Host Nate Kaufman brings Rich Helppie back for a discussion about healthcare access.  A 30-day wait for a first oncology visit after hearing the word leukemia is not an edge case—it’s the new normal in a system where demand outpaces supply and incentives reward the wrong behaviors. Nate opens with a personal story that reveals how access feels when the stakes are life and death, then pulls back the lens to explain why it happens: a 12-year training pipeline for specialists, uneven reimbursement that pushes clinicians toward concierge and direct primary care, and payer tactics that encourage consolidation rather than capacity.

Kaufman and Helppie then get specific about the economics. Medicaid rates that barely cover overhead lead practices to cap panels, while insurers play separate groups against each other until they merge, gaining leverage but not necessarily improving availability. Primary care, which should function like a straightforward retail experience, is instead forced through insurance mechanics that add friction to simple, high-value services. The result is predictable: over 40 percent of ER visits come from Medicaid patients who couldn’t access timely outpatient care, and the most vulnerable pay the highest price in avoidable emergencies.

Their conversation wrestles with the big numbers and the real trade offs. Ten percent of patients drive more than 80 percent of spending across Medicare and commercial plans. Pharma’s incentives to expand lifelong demand clash with insurers’ incentives to deny care. The federal government, the largest health benefits organization in the world, changes leadership every few years, making long-term workforce planning and access expansion difficult. They outline pragmatic moves that can help now: secure continuity with direct primary care or concierge if possible, build a relationship with a PCP who can open specialist doors, and for complex care, shop outcomes rather than prices.

If you’ve felt the squeeze—months-long waits, denials, or a scramble for appointments—this conversation gives language, data, and practical options. Listen to understand why access is collapsing, what levers could ease the pressure, and how to protect your path to timely, high-quality care today. If the ideas resonate, follow and share, and leave a review with your own access story—what worked, what didn’t, and what needs to change next.

Support the show

Engage the conversation on Substack at The Common Bridge!

Politicians argue about subsidies while families face premiums that can top $26,900 and deductibles big enough to delay basic care. We step past the slogans to map how the ACA exchanges actually work today—standardized benefits that reduce real choice, narrow networks that hide access problems, and a pricing spiral that subsidies struggle to catch. Along the way, we unpack ghost networks in mental health, why out-of-network showdowns hit consumers hardest, and how pharmacy benefit manager rebates can reward drug utilization even as patients fight for approvals.

With Nate Kaufman of the Healthcare Bridge, we press on a practical blueprint: unify tax-funded programs into one baseline plan for everyone legally here, financed on a progressive scale. Then let private insurance sell optional add-ons that prove their value on access and outcomes, not marketing gloss. We argue for opening Medicare Part D-style drug purchasing to all, so payers and manufacturers compete in a fair arena. And we make a crucial point often skipped in policy talk: if clinicians aren’t paid enough to say yes, coverage is a promise that collapses at the front desk. Raise rates for high-value services, shrink bureaucracy, and hold networks to transparent, enforceable standards.

This conversation is candid, nonpartisan, and focused on patients and physicians rather than lobby talking points. If you’ve ever felt like the “chump at the table” in healthcare—paying premiums to an insurer incentivized to deny and taxes to a system that can’t align incentives—you’ll find both clarity and a path forward here. Dive in, share with a friend who’s wrestling with open enrollment, and tell us: what’s the first fix you’d make to rebuild access, quality, and affordability? Subscribe, leave a review, and help more listeners find the Common Bridge.

Support the show

Engage the conversation on Substack at The Common Bridge!

One mother’s plea and a judge’s blueprint collide with a terrifying truth: the systems meant to protect people with serious mental illness—and the communities around them—often wait until harm is done. We bring Beverly Gille and Judge Milton L. Mack Jr. together to map how a 28-year struggle, from teen psychosis to homelessness and a mass stabbing in a Traverse City Walmart, reveals the exact points where policy, privacy, and practice failed.

We walk through the pivotal transitions that matter most: when minors become adults and families lose access, when court orders lapse because of rigid renewal windows, and when police lack clear authority to transport someone to a crisis center before danger peaks. Judge Mack explains the shift toward assisted outpatient treatment, why recognizing lack of insight saves lives, and how proposed Michigan bills would empower families to file petitions, broaden who can testify, and end the “seven-day trap” that breaks continuity of care.

