Advocacy / AMAC In The Media / Politics / Radio Interviews

Price Transparency in Health Care – Andy Mangione on Good Morning Ozarks – February 21, 2020

[Charlie Engram] When we became two members, Brad Dalip joined when Bobby Troll

[Keith] He did?

[Charlie] He joined.

[Keith] Good.

[Charlie] And for you that are not part of the finest conservative organization for retired people, You need to join AMAC. Andy, good morning.

[Keith] Hey Andy.

[Andy] Good morning.

[Keith] Good to have you with us. Hey, what’s the age for AMAC? I got some friends. I wanna know if they’re old enough.

[Andy] Anyone can join AMAC. Anyone can join. Now we are, you know, we traditionally build ourselves as a 50 plus organization, but we have plenty of members who are under the age of 50, so feel free to join.

[Keith] Alright. well, my friend’s over 50 so he qualifies.

[Charlie] Andy, I spent a number of years in Upstate New York where my children were born and I had more Italians on my payroll. Took me six months to pronounce the LoPresti’s and the Artigiano’s and so I’m looking at your name and there’s a great Italian chain of restaurants that are spelled almost like this, but I made sure yesterday that I knew you’re Mangione. Correct?

[Andy] That’s right, sir.

[Charlie] Alright. Well, Andy, we want to do some things before we dive into this hospital issue for just a minute and found out a little bit about you. Our good friend, Bobby Charles works with you and he’s been a regular guest on our program for many, many months, and we want to continue to exhort you, your organization and what you’re doing to bring truth in the midst of a clouded society when it comes to truth of conservatism, and we appreciate it a lot.

[Andy] Well we’re very grateful, to have to have the time. We build our membership by being a great program like yours, and we are very happy to be here.

[Charlie] And let’s remind our listeners of the passing of the founder a couple of weeks ago. Remind us of his name and let our listeners know his years that he was with the organization.

[Andy] Thank you. Dan Weber. Daniel C. Weber was our founder. He died on February 3rd after having a series of health setbacks, starting last year. He started AMAC as a private individual. He was retired when he started AMAC. He didn’t feel there was a senior’s organization that represented his values or his beliefs. He looked around for a viable organization to service an alternative and he couldn’t find one. So he literally took his wife’s retirement and started up AMAC as a private citizen back in 2007. We’re headed into our 13th year, we have almost 2.1 million members across the country in all 50 states and our membership, we’re experiencing a surge, currently. Adding about 5000 new members each week. And, more importantly, between four and six thousand of our members are renewing each week. So when people join AMAC, they stick around. Dan Weber’s vision was to have an organization that put faith, family and freedom first. And he also thought that people who are aged 50 plus didn’t have the proper representation in Washington. And he wanted to change that and he certainly did. It was a very sad week. We had Dan’s funeral last Saturday in his beloved Long Island. We were up there with his family. He was waked on Friday, just a wonderful, wonderful man who was gone before his time. But he can rest in peace knowing that there is a committed staff and a committed team that will carry his mission and perpetuate his legacy. So, people that are hearing this that are AMAC members or that are considering joining AMAC, can take comfort in the knowledge that his legacy will be carried on by a team that believes as much as he did. That the constitution was one of the greatest documents ever conceived by man, that we’re fighting for religious freedom. We’re fighting for smaller government, sensible spending. We’re fighting for the Second Amendment. We’re fighting for life. These were all beliefs that Dan’s held true to his heart. He was a faithful man. And we’re taking comfort in the knowledge that he’s in a much better place with his God and his family members that have passed on.

[Charlie] Well, let me tell you. You’re plugged into a town that services almost 8 to 9 million tourists. One of the top one, two, three or four tourist destinations and the number one in the Midwest, and tell them about our mission statement at the city Keith.

[Keith] Well, we wanna keep it family friendly. And that’s the important thing here. And so we strive hard to do that in our brand scenario.

[Charlie] When you guys get a chance to take a look at the Branson Convention Center. What a great place for regional convention for AMAC. I wanna find out a few other things before we dive into the transparency of hospitals. A number of years ago, we had a surgeon on our program from Oklahoma City. He started this years ago, top surgeon, top guy says enough’s enough. So you go to Oklahoma City, remember Keith, he give us a list.

