Healthcare once worked differently.
When doctors led, the focus was on solving problems at the point of care—shorter wait times, faster answers, better outcomes. Now, under health system control, patients experience bureaucracy first and care second.
It’s time to revisit what happens when physicians, not administrators, run the system.
Listen to the entire episode here: The Doctor's Lounge
The Revolving Door at CMS: How Regulators Become Millionaires
It’s supposed to be the Centers for Medicare and Medicaid Services. The referee. The watchdog. The one agency that keeps the world’s biggest health programs from being looted by insurers, consultants, and Wall Street.
Instead, CMS has turned into a career accelerator for the very industries it regulates.
The Game
Look at where the top brass go after their tour in government:
40% head straight into the insurance lobby—AHIP, Blue Cross, Medicare Advantage giants, the same outfits CMS was supposedly regulating yesterday.
30% take cushy gigs in consulting, whispering policy advice back to the same players.
20% go to private equity, where the job is buying up physician practices and flipping them like condos.
The rest? Healthcare tech startups, “innovation” firms, and companies feeding at the trough of CMS’s rules.
It’s not a trickle. It’s a conveyor belt.
The Pattern
Here’s the playbook:
Before CMS: An insurance exec or consultant, already fluent in the hustle.
During CMS: A two-to-four-year stint as a public servant. Enough to make contacts, write rules, and look important.
After CMS: Right back into industry, this time richer, better connected, and able to sell insider knowledge at a markup.
It’s a racket dressed up as public service.
Follow the Money
Why take a government job that pays $175,000 when you can make triple that in the private sector?
Because the government gig is the buy-in.
Government salary: $150,000–$225,000
Post-CMS salary: $300,000–$1 million+
Add stock options and board seats? Now we’re talking millions.
The short stint in public service is just an ante. The jackpot comes after you leave.
Why It Matters
This isn’t about appearances. It’s about incentives.
If you know your next job is at AHIP or United Healthcare, how tough are you going to be on them while you’re at CMS? You’re not a regulator anymore, you’re an intern auditioning for your future boss.
That’s why Medicare Advantage overbilling is ignored. That’s why independent physicians are often bogged down in red tape, while mega-systems receive exemptions. That’s why “reform” never seems to stick.
The referees are playing for the other team.
The Ugly Truth
Here’s the punchline: CMS isn’t a regulator.
It’s a regulatory capture pipeline for corporate America.
The agency doesn’t just write rules for healthcare, it writes résumés.
And while the executives cash out, Americans are rewarded with higher premiums, fewer independent doctors, and a system where policy is designed less for patients than for investors.
That’s the scam. And the scam works because nobody calls it what it is: a revolving door that spins money out of public trust and into private pockets.
Join PHA – Someone has to go to Washington and fight for the independent practice of medicine.
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-Rojas out
