Who I am, and why it may matter to you in healthcare. I’ve lived healthcare from every angle: as a patient, a son, a business leader, and now a father. My story starts back in ’76 when I survived 11 surgeries by age five. Only by the grace of God and the dedication of great healthcare providers am I here today. My parents were told I might struggle, might never have kids or a full life—well, here I am with four incredible kids. Whether that’s proof they were right about my smarts, I’ll let you be the judge! Joking, it's the best blessing ever!! We’ve got two boys in high school, an 8th grade daughter, and a 2nd grade daughter, so life’s never quiet, and I wouldn’t have it any other way. Healthcare is in my blood, literally and figuratively. My dad started Rockwell Medical Supply while still working for another distributor, and by high school, I was already learning from both sides of the business. When I couldn’t play football, I found my way to compete through powerlifting—deadlifting 670 lbs by 23. That taught me an early lesson: when the odds are against you, where there’s a will, there’s a way. After college, I was building a successful career in IT recruiting, but in 2001, my family’s business was struggling, and my dad had already endured two strokes. There was no question—I called off my wedding, took a 90% pay cut, and moved to California to help. I walked into a 25-year-old company with no email, no online ordering, and an ancient fax machine. On paper, we had no chance. But we had a story, and we were willing to go the extra mile with every client. By 2008, we’d tripled in size, led non-acute care on the West Coast, and became one of the most advanced independent distributors in the field. In 2017, I had the blessing of working with Concordance upon selling Rockwell, which gave me insights into the full spectrum of healthcare, its silos, and how they play—or don’t play—together. In 2021/2022, I also had the opportunity to help launch the first FDA-approved urine analyzer in 15 years. Yet, amid all this, I fought my own battle with alcoholism. But by the grace of God and with my wife’s support—the same incredible woman who moved with me back in 2001—I got sober on June 2, 2014. That’s the badge I’m proudest to wear because it gave me the clarity and purpose to be here today. Now, through VIPER Healthcare Supply Chain Solutions LLC, I’m taking those lessons of resilience, faith, and hard work to help healthcare organizations thrive. VIPER is about more than business; it’s personal. I’m on a mission to bring high-touch service, innovative solutions, and heartfelt dedication back into healthcare. Let’s use this knowledge and experience to make an impact together. If this resonates with you, if you believe in something beyond spreadsheets and profits, let’s make a difference together. Join me on this journey with VIPER and let’s work to create real, human-centered solutions for healthcare. Better Together. Focused on the Next Right Thing. Mike mrockwell@vipercarechain.com

Me: So when did you began to feel breathless? 93 yo: three months ago, i was unable to teach our dance class. Me: you… were still teaching dance!? Patient: I’m 93, not dead 😊 so let’s talk about how to get my breathing back. Love this! Clearly we need to invest more in healthy aging 💪

We spent 40 years making healthcare more “efficient.” We got shorter appointments, faster discharges, and higher mortality. Efficiency is a fine goal. Just make sure you’re optimizing for the right thing.

One of the best of all time. The best.

Minnesota’s estimated Medicaid fraud is $9 billion. Somalia’s entire GDP is $12 billion. The fraud in one American state could nearly replace the entire economic output of the country where much of the money ended up. The governor, and former VP Candidate, says it’s “not large or pervasive.”

Lily Marie is here! Momma and baby are great!

I asked for strength. And God gave me difficulties to make me stronger.

What an amazing life I’ve been blessed to live. Surviving surgeries, becoming a competitive powerlifter, overcoming alcoholism… and now, just 3 days after our 21st anniversary, we are waiting to welcome our 5th child, 7 days short of our oldest turning 19 and 2 months after being hired for a dream job in healthcare distribution. It’s a lot to inventory and be grateful for. Happy holidays!

8 of the biggest issues we are watching in health care heading into 2026. This will be an evolving list. I'd love your feedback. 1. Evolving physician shortage issues and huge shortages in specialties and sub specialties. And is the goal of having a pcp largely a lost goal? Behavioral health, anesthesia, surgical specialties, neurology, oncology and many other areas acute. Rural areas are becoming health care deserts. 2. The further breaking down of the health care system into multiple tiers based on affordability. This has a horrible impact on heath equity and more. On one end of the spectrum is the concierging of everything and on the other end is Medicaid and indigent and increasingly rural care. 3. Closely related to number 2 the incredibly high cost of health care whether subsidized or not. Average costs per family are surging again. Employer plan coverage for a family of four is missing close to $30000 a year. The actual average cost for a family of four now exceeds $35000. 4. Whether we are starting to lose on all three fronts of the triple aim. Ie are cost, quality and access all moving in the wrong direction. It used to be thought we can excel into 2 of 3, now it feels as though all three suffering together. Ie increased problems on access, cost and quality as the system gets stretched. AI overview "many experts argue the U.S. healthcare system is struggling with all three parts of the Triple Aim (better care experience, improved population health, lower costs), with rising costs and persistent issues in quality/access, while facing major workforce burnout". 5. The improvement and cascading use cases of artificial intelligence across the health care ecosystem. The movement towards ambient listening, administrative, RCM, predictive analytic and clinical. Truly remarkable. 6. The continued power and strength of the mega payors compared to physicians and health care systems and the continued turning over of government programs to the payors. And whether this is leading to higher versus lower costs. More than half of Medicare is now managed by the payors and many states have turned over management of their Medicaid programs to payors. 2 of the largest 5 companies in America by revenues are payors. 7. The improvement of pharmaceutical treatments for complex diseases and the hope for more progress on challenging cancers. However the progress remains slow in several areas. The prognosis on certain brain and pancreatic and other cancers remains devastating. 8. The impact of the Fed Government on health care funding and health system and hospital management as well increased discussion of what impacts subsidies have on health care inflation. As a society we have a huge challenge here. We need subsidies to help people afford health care. However, it's increasingly argued or understood that subsidies lead to further health care inflation. No easy answer.

