Healthcare Fixed: No Insurance Needed, Same Doctors, 60% Less - David Goldhill

Charles goes one on one with David Goldhill, founder and CEO of Sesame, former president of television at Universal Studios, and author of Catastrophic Care, to tear apart why American healthcare costs so much and what it would actually take to fix it.

They walk through why the United States covers 40 percent of the world's healthcare spending while making up just 3 percent of the population, why insurance companies and government payers killed normal pricing, and why the fix isn't one big policy swing. It's a shift back to treating patients like customers.

The conversation covers the real economics behind a $900 million pill, why Sesame borrows its pricing model from a stone crab restaurant in Miami, why hospitals are stuck with a broken business model, and why the doctor in your neighborhood is about to compete with the best doctor on the planet.

KEY POINTS:

00:34 – Entertainment executive to healthcare founder: David walks through his path from Universal Studios and the Game Show Network to building Sesame, and why Charles calls it a classic swap from one broken industry to another.

01:57 – America is subsidizing world healthcare: David explains why the US pays 70 to 80 percent of the cost of medical innovation while capturing a fraction of the benefit, and why cutting that funding would collapse care standards everywhere.

04:04 – The NATO of medicine: David compares American healthcare spending to defense spending in NATO, and lays out the number that stops most people cold. The US is 3 percent of world population and 40 percent of world healthcare spend.

09:13 – Why the first pill costs $900 million and the second costs a penny: Charles and David break down drug pricing, and why a business model that looks terrible everywhere else works in healthcare because normal competition never gets the chance to bring prices down.

14:42 – The real lifetime cost of healthcare: David shares the number that shocked him while writing his 2012 book, what one employee puts into the healthcare system over a lifetime, and where all of that money actually goes.

27:30 – The Joe's Stone Crab model: Charles and David use a Miami restaurant to explain how Sesame built a cash pay system that gives patients upfront pricing without insurance, and why doctors are lining up to join it.

31:33 – Telemedicine breaks the map: David explains why location is about to stop deciding who gets access to the best doctors, and how remote care strips real cost out of the system inst