Frank Lobb, retired U.S. Navy pilot and author of "The Big Lie in My Healthcare Bill"

0:00 The topics and opinions expressed in the following show are solely those of the hosts and their guests, and not those of W FOURCY Radio. It's employees are affiliates. We make no recommendations or endorsements for radio show programs, services, or products mentioned on air or on our web. No liability explicitor implies shall be extended to W four cy Radio or it's employees are affiliates. Any questions or comments should be directed to those show hosts. Thank you for choosing W FOURCY Radio. Churchill said, those who failed to learn from history are condemned to repeat it. Kevin Helen n believes that certainly applies to business. Welcome to Winning Business Radio here at W four CY Radio. That's W four cy dot com and now your host, Kevin Helen.

0:52 Thanks everybody for joining in today. I am Kevin Hallanan and welcome back to Winning Business TV and Radio on W four cy dot dot com. We're streaming live on talkfour tv dot com in addition to Facebook and that's at Winning Business Radio. And of course we're available in podcasts after the live show on many platforms, all the ones you know, YouTube, iHeartRadio, Spotify, Apple again. Wherever you find your favorite podcasts, we are there. The mission of this show, winning Business radio and TV, as regular viewers and listeners know, is to offer insights and advice, really to help people avoid the mistakes of others, to learn best practices. Those are the how tos, the what twos, the what not tos, to be challenged and hopefully to be inspired by the successes of others. Those consultants, coaches, advisors.

1:39 Today's an author, founders and owners, entrepreneurs. He's also an entrepreneur people with expertise. But you know, virtually every successful person I've ever had a chance to talk to has had some form of failure in their lives and careers. So while we all have to get our knee skin once in a while, I'm driven to keep those scrapes from needing major surgery. Let's endeavor to learn from history so we don't repeat it. I've spent the better part of my career equipping businesses to grow, and that's from solopreneurs to small and medium sized companies all the way up to the fortune fifty. I've seen some of those companies win into varying degrees. I've seen some fail I've had the opportunity to rub elbows with some of the highest performing people around and with some who probably should have found other professions. In my own businesses, I've had lots of success, but some failures too, So I like to think I've learned a lot from those experiences. And of course you're going to hear from me my opinions and insights. But anybody who knows, because excuse me, anyone who knows me will tell you I've sometimes a hard time staying quiet, Frank. But more importantly, together we'll hear from experts, those consultants, coaches, authors, advisors, founders, owners, entrepreneurs.

2:45 And today my guest is Frank Club, retired US Navy pilot and author of Ready, the Big Lie in My Healthcare Bill. I was not I was intrigued, but then not happy when I read this, and so you'll get the same response I think. Frank lab is a retired US Navy pilot with a long and distinguished career outside the Navy, including roles as general manager for DuPont Processed Instruments and then for DuPont's environmental services business. After retiring from DuPont, Frank served as a principal consultant at Monsanto and then Clean Air Engineering on regulatory law and compliance. It was this extensive background in the law in compliance that allowed him to be credited with forcing the EPA to scrap three years of work on the Clean Air Act.

3:27 I want to hear about that and rewrite the compliance section of the Act around his recommendations. And it was this same background that excuse me and expertise that allowed Frank to access and dissect the carefully hidden contractual provisions that the healthcare industry uses to deny care and coverage patients are owed from their health insurance. Now eighty six, Frank lives on a two acre working farm with Angie, his English wife, in Chester County, Pennsylvania, along with Angie's seventeen ducks in their two English Springer Spaniels. From there, together with their son and son in law, they own and operate the leading hardware and supply business in the region, and in keeping with his age and long standing promise to Angie, Frank has promised this will be his very last book on healthcare because he's finally found the solution to the fraud and misrepresentation in the nation self insurance that he has sought for so long. Frank, welcome to Winning Business Radio.

4:20 Thank you very much. I already got to kick out of the introduction. Well it's a good one. I mean it's long, but there's a lot in there, and I didn't want to water it down too much. I want people to understand who you are and how you came to this place something. Yeah, I did force EPA to right the comply, sure, Eric, but I didn't take away the environmental piece. I sent them simply made EPA comply with the law as Congress had written it. Well, that still doesn't sound like an easy task. Different In other words, I wasn't arguing what was right or wrong right other than you can't do something other than Congress dictated in the law. And it's pretty much the same thing I'm doing here. There's a part of the law, or at least in this case, it's contract law that you can't see. And it took me three years with the knowledge that I have to get access to these contracts, and I'm honestly never bumped into anybody except somebody maybe within the industry that's ever read them.

