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Free Markets, Private Equity, and the Moral Case for Medicine
May 17, 2026
Unknown duration
George Tolis: TAVR, Broken Training, and What's Really Wrong With Cardiac Surgery.
May 16, 2026
Unknown duration
Center-Right in a White Coat: Pradeep Shanker on AI, Vaccines, and Medical Orthodoxy
May 10, 2026
Unknown duration
The Surgeon Who Refused to Bow: Dr. Eithan Haim on Blowing the Whistle at Texas Children's
May 3, 2026
1h 24m 17s
From Babylon to Baylor: How Insurance Went Off the Rails
May 2, 2026
Unknown duration
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| Date | Episode | Topics | Guests | Brands | Places | Keywords | Sponsor | Length | |
|---|---|---|---|---|---|---|---|---|---|
| 5/17/26 |  Free Markets, Private Equity, and the Moral Case for Medicine | Episode SummaryJared Rhoads, founder of the Center for Modern Health and senior lecturer in health policy at the Dartmouth Institute, joins Drs. Koka and DiGiorgio for a wide-ranging conversation on the philosophical foundations of healthcare policy. Rhoads — an Objectivist in the tradition of Ayn Rand — argues that physicians have a right to pursue health, not a right to be given it, and walks through what that distinction means for real policy debates: FDA drug approval, prior authorization, the ban on physician-owned hospitals, private equity in medicine, and foreign-trained physician licensure. The episode is a rare attempt to make the moral case for free markets in medicine, not just the efficiency case.Chapter Markers00:00 Introduction and guest background01:52 What is the Center for Modern Health?04:25 Objectivism, Ayn Rand, and rational self-interest11:19 Healthcare as a private good vs. community good13:58 Policy mistakes made for edge cases16:58 You have a right to pursue health — not to be given it20:14 Does Medicare violate rights?22:47 Positive vs. negative rights in healthcare24:47 The FDA, drug approval, and the Prasad/McCary departures31:08 A two-tier FDA review proposal: private vs. public payers42:25 Breaking up Big Medicine — the Hawley-Warren bill49:43 Prior authorization: structural problem or reform target?55:22 High-deductible plans and why price consciousness hasn't taken hold57:43 Price transparency laws: do they actually work?01:02:49 Section 6001 and the de facto ban on physician-owned hospitals01:06:04 Stark Law, Medicare Advantage, and a possible reform path01:11:19 Private equity in medicine: where are the actual rights violations?01:19:02 Free markets and monopolies: the standard objection answered01:21:12 Foreign-trained physician licensure01:34:11 Immigration, physician workforce, and the battle of ideas01:37:40 Center for Modern Health summer fellowshipCo-Host Handles@anish_koka and @drdigiorgioShow Handle@drsloungepodSubscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrRApple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658YouTube: https://www.youtube.com/@TheDoctorsLoungePod | — | ||||||
| 5/16/26 | George Tolis: TAVR, Broken Training, and What's Really Wrong With Cardiac Surgery. | Episode SummaryDr. George Tolis, section chief of coronary and general cardiac surgery at Brigham and Women's Hospital, joins Drs. Koka and DiGiorgio for a wide-ranging conversation on the state of cardiac surgery. He makes the case that TAVR — while genuinely transformative for the right patient — is being systematically applied too broadly, driven by industry incentive and the erosion of meaningful surgical consent. He discusses his collaboration with John Ioannidis that found no statistically significant mortality benefit for any new cardiac surgery technique introduced over the past 35 years, the paper's rejection by every major surgical journal, and what he paid out of pocket to make it open access. The conversation moves to the collapse of surgical training — fragmented pathways, work hour restrictions that leave residents unprepared for attending life, an academic promotion system that ignores teaching, and a culture that routes incompetent trainees around rather than out — and closes with a brief on Vasily Kolesov, the Soviet surgeon from Leningrad who performed the world's first documented coronary bypass years before Favaloro, and whose work was buried by the Cold War.Chapter Markers00:00 Introduction01:02 Air-cooled VWs, concert piano, and how Dr. Tolis got here02:40 TAVR: genuine breakthrough or being abused?08:02 Finding the TAVR threshold — and why informed consent is the real problem11:46 Collaborating with John Ioannidis: no mortality benefit for 35 years of new techniques20:02 Why the major surgical journals wouldn't touch the paper21:52 Minimally invasive surgery: minimal access vs. minimally invasive26:24 When do CABG survival curves diverge — and what does it mean?30:05 Surgeons signing off on TAVRs in young patients33:51 Health system economics and the heart team dynamic37:50 How to actually pick a good surgeon (ask the scrub nurses)40:36 Cardiac surgery training: the three pathways problem44:04 Work hour restrictions and the residency simulation gap51:16 General surgery is like MTV — they don't operate anymore53:21 A resident who finished training without ever applying a cross-clamp56:34 How to evaluate if a program actually trains59:27 Academic promotion has nothing to do with teaching01:01:33 Dr. Tolis's resident outcomes database and three papers nobody cared about01:05:32 The training timeline: finishing at 49, no runway left01:07:08 One-size-fits-all RRC rules for cardiac surgery and psychiatry01:09:16 Cardiac surgery as a disposition, not a therapy01:12:24 When ECMO becomes the final common path01:13:38 How you become nationally recognized without being a good surgeon01:17:16 Vasily Kolesov: the Soviet surgeon who did the first bypassCo-Host Handles@anish_koka and @drdigiorgioShow Handle@drsloungepodSubscribe LinksSpotify: https://open.spotify.com/show/44vw8eirsKKnjgNIrdDvrRApple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1832097658YouTube: https://www.youtube.com/@TheDoctorsLoungePod | — | ||||||
| 5/10/26 | Center-Right in a White Coat: Pradeep Shanker on AI, Vaccines, and Medical Orthodoxy | Episode SummaryRadiologist, National Review senior contributor, and prominent center-right voice in medicine Pradeep Shanker joins Anish Koka and Anthony DiGiorgio for a wide-ranging conversation that covers AI's real (and overstated) role in radiology, the structural dysfunction of GME funding and physician immigration, what went wrong with COVID policy from both the left and right, the asymmetric treatment of physicians like Mary Bowden versus institutional failures like Aduhelm, and whether America is still a creedal nation. Pradeep and Anish agree on more than expected — and disagree sharply where it counts.Chapter Markers00:00 Introduction and guest background02:23 AI in radiology — where it actually helps07:42 Ground truth, image resolution, and the limits of AI diagnostics12:16 Should AI replace the Nighthawk radiologist?19:40 CMS reimbursement and AI — does it help or hurt?21:09 Physician immigration and the GME funding problem27:49 Supplier-induced demand and the third-party payment trap35:52 Why we're not building enough American medical schools39:23 Affirmative action in medical training47:41 How did we do on COVID?51:26 Depoliticizing the CDC and NIH54:09 Vaccine mandates — where Pradeep draws the line56:42 How do you rebuild trust in public health?1:02:30 Mary Bowden, Vinay Prasad, and dissent in medicine1:08:42 The Aduhelm asymmetry1:16:35 Is America a creedal nation?Co-Host Handles@anish_koka and @drdigiorgioShow Handle@drsloungepodSubscribe LinksSpotify: https://open.spotify.com/show/7vE4aCMpVHnSGwuOHiGVLpApple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1489323962YouTube: https://www.youtube.com/@TheDoctorsLounge | — | ||||||