Beverly’s story grounds the policy in lived experience—adult foster care that worked until it didn’t, ACT teams with uneven follow-through, and a release to the streets where legal access to potent cannabis accelerated psychosis. We connect outcomes to dollars and dignity: assisted outpatient treatment reduces hospitalizations, arrests, homelessness, and drug use, delivering better recovery and safer communities without demanding new budget lines. Most of all, we challenge a false choice: untreated illness is not liberty; treatment restores agency, safety, and community trust.

If this conversation resonates, share it with someone who needs to hear it. Subscribe for more evidence-based, people-first conversations, and leave a review so others can find the show. Your voice helps push these reforms over the line.

Support the show

Engage the conversation on Substack at The Common Bridge!

Spine surgery sits at the crossroads of need, nuance, and noise—and few people explain that terrain better than Dr. Rod Oskouian, a high-volume neurosurgeon who has led a complex spine program and also navigated care as a patient.  Dr. Oskouian and Healthcare Bridge host, Nate Kaufman pull back the curtain on how consolidation, denials, and a flood of administrative demands reshape daily practice, why “low value” labels miss the mark, and what truly predicts safer outcomes when your back—or your future mobility—is on the line.

The conversation starts with the evolution of neurosurgery from community coverage to regional referral, as smaller practices disappear and tertiary centers take on the hardest cases across multiple states. From the OR to the boardroom, Dr. Oskouian unpacks how EMRs, siloed decision-making, and repeated reorganizations increase friction (SEE NATE’S ARTICLE Nathan Kaufman: How silos undermine U.S. healthcare | HFMA). He makes a bold case for a mindset shift: treat physicians as the primary customers of health systems so they have the tools, staffing, and data to deliver better patient care. That shift informs smarter choices about enterprise tech, integrated AI, documentation, imaging, and revenue workflows that either free clinicians to practice medicine—or bury them in clicks and appeals.

Kaufman and Dr. Oskouian into the data debate around spine surgery and “low value care,” exploring how Medicare billing data, coding incentives, and risk profiles can warp conclusions. He argues for outcomes that blend patient-reported measures with wearable-driven biometrics—steps, mobility, vitals, adherence—paired with honest risk adjustment for complex cases. For patients trying to choose a surgeon, they offer a pragmatic playbook: prioritize volume, fellowship-trained teams, multidisciplinary pathways, and centers that live and breathe your specific procedure. And they get personal as Dr. Oskouian recounts a severe ski accident, the authorization gauntlet he faced despite insider knowledge, and the hard lesson that navigating networks can matter as much as medical expertise.

If you care about healthcare strategy, spine outcomes, physician leadership, or how to advocate for yourself when it counts, this conversation delivers grounded insight you can use. Subscribe, share with a friend who’s weighing surgery, and leave a review with your biggest question about choosing the right surgeon—we’ll dig into it on a future show.

Support the show

Engage the conversation on Substack at The Common Bridge!

Season seven opens with a clear promise: fewer teams, more truth. We look straight at the incentives that keep America mad—legacy media chasing rage clicks, politicians swapping positions to score points, and a culture that treats every topic like a loyalty test—and we choose a different path. From the first minute, we ask whether the country is truly more divided or just more performative, and why the quiet middle is still hungry for facts, fairness, and practical wins that improve daily life.

We dig into the government shutdown without the typical theater, separate health policy myths from the calendar realities of ACA subsidies, and interrogate the state of media trust as CBS signals an editorial reset toward “news that reflects reality.” That flows into a wider conversation about borders and enforcement: rejecting both open-border slogans and heavy-handed raids, and arguing for humane, targeted systems with firm limits on executive tools. We revisit the lawfare spiral through the Comey saga and shifting intelligence narratives, making the case that equal standards and transparent testimony are the only route back to shared legitimacy. The same principle guides our take on the Epstein files: protect victims, release evidence, and be accountable—whoever it touches.

On the economy, we challenge the conflation of stock market highs and real wellbeing. AI enthusiasm may rhyme with past bubbles, while families still measure success by affordability, stability, and opportunity. We get specific about tariffs, rule certainty, and how dull-seeming policy architecture—like Canadian provincial liquor monopolies—can shape trade far more than speeches. Finally, we map the identity problems facing both parties: a GOP still orbiting Trump and Democrats stuck on questions many voters want answered in plain English. The answer isn’t new labels; it’s consistent principles. Defend civil liberties for everyone, talk policy over personality, and reward leaders who trade heat for light.

Join us as we build on a fiercely nonpartisan mission with sharper reporting, deeper policy focus, and a growing community that keeps us honest. Subscribe on Substack or your favorite app, share this episode with a friend who’s tired of outrage-as-a-service, and leave a review to help more listeners find the bridge.

