Transforming the Insurance Industry: AI, Decentralization, and More with Franco Lofranco

Parker Condit: 0:01

Hey everyone, welcome to Exploring Health macro to micro. I'm your host, parker Condit. In this show, I interview health and wellness experts around topics like sleep, exercise, nutrition, mental health, stress management and so much more. By the end of each episode, you'll have concrete, tangible advice that you can start implementing today to start living a healthier life, either for yourself or for your loved ones. And that's the micro side of the show. The macro side of the show is discussing and having conversations around some of these larger systemic issues that are contributing to health outcomes here in the US. So an example of that is how health insurance hasn't evolved much, and continually rising deductibles and premium costs are just financially squeezing so many people here in this country, and this is something we discussed today. And my guest actually goes over an alternative insurance model as well. My guest today is Cavalieri Franco Lofranco. Franco is a serial entrepreneur and he co-founded a company in the early 90s that became one of Canada's first high-speed internet companies, and he's since expanded to sports, real estate and consulting. One of his latest ventures is called Impact Health Sharing, and we discussed this in much more detail throughout the show. But health sharing is essentially a decentralized insurance model. It's a much leaner model and it provides transparency, which is a very novel concept in the health insurance industry. There's certainly some healthcare jargon in this episode, like repricing charge masters, medical loss ratios, but we spend a fair amount of time breaking down these terms so they're easily understood. If you want to get a better understanding of how health insurance works in the US so you can make better decisions for yourself and for your family, this would be a great episode to check out. So, without further ado, please enjoy my conversation with Franco Lofranco. Franco, thank you so much for being here. We're going to be talking a lot about healthcare and health insurance today, normally two topics that can bore people and put them to sleep, but I think between the two of us, we can keep this very interesting, because you have a very unique business that you started. So I think we should just start there and that's going to give our listeners a really good understanding of kind of the different models of health insurance that are out there, because I think most people just understand I have Blue Cross, I have Aetna. It just is what it is, but most people probably don't know that there is an alternative. So do you want to start just explaining what your business model?

Franco Lofracno: 2:21

is Sure, I'll be happy to start it. I talk about it. First of all, thank you for having me on. Big fan of your show. Love it, the great stuff from the minute I heard it, I go. I love this guy. He's awesome, I love how authentic and real you are and the value you're bringing to your listeners. So great job, parker, and excited to be on here. So excited to be here. It's true, healthcare who thinks healthcare is a very exciting topic? But it's a necessary topic, right? And we're getting to the point where there's more increases coming all the time, and part of the problem is health insurance companies are really they're raking it in record profits. Unfortunately, for most people, costs are going through the roof. 70% of all bankruptcies today in the US are because of healthcare, which is sad. 87% of people right now in the US never meet their deductible. That's another way insurance companies make money, and part of the problem is 5% of Americans are responsible for almost half of all healthcare spending, and so you've got all these dynamics going on, and then the insurance companies want to make money at the same time, and so you put that together. You got a recipe for disaster. So I think most people would agree that healthcare is broken. So a lot of the largest companies are self-funding and trying to get away from health insurance companies if they can, and so one of them created an incredible technology that we were able to. The name of the company is called Impact Health Sharing was able to license from them and so that we could commercialize it and launch it to the country. And we're able to launch it in a very powerful way for individuals, family, small businesses nine out of 10 small businesses cannot afford to provide healthcare. They would love to but they can't. For all the reasons why a small business love to to help a customer, employee retention you know all that good stuff and now it's affordable for them. So typically, what we're doing right now with our program is we're able to save people 50, sometimes. I just say a gentleman in his family has got four kids 70% on his monthly health spending every single month. Plus, insurance companies have deductibles, right. Their deductibles are per family member, so his deductible was about 5,000 per family member. Ours is called a PRA primary responsibility amount. That's what our version is, and it's per household. So he picked a PRA of 2,500 for the whole family, so everybody's contributing to that at the same time. And so it's thinking about that over a five year period, a 10 year period, 20 year, how much, how much money that could save a family or an employee or an individual. And so we're able to lower costs not just there, but also on the prescription drug part. We're doing really great on that, helping people save money as they're. So we're trying to help people every step along the way. It's not just what you're paying every month, which is which we'll help you save money on, but it's every step along the way to do that. So that's what we're doing right now. We're very excited we're growing so fast, helping so many families right now and people's because, especially with the economy. Right now, people need this more than ever. So that's what we're doing right now, and we're excited to be able to provide this for people. Yeah, that's great.

Parker Condit: 5:34

Can you explain what a self-funded plan is, because I think a lot of people don't really understand the difference between a self-funded plan and sort of the regular car they're carrying around in their pockets. Can you explain how bigger employers, so you've got?