| 5/3/26 |  The Surgeon Who Refused to Bow: Dr. Eithan Haim on Blowing the Whistle at Texas Children's✨ | whistleblowingpediatric gender medicine+3 | Dr. Eithan Haim | Texas Children's HospitalTexas Children's+2 | — | whistleblowerTexas Children's Hospital+5 | — | 1h 24m 17s | |
| 5/2/26 | From Babylon to Baylor: How Insurance Went Off the Rails | Anish and Dr. DiGiorgio trace the history of insurance from ancient Babylonian bottomery contracts through Egyptian workers' guilds, Greek risk-pooling societies, Lloyd's of London, and the birth of actuarial science — then walk forward into the Great Fire of London, the 1929 Baylor hospital plan, Henry Kaiser's vertically integrated care, the World War II wage-freeze tax subsidy that chained health coverage to employment, Medicare in 1965, and the ACA in 2010. Along the way they unpack why the insurance model breaks down when applied to events with a 100% chance of happening (like primary care visits), why government-imposed price controls force low-risk payers to subsidize high-risk ones, the role of reinsurance and moral hazard in disaster-prone regions, and how the cultural argument against socializing risk has been quietly losing ground in the West since the Great Depression.Chapter markers00:00 Cold open — blizzard vs. backyard burgers01:45 Why physicians need to understand insurance02:11 Babylon, bottomery contracts, and the Code of Hammurabi05:29 The birth of actuarial science07:16 When insurance stops making sense (the 100% problem)07:42 Egyptian guilds and Greek risk-pooling societies09:40 Lloyd's of London and the coffee-house origins of underwriting10:44 Actuarial tables meet societal mores — pricing risk by sex13:16 What happens when the government caps what insurers can charge16:18 The Great Fire of London and the rise of fire brigades17:42 Reinsurance, FEMA, and Thomas Sowell on flood-zone moral hazard21:36 The 1929 Baylor plan and the seed of Blue Cross24:24 Henry Kaiser's vertically integrated healthcare25:34 World War II wage freezes and the tax subsidy that chained insurance to employment30:51 How Medicare and the ACA redefined "insurance" to mean prepaid care33:04 Bismarck's 1880s gambit — socializing to prevent socialism34:04 Why the argument against socialized risk keeps losing36:23 Hayek, Friedman, and why socialism keeps coming back36:49 Britain, the NHS, and Bevan "stuffing their mouths with gold"Co-Host handles@anish_koka and @drdigiorgioShow handle@drsloungepodSubscribe linksSpotify: https://open.spotify.com/show/7vE4aCMpVHnSGwuOHiGVLpApple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1489323962YouTube: https://www.youtube.com/@TheDoctorsLounge | — | ||||||
| 4/26/26 | Outpatient Brain Surgery: How Buffalo Built America's Only Neurosurgical ASC | Episode SummaryAnish and Anthony are joined by Dr. Elad Levy — Professor and Chair of Neurosurgery at the University at Buffalo, holder of the L. Nelson Hopkins Endowed Chair, and one of the country's most prolific physician innovators — for a wide-ranging conversation on how he and his partners built Atlas Surgery Center, the only physician-owned outpatient neurosurgery center in the United States, now performing roughly 3,000 cases a year including outpatient angiograms, carotid stenting, brain aneurysm treatment, gamma knife radiosurgery, and complex spine work. Dr. Levy walks through the operational efficiencies that let four staff do the work of fifteen to twenty in a hospital, the negotiated device pricing, the inclusion/exclusion criteria for outpatient cases, the constraints of Medicare's inpatient-only list, and why payers have embraced the model at 90% of hospital rates. The conversation also traces his personal arc — from rowing at Choate and Dartmouth, to neurosurgery training at Pitt, to fellowship under Nick Hopkins in Buffalo — and the field-defining work he and colleagues did to establish mechanical thrombectomy as standard of care in the 2015 New England Journal papers, plus his current work on endovascular brain-computer interfaces with Synchron and ongoing conversations with Neuralink. The episode closes on neurosurgery workforce challenges, the alternative pathway to board certification for foreign-trained surgeons, and why physician ownership may be one of the most underrated levers for rural access to specialty care.Chapters00:00 Welcome and introducing Dr. Elad Levy01:05 The origin of Atlas Surgery Center: outgrowing the hospital03:14 Relationship with the hospital system and how the partnership works04:36 SUNY Buffalo, Kaleida Health, and the Atlas LLC structure06:44 The collective pain points that drove physician ownership07:30 Personal journey: Israel, Italy, and rural northern New York08:14 Choate, Dartmouth, and varsity rowing10:35 Med school, Pitt residency, and falling for neurosurgery12:24 Fellowship under Nick Hopkins in Buffalo14:42 The thrombectomy revolution and the 2015 New England Journal papers16:30 "If I had a tomato, I would throw it at your face" — early endovascular pushback18:03 The COMMAND trial and endovascular brain-computer interfaces with Synchron19:43 Neuralink, Precision, CoreTech, and the Wright Brothers phase of BCI22:07 What can move outpatient: angiograms, aneurysms, stenting, functional, spine25:52 Why ASCs are cheaper: device pricing, staffing, and turnover times28:20 Reimbursement at 90% of hospital rates and the case for site neutrality30:23 Inclusion and exclusion criteria — the "is this your mother?" test31:50 Medicare's inpatient-only list and why it locks patients into hospitals34:35 Financial ethics of physician ownership versus corporate medicine39:53 Could Atlas become a physician-owned hospital? The two-midnight rule41:43 Everyone goes home at four — efficiency as patient access44:27 The hospital industrial complex and regulatory drag45:13 IRB and clinical trial speed in an ASC: weeks versus a year46:29 Neurosurgery workforce, foreign medical graduates, and the alternative pathway50:32 Buffalo as a city of good neighbors — and physician retention53:38 Vetting international training and what board certification really protects55:03 Grey's Anatomy, McDreamy, and the Dartmouth rowing connectionCo-Hosts@anish_koka and @drdigiorgioShow@drsloungepodSubscribeYouTube: https://www.youtube.com/@TheDoctorsLounge | — | ||||||