Support the show

Engage the conversation on Substack at The Common Bridge!

The money is already here—so why are the rules still stuck in limbo? We sit down with Tom Dieters to map how NIL evolved from booster-led collectives into university-controlled revenue sharing after House v. NCAA, and what that shift means for athletes across every sport. From donor intent getting sidelined by caps to student fees propping up compensation, we confront the uncomfortable question: if this is now a professional marketplace, who should set the rules and who should be accountable?

Tom explains the real NIL economy beyond the headlines, where most contracts land under $100,000 and often make the difference between staying enrolled and stepping away. We look at Michigan’s push to protect athlete earnings and limit external control, the growing call to recognize athletes as employees, and why a conference-level collective bargaining model may be the only way to reduce transfer chaos, guarantee health and education benefits, and provide fair floors for non‑revenue sports. Along the way, we connect donor-directed funding, transparent carve-outs, and practical contract tools—like buyouts and season-aligned transfer windows—to a more stable and honest system.

The takeaway is clear: college sports don’t need nostalgia for amateurism; they need professional governance that matches the money already in play. If you care about fairness for athletes, continuity for fans, and trust for donors and students, this conversation lays out a realistic path forward. If you enjoyed the episode, subscribe on Substack, leave a review, and share this with a friend who debates NIL at every tailgate. Your take—cap the market or bargain for balance?

Support the show

Engage the conversation on Substack at The Common Bridge!

What's the secret to maintaining physician independence when 70% of doctors now work for corporations or health systems? Dr. Leo Spector, CEO of OrthoCarolina and practicing spine surgeon, offers a masterclass in healthcare leadership and strategic navigation of our complex medical landscape.

After 20 years as a spine surgeon, Dr. Spector has witnessed healthcare's digital transformation while confronting the harsh realities of diminishing physician autonomy. "The loss of autonomy has led to burnout," he explains. "Most physicians entered medicine to care for people and make decisions—not answer to checkboxes or non-peers reading from insurance criteria."

OrthoCarolina's success stems from what Dr. Spector calls their "privademic model," combining private practice independence with academic medicine's commitment to research and education. With 110 shareholders across 35 locations, they've maintained independence by rallying physicians around a greater mission while deploying effective physician leadership—what he humorously describes as "herding cats."

Perhaps most fascinating is OrthoCarolina's evolving "Switzerland strategy" for working with competing hospital systems. This neutral approach faces new challenges as Certificate of Need reforms allow independent surgery centers, creating what hospitals view as an existential threat. "Switzerland just got handed a nuclear bomb," Dr. Spector explains, "and everyone wants to know whose side we're on."

For patients navigating healthcare, particularly those with back pain, Dr. Spector offers practical wisdom: strengthen your core, maintain flexibility, consult experts rather than rely on misinformation, and view surgery as a last resort. These insights reveal why seeking guidance from healthcare insiders might be your most important medical decision.

Looking ahead, Dr. Spector sees healthcare at a tipping point—with an aging population, rising costs, physician shortages, and market forces constrained by government reimbursement structures. What's the solution? Subscribe to Healthcare Bridge for more insider perspectives on building a healthier future.

Support the show

Engage the conversation on Substack at The Common Bridge!

Michigan Secretary of State Jocelyn Benson brings her vision for Michigan's future to The Common Bridge, outlining why she's running for governor in 2026 and what she hopes to accomplish for the state's citizens.

At the heart of Benson's campaign is a commitment to making Michigan "the best place to be a kid, raise a kid, and call home." As a mother raising an eight-year-old son in Detroit, she understands firsthand the challenges facing Michigan families. "The work we do over the next 10 years is going to define his future and the future of our loved ones throughout the state," she explains, highlighting the urgency behind her candidacy.

Affordability emerges as the cornerstone of Benson's platform. From cherry farmers in Traverse City who can't afford housing near their work to Detroit families struggling with utility bills, economic anxiety touches every corner of the state. Benson proposes tackling these challenges through strategic investments in affordable housing, healthcare access, and public education while making government work more efficiently for citizens—something she's demonstrated as Secretary of State by modernizing services and eliminating wait times.

The conversation explores Michigan's potential transformation from the "Rust Belt" to what Benson calls the "Innovation Belt." Her vision includes ambitious infrastructure projects like high-speed rail connecting major cities, making Michigan "the small business capital of the nation," and developing talent pipelines through education and workforce training. This economic strategy aims to reverse Michigan's population decline by creating communities where people want to build their futures.

