
About this episode
America’s healthcare debate has been stuck for decades — framed as a political fight between left and right. But what if that’s the wrong lens entirely?
In this episode of The Puck, Jim Baer sits down with economist Joe Antos of the American Enterprise Institute to unpack the real issue: tradeoffs.
Who pays? Who gets access? How much innovation do we support — and what are we actually willing to spend?
Antos draws on decades of experience inside the Congressional Budget Office, the Office of Management and Budget, and Medicare policy to explain why the system feels broken — and why many of the proposed solutions miss the mark.
Key themes include:
Why insurance coverage ≠ access to care
The government-created bottleneck behind doctor shortages
How incentives — not ideology — drive system dysfunction
Why more subsidies won’t fix the problem
The hidden inefficiencies AI may accelerate instead of solve
Medicare, life expectancy, and the actuarial reality we avoid
Where real reform might actually begin
As Antos puts it: “We have a system under pressure — but it created its own pressure.”
This is a grounded, pragmatic conversation about how healthcare actually works — and what it would take to make it sustainable.
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