I just had a conversation that made me genuinely excited about the future of healthcare.
It also reminded me that there’s a lot of work that still needs to be done.
My guest Brian Reid, health policy expert and former science writer for Bloomberg Health spent years covering the FDA, followed by 20 years of PR, and now runs his own consultancy while writing the Cost Curve newsletter- a fascinating publication covering the technical bits of the business of healthcare - which is how I found his work and decided I had to invite him on.
What he shared wasn't just another doom-and-gloom take on our "broken" system.
It was something much more complex: including proof that we're already fixing it, even as entrenched interests are actively working against us.
Let me show you what I mean.
The $60 Billion Shell Game
There's a program called 340B that perfectly captures everything wrong with healthcare today.
Created in 1992 to help vulnerable patients get cheaper drugs, it now generates $60 billion annually for hospitals.
Here's the scam:
* Hospitals buy drugs at massive discounts (i.e. a $50 drug for 10 cents)
* They give those drugs to insured patients
* Then bill the insurance the full $50 (or maybe $500 since they make it up as they go along)
* They pocket the $40+ difference
* And there’s zero oversight on where the money goes
You might be thinking… well, okay, but at least it’s helping uninsured or more vulnerable patients, right?
Well, no actually.
Brian shared that there’s no evidence of that. Uninsured and lower income patients often still pay “full price.”
So you also might be wondering why am I telling you this awful story and pretending it’s good news, but here’s the exciting part…
You are reading about it right now.
Instead of it flying under the radar as it has for the past 30 years, people are talking about it. A lot.
It’s not just me.
Even better, solutions are being highlighted.
And not just for 340B.
We’re beginning to pay attention to corrupt practices in many areas of healthcare that previously would have gone completely unnoticed.
Brian put it perfectly: "Complexity has been weaponized. Complexity is a barrier to access."
It isn't incompetence. It's intentional.
Every confusing form, every price you can't comparison shop, every procedure that mysteriously costs different amounts at different places – it's all designed to extract maximum profit while keeping you confused and compliant - but the scheme is cracking as more and more of us are waking up.
The Beautiful Counter-Revolution
But here's where it gets exciting.
While the old guard plays their shell games, entrepreneurs are building the future.
Mark Cuban looked at the pharmaceutical pricing mess and said "screw this" – then launched Cost Plus Drug Company to sell medications at transparent prices.
Pharmacists are leaving the corporate chains to start consulting practices, giving families the medication guidance they actually need.
Direct Primary Care doctors are cutting out insurance middlemen entirely, offering unlimited access for monthly fees.
Telehealth platforms are connecting patients directly with specialists, bypassing geographic gatekeepers.
And it’s not theory. It’s happening right now.
The Information War
Complexity isn't just annoying – it's expensive and hurtful.
When you don't understand the system, you make worse decisions. When you can't comparison shop, you pay more. When the system is opaque, you get ripped off.
But here's the thing: You can fight back with information.
Every term you learn arms you against exploitation. Every price you comparison shop is a vote against the old system. Every time you choose transparency over complexity, you're funding the companies leading the revolution.
The Trade-Offs They Don't Want You to See
Brian dropped this truth bomb: "There's no tooth fairy."
Every healthcare solution involves trade-offs. Want cheaper care? You'll have to do more work to find it. Want unlimited access? You might pay premium prices. Want government-controlled costs? You'll get fewer innovations.
The establishment pretends these trade-offs don't exist. Politicians promise more for less. Insurance companies claim better coverage at lower costs. It's all BS.
The entrepreneurs building the new system? They're honest about the trade-offs:
* Direct Primary Care: Lower cost and more access, but you still need something to help with catastrophic events.
* Transparent drug pricing: Better prices, but fewer locations or you wait for shipping.
* Telemedicine: Convenient access, but there’s no real physical examination.
Honesty about trade-offs is how you know who's actually trying to help you.
The Innovation Explosion (Despite the Resistance)
Here's what makes me optimistic: The medical breakthroughs are so good that even the broken system can't stop them.
Gene therapies are curing "incurable" diseases. AI is revolutionizing drug discovery. The free market is fixing access and pricing.
Yes, the old system tries to gatekeep these innovations. Insurance companies deny coverage. Pharmacy benefit managers extract their cuts. Hospitals mark up prices 400%.
But the companies providing real value are so good that they’re breaking through anyway.
We are seeing patients transform their lives with medications that seemed impossible five years ago. That's not happening because the system works – it's happening despite the system being broken.
Your Role in the Revolution
You don't have to wait for Congress to fix anything. You can start opting out today.
Become Healthcare Literate Yes, it's annoying that you have to learn this stuff. But every term you understand is money in your pocket and power in your hands.
Vote with Your Wallet Choose employers with transparent health benefits. Support businesses that post clear prices. Use services that respect your time and intelligence.
Ask Uncomfortable Questions When your hospital can't explain a bill, demand answers. When your insurance denies something, ask for written justification. When prices don't make sense, make them explain the math.
Build Your Own Safety Net Find direct-pay doctors. Research cash prices for procedures. Build relationships with consulting pharmacists. Create backup plans that don't depend on the broken system.
The Compound Effect
Here's what gets me excited: Every person who opts out makes the system a little less profitable.
One employer choosing transparent pricing forces competitors to follow suit. One patient comparison shopping pressures providers to post real prices. One person learning to navigate the system teaches ten others. One entrepreneur solving a healthcare problem inspires a hundred more.
The old system depends on your confusion and compliance. Every act of clarity and choice weakens their grip.
The Future We're Building
Brian mentioned we're in a "thousand flowers blooming" moment.
Not all these experiments will succeed. The entrenched interests will fight back. Some innovative companies will get bought out and neutered. Some regulations will try to protect the status quo.
But enough flowers will bloom to change the landscape forever.
Ten years from now, you'll look back at today's healthcare system like you look back at taxi medallions before Uber.
Expensive. Inefficient. Propped up by regulation. Actively hostile to customer needs.
Your kids will ask why hospitals were allowed to buy drugs for $10 and charge patients $50 with no oversight. They won't believe the answer.
The Revolution is Personal
This isn't just about policy abstractions.
It's about your family getting honest care at fair prices. It's about your community having access to real innovation instead of corporate theater. It's about your future being healthier because you refused to accept b******t as normal.
The healthcare revolution is happening. The old guard is fighting it.
The question is: Which side are you on?
Ready to join the healthcare revolution? Subscribe to get weekly insights on the innovations and entrepreneurs transforming medicine – and the entrenched interests trying to stop them.
Dive deeper into the opportunities emerging from healthcare's broken systems with Brian Reid's Cost Curve newsletter at reidstrategic.com
The future of healthcare is being built right now. Help build it.
Until next week,
Tiffany
