Drug pricing in America is a shell game where patients always lose. Healthcare Bridge host Nathan Kaufman and his guest Richard Helppie pull back the curtain on why Americans pay drastically more for the same medications than patients anywhere else in the world.

At the heart of this problem lies a fragmented system where the United States—effectively operating the world's largest health insurance company—somehow lacks the ability to negotiate bulk purchasing deals. While pharmaceutical companies claim high prices fund critical research, the conversation reveals how your money primarily finances the endless parade of drug advertisements dominating television commercial breaks.

The journey of a pill from factory to patient passes through multiple profit-extracting entities: manufacturers, wholesalers, and pharmacy benefit managers (PBMs). With three PBMs controlling 80% of drug distribution—all owned by insurance companies—conflicts of interest are baked into the system. Through revealing personal anecdotes, the hosts demonstrate how the same medication can cost $5 with one insurer, $330 with another, yet only $20 through Mark Cuban's pharmacy. Many Americans find it cheaper to purchase medications from Canadian pharmacies despite industry warnings about "dangerous" reimported drugs—even when those medications come from identical manufacturing facilities.

Recent policy proposals offer potential paths forward. The Biden administration's efforts to cap Medicare drug expenses met immediate legal challenges from pharmaceutical companies, while Trump's "most favored nation" pricing concept aims to standardize global medication costs. Medicare Part D represents a partial success story by forcing drug companies to negotiate with insurers, maintaining 95% subscriber satisfaction while running 40% below projected costs.

Healthcare policy requires informed leadership, but few politicians truly understand the system's complexities. If you or someone you love needs medical care, finding an insider who understands healthcare's nuances isn't just helpful—it could save your life. Subscribe to the Healthcare Bridge for more conversations that bridge gaps in our healthcare system and work toward solutions that benefit patients first.

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The college sports landscape is undergoing a revolution that few fans truly understand. In this eye-opening conversation, University of Michigan lecturer Greg Dooley breaks down the complex world of Name, Image, and Likeness (NIL) compensation that's transforming collegiate athletics from its century-old amateur foundations into something resembling professional sports.

Dooley expertly navigates the various ways today's college athletes receive compensation—from traditional scholarships to corporate sponsorships, booster-funded "collectives," and new revenue-sharing programs that allow schools to directly pay athletes up to $20.5 million annually. The financial implications are staggering, with even powerhouse programs like Michigan facing budget shortfalls and universities adding student fees to cover costs.

What makes this discussion particularly valuable is Dooley's balanced perspective on both benefits and concerns. While acknowledging that compensating athletes is fundamentally fair given their role in generating massive revenues, he highlights troubling consequences like the cutting of non-revenue sports and the thousands of athletes who enter the transfer portal only to end up without teams, scholarships, or educational opportunities.

Most compelling is Dooley's insight into the potential future of college athletics. Will top programs eventually break away to form professional minor leagues affiliated with universities? How will the relationship between academics and athletics evolve? And who should bear responsibility for developing future professional athletes—universities or the leagues that ultimately benefit from their training?

Whether you're a die-hard sports fan or simply interested in the changing economics of higher education, this conversation provides crucial context for understanding a transformation that extends far beyond the playing field. Subscribe to The Common Bridge for more thoughtful, nonpartisan discussions that bridge the divide on today's most important issues.

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Are you getting what you pay for with your Medicare plan? This eye-opening conversation between healthcare insiders Nathan Kaufman and Rich Helppie pulls back the curtain on what they provocatively call "Medicare Disadvantage" plans.

When something sounds too good to be true, it usually is. Medicare Advantage plans tempt seniors with zero premiums, dental coverage, vision benefits, and even gym memberships. But these apparent perks mask a troubling reality: significantly restricted healthcare options when serious illness strikes. Our experts explain how insurance companies profit from delaying and denying care while creating increasingly narrow provider networks that limit access to specialists and top medical centers.

