WEBVTT
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The topics and opinions expressed in the following show are
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solely those of the hosts and their guests, and not
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Churchill said, those who failed to learn from history are
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condemned to repeat it. Kevin Helen n believes that certainly
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applies to business. Welcome to Winning Business Radio here at
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W four CY Radio. That's W four cy dot com
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and now your host, Kevin Helen.
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Thanks everybody for joining in today. I am Kevin Hallanan
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and welcome back to Winning Business TV and Radio on
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W four cy dot dot com. We're streaming live on
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talkfour tv dot com in addition to Facebook and that's
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at Winning Business Radio. And of course we're available in
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podcasts after the live show on many platforms, all the
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ones you know, YouTube, iHeartRadio, Spotify, Apple again. Wherever you
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find your favorite podcasts, we are there. The mission of
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this show, winning Business radio and TV, as regular viewers
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and listeners know, is to offer insights and advice, really
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to help people avoid the mistakes of others, to learn
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best practices. Those are the how tos, the what twos,
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the what not tos, to be challenged and hopefully to
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be inspired by the successes of others. Those consultants, coaches, advisors.
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Today's an author, founders and owners, entrepreneurs. He's also an
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entrepreneur people with expertise. But you know, virtually every successful
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person I've ever had a chance to talk to has
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had some form of failure in their lives and careers.
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So while we all have to get our knee skin
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once in a while, I'm driven to keep those scrapes
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from needing major surgery. Let's endeavor to learn from history
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so we don't repeat it. I've spent the better part
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of my career equipping businesses to grow, and that's from
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solopreneurs to small and medium sized companies all the way
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up to the fortune fifty. I've seen some of those
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companies win into varying degrees. I've seen some fail I've
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had the opportunity to rub elbows with some of the
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highest performing people around and with some who probably should
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have found other professions. In my own businesses, I've had
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lots of success, but some failures too, So I like
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to think I've learned a lot from those experiences. And
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of course you're going to hear from me my opinions
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and insights. But anybody who knows, because excuse me, anyone
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who knows me will tell you I've sometimes a hard
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time staying quiet, Frank. But more importantly, together we'll hear
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from experts, those consultants, coaches, authors, advisors, founders, owners, entrepreneurs.
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And today my guest is Frank Club, retired US Navy
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pilot and author of Ready, the Big Lie in My
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Healthcare Bill. I was not I was intrigued, but then
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not happy when I read this, and so you'll get
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the same response I think. Frank lab is a retired
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US Navy pilot with a long and distinguished career outside
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the Navy, including roles as general manager for DuPont Processed
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Instruments and then for DuPont's environmental services business. After retiring
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from DuPont, Frank served as a principal consultant at Monsanto
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and then Clean Air Engineering on regulatory law and compliance.
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It was this extensive background in the law in compliance
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that allowed him to be credited with forcing the EPA
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to scrap three years of work on the Clean Air Act.
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I want to hear about that and rewrite the compliance
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section of the Act around his recommendations. And it was
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this same background that excuse me and expertise that allowed
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Frank to access and dissect the carefully hidden contractual provisions
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that the healthcare industry uses to deny care and coverage
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patients are owed from their health insurance. Now eighty six,
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Frank lives on a two acre working farm with Angie,
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his English wife, in Chester County, Pennsylvania, along with Angie's
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seventeen ducks in their two English Springer Spaniels. From there,
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together with their son and son in law, they own
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and operate the leading hardware and supply business in the region,
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and in keeping with his age and long standing promise
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to Angie, Frank has promised this will be his very
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last book on healthcare because he's finally found the solution
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to the fraud and misrepresentation in the nation self insurance
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that he has sought for so long. Frank, welcome to
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Winning Business Radio.
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Thank you very much. I already got to kick out
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of the introduction.
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Well it's a good one. I mean it's long, but
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there's a lot in there, and I didn't want to
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water it down too much. I want people to understand
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who you are and how you came to this place something.
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Yeah, I did force EPA to right the comply, sure, Eric,
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but I didn't take away the environmental piece. I sent
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them simply made EPA comply with the law as Congress
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had written it.
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Well, that still doesn't sound like an easy task.
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Different In other words, I wasn't arguing what was right
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or wrong right other than you can't do something other
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than Congress dictated in the law. And it's pretty much
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the same thing I'm doing here. There's a part of
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the law, or at least in this case, it's contract
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law that you can't see. And it took me three
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years with the knowledge that I have to get access
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to these contracts, and I'm honestly never bumped into anybody
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except somebody maybe within the industry that's ever read them.
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Well, that's unbelievable. Let me back you up. A little bit, though,
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tell us about the business, a little bit about the hardware.
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Cameron's right, Well.
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It's a We have about fifty employees and we're a
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hardware supply business. We're the largest actually firearms supplier in
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the southeast corner of Pennsylvania. Have a long hunting tradition.
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We've got a two hundred acre farm that backs into
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two thousand acres of woods and fields. And that's the
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way we like to live. We live in the in
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the big in the bigger world. But this healthcare thing
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is simply I had a situation years ago where they
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denied care for somebody in the family.
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And this was your first wife, right, yes, and she.
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Died and I had offered to pay for it, I said,
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when Blue Cross refused to pay, I said I'd pay,
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and I was told I couldn't. They wouldn't allow me
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to pay.
