Eric W

Full time learner. Soldier. Very Amateur owner-builder. Looking for the next adventure.

[Eric W @Ericdweber777]

@jamesonhaslam Amen!

[Eric W @Ericdweber777]

@DutchRojas So where does it go?

[Eric W @Ericdweber777]

Chris, I love your work, but I’m going to call you out on this. You have means. There are people legitimately struggling, and they don’t want to have a second child if they aren’t sure they can provide for it. Try to put yourself in their shoes. (This lady may not be one of them, she appears to have a nice car and is choosing nice stuff over a second child). But she is also not wrong — inflation is real and the cost of stuff is out of control.

[Eric W @Ericdweber777]

Love what this guy and others are doing!!!

[Forest Park Pharmacy @ForestParkPharm]

My wife and I own Forest Park Pharmacy, and we don't accept insurance. None of it. That decision is exactly why we could fix what happened to a patient today.

A family came in wanting to transfer their kid's antibiotic to us. The child had already STARTED the course. Then, mid-treatment, the insurance company decided the last 14 tablets suddenly needed a "prior authorization" before the other pharmacy could hand them over. A sick kid, halfway through an antibiotic, and the answer was "please hold."

The drug is linezolid. It's a generic. It's been generic for over a decade. It treats serious gram-positive infections — the kind you do NOT want to stop antibiotics in the middle of, because an interrupted course is how you breed resistant bugs and end up right back where you started.

So why the hold-up on a cheap, common generic? Follow the fake math.

Insurance and the PBMs behind them price drugs off a number called AWP — "Average Wholesale Price." People in my industry have another name for it: "Ain't What's Paid." It's a benchmark number, not a real-world cost. On paper, the AWP for just those last 14 tablets is about $2,500.

My cash price for the same 14 tablets? $18.

Read that again. The system that's supposedly "protecting" this family from cost is the same system that inflated an $18 medication into a $2,500 line item, then slapped a prior auth on it to "review the expense" THEY invented. They manufactured the problem, then billed everyone for the privilege of solving it — and made a sick kid wait while they did it.

This is the whole game. When a drug is priced honestly, there's nothing to "manage." When it's priced off a fantasy benchmark, you get spread pricing, PA paperwork, pharmacy phone trees, and delayed treatment — all dressed up as cost control.

Here's the part nobody tells you: roughly 90% of prescriptions are low-cost generics. For the vast majority of what people pick up every day, running it through insurance does two things — raises the real cost and risks delaying your care. That's it. That's the value-add.

That's why we fired the insurance companies. No middleman deciding your kid can't finish their antibiotics on schedule. No fake prices. Just the real number, on the shelf, today.

The medication was always cheap. The insurance was the expensive part.

[Eric W @Ericdweber777]

@jamesonhaslam This is what’s so great about the army. You counsel the poor performers, chapter them out if needed, and get replacements.

Dealing with humans can tough.

[Eric W @Ericdweber777]

@shawngorham Gotta love inflation…

[Eric W @Ericdweber777]

@georgescruggs9 @shawngorham This is fascinating… just like how Disneyland uses Go Away Green to hide anything it doesn’t want you to notice.

[Eric W @Ericdweber777]

Instead of having taxpayers for the bill, why not just have the patients pay as if they were buying private insurance? Allow their employers to pay as if they were buying a plan. This would almost certainly be cheaper than any commercial plan available. Once you prove this, you could slowly move the age, demographic down and capture more people directly.

[Eric W @Ericdweber777]

Just remember, PE is the worst enemy to this industry. Definitely profitable, but I can tell you that most docs are not printing money the way they used to. If you are reliant on insurance, it’s no bueno. If you are a cash pay service (plastics, cosmetic dentistry, wellness) you can do well and keep up with inflation.

[Eric W @Ericdweber777]

@shawngorham What a great business idea.

[Eric W @Ericdweber777]

@Matt_Titan_ @shawngorham I’m going to be contrarian. Go look at Orbea. Hand made frames from Spain, better paint, better wheels and parts for the money. Can be ordered online or thru local dealer.

[Eric W @Ericdweber777]

Mark is right, always negotiate and in cases of emergencies, the no surprises act should protect you. I know you don’t want to play games, but the hospital is playing games with you. Otherwise they would just give you the fair cash price. Sad, but it’s the way the system is designed.

[Eric W @Ericdweber777]

@jamesonhaslam Don’t slip. I’ve seen larger cans in bad places.

[Eric W @Ericdweber777]

Is the $9000 out-of-pocket because you are paying the difference? In most cases the hospital is supposed to accept that negotiated rate that your insurance paid. They will try to get the rest out of you, but you are protected if this was an emergency. Also, in some cases when they accept the payment from the insurance company, they are agreeing to hold you harmless.

Is Kaiser your insurance? I thought they had pretty good coverage unless you go out of network without their permission.

DM me and I’ll walk you thru your options as I know them. I don’t think you should be out of pocket like that.

[Eric W @Ericdweber777]

As someone that deals with this on the daily, what are your suggestions? Here are my suggestions:

1. Let physicians own hospitals again
2. Eliminate PBMs and vertical integration OR
3. Eliminate coverage gaps for systems that are integrated
4. Require every hospital to be non-profit or mandate profit limits (like government contracts — documented cost plus a fixed profit allowance)

Ready to help me fix it?

[Eric W @Ericdweber777]

@jamesonhaslam Was there anything wrong with it?

[Eric W @Ericdweber777]

@shawngorham @GenZMultifamily I’m just giving you a hard time. You are blessed to live in OC and have bought in when you did.

[Eric W @Ericdweber777]

@shawngorham @GenZMultifamily I thought you were going to Dallas where all that “opportunity” was…

[Eric W @Ericdweber777]

@JoinCrowdHealth @JHartFlips How does Crowd Health handle a catastrophe? Something like a 10 day ICU stay with multiple surgeries… could be over $1m billed.

[Eric W @Ericdweber777]

@Camp4 So true…