TED Talk: Healthcare Stole the American Dream. Here is How We Take it Back

Whether you are a regular citizen, business or union leader, there is a call-to-action for you at the end of the TEDx talk embedded below. It will take all of us working towards a common cause to have a fighting chance to change a wildly under-performing, but entrenched system.

  • Here’s the core idea of my talk: DIY Health Reformers are saving America one community at a time.
  • Quick take-away: We can fix healthcare
  • The objective of my talk: Giving people hope that it’s possible to solve what many consider unsolvable & spur action now

I’ve annotated the talk in brackets & italicized so it’s clear what the transcript is versus the annotations that link to more information behind a portion of the talk.

Healthcare stole the American Dream. But, I’m excited to tell you about how regular people — including nurses and doctors — are taking it back by fixing healthcare. And the great news is it’s working.

[American Has Gone To War For Much Less Than What Healthcare Is Doing]

Think the American economy has recovered? Well if you look at the middle class, think again. Middle class income has been declining for 20 years. Remember, most of the middle class gets health benefits through their jobs. Healthcare is, by far, the biggest reason why 70% of households have less than $1,000 saving. The problem isn’t that employers have been stingy over the last 20 years. Employers are spending far more on employees than ever before. The problem is that every dollar and then some has gone to healthcare because for too long, employers have mismanaged the way they purchase health benefits.

[Healthcare Drives Middle Class Economic Depression & Trump/Sanders Campaign Success, 7 out of 10 American Households Have <$1000 in Savings Thanks to Healthcare]

Why is it that millennials are the first generation in American history to think that life won’t be better for them than their parents? With over half of their lifetime earnings slated to go to healthcare millennials are on track to be indentured servants to the healthcare system.

[Dealt a Terrible Hand By Their Boomer Parents, Millennials Must Drive Healthcare’s Reform]

We pay more and get less every year. Our healthcare system is overwhelming us and making us lose hope.

But hope is actually what this book is about. Regular citizens are restoring The American Dream by applying common sense fixes to healthcare. It’s what America does. When it comes to big societal problems like civil rights, better food, or energy independence — solving these problems from the bottom up is the American way. I’m going to tell you how one American is doing it and how what he’s doing can be recreated in your community and across America to solve our healthcare crisis.

Let me introduce you to Harris Rosen. Like any other business leader, he wants a fair deal for his business and employees. Rosen is a son of immigrants who went out on his own and bought a money-losing hotel in Orlando during the height of the oil crisis in the 70s. He worked five different jobs in that hotel until he turned things around and had a thriving business. But starting in the 90s, the increasing weight of healthcare costs crushed his business. Just like millions of business owners in America, every year he paid more in healthcare costs and got less in healthcare benefits.

[The Health Benefits Fix to CEOs Failing Their Fiduciary Duty — overview of what Rosen Hotels did]

Rosen didn’t know anything about healthcare. But he knew it was crushing his business. And he was fed up. Ignoring the so-called experts, he tackled the challenge with a can-do American spirit. Fortunately, you’ll find every solution to fix healthcare has already been invented and proven — it’s just a matter of will. Rosen had the will and he applied common sense to cut out the middlemen who weren’t adding value. He focused on prevention and relationship-based primary care while carefully managing high cost medical issues. He implemented what I call the 3 C’s: Care team, Cost & Community.

Care Team

Today, when we have a doctor’s appointment, we’re rushed through the visit like cogs on an assembly line. Doctors rush through appointments all day long like hamsters on a hamster wheel. They’re in a hurry because they now spend two hours on bureaucracy for every hour of patient time. It’s no wonder doctors are burning out at record rates. A doctor in a large health system in California shared with me how he and his colleagues were being pressured to amputate diabetics’ feet. You know why? Because carefully managing diabetic foot ulcers takes too much time. In contrast, Rosen employees with diabetes have a care team and every person on this care team has time to do what they do best. Whether they’re a dietician, doctor, health coach, nurse, or pharmacist, they work together to help reverse the symptoms of diabetes and to ensure they never get to the point of having to amputate.

[The Quadruple Aim: A Square Deal for Clinicians (& Patients)]


With today’s perverse incentives, did you know that a health system gets paid over $22,000/hour to amputate a diabetics’ foot and only $200/hour to help the patient manage their diabetes. By comparison, Rosen applies common sense: providing free lifestyle and medication management is far better for his employees’ health and his company’s bottom line.


Data clearly shows that zip code is a better predictor of health than DNA code. Healthcare’s hyperinflation has been stealing from promoters of health such as education, safe neighborhoods, access to good food, clean air and clean water. [Image of Rosen with kids with diplomas] Rosen understands that education is the foundation to achieving the American Dream, so he reinvests money that would have otherwise been squandered in healthcare and pays for college education for Rosen employees and their children. If that wasn’t enough, Rosen reinvests into education for a nearby community Rosen adopted. Rosen funds daycare, pre-k, after-school programs, and at last count 450 college educations. What has this done? Crime decreased 67% and high school graduation rates doubled. And the total cost for all of these gains was less than 5% of what Rosen saves on healthcare compared to similar companies. This success is contagious so they have adopted another community that is 5 times larger.