The most alarming revelation? The trap many seniors find themselves in when they discover these limitations. Once enrolled in Medicare Advantage, leaving becomes nearly impossible if you develop a serious condition, as new supplemental plans can exclude pre-existing conditions. Meanwhile, those with Traditional Medicare maintain freedom to choose providers nationwide, including prestigious research hospitals like Mayo Clinic or MD Anderson, without administrative barriers or insurance company gatekeepers.

For anyone approaching Medicare eligibility or reconsidering their current coverage, this episode provides crucial guidance. Our experts recommend a clear path: Medicare Parts A, B, and D, plus a comprehensive Medigap policy. While this combination involves upfront premiums, it offers something priceless: control over your healthcare decisions precisely when you need it most.

Subscribe to Healthcare Bridge on your favorite podcast platforms or find us at the Common Bridge on Substack to continue exploring the vital connections shaping our healthcare landscape. Your health decisions matter—make them with complete information.

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Ever wondered how a successful women's magazine writer and humor columnist became one of Substack's most incisive media critics? Jenna McCarthy never planned to write about "government corruption, health policy, and politics" - she was perfectly content crafting witty pieces about relationships and lifestyle topics for major publications. Then COVID happened, and suddenly McCarthy found herself questioning policies that "weren't making sense" and facing social media suspensions for her skepticism.

McCarthy's journey from mainstream publishing to independent journalism mirrors the broader transformation happening across the media landscape. With refreshing candor and razor-sharp humor, she dissects how traditional news outlets have abandoned objective reporting in favor of narrative advancement. "When I was growing up," McCarthy reflects, "never once did it occur to me that the news was anything other than fact." That assumption has been thoroughly shattered.

Through specific examples - from selective coverage of political scandals to disturbing revelations about organ harvesting practices - McCarthy and host Rich Helppie explore the systematic ways that important information is kept from public view. Their conversation reveals how humor can function as a powerful antidote to gaslighting, allowing audiences to process difficult truths while maintaining their sanity. As McCarthy explains, her readers tell her: "I stopped reading the news because I can't handle all that negativity. But now I don't have to watch it - Jenna will watch it and summarize it in a way that I can laugh but also know what's going on."

Whether discussing the college debt crisis, media bias in political coverage, or her upcoming books on overlooked medical treatments, McCarthy demonstrates how independent voices are filling crucial information gaps left by mainstream outlets. For anyone concerned about finding truth in a post-facts world, this conversation offers both insights and hope.

Subscribe to find more conversations that bridge political divides and explore important issues with depth, nuance, and occasional laughter.

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The fundamental flaw in American healthcare might be hiding in your benefits package. In this compelling conversation, host Nathan Kaufman and Common Bridge's Rich Helppie challenge the very foundation of how most Americans receive health coverage.

"It needs to go the route of the company car," argues Helppie about employer-sponsored health insurance. The hosts dissect how the current system creates profound inequalities – where two neighbors with similar jobs can receive drastically different coverage quality while enjoying the same tax benefits. They explore the troubling reality that when you're too sick to work or too old to remain employed, you lose your coverage precisely when you need it most.

The conversation reveals disturbing truths about healthcare economics. Insurance companies refer to spending on your medical care as a "medical loss" – highlighting a system designed around shareholder returns rather than patient needs. With family coverage now averaging $25,000 annually (before copays and deductibles) and projected to double within five to seven years, the hosts argue our current trajectory is unsustainable.

Kaufman and Helppie outline potential alternatives, from individual tax credits to consolidating existing government programs into universal coverage. They address the critical need to adjust reimbursement rates and eliminate the cross-subsidization where commercial plans compensate for underfunded government programs. Most importantly, they emphasize finding trustworthy healthcare insiders who can help navigate what they describe as an "asymmetrical market" where medical professionals possess far more knowledge than patients about necessary care.

Subscribe to the Healthcare Bridge on Substack, YouTube, or your favorite podcast platform to join this crucial conversation about reimagining American healthcare for a more equitable and sustainable future.

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When did healthcare marketing become so disconnected from the people it needs to reach? Brandon Edwards, founder of Unlock Health and a 30-year veteran in healthcare marketing, joins us for a provocative conversation about why traditional approaches are failing in what he calls "the post-truth era."

