Professor of Accounting @JHUCarey @JohnsHopkins, Professor of Health Policy & Mgt @JohnsHopkinsSPH @BSPH_HPM, former visiting scholar @USCBO, CPA, Healthcare $
Joined December 2015
- Tweets 6,248
- Following 60
- Followers 5,399
- Likes 33,775
1,458 Photos and videos
ObamaCare Is a Money Pit for Taxpayers @WSJ @WSJopinion
"Using health insurers’ mandatory filings, our study, published Friday in JAMA Health Forum, shows that the ObamaCare individual market has become a money pit for taxpayers. In 2024 they paid nearly 80% of the premiums for subsidized plans—compared with only 30% in 2014.
Taxpayers paid more than $114 billion directly to insurers in 2024—one-third more after inflation than in 2023, more than double the amount in 2020 (before the enhanced subsidies), and more than six times as much as in 2014. According to the Congressional Budget Office, this acceleration continued in 2025...
The market size for unsubsidized ObamaCare plans shrank by a quarter, from $23 billion in 2014 to $17 billion in 2024. ObamaCare is a poor value, a product few Americans would voluntarily purchase without subsidies."
Today's @WSJ op-ed with Elizabeth Plummer: ObamaCare Is a Money Pit for Taxpayers
Congress may yet extend ObamaCare “enhanced” premium subsidies. A new study shows why that would be a reckless act toward taxpayers.
Using health insurers’ mandatory filings, our study, published Friday in JAMA Health Forum, shows that the ObamaCare individual market has become a money pit for taxpayers. In 2024 they paid nearly 80% of the premiums for subsidized plans—compared with only 30% in 2014...
Congress has thrown taxpayers under the bus—forcing them to pay for nearly the entire ballooning cost of subsidized ObamaCare plans, including fraudulent ones. Taxpayers in employer-sponsored plans are also saddled with higher premiums, higher prices and stagnant care delivery caused by ObamaCare’s market distortions.
What Congress sold to the American people as targeted assistance for lower-income families has become a broad entitlement with no spending limit.
ObamaCare’s structural flaws and subsidy design are a direct attack on taxpayers’ hard work, sacrifice and discipline. Taxpayers, who keep the economy running and sustain care for the most vulnerable, deserve empathy and justice.
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Ge Bai retweeted
Technology is deflationary.
Technology paired with deregulation will improve outcomes, expand access to care and increase standards of living. I had many good meetings at the J.P. Morgan health care conference about accelerating innovation.
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Ge Bai retweeted
Social media is THE way to get power back to the patient - physician relationship.
Why?
The free market exists in the social media space. No middle men.
Can social media help physicians and patients take their power back?
Thank you @DutchRojas!
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Ge Bai retweeted
Industry leaders @mcuban, @bgurley, and @Optum CEO @PatrickConwayMD took the stage to tackle one of the toughest challenges in health care: how to disrupt a deeply entrenched system. @GeBaiDC
bit.ly/3LDMkvx
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"Social media is a platform for the people searching for clinicians who fill the deficit that patients get from status quo providers."
"Social media can shift power by giving physicians and patients a direct voice outside traditional gatekeepers."
"I discovered DPC through these discussions!"
"Most patients don't choose their health insurance. The moment you 'open the gift," there are usually only two emotional outcomes: you love it b/c the care you needed is covered like you expected, or you hate it b/c it's the wrong gift, and now you're stuck with it."
Can social media help physicians and patients take their power back?
Thank you @DutchRojas!
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"Remove the link (from HSAs) to insurance. Increase the caps considerably, or remove them altogether." —@mcuban
"Pay doctors directly in free market conditions and you will get the best price." —Karim Wahib
"When people understand their options, when they see models like direct primary care or community-driven prevention they start to reclaim control over both cost and care. That's the part the entrenched interests fear most." —@DrHirschfield
Jan 15
Why are HSAs connected in any way to insurance policies ?
Don't we want people to save as much as possible for their healthcare ?
Remove the link to insurance.
Increase the caps considerably, or remove them altogether
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"Value to the system is very different from value to the patients. The reality is often the opposite. Unnecessary tests and procedures generate revenue even if net harmful. And surgical complications add more revenue than perfect surgical results."
"The best doctor is reimbursed the same as the worst. Outcomes are ignored."
"Standardized reimbursement (one size fits all) flattens value, outcomes & innovation into one line item...In Canada, doctors are paid a salary, equal to all others in their field and have no incentive to better or faster."
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In hospitals, direct costs roughly equal overhead
Our study @JournalGIM: link.springer.com/article/10…
h/t @mcuban
Jan 15
For any hospital that says they lose money on Medicare/caid patients, I would LOVE to see the bill of materials and direct overhead attributed to the procedures you lose money on
How much you pay for that hip implant, the anesthesia, disposables, the doctors/nurses etc, for the period of time they are working on that hip replacement. The same for any operations or procedures
It's crazy that I can't find that information ANYWHERE
Please show me how you lose money on Direct Costs at Medicare or Medicaid rates , then we can discuss the value of all the consultants , paintings , beautiful buildings , etc contribute to your inability to make money on the Medies
I even bought and went through hospital cost accounting text books and found no real numbers 😂
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Is cost of healthcare delivery static?
From two accountants. Thank you, @DutchRojas!
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Full episode: x.com/DutchRojas/status/1993…
26 Nov 2025
The most explosive conversation I’ve had this year.
Dr. Ge Bai (Johns Hopkins) lays out the core truth everyone in Washington avoids:
Healthcare isn’t a right, it behaves like a commodity.
