The Broken System Behind U.S. Healthcare Costs With Mark Newman скачать в хорошем качестве

The Broken System Behind U.S. Healthcare Costs With Mark Newman

Healthcare costs & PBMs — why the system is breaking down. Mark Newman from Nomi Health explains why prices keep rising, why prior authorization delays care, and why employers often pay $1.20–$1.40 for every $1 of healthcare. If you’ve ever wondered why the U.S. healthcare system feels impossible to navigate, this episode gives you the cleanest explanation you’ll hear anywhere. In this episode, I sit down with Mark Newman — co-founder and CEO of Nomi Health — to unpack the structural forces behind America’s $6 trillion healthcare problem. Mark shares how a shocking hospital billing experience during the birth of his son drove him to investigate why cash prices can be 30% cheaper than insurance prices, and why providers only receive around $0.80 on the dollar of what they’re contractually owed. We break down self-insured employers, PBMs, cost-plus pricing, medical billing complexity, and why Americans are angry enough to cheer for whistleblowers — even when the actions are wrong. Mark also explains why the U.S. has better acute care outcomes than many countries, why lifestyle disease drives costs, how drug pricing is distorted by middlemen, and why AI is already reshaping prior authorization, documentation, and provider workflows. Thank you Mark Newman for being my guest. Give Mark a follow: https://nomihealth.com   / marknewman   00:00 The $4,500 hospital bill and 30% discount 00:55 PBMs, payers, Trump’s Pfizer deal and today’s topic 03:02 Mark’s journey: HireVue, HR tech and employer health 04:49 The birth of his son and the “finance lady” 07:10 Self-insured employers and Nomi Health’s direct-pay model 09:21 Why U.S. healthcare became a financing engine 12:07 UnitedHealthcare, Luigi, and why Americans are furious 15:09 Pharma pricing, PBMs and the gross-to-net reality 18:43 U.S. vs other countries: outcomes, lifestyle and GLP-1s 21:21 Obesity, mortality and prevention in America 25:12 TrumpRx, Pfizer and AmericasMedicines.com explained 29:23 My MRI story, paying cash, and prior auth delays 31:32 AI, prior authorization and physician burnout 35:39 Blue Cross Louisiana’s $450M verdict and “no commitment to pay” 38:18 Using AI and data to strip out waste 39:45 Mark’s final message: you can lower healthcare costs Resources Mentioned: • Nomi Health (direct healthcare & payments): https://nomihealth.com/ • Artemis by Nomi Health (benefits analytics): https://www.nomihealth.com/business/a... • TrumpRx prescription drug portal: https://trumprx.gov/ • AmericasMedicines.com (PhRMA direct-from-manufacturer programs): https://americasmedicines.com/ • Mark Cuban Cost Plus Drugs: https://www.costplusdrugs.com/ • AMA prior authorization resources: https://www.ama-assn.org/practice-man... • https://medicalaffairsspecialist.org/ Connect With Me:   / drwilliamsoliman     / will_soliman     / williamsoliman1     / willsoliman   #HealthcareCosts #PBMs #DrugPricing