Franco Lofracno: 5:46

to come to like. A great example is UPS. They'll be self-funded. So large corporations that have a lot of people, they'll typically do that, so they'll try to get away from the insurance company is self-funded, so literally what it means self-funded. They self-fund themselves and provide the underlying guarantees for that themselves, and but it also requires heavy-duty technology to be able to do that and a whole interesting back end. That's what we've got. We've got six patents right now, I think three patents, three patents pending on the technology. So we're more of a kind, very unique, very excited about that. We've improved what some of these companies are doing and so, out of that, we're able to provide that and because of that, when you're in that, you're able to do that. You're able to do that. For example, if you're a health insurance company, they require you to be in network and if you're out of network, then what happens to your deductible? Or it increases or not even available. With us there is no network. That's the beauty of the model. You can go to any place in the country where you were like because imagine you're a truck driver and you have healthcare and you get hurt. You're in Montana and you get hurt in California. Oh, now you're not covered or your deductible is double Like. How does that even make any sense? Right, but that's how most people have to deal with it, and so part of one of the benefits we bring is you can pick any doctor or hospital, no referrals necessary. And one of the cool features we offer which I love I love using it is we have something called MDLive or telehealth. It's included. So I give an example I went from Aetna paying $600 a month to with us, $150 a month, and included in that is free. Telehealth is included. So I wasn't feeling very well. I just get a video call with a doctor, just like that, and I can pick my doctor. There's a bunch that become available. I type in my symptoms when you log into your own portal. You have your own portal. You log in and then all the doctors available the next hour or two and you can do a video call with them. You can do a telephone call with them. They can diagnose you, they can send you prescription drugs. You're gonna be what. It's so really cool. So imagine you're a truck driver back to my original point. And now you're not feeling well. Well, where do you go? Well, you can get on your video call from your truck, first example, and type it and do a video call right from there. Hey, what do I need? And then they can send a prescription right to a pharmacy right near where you're at in the truck. Now, that's cool, right? That's like that's the whole point of taking advantage of technology and that's kind of like how it works.

Parker Condit: 8:12

Yeah, it sounds like a really good example of utilizing technology to address some of the social determinants of health, which is just a big thing right now. It's like seeing how we can make healthcare more equitable across many aspects. Right, it's not just who's the doctor you're seeing, but it's access, it's cost, it's the environment that you're living in. So the idea of including telehealth, I think, is really forward thinking. And also, through the pandemic, it was interesting. Like not a lot of great things came out of the pandemic, but one of the things that was really positive was the fact that the healthcare industry, which is generally very slow to change and very slow to evolve, adopted telehealth in about three weeks across the country. So we're like, okay, we saw that the country can do it right. When it's necessary, we can do it. So that was a very promising thing. And just the ability to provide access to people without having because transportation is an issue in a lot of areas. So the sort of low cost access to care is, I think, a very necessary thing for starting to address social determinants, of which there are many.

Franco Lofracno: 9:11

Yeah, one of the things we learned in the pandemic nobody wants to go to a doctor's office. You know, if I don't want to go, why should I have to go? If I don't want to, why can't I do it from home? Why do I have to actually physically go in? What's wrong with video, like? What are they going to check Really? So one of the cool things that the pandemic that's one of the other positives that came out is, hey, we could do some stuff over video, just like we're doing this podcast right now. You know, this exploded. This whole medium exploded during the pandemic.

Parker Condit: 9:34

Yeah, and it's going to keep a lot of people healthier, because people that are high risk going into an office where there's other sick people, that's where transmission happens. So if you don't necessarily need to be there, I think providing access and care remotely one necessary is a great option and obviously it's not a brand new technology. This was around before the pandemic, but a lot of people just need to be, or a lot of industries just need to be, forced into action, as was the case three years ago. Can you explain a little bit about what repricing is? Because so you can obviously get the, the. The prices you offer for health insurance obviously have to be negotiated somehow on the other end, like the prices that you're gonna, I'm paying the providers. So can you explain what repricing is?

Franco Lofracno: 10:20

Yeah, that's an interesting topic because I sure most people are familiar with. You go to get a bill from a hospital, doctor or clinic and like Like sticker shock, like what is this right? And then some people get the cash price, which is about 50% off. Then there's two other prices. There's the reprice price and then there's the price insurance companies pay. So, for example, blue Cross, bushel is big insurance companies. What they'll do is they'll Do a pre-negotiated price for all these amounts, right, no problem. The problem is they're constantly putting pressure on these hospitals and doctors to lower those prices and lower those prices To the point where some people now will not accept certain Insurance. Kind of fact. If you go to an insurance company right now, they may say on your policy, by the way, what's in network today may not be in network three months from now, because they're constantly In battle with these doctors in hospitals. So what you thought was in network now, six months or no, no longer be a network for you. And so then there's repricing. What is repricing? So there's a base reference pricing and we have an incredible Firm that helps us nationwide do this, and it's more than what insurance comes. So doctors in hospitals love us. That's why we pay on average between 10 and 20 business days, which is one of the fastest in the entire country. We quickly go through the bills, we know what it should be. We have an incredible success rate of doing that. We reprice on average right now between, let's say, 70 and 75 percent, which doctors in hospitals they, they get it, they're fine with it, they get with us what the pricing is and no big deal, and so that's why a lot of them are happy to have Ex be except accepting us in our members to do that. So it's a very, it's a very important thing when you do Repricing, because it's a, it's a necessary evil that we have to go through when you go to the hospital or doctor, whatever you need, and so we have a full-time people that's, that are doing that on our behalf. So you don't have to worry about it, our members don't have to worry about. It's all done for you and it's an. And doctors in hospitals also like it, because we're not trying to you know, bottom feed them, so to speak, like insurance companies would like to do, because you know they also want to get paid and I get it. I have one doctor Work it with. He's retired. He's been retired for 18 months. He's still waiting to get paid on claims from 18 months ago past maybe two years ago, that they, the insurance company, has not even paid him. And I don't know if you saw that's a big, a big Stink from SIGNA, from big article came out them in March. They got caught, obviously by more companies doing this. I can't prove it yet, but I'm sure there is. So SIGNA told their doctors hey, when these claims come in, ignore them. So 300,000 claims just got totally ignored. So the doctor spent that average because they can check 1.2 seconds per claim.

Parker Condit: 13:08

I'm not a claims adjuster, but that doesn't seem like enough time.

