The Pursuit of Health: a podcast on health policy for a free and modern society.

Regulations heavily skew the American healthcare market in favor of big hospitals at the expense of independent doctors. The Centers for Medicare and Medicaid Services (CMS) has proposed modest rule changes to facility fees and the 340B drug program, which hospitals have previously used to consolidate healthcare markets. Anthony DiGiorgio joins us to explain these rule changes and how they will he...

Dealing with health insurance can be deeply frustrating, as John Oliver recently highlighted on Last Week Tonight by taking aim at UnitedHealthcare. While most people blame these systemic failures on the profit motive and look to the government for a solution, the real culprit is using insurance to pay for too much of our care. To regain control and truly protect us from financial catastrophe, we...

Health insurance has constrained the imagination of how doctors and patients can interact. What if, for most of healthcare, doctors and patients shrug off health insurance and build something new? That's the idea behind Direct Primary Care, and in this episode of Healthcare Builders, Josh Umbehr explains how rejecting the comprehensive health insurance paradigm gives doctors and patients the freed...

Medicare for All is presented as both a radical yet sensible alternative to the failing status quo of American healthcare. It isn't. In this episode, Drs. Colleen Smith and Reinier Schuur expose the myths about Medicare for All and point to the real lessons of healthcare from other developed nations, namely, cost-sharing for public programs and a truly private parallel healthcare market. Enjoyed t...

Adjusted for inflation, Medicare has been paying physicians less every year since the implementation of the Physician Fee Schedule in 1992. As a result, independent physicians have either joined the better paid hospital systems or left medicine altogether. In this interview, Dr. Anish Koka offers a simple solution that does not require paying physicians more with taxpayer dollars, namely, to repea...

In our new series on Healthcare Builders, Reinier Schuur interviews Nick Vailas about his wide-ranging career in healthcare from the private to the public sector and back again. Nick Vailas is a serial healthcare entrepreneur, setting up the first ambulatory surgical center in New Hampshire, and serving at the state's commissioner of Health and Human Services, after which he spent 8 years as the c...

Hospital lobbies defend protectionist policies—like Certificate of Need laws and ACA Section 6001—by arguing they need to cross-subsidize unprofitable services to survive. But does keeping competitors out actually justify a broken system? In this episode, Jared Rhoads and Reinier Schuur unpack the economics of cross-subsidization, why traditional hospitals view competition as a threat, and what it...

Much of healthcare in American is regulated at the state level. Because of this, there can be big differences between states in how free they are in healthcare. How free is healthcare in your state? The Center of Modern Health, in collaboration with the Knee Regulatory Center at the University of West Virginia, is proud to present a resource to answer just that question: The 50-State Health Freedo...

The New York Health Act (NYHA) is being sold as a 'public option' health policy to New Yorkers. But make no mistake, there is nothing optional about the NYHA. In this episode, Reinier Schuur and Colleen Smith explain how the NYHA would effectively prohibit the private practice of medicine in New York, stripping providers and patients of their freedom of choice in healthcare. Besides the NYHA's mon...

Our environments do shape our health, yet most attempts to capture such data is mixed in with the assumption that government programs should get more involve in our own pursuit of health. In this article, Jared Rhoads challenges this assumption by arguing how the study of so-called social-determinants of health should instead be used to empower individual choice. You can read the article 'Social D...

The first federal Right to Try legislation was passed in 2018, giving patients with terminal illnesses the right to try investigational drugs without having to wait for lengthy FDA approval over the drug's efficacy. The second Right to Try legislation being proposed fills an important gap, the right to individualized treatment that can't be tested on large groups of people. In this episode, I inte...

Americans are fed up with how they pay for prescription drugs. It's overly complex and opaque. In this episode, Tina Marsh Dalton explains how the complexity of prescription drug pricing is primarily driven by having them covered with health insurance, and challenges us to consider a radical solution: de-insuring most prescription drugs so that consumers can shop for them. Check out Tina Marsh Dal...

