#  @DutchRojas Dutch Rojas Dutch Rojas posts on X about health, insurance, money, business the most. They currently have [------] followers and [---] posts still getting attention that total [-------] engagements in the last [--] hours. ### Engagements: [-------] [#](/creator/twitter::475043222/interactions)  - [--] Week [-------] +217% - [--] Month [---------] -51% - [--] Months [----------] -62% - [--] Year [----------] +1,148% ### Mentions: [--] [#](/creator/twitter::475043222/posts_active)  - [--] Month [---] +9.20% - [--] Months [-----] +167% - [--] Year [-----] +85% ### Followers: [------] [#](/creator/twitter::475043222/followers)  - [--] Week [------] +0.68% - [--] Month [------] +1.60% - [--] Months [------] +45% - [--] Year [------] +84% ### CreatorRank: [------] [#](/creator/twitter::475043222/influencer_rank)  ### Social Influence **Social category influence** [finance](/list/finance) 30.77% [countries](/list/countries) 8.72% [stocks](/list/stocks) 6.67% [travel destinations](/list/travel-destinations) 1.03% [celebrities](/list/celebrities) 0.51% [cryptocurrencies](/list/cryptocurrencies) 0.51% [fashion brands](/list/fashion-brands) 0.51% **Social topic influence** [health](/topic/health) 24.62%, [insurance](/topic/insurance) #811, [money](/topic/money) 6.15%, [business](/topic/business) 5.13%, [west virginia](/topic/west-virginia) #107, [systems](/topic/systems) #205, [united states](/topic/united-states) 3.59%, [ceo](/topic/ceo) 3.08%, [private equity](/topic/private-equity) 3.08%, [cvs](/topic/cvs) 2.56% **Top accounts mentioned or mentioned by** [@realdocspeaks](/creator/undefined) [@heathveuleman](/creator/undefined) [@drdigiorgio](/creator/undefined) [@edwards183](/creator/undefined) [@mcuban](/creator/undefined) [@jeanpierremba](/creator/undefined) [@beckyquick](/creator/undefined) [@learnusahistory](/creator/undefined) [@gebaidc](/creator/undefined) [@drdanchoi](/creator/undefined) [@docshanep](/creator/undefined) [@grok](/creator/undefined) [@howardlutnick](/creator/undefined) [@cnbc](/creator/undefined) [@cogitator88](/creator/undefined) [@alexjung](/creator/undefined) [@drsloungepod](/creator/undefined) [@anishkoka](/creator/undefined) [@sdixitmd](/creator/undefined) [@physicianscap](/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 "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 "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 "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 31.2K followers, [----] 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 31.1K followers, [----] 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 "It is 6:13 the kiddos are awake of course and here are the stories Im following: Ambulatory surgery centers fight CMS for [---] procedure approvals. ASCs cannot compete when medicare academics decide what procedures theyre allowed to perform. Senate exposes UnitedHealths Medicare Advantage tactics. Regulatory capture in action: the largest insurer gaming government programs for higher reimbursements while taxpayers foot the bill. Compounding pharmacy sues Eli Lilly Novo over GLP-1 access. When pharma giants allegedly restrict competition patients lose access and pay more. Prior authorization:" [X Link](https://x.com/DutchRojas/status/2013224308026356135) 2026-01-19T12:17Z 31K followers, [----] engagements "$100000 a year. For [--] years. $3.2 million in malpractice premiums. At retirement that neurosurgeon gets back exactly nothing. The carrier kept the float. The carrier kept the investment income. The carrier kept the underwriting profit. The physician paid the bill" [X Link](https://x.com/DutchRojas/status/2015118664144478331) 2026-01-24T17:45Z 31K followers, 14.7K engagements "The medical malpractice industry generates $12.5 billion in annual premiums. [------] physicians purchase their own coverage. They have no idea they're building someone else's balance sheet. Warren Buffett's Berkshire Hathaway holds 17.72% market share. He thanks you for your premiums. https://twitter.com/i/web/status/2015137559999918472 https://twitter.com/i/web/status/2015137559999918472" [X Link](https://x.com/DutchRojas/status/2015137559999918472) 2026-01-24T19:00Z 31K followers, 14K engagements "I am a healthcare guy. And If I were building a world-class patient-first healthcare system the first thing Id do is ban doctors from owning hospitals. Obviously. We wouldnt want people with clinical experience or a Hippocratic Oath getting in the way of shareholder value. No lets make sure hospitals are owned and operated by private equity firms hedge fund CFAs felons the American Hospital Associations favorite lobbyists bankers and Harvard administrators. You know the real patient outcomes professionals. Next Id insist that governors create committees of insurance executives and hospital" [X Link](https://x.com/DutchRojas/status/2015562798630395920) 2026-01-25T23:09Z 31K followers, 20.2K engagements "Doctors are not good at business. What does being good at business mean Today's article looks at non-profit health systems to find out. I've been told these health systems below are all "Good at Business." Kaiser Permanente. Providence. CommonSpirit. Trinity. Ascension. These health systems also have the largest gaps between the tax exemptions they receive and the community benefits they return. Is that what being good at business means Let's find out" [X Link](https://x.com/DutchRojas/status/2015786060119195718) 2026-01-26T13:57Z 31K 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 "Dr. Oz is exposing fraud while running a department the Centers for Medicare and Medicaid thats been defrauding the American people for decades and is the chief reason for the increase in your health insurance premiums. The irony writes itself. Imagine if every working American knew their paycheck was being siphoned to fund the consolidation of health systems that make care more expensive and less accessible. Imagine if they knew they could buy an aspirin for $4 but Medicare pays $22 for the exact same pill. Or that Medicare routinely pays $40000 to hospitals for the same procedure done in an" [X Link](https://x.com/DutchRojas/status/2015870920322081220) 2026-01-26T19:34Z 31K followers, [----] engagements "I just got back from sledding with the kiddos. Guess what Howard Kern CEO of Sentara Healthcare: $33.2 million. Lloyd Dean CommonSpirit: $35.5 million. Gene Woods Advocate Health: $25.8 million. These are not for-profit hospitals. Tax-exempt. Ostensibly charitable. Is this what people mean when they say doctors are not good at business Yeah sorry mate that's a horrible way to define business" [X Link](https://x.com/DutchRojas/status/2015937859501404617) 2026-01-27T00:00Z 31K followers, [----] engagements "How do nonprofit boards justify $30 million CEO packages They hire consultants. The cycle: [--]. Board hires consultant [--]. Consultant benchmarks against "peers." [--]. Board sets pay at the 75th percentile [--]. This becomes next year's benchmark [--]. Repeat Every board wants to pay above average. No board hires a consultant to recommend below-market. The consultants know who pays their fees. The spiral only moves up. SullivanCotter. Pearl Meyer. Gallagher. Three firms. One direction. Read more depressing news here 😎 👇 https://buff.ly/Ldzpv8z https://buff.ly/Ldzpv8z" [X Link](https://x.com/DutchRojas/status/2017040089008722370) 2026-01-30T01:00Z 31.1K followers, [----] 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 "' : A professional buyer spends six months examining a health system. They walk away without making an offer. A government buyer looks at the same asset. They pay $75 million MORE than asking price. What information did the government have that SSM Health missed Are you really wondering why your health insurance premiums have skyrocketed" [X Link](https://x.com/DutchRojas/status/2018735004575007004) 2026-02-03T17:15Z 31K followers, [---] engagements ": When HCA sells. HCA is the largest for-profit hospital operator in America. They don't sell assets because they're feeling generous. They sell when the math stops working. October 2016: HCA announces they're selling in Oklahoma. The signal was clear. The state paid anyway" [X Link](https://x.com/DutchRojas/status/2018746331402055891) 2026-02-03T18:00Z 31K followers, [----] engagements "The question Thomas Sowell would ask: "Compared to what" Before: The hospital paid federal state and property taxes. Zero appropriations. Shareholders bore risk. After: Hospital receives $463-493 million annually. Taxpayers bear risk. Same building. Same beds. Different economics. Oklahoma didn't acquire a hospital. Oklahoma acquired a subsidy obligation. https://twitter.com/i/web/status/2018814288417173898 https://twitter.com/i/web/status/2018814288417173898" [X Link](https://x.com/DutchRojas/status/2018814288417173898) 2026-02-03T22:30Z 31K 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 "October 2016: Deal announced at $750M. December 2017: Supreme Court approves at $750M. February 2018: Closes at $825M. $75 million increase. 10%. No public explanation. No independent fairness opinion ever made public despite state requirements. 4/" [X Link](https://x.com/DutchRojas/status/2018858530485207503) 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 "The life support system: $493M in annual subsidies. $245.8M State appropriations $111.6M Medicare GME $34.6M Federal UPL match $20-50M 340B drug pricing $22.5M Tax-exempt bond savings This represents 72-77% of total operating revenues. The system is dependent by design. Why does no one talk about where the money actually goes Because the people who know are paid not to. Im not. 6/ https://twitter.com/i/web/status/2018858542350881220 https://twitter.com/i/web/status/2018858542350881220" [X Link](https://x.com/DutchRojas/status/2018858542350881220) 2026-02-04T01:25Z 31.1K followers, [---] engagements "The state money isnt extra cash. Its the match key. $245.8M state appropriation unlocks federal Medicaid matching through THRP. Result: $280.4M in THRP revenue. Without the state input the federal UPL portion ($34.6M) disappears. 7/" [X Link](https://x.com/DutchRojas/status/2018858547900207192) 2026-02-04T01:26Z 31K followers, [---] engagements "Although labeled a State hospital Washington D.C. is the silent majority partner. State contribution: $245.8M Federal value: $210-240M GME UPL match 340B pricing bond tax exemptions federal grants all flow from D.C. Federal subsidies rival state appropriations when you tally all indirect supports. 8/ https://twitter.com/i/web/status/2018858553822371900 https://twitter.com/i/web/status/2018858553822371900" [X Link](https://x.com/DutchRojas/status/2018858553822371900) 2026-02-04T01:26Z 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 "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 31.2K followers, [----] engagements "@AmericanGidget You sound like a positive Catholic American. Where can I get some of that hope for my life. And yes it matters you just dont understand why" [X Link](https://x.com/DutchRojas/status/2019453868640194938) 2026-02-05T16:51Z 31.1K followers, [---] engagements "The pessimism and victimization runs strong. How on earth could anyone shop for the [--] billion treatments and services that are consumed every year [----] billion of which are not emergencies. Continue on victim no reason to get your head out of the sand and learn something. Super Bowl is on Sunday enjoy" [X Link](https://x.com/DutchRojas/status/2019454379602903474) 2026-02-05T16:53Z 31.1K followers, [---] engagements "@SilentMaj843 I heard you a few years ago" [X Link](https://x.com/DutchRojas/status/2019471652908679564) 2026-02-05T18:02Z 31.1K followers, [--] engagements "People think price transparency is about patient shopping. Its not. Once healthcare becomes computable with machine-readable prices and structured data markets will form whether consumers ever looked or not. Benchmarks. Arbitrage. Capital reallocation. Opacity was the moat. Data killed it. Thats 🔥🔥🔥🔥 https://twitter.com/i/web/status/2019486197446218128 https://twitter.com/i/web/status/2019486197446218128" [X Link](https://x.com/DutchRojas/status/2019486197446218128) 2026-02-05T19:00Z 31.1K followers, [----] 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 31.1K 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 "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 31.1K 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 "@BreedJim @LearnUSAhistory @DrOz Hospitals buying practices" [X Link](https://x.com/DutchRojas/status/2020189236172103683) 2026-02-07T17:33Z 31.1K followers, [--] engagements "@realdocspeaks @HeathVeuleman Right. Mark fights first order solutions as hard as Trump does. These are not difficult to do" [X Link](https://x.com/DutchRojas/status/2020190108608340076) 2026-02-07T17:37Z 31K 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 31.2K followers, 28.4K 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 "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 "@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 "@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 "$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 "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 "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 31.2K 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 "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 31.2K followers, 174K 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, 40.7K 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" [X Link](https://x.com/DutchRojas/status/2021298262913831312) 2026-02-10T19:00Z 31.2K followers, [----] 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 "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 "@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 "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 31.2K 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 31.2K 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 31.2K followers, 54.3K 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 31.2K 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 31.2K followers, 26.8K 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 31.2K followers, 35.5K 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 31.2K followers, 352.4K 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 31.2K followers, 1.8M 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 "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 31.2K followers, 30.1K 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 "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 31.2K followers, 42.9K 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 31.2K 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 31.2K followers, [----] 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 