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All right, stop right there? How does that work? I mean,
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that doesn't even make sense.
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Well it does. Let's get into this.
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Sure, Yeah, go ahead, we'll jump in.
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Way back. Thirty five years ago, the Supreme Court ruled
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unanimously that healthcare insurance companies could induce rationing the words
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induce because they can't force it. An insurance company has
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no legal right to determine what is appropriate healthcare.
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That's up to the docks right and escape period.
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Okay, only your doctor can do that, and only the
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doctor in attendance, not the guy down the block, only
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the hold of your hand.
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So it's not a doctor at the insurance company. It's
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not a doctor administrator.
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The right word there. Legally is no standing. I don't
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care what he says. He can do what he wants.
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But the thing is that the insurance companies have had
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the power to decide what they're going to cover, and
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if you look at their contracts, they give themselves the
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power to deny coverage any time they want. But that's
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not I.
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Think we've all experienced that. But go ahead.
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Yeah, but that's not enough for them, and that's what
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I ran into. They don't just deny coverage for you,
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They deny all payment for anybody that's in network. So
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anybody that's got a contract with the insurance industry, when
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they deny coverage, they bar everybody within the in network
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community from accepting any for care for you.
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So that practically speaking, that ceases care for that particular
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ailment or situation.
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And if you think about if you look at healthcare,
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fifty percent of the family bankruptcies in the country are
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for a healthcare bill. Well, that's not for a bill
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for a doctor bill where you win, I spend thirty
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bucks or one hundred bucks to go see your doctor.
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That's for a hospital bill or you cancer.
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That's for major accidents.
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Right, yeah, that's where a hospital bill can three days
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can cost you one hundred thousand dollars. And so how
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many hospitals you think are going to give you care
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when they know they're not allowed to build for it
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and it could cost thousands.
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All right, but they do build.
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Well, well, what they do is they find a way
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to say no. They make it sound like the whole
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issue is the insurance. No, because the rules that they
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have matter figure out. I have a podcast I just
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wrote for a substack, and what I said was Einstein
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said years ago that you have to know the rules
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of the game and then play it better than anybody
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else and everybody. Anything we know about health insurance is
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deliberately false. It's not insurance. It's not yours. You don't
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the bill is not yours. The contracts say they can
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only bill the provider, the in network provider. Okay, and
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we are assured of getting all the care that our doctor,
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our doctor says we need, regardless of reimbursement. Now tell
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me where that where you find that in any discussion
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with your doctor, the hospital, or anybody within the American
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healthcare system.
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All right, So I'm a patient. You know, I'm a
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regular person like you or anybody else. I have a
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series of doctors because I'm older. You know, I don't
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have one pediatrician or you know, one GP because I'm
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young and healthy. Stuff gets stuff happens when you get older.
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So we have a series of doctors. We go there,
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they treat us, then we get a bill. Well, in
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other words, that's our perspective as patients.
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Right, hardware business, I'm sitting in the office, and we
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could send bills to everybody. That doesn't mean they're due
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or they should pay us.
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But we pay them because we don't know otherwise.
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Because we don't know any better. And if I could
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do that in a hardware business, I'd be a billionaire overnight. Okay.
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What do they do they tell you when you that
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you have insurance it's an insurance product. No, it's not
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under law, it is not insurance insurance. There has to
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be a contract between you and the insured, and there
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is no such thing. They make you think it's yours.
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And when you go into any hospital, there's that little
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piece of paper or on the wall you take responsibility.
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For every year, sign a little likenic signature every time
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I go, sign the little electronic signature pad.
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You can't say you can't sell something when you surrender
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the right to bill for it a long time ago,
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when they signed these contracts, they surrender the right to
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bill you so long as it's medically necessary care. And
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any care you get from your doctor is medically necessary
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by definition, because he's not allowed to give you anything else.
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All right, What about the instances where a doctor says
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it's medically necessary but the insurance company says we don't agree.
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Well, I can say it's not medically necessary. What basis
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in law do I have to say that the insurance
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company is simply using its hidden authority to deny coverage
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any time they want and not telling you that you
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can't be billed for it, but you're still owed it.
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Okay, So take us back if you don't mind, give
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me a little bit more of the specific around your
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wife's situation. I mean you got hammered with bills. I mean,
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how did you start to figure this out?
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Well, I had a lot of experience in reading contracts,
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and so for the out of the Navy and I
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went to work for DuPont and I became a general
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manager and any process instruments and a few other things.
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And I was supposedly very good at writing contracts. And
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then I got off onto the environmental side because DuPont
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was very deeply involved in finding the entire environmental at
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least air compliance. And then I got into determining regulatory compliance.
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And I toured the country with EPA, helping people understand
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what constitutes compliance. So when I lost my wife, what
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do you mean, how can you deny me the right
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to pay for the care for my wife? So I
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took him to court and we were in court for
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eight years.
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This is a particular insurance company. Now yeah, okay, yes.
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But see how it's wrong then, because I sued the
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insurance coming, they have a right to do what they did.
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Now they lied like a rug. But that's another story.
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But I did not understand this system until years into it,
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when I finally forced my writer got the ability to
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go into a library and sit down and read the contracts.
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And just to help everybody understand, I knew, because of
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what I was doing in air Compliance and down in Washington,