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, subsidies, and politics

• Why premiums are now the second-largest financial burden after taxes

• What’s really driving 20% of GDP in healthcare spending

• Why DC never sides with physicians—and how the AHA keeps winning

• The math behind a consumer uprising that’s already underway

Heath also reveals the untold story of physician-owned hospitals, the billion-dollar arbitrage that keeps independent doctors locked out, and why the next 12 months will decide the future of the profession.

If you’re a physician who wants independence, leverage, and a path out of the health system trap, this episode is a wake-up call.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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 monopoly shield for the state’s largest nonprofit health systems — and a perfect environment for fraud to thrive.

In this episode, Dutch breaks down how the fraud happened, why the oversight failed, how whistleblowers were ignored, and why Minnesota’s monopoly structure keeps premiums high for families, employers, Medicaid, and Medicare.

This isn’t a partisan story. It’s an incentive story.

When competition is illegal, fraud becomes easy — and prices explode.

If you want healthcare that’s affordable and accessible, start by understanding how Minnesota became the national case study in what not to do.

Full breakdown and receipts on Substack.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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 malpractice, property, and enterprise-risk insurance can be re-engineered to give physicians control instead of draining their operating cash. They cover how to move from premiums to contributions, how to build real enterprise value, how to handle property challenges nationwide, and how multi-specialty groups can insure risks no carrier will touch.

TACTICAL TAKEAWAYS

Physicians can own their own insurance company through a captive—and keep underwriting profit.

Premiums are expenses you never see again; contributions build assets.

Captives allow you to manage claims internally instead of fighting third-party carriers.

Years of actuarial data make practices perfect candidates for self-funded medmal.

Small groups (10+) can build enterprise-risk captives covering risks no carrier underwrites.

Distributed risk across physician-owned captives can reduce property costs nationwide.

Control is the most valuable asset physicians are missing today.

WHO THIS IS FOR

Independent physicians
POHs
ASC owners
Multi-specialty groups
Operators tired of watching insurers build wealth on their backs
Anyone looking to understand enterprise-risk strategy in healthcare

CALL TO ACTION

If you’re a physician who wants to stop paying for someone else’s jet and start building your own balance sheet, subscribe and watch the full episode of The Rojas Report every week.

DUTCH’S MISSION

Affordable and accessible healthcare for everyone, everywhere—powered by physicians who own their future.


4. CONNECT WITH DUTCH: Stan.Store/DutchRojas

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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 with the Marines

• How PBMs manipulate drug pricing

• Medicare Advantage denials and algorithms

• Why employers stay loyal to BUCA plans

• Why young physicians feel trapped

• What it will take to rebuild independence in American healthcare

• Why patients and physicians must unite

A candid, energizing conversation with someone who understands medicine, service, and policy at a deep level.

Follow Dr. O’Leary

X: @RealDocSpeaks

Follow Dutch

Say thank you and Buy Dutch a Cigar: stan.store/dutchrojas

Connect with Dutch on all his socials: stan.store/dutchrojas

Tags: navy physician, marine corps, medicine, healthcare reform, PBMs, Medicare Advantage, healthcare prices, independent physicians, Veterans Day, Dutch Rojas

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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 one of the most powerful tools for independent physicians.

– How he used it to build collaborations, research projects, and entrepreneurial deals.

– Why protecting your name and your voice is non-negotiable in today’s healthcare landscape.

– The traps young doctors fall into when signing their first contract.

– How private practice physicians can avoid isolation and build real leverage.

– What he learned the hard way: consulting, mistakes, financial literacy, and the year-long “residency” every new practice owner must go through.

This is a blueprint for young doctors preparing to enter the workforce, and a reset for established physicians who feel stuck inside corporate healthcare.

If you’re a resident, fellow, private practice doc, or someone who wants to understand what’s actually happening behind the scenes in American medicine, this episode is essential.

Listen in.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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, and it’s the real reason premiums keep rising.