31.2K 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 31.2K 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 31.2K followers, 20K 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 31.2K 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 31.2K followers, 10.7K 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 31.2K followers, 466.1K engagements "@MaddenedRanter @jalbright22 @Darwinismlives @realdocspeaks It doesnt matter. Youll be an anonymous account that argues about nonsense without any skin in the game" [X Link](https://x.com/DutchRojas/status/1992744523546689576) 2025-11-23T23:58Z 25.2K followers, [--] engagements "Freedom isnt free. Its deducted from your paycheck quietly before you get a say" [X Link](https://x.com/DutchRojas/status/1992797832848269407) 2025-11-24T03:30Z 25.2K followers, [----] engagements "Upcoming shows for this week: Tomorrow we have a full episode @GeBaiDC on free market economics Wednesday @mass_marion full episode The life of a Servant. Thursday Thanksgiving. Friday @ScriptCoPharm full episode. How to set your health plan free Saturday @CFroh full episode about sharing faith and freedom. Follow and subscribe for great one on one interviews from the front lines of healthcare" [X Link](https://x.com/DutchRojas/status/1992971265489936679) 2025-11-24T14:59Z 25.2K followers, [---] engagements "The hidden risk physicians never see coming. Most doctors think malpractice premiums are a fixed cost an unavoidable tax you just pay forever. Heres the truth: youre funding someone elses balance sheet while your own enterprise value stays flat. In this conversation Collin Krickl one of the sharpest P&C minds in healthcare explains the uncomfortable reality: You could be self-funding your own risk keeping 3040% of your premiums and building an asset instead of lighting cash on fire. One line from the transcript stopped me cold: Youre paying premiums year after year and youre never getting the" [X Link](https://x.com/DutchRojas/status/1993077170332111103) 2025-11-24T22:00Z 25.6K followers, [----] engagements "The Founders wouldve torched the IRS on principle. They fought a war over a tea tax. Now we just grumble when the government lifts 30% off our paychecks before we even touch it" [X Link](https://x.com/DutchRojas/status/1993167849880183100) 2025-11-25T04:00Z 25.2K followers, [----] engagements "The most radical idea in healthcare is simple: let physicians compete" [X Link](https://x.com/DutchRojas/status/1993287805489787031) 2025-11-25T11:57Z 25.2K followers, [----] engagements "Massachusetts families now pay $6000 more per year in premiums. They banned new ambulatory surgery centers for [--] straight years. Not limited. Not restricted. Banned. [--------]. A decade-long ban + competitor veto power = one outcome: This is what regulatory capture looks like. Watch this" [X Link](https://x.com/DutchRojas/status/1993499954309218733) 2025-11-26T02:00Z 25.3K followers, 10.8K engagements "@EdwardinRaleigh Eddie in Raleigh: North Carolina has an abundance of challenges and one of them is not physicians. North Carolina has CON laws that keep your premiums 20-25% higher than non CON states" [X Link](https://x.com/DutchRojas/status/1993554419225632870) 2025-11-26T05:36Z 25.3K followers, [--] engagements "@LighthouseDPC Interesting. How does that square up with the No surprises Act and GFEs" [X Link](https://x.com/DutchRojas/status/1993554804883558636) 2025-11-26T05:37Z 25.3K followers, [---] engagements "Theres a foundational split in Americas healthcare debate. In my conversation with @GeBaiDC we discuss the core conflict: If healthcare is a right government must sit at the center. If healthcare is a commodity then economic principles must govern it. One belief system produces bureaucracy and dependency. The other produces innovation access and affordability. The philisophy has determined the rise in premiums industry consolidation and quality in patient care. Watch the clip reflect and ask yourself: Which worldview are you The full episode airs at 5pm EST" [X Link](https://x.com/DutchRojas/status/1993671876795675063) 2025-11-26T13:23Z 25.3K followers, 17.2K engagements "Oh for sure In fact that's exactly what I've been working on since [----]. My thesis is how do I help the government lawmakers lobbyists non profit health systems and insurance carriers screw over patients and build the most expensive healhtcare system in the world. You're spot on" [X Link](https://x.com/DutchRojas/status/1993712226083971250) 2025-11-26T16:03Z 25.3K followers, [--] engagements "The only reason physicians think they need to be employed is because the system taught them to fear independence. When did medicine become a job instead of a profession" [X Link](https://x.com/DutchRojas/status/1993737783265931437) 2025-11-26T17:45Z 25.3K followers, [----] engagements "Nonprofit health systems arent mission-driven. Theyre tax-exempt monopolies that eliminate physician competition and then call it charity. Agree or disagree" [X Link](https://x.com/DutchRojas/status/1993749114354327867) 2025-11-26T18:30Z 25.3K followers, [----] engagements "If healthcare is a right government must control it. If healthcare is a market physicians must control it. That belief determines everything else. Which one do you believe" [X Link](https://x.com/DutchRojas/status/1993760431354024214) 2025-11-26T19:15Z 25.3K followers, [----] engagements "The most explosive conversation Ive had this year. Dr. Ge Bai (Johns Hopkins) lays out the core truth everyone in Washington avoids: Healthcare isnt a right it behaves like a commodity. Government doesnt lower costs it blocks the market that would. Price transparency only works when physicians are free. Innovation dies when a nation fears risk. And America must choose between entrepreneurship or stagnation. And if you think shes bold here shes hosting @bgurley and @mcuban at Johns Hopkins on December [--] for a live debate on the future of healthcare. Details here: Full video below." [X Link](https://x.com/DutchRojas/status/1993801944549224852) 2025-11-26T22:00Z 25.3K followers, 26.1K engagements "Why dont nonprofit health systems embrace Office-Based Surgery Because the moment a procedure leaves their building three things disappear: The facility fee The control of the patient funnel The justification for higher prices Office-based surgery is: safer faster cheaper same-day clinic imaging and procedure So instead of choosing whats best for patients they make them wait to protect revenue not outcomes. @DRsLoungePod @DrDiGiorgio @anish_koka @SpineNeuro @drdanchoi @physicianhosp" [X Link](https://x.com/DutchRojas/status/1993869367885390302) 2025-11-27T02:27Z 25.3K followers, [----] engagements "@DrDiGiorgio says it all. The United States is not addressing the root causes of high premiums. The democrats are happy to print more money and pay academic and non profit health systems. @ahahospitals The republicans are happy to print more money and help their insurance buddies. @AHIPCoverage These lobbyist are destroying the company by buying the votes. @DRsLoungePod @DrDiGiorgio @drdanchoi @sdixitmd @anish_koka" [X Link](https://x.com/DutchRojas/status/1993876289472655422) 2025-11-27T02:55Z 25.3K followers, [----] engagements "Respectfully that is not how it works. Self-insured employers that's 105M individuals own their own insurance companies medicare and medicaid are also their own insurance companies. CMS has been allowed to skew the rules in favor of health systems and wipe out independent practices. I am working to build an environment where competition thrives. This means a level playing field and thousands of insurance companies all building products for all types of patients" [X Link](https://x.com/DutchRojas/status/1994109653152837660) 2025-11-27T18:22Z 25.3K followers, [--] engagements "A quick Thanksgiving message while the suns up and the grill is warming: Thank you for the men and women of the United States Marine Corps. Your service is recognized by the Family Rojas today. @USMC Grateful for the self-insured employers who bet on something better than the state quote. Grateful for the independent physicians who keep control of their work. Grateful for the founders building the future of healthcare from the ground up. Most of the work we do never makes it on camera but it matters. Thank you for being part of this community. Enjoy your families today. Weve got a lot more to" [X Link](https://x.com/DutchRojas/status/1994110004341706804) 2025-11-27T18:24Z 25.3K followers, [----] engagements "@JeanPierreMBA Fantastic prose my friend. Happy thanksgiving" [X Link](https://x.com/DutchRojas/status/1994117411310604289) 2025-11-27T18:53Z 25.3K followers, [--] engagements "@GeBaiDC Come on Free enterprise is the golden goose Lets set the market free" [X Link](https://x.com/DutchRojas/status/1994119451432939884) 2025-11-27T19:01Z 25.6K followers, [---] engagements "@Frankthesc56146 @DrNadolsky We have tried nothing Do you see a commodities exchange for lab tests or chemo anywhere Point me to anyone of [--] things a free market must have in order to be one. No they dont exist" [X Link](https://x.com/DutchRojas/status/1994124276165955851) 2025-11-27T19:20Z 25.3K followers, [--] engagements "@ekimyalbmert @PeachyCure If youd let entrepreneurs work instead of worshiping the government we could find solutions to all of the small chronic conditions. I work on CVS which is way bigger killer than cancer. There are government and university impediments that make it almost impossible" [X Link](https://x.com/DutchRojas/status/1994126084192022755) 2025-11-27T19:28Z 25.3K followers, [--] engagements "When employers stop outsourcing healthcare to insurers they discover prices are negotiable" [X Link](https://x.com/DutchRojas/status/1994383776722395249) 2025-11-28T12:32Z 25.5K followers, [----] engagements "@SenWarren champions the same policies that already define Massachusetts. So why do residents of her own state pay some of the highest premiums in America Massachusetts is filled with brilliant people. It is also burdened with some of the most expensive healthcare in the country. If calling healthcare a human right made it affordable Massachusetts would already be the model. Instead it became the warning sign. Boston is a global medical capital yet the entire city operates one ambulatory surgery center. Independent physicians are blocked at every turn. Competition is not encouraged. It is" [X Link](https://x.com/DutchRojas/status/1994392208523313549) 2025-11-28T13:05Z 25.3K followers, [----] engagements "@rrbelloff They are the largest buyers of life insurance" [X Link](https://x.com/DutchRojas/status/1994407368923214062) 2025-11-28T14:05Z 25.3K followers, [---] engagements "Mark youre right about the symptoms; consolidation high prices a few players controlling everything. As you know the cause isnt the market. Its the laws that eliminated the market. Congress banned physician ownership protected facility fees blocked new surgery centers and wrote rules that guarantee consolidation. Break those laws and the few companies disappear without federal micromanagement. Healthcare is failing because of regulatory capture. Healthcare for everyone is not HC for free. We already make it available to everyone. But it's a mess. It's dominated by a just few companies. Break" [X Link](https://x.com/DutchRojas/status/1994473599789388096) 2025-11-28T18:28Z 25.3K followers, 16K engagements "They did it in Vermont. They have effectively done it in Mass. The results Abysmal. Highest insurance premiums. No competition. Just academic and non profit health systems ripping off the population. Every single blue state should enact Medicare For All. Popular. Saves money. Saves lives. Not one has enacted a universal public option. A few tiny "pilot" programs run by private firms all under 3% enrollment. A pathetic failure of the Democratic Party. Every single blue state should enact Medicare For All. Popular. Saves money. Saves lives. Not one has enacted a universal public option. A few" [X Link](https://x.com/DutchRojas/status/1994481548234543580) 2025-11-28T19:00Z 25.7K followers, 34.6K engagements "As a physician do you believe a health system is the appropriate setting for all treatments regardless of risk acuity or cost When the law prohibits physicians from owning their own facilities and when a state like Massachusetts bans ambulatory surgery centers patients are left with no alternative but the highest-acuity highest-cost sites of care. That is not competition. It is a mandated monopoly. @DutchRojas This is called a strawman. @DutchRojas This is called a strawman" [X Link](https://x.com/DutchRojas/status/1994671635303981476) 2025-11-29T07:35Z 25.3K followers, [----] engagements "Free enterprise Allow lower acuity settings to open like other states. Mass banned one of the most effective tools used by physicians nationwide called ASCs. Remove the ban on physician ownership of hospitals. Get rid of academic health system scams that control mass and vt. Lets lower cost independent physicians with better tech and higher sophistication practice medicine" [X Link](https://x.com/DutchRojas/status/1994674894471041408) 2025-11-29T07:48Z 25.3K followers, [---] engagements "What I love about Mark is he will tell you exactly what wont work. And Mark is incorrect. [--]. Removing the employer would absolutely work. [--]. Insurance is the law of large numbers. [--]. Association plans are illegal. [--]. Allow people to bundle together and form their own collectives and the country would easily win. [--]. Remove all the burdens against competition. Wont work because the insurance carriers are so large and vertically integrated they set the rules. The ACA is not employer driven. Hows that working right now. You need to break up the behemoth carriers so there is a chance the market" [X Link](https://x.com/DutchRojas/status/1994679629102108974) 2025-11-29T08:07Z 25.7K followers, 21.9K engagements "We do not have a single-payer system in this state. Technically true on paper no what was what was written and also irrelevant to the outcomes youre pointing out. Mass doesnt need a statutory single-payer law when: physician ownership of hospitals is banned ASCs were prohibited for a decade independent physicians were consolidated and academic nonprofits dominate every market. It functions like a regulated cartel" [X Link](https://x.com/DutchRojas/status/1994695620309684727) 2025-11-29T09:11Z 25.3K followers, [---] engagements "We (MASS) have the same fragmented dysfunctional jumble of insurance types as other states. This is misleading. Massachusetts has non profit Blue Cross Blue Shield of MA as the dominant insurer holding roughly 51% of the commercial market depending on the segment. The rest of the jumble is tiny by comparison. Its not