| 4/25/26 | The Intellectual Case Against Medicare: Buchanan, Tullock, and the Rules of the Game | Anish and Dr. DiGiorgio dig into the intellectual debate that preceded the 1965 passage of Medicare, focusing on the economists — James Buchanan, Gordon Tullock, Friedrich Hayek, Ludwig von Mises, Milton Friedman, and George Stigler — whose arguments against centralized healthcare proved remarkably prescient. They trace how Buchanan's public choice theory (political actors behave as self-interested economic actors) and Tullock's concept of rent seeking (firms spending capital to capture government wealth transfers rather than create value) explain exactly what happened to American healthcare: runaway costs, regulatory capture by industry, EHR mandates that entrenched a handful of vendors, and the RBRVS/RUC system that keeps physician specialties fighting over a fixed pie. The conversation closes on the Buchanan-Tullock distinction between constitutional decisions (changing the rules of the game) and political decisions (playing within them), and why physicians keep losing by focusing only on the latter.Chapter Markers00:00 Introduction and naming the deep-dive series00:46 Setting up the pre-Medicare debate (1965, LBJ, Great Society)02:44 The AMA's opposition and the intellectual roots of the debate04:02 Why Medicare and Medicaid emerged: employer insurance and the uninsured elderly04:29 James Buchanan and public choice theory05:30 Gordon Tullock and rent seeking07:55 Why bureaucrats aren't altruistic either10:39 Epic, EHR mandates, and regulatory capture in action12:13 Unproductive spending: lobbying as digging ditches with spoons13:20 The Moderna flu vaccine case and George Stigler's regulatory capture16:49 Physicians as just another rent-seeking interest group20:30 Medicare before the RUC: UCR and the birth of the RBRVS21:47 The Calculus of Consent: constitutional vs. political decisions25:12 Direct primary care and doctors opting out of Medicare27:13 ASCs, Surgery Center of Oklahoma, and breaking the rules of the game29:40 The employer-insurer link and the tax subsidy distortion31:32 The Breakup Health Care Act and provider-side consolidation32:47 Fraud, waste, and the limits of third-party payment34:38 Wrap-up: the thinkers, the concepts, and why this matters nowCo-Host Handles@anish_koka and @drdigiorgioShow Handle@drsloungepodSubscribe LinksYouTube: https://www.youtube.com/@TheDoctorsLoungeResourcesDr. DiGiorgio's Substack graphic novel on the history of healthcare policy: https://www.offlabelideas.com/The Calculus of Consent: Logical Foundations of Constitutional Democracy (1962), James M. Buchanan & Gordon Tullock — the foundational text on constitutional vs. political decisions. Free full text at Liberty Fund: https://oll.libertyfund.org/titles/buchanan-the-calculus-of-consent-logical-foundations-of-constitutional-democracyThe Rent-Seeking Society (2005), Vol. 5 of The Selected Works of Gordon Tullock, edited by Charles K. Rowley (Liberty Fund): https://about.libertyfund.org/books/the-rent-seeking-society/Russ Roberts has several episodes covering Buchanan, Tullock, and public choice theory — searchable at https://www.econtalk.org | — | ||||||
| 4/19/26 | Rural Health Myths, Mark Cuban's HSA Gambit, and How Neurocritical Care Was Born | Back from hiatus, Anish and Dr. DiGiorgio swap travel notes on Japan and San Diego before diving into Anish's recent Substack piece mapping emergency cardiac care access across the United States — where 98% of Americans live within 90 minutes of a PCI-capable hospital, a level of coverage no peer country (including Canada) comes close to matching. They extend the analysis to thrombectomy-capable stroke centers, trauma coverage, and what it really means when the Commonwealth Fund ranks the US last. The conversation turns to whether the "rural healthcare crisis" narrative justifies continued subsidies (critical access designation, 340B, DISH payments, the new OBBA rural fund) or simply props up a monopoly structure that blocks physician-owned hospitals and ASCs. They unpack Mark Cuban's HSA-plus-catastrophic-coverage proposal, its blind spots on chronic illness and supply-side cost, the two-midnight rule lawsuit between Jefferson and Aetna, cost-plus reimbursement grandfathering, and how CMS's new "efficiency adjustment" has made it financially rational for neurosurgeons to hand off post-op critical care — inadvertently telling the origin story of neurocritical care as a specialty. They close with the new CDC director announcement and a look ahead to next week's guest, Dr. Elad Levy.00:00 Back from hiatus — Japan, San Diego, and American public transit03:45 Happy tax day and the Bay Area commute problem04:45 Anish's Substack piece: mapping PCI access across America07:50 Why PCI capability is the right proxy for emergency care infrastructure10:00 Building the map — counties, census tracts, and the 90-minute door-to-balloon window14:30 98% coverage: the US vs Canada, Russia, China18:24 Thrombectomy-capable stroke centers and the 60-minute brain window22:07 What do you actually want from a healthcare system?27:12 The original sin of Medicare and the employer tax exemption30:13 Rural hospital subsidies: critical access, 340B, DISH, and the OBBA rural fund37:02 Physician-owned hospitals, Stark Law, and ASCs as an alternative model40:30 Mark Cuban's HSA plan: stop-loss, direct primary care, and the $2,100 family premium44:13 Extending the idea to Medicaid — wealth accrual and the 100% benefit cliff46:31 The chronic illness problem and federal reinsurance as a backstop47:57 The missing piece: supply-side deregulation and lowering cost of care50:19 Jefferson sues Aetna: the two-midnight rule and who the real villain is53:04 UCR, cost-plus reimbursement, and the hospitals still grandfathered in55:37 The CMS efficiency adjustment and the neurosurgeon's 8-day break-even58:45 The origin story of neurocritical care as a specialty01:02:16 New CDC director Erica Schwartz and next week's guest Dr. Elad Levy@anish_koka and @drdigiorgio@drsloungepodResources:Quantifying the Rural Access Problem: Emergency Cardiac Care as a Window into American Healthcare — https://anishkokamd.substack.com/p/quantifying-the-rural-access-problemAmerica Has Solved the Hardest Healthcare Access Problem Better Than Anyone Else — Here's the Data — https://anishkokamd.substack.com/p/the-us-healthcare-system-has-basicallyInteractive PCI Access Maps (US & Canada) — https://anishkoka.github.io/pci-access-maps/YouTube: https://www.youtube.com/@TheDoctorsLounge | — | ||||||
| 4/3/26 | From Tehran to the C-Suite: Biotech CEO Ali Mortazavi on AI, Drug Discovery, and the Me-Too Problem | Guest: Ali Mortazavi | CEO, Tangram Therapeutics (formerly E-Therapeutics), London, UKEpisode Summary:Ali Mortazavi is not your typical biotech CEO. A computer scientist by training, former professional chess player, and veteran of financial markets, he invested in an RNAi company in 2012 — and then, by his own admission, made the crazy decision to become its CEO with zero background in biology, chemistry, or medicine.What followed is a 14-year education in the brutal realities of drug development — and a front-row seat to the AI revolution now reshaping it. In this wide-ranging conversation, Mortazavi draws on his extraordinary personal story (fleeing revolutionary Iran as a child, arriving in London unable to speak English, rising through chess and finance) to offer a uniquely cross-disciplinary perspective on why biotech is stuck in a me-too loop, why the incentive system is the real bottleneck, and where AI is — and isn't — changing the game.0:00 - Introduction & Ali's Background1:07 - The Iranian Revolution at Nine Years Old4:44 - Fleeing Iran, Arriving in London6:38 - The Refugee Experience and Starting Over7:49 - Computer Science in 19909:53 - Becoming a Professional Chess Player11:06 - The Vishwanathan Anand Moment13:17 - From Chess to Finance to Biotech CEO14:44 - The Gleevec Illusion and the Reality of Drug Development16:07 - Jay Bhattacharya, Reproducibility, and the PubMed Button18:18 - LLMs as Scientific Compression Systems20:15 - Why LLMs Give "The Average Answer" — The Co-Pilot Model23:44 - Vibe Coding and the Explosion of Code25:36 - AI Won't Replace 10x Coders — It Will Replace 90 of 10026:16 - The GalNAC Case Study: 35 Years of Forgotten Innovation31:10 - The Me-Too Algorithm and Biotech VC Incentives34:40 - GLP-1s: Another 30 Years of Sitting Around35:26 - The FDA, the XBI, and the Current Regulatory Landscape40:43 - Can Politics Fix the Incentive System?42:09 - Why Past Progress Happened Without AI44:24 - Medical Ethics, Experimentation, and the Innovation Tradeoff48:34 - Biotech Is Archaic: The Preclinical De-Risking Problem50:05 - No Animal Model Actually Works52:16 - Over-Regulation vs. Just Plain Hard53:00 - The US Market as the Global Subsidy Engine54:05 - China: Wake-Up Call, Not Innovator56:25 - The London Market: "Don't Call It a Market"58:52 - AI-Native Biotechs: Too Soon to Tell59:36 - Where AI Works: Information. Where It Doesn't: Physics.1:01:29 - Tangram Therapeutics and Libra OS1:04:25 - The Future: SaaS Collapse, Medicine Returns to Fundamentals1:07:36 - Closing: Hope, Broken Glass, and Early AdoptionSubscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSSFollow the Show: X: @DrsLoungePodFollow the Guest: X: @AAMortazaviCo-hosts: @anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | @drdigiorgio | — | ||||||