Edwards reveals a startling reality: roughly half the population deeply distrusts institutions and experts – the very foundation of most healthcare marketing. "There's about half the population that has a heavy distrust of institutions and experts, and if you're a healthcare provider, you're marketing on behalf of an institution and featuring experts in white coats," Edwards explains. This tribal division requires fundamentally different approaches to connect with skeptical audiences.

We tackle the controversial practice of hospitals sponsoring professional sports teams and stadiums – with some organizations spending upwards of $50 million on these arrangements. Are these investments justified when healthcare systems face unprecedented financial pressures? Edwards questions whether these high-profile sponsorships effectively reach new patients or merely reinforce negative stereotypes about healthcare spending.

The conversation dives deep into the increasingly adversarial relationship between healthcare providers and insurance companies. As Edwards bluntly states, "The entire healthcare system is designed for insurance companies – it's their world and we're just living in it." This power imbalance has created a system where providers struggle for sustainability while payers extract enormous profits as middlemen.

For healthcare leaders navigating these challenges, Edwards offers practical guidance: eliminate non-essential services, develop real-time measurement dashboards, and craft marketing that resonates with diverse audiences through authentic messengers they trust. Most importantly, organizations must recognize that commercially-insured patients subsidize their broader mission – making effective marketing to these groups essential for long-term survival.

With Medicare facing insolvency within 7-8 years and recent budget cuts threatening to increase the uninsured population, this conversation couldn't be more timely. What will it take for our healthcare system to evolve beyond its current dysfunctional state? Listen now to explore potential paths forward.

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The American healthcare payment system isn't just broken—it's a non-system that systematically fails providers and patients while generating enormous profits for middlemen. The Healthcare Bridge host Nathan Kaufman and his guest Rich Helppie cut through partisan talking points to expose the real impact of recent Medicaid funding changes that threaten to destabilize healthcare nationwide.

They unpack the complex provider tax mechanism that states have relied on to patch Medicaid's chronic underfunding. With Medicaid typically reimbursing only 70 cents per dollar of costs, these taxes have been lifelines, not loopholes. The new legislation's gradual reduction of this funding stream creates staggering budget gaps—$40 billion in Michigan, $226 billion in California over the next decade—with far-reaching consequences beyond just healthcare access.

The ripple effects extend to state employee health benefits, which will likely face cuts as states scramble to address budget shortfalls. Meanwhile, new work requirements for Medicaid recipients (80 monthly hours of employment or volunteer work with semi-annual requalification) will create wasteful bureaucracy that historically fails to achieve intended outcomes, potentially pushing 11 million Americans into uninsured status.

Perhaps most telling is the misguided $50 billion allocation for rural hospitals, which fails to address their actual problem: insufficient private insurance reimbursement rates. With Medicare Advantage plans already squeezing rural providers with payments 10-20% below traditional Medicare rates, these hospitals face a perfect financial storm that this Band-Aid approach cannot remedy.

This conversation illuminates the healthcare triangle—cost, quality, and access—showing how reduced funding inevitably diminishes either quality, access, or both. Want to understand what's really happening beneath the political posturing and how it affects your healthcare? Listen now and join the conversation about real solutions for America's healthcare crisis.

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Garlin Gilchrist II, Michigan's Lieutenant Governor and gubernatorial candidate, shares how his unique background as a software engineer and tech entrepreneur shapes his vision for the state's future. This fascinating conversation reveals how engineering principles can transform governance and policy-making.

"Being an engineer, you learn to be a problem solver," Gilchrist explains, drawing parallels between fixing broken systems and addressing Michigan's challenges. With experience at Microsoft and multiple tech startups before entering politics, he brings a refreshingly analytical approach to public service rarely found among elected officials.

Gilchrist outlines his major accomplishments, including a landmark $250 million investment in affordable housing and establishing 40 mental health clinics statewide through the Certified Community Behavioral Health Clinic Program. His creation of Michigan's automatic criminal record expungement program—the Clean Slate Program—has helped over 330,000 people gain access to jobs, housing, and education opportunities previously denied them because of past mistakes.