fragmented; its consolidated. By a non profit" [X Link](https://x.com/DutchRojas/status/1994695622805385376) 2025-11-29T09:11Z 25.3K followers, [---] engagements "Mark I agree that contagious diseases raise legitimate questions about shared risk. What I dont understand is the asymmetry. If individuals must be responsible for the risk they pose to others why are pharmaceutical manufacturers exempt from the same standard Youre asking the public to absorb both sides of the risk: responsibility for transmission and responsibility for any adverse effects because manufacturers are legally shielded. A consistent framework would require accountability for everyone involved individuals institutions and corporations. Right now the responsibility flows only one" [X Link](https://x.com/DutchRojas/status/1994709897074659740) 2025-11-29T10:07Z 25.3K followers, [----] engagements "Boston has world-class hospitals elite universities billions in research money And one ambulatory surgery center in the entire city. (@ASCAssociation) One ASC is not bad luck. Its regulatory capture written into law by people who know better. I drop off the receipts" [X Link](https://x.com/DutchRojas/status/1994738932454498445) 2025-11-29T12:03Z 25.7K followers, [----] engagements ". . In Massachusetts and Vermont led by the great leaders of our time: + = - () Its cute watching people defend it. Like watching a toddler argue about dinosaurs" [X Link](https://x.com/DutchRojas/status/1994768405270872190) 2025-11-29T14:00Z 25.3K followers, 15.1K engagements "Or you could use you tech smarts that made you a billionaire and ask some really good questions. Why are premiums high And from there the solutions would be simple At this point Medicare-for-all is the least we can do. We must start the conversation on a national health system like in Sweden or Norway. In US many have no access to quality healthcare at all. And wait times are worse than in our government run healthcare system: the VA. At this point Medicare-for-all is the least we can do. We must start the conversation on a national health system like in Sweden or Norway. In US many have no" [X Link](https://x.com/DutchRojas/status/1994786631270748442) 2025-11-29T15:12Z 25.3K followers, [----] engagements "- ANN ARBOR MI The third quarter of The Game was delayed after officials became aware of an escalating sideline argument between Ohio and Michigan state representatives about which states healthcare system is more anti-competitive. : At least we repealed CON for hospitals : We may have CON but your insurer is a monopoly dressed like a nonprofit The referees stepped in to separate the two parties citing unsportsmanlike conduct related to healthcare regulatory structure. Fans joined in as the argument spilled into the stands. : Your nonprofit systems buy every practice in the zip code :" [X Link](https://x.com/DutchRojas/status/1994798616997704084) 2025-11-29T16:00Z 25.3K followers, [----] engagements "I love it when the intellectuals show up. Last week it was the rednecks defending Georgia Alabama and West Virginia. This week its the Ive never worked a day in my life crowd from VT and Mass. Facts: Massachusetts consistently ranks #1#3 for the most expensive employer-sponsored premiums in the country. Why Because: Academic and nonprofit health systems dominate the market. Certificate of Need blocks competition. Physician-owned hospitals are banned. Ambulatory surgery centers were restricted for decades. No free market no downward pressure on price. Massachusetts is: A top-five most" [X Link](https://x.com/DutchRojas/status/1994822295341203771) 2025-11-29T17:34Z 25.7K followers, [----] engagements "Insurance Fragmentation: Technically Not Single-Payer Functionally No Competition Massachusetts has: A dominant non profit Blue Cross plan A handful of other carriers offering nearly identical products A regulatory structure that makes new entrants nearly impossible So yes its not single-payer and practically speaking its single-chooser the state chooses what can exist" [X Link](https://x.com/DutchRojas/status/1994822299267088415) 2025-11-29T17:34Z 25.3K followers, [---] engagements "This is a good and long conversation. I do everything I can to reduce all the roles of an ASO. When youre big 10000+ you have all the leverage. You can build the first tier network and then use their network as a second. Over 3-5 years their network becomes very small with limited utilization" [X Link](https://x.com/DutchRojas/status/1994827264869974351) 2025-11-29T17:54Z 25.3K followers, [---] engagements "Massachusetts Healthcare in [--] Points 1.Massachusetts has Certificate of Need laws protecting incumbents and blocking competition. 2.Massachusetts has the lowest share of independent physicians in the U.S. 3.Massachusetts lawmakers supported the federal ban on physician-owned hospitals (ACA Section 6001). 4.Massachusetts banned ASCs for more than a decade. Today Boston has just one. [--]. Massachusetts has one of the lowest densities of low-acuity medical facilities in the country. [--]. Five dominant academic medical centers control the market and steer patients into high-priced facilities. 7." [X Link](https://x.com/DutchRojas/status/1994858647831163344) 2025-11-29T19:58Z 25.3K followers, [----] engagements "You might be absolutely right about me maybe Im a terrible entrepreneur a terrible Mexican horrible Marine a bad immigrant and my English is certainly questionable on a good day. None of that changes federal law. And on the substance your assertion is simply incorrect. In the United States a group of unrelated individuals cannot legally bind together and purchase a health plan as a single risk entity. Not for a self-funded plan. Not for a fully insured plan. Not under ERISA. Not under the ACA. Heres why: 1.Association health plans were restricted and then invalidated in federal court. Whats" [X Link](https://x.com/DutchRojas/status/1994876367087755585) 2025-11-29T21:09Z 25.3K followers, [----] engagements "Mark insurers do plenty of damage. Yet the U.S. doesnt have a simple insurer problem. We have a vertically integrated system where the largest nonprofit health systems own or control the insurance plans the PBMs the pharmacies the physician practices the referral pathways and the facility-fee engine. In many parts of the country including Dallas the carrier and the provider are the same enterprise. Thats why costs never fall youre negotiating with a monopoly on both sides of the transaction. We see it in Pennsylvania (UPMC) Utah (SelectHealth) California (Kaiser) Michigan (HAP) Wisconsin" [X Link](https://x.com/DutchRojas/status/1995112361720480016) 2025-11-30T12:47Z 25.7K followers, 12K engagements "Alex youre absolutely right that the U.S. overpays massively. And the overpayment isnt random or accidental. Its the direct result of consolidated delivery monopolies that set prices eliminate competitors and then negotiate with insurance subsidiaries they increasingly own or control. Overpayment is a feature of the structure. When the health system owns the insurer owns the physicians controls the residency pipeline and blocks new facilities with regulation you dont have a functioning market you have a captive system. Thats why spending rises no matter how much we legislate or subsidize: the" [X Link](https://x.com/DutchRojas/status/1995115294386254292) 2025-11-30T12:58Z 25.7K followers, [----] engagements "Sorry And thank you for having a discussion about the expense side. It has to be addressed. Today I am going to beat on West Virginia. The Republicans have made it easier to strip mine coal than to open a clinic. Doctors have fled the state and the lawmakers continue on" [X Link](https://x.com/DutchRojas/status/1995129984013213897) 2025-11-30T13:57Z 25.3K followers, [---] engagements "West Virginia has a Republican governor a Republican supermajority and a Republican bill to eliminate a government barrier to competition. Not even a month later Republicans killed it. CON laws give hospitals veto power over their competitors. Can you do a procedure better faster or cheaper Nah West Virginia doesn't want you. In order to build in the amazing state of West Virginia you need permission from the exact people who profit if you never exist. This isnt a free market. Its Americas China/Russia hybrid a cartel with a committee hearing. And West Virginia Republicans protected it." [X Link](https://x.com/DutchRojas/status/1995142020365734342) 2025-11-30T14:45Z 25.7K followers, 129.5K engagements "When people say healthcare is too complicated what they really mean is: the wrong people are in the room. Dr. Kella nails the real problem ideas die in silos. The second you bring clinicians investors attorneys and operators together The truth starts leaking out. This is why the lobby fights to keep us separated. This is why innovation stalls. This is why patients pay more. Watch this. @PhysiciansCap @DrVipulKella @drslo" [X Link](https://x.com/DutchRojas/status/1995187696512475222) 2025-11-30T17:46Z 25.3K followers, [----] engagements "@maximumbob4real West Virginia and Massachusets are both bought and paid for shitholes" [X Link](https://x.com/DutchRojas/status/1995194533815243180) 2025-11-30T18:13Z 25.3K followers, [--] engagements "@drwillblake YES The socialist were on me yesterday when I said Vermont and Massachusetts were corrupt. The rednecks are fighting back when we talk about North Carolina Georgia and Alabama were absolute garbage. Why Because all of the lawmakers are grifters" [X Link](https://x.com/DutchRojas/status/1995216093468934229) 2025-11-30T19:39Z 25.3K followers, [---] engagements "Everyone talks about healthcare networks. Dr. Slosar describes what were actually building a living organism that can build a real patient centric healthcare system This is why investors walked up to us unprompted and said: Im in. I saw the opportunity. Lets go. People arent buying a fund. Theyre buying a rebellion. Roll it. To learn more about @PhysiciansCap check us out here @drslo @DrVipulKella http://www.phycapfund.com http://www.phycapfund.com" [X Link](https://x.com/DutchRojas/status/1995259044500586609) 2025-11-30T22:30Z 25.3K followers, [----] engagements "Steve Jobs and Jensen Huang share a principle most organizations are too scared to touch: Stop whispering. Stop lobbying in private. Stop protecting ideas from sunlight. Jobs once confronted Jony Ive after learning he held back ideas to avoid public criticism. Jobs told him essentially: If you hide your ideas to protect your feelings the whole company loses. That was the turning point. Ive stopped hiding. Jobs kept attacking ideas in public. And Apple got better because everyone learned together. Jensen Huang runs NVIDIA the same way: debate in public debug in public improve in public. No" [X Link](https://x.com/DutchRojas/status/1995311909814341660) 2025-12-01T02:00Z 25.7K followers, [----] engagements "Mark independents can use accrual. And it is one of the craziest business models to be on cash basis no normal business person would do it but its it bankrupts independents overnight. Hospitals have predictable contracts actuarial teams and payment curves. Independent physicians dont. If we booked revenue the moment we billed wed be paying taxes on money that insurers deny delay reduce or claw back. In a claims-driven world cash accounting is survival not preference" [X Link](https://x.com/DutchRojas/status/1995340342556504434) 2025-12-01T03:53Z 25.3K followers, [--] engagements "The U.S. doesnt have a healthcare cost problem it has a competition elimination problem. For years policymakers insisted Americans pay more because were sicker older more complex. None of that survived scrutiny. Healthcare is expensive because we systematically eliminated every force that makes markets work: We absorbed independent physicians into systems. Banned new hospitals and new medical facilities through CON laws. Prohibited physician-owned hospitals through the ACA. Let nonprofits become tax-free monopolies. Built insurance around trillion-dollar float instead of coverage. The pattern" [X Link](https://x.com/DutchRojas/status/1995478031863791970) 2025-12-01T13:00Z 25.6K followers, [----] engagements "70% of surgeries qualify for ASC-level care. Massachusetts blocked ASCs for a decade. Boston has one ASC. Guess what happened to health insurance premiums" [X Link](https://x.com/DutchRojas/status/1995493186395894187) 2025-12-01T14:00Z 25.7K followers, 10.3K engagements "' . . As @drslo put it people kept coming not because they were invited but because they wanted to be there. Authenticity was the oxygen in the room. Leaders spoke openly without pretense and with the kind of expertise you only earn from decades of doing the work. It felt less like an event and more like a convergence a true Nexus where new relationships new collaborations and new ideas formed in real time. Heres the moment that captured it. @DrVipulKella @PhysiciansCap" [X Link](https://x.com/DutchRojas/status/1995508561015959596) 2025-12-01T15:01Z 25.7K followers, [---] engagements "The biggest lie in healthcare: Medicare saves money. No it shifts costs and then health systems use it to justify raising commercial rates. Regulation is not efficiency" [X Link](https://x.com/DutchRojas/status/1995523032970838431) 2025-12-01T15:59Z 25.4K followers, [----] engagements "When physicians ran healthcare everything started with one question: What does the patient need right now Doctors think about intake time. Doctors think about wait times. Doctors think about frictionless access. Doctors think about why the patient is actually there not pamphlets not care pathways not bureaucratic detours. Back pain You get imaging a plan a treatment and dignity. Thats what happens when physicians run the system. When health systems run the system the question flips: How do we maximize revenue per encounter One model serves the patient. The other serves the balance sheet. We" [X Link](https://x.com/DutchRojas/status/1995553734193983936) 2025-12-01T18:01Z 25.3K followers, 19.5K engagements "Heath opened the episode with a gut punch: he woke up wondering why he keeps fighting for physicians when so many refuse to fight for themselves. Because the stakes are simple: Either you jump on the train or youre gone. Your profession is gone. 3/" [X Link](https://x.com/DutchRojas/status/1995615145750655389) 2025-12-01T22:05Z 25.3K followers, [--] engagements "There are [---] million physicians in America. 68% are employed by consolidated health systems. 12% work for Optum. 6% for private equity. That leaves roughly [------] independent physicians and half are primary care. This is a vanishing species. 