| 3/31/26 | Dr. DiGiorgio Goes to Washington: Site Neutrality, Stark Law Physician-Owned Hospitals & More | Episode SummaryDr. DiGiorgio returns from testifying before the House Energy and Commerce Subcommittee on Health, the third in a series of hearings on healthcare costs covering the provider landscape. The two break down the major policy levers discussed in his testimony — site-neutral payment, Stark Law reform, physician-owned hospitals, and Certificate of Need laws — and why so many obviously good solutions remain politically untouchable. They also dig into the rural access gap, the failure of the NP independence experiment to solve it, Medicare Advantage risk adjustment, and the new HHS healthcare advisory committee. As always, the diagnosis is clear; the politics are the hard part.Chapter Markers0:00 – Welcome back & Dr. DiGiorgio's Congressional testimony3:16 – Site-neutral payment: why everyone knows it's right and no one acts6:26 – You can't do site neutrality without also enabling competition8:20 – How MedPAC's methodology actually works11:50 – Stark Law explained — and why it creates a double standard14:32 – Hospice fraud, Armenian gangs, and Nick Shirley20:30 – The original sin: third-party payment and utilization control23:52 – The case for allowing physician referral networks25:15 – Hospitals' self-referral hypocrisy and the Federation of American Hospitals tweet28:52 – How Section 6001 of the ACA banned physician-owned hospitals30:13 – The new HHS healthcare advisory committee — will it matter?37:44 – The rural access gap: how big is the problem really?42:52 – Why NP independence didn't solve rural shortages47:58 – International medical graduates and the rural fiction50:06 – Let prices rise: the market solution to rural primary care55:25 – Medicaid federal matching rates and state competitiveness56:38 – How Democrats and Republicans engaged at the hearing58:57 – The politics of why nothing gets doneLinks:YouTube Dr. Digiorgio Congressional Testimony: https://www.youtube.com/watch?v=sjPr3fK9jjcWritten Testimony@anish_koka | @drdigiorgio@drsloungepod🎧 Spotify | Apple Podcasts | YouTube | — | ||||||
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| 3/15/26 | The Cost of Dissent: How a Viral Newsweek Op-Ed Led to Medical School Dismissal | Kevin Bass, PhD, joins Anish and Dr. DiGiorgio to tell the story of how a viral Newsweek op-ed apologizing for his support of COVID lockdowns and mandates set off a chain of events that ended in his dismissal from Texas Tech's MD/PhD program. Kevin walks through the internal emails, sham professionalism hearings, and rigged dismissal process he uncovered through FERPA records requests — and his ongoing federal and state lawsuits alleging First Amendment retaliation. The conversation then shifts to what Kevin has been building since: using AI pipelines to do large-scale investigative data analysis, from parsing the Epstein files to probing Medicaid fraud — work he argues would have taken a newsroom months, done now in days by one person.YouTube Chapters:00:00 - Introduction and Kevin Bass background01:16 - Kevin's COVID arc: from establishment supporter to dissenter03:14 - The Newsweek op-ed and Tucker Carlson appearance08:00 - Internal emails and the professionalism complaint campaign13:44 - Sham hearings, appeals, and eventual dismissal19:19 - The rigged consolidated hearing and Darren Gibson27:34 - Dr. DiGiorgio on the medical training dismissal system29:51 - Why Kevin still believes in the broader legal system33:00 - What Kevin has been building since dismissal36:00 - Using AI to analyze the Epstein files40:10 - The messiness of large health data sets46:00 - Immigration policy data analysis49:06 - Medicaid fraud and the limits of legal definitions56:20 - Advice to physicians on AI01:03:10 - The future of health policy research in the AI era@anish_koka and @drdigiorgio@drsloungepod🎧 Apple Podcasts: https://podcasts.apple.com/us/podcast/the-doctors-lounge/id1489323962🎧 Spotify: https://open.spotify.com/show/7vE4aCMpVHnSGwuOHiGVLp▶️ YouTube: https://www.youtube.com/@TheDoctorsLoungeResources:Kevin Bass's case documentation site: https://case.kevinnbass.comKevin Bass on Substack: https://www.kevinnbass.comKevin Bass on X: @kevinnbassKevin's original Newsweek op-ed (Jan. 2023): https://www.newsweek.com/its-time-scientific-community-admit-we-were-wrong-about-coivd-it-cost-lives-opinion-1776630Kevin's Epoch Times essay on his dismissal: https://www.theepochtimes.com/opinion/how-my-medical-school-scandalously-dismissed-me-5580841 | — | ||||||
| 3/9/26 | The Shah's Spleen, Quality Metrics, Health Insurance & the FDA | Dr. Anish Koka and Dr. Anthony DiGiorgio open with the little-known medical story behind the death of the Shah of Iran — how Mohammed Reza Pahlavi came to be operated on in Cairo in 1980 by legendary cardiovascular surgeon Michael DeBakey, and how the "comforting explanation" bias may have contributed to his death from a post-operative abscess rather than his underlying cancer. The case, drawn from a piece by Dr. Li Zhao (NYU Langone), launches a broader conversation about anchoring bias in medicine and the cognitive traps all clinicians face. From there, the hosts turn to the quality metric industrial complex — MIPS, the new low back pain ambulatory model threatening a 12% Medicare penalty for spine surgeons, the hospital readmission program's documented mortality spike, and how 2,266 CMS metrics are costing billions while failing patients. They close with a NEJM perspectives piece from Harvard Business School's Leemore Daphne on health insurance consolidation and her surprisingly free-market prescriptions for reform.Chapters00:00 Introduction02:00 The Shah of Iran — Political Background03:45 The Shah's Leukemia and Michael DeBakey's 1980 Surgery06:30 A Spleen the Size of a Football08:00 The Decision Not to Drain — And Its Consequences10:00 The Comforting Explanation Bias12:30 Subspecialization Matters — The Most Famous Surgeon Isn't Always the Right One14:45 Anchoring Bias in Clinical Medicine17:00 Modern Imaging and Residents as Checks on Bias18:30 Surgeons, Complications, and the M&M Conference21:00 Segue: Judging Doctors by Stats22:30 The Origins of Quality Metrics — Donabedian 196624:00 MIPS and How It Actually Works26:00 The New Back Pain Ambulatory Specialty Model — A 12% Penalty28:00 Evidence That Metrics Harm Patients: Hospital Readmission Reduction Program30:30 Obstetrics and the C-Section Penalty31:30 Press Ganey and the Cafeteria Problem33:00 Risk Adjustment Gaming — 40% Margin Increase from Coder Rounding38:00 2,266 Metrics and 108,000 Person-Hours at Johns Hopkins40:00 Why Doctors Leave Medicare42:00 What Good Metrics Could Look Like — Dr. DiGiorgio's JAMA Proposal44:00 Health Insurance Consolidation — NEJM Perspectives50:30 FDA, Vinay Prasad, and the WSJ Retraction55:00 Next Week: Kevin BassSubscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube Follow the Show: X: @DrsLoungePod Co-hosts: @anish_koka | @drdigiorgio | — | ||||||
