The Musical Innertube - Volume 2, Number 170 - Art Caplan's 2024-25 Medical Ethics Review

JOHN

Ladies and gentlemen, once again we welcome back to the podcast one of our more frequent guests, Art Caplan, medical ethicist. I'm sure you've read some of his great things in so many places. Welcome back to the Musical Innertube.

ART

I have to keep reappearing to cement my Pennsylvania connections. They’ll disappear if I don't talk to you guys and find out what the heck's going on there in the Commonwealth.

JOHN

Well, there's a lot going on in in Pennsylvania. We are taping this just before New Year's and of course, on New Years, Pennsylvania gets absolutely obliterated, and it does all this weird stuff. I was just reading that Bethlehem, PA lowers a gigantic Peep. You know those marshmallow chicks?

DON

And Hershey lowers a huge kiss. And there's a place just south of Harrisburg called Dillsburg that lowers a pickle. Because it's Dills-burg.

JOHN

And Kennet Square lowers a 700-pound steel mushroom.

ART

And what does Intercourse lower?

JOHN

Your blood pressure!  No, actually, I think it raises mine. But anyway, so there's plenty to do on New Year's Eve, folks. You should go out and see the true nuttiness of a Pennsylvania New Year's Eve. There's literally lots of fun things that go down. One town out near Jim Thorpe, changes for three weekends in December to Bedford Falls. I mean really changes. It looks like it’s Bedford Falls. For those who don't know, is the town that It's A Wonderful Life happens in.

DON

Jimmy Stewart.

JOHN

Yeah, so, but this town remakes itself exactly. It's, it's crazy.

ART

That's really funny.

DON

I want to go running down that Main Street saying, “Hi, you old savings and loan!”

ART

Well, that savings and loan was bought by Goldman Sachs, then sold to venture capitalists from Oman years ago. It's not there anymore.

JOHN

Hmm. So art, you are a leading figure in the medical ethics movement in this country, certainly in the world. And you've been thinking about these things. And so I want to ask you, it's the new year coming up or Hanukkah, if you got a Hanukkah present and it's and it was this? What would you say? So, the Hanukkah present is a little piece of paper that says it will be granted to you that the things you really want to have happen in the field of medical ethics will happen in 2025, and those that you don't want will not. Let's start with the things you'd like to see happen.

ART

This is much better than getting that rotten dreidel, which I got for them 20 years.

JOHN

But we made it out of clay!

ART

You know, The funny thing about Hanukkah? And then I will answer your question. Uh, is that it is an absolutely minor holiday of no particular significance. It just. Because it falls around Christmas. It was the. It was the fall back for the. GS, who got left out, or miffed or something that they couldn't get a Christmas tree. But if you said if we went back a few thousand years and said to Jesus, what's this Hanukkah thing they said? I have no idea. I don't know some stupid. There's no significance whatsoever to anything, alright, but nonetheless it has significance here because one thing I could get is presents for seven days.

JOHN

Yes.

ART

So there could be a big, big list. I'll tell you first on my list of things that I would hope we get is finding some way to replace advanced directives. Written things we tell you to fill out about guiding your. End of life care. However you want to do it. It was. I don't want it or I want a lot or I only want things if I'm cognitively with it, or I'll take everything and hope for a miracle. The reality is they don't work. People don't. Fill them out when they do, fill them out. They stick em in their drawer, their office, and they don't get to the hospital even when they get to the hospital, they're usually very old. You know, somebody might fill it up when they're 60. By the time they're 80. Need it to guide their care. All the doctors are. What do you think they still mean it? 20. Should we follow that so? Something to replace that my suggestion might be everybody register online, have a computer thing that remind you to update it. By the way, I've seen people show up at the hospital and somebody come in and say I'm speaking for Don and it turns out to be his former. Wife.

Speaker

Move.

ART

Which which can. Maybe not the best spokesperson. In the situation, but I've seen it myself and so that would be first which replace living wills advance directives with more effective.

DON

Yes.

ART

Tools we still have too much. Going on at the end of life where people get things they don't want or people don't get things they do want or families are still fighting and it's we we can do better. We can do better. Can I ask a question?

