Government Can’t Fix Healthcare

Why is the government so bad at healthcare? They’ve been at it for seventy-five years
and still can’t get it right. It’s expensive. Access is spotty. It’s mired in bureaucracy. And it’s fraught with waste. Obamacare was supposed to fix all this, but
instead, like every other government healthcare program before it, it just made things worse. Why? Because the government is a third-party payer. Let me explain. Suppose you are going to buy something for
yourself. You have two priorities: price and quality. You want the highest quality for the lowest
possible price. Say you’re buying a television. You have many options: the size of the screen,
the quality of the image, the price. Only you know which one best suits your needs
and your budget. And a lot of companies are competing for your
business. You do your research; you make your choice. This is called a first-party purchase – the
person paying is the person using. Now, let’s suppose that either the price
or quality is not controlled by you; in this case, you are buying something for someone
else. You care about the price because you are paying
for it, but you are a little more flexible on the quality. A good example would be a wedding gift – say,
a coffee maker. You might think, by the time it breaks they’ll
forget who gave it to them anyway… the cheaper one will be fine. All of us have bought things for others we
never would have bought for ourselves. We care about the price because we’re paying
for it, but not so much about the quality because we’re not going to use it. Or, suppose that we’re going to use something,
but we’re not going to pay for it. Then we’re concerned about the quality because
we’re consuming it, but the cost is not as important because we’re not paying for
it. Any father who ever got roped into paying
for an open bar at a wedding understands this program. Nobody ever orders the cheap stuff when it’s
free. These are called second-party purchases. The person paying is not the person using. And now, for the coup de grace: when it is
not your money paying for something, AND you don’t use it. Then you’re not concerned about either the
price or the quality. Suppose the boss gives you $150 to buy a door
prize for the office party. In a store window, you see a six-foot tall
stuffed frog marked $149.00 You think, Oh, that’s perfect – let’s buy it. The raffle winner is awarded the six-foot
frog. Everyone laughs at the gag. Now, this is called a third-party purchase
– a purchase that is made with money that is not yours (therefore you don’t care about
the cost) to buy something you’re not going to consume (therefore you don’t care about
the quality). Here’s the point: By definition, all government
purchases are third-party purchases. The government spends other people’s money
on things it won’t consume. It doesn’t care about the price or the quality. Thus, there will always be waste in government
spending. That is why, to paraphrase Abraham Lincoln,
government should do only those things that a man can’t do better for himself. If 300 million Americans were free to buy
health insurance for themselves, just as they buy their own life and home and car insurance,
then that little gecko on television would offer us health insurance with a little more
coverage for a little less cost. And he wouldn’t be the only one. Insurance companies and hospitals would be
working night and day to get our business. Quality would go up, and prices would go down. It’s already happened with laser eye surgery. It used to cost $2,200 per eye. Now it can cost as low as $500 per eye. That’s the way free enterprise competition
works…every time. But when the government gets involved, costs
go up, waste and fraud go up, essential medical services are denied or unavailable. These are the hallmarks of government healthcare
bureaucracies around the globe. The sooner we make health insurance a first-party
purchase again, the sooner Americans will get the health care they want…finally. I’m Bob McEwen for Prager University.

  1. Honestly I dont know which way is best. But, I do know that many people abuse the healthcare system. Most 911 ambulance calls are used by people who need something minor and know it's cheaper than going to their doctor.

    This should be penalized if this service is abused. I dont want to deny a dying person medical attention, but I also dont want to allow a person to abuse the system because they dont want to pay as much money.

  2. The Sig Sauer P320 is another example of this.

    The idiots that write the check, won’t be using it.

    They paid the cheapest price anyone offered. Even though it wasn’t a quality option and didn’t win the competition.

    Glock was the best choice available. But price was a bit more. But of course the government doesn’t care.

    Instead, the people using the handgun should have been able to test different options and look at price and decide what works for them. Oh well.

    Government thinks they know best and it fails.

  3. Universal Health care is not a crazy idea! Most Western Countries have this, including Japan which has over 100 million people!


  5. i want muscle massage. my health care is only one avaliable in this state and costs me 400 per month and wont cover massage. gov says its mandatory that i pay. even though i must pay for chinese massage at the mall

  6. Why does it perfectly work in france then ? (i'm french)
    Why does it perfectly work in sweden then ? (the guy next to me is swedish)

  7. Thats why socialism doesn’t work, its a third party! The government isn’t efficient, but thats the whole permiss of capitalism, and why it works!

