Is there a cure for the real cost of the distressing state of American healthcare?

Dr. Terry Mulligan, an emergency physician and adjunct professor at the University of Maryland School of Medicine, joins Nestor to discuss the documentary “Suck It Up Buttercup” about physician burnout and corporate greed in the U.S. healthcare system. Screening at The Senator Theatre on March 19, Mulligan discusses the film that criticizes the current system, which prioritizes profit over patient care, and advocates for a more cooperative, equitable system.

Nestor Aparicio discusses the Maryland crab cake tour and local sponsors, including the Maryland lottery and GBMC. He introduces Dr. Terry Mulligan, an emergency physician and adjunct professor at the University of Maryland School of Medicine, to discuss the documentary “Suck It Up Buttercup” about physician burnout and corporate greed in the U.S. healthcare system. Dr. Mulligan criticizes the current system, which prioritizes profit over patient care, and advocates for a more cooperative, equitable system. He highlights the need for comprehensive healthcare coverage and public health initiatives to improve overall patient care and reduce burnout among healthcare professionals.

• [ ] @Nestor Aparicio – Read about the film “Suck It Up Buttercup” before the March 19 Senator Theater screening to better understand its content and themes.

Maryland Crab Cake Tour and Sponsors

• Nestor Aparicio introduces the Maryland crab cake tour, mentioning upcoming events at Koco’s and Costa simtimonium.
• He highlights the Maryland lottery as a sponsor and mentions the Harlem Globetrotter scratch offs.
• Nestor also thanks Farnan and Dermer, the HVAC folks, and GBMC for their support.
• He promotes the “Walk a Mile in Their Shoes” event at GBMC on April 17.

Introduction to the Film “Suck It Up Buttercup”

• Nestor Aparicio discusses the film “Suck It Up Buttercup” airing at the Senator Theater on March 19.
• He describes the film as an investigative documentary about physician burnout and corporate greed.
• Nestor expresses his interest in learning from Dr. Terry Mulligan, an emergency physician and adjunct professor at the University of Maryland School of Medicine.
• He mentions his personal experiences with his wife’s cancer and insurance issues.

Dr. Terry Mulligan’s Background and Baltimore’s Medical History

• Dr. Terry Mulligan shares his background, mentioning he grew up in Detroit and now lives in Baltimore.
• Nestor Aparicio talks about his long-term connection with Detroit and Baltimore, highlighting the city’s history and medical significance.
• Dr. Mulligan discusses the history of medical institutions in Maryland, including Johns Hopkins and the University of Maryland.
• They talk about Baltimore’s role as a medicine city and its importance during the COVID-19 pandemic.

Challenges in the US Healthcare System

• Nestor Aparicio shares his personal experiences with his wife’s medical treatment and insurance issues.
• He discusses the complexity of the healthcare system and the challenges faced by patients and caregivers.
• Dr. Mulligan explains the systemic issues in the US healthcare system, including corporate greed and bureaucratic failures.
• They discuss the impact of capitalism on healthcare and the need for a more equitable system.

The Film “Suck It Up Buttercup” and Its Message

• Nestor Aparicio introduces the film “Suck It Up Buttercup” as a solution-driven documentary.
• Dr. Mulligan explains the film’s purpose and its focus on exposing the frailties of the US healthcare system.
• They discuss the film’s features, including interviews with physicians, clinicians, patients, and other key stakeholders.
• Dr. Mulligan emphasizes the need for a systemic change in the healthcare system to improve patient care and reduce burnout among healthcare professionals.

The Role of Insurance and Corporate Greed in Healthcare

• Nestor Aparicio and Dr. Mulligan discuss the role of insurance companies and their impact on patient care.
• They talk about the high costs of healthcare and the lack of transparency in the system.
• Dr. Mulligan explains how the current system is designed to benefit a small number of stakeholders at the expense of patients and healthcare professionals.
• They discuss the need for a more cooperative system that prioritizes patient care over profit.

Personal Stories and the Impact of Healthcare on Families

• Nestor Aparicio shares personal stories about his wife’s medical treatment and the challenges they faced.
• Dr. Mulligan discusses the emotional and financial toll of the healthcare system on patients and their families.
• They talk about the importance of public health and preventive care in improving overall healthcare outcomes.
• Dr. Mulligan emphasizes the need for a system that prioritizes patient care and reduces the burden on healthcare professionals.