Hospitals often use profitable services, like orthopedics, to prop-up unprofitable services, like emergency care. In this episode, Jared Rhoads explains how such cross-subsidization not only distorts healthcare prices, but also why we should challenge hospitals' use of cross-subsidization as a justification to prevent much needed market reforms in healthcare. Check out Jared Rhoads' article on hos...

The independence of physicians to practice medicine as they see fit has been eroded over the decades, with the collapse of independent practices and the growth of medical bureaucracy. What will it take to reclaim physician independence? In this episode, we argue that what it will take is to reclaim the very meaning of physician independence, not as an independence from market forces and business,...

Traditional insurers use provider 'networks' to negotiate lower prices for their policyholders, but they also limit choice and hide prices from patients. What if there is no-network? In this episode, Emily Kolego from Sidecar Health explains how her organization has expanded the idea of no-network health insurance, and how it liberates patients to shop for their own healthcare. We discuss the chal...

Pharmacy Benefit Managers (PBMs) are blamed for making prescription drugs more expensive for profit. Yet, PBMs play a necessary role in navigating a complex third-party payer system. In this episode, Jessica Dobrinsky argues that adding more regulations onto PBMs will simply contribute to the complexity and inflexibility that has distorted the drug benefit market to begin with. Instead, we should...

Corporate Practice of Medicine (CPOM) laws were intended to protect physicians from corporate control. But in practice, CPOM laws disarm physicians against corporations, including private equity backed takeovers. In this episode, we argue that doctors should embrace business, not insulate themselves from it, if they want to regain their professional autonomy. Please like, share, and subscribe to o...

Advocates for free-markets often argue that healthcare is not a right, not if defined as the right to someone else's labor. While not disputing this basic point, Jared Rhoads in this audio-article reframes the case for free-markets in terms of the right that we do have in healthcare, namely, the right to freely pursue our own health with those who can provide it to us in voluntary trade. This refr...

Section 6001 of the Affordable Care Act prohibits Physician-Owned Hospitals from receiving Medicare dollars for providing care to Medicare patients. Should we repeal Section 6001 to introduce more freedom in the healthcare system and competition against corporate-owned hospitals? Or should we maintain the ban if it saves taxpayer's money? This is a false alternative, and in this episode discuss wh...

Marty Makary and Vinay Prasad tried to reform the FDA, increasing standards for some drugs while fast tracking others. Now they are out. Was it impossible to both protect patients from low-value drugs and give quicker access to those who want to use drugs of disputed value? Jared Rhoads proposes a reform to the FDA that can resolve these conflicts, by separating the right the bring a drug to marke...

If acute healthcare services, so-called "sickcare", is more expensive than paying for preventive care to maintain your overall wellness, why don't health insurers invest more in prevention? The answer lies in a broken incentive structure. In this episode, health economist Tina Marsh Dalton breaks down why our system is built for "sickcare"—prioritizing acute crises over long-term wellness. We expl...

While patients no longer get surprise bills for seeing out-of-network providers, the No Surprises Act (NSA) has replaced them with new surprises for all stakeholders in healthcare. In this episode, we discuss how real prices, not more enforcement, is the only truly fair and practical solution to surprise bills and claims. Without real healthcare prices, expect surprises! To support our show, and t...

Large health systems claim Certificate of Need (CON) laws protect the community. In this episode, Jessica Dobrinsky exposes the truth: these laws aren't about serving patients — they are pure economic protectionism designed to stifle competition and access to care. Join us as we deconstruct the bureaucratic "permission slips" holding American medicine back. Check out Jessica's substack Clear Lines...

In this episode Jared Rhoads narrates his article 'Policy and Pluralism in the Age of Modern Medicine'. The future of medical progress and personalized care is incompatible with our one-size-fits-all approach to health policy. In order to truly harness the power of science to serve our individual health needs, the implicit medical paternalism in current health policy approaches needs to be replace...

Healthcare fraud is a billion dollar industry in America. The Trump administration has vowed to 'crush' healthcare fraud. We discuss the limitations of only pursuing bad actors to prevent healthcare fraud, and we argue that reforms should also focus on liberating honest providers. To support our show, and the Center for Modern Health, you can make a tax deductible donation here .