Gott's Gulch - Craig’s Substack Podcast

It is the single most common question I receive as a healthcare attorney and large group benefits consultant. On one hand, answer is frustratingly simple. The entire system is designed to extract maximum profit from your business. Every major player in the game makes more money when your healthcare claims go up. That includes the major insurance companies, massive hospital systems, Pharmacy Benefi...

I've always been a proponent of high-deductible health plans for individuals, families, and smaller employers who cannot safely self-insure or partially self-insure. However, once an employer self-funds, there are a couple of surprising ways in which installing a high-deductible plan can have a very negative impact on your employees and their families. The referenced podcast from Stacey Richter re...

Handcuffed by the standard of care. Twelve minutes or less with each of her 2,500 patients. Pushed to prescribe drugs she knows aren’t the answer. This is the reality of primary care today. Dr. J, as we’ll call her, is a two-decade veteran of primary care, a good friend, and an amazing doctor. In this episode of Gott’s Gulch, she tells us what so many of her peers whisper about between exam rooms...

I’ve been making visits on the Armstrong and Getty Radio Show for sixteen years now. That is a crazy thought. It is always a treat to join the crew, and for me, an even bigger treat that I didn’t have to talk about what an utter nightmare American Healthcare is during this visit! This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, vis...

Dr. Michelle-Linh Nguyen became a Direct Primary Care (DPC) doctor and launched her independent practice in a few short months, and nearly a year in, she’s spent less than $10,000 on the whole project. Yeah, it’s that doable. A DPC doctor is a primary care physician who contracts directly with patients or their employers for healthcare services, instead of billing insurance. Patients pay a flat mo...

Daron and I started in the industry within a year of each other, more than two decades ago. He’s about as guru-ee as gurus get when it comes to stop-loss insurance, underwriting, and self-funding. I had a fantastic time exploring all that and then some with him in this episode of Gott’s Gulch. 2:10 - MGUs, stop-loss, and reinsurance 9:00 - What is stop-loss insurance? 13:20 - Size of employers sel...

Oof. I knew it was going to be bad before I sat down with Zack this morning. But even with low expectations, I wasn’t prepared for just how dirty the PBM scams really are. Want to boast that you return 100% of rebates to your clients? Simple. Route the cash through a shadow intermediary in Europe, reclassify part of it as “appreciation dollars” or some other fictional nonsense, and voilà, you’ve t...

Ben Krambeck is the Founder, CEO & Chairman of the Board of Directors for ClaimDOC, a third-party claim auditing and member advocacy firm focused on creating clarity and transparency in the facility claim space. Also available on YouTube. Hour 1 * 00:00 Introduction & Co-Chair of the Board, Fritz the Giant Schnauzer * 09:28 How Did ClaimDOC Come to Be? * 10:42 Ben and Craig are INTROVERTS? * 26:18...

Whether I’m teaching HR and benefits, as an attorney, or an industry consultant, I’ve had the good fortune to assist several large organizations in selecting their employee benefits consultant. Having sat on both sides of this equation, I can tell you that businesses often focus on the wrong things. In this podcast, I walk through the five most important (and I also think most underrated things) a...

Dive headfirst into the wild world of Reference-Based Pricing, the game-changing strategy that's revolutionizing health plan cost containment like nothing else in the past two decades of employee benefits. Imagine stripping away the cumbersome layers of national carriers and their bloated PPO network fees, paving the way for a bold, new pricing model beyond the tangled web of the Government-Health...

Ever imagine healthcare could feel like the Wild West?  Welcome to the untamed lands of Reference-Based Pricing (RBP), the sizzling frontier where a select few employers unleash radical savings while giving the traditional PPO system a stiff arm. Unveil a world where only 3-4% of employers dare to tread, but where jaw-dropping 30-40% savings rain like gold and concierge-level service is the sherif...

Yesterday, while live with Joe Getty, a wave of nostalgia swept over me. Together with Jack, we had been at the forefront, passionately deliberating the budding transparency regulations in one of their seminal Extra-Large Podcasts. My memory estimated it to be roughly four years ago. Digging deep into the archives, I pinpointed the exact date: March 14, 2019. That pivotal conversation laid the bed...

Your health insurance costs and premiums have skyrocketed compared to the rate of inflation since Obamacare passed. Meanwhile, insurance carrier stock prices have grown by 1900% in the same timeframe. "They're making unimaginable amounts of money... off of you." -Joe Getty Craig Gottwals, aka "Craig the Healthcare Guru,” talks about that and more in a new episode of A&G's Extra Large Podcast. List...

Dive into the zany world of tournament bass fishing with Gary Dobyns – a true legend, a visionary entrepreneur, and the mastermind behind Dobyns Rods. Join us on a journey from a humble home bustling with a dozen foster kids in Olivehurst, California, to the glimmering heart of a 30,000-square-foot empire in Sulphur Springs, Texas. Along the way, explore the triumphs of 40 bass boat victories that...

The labyrinthine American health insurance system, while ostensibly designed to safeguard our health care dollars, is rife with the specter of fraud, a malaise that stealthily siphons off staggering amounts of money. More than $1 trillion — one of every three dollars that passes through the health care system — is lost to fraud, wasted on services that don’t help patients, or otherwise misspent. W...

This podcast discusses my article, We're All Paying More Than Double What We Should for Healthcare - How America's Government Programs, Insurers & Hospitals Relentlessly Pilfer Private Plans. Article: https://gottwals.substack.com/p/we-all-needlessly-overpay-225-for This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit gottwals.su...