5:22 Well, that's unbelievable. Let me back you up. A little bit, though, tell us about the business, a little bit about the hardware. Cameron's right, Well. It's a We have about fifty employees and we're a hardware supply business. We're the largest actually firearms supplier in the southeast corner of Pennsylvania. Have a long hunting tradition. We've got a two hundred acre farm that backs into two thousand acres of woods and fields. And that's the way we like to live. We live in the in the big in the bigger world. But this healthcare thing is simply I had a situation years ago where they denied care for somebody in the family.

6:08 And this was your first wife, right, yes, and she. Died and I had offered to pay for it, I said, when Blue Cross refused to pay, I said I'd pay, and I was told I couldn't. They wouldn't allow me to pay. All right, stop right there? How does that work? I mean, that doesn't even make sense. Well it does. Let's get into this. Sure, Yeah, go ahead, we'll jump in. Way back. Thirty five years ago, the Supreme Court ruled unanimously that healthcare insurance companies could induce rationing the words induce because they can't force it. An insurance company has no legal right to determine what is appropriate healthcare.

6:55 That's up to the docks right and escape period. Okay, only your doctor can do that, and only the doctor in attendance, not the guy down the block, only the hold of your hand. So it's not a doctor at the insurance company. It's not a doctor administrator. The right word there. Legally is no standing. I don't care what he says. He can do what he wants. But the thing is that the insurance companies have had the power to decide what they're going to cover, and if you look at their contracts, they give themselves the power to deny coverage any time they want. But that's not I. Think we've all experienced that. But go ahead. Yeah, but that's not enough for them, and that's what I ran into. They don't just deny coverage for you, They deny all payment for anybody that's in network. So anybody that's got a contract with the insurance industry, when they deny coverage, they bar everybody within the in network community from accepting any for care for you.

8:03 So that practically speaking, that ceases care for that particular ailment or situation. And if you think about if you look at healthcare, fifty percent of the family bankruptcies in the country are for a healthcare bill. Well, that's not for a bill for a doctor bill where you win, I spend thirty bucks or one hundred bucks to go see your doctor. That's for a hospital bill or you cancer. That's for major accidents. Right, yeah, that's where a hospital bill can three days can cost you one hundred thousand dollars. And so how many hospitals you think are going to give you care when they know they're not allowed to build for it and it could cost thousands.

8:47 All right, but they do build. Well, well, what they do is they find a way to say no. They make it sound like the whole issue is the insurance. No, because the rules that they have matter figure out. I have a podcast I just wrote for a substack, and what I said was Einstein said years ago that you have to know the rules of the game and then play it better than anybody else and everybody. Anything we know about health insurance is deliberately false. It's not insurance. It's not yours. You don't the bill is not yours. The contracts say they can only bill the provider, the in network provider. Okay, and we are assured of getting all the care that our doctor, our doctor says we need, regardless of reimbursement. Now tell me where that where you find that in any discussion with your doctor, the hospital, or anybody within the American healthcare system.

9:47 All right, So I'm a patient. You know, I'm a regular person like you or anybody else. I have a series of doctors because I'm older. You know, I don't have one pediatrician or you know, one GP because I'm young and healthy. Stuff gets stuff happens when you get older. So we have a series of doctors. We go there, they treat us, then we get a bill. Well, in other words, that's our perspective as patients. Right, hardware business, I'm sitting in the office, and we could send bills to everybody. That doesn't mean they're due or they should pay us. But we pay them because we don't know otherwise. Because we don't know any better. And if I could do that in a hardware business, I'd be a billionaire overnight. Okay.

10:35 What do they do they tell you when you that you have insurance it's an insurance product. No, it's not under law, it is not insurance insurance. There has to be a contract between you and the insured, and there is no such thing. They make you think it's yours. And when you go into any hospital, there's that little piece of paper or on the wall you take responsibility. For every year, sign a little likenic signature every time I go, sign the little electronic signature pad. You can't say you can't sell something when you surrender the right to bill for it a long time ago, when they signed these contracts, they surrender the right to bill you so long as it's medically necessary care. And any care you get from your doctor is medically necessary by definition, because he's not allowed to give you anything else.

