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📌 Episode Overview:

In this episode, the co-hosts dive into the complexities of healthcare policy, discussing the impact of ACA subsidies, the role of insurance companies, and the potential for HSAs to empower patients. They explore the challenges of healthcare costs, the influence of government subsidies, and the need for a competitive marketplace.

👥 Co-Hosts:

• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

💬 Notable Quotes:

• "Fund patients, not processes."
• "Coverage is not care."
• "We need to walk and chew gum at the same time."

📚 What You’ll Learn:

• The implications of ACA subsidies on healthcare costs.
• How HSAs can be a game-changer for patient empowerment.
• The importance of competition in reducing healthcare costs.

⏱ The Episode (Timestamps):

• [00:00] Introduction and co-hosts' insights
• [10:15] Discussion on ACA subsidies and healthcare costs
• [25:30] The role of HSAs in patient empowerment
• [40:45] The need for competition in healthcare
• [55:00] Closing thoughts and future outlook

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

Show Link: https://www.acpjournals.org/doi/10.7326/0003-4819-153-8-201010190-00274

Why Listen 👥

In this episode, the hosts delve into the complexities of the healthcare system, discussing the impact of large hospital systems as major employers, the broken window fallacy in healthcare, and the challenges of high premiums. They explore the historical context of certificate of need laws and site of service differentials, and how these contribute to rising healthcare costs. The conversation also touches on the role of government intervention, the influence of large health systems, and the potential for free market solutions.

Co-Hosts

Dutch Rojas – Founder, Bliksem Health

Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher

Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator

Episode Overview 📌

The episode covers the economic myths in healthcare, the influence of large health systems, and the potential for free market solutions. It also discusses the historical context of certificate of need laws and site of service differentials.

Notable Quotes 💬

"Healthcare systems as major employers can be problematic."

"The broken window fallacy applies to healthcare economics."

"High premiums are linked to market consolidation and subsidies."

What You’ll Learn 📚

The impact of large hospital systems as major employers.

The role of certificate of need laws in healthcare costs.

How site of service differentials affect healthcare pricing.

The influence of government intervention in healthcare.

Potential free market solutions to healthcare challenges.

The Episode (Timestamps) ⏱

00:00:00 Introduction to Healthcare Economics

00:03:00 The Role of Hospital Systems

00:09:00 Understanding High Premiums

00:15:00 Certificate of Need Laws

00:21:00 Site of Service Differentials

00:27:00 Government Intervention in Healthcare

00:33:00 Free Market Solutions

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

Why Listen 👥

In this episode, the hosts delve into the complexities of healthcare costs, the impact of policy decisions, and the role of market forces in shaping the healthcare landscape. They discuss the consolidation of healthcare providers, the influence of insurance companies, and the challenges faced by independent practices. The conversation also touches on the COVID-19 pandemic, the response of public health officials, and the lessons learned from the crisis.

Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice

Episode Overview 📌

The episode explores the doubling of healthcare premiums since 2010, the consolidation of healthcare providers, and the significant market power held by insurance companies. The hosts discuss the challenges faced by independent practices and the impact of the COVID-19 pandemic on public health responses. They also highlight the potential of direct contracting in healthcare and scrutinize the role of pharmacy benefit managers.

Notable Quotes 💬

• "Healthcare premiums have doubled since 2010."
• "Consolidation is driving up healthcare costs."
• "Insurance companies hold the power in healthcare."
• "Independent practices are struggling to survive."
• "COVID-19 exposed public health weaknesses."

What You’ll Learn 📚

• The systemic issues leading to rising healthcare premiums.
• How consolidation affects healthcare costs and dynamics.
• The challenges faced by independent practices in a consolidated market.
• The role of natural and vaccine immunity in pandemic management.
• The potential of direct contracting to reduce healthcare costs.

The Episode (Timestamps) ⏱

• 00:00:00 Introduction and Episode Overview
• 00:03:00 Healthcare Costs and Consolidation
• 00:09:00 Insurance Companies and Market Power
• 00:15:00 Independent Practices and Policy Challenges
• 00:21:00 COVID-19 Pandemic and Public Health Response
• 00:27:00 Lessons Learned and Future Directions

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

📌 Why Listen
Explore the complexities of the 340B program, its impact on healthcare systems, and the implications for both hospitals and independent clinicians. Understand the need for transparency and potential reforms to align the program with its original goals.