The conversation delves into Michigan's unique assets: unparalleled engineering talent, abundant natural resources (including 21% of the world's fresh water), and the nation's second most diverse agricultural economy. Gilchrist articulates how these advantages position Michigan for leadership in emerging sectors like clean energy, agricultural technology, and creative industries—if the right leadership is in place.

Drawing from personal experience leaving Michigan after college for better opportunities elsewhere, Gilchrist speaks passionately about creating an environment where young talent stays and thrives. "I want everyone to feel, know and experience Michigan being the best place to have an idea," he shares, outlining initiatives like the Michigan Innovation Fund that support local entrepreneurs.

Ready to learn more about Gilchrist's vision for Michigan? Visit garlingilchrist.com and join the conversation about building a Michigan where everyone can stay and succeed.

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What happens when you put one of America's leading healthcare governance experts in conversation with a veteran industry insider? You get a rare, unfiltered look behind the curtain of hospital boardrooms where life-and-death decisions get made every day.

Jamie Orlikoff, renowned governance consultant and active health system board member, joins host Nathan Kaufman to reveal the dramatic transformation of healthcare governance from ceremonial volunteer boards to professionalized leadership structures. With startling candor, Orlikoff explains that what once made hospital boards work—community connections and social relationships—now often prevents them from making necessary but difficult decisions.

The conversation exposes the paradoxes at the heart of American healthcare: hospitals becoming larger yet operating on thinner margins; costs rising for consumers while systems struggle financially; everyone demanding lower prices until it affects services they personally need. "Everybody hates hospitals until they need them," Orlikoff observes, capturing the fundamental tension healthcare leaders must navigate.

Most provocatively, Orlikoff reveals that only about 5% of hospital boards currently operate at the level of "best governance practices" needed to address today's healthcare challenges. The majority function at merely "good" or "normative" levels—an approach increasingly insufficient as financial pressures mount and quality concerns persist. With medical errors remaining the third leading cause of death in America, the stakes couldn't be higher.

You'll learn why more health systems are recruiting directors from outside their communities, why board compensation has become the norm rather than the exception, and why the traditional volunteer model is giving way to professional governance structures that can make tough decisions when necessary.

Whether you work in healthcare, serve on a board, or simply want to understand how hospital decisions affect your care options, this episode provides an insider's guide to the hidden power structures shaping American healthcare. Subscribe now and join us as we build bridges toward a healthier future.

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When half the streetlights in Detroit were dark and the city led America in homicide, poverty, and unemployment, Mike Duggan stepped up to lead its transformation. Now, after 12 years of progress as Detroit's mayor, he's taking aim at Michigan's partisan gridlock with an independent run for governor.

"Every time the Republicans and Democrats switch control in Lansing, they change the rules," Duggan explains, describing how Michigan's education system has suffered through constant policy whiplash. The result? A state that has plummeted from 19th to 44th nationally in fourth-grade reading proficiency. This pattern repeats across critical issues from infrastructure to economic development, with each party undoing the other's work rather than building sustainable solutions.

Duggan's approach stands apart from the typical campaign playbook. Rather than targeting the opposing party, he's drawing crowds of voters fed up with partisan battles. At his events, Republicans and Democrats find themselves in the same room, often surprised to discover common ground with neighbors they'd previously seen only through a political lens. "You've got the only political group in the country where there are smiles at the meetings," one reporter observed.

The Detroit mayor brings substantial credentials to his gubernatorial bid. Under his leadership, the city emerged from bankruptcy to become a model of urban renewal, with rejuvenated neighborhoods, reduced crime, and even population growth after decades of decline. His administration has invested $1.5 billion in affordable housing while attracting manufacturing and technology companies back to the city. Most importantly, he's achieved these results by building consensus rather than exploiting division.

Looking toward Michigan's future, Duggan envisions a government focused on practical solutions to shared challenges: rebuilding the energy grid, improving education, addressing the housing affordability crisis, and creating an economy that keeps young talent in Michigan. His campaign represents not just a bid for office, but a test of whether voters are ready for leadership that transcends partisan lines and delivers meaningful results.

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