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.