[Keith] Yeah, oh yeah.

[Charlie] And you get your list out and here’s what you need done. And I’ll tell you what it is, where we’ll do it, and how we’ll do it, the anesthesiology and all that. Right?

[Keith] Yes.

[Charlie] So we’re gonna talk about that. But Andy, before we do that, how did you — we know that we’re all born, grew up somewhere, We found out all of us are born naked. Right, Keith?

[Keith] Yeah, we did find out, yes.

[Charlie] Okay. And so with you, where was Mom and Dad? What’d you do? And we’ll get that out of the way and then dive right in to transfer to the litigation today.

[Keith] Wanna find out how you got involved in AMAC yourself.

[Andy] Oh, certainly, I’m originally from Cleveland, Ohio and I spent a career in medical sales. And I was able to take a job with Humana down here in Louisville, Kentucky. And I moved to Louisville, about 12 years ago with my family. My boys were three and five and my beautiful wife, we all came down to Derby City, as they call it here.

[Keith and Charlie] Yeah.

[Andy] And I started my job with Humana. And the very, very first you wanna talk about the providential hand of God. The very first sales call that I made — my job was to find people that could externally distribute Humana’s Medicare advantage products, and that would take me to people that had access to the age 65 demographic, the Medicare demographic, and the very first call I made, somebody handed me a piece of paper that had the name Dan Weber, a phone number and AMAC on it. I hadn’t even moved from Cleveland to Louisville. This was my first call representing Humana. And this was in 2008. Dan had 5000 members, most of those memberships, he gave away for free. We went down to Central Florida to talk to him, he was looking for a business partner, we were looking for access to the demographic. And that’s how we met, he laid out his vision for AMAC. And I remember sitting in that meeting, thinking that this man is onto something that was much bigger than any of us in that room. And I knew instantly, even though I was that the onset of a new opportunity, I knew instantly that I wanted to be a part of it. And about four years later, I was able, you know, through God’s providence and through Dan’s generosity, I was able to join AMAC.

[Charlie] Well, let me tell you something you’re with 88.1 KLFC Christian radio streaming all over the world today. But I’ve got to have to take exception with a couple of things in your little dialogue. Number one, I wanna make sure you really know Cleveland, okay. Because when I started 1971, after coming out of Vietnam, our home office was just south of Cleveland in a place called Copley, Ohio. And I wanna make sure, are there still potholes in Cleveland?

[Andy] They are the size of Lake Erie. Okay? Now, they do a nice job of filling them when they get to them and eventually get to that. But you’ll still bend a rim driving through, depending on the time of the year.

[Charlie] That’s number one. Number two, are the roads still under construction in Cleveland?

[Andy] Yes. You know, the seasons we have there. Okay, we have winter and construction. Yes, they’re still under construction. We’re up there frequently.

[Charlie] I heard some–

[Andy] Some fun and nice day. They’re doing a good job, but, yeah, they’re still under construction.

[Keith] I heard somebody that was entertaining up there saying ” some boy Cleveland, Ohio, that’s where we’re at. It’s gonna be a nice city when you all get it done”.

[Andy] (laughs) Alright, they did a very nice job, if you recall they had the 2016 Republican National Convention there

[Charlie] yes

[Andy] And they redid public square downtown, Cleveland. They totally reconfigured it. They did a marvelous job and really spruced up this town for the convention. And all that stuff is permanent and good news just for anybody who’s from Cleveland out there, Sherwin Williams will be building their fortune 500 company. Everybody knows the paint–

[Charlie] Sure, sure.

[Andy] The paint manufacturer that they are. They’ll be building the world headquarters right off public square. That was just a while so–

[Charlie] Oh wow! That’s a big deal.

[Andy] Yeah, it’ll affect the skyline. It’ll be very nice.

[Charlie] So here’s your third question. So far, you’re doing pretty good. I think you’re two for two,

[Keith] Yeah, I think he’s good.

[Charlie] Okay. And so, here we go. We leave Cleveland like I did in 1972. And I went North and East. What is the first town and not in Ohio, that I will come to that I can look across the lake, and I can see vineyards which I’d never seen as a young boy in Missouri, What would that town be that you would pick?