  8. Life is a right. Healthcare is a business.
    Rare and serious, life-threatening diseases should be covered, on the basis that it's for the protection of a human life. But as soon as someone gets a cold and goes to the doctor and government funded healthcare is involved, that's when things blow up and get expensive. That's when taxpayers are ripped off.
    Private healthcare companies are best at covering those.
    Rare and life-threatening illnesses which would cost thousands to treat, should be covered through government funding, since that's not an everyday occurrence in which one can pay out of their own pocket.

  9. 9/15/18…..Great explanation of GOVT/3rd party paying & screwing
    up healthcare/health insurance.
    FREE ENTERPRISE & GOVT just can't/won't co-exist!

  10. Why then do countries with universal single-payer healthcare do better economically and socially than those without? I’m sorry to say but the United States is tumbling in terms of social economics (economics that affect regular people, including those who don’t work). The reason why healthcare wasn’t a problem in America before was because prices were cheaper and people had higher wages. Companies actually helped their employees get healthcare. Today, this isn’t happening. Also, the vast majority of developed countries have universal healthcare, so why can’t America.

  11. My question is that without any government-provided healthcare, what will happen to those who cannot afford private healthcare for whatever reason (specifically those in extreme poverty or jobless/homeless, not those with smaller jobs such as retail wherein they could actually afford healthcare because it would be so much cheaper). This is not a rebuttal or anything, just a genuine question for either PragerU or any person willing to respond.

  12. This is happening in my country Indonesia right now, the universal health insurance is in huge debts and the government needs to pour out more money to cover it.

  13. Now that the penalty is gone it frees up all Americans to at least look at options outside the exchange. There are plans from very basic to fully comprehensive. Even those catastrophic plans that "don't exist" are available. There also private options that cover preexisting conditions. And most of them use Nationwide PPO networks that doctors actually accept. Sure there are cases when the ACA is a great fit but, for most people there are other options that may better fit their need and budget.

  14. The Cap on social security needs to be Eliminated to require richer people to pay more $ into the system than middle class folks.

  15. To people that says that socialized medicine works in other countries….

    Does it mean anything if it results in waiting weeks if not months to see a specialist? Not to mention that even if someone has a heart attack or any life threatening emergency, most hospitals over there will take about 30 mins to a hour to even get to the critically ill patient, which by then it’s already too late. I have numerous friends that live in a single payer system countries and they tell me that it takes forever to even get seen and that vulnerable people are dropped dead while they await for immediate medical attention.

    So yes, socialized medicine is great politics as most people are happy that they don’t have to pay for insurance, but at a grave cost as emergency patients can’t get immediate medical attention due to overcrowding of their hospitals and over utilization of their most basic services.

  16. ohhhh it get so much worse than this. I live in Australia and we have 2 system health care, a quality private system that some people pay for and a public system everyone pays for. Problem with this is good quality doctors work for the private system, where they can charge more per patient, customers demand more time because they have private insurance meaning doctors see less patients leading to a doctor shortage on the public side, the government then panics and starts importing "doctors" from the 2nd and 3rd world. These "doctors" work out that they can milk the system by turnstyling patients, costing taxpayers billions, of course, they don't care, not their country.

    Then the government uses this for an excuse for more immigration, "we need to fix the doctor shortage" and instead end up importing hundreds of thousands of people that mainly end up taking working class jobs and welfare checks, a lot of them both. The Bernie Bros are wrong, Australia isn't a good model of public health care.

  17. Bob McEwen doesn't seem to understand the problem government health care programs seek to address, namely that the poor and the dumb will not be able or willing to buy sufficient health insurance if left to their own devices, and will therefore end up unethically less healthy than their more fortunate brethren. We know this will happen, because it is the way it was a hundred years ago, and it is the way it is in countries that don't offer sufficient government programs.

