How can hospitals break the law for years, while patients still pay the price?

In this episode of Disruptive Dialogue, healthcare insider Chuck Melendi exposes the TRUTH behind the 2021 Hospital Price Transparency Rule and why it’s been basically ignored over the past 5 years.

Despite thousands of hospitals being out of compliance, ONLY 27 have been fined in four years. Chuck breaks down how weak enforcement, meaningless penalties, and industry consolidation keep real prices hidden from patients.

More importantly, Chuck shares SOLUTIONS that would actually work: tying hospital payments to compliance, standardizing prices around Medicare rates, enforcing price-gouging laws, and removing repeat offenders from Medicare.

Follow DISRUPTIVE DIALOGUE WITH CHUCK MELENDI wherever you enjoy your podcasts. Reviews and shares are a big help too!

Together, #LetsFixHealthcare

The Takeaway

U.S. healthcare isn’t failing because reform is impossible—it’s failing because profits are prioritized over patients. With bipartisan support growing and successful state-level models already in place, meaningful reform is closer than most people realize.

In This Episode

In Part 2 of our powerful conversation with Wendell Potter, former health insurance executive turned leading healthcare reform advocate, we move from exposing what’s broken to exploring what can actually fix it.

This episode dives into real legislation, bipartisan momentum,and bold ideas that could rein in insurance monopolies, pharmacy benefit managers (PBMs), and runaway Medicare Advantage abuses. From state-level wins to federal reform efforts like the Patients Over Profits Act and PatientsBefore Monopolies Act, we explore how healthcare could be refocused on patients, value, and access instead of corporate greed.

If you want to understand who really controls U.S. healthcare—and what you can do about it—this episode is a must-listen.

What You Will Hear

• Why Patients Over Profits and Patients Before Monopolieslegislation matters
• How PBMs are driving independent pharmacies out of business
• State-level reform wins in Ohio and Arkansas
• Why 39 state Attorneys General are demanding federal action
• The dangers of vertical integration in healthcare
• How the Stark Law could be expanded to stop corporate self-dealing
• Medicare Advantage: misleading marketing, overpayments, and patient harm
• Why Medicare Advantage costs taxpayers more than traditionalMedicare
• The case for a true public option modeled after Medicare
• How confusion, lobbying, and dark money shape healthcare policy

Resources & Action Steps

Learn more from Wendell Potter: Healthcare Uncovered

Read Wendell’s investigations and reports, including the SunlightReport on UnitedHealth Group

Take Action! Visit DisruptiveDialogue.org → Get Involved Page

-Pre-written letters to your legislators supporting key healthcare reform bills

-Advocacy Tools for consumers and employers

Enjoyed the Episode?

• Subscribe for more healthcare truth and reform-focused conversations
• Share this episode with a friend or family member
• Leave a review—it helps more people find the show

Until next time: stay informed, ask the hard questions, and take charge of your health. Here’s to a healthy and happy 2026!

In Part 1 of this two-part conversation, Disruptive Dialogue host Chuck Melendi sits down with Wendell Potter, former health insurance executive turned advocate and whistleblower, to examine how U.S. healthcare really works—and why it so often fails the people it was created to serve.

Both Chuck and Wendell spent decades in senior healthcare leadership roles before leaving corporate careers to expose the growing influence of profit, consolidation, and Wall Street pressure on the healthcare system. Wendell now leads the Center for Health and Democracy, the Lower Out-of-Pocket NOW Coalition, and serves as publisher and executive editor of HEALTH CARE un-covered.

Together, they unpack how high-deductible health plans became the industry default, why millions of insured Americans still can’t afford care, and how massive consolidation has allowed insurers to extend their reach across nearly every part of the healthcare system.

This episode isn’t just an exposé. It is also a thoughtful, collaborative discussion about how we got here, why the system rewards profits over patients, and what informed consumers and leaders need to understand if real change is going to happen.

Key Topics Discussed:

• How healthcare insiders are trained to shape public narratives

• Why high-deductible health plans dominate U.S. insurance

• Wall Street’s role and quarterly earnings pressure

• UnitedHealth Group’s scale and vertical integration

• Why “having insurance” often isn’t enough

• The real human cost of a profit-driven healthcare system

About our Guest:
Wendell Potter is president of the Center for Health and Democracy, leader of the Lower Out-of-Pocket NOW Coalition, and publisher/executive editor of Substack’s HEALTH CARE un-covered. He is a New York Times bestselling author and former health insurance executive who testified before Congress after becoming an industry whistleblower.

👉 This is Part 1 of a two-part conversation. In Part 2, Chuck and Wendell focus on solutions—the policies, reforms, and actions to move U.S. healthcare in the right direction.

Subscribe, follow, and share to help bring transparency and accountability to American healthcare.