| 2/28/26 | Dr. Mary Talley Bowden Battles the Health System | In this conversation, Dr. Mary Talley Bowden shares her experiences as an independent physician during the COVID-19 pandemic, detailing her courageous battle against health systems and the Texas Medical Board. She discusses the challenges faced by healthcare professionals, the impact of politics on medical practices, and the importance of patient care and medical freedom. Dr. Bowden emphasizes the need for changes in healthcare policies, including the repeal of mandates and the promotion of alternative treatments like ivermectin. Her personal philosophy and motivation to fight for her patients shine through as she navigates the complexities of the healthcare system.Chapters00:00 Introduction to Dr. Mary Talley Bowden02:17 Dr. Bowden's Courageous Battle Against Health Systems06:01 The Role of Telemedicine and Ivermectin in COVID Treatment11:37 Legal Battles and Hospital Privileges17:03 The Texas Medical Board and Its Controversies22:21 Political Dynamics in Texas Healthcare27:22 The Future of Independent Medicine32:19 The Impact of COVID Vaccines on Patients37:26 Ethical Concerns and Medical Mandates40:40 Critique of Public Health Figures46:03 The Role of Independent Physicians50:58 Future of Healthcare and Patient EmpowermentAbout Dr. Mary Talley Bowden:Dr. Mary Talley Bowden is a Stanford-trained ENT physician running a solo, third-party-free practice in Houston, Texas. She became nationally known during COVID for continuing to see patients, offering early treatment, and publicly opposing vaccine mandates. She is currently in ongoing litigation with both Houston Methodist and the Texas Medical Board.Subscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSSFollow the Show: X: @DrsLoungePodCo-hosts: @anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | | — | ||||||
| 2/21/26 | The Week in Review and Understanding the Medicaid Data Dump with Samir Unni | Episode Title: The Medicaid Data Dump: $1.7 Billion in Billing From Shell Companies and Why Nobody Stopped ItGuest: Samir Unni | Biomedical Engineer, former Palantir healthcare data lead, currently working on federal data modernization effortsChapters00:00 Introduction and Technical Difficulties02:47 Reflections on Jay Bhattacharya's Insights06:04 Navigating Polarization in Science08:50 Moderna's Flu Vaccine Controversy11:56 Understanding the FDA's Refusal to File14:58 The Medicaid Data Dump and Its Implications17:50 Duplicate Payments in Medicaid20:59 The Role of Transparency in Healthcare24:01 Home Health Services and Fraud Risks42:57 Understanding Fraud in Government Billing46:51 Political Ramifications of Home Health Agencies50:53 Analyzing Data for Fraud Detection56:30 Incentives and Accountability in Healthcare01:01:52 The Role of Technology in Fraud Prevention01:12:32 Legislative Solutions to Healthcare FraudResources Mentioned:Samir Unni's viral Medicaid data thread (@SamirUnni on X)CMS TMSIS Medicaid provider-level data releaseAnish Koka's deep dive on Fluarix clinical efficacyHHS Office of Inspector General excluded individuals/entities listDr. Mandrola's posts on the Moderna/FDA controversyAlex Berenson's report on autism behavioral therapy billing trendsAbout Samir Unni:Samir Unni is a biomedical engineer who has spent over a decade working at the intersection of healthcare and data analytics. He previously served as a lead at Palantir working with government and healthcare organizations, and is now focused on modernizing how the federal government leverages AI and data tools to identify waste and fraud in public health programs.Subscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSSFollow the Show: X: @drsloungepodCo-hosts: @anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | @DrDiGiorgio | — | ||||||
| 2/14/26 | NIH Director Jay Bhattacharya | In this engaging conversation, Dr. Jay Bhattacharya discusses his unique perspective as a health economist and the impact of his training on his approach to public health, particularly during the COVID-19 pandemic. He reflects on the Great Barrington Declaration, the importance of dissent in science, and the need for reform within the NIH to foster innovation and address the replication crisis in research. Dr. Bhattacharya emphasizes the necessity of a culture shift in science, advocating for transparency and rigorous inquiry into public health issues, including vaccines and chronic diseases.TakeawaysDr. Bhattacharya's background in economics shapes his approach to health policy.The COVID-19 pandemic highlighted the importance of considering trade-offs in public health decisions.Dissent in science is crucial for progress and innovation.The Great Barrington Declaration challenged the prevailing public health narrative during the pandemic.The NIH must adapt to foster a culture of questioning and innovation.Addressing the replication crisis is essential for restoring trust in scientific research.Public health responses must be transparent and trustworthy to gain public confidence.Raising the evidentiary bar for vaccines is necessary to ensure safety and efficacy.The NIH's role in funding research should focus on improving health outcomes.A second scientific revolution is needed to shift the power dynamics in research. TitlesNavigating Public Health: Insights from Dr. Jay BhattacharyaThe Economics of Health Policy: A Conversation with Dr. BhattacharyaChapters00:00 Introduction to Dr. Jay Bhattacharya03:18 The Influence of Economics on Health Policy06:23 Unique Perspectives During the COVID-19 Pandemic10:12 The Role of Authority in Public Health Decisions13:08 The Great Barrington Declaration and Its Impact16:27 Challenges to Scientific Consensus19:08 Leading the NIH: An Economic Perspective22:33 Addressing the Replication Crisis in Science36:56 Addressing Scientific Stagnation and Replication Crisis43:42 Fostering a Culture of Dissent in Science52:56 Setting Research Priorities for Public Health59:58 Navigating Vaccine Safety and Public TrustSubscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSSFollow the Show: X: @drsloungepodCo-hosts: @anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | @DrDiGiorgio | — | ||||||