The Importance of Public Health and Preventive Care

• Dr. Mulligan discusses the role of public health in preventing medical issues and reducing the need for hospital care.
• They talk about the importance of providing healthcare to the entire population, not just those who can afford it.
• Dr. Mulligan explains how a well-functioning public health system can reduce the burden on hospitals and emergency departments.
• They discuss the need for a more comprehensive approach to healthcare that includes preventive care and public health initiatives.

The Role of Global Healthcare Systems and Lessons Learned

• Dr. Mulligan shares his experiences working on global healthcare systems and the lessons learned from other countries.
• They discuss the differences between the US healthcare system and those in Europe and other high-income countries.
• Dr. Mulligan explains how other countries have more effective systems for treating the population as a whole.
• They talk about the need to learn from these systems and implement similar solutions in the US.

The Future of Healthcare and the Need for Systemic Change

• Dr. Mulligan discusses the need for a more cooperative and less competitive healthcare system.
• They talk about the challenges of implementing systemic change and the resistance from stakeholders.
• Dr. Mulligan emphasizes the importance of public education and advocacy in driving change.
• They discuss the potential for a more equitable and effective healthcare system that prioritizes patient care and reduces healthcare costs.

SUMMARY KEYWORDS

healthcare system, physician burnout, corporate greed, insurance issues, medical research, trauma system, public health, emergency medicine, healthcare costs, patient care, systemic failures, healthcare reform, medical professionals, patient satisfaction, healthcare policy

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SPEAKERS

Dr. Terry Mulligan, Nestor Aparicio

Nestor Aparicio  00:01

Welcome home. We are W, N, S T am 1570 Towson, Baltimore. We are Baltimore, positive and positively getting the Maryland crab cake tour back out on the road in the aftermath of opening day. We’re gonna get back at the Koco’s. I’m gonna get back at the Costa simtimonium. But in the meantime, we will be at missoney’s on Tuesday, first time at missones and Perry Hall. It’s all brought to you by the Maryland lottery. I will have the Harlem Globetrotter scratch offs to give away for a limited time. We’re gonna get those beautiful Maryland artistic renderings coming in April after opening day, as well as also brought to you by our friends at Farnan and Dermer, our HVAC folks, the comfort guys and our hospital partners at GBMC, where I’m always talking about the good things they’re doing here in the community, and always having docs on and we’re doing walk a mile in their shoes in April on the 17th. I’m committed to that as well here in Towson. So I like talking medical stuff. I like talking insurance stuff and Doctor stuff, because it it really becomes real life when the bill comes, and I know, for anybody that’s followed my journey and my wife and her cancer, and Johns Hopkins and insurance and 911 and my wife is in the zagroba Act and in the program that, and I’ve done a lot on Obamacare and Maryland Health Connection and the criminal run in the country, and just everything that’s going on here. But on the 19th of March. It’s come to my attention that one of my favorite theaters, or Senator theater, is is airing a film, and it’s got a sort of a title that I’m like, suck it up buttercup. Suck it up buttercup. I have heard that expression, and it’s never that sort of like, rub some dirt on it and get moving an investigative documentary about physician burnout, which we’ve discussed here corporate greed, which is a part of our lives, and the systems that can still save us here to discuss this, and I love when I have doctors on, because I know I’m about to learn Dr Terry Mulligan. Terrance Mulligan is an emergency physician and adjunct professor at the University of Maryland School of medicine on also a Harvard Medical School alum. And Where’d you grow up? I always say I asked that question, Doc, where are you from? I’m from Dundalk. Where are you from?

Dr. Terry Mulligan  02:13

I grew up in Detroit, and to me, I love Baltimore, because I think if I turn around three times and open my eyes and I’m in the middle of Baltimore, actually, it reminds me of being in Detroit, similar field, old brick buildings pre war, except Baltimore has people, whereas Detroit has now become kind of unpopulated.

Nestor Aparicio  02:39

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But yeah, I mean, I’ve been coming to Detroit for 35 years, Tiger Stadium, Linde lac the Joe, you know, all of that Cobo Hall, that stuff, even with Kiss, was there. But I think for cities and that the the administration that’s running the world right now picking on cities and picking on poor people and picking on immigrants and picking on all the things that built Baltimore four or five different times as we go through the generational of what makes Baltimore great, the port city. It’s got great bones, great history, just all of that, Civil War, battles, all of the the what we have here. And I guess we’re celebrating 250 years this year. So we could talk about Federal Hill and the British and, you know, all of this. But we’re, we’re a medicine city around the world, right, right? I would think Johns Hopkins, we’re a medicine city, right?