4/" [X Link](https://x.com/DutchRojas/status/1995615147780714998) 2025-12-01T22:05Z 25.3K followers, [---] engagements "Heath dismantled the myth of political influence: Physicians have no leverage. They dont speak with one voice. They dont fund their future. If a commercial company needs something they deploy $3050 million in lobbying. Physicians debate donating $500. 6/" [X Link](https://x.com/DutchRojas/status/1995615151387758994) 2025-12-01T22:05Z 25.3K followers, [--] engagements "His warning is brutal and accurate: The only way independent physicians win is by cooperating scaling lowering costs and aligning with the consumer. Everything else leads to full absorption into health systems and private equity. This is the last rotation before the door closes. 7/" [X Link](https://x.com/DutchRojas/status/1995615153220464651) 2025-12-01T22:05Z 25.3K followers, [--] engagements "We are entering a generational economic cycle shift. Healthcare is the largest sector of GDP. When the rotation hits the economy it hits healthcare first and hardest. Physicians who organize now will build generational wealth. Those who dont will be employees forever. 8/" [X Link](https://x.com/DutchRojas/status/1995615154793275457) 2025-12-01T22:05Z 25.3K followers, [--] engagements "Share this thread. Subscribe to @DutchRojas Tag a physician who still believes consolidation is inevitable. Follow for more straight unfiltered economic clarity. End/" [X Link](https://x.com/DutchRojas/status/1995615158081589361) 2025-12-01T22:05Z 25.3K followers, [---] engagements "Mark the hospital-bed statistic is accurate but it also describes only a tiny slice of what people actually consume in healthcare. Hospital beds represent a fraction of medical utilization in any modern system. In the US of A its [--] billion treatments less than [--] million involve a hospital bed. The overwhelming majority of care happens outside a bed: physician visits imaging labs outpatient surgeries same-day procedures chronic disease management maternity care rehab cancer care medications emergency visits urgent care dialysis infusion centers mental health home health preventive services" [X Link](https://x.com/DutchRojas/status/1995631350339064125) 2025-12-01T23:09Z 25.8K followers, 10.1K engagements "@TrekDocFan" [X Link](https://x.com/DutchRojas/status/1995639488522191266) 2025-12-01T23:41Z 25.3K followers, [--] engagements "@ASnactivist Write in English" [X Link](https://x.com/DutchRojas/status/1995646021616238945) 2025-12-02T00:07Z 25.3K followers, [--] engagements "@mkominiak Does it" [X Link](https://x.com/DutchRojas/status/1995653887706140762) 2025-12-02T00:38Z 25.3K followers, [--] engagements "@October1859 @volbtc No one likes the AMA. I hope youre old" [X Link](https://x.com/DutchRojas/status/1995663088901554299) 2025-12-02T01:15Z 25.3K followers, [--] engagements "UnitedHealthcare bet that seniors would rather suffer quietly than use the benefits they were sold. Then reality showed up. Sick people used the care they were promised and the entire business model snapped in half overnight. [--] Week High: $622.83 [--] Week Low: $234.60 Today's Price: $329.19 @UHC @Optum" [X Link](https://x.com/DutchRojas/status/1995825276375503057) 2025-12-02T12:00Z 25.7K followers, 190.5K engagements "If Charleston West Virginia is the example then shouldnt the real question be: What happens to healthcare prices and access when a state keeps Certificate of Need (CON) laws blocks independent facilities hides real prices and protects incumbents through policy A [--] year old in Charleston WV making $65000 would see their annual out-of-pocket premium increase from $5525 to $27864 if the enhanced ACA tax credits expire. The same [--] year old living in Charlottesville VA would see their out-of-pocket premium go from $5525 to $12616. A [--] year old in Charleston WV making $65000 would see their" [X Link](https://x.com/DutchRojas/status/1995834669452177813) 2025-12-02T12:37Z 25.7K followers, [----] engagements "Great segment with @BeckyQuick and @JoeSquawk and the SEC Chairman talking about what actually makes free markets work risk accountability and the disciplined deployment of capital. But heres the irony we never confront: healthcare is the one major industry in America where none of that applies. No price discovery. No transparent markets. No competitive discipline. No real consumer choice. No ability for physicians or patients to see or act on prices. Every other sector is governed by markets. Healthcare is governed academics subsidies and exemptions Thats how you end up with the highest" [X Link](https://x.com/DutchRojas/status/1995836659166797952) 2025-12-02T12:45Z 25.6K followers, [----] engagements "@docshanep @dpcalliance @dpcnews1 💡💡💡💡💡💡" [X Link](https://x.com/DutchRojas/status/1995914802816761888) 2025-12-02T17:55Z 25.4K followers, [--] engagements "The function of man is to live not to exist. I shall not waste my days in trying to prolong them. I shall use my time. - Jack London" [X Link](https://x.com/DutchRojas/status/1996037460032377055) 2025-12-03T02:03Z 25.5K followers, [----] engagements "@e77evidence77 Health systems receive $140B of subsidies and the top [--] do not give more in charity care than they receive in subsidies" [X Link](https://x.com/DutchRojas/status/1996078388319236132) 2025-12-03T04:45Z 25.8K followers, [---] engagements "@billychaffin23 Kentucky is a great state with amazing people. They need leadership that puts their needs first" [X Link](https://x.com/DutchRojas/status/1996211848908021920) 2025-12-03T13:36Z 25.6K followers, [--] engagements "@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick @grok What a free enterprise country do Would we let the central planners at Medicare and Medicaid determine assigned prices or would we have a commodities exchange with real Prices" [X Link](https://x.com/DutchRojas/status/1996295267608666156) 2025-12-03T19:07Z 25.6K followers, [--] engagements "@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick Lowest prices patients reduced grift mean reversion transparent and actionable prices no annual renewals and the ability to contract for [-----] or [--] years out. Im a health plan I want to lock in prices" [X Link](https://x.com/DutchRojas/status/1996295889074135377) 2025-12-03T19:10Z 25.6K followers, [--] engagements "@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick Stop worrying about the patents and start thinking MACRO. We can get to the patents. Or are you paid by pharma like everyone else" [X Link](https://x.com/DutchRojas/status/1996296799540088937) 2025-12-03T19:13Z 25.6K followers, [--] engagements "@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick Explain it to a 5th Grader. They think Mr. Joe Smith at Medicare can assign prices to all the drugs in the world. Why can a market do it better cheaper and faster" [X Link](https://x.com/DutchRojas/status/1996297712665247906) 2025-12-03T19:17Z 25.6K followers, [--] engagements "Rand Paul fully supports the largest retailers to sell health plans. In the meantime @SenRandPaul has not removed certificate of need in his own damn state. I support free markets Except in my own state. And now a lan for the largest retailers. I do not have the words for these politicians. Which insurance companies will those retailers use The same that got us into this mess Or will they create their own And who will regulate them to make sure they have th needed capital Will you allow them to make further acquisitions to arbitrage more aspects of Which insurance companies will those" [X Link](https://x.com/DutchRojas/status/1996348150685089819) 2025-12-03T22:37Z 25.6K followers, [----] engagements "Independent pharmacists are being annihilated. Its a joy to paid screwed over by the payers especially those lovely payers owned by the health systems The pharmacy business model is great. You get to buy a product from [--] of the [--] designated wholesalers. Then an insurance company pays you less than that. Then [--] years later you get audited and might have to give all the money back. The pharmacy business model is great. You get to buy a product from [--] of the [--] designated wholesalers. Then an insurance company pays you less than that. Then [--] years later you get audited and might have to give all" [X Link](https://x.com/DutchRojas/status/1996405397243273410) 2025-12-04T02:25Z 25.6K followers, [----] engagements "@MDiPaolaMD @drdanchoi And the top [--] health systems would lose all their power They all have insurance companies Medicaid ACOs PBMs and ASOs" [X Link](https://x.com/DutchRojas/status/1996433826592252085) 2025-12-04T04:18Z 25.4K followers, [--] engagements "Everyone keeps asking why premiums in Minnesota explode every year. Heres the answer in less than one minute. Competition is illegal by design. Watch this. Senator your state has had a Hospital Construction Moratorium since [----]. Not certificate of need. A moratorium. No one builds a hospital. No one adds a bed. Unless your legislature says so. [--] exceptions in [--] years. Each one required a lobbyist. Each one protected the people Senator your state has had a Hospital Construction Moratorium since [----]. Not certificate of need. A moratorium. No one builds a hospital. No one adds a bed. Unless" [X Link](https://x.com/DutchRojas/status/1996686145342857416) 2025-12-04T21:00Z 25.7K followers, 70K engagements "@HunterSprinkle1 Subsidies = profits" [X Link](https://x.com/DutchRojas/status/1998013305114214502) 2025-12-08T12:54Z 25.7K followers, [--] engagements "@stubronstein02 @AmachHealth Republicans are shit. This is bigger than a political side. When we look at the data its both parties. One is insurance and the other is academic and non profit health systems. Bad for America" [X Link](https://x.com/DutchRojas/status/1998082126953287784) 2025-12-08T17:27Z 25.7K followers, [--] engagements "The Number [--] of [---] U.S. senators took $10000+ from pharma and health product PACs in [----]. [--] of those seats are on the ballot next November. They voted to keep the physician ownership ban. They killed site-neutral payment reform. They defended CON laws. The list is in the pinned post" [X Link](https://x.com/DutchRojas/status/1998082649546477712) 2025-12-08T17:30Z 25.7K followers, [----] engagements "@j_luh The health systems are bigger than the commercial insurance companies. They have been very loud" [X Link](https://x.com/DutchRojas/status/1998083484229984458) 2025-12-08T17:33Z 25.7K followers, [--] engagements "The Nine The Free Market Champions: Senators who actually fight: Marshall (R-KS): 3/4 Hassan (D-NH): 3/4 Cassidy (R-LA): 3/4 Grassley (R-IA): 2/4 Tillis (R-NC): 2/4 Lankford (R-OK): 2/4 Cornyn (R-TX): 2/4 Baldwin (D-WI): 2/4 Barrasso (R-WY): 2/4 [--] Republicans. [--] Democrats. These nine did not fold. See pinned post" [X Link](https://x.com/DutchRojas/status/1998097998220575227) 2025-12-08T18:31Z 25.7K followers, [----] engagements "McConnell Mitch McConnell (R-KY) $51500 from top [--] healthcare groups. Reform score: 0/4. Kentucky is a CON state. Four decades in Washington. Over $2 million career from healthcare. He has supported zero pro-competition reforms. Zero. See pinned post for more" [X Link](https://x.com/DutchRojas/status/1998113097677250844) 2025-12-08T19:31Z 25.7K followers, [----] engagements "In Certificate of Need (CON) states health insurance premiums are 20% higher per person per year. Multiply by millions of people. Over decades. The hidden tax of protected monopolies. Paid by every family. Every employer. Every taxpayer" [X Link](https://x.com/DutchRojas/status/1998528585620226157) 2025-12-09T23:02Z 25.8K followers, [----] engagements "Want to open a hospital ambulatory surgery center radiology center or nursing home In [--] states you need government permission. And the hospital you're competing against gets to object. That's not a free market. That's a cartel with a permission slip" [X Link](https://x.com/DutchRojas/status/1998543183592985081) 2025-12-10T00:00Z 25.8K followers, 21.6K engagements "In Alabama Bradford Health Services owned by a New York PE firm used CON to kill Sereno Ridge. 16-bed addiction treatment center. Never opened. Bradford has done it again and again. Veterans' programs. Nonprofits. Private equity weaponizing government regulation to eliminate competition" [X Link](https://x.com/DutchRojas/status/1998589235431956952) 2025-12-10T03:03Z 25.8K followers, [----] engagements "The hospital lobby spent $30 million last year. What were they protecting $54B in 340B revenue $37.4B in tax exemptions $30B in supplemental payments $30B in GME funding Site-neutral payment differentials $125+ billion is worth lobbying for. That's in addition to your sky high insurance premiums" [X Link](https://x.com/DutchRojas/status/1998845258436600180) 2025-12-10T20:00Z 25.8K followers, [----] engagements "@RareCamellia @scareduck @SenRandPaul That's why you're unhealthy. Stop eating Wendy's" [X Link](https://x.com/DutchRojas/status/1998849215250714694) 2025-12-10T20:16Z 25.8K followers, [--] engagements "@MaxManus73 @SenRandPaul Embarrassed By advocating for free markets Never" [X Link](https://x.com/DutchRojas/status/1999078211754619087) 2025-12-11T11:26Z 25.7K followers, [--] engagements "There are no clinical differences between a hip replacement priced at $29000 $49000 $79000 OR $109000 why pay more #surgerypricesfordummies" [X Link](https://x.com/DutchRojas/status/943491436183478272) 2017-12-20T14:41Z 23.4K followers, [--] engagements "@chasedave Rural hospitals are transitioning to micro-hospitals. Its a good transition" [X Link](https://x.com/DutchRojas/status/969682038205825024) 2018-03-02T21:13Z 23.4K followers, [--] engagements "@matthewtaber @dwramzimdmph @DPCNavigator @EFSBenefits @vtdocmom @drcraigwax @ManageMyRisks @Jim_TheRocktor @kenjaques @chasedave @docshanep @DocMElliott @pavtalk @rlamartini @NeuCare @misterchambo @quinnscomments @CathleenWentz @TweetlySaved @GreenHillsDFC @SurgeryCenterOK @HConomics @clayforsberg @PolicyRNAbby @ClarisseTru @FarrowPete @mduanemd @PlumHealthDPC @AlietaEck @myHSAguy @FMPooler @kennethafisher @brianuhlig @DoctorSammyU @AAPSonline @drweeksdpc2016 @dcontorno @RandPaul @FreeMarketMed @dpcalliance @HealthRosetta @ballardsigns @WedgeofFreedom @twilabrase Pratter is small and" [X Link](https://x.com/DutchRojas/status/988823053357350914) 2018-04-24T16:52Z 23.4K followers, [--] engagements "@chasedave With self-insured employers moving away from networks this problem also goes away. In-network and out-of-network are simply scams of the highest order" [X Link](https://x.com/DutchRojas/status/999752074622455810) 2018-05-24T20:40Z 23.4K followers, [--] engagements Limited data mode. Full metrics available with subscription: lunarcrush.com/pricing
@DutchRojas Dutch Rojas
Dutch Rojas posts on X about health, insurance, money, business the most. They currently have [------] followers and [---] posts still getting attention that total [-------] engagements in the last [--] hours.