| 2/7/26 | The $2 Million Verdict: Inside the First Detransition Lawsuit Trial | Benjamin Ryan was the only journalist in the courtroom for every day of the first detransition lawsuit to reach a jury verdict. In January 2025, a White Plains jury awarded $2 million to Fox Varian, who received a double mastectomy at age 16 after being diagnosed with gender dysphoria. Years later, she detransitioned and sued her psychologist and plastic surgeon.What happened in that courtroom tells a bigger story about how American medicine got here, why Europe is walking it back, and what happens when "affirmation" becomes the only acceptable path. Ben breaks down the testimony, the expert witnesses, the coerced mother, and why one of WPATH's own leaders sank the defense.This conversation covers the case details, the prefrontal lobotomy parallel, why the American Academy of Pediatrics can't back down, insurance incentives gone wrong, and what it's like to be the only journalist willing to cover the story everyone's afraid to touch.Chapter List1:00 - Introduction: Benjamin Ryan, The Only Reporter in the Room4:00 - How Ben Got Into Trans Medicine Reporting7:00 - The Case Overview: Fox Varian vs Her Medical Team10:00 - Body Dysmorphia vs Gender Dysphoria: The Fatal Error13:00 - Ken Einhorn and the Philosophy of Affirmation17:00 - The Pride Center Records He Never Requested19:00 - Dr. Loren Schechter: WPATH's President-Elect Testifies for Plaintiff22:00 - Coercing the Mother: "You're Not in Reality, Mom"25:00 - Why Was the Plastic Surgeon Liable?29:00 - The Lobotomy Parallel: When Medicine Gets It Wrong33:00 - The Ethics of Taking Functioning Organs37:00 - Why the Plastic Surgeons Released a Statement39:00 - Expert Witness Testimony: The Game-Changer42:00 - Johanna Olson-Kennedy: "Live Son or Dead Daughter"44:00 - The Nose Job Fallacy: Breasts Have Function46:00 - How Did We Get Here? Internet, Social Media, Civil Rights50:00 - Why Europe Walked It Back and America Didn't54:00 - The Insurance Problem: Perverse Incentives59:00 - Why Medical Societies Can't Say "We Don't Know"1:02:00 - The Media Blackout: "No Institutional Bandwidth"1:05:00 - Closing: Follow Ben's Substack for Case FilesSubscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSSFollow the Show: X: @drsloungepodCo-hosts: @anish_koka | @drdanchoi | @dutchrojas | @sdixitmd | @DrDiGiorgioGuest: Benjamin Ryan on Substack: Hazard Ratio (benryan.substack.com)Ben's Free Press Article : A Legal First That Could Change Gender Medicine | — | ||||||
| 2/6/26 | Ed Gaines: How Independent Physicians Finally Got Leverage Against Insurance Companies | Guest: Ed Gaines, JD, CPC Vice President of Regulatory Affairs, Zotec Partners Honorary Member, American College of Emergency PhysiciansEpisode Summary:If you're a hospital-based physician and you don't understand the No Surprises Act, you're missing the biggest shift in payment leverage in decades. Insurance companies estimated there would be 17,000 disputes. The actual number? Over 2.5 million. And physicians are winning 85-90% of them.Ed Gaines has been fighting for physician payment for 32 years—from the 1990s battle over 1099 independent contractors to today's war over Independent Dispute Resolution. He explains how California's "neutral" stance cost physicians dearly, why Trump's price transparency rule changed everything, and what Anthem's threat to cut hospital payments really means.0:00 - Introduction & Opening1:05 - Who is Ed Gaines?2:25 - The Origin Story: From Healthcare Fascination to Capitol Hill6:31 - The 1099 Battle: A Five-Year Fight (1997-2002)14:19 - What is the No Surprises Act?17:26 - State Laws vs. Federal Action23:48 - California's Mistake: When the CMA Was "Neutral"26:44 - The Consolidation Paradox28:36 - The Legislative Battle: Ways and Means vs. Energy and Commerce31:43 - Becerra's Sabotage: Four Lawsuits, Four Victories37:39 - The Current Battle: Insurance Companies Strike Back40:43 - The Trump Transparency Game-Changer42:55 - Who's Really Using IDR?43:50 - Anthem's New Tactic: Going After Hospitals46:18 - The Antitrust Argument47:40 - Closing ThoughtsIn This Episode:The 1099 battle (1997-2002): How persistence won a 5-year legislative fightWhy the California Medical Association regrets being "neutral" on AB 72The $50 billion that health plans tried to extract from physiciansHow HHS tried to sabotage the NSA—and lost in federal court four timesWhy CMS was off by 147X in predicting IDR case volumeTrump's transparency rule: The data that's winning cases for physiciansAnthem's new strategy: Threatening 10% payment cuts to hospitalsThe antitrust case against insurance company boycottsWhy 70% of IDR users are independent physicians, not just PE groupsKey Quotes:"CMS estimated 17,000 cases. The actual number was over 2.5 million. They missed by just a touch.""The judge literally said the agency tried to put their thumb on the scales of justice in favor of health plans.""The California Medical Association was neutral on benchmarking to 125% of Medicare. To their credit, they realized they'd made a mistake.""They're losing 85-90% of cases at 6, 7, 8X of Medicare. They didn't see this coming.""For years they got to unilaterally decide what out-of-network payment would be, then just blame doctors for balance billing."About Ed Gaines: Ed has worked in physician revenue cycle management for 32 years, supporting over 22,000 physicians across all 50 states. He specializes in emergency medicine, radiology, anesthesia, and orthopedics advocacy. The American College of Emergency Physicians made him an honorary member in 2010—rare recognition for a non-physician.Subscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSS | — | ||||||
| 2/1/26 | Dr. Gantwerker: Medicare Advantage, Private Practice, and Why Doctors Need to Stop Fighting on X | What happens when a spine surgeon who's been in private practice since the Obamacare era sits down with doctors across the political spectrum? You get one of the most honest conversations about healthcare reform we've had.Brian Gantwerker doesn't fit neatly into anyone's box. He's a private practice capitalist who thinks breaking up insurance companies is essential. He believes in "just pricing" for craniotomies (hint: it's more than $2,000). He thinks Medicare was actually a great payer—until Medicare Advantage ruined it. And he has strong opinions about why physicians spend so much time fighting each other on Twitter instead of finding common ground.This conversation covers the Medicare Advantage meltdown (UnitedHealthcare shares tanking), vertical integration nightmares, why the FTC needs to break up both insurers AND hospitals, and what it's like when your congressman literally saves your practice. Plus: the real reason healthcare policy debates get so toxic on social media, and why quote-tweeting might be making everything worse.0:00 - Introduction: Doctors in the Lounge 0:33 - Who is Brian Gantwerker? 2:08 - Starting Private Practice in the Obamacare Era 5:34 - UnitedHealthcare: The Pontine Glioma of Healthcare 7:43 - Medicare Advantage vs Traditional Medicare 10:26 - The Medicare Advantage Denial Story 14:35 - Who Gets the Value in Value-Based Care? 16:07 - The Free Market That Doesn't Exist Yet 19:16 - What Should a Craniotomy Cost? 21:47 - Breaking Up the Monopolies: Insurers AND Hospitals 27:09 - The Labor Theory of Value Debate 30:21 - CPT Codes and Central Planning 32:20 - The "Just Price" vs Free Market 35:42 - HSAs for Medicaid Recipients 38:47 - Price Transparency: Why Can't Healthcare Be Like Amazon? 40:03 - The Workout Period Problem 43:52 - FTC and Vertical Integration 46:04 - Lobbying, Congress, and Changing Minds 48:07 - Why Twitter Makes Physicians Fight Each Other 51:24 - Political Rancor and Taking Sides 55:14 - The Dr. Asghar Tweet Controversy 59:24 - Quote-Tweeting: The Death of Dialogue 1:03:03 - X as Thunderdome vs Real Conversation 1:04:35 - The Ted Lieu Saves: When Congress Actually Helps 1:07:32 - Closing: Shah Rukh Khan Hair and Finding Common GroundSubscribe to The Doctor's Lounge: Apple Podcasts | Spotify | YouTube | RSSFollow the Show: X: @TheDoctorsLoCo-hosts: @anish_koka | @drdanchoi | @dutchrojas | @drdigiorgio | @sdixitmdGuest: @cscla | — | ||||||
