Show Transcript

Hello and welcome back to the Dr. Nilda Foresight Strategies Show and with me today I have my co-host Rachel Calderon and a very special guest Dr. Josh Luke, say hello everyone.

How are you doing?

Good!  So I want to read your bio. It’s a very interesting bio and I’m quite fascinated by it. Dr. Josh. Luke is healthcare futurist and a former hospital CEO. His expertise includes sharing simple tactics and how to make healthcare more affordable, as well as how to access the best doctors and the best hospitals. Dr. Luke started his career as a jet setting, sports marketer, working with some of the most famous athletes in the world. Thereafter, he is careers change to healthcare, and it was brought on by his    grandmother’s disease process. He ascended to become a hospital CEO by age 32. After he panned his first book, he became a best-selling author. He now finds solace in sharing his expertise as caretaker for his job and be without health insurance for his family for a short time. Has Given you a deeply emotional understand of the other side of care delivery. Thank you and welcome Dr. Luke.

Thanks for having me. I’m excited to be on the show.

So is it Dr. Luke or Dr. Josh?

Well, I used to tell my students at the University of Southern California where I teach public policies. to just call me Josh, but then when Forbes recruited me to write this book, “Health Wealth: Is Healthcare Bankrupting Your Business.." they said, hey, from now on your name is Dr. Josh Luke all the time don’t be so nice because you are a Dr., and you’re an authority figure.  On LinkedIn you can find me at Dr. Josh Luke and also on the other social media platforms. So, so I guess from now on is Dr. Josh Luke.

Awesome! OK, so here’s my first question: You are healthcare futurists. Explain to me what a healthcare futurist is?

It’s such a great question… you know, so I’ve been a public speaker as a hospital CEO for about 10 years and after the affordable care act passed I started getting a lot more requests to speak. And, I think people found my presentation style interesting because I started as a nursing home administration because before I became a hospital CEO and that’s really rare in healthcare to find somebody from outside of the acute hospital space that knew a whole lot about what’s going on beyond the hospital because the hospital’s been the center of the universe. So as I was traveling the country and speaking and it’s my first book came out I a few times where people introduced me as the healthcare futurists and that wasn’t on my bio, wasn’t anything I asked to do is people that heard me speak before and said he’s always telling us what’s going to happen. and he’s been right he’s had a really good track record. And so about the third time somebody introduced me as healthcare futurists. I got on the plane that day and went home and said, you know, I better figure out what that means. I’d better give it a definition and it’s kind of got a nice ring to it. And so I added it to my LinkedIn.  and I just came up with, hey, when somebody asks me what a healthcare futurist is, and for your listeners who are on LinkedIn, I actually have a story with that title. You know, what does the healthcare futurist. They can go to drjoshluke.com, click on articles and scroll down to find it.

But what I said is, look, my job as a public policy instructor at USC and as a former CEO is not just to interpret policy for you to share with you how it’s going to impact you, whether you are a mom, whether you’re a doctor, whether you’re a hospital, whether you’re a nursing home or just an individual and corporate America who wants to know how to prepare for the changes in healthcare and not necessarily specific to politics either because what’s going on in America right now, it doesn’t matter if it’s Obama, Trump, Hillary or whoever comes next.

They’re not debating making healthcare affordable for us or reducing prices. They’re only debating who’s going to pay for it and we’re trying to change that narrative.

Oh, I love it. I love that. Wow. So, let’s go back. You, you switch from sports marketing into the career of healthcare. How do you make that shift? Yeah. Tell me a little bit about that story.

Well, I have two older brothers who were professional athletes writing for a high school kid and for college kid, that’s quite a bit of pressure. And of course, I had the same goals, grew up in a sports house, but somewhere around my senior year in high school I’d realized that, but what God had blessed me in many ways that being a professional athlete wasn’t going to be one of them. So, I set my sights on working in sports, professional sports hopefully.  So, went to college, got a master’s degree within about a year. And getting out of college I had already worked in some way, shape or form for all four major sports professional groups in America had worked for PGA tour events. I was really living the dream I was able to, to work for, and do some marketing for some really famous baseball players and things like that.