Dutch and Dr. Deep go deep into:

• Why commercial premiums are the lifeblood of large health systems

• Why catastrophic coverage disappeared

• How ACA rules locked consumers out of affordable plans

• Why employers tolerate 12–20% annual increases

• Why social media feels insane

• Longevity, VO2 max, and living to 120+

• Sleep, muscle loss, and decline

• Medicine 3.0 vs Medicine 2.0

• The model behind Velocity Health Clinic

• Why physician-led care is the only credible path forward

• What policy changes matter in the next 6–12 months

This is a practical, honest, wide-ranging conversation about health, policy, longevity, and the economic incentives shaping American medicine.

New episodes weekly on The Rojas Report.

CONNECT WITH DR. DEEP

Velocity Health: www.velocityhealth.com
X: @DrDeepMD
LinkedIn: https://www.linkedin.com/in/sandeep-palakodeti-md-mph-1b03436a


CONNECT WITH DUTCH / THE ROJAS REPORT

X: @DutchRojas
LinkedIn: linkedin.com/in/dutchrojas
YouTube: @dutchrojas
Substack: dutchrojas.substack.com

healthcare, premiums, employers, insurance, Dr Deep, Sandeep Palakodeti, Dutch Rojas, Rojas Report, Velocity Health, longevity, Medicine 3.0, preventative care, healthcare reform, VO2 max, catastrophic coverage, health policy

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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 taxes over the last decade

• $8 billion in annual revenue

• $12 billion in assets

• $522 million in 2024 profit

• $1.28 billion in 2021 profit

• 0.2% charity care — not a typo

• Millions in zero-interest executive home loans

• Over $1.1 billion in Medicaid supplemental payments

• A negative fair share of nearly $200 million

Stanford Health isn’t a safety net.

It’s a state-backed financial machine, a tax-exempt private empire, operating behind a nonprofit halo.

Dutch explains how we got here, why lawmakers allow it, and what this model means for your premiums, your community, and the disappearance of independent physician practices.

If you want to lower premiums in America, you need to understand this system first.

Support The Rojas Report

If you want to support these efforts, Buy Dutch a Cigar at Stan.Store/Dutch Rojas or connect with Rojas Media, or join the movement at The Rojas Report.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas

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 Ali and Dutch go upstream, to the incentives, structures, and quiet policy decisions that created the middleman economy now dominating medicine.

Dr. Ali breaks down:

• How physicians accidentally empowered intermediaries
• Why insurance CEOs earn more than entire clinical departments
• Why UX, design thinking, and hospitality matter more in medicine than anyone admits
• How “nonprofit” health systems became the most profitable corporations in healthcare
• The true impact of the Affordable Care Act and who wrote the rules
• Why burnout is a symptom of lost agency, not workload
• Why independent medicine is the only sustainable future

Dutch pushes further, into Medicare overpayments, the pricing distortions created by consolidation, the illusion of “virtue” in large health systems, and why the American medical economy rewards opacity instead of outcomes.

This episode is philosophical, technical, and deeply practical.

Dr. Ali explains why he built his own EMR, how surgeons should reclaim the patient experience, and what happens when capital, policy, and medicine collide.

If you’re a physician, policymaker, founder, or anyone trying to understand why American healthcare became a corporate labyrinth, and how to escape it, this conversation is essential.

Dr. Ali: https://www.evofoot.com/

Dutch Rojas: https://www.bliksemhealth.com/

Topics covered include:

middlemen, incentives, pricing, UX design, physician independence, Medicare pricing, ACA politics, burnout, workflow engineering, and the future of doctor-led healthcare.

The Rojas Report is built for people who want the truth without the spin — and who refuse to accept a system where the middlemen own the doctors.

Listen, share, and join the physician-led movement to rebuild American medicine.

Support the show

If you want to support these efforts, Buy Dutch a Cigar, connect via socials, or collaborate, visit:

👉 Stan.Store/DutchRojas