# ![@DutchRojas Avatar](https://lunarcrush.com/gi/w:26/cr:twitter::475043222.png) @DutchRojas Dutch Rojas

Dutch Rojas posts on X about health, insurance, in the, this is the most. They currently have [------] followers and [---] posts still getting attention that total [-------] engagements in the last [--] hours.

### Engagements: [-------] [#](/creator/twitter::475043222/interactions)
![Engagements Line Chart](https://lunarcrush.com/gi/w:600/cr:twitter::475043222/c:line/m:interactions.svg)

- [--] Week [---------] +225%
- [--] Month [---------] -40%
- [--] Months [----------] -61%
- [--] Year [----------] +1,133%

### Mentions: [--] [#](/creator/twitter::475043222/posts_active)
![Mentions Line Chart](https://lunarcrush.com/gi/w:600/cr:twitter::475043222/c:line/m:posts_active.svg)

- [--] Week [--] -26%
- [--] Month [---] +28%
- [--] Months [-----] +168%
- [--] Year [-----] +90%

### Followers: [------] [#](/creator/twitter::475043222/followers)
![Followers Line Chart](https://lunarcrush.com/gi/w:600/cr:twitter::475043222/c:line/m:followers.svg)

- [--] Week [------] +3.70%
- [--] Month [------] +4.60%
- [--] Months [------] +49%
- [--] Year [------] +89%

### CreatorRank: [------] [#](/creator/twitter::475043222/influencer_rank)
![CreatorRank Line Chart](https://lunarcrush.com/gi/w:600/cr:twitter::475043222/c:line/m:influencer_rank.svg)

### Social Influence

**Social category influence**
[finance](/list/finance)  #4929 [stocks](/list/stocks)  8.73% [countries](/list/countries)  6.35% [travel destinations](/list/travel-destinations)  0.79% [celebrities](/list/celebrities)  0.79% [technology brands](/list/technology-brands)  0.79% [cryptocurrencies](/list/cryptocurrencies)  0.79% [automotive brands](/list/automotive-brands)  0.79%

**Social topic influence**
[health](/topic/health) #635, [insurance](/topic/insurance) #80, [in the](/topic/in-the) #3212, [this is](/topic/this-is) 7.14%, [code](/topic/code) #423, [the most](/topic/the-most) 5.56%, [business](/topic/business) #4340, [systems](/topic/systems) #695, [country](/topic/country) #684, [health insurance](/topic/health-insurance) #13

**Top accounts mentioned or mentioned by**
[@heathveuleman](/creator/undefined) [@drdigiorgio](/creator/undefined) [@realdocspeaks](/creator/undefined) [@mass_marion](/creator/undefined) [@edwards183](/creator/undefined) [@andreabee00722](/creator/undefined) [@cogitator88](/creator/undefined) [@mcuban](/creator/undefined) [@nathanlevy10](/creator/undefined) [@alexjung](/creator/undefined) [@datarepublican](/creator/undefined) [@laffincrow](/creator/undefined) [@sock_puppet1787](/creator/undefined) [@x0_1_7ex](/creator/undefined) [@masterly_rex](/creator/undefined) [@recoverydoctor](/creator/undefined) [@docpolymath](/creator/undefined) [@keithmanleyjr](/creator/undefined) [@gopdoctors](/creator/undefined) [@edithatogo](/creator/undefined)

**Top assets mentioned**
[CVS Health Corp (CVS)](/topic/cvs) [Cigna Corp (CI)](/topic/$ci) [Berkshire Hathaway Inc. (BRK.A)](/topic/berkshire-hathaway)
### Top Social Posts
Top posts by engagements in the last [--] hours

"The Most Elegant Monopoly in American Healthcare The most effective monopolies dont ban competition. They simply require competitors to ask permission. Massachusetts offers a masterclass in how to do this politely. A Friday Happy Hour 🧵"  
[X Link](https://x.com/DutchRojas/status/2022449744002383898)  2026-02-13T23:16Z 32.2K followers, [----] engagements


". T1019. Personal care services. Bathing dressing and meal prep. $+       . If this is what T1019 looks like what does T1020 look like What about home health codes DME codes and behavioral health codes The same structural incentives exist across the Medicaid billing landscape: low oversight easy entity creation geographic clustering and authorized official networks. Medicaid is the largest payer in the U.S. healthcare system covering [--] million people. It is also the least transparent. The HHS dataset is now public. https://dutchrojas.substack.com/p/the-billion-dollar-club"  
[X Link](https://x.com/DutchRojas/status/2022935408070250907)  2026-02-15T07:26Z 32.2K followers, [----] engagements


"Boston arguably the most prestigious medical city in the world has exactly one ambulatory surgery center within city limits. Scarcity in this context is not geographic. It is policy-defined. 11/"  
[X Link](https://x.com/DutchRojas/status/2022449824185094170)  2026-02-13T23:16Z 32.2K followers, [---] engagements


"Calling this a scandal is like calling a casino a charity that occasionally takes your money. The PBM model isnt broken; its doing exactly what it was designed to do. It creates opacity and extracts value. The most expensive part of a prescription isnt the drug; its the series of invisible hands it passes through. 🚨 SCANDAL IN TENNESSEE: How a PBM "Stole" $30000000 from Taxpayers 🚨 A bombshell audit by the Tennessee Department of Commerce and Insurance has just exposed the shady underbelly of Pharmacy Benefit Managers (PBMs). The target Express Scripts. The findings are a wake-up"  
[X Link](https://x.com/DutchRojas/status/2022573301592207501)  2026-02-14T07:27Z 32.2K followers, [----] engagements


"@RecoveryDoctor Ill know for sure in the next few days. Its a copious amount of data"  
[X Link](https://x.com/DutchRojas/status/2022857161873691024)  2026-02-15T02:15Z 32.2K followers, [---] engagements


"@dr_hamill Yes physicians live in fear And the billing offices in the worst neighborhoods in the country bill for billions and there is not oversight"  
[X Link](https://x.com/DutchRojas/status/2022976145986080938)  2026-02-15T10:07Z 32.2K followers, [---] engagements


"Every year the United States Government gives $40 billion to insurance companies. And thats just the start. The Official Story: When you buy health insurance on the Obamacare marketplace the government helps in two ways: [--]. They lower your monthly payment (premium subsidy) [--]. Theyre supposed to lower what you pay at the doctor (cost-sharing reduction) That $40 billion is for #2 to make your deductibles and co-pays smaller. The Real Dutch Story: The insurance companies get that $40 billion automatically. Every year. No matter what. Congress doesnt vote on it. Nobody can stop it. It just flows."  
[X Link](https://x.com/anyuser/status/1987136491940651166)  2025-11-08T12:33Z 32.2K followers, 352.5K engagements


"The Five Families of Healthcare. UnitedHealth. CVS. Elevance. Cigna. Centene. 52% of the market. One-fifth of the economy. The full breakdown drops tonight at 5:30pm Central"  
[X Link](https://x.com/DutchRojas/status/2000251665736421828)  2025-12-14T17:08Z 31.1K followers, [----] engagements


". A ruling elite whose power is felt but rarely seen.       : UnitedHealth. CVS. Elevance. Cigna. Centene. The Five Families of Healthcare. A thread🧵 "  
[X Link](https://x.com/DutchRojas/status/2000347587841282265)  2025-12-14T23:30Z 31.1K followers, 14K engagements


"The Nonprofit Architects Who Built the Castle the Five Families Inherited You know the Five Families. UnitedHealth. CVS. Elevance. Cigna. Centene. The for-profit giants everyone loves to hate. The publicly traded villains. The ones whose denials make the news. Yet there is a secret that 99.9% of the American populations does not know and I am going to reveal it to you today. The [--] families didnt build this system. They inherited it. The [--] Dynasties. 11:30am Eastern. https://twitter.com/i/web/status/2000573633660637361 https://twitter.com/i/web/status/2000573633660637361"  
[X Link](https://x.com/DutchRojas/status/2000573633660637361)  2025-12-15T14:28Z 31.1K followers, [----] engagements