[Andy] Erie, Pennsylvania

[Charlie] Heck, G you’re the winner.

[Keith] He got it.

[Charlie] I stood in a phone booth and called my wife. A phone booth Keith.

[Keith] Phone booth, yeah.

[Charlie] And I wasn’t changing my clothes

[Keith] Don’t see those anymore.

[Charlie] And I, am standing in a phone booth looking out over Erie, Pennsylvania and the vineyards. I’d never seen that in my life it’s quite a sight.

[Keith] Wow. Andy, tell me about your personal faith journey.

[Andy] Well, I’m a cradle Catholic. Was born in a very devout Catholic family and have had the privilege of passing that faith on like we’re commanded to do to our sons, like fully. We lost my mother in 2018. She died in her sleep at age on a Sunday morning. And she was very devoted, very instrumental. I lost my father at age 17. He was one of those guys in the 70s that died young of a heart attack. And so my brothers and my sisters and I are acutely aware of heart disease and are taking measures to take care of ourselves. But I remember particularly how my mother handled that situation. She wore white during his wake. She would not let us wear black. We celebrated the resurrection. And I would never forget that. He’s been gone for many, many years. It was a tough time, don’t get me wrong.

[Both] Sure.

[Andy] Well, I still draw a lot of strength from how she handled that.

[Charlie] Our guest today Andy Mangione, Has already become a good friend and we’ll get his contact information will keep him and Bobby right on speed dial. That makes me feel good because you’re not an Ohio State fan. You’re probably Xavier with that Catholic background. So there you go.

[Andy] Hey, you know what, I didn’t go to Ohio State. I like to see them do well though. I’m a big 10 guy. You know, I’m an Ohio fan. You know, some of that Kentucky stuff is creeping in because we’ve been behind for a while

[Charlie] First of all, you said. you gotta get it right. Keith is a Nebraska fan listed in the big 10. I’ve been a Purdue guy for years and years and years. And follow the big 10 we have 14 teams now, Keith.

[Keith] Yes I know.

[Charlie] By the way just thought I let you know.

[Keith] That’s true, nobody.

[Charlie] And so we’ll keep an eye on that. So here we go. Let’s dive in with Andy. Dive into our topic. Here we go Keith.

[Keith] Alright Andy.

[Charlie] Association of Mature American Citizens joins patient advocacy groups in Amicus brief supporting Department of Justice, price transparency litigation. Giving voice to the majority of Americans who want price transparency in health care. The Association of Mature American Citizens, AMAC has joined other patient advocacy groups to jointly submit this brief to support the Department of Justice motion for summary judgment in American Hospital Association. Tell us what this case is about and what we’re seeing.

[Andy] Okay, be happy too. Now let’s give a little context. Last June, President Trump issued an executive order that instructed Health and Human Services to create a rule that would require hospitals to disclose the prices for medical services that they negotiate with insurance companies and also the cash prices that they accept for specific procedures. And these medical services are considered shoppable. Meaning that they are commonly offered by multiple providers in the area. The intent of this executive order is to equip patients with the information that they need and would empower them to shop for healthcare services much in the same way they do for every other purchase they make throughout their lives. That’s the reason for this executive order. The information would be accessible electronically, it would be easy to read, and it would inform patients so they would be able to know before they have a procedure, how much that procedure is, they could cost compare shop, and they could also make a decision based on quality of care. So just let me paint this picture. Can you imagine knowing the cost of a knee replacement from hospitals in your town before having the surgery? And can you imagine the impact on pricing this transparency would have on the cost of procedures. Hospitals would be in a position to compete for your business and we all know how competition benefits consumers. Or how about this? How about having the option to choose a cash price for a medical service if it’s cheaper than an insurer negotiated price?

[Charlie] I don’t know, hang on, Andy, I don’t wanna interrupt you. But we’re very familiar with our Christian organizations that do that. But you go in and when you say cash, they treat you like a third class citizen.

[Andy] Well, you know, in some cases the cash price is, you’ll be surprised at how much less it is. I understand that. And that’s unfortunate. Okay. But in some cases, if that cash price is disclosed, I would venture to say in many cases, it’s less expensive than a hospital, or I’m sorry, an insurance negotiated price.