Franco Lofracno: 13:12

So why cuz? Because look what are insurance companies want to do. They take all your money in and they want to. They buy companies. They do all kinds of stuff with your money because you don't know where your buddy goes when it goes in. So it's actually a really cool way to talk about our technology and how our tech works. So when you pay each month so, for example, I pay 150 dollars per month so that goes into my virtual wallet. So anybody if familiar with crypto understands it. That's why young people love our product because they get it. It makes, sense yeah yeah, your money goes into a virtual wallet. Now, let's say you needed you know God forbid something should happen to you. The AI that we have knows exactly how much you take from each member to pay for you. That's how it works. It's amazing. So the money just sits there until it's needed. It doesn't go to somebody's pocketbook for profits. It doesn't go to some executive CEO that's making 300 million dollars. It doesn't go to any of that. It just goes when somebody needs the money and it's fully transparent. You get your own portal. You can see it might your money. You always have money, your account, how the AI is trained and what it knows to do. It must always leave money in people's accounts until it's needed. That's kind of how it works. That's pretty awesome.

Parker Condit: 14:17

Transparency in healthcare. What a novel idea.

Franco Lofracno: 14:20

It's like like but it's funny. Some people go to shot, but it's like this is, this is amazing, this is real, this is, oh my god. Why does everybody do this way?

Parker Condit: 14:28

This is that you can't make money right, I'm gonna want to come back to repricing because I think people don't appreciate how hilariously high charge master prices are. But Since we kind of got there already, can you talk about medical loss ratio, because that's essentially what you're talking about the difference between established Health insurance companies and then kind of what you're doing where the money just stays Sort of in this decentralized areas, what you're talking about and then in regular health insurance companies they have, they've been required to pay out a certain amount of premium money In claims and then the rest is just used for profit, marketing etc. Etc. But that sort of model leads, if, if your pie is fixed as far as what you can make in profit, the only way to increase profits is to make the pie bigger, which leads to these weird incentives. So if you can share any more about medical loss ratio, I think yeah, that's a great point, Parker.

Franco Lofracno: 15:23

So look, and I Grip in Canada. So how can? Is a little bit different, because For us, I remember when I moved to the US I was in shock. I got to pay how much for health care and I got a visit, the Vuctible and then there's copay, co-share, what is all the? What is it? Prescription drugs or how much, like? I was literally in shock when I moved from Canada to United States. Sure, I couldn't believe it. And then I started studying the industry. I'm like, wow, this is quite the little rocket going on over here. I see how this is works. This is quite interesting. It's actually I was kind of like impressed. This is actually a little bit genius, like and so. And then, every once in a while, you know these companies will raise deductibles. Why? Because if you're not being your deductible, it's more profit for them. Right, because when you're paying money into them to your point, it's a centralized system. It goes into a centralized fund, which is them, and then they dictate they've got your right. Certain measures have to go through that, through paying premiums after that or through acclaims after that. What they do with it is up to them. So what they're doing, they're buying. Companies are doing this, they're doing all these other things. It goes to profit shareholders buying back stock, all these other things that have nothing to do with your money, nothing but to make them more profitable. And so for us, okay, that's an interesting model, but that doesn't help people. It doesn't help companies save money. It doesn't help companies be able to retain their employees so they can take that savings and then hire more employees. So, for us, it's like for us, healthcare is a tool for you to be more profitable, for you to save money, put more money in your pocket. That's what healthcare should be for and provide you great care in great care. Because, look, it's great to cut costs, but you don't want to also cut care. So we want to do is save you money, but also provide better care at the same time, and that's really what we do. So, to your point, yeah, companies are doing healthy health insurance. They had regular profits last year for a reason. So, to your point, our model is Decentralized. Everybody has their own virtual wallet, fully transparent. You can see exactly where every one of your dollar goes, as it should be in the healthcare space. This is healthcare. There's no mess on your car, you know that's like this is for your own well-being. That's what to me. That never made sense to me. Here we are taking people's lives, people going bankrupt, people like it's I can't imagine. I'll tell you a great example. How did that? And he has. He had five kids, four kids. He had four kids, paying 25 $2,600 a month for him, his wife and his four kids, and he couldn't afford it anymore. And he's about to sell his car. He's gonna sell his car. I go, and I'm talking to him. A guy didn't get to work. He goes, I don't care, it doesn't matter to me, I just got to do it because otherwise I can't leave my kids without health care. He started to cry, literally started to cry, because I don't have to sell my car. Now I go. I know there's no need, but see to me, it's those stories that get me excited and motivated to do this, because there's so many people suffering out there. There's 30 million people in the US that have nothing. How do they get? They can't, because they're they make too much money for state aid or or any kind of aid, are not enough to pay for health insurance. Well, what are these? I can't imagine being someone, one of these people that must be terrified every day. Don't get an accident, don't do anything, don't get sick, like how do you live like that?

Parker Condit: 18:39

Yeah, it's sad. I don't think there's another industry in this country that makes people make more tough decisions than the health care industry, exactly to the point you were saying. It's like do I sell my car or do I keep my family covered with health insurance? It's it's just this never-ending string of impossible situations. You hear it with premiums, hospital bills, medications. It just seems like there's no other industry that's even close to putting people into those types of financial situations.