Government doesn’t lower costs, it blocks the market that would.
Price transparency only works when physicians are free.
Innovation dies when a nation fears risk.
And America must choose between entrepreneurship or stagnation.
And if you think she’s bold here, she’s hosting @bgurley and @mcuban at Johns Hopkins on December 16 for a live debate on the future of healthcare.
Details here:
carey.jhu.edu/events/entrepr…
Full video below.
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Ge Bai retweeted
In Employer and Government sponsored plans the patient both Pays AND Consumes.
Employer Plans- patient directly pays half. Patient indirectly pays the 2nd lower salary, fewer raises, poorer working conditions and infrastructure. There are also fewer jobs. It’s a company’s 2nd biggest expense.
Government plans- the government doesn’t own anything. Taxpayers do. Government doesn’t generate wealth. Taxpayers pay for everything. Higher taxes. Fewer jobs.
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Ge Bai retweeted
Jan 15
For any hospital that says they lose money on Medicare/caid patients, I would LOVE to see the bill of materials and direct overhead attributed to the procedures you lose money on
How much you pay for that hip implant, the anesthesia, disposables, the doctors/nurses etc, for the period of time they are working on that hip replacement. The same for any operations or procedures
It's crazy that I can't find that information ANYWHERE
Please show me how you lose money on Direct Costs at Medicare or Medicaid rates , then we can discuss the value of all the consultants , paintings , beautiful buildings , etc contribute to your inability to make money on the Medies
I even bought and went through hospital cost accounting text books and found no real numbers 😂
Jan 15
Unless you serve primarily Medicare/Medicaid patients and your hospital loses money on every single admission. We charge whatever we want, doesn’t mean we’ll actually get anything.
Our safety net hospital is fighting to keep its doors open because others take advantage.
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Ge Bai retweeted
Jan 15
Why are HSAs connected in any way to insurance policies ?
Don't we want people to save as much as possible for their healthcare ?
Remove the link to insurance.
Increase the caps considerably, or remove them altogether
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“$ goes to you, and then you take the $ and buy your own healthcare." —@POTUS
Jan 15
THE GREAT HEALTHCARE PLAN.
President Donald J. Trump unveils the Great Healthcare Plan to lower costs and deliver money directly to the American people. 🇺🇸
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"The visible costs of healthcare such as premiums alone are burdening businesses and hurting competitiveness on the world stage... George Washington's birthday is just around the corner and I cannot help but think what we are lost as a country."
"Working-class families often pay a significant share of the tax burden, but many don't qualify for the very programs their money supports. Meanwhile, politicians get to claim credit for 'funding' those programs—without acknowledging who actually financed them."
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Jan 15
Hospitals have lobbyists. Physicians have something more powerful.
The healthcare cartel spent $744 million on lobbying last year.
Independent physicians? $200,000.
That’s a 3,700 to 1 ratio.
And it shows.
CON laws still block competition in 35 states.
Physician-owned hospital bans remain.
Facility fees keep climbing.
But here’s what the cartel doesn’t understand:
Social media changed the game.
600 million people use X every month.
LinkedIn has 1.2 billion members.
A single viral post reaches more people than a decade of congressional testimony.
The cartel can buy access to 535 members of Congress.
Physicians can speak directly to 330 million Americans.
Lobbyists work in private.
Social media works in public.
When physicians expose the extraction machine, the facility fees, the 340B spreads, the CON law protectionism, voters listen.
The cartel wins in back rooms.
Physicians win in the open.
Can social media help physicians and patients take their power back?
Thank you @DutchRojas!
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"In employer-sponsored plans, the employer buys, the insurer pays, and the patient consumes. In govt-sponsored care, the govt sets the rules and funds the care, but the patient still doesn't have full decision-making power.
In healthcare, private equity has produced a wide range of results, good and bad, just like nonprofit, public, and health system ownership models. Cost inflation in healthcare long predates PE involvement and exists across all of them."
Why hasn't the healthcare market become consumer-friendly?
Third-party payment.
Full episode: x.com/DutchRojas/status/1993…
Thank you, @DutchRojas!
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"Standardized reimbursement (one size fits all) flattens value, outcomes & innovation into one line item...In Canada, doctors are paid a salary, equal to all others in their field and have no incentive to better or faster."
"When the prices are set by a third party (CMS) which also serves a basis for insurance payments (they just negotiate the value of each RVU), then there is no quality premium."
"It is wrong for the payments to be the same. It's not how any other 'service' industry works."
"Only buyers can determine the value and price they are willing to pay. People have different and often unique reasons for valuing something based on their needs and preferences. Same in healthcare, it cannot be valued generically by a third party. The experience of surgeon/physician, their level of expertise etc. is completely discounted."
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Can social media help physicians and patients take their power back?
Thank you @DutchRojas!
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Full episode: x.com/DutchRojas/status/1993…
26 Nov 2025
The most explosive conversation I’ve had this year.
Dr. Ge Bai (Johns Hopkins) lays out the core truth everyone in Washington avoids:
Healthcare isn’t a right, it behaves like a commodity.
Government doesn’t lower costs, it blocks the market that would.
Price transparency only works when physicians are free.
Innovation dies when a nation fears risk.
And America must choose between entrepreneurship or stagnation.
And if you think she’s bold here, she’s hosting @bgurley and @mcuban at Johns Hopkins on December 16 for a live debate on the future of healthcare.
Details here:
carey.jhu.edu/events/entrepr…
Full video below.
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