Mark Root

They’re not buying your practice because they need doctors. 𝐓𝐡𝐞𝐲’𝐫𝐞 𝐛𝐮𝐲𝐢𝐧𝐠 𝐲𝐨𝐮𝐫 𝐩𝐫𝐚𝐜𝐭𝐢𝐜𝐞 𝐛𝐞𝐜𝐚𝐮𝐬𝐞 𝐌𝐞𝐝𝐢𝐜𝐚𝐫𝐞 𝐩𝐚𝐲𝐬 𝟓𝟎–𝟏𝟒𝟓% 𝐦𝐨𝐫𝐞 𝐰𝐡𝐞𝐧 𝐲𝐨𝐮’𝐫𝐞 𝐡𝐨𝐬𝐩𝐢𝐭𝐚𝐥-𝐨𝐰𝐧𝐞𝐝. Same procedure. Same you. Same room. That’s the facility fee. That’s the game. Catholic health systems have acquired hundreds of physician practices. Not to improve care. To capture the billing code. Once you’re inside: → You refer inside → You bill inside → You follow the ERDs Meanwhile: → $3.8 billion in fair share deficits → 2.7% charity care (below national average) → $28 million CEO compensation. → 688 communities with no alternative hospital Ministry on the letterhead. Facility fees in the spreadsheet. Full breakdown dropping today on The Rojas Report at 11:30 EST.

Senator Warren, that’s a compelling soundbite, but let’s deal in facts, not fear. If hospitals are shutting down because they lose access to Medicaid bonuses not payments for care, but bonuses, then maybe YOU built a system more addicted to political subsidies than patient outcomes. Medicaid was meant to be a safety net, not a business model for billion-dollar institutions. Yet your favorite nonprofit health systems in Massachusetts, let’s not pretend we don’t know who they are—receive DSH, UPL, GME, IME, and waiver payments worth hundreds of millions. And then they cry poor, threaten closures, and hike prices on employers while underpaying the physicians who actually do the work. Meanwhile, the independent physicians serving 80% Medicaid populations? They get nothing. No commissions. No bonuses. No headlines. Just losses. And here’s the part you don’t say out loud: If you and the rest of the Senate who don’t actually govern a damn thing about real patient access would simply allow all physicians to receive the same Medicaid bonuses your favorite health systems receive, we wouldn’t have a problem at all. In fact, patients would finally get real access to care and not be forced into ERs where your politically protected hospitals routinely screw over patients and taxpayers under the banner of “community health.” So here’s the challenge, Senator: Open the books. Level the field. Stop confusing political payments with moral high ground. Because the system is rigged. And you helped build it. Not #healthcare

The ACA was the greatest piece of legislation ever passed? Spare me. Such a claim is not merely hyperbolic, it is historically illiterate. The Affordable Care Act passed in 2010, was not a triumph of reform but a masterpiece of political theatre and economic distortion. It did not fix the American healthcare system; it calcified its worst features. The ACA entrenched a reimbursement model that favors bloated health systems over independent medicine. Through CMS, Medicare reimburses more for services rendered in hospitals and HOPDs than independent physician offices. The consequence? A wave of acquisitions. Once nimble and patient-focused, private practices were absorbed by not-for-profit health systems looking to maximize revenue through arbitrage, not outcomes. This is not reform, it is rent-seeking on an industrial scale. Second, mandated coverage inflated prices while distorting risk. One of the ACA’s proudest boasts, essential health benefits, became its most economically illogical mandate. Insurers were forced to cover services like maternity care for men and pediatric dentistry for retirees. Risk pools were distorted. Premiums soared. The healthy were penalized to subsidize the inefficient. In pre-ACA America, a healthy 30-year-old could purchase catastrophic coverage for a few hundred dollars a month. Post-ACA, that same individual faces a $1,200 monthly bill for insurance they neither want nor need. The state declared, in effect, that every American must buy a Mercedes, even if they only needed a bicycle. The claim that “50 million Americans gained coverage” is semantically clever and substantively hollow. Coverage is not care. The expansion of Medicaid, a key pillar of the ACA, placed millions into a program that few physicians accept and that delivers subpar outcomes. The middle class, meanwhile, found themselves with narrow networks, enormous deductibles, and unaffordable care, all behind the illusion of a plastic insurance card. This is the Potemkin village of healthcare: coverage without capacity, access without agency. Finally, the ACA codified a cartel. Section 6001 of the law effectively banned the creation and expansion of physician-owned hospitals. Why? Because physician-owned facilities outperformed corporate health systems in terms of quality and cost. The empirical record was clear. So, instead of fostering competition, Congress, lobbied by the AHA and its allies, shut it down. Imagine a world in which Amazon had lobbied Congress to outlaw any new e-commerce startups after 2010 under the guise of “market stabilization.” That is precisely what happened in healthcare. The ACA chose incumbency over innovation. It outlawed the insurgents and rewarded the monopolists. In sum, the ACA is not a monument to progress, it is a monument to protectionism. It preserved the oligopoly of legacy health systems, empowered insurers by mandating the purchase of their products, distorted prices, crushed physician autonomy, and locked out competition. To call it the “greatest” legislation of our time is to mistake technocratic complexity for genuine reform. It was corporate statism painted in the pastel colors of progressive compassion. #healthcare