Franco Lofracno: 19:10

Well, the problem is, when you look, there's some industries that even education, for example, we know. Look at what tuitions are out for for universities, it's ridiculous. Colleges it's unbelievable. It's higher than anywhere else in the world. Whenever you introduce the profit motive into something that I think is essential to a Community or society to get better, smarter, wiser, help improve society in a general way and you put profit into that, it's never a good thing in my opinion. So to me, look, I'm a big-time capitalist. I believe in capitalism, but I'm cool if we find a way to take care of people for health care and education, and then let people go crazy and do whatever they got to do to become successful in life. But when you to your point, when you're putting that kind of pressure and stress on families, it's tough Like I couldn't imagine. You know, having children, little kids, and not being able to provide for them, being terrified when they go to school. Oh, my god, they're gonna be covered. Are they not gonna be covered? Or what are we gonna do? Are they gonna be okay? What if something? Little Johnny bricks his leg? Oh, how are we gonna pay for this? They're bail, barely paying their mortgage or their rent right now, like all the, and inflation is hitting now, on top of that, with the new rate increases. Come on me, you know it's just unbelievable. So for me you know well, I look at life and businesses what can we do to help those, those families, what can we do to help alleviate them? Because, at the end of the day, they're the ones that drive our economy, they're the backbone of what we do. They're the hard-working families that we really need to make a healthy society.

Parker Condit: 20:40

So I'm with you in yeah, now you brought up a really interesting point which is kind of like the very capitalistic nature of the health care industry and like I look at what these companies are doing, I'm like they're doing exactly what they should be doing in a capitalistic environment. Like they're, they're maximizing profit for the shareholders. They're doing a great job at their job. Unfortunately, it just doesn't align with, like, the health care needs of our country. That's where you get these misaligned.

Franco Lofracno: 21:07

Incentives. You can't even blame them. They're just doing what they're supposed to be. I've been doing the same thing, probably if I was the CEO of that company, who? I probably think about the same thing. That's my job.

Parker Condit: 21:15

The job? Yeah, exactly, and they're doing a great job at it. Um, yeah, so it's hard to be mad at them. For that perspective, it's like that's why you need to look at it very systemically. It's like how do we, how do we not just create a better health insurance company? If you try to do that, you're just gonna you know, you're gonna create something that's competing with blue cross and etna. You need to think totally differently, which is why this decentralized model that you're talking about is so interesting.

Franco Lofracno: 21:37

Yeah, and that's what take the word technology comes in. It reminds me when uber launched. I remember when uber launched and the whole taxi cab industry went bananas like losing their mind. Yeah, how can you be a third of our price, you know? And oh, your car is cleaner and it smells nicer. Well, what's what's going on here? How is this possible? And it was like weird, right, when you first got the app. I'm getting into somebody's car and they're driving me something. This is so strange. But the power of technology to connect us is kind of like what it does, right. Like imagine what Airbnb launched, right. Imagine when the iPhone launched and someone told you hey, parker, guess what, there's a phone gonna come out. I just watched the movie blackberry, which is kind of interesting. I'm originally from Canada, so it was funny because I grew up like 30 minutes from where blackberry was the head of interesting Okay yeah. So for me it was a fascinating movie and but. But imagine when they saw this, this new phone comes out and it's gonna have apps. What's an app? And from this app that you can click something and a car will come get you and drive you wherever you want to go and you can order food from wherever you want and will bring it right to you. Like if you told somebody when you saw when, with that phone with no keyboard, couldn't understand anything, people, how's this pot? They'd be like mind-boggling to more people tell a lot of people. So we're kind of liking that boat right now with how we've created a decentralized model for health care. But you'll see, I believe this, this type of model, will catch on over the next three, four or five years and hopefully, what knows, maybe I'll become the standard model for how we deliver health care in this country.

Parker Condit: 23:06

How easy is like this model to replicate because, like, just based on our so we spoke before this call, so I have a decent understanding of your sort of entrepreneurial background. So I know, I already know that you have the, you have the mind for this. But, like, how easy is it for other Organizations to replicate something like this?

Franco Lofracno: 23:23

well, the cool thing is, I have nothing to do with building it and creating it. That's the good news. There's a lot smarter people than me that are doing that, thank God. Okay, that's like good news. How would you replicate it? Well, you would need an AI that would know how to do it, but you need also People experienced in the industry that understand what the pricing should be, how you price it, what the our primary responsibility amount should be. So there's different things what the co-share should be, setting up the financial systems in place, the protocols in space and in place. Like if you go to our YouTube channel and impact tell, sharing our comments, a great video that the CEO of the company, mr Phil Chrysler, talks about called the protocols and it goes in in the great details. A great video that talks about the protocols behind the pillars, behind Impact, in what's necessary and so it's not easy to do, that's for sure. Can it be done 100%? It's like everything else. Like you know, when Uber came out with, came out after to compete, you're always gonna have your conveyor, these other little guys that compete against it. One called fair, I think it was, so the other little guys that come out afterwards. But it can be done. And then you also need the money behind it to make sure it's solid and the company safe, and all that good stuff okay, so it.

Parker Condit: 24:35

It's not something that somebody's gonna start in the garage next week, but it is also possible.

Franco Lofracno: 24:40

Well, and it's also people's health care. Like we got to be smart here. Like it's like this is not. I'm selling you widgets, you know, and yeah, you could return the widget. You know we got to make sure that that the system works. Hospitals and doctors are excited. Take our product. Like when I go to the doctor Hospital, I bring my card. Here's my card. I just bring it to them and we're on the same. We paid a lot of money to be in the same network billing system is all the major insurance companies, so it's gonna pop in the number. We pop right up.

Parker Condit: 25:06

It's very smart. So are there any other parts of the health care industry that you see sort of like ripe for innovation, because it just seems like such an Inefficient industry. So I see that and I go well, there's plenty of opportunities. Are there any that are really jumping out to you?