👥 Co-Hosts

• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator

📌 Episode Overview

In this episode, the hosts delve into the complexities of the 340B program, exploring its origins, current state, and the implications for hospitals and independent clinicians. They discuss how the program, initially intended to support hospitals serving low-income patients, has evolved into a significant revenue stream for large health systems, often at the expense of independent practices and without clear benefits to the intended beneficiaries. The conversation also touches on potential reforms and the need for greater transparency and accountability.

Episode Links
https://www.healthaffairs.org/content/forefront/340b-drug-pricing-program-capped-safety-net-grant

https://jamanetwork.com/journals/jama-health-forum/fullarticle/2821579

💬 Notable Quotes

• "340B was created to help hospitals serving low-income patients."
• "The program has expanded to include 60,000 sites."
• "Hospitals can profit by reselling discounted drugs."
• "Independent clinicians face competitive disadvantages."
• "340B funds are not always used for patient care."

📚 What You’ll Learn

• The origins and current state of the 340B program.
• How hospitals leverage the program for revenue.
• The competitive disadvantages faced by independent clinicians.
• The lack of transparency in fund usage.
• Potential reforms to align the program with its original goals.

⏱ The Episode (Timestamps)

• 00:00:00 Introduction to 340B
• 00:03:00 The MRI Discussion
• 00:09:00 340B Program Origins
• 00:18:00 Current State of 340B
• 00:27:00 Implications for Clinicians
• 00:36:00 Calls for Reform

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

🎯 Why Listen

When Senator Chuck Schumer joined Dr. Mike’s podcast to discuss “The Truth About the Government Shutdown,” the talk quickly became a lesson in political spin. In this episode, the co-hosts of The Rojas Report dissect Schumer’s claims, challenge Dr. Mike’s deference, and unpack the policy mechanics behind Medicaid, ACA subsidies, and America’s trillion-dollar healthcare debate. Expect blunt analysis, sharp data, and unapologetic truth-telling about what’s really driving costs.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University

📌 Episode Overview

The team takes aim at Dr. Mike’s viral interview with Senator Schumer—an “objective” discussion packed with partisan narratives. They analyze the claim that 51,000 lives would be lost if ACA subsidies expire, break down Medicaid’s ballooning cost, and expose how CON laws and physician ownership bans stifle innovation.

They reveal how so-called “cuts” usually mean slower spending growth, not reductions, and how government subsidies distort markets and drive dependency. From the flawed Yale study to the Medicaid surge, the hosts show how fear-based messaging distracts from the real issue: structural inefficiency and lost patient value.

💬 Notable Quotes

• “This isn’t healthcare—it’s politics disguised as compassion.”
• “Schumer’s Law: when your only rebuttal is ‘you want people to die,’ you’ve lost.”
• “Physicians aren’t asking for permission to get rich. We’re asking for permission to build.”
• “Having an insurance card doesn’t mean you have care—it means you’ve been pacified.”

📚 What You’ll Learn

• Why the “51,000 deaths” claim collapses under scrutiny
• How ACA subsidies and Medicaid expansion fuel inefficiency
• The economics of CON laws and physician ownership bans
• What’s driving the trillion-dollar Medicaid curve
• How fear replaces facts in healthcare politics
• Why competition—not control—drives value

⏱ The Episode (Timestamps)

00:00 – Opening & host reunion

02:00 – The “51,000 deaths” narrative

05:30 – ACA subsidy breakdown

08:00 – Rising costs & access failures

17:00 – Medicaid myths and market distortion

21:00 – CON laws & physician freedom

28:00 – The trillion-dollar Medicaid surge

35:00 – Political spin & “you want people to die”

44:00 – Government control vs. patient value

47:00 – What real reform looks like

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

🎯 Why Listen

This episode is a no-holds-barred takedown of how hospitals manipulate billing codes, exploit DRG loopholes, and increase patient risk—all while squeezing out independent physicians. Whether you’re a patient, policymaker, or healthcare insider, you’ll walk away questioning everything you thought you knew about how hospitals operate behind the scenes.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

The doctors dissect the dysfunction in modern hospital billing and patient care—from the abuses of DRG (Diagnosis-Related Group) upcoding to the death of clinical nuance. You’ll hear how hospital administrators have replaced medical decision-making with spreadsheet logic, pushing sicker patients to outpatient settings and putting them at greater risk.