And it was actually  on the way home on a private jet, the only time I’ve ever been on a private jet, my life back from immediate tour in New York with a really famous baseball player at the time; where I looked at my wife and we’d only been married a week or so at that time. And I said, wow, this is amazing, I’m 26 years old, and I’m living my career But just that one week of marriage helped me understand that my perspectives were changing, my views were changing, and I really had, It had dawned upon me that I wanted to get into an industry where I could make more of a difference, have more of a purpose, and maybe a social mission. And I wasn’t sure what that was. I just asked my young wife to, to support me in that process. And she did. And within a few months, my grandmother was going through, the aging process and it was really frustrating me.

And I heard one of my students at the university I was teaching at, came up to me and said, Hey, I’ve heard you talk about wanting a career change. I’ve heard you talk about your grandmother and the frustration with her inability to access basic health care and the lack of communication between her caretakers and we have an opening in my healthcare facility and I think you’d be perfect for it. And that really got the ball rolling. And I made a switch to healthcare. A few weeks later and within a few years, five years, I think I became a hospital CEO at age 32 was a real blessing.

So, you’re saying you became super passionate about the healthcare industry. And you switched over because it really hit home for you?

Absolutely, yeah. It was personal

Can you tell me a bit about the story, could you share that story?

Yeah. So yeah, so my grandmother basically, you know, I moved away with my wife and we got married, were from southern California and we moved up to a Nevada Northern Nevada, the Reno area. I was getting my PhD at the time and my grandmother who had been close to my whole life who lived in the neighborhood, you know, grandpa had passed away and she was going from an assisted living to a nursing home, to the hospital to some other facility that I never heard of called the and then back home with home care. And it’s amazing that when I called the caretakers they would make comments like, well, she’s only been here two days. We don’t even have her chart yet.

Or, I don’t know where she’s at. She went to the hospital four days ago, but they said she’s not there anymore and I just, it blew me away. The person responsible for my grandmother’s care was making comments like this. And this is of course, back when I was just a sports marketer. And so, as I found myself in healthcare just a few years later, what I learned is this is normal and it’s unfortunate and it’s scary and the motivations of the healthcare delivery model, physicians and hospitals are to put ahead in a bad. That’s how they get paid. It’s called fee for service. And so, I asked a lot of questions, is a 32-year-old CEO and I never stopped asking those questions. And a lot of people would say I’m, I’m now an industry truth teller. After 10 years as a CEO, I expose the underbelly of the hospital and healthcare system.

But I’ll tell you what happened in January of 2018, about two weeks after my book “Health Wealth.." And here’s a copy of what my book looks like. If you haven’t seen it, it’s called “Health Wealth: is healthcare bankrupting your business, Nine Steps to Financial Recovery. It hit number one on Amazon on launch day. But here’s what happened with him two weeks. Amazon, Berkshire hath away and JP Morgan-Chase announced they are blowing up their insurance company, getting rid of it and starting over and doing their own thing. Guests where that concept is introduced right here. And I’m not saying I came up with it. What I’m saying is, folks, if we’re going to end this epidemic, this healthcare affordability epidemic in America, we have to start over. It’s a system broken beyond repair. No coincidence. That’s the name of one of the chapters in the book system, broken beyond repair as a result of the, of greed.

Who are the villains of greed was capitalism and people who want to make money. It’s people like me who used to be a hospital CEO. It’s big Pharma. It’s doctors and you know, they didn’t get into it to be villains of greed. That’s just what, the product that resulted as a result of the fee for service model. So, that really explains my whole has become personal. Let me close that answer with this stat. Recent projections show that between 40 and 50 percent of the millennials, lifetime earnings in America will go to healthcare. That’s tragic. There is no other way to describe this personal for me. My kids, my kids are Gen Z, they’re not even millennial, so, so I can only imagine that’s going to jump over 50 percent unless we do something about it for the Gen Z’s

What are three tips to give our audience on saving thousands annually on health care?