JOHN

Can I ask a question? Does an ex-wife or ex-spouse I should say count as a survivor? Do we know this?

ART

What do you mean in a legal sense of controlling property? And so on.

JOHN

Yes.

ART

No they don't. Mm. Now you can still pick them. I mean, they're amicable divorces and people do it when they have kids in common and say, you know, she can.

Speaker

Sure.

ART

Control their. Didn't send them to school and all. It's not that it never happens. But you gotta make a special provision for it.

DON

1. I could imagine too that somebody at a 60 years old or 50 years old fills out one of these things. Puts down their current wife as a divorce. Remarries goes into the hospital 20 years later. They open it up. Contact is the ex-wife that would lead to that, yeah.

ART

All the time, all the time.

DON

Yeah.

ART

So once you do it, you don't really go back and you're not nagged or reminded to which electronically you could. You know, you could get an e-mail or a text saying it's time to just check in. Still want you know art as your. Decision maker and that kind of thing related to this. Another end of life care miserable situation I would like to see us fix Hospice. Hospice is a great idea. And for those who forgot Hospice is you go into. Palliative care, meaning emotional and physical support of pain and suffering. However, when you go into a Hospice, you have to agree to do no more efforts at therapy. In other words, you're saying. I'm done. Just take care of me and and and don't let me suffer. To put it bluntly. Well, there are a lot of new drugs coming out. Things that aren't yet FDA approved. Jimmy Carter. Had a drug, drug, drug. It helped him move probably 10 more years with cancer that wasn't even approved when he first got it. We have to relax the rules of Hospice to let people chase last ditch drugs if they want to use them, not tell them. Nope. Nope. Can't get it. You're in Hospice. Sorry. You signed away. Any ability to get this and a cousin issue to this? Is there too many for profit hospices that aren't doing the job? Lot of these private equity venture places have seen this as a very lucrative area. Get involved and make money, but they short staff and they don't train properly and Hospice is a great idea when it works well. It's great, by the way, if you don't, if you're a person who opposes medically assist. Ed dying or physician assisted suicide. Letting the doctor give somebody pills to end their life. Your best argument is beefing up Hospice. 'Cause people, what they're afraid of is that they're gonna suffer at the end of life if you tell them you'll take care of them and they'll have a dignified, emotionally supported end. They won't choose to exit, or most people have no interest in exiting religious.

JOHN

Will have. Interest in Don exiting. I you know, so goodbye, John.

