U.S. Health Care Cost Problems

In this episode of the Chuck ToddCast, Chuck examines the sweeping global and domestic implications of Trump’s increasingly personal, transactional approach to foreign policy. He breaks down how the administration has abandoned the post–Cold War order, embraced nationalist movements, sidelined democracy promotion, and even signaled security guarantees in exchange for favors — all while crafting a national security strategy full of dangerous gaps and warmly received by the Kremlin. Chuck then turns to the explosive revelations around Trump’s pattern of selling pardons for loyalty, spotlighting the Henry Cuellar episode as a case study in this mob-style political culture. The conversation also touches on Marjorie Taylor Greene’s recent media tirades and her emerging position as a potential “true MAGA” contender in 2028, before wrapping with a look at the historically low approval of all four congressional leaders and why a dramatic leadership reshuffling by 2029 wouldn’t be surprising.

Then, Chuck sits down with Jared Bernstein — veteran economic adviser to both the Obama and Clinton administrations — for a sweeping, candid breakdown of the American economy, why the data and national mood feel so misaligned, and how technological change is reshaping the labor market. Bernstein explains how the White House approached economic tradeoffs, from inflation and tariffs to the stubborn low-hire, low-fire job market. He and Chuck dig into the uncertainty surrounding AI-driven job displacement, why Americans are more skeptical of AI than peers abroad, and how policymakers failed to build guardrails around the harms of social media. Bernstein argues that a federal jobs guarantee would be far more effective than universal basic income, and that political candidates will increasingly need to get tough on tech as the power of the “Magnificent Seven” distorts markets and discourages regulation.

The conversation then turns to the structural failures of America’s healthcare system — from inelastic demand to weak cost controls — and why “Medicare for more” could be a practical starting point for reform. Bernstein outlines the entrenched inefficiencies of employer-based coverage, the rise of contract work, and the political salience but poor targeting of policies like “no tax on tips.” He also discusses the missed opportunity to protect the expanded child tax credit, the flaws in Trump’s proposed baby bond program, and the broader need for progressive taxation rather than philanthropy by billionaires. Finally, Chuck and Jared confront the realities of the national debt in an era of higher interest rates, the feasibility of reviving a robust child tax credit, and whether new supports — like credits for childcare or elder care — could help families navigate an affordability crisis that shows no sign of easing.

Finally, Chuck hops into the ToddCast Time Machine to revisit the history of the United States relationship with China and the unintended consequences that came with it. He also answers listeners’ questions in the “Ask Chuck” segment and recaps the college football playoff selection.

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Timeline:

(Timestamps may vary based on advertisements)

00:00 Chuck Todd’s introduction

05:00 Trump doesn’t want the U.S. to be the leader of the free world

06:15 Administration rejects post cold war world order

07:30 Foreign policy will be subjective based on Trump’s personal relationships

08:15 There is no more value judgement on who the US does business with

09:15 Administration is proving to be very anti-EU

10:00 Administration signals support for other nationalist movements

12:30 Trump has never believed U.S. should promote democracy

13:30 There are plenty of holes in the national security strategy

14:15 Qatari plane bribe led to NATO like security guarantee

15:30 American presidents should believe in democracy

16:45 Trump’s retreat from the world will create generational damage

17:45 The new security memo was loved by the Kremlin

18:30 Trump mad at Henry Cueller for not changing parties after pardon

19:15 Trump is clearly selling pardons in exchange for money or support

21:15 Trump’s primary complaint with Cueller was “lack of loyalty”

23:00 Trump seemingly thought pardon was in exchange for something

25:30 There should be far more outrage over the weekly sale of pardons

26:30 Marjorie Taylor-Greene blasts GOP lawmakers in 60 minutes interview

27:30 MTG believed the BS & is now finally realizing it’s BS

28:30 MTG could become the “true MAGA” candidate in 2028

29:00 All 4 congressional leaders are incredibly unpopular

30:30 Congressional GOP could use a leadership shakeup

31:15 Schumer & Jeffries are looking over their shoulders

33:15 It wouldn’t be surprising if all four leaders are gone by 2029

41:00 Jared Bernstein joins the Chuck ToddCast

41:30 Jared worked for both the Obama & Clinton administrations

43:15 Drafting economic policy that has the most upside, least downside

44:15 The economic data doesn’t match the vibe of the country

45:15 The Biden WH talked past the electorate but didn’t lie about economy

46:45 Biden thought the job market was most important economic indicator

49:30 Inflation has been stubborn, how long did you assume we’d have it?

