While the government shuts down, America’s largest health agencies keep running on autopilot, funded not by Congress, but by user fees and hidden subsidies.

In this solo briefing, Dutch Rojas dissects how the system continues to enrich insurers and health systems while squeezing out independent physicians and driving premiums ever higher.

Host Dutch Rojas: Founder, Rojas Media and Bliksem Health

Episode Overview: In this morning's rundown, Dutch exposes how the Centers for Medicare & Medicaid Services (CMS) stays operational during a government shutdown and what that reveals about the true structure of U.S. healthcare. He unpacks the politics behind the ACA subsidy cliff, the corruption of the 340B drug program, and the myth of “innovation” paraded at conferences like HLTH 2025. From UPMC’s empire to the illusion of market turbulence, Dutch argues that healthcare isn’t collapsing; it’s consolidating by design.

Notable Quotes

• “If CMS were a private company, the CEO would be fired.”

• “We’ve built a system that rewards scale, not value.”

• “Healthcare isn’t collapsing, it’s consolidating. And consolidation is collapse for everyone else.”

What You’ll Learn

– Why CMS keeps running even when the government shuts down

– How ACA subsidies distort the insurance market

– The real beneficiaries of the 340B drug pricing program

– Why HLTH 2025 showcases gadgets, not solutions

– How consolidation drives up premiums and destroys autonomy

The Episode (Timestamps)

00:00 – Intro: The government shutdown and healthcare’s autopilot system

03:15 – CMS and the illusion of accountability

09:40 – The ACA subsidy cliff and who it really protects

17:55 – 340B reform and the nonprofit profit machine

24:20 – UPMC, market power, and the death of rural hospitals

29:30 – HLTH 2025: Innovation or distraction?

33:45 – Final thoughts: Consolidation vs. collapse