Links:
Wendell Potter: https://www.wendellpotter.com/
Center for Health and Democracy: https://www.centerforhealthanddemocracy.org/
Lower Out-of-Pocket NOW Coalition: https://www.loopcoalition.co/

HEALTH CARE un-covered: https://healthcareuncovered.substack.com/

Today, Chuck is honored to introduce a couple who define devotion as they overcome insurmountable odds. Join us to experience daily life for Tracy Otto—Paralympic archer, disability advocate, and survivor of a horrific domestic violence assault —and her partner Ricky Riessle, her full-time caregiver, fellow survivor, and co-parent to their nine-month-old daughter, Rylee. Together, they join us to muse over the realities of navigating disability, complex care needs, and the systems that shape their everyday routines (and throw roadblocks along theway).

From the challenges of rehabilitation to advocating for better access to medical supplies, Tracy and Ricky’s story highlights both the struggles and triumphs of living with a disability in a system that can often make care difficult to obtain. Along the way, Tracy reinvented herself as a Paralympic archer, representing the United States on the world stage and inspiring others to pursue their goals regardless of the obstacles.

Tracy and Ricky discuss the realities of managing care, working with healthcare providers, and advocating for change. Thisconversation is a powerful look at Tracy and Ricky’s resilience, partnership, and determination that have transformed adversity into opportunity—both in sports and in life.

Follow Tracy at: Instagram: @Tracy_Otto
Facebook: @tracyotto95
Tiktok: @tracyotto

Support Tracy’s Paralympic Journey:👉 https://www.spotfund.com/story/5bf6d088-c89a-47ab-8caf-036cf2b3d7a3?value=otto

Learn More About Tracy & Ricky

NBC News feature:👉 https://www.nbcnews.com/nightly-news/video/paralympian-soars-in-archery-overcoming-life-changing-attack-217793605954

Team USA profile:👉 https://www.teamusa.com/profiles/tracy-otto

Learn more about Ibis Healthcare👉 https://ibishealthcare.org/

Welcome back, disruptors! This week, Chuck sits down with consultant Dr. Seth Glickman, former Chief Medical Officer at Intermountain Health and Chief Health Officer for Blue Shield of California, to expose the hidden incentives and moral conflicts behind U.S. healthcare finance.

Dr. Glickman shares what it’s like to lead inside major hospital and insurance organizations, why he ultimately walked away, and what every patient and physician should know about prior authorizations, ghost networks, and insurance denials.

By the end of this conversation, you’ll understand how the system really works—and what we can do to make it better.

In This Episode:

·      Why the healthcare system rewards the wrong outcomes

·      The hidden incentives driving insurance andhospital decisions

·      How prior authorizations delay or deny care

·      The truth about “ghost networks” and provideraccess

·      How patients and physicians can push for reform

·      Practical steps to get care approved and appealdenials

Guest: Dr. Seth Glickman — Physician, healthcare executive, and founder of Seth Glickman Advisors
Website: https://sethglickmanadvisors.com

Resources Mentioned:

·      KFF Health Policy Brief on Prior Authorization

·      Greater National Advocates: Find a patientadvocate near you

·      Healthcare.gov for insurance information andopen enrollment

Call to Action:
If this episode helped you see healthcare in a new light, follow the show, share it with a friend, and leave a review. Together we can demand better—and make the system work for everyone.

LET'S FIX HEALTHCARE!

This week, host Chuck Melendi sits down with Val Barschaw, author of the new book Surviving the Hospital: Six Secrets Every Patient Should Know and longtime patient advocate. Drawing from her husband’s decade-long journey to a heart transplant and more than 25 years of post-transplant care, Val reveals practical, life-saving strategies for anyone navigating a hospital stay.

Her message is simple but transformative: patients must STOP being passive recipients and become active partners in their own care.

Together, Chuck and Val break down 6 key ways that patients and families can reduce hospital errors, advocate effectively, and prepare for the unexpected—turning the unknown into clarity and control.

About Val’s Book:

Surviving the Hospital: Six Secrets Every Patient Should Know is a concise, empowering guide that equips patients and caregivers with the tools to stay safe, confident, and informed in any hospital setting.

➡️ Learn more and get your copy at www.hospitaltohealth.com.

Resources Mentioned:

• Book: Never Pay the First Bill by Marshall Allen — a must-read for handling medical billing disputes.

• Advocacy Resource: Greater National Advocates — find a patient or billing advocate near you.

• Chuck’s Website: DisruptiveDialogue.org— access templates for contacting legislators and healthcare advocacy tools and so much more.

Subscribe & Share:

If this episode opened your eyes or could help someone facing a hospital stay, please subscribe, rate, and share! Together we can demand better—and make healthcare work for everyone.

Host Chuck Melendi talks with Chet Pietras and Ethel Owen about Medicare and Medicare Advantage coverage and how to make confident choices during open enrollment. They unpack the key differences between Medicare Advantage and Traditional Medicare, offering practical advice for seniorsand healthcare professionals alike.

They share insights on plan costs, provider networks, and how to make smart, confident choices during Open Enrollment (Oct 15 – Dec 7).

