know, we had kind of a nice conversation over the last week about our dads.
RIAZ: Yes. Yes.
GLENN: And losing your dad and what that feels like. It's a weird thing that never seems to go away.
RIAZ: It's like a free fall of sadness and emotion. It's so visceral. It's so hard to explain. When we were going back and forth, it was one of those things that I'm like, if you've been through it, you sort of sense it. It's intense.
GLENN: Yeah. And it's strange because it -- at least with me, and I don't -- you know, I don't know about anybody else, but at least with me, the memories of my mother and my father have changed. And they -- they change as I get older. And -- and it's weird. Depending on which part of them you want to focus on, they become either better or worse than they really were.
RIAZ: Fascinating. Because it's so recent. It's, you know, less than two, three weeks. you know, when we were talking, I couldn't imagine that memory adjusting and changing. But, you know, I'm only a couple weeks in, so I imagine life as long it will.
GLENN: Yeah, you really want to write down everything you knew about your dad because it will change and you'll forget some things.
RIAZ: I started yesterday, per your advice. I actually did. I started writing down all the memories, good, bad, all that, to sort of keep it fresh now and notice how it changes overtime.
GLENN: Yeah. So, Riaz, your dad was a doctor. And he was a doctor on three continents.
GLENN: With three different systems of medicine. And you and I were also going back and forth on health care. And you are, you know, a lefty or a liberal, if you will. But you're also the guy who went up to Alaska during the -- the Trump campaign, and all of your friends were saying, "How could these people ever vote for Trump?" And as you looked at it, you went up to Alaska, and you saw the suffering of people in the country and said, they're afraid of losing everything. And they don't have -- they don't have the money to be able to survive in this, if continues this way.
RIAZ: Yeah. Yeah. Part of the quest of, what do I not know out there? What do I think I know, but I not know?
And you have to be pretty deaf to not be able to hear that health care is broken. And I don't know anyone -- anyone, if you were to ask people to raise their hands, would raise their hand and say, yep, it's working for me.
So it was fascinating, as I was sitting in the aftermath of my father's death and talking to his secretaries -- Bernie and Ruth had been with him, you know, 20, 30 years -- about the patients, the patient community. Because he had been there for 40-plus years. So those patients are going to feel the change.
And as we discussed that patient community of Edgewood, Maryland, I realized it's very much a microcosm of what's happened in America. And what's fascinating is the way my dad adapted his practice and the practice of medicine to the changing economic times.
Edgewood, Maryland, is a blue-collar town. And over the past 40 years, it has statistically decreased its income. I mean, jobs went out. I remember factories closing when I was a teenager, but people still got sick. And people still slipped and fell.
And so what happened when they lost their job, they lost their income, they lost their insurance, but they still got sick. And they went to my dad. And my dad created this island -- you know, and it's not that uncommon, for a doctor to just want to practice medicine and say, to hell with the insurance and the preapprovals.
GLENN: Oh, I -- I think -- I think most doctors are like that. Most doctors just hate the system. They want to treat people. And they hate the system.
RIAZ: You go through four years of undergrad. Four years of medical school. You end up with this enormous amount of debt. And you come out, and you cannot practice medicine freely. You cannot make decisions autonomously between you and your patient that's sitting in front of you bleeding. You have to go consult with people who have nothing to do with that patient dynamic. And that's infuriating to doctors. It's infuriating to patients. And so what I'm really angry about these days is the business of the politics of health care. There is enough money out there, Glenn, to cover us all. I saw patients come to my father's house in the 1970s, when we had it out of our garage. To treat patients on a day-to-day basis is not that expensive. Why does it become so prohibitive? Why can the patient not receive the care, the doctor not treat? Where is the money going?
GLENN: So, Riaz, here's part of the problem: If I am spending somebody else's money and I -- let me say this carefully. One of the problems is, with the -- with the employer insurance and you not having to shop around -- when we are responsible for our own money, when somebody says to us, hey, there's -- I can get you in for a CAT scan right here, right now, and it's -- I'm just making numbers up. $1,000. Or you can drive in Dallas, there's a place you can drive from my -- my house, there's one that you can drive just down the street. You'll have to make an appointment. You'll get it by tomorrow. But it's not right here. And it's half the cost.
Same thing, just half the cost.
RIAZ: Which shows the fluctuation of pricing that has nothing to do with the actual administration of medicine.
GLENN: Well, convenience -- one thing is convenience. And also, these companies being able to gouge your eyes out because most people, they don't care about the price because it's not them paying for it.
GLENN: And so when you remove the responsibility of, wait a minute. It's my money. I'm going to have to pay for it, then you -- you -- for instance, with home insurance. I could file -- my home was struck by lightning this weekend.
RIAZ: Oh. Oh, I would look into that, Glenn.
GLENN: I know. I know. Wait a minute. What are you saying there?
So it was struck by lightning, and I said to my wife -- she was gone and she worked with her dad who was an insurance agent. And I'm like, "Blew the TV. Blew the system. You know, blew a whole bunch of stuff." And she said, "Well, we have a huge deductible." And I thought, "Oh, crap. We do, don't we? Oh, it's not free anymore."
GLENN: So you start to now care, wait a minute. Who did I call? Let's make sure I'm pricing this the right way. And so there is a difference. And it's the free market system. And Washington is taking it even further. They're just making deals with the insurance companies and with all the people who are getting rich, including them.
