The American healthcare payment system isn't just broken—it's a non-system that systematically fails providers and patients while generating enormous profits for middlemen. The Healthcare Bridge host Nathan Kaufman and his guest Rich Helppie cut through partisan talking points to expose the real impact of recent Medicaid funding changes that threaten to destabilize healthcare nationwide.

They unpack the complex provider tax mechanism that states have relied on to patch Medicaid's chronic underfunding. With Medicaid typically reimbursing only 70 cents per dollar of costs, these taxes have been lifelines, not loopholes. The new legislation's gradual reduction of this funding stream creates staggering budget gaps—$40 billion in Michigan, $226 billion in California over the next decade—with far-reaching consequences beyond just healthcare access.

The ripple effects extend to state employee health benefits, which will likely face cuts as states scramble to address budget shortfalls. Meanwhile, new work requirements for Medicaid recipients (80 monthly hours of employment or volunteer work with semi-annual requalification) will create wasteful bureaucracy that historically fails to achieve intended outcomes, potentially pushing 11 million Americans into uninsured status.

Perhaps most telling is the misguided $50 billion allocation for rural hospitals, which fails to address their actual problem: insufficient private insurance reimbursement rates. With Medicare Advantage plans already squeezing rural providers with payments 10-20% below traditional Medicare rates, these hospitals face a perfect financial storm that this Band-Aid approach cannot remedy.

This conversation illuminates the healthcare triangle—cost, quality, and access—showing how reduced funding inevitably diminishes either quality, access, or both. Want to understand what's really happening beneath the political posturing and how it affects your healthcare? Listen now and join the conversation about real solutions for America's healthcare crisis.

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Garlin Gilchrist II, Michigan's Lieutenant Governor and gubernatorial candidate, shares how his unique background as a software engineer and tech entrepreneur shapes his vision for the state's future. This fascinating conversation reveals how engineering principles can transform governance and policy-making.

"Being an engineer, you learn to be a problem solver," Gilchrist explains, drawing parallels between fixing broken systems and addressing Michigan's challenges. With experience at Microsoft and multiple tech startups before entering politics, he brings a refreshingly analytical approach to public service rarely found among elected officials.

Gilchrist outlines his major accomplishments, including a landmark $250 million investment in affordable housing and establishing 40 mental health clinics statewide through the Certified Community Behavioral Health Clinic Program. His creation of Michigan's automatic criminal record expungement program—the Clean Slate Program—has helped over 330,000 people gain access to jobs, housing, and education opportunities previously denied them because of past mistakes.

The conversation delves into Michigan's unique assets: unparalleled engineering talent, abundant natural resources (including 21% of the world's fresh water), and the nation's second most diverse agricultural economy. Gilchrist articulates how these advantages position Michigan for leadership in emerging sectors like clean energy, agricultural technology, and creative industries—if the right leadership is in place.

Drawing from personal experience leaving Michigan after college for better opportunities elsewhere, Gilchrist speaks passionately about creating an environment where young talent stays and thrives. "I want everyone to feel, know and experience Michigan being the best place to have an idea," he shares, outlining initiatives like the Michigan Innovation Fund that support local entrepreneurs.

Ready to learn more about Gilchrist's vision for Michigan? Visit garlingilchrist.com and join the conversation about building a Michigan where everyone can stay and succeed.

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What happens when you put one of America's leading healthcare governance experts in conversation with a veteran industry insider? You get a rare, unfiltered look behind the curtain of hospital boardrooms where life-and-death decisions get made every day.

Jamie Orlikoff, renowned governance consultant and active health system board member, joins host Nathan Kaufman to reveal the dramatic transformation of healthcare governance from ceremonial volunteer boards to professionalized leadership structures. With startling candor, Orlikoff explains that what once made hospital boards work—community connections and social relationships—now often prevents them from making necessary but difficult decisions.

The conversation exposes the paradoxes at the heart of American healthcare: hospitals becoming larger yet operating on thinner margins; costs rising for consumers while systems struggle financially; everyone demanding lower prices until it affects services they personally need. "Everybody hates hospitals until they need them," Orlikoff observes, capturing the fundamental tension healthcare leaders must navigate.

Most provocatively, Orlikoff reveals that only about 5% of hospital boards currently operate at the level of "best governance practices" needed to address today's healthcare challenges. The majority function at merely "good" or "normative" levels—an approach increasingly insufficient as financial pressures mount and quality concerns persist. With medical errors remaining the third leading cause of death in America, the stakes couldn't be higher.