Franco Lofracno: 25:20

Well, if I look up the prescription drug pricing model, that's a big one. So you got guys like Mark Cuban out there doing good stuff. You got good or X doing good stuff out there trying to do different things. A lot of good companies coming out now China. The problem is is when, if these new drugs come out and you know Pharmaceutical companies just abuse, they're charging a gazillion dollars per A thousand times, whatever the price is obviously an exaggerating, but in some cases are not what their cost of the drug is to, so they can make them a lot of money back, and so that's another great industry that we can see in the future. Different ways of drug delivery. I think we won't need a revised FDA to be able to do that and how we create drugs. That's gonna be a big pride. I know you've talked about that before On your show, but that's kind of like what we have to look at. That's gonna be as one big sector. The other sector is, you know, hospitals and doctors and how they build and how they structure that. Then that's another way of Looking at different pricing models and different deliveries. And you know it's not easy because whenever you've got, you've got the the people that Deliver the service right the doctors, the hospitals then you've got the clients. How do you match them up? It's how you make that efficient. So when you've got an insurance company in the middle Taking a big chunk of that money, then that delivers naturally inefficiency in the system. So the with a game is how do you connect the two, but efficiently? In Canada the government decided to do it, so the government could connects you right through a centralized system, government system. The negative of that is it's overwhelming for them. It's not always the best health care. A lot of those doctors leave because they don't feel like they're being Represented properly or compensated properly. So there's inefficiencies in that system. Because you have government involved. It doesn't does not really great at doing what they're supposed to be doing, is not really their place, so that. So maybe there's a way, like we're doing it and other Technologies can come around and have technology be the source of it with AI. I have a lot of faith in AI. I don't be allowed. People are scared of AI. I'm not. I think AI could be a real solution for a lot of this stuff when applied in the right way yeah, you mentioned a few really interesting things there.

Parker Condit: 27:35

One of them was talking about the Canadian system and just the fact that it's like a single-payer system coming from the government. Yeah, a lot of people who don't know a lot about health care they'll say, oh, we just need a single-payer system. And it's like have you heard the expression? Money only solves money problems. Yeah, so like single single-payer system only solves Single-payer problems, right, which we certainly have plenty of in this country, but it, like you said, it leads to its own set of issues as well. So that's not like a, it's just a blanket statement that doesn't. It doesn't solve a wide swath of problems.

Franco Lofracno: 28:08

I did a problem. The other problem is also, as people get an older, it's really puts more of a strain on the system itself, from government for the thing. So it like how can we is? Also, is there a way we can create a better system? Maybe use technology for that? Because remember, right now, five percent of people responsible for almost half of all health care costs, that's a problem. Maybe Government can find a way to efficiently, efficiently deliver that in a way. That's why I be looking right now, because if you think about what is the low hanging fruit here, that's the low hanging fruit. That's half of all costs. So how can we help that five percent Reduce their cost? What can we do? And then, by the way, if we can help that five percent, then that's less burdened on the insurance company, then maybe they can still make their money if you still want to keep insurance companies around, I have them but then lower their costs and therefore increase their profitability, and then maybe they can spread that savings across everybody else.

Parker Condit: 28:59

Yeah, one of the other interesting things that you brought up kind of dovetailing off that point is the idea that the the more inamorid areas you add, the less efficient becomes, the higher the cost is going to be. And I've never seen industry like learning. This industry is so challenging because you you think you know the players, right. You have payers, providers and patients, and then in the middle That'd be like, oh well, there's also a pharmacy benefit managers and that was kind of to your point talking about the cost of prescription drugs and how that's very obfuscated. And then you just start looking at all these different industries or verticals within the industry and you're just seeing be like, oh, there's so many middlemen, there's so many intermediaries. You're like this is why it's so slow and inefficient. So I think you make a great point of Trying to streamline the connection between patient and provider, right? Like how many steps do they really need to be between the two of them? And I think we have way too many that's the game.

Franco Lofracno: 29:53

That's really honestly, if you look at the next decade, that should be what we should be looking at. And how can AI help that? Where we found a way in one way where AI can absolutely do that and help people save a ton of money. But that should be the way. How can AI help us streamline those two things, connecting them together? Hey people, if you're not going to take insurance companies out, cool. How can we streamline that as well and help them as well? Because a lot of these, these insurance companies. The problem with them is they have these old legacy systems that are like if they wanted to be us, they couldn't, like it would take them five years, ten years. If they want to try to be us, just because they've got all this inherent Old architecture and infrastructure in place, that they could not be us even if they wanted to right now.

Parker Condit: 30:33

I mean that's kind of true across the industry, right? I mean the the hassle of getting Hospitals and providers to move from paper records to EHRs. You know that's a government stimulus 15 years and it's still not going well. The idea of interoperability, the ability to share patient data between two providers, that was the whole point of this and it's still a nightmare.

Franco Lofracno: 30:56

So but if well, they're right. I just remember when, when the Obama administration was launching the website, and what that took to launch a simple site.

Parker Condit: 31:08

And I'll have a couple to. Yeah, it's funny, I just roll out, wasn't great, no it's just.

Franco Lofracno: 31:15

Funny it just seems like to me the healthcare industry has more fraught with these disasters that almost every other industry.

Parker Condit: 31:22

Yeah, and you know, just another example of what happens when government tries to run things. And I'm not saying like that's not a long-term solution, but it's just it's. It's not the panacea that I think a lot of people talk about it to be.

Franco Lofracno: 31:34

Well, if you look at what people are paying today, absolutely it's not. I mean, is I think we can all agree today it's failed on what was original mandate to make affordable healthcare available to all, and Every year that goes by we get further and further away from that and so we need to fix it as a broken system or whatever we can do to fix it. We have to do that because people are suffering and we have to help those people.