ART

That's what my wife says. She she. Make me her decision makers. She fears I am too quick on the plug. It's a little. So that's a second wish. And again, in the end of life care space 1/3 wish. That we once and for all agree that if RFK Junior becomes head of Health and Human services or doesn't, someone else will. Take on that office with similar views. Trump has made it clear that we stop arguing that vaccines need to have proof that they're safe and efficacious. They do have proof the polio vaccine, when it was introduced, was actually studied in two million children, and you can even argue about whether that study was ethical. I'm not sure the consent was all that great, but they study them and found out that it worked. Found out that there were. I don't know a tiny number of cases where polio was communicated by the new vaccine, but it was studied. Then they began from the 50s to now to make safer versions. That we don't have to study the measles, mumps, rubella vaccine anymore. We know it doesn't cause autism. We don't have to really study the hepatitis B vaccine. There's a slew of these that critics and doubters and skeptics, including RFK Junior, say, well, I'm not opposed to vaccines. Just want them studied. That's. Bogus. And I wish it would just go away. It it is not what we need these days I see whooping cough cases breaking out in Pennsylvania. Is bouncing around already. That's not the way to go. I wish that would. And I don't think it's good for kids. And you know, we have one vaccine for cervical cancer called the HPV vaccine. Two countries, Australia and I guess Scotland isn't technically a country, but part of the Great Britain, Scotland have eliminated cervical cancer because of aggressive vaccination program. That's a cancer vaccine. We should be following that and arguing about whether. Vaccines are safe. They wiped out a very nasty cancer. You know, a lot of women. In the US, get cervical cancer picked up on a pap smear. Some die, I think 4000 a year die from it. Boy, that's. So that's a wish that that would stop deprecating vaccines that work, they're safe. Need them. We should get them another big wish. I would have. I hope we don't drop out of the WH. Joe, the new president, incoming says he wants to get us out of there. He's mad because he has this view that we funded and pay too much for it. You know he's right. Do fund it and we probably do pay too much for it, but we get our money's worth. Because all of the work that they do to stop diseases and problems in other countries benefits us, not the least of which. If you help people not get sick where they live, then they're less inclined to want to move to where you live. So if you don't like immigration, a nice thing to do would be to beef up the health care system to minimal level in a lot of these countries. Who tries to do that? The mission. They certainly are very active in trying to help out with aid in places like Ukraine and Gaza. Whatever we're putting in. To support them. It's peanuts. I mean, it's nothing. Elon Musk has that much money in his. Yeah, he sell out of his pocket. Whatever the WHL. So uh cost is so I hope we don't do. I think that would just be short sighted, as Ben Franklin said. You know, it would be Pennywise, #, foolish kind of problem. Don't do that. Think that's for a fifth one. I might urgently go for is my Hanukkah gift. I'd say we need to do more. Testing home care testing for things like the flu and disease. Like uh Co? If we could develop better test kits, then you'd know don't go out, don't go to. All that terrible fighting we had about closing the schools, and I'm not myself convinced that that was worth it, so to speak, in terms of preventing. Kids from getting sick or teachers getting. But whether it was or it wasn't. If you know who's sick from things, then you can treat them and also ask them not to go running around in public places. And you have to lock everybody else up this old school idea. Uh. That dominated CDC and public health thinking you have a disease quarantine the sick. Well, if there's like millions of people who are sick, you can't like we learned you can't quarantine the whole society. They hate it. They're mad. They can't go to work. They can't take care of the kids. I don't think that. Homeschooling, by zoom turned out to be a. Plus, I think a lot of kids just fell behind or didn't do it. But if you had testing, then you know your kids sick. Go to school. You're. Don't go to the movies and everybody else gets more freedom.

DON

This would be kinda like the COVID testing that we have now, correct? You would just put a swab in there and it would tell. Whether or not.

ART

You had the flu, correct? OK, we need more testing for these infectious diseases, because even if you can't cure them, at least you know who's got it and who you need to keep. Eye on and everybody else doesn't have to have their freedom. Restricted I I mean I think that that legacy of locking up societies and locking down the schools and job losses and restaurants closing and all that stuff. That really was a huge price to pay for what I'm gonna say was. Some control, but not great control of the spread. You gotta do better. And I think the path is testing. Think testing get you more freedom in terms of others who aren't sick or not infected. Being able to keep doing whatever it is. That they want to do. I got a 6/1. In the news a lot, I would pull cell phones out of. Now there's a bigger debate going on about whether cell phones are transmitting dangerous content to kids, you know, *********** or. A means of bullying and harassment. One of my colleagues at NYU, Jonathan Haight, wrote a book about this, basically saying they are and. It's called the anxious generation, and he argues, you know, we should never let these kids get near cell phones. I think he would probably not let them get near much of the Internet. There. Umm. Australia, it just banned cell phone use for kids. I believe under 18, but you can't have one. Parents tell me they're very nervous. I don't want their kid at school without a cell phone. Have to call if there's an emergency. To which my response is two things. One, you do what I did in school, which is you had to go to the principal's office to call your parents. Now that's slower, but you can do. Or you can give them the phone and let them make emergency calls. Not against the, you know. There's limited phones, but having a kid with a phone in school, scrolling around, paying no attention. Boy, I I don't know if it's corroding their minds, but it's not the place to use it at school. I'd like to see that. Band go into. I'm I'm not anti tick tock and I'm not anti the Internet even though it's full of. Misinformation and disinformation, but school not in school. I I always used to get a little irritated when I taught Med students and they'd open up their computers while I was given Electro. And you're like, you're not paying attention here, buddy. So if you don't pay attention, you have to show up. Don't sit here in front of me and not pay attention. That's. You're like irritating. That's not gonna go well for you later, so that would be one in the social sphere. One and I'll give a little shout out here. Know what Donald Trump and RFK junior. And I agree on get the direct to consumer pharmaceutical ads off TVI know RFK Junior doesn't like them, he and I don't like them for quite the same reason he thinks. They're just promoting too much. Pharmaceutical solutions to your health. I'm not sure that's exactly what's wrong, but they certainly do no good in terms of informing anybody about anything. I keep laughing every time I see one of these ads that comes on and says, you know, we've got Zita, mighty Frieda, Sosin. So if you have Type 4. Genetic stomach. This is for it's like that does not.

