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Your doctor went to medical school for 12 years. The person denying your claim went through a two-week training module.
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Dutch Rojas
56.6K posts
Dutch Rojas
@DutchRojas
Healthcare for everyone, everywhere @therojasreport | At https://t.co/GUdI5ZYo08 we turn expenses into assets | USMC | NL ~ USA
United States Katılım Ocak 2012
2.2K Takip Edilen33.9K Takipçiler
The Stark Law is the most effective physician acquisition funnel in American healthcare and no one built it on purpose.
42 USC 1395nn prohibits independent physician referrals to DHS entities they own.
The employment exception at (e)(2) permits the identical referral when the physician is a hospital employee.
The structural result: the only legal path to integrated clinical delivery runs through a hospital W-2.
Every practice acquisition in the last 30 years followed this logic.
buff.ly/ZZmTqIl
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@fourto5 I write about it all the time in substack. I have taken pieces of the thesis and provided it.
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People ask why an exchange. Because exchanges are the only mechanism in human history that successfully forces institutional buyers to compete on both price and quality simultaneously. Insurance doesn’t do it. Regulation doesn’t do it. Negotiations don’t do it. Exchanges do.
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Dutch Rojas retweetledi
Today, take a hard look at your tax bill.
~$1.9 trillion of federal spending now goes to healthcare. That’s ~27% of total spending.
But the number that actually matters is that it’s ~39% of all federal revenue.
Before you pay a single premium, nearly 40 cents of every dollar the government collects is already committed to healthcare.
But wait - there’s more:
~67% of Americans have private insurance (most through employer-sponsored plans)
And you still pay ~$1,500/year (single) or ~$6,000+/year (family).
Note that is before deductibles. Before copays. Before coinsurance.
So let’s summarize:
You’re taxed for healthcare.
You pay premiums for healthcare.
You pay out-of-pocket for healthcare.
And you still can’t access or afford healthcare.
And here’s the part no one wants to say - the system is working exactly as designed!
The only two groups that can force real change are the consumer and the physician.And both are paralyzed.
Patients have been conditioned to believe there are no alternatives.
Physicians have been absorbed into systems they don’t control. Until one of those groups moves, nothing changes.
Thank you for your attention to this matter!
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@DutchRojas There’s no market unless there are prices. Healthcare needs to enter the economy as a market instead of a racket!
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We don’t have a healthcare cost crisis. We have a healthcare pricing crisis. Costs are knowable. Prices are hidden. An exchange makes prices visible. That’s it. That’s the revolution.
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@EdithaTogo There is no price. There is only central planning. The lawmakers will push until the American people decide they have had enough. U til then Americans will act like victims and lawmakers extract wealth.
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@DutchRojas Any ex's internationally of successful health pricing transparency systems? The Aus Cth undertaking an inquiry into options for this. With great respect, US healthcare pricing is bonkers- it's almost like, "how far can we push this before anyone realizes we're taking the piss"?
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@DutchRojas @NeilFlochMD @DrFerdowsi Susan Reed was 49yrs old when she joined out MedSchool class in 1997.
5 kids, ages 12 to 19.
Graduated in 2001, completed pediatric residency in 2004, private practice for 10yrs, set up medical clinics in Mexico while on Mormon missionary call.
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This is awesome 😎- this guy is amazing!!!!!!!!!!!!!
👑 J³ABz👑@Jabz_CFC
After spending 25 years as a mechanic. Carl Allamby decided in his 40s to go back to school and chase his dream of becoming a doctor. At 51, he now works in the ER. Proving it's never too late to change your life.
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@fourto5 You’re beginning to think on it. I wrote my thesis on this in 2010.
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The exchange needs mechanism to connect buyer and seller directly.
If you describe it as a marketplace wherein the only buyers allowed to bid are large-scale distributors (insurance, hospital systems, large employers) then you are just tweaking the current malignant system. You will have re-created Ticketmaster getting first and exclusive access to buy all tickets and then scalp at absurdly high prices.
Third party payment is the enemy of free and fair competition and resultant fair pricing.
It would be simple to create the exchange mechanism whereby individual (potential patients) may purchase futures (derivative option contracts) directly from sellers (medical professionals) who would directly receive the premium payment.
If large-scale buyers want to participate they may compete with individual buyers on equal basis, rather than enjoying monopoly/monopsony privilege.
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@Stefan11005620 You read my stuff and follow along. We sell forward contracts to employers on medical treatments to generate liquidity…
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@DutchRojas Where do I look for the mechanics of the exchange? ‘How it works’ doesn’t mention the exchange.
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@DutchRojas Almost as if it’s like a naturally emergent market phenomenon or something…
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@DutchRojas I'm starting to see too much of you
I sit and think
How much more do I want to read from someone not in there that should be
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@HeathVeuleman @SacksDisa @SecKennedy @DrOz 🔥🔥🔥🔥🔥. Let us compete. Why don’t doctors want to compete?
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@SecKennedy
@DrOz
This is what must be addressed
It’s not happening by this Administration
Health care delivery fiasco brought to us by both parties
it’s fixable -including things you do t need Congress for
there is no will it seems from this Administration
@DutchRojas
@HeathVeuleman
Brent A. Williams, MD@BrentAWilliams2
The amount of evil that exists in the so-called business practices of United Healthcare cannot be overstated. And our government knows this and is complicit.
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@DutchRojas Actually we do know; the MCOs for Medicaid Medicare Commercial especially the HMOs; we have a contracted price for both hospital and surgeons, etc.
The hospitals displayed charges are not related to their contracted price for the most part.
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We price oil to the penny in real time across 195 countries. But nobody on earth can tell you what a knee replacement costs before you get one. That’s not complexity. That’s a cartel.
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@DutchRojas @kenjaques It’s our own medical Strait of Hormuz
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These turkeys, my twins, are 26 years old today. My pride and joy. Kind, hard working, loving.
And definitely daddy’s girls! Love it. Blessed.
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Float revenue is one of the most beautiful things in the world and I don't say this ironically.
Colin | clerk.com@tweetsbycolin
Do payroll companies earn interest between the time they take money and the time it's sent to employees? 5 days between withdrawal from Clerk and deposit to employees seems excessive, and they do it twice per month @pitdesi seems like something you might know?
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