Engagements: [-------] #
- [--] Week [-------] +217%
- [--] Month [---------] -51%
- [--] Months [----------] -62%
- [--] Year [----------] +1,148%
Mentions: [--] #
- [--] Month [---] +9.20%
- [--] Months [-----] +167%
- [--] Year [-----] +85%
Followers: [------] #
- [--] Week [------] +0.68%
- [--] Month [------] +1.60%
- [--] Months [------] +45%
- [--] Year [------] +84%
CreatorRank: [------] #
Social Influence
Social category influence finance 30.77% countries 8.72% stocks 6.67% travel destinations 1.03% celebrities 0.51% cryptocurrencies 0.51% fashion brands 0.51%
Social topic influence health 24.62%, insurance #811, money 6.15%, business 5.13%, west virginia #107, systems #205, united states 3.59%, ceo 3.08%, private equity 3.08%, cvs 2.56%
Top accounts mentioned or mentioned by @realdocspeaks @heathveuleman @drdigiorgio @edwards183 @mcuban @jeanpierremba @beckyquick @learnusahistory @gebaidc @drdanchoi @docshanep @grok @howardlutnick @cnbc @cogitator88 @alexjung @drsloungepod @anishkoka @sdixitmd @physicianscap
Top assets mentioned CVS Health Corp (CVS) Cigna Corp (CI) Berkshire Hathaway Inc. (BRK.A)
Top Social Posts
Top posts by engagements in the last [--] hours
"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 2026-02-10T14:06Z 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 2026-02-11T12:07Z 31.2K 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 2026-02-11T16:30Z 31.2K followers, [----] 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 2025-12-10T20:30Z 31.1K followers, [----] 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 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 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 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 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 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 2026-01-06T14:00Z 31.1K followers, [----] engagements
"It is 6:13 the kiddos are awake of course and here are the stories Im following: Ambulatory surgery centers fight CMS for [---] procedure approvals. ASCs cannot compete when medicare academics decide what procedures theyre allowed to perform. Senate exposes UnitedHealths Medicare Advantage tactics. Regulatory capture in action: the largest insurer gaming government programs for higher reimbursements while taxpayers foot the bill. Compounding pharmacy sues Eli Lilly Novo over GLP-1 access. When pharma giants allegedly restrict competition patients lose access and pay more. Prior authorization:"
X Link 2026-01-19T12:17Z 31K followers, [----] engagements
"$100000 a year. For [--] years. $3.2 million in malpractice premiums. At retirement that neurosurgeon gets back exactly nothing. The carrier kept the float. The carrier kept the investment income. The carrier kept the underwriting profit. The physician paid the bill"
X Link 2026-01-24T17:45Z 31K followers, 14.7K engagements
"The medical malpractice industry generates $12.5 billion in annual premiums. [------] physicians purchase their own coverage. They have no idea they're building someone else's balance sheet. Warren Buffett's Berkshire Hathaway holds 17.72% market share. He thanks you for your premiums. https://twitter.com/i/web/status/2015137559999918472 https://twitter.com/i/web/status/2015137559999918472"
X Link 2026-01-24T19:00Z 31K followers, 14K engagements
"I am a healthcare guy. And If I were building a world-class patient-first healthcare system the first thing Id do is ban doctors from owning hospitals. Obviously. We wouldnt want people with clinical experience or a Hippocratic Oath getting in the way of shareholder value. No lets make sure hospitals are owned and operated by private equity firms hedge fund CFAs felons the American Hospital Associations favorite lobbyists bankers and Harvard administrators. You know the real patient outcomes professionals. Next Id insist that governors create committees of insurance executives and hospital"
X Link 2026-01-25T23:09Z 31K followers, 20.2K engagements
"Doctors are not good at business. What does being good at business mean Today's article looks at non-profit health systems to find out. I've been told these health systems below are all "Good at Business." Kaiser Permanente. Providence. CommonSpirit. Trinity. Ascension. These health systems also have the largest gaps between the tax exemptions they receive and the community benefits they return. Is that what being good at business means Let's find out"
X Link 2026-01-26T13:57Z 31K 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 2026-01-26T16:30Z 31.1K followers, [----] engagements
"Dr. Oz is exposing fraud while running a department the Centers for Medicare and Medicaid thats been defrauding the American people for decades and is the chief reason for the increase in your health insurance premiums. The irony writes itself. Imagine if every working American knew their paycheck was being siphoned to fund the consolidation of health systems that make care more expensive and less accessible. Imagine if they knew they could buy an aspirin for $4 but Medicare pays $22 for the exact same pill. Or that Medicare routinely pays $40000 to hospitals for the same procedure done in an"
X Link 2026-01-26T19:34Z 31K followers, [----] engagements
"I just got back from sledding with the kiddos. Guess what Howard Kern CEO of Sentara Healthcare: $33.2 million. Lloyd Dean CommonSpirit: $35.5 million. Gene Woods Advocate Health: $25.8 million. These are not for-profit hospitals. Tax-exempt. Ostensibly charitable. Is this what people mean when they say doctors are not good at business Yeah sorry mate that's a horrible way to define business"
X Link 2026-01-27T00:00Z 31K followers, [----] engagements
"How do nonprofit boards justify $30 million CEO packages They hire consultants. The cycle: [--]. Board hires consultant [--]. Consultant benchmarks against "peers." [--]. Board sets pay at the 75th percentile [--]. This becomes next year's benchmark [--]. Repeat Every board wants to pay above average. No board hires a consultant to recommend below-market. The consultants know who pays their fees. The spiral only moves up. SullivanCotter. Pearl Meyer. Gallagher. Three firms. One direction. Read more depressing news here 😎 👇 https://buff.ly/Ldzpv8z https://buff.ly/Ldzpv8z"
X Link 2026-01-30T01:00Z 31.1K followers, [----] 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 2026-01-31T17:07Z 31.1K followers, 15.9K engagements
"' : A professional buyer spends six months examining a health system. They walk away without making an offer. A government buyer looks at the same asset. They pay $75 million MORE than asking price. What information did the government have that SSM Health missed Are you really wondering why your health insurance premiums have skyrocketed"
X Link 2026-02-03T17:15Z 31K followers, [---] engagements
": When HCA sells. HCA is the largest for-profit hospital operator in America. They don't sell assets because they're feeling generous. They sell when the math stops working. October 2016: HCA announces they're selling in Oklahoma. The signal was clear. The state paid anyway"
X Link 2026-02-03T18:00Z 31K followers, [----] engagements
"The question Thomas Sowell would ask: "Compared to what" Before: The hospital paid federal state and property taxes. Zero appropriations. Shareholders bore risk. After: Hospital receives $463-493 million annually. Taxpayers bear risk. Same building. Same beds. Different economics. Oklahoma didn't acquire a hospital. Oklahoma acquired a subsidy obligation. https://twitter.com/i/web/status/2018814288417173898 https://twitter.com/i/web/status/2018814288417173898"
X Link 2026-02-03T22:30Z 31K 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 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 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 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 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 2026-02-04T01:25Z 31.1K followers, [---] engagements
"October 2016: Deal announced at $750M. December 2017: Supreme Court approves at $750M. February 2018: Closes at $825M. $75 million increase. 10%. No public explanation. No independent fairness opinion ever made public despite state requirements. 4/"
X Link 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 2026-02-04T01:25Z 31.1K followers, [---] engagements
"The life support system: $493M in annual subsidies. $245.8M State appropriations $111.6M Medicare GME $34.6M Federal UPL match $20-50M 340B drug pricing $22.5M Tax-exempt bond savings This represents 72-77% of total operating revenues. The system is dependent by design. Why does no one talk about where the money actually goes Because the people who know are paid not to. Im not. 6/ https://twitter.com/i/web/status/2018858542350881220 https://twitter.com/i/web/status/2018858542350881220"
X Link 2026-02-04T01:25Z 31.1K followers, [---] engagements
"The state money isnt extra cash. Its the match key. $245.8M state appropriation unlocks federal Medicaid matching through THRP. Result: $280.4M in THRP revenue. Without the state input the federal UPL portion ($34.6M) disappears. 7/"
X Link 2026-02-04T01:26Z 31K followers, [---] engagements
"Although labeled a State hospital Washington D.C. is the silent majority partner. State contribution: $245.8M Federal value: $210-240M GME UPL match 340B pricing bond tax exemptions federal grants all flow from D.C. Federal subsidies rival state appropriations when you tally all indirect supports. 8/ https://twitter.com/i/web/status/2018858553822371900 https://twitter.com/i/web/status/2018858553822371900"
X Link 2026-02-04T01:26Z 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 2026-02-04T01:26Z 31.1K followers, [---] 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 2026-02-04T15:02Z 31.2K followers, [----] engagements
"@AmericanGidget You sound like a positive Catholic American. Where can I get some of that hope for my life. And yes it matters you just dont understand why"
X Link 2026-02-05T16:51Z 31.1K followers, [---] engagements
"The pessimism and victimization runs strong. How on earth could anyone shop for the [--] billion treatments and services that are consumed every year [----] billion of which are not emergencies. Continue on victim no reason to get your head out of the sand and learn something. Super Bowl is on Sunday enjoy"
X Link 2026-02-05T16:53Z 31.1K followers, [---] engagements
"@SilentMaj843 I heard you a few years ago"
X Link 2026-02-05T18:02Z 31.1K followers, [--] engagements
"People think price transparency is about patient shopping. Its not. Once healthcare becomes computable with machine-readable prices and structured data markets will form whether consumers ever looked or not. Benchmarks. Arbitrage. Capital reallocation. Opacity was the moat. Data killed it. Thats 🔥🔥🔥🔥 https://twitter.com/i/web/status/2019486197446218128 https://twitter.com/i/web/status/2019486197446218128"
X Link 2026-02-05T19:00Z 31.1K followers, [----] 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 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 2026-02-06T15:30Z 31.1K 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 2026-02-06T17:07Z 31.1K followers, [---] 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 2026-02-07T14:00Z 31.1K followers, [---] engagements
"@Doc_Polymath PE in HC is dead. They were slaughtered"
X Link 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 2026-02-07T15:00Z 31.1K followers, [----] engagements
"@realdocspeaks @HeathVeuleman Why do people expect second order solutions to solve problems"
X Link 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 2026-02-07T17:32Z 31.1K followers, [---] engagements
"@BreedJim @LearnUSAhistory @DrOz Hospitals buying practices"
X Link 2026-02-07T17:33Z 31.1K followers, [--] engagements
"@realdocspeaks @HeathVeuleman Right. Mark fights first order solutions as hard as Trump does. These are not difficult to do"
X Link 2026-02-07T17:37Z 31K 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 2026-02-07T17:45Z 31.2K followers, 28.4K 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 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 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 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 2026-02-09T20:45Z 31.1K 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 2026-02-10T19:59Z 31.1K followers, [--] 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 2026-02-11T09:55Z 31.2K followers, [--] engagements
"@NathanLevy10 @HeathVeuleman @elonmusk 48%"
X Link 2026-02-11T12:27Z 31.2K followers, [--] engagements
"@tencentdress Not surprising West Virginia is bought"
X Link 2026-02-11T13:15Z 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. Rule capture"
X Link 2026-01-26T14:00Z 31.2K followers, [----] 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 2026-02-03T20:15Z 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 2026-02-10T17:15Z 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 2026-02-10T19:36Z 31.2K 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 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 2026-02-05T12:21Z 31.2K followers, 174K 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 2026-02-07T10:06Z 31.2K followers, 40.7K 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 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"
X Link 2026-02-10T19:00Z 31.2K followers, [----] engagements
"@HeathVeuleman And he loves the university of Missouri"