JOHN

Respond to aspirin and beer, yeah.

ART

Or yeah, yeah.

JOHN

On days that end with Y. You know, I mean they, they you get the small. In the in the.

DON

Yeah, but my favorite part is when they read the small print. You know this could cause their stomach distress, diarrhea and possible death if.

ART

Yeah. You know, also, I'll tell you what my favorite part is. These things. So ask your doctor about X. Yes. Well, if you have to go ask your doctor about X, you need a new. I mean, I think Doctor supposed to be a specialist in cancer. You're gonna come in and say, oh, you know, I saw on TV there's this ad for this cancer drug. You ever hear of it? Do you think we should try it it? What are you talking about? No other country really permits this. I know that they're spending tons of money on it, the pharmaceutical companies.

JOHN

Right. Because they spent tons of money. You know doing that.

DON

During the R&D, you know? Yeah.

JOHN

You know the R&D.

DON

So my favorite things too, and that in the little. Cautionary thing that they say is don't take it if you're allergic to vit. Amin, until you take it and have a reaction, how?

JOHN

Do you know?

ART

You. When you're on the floor calling the ambulance.

JOHN

With a rapidly closing throat. It's just like. Let me ask you a question. And you know, I think a lot of us would say those commercials run the gamut from being highly embarrassing to. I mean, there's something odd about the some of the commercials that the way that they sort of. Image the good. I mean, they're just an odd, weird commercial. And then or to really irritating. So from embarrassing and irritating. Did the law change because there was a time when you couldn't have commercial? Commercials like that.

ART

It. There was, I forget, the name of the case, but proponents for lawyers for the Pharmaceutical industry one. Cases that you can't intrude on their speech and it was tied up to John Saber case Citizens United, which gave corporations personhood standing so they can speak. And so if you have free speech, plus your corporation is a person, then you've got.

JOHN

You know. A free speech.

ART

Talking pharmaceutical. So yes, it was through legal challenge, but. The the point is, is that free speech, they're not telling you, you know, they're marketing products. Who? This is not. I have these views about whether vanilla is better than chocolate or something. This is marketing.

JOHN

Oh my goodness. Yeah.

ART

It's just ridiculous by the. I hate Citizens United. This whole idea that companies give money and act as persons.

JOHN

Well, now the now the, the personhood standing of corporations goes back to a very early. You know, sort of devil's bargain in the history of the Constitution. Was, you know? And you know. Sort of hard to extricate that. It's sort of, it's baked into the stuff. This is this happened in the early 19th century when it was ruled that the corporations should have the same standing as people and. Be subject to I mean and be have access to the same protections. I'm not defending it. Just noting. It sort of baked into the pie.

ART

Yeah, I mean. Guess part of me wants to say OK. Then, if they're really people, then let's not just give them rights and privileges. What do they get by way of obligations and duties, akin to what other people? Who have to do, who are just human people. So are they obliged to take care of their employees like they would a family member, just as an? You know, I mean, if you want to play that game of moral standing for corporations, then they're just indulging themselves. And no one's saying that it comes with any duties or obligations.

JOHN

That's so good. That's so interesting.

Speaker

Yeah.

JOHN

I I think yes. Human beings, we don't actually have an unlimited freedom of speech. We don't have an unlimited freedom of anything.

ART

Right. People were telling me during COVID and no one can intrude on my freedom.

JOHN

We.

