U.S. $4.6 TRILLION on healthcare
@DutchRojas Not #healthcare
Ever wonder why independent physicians are fighting to stay afloat while health systems are swimming in cash?
It’s not because they deliver better care, it’s because they’ve stacked the deck in their favor.
Health systems have engineered a system of subsidies, tax breaks, and hidden fees that funnel billions into their pockets while independent physicians get squeezed.
They don’t just get paid more for the same work, they collect government handouts, dodge taxes, and manipulate the rules to eliminate competition.
Want to see how deep it goes?
Direct Government Payments & Subsidies:
•Disproportionate Share Hospital (DSH) Payments
•Graduate Medical Education (GME) Payments
•340B Drug Pricing Program
•Medicare & Medicaid Facility Fee Differentials
•Indirect Medical Education (IME) Payments
•Upper Payment Limit (UPL) Funds
•Critical Access Hospital (CAH) Payments
•Hospital Quality Payment Programs
Tax Advantages:
•Property Tax Exemptions
•Sales Tax Exemptions
•Income Tax Exemptions
•Tax-Free Donations & Endowments
•Municipal Bond Issuances
•Government-Supported Loan Forgiveness Programs
Financial Advantages & Market Manipulation:
•Site-of-Service Differentials
•Facility Fees
•Certificate of Need (CON) Protections
•Exclusive Payer Contracting
•Cost-Plus Reimbursement
•Preferred Network Inclusion
•Hospital-Employed Physician Subsidies
•Self-Referral Loopholes
Hidden Revenues & Kickbacks:
•Commercial Insurance Markups
•PBM Rebates
•Medical Device Markups
•Hospital-Based Coding Upcharges
•Emergency Department (ED) Visit Upcoding
•Outpatient to Inpatient Status Manipulation
•Research Grants & NIH Funding
•Hospital-Owned Specialty Pharmacy Profits
•Hidden Administrative Charges
Strategic Market Power & Anti-Competitive Behavior:
•Monopoly Pricing Power
•Group Purchasing Organizations (GPO) Kickbacks
•Vertical Integration
•Cross-Subsidization Strategies
•Land Banking & Real Estate Tax Loopholes
•Political Lobbying & Influence
•Hidden Executive Bonuses Tied to Market Consolidation
•Charity Care Manipulation
•Debt Collection Privileges
The playing field isn’t just uneven, it’s built to ensure large health systems win and independents lose.
They call it healthcare, but it’s really a financial empire. Independent physicians fight to survive while health systems collect subsidies, dodge taxes, and manipulate markets to eliminate competition. The game isn’t just rigged, it was designed this way.