Dutch Rojas - Healthcare

04/08/2026

Kentucky.
Three hospital systems control 100% of Louisville’s inpatient market.

Prices reach 354% of Medicare rates.

CON law: enforced.
Competition: illegal.

https://rojasreport.com/kentucky/certificate-of-need

Kentucky CON score 100/100 (most restrictive). 18 services regulated since 1972. Three systems control 100% of Louisville's inpatient market. Pricing reaches 354% of Medicare.

04/08/2026

CON laws are active in 34 states and the Swamp.

The federal government repealed them in 1987.
States kept them anyway.

Health Systems and Carriers wrote the model legislation. This is not a coincidence.

In 35 jurisdictions (34 states + DC), it is illegal to open a hospital, surgery center, or imaging facility without government permission. Complete investigation with 50-state rankings, origin story, and economic evidence.

04/07/2026

Most digital health companies optimize for the demo. Physicians optimize for the shift. Those are not the same product.

04/07/2026

HCA Healthcare settled the largest healthcare fraud case in U.S. history.

$1.7 billion.
Their CEO now sits on the FAH board.
The FAH lobbies for the physician-owned hospital ban.
On patient safety grounds.

FAH: Federation of American Hospitals represents the for profit health systems.

04/06/2026

Our health system wanted $4,300 for an MRI.
The imaging center two miles away had a price of $490 and posts prices on their website.

And the “experts” keep saying price transparency doesn’t work.

04/06/2026

I used my insurance for a complete metabolic panel: $400.

My wife paid cash at a local lab: $19.

There are 239,000 approved lab vendors.
LaboratoryAssist.com

04/05/2026

A patient with insurance paid $790 for a knee X-ray series.
The self-pay rate at the same facility: $112
Insurance did not protect her. It exposed her.

04/04/2026

Float. Underwriting surplus. Investment income. Hospitals keep all of it. Independent practices didn’t know they were leaving it behind. Now they do.

04/03/2026

“If you like your plan, you can keep your plan.”
5 million individual policies cancelled in the first year alone.
Repeated 137 times. Never true once.

04/03/2026

83% of FAH’s registered lobbyists are former government employees.
This is not a revolving door.
It is the door.

https://fah.rojasreport.com/lobbying/

FAH spent $2.38M on federal lobbying in 2024. 23 registered lobbyists, 83% former government employees. Full revolving door profiles and retained firm data.

04/02/2026

The ACA was written by the insurance lobby.
Liz Fowler drafted the bill.
She came from WellPoint.
Now she is the deputy director of CMMI.
Follow the architect.

04/02/2026

Physician-owned hospitals have lower prices and higher quality outcomes.

Patient experience scores: 3.9 vs 3.2.

Potential Medicare savings: billions annually.

Section 6001 banned them anyway.
The data does not support the ban.
The ban was never about the data.