Justin Dexter

I want to go fast.

[Justin Dexter @315Dex]

#cusegameday

[Deep Psychology @DeepPsycho_HQ]

8 Greatest Laws I know at 40, I wish I knew at 20:

1.

[Dutch Rojas @DutchRojas]

Senator Warren, that’s a compelling soundbite, but let’s deal in facts, not fear.

If hospitals are shutting down because they lose access to Medicaid bonuses not payments for care, but bonuses, then maybe YOU built a system more addicted to political subsidies than patient outcomes.

Medicaid was meant to be a safety net, not a business model for billion-dollar institutions.

Yet your favorite nonprofit health systems in Massachusetts, let’s not pretend we don’t know who they are—receive DSH, UPL, GME, IME, and waiver payments worth hundreds of millions.

And then they cry poor, threaten closures, and hike prices on employers while underpaying the physicians who actually do the work.

Meanwhile, the independent physicians serving 80% Medicaid populations?

They get nothing.
No commissions.
No bonuses.
No headlines.
Just losses.

And here’s the part you don’t say out loud:

If you and the rest of the Senate who don’t actually govern a damn thing about real patient access would simply allow all physicians to receive the same Medicaid bonuses your favorite health systems receive, we wouldn’t have a problem at all.

In fact, patients would finally get real access to care and not be forced into ERs where your politically protected hospitals routinely screw over patients and taxpayers under the banner of “community health.”

So here’s the challenge, Senator:

Open the books.
Level the field.
Stop confusing political payments with moral high ground.

Because the system is rigged.
And you helped build it.

Not #healthcare

[Dutch Rojas @DutchRojas]

The Healthcare Vampire Squid:
How BlackRock & Vanguard Ate American Medicine
By @DutchRojas

While you’re fighting a denial at 2 AM, they’re making billions on your CPT codes.

This isn’t conspiracy.
This is Wall Street healthcare capture.

Let’s go.
🧵

[John Asghar @JahangirAsgha10]

Did you know? That for Medicare advantage enrollees, we pay $2300 more for less care and coverage than the traditional fee for service model.

It is a terrific example of how metrics are abused and quality is manipulated.

Theoretically, it was designed to lower costs and improve care by aligning incentives around value—not volume.

But in reality, metric-derived systems are incredibly amenable to abuse—often more so than traditional fee-for-service.

Here’s what we see:
- Risk scores are inflated through upcoding—boosting revenue without improving outcomes
- Star ratings are gamed—rewarding box-checking over real patient impact
- Rebates and bonuses go toward perks—not better care
- Prior authorization saves money by delaying or denying care, not through efficiency

The results?
•The patient gets less care
•The physician gets disenfranchised
•The taxpayer pays more

So when we talk about honesty in healthcare, we need to admit this:
A system built around performance metrics can be more easily manipulated than one built around actual service.

[Dr. Glaucomflecken @DGlaucomflecken]

With the Guardian reporting that “UnitedHealth managers pressed nurse practitioners to persuade Medicare Advantage members to change their “code status” to DNR even when patients had clearly expressed a desire that all available treatments be used to keep them alive,” I thought I would share this video I made 2 years ago…

[Justin Dexter @315Dex]

@DutchRojas I’m listening.

[Dutch Rojas @DutchRojas]

A physician I know performed a complex surgery at a hospital.

Health System billed: $78,000
Health System Paid: $40,000
Physician Reimbursement: $1,100

Health Systems take the lion’s share.
Physicians take the hit.

No physician wants to be employed.
#healthcare

[Dutch Rojas @DutchRojas]

For years, physicians have stood by while CMS and the health system lobby crippled private practice.

But now that RFK Jr. is making noise about healthcare, suddenly some of you have opinions?

Where was this outrage during the last five HHS secretaries who bent over backward for corporate medicine?

Stop the simpleton complaints and start using RFK Jr. to push real policy change.

1. End the Moratorium on Physician-Owned Hospitals.

Health systems lobbied CMS to block competition by banning POH expansion.

It was never about “patient safety”, it was always about protecting their health system monopoly-grift.

If RFK Jr. wants to fight corruption, get him to attack this head-on.

2. Cut Facility Fees & Increase Physician Payments.

Health systems get paid multiples more for the same procedures.

