Dutch Rojas - Healthcare

Dutch Rojas - Healthcare Making healthcare affordable and accessible for everyone, everywhere… Email us for information!

SanoSurgery brokers surgeries and procedures between hospitals and physicians ("Sellers") and private individuals and self-insured employers ("Buyers").

12/23/2025

A fund notices a 20x spread between two MRI facilities.

They pull outcomes data.
No clinical justification.

They short the spread.

Capital flows to the efficient facility.
Volume migrates.
The overpriced version reprices.

That’s mean reversion.

12/23/2025

An $8,000 MRI and a $400 MRI coexist in the same city.

Why?

No benchmark index.
No tradable spread.
No way to short the markup.

The $8,000 version survives because opacity protects it from capital discipline.

Build the index and that protection evaporates.

12/23/2025

Healthcare is pre-1859 oil.
Pre-CME agriculture.

A massive economy waiting for someone to build the rails.

Oil didn’t always have WTI.
Agriculture didn’t always have futures.

Someone built the infrastructure that turned raw commodities into tradable assets.

Healthcare is next.

12/23/2025

Right now, $5 trillion flows through healthcare with no price gravity.

Every employer, every government, every patient, flying blind.

No instruments to navigate.
No way to hedge.

That’s not a cost problem.
That’s a market structure failure.

Healthcare isn’t expensive. It’s unpriced.Imagine a $5 trillion asset class with no ticker symbol, no forward curve, no ...
12/23/2025

Healthcare isn’t expensive.

It’s unpriced.
Imagine a $5 trillion asset class with no ticker symbol, no forward curve, no benchmark price.

You can’t hedge it.
You can’t short it.

You can’t even know what you’re paying for it until after you’ve bought it.

That’s American healthcare.
The largest unpriced market on Earth.

We’ve built an economy the size of Japan, denominated entirely in opacity.

Every other trillion-dollar sector, energy, agriculture, and equities, has transparent pricing, derivatives markets, and liquidity.

Healthcare remains pre-industrial.
Traded through bilateral contracts, intermediaries, and political negotiation rather than price.

This isn’t a cost problem.
It’s a market structure failure.

Methodist Le Bonheur acquired the West Cancer Clinic.340B profit in year one: $50 million.Duke acquired its oncology net...
12/23/2025

Methodist Le Bonheur acquired the West Cancer Clinic.

340B profit in year one: $50 million.

Duke acquired its oncology network.
340B profit in year one: $69.7 million.

One acquisition.
One year.

The math prints.

The carnage:1,750 community oncology practices, closed, acquired, or struggling since 2008.80%+ went to 340B hospitals.N...
12/22/2025

The carnage:

1,750 community oncology practices, closed, acquired, or struggling since 2008.

80%+ went to 340B hospitals.

Not because they needed doctors.

Because they needed the spread.

340B was created in 1992 for a few hundred safety-net hospitals serving disproportionate shares of low-income and uninsu...
12/22/2025

340B was created in 1992 for a few hundred safety-net hospitals serving disproportionate shares of low-income and uninsured patients.

Today:

$54 billion in annual purchases

36,000+ child sites (up from 1,339 in 2010)

33,000+ contract pharmacy locations

69% of 340B hospitals provide LESS charity care than the national average

36% spend under 1% on charity care

The hospitals with the largest 340B discounts show ZERO correlation with higher charity care

The Lown Institute, GAO, NEJM, JAMA, and Community Oncology Alliance have all documented this.

It’s not a secret.
It’s just ignored by regulators and lawmakers.

And enjoyed by the grifters.
All for a second home and a nicer car.

P.s. Free market transparency would punish all this bu****it.

Gone in one week.

Why did health system buy your oncologist:One oncologist in a 340B hospital = $1 million+ annual profit.So they bought.2...
12/22/2025

Why did health system buy your oncologist:

One oncologist in a 340B hospital = $1 million+ annual profit.

So they bought.
230% more oncologists at 340B hospitals.

Serving fewer low-income patients than before.

And you’re wondering why your Health insurance premiums went up?

12/22/2025

Your hospital bought a cancer drug for $3,444.
They collected $25,425 from your insurer.

$21,981 spread.
One dose.

It’s called 340B.
And you’ve never heard of it.

The finale of Five Dynasties.
11:30am CST.

In the 1990s, UPMC asked a question nobody would say out loud:"If we control the beds, why let the insurers take the mar...
12/21/2025

In the 1990s, UPMC asked a question nobody would say out loud:

"If we control the beds, why let the insurers take the margin?"

So they built their own health plan.
Then they went to war.

12/20/2025

The Fortress Playbook:

Consolidate the hospitals
Build or buy a health plan
Make yourself unavoidable

Use patients as leverage when challenged
Settle if you must
Keep the fortress

UPMC.
Sutter.
Intermountain.
Advocate.
Geisinger.

Same playbook.
Different regions.

Address

3219 E. Camelback Road, Suite 249
Phoenix, AZ

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