11:30 All right, What about the instances where a doctor says it's medically necessary but the insurance company says we don't agree. Well, I can say it's not medically necessary. What basis in law do I have to say that the insurance company is simply using its hidden authority to deny coverage any time they want and not telling you that you can't be billed for it, but you're still owed it. Okay, So take us back if you don't mind, give me a little bit more of the specific around your wife's situation. I mean you got hammered with bills. I mean, how did you start to figure this out? Well, I had a lot of experience in reading contracts, and so for the out of the Navy and I went to work for DuPont and I became a general manager and any process instruments and a few other things.

12:19 And I was supposedly very good at writing contracts. And then I got off onto the environmental side because DuPont was very deeply involved in finding the entire environmental at least air compliance. And then I got into determining regulatory compliance. And I toured the country with EPA, helping people understand what constitutes compliance. So when I lost my wife, what do you mean, how can you deny me the right to pay for the care for my wife? So I took him to court and we were in court for eight years. This is a particular insurance company. Now yeah, okay, yes. But see how it's wrong then, because I sued the insurance coming, they have a right to do what they did.

13:04 Now they lied like a rug. But that's another story. But I did not understand this system until years into it, when I finally forced my writer got the ability to go into a library and sit down and read the contracts. And just to help everybody understand, I knew, because of what I was doing in air Compliance and down in Washington, that if I made enough phone calls, i'd find somebody that would read these. So I was allowed into the library, and I was allowed to take all the notes I wanted, but I could not copy anything, and I could not use anything directly. Now what made it so easy is one, I know contracts too. They're all the same. I don't care whether you're looking at Pennsylvania or California or Florida.

13:57 These are essentially, from a legal standpoint, identical contracts in terms of conditions. Once I understood those, then I had the basis to take the system apart. Because like coverage, if you're buying insurance, the first thing they're going to tell you is what's covered, right, But the first time they say it's not covered, they deny the very thing they said up front was coverage. They use coverage two different ways. It's what they claim they might cover where they don't say it that way. So when they actually deny coverage, well that's not a covered benefit. Well, if you get caught in that loop and haven't read the contracts to separate the two totally different, separate termament definitions, do how do you confront that? How do you deal with it? But let me jump a little further out.

14:56 We can take this thing apart because these are smart people, and they've been doing it for a while. Sure so, and they've got lots and lots of lawyers. There's lots of room to argue about the little pieces here and there and what they've done. But the fundamental point is that they want to ration our healthcare and the only way they can do that is to deny all payment when they deny coverage. All right, we're going to pause on that thought. We're going to come right back to that after one minute. Everybody will be back with Frank Lob In just one minute. You're listening to Winning Business Radio with Kevin Helene on W four CY Radio. That's W four cy dot com.

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16:19 And now back to Winning Business Radio with Kevin Helene, presenting exciting topics and expert guests with one goal in mind to help you succeed in business. Here once again is Kevin Helena. We're back with franklob author of the Big Lie in My Healthcare Bility. You just dropped the bomb. They want to ration care. I think we've I think many people know that conceptually, but I don't think they can prove that or even test it legally, you know, at least from an individual patient's perspective. Dig in, well, this is gonna be fun.

17:02 That's the fun with this. In the very in the Internet introduction, you mentioned that I had promised my wife not to write another healthcare Yeah. Yeah, because I finally had the answer. And the answer is I no longer have to fight them. I only have to ask the right question. Because the thing, there's a thing called the Fair Debt Collection Practices Act. And what that says is if I write a letter asking a couple of questions, reasonable questions about the bill, they have to answer the questions or they cannot enforce the bill. Well, the questions I would ask about the pricing and the cost of this and that are really simple and they're in the book.

17:43 There's letters in the book, I mean, really simple things to do. But they can't answer them because the contracts I'm talking about have a confidentiality provision that doesn't allow any of that information to be disclosed. So who are you writing a letter to the doctor or the insurance company? Well, the tak Host hospital Okay, right, okay, because I mean, let's not go to war with our doctors because we need a good doctor. That's our access point. If we shut that down, we have no access period. Issue really is the big bill with the healthcare the hospitals of across the country, and that's where the money is spent. And only something like seven percent of all the bills really are out of network. So what we're talking about are the in network hospitals across the country that have the same contracts that I'm referring to as provider contracts or provider agreements. Okay, and they bar all payment when the insurer says no to coverage. They're not allowed to take any money whatsoever.