". UnitedHealth. CVS. Elevance. Cigna. Centene. -  . But they didn't build this system. They inherited it. Introducing: The Five Dynasties.🧵"  
[X Link](https://x.com/DutchRojas/status/2000604318265716902)  2025-12-15T16:30Z 31.1K followers, 12.1K engagements


"A nonprofit university hospital in Virginia sued a patient for $13000. She was a schoolteacher. They garnished her wages for [--] years. The university hospitals CEO made $4.2 million that year. Heres what nonprofit actually means in American healthcare: It means they dont pay property taxes. It means they dont pay income taxes. It means they dont pay sales taxes. It does NOT mean: They dont make money They dont hoard cash They dont sue you into poverty The [--] largest nonprofit hospital systems in America hold over $324 billion in assets. Read that again. $324 billion. They have legal teams"  
[X Link](https://x.com/DutchRojas/status/2006364770274791909)  2025-12-31T14:00Z 31.1K followers, 60K engagements


"The "safest" investments are often the most dangerous. In [----] it was housing. Today it's the $4 trillion market funding hospital expansions across America. Michael Burry and a handful of traders saw the housing fraud before everyone else. They bought credit default swaps on mortgage-backed securities. They paid premiums for years. Everyone called them crazy. Then the fraud surfaced. And they made billions. Everyone else got wiped out. The same trade structure exists in municipal bonds today. The spreads are tight. The assumptions are rosy. The market believes the money is real. A Federal"  
[X Link](https://x.com/DutchRojas/status/2008539056406474824)  2026-01-06T14:00Z 31.1K followers, [----] engagements


"$275 billion in annual subsidies. $29 million in lobbying. $33.2 million CEO paydays. This is what "good at business" looks like in American healthcare Not innovation. Not service. Rule capture"  
[X Link](https://x.com/DutchRojas/status/2015786830944149934)  2026-01-26T14:00Z 31.2K followers, [----] engagements


"$275 billion in annual subsidies. $29 million in lobbying. $33.2 million CEO paydays. This is what "good at business" looks like in American healthcare Not innovation. Not service. Just rule capture"  
[X Link](https://x.com/DutchRojas/status/2015824602190983196)  2026-01-26T16:30Z 31.1K followers, [----] engagements


"How do you lose $60 billion in [--] hours By breaking the one rule Wall Street still cares about. Dont lie to the market. And dont insult its memory. UnitedHealth did both. For years they grew their Medicare Advantage empire by selling simplicity: $0 premiums. No deductibles. Everything included until it wasnt. In [----] they flipped the script: Raised out-of-pocket maxes. Introduced new deductibles. Assumed seniors wouldnt notice or wouldnt bother to leave. They were wrong. They didnt just lose patients. They lost trust. And when trust disappears so does valuation. Heres what happened next:"  
[X Link](https://x.com/DutchRojas/status/2016500514460930560)  2026-01-28T13:16Z 31.2K followers, 132.8K engagements


"Many want to blame Private Equity. Well you are wrong and have been wrong. Private Equity has gotten smoked for getting into healthcare. It is the non-profit health systems. It has always been the non-profit health systems. Everything the government does is wrong. Non-profit doesn't mean no profit. Thank you to my friends and hosts Drs. Montero-Baker and Ferrer. Medicine is the field where experts are restricted from owning the tools of their own trade. Private firms have tried to run healthcare like a startup company but theyve overlooked one important detail: the model is failing because"  
[X Link](https://x.com/DutchRojas/status/2017645830002638984)  2026-01-31T17:07Z 31.1K followers, 15.9K engagements


"I have written about the ripoff Medicaid tax sixteen times since [----]. CMS shuts it down in [----] and gives the guilty parties until [----] to resolve it A infamous non-physician doctor on X told me I was full of 💩 and blocked me last year when I wrote this. She has 157k followers. Follower count does not make you right or correct. Im certain I will not hold my breath waiting for her to tell me I was 100% spot on. Provider Taxes: The Most Elegant Grift in American Healthcare Its not a tax. Its a laundering operation. Heres how it works: [--]. A health system voluntarily agrees to a provider tax"  
[X Link](https://x.com/DutchRojas/status/2017979064728813715)  2026-02-01T15:11Z 31.2K followers, 10.4K engagements


"A thought experiment: What happens when you convert a taxpaying entity into a tax-consuming entity The buildings don't change. The beds don't change. The patients don't change. What changes: who pays and who gets paid. HCA paid taxes. OU Health receives $463-493 million annually. Same hospital. Opposite economics. https://twitter.com/i/web/status/2018780301263011963 https://twitter.com/i/web/status/2018780301263011963"  
[X Link](https://x.com/DutchRojas/status/2018780301263011963)  2026-02-03T20:15Z 31.2K followers, [----] engagements


"What $825 million bought: $1.5 billion in debt (June 2023) Ba3 credit rating (junk status January 2023) $96 million appropriation increase (FY2024) The court approved $750 million. The state paid $825 million. The debt exceeded $1.5 billion. The math. It maths. https://buff.ly/CzcR5bi https://buff.ly/CzcR5bi"  
[X Link](https://x.com/DutchRojas/status/2018825590187434158)  2026-02-03T23:15Z 31.1K followers, [----] engagements


"Oklahoma bought a hospital for $825 million. Four years later it was junk-rated and needed a taxpayer bailout. Heres what actually happened. A 🧵"  
[X Link](https://x.com/DutchRojas/status/2018858500927955447)  2026-02-04T01:25Z 31.1K followers, [----] engagements


"Before: HCA owned it. Paid federal state and property taxes. Zero state subsidies. Corporate balance sheet risk. Outpacing peers nationally. After: OU Health. Tax-exempt. $245.8M in state appropriations. $1.5B debt load on taxpayers. Junk credit rating. Same beds. Same patients. Completely different financial model. 1/ https://twitter.com/i/web/status/2018858507114565761 https://twitter.com/i/web/status/2018858507114565761"  
[X Link](https://x.com/DutchRojas/status/2018858507114565761)  2026-02-04T01:25Z 31.1K followers, [---] engagements


"The credit rating tells the story. 2018: Deal closes at Baa3 lowest investment grade. 2022: Downgraded to Ba3. Junk status. March 2023: [--] days cash on hand. FY2024: $96M appropriation increase. De facto bailout. Weve had conversations about bailing them out. Rep. Kevin Wallace House Appropriations Chairman. 2/ https://twitter.com/i/web/status/2018858512332296699 https://twitter.com/i/web/status/2018858512332296699"  
[X Link](https://x.com/DutchRojas/status/2018858512332296699)  2026-02-04T01:25Z 31.1K followers, [---] engagements


"HCAs exit strategy: Leave a low-margin high-indigent market. Escape $400M bed tower cost. Take premium price ($1.06M per bed) and walk. The buyers narrative: Goals of a private company dont mesh with teaching hospitals. The warning sign everyone ignored: SSM Health spent [--] months in due diligence and walked away in [----]. 3/"  
[X Link](https://x.com/DutchRojas/status/2018858525678579992)  2026-02-04T01:25Z 31.1K followers, [---] engagements


"$1.3 Billion bond issuance anatomy: $825M: HCA buyout (base layer) $400M: New patient tower $30M: Proton therapy equipment $45M: Fees and reserves Risk factors: 50-year maturity. Initial Baa3 rating. Current debt: $1.5B outstanding. 5/"  
[X Link](https://x.com/DutchRojas/status/2018858536302944666)  2026-02-04T01:25Z 31.1K followers, [---] engagements