Dr. Terry Mulligan  03:35

Well, that’s right, Hopkins. And also University of Maryland, University of Maryland, I’ve been working there since 2006 and I’m still an adjunct professor there. University of Maryland is the the School of Medicine is the third oldest medical school. It’s the also the oldest dental school, the first dental school, the first school of nursing. It’s the first medical school that came before the university. So this medical school was actually founded before the university was founded in Maryland, and it’s one of the biggest state hospital systems. And of course, Hopkins is world famous research, medical research institution in the world. And so Maryland’s also the, the one of the first statewide ambulance systems, the first trauma system, statewide trauma system, with, you know, shock trauma being, along with the Chicago and LA, the first trauma hospitals and statewide trauma system. So, yeah, it goes back a long way.

Nestor Aparicio  04:45

Well, my wife was battling 12 years ago at Hopkins. All you have to do, I mean, we would go for walks to try to keep her alive at that point, right? And that dome that’s there and the history that’s there, and the bones and the bricks that are there, Henrietta Lacks, we can just go through. Uh, the university, just all of that. Um, I remember back in beginning of covid, we shut the city down. Brandon had to shut the city down and and there was a lot of conjecture about and I thought Baltimore is the one place when Seattle had to break out. In New York, we’re seeing the ambulance to seeing the trauma. People are wearing masks. I thought we’re the one place that can’t go down. We have too many doctors, too many hospitals. We’re important. We’re near DC that when the manure hit the fan, big time in the world, shut down during our lifetime. Baltimore is one of those places we had to protect even more. And I don’t know that the business owners understood that, or shutting down businesses, or, you know, all because I this is where I lived. I lived at the Inner Harbor for 19 This is literally out my window. I lived at Harbor court for 19 years. So I saw the good and the bad and the ugly. But I could see my wife’s hospital. If you look right there, I could see her hospital room where my pen is going, because that’s Johns Hopkins and the Ziad just all of the things that I’ve seen in medicine in the city as to how important our city is. And then I think, well, we have too many damn hospitals because we have too many damn sick people, don’t we want less sick people? And I guess that’s where suck it up buttercup maybe comes in here. And there’s my radio segue for you there. Dr Mulligan, yeah.

Dr. Terry Mulligan  06:17

Well, well, of course, that’s we’re all trying to work towards is make people well and live better, live longer, live more healthy and happier. And I don’t know if necessarily having less hospitals is the way to do it, but, but yeah, I think we’ve kind of backed ourselves into a system that we found especially over the last 20 years or so. But for the last 50 years or so, we’ve been moving towards a system that I think nobody really wanted. Nobody really designed it. We kind of have wound up with a system that doesn’t work. It works for the people who own the sub components of the system. But I don’t think it works for patients. It doesn’t work for the public. It doesn’t work for public health. Doesn’t work for even health professionals like nurses and physicians and other people working giving clinical care and then doing the public health piece, and so I think we, we’ve kind of wound up with a system that is limping along and doesn’t really work. It works for the few, but not for the public.

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Nestor Aparicio  07:35

My wife’s two bone marrow transplants and leukemia, and for Neil, so she’ll be seeing in Italy, in a couple of weeks in Europe, who saved her life twice. He always liked to say that I did it twice. He’s German, and to think of the complexity of all of that, and watching my wife have her life saved at and comas, all of that, and coming out of it, and doing this, instead of arguing about the Orioles and the Ravens all day long, although I’m happy to do it portion of the day, as I get older, was millions of dollars that saved my wife’s life insurance her employer who sent her in to 911 and then the American government and the grove act that’s insuring her hopefully for the rest of her life. It concerns her. She’s diabetic as well, so she’s tethered to the health system completely. My wife’s life is tethered to the health system. You know, like she’s this close to being diagnosed as not diabetic anymore to take pills instead of the shot she’s been taking for 38 years. So, I mean, my wife makes appointments, her eyes all of this, and where the insurance is and where the system is, and where the red tape is, and where I was as a traumatized caregiver in her filling out all of her own medical forms when she was bald and weighed 85 pounds and had wrists the size of my pinkies like I am. We’re smart people. We’re educated people were, you know, we were not affluent by any stretch of the imagination, but we had insurance. We didn’t go, we didn’t wind up on skid row because of it. I just, I know the challenges we’ve been through, and I’m a really healthy dude for the don’t tell the people at GBMC that, but I think I’m healthy at least today. So far, 5850 so I’m okay, but I’ve had surgeries. I’ve had in outpatient this that bills, all of that, I’ve never been driven out of business or had that concern up all night about how I’m going to pay for things where my next insurance is going to come from, where my next vial of insulin is going to come from. And my wife lives for that right, like she’s tethered to it every minute of every day. With that, I would say DC is failing us. And had Kwasi on last week, and I had Johnny, oh, I mean, and I could talk to all of them, but really, capitalism, wonderful concept, wonderful, you know, we talked about it all day. It’s built the whole place. But whether it applies to healthcare. And social welfare and a safety net. The people in Scandinavia and a lot of other countries in the world would say we might have won in hockey. We might win in baseball this week, but we’re not number one. We’re just not we’re amazing at developing medicine and saving lives. We’re terrible at taking care of our citizens, our humans, with the outcome of stuff that, you know, the original doctors, 300 years ago, would marvel at how far we’ve come. I marvel that my wife is alive. Because when they said leukemia, I thought Brian song. I thought my wife’s going to die. She’s in the other room.