[Charlie] That’s tremendous.

[Andy] So it’s an option. It’s an option that we all should know about beforehand to make an informed decision. Okay? So this transparency, this pricing transparency would also protect patients from surprise billing, and we all know what that is.

[Charlie] Ooh yeah

[Any] A surprise bill occurs. A surprise bill occurs when you’re treated in a hospital setting, from an out of network provider. This usually happens in the emergency room. And you go, you get treated. And then weeks later you get a bill from an out of network anesthesiologist. And it’s exorbitant and the hospital goes after you and you have no choice but to accept care from that person because you’re in an emergent situation. This pricing transparency would protect from that type of business practice. Okay, so there’s a situation. Now the American Hospital Association, which is the lobby for hospitals, filed suit late last year against Health and Human Services to stop the Trump administration — the Trump administration’s transparency rule. They maintain that revealing the prices would be a First Amendment violation. So what AMAC did, we joined an Amicus brief with other patient advocacy groups to support this transparency initiative, and we’re arguing, among other things, that hospitals routinely disclose prices in their explanation of benefit statements. So the prices are truly secret. But they’re just disclosed way after the fact when it’s too late for patients to have a choice in more cost effective care. And you’d think that this disclosure in the explanation of benefit statement would negate any First Amendment argument. So that’s the crust if we’re successful here, guys, if we are successful here, and the court recognizes how price transparency and health care leads to a competitive environment for medical services, and will drive down costs. The motion NFA grants the Health and Human Services motion for summary judgment, then the American Hospital Association’s case would be dismissed. And the price transparency rule will stand. And we won’t know for several weeks, but we filed the brief last week and we’re very, very optimistic that we’re gonna be successful.

[Keith] You know, currently, it’s almost like you get the car you drive off the lot and go home, or you buy the house and you live in it for a week or two and then you get this bill, you don’t know how much it is until the bill shows up. And then you’re almost ready to have another heart attack.

[Andy] That’s exactly how it is. Okay? It’s exactly. Where else do you make a major purchase? Say, let’s use your car analogy. Alright?

[Keith] Yeah.

[Andy] You like the car you drive it home. And then you know, three weeks later, the dealer sent you a bill for twice as much as you thought it would be.

[Keith] Yeah.

[Andy] Okay, this is exactly the situation. There’s no other commodity in this country where we pay after the fact, you know, after we’ve had services, this is insane. And this is a positive — and we’re about to have another huge debate in this country about health care reform, pricing transparency. You shine the light on these business practice, you shine the light on these prices, costs will come down and it is a meaningful first step in yet, another debate on health care reform in this country.

[Charlie] Andy, we have talked about this from Obamacare and what they’ve tried to do a one payer system. Fortunately, Keith and I are both over the age of . We have a wonderful Medicare for our situation plus I’m a veteran. And so the the VA health care that we have here in the Midwest, at our particular local VA is excellent. However, my kids are in their 40s. Their kids are looking at these healthcare expenses. And what we have found over the years, is trying to get an answer. Okay? You walk into the hospital and immediately the walls go up, Keith.

[Keith] Oh, yeah.

[Charlie] And we are not telling you nothing. But Andy, to just be transparent, for example, over the years and this aggravates the dickens out of me, but after being married years, I’m just gonna say okay, there are times that I’ve asked my wife about doing something and she said, I’m not gonna do that. It is–

[Keith] Too expensive.

[Charlie] Too expensive. Honey, if you need to have it done. Let’s talk about this. There are millions of Americans that are faced in a situation making a choice between their health and their dollars. And if we had this transparency They would be able to say I could do this I need to have that procedure. And I’m going to go to x, y, z mercy, or x, y, z cox or x, y, z whatever, because they just gave me a price of $ versus $ , . And I can afford that.

[Andy] Exactly, exactly right. If people have to realize, you know, people are smarter than they think. Alright? They make major financial decisions on a daily basis. You buy a house, you buy a car, you pay for college for your kids, you find out a way to finance that. And when it comes to our health care, we discount ourselves. We have to realize that we’re worth the investment. Okay, alright? And not only that, but with price and transparency. It’ll take out all the fear and all the anxiety out of making those decisions.

