@mcuban Eliminate the third parties, and go to direct pay with HSA and catastrophic coverage. Doctors compete for patients outside of the matrix with transparent pricing and third parties lose control.
I don’t know, Professor. Because in Michigan, it’s, illegal to find out.
Your employer, @UMich lobbies the state to keep it that way.
Michigan has “Certificate of Need” laws. Sounds bureaucratic. It’s not.
It’s a permission slip system where health systems get to decide if their competitors can exist.
Want to open a clinic?
Nursing home?
surgery center?
Imaging center?
You need permission from a state commission, staffed by representatives from existing health systems and the carriers.
Want to add an Operating Room to compete?
Same commission.
Same conflicts.
Want to offer a new service?
You’re asking your competitors for permission.
The university, your employer, aquired hundreds of independent physician practices across Michigan
It has used CON laws to block new competing facilities from opening
It converted the practices, so now they bill at Health Systems rates and easily raised prices 5x overnight.
Just acquired Sparrow Health System in 2023, making U of M a $7 billion organization.
Same doctor.
Same procedure.
Same building sometimes.
Different owner.
Different price.
Not because the quality changed. Because the competition was made illegal.
University of Michigan Health now generates $7 billion in annual revenue across 200+ care sites statewide.
They pay zero property taxes on 3.5 million square feet of real estate.
They’ve issued $3.2 billion in tax-exempt bonds meaning Michigan taxpayers subsidize their construction costs.
They receive hundreds of millions in Medicaid supplemental payments (DSH, GME, UPL) every year.
And here’s the kicker:
According to the Lown Institute, U of M Health has a $284 million fair share deficit.
That means the tax breaks they receive exceed the charity care they provide by $284 million.
University of Michigan is a $7 billion tax-exempt empire that uses government power to eliminate competition, then calls it healthcare.
One more thing:
U of M Health operates 340 contracts with 340B pharmacies.
The 340B program was created by Congress to help safety-net hospitals serve poor patients.
The University buy drugs at a discount, then are supposed to pass those savings to patients.
U of M turned it into a profit center with 340 locations.
The discounts don’t go to patients.
They go into the $7 billion revenue pile.
So back to your question, Professor:
“Will giving people money instead of insurance subsidies lead to better functioning markets?”
I don’t know. Because in Michigan, it’s illegal to find out.
Your employer, now a $7 billion organization lobbies to maintain Certificate of Need laws that make it a crime for physicians to compete on price, quality, or service.
I’ve built health plans with no copays, no deductibles, no prior authorizations.
Direct contracts between employers and physicians.
Transparent pricing.
Bundled payments.
They work. Prices drop 30-40%. Quality goes up. Premiums go down. Patients love them.
So before you lecture Americans about “adverse selection” and “market failure,” maybe explain why the University of Michigan gets to use state violence to prevent markets from existing in the first place.
You’re not teaching economics, Professor.
You’re teaching people how to defend a monopoly while collecting a paycheck from it.
✅Physician colleagues:
😔We know reimbursement is dropping
🆕There is a new way to get paid coming down the pipeline! 🤑
👀Check out what @SOUND_HSA is doing
🔜 ₿TC/Bitcoin, backed direct physician payments are coming !
This should be ILLEGAL…
This YT Video Agent is NUTS:
It goes from raw idea → full YouTube video → daily uploads without lifting a finger.
Here’s what it does:
→ Pulls fresh video ideas + captions from Google Sheets → Uses GPT-4o to write 10-scene voiceover scripts + cinematic image prompts → Auto-generates visuals via JSON2Video w/ transitions + subtitles → Converts scripts to voice using ElevenLabs (no mic needed) → Renders the entire video, uploads to YouTube w/ title + description → Tracks links + status in Sheets (so you stay in control) → Handles errors + retries on its own
You can even plug this into the shortform clip agent to go:
Longform → Clips → multi-platform.
Follow + RT + reply “YouTube” and I’ll send you the full setup for FREE.
The foundational problem in our healthcare system is the third-party interference between doctor and patient.
That’s the primary constraint, and the only problem that needs to be solved 1st.
Until that is solved nothing else can be solved.
An Orange Pill Moment at the Bank
I was at the bank today getting a cashier’s check (I know) when a woman on her phone started yelling:
“I’m a diabetic! I need my money to go to the pharmacy and get my medicine. If you don’t give me my money right now, I am going to call the police!”
I looked over at her and simply said: “You need Bitcoin.”
She looked up at me. Two other people in the bank looked up at me. I went about my business, got my check, and was about to leave when one of them said:
“I’m intrigued. How would Bitcoin help this?”
I answered:
“Bitcoin is censorship-resistant money. It means you own it, and no one can stop you from spending it. The bank doesn’t have your money. They’ve already lent it out ten times. And once you give it to them, it’s not really yours anymore, because they can decide not to give it back to you at any time.”
Their jaws dropped.
I walked out.
@jackmallers@dougboneparth@lDrJackkruse
Some conversations plant seeds.
This was one of them.
I am imagining a future where emergency physicians everywhere are released from the burden of having to play the middleman between the orthopedic surgeons who want to admit to medicine and the hospitalist physicians who can’t seem to find a reason for admission outside of the open fracture.
I imagine a world where they have their two AI agents rapidly speaking GiberLink to each other in order to resolve the issue so the patient can get out of my ER and into a hospital bed quicker! lol 😝