A deep dive into The Rojas Report and its core thesis:

American healthcare isn't broken, it's rigged. This episode prosecutes the case against the healthcare cartel, breaking down exactly how large hospital systems extract $275 billion annually through Medicaid supplemental payments, 340B drug arbitrage, site-neutral payment violations, and tax exemptions that benefit the wealthy empires while rural hospitals close.

You'll learn:

• Why Bill Gurley says Silicon Valley succeeded because it's 2,851 miles from Washington
• The Nobel Prize-winning concept of "regulatory capture" and how it crushes independent physicians
• How 340B transformed from helping AIDS clinics to an $81 billion arbitrage machine
• Why the same heart scan costs $150 at an independent office but $400 at a hospital-owned clinic two floors up
• The JAMA study showing 7.3% of nonprofit hospitals capture 50% of all tax benefits
• How the AHA's $29 million lobbying investment protects a 7,000% return

The Prime Directive: No one cares about healthcare policy. They care about getting screwed.

Action item: Look up your local nonprofit hospital's Form 990 on ProPublica's Nonprofit Explorer. Compare executive compensation (Part 7) to actual charity care (Schedule H). Then ask yourself if that looks like a charity.

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If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

In this conversation, Heath breaks down the brutal math reshaping American healthcare:

1.1 million physicians left.

68% employed by health systems.

12% employed by Optum.

6% by private equity.

Barely 220,000 independent—and shrinking.

We talk plainly about:

• Why physicians “had the opportunity of a lifetime in the last six months” and missed it

• How hospitals weaponize provider taxes, subsidies, and politics

• Why premiums are now the second-largest financial burden after taxes

• What’s really driving 20% of GDP in healthcare spending

• Why DC never sides with physicians—and how the AHA keeps winning

• The math behind a consumer uprising that’s already underway

Heath also reveals the untold story of physician-owned hospitals, the billion-dollar arbitrage that keeps independent doctors locked out, and why the next 12 months will decide the future of the profession.

If you’re a physician who wants independence, leverage, and a path out of the health system trap, this episode is a wake-up call.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

Minnesota just lost a billion dollars to the largest Medicaid fraud in American history. Fake kids. Fake meals. Fake providers. Real money. Gone. But the fraud is just the symptom.

For 40 years, Minnesota has enforced a hospital construction moratorium that makes competition illegal. You can’t build a hospital. You can’t add a bed. Not without a law passed by the state legislature. A perfect monopoly shield for the state’s largest nonprofit health systems — and a perfect environment for fraud to thrive.

In this episode, Dutch breaks down how the fraud happened, why the oversight failed, how whistleblowers were ignored, and why Minnesota’s monopoly structure keeps premiums high for families, employers, Medicaid, and Medicare.

This isn’t a partisan story. It’s an incentive story.

When competition is illegal, fraud becomes easy — and prices explode.

If you want healthcare that’s affordable and accessible, start by understanding how Minnesota became the national case study in what not to do.

Full breakdown and receipts on Substack.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas