CEO | Former @WhiteHouse Health Policy Advisor | Recovering Epidemiologist | Naturopath. Hacking the systems that control our health.

Washington, DC
Joined May 2019
The nurses didn't disappear. They left the bedside. Post one nurse navigator job for an employer health plan and hundreds apply. Why do you think that is? Tell me in the replies.
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Hospitals are the most square footage of (tax-free) real estate in America. Are they worth it? You don’t know what anything costs until you get the bill after the fact. But the financial scam would be less egregious if the place were pleasant, flexible, customer/patient-centered. To say it's not is the understatement of the century. I wrote this one about why the modern hospital experience feels so completely detached from the person it supposedly exists to serve. Sharing here in case you missed it (link in comments).
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You went to an in-network ER and still got an out-of-network bill. A law protects you from that, and the form the hospital hands you may be trying to sign it away. Follow for the fine print they hope you don't read.
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We fought for years to make health care prices transparent. The White House economists' argument against it was always the same: "Patients aren’t going to shop for health care" Well, they were right. But they were just wrong about why it mattered. Patients were never the audience. Employers were. I joined Troy Reichert and Dr. Jonathan Bushman on their Patients Win podcast to talk about the fight for price transparency, what employers can finally do with that data, and why the next fight is cash pay at scale. Check it out at the link in comments.
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A pill for every symptom, and the incentives point the wrong way. A healthy customer doesn't come back. Who profits when you stay "managed"? Tell me in the replies.
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For years, I’ve said real health reform means tackling the employer market instead of just arguing over the ACA. Well, it’s happening, and Peter Nelson @CMSGov is leading the charge (along with Daniel Aronowitz at @USDOL). Check out the delicious details at the link in comments.
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"High drug prices pay for the risky research." That's what pharma lobbyists told me constantly. Then I looked at who actually funds the failures. Follow for what they don't tell you in Washington.
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Grandbaby #4 came 5 weeks early but is out of the NICU now, and showing off! (I’ll have things to say later about the totalitarian NICU experience, but it’s Sunday.)
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A Harvard degree and a stint in the Trump White House didn't teach me the system the way fighting corrupt industries for employers and patients did. I was trained on the inside. Now I'm telling you how to get out. Where did you first realize something was off? Tell me in the replies.
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Sometimes when everyone says you're crazy, you have to build your own insane asylum and invite your friends. That's what @jeffreytucker did at the @brownstoneinst. Since then, they have been the consistently correct hub for Team Reality for more than half a decade.
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Hospitals and insurers once swore to me that publishing their prices would crash the internet. Well... It didn’t. Now the FTC is warning hospitals about deceptive pricing, and the prescription drug prices PBMs fought to keep secret are back on Washington’s agenda. There’s a lot to celebrate. But rules don’t write and enforce themselves. Meet the people doing big things (and learn how you can help). Link in comments.
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Insurers in the ACA market must spend at least 80 cents of every premium dollar on care. So they're buying the doctors, the PBMs, and the practices, taking premiums from you in one hand and using it to pay themselves in the other hand. Follow for how employers and patients can stop funding it.
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A drug trial can't catch a side effect rarer than one in the number of people it studied. Have you ever checked how many that was for something you take? Tell me in the replies.
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I used to sneak misfits into government meetings. Tiny companies using price data to help patients find cheaper, better care. Now they’re on stage at HHS and in the footnotes of the Federal Register. Hospitals hiding prices have a new sheriff to worry about. Transparency is going mainstream. I'm breaking down the latest developments tomorrow. Sign up at katytalento.com
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Nobody in Washington is coming to save your health. It was always an inside job. Follow for the tools to take it back.
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A lot of talk these days centers around women with careers. We're scolded for letting our ovaries wither while we recklessly and selfishly push our careers to center stage. But that’s NOT what we’re actually doing - not most of us. We’re not prioritizing career over marriage and motherhood. We didn’t choose to be single. We’re just trying to pay our bills while we desperately - DESPERATELY - search for and hope for Prince Charming to come save us. Being raised with feminism in our blood and on our lips, sometimes by our parents, but always by the culture, we had fortunate opportunities to become good at things that are useful in the economy. That freedom made it easier to pay those bills when Prince Charming was dallying. We got raises, titles, PhDs. Not because we preferred this path, but because we were good at what we did and it paid the bills and no one else was offering to pay rent. Some fields are easier to advance in without becoming a warrior. Most aren’t. My take on embracing the feminine at the link in comments.
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