Great question, Rachel. And what you’re doing is you’re teeing up my next book which comes out in September, called “Is Health Healthcare Bankrupting Your Family?." So that’s the question. And guess what the first sentence of that book is going to say? Are you an EHC (an engaged healthcare consumer). When you buy a car, you shop the car, you shopped the model shop, you shop the price. When you buy a home, you shut the neighborhood price, quality number of bedrooms, right? So, why don’t you do that with healthcare? Well, I’ll tell you why it’s six words that killed American healthcare in those six words of this, don’t worry, your insurance will pay for it. Well, your insurance might pay for it, right then, but next year you’re a company comes to you and says, Hey, we raise your rates, and then the 300 bucks, you did pay for it by choosing the more expensive hospital.

And hospitals have always been able to get away with not being transparent and until we become EHC’s they will continue to not be transplanted. Did you know, they don’t even share their prices with you? They say things like, oh, don’t worry, your insurance will pay for it because that way they can raise raising prices and you’ll never know. So, let me answer your question. Three steps that you as an individual can do to save yourself thousands. OK? So, the first one is, really you become an EHC by doing three things.

The three P’s. You have a plan. It’s the plan based on personalized medicine and based on preventative medicine. So, let’s be more specific than that. Medical tourism, that sounds like, oh, I read about that. You’ve got to get those to recur. And so no, it’s not a can you go to India? Costa Rica and save a bunch and the and the doctors are actually Americans that it’s literally you’re saving 80 percent, but it still sounds pretty crazy, right?

Great Quality. You can go there if you want. But, that’s not medical tourism today. Today is you drive an extra half hour and you can save 60 percent. Your employer might save 80 percent. You will save 60 percent. A little tip for your listeners on point number one, I’m saving thousands. When you choose a center of excellence, a hospital or a surgery center or a physician who is a center of excellence in your company’s network. When you choose that center of excellence over one of the bigger shiny or ones that isn’t a center of excellent, go to your human resources director and say, Hey, if I pick this center of excellence and drive the extra 30 minutes, will you pay my thousand-dollar copay? Do you know why they’re going to say yes to that because it’s going to save them $30,000. That’s a net of $29,000 gain for them saying, yeah, we’ll give you a thousand bucks to do it.

So that’s number one, medical tourism is local, it’s county to county and the average, and I’m going to give props to my colleague David Contorno, who was on my podcast, the Health Wealth Podcast. OK, David said his data shows that the average distance you have to drive to find a center of excellence is only 35 miles. What cash we Drive farther than that to get to work every day, right? About 35 miles. So, number one is become a medical tourist within your city, within your county. Understand it’s only a half hour drive. That’s number one.

Number two is really telehealth and remote monitoring, which is this, you can do a doctor’s appointment from your living room and if you’re a mom with children, think about this for a minute. School age children, instead of having to run to the school, run one home, keep them away from the others. in case they’re contagious, get an appointment, wait all day to get the appointment. Cancel your plans.

No, no, no. That’s how it worked as a young Gen X. So when my mom was trying to get me to the doctor nowadays a, your son wakes up, ill, you go on your phone app and you say, Hey, I need a tele-health consult soon as possible. Within 20 minutes you and your center sitting on your couch talking to a physician asking you questions, using the technology to show, show me his throat, show me his nose, now show me his ears, whatever it is, OK? And you have a prescription waiting for you at the pharmacy. Twenty minutes later I will tell you I’m being GenXers and even some of the, Xcenials or millennials, whichever you are, it took us a little time to get used to this concept with the first time you do it, you will go, why would I ever go to a doctor again without doing this from my couch for 20 minutes?

 Right, right exactly.

 Makes sense.