    If everyone were like Bob, that wouldn't happen, but the fact is that we're not and not addressing that problem will not make it go away. So you can privatize the whole health sector, but you will then inevitably be confronted with more sick people in the streets, outbreaks of infectious diseases, and lower life expectancy. Hey, it's like I'm describing the US in comparison to industrialized countries that do have decent government health care plans! I wonder why that would be…

    Bob then conflates two separate issues. There may be a functioning market for health care insurance, but there isn't for a large portion of the health care sector itself. For elective procedures like breast implants and eye laser surgery, there is a market, and privatization may work. But there is no functioning market for emergency care or stuff like that. Privatizing those functions will lead to less health care being available in lower income and low population areas, and to more suffering and lower life expectancy. If you are from a rural area, you may have to get in your car and drive two hours if you break your leg, even though your own town may have a laser eye clinic and there's a breast implant guy next to the truck stop on the highway…

  18. The US system of healthcare is a mess.

    In the UK whenever some idiot suggests ending the NHS the media, public and sensible people point at the nightmare healthcare system (based on profits before people's health) and everybody realises just how lucky the UK is to have the NHS.

  19. That's why the United States is so regressive. Because they're the only country in the world that don't have a public healthcare system and they're the only ones who still do not adopt the metric system. That's why people became so stupid … they don't even know how big is 1 ft !!! They still measure ingredients with teaspoons !!!

  20. You call this a university? This is just a right-wing ideolog who beliefs the free market is the answer to everything.

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  22. I'd usually agree with free-market solutions, but there are several problems with such market-based solutions in this field:

    1.) You can't always pick a hospital. The core of free market capitalism's ability to drive costs down relies on competition and choice. A business must have competition. Unfortunately, this is usually impossible in small towns — there is only one hospital per town, and many people cannot afford to drive to neighboring towns for treatment.

    2.) Building off of point #1, there is no choice for the end user. Capitalism requires choice on both ends. The ambulance takes you to the nearest hospital, not the best-priced or highest-quality hospital. In effect, even if we make the system "1st part payer" as you suggest, it will always act more or less as though it's a second-party or third-party system.

    3.) The power of the medical lobby has grown too strong to revert the system to a more end-user-friendly format. Originally it may have been a better idea to keep government out of the medical industry, but now that Pandora's Box has been opened, it's virtually impossible to close the demons back in it. The only realistic options available to us now are "status quo," or "state-run healthcare."

    All of this said, I think a good first step we need to work towards is lowering the cost of entry into the medical field tremendously (just the financial cost, not the amount of work necessary to succeed). As it stands, becoming a doctor is only an option open to a very small percentage of the wealthy population. The industry collectively knows that no matter what there will always be a high demand, and as such they are artificially limiting the supply in order to guarantee higher doctors fees for those doctors who do work.

    Another step we should take (in conjunction with the above) is pushing for federal de-regulation and modification of state codes to allow and encourage "healthcare clinics" to offer basic general practicioner services, with cities and local jurisdictions being responsible for puchasing maintaining certain expensive equipment open to scheduling/use by clinics for a small fee/tax to cover costs.

    Finally, I think that either local, state, or the federal government should offer "disaster insurance" to cover unexpected, unusual, or expensive medical treatments for the majority of people. This would basically replace Medicaid/Medicare in function, and would cost less in the long-run as the influx of new doctors and nurses created by the forcible removal of artificial barriers to entry in the field causes doctors to compete more for patients and drive fees down.

    That's my naive approach, anyway. Any commentary?

  23. This whole video used basic concepts to talk about a complex system. It ignored the fact that people cant afford it at this point and didn't explain how cost is increased by any means.

  24. Private investment is unethical. They realise that they can make more profit by keeping you sick longer. At least the government has some degree of ethics in the decisions it makes.

  25. It's very bad example with TV buying.

    Low and fair price you can get only when there is enough competition and oversupply. Medical market is complicated system.

    Explain me how you can create enough competition and oversupply in small town, how it suppose to work based on your example with TV?

    Small towns need 1 hospital, 1 emergency room, 1 urgent care -> this Monopoly can demand any price for services. The only solution to provide/control fair price is single payer system.

  26. Why is it we find it so much easier to bail out banks or endlessly fund a military than to bail out people? Jealously? Envy? Greed? So ready to bail out a bank that took back and lost money on millions of bad home mortgages that they issued, yet unwilling to give back the homes back to the people. So in the end the bank gets to keep the home AND the bail out money?? Truly mind boggling.

  27. Back in New Zealand, we have free public healthcare and it's well funded, we are paying for it (via taxes) so we do care about it and our public healthcare is on par with that of Australia or Sweden.