18:44 Matter. We got a fumble for a minute, but yep, take it done, charl The provider bill, charge, collectedy, pauses, seek compensation, remuter or reimbursement, or have any recourse against the covered person or persons. In other words, you can't bill, you can't take money, they can't do anything. That's what the providers have agreed to. But since you've never seen it, your listeners have never seen it. And there's another neat little These are smart people. There's a thing that most people don't know about. Also, it's called a thirty day window.

19:27 It's actually for collection, but it gets lost. And who is a collection agency and who isn't? And the way it works is that thirty days after the issuing of a bill, if you haven't properly refuted it, contested it in writing to the right person, it's accurate in law. For enforcement's email considered in writing. It's considered accurate and enforceable. So well, you're making your phone calls to the insurance company coverage, which they have no obliguy to give you the bills ticking away on it's thirty day at the provider and your toast, because at the end of the thirty days, whether it's when I say, I want to be careful here. The bill was originally written for collection agencies, but it's very difficult to tell whether it's a collection agency or whether it's the provider, and so forth. The point is, after thirty days, the clock has run out and you don't really have a right to contest it. Now, when I said earlier that I finally had my answer. The Financial Consumer Protection Bureau, which Trump is kind of decimated, but they published studies and so forth, and something like eighty percent of the hospitals are an error. Hospital bills are an error.

20:48 I saw that unbelievable. Yeah, we have a right to ask for a bill that we can understand, and let me just say it and keep it simple. They can't do it. So if we write a simple letter asking for a bill we can understand, they can't give it to us. And let me give you a simple example. And now this one actually was Medicare, but it's the same thing. And I had a small operation. I had to have it surgically. I have a tooth and remove surgically. And I was actually in the operator. We're ready for them to start, and two people commit with a credit card machine who won three thousand dollars before they do that, before they seed?

21:34 And I have four policies. Anyway, I didn't win the argument, so I gave him a credit card, got the operation, and I came out, and I immediately called my credit card company, disputed it, and I sent a letter to the State of Pennsylvania contesting the bill. I had the three thousand dollars back immediately, and they never once tried to defend the bill. Well never. They sent me two invitations to come back for a follow up procedure, and they sent me a birthday card. Now you tell me if you if I had actually stiffed them and owed them three thousand dollars to you, they would have not come after me.

22:22 Not likely. No, they have no legal standing. Simply, I simply had to ask. Well, the practice of doing that in that dramatic moment in the r anyway seems ridiculous. Well, it is. But had I given them the three thousand dollars and not known what I know and how to contest it, and what's in the book. I've lost three thousand dollars. And the only reason I bring up that example because it's personal. Know it will, but the fraud is so big and so real that if you ask the question and disclose it, the system blows up.

23:05 And I have a very good friend who is a former director of billing from one of the largest hospitals in the area, and I asked him about this, and he says, if I got a letter like that, i'd round trash it. I'd put it in the trash can and move on, which is what they do. So I'm not telling you that we can fix the system, but I am telling you, rather than read all the books that just pardon my language, but bitch about the way it is. Why not understand how they're playing the game and then per Einstein play it better than they do and call them on their own game. In other words, I don't owe the money. So do you feel they're being I mean, if I should choose the words carefully or just say what I'm thinking.

23:50 Do you feel like they're being dishonest in the design of their quote program? I cover it in the book, and it's a very good question. I mean, are all these people crooks? No industry? I work for the industry, and there are ethics issues and so forth. If you go back and look at how healthcare was developed, I equate it to being on a pond and you step out on thin ice and every step you take that's not so bad, and then you get so far out on the ice you can't turn around. And so what I think, at least I would describe it is they took step by step by to where we are today, and now nobody knows how to turn around because this is a four point three trillion dollar market that's with a d trillion, and they're making hand money, hands over fist.

24:45 Hard to turn that off. We're not in trouble. They separate their money, they have the trust fund and the Dolman funds and so forth, and then they do their operating costs. They're fine. And what we have is what called it economics and an inelastic market where we've given the insurance companies monopolies. They own their territories, they can charge and do whatever they want because there is no competition. And you know we get from Washington, well, what we need is competition. Are you kidding me. You're talking about healthcare costs. How many people really shop hospitals when they need care? Not many?