So those are two tactics that, that really every, every American can do. And I will tell you, I’m becoming an EHC and engaging in the process. Medical tourism, those are a couple of things. You can do. Telehealth and remote monitoring.

And here’s number three. And this is a fun one. DNA testing now hold on. Don’t go away I read about 23andMe about 10 years ago. Well that was 10 years ago way head of the game. 23andMe would probably be the first to tell you that they created a huge PR issue for themselves and everybody. But DNA testing is real. You take a cotton swab, you put it in your mouth and they send you your results. That say, here are the medications that work on Josh, and here are the ones that don’t here are the dosages he should take. Here are the ones he should never take it’s called pharmacogenetics.

It’s real and it’s here and it’s live. But the only way doctors will do this, because the technology between the hospital, the nursing home, your doctor, the pharmacy isn’t there. They don’t all communicate. They all have their own agenda still

I know and it’s really bizarre especially in this informational age, this should NOT be happening.

So own it that’s the whole point. You get the DNA test, you take a picture of it, you put it on your phone everywhere you go, say, no, don’t prescribe me that doc. Here’s what works for me because now you’re owning it and they’re going to hey, cool, good for you because nobody else does that. You can also do that with.

 I’ll be honest with you. Some of the we’ll say, cool, good for you. But some doctors, they want full control. And I can tell you this, for my mom I take my mom to the doctor, and she never gets sick. But they to give her this shot have given a they want to give her the flu shot. They want to give her this, that and the other. And she’s like, I don’t need that. I don’t get the flu. I don’t need it. And she knows her body. She really understands the body. Never really taken medication and you don’t want it is the biggest fight. Every time she goes to the doctor because the doctor wants to put her on all kinds of medicine. Right. Give her all kinds of injections and you know, the reality is, and they don’t even really look at you. So, they don’t really look at you and they’re not as embracing as we’d all like to think.

Yes, you’re a widget. The fee for service, free for all.

I went to the doctor, this was last year, with my mom and my mom was like, you know my knee hurt. My mom had hit her knee, and she (the doctor) was like, OK, I’m giving you a prescription, it without even looking at her, OK, I’m giving you a prescription for arthritis. You have arthritis! My mom was like, you haven’t even looked at me how do you know that I have arthritis? You see, the doctor said, well, at your age you have to have arthritis. And my mom is like, no, I don’t have to have arthritis. I take very good care of myself. I bumped my knee and I would just like you to take a look at it. but if that’s too much that you don’t bother, don’t even bother to write the script either because I’m not taking it. So that’s a battle. That’s a real battle and it’s not always, well doctors are not always as warm and fuzzy as they would like to think they are.

And you have made the perfect point for me Dr. Nilda. My whole book, we’re going to go right back to the first thing I said before I answered the three points. You know, just become an EHC. The only way that we change American healthcare that we change physician hospital behavior is by creating competition by saying, this is my DNA makeup. You know it’s science better than me. These are the medications you will prescribe me, or I will go to another doctor and that that’s true across the board, just owning it and really owning that process. So, it’s. It’s a really exciting time because nutrigenetics is the same. The technology is not as advanced, but they can point out and say, hey, here are the foods that are fuels for your body. Here are the foods, foods that are blockers, and I’m not going to tell you that nutrigenetics is advanced as pharmacogenetics is yet, but it’s almost there and there’s nothing lost. If you go ahead and start playing the nutrigenetics give based on your DNA makeup.

Now, let me ask you something. Is that something that you. You have to pay out of pocket because I know that’s another issue for a lot of, the audiences are paying so much out of pocket. They’re already paying a lot for healthcare and you know, they have these high deductibles and things like that. So, is it something that we should take on, on our own? Which I think it would either way we would benefit from, but we have to pay for something like this on our own or would our insurance pay for it because I know that insurance refuses to pay for a lot of things that are actually good for us.