Parker Condit: 31:56

Yeah, that's a great point. I want to go back to train price and transparency, because one I think that it's hard for people to just throw their money into a pot and be like well, hopefully I Get my return at some point, which is the normal system, the normal health insurance system where, like, hopefully I get covered when I need to. So I think the fact that you're sort of Providing this like almost blockchain-esque Transparency of like you seeing where the money is every step of the way, that's very smart. Just because I want to go back to a charge master pricing for a second. The way repricing works is, if a hospital knows that they're gonna have to give a 70% discount or 60% discount to a large insurance carrier, they're not starting with like a realistic number. That's why, like, if you look, because of the many hospitals they have to list prices for like the 500 500 common procedures now. So most hospitals you should be able to go to and this is just another thing, it's not policed very well, but you should be able to like get prices from Regular procedures, but you'll see things. So this was from a few years ago, but Stanford Hospital was charging $450 for a comprehensive metabolic panel and that was the cash pay price, so that was discounted from $1100 for a comprehensive metabolic panel which you can get for $20. So I just wanted to highlight just like you're just kind of making up numbers where there's not even a reasonable sniff test because Because there's been there's been no price transparency for so long, like you couldn't, you couldn't put a $200,000 sticker on like a Toyota Camry, it just wouldn't, nobody would. It wouldn't, it wouldn't pass the sniff test for anyone. Just because we have enough transparency in that market. But do you see any? Do you see a larger shift coming towards transparency within the industry? Well, let's so.

Franco Lofracno: 33:52

I give you. I'll give you some we've got I believe we've done. You know thousands and thousands of claims. I'll tell you some of the funny ones we've seen we did. We took one from $3,000 to $288. We took one from $152,000 to $36,000, you know we have all these late claims that it's kind of funny. So, look, I think Transparency is something people are yearning for in general today. I just think we're symptomatic of what people want, whether it's through a podcast like this, a communication. People are seeking authenticity. People want transparency from politicians, from people, from Teachers, from family. I just think it's something that we're yearning for more than ever, and I just think we're we're just a result of what people are looking for. Obviously, all others wouldn't be successful, right? People want transparency. People want to see and be empowered by where is their money going, what's it being spent on? Well, show me, let me see it. So with us, they can literally Log into their portal and they can see every single penny where it goes, every single month that the money goes in and if the money is not needed, sits in your portal. And if you left, by the way, you take that money with you Because it's your money. It does not belong to us. It belongs to the individual member and that's our whole approach and that's transparency and that's the centralization and I think you'll see in the future financial institutions moving that way. I think you're gonna see a whole, whole different sectors moving to a decentralized model where people are empowered because it's their money, it's their Accounts and they should be able to do with what and they can monitor and it's gonna hold a lot of companies more accountable for Individual people's money and I think people are gonna start getting used to this and clamoring for it and you're gonna see and with AI it's gonna be definitely doable over the next decade- yeah, I think that's a great point.

Parker Condit: 35:51

People are certainly clamoring for transparency and it would just help because. So one of the interesting things is that how many people avoid treatment Because they don't know how much it's gonna cost. They're worrying is, I think it's like 40% of people in a given year Will delay or avoid treatment because they don't know how much it's gonna cost. If you and a lot of these things because they're just operating larger made up numbers, they do look artificially high and then maybe if they even did have insurance, they're still not sure what the cost is gonna be. So then to delay treatment and that costs the system and the aggregate significantly more in the long run because symptoms get worse, treatment gets more expensive as you have to go along. So, yeah, I think you're totally right that people are dying for some transplants.

Franco Lofracno: 36:35

I think it's symptomatic Parker to the whole end to everything, all of society today. And if the longest time there was no transparency in anything like corporations could do whatever they wanted, governments could do whatever they want, and now, with technology, with social media, we're scrutinizing more right, we're more skeptical about everything, and so I think transparency now I think companies that can issue, in whatever way they can, transparency to their client base, to their members and to their employees in general, I think they're the ones that in the next decade, I believe will win, and those that don't, I believe will fall behind, because I think it's just what people are looking for today. So those that are and you can see it happening in so many different industries and so those that embrace that, I think over the next decade are gonna really rock and roll with the size and growth of their companies.

Parker Condit: 37:27

Yeah, because like there's so much more choice now and people are just gravitating towards the companies and the organizations that they feel like they have a kinship towards. And the author like there's just so much media out there now like you can't really hide behind like corporate messaging anymore, Like you need to be authentic as a company to sort of draw those people towards you.

Franco Lofracno: 37:46

Yeah, I agree 100%. That's why I'm excited, I'm optimistic, because I just think growing up I've always believed this I go technology, use the right way, can always help better society, and so I'm excited about the possibilities that that AI can bring and that new technology can bring, and transparency especially, can bring. So I think there's two things happening at the same time. We've got a level of social consciousness awareness happening probably faster than maybe any other time in our history. At the same time we have technology coming. Now we have to be careful that this one doesn't go. The technology doesn't supersede how fast our consciousness can accept that technology, because that's what can destroy societies and cultures. But I think if we can manage that, I think we're gonna be in for a really incredible next decade or two.

Parker Condit: 38:36

Yeah. So let's kind of move on to one of the common questions I ask people, which is like if you were a ruler for the day and you could just sort of implement any policy or change in this country to improve at the aggregate level, like population health, what would you try to do?

Franco Lofracno: 38:51

The answer may not be different. I would do a 10% flat tax fee on everybody. That's all I would do. And the reason why I would do that is because, a lot of times, a lot of these big corporations pay nothing and that money could be coming into the pool to helping more people. And so, for me, look, companies and rich people will always find a way around loopholes, because that's what they do and they'll lobby for that. That's why these accounting firms are so big, that's why these lawyers make so much money. That's their job. And so the key to me would be can we just make everybody just pay 10%? I don't care, because, like, if the corporate rate today is in the 20s, okay, let's just say, well, most of the smart companies will never pay that, they will never pay that, and they'll find a way. Look at Apple totally, everything's off, short, everything's off. So, just like you pay this, and then, if it's 10%, they don't care. It's not worth the headache to do all those things to go around it, and so I believe that will cause a big boom in government coffers. Individuals will be paying, the ones that don't. I just think it's a totally doable number and you're gonna see a big boom in income to government people being proud to pay that amount, and then that money can make a big difference, maybe to pay for healthcare, maybe to pay for education, maybe to provide all that stuff at the same time, while helping lower income for our taxes for other people and then having other people that never pay be okay with paying it.

