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Since yall always complain about Health Insurance I decided to start a YouTube channel to help EVERYONE reduce their health insurance costs. Please like, subscribe, and reach out. You are not alone!!
Health Insurance 101 for Dummies youtu.be/tbvVRcxvaVg?si=1W94… via @YouTube
Brilliant post!
Healthcare is a velvet cartel, sustained not by competition, but by regulatory capture.
Cartels cannot survive in genuinely competitive markets. They require barriers to entry, restrictions on supply, insulation from competition, and mechanisms to protect incumbent interests. Government provides all four.
American healthcare has institutionalized these protections in both the delivery and the financing systems.
1. Delivery: Certificate-of-need laws restrict market entry. Scope-of-practice regulations constrain competition. Licensing and credentialing create barriers. Consolidation concentrates market power.
2. Financing: Government dictates reimbursement methodologies. Tax policy privileges employer-sponsored insurance. Regulatory complexity favors incumbent insurers. Public dollars flow through intermediaries whose revenues depend upon preserving their position.
The result is a market where capital, patients, and physicians are subordinated to institutions. The genius of the arrangement is that its beneficiaries need not collude. They need only defend the regulatory framework that protects them.
The velvet cartel doesn’t need to eliminate competition. It merely needs government to decide who is permitted to compete. And they spend millions upon millions of dollars ensuring that legislators and regulators, from city halls to Washington, serve as the consiglieri of the velvet cartel.
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TJ Berke retweeted
CMS is actively destroying independent physicians just like they are actively destroying independent pharmacies by sitting on idle for years not regulating PBMs.
TJ Berke retweeted
The claims of the ACA were:
1. Going to save families $2,500 a year
2. Going to lower the deficit
3. You could keep your doctor
The reality is:
1. 80% of doctors are employed
2. The costs of health insurance have exploded
3. The insurance companies are seeing record profits
4. One in five in-network claims are denied
5. One in three out-of-network claims are denied
We have to borrow money to subsidize the companies that are the problem.
Americans deserve better; eliminate the ACA!
Day ✌🏼 of Open Enrollment — contact me via email [email protected]
I have access to all kinds of plans both on or off the marketplace — would not recommend ACA bc of large prices and limited networks. There are PPO plans available for a third of the price.
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TJ Berke retweeted
Banner day @KaufCare … Wow
Growing steadily and today felt like a full-on ER shift.
- cyst removal
- massive facial lac to bone
- IV meds with complex presentation
- X-rays
- several chill cases
- US r/o DVT
AWESOME.
Volume ✅
Revenue ✅
Absolutely in love with practicing medicine again.
Nothing stops this train.
…And to cap it off, a patient emailed me one of the most profound and meaningful thank-you emails of my career.
This is the way we were meant to practice medicine.
Period.
TJ Berke retweeted
The Future Is Written With Your Intentions:
You & The Stone
Hi, Prolotario here. You have been telling yourself the same lie for years. Tomorrow. Tomorrow you start. Tomorrow you get serious. Tomorrow the version of you that actually does the thing shows up.
Tomorrow never came. It's been tomorrow since 2019.
You watch them win. Scroll past their wins with a sour stomach and a thumb that won't stop moving. You call it "being happy for them." It's envy wearing a smile. You know it. They know it. The algorithm knows it.
You have every excuse in the book dog-eared and memorized. No time. No money. No connections. Bad timing. Bad luck. Bad start. Bad hand. You've rehearsed the excuses so many times they sound like facts. They are not facts. They are choices dressed as circumstances.
Here Is The Ugly Truth You Keep Avoiding:
You are not behind because life cheated you. You are behind because you kept waiting for a better moment to start. Your worst moment is where you are. Is that not enough to get moving?
The moment was never coming. The moment is made. Brick by brick. Ugly, slow, unglamorous, one stone at a time. The giant doesn't fall to the guy with the best plan. He falls to the guy who picked up the stone while everyone else was still talking about how big the giant was.
Your intentions are the blueprint. Your actions are the mortar. Without both, you're just a person with a dream and a phone full of screenshots.
Stop waiting to feel ready. Ready is a feeling invented by people who never moved. Move first. Feel it later.
Stop watching. Start building. The future is not something that happens to you. It is something you write and the pen has been in your hand the whole time while you complained about not having paper to write it on.
No mercy. No rewrite. No rerun.