[Population Health Investments Catastrophically Misaligned]

So with the three Cs — Care Team, Cost, and Community — Rosen is able to spend 55% less per employee on health benefits while providing one of the best benefits packages in the country. That’s about $5,000 every year that can go into the employee’s pocket, the business, or the community. All this, despite having a workforce with significant health challenges (e.g., over half of their pregnancies are categorized as high risk) — simply by having good primary care and carefully managing big-cost items. That’s what’s possible when you have will. That’s how you restore the American Dream.

These successes are sprouting, from the ground up, all over the country from small manufacturers to school districts to publishers to large municipalities. If every employer had the will to adopt these common sense steps, it would be like a $500B citizen-driven economic stimulus every year.

[As has been shown in Georgia, Kirkland, Milwaukee, Orlando, Tulsa, Pittsburgh and other locales, wise companies find ways to thwart the tricks the industry plays to redistribute profits from companies.]

But of course, there are 3 trillion reasons to protect healthcare’s status quo. No industry spends anywhere near healthcare at the local, state and federal level lobbying to preserve such a wildly under-performing system. Let’s be clear about one thing. The 20-year income decline for the middle class clearly fueled the recent presidential election but almost no one talked about the fact that healthcare’s hyperinflation was at least 95% responsible for that. The data from Rand, Brookings, Kaiser, and Health Affairs makes that clear as day.

[Healthcare Drives Middle Class Economic Depression & Trump/Sanders Campaign Success]

Here’s a key point: Those looking to protect the under-performing status quo will try to politicize healthcare and use fear, uncertainty and doubt to protect their interests. To stop progress there’s nothing easier to politicize and frighten people with than healthcare. After all, it’s life and death, right? But each of us must inoculate ourselves against the enablers of the status quo who benefit themselves — at the cost of our health and our wealth — when they infect us with the sense that healthcare is too complex to fix. This is simply false.

[Healthcare’s Biggest Lie: Employers Can’t Do Anything About Massive Pricing Failure]

Americans are no longer waiting for solutions from somewhere else. We’re looking in the mirror and realizing it’s on us to restore the American Dream.

And Americans all over the country are sharing their successes. Hundreds of us have been coming together to create the Health Rosetta: a free resource you can google that shows Americans that healthcare isn’t too complex to fix. In fact, most of it is common sense. For each area such as getting proper primary care, true transparency and more, the Health Rosetta explains how it works, why it is better than the status quo, the challenges to expect, actions steps and links to more resources. We’re just getting started but already organizations representing millions of Americans are jumping on board.

[Healthcare purchasing blueprint and guiding principles for a new health ecosystem]

Here’s the great news. Former adversaries have realized their goals are aligned. For example, in Pittsburgh, unions and management put aside old battles and rethought how to deliver great benefits to teachers by doing things similar to Rosen. This resulted in that fact that Pittsburgh kindergartners will have $2 billion more available for education during their K-12 years than their counterparts in Philadelphia who are doing things the old way and needlessly pay 40% more for health benefits. In Pittsburgh, teachers are paid more, have better benefits, and 30% smaller classes sizes.

[Healthcare No Longer Stealing From Pittsburgh Schools Setting Model for the Nation]

These successes are coming from people across the political spectrum. Progressives are the ones implementing healthcare ideas that people call conservative. Conservatives are implementing ideas that would be called progressive. Each of us has had an awakening that we don’t need a left solution or a right solution. We need an American solution and this good news is spreading like wildfire.

What can you do?

  • If you are an employee, share with your CEO that there’s a way to slash healthcare costs while improving benefits. If you are a business leader, ignore the so-called experts and apply the same discipline to purchasing healthcare that you apply to every other area of your organization. If are a union leader, there’s never been a better time to rethink the health benefits that have been crushing your members.
  • Whether you run a business or union, the Health Rosetta is the blueprint to redesign your under-performing health benefits.

For too long, we’ve let healthcare crush the American Dream. We can’t stand for 20 more years of an economic depression for the middle class. No country has smarter or more compassionate nurses and doctors and no country has more innovators that have reinvented our country time and again. In every corner of healthcare, people went into healthcare for all the right reasons but perverse incentives and outdated approaches have shackled them. Whether we knew it or not, we all contributed to this mess. Now, it’s on us to fix it. When change happens community by community, it’s impossible to stop.

Yes, healthcare stole the American Dream. But it’s absolutely possible to take it back. Join us to make it happen in your community.

Thank you.

Dave Chase is the Managing Director of the Quad Aim Fund, Executive Producer of The Big Heist (the first fiercely non-partisan satirical film to address healthcare), co-founder of the Health Rosetta Institute (a LEED-like organization for healthcare) and author of the forthcoming book, “CEO’s Guide to Restoring the American Dream — How to deliver world class healthcare to your employees at half the cost.

Subscribe to The Future Health Ecosystem Today to stay ahead of healthcare changes. Follow Dave on Twitter.

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