For 30 years, the city of Eugene has had this trusted institution serving a ton of its residents. It's called the Oregon Medical Group. Some of these patients had 15 year relationships or longer with their doctors. That all changed in 2020 when it was bought by Optum. [00:00:17] Optum is, of course, owned by UnitedHealth Group. I found a doctor at Optum with the answers I needed. Optum buys Oregon Medical Group and causes this like huge chain of events that causes thousands of people to lose their doctor. A battle for the future of health care has been taking place in the great state [00:00:36] of Oregon, and this week, Oregon state lawmakers did something fantastic. They passed a bill that cracks down on corporate control of healthcare facilities. Now, this is something we've been covering a lot on TYT, especially when it comes [00:00:53] to like the influence of private equity. And these investors essentially buying up public hospitals, nonprofit hospitals, doing these mergers and acquisitions, which only leads to far worse care and higher prices [00:01:11] when you need to go see a doctor. Now look, we'll explain what the bill does momentarily, but I kind of want to stay on this for a little longer so you understand what the actual issue is. So let's watch more of the more perfect unions reporting on this about the battle between Optum specifically and the people of Eugene. [00:01:28] Here's additional information about the buyout and how United Healthcare tried to pressure residents into buying its healthcare. And this isn't just like a Pacific Northwest problem, right? Optum is buying up doctor's offices across the country. [00:01:43] They're, I think, one of the largest employers of physicians nationwide now. They're the largest. My office has heard from a couple dozen physicians. They describe the ways, both small ways and big ways, where they feel their independence is being corroded by the ownership structures in place. [00:02:00] That's Ben Bowman, the majority leader for Oregon's House of Representatives. The patient might not know that it was a corporate owner, for example, who said, you only get 15 minutes with your doctor, even though the doctor might believe that the patient needs 20 or 30 minutes to have a proper exam. [00:02:17] So a bunch of doctors did the hard thing. They just left. Thousands of people living in Eugene lost their primary care provider. They would call up for an appointment, and they would be told that their doctor no longer worked there. [00:02:33] Quite a few reported this to me that they were told it was because of their insurance, and so they could change to an assurance plan that would help them access care, which just happened to be owned by United Healthcare. [00:02:50] So the doctors who left because this new system under corporate control was awful, unfortunately, had signed non-compete agreements, which is terrible non-compete agreements. Under the Biden administration, we're kind of being reined in, not really [00:03:07] so certain under the Trump administration, but they basically ensure that these doctors would be unable to work anywhere else in the area. They have to tell their patients, or they could not tell their patients where they were going to work instead, or even tell their patients [00:03:23] that they had left in the first place. So that's how, like, ironclad, these non-compete agreements were, to the detriment of the doctors themselves and obviously also to the patients. All of this brings us to the Oregon State bill, which was largely in response [00:03:41] to Optum's takeover. And so here are the details of the bill and how it works. Most states in the country have what's called a corporate practice of medicine law, or corporate practice of medicine doctrine. Basically, what it says is that physicians or advanced practice providers [00:03:57] have to own and control medical clinics. These are non-controversial laws. Republican states, Democratic states. They're widespread throughout the country. The problem is there are loopholes in these laws where basically large corporations and private equity firms have figured [00:04:12] out that they can be in compliance with the law on paper by having a friendly physician or captive physician own the practice. Representative Bowman's bill would change that by restricting corporations like Optum from taking decision making away from doctors and clinical decisions. [00:04:29] It also restricts non-compete and non-disclosure agreements, which caused many of the problems and confusion in Eugene. Now, the bill passed this year, it was signed into law, so they didn't run into any problems with their governor as we did here in California. [00:04:45] But I do want to be clear, it was not easy to get this law enacted. There were challenges to it, but they got it done. Before I move over to, how terrible of a person Gavin Newsom is and how no one should consider voting for him for president. Was. What are your thoughts on this story? [00:05:03] It's pretty cool to see, some level of government pushback against the sort of, I guess, efficiency lens that we've mapped onto to health care. It's just we just. You just can't apply every single market logic [00:05:22] to every single sector of the economy. There are just parts of the economy where your market and efficiency logic will not make any sense, because it's just like, bro, you shouldn't be trying to squeeze every [00:05:38] single dime possible out of healthcare. Like, like this is the most basic of essential needs. And again, like it's very rare that we see pushback against this stuff [00:05:54] in sectors like housing, in sectors like healthcare, you know, the stuff that is so very essential to us pharmaceuticals. You know, you name it. And so it's pretty cool to see Oregon actually do something about this. To again, to something that is not just it's not an entitlement, [00:06:12] it's a straight up human right. It's a need. It's you can't live life Without, you know, medical care. And so it's cool to see that. And with the healthcare professionals being able