ART

It's like. They intrude on your freedom from the time you wake up until you it's daylight savings. Or it isn't. So when you get in your car and you gotta put on your seat belt or you can't speed or. Have to follow. Road. I mean, it goes everywhere.

DON

I remember when seatbelts were made mandatory. There was a huge outcry that. You're infringing upon my personal rights in my car that I bought and you know, but, you know, you know, I remember too, when when Obama care was passed. And I was. I was working for the Senate and we were setting up a video feed and this lady came by to watch. Was going to be in the audience for this particular hearing, and she sat at a table next door. Sat in a chair next to the table where every setting. Everything up. And somebody very close to us was talking about. I don't want you know that shoved down my throat and everything, and she turned to me and she looked at me and she said. So here's a law that says we're going to give you health care when you need it, and we're going to make it affordable. Why would somebody not want that? And I said because of the purchase on their, their ability to get sick and die. I don't know, you know, but. That was that was going around, that was a.

ART

Very prevalent. Use to see people. Demonstrating against federal involvement with Obamacare. Who are absolutely Medicare recipients. Make this comes from what do you. It's it's like a federal subsidized program for all people. It's to say Obamacare is just extending it.

DON

1. I do remember a hearing seeing a hearing, a photo or a video where some elderly person was at a hearing or. You know, community group or? And he was holding up the sign that says keep your government hands off my Medicare.

ART

Exactly. Exactly. Exactly. By the way, that reminds me of another. You know Elon and Vivek there have said they want to cut $2 trillion out of the federal budget. The only way you could do that. Is to come against defense, which they won't. Or Medicare and Social Security 'cause the rest of the budget isn't big enough to get you $2 trillion back. We spend on education or scientific research or. These other things. So I do have a proposal and I know it's gonna get anybody over probably 62 Mattis Hornets at me. But if I were those guys and I was looking to save money, I'd raise the age of eligibility for. Social Security and Medicare. They were done in the 30s. People died much earlier. The demographics make no sense. You can work most jobs, not all I know if you get a physical labor job, you can't. But a lot of jobs. You could work if you can do it at 62, you could do it at 64. They did do it in France. It drove the public nuts. Think it drove Macron? The president there, Prime Minister, partly out of office because people hated losing those retirement years. But I'm telling you, that's the change I would make. Cut benefits and I wouldn't try to do Medicare Advantage in these other. Privatization efforts with. I would raise the age of eligibility. Just doesn't make sense. Eligible in today's demographics. We're we're living.

JOHN

Where would you put the?

ART

65 that you get them enough savings so.

JOHN

Yeah.

ART

And.

JOHN

That's that's very. That's not a very big change.

DON

I.

JOHN

That would that. Save 2 billion, a 2 trillion a year now.

ART

If it's a 2 trillion, but it would. A lot of money.

JOHN

All right, yeah.

ART

I don't know. I don't know I.

DON

Also.

ART

Either way, I'm not saying about current people. Say look. Five years from now, The thing is gonna change. Ready. Save more money in your you know retirement account. If you wanna do that. We're not gonna do this to anybody existing. Got a problem. This we're not changing that, but we are going to change. Literally put a clock in and alert people. This is coming. Get ready, you know. Prepare accordingly.

DON

Is it any surprise that the government turned the Medicare Advantage over to private industry to take care of to to insurance companies? And now we're dealing with a ton of fraud. Is is there any anybody that's surprised by that?

ART

No. No, and you know the administrative cost. Medicare is about 2% of total expenditure. The VA, which is actually a giant. You should say this 'cause. They'll go try to get rid of it. The VA probably has a 3% overhead as a giant socialized. Medical system that you know everybody deals with set prices and bargain prices.

DON

Sure. Yeah.

ART

Private insurance overhead 38%.

JOHN

You know, it's a breathtaking.

ART

So I mean.