51:15 Tariffs have contributed to about half a point of inflation

52:00 Inflation during Covid was a combo of low supply & high demand

53:45 Should the fed be focusing on inflation or the jobs market?

55:30 AI isn’t causing mass layoffs yet, but it has frozen hiring

56:30 We’re stuck in a low hire, low fire jobs market

57:45 Technology displaces the most workers during economic downturns

59:45 How can we avoid job displacement destruction from AI?

1:01:15 Americans are far more negative on AI than other western nations

1:02:30 Politicians failed to create guardrails for the harms of social media

1:03:15 We don’t know the extent of how AI will displace jobs

1:04:15 Government should offer a federal jobs guarantee for AI displaced jobs

1:05:30 Universal basic income pales in comparison to a jobs guarantee

1:07:15 Getting tough on tech will be critical to successful political candidates

1:08:30 Tech companies threaten regulators with exiting the country

1:09:30 Breaking up tech’s power has appeal on both sides of the aisle

1:10:00 Market cap of the magnificent 7 is 22 trillion dollars

1:12:00 The S&P 500 minus the magnificent 7 is basically flat

1:13:45 Non-profit hospital systems make more money than for profit ones

1:14:30 Leaving healthcare to the free market doesn’t work well & is expensive

1:15:15 Healthcare isn’t shoppable and demand is inelastic

1:16:45 The only healthcare solution from congress is subsidizing insurance

1:17:30 The ACA did a lot to control healthcare spending, but not enough

1:18:15 We have very few cost controls in our healthcare system

1:19:00 “Medicare for more” would be a great place to start fixing the system

1:20:15 Competition in the health insurance market has been insufficient

1:21:00 Health insurers don’t want to compete with government, will fight hard

1:22:00 Medicare won’t be free but considerably cheaper than private market

1:22:45 Will a shorter work week be realized in the age of AI?

1:23:45 Social welfare is too often correlated to GDP

1:24:30 A shorter work week isn’t feasible during an affordability crisis

1:26:15 Employer based healthcare system is deeply rooted, but inefficient

1:27:30 Companies have pivoted to contract work to avoid paying benefits

1:28:30 The salience of the “No Tax On Tips” policy

1:30:45 No tax on tips is poorly targeted and inefficient, but will be hard to repeal

1:31:30 Biden should have “died on the hill” protecting the child tax credit

1:33:30 Trump’s baby bond program is poorly targeted & exacerbates inequality

1:35:30 Government shouldn’t rely on philanthropy by billionaires & tax progressively

1:37:15 Raising the corporate tax was always a nonstarter in administration meetings

1:38:15 We’re at a dangerously unsustainable level of national debt

1:39:15 Higher interest rates are making the debt much harder to sustain

1:40:00 A child tax credit is feasible, but needs a pay for

1:41:00 The childcare industry is very responsive to demand

1:41:45 Could we see a “home care” credit for both kids or seniors

1:45:45 ToddCast Time Machine December 1978, 2001, 2025

1:46:30 Jimmy Carter announce normalization of relations with China

1:47:30 Kissinger praised bringing Beijing closer, Goldwater was furious

1:48:15 Business community was ecstatic

1:49:30 In 2001, China joins the WTO: hinge moment of globalization

1:50:30 Democrats & Republicans agreed on China in 2001

1:52:15 Consumers & business loved cheaper good from China

1:53:00 Bush & Gore both had the same view of China

1:53:45 Populists warned of job losses and economic pain

1:54:30 What if US had blocked China’s entry to the WTO?

1:56:15 China is now viewed as a permanent strategic rival

1:57:30 US made a bet they could promote reform in Beijing and failed

1:58:15 Bets on China reshaped the U.S. more than China

1:59:00 Ask Chuck

1:59:15 Why don’t national democrats want to be in Iowa?

2:02:15 How did Obama hurt the DNC beyond endorsing Hillary?

2:06:30 Which member of each branch would be better in another branch?

2:12:00 Could lack of a primary in 2024 lead to broader election reforms?

2:14:30 College football roundup

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