"Indigent care accounts for 72% of operating expenses. Total subsidies: $463-493M Indigent care cost: $406.6M The subsidies are not profit. They are the price of the mission. The transition from HCA to OU Health shifted this $406M burden from corporate shareholders to the taxpayer. 9/ https://twitter.com/i/web/status/2018858559367225779 https://twitter.com/i/web/status/2018858559367225779"  
[X Link](https://x.com/DutchRojas/status/2018858559367225779)  2026-02-04T01:26Z 31.1K followers, [---] engagements


"What a wonderful thought it is that some of the best days of our lives havent even happened yet. - Anne Frank"  
[X Link](https://x.com/DutchRojas/status/2019020113157271958)  2026-02-04T12:08Z 31.2K followers, [---] engagements


".    . Every hospital in America is being forced to publish prices. Most people hear that and think: Cool. Patients can shop now. Thats not the real story. Heres the Dutch insight Healthcare is crossing a line it has never crossed before: Its becoming computable. That matters far more to entrepreneurs and data scientists than to patients. Because once prices exist a chain reaction starts: Markets form Benchmarks emerge Arbitrage appears Bundles can be built Risk can be priced Forward contracts become possible (yes my SurgeryFutures) This is how every modern industry was rebuilt. Not with"  
[X Link](https://x.com/DutchRojas/status/2019385908756177396)  2026-02-05T12:21Z 31.9K followers, 174.1K engagements


".   . Path 1: Private Equity. They acquire your practice at 6-12x EBITDA. You solve the economics. You lose autonomy. They flip you in five years. Path 2: Health System Employment. They employ you. You solve the economics. You lose ownership. You become a badge number. Notice the pattern Both paths solve the same problem: you pay 30% more than the hospital down the street for the same insurance the same benefits the same everything. Both paths solve it the same way: by demanding you surrender what you built. PE takes your equity. Health systems take your autonomy. Both take your independence."  
[X Link](https://x.com/DutchRojas/status/2019743887388991919)  2026-02-06T12:04Z 31.2K followers, [----] engagements


"$71.8 million. That is how much one 50-employee independent practice loses to insurance carriers over a 30-year career. It is insane The grift is real Not to malpractice. Not to bad management. To the middleman. I did the math. Today I published the receipt. Full breakdown here: 60000+ healthcare professionals read The Rojas Report. https://buff.ly/DelccH9 https://buff.ly/DelccH9"  
[X Link](https://x.com/DutchRojas/status/2019795758862467408)  2026-02-06T15:30Z 31.9K followers, [----] engagements


"@Doc_Polymath In fact it took [--] years a serious amount of compliance and legal work. It was almost impossible and yet here we are"  
[X Link](https://x.com/DutchRojas/status/2019820243896659982)  2026-02-06T17:07Z 31.1K followers, [---] engagements


"A Walmart manager may out earn a pediatric subspecialty surgeon. And everyone acts shocked. And its a question @HeathVeuleman @GeBaiDC and I have discussed. Why is a surgeons value determined by a committee instead of a market In every other domain of human expertise the extraordinary practitioner captures extraordinary value. The lawyer who wins the impossible case. The architect whose buildings define skylines. The entrepreneur who sees what nobody else sees (me 🫡). They dont earn 2x their peers. They earn 50x. Medicine is the only profession where a central planning committee the RUC with"  
[X Link](https://x.com/DutchRojas/status/2020076607436714018)  2026-02-07T10:06Z 31.2K followers, 40.8K engagements


"When a practice pays an insurance premium four things happen. The carrier pays claims. The carrier covers operating costs. The carrier keeps underwriting profit. The carrier invests the float. Warren Buffett built Berkshire Hathaway on that fourth one. Your premiums built it for him. https://twitter.com/i/web/status/2020135488498106796 https://twitter.com/i/web/status/2020135488498106796"  
[X Link](https://x.com/DutchRojas/status/2020135488498106796)  2026-02-07T14:00Z 32.1K followers, [---] engagements


"@Doc_Polymath PE in HC is dead. They were slaughtered"  
[X Link](https://x.com/DutchRojas/status/2020146357734977676)  2026-02-07T14:43Z 31.1K followers, [--] engagements


"-  . Academic "non-profit" Centers are the most expensive. Non-Profit Health Systems are next. For-Profit Health Systems are third. Independent practice of medicine is the lowest cost. The entire economic structure of American healthcare is designed to eliminate the cheapest model and protect the most expensive one. Would someone let Dr. Oz and Secretary Kennedy know they're in charge of a cartel"  
[X Link](https://x.com/DutchRojas/status/2020150601837875402)  2026-02-07T15:00Z 31.1K followers, [----] engagements


"@realdocspeaks @HeathVeuleman Why do people expect second order solutions to solve problems"  
[X Link](https://x.com/DutchRojas/status/2020187478964212090)  2026-02-07T17:26Z 31.1K followers, [---] engagements


"@HeathVeuleman @realdocspeaks Hahaha Well maybe we are both nuts. 🤣😂🤣. My substack for Monday is PBM cost plus and TrumpRx and how they are second order patches. They dont solve shit"  
[X Link](https://x.com/DutchRojas/status/2020188970236498304)  2026-02-07T17:32Z 31.1K followers, [---] engagements


"When physicians leave independent practice for hospital employment Medicare costs per patient per year increase by $1327. When they move to models that preserve the practice structure costs decrease by $963. Consolidation does not reduce spending. It increases it. The data is not ambiguous. https://buff.ly/rWTFJY4 https://buff.ly/rWTFJY4"  
[X Link](https://x.com/DutchRojas/status/2020192095365890541)  2026-02-07T17:45Z 31.9K followers, 28.6K engagements


"This is insane. Major Nonprofit Health Systems admit: They own the hospitals clinics urgent caresbasically the entire map of your town They employ your doctors nurses and specialists (who are expected to hit RVU targets like sales reps) They run their own insurance plans (yes nonprofits with insurance subsidiaries let that marinate) They own the labs imaging centers surgery centers and sometimes even the janitorial services Their obligation Expanding the health system brand and executive bonuses not patient care They admit ALL of this: Weve established on the record that the largest nonprofit"  
[X Link](https://x.com/DutchRojas/status/2020599396938002815)  2026-02-08T20:43Z 31.9K followers, 30.4K engagements


"@realdocspeaks Thank you sir Churches are listening Manufacturers are listening Universities are listening The largest VC are listening My largest audience is healthcare folks"  
[X Link](https://x.com/DutchRojas/status/2020600419412836738)  2026-02-08T20:47Z 31.1K followers, [---] engagements


"Stood before a room of physicians this week. Specialists. Decades of training in every chair. I wanted them to see their own story in a story three thousand years old. Samuel anointed two kings. One received the crown in weeks. The other waited two decades. The one who waited lived among the enemy. Lied to survive. Gathered [---] broken men in a cave. Had two chances to seize the throne by force. Refused both times. A physician does not become a physician the day the degree is conferred. That is the anointing. The wilderness is everything after. Saul received the throne. David became the"  
[X Link](https://x.com/DutchRojas/status/2020629976110821686)  2026-02-08T22:45Z 31.1K followers, [----] engagements


"Four Field goals. Lame Super Bowl gets lamer. A national icon telling girls that great nutrition and training are not enough you need Big Pharma. This is where we are. Go NFL"  
[X Link](https://x.com/DutchRojas/status/2020678371802526196)  2026-02-09T01:57Z 31.2K followers, [----] engagements


"@edwards183 @KeithManleyjr Walmart pays market rates. Healthcare delivery does not. The system is second principle thinking. The way to reduce spend and generate cash is by first principle execution. And when we discuss CMS rates Id like to know which of the few schedules we are referring to"  
[X Link](https://x.com/DutchRojas/status/2020962215491502356)  2026-02-09T20:45Z 31.1K followers, [--] engagements