JOHN

I I read something like that. You know, a few months ago, I kind of knew it in the back of my. Because this one of the things we used to say sitting around the editorial board meetings and saying, wow, you know, we wish the government could be. Used to just be you know. We wish government could be as efficient as private insurers, man about about 1/3 of private insurers are managers and administrators. You know, we just. We knew that because we met them all the time, they were the ones were saying give the business to us. Yes, how this is supposed to save? Money for. It it actually is a guarantee that medical costs will go up. More quickly than the cost of living, you know.

ART

Well, remember the thir the 38% number I quoted for United Healthcare and other, you know, big insurers. Does it even include the fraud that Don is talking? I mean, it's probably if you add that it probably makes it to 45% of.

DON

Oh geez, yeah.

ART

It's like absurd. And we've been playing this game with market capitalism to run healthcare for decades and decades. Doesn't work, you know.

JOHN

I was just gonna say that very thing art. And thank you for saying that because now I can tell people kill him not.

ART

It's just.

JOHN

Me, but I think the point. The point that you know, we have been fooling around with ever since the HMO laws in the early 70s in the Knicks era, is that privatized medicine does not work. You can't make money doing it.

DON

40 oz.

JOHN

And nobody in the world does it. Except we're trying to do it. And it just doesn't work. I don't. I don't know how you can make it work and they say, oh, you know, just. Ration care. Oh. Well, then it's not health care.

ART

That's by the way, that's what United Healthcare and the guy who got shot, that is their job. We have hired them to turn down requests for care. Rationing. That is what they're doing.

DON

Yeah.

ART

It doesn't seem to me they're popular. At doing it and I don't know if they do it well because there's no transparency about. Why they turn down something how you appeal. It's all a big black box in a giant corporate.

JOHN

If you lose one of those cases and you can't get it, and if you're poor, then you're a loser and no one hears from you. In other. You don't have the bullhorn. You don't have an equal right of speech. That's not there for you, and it's there's a lot of, you know.

ART

Yeah. And you know, going back to the mainstream. Media I used to try periodically to interest the Inquirer or the Boston Globe, or somebody in the plight of somebody in their area who couldn't get care enough. They would respond and do a nice story on, you know. Little Joey or Miss X or whoever it is, but they're not going to do that week after week. Not the news. You know what I mean? Their. Isn't to become a kind of alternative pathway for complaints. They give you the story of one person and it's sad and often times that one person got a break because the companies don't like the PR and they want to go. Way, but they're not gonna be the the. There's so much of this going on, is what I'm trying to. You only sniff a tiny part of it if you pick it up out of the media because again, the media is gonna get tired of just running those. You know, we do so many poor little Joey stories and then you gotta. On it.

DON

Yeah.

ART

It won't do them forever.

DON

As a bioethicist, I am assuming that you are opposed to the. Way Luigi took care of this, which is his beef with United Healthcare.

ART

I am.

Speaker

Well.

ART

1. You can't have vigilante running around doing this. Am gonna say two things about this. Well, there is a huge history in America of violence against corporate people, including trying to shoot.

JOHN

For.

ART

Frickin the. Old Gilded Age entrepreneurs in his house. I think assassination attempts were tried on John D Rockefeller, slew of people. I hear politicians today say all the time, let's not the American way to go out and try and kill, you know, Ce OS. My comment is, Oh yes, it is, and they do. Since they had the homestead steel strike and, you know, got into these wars between the Union guys and the Pinkertons, they've been trying to blow up and kill very American to be violent.

JOHN

Yes.

ART

That's my point. Very American. The other is no, you shouldn't have to shoot this guy to get people to pay attention to what's wrong. But I fear that this will. Fade. Oh, I I know it's in the news and we're all worried.

DON

Yeah.

ART

You know, they're turning down this and it's not transparent and they're making a ton of money. We'll have to talk about this in six months and see if it'll be. Remembers it. Yeah, it's not.

DON

Really don't think that the the offing of the CEO is going to change corporate anything. It's a terrible thing. You know. People lionize Luigi for being for doing what he did. And yet, and they've lionized him because of the problems they have with insurance. But. It's not gonna change the way insurance works. All I did was set up.

Speaker

Nope.

DON

Fences around outside of insurance company headquarters.