to spend time with you. [00:06:27] Right. So mistakes get made in hospitals all the time, right. Not because they're bad people, but they make their humans. Humans make mistakes in whatever career path they've chosen. Imagine being rushed to the point where you get 15 minutes with each patient, [00:06:44] and you know you're not going to be able to answer all your patient's questions or provide adequate care when you have, like, this ridiculous, you know, restrictive time limit. And honestly, there's nothing more alienating. [00:06:59] Like, you feel so alone when you have a family member or a loved one in the hospital and you don't know if they're going to make it and you're scared. And, you know, obviously I've been going through that a little bit myself. But one of the nurses at the hospital that my mom's at on the day when, like, she [00:07:18] called me to give me updates, I was like, parking at the hospital and I was sobbing like I was crying because she told me that she would have to potentially go to the ICU. And to me, it's like once you go to the ICU, it's over. I know that's not true, but that was what was playing out in my head anyway. [00:07:34] The nurse, she's a freaking angel, okay? She's like, you're gonna park your car, you're gonna come up to the room, I'm going to sit down with you. She sat down with me for an hour and a half, went over all of my mom's lab results, explained what was going on, and had me kind of understand. [00:07:53] This isn't all bad news, okay? It's not over yet. Like, you need to calm down, and I want to help you, you know, understand this, that that is what healthcare should be like. But I also understand how rare that is. Okay. I couldn't even believe that I was sitting there for an hour and a half having a nurse, you know, nurse practitioner explain everything to me like that. [00:08:12] That's something that costs more money. You're going to need more staffing. You're going to need more nurses. Right? But when you have profit motive at the heart and center of what you're doing, right? If you're corporate owned, profits matter above all else. [00:08:29] And so that efficiency is going to cut into care. And it's also going to really harm the patients in some cases. So I'm really happy Oregon did this. I want to end by talking about why California has been unable to do this. [00:08:44] Because, by. The way, before you start and my my doctor is a Optum doctor. Oh, no. 15 minutes. It's usually but like I'm a young ish healthy person, so it's not like. And I'm not in there all the time. [00:09:00] It's like, you know, you go in for your annual and then you go through the thing and it's like, all right, what do I need to do better? But yeah, it is pretty, pretty freaking quick. Although I will say this, when I got my test in, she called me personally to like, actually talk through the results. [00:09:17] Wow. And like, oh, this, this number means this and you can do this. And yeah. So she's a good doctor. It's just yeah I know about that efficiency stuff. Yeah, look, it's usually not the doctor's fault. It's the, you know, restraints of the hospital. [00:09:34] Oftentimes when it's corporate owned. Now, there has been this trend with private equity firms. I mean, private equity firms are buying up everything. They're buying up residential real estate, which we've covered extensively, but they're also buying up hospitals. And so the California State Legislature wanted to do something about that. [00:09:54] And they did pass legislation. The only problem was Gavin Newsom vetoed it. So let's take a look at this Axios headline. Newsom vetoed a bill to let California ban private equity deals for healthcare. [00:10:09] Now, in the piece, they write that if you want to call it a piece in their, compilation of bullet points, they write that private equity firms and hedge funds already are required to notify California's attorney general when buying certain healthcare businesses, but the vetoed legislation would have required the AG [00:10:26] to give written consent Sent at least 90 days prior to transactions valued at $25 million or more. So it was, you know, an obstacle, you know, something to safeguard our health care system in California from private equity firms that don't [00:10:43] care about the quality of healthcare. They want to maximize their profits. Now, the only exemption under that legislation would have been for deals involving for profit hospitals. So if one for profit hospital is trying to merge with another, or if a private equity firm is trying to buy a for profit hospital, they would be exempt in that scenario. [00:11:00] So this would impact, you know, public nonprofit hospitals, which is what we want to protect. The bill also said that investors could not interfere with the professional judgment of physicians, psychiatrists or dentists in making healthcare decisions, including [00:11:16] in areas like determining the need for diagnostic tests or referrals. Newsom vetoed this. Now, he argued that he vetoed it because reviews of these mergers are better suited with the A California state agency known as Healthcare Affordability. [00:11:34] It's the Office of Healthcare Affordability. Just one problem. They cannot block proposed mergers from happening. Is that why you find this agency better suited to deal with the reviews [00:11:49] of private equity firms and corporate interests, buying up nonprofit hospitals? Piece of crap. By the way, Lina Khan was one of the people who supported the legislation in California that Gavin Newsom vetoed because he's a corporate shill and, an empty vessel for corporate interests. [00:12:06] He makes me sick. That's all I have to say. I can't stand Gavin Newsom, and I can't stand the fact that so many Democratic voters in this country are just not privy to how scummy he really is. Any final word was. No. You you pretty much nailed it on the head with Governor Haircut. [00:12:25] So, yeah, you got it. Every time you ring the bell below, an angel gets its wings. Totally not true. But it does keep you updated on our live shows.