[Charlie] Well I’m gonna tell you Andy, you talked about your health issues with your mom and your dad and I’ve had open heart surgery and I understand how important that is to have somebody good working on you when it’s your heart. But I will tell you when my mother was 90 and broke her hip and walked in and I had a wonderful surgeon so just what we have to do, he didn’t say send her to room 4, okay? But under the Bernie Sanders plan and others, they will say Medicare for All. Well that’s not true. They don’t wanna have Medicare for all and they don’t even want you to have private, there’s a name for the concierge service for wealthy people. It’s not coming to me right now. But yet they wanna do away with all of that, that makes no sense at all Andy.

[Andy] It’s insane. Medicare for all is a nice buzz phrase and the left is really really good at coming up with those spiffy little sayings, okay? But Medicare for all in reality is Medicare for none. I had the opportunity to interview United States Senator Rick Scott to the AMAC Magazine just last week when we were in Washington. And he’s a former hospital executive and I asked him, you know, tell me what do you think about Medicare for all? He says it’s Medicare for none. It’ll be too big to manage, it’ll bankrupt the system and it will destroy private insurance. It is unsustainable and unreasonable. And it’s pie in the sky. It’s gonna be a disaster, heaven forbid, this ever comes to reality.

[Keith] Andy, didn’t we do this same kind of thing years ago in the funeral industry? There was a time when you didn’t know what it was gonna cost you for services for your loved one that passed or whatever. But now, they gave you a list. Here’s what it costs you. Here’s the different options you have. And that’s kind of the same thing we’re talking about, isn’t it?

[Andy] Well, yeah. I mean that transparency is transparency. If you know upfront the cost, you’ll be able to make an informed decision.

[Charlie] Well guys, it happens, it happens every day. You know, if you’re a meat lover, or if you’re a vegan and you’re looking for whatever you’re looking for, I’m gonna shop and I’m gonna look around and I found that the rump roast was on sale here. I look for cokes yesterday, Keith. Because cokes if you don’t buy ’em on sale, Okay?

[Keith] Yeah.

[Charlie] You can have a problem.

[Keith] Did you see the new pack that has three other cans in it.

[Charlie] No.

[Keith] No it’s a 15 pack.

[Charlie] Crazy.

[Keith] I gotta tell you that, three more.

[Charlie] So when I walk into the hospital, I just wanna walk in say, I’ve got this Here’s an example.

[Keith] Alright.

[Charlie] I had an elective surgery. Okay, You with me?

[Keith] Right?

[Charlie] And it was the colon surgery with diverticulitis. The doctor looked at me and said, “Charlie, you got some choices here, you can wait until that thing’s ruptured,” And remember the lady we had here that had that happen?

[Keith] I did

[Charlie] If it ruptures buddy I’m gonna tell you what, you better look, the Lord might save you, but you’re in bad shape. I’m suggesting to you that you need to have selective surgery and you need to have a foot of that colon taken out. Which is what we did. That’s a perfect example of walking in and seeing the doctors and what is this gonna cost me? It’s elective, I need it, but I do have some time to make a choice. You wanna comment on that Andy?

[Andy] Exactly right. That’s a very good analogy but, Charlie, think about this too, think about LASIK surgery.

[Charlie] Yes.

[Andy] When it first came, how expensive was it when it first came out? Look at the prices now, when you see the advertising, you have these eye surgeons that are competing for your business and all of a sudden, it’s very reasonable to get your eyes done with LASIK.

[Charlie] Well, I will tell you Andy, this has been great if you don’t mind, if you leave your email address for someone who has a producer get on the telephone, and I’d like to communicate with you and we’d like to put you on our list with Bobby Charles. And you know, do you get to see Bobby at all?

[Andy] Absolutely saw him last week and I’m gonna see him. I’m gonna see him next week. Yeah.

[Charlie] Just a great guy and we’d like to put you on our list. In your expertise, Do you work full time for AMAC or do you still have another full time job?

[Andy] Oh, no. I’m Senior Vice President for AMAC Action which is our advocacy arm. This is a full time job for me.