RIAZ: So my father was in the 1970s and '80s, was a medical director of a hospital, a small hospital in this area. And I watched as a kid as the board -- he ran all the decisions of the hospital: Who needed what, when they needed it, how long they'd stay. Then eventually there was one MBA, then two MBAs. And then eventually, there were no doctors represented.
So everything we're talking about, whether it's two-party system, single-party system, the government, insurance, preapprovals, none of that has anything to do with you and your doctor.
And to me, what my father brought, having trained in Karachi, Pakistan, in London, England, was a very different perspective, that you treat first your physician and then the billing comes next.
And what he did is said, you're sick, you come in. And then you go to billing. And what happened was, it became so personal that Ruth or Bernie would say to Mr. Johnson, "Okay. Here's what happened." And Mr. Johnson would say, "I don't have my job. I don't have insurance. But I can pay $40." And they would be like, "Okay." Because we know, in health care, that's better than nothing.
And my father would just say, the personal responsibility of the physician to treat is the joy of his life. And at a certain point, working at the hospital, it was so bureaucratic with the lawyers and the MBAs and the lobbyists in a small hospital, that he actually left the hospital, built his own surgical center and said, "I cannot practice medicine appropriately in the way it works."
GLENN: So what you're asking for though is a return to common sense and a return to trust in neighbors.
I'm reading this book called Mistakes Were Made, But Not by Me. And it talks about the -- why we don't say I'm sorry. And it gets to this one place about doctors. And they track doctors in a study of those who said, "Wow, I made a huge mistake," all the way to a doctor who came out of surgery, the patient dies, and he says, "Look, I -- I don't know what the -- I don't know what the autopsy is going to show. I don't know. There will be an investigation. But your husband died, and I believe it was my fault."
And they were angry. And he said, "Look, I didn't have any reason to suspect this, but I just really feel like I should have caught that. And I just want you to know I take responsibility."
The doctors that say the truth are the least likely to be sued. But because of the system that has been set up by the attorneys and everything else, nobody is having real conversations with each other.
RIAZ: And that is the problem. And so in this tiny patient community of Edgewood, they were able to create this walk-in medical center, nothing fancy, where neighbors walked in, up to three, four generations and were treated.
And to me -- and my father was diagnosed with cancer and died in seven weeks, literally. I would say we spent 80 percent of our time trying to navigate insurance: Was this preapproved? Was this equipment sent?
And my father, who treated a quarter of a million patients over the course of his life, we could not get a bed for him to ease his pain because we could not track down the paperwork. So the last five days of his life, he sat in pain because the four of us --
RIAZ: -- you have -- I'm a producer. My sister is a lawyer. My other sister is a physician with her own practice. My husband manages health care.
The four of us could not navigate the system. And each day, my father sat there in pain. And we said, "I think the bed is arriving today. I called the office. I called the home health. I called the person." All we did was manage it.
And I'm thinking, after he's dead and I'm standing there near the grave, I'm like, "How can this continue? How can a person get sick and go to their doctor and 4,000 people and 10 million letters will go on, that has nothing to do with that dynamic?"
GLENN: I have about two -- I have about two minutes.
Can you talk a little bit about the off-the-grid medicine that you saw in Alaska?
RIAZ: In Alaska, when I was there, I saw in a local paper that they actually were advertising -- doctors were coming and setting up basically bundling your health care, saying people are not going to doctor's offices because they don't have insurance and money. But you cannot avoid your own health.
And so these doctors would come, roving through these small towns and say, "Look, I'll do it for this much cash." And I think at a certain point, this is all we're discussing. Bringing it bottom-up. We need to bring it back to basics. You and your doctor need to decide what is best for you and how to pay for it. They say one-third is going to policy and bureaucracy. That's insane.
GLENN: So Mike -- Mike Lee, the senator -- the most conservative senator, one of them, just wrote an op-ed and said, "Look. I'll sign on. This is not going to fix anything. It's already premiums from Obamacare are up 140 percent. There's nothing in this Trumpcare that's going to make this any better." He said, "I'll sign on, but only if you let states opt out and come up with their own thing." He said, "Because I believe the people of the country will figure it out in their own way, if you just leave them alone." Do you agree with that?
RIAZ: I believe it is so broken right now, I do not know how to fix it. But I know that people will still slip and fall. They will still feel unwell on a Monday morning, and they need to go to their doctor. So I don't know what DC or politicians or insurance are going to do with their multibillion-dollar lobby, but I really encourage people if they're sick, to go to their local physician and say, "Here's what's going on. This is my life."
The insurance companies have removed that ability to talk to your doctor and vice-versa about the fact that, hey, I'm sick, but I don't have money. How can I be treated? And there's money for all of us to be cared for. But the business of politics and health care is absorbing it at all.
GLENN: Riaz, always good to talk to you. And I'm so sorry for the loss of your father.
RIAZ: Thank you. Good to talk to you. Bye, Glenn!
GLENN: God bless you. We'll see you soon. Thank you, Riaz. Buh-bye. Riaz Patel.
I know that in Texas, this is the feeling of many of the doctors of you know what, I'm just pulling out of the system. And I'll just deal with it myself.
I personally think that as we get closer to universal, single-payer system, those doctors are going to be told, you can't do that. But that is the solution. Leave people alone, and they will work it out on the -- on the most basic level.
Now, maybe they won't in the big cities, so the cities do something else. But they will around the rest of the country.