“I think the next stage of American capitalism includes co-opetition." - Dutch Rojas

On the last episode of Self-Funded with Spencer in 2025, Dutch Rojas joins the show to expose the financial "arbitrage" that he believes is destroying independent medical practices in America. Dutch explains how current CMS incentives allow hospitals to buy independent clinics and immediately charge 165% more for the exact same services, which is a practice that is crushing employers and patients alike.

In this episode, Dutch lays out his bold vision for "Co-opetition”, a new playbook where independent practices, manufacturers, and even churches band together to leverage their collective buying power. We discuss why the traditional "HR-led" model of buying benefits is failing, why CFOs need to take the wheel, and his dream of creating a true "Healthcare Commodities Exchange" to normalize pricing.

We also get personal about his journey from the Netherlands to the U.S., the importance of social media for building influence in DC, and why he believes the next 10 years will be defined by those who can master media.

Tune in for a fascinating look at the future of independent medicine.

Chapters:

(00:00:00) What is "Co-opetition" in Healthcare?

(00:01:00) How Hospital Arbitrage Kills Private Practices

(00:06:40) Why Independent Doctors Don't Work Together (Yet)

(00:14:00) The 165% Markup

(00:29:40) The Dream of a Healthcare Commodities Exchange

(00:41:00) Why HR Shouldn't Make Healthcare Decisions

(00:49:00) Aggregating Buying Power: Churches & Manufacturers

(00:57:00) The 4-Stage Plan to Fix Healthcare

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Healthcare has had no star score, there's been no reliable pricing. It's all been just a black box." - Will Bruhn

An estimated 21% of all medical care in the U.S. is completely unnecessary. My guest this week is Will Bruhn, CEO and Co-Founder of GAM (Global Appropriateness Measures), and he joins the show to explain exactly where that waste comes from and how we can fix it.

Will argues that we've been measuring quality wrong. Instead of just looking at outcomes (did the surgery go well?), we need to measure appropriateness (should the surgery have happened at all?). We discuss the perverse financial incentives driving this waste, using real-world examples like unnecessary spinal fusions and the statistical spike in C-sections on Friday afternoons.

But this episode isn't just about the problem; it's about the fix. Will breaks down how GAM uses data to identify high-value providers and how employers can redesign plans to guide members away from wasteful care, potentially saving millions while protecting patients from unnecessary risks.

Tune in for a blueprint on eliminating the 21% of healthcare spending that shouldn't exist.

Chapters:

(00:00:00) 21% Of Medical Care Is Wasteful. Here’s How We Prevent It.

(00:00:34) Why 21% of Medical Care is Wasteful

(00:01:57) The Missing Metric: Appropriateness of Care

(00:08:29) How Financial Incentives Drive Bad Medicine

(00:17:02) Case Study: Unnecessary Spine Surgeries

(00:24:06) How We Fix It: Identifying the Right Doctors

(00:31:22) Changing Plan Design to Stop the Waste

(00:33:52) The ROI of Steering to High-Value Care

(00:48:44) The Debate on Government Regulation & Drug Prices

(00:53:31) The Future of Healthcare Transparency

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/

"Why in every other industry can we just check out and know exactly what it's going to cost? Why can't it be the same in healthcare? Why are we still mailing physical checks in 2025?" - Cory Morin

My guest this week is Cory Morin, Co-Founder of Benji Card, who has developed a "virtual wallet" strategy that is revolutionizing how self-funded plans pay for care. Cory joined the show to explain how giving members and care coordinators instant access to funds can drastically lower medical claim costs.

Cory breaks down the mechanics of the Benji Card, a virtual payment solution that acts as the financial rails for modern cost containment. We discuss the strategy behind it: by guaranteeing providers immediate payment via a virtual card, plans can negotiate significant discounts (often cash rates) that aren't available through traditional insurance.

We explore how this "virtual wallet" approach aligns incentives - providers get paid instantly without administrative bloat, and employers save 30-50% on claims. We also dive into Cory's entrepreneurial journey and why he believes this model could eventually make traditional PPO networks obsolete.

Tune in to learn how a virtual wallet strategy can fix the broken economics of healthcare.

Chapters:

(00:00:00) The "Virtual Wallet" Strategy for Lowering Medical Claims

(00:12:16) From Insurance Agent to Fintech Founder

(00:20:59) What is the Benji Card?

(00:26:43) Why Healthcare Needs Virtual Payments

(00:29:40) How Instant Payments Negotiate Lower Rates

(00:38:51) Empowering Care Coordinators with a Virtual Wallet

(00:44:03) The Challenge of Scaling Fintech in Healthcare

(00:49:24) Will Virtual Wallets Replace Networks?

Key Links for Social:

@SelfFunded on YouTube for video versions of the podcast and much more - https://www.youtube.com/@SelfFunded

Listen/watch on Spotify - https://open.spotify.com/show/1TjmrMrkIj0qSmlwAIevKA?si=068a389925474f02

Listen on Apple Podcasts - https://podcasts.apple.com/us/podcast/self-funded-with-spencer/id1566182286

Follow Spencer on LinkedIn - https://www.linkedin.com/in/spencer-smith-self-funded/

Follow Spencer on Instagram - https://www.instagram.com/selffundedwithspencer/