You'll learn why more health systems are recruiting directors from outside their communities, why board compensation has become the norm rather than the exception, and why the traditional volunteer model is giving way to professional governance structures that can make tough decisions when necessary.

Whether you work in healthcare, serve on a board, or simply want to understand how hospital decisions affect your care options, this episode provides an insider's guide to the hidden power structures shaping American healthcare. Subscribe now and join us as we build bridges toward a healthier future.

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When half the streetlights in Detroit were dark and the city led America in homicide, poverty, and unemployment, Mike Duggan stepped up to lead its transformation. Now, after 12 years of progress as Detroit's mayor, he's taking aim at Michigan's partisan gridlock with an independent run for governor.

"Every time the Republicans and Democrats switch control in Lansing, they change the rules," Duggan explains, describing how Michigan's education system has suffered through constant policy whiplash. The result? A state that has plummeted from 19th to 44th nationally in fourth-grade reading proficiency. This pattern repeats across critical issues from infrastructure to economic development, with each party undoing the other's work rather than building sustainable solutions.

Duggan's approach stands apart from the typical campaign playbook. Rather than targeting the opposing party, he's drawing crowds of voters fed up with partisan battles. At his events, Republicans and Democrats find themselves in the same room, often surprised to discover common ground with neighbors they'd previously seen only through a political lens. "You've got the only political group in the country where there are smiles at the meetings," one reporter observed.

The Detroit mayor brings substantial credentials to his gubernatorial bid. Under his leadership, the city emerged from bankruptcy to become a model of urban renewal, with rejuvenated neighborhoods, reduced crime, and even population growth after decades of decline. His administration has invested $1.5 billion in affordable housing while attracting manufacturing and technology companies back to the city. Most importantly, he's achieved these results by building consensus rather than exploiting division.

Looking toward Michigan's future, Duggan envisions a government focused on practical solutions to shared challenges: rebuilding the energy grid, improving education, addressing the housing affordability crisis, and creating an economy that keeps young talent in Michigan. His campaign represents not just a bid for office, but a test of whether voters are ready for leadership that transcends partisan lines and delivers meaningful results.

Want to hear more conversations that cut through partisan noise? Subscribe to the Common Bridge on Substack or wherever you get your podcasts.

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Get ready for two power-packed days of essential conversations when I take over hosting duties at WJR, the Great Voice of the Great Lakes! Mark your calendars for June 23rd and 24th, from 2-4pm Eastern Time, as we spotlight the critical issues shaping Michigan's communities.

We'll dive deep into healthcare challenges and opportunities with renowned expert Nate Kaufman, whose insights have guided healthcare institutions nationwide. Michigan's Lieutenant Governor Garland Gilchrist joins us to discuss his vision as he campaigns to become the state's next governor. The connection between housing policy and community wellbeing takes center stage with Greg Colburn, while Chris Allen unpacks the complex social determinants affecting health outcomes and Medicaid systems.

Our mental health focus features Judge Milton Mack, who'll provide updates on legislation moving through Michigan's chambers – a timely discussion as communities nationwide confront growing mental health challenges. Economic concerns get attention when Bill Wild breaks down how tariffs impact retailers and consumers. Education takes the spotlight with NPR's Steve Drummond and Val Orr, whose experience as both superintendent and principal brings practical wisdom to our conversation about the future of learning.

Join these essential discussions by tuning in to AM760, visiting WJR.com, downloading the WJR Player app, or streaming through iHeartRadio and Google Play. These conversations about policies and systems affecting daily life are too important to miss – be part of the dialogue as we bridge divides and explore solutions to our most pressing challenges.

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What does Michigan need in its next governor? Sheriff Chris Swanson believes it's someone who can protect, serve, and unify.

The Genesee County Sheriff joins The Common Bridge to outline his vision as a Democratic candidate for Michigan's 2026 gubernatorial race. Drawing from his 33 years in law enforcement and extensive background in education and emergency medicine, Swanson offers a refreshingly practical approach to the state's most pressing challenges.

Michigan stands at a crossroads. With declining population, housing shortages, and an education system ranked 39th nationally, the state needs leadership that transcends partisan divides. Swanson's candidacy emerges from this landscape with a focus on unity without demanding uniformity – recognizing that diverse perspectives strengthen rather than weaken our communities.

