What happens when a spine surgeon who's been in private practice since the Obamacare era sits down with doctors across the political spectrum? You get one of the most honest conversations about healthcare reform we've had.

Brian Gantwerker doesn't fit neatly into anyone's box. He's a private practice capitalist who thinks breaking up insurance companies is essential. He believes in "just pricing" for craniotomies (hint: it's more than $2,000). He thinks Medicare was actually a great payer—until Medicare Advantage ruined it. And he has strong opinions about why physicians spend so much time fighting each other on Twitter instead of finding common ground.

This conversation covers the Medicare Advantage meltdown (UnitedHealthcare shares tanking), vertical integration nightmares, why the FTC needs to break up both insurers AND hospitals, and what it's like when your congressman literally saves your practice. Plus: the real reason healthcare policy debates get so toxic on social media, and why quote-tweeting might be making everything worse.

0:00 - Introduction: Doctors in the Lounge 0:33 - Who is Brian Gantwerker? 2:08 - Starting Private Practice in the Obamacare Era 5:34 - UnitedHealthcare: The Pontine Glioma of Healthcare 7:43 - Medicare Advantage vs Traditional Medicare 10:26 - The Medicare Advantage Denial Story 14:35 - Who Gets the Value in Value-Based Care? 16:07 - The Free Market That Doesn't Exist Yet 19:16 - What Should a Craniotomy Cost? 21:47 - Breaking Up the Monopolies: Insurers AND Hospitals 27:09 - The Labor Theory of Value Debate 30:21 - CPT Codes and Central Planning 32:20 - The "Just Price" vs Free Market 35:42 - HSAs for Medicaid Recipients 38:47 - Price Transparency: Why Can't Healthcare Be Like Amazon? 40:03 - The Workout Period Problem 43:52 - FTC and Vertical Integration 46:04 - Lobbying, Congress, and Changing Minds 48:07 - Why Twitter Makes Physicians Fight Each Other 51:24 - Political Rancor and Taking Sides 55:14 - The Dr. Asghar Tweet Controversy 59:24 - Quote-Tweeting: The Death of Dialogue 1:03:03 - X as Thunderdome vs Real Conversation 1:04:35 - The Ted Lieu Saves: When Congress Actually Helps 1:07:32 - Closing: Shah Rukh Khan Hair and Finding Common Ground

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Co-hosts: @anish_koka | @drdanchoi | @dutchrojas | @drdigiorgio | @sdixitmd

Guest: @cscla