From the financial shell game of “death to discharge” timing to how non-profit systems rake in billions while physicians are told to “be more efficient,” this conversation is a masterclass in healthcare grift. They also explore the breakdown of physician-hospital trust and how the corporatization of medicine is compromising care at every level.

💬 Notable Quotes

“Hospitals get paid the same if you do a craniotomy on a healthy 30-year-old or a 95-year-old in kidney failure.” – Anthony DiGiorgio

• “DRGs reward risk, not responsibility.” – Dan Choi
• “The ‘death to discharge’ metric is not clinical. It’s financial.” – Sanat Dixit
• “The whole system is designed to offload cost and blame—onto doctors.” – Anish Koka
• “We should not be giving up the power of admitting. That’s the control point of medicine.” – Dutch Rojas

📚 What You’ll Learn

• How DRG reimbursement leads to dangerous patient discharges
• Why hospitals push risky patients to outpatient care
• The shocking flat-rate payment system for complex surgeries
• How hospital metrics hide bad outcomes while gaming revenue
• Why physician autonomy is being eroded by administration
• The financial incentive for “just discharge” over “get well”
• How upcoding and quality metrics warp patient care
• Why real reform must come from physicians—not bureaucrats

⏱ The Episode (Timestamps)

00:00 – Intro & physician burnout

03:45 – DRG basics and gaming the system

08:20 – Death to discharge: a dangerous metric

13:00 – Why outcomes don’t match the data

17:40 – Hospital profit motives vs. clinical sense

23:30 – Why hospitals don’t want to admit

27:00 – The decline of physician-led decisions

32:45 – Hospitalists, PAs, and revenue generation

37:50 – Why quality metrics miss the point

42:10 – The real impact on patients

47:00 – Final thoughts: reform or revolution?

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

🎯 Why Listen

In this fiery and insightful episode, the doctors dissect the political and economic fault lines behind the Affordable Care Act (ACA), the looming government shutdown, and the multi-billion-dollar subsidies keeping America’s healthcare afloat. From insurance distortions and Medicaid loopholes to why the system rewards bureaucracy over care, this is an unfiltered conversation that finally makes sense of why “affordable” healthcare isn’t affordable at all.

👥 Co-Hosts

Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher

Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator

Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice

📌 Episode Overview

The Doctors Lounge crew dives deep into how the ACA reshaped the U.S. insurance market—and why its subsidies, risk-pool manipulations, and Medicaid expansions are once again threatening a government shutdown. The conversation unpacks the math, morality, and market failures behind healthcare costs, from “catastrophic” plan bans to how illegal immigration and emergency Medicaid quietly reshape state budgets. The hosts also debate whether the cost-containment systems (like DRGs) ever truly worked—and whether healthcare’s inflation is an inevitable design flaw or a political choice.

💬 Notable Quotes

• “The reason healthcare is so expensive is because you passed the Affordable Care Act.” – Dr. DiGiorgio
• “Subsidies don’t make plans cheaper—they just hide the real cost from consumers.” – Dr. DiGiorgio
• “We’re shutting down the government over 7% of people—how does that make sense?” – Dr. DiGiorgio
• “Hospitals are thriving because DRGs keep going up; physicians’ payments keep going down.” – Dr. Choi
• “I’m a fan of a safety net program for a safety net population—but it has to run lean.” – Dr. DiGiorgio

📚 What You’ll Learn

• How ACA subsidies artificially lower premiums but raise total system costs
• The real distinction between ACA marketplace plans, Medicaid, and “emergency Medicaid” for undocumented immigrants
• Why healthcare cost control mechanisms like DRGs (Diagnosis-Related Groups) failed to contain spending
• The political tug-of-war between safety nets, subsidies, and moral hazard
• How hospitals and insurers profit from inefficiency—and why patients pay the price

⏱ The Episode (Timestamps)

00:00 – ACA subsidies, shutdown politics, and who’s to blame

05:00 – The myth of “affordable” care: how mandates drove up premiums

10:00 – Catastrophic plans vs. essential benefits: freedom or fairness?