| 1/30/26 | The DPC Revolution: Dr. Josh Umbehr on Making Healthcare Affordable Again | Guest: Josh Umbehr, MD | Co-founder & CEO, Atlas MD | DPC PioneerSummary: In 2010, Josh Umbehr launched Atlas MD charging $50/month for unlimited primary care with no insurance billing. Other doctors said it wasn't sustainable. Fourteen years later, he runs a platform serving 1,800+ practices and built his own insurance company. This conversation covers the full journey: wholesale medication costs ($0.01/pill metformin), the $2M it takes to start insurance, why Singapore's model works, and why 80% of healthcare spending is eliminable.Key Topics:DPC Economics: How $50/month works ($2 CBC tests, cutting 5-6 staff)Building Insurance: $2M startup, actuarial challenges, association modelSingapore Healthcare: What economists miss about primary careFractional Specialists: 1,800 practices sharing one cardiologistCMS Meeting: "We can't participate and innovate"GLP-1 Pricing: Why insurance coverage raises costsVaccine Nuance: Risk/benefit in contextThe 80% Solution: Eliminating waste, not rationingTop Quotes:"80% of $4-5 trillion could be cut out. That's reasonable math, not wishful thinking.""We can't participate and innovate" [to CMS Administrator]"Best way to make GLP-1s affordable: stop covering with insurance""Biggest DPC problem isn't the model—it's getting people to understand high quality + affordable price" | — | ||||||
| 1/25/26 | Journalist Alex Berenson: Fraud and Abuse with Autism therapy in the Medicaid Program | KeywordsAlex Berenson, COVID vaccine, Medicaid fraud, autism services, healthcare, investigative journalism, MCOs, AI in healthcare, public health, healthcare policySummaryIn this conversation, Anish Koka and Alex Berenson delve into critical issues surrounding the COVID vaccine, Medicaid fraud, and the financial incentives within autism services. They discuss the implications of investigative journalism in public health, the role of Managed Care Organizations (MCOs), and the potential future of healthcare with the integration of AI. Berenson emphasizes the need for accountability and transparency in healthcare spending, particularly in Medicaid, which has ballooned to a trillion-dollar program with significant fraud and abuse. The discussion highlights the importance of asking tough questions and the consequences of ignoring systemic issues in healthcare policy.TakeawaysAlex Berenson is a notable investigative journalist who challenges mainstream narratives.The COVID vaccine's efficacy was overestimated, leading to misguided public health policies.Medicaid fraud is rampant, with significant financial implications for taxpayers.The autism services sector has seen explosive growth in spending without adequate oversight.Managed Care Organizations (MCOs) often lack the incentive to control costs in Medicaid.There is a need for more physician oversight in Medicaid-funded services.The financial incentives in healthcare can lead to waste and abuse of funds.AI's role in healthcare could complicate oversight and accountability.Public support for Medicaid could diminish if fraud and waste are not addressed.The conversation underscores the importance of transparency in healthcare spending. Chapters00:00 Introduction to Alex Berenson06:11 Investigating COVID Vaccine Efficacy12:22 Exploring Medicaid Fraud and Abuse20:00 Autism Services and Financial Incentives30:08 The Role of MCOs in Medicaid36:50 The Future of Healthcare and AILinks: Berenson Substack on Medicaid and Autism: (100) Medicaid fraud and abuse are hitting unthinkable levels@X handles:@alexberenson @anish_koka @DrDiGiorgio @drdanchoi @sdixitmd | — | ||||||
| 12/21/25 | Diving Deeper into The Canadian MAID Program and GOP Healthcare Solutions | Send us a textKeywordshealthcare, MAID, patient autonomy, economic implications, GOP healthcare proposals, health savings accounts, dynamic pricing, Instacart, ethical dilemmas, healthcare systemsSummaryIn this episode, the hosts discuss pressing issues in healthcare, focusing on the Canadian MAID program, the implications of patient autonomy, economic factors influencing healthcare decisions, and the GOP's proposals for health savings accounts. They also explore the concept of dynamic pricing in healthcare, drawing parallels with Instacart's pricing strategies, and emphasize the need for transparency and patient empowerment in healthcare decisions.TakeawaysThe MAID program raises ethical concerns about patient autonomy and healthcare access.Economic pressures in healthcare can lead to troubling outcomes for patients.Dynamic pricing models in other industries may not translate well to healthcare.Health savings accounts could empower patients but require a transparent marketplace.The Canadian healthcare system faces significant supply constraints affecting patient care.The conversation highlights the need for a balance between cost and quality in healthcare.Patient experiences reveal the complexities of navigating healthcare systems.Legislative changes can significantly impact healthcare delivery and patient outcomes.The role of algorithms in pricing can lead to inequities in healthcare access.Transparency in healthcare pricing is essential for informed patient choices.TitlesNavigating the Complexities of Modern HealthcareThe Ethics of Assisted Dying: A Deep DiveChapters00:00 Introduction and Overview of Healthcare Challenges02:01 The Canadian MAID Program: A Case Study10:28 Ethical Implications of Assisted Dying15:41 Economic Considerations in Healthcare26:52 GOP Health Savings Account Proposal34:55 Philosophical and Political Objections to Healthcare Reform38:32 Building Capacity in Healthcare38:51 The Ring of Power: Central Planning in Healthcare41:43 The Subscription Model of Healthcare43:27 Government's Role in Healthcare Funding45:09 Health Savings Accounts and Market Dynamics46:03 Dynamic Pricing and Its Implications59:03 The Case of Continuous Glucose Monitors01:02:30 The Future of Pricing in Healthcare🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X | — | ||||||
| 11/4/25 | Side Table: The 340B Dilemma: Who Really Benefits? | Send us a text📌 Why ListenExplore the complexities of the 340B program, its impact on healthcare systems, and the implications for both hospitals and independent clinicians. Understand the need for transparency and potential reforms to align the program with its original goals.👥 Co-HostsAnthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcherAnish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator📌 Episode OverviewIn this episode, the hosts delve into the complexities of the 340B program, exploring its origins, current state, and the implications for hospitals and independent clinicians. They discuss how the program, initially intended to support hospitals serving low-income patients, has evolved into a significant revenue stream for large health systems, often at the expense of independent practices and without clear benefits to the intended beneficiaries. The conversation also touches on potential reforms and the need for greater transparency and accountability.Episode Links https://www.healthaffairs.org/content/forefront/340b-drug-pricing-program-capped-safety-net-granthttps://jamanetwork.com/journals/jama-health-forum/fullarticle/2821579💬 Notable Quotes"340B was created to help hospitals serving low-income patients.""The program has expanded to include 60,000 sites.""Hospitals can profit by reselling discounted drugs.""Independent clinicians face competitive disadvantages.""340B funds are not always used for patient care."📚 What You’ll LearnThe origins and current state of the 340B program.How hospitals leverage the program for revenue.The competitive disadvantages faced by independent clinicians.The lack of transparency in fund usage.Potential reforms to align the program with its original goals.⏱ The Episode (Timestamps)00:00:00 Introduction to 340B00:03:00 The MRI Discussion00:09:00 340B Program Origins00:18:00 Current State of 340B00:27:00 Implications for Clinicians00:36:00 Calls for Reform🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X | — | ||||||