25:29 And even then, how would you know there are seventy seven thousand different billing codes? Is that where most of the errors are? Is that? What is that where most of the errors are? If it's an eighty plus percent error rate on these bills, do you think it's mostly in the codes? One could infer that I'm not going to do that because I know that they have no right to build me in all kinds of areas to start with. So if I throw that in the eighty percent, that sounds small. I had breakfast a number of years ago with a doctor and his wife. There were both doctors, large hospital down in Maryland, and I brought this issue up and they both broke out laughing, and they what they said was that over sixty percent of the bills are created in the billing office, not in the hospital. So that's just hearsay, that's just people. But if you think about it, with seventy seven thousand billing codes, they can't even agree on how to use them, because you can combine them into a single code, or you could split them up and build them separately. The hospitals prefer to split them up because they can build more, and the insurance companies prefer to collect them and bill them as a single code under a number of codes, because then they can pay less. So what the truth just number is I don't know, but it fees my book very well. Oh,

27:00 because what I said earlier was they really can't give you an understandable bill, and under law they have an obligation to do that. And fortunately there have been enough studies and enough work done by the Financial Consumer Protection Bureau that we can cite them and simply, in all due honesty, say I want to get this bill paid, but you need to help me. Help me understand my bill, and they can't do it. And so what I would say to everybody here is, you know, my dad taught me a long time ago, you have to be able to take care of yourself, and if you don't, you deserve what you get. I'm not, but it would be, it would advise.

27:42 It would be, it would serve everybody well if they simply read it and understood it's not a very long book and at least understand the system, as Einstein said, then you can decide how you're going to play it, but I recommend you play it better at least the hospitals. Well, I didn't read the book before the show. I did order it. It's on the way, so I will be reading it because I just think. I mean, I've I'm not a genius. Okay, I like to think I'm pretty smart, but I'm not a genius. I'm simply saying everybody knows what I'm about to say. Healthcare is broken, and you know, the attempt to fix it made it worse in my opinion, and I'm if I were a doctor, I wouldn't I'd be frustrated. And many doctors, at least general practitioners, they're they're going into research, they're consolidating. Our doctor just left her practice for another one and a big Massachusetts group like the gold Standard group, and now she's going to another one. So even they say it's messed up, you know, they can't make sense of it, and we don't. I mean, what would you say to somebody that says, oh, you're just trying to game the system, and I don't believe this, but just the critics might say, you're just trying to gain the system. You found a loophole to not pay for what you should be paying.

28:55 What I'm at a hardware business. Yeah, yeah, I have to adhere to my contracts, right sure. If I contract to pay something, I gotta pay it. There's nothing in my book that doesn't talk about the contracts that they have obligated themselves and to us to perform. All I'm saying in the book, don't stiff them, just pay what's the contract demands? Okay? Point in our system, healthcare system, if you don't take care of yourself, you're going to get hurt because we are going to lose twenty percent of our doctors. Oh next, but ten years twenty.

29:41 Percent and we're hard enough now. It already takes three weeks to see a doctor. What is the credo within a hospital emergency room when you go, it's treat them and streatom. That's not my term, that's theirs. Do as little as you can and throw them out the door, or to go see their doctor. That's the system. Now, I'm not really here criticize it, right, go down, okay, right, I'm just saying that as an individual, I've learned how to deal with the system they. Have, all right, let's hold that thought. We're going to get one more commercial in. We'll be back in about sixty seconds with Folk Club.

30:24 You're listening to Winning Business Radio with Kevin Helene on W four CY Radio. That's W four cy dot com. Don't go away. More helpful information is coming right up right here on Winning Business Radio. The yp dot com website is your local search engine. If you're looking for a good restaurant, it can help you find the right one nearby with ratings and reviews. Or if your car breaks down, you can use the YP app to find the closest repair shop. Or maybe you're just looking for something to do on a Friday night. Well, it has great local coupons for all sorts of things in your area, no matter what, when or where. If you're looking for something, YP local search can help you find it. So go to YP dot com or download the app to search local, find local, and save local.

