The Rojas Report

HCA wanted out. SSM spent six months on due diligence and walked away without making an offer. Then the state of Oklahoma intervened and paid 10% above the asking price. This episode breaks down the OU Health transaction: how the purchase price increased by $75 million between court approval and closing, why Moody's downgraded the system to junk status, and how $1.5 billion in debt now rests...

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 c...

The best lack all conviction, while the worst are full of passionate intensity. Yeats wrote that in 1919.  It could have been written this morning. This week's Deep Dive sits with a harder question:  What if the people making the most critical decisions aren't villains? What if they're not evil at all? What if they're simply hollow? We explore: The difference between evil and a...

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...

As you may know, Dutch Rojas is the co-founder of The Physicians Capital Fund (PhyCap).  PhyCap is a physician-led venture fund that invests in healthcare startups.  All General Partners, except Dutch, are practicing physicians.   He is hosting this debate today to provide additional value and exposure for tech and venture to his physician audience.  Should venture capital be evaluated solely on f...

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...

You're staring at your 2025 P&L. Revenue flat. Expenses up 8-15% across the board. The profit margin that feeds your family is physically smaller than three years ago. The consulting class says run a tighter ship. Cut the bagels. Code better. That advice is a lie. You cannot efficiency your way out of a structural disadvantage. This episode dissects the MedMerge Investment Thesis and brea...

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...

A Sunday deep dive into the original meaning of freedom. We trace the word from 1581 Dutch merchants to the American founders. What we found: freedom wasn't about self-expression. It wasn't about rights. It was about one thing. A lack of dependency. The Dutch called it "ware vrijheid." True freedom. It stood on three pillars: local governance, religious toleration (as a talent...

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 empire...

In this conversation, Heath breaks down the brutal math reshaping American healthcare: 1.1 million physicians left. 68% employed by health systems. 12% employed by Optum. 6% by private equity. Barely 220,000 independent—and shrinking.   We talk plainly about: • Why physicians “had the opportunity of a lifetime in the last six months” and missed it • How hospitals weaponize provider taxes, subsidie...

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 monop...

Physicians have no idea they can own their own insurance company—and stop bleeding cash into carriers who never return a dime. In this conversation, Collin Krickl breaks down how captives, self-funding, and enterprise-risk coverage can transform a practice’s balance sheet. CLIP SUMMARY Dutch sits down with Collin Krickl of Leon Capital & Bastion Insurance Group to explain how medical malpracti...

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 w...

In today’s episode, I sit down with Dr. Jahangir Asghar for one of the most honest conversations we’ve had on this show. We talk about the part of medicine nobody teaches you: how to build a real career, protect your autonomy, negotiate the contracts that shape your life, and use social media as a strategic advantage instead of a distraction. Dr. Asghar breaks down: – Why social media has become o...

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, an...

Why are your premiums so high? Because Stanford Health perfected a state-sponsored wealth extraction model — and did it while flying a nonprofit flag. In this 5-minute breakdown, Dutch Rojas walks through the numbers Stanford never wants the public to hear: • $17 billion in tax-exempt property • $170 million per year in lost funding to schools, roads, and public services • $1.7 billion in avoided...

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 A...

Dutch Rojas and Dr. Anthony DiGiorgio sit down with one of the most respected physician leaders in America, Dr. Carlos Cárdenas , President of PHA and Co-Founder of DHR Health, the only physician-owned Level 1 trauma center in the country. Dr. Cárdenas shares how a handful of doctors in South Texas built a full-service health system from the ground up — guided by one belief: if you take care of yo...

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 train Why muscle is the ultimate insurance policy against decline Sleep as risk management for your brain and lifespan Insulin resistance and the decade of mi...

Section 6001 of the Affordable Care Act quietly outlawed physician ownership of health systems. It was buried deep in the legislation, yet it changed everything about how medicine is practiced in America. Keywords: Section 6001, physician ownership, Affordable Care Act, healthcare reform, independent medicine. This episode was recorded live at the Physician-Led Healthcare for America (PHA) Summit...

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 Orth...

🎯 Why Listen What if patients and doctors could finally see behind the curtain of healthcare pricing? In this episode, Dutch Rojas speaks with the founders of MedReveal—three brilliant student entrepreneurs solving one of the most frustrating problems in medicine: price transparency. Discover how they’re empowering independent practices, fighting for fair negotiations, and wrangling absurdly mass...

  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 leade...

While the government shuts down, America’s largest health agencies keep running on autopilot, funded not by Congress, but by user fees and hidden subsidies.  In this solo briefing, Dutch Rojas dissects how the system continues to enrich insurers and health systems while squeezing out independent physicians and driving premiums ever higher. Host Dutch Rojas: Founder, Rojas Media and Bliksem Health...