The PPO Is Dying. Mike Patton Is Still Screaming. Winter Is Coming.
An update involving hospital profit pools, reference-based pricing, 33 years of friendship, and the music that reminds me why I keep fighting.
Gott's Gulch - Craig’s Substack
My musings on healthcare, bass fishing, free markets & books.
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Latest posts
PBM Suit: Spread Pricing on Steroids, Engineered Retroactively
How Pharmacy Benefit Managers Siphon Millions From Safety Net Hospitals
Working Inside the Box
Embracing the Limits That Finally Fix Large Group Healthcare
No More Tears & the Annihilation of the Medical Ethos
How Big Pharma and Wall Street Looted American Healthcare
The Hospital Monopoly Extortion Playbook
Exposing the exact mechanisms hospital systems use to block fair pricing and crush local competition.
Big Pharma’s Legal Playbook Against International Sourcing and What It Means for Self-Funded Plans
Gilead’s trademark theory is real, but so are its limits.
Hospital Prices Are the Problem. Everyone Knows It. Few Will Say It.
America’s Health Insurance Plans, the “AHIP,” of all people, just published a roundup of expert opinion pointing the finger directly at hospital prices as the root cause of the healthcare affordability crisis.
Decapitating the Carrier Network
How Indiana Built the Ultimate Reference-Based Pricing Safe Harbor.
Nasty Surprises Riddle The No Surprises Act
How a $20,000 Breast Reduction Surgery Extracts $440,000 from the Government-Healthcare Industrial Complex
Reference-Based Pricing Is a Leadership Decision, Not a Plan Design
The savings are real. So is what happens when leadership flinches.