31:14 And now back to Winning Business Radio with Kevin Helene, presenting exciting topics and expert guests with one goal in mind to help you succeed in business. Here once again is Kevin Helena. We're back with Frank Lob, author of The Big Lie in my healthcare bill? What do you want people to know? Practically speaking? Like, for example, my question is, and you've answered a little bit of this, do I alienate my doctor? No? You said you shouldn't, and I agree. How about the hospital? Do I alienate the hospital? Do I need an attorney?

31:55 Does this affect my credit score? Can you answer some of those questions? Well, there's a pretty much an agreement anymore that they can't even enter it in your record for nonpayment. But I think it's one hundred and eighty days, and healthcare bills have become notorious for misreporting, so there's been a lot of work to stop it. And I'm going to argue that if you follow my book, it won't ever get to one hundred and eighty days. I'm going to say it this way. I don't have to be right here. I'll invite anybody within the healthcare system to come in and tell me where I'm wrong. Now, I've talked to them, and every time I've gotten to the subjects of book tell me where I'm wrong, They've left the room. And I'm not joking. My wife and I had dinner and we happen to sit at a bar at golf club, and there was a guy sitting next to me, and I had my book with me and I had it laying on the bar, and we got into a discussion on the book, and he obviously was going to make fun of me and I clearly was an attorney until he learned that I had read the contracts. Then he literally and I do not joke, he literally left his dinner on the bar and left the room. That's real. Well, these contracts are as secret as you can imagine. They've

33:28 been declared by the States as proprietary documents not to be released to the public. So all I'm saying is I've had the opportunity to read them, and since I have, I can share that with the public. And I'm doing that, And if I'm wrong, all the industry has to do is come tell me. Well, the interesting nuance is, and I don't know if people caught this, the contract is not between the insurer and us. It's between the insurre and the provider BINGO. So what's wrong is the insurer is not enforcing its contract. It's backing out of its obligation to provide coverage, knowing that it can pass the bill onto the provider to bounce onto you and in thirty days. It's real. It's perfect system, and if we want to subject ourselves to it, I guess that's anybody's choice. Or you can come tell me where I'm wrong. But if you read these contracts it is clear. Well i'll give you a quick example.

34:40 Every one of these contracts has a utilation review provision. So, okay, you get coverage and you get the operation, and thirty days later, this insurance company takes another look at it. They call it a utilization review, and they go, oh, we made a mistake, we should not covered this. They then have the right to pull the money back. I've never had that happen, Thank god. Oh it's happened, Monny. Oh could give you examples and big money. But what the people and even the attorneys don't realize is that provision. Yes, the insurer can pull the money back from the provider, but the provider is absolutely barred from billing the patient. But they do, yes, because you and I don't know that. We don't know the money. You don't see the contract. If you got insurance for anything else, you'd have a contract you could review and then hold the people accountable. You have no such contract. You have no ownership of what you have.

35:45 The provider, oh, I'm sorry, the employer owes it, or you if you buy it yourself, the insurer owes it. So you don't even have the right to sue because you have no ownership. They basically close it off. It's a great system from their side. Let's go to Einstein's world. Let's learn how they're doing it, and then simply ask a few questions and turn the system around in our favor, because we're not going to get any more healthcare than our doctor says we need, and we're not going to have to pay any more or walk away from any bill that their contracts don't say. We don't know. I does that make sense? It does.

36:25 It's convoluted, but you know it's the only all I'm saying is why should I pay a bill that their very own documents say I do not owe? And if there's anybody in this business community can tell me how to do that, I'm going to apploy it here in my business because I got to make money. The hand of her vest If you could elude that, you're consulting, So how and why not? How? Why did this become your mission. I mean there, you could be doing other things, right, you're going to do it. You're to do who I am? Yeah, I and and he said, and I have a right to look back on my life and have an idea who I am totally.

37:10 I mean a decision a long time ago to stand up for what's right. And I've hurt myself career wise any number of times by saying, ah, nah, I'm not doing that. And this was so wrong that I had to find out how and why I could be wrong. But it just seemed terribly, terribly unfair and against everything I do in law. And once I had it, I'm really the only one with it. You find another book with it, so my only choice is either to share it or shut up and walk away. And you know that's not right. That's not when my grandfather taught me.