X Link 2026-02-10T19:34Z 31.2K 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 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 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 2026-02-10T20:36Z 31.2K followers, [--] engagements
"@cogitator88 Mark believes healthcare is a right"
X Link 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 2026-02-10T22:30Z 31.2K followers, [---] engagements
"@alexjung Bingo Its an appearance win. It will change nada"
X Link 2026-02-11T18:25Z 31.2K followers, [--] 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 2025-07-26T22:28Z 31.2K 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 2025-10-05T10:28Z 31.2K 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 2025-10-09T02:19Z 31.2K followers, 54.3K 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 2025-10-17T14:52Z 31.2K 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 2025-10-28T23:58Z 31.2K followers, 26.8K 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 2025-10-29T15:34Z 31.2K followers, 35.5K 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 2025-11-08T12:33Z 31.2K followers, 352.4K 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 2025-12-29T14:17Z 31.2K followers, 1.8M 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 2026-01-28T13:16Z 31.2K followers, 132.8K 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 2026-02-08T20:43Z 31.2K followers, 30.1K 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 2026-02-10T15:30Z 31.2K 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 2026-02-10T19:26Z 31.2K followers, 42.9K 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 2026-02-11T14:00Z 31.2K 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 2026-02-11T19:00Z 31.2K followers, [----] 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 2026-02-11T20:15Z 31.2K 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 2026-02-10T13:21Z 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 2026-02-10T23:15Z 31.2K followers, 20K engagements
"The man single handily destroyed Vermont Healthcare. And then wonders why its expensive. 😂 https://t.co/5WqtuI9Nov 😂 https://t.co/5WqtuI9Nov"
X Link 2026-02-11T13:16Z 31.2K 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 2026-02-11T18:45Z 31.2K followers, 10.7K 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 2026-02-11T21:19Z 31.2K followers, 466.1K engagements
"@MaddenedRanter @jalbright22 @Darwinismlives @realdocspeaks It doesnt matter. Youll be an anonymous account that argues about nonsense without any skin in the game"
X Link 2025-11-23T23:58Z 25.2K followers, [--] engagements
"Freedom isnt free. Its deducted from your paycheck quietly before you get a say"
X Link 2025-11-24T03:30Z 25.2K followers, [----] engagements
"Upcoming shows for this week: Tomorrow we have a full episode @GeBaiDC on free market economics Wednesday @mass_marion full episode The life of a Servant. Thursday Thanksgiving. Friday @ScriptCoPharm full episode. How to set your health plan free Saturday @CFroh full episode about sharing faith and freedom. Follow and subscribe for great one on one interviews from the front lines of healthcare"
X Link 2025-11-24T14:59Z 25.2K followers, [---] engagements
"The hidden risk physicians never see coming. Most doctors think malpractice premiums are a fixed cost an unavoidable tax you just pay forever. Heres the truth: youre funding someone elses balance sheet while your own enterprise value stays flat. In this conversation Collin Krickl one of the sharpest P&C minds in healthcare explains the uncomfortable reality: You could be self-funding your own risk keeping 3040% of your premiums and building an asset instead of lighting cash on fire. One line from the transcript stopped me cold: Youre paying premiums year after year and youre never getting the"
X Link 2025-11-24T22:00Z 25.6K followers, [----] engagements
"The Founders wouldve torched the IRS on principle. They fought a war over a tea tax. Now we just grumble when the government lifts 30% off our paychecks before we even touch it"
X Link 2025-11-25T04:00Z 25.2K followers, [----] engagements
"The most radical idea in healthcare is simple: let physicians compete"
X Link 2025-11-25T11:57Z 25.2K followers, [----] engagements
"Massachusetts families now pay $6000 more per year in premiums. They banned new ambulatory surgery centers for [--] straight years. Not limited. Not restricted. Banned. [--------]. A decade-long ban + competitor veto power = one outcome: This is what regulatory capture looks like. Watch this"
X Link 2025-11-26T02:00Z 25.3K followers, 10.8K engagements
"@EdwardinRaleigh Eddie in Raleigh: North Carolina has an abundance of challenges and one of them is not physicians. North Carolina has CON laws that keep your premiums 20-25% higher than non CON states"
X Link 2025-11-26T05:36Z 25.3K followers, [--] engagements
"@LighthouseDPC Interesting. How does that square up with the No surprises Act and GFEs"
X Link 2025-11-26T05:37Z 25.3K followers, [---] engagements
"Theres a foundational split in Americas healthcare debate. In my conversation with @GeBaiDC we discuss the core conflict: If healthcare is a right government must sit at the center. If healthcare is a commodity then economic principles must govern it. One belief system produces bureaucracy and dependency. The other produces innovation access and affordability. The philisophy has determined the rise in premiums industry consolidation and quality in patient care. Watch the clip reflect and ask yourself: Which worldview are you The full episode airs at 5pm EST"
X Link 2025-11-26T13:23Z 25.3K followers, 17.2K engagements
"Oh for sure In fact that's exactly what I've been working on since [----]. My thesis is how do I help the government lawmakers lobbyists non profit health systems and insurance carriers screw over patients and build the most expensive healhtcare system in the world. You're spot on"
X Link 2025-11-26T16:03Z 25.3K followers, [--] engagements
"The only reason physicians think they need to be employed is because the system taught them to fear independence. When did medicine become a job instead of a profession"
X Link 2025-11-26T17:45Z 25.3K followers, [----] engagements
"Nonprofit health systems arent mission-driven. Theyre tax-exempt monopolies that eliminate physician competition and then call it charity. Agree or disagree"
X Link 2025-11-26T18:30Z 25.3K followers, [----] engagements
"If healthcare is a right government must control it. If healthcare is a market physicians must control it. That belief determines everything else. Which one do you believe"
X Link 2025-11-26T19:15Z 25.3K followers, [----] engagements
"The most explosive conversation Ive had this year. Dr. Ge Bai (Johns Hopkins) lays out the core truth everyone in Washington avoids: Healthcare isnt a right it behaves like a commodity. Government doesnt lower costs it blocks the market that would. Price transparency only works when physicians are free. Innovation dies when a nation fears risk. And America must choose between entrepreneurship or stagnation. And if you think shes bold here shes hosting @bgurley and @mcuban at Johns Hopkins on December [--] for a live debate on the future of healthcare. Details here: Full video below."
X Link 2025-11-26T22:00Z 25.3K followers, 26.1K engagements
"Why dont nonprofit health systems embrace Office-Based Surgery Because the moment a procedure leaves their building three things disappear: The facility fee The control of the patient funnel The justification for higher prices Office-based surgery is: safer faster cheaper same-day clinic imaging and procedure So instead of choosing whats best for patients they make them wait to protect revenue not outcomes. @DRsLoungePod @DrDiGiorgio @anish_koka @SpineNeuro @drdanchoi @physicianhosp"
X Link 2025-11-27T02:27Z 25.3K followers, [----] engagements
"@DrDiGiorgio says it all. The United States is not addressing the root causes of high premiums. The democrats are happy to print more money and pay academic and non profit health systems. @ahahospitals The republicans are happy to print more money and help their insurance buddies. @AHIPCoverage These lobbyist are destroying the company by buying the votes. @DRsLoungePod @DrDiGiorgio @drdanchoi @sdixitmd @anish_koka"
X Link 2025-11-27T02:55Z 25.3K followers, [----] engagements
"Respectfully that is not how it works. Self-insured employers that's 105M individuals own their own insurance companies medicare and medicaid are also their own insurance companies. CMS has been allowed to skew the rules in favor of health systems and wipe out independent practices. I am working to build an environment where competition thrives. This means a level playing field and thousands of insurance companies all building products for all types of patients"
X Link 2025-11-27T18:22Z 25.3K followers, [--] engagements
"A quick Thanksgiving message while the suns up and the grill is warming: Thank you for the men and women of the United States Marine Corps. Your service is recognized by the Family Rojas today. @USMC Grateful for the self-insured employers who bet on something better than the state quote. Grateful for the independent physicians who keep control of their work. Grateful for the founders building the future of healthcare from the ground up. Most of the work we do never makes it on camera but it matters. Thank you for being part of this community. Enjoy your families today. Weve got a lot more to"
X Link 2025-11-27T18:24Z 25.3K followers, [----] engagements
"@JeanPierreMBA Fantastic prose my friend. Happy thanksgiving"
X Link 2025-11-27T18:53Z 25.3K followers, [--] engagements
"@GeBaiDC Come on Free enterprise is the golden goose Lets set the market free"
X Link 2025-11-27T19:01Z 25.6K followers, [---] engagements
"@Frankthesc56146 @DrNadolsky We have tried nothing Do you see a commodities exchange for lab tests or chemo anywhere Point me to anyone of [--] things a free market must have in order to be one. No they dont exist"
X Link 2025-11-27T19:20Z 25.3K followers, [--] engagements
"@ekimyalbmert @PeachyCure If youd let entrepreneurs work instead of worshiping the government we could find solutions to all of the small chronic conditions. I work on CVS which is way bigger killer than cancer. There are government and university impediments that make it almost impossible"
X Link 2025-11-27T19:28Z 25.3K followers, [--] engagements
"When employers stop outsourcing healthcare to insurers they discover prices are negotiable"
X Link 2025-11-28T12:32Z 25.5K followers, [----] engagements
"@SenWarren champions the same policies that already define Massachusetts. So why do residents of her own state pay some of the highest premiums in America Massachusetts is filled with brilliant people. It is also burdened with some of the most expensive healthcare in the country. If calling healthcare a human right made it affordable Massachusetts would already be the model. Instead it became the warning sign. Boston is a global medical capital yet the entire city operates one ambulatory surgery center. Independent physicians are blocked at every turn. Competition is not encouraged. It is"
X Link 2025-11-28T13:05Z 25.3K followers, [----] engagements
"@rrbelloff They are the largest buyers of life insurance"
X Link 2025-11-28T14:05Z 25.3K followers, [---] engagements
"Mark youre right about the symptoms; consolidation high prices a few players controlling everything. As you know the cause isnt the market. Its the laws that eliminated the market. Congress banned physician ownership protected facility fees blocked new surgery centers and wrote rules that guarantee consolidation. Break those laws and the few companies disappear without federal micromanagement. Healthcare is failing because of regulatory capture. Healthcare for everyone is not HC for free. We already make it available to everyone. But it's a mess. It's dominated by a just few companies. Break"
X Link 2025-11-28T18:28Z 25.3K followers, 16K engagements
"They did it in Vermont. They have effectively done it in Mass. The results Abysmal. Highest insurance premiums. No competition. Just academic and non profit health systems ripping off the population. Every single blue state should enact Medicare For All. Popular. Saves money. Saves lives. Not one has enacted a universal public option. A few tiny "pilot" programs run by private firms all under 3% enrollment. A pathetic failure of the Democratic Party. Every single blue state should enact Medicare For All. Popular. Saves money. Saves lives. Not one has enacted a universal public option. A few"
X Link 2025-11-28T19:00Z 25.7K followers, 34.6K engagements
"As a physician do you believe a health system is the appropriate setting for all treatments regardless of risk acuity or cost When the law prohibits physicians from owning their own facilities and when a state like Massachusetts bans ambulatory surgery centers patients are left with no alternative but the highest-acuity highest-cost sites of care. That is not competition. It is a mandated monopoly. @DutchRojas This is called a strawman. @DutchRojas This is called a strawman"
X Link 2025-11-29T07:35Z 25.3K followers, [----] engagements
"Free enterprise Allow lower acuity settings to open like other states. Mass banned one of the most effective tools used by physicians nationwide called ASCs. Remove the ban on physician ownership of hospitals. Get rid of academic health system scams that control mass and vt. Lets lower cost independent physicians with better tech and higher sophistication practice medicine"
X Link 2025-11-29T07:48Z 25.3K followers, [---] engagements