That’s a great question Rachel, so There’s a complicated answer. Most insurances still don’t pay for it, but through your healthcare savings account you can pay for it and I want to make sure I’m not directing people to 23andMe. Because I’m certainly not here to advocate for one company or the other, they do DNA testing, what’s also known as a partial gene sequence and there’s full gene-sequencing and I know that’s real technical, but gene-sequencing can range from $600 to $1,200. And I’m glad you asked that question because you know what my book recommends. It recommends that after a year on the job, your employer pays for this for you because it’s going to bring your costs down as well as the employer’s cost down and it’s going to ultimately make you healthier, which is the overall goal. So, we talked about the cost. We talked about access. There are ways you can pay for it and also if you live in Nevada, if you live in Pennsylvania, if you live in Texas, those are three areas where I know they have a gene-sequencing pilots going Renowned Health and Reno, a Geisinger Health in Pennsylvania and down in Texas they have a pilot project and I’m sure there’s many more, but these are hospitals that had to champion the effort because they have physicians and CEOs had enough of this. We need to get our communities healthy. They did voluntary programs where people could volunteer to get their DNA test done and all of them, quote unquote sold-out within hours because there’s a thirst and a hunger for this. And I’ll tell you, I am going to take this opportunity to get some off my chest that, that I’m so tired of hearing it was true in Boomers. Gen X, it might be a little true, but I can tell you that with the millennials, it’s not. You always hear this. Oh, I don’t want my employer to know about my health that I used to hear that a lot with Boomers and Gen-Xers. I’m sorry. That’s just silly. In the day and age of HIPPA, your employer is not allowed to know anything about you that you don’t share them when they contract to do an anti DNA test it with a third-party provider and they’re violating the law if they know. So, let’s just get past ourselves and get over ourselves and understand that when our company is offering us these benefits and they almost always start as voluntary because that’s how that more so because we need to wrap our brain around it, right? So, let’s move past that whole privacy thing because federal law requires that remains. It’s private.

So, here’s my question. How, how do you propose that somebody who is either a solopreneur, which a lot if my audience are solopreneurs or small, very small business, how you proposed that they handle this because they don’t have an HR department. They are the HR department, you know, they wear all the hats. So how do you propose they handle their healthcare? Cause I’ve had people, again, we talk all the time and the biggest problem is that their deductibles, you pay higher rates to have health and the deductibles are impossible to meet. I’ll let you die if you’re dying, you can’t work. How does that work for those people?

So at Health-Wealth.com which is my website, you can find me on Linkedin and Dr. Josh Luke, or you can go to help desk  at Health-Wealth.com and what we did at Helpdesk at Health-Wealth.com is even though Forbes published my book and it’s really a real resource for mid-market and fortune 500 companies as you’ve already pointed out, we didn’t want to leave out the solopreneur and on the entrepreneurs on the website there’s free resources that she can do a loss assessment for your company that really is just a 10 minute or less 10 questions to tell us what you’ve done and we’ll tell you how much money or what I call a wasteful healthcare spending, which you’re kind of just thrown into the wind because you’re not doing it better. So, there’s free resources there. You can also, that’s where one of the place where you can access the book, if not Amazon.com. But there’s also a series of partners on there that I have.

I’m not a consultant other than I come in and I helped do the evaluation and I’m kind of a matchmaker for programs that work for you. I think of the short answer to your question is read the book Health Wealth because there’s enough in there for entrepreneurs to understand. One chapter talks about alternative insurance options and one thing that the Trump administration has done is they’ve gotten rid of the individual mandate to have health insurance through Obamacare brought forward. OK, so now that opens up the door for you to be more creative because you’re not being forced to pick one. You get the choice to pick one. And I’m actually excited about that because that combined with insurance crossing state lines is really going to create competition. And what you’re going to find is products that are catered more to this Solopreneur and the entrepreneur as opposed to just cookie cutter play by our rules, which has been in the past.

So a lot of this stuff, there’s several chapters in Health Wealth is Healthcare Bankrupting Your Business that really appeals to the entrepreneur and the solopreneur about living healthy, about consum