It’s a Long December kind of season. Yesterday marked 21 years of marriage for my wife and me. Twenty-one years of shared wins, hard conversations, late nights, losses, laughter, and choosing each other even when life wasn’t gentle. And here we are—on the edge of welcoming our fifth child, baby Lily, this Sunday. At the same time, this year has carried real weight. I lost my mom in January. My father is fading quickly now. Joy and grief aren’t taking turns—they’re showing up together. That’s what the holidays really are: a confluence of emotions. Some moments are full and bright. Some are deeply sad. Most live in that messy middle—layers of gratitude, exhaustion, hope, and ache all at once. And seasons like this have a way of clarifying things. It’s not about what we make. It’s not about titles or wins on paper. It’s about legacy. Who we love. How we show up. What we pass on—values, faith, resilience, kindness, and the ability to keep going even when December feels long. Holding space for all of it this season. The joy, the grief, and everything in between.

In healthcare and technology, success comes down to two things: capability and willingness. Capabilities are easy to spot—features, functions, specs. Willingness is harder to see, and far more important. Willingness to listen. Willingness to learn the customer’s reality. Willingness to collaborate, share data, and stay engaged when it’s no longer easy. Capabilities open the door. Willingness determines whether anything meaningful happens after. That’s the difference between a vendor… and a true partner.

Winner for cutest Christmas ornament!

8 Key Stories We Are Following This Week 1. Alphabet Inc. keeps winning. Here is the latest win. Alphabet/Google is a significant shareholder in SpaceX dating back to 2015. When SpaceX was revalued several months back, Alphabet booked a large gain worth about $8 billion. It's likely that SpaceX based on private sales is going to see another huge upward revision. This will accrue to Alphabet and lead to another large gain. Alphabet is up 62% YTD. As background, SpaceX is likely to be revalued from around $350 billion to $800 billion. 2. Is Nvidia undervalued? Both The Motley Fool and another publication make the case that NVIDIA, even it has a market cap of nearly $4.5 trillion, may be undervalued given its growth rate and free cash flow. Fascinating. Nvidia is up 31% YTD. 3. Roomba goes broke. iRobot is the owner of Roomba. Roomba the robotic vacuum and one of the first real common robotic use cases is going bankrupt. The common shareholders will come out empty. The stock is down almost 99% over the last five years and was down yesterday another 72% plus. ServiceNow, Circle Internet and Zillow also all fell significantly yesterday. Bitcoin was also down and opens at $87000 and is down 18% over the last year. 4. Consulting services-- the good, the bad and the ugly. The good --you get what you pay for and it offers really useful insight and it's helpful and useful and the overall customer experience is great too. The bad -- good insight but awful follow up and awful customer services. It's like pulling teeth to get follow up and they seem annoyed when you need follow up help. You clearly bought a "product" and not what feels like a service. The ugly -- you paid for the insight and consulting but even the insight seems useless and non sensible. 5. Please do us a huge favor and go to Amazon and pre order the hardcover of the new book authored by myself with Molly Gamble. The link is here. lnkd.in/gph4Y8im. We would hugely appreciate it. Thank you. Thank you. We are so thankful to all of you that have bought it so far and made it an Amazon top seller in motivation and leadership. 6. Elon Musk, like Alphabet and Nvidia, keeps winning. His net worth is now estimated at close to $600 billion based on the updated valuation of SpaceX. Forbes. Tesla also had a very good day yesterday. Tesla is up 17% YTD. 7. The S&P 500 is up 15.29% YTD. The Nasdaq is up 19.62% YTD. One positive note yesterday as Bloomberg reports "What Bears? BofA Poll Shows Sweeping Investor Optimism Into 2026". 8. Ford is reportedly taking nearly a $20 billion hit as it takes a massive write off regarding its EV business. The stock is up 37% YTD and has a market cap of $54 billion. I don't even understand how a company with a market cap of $54 billion can take that big a hit and not have it be devastating. It's not University of Chicago math. Ps. A great pleasure to interview great leaders Rachel Feldstein Axelrod, Chris Papin and Jeff Freedman on our podcast this past week. Great people and leaders.  

I just subscribed to @DutchRojas' newsletter! I recommend you do the same, and my only regret is that I waited this long!

No baby last night.. date night tonight!

My latest has what I said on the lawn of the US capitol. Pharmacist Nikki Adams Bryant opened a bakery and coffee shop inside her pharmacy just to make ends meet. She now starts rolling biscuits and brewing coffee at 4:00 a.m. "A man who walked the earth about two thousand years ago was spot on when he said that no one can serve two masters. Congress: Serve WE THE PEOPLE. WE need reform. bucksindependence.com/can-co…

At labor and delivery.. maybe a father for the 5th time tonight. Fingers toes and eyes crossed all goes well :)

Healthcare consolidation is not a market outcome. It's a policy outcome. $125 billion in annual advantages. 11 structural pillars. All flowing to incumbents. Independent physicians never had a chance.

Recommending @DRsLoungePod evaluate the current congressional healthcare proposals and their recommendations. Should be an episode that if congress watched they could implement. @DrDiGiorgio @anish_koka @drdanchoi @sdixitmd @DutchRojas