In this week’s clip, we break down why the smallest edge, just a few basis points, can be the difference between failure and scale in healthcare innovation. When programs are built through the lens of a physician, the outcomes shift.
And, just like in Formula 1, the founder might be the driver, but without the right pit crew and network, they’re going nowhere fast. This is the power of a physician-led coalition: alignment, execution, and speed.
We are closing our first physician-led healthcare venture fund, investing in startups that are leading the future of healthcare. Don’t have fomo. Invest with us.
America’s Health Systems Are “Struggling”.
Just Kidding, They’re Flush and Subsidized Like Soybeans.
The largest health systems in America would have you believe they’re barely scraping by. But pull back the curtain, and you’ll find balance sheets that rival Fortune 100s:
• CommonSpirit: $56.4B
• University of California Health: $48B
• Advocate Health: $47.8B
• Mass General Brigham: $32.6B
• Intermountain Health: $31.4B
• Cleveland Clinic: $26B
• Jefferson Health: $11.83B
• Indiana University Health: $10.
These are not charities. They’re industrial-scale corporations wrapped in nonprofit tax codes, aggressively acquiring, vertically integrating, and lobbying their way to empire.
But They’re Nonprofit, Right?
Only in the same way, the NFL is a “nonprofit.” They don’t distribute earnings to shareholders, but that doesn’t stop them from amassing capital, hoarding real estate, and racking up assets like a hedge fund with an emergency room.
Their business model?
Consolidate market share, plead poverty, collect subsidies.
Rinse. Repeat.
The Federal Free Money Buffet: A Quick Tour
1. 340B: Pharmaceutical Arbitrage in a White Coat
They buy drugs at Medicaid-discount rates, sell them to privately insured patients at a markup, then pocket the delta. Originally intended to help the poor, it is now weaponized for profit.
2. DSH Payments: Disproportionate Subsidies for Disproportionate Expansion
Hospitals claim they serve low-income patients, then use those dollars to acquire boutique hospitals in affluent ZIP codes. It’s not about charity; it’s about conquest.
3. GME: Government-Funded Labor Supply Chain
Graduate Medical Education subsidies were meant to train doctors. Instead, they prop up revenue centers staffed by residents who work 80 hours a week for less than minimum wage.
4. Tax-Free Bonds: Public Financing for Private Dominance
Glass towers, marble lobbies, and $400 million surgical centers are financed through municipal bonds that you help subsidize. Your retirement fund is underwriting their next monument.
5. Provider Taxes & UPL: The Match Game Scam
States levy fake “provider taxes” on health systems, then use those funds to extract more Medicaid dollars from the federal government. It’s not healthcare. It’s a laundering operation with ICD codes.
Why the Obsession With Subsidies?
Asset-Rich, Cash-Dependent
Running a multi-billion-dollar monopoly is expensive, especially when you employ 300 Vice Presidents of Integration and own a fleet of da Vinci robots.
Debt Obligations
All those empire-building expansion projects don’t come cheap. And tax-free debt still demands real repayment.
Consolidation Costs Money
Buying up every independent hospital within a 100-mile radius takes capital, and your tax dollars help foot the bill.
Bottom Line: We’re Subsidizing Scale, Not Service
These institutions aren’t struggling. They’re leveraging a decades-old regulatory machine to extract public funds under the guise of public service, while outcompeting independent physicians who treat underserved patients.
So the next time a health system CEO issues a somber press release about “unsustainable headwinds,” remember: it’s not austerity driving the narrative, it’s strategy.
The real crisis isn’t financial. It’s moral.
It is time to end the nonsense. Healthcare is supposed to be about patient care. Let’s get back to that…. Rojas out.
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