"What I love about Mark is he will tell you exactly what wont work. And Mark is incorrect. [--]. Removing the employer would absolutely work. [--]. Insurance is the law of large numbers. [--]. Association plans are illegal. [--]. Allow people to bundle together and form their own collectives and the country would easily win. [--]. Remove all the burdens against competition. Wont work because the insurance carriers are so large and vertically integrated they set the rules. The ACA is not employer driven. Hows that working right now. You need to break up the behemoth carriers so there is a chance the market"
X Link 2025-11-29T08:07Z 25.7K followers, 21.9K engagements
"We do not have a single-payer system in this state. Technically true on paper no what was what was written and also irrelevant to the outcomes youre pointing out. Mass doesnt need a statutory single-payer law when: physician ownership of hospitals is banned ASCs were prohibited for a decade independent physicians were consolidated and academic nonprofits dominate every market. It functions like a regulated cartel"
X Link 2025-11-29T09:11Z 25.3K followers, [---] engagements
"We (MASS) have the same fragmented dysfunctional jumble of insurance types as other states. This is misleading. Massachusetts has non profit Blue Cross Blue Shield of MA as the dominant insurer holding roughly 51% of the commercial market depending on the segment. The rest of the jumble is tiny by comparison. Its not fragmented; its consolidated. By a non profit"
X Link 2025-11-29T09:11Z 25.3K followers, [---] engagements
"Mark I agree that contagious diseases raise legitimate questions about shared risk. What I dont understand is the asymmetry. If individuals must be responsible for the risk they pose to others why are pharmaceutical manufacturers exempt from the same standard Youre asking the public to absorb both sides of the risk: responsibility for transmission and responsibility for any adverse effects because manufacturers are legally shielded. A consistent framework would require accountability for everyone involved individuals institutions and corporations. Right now the responsibility flows only one"
X Link 2025-11-29T10:07Z 25.3K followers, [----] engagements
"Boston has world-class hospitals elite universities billions in research money And one ambulatory surgery center in the entire city. (@ASCAssociation) One ASC is not bad luck. Its regulatory capture written into law by people who know better. I drop off the receipts"
X Link 2025-11-29T12:03Z 25.7K followers, [----] engagements
". . In Massachusetts and Vermont led by the great leaders of our time: + = - () Its cute watching people defend it. Like watching a toddler argue about dinosaurs"
X Link 2025-11-29T14:00Z 25.3K followers, 15.1K engagements
"Or you could use you tech smarts that made you a billionaire and ask some really good questions. Why are premiums high And from there the solutions would be simple At this point Medicare-for-all is the least we can do. We must start the conversation on a national health system like in Sweden or Norway. In US many have no access to quality healthcare at all. And wait times are worse than in our government run healthcare system: the VA. At this point Medicare-for-all is the least we can do. We must start the conversation on a national health system like in Sweden or Norway. In US many have no"
X Link 2025-11-29T15:12Z 25.3K followers, [----] engagements
"- ANN ARBOR MI The third quarter of The Game was delayed after officials became aware of an escalating sideline argument between Ohio and Michigan state representatives about which states healthcare system is more anti-competitive. : At least we repealed CON for hospitals : We may have CON but your insurer is a monopoly dressed like a nonprofit The referees stepped in to separate the two parties citing unsportsmanlike conduct related to healthcare regulatory structure. Fans joined in as the argument spilled into the stands. : Your nonprofit systems buy every practice in the zip code :"
X Link 2025-11-29T16:00Z 25.3K followers, [----] engagements
"I love it when the intellectuals show up. Last week it was the rednecks defending Georgia Alabama and West Virginia. This week its the Ive never worked a day in my life crowd from VT and Mass. Facts: Massachusetts consistently ranks #1#3 for the most expensive employer-sponsored premiums in the country. Why Because: Academic and nonprofit health systems dominate the market. Certificate of Need blocks competition. Physician-owned hospitals are banned. Ambulatory surgery centers were restricted for decades. No free market no downward pressure on price. Massachusetts is: A top-five most"
X Link 2025-11-29T17:34Z 25.7K followers, [----] engagements
"Insurance Fragmentation: Technically Not Single-Payer Functionally No Competition Massachusetts has: A dominant non profit Blue Cross plan A handful of other carriers offering nearly identical products A regulatory structure that makes new entrants nearly impossible So yes its not single-payer and practically speaking its single-chooser the state chooses what can exist"
X Link 2025-11-29T17:34Z 25.3K followers, [---] engagements
"This is a good and long conversation. I do everything I can to reduce all the roles of an ASO. When youre big 10000+ you have all the leverage. You can build the first tier network and then use their network as a second. Over 3-5 years their network becomes very small with limited utilization"
X Link 2025-11-29T17:54Z 25.3K followers, [---] engagements
"Massachusetts Healthcare in [--] Points 1.Massachusetts has Certificate of Need laws protecting incumbents and blocking competition. 2.Massachusetts has the lowest share of independent physicians in the U.S. 3.Massachusetts lawmakers supported the federal ban on physician-owned hospitals (ACA Section 6001). 4.Massachusetts banned ASCs for more than a decade. Today Boston has just one. [--]. Massachusetts has one of the lowest densities of low-acuity medical facilities in the country. [--]. Five dominant academic medical centers control the market and steer patients into high-priced facilities. 7."
X Link 2025-11-29T19:58Z 25.3K followers, [----] engagements
"You might be absolutely right about me maybe Im a terrible entrepreneur a terrible Mexican horrible Marine a bad immigrant and my English is certainly questionable on a good day. None of that changes federal law. And on the substance your assertion is simply incorrect. In the United States a group of unrelated individuals cannot legally bind together and purchase a health plan as a single risk entity. Not for a self-funded plan. Not for a fully insured plan. Not under ERISA. Not under the ACA. Heres why: 1.Association health plans were restricted and then invalidated in federal court. Whats"
X Link 2025-11-29T21:09Z 25.3K followers, [----] engagements
"Mark insurers do plenty of damage. Yet the U.S. doesnt have a simple insurer problem. We have a vertically integrated system where the largest nonprofit health systems own or control the insurance plans the PBMs the pharmacies the physician practices the referral pathways and the facility-fee engine. In many parts of the country including Dallas the carrier and the provider are the same enterprise. Thats why costs never fall youre negotiating with a monopoly on both sides of the transaction. We see it in Pennsylvania (UPMC) Utah (SelectHealth) California (Kaiser) Michigan (HAP) Wisconsin"
X Link 2025-11-30T12:47Z 25.7K followers, 12K engagements
"Alex youre absolutely right that the U.S. overpays massively. And the overpayment isnt random or accidental. Its the direct result of consolidated delivery monopolies that set prices eliminate competitors and then negotiate with insurance subsidiaries they increasingly own or control. Overpayment is a feature of the structure. When the health system owns the insurer owns the physicians controls the residency pipeline and blocks new facilities with regulation you dont have a functioning market you have a captive system. Thats why spending rises no matter how much we legislate or subsidize: the"
X Link 2025-11-30T12:58Z 25.7K followers, [----] engagements
"Sorry And thank you for having a discussion about the expense side. It has to be addressed. Today I am going to beat on West Virginia. The Republicans have made it easier to strip mine coal than to open a clinic. Doctors have fled the state and the lawmakers continue on"
X Link 2025-11-30T13:57Z 25.3K followers, [---] engagements
"West Virginia has a Republican governor a Republican supermajority and a Republican bill to eliminate a government barrier to competition. Not even a month later Republicans killed it. CON laws give hospitals veto power over their competitors. Can you do a procedure better faster or cheaper Nah West Virginia doesn't want you. In order to build in the amazing state of West Virginia you need permission from the exact people who profit if you never exist. This isnt a free market. Its Americas China/Russia hybrid a cartel with a committee hearing. And West Virginia Republicans protected it."
X Link 2025-11-30T14:45Z 25.7K followers, 129.5K engagements
"When people say healthcare is too complicated what they really mean is: the wrong people are in the room. Dr. Kella nails the real problem ideas die in silos. The second you bring clinicians investors attorneys and operators together The truth starts leaking out. This is why the lobby fights to keep us separated. This is why innovation stalls. This is why patients pay more. Watch this. @PhysiciansCap @DrVipulKella @drslo"
X Link 2025-11-30T17:46Z 25.3K followers, [----] engagements
"@maximumbob4real West Virginia and Massachusets are both bought and paid for shitholes"
X Link 2025-11-30T18:13Z 25.3K followers, [--] engagements
"@drwillblake YES The socialist were on me yesterday when I said Vermont and Massachusetts were corrupt. The rednecks are fighting back when we talk about North Carolina Georgia and Alabama were absolute garbage. Why Because all of the lawmakers are grifters"
X Link 2025-11-30T19:39Z 25.3K followers, [---] engagements
"Everyone talks about healthcare networks. Dr. Slosar describes what were actually building a living organism that can build a real patient centric healthcare system This is why investors walked up to us unprompted and said: Im in. I saw the opportunity. Lets go. People arent buying a fund. Theyre buying a rebellion. Roll it. To learn more about @PhysiciansCap check us out here @drslo @DrVipulKella http://www.phycapfund.com http://www.phycapfund.com"
X Link 2025-11-30T22:30Z 25.3K followers, [----] engagements
"Steve Jobs and Jensen Huang share a principle most organizations are too scared to touch: Stop whispering. Stop lobbying in private. Stop protecting ideas from sunlight. Jobs once confronted Jony Ive after learning he held back ideas to avoid public criticism. Jobs told him essentially: If you hide your ideas to protect your feelings the whole company loses. That was the turning point. Ive stopped hiding. Jobs kept attacking ideas in public. And Apple got better because everyone learned together. Jensen Huang runs NVIDIA the same way: debate in public debug in public improve in public. No"
X Link 2025-12-01T02:00Z 25.7K followers, [----] engagements
"Mark independents can use accrual. And it is one of the craziest business models to be on cash basis no normal business person would do it but its it bankrupts independents overnight. Hospitals have predictable contracts actuarial teams and payment curves. Independent physicians dont. If we booked revenue the moment we billed wed be paying taxes on money that insurers deny delay reduce or claw back. In a claims-driven world cash accounting is survival not preference"
X Link 2025-12-01T03:53Z 25.3K followers, [--] engagements
"The U.S. doesnt have a healthcare cost problem it has a competition elimination problem. For years policymakers insisted Americans pay more because were sicker older more complex. None of that survived scrutiny. Healthcare is expensive because we systematically eliminated every force that makes markets work: We absorbed independent physicians into systems. Banned new hospitals and new medical facilities through CON laws. Prohibited physician-owned hospitals through the ACA. Let nonprofits become tax-free monopolies. Built insurance around trillion-dollar float instead of coverage. The pattern"
X Link 2025-12-01T13:00Z 25.6K followers, [----] engagements
"70% of surgeries qualify for ASC-level care. Massachusetts blocked ASCs for a decade. Boston has one ASC. Guess what happened to health insurance premiums"
X Link 2025-12-01T14:00Z 25.7K followers, 10.3K engagements
"' . . As @drslo put it people kept coming not because they were invited but because they wanted to be there. Authenticity was the oxygen in the room. Leaders spoke openly without pretense and with the kind of expertise you only earn from decades of doing the work. It felt less like an event and more like a convergence a true Nexus where new relationships new collaborations and new ideas formed in real time. Heres the moment that captured it. @DrVipulKella @PhysiciansCap"
X Link 2025-12-01T15:01Z 25.7K followers, [---] engagements
"The biggest lie in healthcare: Medicare saves money. No it shifts costs and then health systems use it to justify raising commercial rates. Regulation is not efficiency"
X Link 2025-12-01T15:59Z 25.4K followers, [----] engagements