Dr. Terry Mulligan  10:35

Yeah, well, I mean, I’m I hear what you’re saying. You know, I think capitalism is not a force of nature. It’s something that we designed, as, you know, human beings. And it’s not even old, ancient in terms of human history. It’s only six or 700 years old as a human endeavor. And capitalism, I think, is like a fire in the fireplace. Fire in the fireplace is good. Fire in the boiler of your building to heat the building is good. Fire in the forest, burning down the forest, fire in your living room, burning down the furniture in your curtains, uncontrolled, is not good. And so capitalism really needs rules and needs a system that it can operate in and in medicine, in a lot of sectors in the US, but especially medicine, we do not have capitalism. We don’t have this kind of self correcting, self governing, regulated system that consumers or patients or people who are involved in paying for it as a product, can make choices and then come up with a system that winds up working for everybody. So that’s not what we have in the US we in fact, I don’t think the healthcare system is broken. I think it’s fixed. I think it’s designed to operate in the way that it operates, and the design has very little to do with giving health care or even appropriate medical services to people. And so that’s something we need to kind of we all need to recognize that, and we have to decide collectively, somehow, whether this is something we want to continue to put up with.

Nestor Aparicio  12:26

I’m going to read about the film. The film is called suck it up buttercup. My guest is Doc Terry Mulligan, and the US healthcare system is facing a multifaceted crisis. This is a documentary to drive change. It is a purpose film. It’s at the Senator. It’s on the 17th. They say, 17th, I get that right? 19. I’m sorry. I’m thinking St Patrick’s Day, 19th. Senator, my bad. Suck it up buttercup. Is an investigative, emotional solution driven film featuring so we have a solution. I like, I like when I like cliffhangers, but I like it better when, like, give me a way we fix this, right? So featuring physicians, clinicians, patients and other key stakeholders, exposing the frailties of the US healthcare system in terms of corporate greed, which we can’t agree on anything, and it’s we can all agree that there’s a lot of corporate greed going on in pharma, systemic, bureaucratic failures. I’ve seen some of these folks and a deteriorating work environment. I’ve spent a lot of time in hot do you know how many fights I had with the Johns Hopkins people to see the guy who was running Johns Hopkins at the time, got on the phone with me when they brought my wife, who was neutropenic and dying, a bullion cube and boiling water, and told her it was nutrition, the cancer war. I lost my mind on how bad the food was in the hospital just so I’m throwing that out so, man, you could put me back there in a minute. Doc, you know, she spent 151 nights in Hopkins. It doesn’t take much for me to go back and be so incredibly inspired by the doctors, by the nurses, by the medicine, by the care, by the tears, by the by people’s true, incredible concern. My wife was at a teaching hospital so interns doctors would come around every day. There’d be 15 doctors in the in there every day trying to figure out what the hell was trying to kill her. Turned out it was 911 which we didn’t know until afterward, but like, I have so much respect for all of the research. I’ve raised money, I’ve given speeches, I’ve hosted dinners, I’ve like, I’ve done all of that for 35 years, and I know how far we’ve come. I got proof in the other room. She was her mother. She’d be dead a generation. She could. Deep shot. He lost his father. A Raven’s owner lost his father to leukemia in the 60s. He grew up without a father because his father died of leukemia. I know pay I I’m connected to that world now. So I see survivors, you know, Eric and Michelle, and people that found that there goes my hero. And I think about all of that, all that good stuff, all that amazing stuff, and the mag magnanimous people in Europe to help save her life, and doctors over there, and all the science that went into this, and all the research and people swabbing just for my wife, just in my space so my wife can be alive. And think about the insurance company it met life that tried to force her back to work when she wasn’t ready to go back to work and the bills that came with big zeros on the end, and then the government, these creeps like Mitch McConnell trying to go in and take her insurance away, so that John Stewart had to go to politicize that My wife should have insurance the rest of her life after going to 911 on September 13 and so, like, that’s my personal bitch story. Complaint about this. So I love that a film has been put together that my wife might want to see other people might want to see, to say, How can this be better the next time around? How can we make this better because we’ve made the medicine better. We’re not even trying to make the system better.