[Charlie] Well, let me tell you something, you passed all the tests, but you missed one Andy. And I don’t wanna do this to you but I got two buddies. Okay. It’s “Louiville” around here. It’s not “Berryville,” it’s “Berryville.” Okay, we got him

[Andy] I’ll work on that guys.

[Charlie] Do you follow sports at all?

[Andy] Absolutely.

[Charlie] Man, the Louisville Cardinals what happened four in a row went from number five down What happened to them?

[Andy] Well, they just drilled Syracuse night before last. So they’re ranked 11th. I think they had a reality check, but I think they’re coming around.

[Charlie] Well, I’ll tell ya, it’s gonna be a fun NCAA Tournament, your take on the Houston Astros, should there be an asterisk by their name? Keith tell him what you thought this morning.

[Keith] I think, you know, they get a bonus for going into the World Series. I think they need to fine them, at least one, get that bonus back or fine them twice, double the bonus. Get the pocket.

[Andy] I think there should be, excuse me, I think what they did was horrible. I love baseball and in 2017 they beat my Cleveland Indians and it was one of the rounds of the playoffs and that shenanigans was going on. I think their championship should be tainted. I don’t think the commissioner came down on them hard enough. I think some players should be disciplined as well. I think what they did for the game is horrible and borderline irreparable.

[Charlie] Andy, did you happen to read the article yesterday about the little league Commissioner in the East Coast in Ohio, Pennsylvania area? Did you happen to read?

[Andy] I saw the headline but did not get the chance to read the article.

[Charlie] Well, here it is. You know how little league teams we all did that. Keith, you, me all of us have played little league baseball, we were there, we’re big Cardinal fans. So we’re here in the shades and Busch Stadium, the Cardinal nation, one of the finest organizations in the United States. That’s why Cleveland likes to come to town, every once in a while. But yet, the commissioner of little league baseball said we’re not allowing any of our teams to use the Houston Astros monicker this year because it’s still–

[Andy] Good for him.

[Charlie] This is what we believe in. Andy, thank you very much. And if you’ll stay on the phone, I appreciate what you’re doing. Where are you living now?

[Andy] I’m in Louisville.

[Charlie] You’re still there?

[Andy] Yes, sir.

[Charlie] Keith, did you realize that?

[Keith] Yes, I did (laughs)

[Charlie] Hey look

[Keith] He said that up front.

[Charlie] Alright (mumbles) I realized that

[Keith] Andy, he was sleeping through the beginning. So you gotta forgive him. He’s okay. He got up early to take his granddaughter to basketball practice. So we’ll forgive you, brother.

[Charlie] You know what, I’m gonna go to my AMAC membership. There’s a chat line on that right? And I’m gonna go in there this morning. Hey, here’s our job today. Let’s try to get some new members to call today. Tell us what they get. There’s a special AMAC deal. Did I join for life or for five years?

[Keith] Five years

[Charlie] Okay.

[Keith] Both of us joined for five years.

[Charlie] Five years. Tell us what the program is.

[Andy] Well, it costs $ for you to join AMAC. And it covers a household that’s for one year. So that’s you and your spouse. or you can join for three, five years or we have a lifetime membership as well. You would have access to a very robust roster of member benefits. All the insurance products, all the travel discounts, all the lifestyle products, financial services, advisory services, all kinds of member benefits. In addition to that you receive the AMAC Magazine that comes out every other month. And, excuse me, as well as roadside assistance. So it’s just our member benefits continue to grow and people can go to amac.us. A-M-A-C dot US. on the internet to join.

[Charlie] Hey, before we let you go, let me tell you without the benefits. I’ll tell you who we had on our show. The people from Maine Lobster, after we joined AMAC we had him on the telephone. We did an interview with him, we gave away some lobster. And so we love AMAC. We love you guys, for what you’re doing. Thank you for being part of Good Morning Ozarks today.

[Keith] Thank you, Andy.

[Andy] My pleasure, Charlie and Keith, Thank you.

[Charlie] You know where he’s at Keith?

[Keith] Yeah.

[Charlie] He’s in Louisville.

[Keith] He’s in Louisville.

[Charlie] Yeah. See you Andy.

[Keith] See you Andy.

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