His innovative approaches to persistent problems showcase his leadership style. The "Ignite" program, which has transformed education in jails across 23% of states, demonstrates how innovative thinking can break cycles of incarceration. His proposal to expand career training to middle school addresses the skills gap plaguing Michigan's workforce. His commitment to building 140,000 new homes acknowledges the housing crisis facing families throughout the state.

Perhaps most compelling is Swanson's response to the 2020 protests, when he chose to walk with demonstrators rather than confront them. This moment exemplifies his leadership philosophy: listen first, find common ground, and work toward solutions that benefit everyone. "Nobody can convince me that unity can't be done," he asserts. "It just needs strong leadership."

As Michigan prepares for the post-Whitmer era, Swanson offers voters a candidate focused on practical solutions rather than partisan talking points. His message resonates beyond party lines: protect what matters most, serve as a servant leader, and build bridges across divides.

Want to see Michigan thrive again? Join the conversation about what leadership should look like in 2026. Subscribe to The Common Bridge for more nonpartisan discussions that challenge conventional political wisdom.

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America stands at a crossroads as Marines deploy on the streets of Los Angeles. This gripping analysis examines whether we're witnessing the early stages of a modern civil war or something else entirely. The evidence is sobering: combat-trained Marines entering densely populated urban areas, coordinated opposition with pre-positioned supplies, and definitions of conflict that match our current situation with disturbing accuracy.

At the heart of this crisis lies America's immigration dilemma. Millions entered the country under what appeared to be an open invitation, seeking better lives only to become pawns in an escalating political battle. Now, as deportation policies move forward, battle lines are drawn between federal authorities and local governments. CBS News polling reveals the stark partisan divide fueling this conflict – 93% of Republicans support current deportation efforts while 82% of Democrats oppose them. This leaves political leaders like Governor Newsom and Mayor Bass trapped by their bases, unable to compromise without significant political fallout.

Where do we go from here? The episode explores multiple potential outcomes ranging from military confrontation to diplomatic resolution. The most disturbing possibility is an endless quagmire that drains public support and creates generational conflict. A negotiated settlement between federal and state authorities offers the most humane path forward, but requires leaders willing to risk political capital for the greater good. As partisan extremes tear at America's fabric, this nonpartisan analysis offers sober reflection on how we might step back from the brink before more blood is shed. Previous episodes from 2020-2021 warned about these exact scenarios – now they're unfolding before our eyes. The question remains: can we find common ground before it's too late?

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What happens when a state that was once the crown jewel of American prosperity finds itself near the bottom in employment, education, and population growth? Former Michigan Attorney General Mike Cox believes it's time for a dramatic course correction, and he's running for governor to make it happen.

The son of immigrants who chose Michigan in the 1950s because it was "the greatest state in America," Cox paints a stark picture of Michigan's decline. Today, the state ranks second-worst in unemployment, loses more young people than almost any other state, and sees its fourth-graders reading at levels only surpassed in underperformance by Alaska and New Mexico. Most painfully for Cox, three of his four children have left Michigan, with one choosing Mississippi where, surprisingly, her children now receive better education than kids in his Michigan neighborhood.

Cox's revitalization plan centers on two bold economic policies: eliminating the state income tax and reinstating right-to-work legislation. He points to compelling evidence that the eleven most prosperous states share one feature – they don't tax income. "If we're a society that values work," Cox argues, "that should be the last thing we tax." For workers, he believes freedom of choice should extend to union membership, creating an environment that welcomes all job creators, not just those creating union positions.

Beyond economics, Cox challenges conventional wisdom on education and diversity. After 50+ years of DEI programs at institutions like the University of Michigan, he notes African American enrollment has increased only marginally despite massive investment. His alternative approach focuses on fundamental educational improvements and merit-based opportunities like accepting the top 10% of graduates from every Michigan high school.

With Michigan positioned as a critical battleground in 2026, Cox brings a unique background as both successful public servant and entrepreneur. From Marine squad leader to homicide prosecutor, from two-term Attorney General to business owner who's met payroll and created jobs, Cox believes his proven leadership can restore Michigan's rightful place as a state where children can expect to do better than their parents.

Ready to see Michigan reclaim its status as the best state in America? Explore Mike's vision at MikeCox2026.com and join the movement to raise expectations for Michigan's future.

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