Dr. Terry Mulligan  16:24

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Doc, well, that’s, that’s the that’s part of the reason the title was chosen is that the suck it up buttercup is the is the ultimate that all of us are facing when we’re dealing with the healthcare system, whether we’re patients and you’ve, you know, described your experience with this. You don’t like, it tough. This is what you get. This is what you get when you don’t have insurance. Is what you get when you do have insurance. This is what you get when you go to the best hospital system in the world. You don’t

Nestor Aparicio  16:58

like, I gotta tell a story. My wife was nauseous during this whole thing, and she had a patch that was keeping her from throwing up. There was a lady in the next room, and I don’t know if she lived or died. We kind of think she probably she was struggling. She had three kids. They were in Northern Virginia. Husband, she was in her 30s. Man, you know, I mean, she was and they were the family would come up on the weekends, kids in the hallway. Mom’s dying. It’s awful. Um, she’s throwing up. Her insurance didn’t cover these patches. They were, like, $400 a piece. My wife had a stack of them sitting there, yep, of course, we gave her the patches, you know, like it was insane, the shit we saw insane. I apologize, but you got the wrong host today. Doc, sorry. Well, I mean, it’s maybe got the right host.

Dr. Terry Mulligan  18:02

Well, I think we’re on the same page. You know, you as patients and just as citizens. We’ve been upset and dissatisfied and unbelievably angry, justifiably angry, at our healthcare system for a long time, for a long time. But now it’s not just patients and the consumers who are getting screwed. It’s everybody who’s in, involved in the system, people who work in the hospitals, the physicians, the nurses, the other all the multiple, multiple health professionals who are providing care, everybody trying to do their best, like you mentioned, seeing the students and the residents learning, trying to learn how to help people.

Nestor Aparicio  18:45

It was a resident that diagnosed, a resident from Saudi Arabia, excuse me, Egypt, who diagnosed my wife’s illness. Found her leukemia and like at Hopkins, literally, yeah, incredible international effort. Incredible how the world comes together to save lives in

