Mike Beisner

A movie that couldn’t be made today that’s better than everything being made today.

Inflation is completely out of control, you can’t even take 3 kids to a Detroit Tigers game anymore without spending an arm and a leg! Crazy!

Even the people defending this "strategy" know that this is an impossibly stupid thing to say.

BREAKING: Class of 2027 IOL Luke Injaychock has Committed to Missouri, he tells me for @Rivals The 6’6 285 IOL chose the Tigers over Illinois, Wisconsin, Ohio State, and Auburn “Locked in. MIZ🐯” on3.com/rivals/luke-in…

You know, one of the places that teaches about Midway as a turning point in the war is the naval war college, which Hegseth did not attend. We snuck it in among all the other woke stuff

How many of you go out for early dinners and then call it a night? This hits harder as the days pass

What do independent pharmacies and cattle ranchers have in common? Greedy and corrupt middlemen that are driving them out of business. America can do better than this to protect the small business backbones of the economy.

LFG!

A 501(c)(3) hospital is tax-exempt. You knew that. A state hospital is something different. It is the state. The University of Missouri’s hospital system runs $1.91 billion in revenue, owns roughly $2 billion in assets, and pays no federal tax, no state tax, no property tax. Not because of an exemption. Because Section 115 of the Internal Revenue Code says the state does not pay income tax to itself. The interesting question isn’t whether this is fair. The interesting question is what happens to the surrounding healthcare market when one player operates at zero tax basis and everyone else doesn’t. What I keep coming back to: most physicians within 250 miles of Columbia, Missouri have not worked through what their actual competitor. They are, in fact, competing against an arm of the State of Missouri funded by taxpayers… @HawleyMO @RepJasonSmith @RepMarkAlford

Somewhere @DutchRojas is smiling

@RepJasonSmith is correct. The uncomfortable part: his own committee members built the machine pricing Americans out. Nonprofit health systems are the #1 culprit. @elonmusk flagged how @OpenAI hijacked a nonprofit and pivoted to profit. Nonprofit hospitals ran the same play decades ago. They deploy cash inefficiently. They operate REITs. They run investment offices. They own private jets. They pay executives like hedge fund partners. They warehouse capital instead of deploying it into care. Tax-exempt in name. Extractive in practice. Red and blue could cut Medicare and commercial premiums by Friday. Walk 100 yards to HHS. Demand a handful of rule changes. That is the entire distance between rhetoric and relief. They won't. Ask why.

Missouri is closer than ever to PBM reform—let’s be clear what real reform means: ✔️ Transparency for employers ✔️ Fair pharmacy reimbursement (≥ cost + fee) ✔️ No spread pricing or clawbacks If it doesn’t change PBM incentives, it’s not reform—it’s optics. #PBMReform #Missouri

I truly believe God sends messengers to show us the path… normal, ordinary people who speak truth, absolute truth, that is undeniable because of their circumstance. Nothing to gain. Nothing to lose. Just truth. In hopes of helping his fellow humans find their way. Listen to it. Heed it. He has nothing to lose. He gains nothing. It is tragic that truth and its acceptance require such sacrifice; But yet it is. Ben has in his pain, in his impending demise, made his mark on this world. Will we learn from it or scroll to the next distraction from truth? Stop scrolling. Listen again. It matters.

Doctors think political donations are unseemly. Hospitals think political donations are insurance premiums. Insurance is a tax-deductible cost of doing business. Unseemly is what you call something you have already decided not to do. open.substack.com/pub/dutchrojas…

I practice in Troy, MO - a rural town outside of St Louis. Im the only dermatologist in town. Medicare’s Physician Fee Schedule (should be called the outpatient fee scheduled) In real (inflation-adjusted) terms, has decreased 33% since 2001… Paradoxically, patients are paying more, not less, and healthcare costs keep rising … even as physician payment declines. Doctors represent 6% of healthcare costs; nurses 6% … so a patient would still owe 88% of their bill if all the doctors and nurses worked for free … …. healthcare costs have outpaced inflation … why? Because Washington has systematically rigged the system to support large hospitals … 75% of independent doctors office have closed since 2008. A major driver is “site-of-service” payment inequity. When the same outpatient service is provided in a hospital outpatient department (HOPD) instead of an independent physician office, Medicare and beneficiaries can be charged roughly double (or more). As physicians are acquired and services shift into HOPDs, taxpayers and patients spend more for the same care. Federal policy also amplifies this imbalance. Our practice accepts Missouri Medicaid… yet we are excluded from Disproportionate Share Hospital (DSH) payments … yet the hospitals benefit from this program while doctors offices caring for patients with Medicaid are excluded! Hospitals receive substantial subsidies and special payment streams, including 340B revenue, DSH payments & GME payments that independent doctors offices are systematically excluded from. And what happens to the cost of healthcare??? …. It keeps rising and we wonder why? Because we’ve drained the reimbursement of the most cost effective affordable care and What can congress do? 1. Index physician reimburse to inflation just like hospitals reimburse is and facility fees are … rename physician reimbursement to “Outpatient Reimbursement” 2. Site neutral payments - same payment for the same work. Quit paying hospitals 200% more for the same care and wondering why costs keep increasing 3. Allow doctors offices to participate in all programs hospitals can at a prorate share: DSH, 340b, GME This would actually reduce healthcare costs while return doctors to rural communities. You Can Do It!

Well, as long as you boys are having a good time while the country's at war, that's what really matters

the CATO Institute.. a libertarian think tank funded by the Koch brothers.. just published a study showing immigrants paid more in taxes than they received in benefits every single year from 1994 to 2023.. not a left-wing university.. not a Democratic PAC.. the Koch brothers' own research institute.. they reduced the deficit by $14.5 trillion over 30 years.. they earn less per hour but work at higher rates.. which means higher per capita income.. which means higher taxes paid.. the country spent 30 years being told immigrants were draining the system.. turns out they were funding it.. and the people who told you that knew the numbers the whole time

I’m waiting for an Oklahoma Governor candidate to dare speak the words: “I disagree with President Trump on…”. Anything. Pick anything. Not everything… you can still support him, while disagreeing about at least one decision and having the cajones to say it. Just one teeny tiny little thing. It’ll give a glimmer of hope that you are not a complete lemming… Not being a complete sycophant is a great way to break away from the herd.

This is by far the best interview I have ever seen with someone who holds or held elective office Every school should show this to the students @BenSasse - exactly what we need

So why haven't you come out in support of the Break Up Big Medicine Bill ? Or did I miss it ? Until that passes, there is absolutely zero chance of affordable healthcare or universal healthcare Full Stop