"@DaveBondyTV 340B is the beginning. I dont recommend the rabbit hole. Its deep and once you see it youre responsible. @DrDiGiorgio @HeathVeuleman"  
[X Link](https://x.com/DutchRojas/status/2021212877042909272)  2026-02-10T13:21Z 31.9K followers, [----] engagements


"Jessica has a deep understanding of the CON laws and healthcare in West Virginia. Absolutely brilliant. Counties with the highest medical debt in West Virginia are often the same places receiving the least charity care from local hospitals. Are non-profit hospital systems serving communities with the greatest need https://t.co/5C7AXBY5PO Counties with the highest medical debt in West Virginia are often the same places receiving the least charity care from local hospitals. Are non-profit hospital systems serving communities with the greatest need https://t.co/5C7AXBY5PO"  
[X Link](https://x.com/DutchRojas/status/2021224137876808107)  2026-02-10T14:06Z 31.2K followers, [----] engagements


"The most expensive thing in healthcare is not any particular drug. It is the absence of a market. Every industry that built an exchange got cheaper. Agriculture. Energy. Telecom. Finance. Healthcare skipped this step entirely. Then everyone appeared surprised when costs increased"  
[X Link](https://x.com/DutchRojas/status/2021245343480861010)  2026-02-10T15:30Z 31.2K followers, [----] engagements


"A GoodRx coupon does not lower drug prices. It arbitrages the gap between two fake numbers and takes a cut. The company went public at $12.7 billion. Its entire business model depends on the system staying exactly as broken as it is. That is not a bug. That is the product"  
[X Link](https://x.com/DutchRojas/status/2021271740173750722)  2026-02-10T17:15Z 31.9K followers, [----] engagements


"Ah yes nothing screams affordability like crushing independent docs and handing the keys to corporate hospitals. Warren and Hawley out here cosplaying reformers while their states are graveyards for private practice. Premiums sky-high Thats not a mystery thats math. UPPs are cheaper. The data screams it. But instead we feed the hospital-industrial complex like its Thanksgiving every day. You want affordable healthcare Try not vaporizing the only model that actually saves money. Are politicians this organically dumb Or are they paid to feign stupidity Sens. Elizabeth Warren and Josh Hawley are"  
[X Link](https://x.com/DutchRojas/status/2021272665802096774)  2026-02-10T17:18Z 31.2K followers, [----] engagements


"Imagine if grocery stores worked like pharmacies. You would never see a price tag. A third party would "negotiate" on your behalf. You would pay a different amount each time you visited for the same loaf of bread. And someone would build an app that finds you a "coupon" and go public at $12.7 billion. You would call that insane. Americans call it healthcare. https://twitter.com/i/web/status/2021298262913831312 https://twitter.com/i/web/status/2021298262913831312"  
[X Link](https://x.com/DutchRojas/status/2021298262913831312)  2026-02-10T19:00Z 31.9K followers, [----] engagements


"I would never support two Senators that encourage healthcare consolidation in their own states. They dont understand healthcare much less know how to reform it. And I want to lower expenses and costs and actively do so. Hell Ive personally done more for patients than Warren and Hawley combined. Mark CMS the hospital associations and lawmakers in government want to shut down private industry and make everyone bow the knee to government. Great job @HawleyMO & @SenWarren LOVE THIS. Anyone in Congress that doesnt support this doesnt want lower cost healthcare for Americans. This is a no brainer."  
[X Link](https://x.com/DutchRojas/status/2021304795127030112)  2026-02-10T19:26Z 31.4K followers, 43K engagements


"@HeathVeuleman And he loves the university of Missouri"  
[X Link](https://x.com/DutchRojas/status/2021306868866388384)  2026-02-10T19:34Z 31.2K followers, [---] engagements


"@HeathVeuleman Oh yeah And their support of the moratorium is lovely. MO did give an exemption for ASCs. Immediately ortho left all advocacy groups"  
[X Link](https://x.com/DutchRojas/status/2021307379434823851)  2026-02-10T19:36Z 31.2K followers, [--] engagements


"Two senators that support consolidation by non profits despise independent medicine and Mark who on two occasions has said to me Dutch get with it healthcare is a right. Their solutions are fascism and control. Cant support it. The way to lower prices is competition removal of subsidies site neutral payments etc (which you know well). https://twitter.com/i/web/status/2021313079351652860 https://twitter.com/i/web/status/2021313079351652860"  
[X Link](https://x.com/DutchRojas/status/2021313079351652860)  2026-02-10T19:59Z 31.1K followers, [--] engagements


"TrumpRx dropped Ozempic from $1028 to $350. People celebrated. Nobody asked the uncomfortable question: what happens if the next President does not want to call pharmaceutical CEOs personally A price that requires the White House to exist is not a price. It is a favor"  
[X Link](https://x.com/DutchRojas/status/2021317012765507712)  2026-02-10T20:15Z 31.2K followers, [----] engagements


"Markets are as a general matter seperated into three segments. 1) retail 2) business 3) institutional Today governments around the world set medical treatment prices by central planning. Exchanges solve the challenge to pricing hundreds thousands and millions of services in real time. https://twitter.com/i/web/status/2021320183160402296 https://twitter.com/i/web/status/2021320183160402296"  
[X Link](https://x.com/DutchRojas/status/2021320183160402296)  2026-02-10T20:27Z 31.2K followers, [--] engagements


"What isnt logical Buyers would never again need renewals. Consumer apps could be built in the pricing data. Analyst could advise on value versus brokers selling products. Exchanges are an excellent mechanism for exchange. There are 350+ exchanges for energy lumber currency metals etc. https://twitter.com/i/web/status/2021322372297433490 https://twitter.com/i/web/status/2021322372297433490"  
[X Link](https://x.com/DutchRojas/status/2021322372297433490)  2026-02-10T20:36Z 31.2K followers, [--] engagements


"@cogitator88 Mark believes healthcare is a right"  
[X Link](https://x.com/DutchRojas/status/2021327481857273888)  2026-02-10T20:56Z 31.2K followers, [--] engagements


"The Amsterdam Bourse opened as a commodity exchange in [----]. Grain. Herring. Spices. Tulips Middlemen became optional. Costs came down. Every modern exchange on earth followed. Five hundred years later American healthcare still has no exchange. The middlemen are doing extremely well. https://twitter.com/i/web/status/2021351013894979943 https://twitter.com/i/web/status/2021351013894979943"  
[X Link](https://x.com/DutchRojas/status/2021351013894979943)  2026-02-10T22:30Z 31.2K followers, [---] engagements


"Cost Plus sells drugs at cost plus 15%. Transparent. Honest. Admirable. It also covers roughly 12% of total drug spending. The other 88% has no transparent pricing mechanism at all. Building an honest calculator inside a rigged casino is noble. It is not a solution. It is a proof of concept"  
[X Link](https://x.com/DutchRojas/status/2021362308950249769)  2026-02-10T23:15Z 32.1K followers, 20.1K engagements


"@WildWildArrest @mcuban @Alva5915George @DrDiGiorgio @HammondOnHealth Are you retarded The United States government gives $300 billion to the health systems in subsidies and that doesnt include the accounting for tax free donations"  
[X Link](https://x.com/DutchRojas/status/2021523494815568100)  2026-02-11T09:55Z 31.2K followers, [--] engagements


"Two Senators Want to Break Up Big Medicine. Their States Perfected It First. One represents a state that regulates [--] healthcare services through Certificate of Need. The other represents a state that banned new surgery centers for [--] years. Mark Cuban called it a no brainer. [----] of his [---] million followers agreed. Thats 0.08%. They are not fighting the monopoly. They are the monopolys landlords. https://open.substack.com/pub/dutchrojas/p/two-senators-want-to-break-up-bigr=3mc0ds&utm_medium=ios&shareImageVariant=poster"  
[X Link](https://x.com/DutchRojas/status/2021556737476616198)  2026-02-11T12:07Z 31.2K followers, [----] engagements