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Dr. Terry Mulligan  19:07

that, yeah, yeah. And so I am, I’m really, I think the movie winds up talking to the unbelievable frustration and anger that that you’re exhibiting, and you’re justified in exhibiting that. You know what’s, what’s, what’s more tragic, somebody having pain and suffering because of a diagnosis for something that we don’t know how to fix yet. So most cancers we don’t know how to fix yet. A lot of heart disease we can manage, maybe, but we can’t really fix it. There are a lot of things that we have not figured out. We in the medical world, we in the scientific world, just we haven’t figured that out. That’s a tragedy. But what’s worse, that of people dying and having suffering from things that we do know how to fix, that we do have the medicine for, we do have the science for, but we’re choosing not. To deliver it. We’re choosing not to distribute it. We’re choosing not we, meaning the system that we work for. I think that’s a double or triple tragedy. It’s it’s a, it’s a, it’s a crime. I think it’s worse than just being tragic. It’s unnecessary, and it’s unnecessary for the for the complete wrong, unnecessary reasons. So, you know, I got involved with this film because I’m an emergency doctor, and, you know, I went to medical school, and they teach you how to take care of patients, but they don’t teach you how to take care of how to build the system. They don’t teach you how to build the healthcare system. What a healthcare system is, I think most doctors, most people, don’t understand how the healthcare system even works. And I became really interested in emergency medicine, and then I got involved in global emergency medicine development, so how to build emergency systems and trauma systems in other countries. And so over the last 20 years, I’ve been working in 40, 5060, countries, four or five months a year, helping build emergency systems. And I see, you know, systems are overseas that work, and see systems that don’t. And while there is no perfect system, there’s no one system that fits everything. There are a lot of similarities between systems. And I felt like, coming out of my training, I didn’t understand how systems worked, and if I was going overseas, trying to teach and work with people building their emergency systems, their trauma systems, their ambulance systems, disaster systems. I really had to learn more about the healthcare system. So I kept going back to school and back to school and back to school after my emergency training, and I became kind of a pseudo expert in healthcare systems and global healthcare systems. And after all of this 1520, years of learning, I kept expecting that I was going to come on some I was going to stumble across the thing that I had been so confused about for so long. But what was it that How come our system is so broken and how come it doesn’t work? There must be some arcane, hidden health economics set of laws or rules that I just didn’t understand, that most people don’t understand that if they only understood this. You know, economics and business and the way insurance works, and the way that actually they would see that it has to be the way it is, but, but, you know what? I was mistaken. I After studying this for 20 years and all around the world, especially in the US this, the reason is that it’s the way it is in the US, especially, it’s not because of some arcane set of health economics laws, that means the healthcare system has to be horrible the way it is. It’s this way on purpose, because it’s designed to benefit a different set of priorities than the priorities that we think it should be designed for. We think it should be there to help people, to help them when they’re sick, to help them stop from getting sick and to stay healthy. And it’s just not designed that way. It’s more designed, especially in the last 2030, years, more designed like a business, designed like a business to deliver profit, and it’s designed to deliver profit to a very, very small number of people who actually own the companies and the major stakeholders, insurance companies, pharma companies, some hospital groups and a couple other small device companies. And so, you know, we’re we’re not part of this calculation of theirs. Patients are there to pay the premiums and then to shut your mouth and take what you get, suck it up. You don’t like the coverage, you can get insurance somewhere else, except the insurance somewhere else is pretty much the same or worse than the one you got. So you know, if we were talking about buying products like a car or you’re buying a house or so you’re going on the market trying to buy something if you don’t like the quality, if you don’t like the price, you can choose not to buy it, and then that helps, you know, change the market, and somebody will come up with a better product for you. But we can’t do that with healthcare. Healthcare is this grudge purchase where we have to consume healthcare, or the alternative is you get sick or you suffer, or you die, or your family does, or your children do. And so we have to choose and take the things that they’re offering to us, and they know that they got us where they want us. You know, I have one of these cart I have a cartoon in one of my lectures, there’s a mama and a daughter sitting on a couch, and the daughter says, Mama, how does the health care? How does health insurance work. And the mama says, well, first they collect these really giant premiums. And the daughter says, and then what? And the mama says, Oh, that’s it. They collect the premiums, and then they do their best to not deliver it, not pay, not per. Either services, and now we’re seeing it reaching all the way down to physicians, nurses. Everybody who’s delivering the care is now burning out, burning out, not just because of overwork and underpay and understaffing, deliberate under resourcing, deliberate understaffing, deliberate overwork, because that makes money for the organizations that are, you know, work we work for, but it’s, it’s, it’s doing it in a way that it’s this double or triple tragedy that I talked about. I don’t think most people are not afraid of hard work. I know most doctors and health professionals are not afraid to work hard, and we got into it knowing we were going to work hard, but I want to work hard towards something. I want to work hard for the right reason. I don’t want to work hard to do double or triple work in order to make 1% of the people who own these companies rich and at the expense of human beings and their pain and suffering and their lives. It’s just and so that’s the suck it up buttercup. That’s the message. Is the system is telling patients, you don’t like it tough. It’s telling doctors nurses, you don’t like it you can quit and go work for the hospital across town, except, you know what, they pretty much are going to treat you the same way so, and I think we’re working for a system that is designed to run healthcare like a business. I don’t think there are, you know, that many evil CEO like Mr. Burns types who are really, you know, evil bastards who are responsible for all the major problems. Although, you know, of course, we have our share of those. I think it’s not so much bad human beings. I think it’s the machine that we have built, or the machine that we have allowed to have been built.