| 10/29/25 | When Politics Masquerades as Healthcare: A Deep Dive into Schumer’s Claims | Send us a text🎯 Why ListenWhen Senator Chuck Schumer joined Dr. Mike’s podcast to discuss “The Truth About the Government Shutdown,” the talk quickly became a lesson in political spin. In this episode, the co-hosts of The Rojas Report dissect Schumer’s claims, challenge Dr. Mike’s deference, and unpack the policy mechanics behind Medicaid, ACA subsidies, and America’s trillion-dollar healthcare debate. Expect blunt analysis, sharp data, and unapologetic truth-telling about what’s really driving costs.👥 Co-HostsDutch Rojas – Founder, Bliksem HealthAnthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcherAnish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentatorDan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocateSanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University📌 Episode OverviewThe team takes aim at Dr. Mike’s viral interview with Senator Schumer—an “objective” discussion packed with partisan narratives. They analyze the claim that 51,000 lives would be lost if ACA subsidies expire, break down Medicaid’s ballooning cost, and expose how CON laws and physician ownership bans stifle innovation.They reveal how so-called “cuts” usually mean slower spending growth, not reductions, and how government subsidies distort markets and drive dependency. From the flawed Yale study to the Medicaid surge, the hosts show how fear-based messaging distracts from the real issue: structural inefficiency and lost patient value.💬 Notable Quotes“This isn’t healthcare—it’s politics disguised as compassion.”“Schumer’s Law: when your only rebuttal is ‘you want people to die,’ you’ve lost.”“Physicians aren’t asking for permission to get rich. We’re asking for permission to build.”“Having an insurance card doesn’t mean you have care—it means you’ve been pacified.”📚 What You’ll LearnWhy the “51,000 deaths” claim collapses under scrutinyHow ACA subsidies and Medicaid expansion fuel inefficiencyThe economics of CON laws and physician ownership bansWhat’s driving the trillion-dollar Medicaid curveHow fear replaces facts in healthcare politicsWhy competition—not control—drives value⏱ The Episode (Timestamps)00:00 – Opening & host reunion02:00 – The “51,000 deaths” narrative05:30 – ACA subsidy breakdown08:00 – Rising costs & access failures17:00 – Medicaid myths and market distortion21:00 – CON laws & physician freedom28:00 – The trillion-dollar Medicaid surge35:00 – Political spin & “you want people to die”44:00 – Government control vs. patient value47:00 – What real reform looks like🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X | — | ||||||
| 10/10/25 | The ACA Bubble: How Insurance Giants Hijacked American Healthcare | Send us a text🎯 Why ListenThis episode of The Doctor’s Lounge cuts straight into one of the most polarizing questions in U.S. healthcare: Did the Affordable Care Act (ACA) fix the system—or hand it to corporate interests? The doctors debate how government mandates, corporate lobbying, and political theater have created a bloated insurance economy that benefits everyone but patients and doctors.👥 Co-HostsDutch Rojas – Founder, Bliksem HealthAnthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcherAnish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentatorDan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voiceSanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur📌 Episode OverviewThe doctors dissect how the ACA’s “essential health benefits” reshaped the insurance market—outlawing affordable catastrophic plans and driving premiums sky-high. From the Oregon RCT to RAND data, they reveal how mandated coverage hasn’t improved health outcomes but has fueled massive corporate profits. The group also connects the dots between nonprofit hospitals, political paralysis, and the healthcare bubble that could rival the 2008 financial crisis.They ask the hard questions:Why do politicians fight over “coverage” while ignoring the cost of care?Is America heading toward single payer—or collapse?Can innovation, transparency, and cash-based models save us from our own system?💬 Notable Quotes“Coverage is not care.” – Dr. Anish Koka“If I don’t change my tires, I risk an accident—but that doesn’t mean auto insurance should pay for tire changes.” – Dr. Anthony DiGiorgio“The number one problem in the U.S. isn’t debt—it’s premiums. Congress could fix that tomorrow.” – Dutch Rojas“Hospitals were once charities. Now they own 6% of major cities.” – Dr. Dan Choi📚 What You’ll LearnHow ACA mandates distorted the insurance marketplaceWhy nonprofit hospitals are “too big to care”The difference between coverage and care—and why the public confuses themHow regulatory gridlock blocks innovation in healthcare deliveryThe real economics of “float” and why insurance giants love the status quoWhat happens when the healthcare bubble finally pops⏱ The Episode (Timestamps)00:00 – Why tire changes and colonoscopies shouldn’t both be “insurance”02:00 – Dr. Choi on ACA subsidies and the outlawing of catastrophic plans06:00 – Essential health benefits: paternalism or policy failure?09:00 – The illusion of coverage vs. the cost of care12:00 – The business of “float” and how insurance companies built empires15:00 – The $34 trillion industry and why catastrophic plans could end it20:00 – Politicians, ignorance, and the illusion of reform27:00 – Nonprofit hospitals: charity or corporate real estate giants?35:00 – Americans waking up to the healthcare paradox43:00 – The bubble nobody talks about: premiums and power49:00 – The rise of DPC🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X | — | ||||||
| 8/9/25 | Medicaid: The Safety Net with Cracks | Send us a text🎯 Why Listen:A candid conversation on whether non-compete clauses in physician contracts harm doctors, patients, and the healthcare system — and what real reform might look like.Co-Hosts:Dutch Rojas - Private Healthcare AdvocateAnthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher.Anish Koka, MD – Private practice cardiologist, Philadelphia; healthcare policy commentator.Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice.Sanat Dixit, MD, FACS Episode Overview:Dutch and Anthony tackle the controversial topic of non-compete clauses in physician contracts — exploring their history, how they affect patient access, and whether proposed bans could change the landscape for both independent and employed doctors. Along the way, they discuss the unintended consequences of eliminating non-competes, the corporate pushback against reform, and what a balanced solution might look like.Notable Quotes:“When a hospital locks down a doctor with a non-compete, they’re really locking down the patients.” – Anthony DiGiorgio“If we want more competition in healthcare, we can’t keep building fences around physicians.” – Dutch RojasThe Episode:00:00 – Welcome & Introduction01:10 – What Are Non-Competes?03:45 – The History Behind Physician Non-Competes07:20 – How Non-Competes Limit Patient Access10:40 – The FTC’s Proposed Ban & Pushback15:05 – Hospital Arguments for Keeping Non-Competes19:15 – Potential Unintended Consequences24:00 – Case Studies: When Non-Competes Hurt Communities29:30 – Alternatives to Non-Competes34:50 – What Real Reform Could Look Like38:10 – Closing Thoughts🔗 Connect with the Hosts: • Dutch Rojas on X • Dr. Anthony DiGiorgio on X • Dr. Anish Koka on X • Dr. Dan Choi on X • Dr. Sanat Dixit on X | — | ||||||
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