What I Learned from Marilyn Bartlett

At the #healthrosetta conference, I learned from #MarilynBartlett

  • 340(b) set up in ‘92 by feds to allow non-profits wholesale access to Meds—so to fulfill the mission serving the poor.
    No provision forced anyone to pass this through to the needy so it became a cash cow.
  • Bigs hijacked it so today most of the 67,000 players shuffle profits from pharma into the hospital. Ex Humira costing 1 penny is charged out at $5000. Hospitals enjoy the difference. Other middles. I was asked by a CEO do docs get rich off drugs they sell? No, that’s not how medicine works— but was half wrong. That IS how medicine works for Bigs, Community Clinics, “Charitable” players some of whom ignore mission statements invoking God. Serving. And those some often have skyboxes, private jets, and offshore accounts. They’ve lost their way. Confused by abundant opportunity to drive EBITDA.

States are reeling this boondoggle in. State AGs with ambition and cajones will revoke nonprofit charters.

My Conversation with an Orthopedic Surgeon

I had to ask the #orthopedicsurgeon twice last night at dinner.

“Ron, I make $2,000 per surgery. That’s it.”

I asked where does the other $106,000 go? He truly did not know but agreed in his career spinal surgeons once made healthy seven figures. He’s at half that now. What happened?

How do I get a better-paying client? He asked.

Via direct contracting with the likes of #SanoSurgery who connects him to employers who are self-insured. I used to think everyone in healthcare was getting hammered except docs like him. I live in a future where everybody wins. #Doctor #Employer #Customer / #Employee.