🧭 What You’ll Learn

The 4 Parts of Medicare

How to compare Medicare Advantage vs. Traditional Medicare

Financial and network factors that affect your plan

Why guidance from a trusted professional matters

✅ Action Items

Educate yourself on coverage differences and costs

Partner with a licensed insurance agent for guidance

Compare plans locally to fit your specific needs

Empower yourself and those you know to be informed health advocates

🔗 Resources

Medicare.gov – Official Plan Finder

CMS – Open Enrollment Information

SHIP – State Health Insurance Assistance Programs

Connect with Chet Pietras (Florida Residents): Phone: 727-946-8294 Email: [email protected] https://www.yourmedplan.com/

Slides from this episode are at disruptivedialogue.org/getinvolved

📱 Connect & Subscribe

Stay informed with Disruptive Dialogue — real conversations about healthcare reform and smart decision-making.
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Choosing health insurance doesn’t have to be overwhelming - but it can be! In this episode, Chuck is joined by health insurance advisor Chet Pietras, who brings 40+ years of experience helping individuals and families make smartcoverage decisions.

Together, they cover:

• Open enrollment for 2026 (Nov 1 – Dec 15, 2025)
• The biggest mistakes people make when choosing a plan
• Key differences between HMO and PPO networks
• When to use the ACA Marketplace vs going direct to a carrier
• How to budget for premiums, deductibles, and copays
• What to check if you take prescription meds or have chronic conditions
• Why working with an agent costs you nothing but can save you thousands

In these 50 minutes, you’ll understand how to prepare for openenrollment, what factors really matter in choosing a plan, and how to avoid costly pitfalls.

• Resources Mentioned:
• Healthcare.gov: For research and shopping for ACA plans and determining subsidies
• Federal Poverty Level Charts (for subsidy eligibility): https://aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
• Connect with Chet Pietras (for Florida Residents):Phone: 727-946-8294Email: [email protected]
• https://www.yourmedplan.com/
• Chat GPT and other AI tools are helpful for personalizing your research. Check out our last episode to see why!

Was this the resource you needed? If so, please share with a friend who needs to know. And give us a like!

How do you cut through the complexity of U.S. private health insurance? In this episode of Disruptive Dialogue, Chuck shares actionable strategies to help you make faster and smarter choices, lower your costs, and take full advantage of the benefits you already pay for.

Learn:

• Key timelines for open enrollment and when insurers release plan details

• Which preventive services are 100% covered at no cost under the ACA & employer plans

• Practical tips for fighting denials and advocating for yourself

• A scenario-based dive into how tools like ChatGPT can simplify insurance research and decision-making. Mind-blowing!

Whether you’re choosing your first plan or reevaluating coverage this fall, this episode arms you with the knowledge and resources to take control of your healthcare decisions.

👉 Subscribe to catch our upcoming episodes featuring experts with more tools, plus the fascinating guests in past and future seasons!

In this episode of Disruptive Dialogue, Chuck continues hisHealthcare 101 series on private insurance. Healthcare literacy matters in our complicated system, and learning the basics makes all of us better consumers. Listen in!

After recapping the basics of premiums, deductibles, and copays from the last episode, he dives into the barriers that keep patients from accessing the care they need—and how to overcome them. This episode equips you with practical knowledge and strategies to advocate for yourself and your family.

Learn About

Common barriers to accessing care with private insurance

How/why insurers use administrative tools like prior authorization and step therapy

Ways patients can appeal denials and delays

Strategies to prepare during enrollment to avoid costly surprises

The pros and cons of private insurance from the patient’s perspective

Key Terms & Definitions

Premium: The fixed monthly payment you make for insurance coverage, whether or not you use services.

Deductible: The amount you pay out of pocket before insurance begins to cover costs.

Copay/Coinsurance: Your share of the cost for services or prescriptions after meeting your deductible.

Prior Authorization: Requirement for insurer approval before certain tests, drugs, or procedures are covered.

Step Therapy (Fail-First Policy): Policy requiring patients to try lower-cost drugs or treatments before moving to more expensive options.

High Cost Sharing: Large deductibles, copays, or coinsurance amounts that make care unaffordable.

Copay Accumulator / Maximizer: Insurer policies that absorb drug manufacturer copay assistance, leaving patients with higher costs once assistance runs out.

Non-Medical Switching: When insurers force patients to change medications for cost reasons rather than medical ones.

Formulary: A list of prescription drugs covered by an insurance plan, often with restrictions.

Quantity Limits: Restrictions on how much medication can be dispensed at one time.

The Takeaway

Private insurance can provide choice and financial protection, but navigating its barriers requires preparation, persistence, and advocacy. Be prepared!

Season 2 of Disruptive Dialogue will give you the tools you need, so subscribe today, and share with your friends and family before open enrollment season starts.

Stay Connected!

Visit https://www.disruptivedialogue.org/get-involvedfor episode slides and more resources.

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