ART

And they all. And they all pulled their pictures down in info from their websites. That's about it. You know, that's, and I hate to say it, but that is exactly what happened when people were trying to get the right to unionize or trying to get a shorter work day. And begin to attack Ce OS in the 1900s. They just built up their security and pulled back into a more isolated lifestyle. All you know, they went to the Vanderbilt, went to their house in Asheville and invited their friends. Built a lot of fences around it, and that was the end of that. Didn't change. So yeah that you know. I'd I'd like to say, well, this will trigger a discussion that'll achieve reform. I don't know. Don't know.

JOHN

Every year brings new discoveries in medicine and and none of them come without questions and and an ethical issue. So. My friend, you're going to have business for. Long time.

ART

You must not forget that Elon Musk is a huge effort under. To try and study the brain by implanting things into the brain, and he's doing it on people right now, it's called Neuralink. So if you like Elon Musk, then he said that cynically. I'd like him controlling your brain directly from a computer station.

JOHN

What if? Could arrange for that not to happen to me.

Speaker

I mean, I I don't.

JOHN

Want to talk out of turn here?

ART

But yeah, well, you probably protest for a while.

JOHN

Yeah.

ART

Think it was cute.

JOHN

So does he propose? I know that the implanting idea is going on, that he's getting volunteers. And people are coming right up and go oh. So like the old box. Yes, please put a A sensor in my brain. So do they disturb the neural? Do they actually disturb the neat up there? How is? How is implanting done?

ART

Well, it's a great question and we don't know the answer because it's completely. Off the books. He doesn't report on it.

JOHN

Trust us.

ART

He doesn't publish. He doesn't get it reviewed by the usual committees because it's privately funded, so there's no law. If you're funded by the NIH, you have to go through a lot more committee review and transparency. If you're a gazillionaire running your own little company, you don't have to do. And we don't know. I'll tell you that when somebody goes in and has a brain stimulation treatment for parkinsonism and you may have heard of that, some licenses will know about that. It's. Needle. It hits a few cells in the brain and seems to help. I've seen the size of the stuff he's putting in people's brains, and it's 1000 times bigger. So would I imagine that it shakes up the gunk in your head? I would, but I don't know.

JOHN

Oh man, with my teeny cranium, there's a lot of room to put. Sorts of.

Speaker

Crap.

ART

Well, they tha that's right. Called the targeting. They may have to fish around for a long time when they hit something.

DON

Yeah.

ART

Yeah, yeah.

DON

No. All I can say is I remember reading science fiction when I was in high school, and the big thing in science fiction books and movies back then was corporates take over. Corporations take over. Exploration of space medicine, you know, and and it was all bad. Robots were bad. You know when? When? When cruisers went out to Mars and blew up, nobody knew anything about it because the corporate covered it up. And that's that seems to be where we're headed, isn't it?

ART

Yeah. Well, Americans are much more afraid of a government owning the technology. To manipulate your brain or, you know, manipulate our future or us than they are corporations. They're more accepting of Elon Musk. Acting out in his profit driven way to modify our brains than they are, say, you know Anthony Fauci. And I'm not sure where that all comes from. Great fear of government more than. Private sector. I don't know, but yeah, I mean that's right there. Space program is becoming corporatized. Medicine is heavily. This brain research is heavily. Corporatized, and it doesn't have a lot of accountability behind it. It's like. They are the billionaires. To play. You know, by their rules. So that'll create a lot of ethics to limits to talk about. Real problem is whether anybody's. Do anything about it. A separate we.

JOHN

Skip 2025 and goes straight to 2000 and I don't know when the next election is, it's.

ART

Separate matter.

JOHN

You're frightening me, that's all.

ART

Nothing to worry. The Borg will be here very soon inside. Inside joke for you sci-fi.

JOHN

There. Go, that's. It's it's. It's a neck and neck race between the Borg and and the singularity. So art Kaplan, the freewheeling slash slashing and burning Swash, buckling art Kaplan we have covered such wonderful territory today and I just want to thank you. We want to have you. One of the things that we look. Next year. We'll have you on again. Thanks, heart.

ART

Very. I enjoy it. Guys.