Pick up the stone.
It's Game Time Rookie
God is with you.
TJ Berke retweeted
The PBMs and their cousins, the GPOs, have an exemption from a Medicare fraud and abuse statute.
That is the Anti-Kickback Statute. Either the law is good and should apply to everyone, or it sucks and should be repealed.
Full episode here: youtu.be/lPsNHC5P-h0?si=nMii… @AndreaBee00722 @DutchRojas @HeathVeuleman @Laffincrow @noahkaufmanmd @BrandiChane
TJ Berke retweeted
this post is 100% incorrect.
1. the PBM‘s are owned by the insurance companies and that is the first conflict of interest.
2. The PBM‘s don’t negotiate discounts at all. They negotiate rebates that don’t go to the customer at the pharmacy counter.
3. The PMs increased the list price, and that is what the patient see at the pharmacy counter. If they have a high deductible, or if they are uninsured, they are paying this false increased this price.
We don’t need PBM’s, and the major PBM’s elevate, the price of prescription drug drugs.
This Post is from a suspended account. Learn more
London❤️
Without Jesus Christ. My Lord and Savior, o would have never qualified for this trip through one of my insurance carriers.
We have ❤️ it so far. Out here just living life and thanking God for all this.
Here I am, but there o was.
Love this life
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Happy Labor Day to all the breadwinners out there.
Can’t think of a better way to celebrate than with a glass of champagne and a pedicure.
Hard work pays off — my family is fed and housed and we’re headed to London on Tuesday as a reward from one of our carriers. Grateful ❤️
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TJ Berke retweeted
for all my criticisms about our healthcare system i think every other country has it worse and it’s not even close
and we routinely subsidize clinical research for the rest of the world
TJ Berke retweeted
The Questions to ask your Broker before renewal.
Write these down or copy and paste them.
1. How much are you paid on my account — ALL of it? Commissions, overrides, bonuses, contingent compensation, retention payments, trips, and anything else, direct or indirect.
2. Who actually pays you — me, or the carrier?
3. Do you earn more when my premiums go up?
4. Am I a fiduciary of this health plan?
5. Will you accept fiduciary status on this plan, in writing?
6. What do my hospital contracts actually pay as a percentage of MEDICARE — not as a "discount" off billed charges?
7. Do I own my claims data, and will I receive it — complete and monthly? Detailed?
8. Who keeps the pharmacy rebates — and can we audit the PBM contract?
9. Will you help me pull the federally mandated machine-readable files and see the actual negotiated rates at my top hospitals?
10. If I use a network, are fees charged for negotiation of out-of-network claims?
Pro Tip: The fiduciary liability on your health plan is yours, and employees have started suing plan sponsors over exactly the money these questions expose. Your broker keeps the commission either way. If they can't answer these questions clearly, confidently, and in writing, they're either uninformed or working for someone else's benefit — not yours. Walking away isn't rude. It's prudence, and prudence is your legal duty.
TJ Berke retweeted
@DutchRojas is calling for the development of a commodities market for all non-emergent medical services.
Every day, the commodities markets set the price for all types of:
• Energy
• Metals
• Agricultural products
• Flowers
The prices are transparent and available to all. The Flower market is in Amsterdam and is available to tour.
I agree that we need a market-based approach to healthcare, and we need to lower prices so much that there is NO room for middlemen. @HeathVeuleman @anish_koka @DrDiGiorgio @AtlasMD @SurgeryCenterOK
What a legacy Dolly left. Literally uniting X and we’re all mourning together
She was such a gift to us for God. Generations just enjoyed her presence.
Well done good and faithful, Doll
We will all miss you forever 🦋
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TJ Berke retweeted
youtu.be/uez2iMiWTL0?si=oh0x… Today's episode of the RealDocSpeaks Podcast is with @DutchRojas, and he never disappoints!
Dutch covers a wide range of great topics including:
• Physician-owned hospitals
• Direct Contracting
• Cooperation among doctors
And so much more. Please listen and comment.
@HeathVeuleman @HEALTHCOSTtruth @molsjames @anish_koka @tiffanyryderusa @KatyTalento @AtlasMD @SurgeryCenterOK
TJ Berke retweeted
I highly encourage patients to find an independent pharmacy and pay cash for most things.
If you don't support them now, they will not be there when you need them.
We need to teach big chains a lesson--this crap won't stand!