"@NathanLevy10 @HeathVeuleman @elonmusk 48%"  
[X Link](https://x.com/DutchRojas/status/2021561752195051546)  2026-02-11T12:27Z 31.2K followers, [--] engagements


"@tencentdress Not surprising West Virginia is bought"  
[X Link](https://x.com/DutchRojas/status/2021573782528315579)  2026-02-11T13:15Z 31.2K followers, [--] engagements


"The man single handily destroyed Vermont Healthcare. And then wonders why its expensive. 😂 https://t.co/5WqtuI9Nov 😂 https://t.co/5WqtuI9Nov"  
[X Link](https://x.com/DutchRojas/status/2021574117959344370)  2026-02-11T13:16Z 31.8K followers, [----] engagements


"$275 billion. Thats how much the federal government takes from hard working Americans and hands to hospital systems every year in subsidies tax breaks and payment advantages. Independent physicians receive $0 of it. The Break Up Big Medicine Act touches $0 of it. Not a coincidence. Warren and Hawley love the American Hospital Association. And where are the @GOPDoctors Nowhere"  
[X Link](https://x.com/DutchRojas/status/2021585041558519927)  2026-02-11T14:00Z 31.9K followers, [----] engagements


"The Break Up Big Medicine Act targets: Insurer-PBM-physician conglomerates The Break Up Big Medicine Act ignores: Medicaid fraud 275B hospital subsidy apparatus Certificate of Need laws in [--] states Physician-owned hospital ban Nonprofit tax exemptions ($37.4B) 340B program expansion ($81.4B) Site-neutral payment violations ($14.1B) One column got a press conference. The other got nothing. Surprising Nothing good comes out of Washington D.C. https://twitter.com/i/web/status/2021622787484324285 https://twitter.com/i/web/status/2021622787484324285"  
[X Link](https://x.com/DutchRojas/status/2021622787484324285)  2026-02-11T16:30Z 31.8K followers, [----] engagements


"@alexjung Bingo Its an appearance win. It will change nada"  
[X Link](https://x.com/DutchRojas/status/2021651752916079068)  2026-02-11T18:25Z 31.2K followers, [--] engagements


"Colonoscopy with polyp removal. ASC: $1234. Hospital: $2122. 41% markup. Not for a better doctor. Not for a better outcome. 6/"  
[X Link](https://x.com/DutchRojas/status/2022314174290755860)  2026-02-13T14:17Z 32.2K followers, [---] engagements


"@TrentDJ023 Certificate of Need"  
[X Link](https://x.com/DutchRojas/status/2022336250607436169)  2026-02-13T15:45Z 32.1K followers, [--] engagements


"@EdithaTogo @EricCrampton @DrDiGiorgio Legibility and a single-payer agenda by the administrative state"  
[X Link](https://x.com/DutchRojas/status/2022450409818947777)  2026-02-13T23:18Z 31.2K followers, [--] engagements


"@Markroot14 @TwoEaglesMom2 @Why45huh Mark with the Flamethrower"  
[X Link](https://x.com/DutchRojas/status/2022784340040577390)  2026-02-14T21:25Z 31.9K followers, [--] engagements


"@pr0650 @DrOz He says that from his $40M home in West Palm Beach"  
[X Link](https://x.com/DutchRojas/status/2023083697868833120)  2026-02-15T17:15Z 32.2K followers, [--] engagements


"The real reform agenda is five items: Repeal the physician-owned hospital ban Eliminate Certificate of Need laws Enforce site-neutral payments Condition nonprofit tax exemptions on actual community benefit Separate insurer-PBM-physician conglomerates This bill does one of five and calls it a revolution. Do all of it or admit the rest is theater. https://buff.ly/k2aHceS https://buff.ly/k2aHceS"  
[X Link](https://x.com/DutchRojas/status/2021660663450423349)  2026-02-11T19:00Z 32.2K followers, [----] engagements


"About time. The US government needs to get serious about misuse of 501(c)(3) status. And it ought to start with nonprofit health systems: $300B+ in annual tax advantages Executive compensation rivaling private equity Aggressive consolidation of independent physicians Facility fee arbitrage protected by regulation Minimal charity care relative to subsidy Tax exemption was meant for community benefit. Not market dominance. Lets see where this goes. The IRS will launch a dedicated fraud task force focused on targeting the misuse of funding by 501(c)(3) tax-exemptentities. Lets start with the"  
[X Link](https://x.com/DutchRojas/status/2022486918978511184)  2026-02-14T01:43Z 32.2K followers, 11.1K engagements


"Eight organizations on the OIG exclusion list continued billing Medicaid for personal care services. The HHS Medicaid data is a treasure trove. Join me as I go through it over the next few weeks. Combined: $28.4 million in payments they were legally barred from receiving. One has been excluded since [----]. Seven years. Payments are still flowing. State Medicaid agencies are responsible for checking the exclusion list before paying claims. They are supposed to do it monthly. The data says they are not. https://dutchrojas.substack.com/p/the-billion-dollar-club"  
[X Link](https://x.com/DutchRojas/status/2022830722302492894)  2026-02-15T00:30Z 32.2K followers, [----] engagements


"$978 million a month. That was Medicaid T1019 home care spending before COVID. Today its $1.93 billion a month. The Medicaid data set released Friday is a treasure trove. This is my second day of digging in. The Covid emergency ended in May [----]. The spending hit its peak in May [----]. You can learn how entitlement baselines get permanently reset. Are these actions the result of a responsible government Todays article: https://tinyurl.com/ycy87xvn https://tinyurl.com/ycy87xvn"  
[X Link](https://x.com/DutchRojas/status/2023012382625165628)  2026-02-15T12:31Z 32.2K followers, [----] engagements


"Congress says theyve known for years. Good. Then explain this. Across the HHS Medicaid dataset more than $120B has been paid under this single code. [--] entities collected $30.4B. Seven billion-dollar entities in one state. $28.4M paid to organizations barred from billing. If this is legal the structure is broken. If its illegal enforcement is broken. Where was: HHS OIG CMS Program Integrity DOJ Civil Division State Medicaid Fraud Units Oversight or admission. Which is it https://twitter.com/i/web/status/2023077508443242585 https://twitter.com/i/web/status/2023077508443242585"  
[X Link](https://x.com/DutchRojas/status/2023077508443242585)  2026-02-15T16:50Z 32.2K followers, [----] engagements


"@no_stp_on_snek @RepJasonSmith @RepGregMurphy @RepRichardNeal @RepTomSuozzi @RepAOC @GovKathyHochul Thank you sir Amazing what happens when the government sets data free"  
[X Link](https://x.com/DutchRojas/status/2023143275582886192)  2026-02-15T21:11Z 32.2K followers, [---] engagements


"Look around your city. That gleaming new hospital tower Tax-exempt. That land its sitting on Property tax-free. The municipal infrastructure: roads police fire utilities Youre paying for all of it. Meanwhile the not for profit health system charges $3800 for a CT scan and sues patients for nonpayment. See the University of Virginia and the University of Colorado for some of the most egregious collections efforts. We dont need more nonprofit logos. We need market discipline and transparency. Lets end the fiction. These are corporations and they must be treated accordingly. #healthcare End"  
[X Link](https://x.com/anyuser/status/1906301881917325702)  2025-03-30T11:06Z 32.2K followers, 25.7K engagements