This scam is driving up costs, bankrupting independent physicians, and padding their profits.

Push RFK Jr. to end the facility fee loophole and shift payments back to physicians.

Physicians must stop playing defense and start setting the agenda.

If RFK Jr. is serious about fighting healthcare corruption, make him prove it.

The biggest threat to the success of physicians isn’t him—it’s the cartel of health systems and insurers rigging the game.

Start working with him.
Use him as a weapon against CMS.

Or keep complaining while health systems and carriers keep winning.

#healthcare

@waysandmeans
@GOPDoctors
@SecKennedy
@cmsgov

[Justin Dexter @315Dex]

@anish_koka @DOGE Overpaying for cataracts? Maybe on hospital facility fees. For most surgeons, cataract professional reimbursement has fallen to the point that it’s more profitable to not operate and just see patients in the office. How about we stay in the same team. Happy to discuss this.

[Justin Dexter @315Dex]

#cusegameday #cusesuperfan

Beat duke!

[independent physician @independentMDs]

Physician compensation has been trending down for 20 years. Once prospective physicians realize that the ROI of the same time, effort, and money will pay off in multiples at McKinsey vs. medical school....the physician supply (and quality) will further constrain.

[Justin Dexter @315Dex]

@ouraring any plans to release o2 saturation as a graph with all data recorded while asleep? I am an ophthalmologist and am trying to collect data on time spent below 90%. Turns out it relates to progression of optic nerve fiber loss in glaucoma.

[Doctor Money Matters @drmoneymatters]

Nowdays No intelligent person who understands basic math should go into medicine. You will make less than doctors of 50 yrs ago while training longer and an online MBA grad will be your boss and make far more than you while taking less risk.
Become a self storage bro instead!

[Dutch Rojas @DutchRojas]

Welcome to US healthcare, where logic takes a back seat, and we drive full speed into chaos!

Step one: ban physicians from owning hospitals.

After all, who needs people who actually understand patient care running the show?

We’ll give the reins to conglomerates whose only experience with medicine is maximizing profit margins. Efficiency at its finest!

Next, we’ll go one step further.

Convince the public that doctors are out to get them!

Paint them as greedy villains, and just to be safe, ban them from owning anything remotely connected to patient care—like ambulatory surgery centers (ASCs).

Who needs affordable, high-quality care when we can have sprawling hospital monopolies charging $50 for an aspirin?

But we’re just getting started.

To really cripple the system, we’ll slash residency funding.

Why invest in training new doctors when we can flood the market with bureaucrats?

No need for more physicians when you can have an army of administrators creating more paperwork!

And let’s give even more power to pharmacy benefit managers (PBMs)—those unsung heroes who masterfully drive up drug prices while pretending to save patients money.

Now, onto Medicare.

Let’s make it mandatory for all doctors! But here’s the catch: we’ll pay them less every single year.

Because nothing motivates people like knowing they’ll make less for working harder.

It’s called “building character,” and boy, do we want our doctors to have character!

Finally, for the cherry on top, let’s team up with our corporate friends to guarantee skyrocketing premiums.

And we’ll make sure it’s a group effort—because nothing brings people together like collectively paying more for less.

In this brave new world, patients will have the privilege of navigating a healthcare system that’s been optimized for inefficiency.

And remember, this isn’t just about healthcare—it’s about innovation!

Together, we can create a system so complex, so expensive, and so ineffective, people won’t even recognize it as healthcare anymore.

Welcome to the American Dream, where the only thing more inflated than the premiums is the irony.

Not #healthcare

[Justin Dexter @315Dex]

Beat western Michigan!

#cusegameday #cusesuperfan #cusepromos

[Justin Dexter @315Dex]

#cusesuperfan #cusepromos #cusegameday

Beat Colgate!!!

[Justin Dexter @315Dex]

Buying a @Tesla X plaid. This is typical customer service when spending $110,000. No one responds.

[Justin Dexter @315Dex]

@facebook my personal account was hacked even with 2 factor authentication turned on. Then my account name was changed. Then Facebook disabled my account permanently. What’s up with this? No review? Can I get some help from anyone?

[Justin Dexter @315Dex]

#cusegameday #cusesuperfan @CusePromos beat Duke!!!!