Where the hell is our healthcare money actually going? While total U.S. healthcare spending has soared past $3.6 trillion, industry data reveals a staggering truth: up to $1.6 trillion is consumed entirely by systemic waste, fraud, and administrative abuse every single year. In this episode, Jude Odu, healthcare veteran and author of Model Optimal Care, joins the show to dismantle the complex infrastructure designed to profit off inefficiency. We move past the abstract policy debates to audit the real-world mechanics of the crisis, exposing how PBM "spread pricing" taxes the sick, why hospital "charge master" prices are completely fictional, and how algorithmic AI tools are being deployed at scale to automatically deny valid patient claims. From the rise of "pop-up" behavioral health fraud in Medicaid arrangements to the structural potential of price transparency rules, we look at what happens when fast-moving innovation clashes with a lack of fiduciary oversight—and how self-insured employers and everyday patients can finally start clawing back their data and their dollars.

CONNECT W/ JUDE

• https://judeodu.com/
• BUY THE BOOK

USEFUL RESOURCES

• The Challenge of Health Care Fraud
• PSL's 12/2025 Statement on Medicare For All
• Green Party Statement on Single Payer System
• Transparency Amendment
• Pros and Cons of AI in Healthcare

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