John R. Graham

@mcuban On average, hospitals do not care about costs because they operate as cost-plus businesses and Medicare rewards them for having high costs. Insurers have a conflict of interest with plan sponsors because they profit from high costs too.

Most hospitals don't know their costs. Things I've asked for that made them roll their eyes : A BOM for surgeries P&L for each insurance carrier P&L for Medicaid or Medicare business Why do they need consultants for everything. Why doesn't their CSuite know how to do any of it Why do they use GPOs when prices are insane Why do they work with carriers that underpay, late pay, deny everything, waste docs time with denial committees run by 97 yr old pediatricians. Why do they make no effort to sell direct to employers (excluding those on costpluswellness.com to avoid all the carrier abuse , and avoid being sub prime lenders for patient OOP Why do they abuse 340b Why do facilities fees exist Why do they abuse site neutrality Why do they abuse patients with charge master based bills Why do they not push for standard contract templates to reduce admin. Why do they accept so many different ins plans Anyone want to add more And for context, remember I think the biggest insurance companies are worse

The Trump administration's multi-year insurance initiative potentially improves the value of insurance by making it easier for insurers to pool high- and low-risk enrollees. healthaffairs.org/content/forefr…

For all the lobbyist-fueled angst about hospital closures, the number of U.S. community hospitals actually increased from 5,112 to 5,121 over the past year. web.archive.org/web/2025040103… web.archive.org/web/2026032819…

The median post-subsidy ACA '26 premium was ~$42. The avg. premium was $741. The median enrollee received a $699 monthly subsidy, covering 94% of the total premium. The ACA subsidies are very generous, even after the COVID-era subsidy boosts expired. insidehealthpolicy.com/sites/insidehe…

In this clip from Episode 130 of DC EKG with Joe Grogan, Ryan Long explains why the 340B program can drive higher costs, reward consolidation, and advantage wealthier institutions over poorer ones. Watch the full episode on YouTube: youtu.be/rcOBwOMx5Dw

Fraud, waste & abuse in government health programs aren't random—they're predictable consequences of structural design flaws. Read Paragon's response to CMS's CRUSH Fraud RFI. We highlight durable reforms needed across Medicare, Medicaid & ACA exchanges t2m.io/pJ8DTEC

Want to lower healthcare costs? Start with policy distortions. Fix 340B. End site-based payment disparities. Right now, government policy is rewarding consolidation — and patients are paying the price. newsmax.com/sallypipes/ins…

A new @Paragon_Inst PIC on California's out-of-control Medicaid program. California has a significant number of ineligible people on the program & has jacked up its use of Medicaid money laundering schemes over the past decade. paragoninstitute.org/paragon-pic/th…

Today, CMS issued a memo to every hospital telling them to stop serving sugary drinks + inflammatory processed food to patients or risk federal reimbursement. Bold, common sense action that will save lives. We are anxiously awaiting how the media spins this negatively.

Any serious Medicaid discussion has to start with program integrity. One estimate suggests 6.6 million enrollees are ineligible — costing taxpayers about $37B annually. Oversight isn't optional in a program of this scale. washingtontimes.com/news/2026/mar/…

How much does Medicare Advantage really cost compared to traditional fee-for-service Medicare? The answer is more complicated than you'd think.👇 t2m.io/yGBqeZo

Claims that hospital provider taxes protect rural hospitals don’t match the facts. Over the past two decades: • States with provider taxes: 21 rural hospital closures • States without provider taxes: 1 closure Population-adjusted closures were 3x higher in provider tax states. t2m.io/QZdAu6s

The U.S. healthcare system is among the most expensive and complex sectors of the economy, consuming a growing share of family budgets and federal spending. @brian_blase, president and founder of the @Paragon_Inst, argues that the core problem is not a lack of government involvement, but too much of it—distorting incentives, restricting supply, and enabling massive levels of fraud across federal programs. buff.ly/YwygSdH

A new Prognosis takes a closer look at claims that Medicare Advantage costs more than traditional Medicare and finds the debate is far more complicated than critics suggest. Policymakers should be cautious about relying on incomplete cost comparisons. t2m.io/UvmF8nV

Quick update on White House's anti-fraud effort: Alongside the Centers for Medicare & Medicaid Services, the Vance-led task force has identified and suspended 70 hospice and home health providers in Los Angeles flagged as high-risk fraudulent providers. That number is expected to grow exponentially as the task force ramps up its work

Kansas is now the latest state to adopt a bell-to-bell school cell phone ban—part of a growing national shift toward stronger student phone restrictions. As this Paragon PIC shows, more states are moving beyond half-measures and recognizing that full-day bans are the best way to improve focus, behavior, and academic outcomes in the classroom. t2m.io/QEVo08P

Medicare "Graduate Medical Education" subsidies are a great lobbying/marketing achievement. They are designed to get high-priced Academic Medical Centers to accept Medicare patients. They do not significantly alter the supply of new physicians. theincidentaleconomist.com/wordpress/gme-…

Medicare often pays more for the same service just because it's done in a hospital. Same care. Higher cost. That's a broken incentive in need of major reform. newsmax.com/sallypipes/aff…

Today marks 16 years since Obamacare was signed into law. It was sold with big promises: lower costs, lower deficits, better coverage, and more choice. But the reality has been higher premiums, bigger deficits, narrower networks, and millions losing plans they wanted to keep.

Health Savings Accounts keep growing. From 6.3 million accounts in 2011 to nearly 40 million in 2025, HSAs are giving millions of Americans more control over their health care dollars. Learn more: t2m.io/ptK3nFG