37:57 I get a little mushy, but you know I still believe right right ethics. So this may be an obvious question. Why don't you think more people are aware of this? How is it perpetuated? It's completely counterintuitive If I call it insurance, every other insurance I owe what isn't paid? All right, So you did make the point this is not insurance. No, it's not. What would you say, what is it? I have an attorney come in and told me how it's insurance. It's not okay, and it just doesn't meet the definition of insurance. As a matter of fact, originally it wasn't called insurance, but there's some tax benefits from being called and ensure, so it got Let me put it around another way. In the state and state law, you have a right to call yourself pretty much what you want to call yourself. That doesn't mean you're really an insurance company. So I can label myself as insurance without meeting the needs of an insurance cump me. And these are smart people. And by the way, this is not a very simple solution or to solve. I just believe if we're honest and we get in the room and we talk about the needs of both the country and the people, we could find an answer as long as we stay within the truth and not try to play games with it. And what's happened here is they and tell you very quickly they started originally giving all

39:29 the care you need for a very simple monthly payment. That was the model, and that was back in around nineteen twenty nine. Well, as healthcare became more expensive, they began looking for ways to cut costs deny coverage. So the old model was all the care you needed for a small upfront payment. They were never able to change it. They were able to pull it back from the MA marketplace. So they've kept all the care that you need. Look at the TV commercials, but will you get it all except when you need it? And then little by little they look for clever ways to deny coverage but carry it back to actual care. And let media say it this way. If I had been successful upfront when my wife was ill and had been allowed to pay, I could have taken them into court and they'd a lost because it was definitely necessary health care promise, not that theiry health care. They have no right to deny it, and a jury would have given me the verdict. They know that they can't afford to have this go into court.

40:47 So why is there not And maybe there is and we just haven't talked about it yet. Why is there no pushback? Nobody knows to push back. Like you're dealing with companies. You're bringing awareness to this show and others. You're telling me, you're telling you know thousands of people listening and watching at some point. It's a ground swell, and you haven't experienced any pushback yet. I I'm gonna say it this way. I think if we try to fix the system, we're just we're wasting our time. I'm focused on helping you and your individually fix it themselves, because the laws are still there. The doctor still works for me. I don't care who pays him the losses. He's mine, Okay. And I've never found a doctor yet that when I reminded Dame of of that didn't appreciate it.

41:41 Yeah. And when I remind them that I of the payment and the system and I don't know what the insurer fails to pay, they know and appreciate it because that's the system they're working in. Okay. So they don't like this system any better than you do. Yeah, just going to say, I've had conversations with doctors and nurses and providers and they don't like the system. No. And by and large, they're not directly tied to the payment. They're working for a much larger company and have nothing to do with the billing. They're just giving you there fifteen minutes of time and on to the next and to show you how disconnected they are. Doctors used to aim for something like eight hundred patients. They're now being asked to service three thousand. Wow. Yeah. Wow.

42:33 I'm an engineer and I was suppressed. Yeah, that math doesn't really work. You give me three thousand projects that I'm going to leave. Yeah, and that's happening. Oh yeah, it's happened. And that's when the doctor comes in and knows, you know, better than what's in the on his flat screen on his laptop. But there's no way he could know three thousand patients and know you, you know, individually, and what's really Yeah, you know, one last quick commenty here, Yeah, we're talking about AI. Think of AI. How do you know who made the decision? If you're using AI? I now know that if my doctor makes a decision of what I need, it's him.

43:14 Look to him. He's responsible, just like an engineer. If I build a bridge and put my name. If AI makes a decision, who do we look to for the decision? Great point, let's hope it doesn't come to that. It's huge. I mean, you can't say, well the software did it. Somebody at least an r system of law has to be responsible for putting their name on the document and computer. And by the way, there was a period of my time when I designed computer systems. Anyway, it's once systems get that complicated, you cannot understand the mind, cannot understand how we got here. So anybody that would sign for the decision made on made I under an AI system their mind because they'd have no idea how we got there. So, by and large you asked me back, why am I doing this? I have the information. I'm just not somebody to bury it. I've done my best to share it. I really do mean, I'm not writing another book. I've had it fortunately, the Consumer Production Protection Viewer and the Fardet Collection Practices Act, and the studies that have been shown where hospital bills are so much at error, and there's a real issue about bankruptcy across the nation.

44:40 With healthcare, and well you said earlier, but I've heard it elsewhere. It's just medical bills are the number one cost exactly. And I'm just hoping that the information I have in the book is significant enough to help the individual deal with this really very very large problem. Is trying to solve the overall problem is that's too It's just too big a shift to me. Yeah, as much as they tried a number of years ago. Yes, Obama administration, and even if we said they had the right intentions, well I think they made it worse. Obama had the same problem you and I are just discussing.