"The United States Government didnt make healthcare affordable with the Affordable Care Act it outlawed the only plan that made it affordable. Catastrophic plans protected families from bankruptcy. The Affordable Care Act made them illegal. I explain why in this short clip 👇 🤯 This is for self employed married parents in their 30s with [--] kids. Democrats did this with Obamacare [--] yrs ago and Johnson says Republicans have a mystery plan that is yet to be revealed to fix it. But no one knows what it is and were told to stay home in our districts. 🤯 This is for self employed married parents in"  
[X Link](https://x.com/anyuser/status/1983558056186179587)  2025-10-29T15:34Z 32.2K followers, 35.6K engagements


"James Van Der Beek passed away today. Im a healthcare guy and I post about healthcare. Now I want to talk about James. He was special he was [--] years old a Father of six a Husband. He was man who spent his final chapter teaching the ultimate guide to real life. James was part of my growing up. Dawsons Creek. Varsity Blues. The 90s. He was just there woven into the background. What he did over the last few years was bigger than any of that. He recorded a video on his last birthday. Cancer had taken everything he used to define himself. He couldnt be the husband who helped around the house. He"  
[X Link](https://x.com/DutchRojas/status/2021695595560288761)  2026-02-11T21:19Z 32.2K followers, 475.7K engagements


"Dear Mr. Axelrod: As you know there are real solvable structural issues in healthcare that deserve serious discussion. For example: Repealing Section [----] of the ACA Moving to site-neutral payments to eliminate site-of-service arbitrage Reducing reliance on centralized pricing mechanisms like the AMA RUC Encouraging transparent market-based pricing models Reforming or eliminating outdated CON laws None of these are abstract theories. They are policy choices. CMS and Congress have the authority to address many of them some by end of this week and all of them by end of Q1-2026. If the US"  
[X Link](https://x.com/DutchRojas/status/2021936116236951744)  2026-02-12T13:15Z 32.2K followers, [----] engagements


"MedPAC told Massachusetts directly. States with Determination of Need laws have fewer surgical centers. Massachusetts heard that. Then weaponized licensure to protect hospital market share anyway. 7/"  
[X Link](https://x.com/DutchRojas/status/2022314185858629907)  2026-02-13T14:17Z 32.2K followers, [---] engagements


"The article is live. https://dutchrojas.substack.com/p/the-billion-dollar-club The HHS Medicaid Provider Spending dataset just went public for the first time. I pulled every organization in the country that bills under code T1019 Personal Care Services. Thats bathing dressing meal prep for Medicaid beneficiaries. Non-medical. Delivered by home health https://dutchrojas.substack.com/p/the-billion-dollar-club The HHS Medicaid Provider Spending dataset just went public for the first time. I pulled every organization in the country that bills under code T1019 Personal Care Services. Thats bathing"  
[X Link](https://x.com/DutchRojas/status/2022781258896478257)  2026-02-14T21:13Z 32.2K followers, [----] engagements


"And you guys wonder why I respect @DataRepublican so much. She is a brilliant researcher and a great collaborator. Thank you Check out her thread below. @DutchRojas I promise I didn't see this post before I posted this thread https://t.co/BGN34fcS5c @DutchRojas I promise I didn't see this post before I posted this thread https://t.co/BGN34fcS5c"  
[X Link](https://x.com/DutchRojas/status/2022783125407793177)  2026-02-14T21:20Z 32.2K followers, 25.2K engagements


"There are [----] organizations in the United States that bill Medicaid under code T1019 Personal Care Services. The top 1% of them just [--] entities collected $30.4 billion. Thats 42.5% of all T1019 spending nationally. Nine of those entities crossed the billion-dollar threshold individually. The top [--] alone absorbed $28 billion. And the geographic concentration will stop you cold: [--] of the top [--] are in New York State. Seven of them are in Brooklyn. This is not a story about healthcare. This is a story about industrial-scale wealth extraction from a system designed to serve the most"  
[X Link](https://x.com/DutchRojas/status/2022815636330598513)  2026-02-14T23:30Z 32.2K followers, 18.8K engagements


"This investigation began with a single billing code. T1019. Personal care services. Bathing dressing meal prep. The data revealed findings that extend far beyond personal care. If this is what T1019 looks like what does T1020 look like What about home health codes DME codes and behavioral health codes The same structural incentives exist across the Medicaid billing landscape: low oversight easy entity creation geographic clustering and authorized official networks. Medicaid is the largest payer in the U.S. healthcare system covering [--] million people. It is also the least transparent. The HHS"  
[X Link](https://x.com/DutchRojas/status/2022868481427792133)  2026-02-15T03:00Z 32.2K followers, [----] engagements


"7000 bureaucrats at @cmsgov. Exposed by DOGE. And not a single one of them was looking out for you. [----] employees overseeing $1.52 trillion in spending 22.5% of the entire federal budget. Thats 0.3% of the federal workforce controlling nearly a quarter of all federal dollars. Where do they come from Insurance companies. Hospital chains. Consulting firms. Where do they go when they leave Right back. 53% of CMS appointees exit to private industry after their government stint. Only 15% came from industry. The pipeline flows one direction toward the money. Marilyn Tavenner ran CMS then became"  
[X Link](https://x.com/DutchRojas/status/2023160393493807125)  2026-02-15T22:20Z 32.2K followers, 12.6K engagements


"A group of physicians built a hospital in South Texas anyway and now its a 520-bed system with a Level [--] trauma center. Of course everyone said it couldnt be done. Dr. Carlos Crdenas joins The Doctor's Lounge to explain how they did it and why doctors must lead again. @physicianhosp @DHRhealth @DrDiGiorgio @sdixitmd @anish_koka @DRsLoungePod"  
[X Link](https://x.com/DutchRojas/status/1987149519042048465)  2025-11-08T13:25Z 32.2K followers, 27.4K engagements


"Had a chance to present our Co-Opetition model to my friends in commercial real estate this morning. 40+ building owners including multi-family office and retail. They were individually negotiating their property work comp liability and benefits. [--] things happen when they cooperate + compete = co-opetition [--]. Expenses go down dramatically. [--]. You move from expenses in your P&L to assets in your balance sheet. https://twitter.com/i/web/status/2019063985320972733 https://twitter.com/i/web/status/2019063985320972733"  
[X Link](https://x.com/DutchRojas/status/2019063985320972733)  2026-02-04T15:02Z 32.2K followers, [----] engagements


"Congress outlawed physician-owned hospitals in [----]. The American Hospital Association and the Federation of American Hospitals lobbied for it. CMS data shows [--] of the top [--] hospitals for quality access and cost are physician-owned. Charges are one-third lower than traditional hospitals for the same procedures. Congress banned the best model and now wonders why healthcare is expensive. And youre wondering why your premiums are high Kennedy and OZ could fix it tomorrow"  
[X Link](https://x.com/DutchRojas/status/2021656755432718678)  2026-02-11T18:45Z 32.2K followers, 12.3K engagements


"Who is NOT threatened by the Break Up Big Medicine Act: Largest nonprofit hospital system in America. Every state Certificate of Need board. Lobbyist who helped write Section [----]. The American Hospital Association. The Federation of American Hospitals. The entire $275 billion annual subsidy apparatus. Who IS threatened: The insurer-PBM-physician conglomerates that make good headlines. One group funds campaigns. The other gets regulated. Do you really trust the politicians"  
[X Link](https://x.com/DutchRojas/status/2021679425461317715)  2026-02-11T20:15Z 32.2K followers, 34K engagements


"Its 7:05am EST. Healthcare still not fixed. Solutions already exist. Your health insurance premium went up again this year. Your doctor cant get OR time because one system controls every surgical suite in town. Your employer was quoted $28000 per employee for family coverage. This is the story of the 60-year-old law that made all of it inevitable. Its the law responsible for more unnecessary death than any other I have studied. https://twitter.com/i/web/status/2022282037025997042 https://twitter.com/i/web/status/2022282037025997042"  
[X Link](https://x.com/DutchRojas/status/2022282037025997042)  2026-02-13T12:09Z 32.2K followers, [----] engagements


