The Rojas Report

While everyone watched the front door for private equity, the house was being dismantled from the inside. The GAO report is clear: More than 50% of physicians are now consolidated with hospital systems. Private equity? 6.5%. The real predator isn't on Wall Street. It's the massive nonprofit complex right down the street. This episode prosecutes the case against university health system consolidation, what The Rojas Report calls "soft nationalization": the absorption of private medicine by ent...

Seven states found a loophole to extract $24 billion annually from federal taxpayers while contributing nothing to Medicaid. California alone took $13 billion. The scheme was technically legal until January 29, 2026. Dutch Rojas breaks down: The 157-to-1 tax ratio California used to game the system ($274/month for Medicaid plans vs. $1.75/month for commercial)How states used the B1/B2 statistical test as a "lockpick" for the federal treasuryWhy New York got a shorter deadline than other state...

Howard Kern retired from Sentara Healthcare in 2021. His payout: $33.2 million. Sentara is a nonprofit. Tax-exempt. A charity. How does a charity write a $33 million check to its CEO? A financial instrument called a SERP. A Supplemental Executive Retirement Plan. Your 401(k) limit: $23,000. Executive SERP limit: None. This episode breaks down the forensic accounting of nonprofit hospital executive compensation: THE MECHANISM: How SERPs let tax-exempt hospitals stockpile unlimited retireme...

A $12.5 billion industry. One million physicians paying in. And a wealth transfer hiding in plain sight. In this episode, we break down the malpractice insurance market and expose the financial structure that separates the renters from the owners. The data: Berkshire Hathaway collects $2.2 billion annually from physicians who treat insurance as an expense. Meanwhile, 75% of hospitals run their own captive insurance companies and keep the profits. The math is simple. A high-risk specialist pay...

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'...

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...

Dr. James O’Leary served as a Navy physician assigned to the Marines and carried those lessons through an entire career in medicine. After retiring, he became a powerful voice on X, speaking openly about PBMs, Medicare Advantage, physician autonomy, and the structural incentives that drive healthcare costs out of control. In this episode, Dutch and Dr. O’Leary explore: • Life as a Navy physician with the Marines • How PBMs manipulate drug pricing • Medicare Advantage denials and algorithms ...

In this episode, Dutch Rojas talks with Dr. Sandeep “Dr. Deep” Palakodeti about the financial engine running American healthcare — and the part nobody sees. Academic health systems break even on Medicare. They lose money on Medicaid. And they make their profits on one thing: commercial insurance paid by employers. That means employers and employees are subsidizing the entire healthcare system, and it’s the real reason premiums keep rising. Dutch and Dr. Deep go deep into: • Why commercial pre...

In this episode of The Rojas Report, Dutch sits down with Dr. Ali, physician, technologist, designer, and fierce defender of physician autonomy, for one of the most unfiltered conversations you will ever hear about the real forces shaping American healthcare. Most people blame one another for the system’s failures. Doctors blame insurers. Insurers blame hospitals. Politicians blame everyone. But Ali and Dutch go upstream, to the incentives, structures, and quiet policy decisions that ...

Dr. Sandeep “Deep” Palakodeti joins Dutch Rojas to unpack Medicine 3.0, a first-principles, physician-led approach to prevention and longevity. They explore what it takes to live to 150: VO₂ max as the most powerful mortality signal you can trainWhy muscle is the ultimate insurance policy against declineSleep as risk management for your brain and lifespanInsulin resistance and the decade of missed opportunity before diabetesThe science and structure of Velocity Health, a precision care model ...

Why Listen: An orthopedic surgeon who built and sold a physician-owned surgical hospital explains, in plain language, how practices win on contracts, culture, and capital. If you’re serious about independence, this is your operating manual for the next 12–24 months. 👥 Host: Dutch Rojas – Founder, Rojas Media and Bliksem Health Guest: Dr. James “Jamie” McAtee – Orthopedic Surgeon, Partner at Orthopaedic & Sports Medicine Center (Manhattan, KS); Co-founder/leader at Manhattan Surgical...

Why Listen? This episode dives into what drives the next generation of physicians to fight for their profession. Dutch Rojas sits down with neurosurgeon and podcast host Dr. JP Kolcun for a candid, funny, and deeply human conversation about the moral obligation to speak up, the optimism of young doctors, and why the future of medicine might depend on radical honesty and renewed physician leadership. Host: Dutch Rojas – Founder, Rojas Media and Bliksem Health Guest: Dr. JP Ko...