Nestor Aparicio  26:53

Well, the cynic in me would say it’s about the politicians in DC and money that influences both sides of the aisle and the middle of the aisle and anywhere else. When you’re talking about, to your point, this isn’t about gas and cars and transportation. Yeah, that’s important. This isn’t, you know, it’s not about jobs or this is about health care, and all of us are going to need it at some point, even those we’re really healthy, we’re all going to need it. And it, and we all know, like everything else, the cost of it, it’s not optional. You know, it’s like having a cell phone, like having a mobile though there’s certain things, vehicle, if you live in certain places that are built in that all sounds great. There really are all of these are optional. When you’re sick, when diabetes, there’s not there’s no option on my wife having insulin today. None, zero. Without it, she’s dead by the end of the week, right? So that that’s a whole different level of we got you by the short hair. No, you you got the short hairs. You got all you know, you got everything. You got everything health. So the film was on the 19th at the Senator. I’m assuming this will be available in other places, but it’s being premiered. Give me a little bit about the film, Doc, and I’ll let you roll and we’ll send everybody out. Suck it up buttercup. Film, you can learn more about it. There is a solution provided in this film, and I don’t know if you want to get into that. I don’t think you want to keep it too much of a secret, but encouraging folks to come out and learn about these issues that affect all of us, and at a level where I think everybody that sees the film will learn something about this, right, some little nuance of, holy shit, they’re doing what? I’m sure there’s a little bit of that, right?

Dr. Terry Mulligan  28:36

Yeah, well, I mean, I don’t think, I think the healthcare system now is probably at the bottom of the rung of businesses or parts of society that people are the most dissatisfied with. You probably have politicians and congressmen, and then maybe your healthcare system, like right? At that level of people being dissatisfied your

Nestor Aparicio  28:58

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healthcare system, everybody’s paying for their healthcare, right and

Dr. Terry Mulligan  29:01

we’re paying unbelievably high amounts, and we’re not getting not only are we not getting service, we’re getting worse service every year. It’s like if you bought a new cell phone every year, and next year it’s twice as much as it was this year, but it has half the functions, and then two years later, it’s twice as much from there and has half the functions from there. And so the only real strategy that insurance and the healthcare system has been delivering outside of the scientific breakthroughs from year to year, has been to raise their prices. So I think we’ve where this is the healthcare system in in the top g20 or G 50 countries. The top 50 countries, healthcare sector is the number one, two or three, biggest sector we spend $5.3 trillion a year. Money goes through the

Nestor Aparicio  29:48

healthcare system, even in healthy countries, even even in the healthiest places, right? And healthcare

Dr. Terry Mulligan  29:53

is expensive. Lots of things that we do in society are expensive. Education, the judicial system, the democratic system. You know where? Where it exists. There are a lot of things, you know, the infrastructure, the plum, the electrical grids. These things cost money, and we, as a society, we elect and decide to pay for it. But there are certain sectors where that, like you mentioned, you get the policy and you get the laws that you pay for. You get the policy that you lobby for. It’s the best democracy money can buy with this legalized lobbying, legalized bribing. You get, you get the the policy that that favors the the incumbents, and it favors the stakeholders, the major stakeholders being insurance and pharma and and major hospital groups, and you know, the physicians and healthcare workers. We’re really kind of pawns in this system, but the real ultimate pawns are the public, the patients. So the film is on March 19. The website is suck it up buttercup. Film.com you can go there. And there are multiple different levels of tickets. You can see the movie in person. You can see the movie and have a there is a 30 minute question and answer session afterwards. There’s also an opportunity to go to kind of a banquet we have down the street right after the film. And the film is has a lot of like healthcare professionals, doctors, patients. Mark Cuban is in the movie. Don Berwick, who used to run CMS Center for Medicaid, Medicare under President Obama, is in the film. And I am featured for about 30 seconds or so, yeah,

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Nestor Aparicio  31:45

15 minutes here at least, right? So

Dr. Terry Mulligan  31:47

that’s right. And, you know, I think, I think it’ll resonate people, anybody who is a patient, or somebody who’s worked, we’ve all had our interactions with the healthcare system, and I don’t think anybody is 100% satisfied with their interactions, with with the healthcare system.

Nestor Aparicio  32:04

Can I ask you, because you’re a real expert, unless you’ve been around. I mean, obviously, where is it great if you could pick a system and say, we got the best, we have more money than anyone. Where the we’re the we’re the greatest society in the history societies, if you ask Trump or anybody else, we’re further along in all of these things. Let’s buy the best medical system. We can import it. Like the NFL does this. When there’s an offense or defense, they just steal it, right? Let’s steal that idea. That’s what they do in industries everywhere. What would be the idea we would steal?