15:00 – How subsidies distort the market and reward inefficiency

20:00 – Medicaid, undocumented care, and the “emergency reimbursement” loophole

30:00 – State-level financing tricks and the hidden federal dollars behind them

35:00 – Why hospitals profit under DRGs while physicians stagnate

45:00 – The DRG vs. cost-plus debate: can healthcare costs ever be contained?

50:00 – Insurer incentives, monopolies, and the myth of quality-based care

55:00 – The unfixable math of “affordable” healthcare

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

🎯 Why Listen

This episode of The Doctor’s Lounge cuts straight into one of the most polarizing questions in U.S. healthcare: Did the Affordable Care Act (ACA) fix the system—or hand it to corporate interests? The doctors debate how government mandates, corporate lobbying, and political theater have created a bloated insurance economy that benefits everyone but patients and doctors.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

The doctors dissect how the ACA’s “essential health benefits” reshaped the insurance market—outlawing affordable catastrophic plans and driving premiums sky-high. From the Oregon RCT to RAND data, they reveal how mandated coverage hasn’t improved health outcomes but has fueled massive corporate profits. The group also connects the dots between nonprofit hospitals, political paralysis, and the healthcare bubble that could rival the 2008 financial crisis.

They ask the hard questions:

• Why do politicians fight over “coverage” while ignoring the cost of care?
• Is America heading toward single payer—or collapse?
• Can innovation, transparency, and cash-based models save us from our own system?

💬 Notable Quotes

“Coverage is not care.” – Dr. Anish Koka
“If I don’t change my tires, I risk an accident—but that doesn’t mean auto insurance should pay for tire changes.” – Dr. Anthony DiGiorgio
“The number one problem in the U.S. isn’t debt—it’s premiums. Congress could fix that tomorrow.” – Dutch Rojas
“Hospitals were once charities. Now they own 6% of major cities.” – Dr. Dan Choi

📚 What You’ll Learn

• How ACA mandates distorted the insurance marketplace
• Why nonprofit hospitals are “too big to care”
• The difference between coverage and care—and why the public confuses them
• How regulatory gridlock blocks innovation in healthcare delivery
• The real economics of “float” and why insurance giants love the status quo
• What happens when the healthcare bubble finally pops

⏱ The Episode (Timestamps)

00:00 – Why tire changes and colonoscopies shouldn’t both be “insurance”

02:00 – Dr. Choi on ACA subsidies and the outlawing of catastrophic plans

06:00 – Essential health benefits: paternalism or policy failure?

09:00 – The illusion of coverage vs. the cost of care

12:00 – The business of “float” and how insurance companies built empires

15:00 – The $34 trillion industry and why catastrophic plans could end it

20:00 – Politicians, ignorance, and the illusion of reform

27:00 – Nonprofit hospitals: charity or corporate real estate giants?

35:00 – Americans waking up to the healthcare paradox

43:00 – The bubble nobody talks about: premiums and power

49:00 – The rise of DPC

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

🎯 Why Listen

What happens when private equity buys hospitals? Do staffing cuts and profit motives compromise patient safety? This episode of The Doctor’s Lounge dives into the controversial world of private equity in healthcare, the role of RVUs and the RUC, and why physicians are losing control over their profession. Expect an unfiltered discussion on power, profit, and the future of independent practice.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

This conversation unpacks:

• The hidden mechanics of RVUs and the RUC committee (and why most doctors don’t know how their pay is set).
• How private equity staffing cuts may be tied to increased ER deaths.
• Why physicians are forced to “take shelter” with private equity or large health systems.
• The structural inequities in U.S. healthcare that tilt the system against independent doctors.
• The hope found in physician-owned hospitals and physician-led enterprises.