Parker Condit: 40:22

Yeah, like you brought up a really good point which is sort of like the closed loop system of like rich companies paying other rich companies to help them avoid paying taxes. Like if some of that money just went back into the agri-pool it'd probably be pretty beneficial to society, but it kind of just stays in, like the EYs and the consulting firms of, or the accountancy firms of, the world.

Franco Lofracno: 40:45

Yeah, and I've seen a bunch of now, look, it may put a lot of accounting firms out of business because it's so simple than to do accounting right, because there's no loopholes, there's no tax credit. No, this stuff, just 10%. And I've seen a lot of studies that would show how so many companies would then say, yeah, I'll pay the 10%. Now it's not worth it for me to bypass that or to go around that or to avoid that or to bring it down to 2% or 5% or move the whole company to go here or go do that. It's not worth it to them anymore. And so there'd be so much more money, I believe, coming into the system, and then we would create an incredible culture of people just proud to support each other and help each other and say, yeah, I pay my 10%. By the way, what's tithing normally biblically, what's it always been 10%? It's for a reason. It's 10%. It's an interesting number that goes back thousands of years.

Parker Condit: 41:33

Yeah, that's a very interesting perspective. Do you think growing up in Canada gave you a different perspective? Now coming here and operating in the US space?

Franco Lofracno: 41:42

I think so. I mean, given I can see like education is so much less expensive there and it's so great quality healthcare, same thing because it comes out of our taxes. I mean, obviously there's things that don't work great about either of them, but I think what it's shown me is because we didn't have the stress of it there. That's the difference. So okay, then it wasn't the greatest healthcare, but there was no stress around it. Remember, when I first came to the US, the stress are I gotta pay how much every month and this thing called the deductible and I could afford it, so it's fine for me. And then I think but how many people cannot? And what's that stress putting on a family? So to me it really had like what can I do? How can I get involved? How can I help this? Because I know what that feeling's like and I can't imagine family, Like I've talked about this, obviously at Nausea about this podcast, but it really is. It's a horrible feeling to be a family or a parent and not being able to take care of your family, even yourself. Like you're driving around, I have no healthcare, Something happens, oh well, you know. But this is why 70% of the bankrooms are because of healthcare, Because they're like what can I do? I have nothing.

Parker Condit: 42:50

Yep, yeah.

Franco Lofracno: 42:51

That's where it's shifting me. And then one thing that's interesting about Canada and the US. I know it's a difference. I'm not making a judgment about whether this is right or wrong. I notice in Canada we primarily say things like we have to help each other, we have to do this, we have to do that. It's mostly we. It's very different Versus in the US it's my rights, it's my stuff, it's my this, it's my that More for individual rights and that's okay, it's not nothing. It's right or wrong, but they have unintended consequences for each one. So in Canada it'll tend more towards socialism because you speak that way, because I believe speaking gives you the reality of what you live in. And so if you're always speaking in we, this us, then you're gonna be creating policies that reflect that. But whereas if you're talking about this is my house, this is my rights, this is my, then you'll be taking creating policies that reflect the individual, and that's what we see happening consistently across the board, and this pros and cons to both. So what we can clearly see, having lived in both, is the dichotomy of each, which is really interesting to see, and like gun rights and this and that, all different things that come aboard. So I'm not making a judgment around it. I'm just saying there's consequences of the speaking, of how we talk and what we say and what we create.

Parker Condit: 44:11

I think that's a very underrated point that you just made. The I mean like largely in like the self-help groups, circles of the world, the understanding your belief system in the words you speak to yourself and out loud are incredibly powerful. But I think it's a great point from a societal standpoint. Speaking about the general collective we that is probably more common in Canada versus the more me or I that you experience here. That's really interesting, not the answer to the expected and it was really.

Franco Lofracno: 44:37

I remember when I first moved here I was like, wow, it's really. You really notice that it's pronounced and it was interesting at first. You get used to it eventually. Then you get used to playing. Then cause, both can be annoying and both can be great. Like people have the positives and negatives. Like I go back to Ken, I'm like can you not think for yourself, man? Think for yourself, right. Why is everything gonna be about a sin, we, and then you come down here and it goes guys, think about everybody else around, like you, so you get. Like you get to see both sides. It's really interesting and both to drive you crazy and both can be powerful.

Parker Condit: 45:09

Like I said, no perfect solution.

Franco Lofracno: 45:10

No, there's not a perfect solution, it's just so I've always. What it's made me think, though, is what is a solution that can satisfy both? Is there a way actually, you strain me to think that way versus one or the other, because a lot of times, when you're in it, you don't realize you're doing it, because, if you're born into it, you don't see that you're doing it Versus when you can go outside of both, you see it happening and you say, okay, this is how this speaks, this is how this speaks. What can we create that satisfy both ways?

Parker Condit: 45:40

Yeah, Now, I think it's a great mentality to take. It's just forcing you to open up to different perspectives Probably very beneficial, I would assume. I guess one of the last things I want to wrap up with is going to be if you couldn't be doing what you're doing today, what is another field or profession you could see yourself kind of taking on professionally?