  28. Even before obamacare, the level of regulation on health insurance companies was pretty heavy. Competition was limited at the state level by limiting how many companies could offer plans in that state, coverages the plans had to offer, etc.

    So if the talking gecko was offering affordable medical plans and forging good relationships with medical providers in Ohio, West Virginia, and Maryland, the blue plus sign could go to the Pennsylvania bureaucracy and argue that the plans the gecko wants to offer in Pennsylvania are sub-par because they don't include this or that little-used benefit, or are too cheap to be effective, buy a few people a weekend in Atlantic City, and the talking gecko won't be allowed into Pennsylvania.

  29. Too much free cash coming into the govt for any real change to happen. Especially when you make giving up this cash the law…

    When he said “waste and fraud” all I heard was “most people lining their pockets with your money” and we get next to nothing in return.

  30. In india the govt healthcare is very good in terms of quality of healthcare.A doctor from a govt medical college is much better than from a private medical college.But the problem is govt hospitals are less maintained and they have so much rush so each patient gets very less doctor's time.Otoh private hospitals are good looking and maintained and they give time to patients but charge too much .Hence the rich go to private hospitals and the poor to the govt hospitals.For a country like india with so many people below poverty , govt can't let go the healthcare coz a large population is dependent on them

  31. Right Wing Nonsense Alert thanks to Obama care my premiums have come way down and I don't have to worry about a insurance company kicking me off if I get sick Bernie Sanders for President

  32. The last line really sums up the problem with the rights idea of health care. "Americans will get the helath care they want" is true for some (ignoring the possibility of companys agreeing to raise cost across the board) but many will still lack the funds needed to pay for healthcare and would become bankrupt, or even die.

  33. For people who claim to know a lot about economics you don't seem to know a lot about what price elasticity is…

  34. What Is God’s Kingdom?

    What Will God’s Kingdom Accomplish?

  35. Healthcare is a very tricky issue, I think it’s very easy to point the finger at Europe and claim that single payer healthcare is obviously better. But remember quality of care in any single payer system sucks. You can’t have a dual system either because it inevitably leads to rich people getting the best quality care while the poor get crappy state run “conveyor belt” healthcare. When you have a serious health problem you want the best money can buy and your doctor needs to understand your personal needs.

    Also remember that health insurance is meant for catastrophes, not everyday use. If you payed for healthcare upfront it would be much cheaper, hospitals only charge so much because they know insurance will cover the cost. The same with drugs, they are not really that expensive, the reason epipens cost so much is because the company lobbied for exclusive rights to it. When you open up a drug to the free market prices go down, thats what happened with viagra.

    The best way to solve rising healthcare costs is to get rid of unnecessary regulations. We also need to fight lobbyists they create crony capitalism that destroys competition. Its not an easy subject and I can understand why people think a public option is the solution.

  36. I support Medicare for everyone and how to pay for it charge a sliding scale fee from 0 and up also allow Medicare to negotiate drug prices shut down Medicaid and veterans health care no sense in the federal government funding all these different health care programs and use all that money to make Medicare for everyone stronger allow health insurance companies to sale Medicare gap policies to anyone who wants them if that's needed I think this would be a great start understand we are already paying health care costs for everyone in one way or another thank you very much

  37. Thank God I live in America. Last year I had excruciating pain in my head and my doctor suggested MRI with contrast. I called to set my MRI appointment and I was free to choose when, soonest or later. When I arrived in the hospital, there were only 3 of us. No long line and I had my MRI just 5 minutes after filing forms. So fast, the quality is good. Yes, I payed for it with the help of my insurance, but I was treated immediately.

    Quality of everything.

  38. "To keep our videos free…" I thought Youtube didn't charge you anything to host your videos. Are you paying these people, who are usually college professors (except this guy who is paid by us), to make videos that are based on their lectures, that they're already paid to give?

  39. I'm sorry, but Bernie Sanders is simply wrong. Canada does NOT have a good healthcare system. People are dying waiting in line for surgery there because there aren't enough surgeons because the government's control has taken away all incentives to become a surgeon!

