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The Business of Healing
Joseph Kumka
4 episodes
4 days ago
Healthcare podcast covering hospital systems, medical education, physician employment, healthcare policy, and the future of academic medicine. Exploring corporate healthcare, nonprofit hospital governance, medical school funding, and patient care quality. Real cases, expert analysis, systemic change.
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All content for The Business of Healing is the property of Joseph Kumka and is served directly from their servers with no modification, redirects, or rehosting. The podcast is not affiliated with or endorsed by Podjoint in any way.
Healthcare podcast covering hospital systems, medical education, physician employment, healthcare policy, and the future of academic medicine. Exploring corporate healthcare, nonprofit hospital governance, medical school funding, and patient care quality. Real cases, expert analysis, systemic change.
Show more...
Business
Education
Episodes (4/4)
The Business of Healing
Medicare Advantage Explained: Why Your "Medicare" Might Not Actually Be Medicare

Medicare Advantage vs Original Medicare: What seniors need to know before choosing coverage. In this comprehensive episode, we break down the critical differences between Medicare Advantage (Part C) and Original Medicare, exposing the hidden costs, network restrictions, and prior authorization requirements that affect over 31 million Americans.


Discover why major hospitals like Mayo Clinic are dropping Medicare Advantage contracts, how insurance companies profit from denying care, and what "risk adjustment upcoding" costs taxpayers $25 billion annually. We explain complex healthcare policy using simple analogies anyone can understand—no medical degree required.


Topics covered:

  • How Medicare Advantage actually works (and who pays whom)
  • Real-world cost comparisons for healthy vs. sick seniors
  • The truth about "$0 premium" plans and hidden out-of-pocket costs
  • Prior authorization nightmares and denial rates 10x higher than traditional Medicare
  • Why Medicare Advantage might save you money when you're healthy but cost thousands more when you're sick
  • Network adequacy problems and access to specialized care
  • Hospital and physician perspectives on MA reimbursement rates
  • Political reasons Medicare Advantage persists despite costing more
  • Practical advice for choosing the right Medicare coverage

Whether you're approaching Medicare eligibility, helping aging parents navigate their options, or simply want to understand one of America's most expensive healthcare programs, this episode provides the clear, unbiased information you need to make informed decisions.


This podcast was created with the assistance of artificial intelligence with publicly available resources. 

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3 weeks ago
39 minutes

The Business of Healing
The Accidental Architecture of American Healthcare

How American Healthcare Became an Accidental System: The Untold History of HMOs, PPOs, and Academic Medicine

Ever wondered why healthcare in America feels so complicated? This episode reveals the surprising truth: nobody actually designed our current system.

We trace the fascinating origins of health insurance back to the Great Depression, when desperate hospitals invented prepaid plans just to survive. Discover how World War II wage controls accidentally created employer-based insurance, how a single tax code decision locked in this bizarre system, and why the "father of the HMO," Dr. Paul Ellwood, thought managed care would save American medicine.

In this episode, you'll learn:

  • Why hospitals were going bankrupt in the 1930s and how the Baylor Plan became Blue Cross
  • The forgotten history of prepaid group practice and why the AMA tried to crush it
  • How WWII wage freezes accidentally created our employer-based insurance system
  • The real difference between HMOs and PPOs—and who actually invented them
  • Why academic medical centers nearly collapsed in the 1990s
  • How "prior authorization hell" became the compromise nobody wanted

This is a story of path dependence. Each generation made rational choices to protect their own interests: hospitals stabilizing revenue, employers avoiding wage controls, politicians preserving the status quo. But those individual decisions accumulated into a system that serves nobody's original vision.

Whether you're a physician frustrated by prior authorizations, a patient confused by your insurance, or just curious about how we ended up here, this episode connects the dots between century-old decisions and today's healthcare chaos.


This is an AI generated podcast curated from publicly accessible sources.

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1 month ago
29 minutes

The Business of Healing
The Billion-Dollar Knot: How Minnesota's Academic Medicine Became an Unsolvable Puzzle

The Minnesota Medical Center Puzzle: A Billion-Dollar Governance Knot No One Can Untie

How did three nonprofits, a state university, a hospital system, and a physician group, become so financially entangled that none can survive without the others, yet none can agree on who should lead? This deep-dive investigation unpacks the 28-year saga of Minnesota's M Health Fairview partnership, where $500 million flows annually through a three-way structure that's breaking down.


What You'll Learn:

  • The 1997 hospital sale that created today's crisis, when the University of Minnesota sold its teaching hospital for $87.5 million to escape near-bankruptcy, never imagining the long-term consequences
  • Why Fairview Health Services lost nearly $740 million between 2020-2023 yet still operates with billions in assets, and why "losing money" doesn't mean what you think it means
  • How $440 million moves annually from physicians to the University with no visible independent valuation, and why that creates serious governance questions
  • The real story behind two spectacular merger failures (Sanford Health and Essentia Health) and what they revealed about power, control, and institutional survival
  • Why the University's dean voted against a major partnership deal but was outvoted on his own board—exposing the governance paradox at the heart of this crisis


Perfect For: Healthcare executives, policy experts, nonprofit board members, medical students and physicians, anyone interested in how billion-dollar institutions actually work—and sometimes don't.

What Makes This Different: No conspiracy theories. No villains. Just meticulous analysis of public financial filings, governance documents, and institutional history to understand how reasonable people making rational decisions created an unsolvable structural problem.

The Core Question: When a university needs a hospital it can't afford, a hospital needs academic prestige it doesn't control, and physicians need both partners to survive—who should hold ultimate authority? Minnesota has been trying to answer that question for 28 years.

Based Entirely on Public Records: IRS Form 990 filings, audited financial statements Attorney General communications, and credit rating reports. Every claim is sourced and verified.


This is an AI generated podcast from most accessible sources at present time. 

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1 month ago
41 minutes

The Business of Healing
Power, Money, and the Fight for Academic Medicine

The Hidden Hospital: Power, Money, and the Fight for Academic Medicine

When you see "University of Minnesota Medical Center" above a hospital entrance, you assume it's where the state's brightest medical minds teach, research, and heal. But what if that prestigious name is just branding, and the reality underneath is far more complicated?

In this episode, we investigate a 30-year power struggle that began with a desperate financial rescue and has now erupted into a full-blown institutional crisis. In 1997, the University of Minnesota sold its failing hospital to Fairview Health Services for $87.5 million, and even paid them $20 million to take it. The deal was supposed to save academic medicine in Minnesota. Instead, it set the stage for a slow-motion divorce.


What you'll learn:

  • How a deal between Fairview and university physicians blindsided university leadership in 2025
  • Why the Medical School dean voted against his own doctors' agreement
  • What happens when academic medicine becomes a "side hustle" squeezed between clinical productivity targets
  • The hidden transformation happening at academic medical centers nationwide
  • Why a university that lost its hospital decades ago may never get it back

This isn't just about Minnesota. It's about what we lose when healthcare becomes purely business, and why the deals we make in crisis can reshape our future in ways we don't understand until it's too late.

This is an AI generated podcast from most current available sources. 

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1 month ago
13 minutes

The Business of Healing
Healthcare podcast covering hospital systems, medical education, physician employment, healthcare policy, and the future of academic medicine. Exploring corporate healthcare, nonprofit hospital governance, medical school funding, and patient care quality. Real cases, expert analysis, systemic change.