"The Massachusetts ASC Deficit. All data cited here comes from the Massachusetts Health Policy Commission itself. This isnt conjecture. Its arithmetic. 2/"  
[X Link](https://x.com/DutchRojas/status/2022449754479993119)  2026-02-13T23:16Z 32.2K followers, [---] engagements


"Nationally there are [----] ambulatory surgery centers per million people. Massachusetts has [--]. The state ranks 4th lowest in the country. There are no demand anomalies. Its structural. 3/"  
[X Link](https://x.com/DutchRojas/status/2022449757575352575)  2026-02-13T23:16Z 32.2K followers, [---] engagements


"While most states decentralize routine surgery into lower-cost outpatient centers Massachusetts concentrates it inside huge health systems. Decentralization diffuses margin. Concentration preserves it. 4/"  
[X Link](https://x.com/DutchRojas/status/2022449770204401712)  2026-02-13T23:16Z 32.2K followers, [---] engagements


"Operating rooms per million: Massachusetts: [--] National average: [--] A 59% structural gap. When supply is restricted high utilization can look like necessity. 5/"  
[X Link](https://x.com/DutchRojas/status/2022449778970222984)  2026-02-13T23:16Z 32.2K followers, [---] engagements


"Massachusetts has: 4th fewest ASCs per capita A 59% operating room gap vs. national average Up to 57% price differentials favoring hospital settings When incumbents participate in rulemaking outcomes tend to favor incumbents. 12/"  
[X Link](https://x.com/DutchRojas/status/2022449833639092700)  2026-02-13T23:16Z 32.2K followers, [---] engagements


"@DrDiGiorgio @DataRepublican 🔥🔥🔥🔥🔥🔥🔥"  
[X Link](https://x.com/DutchRojas/status/2022784566260330948)  2026-02-14T21:26Z 32.2K followers, [----] engagements


"The numbers are so large they lose all meaning. $12.1 billion in profit for one insurer. The problem isnt the number itself but the fact that these profits are generated not by creating health but by navigating a regulatory maze of their own design. Theyre not in the health business; theyre in the complexity business. https://buff.ly/AkILaui https://buff.ly/AkILaui"  
[X Link](https://x.com/DutchRojas/status/2022672226609185242)  2026-02-14T14:00Z 32.2K followers, [----] engagements


"The HHS Medicaid Provider Spending dataset just went public for the first time. I pulled every organization in the country that bills under code T1019 Personal Care Services. Thats bathing dressing meal prep for Medicaid beneficiaries. Non-medical. Delivered by home health aides. The national spend on this single code from [----] to 2024: $122.7 billion. [--] entities collected 42.5% of it. Nine of them each crossed a billion dollars. Seven are in Brooklyn. Some share the same block. Some share the same authorized official. Some share the same address four doors apart. Physicians face prior"  
[X Link](https://x.com/DutchRojas/status/2022717569740775826)  2026-02-14T17:00Z 32.2K followers, 124.2K engagements


"There are [----] organizations in the United States that bill Medicaid under code T1019 Personal Care Services. The top 1% of them just [--] entities collected $30.4 billion. Thats 42.5% of all T1019 spending nationally. Nine of those entities crossed the billion-dollar threshold individually. The top [--] alone absorbed $28 billion. Per OpenClaw: NY is two-thirds of all personal care aide billing in the entire country. And the top [--] zips nationally for T1019 per capita are almost entirely NYC zip codes with [-----] (Stoughton MA Tempus Unlimited HQ) and [-----] (Latham NY Public Partnerships HQ) at"  
[X Link](https://x.com/DutchRojas/status/2022790325882802228)  2026-02-14T21:49Z 32.2K followers, 116.9K engagements


"@no_stp_on_snek 🫡"  
[X Link](https://x.com/DutchRojas/status/2022854325668626623)  2026-02-15T02:03Z 32.2K followers, [---] engagements


"We put out article [--] of [--] we have prepared with the HHS Medicaid data. https://open.substack.com/pub/dutchrojas/p/the-billion-dollar-clubr=3mc0ds&utm_medium=ios&shareImageVariant=split https://open.substack.com/pub/dutchrojas/p/the-billion-dollar-clubr=3mc0ds&utm_medium=ios&shareImageVariant=split"  
[X Link](https://x.com/DutchRojas/status/2023160403706904932)  2026-02-15T22:20Z 32.2K followers, [---] engagements


"Big news: A new bill supporting Physician-Owned Hospitals just dropped. It is a turning point. If passed this bill removes key restrictions on physician-owned hospitals especially those that serve rural and underserved areas. What can you do Contact your representative Join advocacy groups like the PHA. Share this post to spread awareness Build or partner with POHs in your region We dont need fewer hospitals. We need better onesphysician-led transparent efficient and community-focused. Lets bring healthcare back to the hands of those who deliver it. #physicianled #ruralhealth #POH"  
[X Link](https://x.com/anyuser/status/1903765169064296602)  2025-03-23T11:06Z 32.2K followers, 99.5K engagements


"Healthcare isnt broken. Its functioning exactly like a cartel: consolidated exclusionary and systematically hostile to price discovery. Independent physicians arent just participants theyre the only remaining counterforce. Everyone else has already sold their autonomy or been absorbed. This is about saving the independent practice of medicine and restoring competitive forces to a sector deliberately designed to suppress them. Opt out of the rigged game. Build your own plan. Set your own price. And never ask permission to do what the market requires. History doesnt reward the compliant. It"  
[X Link](https://x.com/anyuser/status/1904517372171440220)  2025-03-25T12:55Z 32.2K followers, 63.3K engagements


".   .%. Medicares physician payment formula (the Conversion Factor) Down 9.9%. Thats not fiscal responsibility. Thats institutional gaslighting.     . But the doctors treating Medicare patients Theyre being asked to do more with less year after year because      while the cost of running a practice skyrockets. If the American people want Congress to preserve access to care for aging Americans its time to speak up and tie Medicares payment formula to inflation just like their own salaries.     . Theyre busy trying to survive the 20th century in the 21st. #HealthcarePolicy #Medicare"  
[X Link](https://x.com/anyuser/status/1921377513034420611)  2025-05-11T01:31Z 32.2K followers, 137.3K engagements


"1/ BREAKING: The Medicaid-insurer model is collapsing in real time. Centene: down 61% Molina: down 55% Humana: lost $300/share UnitedHealth: down 46% YTD and under federal investigation This isnt just a sell-off. Its the end of the myth. 🧵 Lets go"  
[X Link](https://x.com/anyuser/status/1949235448838246711)  2025-07-26T22:28Z 32.2K followers, 231.5K engagements


"Ruben May I take a shot at helping you understand You receive donations and have become a spokesperson for Banner Health and the University of Arizona teaching hospital Arizonas largest nonprofit health system. You say youre fighting to make sure insurance premiums dont go up by hundreds or thousands of dollars. Heres how your policies make that happen: CMS the federal agency running Medicare and Medicaid does not negotiate prices. It assigns reimbursement rates based on where care is delivered. Banner Health is assigned higher rates because it is classified as a hospital or hospital"  
[X Link](https://x.com/anyuser/status/1974783631580160358)  2025-10-05T10:28Z 32.2K followers, 429.7K engagements


"Who benefits from ACA subsidies Hint: Its not patients physicians or taxpayers. Every subsidy dollar moves through a predictable chain of custody and every stop on that chain earns yield before a single claim is paid. Lets follow the money [--] UnitedHealth Group (UNH) The largest beneficiary of all. ACA subsidies premium payments float investment income Optum integration. They profit on the insurance side the PBM side and the provider side. Result: $500B market cap. Sold by lawmakers. Funded by your taxes. [--] Centene (CNC) The Medicaid king. Over 70% of its revenue comes directly from government"  
[X Link](https://x.com/anyuser/status/1976110123798978610)  2025-10-09T02:19Z 32.2K followers, 54.4K engagements