"When physicians ran healthcare everything started with one question: What does the patient need right now Doctors think about intake time. Doctors think about wait times. Doctors think about frictionless access. Doctors think about why the patient is actually there not pamphlets not care pathways not bureaucratic detours. Back pain You get imaging a plan a treatment and dignity. Thats what happens when physicians run the system. When health systems run the system the question flips: How do we maximize revenue per encounter One model serves the patient. The other serves the balance sheet. We"
X Link 2025-12-01T18:01Z 25.3K followers, 19.5K engagements
"Heath opened the episode with a gut punch: he woke up wondering why he keeps fighting for physicians when so many refuse to fight for themselves. Because the stakes are simple: Either you jump on the train or youre gone. Your profession is gone. 3/"
X Link 2025-12-01T22:05Z 25.3K followers, [--] engagements
"There are [---] million physicians in America. 68% are employed by consolidated health systems. 12% work for Optum. 6% for private equity. That leaves roughly [------] independent physicians and half are primary care. This is a vanishing species. 4/"
X Link 2025-12-01T22:05Z 25.3K followers, [---] engagements
"Heath dismantled the myth of political influence: Physicians have no leverage. They dont speak with one voice. They dont fund their future. If a commercial company needs something they deploy $3050 million in lobbying. Physicians debate donating $500. 6/"
X Link 2025-12-01T22:05Z 25.3K followers, [--] engagements
"His warning is brutal and accurate: The only way independent physicians win is by cooperating scaling lowering costs and aligning with the consumer. Everything else leads to full absorption into health systems and private equity. This is the last rotation before the door closes. 7/"
X Link 2025-12-01T22:05Z 25.3K followers, [--] engagements
"We are entering a generational economic cycle shift. Healthcare is the largest sector of GDP. When the rotation hits the economy it hits healthcare first and hardest. Physicians who organize now will build generational wealth. Those who dont will be employees forever. 8/"
X Link 2025-12-01T22:05Z 25.3K followers, [--] engagements
"Share this thread. Subscribe to @DutchRojas Tag a physician who still believes consolidation is inevitable. Follow for more straight unfiltered economic clarity. End/"
X Link 2025-12-01T22:05Z 25.3K followers, [---] engagements
"Mark the hospital-bed statistic is accurate but it also describes only a tiny slice of what people actually consume in healthcare. Hospital beds represent a fraction of medical utilization in any modern system. In the US of A its [--] billion treatments less than [--] million involve a hospital bed. The overwhelming majority of care happens outside a bed: physician visits imaging labs outpatient surgeries same-day procedures chronic disease management maternity care rehab cancer care medications emergency visits urgent care dialysis infusion centers mental health home health preventive services"
X Link 2025-12-01T23:09Z 25.8K followers, 10.1K engagements
"@TrekDocFan"
X Link 2025-12-01T23:41Z 25.3K followers, [--] engagements
"@ASnactivist Write in English"
X Link 2025-12-02T00:07Z 25.3K followers, [--] engagements
"@mkominiak Does it"
X Link 2025-12-02T00:38Z 25.3K followers, [--] engagements
"@October1859 @volbtc No one likes the AMA. I hope youre old"
X Link 2025-12-02T01:15Z 25.3K followers, [--] engagements
"UnitedHealthcare bet that seniors would rather suffer quietly than use the benefits they were sold. Then reality showed up. Sick people used the care they were promised and the entire business model snapped in half overnight. [--] Week High: $622.83 [--] Week Low: $234.60 Today's Price: $329.19 @UHC @Optum"
X Link 2025-12-02T12:00Z 25.7K followers, 190.5K engagements
"If Charleston West Virginia is the example then shouldnt the real question be: What happens to healthcare prices and access when a state keeps Certificate of Need (CON) laws blocks independent facilities hides real prices and protects incumbents through policy A [--] year old in Charleston WV making $65000 would see their annual out-of-pocket premium increase from $5525 to $27864 if the enhanced ACA tax credits expire. The same [--] year old living in Charlottesville VA would see their out-of-pocket premium go from $5525 to $12616. A [--] year old in Charleston WV making $65000 would see their"
X Link 2025-12-02T12:37Z 25.7K followers, [----] engagements
"Great segment with @BeckyQuick and @JoeSquawk and the SEC Chairman talking about what actually makes free markets work risk accountability and the disciplined deployment of capital. But heres the irony we never confront: healthcare is the one major industry in America where none of that applies. No price discovery. No transparent markets. No competitive discipline. No real consumer choice. No ability for physicians or patients to see or act on prices. Every other sector is governed by markets. Healthcare is governed academics subsidies and exemptions Thats how you end up with the highest"
X Link 2025-12-02T12:45Z 25.6K followers, [----] engagements
"@docshanep @dpcalliance @dpcnews1 💡💡💡💡💡💡"
X Link 2025-12-02T17:55Z 25.4K followers, [--] engagements
"The function of man is to live not to exist. I shall not waste my days in trying to prolong them. I shall use my time. - Jack London"
X Link 2025-12-03T02:03Z 25.5K followers, [----] engagements
"@e77evidence77 Health systems receive $140B of subsidies and the top [--] do not give more in charity care than they receive in subsidies"
X Link 2025-12-03T04:45Z 25.8K followers, [---] engagements
"@billychaffin23 Kentucky is a great state with amazing people. They need leadership that puts their needs first"
X Link 2025-12-03T13:36Z 25.6K followers, [--] engagements
"@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick @grok What a free enterprise country do Would we let the central planners at Medicare and Medicaid determine assigned prices or would we have a commodities exchange with real Prices"
X Link 2025-12-03T19:07Z 25.6K followers, [--] engagements
"@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick Lowest prices patients reduced grift mean reversion transparent and actionable prices no annual renewals and the ability to contract for [-----] or [--] years out. Im a health plan I want to lock in prices"
X Link 2025-12-03T19:10Z 25.6K followers, [--] engagements
"@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick Stop worrying about the patents and start thinking MACRO. We can get to the patents. Or are you paid by pharma like everyone else"
X Link 2025-12-03T19:13Z 25.6K followers, [--] engagements
"@grok @JeanPierreMBA @howardlutnick @CNBC @BeckyQuick Explain it to a 5th Grader. They think Mr. Joe Smith at Medicare can assign prices to all the drugs in the world. Why can a market do it better cheaper and faster"
X Link 2025-12-03T19:17Z 25.6K followers, [--] engagements
"Rand Paul fully supports the largest retailers to sell health plans. In the meantime @SenRandPaul has not removed certificate of need in his own damn state. I support free markets Except in my own state. And now a lan for the largest retailers. I do not have the words for these politicians. Which insurance companies will those retailers use The same that got us into this mess Or will they create their own And who will regulate them to make sure they have th needed capital Will you allow them to make further acquisitions to arbitrage more aspects of Which insurance companies will those"
X Link 2025-12-03T22:37Z 25.6K followers, [----] engagements
"Independent pharmacists are being annihilated. Its a joy to paid screwed over by the payers especially those lovely payers owned by the health systems The pharmacy business model is great. You get to buy a product from [--] of the [--] designated wholesalers. Then an insurance company pays you less than that. Then [--] years later you get audited and might have to give all the money back. The pharmacy business model is great. You get to buy a product from [--] of the [--] designated wholesalers. Then an insurance company pays you less than that. Then [--] years later you get audited and might have to give all"
X Link 2025-12-04T02:25Z 25.6K followers, [----] engagements
"@MDiPaolaMD @drdanchoi And the top [--] health systems would lose all their power They all have insurance companies Medicaid ACOs PBMs and ASOs"
X Link 2025-12-04T04:18Z 25.4K followers, [--] engagements
"Everyone keeps asking why premiums in Minnesota explode every year. Heres the answer in less than one minute. Competition is illegal by design. Watch this. Senator your state has had a Hospital Construction Moratorium since [----]. Not certificate of need. A moratorium. No one builds a hospital. No one adds a bed. Unless your legislature says so. [--] exceptions in [--] years. Each one required a lobbyist. Each one protected the people Senator your state has had a Hospital Construction Moratorium since [----]. Not certificate of need. A moratorium. No one builds a hospital. No one adds a bed. Unless"
X Link 2025-12-04T21:00Z 25.7K followers, 70K engagements
"@HunterSprinkle1 Subsidies = profits"
X Link 2025-12-08T12:54Z 25.7K followers, [--] engagements
"@stubronstein02 @AmachHealth Republicans are shit. This is bigger than a political side. When we look at the data its both parties. One is insurance and the other is academic and non profit health systems. Bad for America"
X Link 2025-12-08T17:27Z 25.7K followers, [--] engagements
"The Number [--] of [---] U.S. senators took $10000+ from pharma and health product PACs in [----]. [--] of those seats are on the ballot next November. They voted to keep the physician ownership ban. They killed site-neutral payment reform. They defended CON laws. The list is in the pinned post"
X Link 2025-12-08T17:30Z 25.7K followers, [----] engagements
"@j_luh The health systems are bigger than the commercial insurance companies. They have been very loud"
X Link 2025-12-08T17:33Z 25.7K followers, [--] engagements
"The Nine The Free Market Champions: Senators who actually fight: Marshall (R-KS): 3/4 Hassan (D-NH): 3/4 Cassidy (R-LA): 3/4 Grassley (R-IA): 2/4 Tillis (R-NC): 2/4 Lankford (R-OK): 2/4 Cornyn (R-TX): 2/4 Baldwin (D-WI): 2/4 Barrasso (R-WY): 2/4 [--] Republicans. [--] Democrats. These nine did not fold. See pinned post"
X Link 2025-12-08T18:31Z 25.7K followers, [----] engagements
"McConnell Mitch McConnell (R-KY) $51500 from top [--] healthcare groups. Reform score: 0/4. Kentucky is a CON state. Four decades in Washington. Over $2 million career from healthcare. He has supported zero pro-competition reforms. Zero. See pinned post for more"
X Link 2025-12-08T19:31Z 25.7K followers, [----] engagements
"In Certificate of Need (CON) states health insurance premiums are 20% higher per person per year. Multiply by millions of people. Over decades. The hidden tax of protected monopolies. Paid by every family. Every employer. Every taxpayer"
X Link 2025-12-09T23:02Z 25.8K followers, [----] engagements
"Want to open a hospital ambulatory surgery center radiology center or nursing home In [--] states you need government permission. And the hospital you're competing against gets to object. That's not a free market. That's a cartel with a permission slip"
X Link 2025-12-10T00:00Z 25.8K followers, 21.6K engagements
"In Alabama Bradford Health Services owned by a New York PE firm used CON to kill Sereno Ridge. 16-bed addiction treatment center. Never opened. Bradford has done it again and again. Veterans' programs. Nonprofits. Private equity weaponizing government regulation to eliminate competition"
X Link 2025-12-10T03:03Z 25.8K followers, [----] engagements
"The hospital lobby spent $30 million last year. What were they protecting $54B in 340B revenue $37.4B in tax exemptions $30B in supplemental payments $30B in GME funding Site-neutral payment differentials $125+ billion is worth lobbying for. That's in addition to your sky high insurance premiums"
X Link 2025-12-10T20:00Z 25.8K followers, [----] engagements
"@RareCamellia @scareduck @SenRandPaul That's why you're unhealthy. Stop eating Wendy's"
X Link 2025-12-10T20:16Z 25.8K followers, [--] engagements
"@MaxManus73 @SenRandPaul Embarrassed By advocating for free markets Never"
X Link 2025-12-11T11:26Z 25.7K followers, [--] engagements
"There are no clinical differences between a hip replacement priced at $29000 $49000 $79000 OR $109000 why pay more #surgerypricesfordummies"
X Link 2017-12-20T14:41Z 23.4K followers, [--] engagements
"@chasedave Rural hospitals are transitioning to micro-hospitals. Its a good transition"
X Link 2018-03-02T21:13Z 23.4K followers, [--] engagements
"@matthewtaber @dwramzimdmph @DPCNavigator @EFSBenefits @vtdocmom @drcraigwax @ManageMyRisks @Jim_TheRocktor @kenjaques @chasedave @docshanep @DocMElliott @pavtalk @rlamartini @NeuCare @misterchambo @quinnscomments @CathleenWentz @TweetlySaved @GreenHillsDFC @SurgeryCenterOK @HConomics @clayforsberg @PolicyRNAbby @ClarisseTru @FarrowPete @mduanemd @PlumHealthDPC @AlietaEck @myHSAguy @FMPooler @kennethafisher @brianuhlig @DoctorSammyU @AAPSonline @drweeksdpc2016 @dcontorno @RandPaul @FreeMarketMed @dpcalliance @HealthRosetta @ballardsigns @WedgeofFreedom @twilabrase Pratter is small and"
X Link 2018-04-24T16:52Z 23.4K followers, [--] engagements
"@chasedave With self-insured employers moving away from networks this problem also goes away. In-network and out-of-network are simply scams of the highest order"
X Link 2018-05-24T20:40Z 23.4K followers, [--] engagements
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