💬 Notable Quotes

• “Just because you have a higher RVU count does not mean you’re a better physician.” – Dr. Dan Choi  
• “The real problem isn’t that the RUC exists—it’s that CMS has built an entire system on centrally planned values.” – Dr. Anthony DiGiorgio  
• “When private equity is the boss, the boss isn’t a physician—it’s a portfolio manager.” – Dr. Dan Choi  
• “We went from 75% independent practice to 12%. That’s the legacy of partnerships that never built enterprise value.” – Dutch Rojas  
• “You don’t need to import H1Bs or expand scope. You need to let physicians own hospitals in their own communities.” – Dr. Anthony DiGiorgio  

📚 What You’ll Learn

• How RVUs and the RUC committee determine physician pay.
• The risks and trade-offs when hospitals are acquired by private equity.
• Why many “boomer doctors” cashed out, leaving younger physicians holding the bag.
• The differences between profit-driven care and physician-led models.
• Why physician-owned hospitals may be a solution to America’s healthcare crisis.

⏱ The Episode (Timestamps)

00:00 – The growing demand for private practice

02:00 – Private equity: efficiency or exploitation?

06:00 – Explaining RVUs and the RUC committee

15:00 – Gaming the RVU system & compensation models

20:00 – Myths and realities of the RUC process

22:00 – Harvard study: private equity, staffing cuts & ER deaths

27:00 – Physicians vs. portfolio managers: who should run healthcare?

33:00 – Selling out: boomer doctors and the PE cash-out

37:00 – From 75% independent practice to just 12%

39:00 – Physician-owned hospitals as a solution

43:00 – Can capitalism coexist with morality in medicine?

50:00 – What happens if private equity is banned?

52:00 – The federated model and the fight

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X

Send us a text

🎯 Why Listen

Ever wonder who actually decides how much doctors earn for surgeries, visits, or procedures? This episode takes you inside the mysterious but powerful Relative Value Scale Update Committee (RUC) — the body that determines physician payments for Medicare and beyond. If you care about fairness in healthcare, innovation, or why a complex surgery can pay the same as a routine one, this conversation is for you.

👥 Co-Hosts

• Dutch Rojas – Founder, Bliksem Health
• Anthony DiGiorgio, DO, MHA – Neurosurgeon, UCSF; health policy researcher
• Anish Koka, MD – Cardiologist, Philadelphia; healthcare policy commentator
• Dan Choi, MD, FAAOS – Orthopedic spine surgeon, Long Island; healthcare advocate and social media voice
• Sanat Dixit, MD, FACS – Neurosurgeon, Huntsville, AL; Faculty, Vanderbilt University; healthcare entrepreneur

📌 Episode Overview

In this special “Side Table” edition, the Doctors Lounge digs into the RVU Update Committee (RUC) — the physician-led but AMA-controlled group that sets values for CPT codes, essentially determining how doctors get paid. The hosts explore:

• How the RUC works and who sits on it
• Why budget neutrality forces specialties to fight for value
• The unintended consequences of central planning, including stifling innovation
• The fairness debate between primary care and high-intensity procedural specialties
• Why physicians themselves are both defenders and critics of the system

💬 Notable Quotes

• “The RUC is essentially central planning — every doctor gets paid the same for the same code, no matter the experience.”
• “Becoming better at your procedure can actually punish you — the faster and safer you get, the less you’re paid.”
• “It’s a system that preserves order, but at the expense of innovation and sometimes fairness.”

📚 What You’ll Learn

• What the RUC is and how it shapes U.S. physician payment
• The mechanics of how CPT codes are valued
• Why Medicare’s budget neutrality keeps physician fees locked in zero-sum battles
• How new technologies like robotics and advanced ablation are undervalued
• Why primary care vs. specialty debates rarely get settled at the RUC table
• The pros and cons of a physician-run payment-setting system

⏱ The Episode (Timestamps)

• [00:00] What is the RUC and why it matters
• [02:00] The history: from “reasonable and customary” to RVUs
• [05:00] Who sits on the RUC and how they’re chosen
• [07:00] Central planning vs. innovation — robotic surgery as a case study
• [10:00] How physician surveys shape payment values
• [15:00] Specialty vs. primary care debates
• [20:00] Why new procedures often get undervalued
• [23:00] Should the RUC be reformed… or blown up?

🔗 Connect with the Hosts:

• Dutch Rojas on X

• Dr. Anthony DiGiorgio on X

• Dr. Anish Koka on X

• Dr. Dan Choi on X

• Dr. Sanat Dixit on X