  40. The problem with it is that people expect Cadillac brand healthcare at the most minimum rate… which is not feasible without paying up some considerable dough

  41. rich old men asking for more money at the end of the video when theyre backed by billionaires , that 500 dollar lasik is for simple procedures, its still 2000 $ an eye i just had it done

  42. I have one huge problem with the free choice of either paying or not paying a health insurance. Suppose you have the bad luck to get lung cancer even though you stopped smoking a few years ago. Surgeries are expensive, and your insurance denies you the payback because you USED to smoke. That's just one example among many others.
    Another problem I have is this: what happens if the consumer gets involved in an accident where he can't work for the rest of his life and therefore not pay anymore for insurance? Sure the insurance company might pay the bills for the surgeries, but will they offer him the aid that person needs for the rest of his life?
    Also what would happen if the insurance company goes bankrupt?
    Or worse, what if an insurance company / hospital company gets the monopole of the entire country?
    A suggestion I have is that health care insurance companies should be private to create competition and therefore more quality for cheaper prices, BUT they need to follow certain rules of ethic to avoid the above mentioned problems. I mean we are talking about people's health, not products. I would also push a law to force people to choose from at least one insurance company, because I strongly believe that one shouldn't make savings at the cost of his own health.

  43. Health insurance should be just like any other insurances. People should choose it and not delegate this responsibility to the government.
    Free market competition is always good for the consumers. It drives down the costs and raises the quality.
    The government should only take care 2 aspects of a society: Arbitration and defense anything else is a waste of resources and prone to hijacked it's citizens freedoms and rights.
    America was founded based on 3 cores values: Judeo-Christian morals, limited government and free market. Has worked wonders for the past couple of centuries and should not be changed.

  44. I actually agree that health insurance should be like auto insurance, where only serious healthcare issues utilize insurance and preventative care is paid out of pocket. My only concern are the people who are dead broke, living on the streets and have absolutely nothing. I have spent time thinking & thinking it over and the only solution I can come up with is , as much as we don’t like it, middle and upper class would have to pay a tax fee to cover these people. I’m not a fan of me having my hard earned money taxed to give it to someone who doesn’t work at all. But whatever the circumstance of an individual poor person, I don’t think our country as whole would have a good image if we allow people to die simply for not being able to afford health insurance or even simple preventative health care.
    I don’t want to make it a “gotcha” thing, I’m seriously interested if anyone has come up with a better solution to this.

  45. BS.

    I want Prager or someone else to tell me what is wrong with, let’s say, Danish health care. And don’t bring up annoying principles like in this video, which is far from the truth, considering most of Northern Europe health care. And don’t bring up ideology or theory. We have everything in practice to analyze from anyway.

    Which works better? Well, here obviously. Health care is not even debated here! We love it and feel pride paying our taxes to keep us all safe, without receiving bills that are not a good representation of a free medical market. The pharma industry is highly corrupt in America and the bills people get for treatment is insane.

    Every medicine we can buy or get from prescription is quality tested and nothing below high quality is allowed to be sold here. As soon as government would even consider making cuts in health care, there would be a public outrage.

    So, Americans, I agree on your free market preaching, just not in this dumb discussion.

  46. Mister McEwen, i have a couple of questions for you. One, do you really understand the mechanics of healthcare and politics? If so, then why are you saying that goverment can't do squat about healthcare, except to let the private sector, which is only concern by making a profit, have their way with it? Second, if the goverment is a third party, and therefore, does not consume something that has not been paid by their money, then where are they getting their healthcare from? Thirdly, if the goverment is incapable of providing healthcare, then why have other countries, like Canada, England, France, Russia, Germany, Cuba, and so on, have taken the folly of instituting public universal healthcare, at the risk of getting a low quality healthcare? Four, despite the dangers, this countries, despite having problems with their systems, have created a well funded, good quality, access for all towards healthcare. I should know because i live in one of these countries. That's right, i am a Quebecois, and my province has it's own public healthcare system (a province that can provide it's own heathcare, with little help from Ottawa, could you imagine that?). Could you explain to me how is this possible? Question five, by saying that the goverment is like the guy thats buys something of low quality for someone else, and therefore, is someone that dosen't care what it's buying, and therefore, dosen't give a shit for the people that is receiving the thing of low quality, then why are you Americans even bothering having a goverment? Why not just do away with it, and let the private sector take over everything, not just healthcare, but education, justice, the army, the roads, etc… if you believe that they would do a way better job then the public sector? Fifth question, you gave a quote from Abraham Lincoln that says: the goverment should only take care of things that the individual can't do better for himself. What does that imply? Where do you draw the line between the individual and the goverment? What if i was a struggling middle class american, with a low paying job, and i couldn't get a higher education because i couldn't afford it, and i can't find anything better, and therefore, i can't afford healthcare, or even insurance? And it's not just me. Their are millions, if not tens of millions of Americans that live without insurance, or poor insurance that don't do much for them when they have a health crisis, like a heart attack, cancer or a broken leg. They dindn't choose to live without insurance, they don't have a choice. Should the goverment do something about that, or should they just ignore it, like a third party person would? And finally, if the goverment really can't do squat about healthcare, then why am i living in Canada, with a goverment control healthcare, when i should be living in the United states?