What distinguishes Benson's approach is her commitment to collaboration across partisan lines. Having won her 2022 election by 14 points—carrying counties other Democrats couldn't win—she emphasizes the importance of listening to all voices and finding common ground. "No one party has all the ideas," she says, rejecting the polarization that dominates much of today's political discourse.

As Michigan's chief election officer who improved the state's ranking from 31st to 2nd in election administration, Benson understands how good governance builds trust. Her campaign represents an opportunity to demonstrate that politics can still be about solving problems rather than stoking division—a message that resonates in these challenging times.

Whether you're concerned about economic opportunity, education, infrastructure, or the political climate, Benson's conversation offers a thoughtful perspective on Michigan's challenges and potential solutions. Subscribe to The Common Bridge for more nonpartisan discussions exploring our shared political landscape.

Support the show

Engage the conversation on Substack at The Common Bridge!

What does it take to transform a state facing serious economic and educational challenges? In this illuminating conversation, former Michigan House Speaker Tom Leonard outlines his vision for revitalizing Michigan as he campaigns for the governor's office.

Michigan's struggles are starkly quantified—ranking 49th in unemployment, near last in population growth, and facing an education crisis where only 25% of fourth graders read at grade level. But Leonard sees tremendous untapped potential in the state's natural resources, research institutions, and hardworking citizens. "This state has all the ingredients it needs for success," he explains. "We just need the right recipe, the right policy, and the right leadership."

Drawing from his experience as a prosecutor in Flint and his legislative accomplishments, Leonard presents specific solutions to Michigan's most pressing problems. His education plan draws inspiration from the "Mississippi Miracle" that transformed literacy rates through early assessment, targeted tutoring, and parental empowerment. For economic growth, he advocates reinstating right-to-work laws, implementing regulatory and licensure reform, and addressing the property tax burden that has many residents feeling "taxed out of their homes."

The conversation goes beyond standard talking points to explore innovative approaches to healthcare, environmental justice, and criminal justice reform. Leonard makes a compelling case for telehealth expansion, highlighting how tele-mental health services could reach every Michigan teenager for just $6 million—compared to $600 million for traditional in-school counselors. He also addresses environmental cleanup of the Rouge River as both an ecological necessity and a matter of social justice.

Throughout the discussion, Leonard emphasizes a positive, solutions-focused approach to governance that transcends partisan divides. "When a party is void of ideas, void of vision, and focused only on hatred of one person, they lose," he observes. His campaign offers an alternative centered on problem-solving and demonstrated success in bringing diverse stakeholders together.

Ready to learn more about a vision for Michigan that prioritizes education, affordability, and opportunity? Subscribe to The Common Bridge for more nonpartisan discussions on policies shaping our future.

Support the show

Engage the conversation on Substack at The Common Bridge!

The assassination of Charlie Kirk has shaken our nation to its core, prompting a raw, emotional response from Rich Helppie in this urgent episode of The Common Bridge. Beyond expressing profound grief for Kirk's family and friends, Helppie grieves for America itself – a country increasingly torn apart by political violence and dehumanizing rhetoric.

With unflinching clarity, Helppie dissects how our political discourse has deteriorated to the point where bullets replace dialogue. He identifies a troubling pattern: public figures condemn violence while simultaneously qualifying their statements with justifications that essentially blame victims for provoking their attackers. This "it's not okay, but..." mentality reveals how deeply entrenched our tribal divisions have become.

Drawing from historical examples like the Civil War and World War II, Helppie reminds us that even the bloodiest conflicts ultimately end through conversation, not continued violence. Tribalism, left unchecked, ends only with the eradication of the opposing side – a path that leads to unspeakable suffering. Instead, he advocates for finding common ground on issues like immigration, healthcare, and free speech, emphasizing that extreme positions on either side offer false choices rather than workable solutions.

The episode concludes with a powerful call to action: turn away from rage-inducing media, abandon recycled partisan narratives, and engage in genuine conversations with those who hold different views. As Helppie puts it, "Quit thinking your tribe is going to win. All it will mean is more carnage." The path forward requires recognizing our shared humanity and working together to build the common bridge our divided nation desperately needs.

Subscribe to The Common Bridge on Substack.com or the Substack app to join this vital conversation about healing America's deepening divides. Your voice matters in creating the more perfect union we all deserve.

Support the show

Engage the conversation on Substack at The Common Bridge!