"A physician billing $1200 for a procedure is greedy. A health system billing $18000 for the same CPT code is community benefit. Thanks @cmsgov"  
[X Link](https://x.com/anyuser/status/1979198735813853330)  2025-10-17T14:52Z 32.2K followers, 33.1K engagements


"If youre asking Why are my health insurance premiums so high this is for you The University of Michigan Health operates as a $6.9 billion revenue machine while enjoying complete tax immunity. Heres what that looks like: THE NUMBERS DONT LIE: $6.9B annual revenue (rivals major for-profit systems) $2.9M CEO salary (more than most Fortune [---] executives) -$348M fair share deficit (tax breaks exceed community benefit) $0 in property taxes paid (despite 2.5M sq ft of real estate) $3.4B in tax-exempt bonds issued since [----] THE PLAYBOOK: Tax Avoidance at Scale: Exempt from federal state local and"  
[X Link](https://x.com/anyuser/status/1983322397588537535)  2025-10-28T23:58Z 32.2K followers, 26.8K engagements


"Heres a puzzle: Why does health insurance work so differently from every other kind of insurance Your car insurance doesnt pay for oil changes. Your homeowners insurance doesnt cover paint. Insurance is supposed to protect against catastrophic unpredictable costs. But weve built a system where insurance pays for everything routine visits predictable care all of it. This divorces the consumer from the cost. Nobody asks what anything costs because nobody directly pays. The result Premiums rise. Deductibles rise. Coverage narrows. Weve turned insurance into a wildly inefficient payment system."  
[X Link](https://x.com/anyuser/status/1985104712270573704)  2025-11-02T22:00Z 32.2K followers, 122.6K engagements


"When independent practices fail it's not because of the market. It's because they: Pay full taxes Buy drugs at full price Receive lower reimbursement Can't access tax-free financing Can't open new hospitals The game is rigged"  
[X Link](https://x.com/DutchRojas/status/1998852746665922965)  2025-12-10T20:30Z 32.2K followers, [----] engagements


"A restaurant in Minneapolis called Safari. Seats [--] people. Claimed to serve [-----] meals a day to hungry children. The federal government paid them for every single one. The children didnt exist. The meals didnt exist. The money did. And its gone. This is just one piece of a $9 billion Medicaid fraud in Minnesota the largest in American history. Today Im publishing the whole investigation. The fraud. The cover-up. The whistleblowers who were ignored. https://twitter.com/i/web/status/2005644231168196962 https://twitter.com/i/web/status/2005644231168196962"  
[X Link](https://x.com/anyuser/status/2005644231168196962)  2025-12-29T14:17Z 32.2K followers, 1.8M engagements


"Your insurance company didnt raise your premiums. Your doctor didnt raise your premiums. In Massachusetts your health systems raised your premiums. And the state with federal dollars 😉 gave them the law to do it. Heres how. 🧵"  
[X Link](https://x.com/DutchRojas/status/2022314123531276327)  2026-02-13T14:17Z 32.2K followers, [----] engagements


"The obsession with a plan is the problem. It presupposes that [---] million peoples healthcare needs can be centrally managed. Imagine if we had a national food plan. The solution isnt a better plan; its a better marketplace. One where the price of a knee replacement is as knowable as the price of a Kia. House Republicans should come up with a healthcare plan that reduces the outrageous costs of health insurance instead. House Republicans should come up with a healthcare plan that reduces the outrageous costs of health insurance instead"  
[X Link](https://x.com/DutchRojas/status/2022572511494312127)  2026-02-14T07:23Z 32.2K followers, [----] engagements


"@mburkhold @DOGE @DOGE_HHS DME.Oh Lord please help us"  
[X Link](https://x.com/DutchRojas/status/2022792882642702665)  2026-02-14T21:59Z 32.2K followers, [---] engagements


"@Jtfawver BOOOOOOMMMMM I was up all night the kiddos were sick and I thought I'd start poking around on this medicaid data. Jaw-dropping doesn't begin to explain the things I saw"  
[X Link](https://x.com/DutchRojas/status/2022793221340819967)  2026-02-14T22:01Z 32.2K followers, [----] engagements


"The HHS Medicaid Provider Spending dataset is now publicly available for the first time. I pulled every organization in the country that bills under code T1019 Personal Care Services. That's bathing dressing and meal prep for Medicaid beneficiaries. Non-medical. Delivered by home health aides. The national spend on this single code from [----] to 2024: $122.7 billion. [--] entities collected 42.5% of it. Nine of them crossed the $1 billion mark. Seven are in Brooklyn. Some share the same block. Some share the same authorized official. Some share the same address four doors apart. Physicians face"  
[X Link](https://x.com/DutchRojas/status/2022800521552421358)  2026-02-14T22:30Z 32.2K followers, [----] engagements


"Five individuals are listed as the authorized official for ten separate Medicaid billing entities. Combined T1019 billing: $11.8 billion. And you're wondering why I am always complaining about the high cost of insurance premiums Two entities operate out of Flushing. Same building. Four doors apart. $2.3 billion combined. Another operator has two entities. Same addresses. $809 million. Entity proliferation is one of the oldest structures in healthcare billing. You split operations across multiple NPIs to stay below audit thresholds create the appearance of competition or maintain billing when"  
[X Link](https://x.com/DutchRojas/status/2022849593143333317)  2026-02-15T01:45Z 32.2K followers, 12.9K engagements


"The HHS Data continues to bring light to the darkness Congress just hauled the Big [--] insurance CEOs in front of Ways and Means. Good start. Now do these five. Five people. Ten Medicaid billing entities. $11.8 billion. One operates from Suite [---] and Suite [---] in the same building. $2.3 billion. Another runs two companies with the same name. One comma different. Same address. $809 million. The insurance executives have lawyers and lobbyists. These five have something better: anonymity. Nobody in Washington knows their names. You do now https://twitter.com/i/web/status/2023025462910255259"  
[X Link](https://x.com/DutchRojas/status/2023025462910255259)  2026-02-15T13:23Z 32.2K followers, 24.5K engagements


"@DrDiGiorgio @chrissyfarr Oh you're going to get in trouble now. There is no way he spent $2M. I was told he had benefits via the union. Let's have that discussion. It is right and appropriate"  
[X Link](https://x.com/DutchRojas/status/2023084565506760780)  2026-02-15T17:18Z 32.2K followers, [---] engagements


"Why are your health insurance premiums high Whenever I want to build a new hospital or clinic I have to beg for permission from other hospitals and the insurance carriers. Thats not capitalism. Thats called Certificate of Need. Before you can build. Before you can expand. Before you can buy equipment. The FTC and DOJ have already said it: CON laws fail to contain costs and pose anticompetitive risks. Eight states score a perfect [---] for restrictiveness. Five Democrat governors. Five Republican governors. This is definitely not left vs right. Its incumbents vs competition. When competition"  
[X Link](https://x.com/DutchRojas/status/2023110310778065117)  2026-02-15T19:01Z 32.2K followers, [----] engagements


"Why is mainstream media ignoring the HHS Medicaid data release Great question. After [--] years speaking with reporters heres my experience: [--] in [---] understands Medicare Medicaid CMS insurance or healthcare economics at all. Thats not an insult. Its a structural problem. Second question: How much advertising revenue do major media outlets receive from: Pharma Insurance Device manufacturers Health systems CMS-related programs Healthcare is a trillion-dollar ecosystem. Media runs on advertising. Is this incompetence Or incentive alignment Looking around for mainstream media stories on this. I"  
[X Link](https://x.com/DutchRojas/status/2023208718192513337)  2026-02-16T01:32Z 32.2K followers, [----] engagements

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