  47. All that smug, condescending, lying prick said was "I know you're stupid and ignorant, so I'm going to pray on that to get you to support policies that keep me rich, and you stupid." How his false equivalencies, and deliberate misrepresentations are not immediately transparent to you all is troubling.

  48. Let's create free health care for all. Like in Europe. Cheaper, less lobbying and everyone has excess to it.

  49. What about sick people? When u are a bad driver, auto companies drop you. So if u have a chronic condition, medical companies can drop you?

  50. It this were true why would the most privatized healthcare system in the world be also the most expensive in the world?

  51. Current health care is mired by too much administration and too little service (ie: HCProcedureCodingSystem and PBenefitManagers)—there is definitely huge flaws with the current system. However, any solutions proposed by policymakers should have a 'sunset clause'.

  52. My LASIK was the best experience ever. I paid once and all my pre and post op appointments, meds and surgery were included in that one price. Very little administrative cost!

  53. Simplistic market mechanisms don't work for healthcare for a number of well known reasons. 1. People are unable to to analyze and compare the service options available because not everyone has medical training. 2. As an individual in need of care, your own desperation eliminates consumer leverage at the individual level. 3. There are relatively few providers, and they collude on prices to drive up profits. As proof, of the effectiveness of free markets, you point to LASIK, but look at the price of insulin. It's an example in direct contradiction to your LASIK example. LASIK is elective, insulin is not. Therefore the consumer MUST buy the product regardlesss of the cost, and the few producers conspire to keep prices increases. Therefore, the price of insulin keeps going up even though its a very old drug that is off patent.

    I would love to see a functional free market that can deliver affordable healthcare, but no nation has succeeded in doing so for the above reasons. They all decided that the only way to avoid these problems was to nationalize it to at least some degree, and it has been demonstrated to work quite well. The US spends about %18 of GDP on healthcare, even without universal coverage, which is almost double what the rest of the industrialized world spends. The next most expensive is only 12%, and all of the rest of the world uses some form of government-run program.

    In the case of healthcare, government doesn't create fraud, government involvement reduces fraud. Just look at the prices paid by Medicare vs what you or I would pay in the "free" market. For example, one provider in Montana charged an individual $14 thousand dollars for a session of dialysis, when the same treatment was provided to people on medicare for $250.

  54. Lol, people actually buy into this? There is no such thing as free enterprise in nonelective healthcare. People will pay anything to not die or lose a loved one, thus no one has to compete for the “consumer”.
    Yeah free enterprise works with laser eye surgery and plastic surgery. Because their consumer base is smaller and people have time to shop around.
    You don’t start looking for the hospital with the best prices while you’re having a heart attack, or ask them if they are using cheaper generic medication when you’re in so much pain you wish someone would just punch you and knock you out.
    Also most people are forced to use whatever ins provider their company chooses. Which takes shopping around for ins plans out of most individuals hands. While the owners and ceos can still afford quality private health ins.

    If its single payer the people in the government making the healthcare choices will be forced to use the same plan everyone else has to use. With the internet, social media, and the ability to sleuth like never before, it would come out if the gov officials had a separate plan just for them it would cause an uproar and they wouldn’t get be voted back into office.

  55. I love the option I get from my work. I work 2 jobs but Red Lobster gives me the option for dental, vision and medical. Because I have a second job that offers no benefits I get the highest quality of all through red lobster. I love this option, not gov insurance

  56. Spot on as always, what so we call the insurance scam? It's a goverent sanctioned franchise, prices could really normalize without that middle man…. yeah

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