45:21 Obama is not insurance. Obamacare is simply the requirement that you buy insurance. I'm the marketplace, Yeah, policies. In other words, he fell back instead of trying to go for Medicare or whatever, a government model, he simply adopted a model where you buy private insurance off the marketplace or get it from your employer. Well, they ignored the problem that we're discussing, or that it's in my book. And I don't think I would bet heavy money he didn't know it. People who have signed, you know, for the legislation so forth. I'll bet you heavy money do not know the way that that care is being denied.

46:06 There's the actual lynchpin in the system. And the lynchpin is that they've able to deny all payment, which, by the way, I can if you have more time, I tell you, I give you great proof how it's not only unconstitutional, but the states have gone way out of the way to try to hide it. They cannot deny us the right to pay for our own healthcare. And so the issue is so big and they've done it that if you raise it in a simple little letter under the Fardet Collection Practices Act, they had no place to go. I'm going to say it this way. The emperor has no clothes. Well, I bought the book twenty bucks delivered from Amazon.

46:50 Is that the best place to find it? Well, if you go to either killerbill dot com it tells a QR code, it'll take you there. Or you can go to Amazon and ask for it my name or the killer bill dot yeah under the big lie to your healthcare vital healthcare bill, but the name of the book or killibill dot com on the website. That both will take you there. And by the way, somebody comes up with an explanation where I'm wrong, Yeah, I welcome it. Challenge has put out there. The gallet's been dropped. So two questions, who in the listening and viewing audiences may want to reach out to you? And why? Number one? Who you say, who watching or listening may want to reach out to you? And why?

47:36 I think it's the individual. Yeah, because I originally thought professionals would want to do it, and they are so tied in the system, yeah, financially and whatever, they don't want to touch it. I mean I really thought I was an engineer. I would have read it simply out of intellectual curiosity within my own professional Okay, I don't find that to be the case. The people who are closest to it don't want to touch us with a ten foot poll. Well, there's no good answer to your point of the system, right, no good answer there. So to your point again, goes to the individual to take care of themselves.

48:17 Short of really retooling the whole thing, rewriting it, restructuring it, there's not you know, but there can be a solution for the individual. And eventually, like most things in the United States, money brings solutions. Yeah, it does. And if enough of us put our hand up and ask a couple of questions, they'll have to address it and we'll sit down probably come up with a solution. Well, that's why I want to get this word out. I know it's grassroots, I know it's a long slog, but getting this message out is important. It also speaks to your entrepreneurial entrepreneurial nature. By the way, thank you for serving for twenty more than twenty years twenty two years in the Navy. Appreciate that he is. His name is Frank Lob. The website is killbill dot com. You can reach him there and you can also reach him at his phone two six seven four four six three eight two six Frank, we're out of time. Thank you so much for being I really appreciate it.

49:14 I do too. I really appreciated this and enjoyed the discussion seriously. Thank you and thanks everybody for watching and listening this. This is a show about business and business challenges. This one happens to be personal. If you have concerns though about the sales effectiveness of your company, whether your sales team is you are very small or it's very large, feel free to reach out to me on Facebook or LinkedIn at Winning Business Radio. Drop me a note if you want. One of my many email addresses is Kevin at Winning Business Radio dot com. Our company is Winning Incorporated. We are part of Sandler Training. We develop sales teams into high achievers and sales leaders into true coaches and mentors. Hey, we're not right for everybody, but maybe we should have a conversation. Thank you, as always to one producer and engineer extreme for another job well done. Be sure to join us next week that's Monday, April twenty. First my ghost would be longtime friend and author John Katie. He's authored several books, including the new young adult urban fantasy novel series Angela of Death. Until then, this is Kevin Helen.

50:15 You've been listening to Winning Business Radio with your host, Kevin Helene. If you missed any part of this episode, the podcast is available on Top four Podcasting and iHeartRadio. For more information and questions, go to Winning Business Radio dot com or check us out on social media. Tune in again next week and every Monday at four pm Eastern Time to listen live to Winning Business Radio on W four CY Radio w fourcy dot com. Until then, let's succeed where others have failed and win in business with Kevin Helenan and Winning Business Radio.