In Episode 131 of DC EKG, Joe Grogan sits down with Dr. John Goodman to discuss what both parties continue to get wrong about healthcare, why patient incentives still matter, and how market-based reforms could lower costs and improve access. Drawing on decades of work in health economics and policy, Dr. Goodman explains how special interests helped shape Obamacare, why supply-side constraints still distort care, and why patients are too often left out of the policymaking process. 

The conversation then turns to Health Savings Accounts, Medicaid reform, emergency room overuse, and why policymakers remain so resistant to giving patients more control over healthcare dollars. Dr. Goodman also outlines his view that self-directed care and consumer choice can improve value and expand access, especially for vulnerable populations. 

In the second half, Joe and Dr. Goodman dive into reference pricing as a major reform idea. Using real-world examples, they discuss how clearer prices and patient-driven decision-making could create more meaningful competition across healthcare markets. The episode closes with a broader conversation on bipartisan reform, the tax code, and why durable change remains so hard to achieve in Washington. 

In This Conversation

What both parties keep getting wrong about healthcare

How special interests shaped Obamacare and why patients were left out

Why HSAs remain controversial and what they change about incentives

Medicaid reform, emergency room use, and patient access

How self-directed care can improve outcomes and satisfaction

What reference pricing is and why it could create real competition

Why bipartisan healthcare reform keeps breaking down in Washington

Timestamps0:00 How special interests shaped Obamacare0:46 Joe welcomes Dr. John Goodman1:09 Dr. Goodman’s background and the origins of HSAs5:22 What both parties get wrong about healthcare7:36 Why physician supply stays restricted9:26 Spending more without getting healthier14:16 What Washington should actually be debating15:52 Insurance that meets patients’ needs20:06 HSAs and consumer-directed care22:29 Why Medicaid patients rely more on emergency rooms24:50 Medicaid reform and letting patients pay the difference28:07 Self-directed care and “Cash and Counseling.”29:35 Reference pricing explained32:14 How reference pricing could reshape insurance markets36:06 Why Dr. Goodman is optimistic40:36 The tax code and healthcare policy44:22 Where to find Dr. Goodman’s work45:42 Outro

Obamacare, health savings accounts, HSA, John Goodman, Joe Grogan, healthcare reform, healthcare policy, Medicaid reform, emergency room visits, patient incentives, consumer-directed care, reference pricing, tax policy, bipartisan reform, healthcare economics

About Our GuestJohn C. Goodman is President of the Goodman Institute for Public Policy Research and is widely known for his work in health economics, Health Savings Accounts, and consumer-directed healthcare reform. 

Podcast: DC EKG with Joe GroganEpisode: 131Guest: John C. GoodmanSponsor: Survivors for Solutions – https://survivorsforsolutions.orgExecutive Producer: John “CZ” Czwartacki, DC EKG PodcastProducer: Stay on Course Studios – https://www.stayoncourse.studio