Start Here: The Prosecution and the Operating Manual.
The system is not failing. It's succeeding at making you lose.
The Prosecution, and the Operating Manual.
A 50-person independent practice pays $480,000 more per year than an identical hospital system. Same carrier. Same coverage. Same risk.
That gap is no accident. It’s by design.
Why is healthcare expensive? You’ll find out here.
I’m Dutch Rojas. 27 years in supply and demand side healthcare including the development of ASCs and building new independent medical practices. Founder of MedMerge. General Partner at PhyCap. Board Member at PHA. I’ve built and exited physician-patient companies, structured insurance programs most institutions and physicians have never seen, and watched consolidation eat specialty after specialty. The solutions exist and we deploy them.
The Rojas Report runs on two tracks.
THE PROSECUTION.
Named actors.
Documented relationships.
Receipts.
Health systems. Atrium Health is absorbing WakeMed under a “combination” structure that dodges Hart-Scott-Rodino review. Michigan Medicine is clearing $8.7B in revenue with a $92M fair-share deficit and an active BCBSM contract fight that comes due June 30. Charlotte-Mecklenburg Hospital Authority operates as a “unit of local government” with eminent domain power and antitrust immunity.
Insurance carriers. Float capture. Underwriting margins that belong to physicians sitting on carrier balance sheets. Stop-loss structures are priced to keep physician groups fully insured and dependent.
Medical schools. Marschall Runge on Eli Lilly’s board with undisclosed compensation. State university health systems are absorbing private medicine with taxpayer dollars. Academic medical centers are running as the largest acquirers in their own markets.
Members of the GOP Doc Caucus are taking hospital industry PAC money while setting Medicare physician payment rates from the Ways and Means Health Subcommittee. Section 6001, written by the Federation of American Hospitals, was designed to kill physician-owned hospitals. 340B contract pharmacies. HOPPS site-of-service differentials. Five statutes are engineering the consolidation that everyone keeps demanding, an antitrust breakup.
Governors. State CON laws in 34 states plus DC are blocking new entrants and protecting incumbents. State seals authorizing taxpayer-funded acquisitions by state university health systems.
Attorneys General. Looking the other way while nonprofit hospitals run market capture under a 501(c)(3) wrapper. Selective Sherman Act enforcement that prosecutes the smallest deals and waves through the largest.
The relationships connect. The PAC money funds the campaign. The campaign elects the legislator. The legislator writes the statute. The statute protects the system. The system donates to the academic medical center. The medical center trains the next generation of physicians inside an employed model. The cycle compounds.
That’s why healthcare is expensive.
THE OPERATING MANUAL
How $2.5M in annual premiums becomes $30M on your balance sheet through a properly structured captive. The 30 to 45 day cancellation provision is buried in your fully insured contract, which 99.9% of physicians don’t know about. Direct-to-employer contracting. Forward pricing on medical treatments. How independent physicians retire with $10M not whatever they’ve managed to save. What your practice actually keeps.
Diagnosis and treatment. Same publication.
Every article opens to everyone.
The accusation.
The setup.
Enough to see where the money trail leads.
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-Rojas out.