Dr. Terry Mulligan  32:36

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Doc, yeah. Well, I think, unfortunately, it’s not one thing, but I could say they’re about five or six things. One thing is something you mentioned earlier. A lot of places in Europe, in northern Europe, Scandinavia, also a lot of there are a lot of other high income countries, not just European, where their healthcare system is fantastic. And part of the reason is because, in general, I found this out over my, you know, 20 years experience. There are a lot of other countries that are better at treating the herd than they are at treating the individual. And you the herd needs to be covered. The whole population needs to have health care, preventive health care, public health and coverage for the medical problems when we have them. So I had a professor, teacher, one of the fathers of Emergency Medicine, Louis gold Frank. He’s the chair of Bellevue emergency department in New York City. He said every person who presents to the emergency department represents a failure of the public health system, which means if we had a perfect public health system, we wouldn’t need the emergency department, we wouldn’t need these major hospitals and medical care the way we do but, but we don’t have a perfect public health system. Some of it is because we haven’t discovered everything yet, but some of it is because we have discovered things, or that the world has discovered good ways to provide health care, but the system has decided not to do it. And in some cases, individuals have decided that they like the system that way. And so I think one of the solutions that we need to concentrate on providing healthcare everybody and the insurance system. The concept of insurance is actually a very good, very economically sound system, but not insurance for a profit, or insurance for a profit at any cost, with any regardless to the negative consequences. It’s kind of like if the fire department shows up at your house while your house is on fire, they can charge you whatever, whatever you whatever they want. They don’t charge you at the time when your house is burning. We shouldn’t charge people when they’re sick. We shouldn’t. We should have a system where the coverage is there and it’s covering everybody, and it doesn’t cost more than your house mortgage to pay for insurance that then doesn’t cover when things get really tight and things get really rough.

Nestor Aparicio  35:16

Well, we’re talking about healthcare. Dr Terry Mulligan is here and you’re local, or, as we say around your local one, right?

Dr. Terry Mulligan  35:24

Yeah, sure. You know I live, I live in Mount Washington. I have done some moonlighting work at GBMC. Is fantastic institution. And, yeah, I love the healthcare environment in in Maryland is, is robust. It’s, it’s, it’s very well developed. But you know, we are, we are victims of the healthcare system designed the same way everybody else is. So I think, you know, we have to move away from a competitive system where insurance is fighting for its bigger slice of the pie, and it’s fighting Pharma. It’s fighting for its slice of the pie, and the hospital systems are, you know, taking whatever the insurance and pharma decide to give them, and they’re fighting for their slice of the pie, but they’re all fighting so it’s like three boxers in a boxing ring fighting over the prize money, which is the five point or, sorry, 3.5 point 3 trillion a year.

Nestor Aparicio  36:25

And meanwhile, the lady in the in the room next to my wife, who’s dying, can’t get a patch to stop throwing up. I mean, that’s right, that’s right. Insane, insane. So we

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Dr. Terry Mulligan  36:33

need to move from this fighting, competitive system, where they’re fighting against each other more to like cooperative system, where imagine these three fighters rowing in a rowboat all in the same direction, so that instead of having a competitive system, we have a more cooperative system. I think that works, and it provides better care. It ultimately could provide for profit and the ability for people to make a living doing health care, and we just we know our the way our system is now is making some very small percentage of people who run and own insurance companies and pharma companies and hospital companies, making them insanely cartoonishly rich, and it’s at the expense of our family members and

Nestor Aparicio  37:21

our people doing the work too, the people doing the work, I’ll get everybody out for this. Suck it up buttercup. That’s that’s their message to all of us, an investigative documentary about physician burnout, corporate greed and the systems that can still save us. Dr Terry Mulligan has been a good chap in a you know, it says, right here on your LinkedIn, it says here, adjunct professor, so you teach this stuff. So, I mean, yeah, and you did a very good job of teaching me and dealing with me, keeping me in line as well. And I can get a little animated talking about the insurance system and medical system, because I’ve been involved in it. So good luck with the film. It’s the 19th of March at the Senator. You can find all the information out at suck it up buttercup. Film.com, thanks for coming on, Doc. I appreciate you. Hey. Thanks so much. My appreciation to Karen for putting this together as well, and for all the doctors and nurses and friends and people and the folks took care of my mother when she was older in life, and just I did a whole thing on kindness earlier with the Secretary of kindness in Salisbury, Maryland, Grace Foxwell, Murdoch. You want to check that thing out too, but we’re finding ourselves around here because he’s not going to be president forever, and we’re going to have to piece this thing together in a better way. I’m Baltimore positive. Stay with us.