Franco Lofracno: 46:00

If I could do anything, whatever skill I wanted, I would be the general manager of an NFL football team. Oh, that's what I would do Not today, obviously, because it's like it's a lot of training and a lot of stuff but that just seems like so much fun to me, where you could build a team and get players and side players and recruit and all that stuff. It just seems like fun to me. So that, or own a team I don't know if I ever one day I'll never make enough money to own one. It'd be kind of fun. But be the general manager would be so fun. That or a professional soccer team would be really fun. My dad was. My dad used to own a professional soccer team in Canada, oh wow, and so I used to go to the games and watch and learn and how he would run the team and operate it and it was really. I ended up playing for the team eventually, so it's kind of fun. So it was really. And then he had me doing all the odd jobs, like being the, being the announcer at the game, cleaning up like towel boy when I was a kid. So you got to see all aspects of owning a professional team, which is kind of fun. But he was also the general manager. I guess. Because he's my dad, I have my hero, so I was admired that. So to be a fan of a big professional team be kind of a cool thing to be able to achieve.

Parker Condit: 47:12

Very interesting A whole other side to you that I did not know about. I was going to ask did you play sports growing up? But it sounds like you played soccer. Did you play in any of those?

Franco Lofracno: 47:19

Yeah, I played a little football. I played a little soccer. I played some hockey, ball hockey. I played a bunch of. I played ping pong, tennis. I love playing. I love sports in general. It's just so fun. Had always a great time playing all sports.

Parker Condit: 47:32

Okay, great, yeah, I was. Yeah, the sports thing threw me off. That's really interesting. Sorry, no, no, no, it's great. Do you have, like, an NFL team that you're a big fan of?

Franco Lofracno: 47:44

Oh, yeah, yeah. Well, I grew up in Toronto, so the closest team to us was the Buffalo Bills.

Parker Condit: 47:48

Okay.

Franco Lofracno: 47:49

So that's who I grew up watching as a kid, right, and I remember they were the ones I would watch, and I went through the four Super Bowl losses, getting depressed as they lost each and every year. And now I'm excited because they're getting better, which is kind of cool, but every year they seem to have one heart breaking loss after another. It's like I look at the Buffalo Bills as a team that builds your character, because if you can survive them, being a fan of their team, you can survive anything.

Parker Condit: 48:15

Yeah, no, it's really interesting. Like the Buffalo Bills, they sort of take on now we're just talking about sports they just they really take on the mentality of sort of the city and Buffalo is like a very like blue collar tough, but like loving in, like that New Yorkish sort of way. Yeah, buffalo is a really interesting city, but I love that that city. Yet I love that they haven't moved the team out of that city.

Franco Lofracno: 48:38

Yeah, I think it's a win. That's a win, it's a success story. I think it's a great thing that you can have a small town and be that successful in a sport because of the way they do the revenue sharing. And that's the one thing the NFL has done really great in doing revenue sharing. And Buffalo is a great town, great people. I've been there so many times, being having so close to it. I've gone to a bunch of games, so fun, not crazy about the snow. That's why I left, moved to Arizona.

Parker Condit: 49:05

Makes sense.

Franco Lofracno: 49:06

But love, love the town, love the people. It's funny when, when we're, I see a lot of Buffalo Bill's fans down here and some of them they're a licensed plate. They're, like my wife's doctors, a big Buffalo Bill's fan, so we have a lot to share. It's really fun. So it's really cool when we get to and also NFL teams have that like. They have that kindred like on my street. I have a lot of Kansas City Chief fans on here. I'm like, oh God, I can't get all these Kansas City Chief fans on my street.

Parker Condit: 49:32

Yeah, hard, hard, being a Bill's fan with how good they are right now yeah, Anyway let's go All right, anything you want to wrap up with. I think you dropped a lot of like really interesting nuggets, but do you have any sort of closing thoughts before I let you go?

Franco Lofracno: 49:45

I'm just excited. I'm excited about the times we're living. I know some people get like, oh, it's a horrible time to be a lie, all this negative stuff, and you look, you can focus on whatever you want to focus on. I choose to I the one thing. Here's one of my my dad taught me. My dad was one of the happiest people I've ever met Happiest people and he had this little cube. We had this little cube on our coffee table and it was six-sided and it would say it had a really cool sayings on it. And one of them said you see, the opportunity in the problem you have today is one of the sides and each side has something really cool. Like one side had had work, ethic and freedom, like together. So when I was watching TV, this thing will be stirred on me the whole time, right? So one of the things they trained me to do was whenever I see a problem, what is the opportunity for that problem? Because all that is is a muscle that you can work on, versus if you have a problem, most people get debilitated by it. Oh, they become a victim to the problem, versus a challenge and a game to overcome it. And so I'm excited. What I see is positivity. I see excitement, I see great things happening. Just got to look for the positivity and things and if you see, if you look for it, you will find it. So I challenge everyone Look when you wake up tomorrow, when you go to bed tonight. Look for the positivity. Be grateful for what you got. Look for the positivity. I promise you you will find it. I promise you.

Parker Condit: 51:12

I can't imagine a more elegant way to wrap up this episode. So I'm just going to leave it at that, and thank you so much for coming on, frank. It's been a real pleasure, my pleasure.

Franco Lofracno: 51:21

Parker, you're awesome.

Parker Condit: 51:24

Well, to those of you still here, that's all for today's show. I want to thank you so much for listening. I really hope you enjoyed today's conversation. If you want to learn more about today's guests, please visit our website exploringhealthpodcastcom. There you can find show notes for today's episode, links to the guests and our full episode archives. If you enjoyed today's show and you want to hear more, make sure to subscribe on your favorite podcast platform. I really appreciate each and every one of you listening Until next time.